THE RELATIONSHIP BETWEEN STUDENT'S NUTRITION AND COGNITIVE

DEVELOPMENT AMONG SENIOR HIGH SCHOOL STUDENTS

A QUANTITATIVE RESEARCH

Presented To

The Faculty Mesaoy National High School

Presented By:

Amante, Charleen

Beniga, Merry Joy

Ciudad, Elvin Rey

Ebagat, Novalyn

Paimalan, Ricardo
 CHAPTER 1

RATIONALE

Poor nutritional statics is one of the major cases of law academic performance
and productivity in primary education which may affect the physical and cognitive
development in children during their early years of life influencing the achievement of
school children is of great importance to the Nigerian since it would serve as an
essential tool for develop and be conscious to everyone health (Adebis et. al., 2016).

Hongkong is a cosmopolitan city in the southeast coast of china and enjoys

hygienic environment and immunization comparable to that of developed countries in
the west and considered as free of illnesses and well nourished. Hongkong also
concerned with the cognitive development of the health of each people is important
to which avoid form any diseased and illness. Cognitive to nutrition helps the young
people to adopt healthy lifestyle that’s promote the health of individuals and the
citizenry if the Hong Kong community (Lee and Loki 2009). Furthermore, cognitive
on nutrition of school children is included in compulsory education in Slovenia. This
is to establish nutrition knowledge, attitudes, and nutritional habits. Helping also
themselves in forming healthier nutritional habits to their home, school and in the
community (Janez et.al., 2012).

The failure in the Philippines educational system in sustaining the students

interest throughout the school year and poor performance of students are sometimes
connected to the underlying problem which poor nutrition among students. Filipino
are still facing a serious public health condition of the students although the
Government are making ways to solve to problem with the help giving knowledge of
nutritional value to everyone (Naelga and Doncillo, 2016).

Investments in education have traditional ignored the productive role of

nutrition. The relationship between nutritional status and learning among urban and
rural Filipino children shows the possible complementary of nutrition others social
investments aimed at improving school achievements. With the help of cognitive
development children could able to understand healthy lifestyle to their selves. To be
conscious also to their body and develop more healthier foods to eat (Popkin and
Ybanez, 2009).

Davao Region has high prevalence of unhealthy children according to the

2011 survey by the food and Nutrition Research institute (FNRI). Two in every10
children aged 0-5 years old, and three in the region are underweight experience slow
growth and development, perform poorly in school and are sickly. Stunting, which is
being underweight for age was every high in Davao del Norte it said to be that six (6)
in every low school age children are underweight for height or wasted. Parent’s
blames poverty and lack of job as the main reason why some of them could not
afford to give their children proper nutrition and lead to poor academic performances
and lack of achievements in the school (Cascaro, 2012).
 We observed nowadays students don’t mind what they eat they treat junk
food and soft drink as their healthy foods and vegetables are their distance for food
without realizing the cognitive effects of such unhealthy foods. For this reason the
researchers want to conduct a study about the relationship of student’s nutrition and
cognitive development among Senior High School Students at Mesaoy National High
School. In addition, researchers also observe that there is no further research who
studied the correlation between student’s nutrition and cognitive development among
Senior High Students of Mesaoy National High School.

Research Objectives

The main purpose of this study is to find out the relationship between students
nutrition and cognitive development among Senior High School students of Mesaoy
National High School. This tudy aims to answer the following objectives:

1. To described the impact of students nutrition in terms of:

1.1 Obesity

1.2 Overweight

1.3 Underweight

1.4 Severe Malnourish; and

1.5 Normal

2. To described the level of cognitive development in terms of:

2.1 Decision-Making; and

2.2 Critical Thinking

3. To find out the significant relationship between students nutrition and

cognitive development.

Null Hypothesis

There is no significant relationship between student’s nutrition and cognitive

development among Senior High School students of Mesaoy National High
School.
Theoretical Framework

The study is mainly anchored to Piaget's theory, (1936) of Cognitive

Development which clarifies how a child invents a mental model of the world. He
stated that he is none concurred with the idea that intelligence was a certain trait and
regarded Cognitive development as a course with transpires to biological maturation
and intervention with the environment. Cognitive Development is from the intellectual
process that helps individuals understand and find out about the world around them.
Cognitive comprehend all the mental activities related to thinking, knowing, problem
solving, remembering and communicating. According to his statement, the matter is
not the point where the intelligence unfolds to understand the mechanism of this
progress.

As a claimed by Albert Bandura, (1925) that human learn from the one to
another, it's either via notice, replica and modeling. The theory of social learning had
expounded the human demeanor in terms of continuous reciprocal intercourse
between cognitive behavioral and environmental. It's been stated that the theory
constantly named a bridge between behaviorist and cognitive learning theories
because it affect the attention, memory and boost.

This study is also based on the concept of Dr. Pollitt Ernest, (1984) which
states the nutrition is an endogenous that affects learning ability and skills before
and after the child is in School. Nutrition received little immersion as determinant of
school progress. Nutrition as a determinant of schooling in comparison to studies on
the social and economic determinants of schooling, there is a lack of information on
the effects that nutrition and health have an school enrolment and academic
progress. He stated that Malnutrition is a significant problem across the world both in
developed and developing countries and deficiencies in some nutrients have been
reported to cause disease which could lead to impaired cognitive development.
Many other studies have related lifestyle of students, particularly breakfast
consumption to their cognitive abilities as reflected in their academic performance.
It's been stated that, The Nutrition problem with the highest prevalence in developing
countries is protein-energy malnutrition. This is generally caused by deficient diet
with in a severely economically impoverished environment.
Conceptual Framework

Figure 1 shows the conceptual framework of the study. It is conceptualized in

this study that student’s nutrition would bring an effect to the cognitive development
on their health. The independent variable is the Students Nutrition with the indicators
of Obesity, Overweight, Underweight, and Severe Malnourish.

Students Nutrition is the most significant problem in the world and of the most
important causes for improper physical and mental development of children. This
indicates the obesity, overweight, underweight, and severe malnourish as the most
students’ nutritional problem while normal nutrition is indeed a needs of everyone as
the most top priority of every people specifically on adolescents. Under-nutrition,
which is expressed underweight and severe malnourish, is linked to nutritional
deprivation and the worldwide malnutrition estimation rates that indicate that 3.5% of
children in developing countries are underweight and 9.2% are severely malnourish.
Similarly, over-nutrition expressed as overweight and obesity is associated with
sedentary lifestyle and preponderance of energy dense foods over balanced diets
following increasing urbanization and technology. Moreover, normal nutrition receive
children the correct amount of all essential type of food necessary for normal growth
and good health. They have diet which contains the correct amount of each nutrient
(food type). Although the type of food varies with age, it is important that all children
have an adequate diet which contains all the main nutrients in the correct proportion
(Awotidebe et. al., 2015).

On the other hand, the physical health of the students is the dependent
variable that conceptualizes the decision-making and critical thinking. The moderator
is the gender.

Role of cognitive development and maturation is indispensable. According to

Piaget, ones cognitive competence becomes sophisticated throughout four
developmental stages according to ones age. Children aged between 7 and 11 years
are at the concrete operational stage. There logical reasoning is developing which
allow them to mentally arrange and compare things. Critical thinking starts to
blossom as their thinking becomes decentered and less egocentric, which allows
them to consider others' perspective and clarify one thought. This becomes more
advance when they rich the formal operational stage (age 12 or above) because they
are able to think systematically, manipulate mental objects, test hypothesis, and
draw conclusions based on reasoning. Followed by the decision-making which is
taken when several exclusive option are available or when there is a choice of action
or not. The decision is the selection of appropriate actions to fulfill the desired
objective trough critical thinking. On making decision successfully we should all try to
achieve some level of critical thinking to solve problems (Hui, 2011).

Critical Thinking and Decision making is the significant indicator for cognitive
development. Critical Thinking refers to a purposeful method of reasoning that is
systematic, reflective, rational, and outcome oriented. It is an important part of
psychiatric-mental health nursing and the interpersonal relationship. Through the use
of critical thinking, psychiatric-mental health nurses make clinical decisions that
translate into an appropriate plan of care for the patient Critical thinking correlated
with decision making does not refer to thinking that is judgmental, negative, or
dismissive about a given strategy, plan, or subject under consideration. Rather, it is a
conscious, organized activity that requires development over time through consistent
effort, practice, and experience. Critical thinking is dynamic, not static, and ever-
evolving based on the circumstances of the individualized situation (Harding &
Snyder, 2015).
 CONCEPTUAL FRAMEWORK

INDEPENDENT VARIABLE DEPENDENT VARIABLE

Cognitive Development
Students Nutrition
 Decision-Making
 Normal
 Critical Thinking
 Obesity
 Overweight
 Underweight
 Severe Malnourish

 Gender

MODERATOR

Figure 1: Conceptual Paradigm Showing the Variables of the Study

SIGNIFICANCE OF THE STUDY

The result of this study may serve for the DepED Officials in
implementing activities for Senior High School Students. This also may help and
attain as guide for the School Heads in developing activities in their respective
schools. The community and Barangay also may conduct significant activities to help
the people in health perspective. It adds the body of information to the Parent and
Teachers to guide their children and students in giving healthier foods and
knowledge, and also in making choices in their high school programs. To the
students this study will help and provide to know the relationship between students
nutrition and cognitive development. For the future researchers they may find this
study useful by gathering some information that may help in future researches.

Definition of Terms
The following terms used in this study are defined operationally and
contextually.

Student’s Nutrition. Nutrition begins with food and the process by which the body
nourishes itself by transforming food into energy and body tissues. The science of
nutrition concerns everything the body does with food to carry on its functions. Food
provides essential substances called nutrients. The body needs these nutrients to
help it make energy; to grow, repair, and maintain its tissues; and to keep its different
systems working smoothly (Feinstein and Sorhaindo, 2014). Operationally, the term
used is well defined as essential substances which build energy to create an action,
this substances help our body to have a normal process to repair and maintain the
damages on our tissues, and make our organs work so well. The process of
providing or obtaining the food necessary for the health and growth.

Cognitive Development. The study of childhood neurological and psychological

development. Specially, it is assessed based on the level of conception, perception,
information processing, and language as an indicator of brain development. It is
generally recognized that cognitive development progress with age, as a human
awareness and understanding of the world increases from infancy to childhood, and
the gain into adolescence (Newcombe, 2013). Operationally, the term used is well
defined as the mental action or process as the mental action or process of getting
knowledge and understanding through thought, experience, and the senses. Having
comprehension to the environment the people used to be.
 REVIEW OF RELATED LITERATURE

This section unfolds the various ideas that were considered relevant to the
present investigation so that the readers are given clear picture of what is being
emphasized in the study.

There have been a number of studies that have studied and analyzed the
relationship between student’s nutrition and cognitive development. Sinurat et. al.,
(2018) concluded in their study that students nutrition and cognitive development has
correlation to each other.

Cognitive Development

Cognitive development is the development of the ability to think and reason.

The ability to think in concrete ways such as how to combine, separate, order, and
transform objects and actions. Adolescence marks the beginning development of
more complex thinking process including abstract thinking, the ability to reason from
known principle and to think about the process of thinking (Stanford Children's
Health, 2009).

Higher cognitive ability also improves individuals access to better

environments and enables individual, institutions, society and cultures to improve
the quality of the available environment. Cognitive ability also brings about distal
consequences, such as greater wealth and health; a more complex culture and
longitudinally, by backward effects of the environmental factors again enhance
cognitive ability (Rindermann, 2012).

Deficiencies in some nutrients have been reported to cause disease which

could lead to impaired cognitive development. Other studies have related lifestyle to
studies, particularly breakfast consumption, to their cognitive abilities as reflected in
their academic performance (Bhattacharya et.al., 2013).

Decision Making

Decision making is one of the basic cognitive processes of human behaviors

by which a preferred option on a course of actions is chosen from among a set of
alternative based on certain criteria. Real world decision is the perceived as
repetitive applications of the fundamental cognitive process. The cognitive process of
decisions making may be applied in a wide range of problems, solving and more
complex and right decisions (Wang, 2010).

People who think more had a better decisions making process than concrete
thinkers and made more health promoting decisions. Health educators are
challenged to create educational strategies that enhance abstract development and
teach classic steps of decision making theirs improves the decision making ability of
the adolescents (Duryea and Hammes, 2010).
 Moral decision-making occurs, mature over time and relates to behavior is
complex. To develop a full premature of moral decisions making, moral development
and moral behavior it is necessary to understand the real time moral decision are
made, the process to required to develop and to enable mature moral decision these
process develop over time and in moral decision relate to behavior (Adlam, 2018 ).

Critical Thinking

Critical thinking means one needs to be critical to the concerned issue as well
as one's thinking, so that one can proceed to make inference and deduction from the
information collected for doing a rational evaluation and making reasonable solution.
Critical thinkers like to reason about their reasoning and make inference and
conceptualization with rational justification. Their habitual inspection of the thinking
is, in fact "an action of ongoing creation" contributing to their cognitive and
intellectual advancement (Sun, 2012).

The development of critical thinking is an important step in achieving the goals

of holistic education, not only through helping students gain knowledge but abuse all
through ensuring that they think effectively and strengthen their motivation to think
critically, developed more comprehension to skillfully conceptualizing, applying
analyzing, synthesizing, and/or evaluating information gathered from generated
observation, experience, reflection, reasoning, or communication, as a guide to belief
and action (Remienel, 2010).

In engaging critical thinking, one should make reference to reliable, strong,

and relevant criteria, such as norms, shared values, laws, rule, definition, facts, and
valves, and pay attention to the situational factors, such as special circumstances
and limitations, and variations in culture, context, time, and people. One should also
reflective and self correcting so as to question one's own thought, identity and errors
in one's own thinking, and made reasonable corrections (Elder and Paul, 2010).

Students Nutrition

Nutrition in the early life has been shown to have a substantial influence on
long-term health and development. There are critical period when the system and
organs of the human body are plastic and sensitive to the environment, and most
occur in uterus, except for the brain, liver and immune system, which remain plastic
after birth. Nutrition plays an important role in pregnancy as these are the critical
periods of brain formation that will served as a foundation for the development of
cognitive, motor and socio emotional skills throughout life (Nurliyana et.al 2016).

Nutrition is an issue of great academic and public importance as change

dietary habits could results in a healthier and longevity. Many medical schools have
been trying to improve their nutritional education curricula. Some form of nutrition
education belongs to the curriculum of most medical schools worldwide
(Yfanki, 2011).
 Normal

Contemporary philosophy of health has been quite focused on the problem of

determining the nature of the concepts of health, illness and disease from a scientific
point of view. Other philosophers claim that the concept of health, together with the
other medical concepts, is essentially value-laden. To establish that a person is
healthy does not just entail some objective inspection and measurement. It
presupposes also an evaluation of the general state of the person. A statement that
he or she is healthy does not merely imply certain scientific facts regarding the
person’s body or mind but implies also a (positive) evaluation of the person’s bodily
and mental state (Nordqvist, 2013).
Your weight can affect your health and the way you feel about yourself. How
much you weigh mainly depends on your lifestyle and your genes. A healthy weight
is a weight that does not create health or other problems for you. A healthy eating
plan that helps you manage your weight includes a variety of foods you may not
have considered. We recognize that many people find it hard to maintain a healthy
weight and unfortunately there is no easy fix to losing excess weight and keeping it
off. Our biology, the environment we live in, influences from our society and cultures,
and the choices we make about the foods we eat and the activity we do all affect our
weight. We all live in a world today that more readily promotes unhealthy rather than
healthy eating, and fosters sedentary activities more than physical activities. We also
recognize that over recent years, people’s perception of what is a she perception of
what is healthy weight has changed (Nordenfelt, 2009).

Consuming a healthy diet throughout the life-course helps to prevent

malnutrition in all its forms as well as a range of no communicable diseases (NCDs)
and conditions. However, increased production of processed foods, rapid
urbanization and changing lifestyles has led to a shift in dietary patterns. People are
now consuming more foods high in energy, fats, free sugars and salt/sodium, and
many people do not eat enough fruit, vegetables and other dietary fiber such as
whole grains. A healthy diet and regular exercise can help prevent overweight and
obesity. Poor food and drink choices and not enough physical activity often lead to
weight gain. Maintaining a healthy weight reduces your risk of cancer. Eating well
provides you with nutrients and energy, and will help you to reach and maintain a
healthy weight. Understanding energy density and portion control will help you to eat
well. Reaching and maintaining a healthy weight is not only about what you eat, but
also about how much you eat. Portion control is very important in helping you to
achieve your healthy weight goals. (World Health Organization 2018)

Obese

Obesity consist a major nutritional health problem in developed and

developing countries which has reached epidemic proportions. Obesity is defined as
the condition of excessive fat accumulation to such an extent that affects the
individuals’ health. Obesity is chronic disease which has spread all over the world
and threatens public global health. The phenomenon of obesity has drawn the
attention of the scientific community organizations and governments worldwide
because it affects peoples’ lives negatively and imposes excessive financial
implication in every health system. In addition, Obesity has been the major interest in
health sciences and among research studies have focused not only on the
prevalence and the risk factors of obesity but also on the significant consequences
on the quality of patients’ life. Furthermore is associated with increased incidence of
type 2 diabetes mellitus, hypertension, coronary heart disease, arthritis, sleep apnea
and certain forms of cancer (Polkandrioti and Stefanou, 2009).

Obesity/and overweight is a global epidemic among children of all ages. Pre

and primary school children who are obese are more like to continue to be obese as
adolescents and adults, as well as stand at an increased risk poor health outcomes
associated with excess weight. Excessive fat accumulation in the body may impair
health leading to a significant long term health consequences including the
development of diabetes, coronary heart disease and osteoarthritis as well as
increasing the risk of developing certain cancers and influencing their outcomes.
Obesity is an abnormal accumulation of the body fat (usually 20% above the normal
ideal body weight) to the extent that it may have adverse effect on health. It is
chronic disorder officially classified as a disease in 1990 and defined as a body mass
index (BMI) of 30 kg/m or more. Obesity is a rapidly growing public health problem
affecting on increasing number of countries worldwide because its prevalence, cost
and health effects (William and Greene, 2018).

Overweight

Overweight in the pediatric population has attracted much attention because

childhood and adolescence are critical development periods during which individuals
established the found actions for their future health .It defined as excessive weight
presenting health risk because of the high proportion of body fat. The most
frequently used measure is based on the body mass index (BMI) which is a single
number that evaluates in individuals weight in relation to height or vice versa
(Sabo et.al., 2012).

Childhood overweight is associated with higher probability of obesity in

adulthood, which can lead to a variety of disabilities and diseases, such as diabetes
and cardiovascular disease. The risks for most non-communicable diseases
resulting from obesity depend partly on the age at onset and duration of obesity. It
has been implicated as factors in poor academic performance for elementary and
high school aged students. Several studies have implicated early childhood and
adolescent obesity and/or being overweight in poor performance in school (Yates et
al., 2012).

The Development of overweight may result from stress connected with

unhealthy eating habits. Stress related eating behavior was more common among
girls (43%) rather than boys (15%) and persons eating more in stressful situations
were characterized by a higher incidence of overweight. Childhood is associated with
higher probability of overweight in adulthood which can lead to variety of disabilities
and disease. Overweight children had significantly reading test scores compared
with non overweight in kinder garden (Joaskelainen et. al., 2014).

Under Weight

Underweight is body weight that is too low for a normal healthy adult or child.
It is also known by various other names such as wasting, emaciation, thinness,
stunting, etc, and is caused by multiple factors especially lack of adequate nutrients
in the body. Underweight can potentially by itself lead to adverse health effects such
as higher disease burden, it affects the outcome for several medical conditions and it
is a known risk factor (Uzogara, 2016).

An underweight child who is often irritable, depressed or aggressive is not

likely to effectively develop these social skills. This has negative consequences for
later academic achievement as the development of social skills lays the foundation
for academic achievements as well as work related skills later in life. Underweight
children having increased risk for delay in hearing and language domain and
interactive social domain. It is also important to further strengthen nutrition
programmed aimed at reducing the burden of under nutrition such as food
fortification, food diversification and school feeding programmed as well as the well
established optimal in font and young child feeding recommendation to exclusively
breastfeed for the first six months with continued breastfeed to 2 years, together with
the introduction of safe, age- appropriate and adequate complementary foods from 6
months (Anyiam et al., 2017).

Severely Malnourish

Severely Acute Malnourish (wasting) is defined as reflected a nutritionally

deficient state of recent onset related to sudden food deprivation or mal-absorption
utilization of nutrients which results weight loss, weight-for-height below-2SD from
the NCHS/WHO median value severe wastage was diagnosed if it was-3SD.
Malnutrition remains one of the most common causes of morbidity and mortality
among children under five children throughout the world. Worldwide over 10 million
children under the age of 5 years die every year from preventable and treatable
illness despite effective health interventions. At least half of these deaths are caused
by malnutrition. Acute Malnourished children have a lowered resistance to infection
therefore they are more likely to die from common childhood ailments such as
diarrhea diseases and respiratory infections. In addition, Malnourished children that
survive are likely to suffer from frequent illness, which adversely affects their
nutritional status locks them into a vicious cycle of recurring sickness faltering
growth. In developing countries, malnutrition is a major health problem
(Debebe et. al., 2016).
 Severe Acute Malnutrition affects nearly 20 million Pre-school age children
mostly from the World Health Organization (WHO) African Region and South-East
Asia Region. Malnutrition is significant factor in approximately one third of the nearly
8 million deaths in children who are under 5years of age worldwide. WHO
established guidelines for the treatment of severe acute malnutrition of severe
malnutrition. Severe Malnutrition is both a medical and social disorders. Successful
management of these severely malnourished patients requires that both medical and
social problems be recognized and corrected. If the illness is viewed as being only a
medical disorders, the patient is likely to relapse when he/she returns home and the
rest of the family will remain at risk of developing the same problem. Therefore,
successful management of severe malnutrition does not require sophisticated
facilities and equipment neither highly qualified personnel. It does, however requires
that each children be treated with proper care and affection (World Health
Organization, 2013).

Correlation between Student Nutrition and Cognitive Development

Cognitive development is influence by many factors, including nutrition. There

is an increasing body of literature that suggest a connection between improve
nutrition and optional brain function to development is faster in the early years of life
compared to the rest of the body which may make it more vulnerable to the health of
everyone. Cognition represent a complex set of higher mental functions sub served
by the brain, and includes attention, memory, thinking, learning, and perception.
Education increases and individuals sense of personal control and self esteem, there
factors behave also been shown to influence better health behavior (Foster, 2013).

Physical activity and healthy lifestyle in early childhood are associated with
better cognitive outcomes in young children. Given that the early childhood years are
critical for both obesity prevention and neurocognitive development, evidence that
the same healthy behaviors could promote both should inform future interventions.
Independent weight status, poor diet and activity levels may also have
consequences for children’s current and future health development. The early
childhood years are a time for rapid robust growth in cognitive development, but also
a time for great vulnerability in this regard (Amso et. al., 2016).

Given the high prevalence of suboptimal nutrition and activity levels in

children today and our limited knowledge of the effect on cognitive outcomes, a
systematic review of the associations between physical activity, nutrition, and
cognitive development in early childhood is needed. Although the relationship
between health nutrition and cognitive development in young children is not well
understood. There are pathways through which aerobic. The cognitive demands of
goal-directed and engaging exercise, cognition required exercising complex motor
movement and the short-and long-term physiological change in the brain induced by
aerobic exercise. Compelling evidence exists in older children and adults and
physical activity, particularly aerobic exercise and progressively challenging
activities, and physical fitness, enhance cognitive development (Carson et. al.,
2015).
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