NUTRITIONAL INTAKE OF PRIMARY SCHOOL PUPILS AND ITS IMPACT ON THEIR ACADEMIC PERFORMANCE
CHAPTER TWO
LITERATURE REVIEW
INTRODUCTION
Our focus in this chapter is to critically examine relevant literature that would assist in explaining the research problem and furthermore recognize the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps.
Precisely, the chapter will be considered in two sub-headings:
Conceptual Framework
Chapter Summary
2.1 CONCEPTUAL FRAMEWORK
Nutrition
Nutrition is a fundamental pillar of human life, health and development across the entire life span. From the earliest stage of foetal development, at birth, during infancy, childhood, adolescence, into adulthood and old age, proper food and good nutrition are essential for survival, physical growth, mental development, performance and productivity, health and well being. It is an essential foundation of human being and national development (WHO, 2002)
Nutrition is the study of food in relation to the physiological processes that depend on absorption by the body (Growth, energy production, repairs of the body tissue etc). The science of nutrition includes the study of diets and of deficiency diseases. (Concise Medical Dictionary, 6th Edition). In hospitals, nutrition may refer to the food requirement of patients, including nutritional solution deliver via any IV (intravenous) or IG (intra gastric) tube.
Nutrition also involve identifying how certain diseases, conditions or problems may be caused by dietary factors, such as poor diet (malnutrition), food fallergies, metabolic diseases, etc. The human body requires seven major types of nutrients. A nutrient is a source of nourishment, an ingredient in a food e.g protein, carbohydrate, fat, vitamin, mineral, fiber and water. Life styles have change considerable over the years. With the hurried life style of day’s families, quickly and less nutritional meals have become typical, and adolescents are adopting these unhealthy eating habits.
What nutrients do children need?
There are a number of nutrients that individual, particularly the young, need to ensure proper development and health. Children in the UK are falling short of meeting some of their daily nutritional requirements (scientific Advisory committee, 2005). The basic for the nutritional requirements for children and adolescents is debated. In fact, some researches propose moving to measures such as the “functional effects of food and concepts such as optimal nutrition, which take into account the prevention of particular negative health outcomes ( Aggett, 2004).
Generally, it is the management and optimization of nutrients that amounts to a healthy diet. In fact, there are no bad food, only badly managed diets. For example, in an investigation of the relationship between the percentage of energy consumed from fact, had a negative effect on the intake of other nutrients such as zinc, retinol, iron and vitamin c (Rogers et al., 2002). Below is a summary of nutrients traditionally considered important in certain amounts for a healthy diet (British Nutrition Foundation, 2005)
Zinc
Zinc is found in protein rich foods, such as meat, shellfish, dairy products, bread and cereals. It is found to help with the production of new cells and enzymes. It helps process protein, fat and carbohydrate and with the healing wounds, however, excess zinc can lead to anemia and weaking of bones.
Iron
Iron is found in liver, meat, beans nuts, dried fruit, whole grains (brown rice) soya bean flour and dark leafy vegetables, iron helps with the production of red blood cells that carry oxygen around the body.
Sugars (glucose/sucrose)
Sugars, such as sucrose, fructose, and maltose, are naturally found in fruit and milk, but are added to many other manufactured foods.
Carbohydrates
Carbohydrates are found in sugars and starch and area major sources of energy. In terms of sugars, there are two types; extrinsic, not part of the cellular make up of the food, e.g. , in whole fruits and vegetables. Starch can be found in item such as potatoes and bread.
Thiamin (vitamin B1)
Thiamin is found in pork, vegetables (especially peas), milk, cheese, fresh and dried fruit, eggs, whole grain breads and some breakfast cereals. It helps to break down and release energy from the food that we eat and also helps to maintain nerves and muscles tissue.
Essentially fatty acids
There are two categories of essential fatty acids; unsaturated fat found in only fish, avocados, nuts and seeds, sunflower and vegetable oils and saturated or trans- fat, found in meat, cheese, butter and pastry. Essential fatty acids help the body to absorb vitamins and are also a source of energy. However, too much fat, particularly saturated and trans-fat, leads to weight gain and increased cholesterol in the blood that lead to heart disease.
Sodium chloride (found in salt)
The amount of sodium needed can easily be obtained from a healthy diet. Too much can raise blood pressure, potentially leading to heart disease and stroke.
Fibre
Fibre is a type of carbohydrate found in plants and is important for digestion.
Protein
Protein is essential for growth and repair of body. The main sources of protein include meat, fish, eggs, milk, cheese, cereals and cereal products (e.g bread), nuts.
Calcium
Calcium is mainly important for the development and maintenance of bones and teeth. The primary sources in the UK are milk, cheese and other dairy products.
Vitamin A (Retinol)
Vitamin A is important for the function of the skin and mucous membrane. It is also essential for vision and the immune system. It is related to cell differentiation and thus is crucial for growth and development. Vitamin A is always found in liver, milk, cheese and butter and it can also be found in vegetable such as carrots and leafy vegetables.
Vitamin C
Vitamin C is responsible for the formation of connective tissues found in skin, cartilage and bones and thud is part of the healing process from injury. It is also implicated the development of blood vessels and in neurological functions. It is mostly found in fruit and vegetables, but can also be sourced in milk and liver
Folate
As with vitamin A, folate is important for normal cell division that preludges growth and development. It is also partly responsible for the formation of blood cells. Folates are found in liver, yeast extract, orange juice and green leafy vegetables.
Although, nutritional requirements varies between individuals and at different stages of health. It varies with age, gender and stage of health. Individual requirement depends not only how much of particular nutrient the respondent needs to successfully digest, but also on their ability to absorb and make use of each type of nutrient, (British nutrition foundation, 2005).
Effects of Nutrition
The effects of nutrition on student’s academic performance maybe difficult to be discuss, but for the purpose of this study, discussion will be base on this area;
a. Sight, hearing and speech
b. Motor skills
c. Skeletal development
d. Body mass index and obesity.
The Nature Of The Child’s Nutrition
History shows that societies that meet women’s and children’s nutritional needs and lists their capacities for greater social economic and education progress more than others. For instance, good nutritional habits depends on how well nourished a woman was before pregnancy, as well as how much weight she gains while she is pregnant. But fulfilling these interlocking food, health and care need can be a struggle for many poor parent who have children that attends primary six.
Young (2005) opined that poor nutrition is a hitch to how birth weight babies that is weighing less than 2.5 kilograms, and they are at greater risk of dying before reaching primary six level of education. The report added that if the survive, they will have more episodes of illness, their cognitive development may be impaired which will lead to their poor performance in school.
Child’s nutrition at the right time of baby’s life could make the difference between mental and physical health or, even determine whether not the child’s degree of intelligence was 135, rather than the average 100.
According to a respected researcher and biologist Part (2008) in his report “Progesterone Essential to your well being” opined that imprinting the found to be the existence of certain time in the development of the unborn baby where effects of hormones, vitamins and other internal child nutrition factors within the womb, will have a maximal influence on, not only the unborn baby’s health, but on its later health during its entire human life cycle. He suggested that when the vital time, called imprinting is taken into consideration, child’s nutrition becomes the single most dominant factor determining the child’s health and therefore, his or her future success. He further urged for the urgent needs for progesterone therapy during pregnancy. (that is, a steroid hormone that prepares the uterus for pregnancy, maintains pregnancy and promotes development of the mammary glands) which he thinks is preventing a continuing epidemic of brain damage.
Taking a somehow similar position, Sterling Morgan (2011) also agreed that the use of natural progesterone increases a child’s intelligence quotient level, typically by around 35 points and produces personalities that are more independents, individualistic, self-assured, self-sufficient and sensitive. It appears that child nutrition can produce such a critical difference, but only, at the right time. The time for maximal child nutrition influence is prior to the baby’s birth. Yet, one’s genetic inheritance is often assumed to be equal or of appear unattainable. Hence, we might bear that nature, that is to say genes, determines 75% of heart health and nature in the final analysis, was the ultimate determiner of human health failed to consider the influence of child nutrition in Uterus (womb), that is to say, the effect of the child nutrition on the foetus, the unborn baby.
He further revealed that the natural progesterone, not synthetic drug. Like provera and progestin, but rather Mexican Wild Yam, Fesgreek and Soya Beans which precisely duplicates the chemical structure of nature progesterone as produced by the human body. He also opined that this natural version is in expensive and unpatentable
Adding yet more weight to Morgan’s findings a British Doctor Katerina Dalton in (2011), researched the supplemental use if natural progesterone for pregnancy. She found that the children of mothers treated with it actually had faster development of motor skills, higher intelligence, graduated from College more often. They were calmer, better adjusted babies than the babies whose mother did not take it. The “progesterone” children were standing and walking at the age of one. She further observed that progesterone children scored much higher in mathematics, verbal reasoning skills, academic subjects and significantly better in physical education and English Language. In fact, the only skill where non-progesterone children scored almost as high as the progesterone children was in crafts. They were about seven times more likely to gain entrance to a University apparent increase intelligence quotient (IQ) and academic performance.
Playing up the high impact of progesterone not only in children, Dr. Uzzi Reiss, Beverly Hills Gynecologist and obstetrician in a term paper presented at natural super-woman summit October, 2011 revealed that progesterone on the other hand, is the most protective breast hormone, it increases the activity of a gene called P53, WHICH PROTECTS US FROM CANCER. IT ALSO DOWN REGULATES AND DECREASES THE FUNCTION OF BCL2, a gene that causes cancer, it also prevents calls from replication. It also causes adhesion in the cell. It also moves estrogen from a strong state to a less strong state and exhibiting other cancer blocking effects.
The mothers of Imillike town appear to have little or no knowledge of this “progesterone”, thereby their wards who are pupils in primary schools have dull brain from birth. In the villages like OVOKKO, they refuse to take drugs, talk of attempting anti-natal check-up their children perform very poor that even at primary six, they cannot identify alphabets, cannot make a simple sentence in English or read a small passage. Also cannot attempt decimal fraction in mathematics and quantitative reasoning all as a result of absent of progesterone in their mothers.
More so, the high rate of cancer disease (breast is alarming and Ovokko women are not exemption. Due to poor attention given to pre-natal and post-natal care in the hospitals they prefer taking native medicine (Maga) at home, sometimes, they suffer from breast cancer and died after given birth to one or two issues. If the pregnant women in Imillike town will embrace medical care and pay less attention to native medicine, the pupils intelligence quotient will increase up to 135 and cases of cancer will reduce drastically.
The Nutrition For Chilren
It is very obvious that the time from birth to adulthood is the one of growth, development, maturation and activity. The nutritional needs of children vary with age, activity levels, health status, physical size and current rate of growth. Different processes require different nutrients. For instance, Omega-3 fatty acids protein are crucial for brain development in babies and toddlers, iron in particular is important when girls commence their menstrual cycle and energy needs will be greater during the rapid growth (World Summit for Children, 2000).
In their discussion on the interplay between habit and nutrition, the American Journal of Clinical Nutrition (2009), revealed that nutritional habits, once formed can be hard to break. For instance, a child who develops a sweet tooth and dislike for vegetables find it much harder to maintain a healthy diet through their later life than a child raised with a balanced diet of fresh fruits, vegetables, grains, meat and dairy. They went on to note that the fact a child rejects a food on the first few occasions it is served, does not necessarily indicate a dislike for the food, but more commonly a fear of new foods or a confusion over the unfamiliarity of the new item.
The report also opined that the role of parents and caregivers cannot be understated in the child’s nutrition. Children learn from observation and when very young have no choice but to eat what is provided to them. A health diet helps children grow and learns. It also helps prevent obesity and weight related diseases such as diabetes. The nutrition diet of a child include five serving fruits (orange, Watermelon, Paw-paw and vegetables (spinach, pumpkin leaves) a day. The report further outlined the guidelines that will help give a child a nutritious diet:
I.Offer five serving of fruits and vegetable a day
II.Choose healthy source of protein, such as lean meat, nuts and eggs.
III.Serve whole grain breads and cereals because they are high in fiber.
IV.Boll, grill or steam foods instead of frying them
V.Limit fast food and junk foods.
VI. Offer the child with water and milk instead of sugary fruit drinks and sodas.
It is doubted whether the situation in Imillike town with regard to poor nutritional needs on the academic performance of primary six pupils reflects the above mentioned. On the contrary, there is a preponderance of a near state of malnutrition in Imillike that leads to unbalanced dieting. Starchy food like yam, maize and few other food items dominate their meals. Adding vegetable when preparing yam will help balanced their diet.
Additionally, since the major food in Imillike town are Akpu and pounded yam, they should be making quality soups like bitter leave and vegetable soups to eat with their Akpu or pounded yam, give the children orange or watermelon to lick after the food and a good drinking water to aids digestion
Nutrition and Cognition
Relationships between nutrition and brain function have been the focus of much research. Studies have shown the impact of dietary foundations on normal brain functions. Chemical messengers within the brain called neurotransmitters have been studied in conjunction with nutrition. Growden and Wurtman (1980) suggested that the brain can no longer be viewed as an autonomous organ, free from other metabolic processes in the body; instead, the brain needs to be seen as being affected by nutrition, the concentration of amino acids and choline (in the blood) which let the brain create and use many of its neurotransmitters such as serotonin, acetylcholine, dopamine, and norepinephrine. Food consumption is vital to the brain being able to make the right amount of amino acids and choline. These are two precursor molecules obtained from the blood that are needed for the brain to function normally. It is no surprise that what we eat directly influences the brain (Colby-Morley, 1981). Wood cited Kretsch et al. (2001) showed further possibilities that our nutrition has a role with affecting our cognitive functioning. Studies have been done with school-aged children and point to a direct correlation between poor nutrition and lowered school performance. Iron has also been shown to play an important role in brain function as well. Kretsch et al. cited details from a study done with men aged 27 to 47 that looked at iron and its effect on concentration. Low scores on a concentration test corresponded with lowered levels of iron in the bodies of the subjects. A connection was made between low iron levels in children with attention span; children with iron deficiency anemia have been shown to have short attention spans. Kretsch et al. also found that zinc was another nutrient that had a role with cognition, specifically with memory. In a test of mental function called verbal memory, scientists found that volunteers’ abilities to remember everyday words slowed significantly only after three weeks of a low-zinc diet (Wood, 2001). Erickson (2006) pointed out five key components, based on research, required to keep the brain functioning correctly. The substances, all found in food, are important to brain development and function. Proteins are found in foods such as meat, fish, milk, and cheese. They are used to make most of the body’s tissues, including neurotransmitters, earlier identified as chemical messengers that carry information from brain cells to other brain cells. A lack of protein, also known as Protein Energy Malnutrition, led to poor school performance by children and caused young children to be lethargic, withdrawn, and passive, all of which help affect social and emotional development. Carbohydrates are commonly found in grains, fruits, and vegetables. Carbohydrates are broken down into glucose (sugar) which is where the brain gets its energy. Fluctuating levels of carbohydrates may cause dizziness and mental confusion, both of which can affect cognitive performance. Eating a carbohydrate-heavy meal can cause one to feel more calm and relaxed because of a brain chemical called serotonin and its effect on mood. Serotonin is created within the brain through the absorption and conversion of tryptophan. Tryptophan is absorbed within the blood and this absorption is enhanced with carbohydrates (Erickson, 2006). Erickson also noted that fat makes up more than 60% of the brain and acts as a messenger in partial control of aspects such as mood. Omega-3 fatty acids are very important to the optimum performance of the brain and a lack of these fats can lead to depression, poor memory, low IQ, learning disabilities, dyslexia, and ADD. Important foods to consume to ensure an Omega-3 fatty acid diet are certain fish and nuts (Erickson, 2006).
Erickson (2006) discussed vitamins and minerals as an important substance for the functioning of the brain. Most important are the vitamins A, C, E, and B complex vitamins. Manganese and magnesium are two minerals essential for brain functioning; sodium, potassium and calcium play a role in message transmission and the thinking process. Aforementioned in the research, neurotransmitters are crucial to brain function in the transferring of messages. Erickson stated research that shows nutrition is important to the production of key neurotransmitters such as acetylcholine, dopamine, and serotonin. Furthering the research supporting nutrition and its effects on cognition, Wolpert and Wheeler cite research done by Gomez-Pinilla, a UCLA professor of neurosurgery and physiological science. According to the article, diet, exercise, and sleep have the potential to alter brain health and mental function. Gomez-Pinilla stated that it stands to reason that changes in diet could be used to enhance cognitive abilities. His research has shown that Omega-3 fatty acids such as those found in salmon, kiwi fruit, and walnuts, provide many benefits in improving memory and learning, much of which occurs at the synapses. Omega-3 fatty acids support synaptic plasticity and seem to positively affect the expression of several molecules related to learning and memory that are found on the synapses. Omega-3 fatty acids are essential for normal brain function. The article states that a deficiency in Omega-3 fatty acids can lead to increased risk of attention-deficit disorder and dyslexia. According to Gomez-Pinilla, children who had an increase of Omega-3 fatty acids performed better in reading, spelling, and had fewer behavioral problems (Wolpert & Wheeler, 2008) Wolpert and Wheeler also highlighted a study in England that found school performance improved among a group of students receiving Omega-3 fatty acids. The article also tells of an Australian study of 396 children between the ages of 6 and 12 who were given drinks with Omega-3 fatty acids along with other nutrients like iron, zinc, folic acid and vitamins A, B6, B12, and C. These students showed higher scores on tests measuring verbal intelligence, learning skills, and memory after six months and one year as compared to a control group of students who did not receive the drink (Wolpert & Wheeler, 2008). In the Wolpert and Wheeler article, Gomez-Pinilla suggested that diets high in trans fats and saturated fats negatively affect cognition. These trans fats are found in common fast food and most junk foods. Through these trans fats, junk food affects the brain synapses as well as many molecules that aid in learning and memory. A diet low in trans fats and high in Omega-3 fatty acids can strengthen synapses and provide cognitive benefits (Wolpert & Wheeler, 2008). Wolfe and Burkman (2000) began by creating an equation: good nutrition + exercise = optimal learning. They support the following questions with research:
1. How does breakfast help kids do better in the classroom?
2. Can certain foods enhance a child’s learning or memory?
3. Do supplements help children perform better in the classroom?
Wolfe and Burkman cited research that confirmed proper nutritional support is important to allow the brain to function at its highest ability and to enhance learning. Wolf and Burkman suggested that it didn’t take much complication or obscurity through expensive foods and supplements to help students reach their potentials; healthful nutritional habits learned early in life help endure normal physiological and neurological growth and development, which translated into students’ achieving optimal learning, defined as the abilities to recall information, to problem solve, and to think critically. Wolfe and Burkman pointed out the importance of utilizing the Food Guide Pyramid for Young Children, which is an adaptation of the Food Guide Pyramid from the U.S. Department of Food and Agriculture. This food guide focuses on food preferences and nutritional requirements of young children and needs to be the foundation of their diets (Wolf & Burkman, 2000). Wolf and Burkman stated several dietary components support brain function and neurotransmitter activity, and that scientists recommend a wide range of foods as nutrient sources; the most important known today are protein, fat, B vitamins, iron, chlorine, and antioxidants. Offering students the right food choices and helping them develop positive, healthy eating habits will support optimal functioning of the brain. Eating breakfast helps students to eliminate or reduce stomach pain, headache, muscle tension, and fatigue, all which lead to an interference with learning. School personnel have the perfect access to students’ breakfast eating habits and need to utilize the opportunity to teach students good breakfast eating habits, whether at school or home. The negative impact of skipping a meal is also highlighted by Wolfe and Burkman. Without an adequate daily intake of nutrients from food, the body puts learning on a lower shelf below its need to sustain life-support functions. Therefore, in many cases, skipping a meal negatively affected the body and its learning functions. Wolf and Burkman concluded that as many as half of low-income elementary students skipped breakfast and that children who eat a good breakfast at school perform better on standardized tests. Also, they found that children who eat breakfast have improved attention in late-morning performance tasks, retrieve information more quickly and accurately, make fewer errors in problem-solving activities, and concentrate better and perform more complex tasks. Also, what the child eats for breakfast is important. A breakfast comprised of protein, fat, and sugar will prevent drops in blood sugar for several hours, whereas, as breakfast of just starch and sugar will sustain a child for only about two hours. A meal that included food from several food groups was the best for a child who was expects to perform at his or her best in school, educationally and physically. Wolfe and Burkman called attention to school food programs and contend that such programs need support, not disdain. Every lunch must contain at least one-third of the Recommended Daily Allowance (RDA) for specific key nutrients, and every breakfast must contain one-fourth of the RDA for specific nutrients. School meals must conform to the U.S. Dietary Guidelines and on a weekly average, no more than thirty percent of the calories can be from fat (Wolfe & Burkman, 2000). To sum up Wolfe and Burkman’s findings, the performance possibilities of children are very dependent upon their health and well-being; minds that have been given the proper nutrition will perform better on tests and general classroom tasks. Lahey and Rosen (2010) furthered the research that nutrition affects learning and behavior and suggested that diet can influence cognition and behavior in many ways, which include the condition of not enough nutrition or the condition of the lack of certain nutrients. About one-third of children who completed a food-habit questionnaire had inadequate fruit and vegetable intake. These students also showed poor school performance as compared to those students who had an adequate intake of fruits and vegetables (Lahey & Rosen, 2010). Zhang, Hebert, and Muldoon (2005) looked specifically at fats in the American diet, as the customary diet of American children and adults is high in total fat, saturated fat, and cholesterol. Zhang et al. sought to identify associations with fat intake and psychosocial and cognitive functioning in U.S. school-aged children, since it had been unclear whether and how specific fats may affect social and cognitive development. Data was used from the Third National Health and Nutrition Examination Survey (NHANES III). Medical and cognitive examinations and interviews were conducted with children and proxy respondents. A total of 5,367 children aged 6-16 participated in the Household Youth Interview. After attrition, a total of 3,666 children remained for the analyses (Zhang et al., 2005).
Mothers were asked a series of questions concerning their children’s behaviors and social skills. Children were administered the Arithmetic and Reading Subtests of the Wide Range Achievement Test, Revised (WRAT-R) and the block design and digit span subtests of the Wechsler Intelligence Scale for Children, Revised (WISC-R). The WRAT-R arithmetic subtest consists of oral and written problems ranging from addition to calculus, and the Reading subtest assesses letter recognition and word reading skills (Zhang et al., 2005). A twenty-four hour diet recall interview was administered to the proxies of the children in the study using a trained dietary interviewer using the Dietary Data Collection System designed to probe for fat and salt used in the preparation of foods. The interviewees were asked to report all foods and beverages consumed during the previous twenty-four hours, from midnight to midnight. Also, proxies were asked to rate their children’s health as excellent, very good, good, fair, or poor. A dichotomous variable was used that compared the children of the study in fair or poor health with children who were in excellent, very good, or good health (Zhang et al., 2005) Individuals with a high intake of polyunsaturated fatty acids (PUFAs) had a lower proportion of poor reading performance but a higher proportion of reported difficulties in getting along with peers. However, increasing or decreasing total fat or saturated fat was not associated with cognitive functioning Zhang et al. (2005). There are a few possibilities that the data obtained from the interviewees could have been inaccurate. This is always a possibility with studies that utilize interviews. Proxies may have been influenced by the perceived value of a particular response choice such as social desirability and social approval of dietary intake. Also, as with any cognitive test, it is always debatable whether the test actually measures what it was designed to measure. With these possibilities in mind, the researchers observed poor performance on the digit span test but not the other cognitive test was significantly associated with high cholesterol intake (Zhang et al, 2005). Kar, Rao, and Chandramouli (2008) examined the effect of stunted growth on the nature of cognitive impairments and on the rate of cognitive development. The study investigated if malnutrition would result in a concentrated impairment and a general slowing in the rate of development of all cognitive processes or these effects could be present for some specific cognitive processes. Effects of malnutrition on cognitive processes were also looked at in relation to impairment without affecting the rate of development and its effect on the rate of development of the cognitive process itself. The participants were identified as being malnourished or adequately nourished in the age groups of five- to seven-year olds and eight- to ten-year olds. Students in the malnourished group were identified by their height (stunting) and weight (wasting) of children in the same age categories with reference to the national center of health statistics (NCHS). Height for age/weight for height score less than two standard deviations from the mean were considered an indicator for moderate to severe malnutrition. Adequately nourished students were identified as children who were in or above the 50th percentile of height and weight as stated by the NCHS standards. Adequately nourished students were paired with malnourished students with respect to age and grade level. Each group had 20 participants (Kar et al., 2008). Students were tested individually in a well-controlled environment. The test they were given was the NIMHANS neuropsychological battery for children. It was developed for children aged five to fifteen. The battery consists of neuropsychological tests to assess motor speed, attention, executive function, visuospatial relationships, comprehension, learning, and memory.
Each section was grouped under a specific cognitive domain on the basis of theoretical rationale and factor analysis (Kar et al., 2008). Kar et al. (2008) compared the performance of adequately nourished children to malnourished children and also compared age related differences in cognitive function and found that the malnourished children differed from the adequately nourished children on tests of phonemic fluency, design fluency, selective attention, visuospatial working memory, visuospatial functions, verbal comprehension and verbal learning, and memory. Results for the verbal fluency test show adequately-nourished children achieved higher mean scores in both age categories, five- to seven- year olds and eight- to ten- year olds (4.3 and 5.7 respectively), when compared to their malnourished counterparts (1.36 and 4.4 respectively). Some of the other results had similar findings such as visual construction adequately nourished in both age categories (10.0 and 15.8) score higher than malnourished students (3.0 and 4.8) in the same age categories and also for verbal learning (32.4 and 42.3 vs. 26.9 and 30.7). These results show age related differences within each group as well as between the two age groups. Kar et al. also found a lack of age-related improvement in malnourished children when looking at cognitive functions of attention, cognitive flexibility, visuospatial construction, ability and verbal learning. Malnourished students showed lower results than the adequately nourished students but they did show age related improvement for these same functions. Differences were tested for statistical significance. Test scores for adequately nourished children between 5- to 7- years olds and 8- to 10- year olds were found significant but most of the test scores for undernourished children showed a delay in development of certain cognitive functions.
Kar et al. (2008) findings should be retested with a larger sample of participants to see if the trend is consistent with not only malnourished and adequately nourished children but those who are obese from an unhealthy diet. Li, Dai, Jackson, and Zhang (2008) examined the associations between academic performance, cognitive functioning, and increased BMI. They studied a nationally representative sample of 2,519 children ages eight to sixteen years old. Each participant had completed a brief neuropsychological battery and measures of height and weight. Trained examiners administered tests in a standardized environment using uniform procedures. Body weight was measured to the nearest 0.05 kg and height was measured to the nearest 0.1 cm. BMI was calculated in kilograms per meter square and then converted to a sex and age specific BMI percentile. Each participant was then categorized to an overweight BMI, an at-risk BMI, or a normal BMI. Parent-reported measures of children’s TV watching habits were also surveyed. Children were asked to report how many times per week they played or exercised enough to sweat or breathe hard. This question did not exclude school involvement, but another question about sports and exercise did. Children were then categorized as a participation group or nonparticipation group. Blood pressure, cholesterol, serum triglycerides levels, and iron deficiency were also observed. Iron deficiency has been known to be associated with poor cognitive function, and a high occurrence of iron deficiency was observed among overweight and obese children and adolescents. The average age of participants was 12 and they were about equally divided in gender. The subjects included differed on most of the characteristics from the subjects excluded. Those excluded were likely to be non-white and come from families with a low socioeconomic status. Among the subjects 20.33% were classified as overweight and 15.92% were obese. Li et al. (2008) found the association between BMI, cognitive functioning, and academic performance to be noteworthy. Test scores decreased as BMI on increased. The block design test had the greatest discrepancy among participants with 5.04% of normal weight children scoring poorly, 9.19% of at-risk children scoring poorly, and 12.18% of obese children scoring poorly. Test scores were defined as poor when they were less than 2 standard deviations from the mean. The odds of poor performance in visuospatial organization and general mental ability were doubled among at-risk children and tripled among overweight children when compared to normal weight children. Academic performance was measured by a test designed to assess basic school performance. Li et al. (2008) observed that being overweight was not the root cause of poor academic performance but found that obese adolescents consider themselves worse students. Another result from the study was that decreased cognitive function was associated with increased weight status. Cognitive deficits on tests of motor speed, weakened performance on motor speed and manual dexterity, and executive function were found. Poor performance on memory tasks was also common among obese people. Those with poorer cognitive ability may do worse in school and opt for a lifestyle that promotes weight gain. This study verified that this association may exist among overweight children or children at-risk of being overweight without clinically diagnosed diabetes mellitus, vascular disease, or cardiac disease that often characterize adult patients. Li et al. also found a relationship with decreased block design and weight. Block design is a measure of visuospatial organization and general mental ability which has been shown to be sensitive to brain damage. Results showed that the unfavorable effects of increased body weight on cognitive function start showing as early as childhood. Cognitive function decline may occur in younger persons and findings show an increase body weight worsens other risks factors for cardiovascular disease as time passes.
One of the most concerning outcomes of iron deficiency in children is the change of behavior and cognitive performance. Halterman, Kaczorowski, Aligne, and Szilagyi (2001) looked at the relationship between iron deficiency and cognitive test scores among school-aged children and adolescents. The objective of this study was to evaluate the relationship between iron deficiency and standardized test scores among six to 16-year-old US children. This relationship was considered for both children who had iron deficiency with anemia and for children who had iron deficiency without anemia. The National Health and Nutrition Examination Survey III (NHANES III) provided cross-sectional data for 5,398 children aged six to 16 and contained measures of iron status including transferrin saturation, free erythroirin status, protoporphyrin, and serum ferritin. Children were considered iron-deficient if any two of these variables were abnormal for their age or gender. Status hemoglobin values were used to detect anemia (Halterman et al., 2001). Among the 5,398 children in the study, 3% were iron deficient. This translated into 1.2 million school-aged children and adolescents in the United States who have an iron deficiency. Iron deficiency with or without anemia was determined for children with different age, gender, and demographic characteristics. Iron deficiency without anemia was more widespread than was iron deficiency with anemia. Iron deficiency was less than three percent among six- to 11-yearold children. Among 12- to 16-year-olds, iron deficiency was common among 8.7% of females, but only 0.9% of males (Halterman et al, 2001). Halterman et al. (2001) examined results from the Standardized Test and found a trend of lower scores with diminishing iron status. This trend was most evident in math. Math scores were lower for the iron-deficient children without anemia compared to normal iron status children. Children with anemia also had lower math scores when compared to children with normal iron status. Seventy-one percent of children with an iron deficiency scored below average in math as well as 72% of children anemia. Only 49% of children with normal iron status scored below average. There were no real discrepancies found among these students with reading, block design, and digit span but children with normal iron status performed better. Results from this comparison were adjusted for age, gender, race, poverty status, caretaker education, and lead status. There were potential limitations with this study. First, there were a limited number of cognitive measures available in the NHANES III data base. Therefore, iron deficiency with other cognitive scores could not be assessed. Secondly, the small number of children in certain subgroups may have allowed some associations to go undetected. Also there was no way to determine whether or not the sample students were iron deficient as infants and it is not known at this time whether the association of iron deficiency in older children and lower math scores would continue after treatment with iron. The 3% of children in this sampling with iron deficiency represent over a million schoolaged children and adolescents. Iron-deficient children without anemia represent the largest portion of children with an iron deficiency. Halterman et al. (2001) suggested this should be an important health concern. Halterman et al. (2001) proposed a need for screening not only for iron deficiencies with anemia but for those high-risk children without anemia.
Determinants Of Poor Nutrition Among Primary Pupils
UNICEF (2005) explained that, malnutrition is a broad term commonly used as an alternative to under-nutrition. It further said the malnutrition is largely a silent and invisible emergency, exacting a terrible toll on primary school pupils and their families. The result of multiple cause include lack of food, common and preventable infection like kwasiokor and marasmus, inadequate care and unsafe water.
It plays many roles in primary school pupils in the rural primary school, such a primary school in Imillike town. Because the pupils are malnourished, that is insufficient food nutrients in their bodies which will enable that to carry out their academic work and help in effective, cognitive and psychomotor skills, it affects their performance negatively.
Malnutrition blunts intellect and saps the productivity and potential of everyone. It touches and perpetuates poverty. Poverty, as one of the causes of malnutrition is also a consequence, a tragic bequest by man to the next generation (Philip, 1997). The majority of parents in Imillike town are rural dwellers and their major occupations are subsistence farming, which they have little or no agricultural product to sell. They are faced with poverty and this diminishes the means of providing food for the family as no other food when the available ones finish from the farm. It continues form father to children as they are ignorance of mechanized farming.
In the same view, Barker (1992) revealed another causative factor of poor nutrition that children may not eat enough because they have a poor diet which may be due to lack of food or lack or particular nutrient, low concentration of energy and nutrients, infrequent meals and inappropriate breast feeding practice by the parent before the children attain primary school.
Benton nutrition reviews (2001) opined that primary school pupils grow significantly, but at slower rate, their nutritional needs give high and critical. Additionally, genetic background, gender, body size and shape are all important determinants of nutrient requirements.
Mendoza (1997) contributed that poor nutrition cause’s weakness of mind. He further outlined the factors that determine bad nutrition underdevelopment, violence, unemployment (parent), poverty, lack of education and affection, lack of access to health care services, lack of equal distribution of resources of family, community and national levels.
All the above mentioned retards the level of academic performance of the pupils in primary school and primary six pupils in Imilike town are not an exemption.
The sate of world children (1998) also summed up that famines, wars and other catastrophes are responsible for poor nutrition, which early in life is linked to deficits in children intellectual development that persist in spite of schooling and impair learning ability. Hence, poverty, unemployment, underdevelopment, ignorant of what to eat and how to cook the food are major determinants of poor nutrition in Imilike town which affects the performance of pupils in the school.
Effects Of Poor Nutrition Needs On Primary Six Pupils Academic Performance
Olusanya (1990) asserted that it is only when the pupils well fed that he can listen attentively and understand what he/she is being taught by the teacher. “A hungry person will not be responsible to any form of training.” They added that there is a strong correlation between good food and the intellectual development of human beings. Therefore, for a nation to progress, her people must be well fed. This means that the nutrition should be consumed in the proper proportion of the nutrient consumed is very important because it has been found that consumption of too much as well as inadequacy of the nutrients can be of deleterious effects on the body. Hence there is need to study Home Economics at primary level.
Okenwa (2010) explained that pupils’ academics performance can be affected by nutritional intake. He further explained that inadequate nutrition negatively influences intelligence and academic performance of primary school pupils. He revealed that those pupils with poor nutrition scored lower on test of vocabulary, reading comprehension, mathematics and general knowledge. He added that those pupils who don’t take breakfast are likely to score lower in test of speed and accuracy in problem-solving such as basic science and mathematics.
Observing further, American Journal of clinical Nutrition (2010) concluded that pupils with iron deficiency (anemia) have shorter attention spans, irritability, fatigue and difficulty with concentration which lead to poor vocabulary, reading and other test scores. While the journal of personal an individual differences notes that those pupils that are slightly malnourished showed that their intelligence and performance were affected. But improved nutrition corrected these impairments they added that skipping breakfast interferes with cognition, learning and alertness, problem solving tasks such as mathematics and basic science.
The introduction of school breakfast by Federal Government of Nigeria impacted a lot positively in the life of primary school pupils in Imilike town. At that time, the pupils were ready to learn because there is hope of tea or food items at morning break, precisely 10’0clock. Their pupils performances were affected as learning condition changed when the breakfast stopped. Inadequacy of parents to provide the pupils with breakfast retards their performance in school.
Jenny, (2010) opined that hunger have detrimental effect on academic performance of pupils in primary school. She added that those pupils have more difficulty in resisting infections, thus, they are more likely to get sick, miss school and fall behind in class. Because of their lack of inadequate nutrients they are low in energy, which can limit their physical activity and this in turn affects cognitive functioning.
In the same view, Jungana (2005) added that over weight pupils were likely to have lower grades in English language and mathematics.
In addition to the above mentioned, primary six pupils in Imilike town are experiencing hungers due to food insufficiency, thereby affecting their performance in the school work. They have problem in reading comprehension and solving simple mathematics, due to their poor nutrition status. They often get sick, thereby absenting themselves from school. The pupils in Ogbodu and Ezimo often go to bush in search of seasonal fruits like mangoes, guava and other to stave hunger. In the process they miss their lessons thereby lowering their standard.
In same school like LEA Odumegu primary school Nshama, the primary six pupils as paramount in the school and sometimes in the family, find it very difficult to come back after morning break or breakfast due to physical discomfort and mental distraction caused by hunger. They prefer farming all these contributed to their poor performance in academic, which might prevent school gaining entrance into secondary school.
Gordon (2011) advocated that “there is no such thing like a lazy child…. That is a symptom. It’s a question of motivation or if the child is having a problem home, such as parents going through divorce. He added that reasons for poor academic performance of pupils is food insufficiency that’s, they will not have adequate amount of food to eat, thereby bringing physical discomfort and mental distraction lower mathematics scores, grade repetition, absenteeism, tiredness, increased levels of anxiety and aggression, psychological dysfunction and social interaction difficulties and poor sleep. He also suggested that school-aged children should sleep for a minimum of nine hours restful sleep each night, for better performance in the school. In practice therefore, if the primary six pupils in Imilike town will have enough resting period, their academic performance will improve.
Good Nutrition Provision to The Primary Pupils With Poor Nutrition
Jocelyn, (2009) asserted that you cannot educate a child who is not healthy and you cannot keep a child healthy who is not educated. The poor nutrition status of primary six pupils in Imilike town will be corrected if adequate nutrition information will be passed to the pupils and their parents/caregivers.
In the same view, young (2008) explained that poor nutrition is a hitch to low birth weight babies, defined as weighting less than 2.5 kilograms, are at greater risk of dying before reaching primary six level education. They added that if the survive, they will have more episodes of illness, their cognitive development may be impaired which may lead to poor performance in school. The pregnant or expectant mothers in some areas like Ogblu, Ezimo and Nshama have little knowledge in the importance of pre-natal check up. The prefer to stay at home and take care of the pregnancy with local herbs and even delivered their babies at home with the help of the neighbours who have little or no knowledge about birth delivery. Also they goes on using unsterilized razor blade and rust razor or scissors to cut the umbilical card or placenta.
Dada (2010) in her lecture on importance of community nutrition regretted that parents in the rural communities sell their fowls and eggs to make money and also claimed that giving children eggs is a taboo. She explained that egg is among the high quality protein, thiamin, niacin, riboflavin and iron which helps children in psychomotor and effective domains or development of educational objectives. The poor academic performance of primary six pupils in Imilike town will improve, if all these nutrients status will change.
The world summit for children (1990) outlined 5 micronutrients needed by the children to improve their health standard at primary school. These, the summit said are: iodine, vitamin A, iron, Zinc, and foliate (folic acid).
The summit called these “micronutrients” because they are needed by the body only in minute amounts, play reading roles in the production of enzymes, hormones and other substances, helping to regulate growth, activity, development and the functioning of the immune and reproductive systems, thereby improving the cognitive and psychomotor domains of the primary six pupils.
Also, the state of the world’s children (2010) mentioned that Zinc promotes normal growth and development in primary school pupils and development in primary school pupils and is an element in enzymes that work with red blood cells which move carbon dioxide from tissues to lungs. The report also said that Zinc helps maintain an effective immune system.
Observing further, United Nations, The Worlds Women (2011) reported that foliate is a B vitamin that helps in the formation of red blood cells, aiding language development and helping to prevent serious neural tube defects of the spinal cord and brain of the area. Ezra (2011) from Columbia University’s mailman school of public Health said. The recommendation worldwide is that women should be on foliate supplements through all their reproductive years.
The Importance of Teaching and Learning Nutrition in Primary School
Primary education is referred to as the lowest school formal institution, teaching the rudiments of leaving and extending usually from six to eleven years (NPE 2001).
Eating habits are established early in the life cycle and tend to carry through to adulthood. As a result, the food children eat now will undoubtedly influence their state of health in later life. Making informed food choices is an integral part of child’s normal growth and development. However, it must be emphasized that teachers, Nutritionist Dieticians and other health workers need to tread this path with care, so that excess and poor intake of food will not affect the performance of the children in primary school particularly those of primary six that is entering secondary school.
Osaai (2004) said teaching of nutrition is primarily concerned with aim of creating a conducive learning environment where street children and those orphaned by the consequences of war, fatal accident, the HIV/AIDS pandemic, manmade and natural disasters, ethnic clashes, socio-economic factors and so on, can be nurtured and empowered to stand on their own and create wealth for themselves. This implies that children can do better even after graduation from primary six as effective teaching and learning situation between the teacher and pupils.
In a similar view, UNESCO (2002) high-lifted that teaching of nutrition among primary school children is designed to pursue the objectives of enhancing the survival capabilities and potential of children of neglect. Programmes like acquisition, education scheme, vocational training, food formulae/supplement, health incentives, and micro-credit facilities and so on, could greatly assist in the regard.
Continuing UNESCO (2004) outlines some of the aims and objectives of teaching nutrition in primary schools:
1.To improve nutrition, health and social skills in disadvantaged and underprivileged groups particularly primary six pupils.
2.To reduce inequality in school access and achievements by specifically poor and disadvantaged pupils especially girls.
3.To reduce violent behavior and illicit activities among primary school pupils.
4.To improve disease prevention skills and health care practices of parents and control the spread of HIV/AIDS and other sexually transmitted disease and blood-borne infection.
5.To reduce maternal and child mortality rates and to improve child mortality rates and to improve child survival and development in the poorest areas of Nigeria.
6.To increase access to this vulnerable group, vocational skill acquisition opportunities.
7.To reduce malnutrition in orphans and to strengthen survival capacity and capabilities to overcome life challenges.
8.To identify existing resources and capabilities in these young children especially as a result of HIV/AIDS and see how best they can be useful.
9. To propagate awareness campaigns in remote area over the ten-year project period to promote education and health supplies to underprivileged children with priority given to girls. They added that, it is advisable to train community caregivers in the design and dissemination of learning and play materials, and also in the psycho-social development of primary school children.
It becomes instructive that, if the above listed will be judiciously executed in Nigeria by the stakeholders in education, the nutritional status and academic performance of Nigeria pupils, particularly primary six pupils will derive intellectual benefit or improvement more so, the primary six pupils in Imilike town will be best the beneficiaries. Their parents/guardians will get appropriate information on how to handle their food to prevent diseases and how to combine their food, that is, their agricultural products outcome to gain all the nutrients in the rightful proportion. Also incentives such as school free food, breakfast or lunch, free distribution of vitamin C, Glucose D, Omega b and fatty acids supplements and other things the nutritional state of primary six pupils in Imilike town will progressively be corrected and balance. This will boast their academic performance in the school.
Teachers should develop confidence in Home Economics as a science subject, particularly in the practical aspect, but the semen is flexible enough about its application in the primary school where scientific equipment and other utensils are totally absent or insufficiently present. The skill, when acquired would enable the pupils see problem as the actually occur in nature or cause and learn how to solve them scientifically.
The experience of this researcher with the primary schools in Imilke town shows that there is no trace of practical equipment and utensils, which shows that teaching and learning nutrition is half baked, that is move theory and less practical.
In the contrary, primary six pupils in Imilike learning of nutrition should also embrace teaching and learning of nutrition which was in the recent time made compulsory. It should be taught at primary schools and to be effectively carryout the practical.
The practical should contain the six classes of food nutrients, the three course meals of the day, including fruits and fruit juices.
Observing further, UNICEF (2066), portrayed that importance of teaching and learning process of nutrition in the primary school for the fact of acute shortage of sufficient food item at home for the children’s food abundant equipment and food item to teach them how to prepare balance diet and also to offer them with food as breakfast in the school to boast them morale towards learning. It is very important for parents and schools to encourage pupils to eat breakfast. A good night’s sleep followed by food in the morning help the primary six pupils to stay active and concentrate at school work. It also means that the pupils are less likely to be hungry during the morning and it helps with their cognitive and psychomotor performance at school.
2.2 THEORETICAL FRAMEWORK
The theoretical foundation of this study is anchored on Abraham Maslow’s theory of needs.
Abraham Maslow’s Theory Of Needs
Maslow proposed a theory of needs based on a hierarchical model of the basic needs at the bottom and higher needs at the top (physiological, safety, love, esteem, cognitive, aesthetic, self-actualisation and transcendence needs). The most fundamental and basic four layers of the pyramid contain what Maslow called deficiency needs or d-needs, the individual does not feel anything if they are met, but feels anxious if they are not met (Snowman & Biehler 2011:79). Needs beyond the D-needs are called growth needs, being needs or B-needs. When fulfilled, they do not go away, rather they motivate further. Mwamwenda (2010) posited a hierarchy of needs based on two groupings, physiological needs and psychological needs. The central point in Maslow’s theory is that people tend to satisfy their needs systematically starting with the basic physiological needs and moving up the hierarchy. He believed that the higher level needs can only be achieved if the lower order needs have been satisfied first. For example, a hungry child is not likely to be motivated to self-actualise until her hunger is satisfied.
The Hierarchy of Needs theory remains valid today for understanding human motivation; personal growth and academic performance of grade seven learners in poverty stricken households.
CHAPTER SUMMARY
In this review the researcher has sampled the opinions and views of several authors and scholars on nutrition, nutritional need for children, nutrition and cognitive ability etc. The works of scholars who conducted empirical studies have been reviewed also. The chapter has made clear the relevant literature.