Sultan Qaboos University

College of Medicine and Health Sciences

Department of Family Health and Community Medicine

Nutrition and Health

“Patterns of Energy-dense Foods Consumption among Adults and Elderly in
Al Khoudh Village”

Group 9

Mustafa Al Balushi 81555

Samir Al Balushi 81581
Abjad Al Busaidi 81553
Shahrazad Al Belushi 83445
Nada Al Saadi 81600
Safiya Al Busaidi 83447
Hajer Al Gilani 81613
Shaima Al Ruziqi 81620
Khulood Al Mamari 83569
Patterns of Energy-dense Foods Consumption among
Adults and Elderly in Al Khoudh Village

Abstract

a. Background
Since the beginning of the modern renaissance in Oman in 1970, the Omani
society has gone through enormous progressive social and economical changes.
However, along with the advances, there were a number of changes in lifestyle and
food consumption that could not be described as progressive, albeit predominant in
most modern societies in the world.

b. Objectives
This paper aims to assess and address the mode of consumption of different
food categories in Al Khoudh village and to study the patterns of consumption of
energy-dense foods among the adult and elderly residents.

c. Methodology
Segregated households were chosen to obtain the needed data. The data was
collected via per person survey forms, a weighing balance and a measuring tape
during field visits conducted by medical students. Adults and adolescents were
interviewed and asked about their food consumption routines. Mothers with
children below 5 years were asked about their children‟s health and nutrition
statuses.

d. Results
It was found that the consumption of energy dense foods was not high
among adults. There was less reliance on these foods to attain daily energy needs.

e. Conclusion
Modern life forced many families to change their diet-related habits and
lifestyle. Many people have adopted sedentary lifestyle and this had negative
impacts in regard to health and longevity.
Introduction

Throughout history, diet and nutrition played important roles in humans‟

lives. And food consumption varied vastly from a period to period and a place to
place.

In Oman, the situation was not very different. Staple foods prior to 1970
consisted of five major foods; rice, fish, milk, dates and bread. However, after the
rapid modernization of the country, nutrition and food consumption changed
dramatically in pattern, quantity and quality. Now, different kinds of foods are
imported into the country thanks to the country‟s open financial policies. Fast food
and takeaway restaurants are to be found in nearly every major city in the
Sultanate.

In addition to all that, Omani people themselves started changing their eating
habits gradually to cope up with the rapid changes that their country is going
through. Families that used to have three major nutritious meals together and a date
and coffee snack in between these meals now have their food in an inconsistent
pattern, snacks eaten throughout the day, major meals missed and excessive
consumption of energy-dense foods and drinks.

The enormous changes in lifestyle eased many things, but, be that as it may,
it caused the emergence of many deleterious health concerns which irk health
facilities throughout the world. Insulin dependent diabetes, hypertension, sight
problems, obesity..etc are a few examples of the long list of health conditions that
were not predominant in old days but started appearing in Oman during the last
three decades due to the changes that were explained above.

The large number of patients suffering from such nutrition and sedentary life
style related conditions who are admitted and treated in hospitals and other health
facilities put enormous pressure on the government and this depletes a large
amount of the health budget.

Fortunately, conditions that are caused by sedentary lifestyle can be

prevented by changes in daily nutritional habits.
Methodology

A total of four field

visits were conducted to Al
Khoudh village in the period
between 24th and 27th of
January, 2011. Al Khoudh
village is a small and sparsely
populated area of Wilayat As‟
Seeb, Muscat governorate.

The field visits were

part of the course: Village
Health Care II, which is a
mandatory course that aims to
equip medical students with the necessary communication and data collection
skills for their future careers. Additionally, it is an important method to obtain
information regarding nutrition in different areas of Oman. Moreover, student
doctors can practice health education with the residents using the material
provided. The course particularly concentrates on nutrition, diet and health
education.

Three male and six female students who were designated as group 9 visited
the households and collected the data over the period and under the supervision of
a qualified nurse from the Sultan Qaboos University Hospital (SQUH).

One questionnaire form that was designed particularly to meet the

requirements of the course was used. It was prepared to obtain detailed and
relevant information regarding nutritional habits of the people, general health
questions and anthropometric measurements. Additionally, A metric measuring
tape was provided for height measurements and a weight balance scale for weight
measurements. Educational material about healthy nutrition, 12345+ diet, children
dietary advices, breast feeding food guide and sample growth charts were provided
by the course coordinator in separate clipboards.
 The designated spot for group number 9 was in the middle of the village,
where the students went last
year for the pre-requisite
course: Village Health Care I.
Transportation to the area and
back was provided by the
University.

Arrival on the first

three days was in the morning
at 9:00 a.m. Segregated
houses were chosen and
household members were
interviewed. For each household, a list of all members was obtained. In addition to
that, source of drinking water, the approximate income of the family and total
amount of money spent on food was questioned. For each member, a questionnaire
form was filled.

A total of 132 people from different age groups were interviewed in the
centre of the village and the area of the village beside the central area called Hillat
Al Qartah.

The residents were cooperative and welcoming. The majority of adult

members have shown that they
were aware about some of the
health hazards inflicted by non
healthy foods and were very
interactive during the health
education session at the end of
the interview. The educational
material and particularly the
ones which were concerned
with nutrition of people
affected by certain health
conditions like anemia or
 pregnant women and lactation
were carefully distributed on the
families or family members.

The questionnaire form

was divided into a number of
categories. First, the participant
was asked about his/her name,
age, gender and relationship
status. Additionally, educational
level and current employment
status was investigated.
Food Item
Fish
Information about physical activity and its nature was also Meat
collected and the participant‟s perception of his weight was Sausage
Burger
recorded. Eggs
Legumes
Milk
The interviewees were also asked about signs of
Cheese
constipation to know whether they had enough fibers or not. Yoghurt
Furthermore, The weekly routine of consumption of major meals, Rice
Pasta
snacks and certain foods was obtained. Family history of few Potato
age-related and genetic conditions was collected. Bread
Cereal
Dates
Information about children below 12 was obtained from Fruit
Nuts
their mothers due to concerns about validity of information that Coffee
would be obtained from youngsters and the professional Tea
Fresh fruit juices
communication barrier. Fizzy drinks
Fruit drinks
Cooked Vegetables
Moreover, children below five had an additional category
Water
that included birth weight and length, breast feeding duration, Chocolate
first food consumed after birth, weaning practices, signs of Halwa
Crisps
malnutrition, weight and height categories. Additionally, a Ice-cream
separate table of certain foods was filled for them. The weight Sweets
Corn puff
was obtained by weighing both the mother and baby and later
subtracting the weight of the mother from the total number.
 Nearly all households had a few members who were either not present in the
morning time or were sleeping. A fourth visit was conducted on Thursday
afternoon to collect the data for the remaining missing members and the
breadwinners of the households. Unluckily, even on the fourth day, some members
were not available for interview. Those members were not included in this study.

Results

The number of participants and interviewees in this survey was 132 people
of different ages. About 36.4% of those were adults belonging to the age group (20
- 50) years and about 23.5% of the participants belonged to the age group (6 - 12)
years, representing children above the age of 5 in the population, whilst 15.9% of
the population belonged to the teenagers age group (13 - 19) years. Children
belonging to the age group (X ≤ 5) were 15.2%. Lastly, 9.1% of the population was
elderly above the age
Table (2): Age distribution of 132 people
of 50.
Frequency Percent Cumulative
Out of Percent
seventeen families, age below 5 20 15.15 15.15
eight have mentioned group children 31 23.48 38.64
family history of teenagers 21 15.91 54.55
diabetes and six other adults 48 36.36 90.91
a
families recalled elderly 12 9.09 100
history of arthritis Total 132 100
while three families a. Oldest person is of 80 years
mentioned to the
interviewer the presence of at least one family member with anemia and two other
families mentioned skin disease. Only one family had a heart disease history.
Table (1): Family history of diseases

Disease No. of families

Diabetes 8
Heart disease 1
Anemia 3
Osteoporosis 0
Arthritis 6
Obesity 0
Skin disease 2

Figure (1): Bars showing the level of education among the population. Note that non applicable
group includes children below the school age (school age: 7 =< X in Oman)
 From figure (1), it was noted that about 6.8% of the population have
successfully finished their high school education and pursued post secondary
education. Interestingly, the percentage of illiterate people is equal to the
percentage of people who gained higher education.

After measuring the body mass index (BMI) for the non pregnant females
and individuals above the age of 18 people in the population, it was found that over
half of those, roughly 51.6%, had a normal BMI. About 21% of those were
overweight and 17.7% were obese. Only 9.7% of those were underweight
according to the BMI measurements.

Figure (2): Distribution of non pregnant and above the age of 18 members of the population in the
BMI categories
Figure (3): BMI for males Figure (4): BMI for females

From figure (3) and (4), the percentage of overweight men is significantly higher
than women. Additionally, the percentage of obese women and women of normal
weight are higher than that of the men.

Type of Foods Every Day Some Days Not Often

Sweets 8 5 47
Fizzy Drinks 3 20 36

Crisps 7 12 40

Ice cream 0 1 59

Corn puff 8 6 45
Halwa 2 5 54

Figure (5): Consumption of energy dense foods for non pregnant and above the age 18 members of
the population

Figure (5) indicates that the majority of targeted members did not consume these
foods as a routine. However, some foods like fizzy drinks were consumed more
often and in a higher frequency.
 Type of food Every Day Some Days Not Often
Fish / Meat 4/0 24/ 16 34 / 46
Egg 8 31 23
Bread / Rice 60 / 55 2/5 0/ 2
Fruits / Vegetables 38 / 38 16 / 17 8/ 9
Dates 52 8 2
Milk 43 8 7

Figure (6): Consumption of staple foods for non pregnant and above the age 18 members of the
population

More or less, staple foods for most of the interviewees included: bread, rice, fruits,
vegetables and dates. Refer to figure (6).

Table (3): Total income for 17 families

Cumulative
Frequency Percent
Percent
income group low 3 17.6 17.6
moderate 10 58.8 76.4
high 4 23.5 100.0
Total 17 100.0
Low= below 250, moderate=250-800, high = above 800

Table (3) shows the different income categories that were found in the village. The
percentage of people of moderate income was extremely higher than the other two
categories.
N/A people between 12 and 0
Figure (7): Perception of body weight for sample the population

Type of foods Every day Some Not often

days
Fizzy drinks 6 6 19
chocolate 15 11 5
crisps 13 11 7
ice cream 7 3 21
Sweets 16 5 10
corn puff 17 12 2

Figure (8): Consumption of foods among children aged (6 - 12)

 According to figure (7), it was found that about 19% of people were
pessimistic about their weight. They wished to lose a few kilos. However, the
percentage of people who were satisfied about their weight was about 25%.

The pattern of consumption of the same elected energy-dense foods was

somewhat random and it did not follow a defined pattern among the children.
Foods like corn puffs, sweets and chocolate were consumed more often than other
foods. Refer to figure (8).

Discussion

The distribution of BMI values for over half of the measured population was
normal and the number of normal females was higher than normal males by
roughly 6%. This can be explained by the fact that the majority of adult women in
the village performed light daily chores. Additionally, many of the houses were
found to have small farms or animal yards annexed to their houses. During the
interview, the majority of women explained that it was their duty to look after the
animals and clean their yards.

Conversely, the number of obese women was significantly higher than the
number of obese men. This was found in houses with multiple related families. In
such households, a few women took the responsibly of doing the chores while
others followed a sedentary lifestyle and rarely performed any kind of activity
around the house or outside. Such findings were also evident in households with
housemaids. However, these houses were not abundant in Al Khoudh village.

The majority of men in the village had jobs that required light physical
activity and there was nothing peculiar about the findings among men except for
the underweight men. Those were majorly found in less privileged families with
lower income and poorer sanitary conditions. It also applies to female underweight
individuals. Interestingly, one young adult female in a more privileged family
admitted that her weight was low because of her obsession with current pop trends
among youngsters and not because of poor surrounding conditions. These trends
favor people, particularly females, with low weight and more lean and slim looking
bodies.
 Staple foods for the majority of the residents in the village consisted of: rice,
bread, vegetables, fruits, dates and milk. However, fish and meat were consumed
in an inconsistent pattern. It can be roughly stated that the consumption of the latter
two foods was less often, especially red meat.

Red meat and fish meat were replaced by white meat which was consumed
very often in nearly all households. Many of the families used poultry products
from their farms. Dates were heavily consumed in the village. Many families had
two snacks a day that consisted solely of dates and Omani coffee. It is rare to find a
family without, at least, one member who consumed dates on a daily basis.

The consumption of commercial, energy-dense and sugar-dense foods

among adults and elderly was satisfactorily moderate. Fizzy drinks, which are
probably available in every convenience store around the town were consumed
many days per week by a considerable number of people. Generally, the pattern of
consumption of these foods was moderate to low because of a number of
hypothesized reasons:

- The majority of adults confined from consuming such foods, because of the
negative perception they had about them. They were often described as „kids
foods‟, „disease inflicting foods‟…etc.

- Approximately all adults had three nutritious major meals.

- Most of the families had moderate income and paid less attention to
„luxurious bounties‟ as it has been expressed by many of them.

- A number of adults mentioned that they do not consume these foods because
they were not used to do so since they were little.

Yet, many of the families did not restrict these foods on their children and
allowed them to consume the foods in an inconsistent pattern. However, certain
foods like Halwa and fizzy drinks were promptly limited.
Conclusion

Oman has gone through diverse and rapid economical and social changes in
the past 30 years. Nutritional and food consumption practices were evidently
altered. In this paper which aims at assessing the nutritional statuses of a sample
population from Al Khoudh village and studying the patterns of consumption of
energy-dense foods among adults, it was evident that the consumption was
moderate and over half of the population had normal BMI. The number of
overweight and obese people was not very high. Participants reported that they
confined from consuming these foods and limited the availability of some of them
on their children.

It is recommended that the health education providers should concentrate on

delivering relevant dietary information to adults and child bearing mothers. Field
education is commended as well for many of the participants showed much interest
in the educational session at the end of the interview.
References

- Village Health Care II manual, Jan, 2011.

Acknowledgements

Efforts of course coordinator Mrs. Wahida Al Maskari & the group

supervisor Ms. Jovylyn are highly regarded.