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POOR NUTRITION Literature Review According to the Oxford Dictionary of Food and Nutrition; nutrition is the process by which living organisms take in and use food for the maintenance of life, growth, the functioning of organs and tissue, the branch of science that studies these processes (Bender 2006). Nutrients are consumed through the food that we eat, and through metabolic processes in the digestive system these nutrients are absorbed at a cellular level in the body (Gibney 2009). Nutrition Nutrition is the science that deals with food and how the body uses the nutrients from the food. Food supplies the energy for every action the body performs, from reading to running. Food also provides substance that the body needs to build and repair its tissues and to regulate its organs and systems. The type of food intake into the body impacts or affects our health. A proper diet helps prevent certain illnesses and aids in the recovery from others. An improper or inadequate diet increases the risk of various diseases. Optimum nutrition contributes to health, wellbeing, normal development, and high quality of life (Gibney 2009). However, undernutrition, over nutrition, and malnutrition are linked to sub-optimal health outcomes (Gibney et al. 2009). Based on research, Poor nutrition habits can be a behavioral health issue, because nutrition and diet affect how you feel, look, think and act. A bad diet results in lower core strength, slower problem solving ability and muscle response time, and less alertness. Poor nutrition creates many other negative health effects as well. Some of these health effects may include obesity, hypertension, High Cholesterol and Heart Disease, diabetes, stroke, gouts, cancer. POOR NUTRITION Role of Nutrition Blake (2010) hypothesize that nutrition is the study of food and nutrients we need to sustain life and reproduce. They also examined the way food nourishes the body and its health effects. Rolfe’s et al had a parallel meaning for the term nutrition where it states that ‘nutrition is the science of foods, the nutrients and other substances they contain, and of their actions within the body (including ingestion, digestion, absorption, transport, metabolism an excretion)’. Nutrition plays an imperative role in students’ lives. It is the study of food at work in our bodies, our source for energy, and the medium for which our nutrients can function. Ladau (2010) posits nutrition as the building blocks of life, it includes the utilization of food to grow, it maintains and repairs our bodies, getting the right amount of nutrients from healthy foods in the right combinations, making smart choices about the foods you eat and proper nutrition helps you develop and maintain good health. Nutrition has great impact on students. At a particular primary school in central Manchester a pilot study was conducted by the researcher in which it was on this foundation that the problems associated with nutrition will be scrutinized in order to disclose the causes and implications of nutrition on academic performance. Nutrition and Cognition Relationships between nutrition and brain function have been the focus of much research. Studies have shown the impact of dietary foundations on normal brain functions. Chemical messengers within the brain called neurotransmitters have been studied in conjunction with nutrition. Growden and Wurtman (1980) proposes that the brain can no longer be viewed as an autonomous organ, free from other metabolic processes in the body; instead, the brain needs to be seen as being affected by nutrition, the concentration of amino acids and choline in the blood which let the brain create and use many of its neurotransmitters such as serotonin, acetylcholine, POOR NUTRITION dopamine, and norepinephrine. Food consumption is vital to the brain being able to make the right amount of amino acids and choline. These are two precursor molecules obtained from the blood that are needed for the brain to function normally. Kretsch. (2001) shows further possibilities that our nutrition has a role with affecting our cognitive functioning. Studies have been done with school aged children and point to a direct correlation between poor nutrition and lowered school performance. Importance of nutrition. Erickson (2006) points out five key components, based on research, required to keep the brain functioning correctly. The substances, all found in food, are important to brain development and function. Proteins are found in foods such as meat, fish, milk, and cheese. They are used to make most of the body’s tissues, including neurotransmitters, earlier identified as chemical messengers that carry information from brain cells to other brain cells. A lack of protein, also known as Protein Energy Malnutrition, led to poor school performance by children and caused young children to be lethargic, withdrawn, and passive, all of which help affect social and emotional development. Carbohydrates are commonly found in grains, fruits, and vegetables. Carbohydrates are broken down into glucose (sugar) which is where the brain gets its energy. Fluctuating levels of carbohydrates may cause dizziness and mental confusion, both of which can affect cognitive performance. Eating a carbohydrate heavy meal can cause one to feel more calm and relaxed because of a brain chemical called serotonin and its effect on mood. Serotonin is created within the brain through the absorption and conversion of tryptophan. Tryptophan is absorbed within the blood and this absorption is enhanced with carbohydrates (Erickson, 2006). Erickson also notes that fat makes up more than 60% of the brain and acts as a messenger in partial control of aspects such as mood. Omega3 fatty acids are very important to the optimum performance of the POOR NUTRITION brain and a lack of these fats can lead to depression, poor memory, low IQ, learning disabilities, dyslexia, and ADD. Important foods to consume to ensure an Omega3 fatty acid diet are certain fish and nuts (Erickson, 2006). Erickson (2006) discussed vitamins and minerals as an important substance for the functioning of the brain. Most important are the vitamins A, C, E, and B complex vitamins. Manganese and magnesium are two minerals essential for brain functioning, sodium, potassium and calcium play a role in message transmission and the thinking process. Aforementioned in the research, neurotransmitters are crucial to brain function in the transferring of messages. Erickson states research that shows nutrition is important to the production of key neurotransmitters such as acetylcholine, dopamine, and serotonin. Effects of nutrition on cognition. Furthering the research under the heading nutrition and its effects on cognition, diet, exercise, and sleep have the potential to alter brain health and mental function. Gomez-Pinilla (2008) states that it stands to reason that changes in diet could be used to enhance cognitive abilities. Gomez-Pinilla (2008) research has shown that Omega3 fatty acids such as those found in fish, kiwi fruit, and walnuts, provide many benefits in improving memory and learning, much of which occurs at the synapses. Omega3 fatty acids are essential for normal brain function. The article states that a deficiency in Omega3 fatty acids can lead to increased risk of attention deficit disorder and dyslexia. According to Wolpert and Wheeler (2008), children who had an increase of Omega3 fatty acids performed better in reading, spelling, and had fewer behavioral problems. In addition, Gomez-Pinilla (2008) suggests that diets high in Tran’s fats and saturated fats negatively affects cognition. These Trans fats are found in common fast food and most junk foods. Through these Trans fats, junk food affects the brain synapses as well as many molecules POOR NUTRITION that aid in learning and memory. A diet low in Tran’s fats and high in Omega3 fatty acids can strengthen synapses and provide cognitive benefits (cited Wolpert & Wheeler, 2008). Wolfe and Burkman (2000) began by creating an equation: good nutrition + exercise = optimal learning. They support the following questions with research: 1. How does breakfast help children do better in the classroom? 2. Can certain foods enhance a child’s learning or memory? 3. Does supplements help children perform better in the classroom? Research that confirmed proper nutritional support is important to allow the brain to function at its highest ability and to enhance learning (cited Wolfe, 2000). Wolf (2000) further proposed that it didn’t take much complication or anonymity through expensive foods and supplements to help students reach their potentials; healthful nutritional habits learned early in life help endure normal physiological and neurological growth and development, which translated into students’ achieving optimal learning, defined as the abilities to recall information, to problem solve, and to think critically. Wolf (2000) state several dietary components support brain function and neurotransmitter activity, and that scientists recommend a wide range of foods as nutrient sources; the most important known today are protein, fat, vitamins B, iron, chlorine, and antioxidants. Offering students, the right food choices and helping them develop positive, healthy eating habits will support optimal functioning of the brain. Eating breakfast helps students to eliminate or reduce stomach pain, headache, muscle tension, and fatigue, all which lead to an interference with learning. School personnel have the perfect access to students’ breakfast eating habits and need to utilize the opportunity to teach students good breakfast eating habits, whether at school or home. POOR NUTRITION Wolfe (2000) postulated that without an adequate daily intake of nutrients from food, the body puts learning on a lower shelf below its need to sustain life support functions. Therefore, in many cases, skipping a meal negatively affected the body and its learning functions. Wolf (2000) concluded that as many as half of low income primary students skip breakfast and that children who eat a good breakfast at school perform better on standardized tests. Also, they found that children who eat breakfast have improved attention in late morning performance tasks, retrieve information more quickly and accurately, make fewer errors in problem solving activities, and concentrate better and perform more complex tasks. Similarly, what the child eats for breakfast is important. A breakfast comprise of protein, fat, and sugar will prevent drops in blood sugar for several hours, whereas, as breakfast of just starch and sugar will sustain a child for only about two hours. A meal that included food from several food groups was the best for a child who was expects to perform at his or her best in school, educationally and physically. Wolfe (2000) called attention to school food programs and contend that such programs need support. Lahey and Rosen (2010) research that nutrition affects learning and behaviour and suggested that diet can influence cognition and behavior in many ways, which include the condition of not enough nutrition or the condition of the lack of certain nutrients. About one third of children who completed a food habit pallet had inadequate fruit and vegetable intake. These students also showed poor school performance as compared to those students who had an adequate intake of fruits and vegetables (cited Lahey & Rosen, 2010). Kar (2008) examined the effect of stunted growth on the nature of cognitive impairments and on the rate of cognitive development. The study investigated if malnutrition would result in a concentrated impairment and a general slowing in the rate of development of all cognitive processes or these effects could be present for some specific cognitive processes. Effects of POOR NUTRITION malnutrition on cognitive processes were also looked at in relation to impairment without affecting the rate of development and its effect on the rate of development of the cognitive process itself. The participants were identified as being malnourished or adequately nourished in the age groups of five- to seven-year olds and eight- to ten-year olds (cited Kar, 2008). The performance of adequately nourished children to malnourished children were compared with age related differences in cognitive function and found that the malnourished children differed from the adequately nourished children on tests of phonemic fluency, design fluency, selective attention, effectively working memory and functions, verbal comprehension, verbal learning, and memory (cited Kar, 2008). Nutritional practices by students Several writers, states that “family, peers, media, and environment influence the health habits, especially eating habits, of children”. Research has shown that eating habits developed during childhood continues into adulthood. Thus, childhood eating habits should optimally have positive effects on every child to create healthy eating habits in the future. These positive influences will help form a basis for good nutrition and physical activity habits to be followed throughout an individual's primary, adolescent and adult life. Therefore, students may imitate the eating habits of their parents who plays a vital role in their lives. Most parents do not practice healthy diets at home in which their children are forced to adapt to these practices. They normally complain that purchasing food from all the food groups are highly expensive. It is well established that young children living in poor communities are at risk for under nutrition and malnutrition. This is due to lack of resources, neglect, abuse, and inappropriate care by parents and caregivers, who are often under physical and emotional stress. According to Little-White’s (2012) in Jamaica, approximately one in every four children under POOR NUTRITION the age of four lives in poverty. That is approximately 70,000 children. Promotion of this behaviour may require attention to nutritional education and child feeding strategies of parents. Therefore, it can now confirm that parents play a vibrant role in their children food intake. The statistics have shown that children eat vegetables for different reasons while their parents partially encourage them to it. However, their environment also influences what they eat. Whereas they monitor trends and patterns of peers and other sources. Implications of poor nutrition Wood (2001) shows possibilities that our nutrition has a role with affecting our cognitive functioning. There are several studies which have been done with school aged children and point to a direct connection between poor nutrition and lowered school performance. Iron plays a vital role in brain function. Kleinman (2002) reported that persistent or involuntary lack of food over time may result in malnutrition. Mild-to-moderate malnutrition can be a developmental risk factor. Malnutrition can limit a child’s ability to comprehend even basic skills and weaken overall learning potential. Children from food insufficient households may not perform as well on academic achievement tests as children from food sufficient households. Students who experience food insufficiency are likely to repeat a grade in school and experience tardiness or absences from school which may affect their academic performance. Impact of nutrition on students’ performance Jensen (1985) hypothesizes that ‘nutrition plays a crucial role in education’. Children who grow up in poor families are exposed to food with lower nutritional value in which this can adversely affect them even in the womb (Antonov-Schlorke, 2011). Skipping breakfast is highly prevalent among urban minority children, and it negatively affects students' academic POOR NUTRITION achievement by adversely affecting cognition and raising absenteeism (Basch, 2011). According to Jensen (1985) when students experience poor nutrition and diminished health practices, it's harder for them to listen, concentrate, and learn. Students can often appear listless with low energy or hyperactive on a sugar "high”. ‘Advancing the Approach and Practice of Students of Social Work’ article, states that the quality of nutrition of families and children has been seen as an individual affair, and is usually labelled under ‘life style’ rather than being seen as a basic entitlement. A diet high in cholesterol and saturated fat is also known to have an adverse effect on memory, (Burke, 2010). The Jamaica Teachers' Association (JTA) is calling for a national campaign focusing on the health and nutrition of students. JTA Wants National Focus On Nutrition Adams (2010) states “poor nutrition is having a severe impact on students' ability to learn. A number of them are not able to take part effectively in physical activities, and it severely affects their concentration”. Students sometimes fall asleep in class, and it opens them up to a lot of weaknesses where they are unable to learn. They experience fainting spells in the schools because students are not eating breakfast in the mornings, (Adams 2010). Nutrition is very important in students’ performance at school. Students tend to lose focus in school and lack energy when they do not eat breakfast or when they are unhealthy. They normally faint during school sessions; some are hyperactive while others may seem very lazy because they lack energy. This has been evident in most schools in Jamaica where teachers are faced with the poor performance of students. Protein-energy malnutrition POOR NUTRITION Chronic undernutrition manifests primarily as protein-energy malnutrition (PEM), which is the most common form of malnutrition worldwide. Also known as protein-calorie malnutrition, PEM is a continuum in which people, all too often children consume too little protein, energy, or both. At one end of the continuum is kwashiorkor, characterized by a severe protein deficiency, and at the other is marasmus, an absolute food deprivation with grossly inadequate amounts of both energy and protein. An infant with marasmus is extremely underweight and has lost most or all subcutaneous fat. The body has a “skin and bones” appearance, and the child is profoundly weak and highly susceptible to infections. The cause is a diet very low in calories from all sources (including protein), often from early weaning to a bottled formula prepared with unsafe water and diluted because of poverty. Poor hygiene and continued depletion lead to a vicious cycle of gastroenteritis and deterioration of the lining of the gastrointestinal tract, which interferes with absorption of nutrients from the little food available and further reduces resistance to infection. If untreated, marasmus may result in death due to starvation or heart failure. Marchand, Miles, Glen, Gayle, & Campbell, (2013). POOR NUTRITION Reference Adams, P. (2012). JTA wants national focus on ntrition. The Gleaner. Retrieved from: http://jamaica-gleaner.com/gleaner/20120407/lead/lead4.html Antonov-Schlorke, I.; Schwab, M.; Cox, L.A.; Li, C.; Stuchlik, K.; Witte, O.W., et al. (2011). Vulnerability of the fetal primate brain to moderate reduction in maternal global nutrient availability. Proceedings of the National Academy of Sciences USA. Basch, C. (2011). Healthier students are better learners: a missing link in school reforms to close the achievement gap. Retrieved November 5, 2013 from: http://www.researchgate.net/publication/51648318_Healthier_students_are_better _learners_a_missing_link_in_school_reforms_to_close_the_achievement_gap Bender, D. A. (2002). Food and Nutrition. Oxford Dictionary of p378-9 Blake, J. S.; Munoz, K. D.; Volpe, S (2010). Nutrition from science to you. Glenview IL 60025. Pearson Education Inc. Burke, T. (2010) Five bad habits that affects performance. The Daily Gleaner. Retrieved from: http://jamaicagleaner.com/gleaner/20100920/news/news9.html Erikson, J. (2006). Brain food: the real dish on nutrition and brain function. WisKids Journal. Gibney, M., Lanham-New, S., Cassidy, A. & Vorster, H. (2009). Undernutrition. Introduction to Human Nutrition. POOR NUTRITION Gomez-Pinilla, F; and Wolpert, S. (2008). Scientists learn how what you eat affects your brain -and those of your kids. UCLA news room. Retrieved from: http://newsroom.ucla.edu/releases/scientists-learn-how-food-affects-52668 Growdon, J. H.; and Wurtman, R. J. (1980). Contemporary nutrition: nutrients and neurotransmitters. New York State Journal of Medicine. Jensen, E. (1985). How Poverty Affects Classroom Engagement. Educational leadership. Retrieved from; http://www.ascd.org/publications/educationalleadership/may13/vol70/num08/How-Poverty-Affects-Classroom-Engagement.aspx Kar, B.; Rao, S.; and Chandramouli, B. (2008). Cognitive development in children with Chronic protein energy malnutrition. Behavioral and Brain Functions. Research Journals. Kleinman, R.; Hall, S.; Green, H.; Korzec-Ramirez, D.; Patton, K.; Pagano, M.; and Murphy, J. (2002). Diet, breakfast, and academic performance in children. Annals of Nutrition and Metabolism Journal. Lahey, M., Rosen, S. (2002). Dietary factors affection learning behavior. Retrieved from: http://childrensdisabilities.info Ladau, K (2010) Nutrition and health. Retrieved from: http://whatisnutritiontips.com/ Little-White, Heather (2012). Improve nutrition among children. The Gleaner. Retrieved from http://jamaica gleaner.com/gleaner/20121221/news/news3.html. Marchand, C; Miles, I; Glen, H; Gayle, R; Campbell, S. (2013); Malnutrition. Home Economics for the Caribbean. POOR NUTRITION Wolfe, P.; Burkman, A.; Streng, K. (2000). The science of nutrition. Educational Leadership. Research Journal. Wolpert, S.; Wheeler, M. (2008). Food as brain medicine. UCLA Magazine Online. Retrieved from: http://magazine.ucla.edu Wood, M. (2001). Studies probe role of minerals in brain function. Agriculture Research.