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lifestyle ; weight ; overweight ; obesity ; students ; medical sciences
Abstract:
Introduction: A growing population of the overweight and obese in Poland and worldwide promotes research activity in various domains of medical and health sciences focused on uncovering causes of the phenomenon and inventing measures limiting its scale. Lifestyle is considered one of the most significant factors which underlie the prevalence of excessive weight. Aim: The aim of the study was to assess selected lifestyle components’ effect on the prevalence of overweight and obesity among students of medical sciences. Materials and methods: The study population comprised 375 medical sciences students of State Higher Vocational School in Nowy Sącz (Państwowa Wyższa Szkoła Zawodowa w Nowym Sączu) who were divided into three groups according to gender and age. The research was conducted on campus. The following methods were included in the study: 1) A) anthropometric measurements, which were used to calculate BMI; B) blood pressure measurement; C) body composition analysis and 2) survey questionnaire technique A) a questionnaire on dietary habits and opinions on food and nutrition; B) lifestyle questionnaire. Statistical analysis was computed using R software version 4.1.2. and 4.1.3. with the significance level set at α=0,05. Statistical analysis of quantitative and qualitative variables was conducted using: the chi-square test (including Yate’s correction), the Fisher’s test, ; the Kruskal-Wallis test and the Dunn’s test. Results: The research results indicated statistical correlation (p<0,001) between the students’ age and gender and the prevalence of overweight and obesity. Obesity (12,2%) and overweight (43,8%) were more prevalent in females over 25 years than in other groups (respectively in females under 25 years obesity 0,85%, overweight 8,55%; in males obesity 8,40%, overweight 29,41%). Body composition analysis confirmed that waist circumference exceeded the norm in 50% of females over 25 years, while 92,31% of males and all females under 25 years had normal waist circumference. Older female students had more body fat measured in [kg] and higher volume of body fat [%] than students from other groups. Only 20% of females over 25 years had normal body fat [%] and body fat [kg] as compared to more favourable results in the group of males and younger females with over 40% and 80% with normal body fat respectively. The analysis of correlation between particular body components according to the BIA method indicated significant and positive correlation (p<0,001) between: skeletal muscle mass and fat free mass, body fat measured in [kg] and in [%] and visceral adipose tissue mass, waist circumference and visceral adipose tissue mass and basal metabolic rate. A significant and positive correlation was found between BMI and body fat in [kg] and body fa ; t in [%] which demonstrates that the higher BMI, the higher rates of body fat in [kg] and body fat in [%] and conversely. The results of students who had their body composition analysed according to the BIA method did not indicate metabolic obesity, which occurs in case of normal BMI and VFA above the norm. No statistically significant correlation (p=0,523) was found between age and gender of the participants and the amount and regularity of main meals consumed. Almost half of male and female students of each group claimed consuming four meals a day. Regrettably, over 50% of the students admitted consuming irregular meals, i.e. 62,3% of younger females, 49,6% of older females and 52,9% of males respectively. Snacking between main meals was the most common among younger females (88,9%). Snacking was also confirmed by 84,9% of older females. It was the least common among males (76,47%). The analysis of consumption of selected food items concluded that 12,6% of males, 8,6% of older females and 3,4% of younger females consumed meat and cured meat several times a day. Bread was Males consumed bread the most often (12,6% of students consumed bread even for lunch). They mostly consumed white and mixed flour bread. Whole wheat bread was consumed everyday by 5,7% of older females and 4,3% of younger females, whereas no male student consumed it daily. Fish was consumed several times a w ; eek by 23% of older females, 10% of males and 9,4% of younger females. The consumption of raw vegetable salads was of statistical significance. It was confirmed by 89,2% of older females, 74,4% of younger females and 68,1% males. Statistical significance (p<0,001) was confirmed regarding the students’ fast food consumption. Males (15,9%) and younger females (5,9%) consumed it several times a week, while 90,6% of females over 25 years consumed it occasionally. The results showed statistical significance (p<0,001) concerning consumption of fruit and vegetables. Fruit was consumed several times a day by 38,1% of older females, 11,1% of younger females and 5,8% of males, whereas vegetables were consumed daily by 25,1% of females over 25 years, 7,6% of younger females and 4,2% of males. Adding two or more spoonfuls of sugar to hot beverages was practised by in 55,5% of males, 34,2% of younger females and 23,0% of females over 25 years. Adding salt to food was of statistical significance (p<0,001). The percentage of participants who added salt to food at the table was similar in younger females (10,3%) and males (10,1%). It did not happen as often in older females (3,6%). Males drunk more mineral water. Drinking up to six glasses a day was declared by 25,2% of males, 9,4% of older females and 7,7% of younger females. Sweet carbonated beverages were drunk several times a day by 8,4% ; of males, 1,7% of younger females and 1,4% of older females. A correlation of statistical significance (p<0,001) was found between the amount and type of consumed alcoholic beverages and age and gender of the participants. Alcoholic beverages were consumed once a day by 4,2% of males. No female of each age groups consumed alcohol daily. Strong alcoholic beverages were mostly consumed by males (13,5%). Younger females (9,4%) and older females (1,4%) consumed strong alcohol less often. The findings were similar in case of beer. It was mainly consumed by males (67,2%) and younger females (39,3%). Females over 25 years (12,9%) consumed beer with the least frequency. However, they expressed a preference for wine (46,8%). Abstinence from alcohol was declared by 14,4% of older females, 8,4% of males and 4,3% females under 25 years. The analysis of habits regarding smoking tobacco products proved statistical significance (p<0,001). Males (24,4%) and older females (11,5%) admitted to smoking the most often. There slightest number of smokers was found among younger females (4,3%). The average age of smoking initiation was mean±SD 18,92±4,8. Unfortunately, younger females admitted to having begun smoking at the earliest age (mean±SD 15±4,24), followed by males (mean±SD 17,27±1,72). Older females admitted having initiated smoking at the latest (mean±SD 23,25±5,96). The results confirmed ; that undertaking physical activity was related to students’ age and gender. The discrepancies referred i.a. to commuting to work and school as 61,5% of younger females, 35,9% of older females and 44,5% of males used a car. Females over 25 years spent more time doing physical activity connected with household chores (mean±SD 2,87±1,35) than younger females (mean±SD1,94±1,07) and males (mean±SD 1,1±0,74). The time spent watching television was the longest in case of males (mean±SD 3,18±1,71) and younger females (mean±SD 2,73±2). Females over 25 years spent the shortest time watching television (mean±SD 2,09±1,27). Older females spent the most time daily walking and gardening (mean±SD 1,37±1,16), while males spent mean±SD 1,08±1,09 and younger females spent mean±SD 1,05±0,83 time for that kind of activity. Males undertook more activity such as brisk walking, cycling and doing aerobics. They spent mean±SD 1,04±0,88 time a day undertaking that kind of physical activity, whereas younger females spent mean±SD 0,88±0,82 and older females spent mean±SD 0,51±0,59 time. Similarly, males spent the longest time jogging, doing martial arts and skiing (mean±SD 1,41±1,03), followed by younger females (mean±SD 0,74±1,08) and older females (mean±SD 0,31±0,67). The results concluded statistical significance (p<0,001) concerning the participants’ sources of gaining knowledge about nutrition. Youn ; ger females gained knowledge about nutrition mainly from the Internet (67,5%) or school (58,1%), while older females mostly from home and/or relatives (49,6%) as well as from the radio and television (46,0%). Males mostly gained that kind of knowledge from home and/or relatives (76,5%) and the Internet (60,5%). Statistical significance (p<0,001) was observed between blood pressure and age and gender of the participants. The group of males had higher blood pressure results (SBP mean±SD 119,57±10,42; DBP mean±SD 73,88±5,85) than the group of older females (SBP mean±SD 115±12,87; DBP mean±SD 72,7±7,71) and younger females (SBP mean±SD 112,04±10,41; DBP mean±SD 70,26±7,67). Unfortunately, antihypertensive medication was used by 12,2% of older females, 1,7% of younger females and 0,84% of males. More than half of females over 25 years (61,1%) had an inherited predisposition to hypertension. In case of males it was 42,8% and in case of younger females 42,7%. The analysis of dietary habits of overweight, obese and normal weight students indicated statistical significance only in some aspects, e.g. consumption of bread (p=0,039) which was more frequent in case of the obese (14,3%). However, obese students consumed whole wheat bread more frequently (35,7%) than overweight students (26,4%) and students with normal weight (19,2%). Adding up to two spoonfuls of sugar to hot beverages was ; the most frequent habit in the group of students with normal weight (40,4%). Sugar was added to beverages by 32,0% of overweight and 25,0% of obese students. There was no statistical significance regarding consumption of alcohol (p=0,563) and smoking tobacco products (p=0,258) among groups of students with various BMI. A statistical significance was observed only in case of undertaking selected forms of physical activity. Cycling was popular among 10,7% of obese students, 2,5% of students with normal weight and 0,9% of overweight students. Obese students more frequently exhibited higher blood pressure. Although home was the source of gaining knowledge about nutrition in case of 57,0% of students with normal weight, 58,5% of overweight and 57,1% of obese students, 60,4% of students with normal BMI, 44,3% of overweight and 42,8% of obese students admitted they gained knowledge about nutrition from the Internet. Conclusions: 1. The prevalence of excessive weight was statistically significantly correlated with age and gender of male and female students of medical sciences. Overweight and obesity were more prevalent in the group of females over 25 years than in the groups of younger females and males. 2. Statistically significant discrepancies in body composition estimated according to the bioelectrical impedance analysis method were related to gender and age of male and female s ; tudents of medical sciences. Excessive volume of body fat expressed in percentage was more frequently observed in the group of females over 25 years than in younger females and males, whereas male students displayed more skeletal muscle mass than female students of each age groups. 3. There was a statistically significant correlation between the consumption of fast food, sweet beverages and adding sugar to beverages and age and gender of male and female students of medical sciences. Fast food was the most often consumed by male students, while females over 25 years used those kind of products less frequently. Similarly, adding sugar to hot beverages and consumption of sweet carbonated beverages were the most common habits among male students, while younger females displayed those habits with less frequency and females over 25 years with the least frequency. 4. The physical activity associated with household and occupational activity as well as leisure activity (walking, skiing, jogging) was statistically significantly related to age and gender of male and female students of medical sciences. Females over 25 years spent the longest time doing occupational activity, while males spent the longest time undertaking leisure activity, on which females over 25 spent the shortest period of time. 5. Statistical significance was observed between blood pressure (systolic – SBP and diast ; olic – DBP) and age, gender and inherited predispositions of male and female students of medical sciences. The values of both SBP and DBP were higher in males than in females under and over 25 years. Individual instances of hypertension or using antihypertensive medication were identified among females over 25 years. Regrettably, a large group of male and female students of medical sciences had an inherited predisposition to hypertension. Instances of a family history of hypertension were prevalent among females over 25 years, whereas in the group of students under 25 years, both male and female, the occurrence of inherited predisposition to hypertension was comparable. 6. Statistical significance has been found related to medical students` sources of knowledge about nutrition. The main sources are: home, school and the Internet. 7. No significant differences in lifestyle have been fund among medical students with appriopriate weight, overweight or obese. What is interesting, obese students showed more beneficial habits regarding regularity and composition of meals. It may be due to the fact that their obesity started earlier and now during their studies, they gained knowledge about healthy lifestyle, which helped them to improve their dietary habits. 8. The following unhealthy dietary habits among medical students have been observed: low intake of wholemeal bread, vegetable ; s, fruit and fish. Apart from that: not sufficient intake of beverages, drinking sugared drinks, sweetening drinks and salting food at the table.
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Rada Dyscypliny Nauki o zdrowiu
Promoter:
Bonior, Joanna ; Skop-Lewandowska, Agata