AN INVESTIGATION INTO THE KNOWLEDGE, ATTITUDE AND PRACTICE ON FRUITS AND VEGETABLES CONSUMPTION AMONG RESIDENTS IN LAGOS STATE COMMUNITIES (Chapter 1-5)

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CHAPTER ONE

INTRODUCTION

Background to the Study

For more than a century, experts have produced dietary guidance aimed at increasing consumption of certain nutrients and food groups, yet compliance remains poor. The most visible example to date is the campaign to increase consumption of fruits and vegetables.

Ample research has indicated that nutritional factors contribute substantially to the burden of preventable illnesses and premature deaths worldwide (Beaglehole & Yach, 2013). A balanced diet has been shown to promote overall well-being and health (Adebanwo, 2010; Scott, 2003). Dietary patterns with higher fruit and vegetable  intake are associated with treating and preventing metabolic syndromes (Feldeisen & Tucker, 2007) and promoting a variety of health benefits; including decreased risk for certain cancers (Lee, Johanssen & Mitchelle, 2006), reduced morbidity and mortality from heart disease (Feldeisen & Tucker, 2007), enhanced diabetes prevention (Hodge, Carston & Vanelli, 2007) and improved weight management (Bazzano, 2006).  Furthermore, the consumption of food of low fat content and high fiber content such as fruits and vegetables with regular exercises has been recommended as important step to maintain healthy living (Adebanwo, 2010). Facts from WHO information sheet showed that approximately 2.7 million of deaths and1.8% of global disease burden worldwide are attributable to low fruit and vegetable consumption and insufficient intake of fruit and vegetables is estimated to cause around 14% of gastrointestinal cancer deaths, about 31% of heart disease and about 11% of stroke deaths (WHO, 2013).

Fruits and vegetables are not only rich in vitamins, minerals, and dietary fiber; they are also low in calorie required for the normal functioning of human body (Douglas, 2010). The micronutrients supplied by fruits and vegetables are also vital for the optimal functioning of the gastro-intestinal tract as they also enable the body to use other nutrients required for its normal function like deriving energy from fats and carbohydrates.  Also fruits and vegetables act as a source of vegetable proteins and dietary fibres which help to prevent constipation (WHO, 2013). They are foods with low energy density, i.e. with few calories in relation to the volume of the food consumed, which favors maintenance of healthy body weight (United States Department for Agriculture, 2009). Vishal (2014) added that eating vegetables appears to help keep the brain young and may slow the mental decline sometimes associated with growing old. Morris (2010) also asserted that a diet including mainly spinach can boost memory power and help in cognition and better learning.

Numerous interventions, such as social marketing, printed educational material and environmental approaches, aim to increase the intake of fruits and vegetables by targeting both the general population and at-risk subgroups (Marcus et al., 2008). However, Studies have found numerous correlates inhibiting the consumption of fruits and vegetables, such as low socio-economic status, ignorance, inaccessibility to fresh fruits and vegetables and lack of self-efficacy (Siega-Riz & Popkin, 2001).

Ruel, Candela & DiSilva (2004) revealed that Nigeria is the largest consumer of vegetable in Sub-Saharan Africa with about 61.31g/capita/day.  The researchers however noted that this is still far below far below the WHO/FAO minimum recommendation of 400g per person per day or 146kg per person per year.

Good health is needed to achieve a productive and successful life, and one of the factors needed to maintain good health is a lifestyle of adequate nutrition (Onwuama, 2006). Judging by the findings of research stated above, it is well-established that regular consumption of the right amount of fruits and vegetables is a way to contribute to healthy living. However, for anyone to know the importance of consuming fruits and vegetables, it is necessary that they get informed about it. It is that information that brings about knowledge and enlightenment (Olabode, 2015). Furthermore, when a person gains knowledge about something, their attitude towards that thing is likely to be influenced (Mohammed, 2010) and by extension, their compliance towards utilizing such a thing.

Nigeria is a country in Sub-Saharan Africa blessed with myriads of stores of nourishment and vitality in the forms of fruits and vegetables. Among the fruits are oranges, water melon, pineapples, banana, apples, grape, pear and lemon while a few of the vegatables are  wild lettuce (yanrin), bitter leaf (ewuro), African spinach (tete), celosia (shoko), water leaf (gbure), eggplant,  Malabar spinach (amunututu), African basil (efinrin), pumpkin (ugwu), carrots, lettuce, beans and onions (The Punch, 2011). Infact fruits and vegetables are so abundant in Nigeria that their potential as a major source of export and foreign exchange has been established (The Punch, 2016). It would therefore be disappointing if Nigerians fail to exploit the benefits of these resources which are available in abundance.

Only a few studies have assessed factors that predict the knowledge, attitude and compliance of individuals to fruits and vegetables consumption. Some of such studies were those of Eze, Udeani & Anieze (2009) who revealed that age, morbidity, level of education and geographical location are factors. Banwat, Lar & Daboer (2012) see occupation and marital status as factors.

To be able to create more awareness about fruits and vegetables consumption among Nigerians, it is reasonable to start by examining their knowledge, attitude and compliance about these food substances. It is in light of this that this study is being carried out.

Statement of Problem

It has been discovered through research that knowledge, attitude and compliance to fruits and vegetables consumption among Nigerians is not favourable , ranging between 70 to 312g per person which is  far below the WHO/FAO minimum recommendation of 400g per person per day or 146kg per person per year as revealed by Ruel, Candela & DiSilva (2004).

This means that a lot of people are not consuming these food items, and many who are consuming them are not doing so in the right quantity. Research has also made it known that fruits and vegetables are highly supportive of good health. However, ignorance, poor attitude and a couple of other factors are depriving many Nigerians of the opportunity to take advantage of the health benefits that fruits and vegetables provide.

At the WHO revealed, a dietary intake of fruits and vegetables is a preventive heath measure, which means it could help the government cut its expenses on health by raising the average wellness of the populace.

The problem of this study therefore is to assess the knowledge, attitude of compliance of Lagos residents to fruits and vegetables consumption with a view to creating more awareness in the state.

Purpose of Study

The main purpose of this study is to assess the knowledge, attitude and practice of Lagos residents on fruits and vegetables consumption. Specifically, this study aims to:

1. Find out if knowledge of nutrition will influence fruits and vegetables consumption among residents in Lagos communities
2. Determine if attitude will influence fruits and vegetables consumption among residents in Lagos communities.
3. Determine if availability will influence fruits and vegetables consumption among residents in Lagos communities.
4. Find out if current dietary practice will influence fruits and vegetables consumption among residents in Lagos communities.
5. Determine if cultural practice will influence fruits and vegetables consumption among residents in Lagos communities.
6. Find out if food choice will influence fruits and vegetables consumption among residents in Lagos communities

Research Questions

The following research questions were answered in this study:

1. Will knowledge of nutrition influence fruits and vegetables consumption among residents in Lagos communities?
2. Will attitude influence fruits and vegetables consumption among residents in Lagos communities?
3. Will availability influence fruits and vegetables consumption among residents in Lagos communities?
4. Will current dietary practice influence fruits and vegetables consumption among residents in Lagos communities?
5. Will cultural practice influence fruits and vegetables consumption among residents in Lagos communities?
6. Will food choice influence fruits and vegetables consumption among residents in Lagos communities?

Research Hypotheses

The following research hypotheses were tested in this study:

1. Knowledge of nutrition will not influence fruits and vegetables consumption among residents in Lagos communities
2. Attitude will not influence fruits and vegetables consumption among residents in Lagos communities
3. Availability will not influence fruits and vegetables consumption among residents in Lagos communities
4. Current dietary practice will not influence fruits and vegetables consumption among residents in Lagos communities
5. Cultural practice will not influence fruits and vegetables consumption among residents in Lagos communities
6. Food choice will not influence fruits and vegetables consumption among residents in Lagos communities.

Significance of the Study

Firstly, this study would help to generate useful data pertaining how much the public know about the importance of consuming fruits and vegetables, their attitude and their compliance. This may help policy makers address the concern of low consumption of these food items in Nigeria. This is very important because without a clear understanding of defining characteristics of the poor and malnourished in Nigeria, studies have shown that the country will be unable to achieve the Millennium Development Goals of reducing poverty and food insecurity (International Food Policy Research Institute, 2012). And thus, this study would provide a statistical background for health stakeholders with a view towards awareness creation and education.

Through this study, individuals would learn to adopt a lifestyle of improved nutrition which supports good health.

Delimitation of the Study

This study was delimited to the following:

1. Knowledge, attitude and compliance of Lagos residents to fruits and vegetables consumption
2. The survey research design
3. Use of questionnaire
4. 200 civil servants.
5. Pearson’s Product Moment Correlation statistical tool.

Limitations of the Study

The main limitation of this study was the reluctance of respondents to participate in the study.

Significance of the Study

Firstly, this study would help to generate useful data pertaining how much the public know about the importance of consuming fruits and vegetables, their attitude and their compliance. This may help policy makers address the concern of low consumption of these food items in Nigeria. This is very important because without a clear understanding of defining characteristics of the poor and malnourished in Nigeria, studies have shown that the country will be unable to achieve the Millennium Development Goals of reducing poverty and food insecurity (International Food Policy Research Institute, 2012). And  thus, this study would provide a statistical background for health stakeholders with a view towards awareness creation and education.

Through this study, individuals would learn to adopt a lifestyle of improved nutrition which supports good health.

 Definition of Key Terms

Attitude: a settled way of thinking or feeling about something, typically one that is reflected in a person’s behavior.

Compliance: to act in accordance with a certain knowledge or information.

Cultural Practice: Nutritional practices that are common to each ethnic group.

Food Choice: Food preferences of different individuals.

Fruit: The sweet and fleshy product of a tree or other plant that contains seed and can be eaten as food e.g mango, pawpaw, oranges, pear etc.

Knowledge: facts or information acquired by a person through experience or education

Vegetable: a plant or part of a plant used as food, typically as accompaniment to meat or fish, such cabbage, cabbage, potato, carrot, or spinach etc.

 Project Overview

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