FINDINGS OF GLOBAL SCHOOL-BASED STUDENT HEALTH SURVEY MALDIVES 2009: DIETRY BEHAVIOUR

Background

During adolescence, overweight is associated with hyperlipidaemia, raised blood pressure (hypertension), abnormal glucose tolerance, and adverse psychological and social consequences.

Overweight acquired during childhood or adolescence may persist into adulthood and increase risk later in life for coronary heart disease, diabetes, gallbladder disease, some types of cancer, and osteoarthritis of the weight-bearing joints. Nutritional deficiencies as a result of food insecurity (protein-energy malnutrition, iron, Vitamin A, and iodine deficiency) affect school participation and learning (8).

Fruits and vegetables are good sources of complex carbohydrates, vitamins, minerals, and other substances important for good health. Dietary patterns that include higher intakes of fruits and vegetables are associated with several health benefits, including a decreased risk for some types of cancer (9).

According to the 2004 NCD Risk Factor Survey conducted in the urban city of Maldives, the prevalence of NCD risk factors was high among both men and women in the low education group: overweight (BMI >/= 23 kg/m(2)) (60.8, 65.5%); abdominal obesity (24.2, 54.1%); raised blood pressure (29.7, 32.9%); raised blood glucose (4.3, 4.7%); hypercholesterolemia (53.7, 54.9%). Fruits and vegetables were consumed on a median of 3 days per week each with a median of one serving per day. Only 2.7% of the subjects had five or more servings of fruits and vegetables a day (10, 11).

The 2001Multiple Cluster Survey, conducted in Maldives shows that 30.4% of children under five years of age are underweight, 24.8% are stunted and 13.2 % are wasted. The percentage of children who received Vitamin A supplements within the last 4-6 months prior to the survey was 50.6%. Likewise, more than 5% of children have reported vision difficulty and are suffering from Vitamin A deficiency among children aged 24-59 months. This indicates that Maldives has severe Vitamin A deficiency among children as under functional classification.

Similarly, during their last pregnancy 55% of women had difficulty seeing in daylight and the same number of women suffered night blindness. The mean BMI for women in Maldives is 23.5. 23% of women in the Maldives have a BMI below 18.5 indicates a high prevalence of nutritional deficiency. This deficiency is high among women in the age groups 15-19 and 20-24. The survey also indicates that 41% of women are mildly anaemic, 10% moderately anaemic, and 1% severely anaemic (12).

Results

Prevalence of Hunger

National

Overall, in Maldives 6.9% of students went hungry most of the time or always because there was not enough food in their home during the past 30 days. Male students (7.4%) and female students (6.4%) are equally likely to go hungry most of the time or always because there is not enough food in their home.

Sub national

In comparison, students (7.6%) from Atoll are slightly more likely than students (5.2%) from Male’ to go hungry most of the time or always because there was not enough food in their home. Male students (8.2%) from Atoll and (5.5%) from Male’ and female students (7.1%) from Atoll and (4.8%) from Male’ are equally likely to go hungry most of the time or always because there is not enough food in their home.

Fruit and vegetable intake

National

Overall, in Maldives 22.7% of students usually ate fruit such as banana two or more times per day during the past 30 days. Male students (26.4%) are significantly more likely than female students (19.3%) to eat fruit two or more times per day.

Overall, in Maldives 10.1% of students usually ate vegetable such as pumpkin three or more times per day during the past 30 days. Male students (12.6%) are significantly more likely than female students (7.7%) to eat vegetables three or more times per day.

Overall, in Maldives 12.9% of students usually ate fruit and vegetable five or more times per day during the past 30 days. Male students (15.6%) are significantly more than female students (10.4%) to eat vegetables five or more times per day.

Sub national

In comparison, students (24.7%) from Atoll are significantly more likely than students (5.2%) from Male’ to eat fruit two or more times per day. Male students (29.3%) from Atoll and (19.3%) from Male’ are significantly more likely than female students (20.4%) from Atoll and (16.7%) from Male’ to eat fruit two or more times per day.

In comparison, students (11.2%) from Atoll are significantly more likely than students (7.5%) from Male’ to eat vegetables three or more times per day. Male students (13.8%) from Atoll and (9.6%) from Male’ are significantly more likely than female students (8.6%) from Atoll and (5.6%) from Male’ to eat vegetables three or more times per day.

In comparison, students (14.5%) from Atoll are significantly more likely than students (9.1%) from Male’ to eat fruit and vegetables five or more times per day. Male students (17.7%) from Atoll and (10.5%) from Male’ are significantly more likelythan female students (11.4%) from Atoll and (7.9%) from Male’ to eat fruit and vegetables five or more times per day.

Consumption of carbonated soft drinks

National

Overall, in Maldives 33.0% drink carbonated soft drinks such as coke one or more times per day during the past 30 days. Male students (35.7%) and female students (30.5%) are equally likely to drink carbonated soft drinks one or more times per day.

Sub national

In comparison, students (36.2%) from Male’ is more likely than students (31.7%) from Atoll to drink carbonated soft drinks one or more times per day. Male students (35.3%) from Atoll and (36.5%) from Male’ and female students (28.2%) from Atoll and (35.9%) from Male’ are equally likely to drink carbonated soft drinks one or more times per day.

Consumption of food from fast food restaurant

National

Overall, in Maldives 15.7% eat food from fast food restaurant such as Dine-more on three or more times per day during the past 7 days. Male students (18.6%) and female students (12.4%) are equally likely to eat food from fast food restaurant on three or more times per day.

Sub national

Likewise, students (15.4%) from Male’ and students (15.9%) from Atoll are equally likely to eat food from fast food restaurant on three or more times per day. Male students (18.5%) from Atoll and (18.9%) from Male’ and female students (12.6%) from Atoll and (11.8%) from Male’ are equally likely to eat food from fast food restaurant on three or more times per day.

Perception about weight

National

Overall, in Maldives 20.4% of students describes their weight as slightly or very over weight. Male students (20.7%) and female students (20.2%) are equally likely to describe their weight as slightly or very over weight.

Sub national

In comparison, students (24.0%) from Male’ is significantly more likely than students (18.9%) from Atoll to describe their weight as slightly or very over weight. Male students (19.4%) from Atoll and (18.5%) from Male’ and female students (23.8%) from Atoll and (24.1%) from Male’ are equally likely to describes their weight as slightly or very over weight.

Maintenance of weight

National

Overall, in Maldives 22.2% of students are trying to lose weight. Male students (21.0%) and female students (23.6%) are equally trying to lose weight.

Overall, in Maldives 31.3% of students are exercising to lose weight or to keep from gaining weight during the past 30 days. Male students (35.0%) are significantly more likely than female students (27.4%) are exercising to lose weight or to keep from gaining weight.

Overall, in Maldives 35.7% of students are eating less food few calories or food low in fats to lose weight or to keep from gaining weight during the past 30 days. Male students (36.6%) and female students (34.7%) are equally likely to eat less food few calories or food low in fats to lose weight or to keep from gaining weight.

Sub national

In comparison, students (30.9%) from Male’ is significantly more likely than students (18.6%) from Atoll, to try to lose weight. From Atoll, male students (17.8%) and female students (19.6%) from Atoll are equally trying to lose weight. However, from Male’ female students (32.9%) are more likely than male students (28.8%), to try to lose weight.

Similarly, students (31.5%) from Male’ and (31.0%) from Atoll are equally exercising to lose weight or to keep from gaining weight. However, Male students (35.8%) from Male’ and (34.7) from Atoll are significantly more likely than female students (27.5%) from Male’ and (27.4%) from Atoll to exercise to lose weight or to keep from gaining weight.

Similarly, students (36.6%) from Atoll and (33.6%) from Male’ are equally likely to eat less food few calories or food low in fats to lose weight or to keep from gaining weight. From Atoll, male students (39.3%) are significantly more than female students (33.8%) to eat less food few calories or food low in fats to lose weight or to keep from gaining weight. In contrast, from Male’, female students (37.0%) are significantly more than male students (29.9%) to eat less food few calories or food low in fats to lose weight or to keep from gaining weight.

Consumption of breakfast

National

Overall, in Maldives 46.5% of students eat breakfast most of the time or always during the past 30 days. Male students (48.0%) and female students (45.0%) are equally likely to eat breakfast most of the time or always.

Overall, in Maldives 3.4% of students did not eat breakfast because there was not always food in their home. Male students (4.1%) and female students (2.7%) are equally likely not eat breakfast because there was not always food in their home.

Sub national

Similarly, students (45.9%) from Atoll and (48.2%) from Male’ are equally likely to eat breakfast most of the time or always. From Atoll, male students (45.6%) and female students (45.9%) are equally likely to eat breakfast most of the time or always. However, in Male’, male students (54.0%) are significantly more likely than female students (42.8%) to eat breakfast most of the time or always.

Similarly, students (3.4%) from Atoll and Male’ did not eat breakfast because there was not always food in their home. Male students (4.4%) from Atoll and (2.4%) from Male’ and female students (3.5%) from Atoll and (3.3%) from Male’ are equally likely not eat breakfast because there was not always food in their home.