Sunday, February 26, 2017

A study on the Association between lamp flaps consumptions and Obesity in a peri-urban setting in Papua New Guinea



A study on the Association between lamp flaps consumptions and Obesity in Sisiak peri-urban setting
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A research paper submitted to the Department of Environmental Health Science at the Faculty of Health Sciences
Divine Word University

In partial fulfillment of the requirement for the Bachelor of Health Science (Environmental Health)
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JWL & AK

Guide:  K. Totona (Mr)

MADANG
2011


Acknowledgement
First and foremost, we would like to thank God for his imparting knowledge, guidance and protection through the entire process of the study from the beginning through to the end. Though, the study was conducted outside of the university and in a settlement, we have not faced any problems when conducting the research. It was under his guidance and protection that this research study has finally come to a completion successfully. Without him, this research would not have come out fruitfully, otherwise.
Secondly, we would like to thank our guide Mr. Kari Totona, the Head of Department for Environmental Health for his continuous guidance on the progress of the research study and his assistance in providing us with the meter ruler and the clinical scale that were used in the study. His contributions throughout the study are highly appreciated. We extend our appreciation to our research course lecturer and coordinator Mrs. Rose Begani for her guidance and support to the study for it to come out a success for us.  
Thirdly, we convey our thanks to the research participants at the Sisiak peri-urban setting for part taking in the research in filling out the research questionnaires, taking part in the interviews and involved in the gathering of weight and height measurements. We also, would like to thank Paul Kapo and John Pang for their tireless support and assistance for us in carrying out the research from day one up until the data collection process ended fruitfully as initially planned for.   
Finally, we express our gratitude towards the 2011 final year environmental health students. They have been very supportive in whatever ways in working together as a class from the first year in 2008 till the final year. Despite a lot of difficulties and pain we encountered, some had left, however we have finally made it through to the end together successfully.
Abstract
This explorative study purposely investigated the frequency of lamp flaps consumptions and its impacts on the weights of individual lamp flaps consumers in the Sisiak Peri-urban setting in Madang. The study further investigated the reasons to lamp flaps consumptions and the methods of lamp flaps preparations for human consumptions in the Sisiak area. The researcher made questionnaires, face to face interviews, physical measurements and observation methods were used for gathering the raw data for the research study. The study involved a total of 100 participants who voluntarily participated. The voluntary participation in the data collection gave naturally a random participation of individuals in the research. From the total, 50 participants were males and the other 50 were female participants involved. They all aged between 15 and 35 years, who have been living in Sisiak peri-urban setting for more than three months.
The findings of the study showed that 66% majority of the obese population in the Sisiak urban-setting consumed lamp flaps more frequent followed by overweight population and the underweight population was the least frequent lamp flaps consumers. It was revealed from the findings of the study that 46% majority of the total population in Sisiak peri-urban setting was under the normal weight range whilst 30% of them were under the overweight range and a handful of them were obese. Further, the findings of the study showed that low price of lamp flaps was the leading reason (32%) for lamp flaps consumption in Sisiak area and 23% of them consume lamp flaps because it is more accessible to them whilst only 10% consume lamp flaps because of other reasons.  The findings of the study further revealed that boiling was the most common preferred method (44%) of lamp flaps preparation for human consumptions in the Sisiak peri-urban setting and frying was the second most (35%) preferred method. Other methods such as roasting, karamap and smoking were the least preferred methods of lamp flaps preparations for human consumptions in Sisiak peri-urban setting.

Key words
Peri-urban setting:  A human inhabiting settlement at the outskirts of a city or town
Saturated fats:   Fats containing triglycerides made up of saturated fatty acids that have single carbon bonds in their chemical structure
Lamp flaps: meats from sheep that are less than a year old which are killed for commercial purposes
Mumu: A pidgin word referring to the style of food preparation by steaming food in an open pit using heated hot stones and banana leaves
Karamap: A style of lamp flaps preparation in Papua New Guinea to which lamp flaps is wrapped up with greens and boiled for human consumptions
Calories: A measurement of the amount of energy that a food item yields when consumed and it is measured in joules

Abbreviations
BMI: Body Mass Index
PNG: Papua New Guinea


List of Figures and Tables
                                          List of Figures
                                                                                                                                                Page
Figure 1 The reasons to lamp flaps consumptions in Sisiak area                                              1  
Figure 2 Methods of lamp flaps preparations for human consumptions in Sisiak                       2
Figure 3 Frequencies of lamp flaps consumptions in Sisiak area                                               3
                                           
 List of Tables
Table 1   Distribution of participants in Body Weight Ranges (BMI)                                        4
Table 2   Frequencies of lamp flaps consumptions for individual BMI range 5                                                                                                               





Table of contents


Acknowledgement------------------------------------------------------------------------------------ i


Abstract--------------------------------------------------------------------------------------------- ii



List of Figures & Tables----------------------------------------------------------------------------- iii



Chapter 1 Introduction/ Literature review-----------------------------------------------------------------------------------------------1


1.1 Statement of the problem---------------------------------------------------------------------------------------------2


1.2 Review of Literature---------------------------------------------------------------------------- 3


1.3 Significance of the study-------------------------------------------------------------------------- ----- 4


1.4 Statement of objective---------------------------------------------------------------------------- 5



Chapter 2 Methodology------------------------------------------------------------------------ 6



2.1 Research design------------------------------------------------------------------------------- 7


2.2 Sample size---------------------------------------------------------------------------------- 8


2.3 Instruments--------------------------------------------------------------------- 9


2.4 Procedures---------------------------------------------------------------------- 10


2.5 Data collection---------------------------------------------------------------------------- 11


2.6 Data analysis and interpretation of results------------------------------------------------------- -----------------------12



Chapter 3 Results-------------------------------------------------------------------13



Chapter 4 Discussion-------------------------------------------------------------------------- 17
 ------------------------------------------------------------------------------------ 18

4.2  -------------------------------------------------------------------------------- 19

4.3 -------------------------------------------------------------------------------- 20

4.4 ------------------------------------------------------------------------------ --21

4.5 ------------------------------------------------------------------------------ - 22


Chapter 5 Summary and general 

conclusions----------------------------------------------------------------------------- 23

5.1 Summary------------------------------------------------------------------------ -- 24

5.2 Conclusion-------------------------------------------------------------------------- 25

5.3 Limitations------------------------------------------------------------------------- 26

5.4 Recommendations------------------------------------------------------------------ 27


References----------------------------------------------------------------------------- 28








Chapter 1

Introduction
1.1            Statement of problem
Obesity is one of the physical symptoms to unhealthy conditions in human health to which lifestyle diseases evolve from it. Generally the increasing weight of a person is coincided with increasing obesity level. Obesity levels are clinically categorized according to the different weight ranges, but it is not worked out clinically. Obesity is physically observable and is worked out through manual calculations using weight and height measurements of a person. Fat people are generally obese than thin people, meaning that fat people exceed the normal healthy weight range and are obese thus having better chances of developing lifestyle diseases. At its lower level, obesity is seemed to be of no concern to human health, but it is risky at its higher levels.   Obesity is closely associated to indolence lifestyles, genetic factors and the dietary levels of a person. According to Mayo Foundation for Medical Education and Research (2011), higher dietary level is the leading factor to obesity and the evolving of lifestyle diseases.
Dieting is the leading factor to obesity as obesity depends wholly on the type and amounts of food that are consumed. Different food stuff yield different amounts of calories to the body when they are consumed. According to European Food Information Council or EFIC (2011), lamp flaps is one of the leading meats that contributes much calories to the body when it is consumed. This is because of its over 80% fats content that yields 37kilojoules/g of energy to the body if lamp flaps is consumed to which the excess fats are readily stored in the body (Hungary Institute for animal breeding and nutrition, 2010). Lamp flaps is widely consumed in the world, but its highest consumptions are in the Pacific Region (Herald of New Zealand, 2011). The Herald of New Zealand further stated that Pacific Island Nations import tonnes of lamp flaps into the countries where there are high prevailing rates of obesity and lifestyle diseases. Kila (2010), stated that of the 19% of the lamp flaps exported to the pacific island nations, PNG alone imports over 40 000 tonnes of lamp flaps into the country every year. Lamp flaps importations in tonnes enable its accessibility to the entire country.
 Papua New Guinea’s change of lifestyle towards westernization has greatly affected the diet of its people and their health (Allison, 1995). Most of the staple foods are either replaced or supplemented by those of the processed or imported foods. PNG local meats from fish, cuscus and pork meats are replaced or supplemented with imported and processed meats such as lamp flaps. According to Kila (2010), PNG elites and members of parliament such as Jamie Graham proposed that lamp flaps consumption is amongst the leading factors to obesity and lifestyle diseases in PNG. According to Dr. Vinit, the countries’ national elites are dying of obesity and lifestyle diseases that really affect the Gross Domestic Product (Post Courier April 2011). The PNG Government proposed a bill to ban the importation of lamp flaps from the lamp producing countries such as Australia and New Zealand as a way of addressing the issue of lamp flaps consumptions and obesity or lifestyle diseases in the country.  The reason (s) to a wider lamp flaps consumptions in PNG, the relationships between lamp flaps consumptions and obesity or lifestyle diseases and the extent of prevalence of obesity from urban centers to rural areas in PNG are necessary to be known.  
1.2             Review of literature
Obesity is the increasing human weight subduing a clinically set standard normal healthy weight. According to Obesity International Task Force or OITF (2006), obesity is the main factor to lifestyle diseases s such as diabetes, heart attack and other cardiovascular diseases. The OITF further stated that obesity is most common in urban communities in almost all cities and towns in the world. This international organization stated that obesity is the medical condition to which the excess fats and other calories taken into the body are stored in the adipose cells in tissues and organs within the body. Consequently, this increases the body weight of a person. According to the Center for Diseases Control and Prevention (2010), obesity is worked out through BMI. The categories of BMI are; BMI values >30 are considered as obese, BMI between 25-30 are considered as overweight, BMI between18.5-25 are considered as normal weight & BMI < 18.5 are considered as underweight.
The prevalence of obesity in the developing countries is associated to change of lifestyle and replacement or supplementation of local staple food stuff by introduced and processed food stuff (Alison, 1995). The rapid adaptations to western lifestyle by developing countries have influenced their diet and the pattern of dieting. The introduced and processed food stuffs are more accessible, available and attractive for people to consume than the locally grown food stuffs. This draws away the attention of people from local staple food stuffs to those of introduced food stuffs, regardless of the cost they bear. The adaptation to western lifestyle enabled frequent and increased amounts of dieting on the introduced or processed food stuffs, which is abnormal to the local lifestyle. Alison (1995) further stated that Adaptation to western lifestyle has been influencing people’s dieting which has impacted the health of the people of the developing nations.
Amongst the introduced and processed food stuff, lamp flaps has either replaced or supplemented the local meats and meat products in the Pacific Island Nations. According to European Food Information Council (2011), lamp flaps is the principle meat in the regions of North Africa, the Middle East, India, part of Europe, and the Pacific regions. EFIC (2011) further stated that lamb meat consumptions account for 6% of all the meats’ from animals consumed in the world.  It also, stated that New Zealand and Australia are the leading lamp flaps producing countries in the world where thousands of tones of lamp flaps are produced every year. Amongst the tonnes of lamp flaps produced and exported from New Zealand and Australia, 19% of it is exported to the Pacific Island Nations, including Fiji, Samoa Tahiti, New Caledonia and Papua New Guinea. 
In Papua New Guinea alone the importation of lamp flaps from New Zealand and Australia exceeds 40,000 tonnes, costing close to K90 million a year (Kila, 2011). Lamp flaps contains protein, viatminB12, vitamin B6, Zinc, phosphorus, riboflavin, niacin, patothenic acid, selenium and vitamin D and its fats contents is over 80% including saturated fats (Hungary Institute for Animal Breeding and Nutrition, 2010). Large importation of lamp flaps enables its accessibility to most of the settings in PNG, where it is widely consumed. From urban centers to rural areas, lamp flaps is now a common meat in celebrations, ceremonies and in special occasions in PNG.
Lamp flaps because of its 80% fats and its wider consumptions in Papua New Guinea, there is an emergence of belief and concern that it is associated to obesity, lifestyle diseases and other undiagnosed deaths in the country (New Zealand Island Business International, 2007). According to the Herald of New Zealand (2011), previous studies done in PNG indicated that 28% of the men in PNG are obese or overweight, whilst 38% of all women in PNG are obese to some extent. The concerns relating to the associations between the lamp flaps consumptions and obesity or the undiagnosed deaths alerted the Papua New Guinean Government to ban lamps flaps importations from lamp flaps producing countries particularly New Zealand and Australia into Papua New Guinea. Some bureaucrats in Papua New Guinea have opposed the bill proposed by relevant parliamentarians and other health concerned stakeholders.
1.3             Significance of the study
This explorative study was to investigate any association (s) between the lamp flaps consumptions and obesity and to document the findings of the study for the knowledge on this area of study. It also, would like to provide data for any future studies on this setting of study.        
The study aimed at providing scientific data on the consumptions of lamp flaps and obesity with other objective related findings for the relevant and concerned authorities on the issue of lamp flaps consumptions and obesity specifically for Papua New Guinea. This is for the provision of data for authorities for making any informed decisions on the issue of lamp flaps consumptions and obesity in Papua New Guinea.

1.4 Statement of objectives
a.     General objectives
To examine the availability of lamp flaps in the Sisiak Peri-urban setting and the frequency of lamp flaps consumptions by the Sisiak settlers. The aim of this is to find out any association (s) between the frequency of lamp flaps consumptions and obesity that related to lifestyle diseases.


b.    Specific objectives
i. To document any association (s) between the consumptions of lamp flaps and obesity
ii. To investigate the leading reasons to lamp flaps consumptions in the Sisak Peri-urban setting
iii. To investigate the methods which are frequently used to prepare lamp flaps for human consumptions










Chapter 2
Materials and Method/methodology
2.1 Research design
The research was an explorative study that merely investigated the frequency of lamp flaps consumptions and the weight range (BMI) of individuals in the Sisiak peri-urban setting to find any correlations between them. The study also, investigated the reasons to lamp flaps consumptions in Sisiak. The study investigated the methods of lamp flaps preparations for human consumptions as lamp flaps fats are reduced at different levels in those ways of preparations. The research study used researcher made questionnaires for the first 30% of the participants and the other 70% were face to face interviewed. The height and weight measurements of all participants had been taken before they were separately issued with questionnaires and interviewed.
2.2 Sample size
The sample size of this explorative research study strictly consisted of 100 participants who were residents to the Sisiak peri-urban setting for more than three (3) months. Out of the 100 randomly selected participants, 50 of them were males, whilst the other 50 were females and they all aged between 15 and 55 years of age. From the 100 total participants, 30% of the participants were given questionnaires to fill in and the remaining 70% of them were individually interviewed. Out of the 30 questionnaires distributed, 25 of the questionnaires were promptly filled and returned and 5 questionnaires were not returned or went missing after they were issued. Of the 70 participants that were interviewed, 63 of them have successfully completed the interviews, whilst 7 of them have not completed the interviews and left during the interviews. The weight and height measurements of the fully participated individuals were carefully taken and recorded separately.
2.3 Instruments
The explorative study was carried out using the researcher made questionnaires, face to face interviews and measuring weights and heights of all participants. The questionnaires were written in Pidgin to suit the semi-educated settlers at Sisiak and the responses given were later translated and recorded in English. Similarly, all interviews were conducted in Pidgin and the responses given by the individual interviewees were translated into English and all were separately recorded in English.
 The heights of the participants were taken using a 2meter ruler carefully made from a plane timber to which the measurements and the markings were similar to a standard 1meter blackboard ruler. The weight measurements of the participants were taken using a calibrated clinical scale. The measurements taken were all recorded using biros in a response recording structured white sheets of papers. Close observations were made on each participant in the data collection process, ensuring the accuracy and relevance for the collected data.
2.4 Procedures
An official letter was sent to the Sisiak Ward Six Councilor for his approval and his permission to conduct this explorative study on the council ward that is under his care. When waiting for approval from the councilor, a pilot test on the appropriateness of the questionnaires and the use of instruments for measurements was done at the DCA Compound and all the irrelevances were corrected. Upon the council’s approval, the study was conducted for collection of raw data, starting from May and came to completion in August, 2011. The study was conducted on Wednesdays, Fridays and on Saturdays amongst the communities only within the Sisiak peri-urban setting. In the researcher made questionnaires, the columns to required and wider responses were provided, but for interviews, the participants were given the opportunity to express their thoughts and ideas during the interviews. Due to less number of participants willing to take part in the research in each scheduled day for research, it took much time from May to August for the completion of data collection process. Until then, the required and relevant raw data was available for data collation and data analysis for the study.
2.5 Data analysis
The data collected from the data collection process were collated and analyzed separately according to the set of questions produced in the questionnaires and the set of questions asked in the interviews conducted. Each set of data were separately collated manually on the blank white sheets of papers before they were entered into the laptop computer for processing. Some collated data were initially entered into the school given laptop computer using the Microsoft excels for processing and formulation of graphs and pie charts for data interpretations. The graphs and pie charts produced were then copied and pasted onto the Microsoft word documents for further reading, interpretations and for understanding.  Other data were directly entered into the tables using Microsoft word. Percentages of the tallies and frequencies of collated date entered into table were worked out using Microsoft word. The raw data was then became reliable information which was readable, interpretable and understandable for the study.


Chapter 3
Results
Add caption
Figure: 1 shows 31% of population in Sisiak consume lamp flaps because it is cheap, 23% consume it because it is easily accessible, 20% consume it because of its sweet taste and 16% of the population consume lamp flaps because there is less accessibility to other meats whilst 10% consume it for other reasons.

Figure: 2 shows 45% of the population in Sisiak prefer boiling method, 35% prefer frying and 14% of them prefer mumu whilst 6% prefer other methods.
           
                                             
Figure: 3 shows 29% of the population in Sisiak consume lamp flaps 2_4 times per week, 24% consume lamp flaps 2_4 times every two weeks, 23% consume lamp flaps 2_3 times a month whilst 20% of the population consume lamp flaps 1-3 times a day and 4% consume lamp flaps once every month.
Table: 1 showing the range of weights (BMI) and the number of individual responses with their percentages.
Range of weights (Body Mass Index)
No of individuals
Percentage (%)
Under weight (Less than 18.5)
12
14
Normal weight (18.6-24)
41
46
Over weight (25-30)
26
30
Obese (More than 30)
9
10
Total
88
100

Table: 2 showing frequencies of lamp flaps consumptions by the number of individuals in each of the BMI ranges.
Frequency of lamp flaps consumptions
1-3 Times/day
3-4 Times/week
2-4 Times/2week
2-3 Times/month
Total No of individuals
Under weight
0
2 (16.5%)
2 (16.5%)
8 (67%)
12 (100%)
Normal weight
5 (12%)
6 (15%)
9 (22%)
21 (51%)
41 (100%)
Over weight
9 (34%)
10 (38%)
4 (15%)
3 (11%)
26 (100%)
Obese
6 (66%)
 2 (23%)
0
1(11%)
 9 (100%)


Chapter 4
Discussions
4.1 The reasons to lamp flaps consumptions in the Sisiak peri-urban setting
The results of the study showed that lamp flaps is widely consumed in Sisiak area because it is cost effective for purchasing it. Out of the total population, 32% of the population purchase lamp flaps for consumptions because it is very cheap to purchase it than other alternative meat and meat products in the area. As it was noted above that 40 000 tonnes of lamp flaps are imported to Papua New Guinea every year and consequently the lamp flaps supply is high makes it a cheap meat alternative for the people in Sisiak area. Like any other peri-urban settings in PNG, it was observed that most people in Sisiak area are illiterates or semi educated that they have no highly paid jobs, thus they rely on lamp flaps for their meat supplements for their diets as it is affordable to them. As Island International Business (2011) mentioned above, the lamp flaps producing countries regard lamp flaps as a waste and low quality meat that is produced and exported in large quantities has greatly impacted the supply and the price of lamp flaps in the Sisiak peri-urban setting like any other settings in PNG.
The findings of the study also indicated that 24% of the population consumes lamp flaps because it is more accessible to them. It was observed that the Sisiak peri-urban setting is within the Madang Urban Center which makes more accessibility to butcheries, retail outlets and other shops that sell lamp flaps either in bulk or in small affordable scales. It was observed that even lamp flaps were bought in bulk, it was prepared in various methods and it was sold in small pieces at the local community markets within the Sisiak area. If people can not afford to buy lamp flaps at the shops in large quantity, they still go for small pieces of lamp flaps that were sold at the local markets which were affordable to them.
It was revealed from the findings of the study that a portion of the population in Sisiak peri-urban setting consumes lamp flaps because of its taste. Out of the total population, 21% of them consume lamp flaps as it tastes sweet for them. It was observed and tried out that some of the methods of lamp flaps preparations for sales especially at the local markets including frying and karamap were attractive and tastes sweet for human consumptions. Other household methods of lamp flaps preparations such as boiling and mumu had also given a sweet taste for those who prefers them.  
The findings of the study further revealed that 17% of the total population in Sisiak area consumes lamp flaps because the accessibility to other meats and meat products were limited. From the responses given at the interviews, it was noticed that there were no rivers or seas close by for catching fish and hunting grounds for cuscus or wild pigs local for local meats. Even tinned fish and tinned meats were accessible, they were expensive to afford for the Sisiak settlers compared to local readily made pieces of lamp flaps that were sold at 20 toea to k1.00 per piece, which were easily affordable.
Amongst the other reasons to lamp flaps consumptions to the Sisiak peri-urban setting, only 6% of the population consumes lamp flaps because other minor reasons such as religious beliefs that other local meat are unclean for them.
4.2 Methods of lamp flaps preparations for human consumptions
The findings of the research study showed that the majority of the total population in Sisiak area prefers boiled lamp flaps for consumptions. This method of lamp flaps preparation was the leading method (45%) that was widely used by the people in Sisiak to prepare lamp flaps for consumptions. It was the method that the people boil lamp flaps with greens and vegetables for the entire family consumptions at major meal times. Because of the 80% fats content, lamp flaps when boiled provides oils for greens and vegetables and other foods that are boiled with it especially in a sauce pan. Some people like greasy food stuff such as greens and vegetables that are boiled with lamp flaps and so they prefer this method.  It was observed that most people in Sisiak area were migrants from rural areas especially the Highlands Region of PNG where this method of food preparation is commonly preferred and used. This is because they were used to preparing large amounts of greasy pork meats for consumptions. The pork fats storage in their bodies keeps them warm in the cold climate. Therefore majority of the people in Sisiak preferred boiling method than other methods.   
Out of the total population in Sisiak, 35% prefer to consume fried lamp lamps. In Sisiak peri-urban setting, there were a lot of informal markets involving the selling of fried lamp flaps in small affordable pieces.  Every day people gather at small markets and were exposed to fried lamp flaps. Frequent consumptions of fried lamp flaps enabled a handful of people to prefer frying method. Moreover, fried lamp flaps is more attractive in appearance for consumptions and it enhances the taste of lamp flaps when it is consumed and so a handful of the population in Sisiak peri-urban setting prefers this method.
 The study revealed that Mumu was the third (14%) common method of lamp flaps preparations for human consumptions in Sisiak area. This is the method that is used for preparations of lamp flaps in large quantities for a greater number of people’s consumptions. It is a common method at big gatherings such as parties, church gatherings and other significant social occasions. This is the method to which lamp flaps is steamed with greens and vegetables that enhances its taste to which some people prefer it. This implies that those who consume lamp flaps from this method are people who go to party or to special occasions and favored the taste of lamp flaps prepared in this way. This is because mumu is the common method used in big gatherings where large amounts of lamp flaps are prepared for consumptions. Therefore,
A small percent (5 people) of people prefer other methods of lamp flaps preparations. Other methods include roasting and smoking of lamp flaps for human consumptions. 
4.3 Frequency of lamp flaps consumptions
From the results of the study, it was seen that 29% of the total population consume lamp flaps 3 to 4 times a week. This showed the extent of lamp flaps consumptions in the Sisiak area was widely consumed. The implication of this is that the majority (29%) of the total population in Sisiak area consumes lamp flaps at least every week. The wider consumptions of lamp flaps correlated to the easy accessibility of lamp flaps to the people and the wider distribution of lamp flaps from retail outlets and from the local markets.  Out of the total population, about 24% of them consume lamp flaps 2 to 4 times every two weeks. This indicates that approximately one quarter of the people in Sisiak area consume lamp flaps at least once every week. The other portion of the population about 23% of them consumes lamp flaps 2 to 3 times a month. This showed that some people in Sisiak area consume lamp flaps infrequently once or twice in a month. The remaining 20% of the population consumes lamp flaps 1 to 3 times a day. This implied that one fifth of the people in Sisiak area consume lamp flaps every day.


4.4 Range of body weights (BMI)
The findings of the study showed that 46% of the total population in Sisiak area was under the category of normal weight category (BMI of 18.5-25). This revealed that the majority of the Sisiak settlers were under the safe weight range despite consuming lamp flaps. As scientifically stated by the International Obesity Task Force, 46% of the population were under the normal weight range balanced their calories intake with their body calories expenditure or they take enough calories only for their body needs. It was also found from the study that 30% of the population was under the overweight category. This implies that 30% of the population in Sisiak area was on the edge of becoming obese because they were nearing the BMI above 30 which was the obese body weight category.  
The findings of the study also revealed that 10% of the population in Sisiak was in the obese weight category. This showed that those people who were inactive or take too much fatty foods such as lamp flaps that subdue their body requirements became obese. The excess calories taken into their bodies were stored in their bodies as fats and consequently this has increased their BMI. On the other hand, 14% of the total population was in the underweight category. This indicated that 14% of the population in Sisiak peri-urban setting was at the edge of becoming malnourished. This signifies that they did not take enough calories into their bodies to meet their body calories requirements resulted in underweight categories clinically.
4.5 Associations between the frequency of lamp flaps consumptions and BMI
The findings of the study revealed that 66% majority of the obese population in Sisiak area consume lamp flaps 1 to 3 times a day. The high frequency of lamp flaps consumptions by the 66% majority of the obese population signifies that because of its 80% fats content, lamp flaps have impacted the BMI of the obese individuals. This denoted a significant finding to the study that showed a correlation between the lamp flaps consumptions and obesity. From the total overweight population, about 34% of them consume lamp flaps 1 to 3 times a day. This showed that a handful of overweight population in Sisiak area consume lamp flaps every day. Whilst, only 12% of the normal body weight population consumes lamp flaps 1 to 3 times a day. This indicated that the people that were having normal body weight have low frequency of lamp flaps consumptions.
Further the findings of the study showed that 67% of the underweight population consumes lamp flaps 2 to 3 times a month. The frequency of lamp flaps consumptions for the underweight people in Sisiak area was very low denoting that infrequent lamp flaps consumptions did not have any effects on their weights.  For those who have normal body weights, 51% of them consume lamp flaps 2 to 3 times a month. This indicated that about half of the normal body weight population in Sisiak area was infrequent lamp flaps consumers. Their    low frequency lamp flaps consumptions resulted to them having no effects of lamp flaps consumptions to their weights. That means their infrequent calories intake was just enough for their body needs and no calories was stored in their bodies.  Out of the overweight population, 11% of them consume lamp flaps 2-3 times a month. This showed that 11% of the obese people in Sisiak area despite that they did not frequently consumed lamp flaps, they were still obese. The above findings of this research revealed a pattern in the frequency of lamp flaps consumptions by the different body weight categories and their BMI. It was revealed by the study that the frequency of lamp flaps consumptions increased from the underweight population up to the obese population.

Chapter 5
5.1 Summary
This explorative study investigated the associations between the consumptions of lamp flaps and obesity among the settlers at the Sisiak peri-urban setting in Madang. The study also investigated the ways of lamp flaps preparations for human consumptions. Further, the study investigated the reasons to lamp flaps consumptions in Sisiak. The study used researcher made questionnaires, face to face interviews, measurements and physical observations for data collection. A total of 100 participants were voluntarily participated in the study; however12 of them were either did not hand in their questionnaires or left during the interviews resulting in a total of 88 participants whom were fully participated in the study. 30% of the sample population were given the researcher made questionnaires whilst, 70% of the sample population were interviewed after the height and weight measurements for all individual participants were taken. The main findings of the study are summarized as follows;
Ø  The study revealed that the frequency of lamp flaps consumptions was the highest in the obese population and decreased down to the underweight population. That signified an underlying aim of the study to which a correlation between the lamp flaps consumption and obesity was notified.
Ø  It was seen from the study that the low price of lamp flaps was the leading reason to lamp flaps consumption in Sisiak peri-urban setting followed by the close accessibility to lamp flaps. Inaccessibility of other meat and meat products for consumption was the second least reason and other reasons shared the lease percentage.
Ø  It was found that boiling was the main method of lamp flaps preparations for human consumptions and mumu was the least method of lamp flaps preparation for human consumptions in the Sisiak peri-urban setting.
Ø    It was seen that the vast majority of the population in Sisiak were healthy, some were obese and a handful of them were underweight.
Ø  The study indicated that a larger portion of the population in Sisiak consumes lamp flaps two or three times a week and a few people consume lamp flaps once or twice a month.
5.1 Limitations
The research only concentrated on the frequency of lamp flaps consumptions and the BMI to find out any associations between lamp flaps consumptions and obesity. There are other factors that contribute toward obesity such as genetic factor, amount of calories intake and the calories expenditure of a day and the activity level of each individuals that were not taken into consideration in this explorative research study. The results would have been more precise if other factors to obesity were independently controlled to see the effect(s) of one factor.
During the process of collecting the data, most young people aged 15 and above were willing to participate whilst, people aged above 40 were reluctant to participate. This gave unequal distribution of individuals in each of the aged groups because the study concentrated on the participants aged between 15 and 55. It would have been better if equal number of individuals in each of the age groups had participated and the data would have been representative of all age groups.
Some participants were reluctant to remove their shoes and other heavy clothes when asked to stand on the clinical scale even they were asked to do so. Some kilograms were deducted from shoes and heavy clothes worn, but this was through guessing. The readings of weights would have been more accurate if shoes and other heavy clothes worn by those participants were removed before they stood on the scale.
5.2 Recommendations
In the light of the above findings of this explorative research study, the following recommendations are made.
Future research on this area should more focus on all the factors that contribute to obesity rather than concentrating on consumptions of lamp flaps alone. In doing so the result would turn out for each individual factor’s effects on obesity.

There is a need for more studies in this area in urban, peri-urban areas and in rural areas of Papua New Guinea. From there, the extent of lamp flaps consumptions and obesity from urban areas to rural areas would be clearly identified in all settings in Papua New Guinea. Until then, a decision undertaken by the Papua New Guinean Government on the ban of lamp flaps would be relevant, appropriate and fair to all settings in Papua New Guinea. 

 Lamp flaps should not be banned in Papua New Guinea. Rather the lamp flaps importation from overseas should be regulated so that the parts of commercial sheep that contain 80% saturated fats must be removed and only the meat components of lamp should be imported for human consumptions and for human health.

4.5 Conclusion
The findings of the explorative research study showed that 46% majority of the entire studied population in Sisiak was under the normal weight range and only 10% of the population was obese. This showed that most people in Sisiak area are healthy from obesity but only few are vulnerable to develop lifestyle diseases that are related to obesity. Also, the findings of the research study showed that the cost effective and accessibility of lamp flaps were the leading reasons to wider lamp flaps consumptions in the Sisiak peri-urban setting. It was further identified that boiling and frying were the most common methods of lamp flaps preparations for human consumptions in the Sisiak peri-urban setting. Moreover, the findings of the explorative research study revealed that obese population in Sisiak peri-urban setting consumes lamp flaps more frequent than the underweight population. This showed that the BMI of the population in Sisiak area increased coincidently with increasing frequency of lamp flaps consumptions. This signified that there was an association between the frequency of lamp flaps consumptions and obesity in the Sisiak peri-urban setting in Madang.   





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