Validation Of Nutritional Status Assessment Methods Using Stable Isotope Dilution Technique Among School Children In Nairobi City County, Kenya

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ABSTRACT 

Methods used to assess overweight and obesity generate information that can be used to design interventions and policies which can address over-nutrition. Dietary practices, physical activity and anthropometry are the commonly used methods for assessing overweight and obesity. However, studies have cited their limitations since these methods do not indicate fat mass which is the factor that predisposes individuals to weight-related health risks. This study aimed to validate anthropometry, dietary practices and physical activity as commonly used methods for assessing overweight and obesity using stable isotope dilution technique (SIDT) as the gold standard for measuring body fat (BF). The study further aimed to model prediction equations for estimation of body fat among Kenyan children. A cross-sectional analytical study design was used to collect both qualitative and quantitative data from 202 randomly selected children aged 8-11 years in four randomly selected schools in Kasarani sub-county, Nairobi. Data were collected on demographic characteristics of the children, dietary practices, physical activity, anthropometric measurements, and body composition measurements. Anthropometric data were analyzed using WHO anthroplus software. The distribution of body mass index (BMI)-for-age z-scores and waist to height ratio (WtHR) were categorized according to WHO guidelines. Saliva samples for determination of body composition were analyzed using Fourier Transform Infrared Spectrometry. Physical activity score was calculated from the total score of nine questions in physical activity questionnaire for children and accelerometer data was analyzed using Acti-life computer software. Nutrient intake was analyzed using Nutri-Survey software. Relationships between variables were established using Pearson correlation, odds ratio and chi-square while differences were established using t-test and Wilcoxon test. Validation was done using Cohen’s Kappa coefficient and Bland-Altman analysis. Multiple regression was used to model equations. The mean percent body fat was 27.52±6.4 for girls and 19.65±5.9 for boys with 24.0% of children having excess fat. The mean BMI-for-age was 16.0±2.4 with 5.0% being overweight and 3.0% obese. Central obesity using WtHR was 6.9%. Children with excess energy intake above 120% of RDAs were 29.7%. Energy intake significantly correlated with body fat (r = 0.621, P<0.001). The mean physical activity score was 2.9±0.6. The physical activity significantly correlated with body fat (r = -0.396, P<0.001). There was low concordance between nutritional status assessed by BMI-for-age z-score (κ = 0.129) and WtHR (κ = 0.357), compared to SIDT. Similarly, low concordance was noted among children with high energy intake (κ = 0.119) and low physical activity (κ = 0.241) in respect to body fat. The prediction equations that provided reliable estimates of body fat modeled using weight (wt), height (ht), waist circumference (wc) and BMI-for-age were; BF= 0.683 (wt) - 0.223 (ht) + 16.15, BF = 0.525 (wc) - 24.36 and BF = 1.381 (BMI-for-age) - 16.22 for boys. Equations for girls were; BF = 0.704 (wt) - 0.230 (ht) +18.61, BF = 0.510 (wc) - 21.78 and BF = 1.510 (BMI-for-age) - 15.65. All the equations had strong concordance coefficient >0.9 in estimating body fat when compared with SIDT. This study concludes that dietary intake and physical activity are not absolute measures of body fat. Anthropometric measurements under-estimate body fat. Prediction equations can be used to accurately measure body fat. This study recommends the use of the modeled equations to estimate body fat among school children from low income population.

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APA

Edu, F (2021). Validation Of Nutritional Status Assessment Methods Using Stable Isotope Dilution Technique Among School Children In Nairobi City County, Kenya. Afribary.com: Retrieved June 18, 2021, from https://afribary.com/works/validation-of-nutritional-status-assessment-methods-using-stable-isotope-dilution-technique-among-school-children-in-nairobi-city-county-kenya

MLA 8th

Frontiers, Edu. "Validation Of Nutritional Status Assessment Methods Using Stable Isotope Dilution Technique Among School Children In Nairobi City County, Kenya" Afribary.com. Afribary.com, 05 Jun. 2021, https://afribary.com/works/validation-of-nutritional-status-assessment-methods-using-stable-isotope-dilution-technique-among-school-children-in-nairobi-city-county-kenya . Accessed 18 Jun. 2021.

MLA7

Frontiers, Edu. "Validation Of Nutritional Status Assessment Methods Using Stable Isotope Dilution Technique Among School Children In Nairobi City County, Kenya". Afribary.com, Afribary.com, 05 Jun. 2021. Web. 18 Jun. 2021. < https://afribary.com/works/validation-of-nutritional-status-assessment-methods-using-stable-isotope-dilution-technique-among-school-children-in-nairobi-city-county-kenya >.

Chicago

Frontiers, Edu. "Validation Of Nutritional Status Assessment Methods Using Stable Isotope Dilution Technique Among School Children In Nairobi City County, Kenya" Afribary.com (2021). Accessed June 18, 2021. https://afribary.com/works/validation-of-nutritional-status-assessment-methods-using-stable-isotope-dilution-technique-among-school-children-in-nairobi-city-county-kenya