IJRRMS 2012;2(3)
Original Research Paper
Dietary and lifestyle pattern in relation to overweight and obesity among
the medical and nursing students
Chhaya S, Jadav P
ABSTRACT
Background: Obesity is a global epidemic affecting all levels of society. Unhealthy eating habits and
sedentary life style are crucial etiological factors. Medical and nursing students by virtue of their imparted
education are believed to be more aware of it.
Objectives: To know the dietary pattern of students studying in a tertiary care institution and compare it with
the Body Mass Index (BMI) as an index of overweight and obesity; also to find an association between lifestyle
and BMI.
Material and methods: A cross-sectional study was conducted on 242 students of Medical and Nursing stream
in a tertiary care institution in Vadodara, Gujarat. Data were collected through self-reported questionnaire.
Anthropometric measurements (height and weight) were measured by examiners, and their BMI was
calculated. Descriptive and Univariate analysis were calculated through SPSS version 11.5 for windows.
Results: The mean age of students was 19.71± 1.23.The mean BMI was 23.00± 4.4. A total of 25.6% of the
students were obese and 17.4% were overweight. Non nutritious food, lack of physical exercise and irregularity
in breakfast were prominent drivers of obesity, in addition to other lifestyle behaviour.
Conclusion: The rates of overweight and obesity are high among students due to unhealthy eating habits. There
is a need felt to reinforce awareness of healthy eating habits.
Key words: obesity, BMI, dietary pattern, lifestyle
INTRODUCTION
Obesity is one of the most neglected and pervasive
health problems worldwide affecting all ages,
socioeconomic classes and ethnicities. It is rightly
referred as “Globesity”, as it has emerged as a
global non-communicable epidemic. Obesity is
defined as an abnormal and excessive deposition
of adipose tissue to the extent that the health may
be adversely affected. It is the fifth leading cause of
death all over the world.1,2 It has been perceived
that developing countries like India are
encountering dual burden of under-nutrition and
overnutrition.3 The most crucial time of the life
when obesity can develop easily is college years
when healthy and unhealthy life style can be
adopted and may be carried out in the later life.
Overweight and obesity predispose more strongly
to certain diseases if they arise in early age.
Irregularity in diet, stress, lack of exercise and
addiction are independent risk factors of the
overweight and obesity; which are inadvertently
present in the medical and paramedical students
especially who live far away from their home in the
hostels.4,5
There is paucity of researches regarding nutritional
status in college students in western India. This
study, therefore, had been aimed to know the
relation of the dietary and other health related
habits to overweight and obesity in undergraduate medical and nursing students staying in
hostels.
MATERIAL AND METHODS
A cross-sectional study was done on 2nd year of
medical and nursing students was carried out in a
tertiary care institute, located at the periphery of
Vadodara city of Gujarat. Majority of the students
are living in hostel and having food from the central
mess.
Sample size and sampling: A sample size of 242 was
obtained using the hypothesis testing method and
based on following assumptions: 95% confidence
IJRRMS | VOL-2 | No.-3 | JUL - SEP | 2012
9
Chhaya S et al. Dietary and lifestyle pattern in relation to overweight and obesity among the medical and nursing students
intervals, prevalence of obesity in undergraduate
medical student India was 17.5 from the previous
5
study and 5% allowable error. The calculated
minimum sample has been inflated by 10% to
account for anticipated subject non response.
Data collection: After briefing about nature and
scope of the study, informed consent was obtained
from the students. They were guided to fill up the
pre made questionnaire properly and truthfully.
First part of the questionnaire contains sociodemographic questions and food related habits.
Second part consist Food Frequency Questionnaire
(FFQ).
Measurements: Weight was measured on
electronic balance with minimal clothing just
before lunch. Height: Students were asked to take
off their shoes and stand straight with head in
Frankfurt plane, feet together, knees straight, and
heels, buttocks and shoulder blades in contact with
the vertical surface of the scale.
Body mass index (BMI) was calculated as ratio of
weight in kilogram to height in meter square. It was
classified according to new diagnostic definitions,
underweight (BMI < 18.5), normal (BMI = 18.522.9), overweight (BMI = 23-24.9), Obese (BMI ≥
6
25).
Data analyses: Data were cleaned, validated and
analyzed on the SPSS version of 11.5. Continuous
variables were expressed as mean ± SD and
categorical variables as proportion and
percentage. Univariate analyses were done by chisquare test. Differences were considered
statistically significant at p value < 0.05.
RESULTS
Participants' characteristics: A total of 242
students; 126 girls and 116 boys participated in
current study. The average age of students under
study was 19.71± 1.185 years. The mean height,
weight and BMI were 164.35 ± 9.143, 62.42 ±
14.26, and 23.00 ± 4.4 respectively. Table-1
illustrates the baseline characteristics of the
10
IJRRMS 2012;2(3)
participants. 43.4% of students had normal BMI,
and equal proportion (43%) of students had more
BMI. The noteworthy risk factors, the students are
exposing themselves to, were sedentary lifestyle
(81%) and spicy food preference (60.7%). Table 2
represents the association of students
characteristic, diet and health related behaviour to
BMI. While there were 9.5% of underweight
students in medical stream, it was 28% in nursing
stream (÷2-12.86; p 0.005). Only 13% of the
2
participants had a family history of obesity (÷ 16.376; p 0.001). The students who were taking
breakfast regularly maintained normal weight
2
compared to overweight students (÷ -16.376; p
0.001). Observable differences were seen in fasting
practices among the students- more number of
2
normal weight students resorted to fasting (÷ 12.449; p 0.006). Dietary pattern during stress also
played significant role in relation to obesity with
2
40% of binge eaters participants were obese (÷ 19.270; p 0.004).
Table 1. Baseline characteristics of the participants
Variables
n=242 (%)
Sex
Male
Female
Stream
Medical
Nursing
Body mass index
116 (47.9)
126 (52.1)
189 (78.1)
53 (21.9)
Underweight
33 (13.6)
Normal
105 (43.4)
Overweight
42 (17.4)
Obese
62 (25.6)
DISCUSSION
According to WHO, 60% of the quality of an
individual's health depends on his/her life style
and behavior. Early adoption of healthy habits can
prevent problems of future years.7 Present study
reflected that 43% of students were above normal
weight (pre-obese 17.4% and obese 25.6%).
Prevalence of obesity in this study is 25.6 % which
is very high compared to other studies from India
as well as abroad.2,3 This could be due partly to
adopting new guidelines for Indians wherein
6
obesity is considered when BMI >24.99.
IJRRMS | VOL-2 | No.-3 | JUL - SEP | 2012
Chhaya S et al. Dietary and lifestyle pattern in relation to overweight and obesity among the medical and nursing students
Table 2. Association of students characteristic, diet and health related behaviour to BMI
Variable
Sub-variable Under
Normal
Over
Obese
Total
IJRRMS 2012;2(3)
P value
Sex
Female
Male
21
12
51
54
20
22
34
28
126
116
2.808
(0.422)
Faculty
Medical
Nursing
18
15
85
20
36
6
50
12
189
53
12.86
(0.005)*
Diet pattern
Mix
Ovo-veg
Veg
9
2
22
14
10
81
4
6
32
14
4
44
41
22
179
7.975 (
0.24)
Food preference
Salty
Spicy
Sweet
6
13
14
9
65
31
0
29
13
5
40
17
20
147
75
12.555
(0.05)*
F/h of obesity
No
Yes
Irregular
Regular
33
0
15
18
95
10
30
75
33
5
20
16
44
18
31
31
209
33
102
140
19.304
(<0.001)*
16.376
(0.001)*
Lunch
Irregular
Regular
8
25
16
89
7
35
19
43
50
192
6.321
(0.097)
Dinner
Irregular
Regular
8
25
17
88
8
34
16
46
49
193
2.620
(0.454)
Fasting practice
No
Yes
20
13
43
62
28
14
39
23
130
112
12.449
(0.006)*
Breakfast
Diet during stress
Less
More
No change
23
6
4
87
15
3
Overweight students represented 17.4%. This
finding is consistent with studies done in Kolkata
and Delhi in which prevalence of overweight was
17.5% and 11.7% respectively and also similar with
a study of Saudi Arabia where the prevalence was
2,3,5
15.7%.
Irregularity of breakfast was found in 42.1 % of
students and significant association was found in
irregularity of breakfast and obesity. Breakfast
consumption and meal frequencies have been
linked to the risk of obesity in youth. This is
somewhat comparable with a study conducted on
8,9
students in Saudi Arabia.
Recent studies
conducted in Finland and USA showed that the
adolescents (both boys and girls) who ate
breakfasts regularly were at lower risk for
overweight/obesity and hypertriglyceridaemia.10,11
It might be the case that students skip breakfast as
a strategy to control one's weight, but not much is
known from literature about such a mechanism. It
is however more likely that, also considering the
age of the students, the skipping of breakfast
contributed to the excess weight gain and not the
31
5
6
45
17
0
186
43
13
19.270
(0.004)*
other way around. It is known from literature that
people, who do not eat breakfast, are more likely to
consume unhealthy foods during the day, which
induces the development of overweight.12
In our study 64.5% of obese students (overall 60.7%
of participants) had a spicy-food preference. This
finding is surprising since high fat intake, rather
than spicy food, would supposedly be associated
with obesity. What this finding may actually be
reflecting, however, is that the increased intake in
fat may be coming from snacks rather than from
meals.13
Sedentary lifestyles, family history of obesity are
established and independent risk factors that are
also seen among the study population. A sedentary
lifestyle is a very serious worldwide problem,
affecting all strata of life. Physical inactivity, which
has progressively increased over the past several
decades, significantly increases the risk of
numerous diseases/disorders, including several
forms of cancer, diabetes, hypertension, coronary
and cerebrovascular diseases, overweight/obesity,
11,12,13
and all-cause mortality, among others.
Unless
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Chhaya S et al. Dietary and lifestyle pattern in relation to overweight and obesity among the medical and nursing students
there is a reversal of this sedentary lifestyle, the
incidence of these diseases/disorders will
increase, life expectancy will decrease, and
medical costs will continue to rise.
CONCLUSION
In conclusion, the current data provides strong
evidence that supports the idea that consuming
spicy foods; sedentary lifestyle pattern and
irregular meal consumption are directly related to
the risk of obesity. In order to prevent the
epidemic, it is imperative to govern one's lifestyle
choices by reducing the consumption of fast food,
being involved in regular meals, and increasing the
number of hours spent on physical activities. In
order to avoid greater pressure on future
healthcare-related issues caused by obesity-
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related disorders, it is crucial to develop effective
prevention strategies, for those hostel boarders in
urban areas who tend to be at a higher risk of
obesity.
AUTHOR NOTE
Sheetal Chhaya, Chief Dietician & Assistant
Professor. Contact - +919537477347,
E-mail: [email protected]
(Corresponding author)
Dhiraj General Hospital, Sumandeep Vidyapeeth,
Piparia, Vadodara, Gujarat.
Pranay Jadav, Resident
Department of Community Medicine, SBKS
Medical Institute & Research Center, Sumandeep
Vidyapeeth, Piparia, Vadodara, Gujarat.
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