FOOD HABITS, NUTRITION KNOWLEDGE AND NUTRIENT INTAKES 
OF ADOLESCENT STUDENTS IN SELECTED BOARDING SCHOOLS IN GHANA
BY
EILEEN CECILIA HEVI ADIGBO
A THESIS PRESENTED TO THE DEPARTMENT OF HOME SCIENCE, FACULTY 
OF AGRICULTURE, UNIVERSITY OF GHANA, LEGON. IN PARTIAL 
FULFILMENT OF THE REQUIREMENTS FOR THE AWARD OF 
M. PHIL DEGREE
SEPTEMBER, 1993.
342653
T x zt>\: C& Wh
DECLARATION
I, Eileen Cecilia Hevi Adigbo, hereby declare that, 
except for references to other peoples work which have been 
duly cited, this work is the result of my own original 
research and that this dissertation had neither in whole nor 
in part been presented for another degree elsewhere.
{Eileen Cecilia Hevi Adigbo) 
Student
(Clara Opare-Obisaw (Mrs.)
Supervisor
ii
DEDICATION
Dedicated to my late Father, Cyprain Hevi, the reasons 
for remembering are too many to forget, to my Husband; Lt. 
Col. C. J. Adigbo and my children, Akpene, Sena, and Kafui. 
Thanks for your patience.
TABLE OF CONTENTS
Declaration .......................................  11
Dedication ........................................  111
Table of Contents .................................
Acknowledgements .................................. vl
Abstract ...........................................
List of Tables ..................................... ix
List of Figures .................................... xi
List of Appendices ................................  xii
CHAPTER ONE: INTRODUCTION
1.0 Introduction ......................    1
1.1 Statement of the problem ...................  3
1.2 Objectives ...................................  4
1.3 Significance of the Study ...................  4
CHAPTER TWO: LITERATURE REVIEW
2.1 Developmental Characteristics that affect
Food Habits .................................  6
2.2. Nutrient Needs of Adolescents ..............  8
2.3 Food Habits of Adolescents .................. 15
2.4 Food Preference of Adolescents .............  28
2.5 Nutrition Knowledge of Adolescents .........  30
2.6 Nutrient Intakes of Adolescents ............  31
Page
iv
Page
CHAPTER THREE: RESEARCH DESIGN AND
METHODOLOGY
3.1 Site Selection .......................flfi.....  37
3.2 Sampling ...... ................................  37
3.3 Instruments for Data Collection  ........... 38
3.4 Procedure for Data Collection ................  41
3.5 Pre-testing ...................................  42
3.5 Analytical Procedure  .......................  43
3.7 Limitations of the Study .....................  46
CHAPTER FOUR: RESULTS AND DISCUSSION
4.1 Description of the Sample ...................  4 9
4.2 Food Habits of Respondents ..................  53
4.3 Nutrition Knowledge of Respondents .........  69
4.4 DietfiS,\' Assessment ........................... 72
4.5 Growth Performance of the Students .........  82
CHAPTER FIVE
Summary ............     . 96
CHAPTER SIX
Conclusion  ...........................  100
CHAPTER SEVEN
Recommendation ...............................  102
Bibliography  ..............   104
Appendices ..................................   112
v
ACKNOWLEDGEMENTS
I am indebted to Mrs. Clara Opare-Obisaw, my supervisor, 
for her guidance, patience and assistance during the 
preparation of this thesis.
My sincere thanks also go to Mrs. Anna Lartey of the 
Nutrition and Food Science Department and Prof. E. V. Doku and 
Dr. F. Y. M. Fiadjoe of the Faculty of Agriculture for their 
valuable suggestions.
Finally, I am grateful to Mr. Owusu Barfi for analysing 
the data, and Miss Beryl S. Kotei for typing this thesis.
A B S T R A C T
The eating habits, nutrient intakes and nutrition 
knowledge of one hundred and forty adolescent students from 
four secondary schools in the central region of Ghana were 
investigated.
Instruments used for the dator collection included 
questionnaires, food records, anthropometric measurements and 
observations.
Data obtained were analysed using a computer and 
descriptive analysis was used to present the data.
Jellife's anthropometric reference data, Kaufman's weight 
classification and Body Mass Index (BMI) were used to classify 
respondents as obese, overweight, normal or underweight.
The sample was made up of 52% females and 48% males . 
Their mean age was sixteen years and most of their parents 
were highly educated and gainfully employed. Eating habits 
found to affect nutrient intakes of the respondents include 
breakfast skipping and snacking. Drug-related habits like 
alcohol intake was also found among a few. The majority of 
respondents were taking nutrient supplements. Nutrition 
knowledge was generally poor.
Meals served in the dining halls of all the schools 
studied did not meet the energy requirements of the 
adolescents. Even when the respondents supplemented the 
dining hall meals with extras from elsewhere, the calories 
obtained were still below the FAO recommended nutrient
vii
intakes, especially for the 16 to 18 year old males. The 
weights of the majority of this age group was below that of 
Jellifes' reference group.
The growth performance of the majority of the students 
was poor. Respondents were getting one-third of their daily 
nutrient intakes from extra foods eaten outside the dining 
hall. There were occurrences of underweight and overweight.
The findings of the study strongly urge school 
authorities to ensure that meals provided for students are 
well prepared and served injsufficient quantities. Fly proof 
nets should also be used in the kitchens. There is also no 
doubt that nutrition knowledge of adolescents should be 
improved in order that they would make proper food choices. 
Food vendors on the school campuses must be screened and 
supervised so that food bought is wholesome. Education on 
dangers of drug-related habits like alcohol consumption should 
be intensified, to forestall the spread of the habit among the 
adolescents. Parents would either have to agree to pay a 
higher amount of fees for the improvement of meals in the 
schools or continue to provide extra food and more pocket 
money for their wards if they must be well nourished. Schools 
should intensify their agricultural activities and make school 
farms where some of the food commodities could be obtained.
1 FAO Nutrient Intakes 1985   9
2 Rating of Nutrition Knowledge .............  44
3 Distribution of Parents or Guardians'
Educational Levels ........................  50
4 Distribution of Parents or Guardians
Occupation .....................................  51
5 Distribution of Respondents by Activities
They Participate in at School .............  52
6 Distribution of Respondents by the Number of
Meals Eaten Daily at Home and in School ....  53
7 Distribution of who Determines what Should
be Prepared for Family Meals .................  56
8 Distribution of Respondents Accroding to people
who eat with them at School and at Home .......  57
9 Preference for Toffee by Gender of Respondents 59
10 Preference for Alcoholic Beverages by Gender
of Respondents   60
11 Percentage Distribution of Frequency of Meals
Skipped at Home and at School .................  65
12 Distribution of Number of Snacks Eaten in
A Day at Home and at School .................... 67
13 Foods usually eaten between meals ............. 68
14 Distribution of Nutrition Knowledge of
Respondents .............................   69
15 Nutrition Knowledge of Repondents by Gender 70
16 Nutrition Knowledge by type of Schools..........  71
17 Energy, Protein, Calcium and Iron Contribution of 
Meals Eaten in the Dining Halls Per Student Per
Day for Schools .................................  72
LIST OF TABLES
Table Page
ix
Table Page
18 Percentages of RNI for Energy, and three 
nutrients met by Dining Hall Meals
in the Schools Studied ...................... 73
19 Mean Intakes of Calories, Protein, Calcium 
and Iron Obtained from Foods Eaten Outside
the Dining Halls..............................  76
20 Means and standard deviations of total Daily Energy, 
Protein, Calcium and Iron Intakes of
Respondents .................................. 77
21 Percentage of Daily intakes of Energy and 
three Nutrients provided by Meals eaten
Outside Dining Halls.........................  "79
22 Percentage of respondents who did not meet the 
RNI for Energy, Protein, Calcium and Iron
by School Type and Gender .................  8 0
23 Percentage Distribution of Respondents
Comments about Dining Hall Meals ...........  81
24 Comparison of mean Weights and height of 
Respondents with Jellife's Reference Weight
and Heights .................................. 83
25 Classification of Respondents into Various
Weight Categories in Percentages .......... 87
26 Percentage Distribution of Respondents by
their Body Mass Index ....................... 8 9
2 7 Comparison of Mean Weights and Heights of
Respondents with those recorded by Fiawoo .. 90
28 Distribution of Respondents According to their
Perception of their Body Weights .......... 94
2 9 Students' wish to Lose or Gain Weight ...... 94
x
LIST OF FIGURES
Fig. 1. Weight-for-age of Female Respondents compared
with Jellife's Reference ....................  84
Fig. 2 Height-for-age of Female Respondents Compared
with Jellife's Reference ...................  84
Fig. 3. Weight-for-age of Male Respondents compared
with Jellife's Reference ...................  85
Fig. 4. Height-for-age of Male Respondents compared
with Jellife's Reference ...................  85
Fig. 5 Weight-for-age .of Female Respondents compared
with Fiawoo's recorded weights ..............  91
Fig. 6 Height-for-age of Female Respondents compared
with Fiawoo's recorded weights ..............  91
Fig. 7 Weight-for-age of Male Respondents compared
with Fiawoo's recorded weights ..............  92
Fig. 8 Height-for-age of Male Respondents compared
with Fiawoo's recorded weights .............  92
Page
xi
1 Percentage distribution of respondents by
their preference for foods .................  112
2 Percentage Distribution of Frequency of
Food Consumption ..............................  116
3 Nutritive value of meals eaten in the dining
halls on a per person per day basis............  120
4 Mean weights and heights according to age and
socio-economic groups by Kpedekpo..............  122
5 Weight-for-age for Boys and girls 10-18 years
NCHS/WHO ........................................  123
6 Height-for-age for Boys and Girls 10 - 18 years
NCHS/WHO) ...................................... 124
7 Improvised stadiometer ......................  125
8 Format for Recording Weights of food eaten
in the Dining Halls ............................  126
9 Format for Recording Weights of food eaten
Outside the Dining Hall ...................   127
10 Glossary of Local terms used in this Text 128
It Questionnaire ................................... 129
LIST OF APPENDICES
Page
xii
CHAPTER ONE
1.0 INTRODUCTION
Feeding students in secondary schools has been a long 
standing problem for school authorities in Ghana. As far back 
as the late 1950s, when the Government Educational Trust (GET) 
Schools were established, there were lots of student strike 
actions which were invariably sparked off by students 
dissatisfaction with the meals which they were provided in the 
dining halls. Looking back, one would say that those meals 
were better compared with what students eat today. One study 
in 1968 by Whitby showed that breakfast in Ghanaian secondary 
schools then, consisted of fruits, tea, bread, margarine and 
marmalade in addition to corndough or roasted corn meal 
porridge. Presently, breakfast is usually made up of only a 
cereal porridge with or without bread.
The decline started when expansion of education began in 
the early part of 1960, when more boarding schools were built. 
Student enrolment increased every year to such extent that by 
the end of the 1970's some of the GET schools had more 
students than their facilities could cope with. Feeding these 
large numbers of students then became a problem. Meals served 
in secondary schools deteriorated especially when judged by 
the quantity served.
Until the end of 1991, when the Conference of Heads of 
Assisted Secondary Schools (CHASS) decided to charge a fee of 
C200 a day per student, parents were paying <£90.00 a day 
towards the boarding and lodging of their wards with the
Government adding CIO.00 as subsidy for each student. The 
inadequacy of the increase notwithstanding, students are still 
provided with three meals in a day. The question then arises 
as to how satisfactorily these meals cater for the nutrient 
needs of the students.
Most students enter secondary schools at an average age 
of thirteen years and they might have had a well established 
pattern of eating based on food habits that have been formed 
at home. Thus the college kitchen has to cater for students 
with divergent food habits.
According to Whitney and Cataldo, (1983), the period 
between ten and nineteen years is also referred to as 
adolescence. Students in secondary schools are therefore in 
their adolescent years. The rapidity and extent of growth and 
maturation during this period of life distinguishes it from 
both childhood and adulthood. Uddoh, (1980) observed the 
enormous appetite of this age group and emphasized that it 
must be satisfied if adolescents are to receive enough food to 
meet their normal physiological requirements. Optimum 
nutrition is crucial at this stage if the body is to achieve 
its maximum growth potential. However, as observed by 
Oguntona et al., (1978), adolescents in boarding schools are
able to a very large extent, to exercise free choice of foods, 
sometimes for the first time, free of parental guidance.
Parents in Ghana worry a lot over their wards when they 
are at school. In their bid to ameliorate whatever
2
inadequacies the school meals might have, they spend huge sums 
of money on provisions and pocket money for their wards. If 
these students must benefit from the enormous investments made 
in their education and have better health in future, they must 
be provided with adequate diets and helped to make conscious 
efforts to select foods wisely. In the light of the above 
problems and concerns, one must seriously consider the 
nutritional content of the meals students eat in the dining 
halls and what choices they make when they have to purchase 
street foods.
1.1 STATEMENT OF THE PROBLEM
Life long health status of the individual depends to a 
large extent on the food habits and nutrient intakes during 
the growing years. In Ghana, students spend a substantial 
part of their adolescent years in boarding institutions. 
Their nutrient intake is therefore dependent on the meals 
they eat in the dining halls, their food habits and their 
nutrition knowledge. There is therefore the need to find out 
whether the food provided by the boarding schools is adequate 
in quantity and quality for optimum growth and also to find 
out the nutrition knowledge and food habits of adolescent 
students in boarding schools.
3
1.2 OBJECTIVES
The objectives of the study were :
1. To examine the food habits of the students.
2. To assess the nutrition knowledge of the students and the 
sources of such knowledge.
3. To evaluate the nutrient content of the meals eaten in 
the dining halls and to ascertain the adequacy of these 
meals.
4. To estimate the nutrient contribution of meals eaten 
outside the dining hall.
5. To compare the contribution of school meals to the total 
nutrient intake of the students with the contribution of 
meals obtained from other sources.
6. To measure the growth performance of the students.
1.3 SIGNIFICANCE OF THE STUDY
1. This study has important implications for nutrition
education. It will increase the understanding of factors 
affecting adolescent food habits and nutrient intakes and 
will be valuable for planning nutrition education
programmes for them.
2. The food preference information will greatly assist
school administrators in the planning of meals for their 
students.
3. A knowledge of food and nutrient intakes of adolescents 
will indicate the possible need for, as well as the level
4
of nutritional support necessary for this group. This is 
particularly relevant because the need for good health, 
including proper nutrition, is great during adolescence 
and thus early emphasis on good nutrition will lead to an 
improvement in the feeding of future generations.
4. Currently a National School Health Policy has been 
promulgated and its guidelines will soon be implemented. 
This study will certainly create awareness of nutrient 
intakes of secondary school students and thus help in the 
planning of realistic implementation strategies.
5. Testing the nutrition knowledge of students will provide 
information that will reflect the students' accumulated 
nutrition knowledge from previous years of schooling. In 
this way the results will serve as a guide for future 
nutrition education and curriculum development.
6. Adolescents who have poor food habits may not be 
supplying their bodies with enough of some of the 
essential nutrients to maintain health and this may 
affect them in future. The correction of poor food 
habits among adolescents presents a challenge to 
nutrition educators and all adults. This study will 
provide information which will help in this regard.
7. Finally, results from this study will fill the gap in the 
void of information on adolescent nutrition in Ghana.
5
CHAPTER TWO
2.0 LITERATURE REVIEW
Many researches have been conducted on adolescent 
nutrition in several countries especially western countries 
such as in the United States. There is a large volume of 
information on nutrient requirements, adequacy of diet, food 
habits, nutrition knowledge, food preferences and growth 
patterns of adolescents, (Hueneman et al. , 1968; Dwyer, 1980; 
Duyff et al., 1975). There is however, little scientific 
information in these areas on Ghanaian adolescents. The 
review of available literature will therefore be mainly on 
work done elsewhere.
These include:-
2.1 Developmental Characteristics That Affect Food Habits.
2.2 Nutritional Requirements of Adolescents.
2.3 Food Habits of Adolescents.
2.4 Nutrition Knowledge of Adolescents.
2.5 Nutrient intakes of adolescents.
2.1 Developmental Characteristics That Affect Food Habits.
Adolescence is a range of years during which the
individual grows from a child to an adult (Runyan, 1976) .
Psychologists identify this period as a stage during which the
individual attempts to develop an understanding of himself and 
to find a way of relating to the adult world. The
6
nutritionist, however, views this period as a time for
significant growth in a physical sense rather than the
psychological growth involved in the development of self 
identity (McWilliams, 1975; Hurlock, 1978). According to 
McWilliams (1975) , adults become very concerned about the 
adolescent period because behaviour patterns at this time are 
different from other times in the life of the individual. For 
instance, for many adolescents, the peer group is the dominant 
influence on thought and behaviour and therefore, most 
teenagers' food habits are influenced by the peer group.
(Runyan, 1976) . Again Hamilton and Whitney, (1988) , identified 
adolescence as a well known time of rebellion which extends to 
all aspects of life styles including feeding. Mead, (1943), 
noted that adolescents demonstrate their independence by
refusing to eat what is good for them. Lavik, (1981), also 
showed that this period is one of increasing social activity. 
These activities according to Spindler, (1963), keep them away 
from home longer. Their need for establishing independence 
from parents and their mobility lead to some modification in 
their dietary patterns (Hurlock, 1978), which Spindler, 
(1963), found to have changed their food habits for the worse.
At this period also, the body image (the total 
spontaneous inner feelings and concepts of the body), is of 
special importance to them (Lavik, 1981). Lavik reported that 
the role played by this body image in the life of the 
adolescent, serves as an important bridge to food, eating
7
habits and nutrition and that a kind of equilibrium exists 
between identity, body image and nutrition. Changes and 
disturbances in any of these aspects may have a far reaching 
effect on the other. For instance, an identity crisis in an 
adolescent provoked by psychological problems in the family 
may result in either obesity or anorexia nervosa. On the 
other hand, nutritional deficiencies can burden the adolescent 
and her family with psychological problems and social 
conflicts.
The changes in body shape and size and the development of 
other related structures during adolescence begin in 
individual girls at any age from eight to thirteen years. In 
boys such changes occur approximately two years later (Whitney 
and Cataldo, 1983). Meredith, (1967) noted that in addition 
to the variation in the timing of adolescent changes, the 
sequence of these changes is different in each individual. 
This wide variation, as observed by Dwyer, (1981) , causes much 
concern to the adolescent because he dislikes being too 
different from his peers. Early as well as late maturation 
may cause psychological problems too.
2.2 Nutrient Needs of Adolescents
Adolescents vary in their nutritional needs as well as in 
the timing of growth and maturation. (Basley et al.,) 1968).
The most obvious difference is an increased need for 
nutrients during the adolescent growth spurt regardless of the
8
age at which this occurs. The increase in girls' nutritional 
needs is correspondingly early since they generally begin 
their pubertal changes about two years earlier than boys. The 
Food and Nutrition Board of the National Academy of Sciences 
of the United States has given the recommended dietary 
allowances separately for boys and for girls, with higher 
figures for boys. Stare and McWilliams, (1977) justified the 
higher figure for boys by the rapid growth rate, greater 
ultimate body size and generally greater physical activity of 
boys during this period. They also observed that males 
experience very rapid gain in lean tissue and in mineral 
skeleton with resulting increases in needs for protein, iron, 
calcium and zinc, which reside in lean body mass or skeleton. 
Females also experience a smaller increase in lean body mass 
but greater increase in adipose tissue and thus their needs 
for these nutrients are less (Dwyer, 1981). The recommended 
allowances for calories, proteins, calcium and iron for the 
different age groups are summarised below :
TABLE 1: FAO RECOMMENDED NUTRIENT INTAKES
AGE (YRS) AVERAGE CALORIES PROTEIN CALCIUM IRON
WT (kg) kcal g mg mg
Males :
13-15 51.1 2, 900 37 600-700 18
16-19 62 . 9 3, 070 38 500-600 18
Females
13-15 49.9 2,490 31 600-700 24
16-19 54 .4 2,310 30 500 24
Source: F.A.O. Recommended nutrient Intakes 1985.
9
Nutrient requirements in this second decade of life are 
more closely related to physiological than chronological age 
since they are affected by growth and the resulting 
alterations in body composition and physiology. Adolescence 
is a critical period for proper nutrition. Adequate nutrition 
during adolescence can improve the lives of tomorrow's 
children. Adolescent boys and girls who have poor dietary 
habits may suffer improper growth of body organs and systems 
and any children born of such boys and girls even in their 
adulthood may be adversely affected (Mcginly, 1980) .
(a) Energy Requirements of Adolescents
According to Dwyer, (1981), the major component of 
energy requirements are those for maintenance of the body 
at rest (B.M.R.), and the highly variable component 
contributed by physical activity. Guthrie, (1971), 
showed that the metabolic rate reflects the energy 
consumption of actively metabolizing tissues of the lean 
body mass especially the brain, liver and muscles. Lean 
body mass increases dramatically especially during the 
pubertal growth spurt, therefore metabolic rates increase 
accordingly. Boys have more lean body mass than girls, 
therefore their B.M.R. would consequently be higher. 
B.M.R. accounts for about half or more of the total 
energy requirements of the adolescent (Guthrie, 1 9 7 1) .
Added to the need of energy for B.M.R. is the need 
for physical activity. The energy cost of physical
activity which involves moving mass over distance varies 
with physiological age. As weight increases, so does the 
energy cost of physical activity. The rapid increase in 
weight of the adolescent requires increase in energy 
needs. In addition, a small percentage of the total 
calorie intake of adolescents is used for growth (Dwyer, 
1981). Hamilton and Whitney, (1988) found that although 
mental activity makes students tired, it requires very 
little energy. This finding is contrary to popular 
belief that students expend a lot of energy when 
studying. The recommended allowance for energy is 
therefore based mainly on the need for basal metabolism 
and physical activity.
(b) Iron
During the adolescent period, lean body mass 
increases dramatically and accounts for a high proportion 
of the total weight gain particularly in males. 
Increment in body composition alone increases iron needs 
greatly since each kilogram of fat free body weight 
contains a good deal of iron. Furthermore, increases in 
blood volume and haemoglobin which occur in both sexes 
but which are greater in males add to iron requirements 
(Bowering et al., 1976) . Added to these uses of iron is 
the need to replace that lost during menstruation in 
females (Dwyer, 1981).
11
Sjoln, (1981) observed that the incidence of iron 
deficiency anaemia in adolescents is often extremely high 
in developing countries. Dwyer, (1981) ranks it as the 
most common nutritional disease among adolescents. This 
observation is very significant especially when Pollit et 
al., (1989) and Soematri et al., (1985) found that iron
deficiency anaemia can have adverse effect on learning. 
Anaemia has also been shown to affect psychological and 
physical health by increasing susceptibility to disease, 
lowering resistance, increasing fatigue and affecting 
work capacity (Hamilton et al., 1988).
The sources of iron include liver, beef, eggs and 
dark green leafy vegetables (Hamilton et al., 1988).
Ghanaian adolescents can obtain their iron from 
'kwannsusua' (Solanum Nigrum), which although not widely 
used, contains a substantial amount of iron about 
1.09/l00g (Nutrition and Food Science Department, Legon, 
1992) . This fruit which grows wild can be added to 
palmnut soup or edible leaves stew at negligible cost,
(c) Calcium
Calcium requirements are closely associated with 
growth of lean mass and the mineral skeleton (Dwyer, 
1981). Green et al., (1991) also noted the use of
calcium for nerve transmission and muscular contraction.
Factors that encourage positive calcium balance in 
the body include physical activity and diets containing
12
adequate levels of biologically available sources of 
calcium, vitamin D and phosphorus (Recker and Heaney, 
1985) . Optimal intakes of calcium and Vitamin D coupled 
with a physically active life style also promote and 
maintain peak bone mass during childhood and adolescence 
(Spencer and Kramer, 198 6).
A factor generally recognized to promote calcium 
loss is a high phosphate diet as found in soft drinks 
(Spencer and Kramer, 1986). Soft drinks contain large 
amounts of phosphoric acid and no calcium. Incidentally, 
soft drinks rank high is adolescent snack foods. Again 
Green et al., (1991) emphasized that adolescents in the
United States consume foods low in Calcium and vitamin D, 
they smoke cigarette and drink alcoholic beverages. 
These habits, they said, may endanger their normal 
skeletal, development. Fleck, (1976) cited some 
investigators who discovered that emotional stress and 
strain, which are characteristic of the adolescent 
period, may interfere with the retention of body calcium.
Dwyer, (1981) also found that approximately forty- 
five per cent of the total adult skeletal mass is laid 
down during the adolescent period and severe rickets 
during this period can deform the bony structure of the 
pelvis which may contribute later to difficulties in 
child bearing among females and according to Anderson, 
(1990), to rapid loss of bone calcium following
13
menopause. No adolescent diet could be described as good 
if it did not satisfy calcium requirements for bone 
growth and maturation (Trenholme and Milne, 1963) .
Dairy products especially milk are the richest 
sources of calcium in the American diet (Wallach, 1989 
quoted by Green et al., 1991). Milk drinking is not a 
common habit of adolescents in developing countries such 
as Ghana where dairy products are expensive, . In view of 
the critical nature of calcium intake at this period, 
King et al. , (1986) suggested the use of 'Capenta' or
sprats and millet. Oranges, apart from their ascorbic 
acid contribution, also furnish calcium to the diet. 
Cereals and legumes can also be sources of calcium but 
they contain phytic acid which combines with the calcium 
to make it unavailable to the body when ingested.
(d) Protein
One function of protein in the body is to ensure 
that amino acids are available to build the proteins of 
new tissues (Hamilton and Whitney, 1988). Gain in body 
weight represents an increase in protoplasm as well as an 
increase in fat during growth periods as adolescence. 
Approximately one-sixth of the protoplasm gained during 
growth, consists of protein (Runyan, 1976) . Fleck, 
(1976) cited studies of child health and development 
which have indicated the close relationship between 
growth in height and protein intake during the entire
14
childhood and specific periods such as adolescence. 
Furthermore, Valadin et al., (1981) found that women who
had a relatively high concentration of protein in their 
diet during early adolescence tended to have a more 
successful reproductive experience.
Adolescent growth therefore requires substantial 
amounts of protein, iron calcium and calories. It is 
paramount that their meals are planned in such a way that 
they are provided with all these necessary nutrients. 
Adolescents in secondary schools are of particular 
interest because a greater part of their adolescent years 
is spent in school. Besides, individual differences are 
not considered when meals are planned for them, and the 
students often resort to eating outside the dining hall, 
a phenomenon which calls for a look at their food habits.
2.3 FOOD HABITS OF ADOLESCENTS
Food is one of the basic needs of existence and it plays 
a major role in peoples beliefs about life and health. It is 
very important to life for, without it man will not survive 
(Guthrie, 1971) .
The way people select, utilize and consume food forms the 
basis of their food habits. Food habits of any group of 
people are shaped by several factors. For adolescents, these 
factors include the influence of the home, the culture, the 
impact of peers and nutrition knowledge (Fleck, 1976)
15
(a) Influence of the Home
Uddoh, (1980) found that the family plays a. vital
role in the shaping of the food habits of its young and 
Krause et al., (1972) emphasized the role of mothers in
the acquisition of food habits. Mothers most often pass 
on their personal preferences of various foods to their 
family members^ Since they are the ones involved with 
the provision of food for the family. If a mother is 
ignorant or indifferent about what to provide for her 
family, the members are surrendered to chance, likes and 
dislikes which may not help in the development of good 
eating habits (White, 1972). Emmons and Hayes, (1973) 
rather thought that attitudes, customs and financial 
constraints play an important role in food habits 
formation. They believe that though a mother may be 
knowledgeable, her knowledge, whatever its scope may not 
necessarily be applied fully in providing meals which 
will help in the formation of good food habits.
The attitudes of the family members, customs of the 
people they belong to, and financial constraints may 
prevent her from providing what she may know as 
nutritionally adequate. A 1992 study designed to 
determine parents' self reported influence over food 
behaviour of 3-5 year old children revealed that parents 
believe that their own actions are important in 
determining the food behaviour of their children.
16
(Burroughs et al., 1992).
The part played by fathers in the shaping of
children's food habits has been studied. White, (1972)
realised that it is the father as a rule whose tastes are
most influential in deciding a family's food choice. If
the father has food prejudices, his children are quick to
adopt such prejudices. Lowenberg and Brian, (1952)
summarised it this way:
"The food father did not like and which 
mother therefore did not serve were not 
familiar and would not be eaten by the 
child".
The home is indeed one of the factors that shape the 
adolescents' food habits. These food habits are carried 
over to wherever the children go and in the case of the 
adolescent student they are carried over to their 
boarding institutions.
(b) Peers
The child learns more aspects of food-related 
behaviour from other people or institutions outside the 
home after the initial acquisition of food habits within 
the home environment. A major force is the school where 
behaviour can be learned from peers, formal teaching in 
lessons and through its school meals. All of these will 
broaden the child's view of food and will contribute to 
his own food behaviour patterns.
The Peer Groupj is a major influence on food habits 
formation. Ohl et al. , (1981), noticed that friends or
17
peers influence one's food decisions as one grows up. 
Meals eaten by peer groups may be quite different from 
familiar family meals, hence eating away from home may 
broaden the awareness of food and influence the food 
habits of the individual. Queen was quoted by Cosper and 
Wakefield, (1975) as indicating that individuals accept 
food advice best from those they consider as friends or 
allies. If the suggestions made are not based on sound 
nutritional judgements, poorer food habits may be 
acquired.
(c) Advertisements
The effect of advertisements cannot be ruled out in 
food habits formation. Holden et al. , (1971) reported
that advertising can potentially influence peoples' 
attitude favourably towards new and better foods or new 
but nutritionally poor foods. A columnist in the Ghana 
Weekly Spectator, Albin Korem, (1992) pointed out that 
perhaps the biggest harm to traditional eating habits is 
done by food advertisements on television and elsewhere. 
According to him millions are spent every year to 
advertise refined foods and sweet drinks which our bodies 
can do well without. Adolescents are particularly 
handicapped because they are easily taken in by such 
advertisements.
(d) Food Availability
Yet another influence on food habits is the
18
availability of food (Araya, 1981). Usually the 
geography of an area and variations in climate influence 
the types of foods that area cultivates and are readily 
available. This affects the eating patterns of people. 
However, with improved transportation, it is possible 
these days to have all types of food all the year round 
provided money is available for the purchase of these 
foods. People will buy foods which they can afford 
irrespective of its nutrient content.
(e) Culture
Another factor that needs consideration in food 
habits formation is the culture of the people. Although 
many foods may be accessible to the adolescents, they may 
not be acceptable to them because they do not fit into 
their cultural pattern of eating. The culture in which 
one develops according to Bennion, (1985) determines to 
a large extent one's food patterns or habits. Foods are 
eaten in combinations with other foods in ways that are 
determined by the culture. Again, each culture has clear 
ideas about what constitutes food and non-food. No group 
of people ever eats all the potentially edible 
commodities available to it (Bogert et al., 1973). For 
various cultural or other reasons, some foods are not 
defined as food at all even though they may be safely 
eaten. An example is the way the 'Krobo's' of Ghana look 
on snails and Moslems on pork. In addition to these
19
taboos as they are called, many cultures also have food 
prohibitions associated with gender, age and 
physiological conditions (Passin and Bennet, 1943) . Some 
of these prohibitions may restrict intakes of foods which 
provide useful nutrients. In Ghana such prohibitions 
affect pregnant and lactating mothers, children and 
adolescent girls.
(f) Physical characteristics of Food
The physical characteristics of food also exert a 
profound influence on its acceptability and intake 
(Macfie, 1990). Foods would be acceptable and eaten if 
they are able to stimulate the chemical senses of taste, 
smell, vision and touch. Martin et al. , (1976)
indicated that a meal is often evaluated first on the 
basis of its appearance on the plate. For most persons 
and under ordinary circumstances, food must be palatable 
or have appetite appeal if it is to be eaten. A food is 
palatable to an individual if it is acceptable and 
agreeable to taste (Zifferblatt, 1980). Indusogie et
al., (198 0) also mentioned that the taste of food
determines what food and how much of a certain food is 
eaten during any meal. The colours, shapes and forms of 
foods may have such eye appeal as to entice one to accept 
that food even when one is not hungry. An unattractive 
array of food on the other hand dampens appetite and food 
may be rejected without tasting (Martin et al., 1976).
20
The problems we now have in schools where adolescent 
students do not patronise foods given in the dining halls 
may be ascribed to the absence of some of the above 
physical characteristics in the foods provided for them,
(g) Dietary Patterns
Selection and choice of food is determined by an 
individual's dietary patterns. Dietary patterns are 
those aspects of food habits which deal with the number 
of meals eaten, who prepares the food, what time of day 
the food is eaten and who eats with who (Barasi et al. , 
1987) . The food patterns of a country are moulded by her 
agricultural resources, technological progress, buying 
power and cultural patterns (Krause et al., 1972). In 
addition, the socio-economic conditions, nutrition 
knowledge and food related attitudes are known to 
influence food patterns (Sukhumsivum et al., 1988) . The 
number of meals prepared and their timing during the day 
is also culturally determined. Barasi and Mottram, 
(1987) found that people in the Western countries such as 
the United States accept the pattern of three meals a day 
as normal but in some cultures as found by Uddoh, (1980) . 
As few as one meal a day is eaten in some homes. Messer, 
(1989) also observed similar patterns in other African 
societies. She found that for most of the day, such 
families fed on palatable wild fruits to alleviate the 
accompanying hunger brought about by this pattern of
21
eating. As well as prescribing how many times meals can 
be eaten, cultural identity also determines who should 
eat with whom and what portion of the food each member 
should eat.
Unlike the structures of Western meals, Ghanaians do 
not often differentiate between foods for breakfast, 
lunch and supper. Left over foods from the previous 
evening's meal might be eaten for breakfast the following 
day. Specific foods are not reserved for specific 
courses within a meal because all dishes are served and 
eaten simultaneously. Fruits normally do not form part 
of the normal meals in the Ghanaian home. They are
usually eaten as snacks when they are in season and are
cheap.
Students from low or middle income families or from 
families where mothers work outside the home, may have 
meal patterns similar to the one described above. Even 
so. Stare and McWilliams, (1977) found that the
increasing independence and mobility of adolescents lead 
to modification of their dietary patterns. The
influences of parents no longer completely dominate and 
determine food consumption.
Guthrie, (1971) has presented factors that may 
contribute to the poor food habits observed during the 
teen years as failure to eat breakfast or some other meal 
of the day, lack of time for regular meals, drinking no
22
milk, lack of supervision in the selection of meals, 
eating away from home, an over riding fear of obesity 
especially among girls and a concern that certain foods 
will aggravate adolescent acne. Most of these factors 
may not be applicable to Ghanaian adolescents. Meal 
skipping, Snacking, Dieting and Drug related habits will 
be discussed here.
(h) Meal Skipping
Meal skipping habits of adolescents have been 
documented by Hueneman et al., (1968) . They studied 1000 
high school students in Berkeley in California and found 
that dinner was the meal eaten most consistently by the 
students. Lunch was omitted more than breakfast. Their 
investigations also revealed that meal regularity tended 
to increase with rise in socio-economic status of 
parents. In Ghana, rich families could afford to feed 
their children with three meals in a day and could 
afford house helps to prepare meals even when mothers 
were away at work.
The omission of breakfast by adolescents is a 
problem of considerable importance (Cooksey and Ojeman, 
1963). Several studies have suggested that it may be a 
contributory factor in dietary deficiencies of this group 
(Eppright, 1959) . When children skip breakfast after 
fasting overnight, their ability at midday to detect 
environmental cues necessary to solve simple visual tasks
23
and attention is affected. The stress response to the 
induced hunger also results in increased attention to 
peripheral information not relevant to the problem at 
hand. Those who miss breakfast are less able to 
concentrate, tire more easily and are hungry by mid­
morning. Broadfoot et al. , (1965) recorded studies done
by Tuttle et al. , on school boys whose attitudes and 
scholastic attainments were found to be adversely 
affected when they missed breakfast. Again, Hueneman et 
al. , (1968) emphasized that when breakfast is skipped it
meant that during much of the day the body's need for 
nourishment was likely to have been neglected. Omission 
of food in the morning or any other time of the day can 
therefore adversely affect the total nutrient intake for 
the day. Guthrie, (1971) reported studies which show 
that the calcium and ascorbic acid intakes of persons who 
omit breakfast were reduced by about 4 0 per cent and 
intakes of iron and thiamin by 10 per cent. Leverton, 
(1968) also found that 17-19 year old college women who 
skipped breakfast obtained nineteen per cent of their 
energy intake from snacks whereas those who ate breakfast 
snacked less frequently and obtained only seven per cent 
of their energy intake from snacks. Teenagers need to be 
encouraged to eat different foods throughout the day if 
their diets are to supply sufficient amounts of nutrients 
for their needs (Duyff et al., 1975).
24
Runyan, (1977) and Guthrie, (1971) gave the reasons 
for adolescents skipping breakfast, as determined 
attempts to reduce weight and the desire to spend morning 
time on sleeping and grooming. Other reasons were lack 
of appetite, lack of time and fear of becoming fat.
(i) Snacking
The standard meals sometimes omitted are made up for 
with snacks. Adolescents are seen as eating more of 
their foods as snacks than adults. Guthrie, (1971) 
reported that between meal foods provided on the average 
eleven to nineteen per cent of the energy of adolescents 
in New York. The study showed that boys had on the 
average 6.4 day time snacks and 2.9 evening snacks per 
week while girls had 7.7 day time and 3.8 evening snacks 
per week. The difference in the number of snacks eaten 
was probably due to the fact that more females than males 
skip meals and therefore had to make up with snacks. 
Leverton, (1968) found that boys ate breakfast more 
frequently than girls and their choice of breakfast 
provided more nutrients.
Snacking per se, is not detrimental as it can 
sometimes provide the nutrients which would help to 
balance up what is deficient in the main meals. However, 
Fleck, (1976) emphasized that when snacks are made up of 
foods providing only calories, they might be detrimental 
to the health of the adolescent. Unfortunately, one
25
feature of many foods liked and consumed by adolescents 
is their mainly high energy content (Fleck, 1976) . 
Stasch et al., (1970), recorded that soft drinks were the
most commonly chosen snacks by adolescents both at home 
and at school. They also noticed a greater use of 
coffee, candy and hamburgers at school than at home. 
Milk, cheese and fruits were used more at home than at 
school. At home the adolescents might have a wide 
variety of snack foods to choose from and a wise 
homemaker would fill her ladder or fridge with foods that 
provide many more nutrients than just calories. At 
school where adolescents have to purchase snacks 
themselves, the tendency of choosing foods which will 
provide mostly calories are high. For adolescents who do 
not need to watch their weight, these foods may be eaten 
almost without restriction if foods carrying other 
nutrients are eaten during normal meals. Snacking 
however, must be condemned if it constitutes overeating 
with disregard to the total food pattern (Guthrie, 1971). 
(j) Dieting
Dieting is another aspect of adolescent food habits 
that need to be considered. Dieting means one does not 
eat the kinds or amounts of foods one likes because one 
wants to lose or gain weight. Adolescents, according to 
Guthrie, (1971) are either fat or fear to be fat. 
Cultural perceptions of appropriate or attractive body
26
size and shape seem to be the deciding factor in the food 
intakes of adolescent girls. The impact on the 
adolescent's health of the "thin is beautiful" norm in 
Western cultures is attracting serious attention 
especially as it relates to eating disorders (Leslie et 
and Jamison, 1988) . Because thinness in females is 
highly cherished in the United States, food habits are 
altered sometimes with considerable duress because 
favourite foods which may be nutritious may be foregone. 
Wakefield and Miller, (1971) cited studies done by 
Hueneman and Dwyer, on College students, which found that 
adolescents are sensitive about appearance particularly 
weight. Hueneman noted that students generally expressed 
dissatisfaction with both their size and shape. Dwyer in 
her study found that while 15 per cent of the high school 
students she studied were really overweight 3 0 per cent 
were on a diet and 60 per cent had been on diet prior to 
the time of the research.
Where the cultural norms dictate that plumpness 
rather than thinness is what is regarded as attractive, 
girls may eat a lot in order to be fashionably plump 
(Fleck, 1976). In Ghana girls and women are fattened 
when they are going into marriage (Nukunya, 1968).
(k) Alcohol Drinking Habits
The final food-related habit usually acquired by 
adolescents is their alcohol drinking habit. Hamilton et
27
al. / (1988), observed that the mid-teens is a choice
point of whether to drink alcohol or abstain from it. 
According to them, a survey conducted in 1975 in the 
United States showed that more than half of all seventh 
graders nation wide had tried alcohol at least once 
within the previous year and nine out of ten of all high 
school seniors had experience with alcohol. These 
writers contend that alcohol drinking has predictable 
nutritional effects on the body since its breakdown in 
the liver is done at the expense of other food nutrients 
which require the use of thiamin and Niacin for their 
break down. Apart from this, malnutrition is common in 
heavy drinkers due to the displacement of nutrients by 
alcohol.
2.4 FOOD PREFERENCES OF ADOLESCENTS
The preference for certain foods is one aspect of food 
habits that is an expression of the consumer's attitude 
towards food. To prefer a food is to choose it over another. 
Preferences can be genetically determined (Rozin, 1990) or 
acquired (Ohl et al. , 1981) . Genetically, humans will accept 
sweet tastes and avoid bitter tastes (Rozin, 1990). Man has 
often preferred certain plant and animal products as food to 
others. Favourite foods may be traced to pleasant 
circumstances and experiences while disliked foods may be 
traced to unpleasant experiences. Often when parents force
28
children to eat certain foods because they were good for them, 
the children grow up to dislike such foods because they bring 
back the sad memories of the unpleasant meal times Ohl et al., 
(1981) rightly observed, that the preferences for certain 
foods and flavours are related to cultural and childhood 
experiences.
Researchers have documented several other factors that 
shape food preferences of children and adolescents. Teachers 
and parents attitudes towards food can be a major influence in 
creating children's preferences. In a study by Sanjur and 
Schorr, (1971) the children surveyed were found to have 
similar food preferences as their mothers.
Rozin, (1990) also believes that the widespread notion 
that one takes on the properties of what one eats as in the 
saying 'You are what you eat', can strongly influence food 
preferences causing avoidance or acceptance. Foods designated 
as female foods according to her may not be eaten by some 
males and people will avoid animal foods on the grounds that 
they will make them behave like animals.
Rozin, (1990) again noted that food preferences can be 
determined by the desire to maximize the pleasure of eating. 
Someone may prefer chocolates to biscuits not because she 
likes chocolates better but because she derives more pleasure 
in eating chocolates.
29
2.5 NUTRITION KNOWLEDGE OF ADOLESCENTS
Indusogie et al., (1980), mentioned that there is a need
to develop a level of sound public knowledge and responsible 
understanding of food that will promote maximum nutritional 
health. According to them, in order to utilize food to the 
greatest benefits, the individual must have some basic 
understanding of food and nutrition.
Even though nutrition is one of the oldest and most practised 
science by man, many people have no basic understanding of 
food and nutrition in relation to requirements for health. 
(Indusogie et al., 1980)
A survey done in the United States indicate that young 
children have a fairly good grasp of the basic principles of 
nutrition and are both receptive to and capable of learning 
more about nutrition and its relationship to health. For 
instance, surveys conducted by the International Food 
Information Council (IFIC) of 9-15 year olds show that 
children in this age group demonstrated a good understanding 
and awareness of the basic principles of nutrition and health. 
The majority in the survey were found to be familiar with the 
basic food groups and could identify all of them.
Also a study of 5116 5-18 year old school children, 
showed that most of those surveyed were generally aware of the 
health effects of dietary fat, fibre and cholesterol (Resnicow 
et al., 1991).
30
Studies done in Ghana by Agyeman-Mensah, (1980) and 
Duwuona-Hammond, (1978) showed that the study subjects had 
only fair knowledge in nutrition.
2.6 NUTRIENT INTAKES OF ADOLESCENTS
Several investigators have looked at nutrient intakes of 
adolescents all over the world. Throughout all these 
investigations the revelation was that the recommended 
allowance of one or more nutrients were not met by 
adolescents. This phenomena is not a recent occurrence 
because as far back as 1954 dietary deficiencies have been 
recorded. The developmental characteristics of adolescents 
may probably be implicated in this trend of affairs.
The fact that adolescents are becoming mini adults and 
therefore crave for independence was documented by Hurlock, 
(1978). This independence no longer places them under the 
authority of parents and therefore they can no longer be 
forced to eat certain foods. Again, their social activities 
and school work keep them away from home so they no longer 
follow family meal patterns. As one investigator puts it, 
they eat what they like when they feel like and when they have 
time. Meal skipping becomes a past time for some of them 
(Hurlock, 1978) and as they strive to achieve an image 
pleasing to themselves, they also attempt to be attractive to 
their peers. As a result of this, they are pre-occupied with 
achieving a slim body especially the females. This makes them
31
cut down their food intake and the resulting effect is the 
deficiency in the various nutrients.
In a co-operative study on the nutritional status of all 
age groups in the Western Region of the United States, Wilcox 
et al., (1956) indicated that adolescents comprise the age 
group least likely to be consuming food which provides the 
recommended amounts of all nutrients. Emerson, (1967) 
documented studies of nutritional status of adolescents, 
which showed that adolescents had poorer diets than younger 
children and that teenage girls had perhaps the poorest diets 
of any population group.
In 1950, Blewett and Schuck compared food consumption of 
men and women college students. They found that generally, 
the young males consumed more milk, cereal and meat than did 
the young females who preferred to eat more fruits. They also 
found that iron was most likely to be inadequate in the diets 
of the females.
Wilson, (1954) examined representative groups of school 
girls aged 10-18 years in Northern Nigeria. In all groups the 
intake of calories was low for poorer members of the group. 
Three-quarters were short of thiamin and three quarters of 
folacin and pyridoxine.
Schwartz and Dean, (1955) in their study in Uganda to 
measure the amounts of food eaten by boys in a boarding 
school, revealed that the Ugandan boys were receiving 1,500 
calories less than their British counterparts. The total
32
protein and fat were also very much lower. All the food 
intakes were below 90% of those of British boys of the same 
age and they all supplemented the school meals with extras.
Again in 1963, a study of nutritional adequacy was 
conducted by Tabrah and Hauck in Nigeria. They found high 
incidencies of reduced haemoglobin levels in groups of 
children. Protein and riboflavin deficiencies were also 
observed. Mcdonald, (1963) found that 27% of the Navajo Indian 
adolescents she studied had diets deficient in ascorbic acid.
As part of a longitudinal study of students' nutritional 
status in the United States, nutrient intakes were calculated 
from students dietary records by Atkinson and Wyn-Jones, 
(1972) . They reported that most group mean intakes were above 
the Recommended Dietary Allowances (RDA) . Males generally had 
higher intakes of energy, protein and iron whereas females had 
higher intakes of ascorbic acid. In the same year Stordy and 
Cowling, studied the food habits and nutrient intakes of 
students in different residential accommodation in U.K. In 
this study women living in flats and bed-sitters and who cater 
for themselves were receiving less than the RDA of all 
nutrients. Results from this study seem to point to the fact 
that self catering in residential accommodation seem to 
negatively affect nutrient intakes.
Schorr et al. , (1972) studied the food habits of
teenagers in the United States. They realised that, the 
extent of the teenagers' social participation affects the
33
complexity of their diets. Twenty one percent of the students 
in the study consumed less than 66 per cent of their Vitamin 
C, 44% Calcium, 51% Vitamin A and 69% Iron. The nutritive 
intakes of the male subjects was again considerably superior 
to that of the females.
In 1976, Olusanya did a study of the feeding patterns and 
nutrient intakes of students in five secondary schools in 
Nigeria. The results of the study showed that all the 
students were not getting the F.A.O. recommendation for 
energy, riboflavin and protein.
Nutrient intakes of University of Ghana students were 
looked at by Dowuona-Hammond, in 1978. Although calcium, 
iron, vitamin A and ascorbic acid intakes were greater than 
the FAO recommended nutrient intakes, the intakes of energy 
and protein satisfied 70-80% of the R.D.A. riboflavin intakes 
were found to be very low (only 45-49% of the RDA was met.)
Jakobovits, (1977) studied food intakes of junior and 
senior female students at Cornell University. It was shown 
that except for energy, thiamin and iron, all other nutrient 
recommendations were exceeded. The mean iron intake was 
however low.
In 1979, Kazimi evaluated the diets of college students 
in Iraq and found that severe nutritional deficiencies were 
not prevalent and the protein intake was well over the F.A.O. 
requirements.
Agyeman Mensah, (1980) observed that all the students he
34
studied in Achimota school did not meet F.A.O.'s, RNI for 
calories, calcium and riboflavin. His study also revealed 
that despite the high preference for local foods, there also 
existed among the students a taste for imported foods. The 
mean heights and weights of the students were generally low 
when compared to American standards but compared to similar 
data on other children in Ghana the mean weights and heights 
of Achimota school students were relatively high.
Story et al., (1986) studied anthropometric measurements 
and dietary intakes of Cherokee Indian teenagers in North 
Carolina. The purpose of this study among others was to look 
at physical growth (height and weights) of Native American 
adolescent population and compare the measurements with 
national reference data and determine energy and nutrient 
intakes. Mean intakes for energy, iron, thiamin, protein, 
calcium and riboflavin were lower for girls than for boys. 
Females had higher mean intakes of Vitamin A and ascorbic 
acid. When compared with RDAs, mean intakes of Vitamin A and 
thiamin were low for males and calcium and iron intakes were 
low for both sexes.
In all the studies reported so far, three things were 
evident. The adolescents in all the studies were not 
receiving the recommended allowances of energy and other 
nutrients and those especially below the recommended 
allowances were calories, calcium, iron and vitamin A. It was 
also evident that male adolescents had better nutrient intakes
35
than female adolescents and also that adolescents in developed 
countries fared better than those in developing countries.
In Ghana only few studies have been done on nutrient 
intakes of adolescents hence the need for a survey of this 
nature.
36
CHAPTER THREE
3.0 RESEARCH DESIGN AND METHODOLOGY
3.1 SITE SELECTION
The study was conducted in some boarding secondary 
schools in the Central Region. This region was particularly 
chosen because it has the largest number of boarding secondary 
schools in the country. According to the West African 
Examinations Council's Common Entrance School selection list, 
there are sixteen boarding schools in the Central Region alone 
with the highest concentration in Cape Coast. Many of the 
oldest well-established secondary schools are found in this 
region.
3.2 SAMPLING
The population comprised adolescents between fifteen (15) 
and nineteen (19) years in secondary schools with boarding 
facilities in the Central Region. A list of all the boarding 
secondary schools in the Region was obtained from the West 
African Examinations Council and stratified into the following 
categories :
1. Urban Boys' Schools A
2. Urban Girls' Schools B
3. Rural Co-educational Schools - C
4. Urban Co-educational Schools - D
One secondary school was selected from each stratum using the 
lottery method. In each of these secondary schools, thirty-
37
five (35) form four students aged fifteen to eighteen years 
were selected from their class lists using simple random 
sampling technique. Where a student fell outside the age 
range being studied the next student in the list was picked 
instead. Form four was chosen because most of the students in 
this class were within the age range being studied.
3.3 INSTRUMENTS FOR DATA COLLECTION
Four instruments were used to collect data for this 
study. These were questionnaires, dietary records,
anthropometric measurements and observations.
3.3.1 The Questionnaire (see appendix 10)
A 51 item, self administered questionnaire was the main 
instrument used to collect information from the respondents 
between 1st June and 30th June, 1992. The questionnaire 
covered the following topics:
(i) Demographic and Socio-economic Characteristics
The Demographic and socio-economic data included 
age, sex, parents' educational background, parents' 
occupation and the students' activities.
(ii) Food Habits
Questions covered the number of times students ate 
in a day, meal skipping habits, snacking habits and the 
types of meals eaten at school and at home.
38
(iii) Nutrition Knowledge
Since there were no standard tests available for 
testing nutrition knowledge of Ghanaian adolescents, the 
researcher designed a ten test question to find out how 
much an adolescent knew about why he eats and what his 
basis for choosing foods are.
(iv) Food Preference
Students were asked to indicate their favourite 
meals for breakfast, lunch and supper at home and at 
school. They were also given a list of fifty-six (56) 
food items and asked to indicate whether they liked them 
very much, disliked them or had never eaten them.
(v) Frequency of Food Consumption
Students were asked to indicate how often they ate 
the foods that appeared in the food consumption list.
3.3.2 Dietary Assessment
The nutrient intakes of the students were obtained by 
direct weighing of the meals eaten in the dining halls for 
three consecutive days to minimize respondent burden. A 
modified form of the weighed household food record described 
by Burk and Pao, (1976) and quoted by Gibson, (1989) was 
obtained for all meals eaten in the dining hall from Thursday 
through Saturday (Appendix 8) . Each dining hall table was 
taken to represent a household. The two week days were 
similar to all the other week days and the weekend day
39
represented the week end days and covered any differences in 
the types of meals eaten at week ends. Nutrient intake of 
respondents were obtained by multiplying the weights of the 
meals served in the dining hall by the corresponding nutrient 
values obtained from food composition tables and dividing the 
result by the total number of students on each table.
Respondents were also given food record sheets on which 
they were asked to indicate, as they ate, the estimated 
quantity in terms of dessert spoons or cedis equivalent of 
foods and drinks consumed outside the dining halls (See 
Appendix 9) . This was done within the three days during which 
the weighed food record was taken, The researcher bought and 
weighed the food items listed by the students from vendors on 
the school compounds. Nutrients from these foods were 
calculated using food composition tables on Ghanaian foods by 
Ghana Food Research Institute, (1975). The food composition 
table made by Paul and Southgate, (1979) was also used.
3.3.3 Anthropometric Measurements
The growth performance of the respondents was assessed by 
means of their weight and height measurements. The weights 
and heights of the respondents were taken when they were 
responding to the questionnaire, three hours after their 
lunch. Weights were taken using a bathroom scale calibrated 
to the nearest 0.5 kilogram and the standard weighing 
procedure described by Gibson, (1989) were followed.
40
Height measurements were taken at the same time using an 
improvised stadiometer a straight two meter rectangular 
stick on which was carefully tapped a dressmaker's measuring 
tape (See Appendix 7) . The stick was then tagged to a 
straight wall in the classrooms. Again standard procedures 
for measuring height described by Gibson, (1989) was followed 
to obtain the measurements. A flat plywood specially designed 
to slide on the stick was used to press the hair down and to 
facilitate reading. The weights and heights were compared 
with Jelliffe, (1989) and NCHS growth reference data to 
ascertain growth performance of respondents.
3.3.4 Observation
The conditions under which the meals were prepared and 
served and the methods used in preparing the meals for the 
students were observed. Student patronage of dining hall 
meals were also observed.
3.4 PROCEDURE FOR DATA COLLECTION
A letter written by the Head of Home Science Department 
of the University of Ghana introducing the researcher to the 
Heads of the chosen schools and to obtain permission to use 
the schools for the research, was distributed to the 
Headmasters/mistresses between 21st April and 30th April, 
1992. The researcher then spent from Wednesday to Saturday 
evenings each week in each of the schools to collect the
41
responses for the questionnaire, weights of meals which the 
respondents ate in the dining halls, respondents weights and 
heights and types and quantities of foods eaten outside the 
dining halls. The questionnaires were given to thirty-five 
(35) respondents in each school in one of their classrooms on 
Wednesdays at about four o'clock. The purpose of the research 
was explained to the respondents and the questionnaire items 
discussed with them to remove any doubts as to the meaning of 
the questions. The students were then asked to complete the 
questionnaire while the researcher supervised to make sure 
that individual answers were written to eliminate the 
influences of other students. Weight and height measurements 
were taken at the same time, using a bathroom scale and the 
improvised stadiometer.
3.5 PRE-TESTING
The Instruments for this study were pre-tested in a 
boarding school in the Central Region other than any of those 
used for the study. Six form four students aged between 15 
and 18 years responded to the questionnaire. Heights and 
weights were taken and the meals given to the students were 
weighed. The pre-testing helped the researcher to rectify 
problems of ambiguity or clarity of some of the questions and 
also to ascertain the validity and reliability of the 
responses. It also helped her to select a 10 kilogram scale 
for weighing the dining hall foods because the 5kg scale used
42
during the pre-testing was too small. Her interaction with 
the domestic bursar gave her an idea of the situation she was 
likely to meet at the selected schools.
3.6 ANALYSIS OF DATA
3.6.1 Questionnaire
Responses on completed questionnaires were hand coded. 
Frequency and percentage distributions and cross tabulations 
were used to analyse the data.
3.6.2 Food Preference Data
The food preference data, the frequency of food
consumption data and the nutrition knowledge data in the 
questionnaire were treated in the following way :
{i) Food preference
The number and percentage of respondents mentioning 
each food items in each of the four preference 
classifications were computed. This gave the percentage 
of respondents who liked or disliked the food items given 
in the list.
(ii) Frequency of Food Consumption
How frequently food items were consumed was
discussed under the various food groups of Ghana.
43
3.6.3 Nutrition Knowledge
The responses to each of the questions were scored. The 
scores were then used to rate the nutrition knowledge of the 
respondents as follows:
TABLE 2: RATING OF NUTRITION KNOWLEDGE
Rating Nutrition Knowledge Category
Good
Fair
Poor
Respondents who scored 60-100% 
Respondents who scored 40-59% 
Respondents who scored 0-39%
3.6.4 Nutrient Intake
In designing the study, it was reasoned that insufficient 
food intake would manifest itself as inadequate nutrient 
intake, therefore nutrient intake rather than food intake was 
considered as the independent variable in the data analysis. 
Each respondent's average daily intake of energy, protein 
calcium and iron was computed. This was arrived at by 
calculating the nutrients provided by the meals eaten in the 
dining hall and that from foods eaten outside the dining hall 
and adding the two values. Protein values were corrected for 
N.P.U. using the 0.7 factor. The following results were 
further calculated from the intake data :
a) The percentage of the Recommended Dietary 
Allowances of each of the four nutrients met by the 
dining hall meals. (This will show whether 
students are receiving adequate levels of nutrients 
from dining hall meals).
44
b) The percentage of the RNI, of each of the nutrients 
met by the total daily intake for each respondent.
This was used to find out the proportion that 
received above or below two-thirds of the RDA.
c) The proportion of the total nutrient intake 
supplied by the dining hall meals and that supplied 
by meals eaten outside the dining hall.
d) The mean daily intake and standard deviation of the 
mean for all respondents for each school and sex.
3.6.5 Weight and Height Measurements
Weight-for-height and height-for-age of the respondent 
was compared with Jelliffe's and NCHS growth reference data 
using bar charts.
The weights and heights data were also used to classify 
the respondents into normal, overweight, underweight and obese 
categories using Kauffman et al. , (1975) classification which
stated that if the relative weight is 91-110% of the standard 
or reference weight the individual has normal weight. When it 
is less than 90%, he is underweight. From 111% to 120%, the 
person can be regarded as overweight and from 120% and above 
the person is obese.
Again, the Body Mass Index of the students was calculated 
and the classifications used by the Health and Welfare Canada 
1988a was employed to classify them as follows :
45
BM1 Evaluation
<20 Underweight
20-25 Normal
>25<30 Overweight
>30 Obese
3.7 LIMITATIONS OF THE STUDY
1. Food record studies should involve adequate
measurements of individual food intake by carefully
weighing all the different raw foods that go into 
the preparation of the meal. Alternatively, the 
portions per individuals could be analysed in the 
laboratory to establish the quantities of the 
various nutrients present in the meal. These
methods were however, not used because of the 
nature of meal service in the institutions and lack 
of the necessary equipment for laboratory analysis 
of the food. The calculated values obtained are 
therefore not absolute.
2. Since all students paid the same amount of money
for feeding, the food was shared equally
irrespective of gender and age. Some of the 
students may be receiving adequate amounts of 
nutrients because of their age and build whilst 
others would be receiving less than the amount they 
require. The adequacy or otherwise of dining hall 
meals is therefore subject to the age and size of 
the student.
46
3. Again, the use of food composition tables to 
calculate nutrients has its limitations. Food 
compositions are arrived at either using small 
quantities of raw foods or cooked foods prepared 
from family recipes. The use of such tables to 
calculate the nutrient intakes of people whose 
meals are cooked with large-scale methods and 
equipment like school meals, may have errors since 
the recipes used are often different both in 
ingredients and proportions from family recipes. 
The duration of cooking may also vary leading to a 
variation of amounts of nutrients especially the 
heat labile nutrients. Stock and Wheeler, (1972) 
found that there was a wide difference between the 
calculated values of nutrients in foods and the 
analytical values (the calculated values being 
higher). So values obtained in this study may be 
higher than the actual values.
4. The use of recommended nutrient intakes to 
establish adequacy of a diet is also a limitation 
because with the exception of energy, the values 
for all nutrients were inflated to cater for 
individual differences. Hence, where the values 
obtained fall below the RNI, it does not 
necessarily mean that the meals are inadequate.
47
When nutrient intake data are evaluated the bio­
availability of the nutrients from the diets must be 
considered. The calculated nutrient intakes may not be 
absolutely available for use in the body due to problems 
of digestion, absorption and assimilation.
Although care was taken to make the improvised 
stadiometer as accurate as possible one cannot rule 
out errors due to improvisation. For example the 
dressmakers tape on the stick may move as a result 
of the movement of the sliding board which could 
affect the reading of the height of the subject.
The data collected for the 3-day food record were based 
on self-report and is therefore subject to the biases 
that self-report data involve. Students may be talking 
the 'good diet' to impress the researcher.
All the above limitations point to the fact that the 
values obtained for the various nutrients and other 
measurements could only be approximations and therefore 
conclusions drawn from them may not be absolute.
CHAPTER FOUR 
RESULTS AND DISCUSSIONS
The results and discussions of the study are presented 
under the following headings:
1. Description of the sample.
2. Food habits of the respondents.
3. Nutrition knowledge of the respondents.
4. Dietary Assessment and Nutrient intakes of Respondents.
5. Growth Performance of the respondents.
4.1 DESCRIPTION OF THE SAMPLE
4.1.1 Age, Gender, Religion and Ethnicity
One hundred and forty adolescent students from four 
secondary schools, (two co-educational and two single sex) 
took part in the study. Their mean age was sixteen years with 
a range between fifteen and eighteen years. The sample 
comprised 48% males and 52% females. Ninety-five per cent of 
the respondents were Christians and the rest were Moslems. 
Fantes dominated the sample forming 71%. The rest were Guans 
(10%), Ga-Adagbe (9%). Ewes (7.9%) Dagbanis (2.1%).
4.1.2 Educational Backgrounds of Parents
Most of the parents of the respondents had high 
educational backgrounds. A few of them were however, farmers 
and artisans whose educational levels were low. Table 3
49
indicates the level of education of parents or guardians of 
the students.
TABLE 3: DISTRIBUTION OF PARENTS OR GUARDIANS EDUCATIONAL
BACKGROUND
EDUCATIONAL BACKGROUND
FATHER
N %
MOTHER 
N %
No formal Education 4 2 . 9 3 2 .1
Primary School 1 0.7 10 7.1
Middle School 15 10.7 12 8.6
Sec./Com./Vocational 35 25.0 39 27. 9
Teacher Trg./Poly/Agric. 18 12 . 9 25 17.9
University 64 45.7 41 29 .3
No Response 3 2.1 10 7.1
Total 140 100.0 140 100.0
Many of fathers 46% and over a quarter of the mothers 
(29%) were University graduates whilst 13% of fathers and 18% 
of mothers schooled up to polytechnic level. It is therefore 
expected that this high educational level of parents would 
have great influence on respondents' eating habits and their 
nutrition knowledge.
Mothers especially would want to make sure that their 
children eat nutritious meals.
50
4.1.3 Occupational Status or Parents or Guardians
Parents or guardians of all the respondents were employed 
either in the public or private sector. Table 4 shows the 
distribution of occupations of parents and guardians.
TABLE 4: DISTRIBUTION OF PARENTS OR GUARDIAN'S OCCUPATION
OCCUPATION OF PARENTS' FATHER
N %
MOTHER 
N %
Professionals 88 62 . 8 57 40.7
Bus ine s smen/women 26 18 . 6 53 37 . 9
Artisans 4 2 . 9 11 7 . 9
Farmers 4 2 . 9 2 1.4
Housewives - - 3 2.1
Others - 3 2 .1
No Response or don't know 18 12.8 11 7.9
Total 140 100 . 0 140 100.0
Most of the fathers (63%) were professionals such as 
engineers, bank managers, doctors, lecturers and army 
officers. Eighteen per cent were business men. Over one 
third of the mothers (40.7%) held professional positions as 
doctors, lawyers, and lecturers. About one third (38%) were 
business women and these were mostly traders. It is 
anticipated that since most parents are gainfully employed, 
their children would be well fed because they would have the 
means to purchase food for the family.
51
4.1.4 Extra Curricular or Recreational Activities of 
Respondents
One of the developmental characteristics of adolescence 
is the increase in activity levels which increases their need 
for energy. Table 5 gives the different activities in which 
the students participated at school.
TABLE 5: DISTRIBUTION OF RESPONDENTS BY ACTIVITIES THEY
PARTICIPATE IN AT SCHOOL
ACTIVITY N %
- Games and Sports 130 93
- Indoor Games 39 28
- Cultural and Club activities 16 12
- No activity 5 3.6
- No response 9 6.4
Activities participated in by the majority of the 
respondents (93%) were games such as football, tennis, 
volleyball and sports such as sprints and jogging. These are 
activities which require the use of the whole body and 
therefore require a lot of energy. They would therefore 
require proper feeding if they must obtain enough energy for 
such activities. Twenty-Eight percent took part in indoor 
games such as Ludo, cards and weight-lifting. The cultural 
and club activities mentioned were Red Cross, debates, drama 
and press conferences which do not require so much energy 
expenditure.
52
4.2 FOOD HABITS OF RESPONDENTS
Food habits of adolescents could be quite varied. Meal 
patterns, food preferences, meal skipping and snacking were 
aspects of food habits investigated in this study,
a. Meal Patterns
The number of meals eaten daily by the students are 
presented in Table 6.
TABLE 6: DISTRIBUTION OF STUDENTS BY THE NUMBER OF MEALS 
EATEN DAILY AT HOME AND IN SCHOOL
NO. OF MEALS EATEN DAILY
IN
N
SCHOOL
%
AT HOME
N %
One 1 0 . 7 0 0
Two 8 5.7 7 5.0
Three 94 67.2 91 65.0
More than three 37 26 .4 42 30 . 0
Total 140 100 140 100
Most respondents ate three meals a day at home. This is 
not surprising because as has already been indicated, parents 
or guardians of the majority of respondents are highly 
educated and gainfully employed and therefore can afford to 
feed their children three meals a day.
A similar meal pattern was found in school.
53
b. Types of Meals Eaten
At home, a wide variety of meals were eaten by 
respondents for breakfast, lunch and supper. The 
majority (63.4%) consumed light breakfasts, mostly cereal 
dishes. Thirty-six per cent ate heavy breakfasts 
comprising rice or 'kenkey' or 'banku' or yam served with 
a stew or soup. Beans and fried plantain or 'gari' were 
also eaten.
Meals for lunch varied from very light meals such as pie 
and soft drinks to heavy meals like 'fufu' and palmnut 
soup. Cereal-based meals dominated what respondents ate 
for lunch. It is not surprising that 'kenkey' and 
'banku' were common meals consumed because most of the 
respondents were Fantes from the coastal plains where the 
staple food is corn. Meals eaten for supper were similar 
to those eaten for lunch.
In school, breakfast consists mainly of rice 
porridge or corndough porridge with or without bread and 
with no protein rich food. Lunch and supper were mainly 
rice, 'kenkey' or 'gari' served with stew or soup.
A close look at the meals consumed at School especially 
showed breakfasts consisting of foods which provide 
mainly carbohydrate. This suggests that some of them 
probably do not obtain adequate amounts of proteins and 
other nutrients.
54
When asked what respondents' favourite meals were, 
about half of them (51%) said they liked Gari* and Beans 
and 'kenkey' and stew for breakfast. Twenty six percent 
preferred beverages like horlicks, cocoa or tea and the 
rest liked cornflakes and oats. For some of the 
respondents therefore, the breakfasts provided in the 
schools are not meals they liked. It is therefore likely 
that they would not eat such breakfast. This could 
further compound the problem of low nutrient intake 
envisaged.
Students' preference for imported foods like 
cornflakes and oats was documented in 1987 by Agyeman- 
Mensah in his study at Achimota School in the Greater 
Accra Region. Almost eight years after, similar 
preferences were found among respondents in four 
Secondary School in the Central Region. It could be said 
that students prefer these foods because of the 
convenience in storing and preparing them or because it 
showed how affluent they are since most of them come from 
affluent backgrounds.
55
c . Persons Who Determine What Should be Cooked at Home
Persons who determine what should be cooked at home 
are shown in Table 7 -
TABLE 7: DISTRIBUTION OF WHO DETERMINES WHAT SHOULD BE
PREPARED FOR FAMILY MEALS
PERSON WHO 
DETERMINES MEALS
BREAKFAST
%
LUNCH
%
SUPPER
o,
o
Mother 53 . 0 53 .4 56.4
Self 35 . 7 30 . 9 24.3
Father 9.3 12 . 9 13 . 6
Others 1.4 1.4 3.6
No response 1 . 6 1.4 2.1
Total 100 100 100
Lewin's channel theory (1943) indicates that the 
mother or homemaker is often the gatekeeper of the 
household. It is not surprising therefore that in this 
study, the mother was the one who most often determine 
what to cook for the family. Its been over fifty years 
ago when Lewin's theory was promulgated and one would 
have thought that this trend would change drastically. 
This study has shown that this theory has had very little 
change probably because of our cultural and traditional 
norms. It is however, encouraging to note that inspite 
of these norms, the gate-keeper responsibility of mothers 
is being shared by other members of the family especially 
fathers.
56
d. People Who Eat With the Respondents
Concerning whom the respondents eat their meals with 
they gave the responses outlined in Table 8.
TABLE 8: DISTRIBUTION OF RESPONDENTS ACCORDING
TO WHO EATS WITH THEM AT HOME AND AT SCHOOL
PERSONS WHO EAT 
WITH RESPONDENTS
AT HOME
%
IN SCHOOL
0^
o
Alone 54.3 26 . 5
Friends 0 70 . 0
Brothers 12 . 9 1.4
Sisters 9.3 2.1
Mother 14.3 0
Father 7 .1 0
Others 2 .1 0
Total 100 100
It was evident from the study that most of the 
respondents (54%) ate individually at home rather than 
sharing with other family members. In many homes in 
Ghana especially in the rural areas, fathers share meals 
with their sons, mothers with their daughters, sisters 
with their sisters and brothers with brothers. In more 
affluent homes, meals are eaten individually at the 
family table. Since most of the respondents come from 
homes where parents are highly educated, their mothers 
would probably see to it that they are served with 
individual portions, hence the large percentage that ate
57
meals alone at home. Again, it may also be that the 
adolescents themselves were away from home when meals 
were served and therefore, they came back to eat alone.
At school, most respondents (70%) ate their meals 
with friends and only 27% ate alone. These meals can only 
refer to those eaten outside the dining hall since only 
individual portions are served in the dining halls. It 
is likely that most respondents would like to eat with 
their peers so that they can stretch the provisions that 
they take to school. In this case unfamiliar foods may 
be introduced by friends and this could influence their 
eating habits. Good or bad eating habits can be 
cultivated.
e. Food Preferences of the Students
Details of foods liked or disliked by the students 
are given in Appendix 1. The discussion of food 
preferences was done in the food groups.
The protein rich foods the respondents liked include 
eggs, chicken, milk, beef and fish. Fruits and 
vegetables liked are pineapples, oranges, ' nkontomire' 
and cabbage.
In the root and tubers' group respondents said they 
like yam, sweet potatoes and plantain. The cereals liked 
are wheat in the form of bread, oats, rice and corn. 
Respondents do not like millet and sorghum. In the 
legume group they prefer groundnuts and cowpeas and
58
disliked bambara beans and soya beans. Respondents liked 
all types of oils except Palm kernel oil.
Each of the 51 food items listed for respondents to 
indicate preference (see appendix 2) were cross-tabulated 
with the gender of respondents. Most of the preferences 
or dislikes did not favour any gender. However, it was 
seen that more female respondents preferred toffee and 
alcoholic beverages than males. This is indicated in 
tables 9 and 10.
TABLE 9: PREFERENCE FOR TOFFEE BY GENDER OF RESPONDENTS
GENDER NO
RESPONSE
LIKE VERY 
MUCH
DISLIKE NEVER
EATEN
ROW
TOTAL
Male 2.1 37.9 7.2 0 . 7 47.9
Female 2.3 49.1 0.7 0 52.1
COLUMN
TOTALS 4.4 87 7.9 0 . 7 100
The high preference for toffee is quite alarming 
because eating too many sweets have been implicated in 
the problems of tooth and gum decay. According to Garn 
et al., (1980), sugar is the best energy source for the
bacteria that cause tooth decay and that when eaten 
continuously, over several hours or in sticky forms, they 
can produce dental caries.
The respondents are therefore at risk of developing 
dental problems. Besides, they may be using the food
59
money given them to buy sweets and this is likely to
lower their nutrient intake.
TABLE 10: PREFERENCE FOR ALCOHOLIC BEVERAGES BY GENDER
OF RESPONDENTS
GENDER NO
RESPONSE
o,
o
LIKE VERY 
MUCH 
%
DISLIKE
%
NEVER
EATEN
o,“o
ROW
TOTAL
o,*o
Male 2 . 9 12 . 9 18.5 13 .6 47 . 9
Female 5.0 22 .1 8 . 6 16 .4 52.1
COLUMN
TOTALS 7.9 35 27.1 30 100
Table 10 shows that (35%) of respondents indicated
that they liked alcohol very much. More females than 
males showed preference for alcoholic beverages. This is 
an alarming revelation especially since the respondents 
are students.
Drug-related habits among the youth of today had been the 
subject of concern for both school authorities and the 
general public. Hamilton et al. , (1986) have indicated
that a couple of drinks set in motion, many destructive 
processes in the body. Repeated onslaughts of alcohol 
gradually takes a toll on the body. For example, 
nutrient deficiencies are virtually inevitable because 
the more alcohol a person drinks, the less likely it is 
that he or she will eat enough food to bbtain adequate 
nutrients. Alcohol displaces food and at the same time 
interferes with the body's use of nutrients.
60
When alcohol flows to the brain it sedates the 
reasoning part and interferes with reasoning and 
judgement. Hooliganism and violence that leads to 
destruction of school property, disrespect for authority 
and all other forms of deviant behaviour could be 
triggered off by the intake of alcohol. If over a third 
of the respondents indicate that they like alcohol, it is 
likely that they would spend their pocket money to 
purchase the drinks and therefore would not be eating 
well which would affect their nutrient intakes. Again 
there is no guarantee that this group of students would 
not go on to use other forms of drugs. Worst still, they 
may grow to become alcoholics, a problem for the family 
and a drain on the human resources of this country. 
These are the reasons why we should be concerned with 
this revelation. There is the need to intensify education 
on drug-related problems in our schools to protect our 
children, for, they are the parents of tomorrow,
f. Food Restrictions
Although the respondents seemed to like a wide 
variety of foods, there were a few restrictions as to 
what they could or could not eat. Sixty-seven per cent 
had no food restrictions or taboos in their families. 
They were free to eat any food of their choice. However,
3 0% were not allowed to eat some plant and animal foods 
like pork, snail, grasscutters, crabs, mushrooms, sorghum
61
and beans. Incidentally, these were foods which are not
served in the schools so the restrictions would have no
effect on their food intake at school. The majority of
those who have food restrictions did not know the reasons
why they were restricted from eating the foods. Moslems
however, gave religious reasons for not eating pork. The
other (15%) attributed the restrictions to ethnic taboos
observed by their parents. Snails and beans are however
sources of protein, which could improve the diets of the
adolescent if they are allowed to eat them.
g. Dietary Diversity of Students Based on the Frequency 
of Food Consumption
The frequency of consumption of various foods would 
be used here to describe dietary diversity of 
respondents, (see appendix 2).
Animal Products
Fish and meat were eaten daily by 67.9% and 26.4% of 
the sample respectively. Fifty-two percent of thetnalso 
ate meat a few times a week. Other animal products 
consumed weekly or a few times a week included chicken, 
sardines, eggs and milk. It will be recalled that these 
were the animal products liked by the respondents. 
Legumes
Beans and groundnuts were eaten a few times a week 
by 42.1% and 39.3% respectively. Bambara beans and soya 
beans were not popular among the adolescent respondents 
hence most of them never ate them.
62
Roots Crops and Plantain
The most frequently consumed root crops were 
plantain, yam and cassava, consumed on a daily basis by 
49.9%, 42.9% and 29.3% of respondents respectively. 
Fruits
The majority of the respondents ate bananas, oranges 
and pineapples often. Pawpaws, mangoes and watermelons 
were eaten seasonally by most respondents.
Vegetables
Forty percent and 46.4% of respondents ate garden 
eggs, nkontomire and other leaves a few times a week 
respectively. In Ghana vegetables always form part of 
the stews and soups that accompany the staple foods. 
This is why tomatoes and pepper were omitted from the 
list of foods.
Fats and Oils
Refined vegetable oil, palm oil, margarine and 
groundnut oil were popular among the respondents. 
Coconut oil and palm kernel oil were not eaten as much. 
Cereals
Among the cereals mostly consumed daily by the 
respondents were wheat as bread (52.9%) Rice (42.9%) 
and corn (35.7%). Corn flakes was eaten a few times a 
week by 43% of the respondents. Cereals such as millet 
and sorghum were never eaten by 37% and 47% of the 
respondents respectively, probably because they were not 
familiar foods.
63
Miscellaneous food items like sweets such as Toffees 
and chocolate bars are consumed daily by 21% and 15% of 
the students respectively and few times a week by 55% and 
56% respectively. As discussed earlier the proportion of 
respondents who consumed sweets is quite high and needs 
to be addressed considering the damage sweets could cause 
to the teeth and to body weight.
Alcohol
Hamilton and Whitney, (1978) reported that alcohol 
drinking was becoming very common among adolescents, in 
the U.S. About 3.6% consumed it daily and 14.3% a few 
times a week. Twenty-four percent said they consume 
alcohol on daily to monthly basis. This seems to confirm 
an earlier discussion which indicated that 3 5% of 
respondents said they liked alcohol very much. This 
study probably suggests that alcohol consumption among 
adolescents is real and could become a social problem if 
not handled early enough.
Nutrient Supplements
Most of the respondents took nutrient supplements. 
Twenty-six per cent took it daily and 24% a few times a 
week. Only 7% of the respondents said they did not take 
nutrient supplements. Nutrient supplements can never 
replace a well balanced diet. They may even be dangerous 
especially if they are not taken on medical advice. As
64
much as respondents may need these supplements to augment 
those obtained from foods, they should not abused. It 
could be said that respondents consume a variety of food 
items. Comparing the food consumption with food 
preferences, the majority of respondents consumed foods 
they liked. Therefore food preferences do dictate what 
foods are consumed.
h. Meal Skipping Habits of the Respondents
Respondents' meal skipping habits are given in Table 11.
TABLE 11: PERCENTAGE DISTRIBUTION OF FREQUENCY OF MEALS 
SKIPPED AT HOME AND AT SCHOOL BY RESPONDENTS
MEALS
AT HOME IN SCHOOL
ALWAYS SOMETIMES NEVER ALWAYS SOMETIMES NEVER
Breakfast 12.1 45.7 42.2 24 .3 43 .6 32.1
Lunch 11.4 37.1 51.5 10 .7 40.3 40 .0
Supper 8.6 34.2 57.2 12 . 9 42 . 9 44 .3
Meal skipping habits of adolescents have been 
documented by several researchers (Hueneman et al. , 1966; 
Eppright et al. , 1963; Shapiro et al. , 1963; White,
1972) . The adolescent respondents in this study also 
skipped meals both at home and in school.
Breakfast was the meal skipped most and supper was 
eaten most consistently at home and in school. Table 11 
suggests that the eating patterns followed at home were 
carried over to school. For example, 35.7% of
respondents sometimes skip breakfast at home and 43.6% 
sometimes skip it at school. These are quite close. It 
is therefore important that parents of adolescents should 
help their children to form good eating habits from 
childhood so they can pass it on to their children and 
peers.
Skipping meals especially breakfast could have an 
adverse effect on respondents academic performance, 
especially in school, since the ability to work 
physically and mentally, the attention span and the 
attitude towards work are lowered when breakfast is 
missed.
Respondents mentioned several reasons why they 
skipped meals at home and in school. These include
1. Respondents did not like the food served
2. Some respondents were too tired or too 
lazy to walk to the dining hall.
3. Respondents have provisions which they 
ate when they were hungry.
Where market facilities were not available meal skipping 
was not common. In one of the schools for example, only 
fruits and groundnuts were sold on the school compound. 
Attendance at meals was also compulsory so there was no 
way one could skip dining hall meals.
At home, the reasons given for skipping meals included :
66
The fact that the student did not feel
like eating.
Over sleeping.
Students were absent from home,
i. Snacking Habits
The meals skipped by the respondents were sometimes 
replaced with snacks. Table 12 shows the number of 
snacks respondents ate in a day both at home and in 
school.
TABLE 12: DISTRIBUTION OF NUMBER OF SNACKS EATEN DAILY
AT HOME AND AT SCHOOL
NUMBER OF SNACKS AT
N
HOME
%
AT SCHOOL 
N %
None 0 0 10 7.1
1 - 2 92 65 85 60.7
3 or more 48 35 45 32.2
Total 140 100 . 0 140 100.0
Almost all the respondents ate one or two snacks at 
home and at school. Only 7.1% of the respondents did not 
eat snacks at school. Though this percentage is small, 
it needs to be looked at since it could have nutritional 
implications. If the normal school meals are not 
nutritionally adequate, it might affect the nutritional 
status of such respondents. Besides, Hamilton et al.,
(1988) realised that about Vi of the teenagers' total 
daily nutrient intake comes from snacks.
Generally, snacking habits at home were not
67
different from snacking habits at school.
TABLE 13: FOODS USUALLY EATEN BETWEEN MEALS
FOOD N O,o
AT HOME
Soft drinks and cakes or pies 72 51.4
Fruits 52 37.1
Heavy meals (e.g. Kenkey) 7 5.0
AT SCHOOL
'Soaked Gari' 89 63 .5
Soft drinks, cakes or pies 52 37.1
Fruits with groundnuts 38 27 .1
Sweets e.g. toffee 5 3.5
About half and one third of respondents consume soft
drinks at home and at school respectively. The soft
drinks usually contain phosphates which Spencer and 
Kramer, (1986) found to promote calcium loss. The more 
soft drinks teenagers consume, the less likely they are 
to meet their recommended nutrient intakes (RNI) for 
Calcium (Guenther, 1986).
It is interesting to note that at school, well over 
half of the respondents consume 'gari' either mixed with 
sugar and milk or with 'Shitto' . Gari is the food
normally taken to school and it is the cheapest
supplement for dining hall meals.
68
Nutrition knowledge of respondents was categorized into 
good, fair and poor using the criteria described in the 
methodology. Students who scored 60 100% were regarded as
good, 40 59 as fair and below 40 as poor, Table 15 shows the
distribution of the nutrition knowledge by these categories.
4.3 NUTRITION KNOWLEDGE OF RESPONDENTS
TABLE 14: DISTRIBUTION OF NUTRITION KNOWLEDGE OF RESPONDENTS
KNOWLEDGE CATEGORIES N "o
Good 1.0 0 . 7
Fair 38.0 27 . 9
Poor 61.0 71.4
Total 140 100
It is evident from Table 14 that the majority of the 
respondents had little or no knowledge of nutrition as far as 
the questions asked were concerned. This is disappointing 
especially because the syllabus for Home Economics for 
secondary schools required that students are taught some basic 
nutrition concepts during their first three years in school. 
All the female students should have at least had some exposure 
to basic knowledge in nutrition since they were required to do 
home economics in their first three years in secondary school. 
This did not reflect in the answers given in the test.
69
4.3.1 Nutrition Knowledge and Gender of Respondents
Table 15 shows the distribution of nutrition knowledge by 
Gender of respondents.
TABLE 15 : NUTRITION KNOWLEDGE OF RESSPONDENTS BY GENDER
NUTRITION KNOWLEDGE 
CATEGORIES
MALE
o .
FEMALE
o,
"o
TOTAL
'o ’
Good 0 0 . 7 0.7
Fair 5 . 0 22 . 9 27 . 9
Poor 42 . 8 28 . 6 71.4
Total 47 . 8 52 . 2 100
Female respondents appeared to be more nutritionally 
literate than males. Of the proportion of respondents who 
performed poorly in the in the nutrition knowledge test 42.8% 
were males. The poor knowledge of nutrition exhibited by male 
respondents could be due to the fact that formal classroom 
foods and nutrition lessons do not feature in the curriculum 
for boys' schools in Ghana. In addition, in co-educational 
institutions, boys who did Home Economics did so only by 
choice. However, looking at the educational background of 
most of the parents of these respondents, one would have 
expected the respondents to have a fair knowledge concerning 
the nutrition questions asked. Since this was not the case 
one is inclined to think that the parents were also not 
nutritionally literate. Being highly educated does not 
necessarily mean being nutrition literate then.
70
4.3.2 Nutrition Knowledge by Types of Schools
The nutrition knowledge of respondents was also looked at 
by types of schools in Table 16.
TABLE 16: NUTRITION KNOWLEDGE BY TYPE OF SCHOOLS
KNOWLEDGE
CATEGORIES
SCHOOL A 
BOYS ONLY
SCHOOL B 
GIRLS ONLY
SCHOOL C 
RURAL MIXED
SCHOOL D 
URBAN MIXED
- Good 0 0 . 9 0 0
- Fair 2.9 58 . 1 22 . 8 28 . 6
Poor 97 .1 40 . 0 77 . 2 71 .4
Total 100 100 100 100
As has already been indicated, males fared poorly in the 
nutrition knowledge tests hence the male school and mixed 
schools in this study had higher percentages in the poor 
knowledge categories.
There was not much difference between the performance of 
respondents in the co-educational schools in the rural area 
and that in the urban area. This indicates that in this 
study, location of school may not be a factor as to how much 
nutrition knowledge students have.
4.3.3 Sources of Nutrition Knowledge
Sources of nutrition knowledge were mainly from tutors 
(44.3%) books, pamphlets and the media (26.4%) and from 
parents (22.1%). This indicates that tutors, parents and the
71
zsx's. a crucxax rc~3 to play in the shaping of food 
behaviour of students. Irresponsible media advertisements 
could therefore be misleading and detrimental to the 
uninformed adolescent. The family also plays a vital role in 
the shaping of the food habits of its young (Uddoh, 1981) . 
Parents should therefore upgrade their knowledge in nutrition 
so that they could provide good guidance for their children. 
It is also important that tutors give accurate and practical 
information to their students because any misinformation on 
their part would lead to problems for the adolescent in 
future.
4.4 DIET QUALITY ASSESSMENT
4.4.1 Assessment of Quality of Dining Hall Meals
Using literature values, the calorie, protein, calcium
and iron contents of dining hall meals were calculated. These
are presented in table 17. (See also appendix 3).
TABLE 17: ENERGY, PROTEIN, CALCIUM AND IRON CONTRIBUTION
OF MEALS EATEN IN THE DINING HALLS PER PERSON 
PER DAY IN THE SCHOOLS
SCHOOL ENERGY
kcal
*PROTEIN
gm
CALCIUM
mg
IRON
mg
School A (Males only) 1507 25 . 9 882 22
School B (Females only) 1301 25.9 422 18
School C (Rural mixed) 1885 31.5 567 19
School D (Urban mixed) 1627 37.1 1116 55
* Corrected for N.P.U.
The figures in table 17 were used to compute the 
percentage of recommended energy and nutrient intakes provided 
by dining hall meals and presented in table 18.
72
TABLE 18: PERCENTAGE OF RNI OF ENERGY AND THREE NUTRIENTS MET
BY DINING HALL MEALS IN THE SCHOOLS STUDIED
ENERGY & 
NUTRIENTS
AGE RANGE OF 
RESPONDENTS 
(YRS.)
RNI*
PERCENTAGE RNI MET BY RESPONDENT IN 
THE SCHOOLS
A % B % C % D %
MALES
ENERGY (KCAL) 13-15 2, 900 52 , 9 65 56
16-19 3, 070 49 . 0 61 53
PROTEIN* (g) 13-15 37.0 70 85 100
16-19 38.0 68 .2 82.9 97 . 6
CALCIUM (mg) 13-15 600-700 126 81 159
16-19 500-600 176 114 186
IRON (mg) 13-15 18 122 107 307
16-19 18 122 107 307
FEMALES
ENERGY 13-15 2,490 52 76 65
16-19 2,310 56 82 70
PROTEIN* 13-15 31.0 83 .5 101.6 119 .6
16-19 30.0 86 .3 105 123 j
CALCIUM 13-15 600-700 70 81 159 |
16-19 500-600 84 114 186
IRON 13-15 24 74 80 230
16-19 24 74 80 230
1 FAO/WHO 1985
* Corrected for N.P.U.
The above figures show that the energy values of the 
meals for the day were rather low in all schools. Calcium and 
iron values were high in school D probably because of the 
predominantly cereal dishes served.
Energy values were low ranging from 49% to 65% of the RNI 
for male respondents and 52% to 82% for females respondents in 
all the schools studied. Sixteen to nineteen year old male 
respondents had the lowest energy intakes (49% of RNI) . 
Adolescents, as observed in this study, are very active and 
must therefore be provided with food to augment that given 
them in the dining halls. This low level of calorie intake
73
could jeopardize their development since it has been 
documented that nutritional deficiencies, either of individual 
nutrients or of total energy intake, retard physical growth 
and maturation (Read, 1973) . It could also be responsible for 
the loss in weight of students, usually observed when they 
return home from school. The low calorie content of the meals 
was mostly the result of the small quantity of food given to 
respondents. For those respondents who did not eat any snacks 
at school, this low calorie intake could affect their growth.
When protein values are corrected for N.P.U, 3 Schools 
(A,B & C) did not meet the RNI for protein. However, 
respondents in school C, exceeded the RNI for protein. The 
sources of protein in the meals were mainly from legumes and 
cereals. Very little animal protein if any was served in the 
dining halls.
The calcium and iron values in all the schools were high 
except in the exclusively female school and the urban mixed 
school where levels were below the RNI. The high values of 
calcium and iron were due to the predominantly cereal and 
legume diets of those schools. However cereals and legumes 
are known to contain phytates which often make calcium and 
iron unavailable to the body (Bingham^ 1978) Even though 
calcium and iron values were high, some of it may not be 
available for use in the body.
Looking at the overall picture of nutrients provided by 
the schools studied, it could be said that except for energy.
74
all the schools provided more than 2/3 of the recommended 
nutrient intakes for protein, calcium and iron. According to 
Gibson, (1989) this would be regarded as adequate since RNI of 
all nutrients are inflated to cater for individual 
differences. She however, cautioned that the more habitual 
the low intakes and the longer the duration, the greater the 
risk of nutrient deficiency.
Since the quality and quantity of the meals eaten by 
respondents remain the same throughout the term, the 
respondents may be at risk.
4.4.2 Nutritional Contribution of Foods Eaten Outside the 
Dining Hall
Literature values obtained from the 3 day estimated 
food records were used to calculate the means and standard 
deviations for energy, protein, calcium and iron. The values 
obtained are shown in table 19.
75
TABLE 19: MEAN INTAKES OF CALORIES, PROTEIN, CALCIUM AND
IRON OBTAINED FROM FOODS EATEN OUTSIDE THE DINING HALLS
SCHOOL AND GENDER ENERGY
Kcal
PROTEIN
gm
CALCIUM
mg
IRON
mg
School A (Males only) 
School B (Females only) 
School C (Rural mixed) 
School D (Urban mixed) 
Males of Total Sample 
Females of Total Sample
8 53 ±2 6 8 *
732±319
912±4 6 9
953±383
887+359
882+406
22 ± 13* 
17 ± 8 
24 ± 12 
26 ± 19 
22 ± 11
23 ± 15
383±183*
374±187
543±366
321+218
419±3 93
446+282
5 ± 2* 
5 ± 3 
9 ± 5
5 + 2
6 + 3 
6 ± 4
* Standard deviations from mean.
Respondents in the two co-educational schools have higher 
intakes of most of the nutrients than respondents from the 
single sex schools. The exclusively girls school (B) had the 
lowest mean energy intake. Respondents in the co-educational 
schools ate mostly 'gari' and foods sold by food vendors in 
the schools hence, the nutrients provided by the meals eaten 
outside the dining hall were higher. In school (B) for 
example, market facilities were not available for respondents 
to buy food to supplement dining hall intakes and therefore 
meals eaten outside the dining hall comprised, biscuits, 
bananas and groundnuts. Hence the low calorie contribution of 
such meals.
Respondents in this school said they received food from 
home frequently but they were unable to estimate the 
quantities they really ate because they shared the food with 
their friends. Consequently, these were not included in the
76
estimates of quantities of food consumed outside the dining 
hall. It is obvious than that their intakes would be more 
than what has been reported here.
4.4.3 Total Estimate of Energy and Nutrient Intakes of 
Respondents
Total daily estimates of Energy and the other nutrients 
was computed by adding values obtained from dining hall meals 
to that eaten outside the dining hall. This is presented in 
table 20.
TABLE 20: MEANS AND STANDARD DEVIATION OF TOTAL DAILY
ENERGY, PROTEIN, CALCIUM AND IRON INTAKES OF RESPONDENTS
SCHOOL AND GENDER ENERGY
Kcal
PROTEIN
g
CALCIUM
mg
IRON
mg
School A (Males only) 2360±268* 59 ± 13* 12 65 + 183*'
*
27±2
School B (Females only) 2033+219 5 4 + 8 778±177 21±3
School C (Rural mixed) 2845±469 70 ± 12 1124+363 28+5
School D (Urban mixed) 2580+383 79 + 19 1437+212 60±2
Males of total Sample 2 611±3 58 68 ± 14 1274+260 36+14
Females of total Sample 2379±479 64 + 17 1073+377 35+25
* Standard deviation
Values given in Table 20 still show that there is some 
deficit in the calorie intakes of respondents. Mean calorie 
intakes are lowest for fifteen to nineteen year old females, 
when compared with the FAO/WHO (1985) recommended intakes.
77
The male respondents had higher energy protein, calcium 
and iron intakes than the female respondents. This was 
because male respondents consumed larger quantities of heavier 
meals and not the chocolate and biscuit type of snacks eaten 
by the females.
This finding seems to support that of Atkinson and Wyn- 
Jones, (1972) who also found that, male adolescents had higher 
nutrient intakes than the females indicating that adolescents 
seem to have similar behaviour across countries. The low 
calorie intakes of adolescents in this study seem to suggest 
a need for serious attention concerning the deficiency 
especially since Dowuona-Hammond, (1978) and Agyeman Mensah, 
(1980) also found in their studies in Ghana, that students did 
not meet the FAO/WHO recommended intakes for calories. The 
attendant hunger associated with the small amounts of food 
served in the dining halls could lead to apathy, inability to 
pay attention, disruptive behaviour patterns and over concern 
about food (Read, 1973). This could adversely affect 
learning.
4.4.4 Percentage of Daily Intake of Energy, Protein,
Calcium and Iron Provided by Meals Eaten Outside the 
Dining Halls
The percentage of the daily energy, protein, calcium and 
iron intake provided by meals eaten outside the dining halls 
was assessed and shown in Table 21.
78
TABLE 21: PERCENTAGE OF DAILY INTAKE OF ENERGY AND THREE
NUTRIENTS PROVIDED BY MEALS EATEN OUTSIDE DINING HALLS
SCHOOL TYPE AND GENDER ENERGY
%
PROTEIN
%
CALCIUM
a,
"O
IRON
a.
"o
School A (Males only) 37 38 30 18
School B (Females only) 36 31 48 17
School C (Rural mixed) 32 53 48 30
School D (Urban mixed) 37 33 22 8
Males of total Sample 33 32 33 15
Females of total Sample 37 35 43 16
It is clear from the table that meals eaten outside the 
dining hall provided a significant proportion (over one-third) 
of the total daily intakes of energy and the nutrients 
assessed except for iron which is 18%.
The choices that the respondents make, as far as between 
meals foods are concerned, are crucial in their total nutrient 
intake. Since parents of most of the respondents are highly 
educated, it is expected that food habits of the respondents 
would be good. On the contrary this was not evident in the 
types of snacks they chose.
4.4.5 Percentage of Respondents Who Did Not Meet the
Recommended Intakes of Energy, Protein, Calcium and 
Iron
Table 22 shows the percentage of respondents who did not 
meet the RNI for energy and the selected nutrients evaluated. 
These percentages were arrived at by taking the number of 
respondents whose nutrient intakes fell below the RNI in each 
school and for each gender, as a percentage of the total 
number of respondents in the school and for each gender.
79
TABLE 22: PERCENTAGE OF RESPONDENTS WHO DID NOT MEET
THE RNI OF ENERGY, PROTEIN, CALCIUM AND IRON 
BY SCHOOL TYPE AND GENDER
SCHOOL TYPE AND GENDER 
OF RESPONDENTS
ENERGY
%
PROTEIN
%
CALCIUM
%
IRON
%
School A (Males only) 100 0 0 0
School B (Females only) 89 . 6 0 0 86.2
School C (Rural mixed) 35.4 0 0 0
School D (Urban mixed) 48 0 0 0
Males 49.3 0 0 0
Females 42 . 5 0 0 34.2
As evident in Table 22, none of the respondents in the 
all males school, met the RNI for energy. Over 3/4 did not 
meet it in the all females school and about 1/3 of the 
respondents in the mixed schools did not meet the RNI for 
energy. All respondents met the RNI for protein and calcium. 
Eighty-two percent females in school B did not meet their iron 
requirements inspite of the extra meals they ate outside the 
dining halls. The data further emphasise that a large 
proportion of respondents experience energy shortages. The 
exclusively male and female schools tend to suffer most. It 
is also important to note that a large proportion of the 
females did not receive adequate amounts of iron which should 
be a cause for concern for those who feed adolescent females 
in order to avert iron deficiency anaemia which has been found 
to be particularly widespread in developing countries among 
women of reproductive age (DeMaeyer & Adiels - Tegman, 1985).
80
4.4.6 Respondents' Comments About Dining Hall Meals
When respondents were asked whether their dining, hall
meals were adequate or inadequate, over 57% said their meals
were inadequate.
When asked to comment or give reasons why they said the
meals were inadequate, comments shown in Table 23 were given.
TABLE 23: PERCENTAGE DISTRIBUTION OF RESPONDENTS COMMENTS
ABOUT DINNING HALL MEALS
COMMENTS % OF RESPONDENTS
Quantity is too small. 63.5
Food not tasty. 48 . 5
Meals are monotonous. 45 . 0
Food is not clean. 14 .2
Food contains too much 
carbohydrate and little protein. 13 .5
Sanitary conditions around the 
kitchen are poor. 11 .3
Food is sometimes not well cooked. io. e
No response. 10 . 6
The most common reason given for the inadequacy of dining 
hall meals were the quantity being too small, the food not 
being tasty and the food being monotonous. Only a few
students (14.2%) considered the nutritional value of the 
meals.
Certainly, these are clear reasons why students' intake 
of nutrients were low. Since only few of them considered the 
nutrient content of the meals, it reflects their nutrition
81
knowledge as well. It must be emphasized that it is only when 
students are able to relate their food intakes to their
general health and well being, that the nutritional
considerations for eating food would outweigh considerations 
of palatability and likes or dislikes.
4.5 GROWTH PERFORMANCE OF THE STUDENTS
4.5.1 Anthropometric indices of height-for-age and weight- 
for-height were used to measure the growth performance of the 
study group. Weights and heights were compared with Jellife 
et al.'s, (1989) reference data and Fiawoo's weights for urban 
adolescents. Kaufman's weight classification was also used to
classify the students into various weight categories. The
Body Mass Index (BMI) was employed to classify respondents as 
normal, overweight or underweight.
4.5.2 The mean weights and heights of respondents were
compared with Jellife et al.'s anthropometric reference data
(1989) and presented in Table 24.
82
TABLE 24 : COMPARISON OF MEAN WEIGHTS AND HEIGHTS OF
RESPONDENTS
WITH JELLIFE'S REFERENCE DATA*
AGE
(YEARS) NO. OF 
RESPONDENTS
WWEIGHTS HEIGHTS j
MEAN WEIGHT OF 
RESPONDENTS 
(kg)
JELLIFES 
REF. MEAN 
WEIGHT 
(kg)
MEAN 
HEIGHTS OF 
RESPONDENTS 
(CM)
JELLIFFE'S 
REF. MEAN 
HEIGHTS 
! (CM)
FEMALES
15 16 5Q .6 53 .7 160.7 161.8
16 26 52 .2 55 . 9 160. 9 162.4
17 17 59.2 56 .7 160 . 8 163 .1
18 14 55.4 56 .6 163 .9 163 .7
MALES
15 2 63 .5 56.7 171.2 169.0
16 19 59.4 62 .1 168 .4 173 .5
17 21 61.0 66.3 172 . 7 176.2
18 25 61.2 68 . 9 171.4 176.8
* Source: Jellife et al., 1989
The weight range of the male respondents was between 3 8kg 
and 91kg and for the female 34kg and 93kg. These extremes in 
weights were not taken into consideration in calculating the 
mean because the figures would unnecessarily inflate or 
deflate the average weight of respondents. In order to show 
a clearer comparison of weights and heights, bar graphs are 
used.
83
- 0 r-AGE O P  FEMALE
RESPONDENTS COMPARED WITH JELLIFE’S REFERENCE
6 0 -
15 16 17 18
age  in years
y'jj Weight o f respondents H  Jellife's reference weight
flS HEIGHT FOR AGE O P. FEMALE 
RESPONDENTS COMPARED WITH JELLIFE’S REFERENCE
164
163 -
EoV-/
■*—
-CO)
CDH
coa)
£
162
161
160
16 17
ag© in years
Height of respondents Jellife's reference height
m
ea
n 
he
ig
ht
 (
cm
)
r ^ ' i f
. : r  for  age  o  p  male
RESPONDENTS COMPARED WITH JELLIFE’S REFERENCE
O)
szO)
©
£
co
0
E
6 9 -
68 -
6 7 -
6 6 -
6 5 -
6 4 -
6 3 - V /
6 2 -  
61 - & 
’ /  <
6 0 - 1 r , 
r U
5 9 -
5 8 -
> i
r r  (  %\
y:\
5 7 -
5 6 -
V  "
■
f <  V  
' i ’ l r 'A  
i ' / /pH]
f  i  ' i
15 16
rV'
V'l<<'!
/ "< I
',nY
17
' €. 
Mf ,J 
n <rJ
18
age  in years
1 Weight o f respondents Jellife's reference weight
, HEIGHT FOR AGE O P  MALE 
RESPONDENTS COMPARED WITH JELLIFE’S REFERENCE
1 78 -
177 
1 7 6 -  
175 
174 
173 
172 — 
171 -  
170 —
169-
168-
n > </
h
'M, l] 
«/, i
l i H f
,11
tv?
fefli
v.y-
V ,
16 17
age In years
18
(1 lV Respondent heights Jellife's reference heights
From Fig. 1, it is observed that the younger age groups 
fell well below Jellife's reference group. However, for the 
older females especially the 17 year olds, the mean weight- 
for-age was higher than Jellife's reference, suggesting 
probably a catch up growth. The heights also showed similar 
trends. It was therefore evident that the majority of 
respondents have weights-for-age and heights-for-age which 
were below that of the reference group, an indication that 
they were not following their normal growth.
The below average growth performance as represented by 
weights and heights of most of the respondents, especially the 
low weight-for-age, could be attributed to their low energy 
intakes. The majority of male respondents seem to be below 
the reference group (fig 3) . This is cause for concern 
(especially when no catching up growth occurred among the
older ones) if our males should reach the standard weights and
%
heights expected of them.
4.5.3 Use of Kaufman and Co-Worker's Criteria to Classify 
Respondents as Underweight, Normal, Overweight and 
Obese
The study looked at the occurrence of underweight, 
overweight and obesity among respondents using the 
classification employed by Kaufman and co-workers (1975). It 
stated that if the relative weight of the respondent is 91- 
110% of the standard or reference weight, the individual has 
normal weight.
86
111% 120% is overweight
121% and above is obese 
below 91% is underweight.
The percentages were calculated for each student using 
Jellife's standard as follows
____ Respondent' s weight__________ x 100
Jellife's standard weight-for-age 
Table 25 gives the percentage distribution of respondents 
under the various classifications.
TABLE 25 : CLASSIFICATION OF RESPONDENTS INTO 
VARIOUS WEIGHT CATEGORIES (IN PERCENTAGES)
STUDENT AND SCHOOLS KAUFMAN'S CLASSIFICATION
UNDER­
WEIGHT 
90% OF 
REF
NORMAL 
91-110% 
OF REF.
OVER 
WEIGHT 
111-120% 
OF REF.
OBESE
120%
OF REF.
All Students 23.6 61.4 8 . 6 6.4
All Males 24.2 65 . 2 9.1 1.5
All Females 23 . 0 58 .1 8 .1 10.8
School A (Males only) 40.0 51.4 8 . 6 0
School B (Females only) 22 . 9 57 .1 8 . 6 11.4
School C (Rural mixed) 40 . 0 51.4 5 . 7 2.9
School D (Urban mixed) 5 . 8 51.4 11.4 11.4
* Source: Jellife et al., (1989)
Nearly two-thirds of the respondents (61.4%) were of 
normal weight according to Kaufman's classification. However, 
quarter were underweight. More of the underweight respondents 
were found in the exclusively boys' school and rural mixed
87
school. Even though the respondents in the rural mixed school 
had one of the highest calorie intakes, a lot more of them 
classified as underweight probably because they might have 
come from poor homes and hence might have been underweight, 
before coming to school. The percentage of underweight 
respondents by this classification seems to confirm the 
earlier indication of low calorie contents of the total daily 
meals consumed.
4.5.4. Body Mass Index (BMI)
Table 26 gives the percentage distribution of respondents 
in the various classifications using the body mass index. To 
calculate the BMI, the formula below was used. 
wt (kg) = BMI 
height2 (m)
The BMI for each respondent was calculated and the results 
categorised into the following:
20 and below = Underweight 
20 25 = Normal Weight
26 - 3 0 = Overweight 
3 0+ - Obese
88
TABLE 26: PERCENTAGE DISTRIBUTION OF RESPONDENTS BY
THEIR BODY MASS INDEX
RESPONDENTS GENDER AND 
SCHOOLS
UNDER
WEIGHT
BMI
20
NORMAL 
WEIGHT 
BMI = 
20- 25
OVER­
WEIGHT
BMI
25-30
OBESE
BMI
>30
Total Sample 42 . 9 50 . 7 5 . 0 1.4
All Males 44 . 2 53 . 8 1.5 1.3
All Females 40 . 0 49.0 9 . 3 1.7
School A (Males only) 51 . 4 48 . 6 0 . 0 0.0
School B (Females only) 37.1 54 .3 8 . 6 0 . 0
School C (Rural mixed) 54 .3 42 . 9 2 . 8 0 . 0
School D (Urban mixed) 28 . 6 60 . 0 8 . 6 2 . 8
About one half of the sample (50.7%) could be classified 
as of normal weight. This is almost similar to what was 
obtained using Kaufman's classification. However, in using 
the BMI, the proportion of underweight respondents seem to be 
high (42.9%). This probably indicate that some respondents 
were indeed not meeting their daily calorie needs as was 
evident in table 19.
It looks like the BMI gave a better picture of the 
respondents growth performance especially because it was 
arrived at using the weight and height of the respondents and 
did not depend on any standard.
4.5.5 Weights and Heights of Respondents Compared with Those 
recorded by Fiawoo
The weights and heights of the respondents were compared 
with those recorded by Fiawoo as quoted by Kpedekpo. The
89
original weights and heights recorded were in pounds and 
inches. These have been converted into kilograms and 
centimetres.
TABLE 27: COMPARISON OF MEAN WEIGHTS AND HEIGHTS OF STUDENTS
WITH THOSE RECORDED BY FIAWOO
WEIGHTS(kg) HEIGHTS(cm)
AGE MEAN WEIGHT RECORDED BY MEAN HEIGHT RECORDED
(YEARS OF
RESPONDENTS
FIAWOO* OF
RESPONDENTS BY * FIAWOO
FEMALES
15 50 . 6 47 . 2 160.7 159 .4
16 50.2 49.1 160 . 9 161.5
17 59.2 53 . 9 160 . 8 164.8
18 55.4 57 . 7 163 . 9 167.7
MALES
15 63.5 41. 8 171. 2 158 .3
16 59.4 46 . 6 168 .4 160.7
17 61. 0 50 . 6 172 . 7 165.6
18 61.2 55 . 0 171 .4 169.3
OUXGe,’, *Fiawoo as quoted by Kpedekpo (197 0)
Bar charts are used to givge a clearer presentation of 
the comparisons.
,, ~DR AGE OF FEMALE
RESPONDENTS COMPARED WITH FIAWOO’S REFERENCE
a>
-C
i?
0
£
age in years
•'< Respondents weight Fiawoo's recorded weight
HEIGHT FOR AGE OF FEMALE
RESPONDENTS COMPARED WITH FIAWOO’S RECORDED HEIGHT
Eov-'
£g>
0
JZ
16 17
age in years
Respondents height Fiawoo's recorded height
BORAGE O F  MALE
RESPONDENTS COMPARED TO FIAWOO’S RECORDED WEIGHT
nD)
©
5
age  in years
fH*! Respondents weight £  Fiawoo's recorded weight
P H .  s .  HEIGHT FOR AGE O P  MALE
RESPONDENTS COMPARED TO FIAWOO’S RECORDED HEIGHT
173
172
171
170
169
168
167
166
£
o 165v—'
£ 164
a>
163
■C
162
161
160
159
158
157
<!\\ Respondents height { j  Fiawoo's recorded height
age in years
When the mean weights and heights of the respondents were 
compared with those recorded by Fiawoo as quoted by Kpedekpo 
(1970) (See Appendix 4), the values for the study group, were 
higher (Table 28 and Figs 5-8). Tanner, (1981), has pointed 
out that children have been getting bigger and growing to 
maturity more rapidly than before, a phenomenon known as the 
secular trend. Weights of respondents in the present study 
taken two decades later are generally higher especially for 15 
year olds even though the growth performance of the study 
group was found to be below that of Jellife's reference group. 
Heights for the 16,17 and 18 year old females however, was 
seen to be below Fiawoo's group, probably because of previous 
nutritional status. Nevertheless, there seems to be gain in 
weight and height among adolescents over the years probably 
reflecting improvement in nutrition generally. If Ghanaian 
adolescents should grow up to reflect weights and heights 
comparable to reference standards, there would be the need for 
improvement in the quality and quantity of meals prepared in 
the school dining halls, since most adolescents spend a 
significant period of their growing years in school. This 
calls for vigilance and honesty on the part of the college 
bursars and the domestic bursars so that every cedi paid as 
fees is utilised judiciously for the benefit of the students.
4.5.6 Student's Perception of Themselves
The respondents' perception of themselves with regards to
93
being either overweight or underweight is summarised in tables 
28 and 29.
TABLE 28: DISTRIBUTION OF RESPONDENTS ACCORDING TO THEIR
PERCEPTION OF THEIR BODY WEIGHTS
RESPONSE OVERWEIGHT % UNDERWEIGHT %
Yes 10 . 7 45.7
No 85 . 0 43 . 6
No Response 4 . 3 10.7
TOTAL 100 100
TABLE 29: RESPONDENTS' WISH TO LOSE OR GAIN WEIGHT
RESPONSE TO LOSE WEIGHT % TO GAIN WEIGHT %
Yes 11.4 42.1
No 37.2 25 . 7
No Response 51.4 32 .2
TOTAL 100 100
Whereas an earlier classification (table 26) showed that 
15% of the sample was overweight and obese only 10.7% of 
respondents perceived themselves as being overweight. Even 
though Kaufman's classification showed it was found that 23.6% 
were underweight, (table 25,)>the 45.7% perceiving themselves as 
underweight seem to be close to the percentage found using the 
Body mass index (42.9) . The BMI probably gives a better 
picture since respondents themselves felt that they were 
underweight. Some of those who were really overweight did not 
see themselves as such. This was probably due to the cultural
94
dimension to the perception of overweight. A 
regarded not as overweight but perceived as 
living or richness. Maybe this also accounts 
respondents wishing to gain weight.
plump figure is 
a sign of good 
for many of the
95
SUMMARY
The purpose of this study was :
To examine the food habits of the respondents.
To find out the nutrition knowledge of the 
respondents and the sources of such knowledge.
To evaluate the energy and nutrient content of 
the meals eaten in the dining halls and to 
ascertain their adequacy.
To estimate the energy and nutrient 
contributions of meals eaten outside the 
dining halls.
To compare the contribution of school meals to 
the total daily energy and nutrient intake of 
the respondents with the contributions of 
meals obtained from other sources.
To measure the growth performance of the 
respondents.
The population comprised of adolescents between fifteen 
and nineteen years in secondary schools with boarding 
facilities. Four schools were selected from a list of schools 
supplied by West African Examinations Council (W.A.E.C.) using 
the lottery method. In each of the selected schools, thirty- 
five form four students were selected from their class list 
using simple random sampling.
CHAPTER FIVE
96
Instruments used for collecting the data included : 
Questionnaire.
Anthropometry.
Dietary records.
Observations.
The questionnaires were given to thirty-five students in 
each of the schools and their weights and heights were taken. 
A three-day estimated food intake record sheet was given to 
each student to complete. Foods eaten in the dining halls 
were also weighed.
Descriptive analysis and cross-tabulations were used for 
the analysis. Anthropometric indices of height-for-age and 
weight-for-age were used to describe the growth performance of 
the study group. Kaufman's weight classification and Body Mass 
Index were also used to classify students as normal, 
overweight, obese or underweight.
Forty-eight per cent of the students were males and 52% 
were females. The mean age of the students was sixteen years 
and about 90% came from homes where parents were highly 
educated and gainfully employed.
The results showed that about two-thirds of the students 
ate three meals both at home and at school. There was a wide 
variety in the types of meals eaten for breakfast, lunch and 
supper. These meals were mainly cereal dishes like boiled 
rice, 'kenkey' and 'banku', which were made from the staple 
foods available in the study area.
97
The students liked a wide variety of both local and 
foreign foods. More females than males said they liked toffee 
and alcoholic beverages very much. Students preferences for 
foods were reflected the type of meals they consumed.
Most students took nutrient supplements daily or a few 
times a week. It was found that the students skipped meals 
both at home and in school.
All respondents ate snacks in school and at home. More 
females than males ate two or more snacks daily. Foods mostly 
eaten between meals were soft drinks, pies, fruits, 'gari' and 
'shitto’, sweets and chocolate.
Respondents demonstrated a poor understanding and 
awareness of the basic principles of nutrition. Sources of 
nutrition knowledge for most respondents were from tutors, 
books and magazines, the media and parents.
The dietary analysis showed that meals served in the 
dining halls in all the four schools did not meet the 
Recommended Nutrient Intakes (RNI) for energy. Protein values 
exceeded the RNI in all the schools except for school A (males 
only). But when corrected for N.P.U. the values for schools 
B (Females only) and C (Rural mixed) fell below the RNI. 
Calcium and iron levels were also exceeded except for school 
B (Females only). None of the schools served fruits as part 
of their meals. The majority of the students described dining 
hall meals as inadequate.
Nutrients provided by meals eaten outside the dining 
halls supplied about one-third of the total daily intake of
98
calories, protein and calcium. It also provided about twenty 
per cent of the daily iron .'intake. The mean daily intakes of 
these nutrients were higher for the male students than for the 
female students.
When compared with the FAO/WHO, (1985) nutrient intakes 
mean intakes of calories were very low for fifteen to nineteen 
year old males and fifteen year old females. For all other 
nutrients assessed, the mean intakes exceeded the RNI.
The weight and height measurements were used to assess 
growth performance. In comparing mean weights of the students 
with Jelliffe's et al. , reference data (1988), distinct 
differences were found in the mean body weights. Female 
respondents had lower mean body weights at all ages except at 
fifteen years. The male students also, fell slightly below the 
reference group at all ages except at fifteen years. By 
Kaufman et al.'s (1975) criterion, most of the students (61 
per cent) were of normal weight. Occurrence of overweight was 
more among the female students than the male students and the 
prevalence of underweight was more evident than overweight in 
the sample. When the Body Mass Index (BMI) was used, 43% of 
the respondents were underweight and five per cent overweight.
When the mean weights and heights of the students were 
compared with those recorded by Fiawoo as quoted by Kpedekpo 
(1970), the present samt)l 2 were generally taller and heavier 
than their age matas in that study. Female respondents 
however were shorter at 17 and 18 years.
99
CHAPTER SIX
CONCLUSIONS
The following conclusions have been drawn based on the
findings of this study.
1. Some characteristic features of the eating habits of the 
students studied included breakfast skipping and regular 
snacking.
2. Drug-related habits like alcohol intake seems to be 
practiced among the study group and the majority were 
taking nutrient supplements.
3. Nutrition knowledge of the respondents was poor.
4. Meals served in the dining halls of all the schools was 
not enough to satisfy the energy requirements of the 
adolescent respondents and even when they supplemented 
the dining hall meals with extras from elsewhere, the 
calories obtained were still below the RNI especially for 
the sixteen to nineteen year old males. Thus the 
weights of the majority of this age group was below 
Jellife's reference group. Iron levels were also low. 
However all other nutrients assessed were adequate.
5. The growth performance of the majority of the students 
was poor and this may be attributed to their diets which 
did not meet the RNI for energy. The respondents 
obtained about one-third of their daily nutrient intakes 
from the extra food they ate outside the dining halls.
100
6. It was apparent that food eaten outside the dining hall 
meals made an immerse contribution to the total nutrient 
intake of the respondents. Respondents who do not take 
food or money to school stand at a disadvantage and this 
must be closely looked at.
101
RECOMMENDATIONS
From the foregoing conclusions it is recommended that:
1. Since students were found to miss meals in the dining 
halls, school authorities would have to ensure that there 
is enough discipline in the schools so that students 
patronize dining halls meals. At the same time the 
quantity and quality of meals must be improved. Students 
should be allowed to form committees to monitor the 
planning and preparation of their meals.
2. The energy content of the dining hall meals were low 
because of the quantities given to the students. The 
schools should discourage breakfasts that consists of a 
beverage and bread because this meal provide very little 
energy. The quantity of bread ought to be increased 
above what is given currently, to increase the energy 
value of breakfast.
3. The poor growth performance of the study group needs to 
be addressed. Heads of boarding schools may have to 
apply for food aid to supplement what the fees can buy as 
an interim measure and then embark on some farming 
activities to help provide more food for the students.
4. Parents would have to continue to provide their wards 
with extra food and pocket money, if they want them to be 
well nourished, until such time that the quality and 
quantity of meals in the school are improved.
CHAPTER SEVEN
102
The nutrition knowledge of the students was found to be 
poor. Teachers, parents and the mass media have a task 
of helping adolescents to improve their knowledge in 
nutrition. Nutrition lessons should be taught using the 
integrated approach so that individuals can easily link 
it with health. It is a subject that must be lived and 
not just learnt to pass an examination. It must be 
taught in all subject areas and taught to all students 
irrespective of gender.
Since students depend on food vendors around their 
campuses for some of their meals, the latter must be 
screened by the school authorities so that food brought 
to the schools for sale would be wholesome.
The sanitary conditions of some of the kitchens was poor. 
Kitchens and dining halls need to be insect proof.
Since this study investigated the food habits adolescents 
in boarding schools, it is suggested that a further study 
be carried out using adolescents who are day students and 
those who are not in school to find out whether their 
eating habits are different and whether their nutrient 
intakes are adequate. Assessment methods like clinical 
observations and laboratory tests and skinfolds 
measurements which were not used in this study should be 
employed, in combination with the diet survey to get a 
more accurate assessment of their nutritional status. 
The alcohol intake of female students also need further 
investigation.
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Ill
APPENDIX 1
PERCENTAGE DISTRIBUTION OF RESPONDENTS ACCORDING TO 
THE DEGREE OF PREFERENCE OF SELECTED FOODS
FOOD NO RESPONSE LIKE VERY 
MUCH
DISLIKE NEVER EATEN
Animal
Products
Beef 1.4 78.6 19.3 0.7
Mutton 5.0 60.0 26.4 8.6
Pork 2.1 52 . 9 34 .3 10.7
Chicken 4.3 84 .3 10 . 7 0 . 7
Turkey 5.0 63 .6 26.4 5 . 0
Bush Meat 4.3 38 . 6 39.3 17.9
Corned
Beef 8.6 72.1 17.1 2 .1
Sardine 7.9 69.3 21.5 1.4
Eggs 6.4 85.0 8 . 6 0
Milk 6.4 80 13.6 0
Cheese 2 . 9 55 35.7 6.4
Legumes
Beans 5.7 42 . 9 43 .6 7.9
Groundnut 7.1 52 .1 40 0.7
Bambara
Beans 4.3 32.9 40 . 7 22 . 1
Soya Bean 7.1 31.4 37 . 9 23 . 6
112
APPENDIX 1 (CONTD.)
FOOD NO
RESPONSE
LIKE VERY 
MUCH
DISLIKE NEVER EATEN
Starchy roots 
and Plantain
Plantain 5.0 69.3 23 . 6 2.1
Cassaya 7.9 42 . 9 47.2 2.1
Cocoyam 4.3 43.6 50.7 1.4
Sweet
Potato 6.4 72 . 9 18.6 2.1
Yam 2.9 79.3 17.9 0
Water yam 6.4 19.3 52 . 9 12 .4
Fruits
Orange 3.6 84 .3 12.1 1.4
Pineapple 2.1 85.7 12.2 0
Pawpaw 2 . 9 50.7 42.1 4.3
Mango 4.3 62 .1 32 .9 0 . 7
Watermelon 4.3 52 .1 38.6 5.0
Banana 3.6 69.3 26 .5 0.7
Vecretables
Garden Eggs 5 . 0 54 .3 40 . 0 0.7
Okro 5 . 0 59.3 35.7 0
Kontomire
Leaves 2.9 72 .1 24 .3 0.7
Cabbage 7 .1 65 . 0 26.4 1.4
Lettuce 7 . 9 55.7 26.5 10 . 0
Cucumber 7.1 40.7 36.5 15.7
113
APPENDIX 1 (CONTD.)
FOOD NO
RESPONSE
LIKE VERY 
MUCH
DISLIKE NEVER EATEN
Veaetables 
(Contd.)
Carrots 5.7 57.9 28.6 7.8
French
beans 8.5 36.4 32.2 22.9
Fats and 
Oils
Groundnut
oil 6.4 23 . 6 54.3 15.7
Palm Ker­
nel oil 0.7 25 . 0 55.7 8.6
Refined
vegetable
oil 8 . 6 62 . 8 25.0 3.6
Margarine 2.9 65.7 29.2 2.2
Butter 3.6 65.7 27 . 9 2.8
Palm oil 5 . 0 68.6 25.7 0.7
Cereals
Corn 10.7 44 . 3 44.3 0.7
Rice 7.1 80 .7 12 .1 0
Wheat 7 . 9 43 . 6 47.2 1.4
Oats 7.9 66.4 21.5 4.3
Millet 8.6 17.1 42 . 9 31.4
Sorghum 7 .1 14.3 42.8 35.7
114
APPENDIX 1 (CONTD.)
FOOD NO
RESPONSE
LIKE VERY 
MUCH
DISLIKE NEVER EATEN
Miscellaneous
Toffee 4.3 60.0 35 . 0 0.7
Chocolate
bar 3 . 6 75.0 20 . 7 0.7
Jam/
Marmalade 5.0 59.3 27.1 8 . 6
Coffee 3 . 6 37 . 9 52.8 5.7
Tea 5.0 75.7 17.8 1.5
Milo 2 . 9 67.9 8.6 0.6
Corn Flakes 2 . 9 67.1 25.0 5 . 0
Alcoholic
Beverages 7.9 15 47.1 3.0
Soft drinks 2 . 9 82 .1 14.3 0.7
115
APPENDIX 2 
PERCENTAGE DISTRIBUTION OF FREQUENCY OF 
FOOD CONSUMPTION
food ite m NO
RESPONSE
DAILY A FEW 
TIMES 
A WK.
FORTH- 
NIGHTLY
MONTHLY SEASO­
NALLY
NEVER
Animal
Products
Meat 2.9 26 .4 62 . 8 2.9 36 0 . 7 0.7
Corned
beef 2 . 9 5 . 0 40.0 16 .4 12.1 20.7 2 . 9
Fish 2 . 9 67.9 26.4 1.4 0.7 0.7 0
Sardine 3.6 12.1 72 .2 2.1 3.6 4.3 2 .1
Eggs 1.4 27.1 62 .2 2.1 2.1 4.3 0.7
Milk 4.3 57. 9 30.7 1.4 1.4 4.3 0
Chicken 4.3 5.7 42.2 12 . 9 16.4 16.7 2.9
Cheese 5.0 10.0 42.8 10.7 6.4 14 .3 10.7
Leerumes
Beans 2 .1 17 .1 61.4 7.1 2.1 2 .1 7.9
Ground­
nuts 2 . 9 13 . 6 60 . 7 7 .1 5.0 6.4 4 . 3
Bambara
beans 6.4 2 . 9 27 . 1 6.4 9.3 17.1 30.7
Soybeans 6.4 1.4 22.1 3 . 6 14 .3 10 . 7 31.4
116
APPENDIX 2 (CONTD.)
FOOD ITEM NO
RESPONSE
DAILY A FEW 
TIMES 
A WK.
FORTH- 
NIGHTLY
MONTHLY SEASO­
NALLY
NEVER
Cereals
Corn 2.9 35 . 7 49.2 2 . 9 3 . 6 2 . 9 2 . 9
Rice 1.4 42 . 9 54.3 0.7 0 0 . 7 0
Bread 3.6 52 .9 40.7 1.4 0 . 7 0.7 0
Millet 4.3 4.3 24 . 3 5.7 5 . 0 19.3 37 .1
Sorghum 7.9 2 . 9 18.5 4.3 4.3 15 . 0 47.1
Plantain 
and Starch 
roots
Plantain 3.6 10 . 7 67.9 5 . 0 2.9 7.1 2.9
Cocoyam 5.0 5.7 42 . 9 12.9 7.1 20 . 0 6.4
Sweet
potato 2.9 5.7 42 . 9 11.4 12 . 9 21.4 2.9
Yam 2.1 15 . 0 59.0 7.1 5.0 7.9 3.6
Wateryam 9.3 2 .1 25 . 7 8.6 4.3 16 .4 33 . 6
Cassava 5.7 9.3 55.7 5.7 8.6 8 . 6 6.4
Fruits & 
Veaetables
Banana 1.4 25 . 7 49 . 3 1.4 4.3 5.7 2 .1
Orange 3.6 25 . 0 57 . 8 2.9 3 . 6 6.4 0.7
Pineapple 5.7 12 . 1 51.4 8.6 7.9 12 . 9 1.4
Pawpaw 7.9 7.1 35.0 5.0 5.7 26.4 12 . 9
Mango 7.9 13 . 6 30 . 0 1.4 7.9 33 .6 5.7
117
APPENDIX 2 (CONTD.)
food it e m NO
RESPONSE
DAILY A FEW 
TIMES 
A WK.
FORTH- 
NIGHTLY
MONTHLY SEASO­
NALLY
NEVER
Water­
melon 5.0 8.6 25.7 7.1 9.3 28.6 15.7
Garden
eggs 5.0 7.9 55.7 6.4 10.0 10.7 4.3
Kontomire 7.9 8.6 67.8 5.7 4.3 4.3 1.4
Okro 4.3 7.9 57.1 10.0 9.3 7.9 3.6
Fats and 
Oils
Ground­
nut oil 7.9 18.6 45.0 12.1 4.3 9.3 12.9
Coconut
oil 13.6 5.0 35.0 7.1 7.9 13.6 17.9
Palm
Kernel
oil 10 . 0 5.7 35.0 10.0 5.7 13.6 20.0
Refined
vegetable
oil 11.4 20.7 50.7 4.3 4.3 5.0 3.6
Margarine 5.0 25.7 5 . 0 7.9 7.9 3 . 6 2.1
Butter 9.3 20.0 47.1 6.4 6.4 4.3 6.4
Palm oil 9.3 17.9 60.0 5.7 3.6 2 .1 1.4
Miscella­
neous
Toffee 4.3 20.7 55 . 0 5.7 4.3 6.4 3.6
Choco­
late 5 . 0 15 . 0 55 . 7 7.9 5 . 0 8.6 2 . 9
Jam 5.7 13 . 6 40 . 7 9.3 7 . 1 15 . 7 7.9
Coffee 7 . 9 10.0 37.2 6.4 3 . 6 13 . 6 21.4
118
APPENDIX 2 (CONTD.)
FOOD ITEM NO
RESPONSE
DAILY A FEW 
TIMES 
A WK.
FORTH- 
NIGHTLY
MONTHLY SEASO­
NALLY
NEVER
Milo 4.3 38.6 50 . 0 1.4 2 . 9 1.4 1.4
Tea 8.6 34 .3 45.7 5.0 1.4 2.1 2.9
Corn­
flakes 9.3 9.3 43 . 6 9.3 9.3 7.9 11.9
Alcohol 10.0 3.6 14.3 2.1 4.3 13 . 6 52.1
Soft-
drinks 13 .6 6.4 48 . 5 7.1 5.0 7.1 2.1
Vitamin
Supple­
ments 14 .3 6.4 34.3 5.0 6.4 6.4 7.9
119
APPENDIX 3
a. ESTIMATED NUTRITIVE VALUE OF MEALS EATEN IN THE
DINING HALL PER PERSON PER DAY FOR SCHOOL A (MALES ONLY)
MEAL ENERGY
Kcal
PROTEIN
g
CALCIUM
mg
IRON
mg
Breakfast 379 5.4 246 . 0 4 . 8
Lunch 587 13.5 109 .4 3.7
Supper 541 17.7 524 . 0 13 .4
Total for day 
% RDA 1,507 36.6 882.0 21.9
13-15 years 51.9% 98.9% 126.0% 121.7%
16-19 years 49.1% 96.3% 176.0% 121.7%
b. ESTIMATED NUTRITIVE VALUE OF MEALS PER PERSON PER DAY 
FOR SCHOOL B (FEMALES ONLY)
MEAL ENERGY PROTEIN CALCIUM IRON
Kcal mg
g mg
Breakfast 449 10 . 8 77 . 0 2 .27
Lunch 422 14 . 9 145 . 8 4 . 5
Supper 410 11.6 199.3 10 . 9
Total for day
% RDA 1, 301 37.3 422 . 0 17.8
13-15 years 52 . 2% 120.3% 40.3% 73 .6%
16-19 years 56.3% 124.0% 84 .4% 73 . 6%
120
c ESTIMATED NUTRITIVE VALUE OF HEALS PER PERSON 
PER DAY FOR SCHOOL C (RURAL HIXED)
MEAL ENERGY
Kcal
PROTEIN
g
CALCIUM
mg
IRON
mg
Breakfast 335 8 .03 36.1 4 . 05
Lunch 730 16.3 261.2 4.6
Supper 820 20.9 270 .1 10.6
Total for day
% RDA 1,885 45 .2 567.4 19.3
Males
13-15 years 65.0% 122.0% 81.1% 107.2%
16-19 years 61.4% 118.8% 113.5% 107.2%
Females
13-15 years 75.7% 145.8% 81.1% 80.4%
6-19 years 81.6% 150.7% 113.5% 80 .4%
d. ESTIMATED NUTRITIVE VALUE OF MEALS PER PERSON 
PER DAY FOR SCHOOL D (URBAN MIXED)
MEAL ENERGY
Kcal
PROTEIN
g
CALCIUM
mg
IRON
mg
Breakfast 269 9.7 74 .6 4.0
Lunch 66 2 17.9 201.0 28 .4
Supper 669 25.4 840 . 0 23 .2
Total for day
% RDA 1, 627 53 .0 1115.4 55.4
Males
13-15 years 56.0% 143 .0% 159 .4% 307.0%
16-19 years 53 .4% 139 .8% 185 .9% 307.0%
Females
13-15 years 65.3% 170.9% 159.4% 230%
16-19 years 70.4% 176.6% 185.9% 230%
121
APPENDIX 4
MEAN WEIGHTS (LB) ACCORDING TO AGE AND SOCIO-ECONOMIC GROUPS (10) 
Age in years 5 6  7 8 9 10 11 12 13 14 15 16 17 18
BOYS
Rural 40.7 45.4 50,5 55.0 57.8
Urban 35.0 40.6 44.0 48.4 53.9 66.2
Urban 45.9 51.9 57.7 62.2 69.5 75.0
Priviledged
Expatriate 45.5 50.4 59.4 66.0 69.4 71.7
GIRLS
Rural 41.5 40.7 45.0 51.6 53.3 60.8
Urban 43.0 45.7 49.7 52.1 57.2 62.6
Urban 45.7 49.6 55.8 64.1 72.7 78.2
Priviledged
Expatriate 44.4 48.7 56.6 65.8 67.1 74.5
MEAN HEIGHTS (IN.) ACCORDING TO AGE
63.5 71.2 76.1 81.1 88.7 99.2 109.9114.8
63.1 71.3 77.1 83.8 92.0 102 .5111 .3121.0
83.2 86.1 88.0
87.7 91.5 91.0
67.2 73.4 78.1 85.0 96.3 104.5 106.8114.7
69.8 83.0 91.1 99.2 103.8109.8 118.5127.
88.6 95.5 99.0
89.7 94.3
SOCIO-ECONOMIC GROUPS
BOYS
Rural 45.2 47.1 49.2 51.0 52.0 53.6 55.9 57.2 58.4 60.5 62.4 64.1 65.2
Urban 42.0 44.6 46.5 48.4 50.3 52.3 53.6 56.0 57.4 59.1 60.9 61.8 63.7 65.1
Urban 45.0 48.1 49.2 51.2 53.7 55.4 57.1 58.1 59.0
Priviledged
Expatriate 44.8 46.3 48.4 52.1 54.4 55.2 58.1 58.9 59.0
GIRLS
Rural 44.5 44.5 47.1 49.7 51.1 52.7 55.0 56.7 58.8 59.4 61.0 61.8 62.7 63.9
Urban 45.9 48.2 49.7 51.3 53.5 55.6 58.2 59.7 61.9 61.3 62.1 63.4 64.5
Urban 44.5 46.7 48.4 51.4 53.7 56.0 58.2 61.5 62.7
Priviledged
Expatriate 44.7 45.9 49.1 51.7 53.3 53.3 59.1 60.7
Source: Kpedekpo 1970
Table AP 9-8 Weight-for-age (kg) of children aged 10-18 years 
(sexes separate) as standard deviations from reference 
(NCHS/WHO data)
APPENDIX 5
Weight(kg)
Boys Girls
Age
(years)
+2SD Mean -2SD +2SD Mean -2SD
10 . 0 46 . 0 31.4 22.1 49.2 32.5 21. 9
10 .5 49.3 33 .3 23 .1 52 . 8 34.7 23 .1
11.0 52.7 35.3 24.1 56 .4 37.0 24 . 5
11.5 56 .3 37.5 25 .4 60 . 0 39.2 25.9
12.0 59 . 9 39.8 26 . 8 63 .3 41. 5 27 .4
12.5 63 .5 42 .3 28.4 66.5 43 . 8 29.1
13.0 67.2 45.0 30.4 69.4 46 .1 30.8
13 . 5 70 . 9 47.8 32 .5 72 .1 48 .3 32.5
14 . 0 74.6 50.8 34.9 74.5 50.3 34 .2
14 .5 78.2 53 . 8 37.4 76.5 52.1 35.9
15 . 0 81.6 56.7 39.9 78.3 53 .7 37.4
15.5 84 . 9 58.5 42 .4 79 . 6 55 . 0 38.7
16.0 87.9 62.1 44 . 7 80 . 6 55.9 39 . 8
16.5 90.7 64 .4 46.8 81.2 56.4 40 . 7
17.0 93 .2 66.3 48 . 6 81.5 56.7 41.3
17.5 95.3 67.8 49.9 81. 5 56.7 41. 8
18 . 0 97.0 68.9 50.9 81.3 56.6 42 .1
Source: Jellife et al., 1989
123
APPENDIX 6
Table AP 9-8 Height-for-age (kg) of children aged 10-18 years 
(sexes separate) as standard deviations from reference 
(NCHS/WHO data)
Height(kg)
Boys Girls
Age
(years)
110% Reference 90% 110% Reference 90%
10.0 151.3 137.5 123 . 8 152 .1 138 .3 124.5
10.5 154 .3 140.3 126.3 155 .7 141.5 127.4
11.0 157.6 143 .3 129 . 0 159.3 144 . 8 130.3
11.5 161.0 146 .4 131.8 163.0 148 . 2 133 .4
12 . 0 164 . 7 149.7 134 .7 166 . 7 151.5 136.4
12.5 168.3 153 . 0 137.7 170 .1 154 . 6 139.1
13 .0 172.2 156.5 140.9 172 . 8 157.1 141.4
13 .5 175.9 159 . 9 143 . 9 172 . 9 159 . 0 143 .1
14 . 0 179 .4 163 .1 146.8 176 .4 160 .4 144.4
14.5 182.8 166 .2 149.6 177.3 161.2 145 .1
15.0 185.9 169.0 152.1 178 . 0 161.8 145.6
15 . 5 188.7 171.5 154 .4 178 .3 162.1 145 . 9
16 . 0 190.9 173 . 5 156.5 178.6 162 .4 146 .2
16 . 5 192.7 175.2 157.7 179.0 162.7 146 .4
17.0 193 . 8 176.2 158 .6 179 .4 163.1 146.8
17.5 194 .4 176 .7 159.0 179.7 163 .4 147 .1
18 . 0 194.5 176.8 159.1 180 .1 163 .7 147.3
Source: Jellife et al., 1989
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APPENDIX 8
Weight of food eaten in the Dining Halls. 
School:
Day:
Date:
Meal Weight of Bowl Weight of Bowl 
and Food
Weight of Food
Breakfast
Lunch
Supper
126
APPENDIX 9
WEIGHT OF FOOD EATEN IN THE DINING HALL
FORMAT FOR RECORDING WEIGHTS OF FOOD EATEN OUTSIDE THE DINING 
HALL
Name of Student:
School:
Please record as you eat all foods and drinks taken outside the 
dining hall on the sheet provided. Give estimates of quantities 
or cedis equivalents.
FOOD OR DRINK QUANTITY OR 
CEDI 
EQUIVALENT
TIME OF DAY
127
APPENDIX 10 
GLOSSARY
1. Kenkey A steamed dish made from fermented corndough.
2. Gari A grit-like convenience food made by roasting
grated cassava.
3. Banku Boiled fermented corndough
4. Shitto - A kind of preserved stew usually containing hot
pepper.
5. Nkontomire Tender cocoyam leaves.
128
APPENDIX 11 
STUDY QUESTIONNAIRE
Questionnaire on Food habits, Nutrition knowledge and Food 
intakes of Adolescent in selected Secondary Schools in the 
Central Region.
INTRODUCTION
This is a study being carried out by the Department of Home 
Science; University of Ghana to find out the food habits, 
nutrition knowledge and food intakes of adolescents. I shall be 
grateful if you would kindly and carefully complete this 
questionnaire. Opinions expressed on this questionnaire would be 
treated confidentially.
1. DEMOGRAPHIC AND SOCIO-ECONOMIC DATA:
1. Age of student (at last Birthday) : =====^ ========^ =!
2. Sex: Male [ ] Female: [ ]
3. Weight: .............................................
4. Height: .............................................
5. Religion (Tick)
a. a. Christian [ ]
b. Moslem [ ]
c. Other specify.................... .
6. Ethnic Origin:
129
Number of siblings (brothers and sisters):
9.
10 .
Educational level of Parents Highest level 
attained: Father Mother
(a) Primary [ ] [ ]
(b) Middle/JSS [ ] [ ]
(c) Secondary/
Commercial/ [ ] [ ]
Vocational
(d) Teacher Trg./
Polytechnic/
Agriculture [ ] [ ]
(e) University [ ] [ ]
(f) None [ ] [ ]
(g) Other (specify) .......................
Occupation of Parents:
Father: ........................................
Mother: .........................................
What other types of activities do you participate in 
at School eg. games.
(a) ...................................................
(b) ...................................................
(c) ...................................................
11. Do you consider yourself overweight: 
Yes [ ] No [ ]
130
12. If yes would you want to lose weight
Yes [ ] No [ ]
13. If no do you consider yourself underweight
Yes [ ] No [ ]
14 . If yes would you want to gain weight
Yes [ ] No [ ]
15. Are you satisfied with your height:
Yes [ ] No [ ]
16. If no which of these would you want
To be shorter [ ]
To be taller [ ]
II. Food Habits
17. How many times do you normally eat in a day?
(a) at school: .............................
(b) at home: ...............................
18. What meal do you normally eat at home for:
(a) Breakfast (list)
i . ........................................
ii. ........................................
iii. ......................................
iv. ......................................
(b) Lunch:
i .  .....................................................................................................................................................................................................
ii.  
iii. ......................................
iv. ......................................
131
(c) Supper:
ii.  
iii.  
iv.  
19. What meals do you normally eat at school for:
(a) Breakfast (list)
ii. ........................................
iii.  
iv.  
(b) Lunch:
i .  ..........................................................................................................................................................................................................
ii.  
iii.  
iv.  
20. How often do you eat between meals daily?
(Tick where appropriate)
Once Twice 3 or more times Never
a . at home.........  ...............  ......
b . at school.......  ...............  ......
21. What foods do you normally eat between meals? (list)
a . at home ........................................
132
b, at School:
22. Do you skip any of the following meals at home? (tick) 
Always Sometimes Never Reasons
Breakfast ....  .......................................
Lunch ........  .......................................
Supper .......  .......................................
23. Do you skip any of the following meals at school? (tick)
Always Sometimes Never Reasons
Breakfast ....  ......................................
Lunch ........  ......................................
Supper .......  .......................................
24. What foods do you eat outside the dining hall?
a .......................................................
b .......................................................
c .......................................................
d .......................................................
25. Who normally eats with you at home? (Tick) 
alone [ ] mother [ ] sisters [ ]
brothers [ ] father [ ]
Others specify: .......................................
26. Who normally eats with you at school (outside the 
dining hall)? (tick)
133
Brother [ ]
Sister [ ]
Friends [ ]
Alone [ ]
Other specify: .......................................
2 7 . How often do you receive food outside campus? (tick) 
everyday [ ] once a week [ ]
week ends [ ] not at all [ ]
Other specify: ....................... ................
2 8 . If you receive food from outside, who sends the food? 
(tick)
Mother [ ] Aunt [ ]
Sister [ J Guardian [ ]
Other specify ........................................
2 9 . How much pocket money do you spend on food including 
sweets and drinks per week?
30. Who determines what should be eaten at home for- 
(tick)
Mother Father Self Others Specify
(a) breakfast ....  .....  ...................
(b) lunch ....  .....  ...................
(c) supper ....  .....  ...................
31. Is there any foods that your family does not take? 
Yes [ ] No [ ]
134
32. Name it and give the reason why members of your family 
are not allowed to take this foods?
Name of food Reason
III. Food Preference Data
33. What is your favourite breakfast?
a. at home: ....................
b. at school: ..................
lunch
a . at home: ....................
b. at school: ..................
Supper
a . at home: ....................
b. at school: ..................
34. What food do you dislike most?
a . at home: ....................
b . at school: ..................
135
35. Food Preference data
Indicate in the columns provided which of these foods you
like very much, like least, dislike or you have never eaten.
Foods
Beef
Mutton
Pork
Chicken
Turkey
Bush
Meat
Corned
Beef
Sardine
Eggs
Milk
Beans
(cowpea)
Ground­
nuts
Bambara
beans
Soya
beans
in what 
form
like very 
much
likes
least
dislikes has never 
eaten
136
Foods
Corn
Rice
Wheat
Oats
Millet
Sorghum
Plantain
Cassava
Cocoyam
Sweet
potato
Yam
Water
yam
Banana
Orange
Pine­
apple
Pawpaw
Mango
Water
melon
in what 
form
like very 
much
likes
least
dislikes has never 
eaten
137
Foods in what 
form
like very- 
much
likes
least
dislikes has never 
eaten
Garden
eggs
Okro
Kontomire
leaves
Cabbage
Lettuce
Cucumber
Carrots
French
beans
Ground­
nut oil
Kernel
oil
Refined
Vegetable
oil
Margarine
Butter
Palm oil
Toffee
Chocolate
bar
Cheese
138
Foods in what 
form
like very 
much
likes
least
dislikes has never 
eaten
Palmnuts
Jam/
Marmalade
Coffee
Tea
Milo
Corn­
flakes
Alcoho­
lic
beverages
Soft
drinks
Other (specify)
IV. Nutrition Knowledge
36. What is the use of food in the body?
37. What is the most important thing you would consider when 
choosing what to eat?
38. Which is better? (tick one)
a. a variety of foods for a meal [ ]
b. single food item for a meal [ ]
139
39. Name all the food groups you know. Giving two examples
40. Name 2 foods that would help you build up your blood
41. Do you think teenagers should eat a lot of energy giving
foods?
Yes [ ] No [ ]
42. If Yes why? .............................................
43. If No, why not?
44. Do you think eating once a day is adequate?
Yes [ ] Reason:................
45. No [ ] Reason:
46. Why should children be given a lot of milk?
47. Do all people require the same quantity of food daily? 
Yes [ ] Reason:.............................
No [ ] Reason:
140
48. Do you think the meals you eat in the dining hall are
adequate for good health? Yes [ ] No [ ]
49. if No, why? Reasons: ....................................
Suggestions for improvement:
Sources of Nutrition Knowledge
50. From which of these sources do you receive your nutrition 
knowledge?
(a) Books, Pamphlets, news papers [ ] (b) Tutors [ ]
(c) Parents [ ] (d) Talks [ ]
141
FREQUENCY OF FOOD CONSUMPTION
51. How often do you eat the foods listed below? (tick)
Food Group & 
Food Item
Daily Few Times 
a week
Weekly Fort­
nightly
Mon­
thly
Seaso­
nally
Never
Animal Products 
Meat
Corned beef 
Fish
Thinned Fish 
(Sardine)
Eggs
Milk
Chicken
Lecrumes, Oil 
Seed & Nuts
Beans
(cowpea)
Groundnuts
Bambara
beans
Soybeans
Cereals &
Grains
Corn
Rice
Bread
Millet
Sorghum
142
FREQUENCY OF FOOD CONSUMPTION (CONTD.)
Food Group & 
Food Item
Daily Few Times 
a week
Weekly Fort­
nightly
Mon­
thly
Seaso­
nally
Never
Root Tubers & 
Plantain
Plantain
Cocoyam
Sweet
potato
Yam
Water Yam
Cassava
Fruits and 
Vecretables
Banana
Orange
Pineapple
Pawpaw
Mango
Watermelon
Garden egg
Kontomire/
leaves
Okro
Fats and oils 
Groundnut oil 
Coconut oil
143
FREQUENCY OF FOOD CONSUMPTION (CONTD.)
Food Group & 
Food Item
Daily Few Times 
a week
Weekly Fort­
nightly
Mon­
thly
\
Seaso­
nally
Never
Fats and oils 
(contd.)
Palm kernel oil
Refined vege­
table oil
Margarine
Butter
Palm oil
Miscellaneous
Toffee
Chocolate bar
Cheese
Jam
Coffee
Milo
Tea
Cornflakes
Soft drink
Vitamim Supple­
ment
Others (specify)
144