GÖRME ENGELLİ ÇOCUKLARDA BESLENME DURUMU, FİZİKSEL AKTİVİTE VE DİYET KALİTESİNİN DEĞERLENDİRİLMESİ

Öz

Bu araştırma, yetersiz fiziksel aktivite ve şişmanlık açısından risk altında bulunan görme engelli çocukların beslenme durumlarını, diyet kalitelerini ve fiziksel aktivite düzeylerini değerlendirmek amacıyla planlanmıştır. Araştırmaya Ankara’daki bir görme engelliler ilköğretim okulunda öğrenim gören ve farklı düzeylerde görme kusuru bulunan 6-11 yaş arası 59 çocuk dahil edilmiştir. Aile ve okul öğretmenleri ile görüşülerek anket formu doldurulmuş ve Akdeniz Diyeti Kalite İndeksi (KIDMED)  uygulanmıştır. Çocukların boy uzunlukları ve vücut ağırlıkları ölçülerek, beden kütle indeksleri (BKİ) hesaplanmıştır. BKİ sonuçları, Dünya Sağlık Örgütü (WHO) 2007/5-19 yaş referans değerlerine göre değerlendirilmiştir. Çocukların fiziksel aktivite süreleri saat bazında kaydedilmiştir. Günlük uyku süresinin erkek çocuklarda 9.4 ±1.1, kız çocuklarda 9,6 ±1.1 saat olduğu ve çocukların günde yaklaşık 2.8 saatlerini bilgisayar/TV başında ve ders çalışarak geçirdikleri belirlenmiştir. Erkek çocuklarda günlük kalsiyum, posa ve niasin, kız çocuklarda posa, kalsiyum ve enerji gereksinimlerini karşılama oranlarının düşük olduğu saptanmıştır. KIDMED skorlarına göre çocukların %27.1’inin diyet kalitelerinin çok düşük olduğu, %55.9’ünün diyetlerinin iyileştirilmesi gerektiği belirlenmiştir. Tüm çocukların %44’ünün hafif şişman/şişman olduğu bulunmuştur. Görme engelli çocuklarda özellikle açık alanda yapılan fiziksel aktivitelerin sınırlı olduğu, diyet kalitelerinin düşük olduğu ve aynı yaş grubu sağlıklı çocuklara göre hafif şişmanlık/şişmanlık görülme sıklığının bu çocuklarda daha yaygın olduğu gösterilmiştir. 

Anahtar Kelimeler

• Görme engeli,Beslenme durumu,Akti-vite,Diyet kalitesi

ASSESSMENT OF NUTRITIONAL STATUS, PHYSICAL ACTIVITY AND DIET QUALITY OF VISUALLY DISABLED CHILDREN

Abstract

This research was designed to evaluate nutritional status, dietary quality and physical activity of visually impaired children, who have been shown to have ahigh risk for insufficient physical activity and obesity. The research was conducted in a primary school for visually impaired children in Ankara, Turkey. 59 children aged 6-11 years were included, with different degrees of visual impairment. Parents and school teachers helped to complete a questionnaire, from which the Mediterranean Diet Quality Index (KIDMED) was calculated. Height and body weight of the children were measured and body mass index (BMI) calculated. BMI values were evaluated in comparison to the World Health Organization’s (WHO) 2007 reference values for children aged 5-19 years. The children’s’ physical activity time was recorded on an hourly basis. Average sleep duration during the day was 9.4 ±1.1 hours for boys and 9.6 ±1.1 hours for girls. The children spent a mean 2.8 hours per day sitting to play computer games or watch TV. Daily calcium, fiber and niacin intake were low in boys, and daily fiber, calcium and energy intake low in girls. According to the KIDMED score, 27.1% of children had a diet identified as “very low quality diet” and 55.9% were categorized as “needs to be improved”. 44% of all children were overweight/obese. Physical activity of visually impaired children is limited, especially outdoor activity. Visually impaired children also have a low quality diet compared with healthy children of the same age group. Furthermore, they have a tangentially higher risk for overweight/obesity.

Keywords

• Visual impaired,Nutritional status,Activity,Diet quality

References

1. European Food Information Council (2013): Child and Adolescent Nutrition. http://www.eufic.org/article/en/health-and-lifestyle/food-for-all-ges/expid/basics-child-adolescent-nutrition/ (accessed 11.10.2014)
2. Adachi-Mejia, A.M., Longacre, M.R., Gibson, J.J., Beach, M.L., Titus-Ernstoff, L. T. & Dalton, M.A. (2007). Children with a TV in their bedroom at higher risk for being overweight. International Journal of Obesity, 31(4), 644-651. doi:10.1038/sj.ijo.0803455
3. Armbruster, J., Ponchillia, P. & Wiebold, J. (2005). The national sports education camps project: Introducing sports skills to students with visual impairments through short-term specialized instruction. Journal of Visual Impairment & Blindness (JVIB), 99(11), 685-696.
4. Aslan, U.B., Calik, B.B. & Kitiş, A. (2012). The effect of gender and level of vision on the physical activity level of children and adolescents with visual impairment. Research in Developmental Disabilities, 33(6), 1799-1804.
5. Bach-Faig, A., Berry, E.M., Lairon, D., Reguant, J., Trichopoulou, A., Dernini, S. & Miranda, G. (2011). Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutrition, 14(12A), 2274-2284.
6. Bakanlığı, T.S. (2011). Türkiye’de Okul Çağı Çocuklarında (6-10 Yaş Grubu) Büyümenin İzlenmesi (Toçbi) Projesi Araştırma Raporu. Ankara; Kuban Matbaacılık Yayıncılık
7. T.C. Sağlık Bakanlığı (2014). Türkiye Beslenme ve Sağlık Araştırması 2010: Beslenme Durumu ve Alışkanlıklarının Değerlendirilmesi Sonuç Raporu. Retrieved from: http://www.sagem.gov.tr/TBSA_Beslenme_Yayini.pdf (erişim 11.12.2015)
8. Baysal, A. (2009). Beslenme (Vol. 12). Ankara: Hatipoğlu Yayınevi, ISBN: 975-7527-73-4

9. Benetou, V., Trichopoulou, A., Orfanos, P., Naska, A., Lagiou, P., Boffetta, P. & Trichopoulos, D. (2008). Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort. British Journal of Cancer, 99(1), 191-195.
10. Brown, C.M., Dulloo, A.G. & Montani, J.P. (2008). Sugary drinks in the pathogenesis of obesity and cardiovascular diseases. International Journal of Obesity, 32 Suppl 6, S28-S34. doi:10.1038/ijo.2008.204
11. Case, A., Lubotsky, D. & Paxson, C.. (2002). Economic Status and Health in Childhood: The Origins of the Gradient. The American Economic Review, 92(5), 1308–1334. Retrieved from http://www.jstor.org/stable/3083252 (erişim 11.12.2015)
12. Chen, C.C. & Lin, S.Y. (2011). The impact of rope jumping exercise on physical fitness of visually impaired students. Research in Developmental Disabilities, 32(1), 25-29.
13. Datar, A., Sturm, R. & Magnabosco, J. L. (2004). Childhood overweight and academic performance: national study of kindergartners and first-graders. Obesity Research, 12(1), 58-68. doi:10.1038/oby.2004.9
14. DeMattia, L. & Denney, S.L. (2008). Childhood obesity prevention: successful community-based efforts. The ANNALS of the American Academy of Political and Social Science, 615(1), 83-99.
15. Eaton, D.K., Kann, L., Kinchen, S., Shanklin, S., Ross, J., Hawkins, J. & Chyen, D. (2010). Youth risk behavior surveillance-United States, 2009. Morbidity and mortality weekly report. Surveillance summaries (Washington, DC: 2002), 59(5), 1-142.
16. Eisenmann, J.C., Bartee, R.T., Smith, D., Welk, G. & Fu, Q. (2008). Combined influence of physical activity and television viewing on the risk of overweight in US youth. International Journal of Obesity, 32(4), 613-618.
17. Fujiura, G.T. & Yamaki, K. (2000). Trends in demography of childhood poverty and disability. Exceptional Children, 66(2), 187-199.
18. Giammattei, J., Blix, G., Marshak, H.H., Wollitzer, A.O. & Pettitt, D. J. (2003). Television watching and soft drink consumption: associations with obesity in 11- to 13-year-old schoolchildren. Archives of Pediatrics and Adolescent Medicine, 157(9), 882-886. doi:10.1001/archpedi.157.9.882
19. Global Recommendations on Physical Activity for Health. Geneva: World Health Organization; 2010. http://www.ncbi.nlm.nih.gov/books/NBK305057/ (erişim 11.12.2015)
20. Goodman, E. (1999). The role of socioeconomic status gradients in explaining differences in US adolescents' health. American journal of public health, 89(10), 1522-1528.
21. Gordon‐Larsen, P., Adair, L.S. & Popkin, B.M. (2003). The relationship of ethnicity, socioeconomic factors, and overweight in US adolescents. Obesity Research, 11(1), 121-129.
22. Haynos, A.F. & O'Donohue, W.T. (2012). Universal childhood and adolescent obesity prevention programs: review and critical analysis. Clinical Psychology Review, 32(5), 383-399.
23. T.C. Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü, (2004). Türkiye’ye özgü beslenme rehberi: Ankara Gökçe Ofset Matbaacılık, ISBN: 975-590-101-9
24. Houwen, S., Hartman, E. & Visscher, C. (2009). Physical activity and motor skills in children with and without visual impairments. Medicine and Science in Sports and Exercise, 41(1), 103-109. doi:10.1249/MSS.0b013e318183389d
25. Jahns, L., Siega-Riz, A.M. & Popkin, B.M. (2001). The increasing prevalence of snacking among US children from 1977 to 1996. The Journal of Pediatrics, 138(4), 493-498. doi:10.1067/mpd.2001.112162
26. Kasser, S.L. & Lytle, R.K. (2005). Inclusive physical activity: A lifetime of opportunities: Human Kinetics, ISBN 0-7360-3684-9, 800-747-4457
27. Kiess, W., Marcus, C. & Wabitsch, M. (2004). Obesity in childhood and adolescence: Karger Basel, ISBN: 978-3-8055-7730-4
28. Kontogianni, M.D., Vidra, N., Farmaki, A.-E., Koinaki, S., Belogianni, K., Sofrona, S. & Yannakoulia, M. (2008). Adherence rates to the Mediterranean diet are low in a representative sample of Greek children and adolescents. The Journal of Nutrition, 138(10), 1951-1956.
29. Kozub, F.M. & Oh, H.K. (2004). An exploratory study of physical activity levels in children and adolescents with visual impairments. Clinical Kinesiology: Journal of the American Kinesiotherapy Association, 58(3), 1-8.
30. Kutluay, T. (1994). Toplu beslenme yapılan kurumlar için standart yemek tarifeleri: Ankara; Hatipoğlu Yayınevi, ISBN : 9789757527572
31. Lamerz, A., Kuepper-Nybelen, J., Wehle, C., Bruning, N., Trost-Brinkhues, G., Brenner, H. & Herpertz-Dahlmann, B. (2005). Social class, parental education, and obesity prevalence in a study of six-year-old children in Germany. International journal of obesity, 29(4), 373-380.
32. Lee, R.D. & Nieman, D.C. (2003). Measuring Diet Nutritional assessment (pp. 83-84). New York: TheMacGraw-Hill Company. ISBN: 978-0072927313
33. Lieberman, L. & McHugh, E. (2001). Health-related fitness of children who are visually impaired. Journal of Visual Impairment & Blindness (JVIB), 95(05), 272-287.
34. Lieberman, L.J., Stuart, M.E. Hand, K. & Robinson, B. (2006). An investigation of the motivational effects of talking pedometers among children with visual impairments and deaf-blindness. Journal of Visual Impairment & Blindness, 100(12), 726-736.
35. Lobstein, T. & Baur, L. (2005). Policies to prevent childhood obesity in the European Union. The European Journal of Public Health, 15(6), 576-579.
36. Longmuir, P. E., & Bar-Or, O. (1994). Physical activity of children and adolescents with a disability: methodology and effects of age and gender. Pediatric Exercise Science, 6(2). 168-177.
37. Longrnuir, P.E. & Bar-Or, O. (2000). Factors influencing the physical activity levels of youths with physical and sensory disabilities. Adapted Physical Activity Quarterly, 17(40), 40-53.
38. Ludwig, D.S. & Gortmaker, S.L. (2004). Programming obesity in childhood. Lancet, 364(9430), 226-227. doi:10.1016/s0140-6736(04)16688-9
39. Magarey, A.M., Daniels, L.A., Boulton, T.J. & Cockington, R.A. (2003). Predicting obesity in early adulthood from childhood and parental obesity. International journal of obesity, 27(4), 505-513.
40. Mariscal-Arcas, M., Rivas, A., Velasco, J., Ortega, M., Caballero, A.M. & Olea-Serrano, F. (2009). Evaluation of the Mediterranean Diet Quality Index (KIDMED) in children and adolescents in Southern Spain. Public Health Nutrition, 12(09), 1408-1412.
41. Martínez-González, M.Á., De la Fuente-Arrillaga, C., Nuñez-Cordoba, J.M., Basterra-Gortari, F.J., Beunza, J.J., Vazquez, Z., Bes-Rastrollo, M. (2008). Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. British Medical Journal, 336(7657), 1348-1351.
42. Mikkila, V., Lahti-Koski, M., Pietinen, P., Virtanen, S.M. & Rimpela, M. (2003). Associates of obesity and weight dissatisfaction among Finnish adolescents. Public Health Nutrition, 6(1), 49-56.
43. Montero, P. (2005). Nutritional assessment and diet quality of visually impaired Spanish children. Annals of Human Biology, 32(4), 498-512. doi:10.1080/03014460500142744
44. O'Toole, T.P., Anderson, S., Miller, C. & Guthrie, J. (2007). Nutrition services and foods and beverages available at school: results from the School Health Policies and Programs Study 2006. The Journal of School Health, 77(8), 500-521. doi:10.1111/j.1746-1561.2007.00232.x
45. Ogden, C.L., Carroll, M.D., Curtin, L.R., Lamb, M.M. & Flegal, K.M. (2010). Prevalence of high body mass index in US children and adolescents, 2007-2008. Journal of the American Medical Association, 303(3), 242-249.
46. Organization, W.H. (2000). Obesity: preventing and managing the global epidemic: World Health Organization.
47. Pediatrics, A.A.o. (2001). American Academy of Pediatrics: Children, adolescents, and television. Pediatrics, 107(2), 423.
48. Pekcan, G. (2008). Beslenme durumunun saptanmasi. Baysal A. (Ed.) Diyet El Kitabi. (p. 67-141) Ankara: Hatipoglu Yayinevi.
49. Ponchillia, P., Ponchillia, S., & Strause, B. (2002). Athletes with visual impairments: Attributes and sports participation. Journal of Visual Impairment & Blindness (JVIB), 96(04), 267-273.
50. Rakıcıoğlu, N., Acar, N.T., Ayaz, A. & Pekcan, G. (2012). Yemek ve Besin Fotoğraf Kataloğu-Ölçü ve Miktarlar: Ankara; Danone Enstitü Yayınları, ISBN: 9789944-5508-0-2
51. Rimmer, J.H. (2005). The conspicuous absence of people with disabilities in public fitness and recreation facilities: lack of interest or lack of access? American Journal of Health Promotion, 19(5), 327-329.
52. Rimmer, J.H., Rowland, J.L. & Yamaki, K. (2007). Obesity and secondary conditions in adolescents with disabilities: addressing the needs of an underserved population. Journal of Adolescent Health, 41(3), 224-229.
53. Sahingoz, S.A. & Sanlier, N. (2011). Compliance with Mediterranean Diet Quality Index (KIDMED) and nutrition knowledge levels in adolescents. A case study from Turkey. Appetite, 57(1), 272-277.
54. Samur, G., Günebak Sahin, T., Dönmez, N. & Besler, H. (2008). Mediterranean Diet Quality Index (KIDMED) as an indicator of nutritional habits and the relationship between BMI and body composition in 10-12 years old children. Paper presented at the IV. International Nutrition and Dietetics Congress Proceedings.
55. Serra-Majem, L., Ribas, L., Ngo, J., Ortega, R. M., García, A., Pérez-Rodrigo, C. & Aranceta, J. (2004). Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutrition, 7(07), 931-935.