Association of Gastrointestinal Symptoms and Psychological Issues With the Intake of Fruits, Vegetables, and Junk Food in School Children: A Community-Based Study From Melmaruvathur, Tamil Nadu, India

TL;DR

This study finds that poor fruit and vegetable intake and high junk food consumption in schoolchildren are linked to gastrointestinal issues, psychological problems, and poor nutrition.

Contribution

The novel contribution is identifying the significant association between junk food intake and adverse health outcomes in schoolchildren in a semi-rural Indian setting.

Findings

Junk food intake is significantly associated with gastrointestinal, psychological, and nutritional issues in schoolchildren.

Fruit and vegetable intake is far below recommended levels in most children.

High rates of abnormal BMI and psychological issues are observed among the studied children.

Abstract

Background

Gastrointestinal (GI) symptoms are among the most common and rapidly increasing symptoms in pediatric outpatient practice. Similarly, psychological issues and abnormal nutritional status are also worsening in school-going children. GI morbidity, psychological issues, and nutrition are intricately related to diet, especially fruit and vegetable (F&V) and junk food intake. This study aimed to explore the current prevalence of significant GI symptoms, psychological issues, and nutrition in schoolchildren and their association with F&V and junk food intake.

Methodology

This was a cross-sectional study conducted among schoolchildren in classes 1-10 from a semi-rural private school. A prevalidated questionnaire for common GI symptoms and their severity was completed by 394 students. A semi-quantitative focused Food Frequency Questionnaire (FFQ) was used for F&V and junk food intake. Psychological screening was done using the Strengths and Difficulties Questionnaire (SDQ). Body mass index (BMI) was obtained from school records. Microsoft Excel and SPSS version 29 were used for descriptive statistics, and Mann-Whitney U tests with effect sizes were used for non-parametric analysis.

Results

Significant GI symptoms were present in 113/394 (28.7%) children. SDQ screening revealed that psychological issues were probable in 66/354 (18.6%) and definite in 58 (16.4%) students. BMI was abnormal in 149/385 (38%), with thinness noted in 43 (11.3%), severe thinness in 32 (8.3%), overweight in 53 (13.7%), and obesity in 21 (5.55%) children. Median greens intake was 6.43 g/day, at a median frequency of one to two times per week, with 74.4% of the children consuming less than 25% of the recommended intake. Median intake of vegetables was 30.5 g/day, at a frequency of one to two times per day, with 83.3% of children consuming less than 25% of the recommended intake. Fruit intake was 40 g/day, at a frequency of three to four times per week, with 45% of the children consuming 50-75% of the recommended intake. Total median F&V intake was 77.4 g/day, at a frequency of one to two times per day, with 63% consuming less than 25% of the recommended intake, and a mere 1.8% consumed 100% or more of the recommended intake. The median frequency of junk food intake was 2.3 times per day. Common junk foods included biscuits, health drinks, and home-made oily, high-calorie foods. Junk food intake was associated with statistically significant, adverse GI, psychological, and nutritional outcomes. F&V intake did not show a statistically significant association with any of the above parameters.

Conclusions

Significant GI symptoms are very common in schoolchildren. Nutritional indices are worsening, and psychological issues are also not uncommon in school children. Junk food intake is very high and increasing alarmingly, and is significantly associated with adverse GI, psychological, and nutritional outcomes in schoolchildren. F&V intake is very poor and is decreasing more than ever before in schoolchildren. These findings are concerning. Suitable action must be taken on a war footing at the individual, family, school, and governmental levels to increase F&V intake and decrease junk food intake in schoolchildren to reduce both immediate morbidity and ensure the future health of children. This can be done through greater awareness among parents, children, teachers, and governmental commitment to improve gut health, psychological health, and nutrition of schoolchildren.

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