Awareness of BMI and life style including physical activity, food habits and personal history among first year medical students at a rural medical college setup in Kerala

 

 

Abstract               Background and Objectives: Medical education is stressful throughout the course of training. The extensive amount of material knowledge to be absorbed, social isolation, pressure of examination, discrepancies between expectation and reality all can be anticipated to bring psychological stress. As future physicians and health care providers, it is generally assumed that the medicos have better knowledge about healthy life style and dietary  practices when compared to their peer age group undergoing other courses. However there is no evidence to indicate that the knowledge which has been gained is translated into practice. Also medical students have been shown to exhibit early risk factors for chronic diseases. This study is designed to assess the awareness of body mass index and life style including physical activity, food habits and personal history among first year medical college students at a rural medical college in Kerala. Material and methods: The study was done at PK Das Institute of Medical Science, Vaniamkulam, Ottapalam, Kerala, 134  first  year medical college students were enrolled. The study was conducted between December2017 to May 2018. A written consent was obtained from the entire student. A structured questionnaire was given to all the participants. Results obtained was tabulated and expressed in percentage. Result and Conclusion: As future physicians and health care providers it is very important for medical college students to have good physical health and fitness .This study has shown  71.61% of students are unaware about  BMI, 49.2% do not do any physical  activity, 80%  do not know their calorie requirement and only 5.9%  are knowing their lipid  profile.  Policy makers and curriculum designers should lay importance on hands on skills rather than to have material knowledge imparted. Practical sessions should include anthropometry, calculation of BMI and calorie requirement. Nutrition should be added as a practical session. De-stressing activities and yoga can be added as a part of the curriculum.

Key Words: Medical College students, Body Mass Index (BMI), Physical activity, Food Habits

 

 

INTRODUCTION

India has the world’s largest youth population, with 356 billion in the age group of 10-24 years old. The 21^st century has seen a shift from communicable disease to non communicable disease globally^1,2 This poses a major public health concern, the large part of which is preventable.³ Obesity in childhood and youth leads to breathing difficulties increased risk of fractures,    hypertension, diabetes and psychological effects leading to large amount of morbidity and mortality⁴. Obesity is seen to be on the rise in young individuals, of the factors contributing to obesity stress seems to be particularly important mainly leading to irregularity in diet, lack of exercise and addiction each being independent factors leading to obesity and the prevalence of obesity worldwide.^5,6 Medical education is stressful throughout the course of training. The extensive amount of material knowledge to be absorbed, social isolation, pressure of examination, discrepancies between expectation and reality all can be anticipated to bring psychological stress.⁷ As future physicians and health care providers, it is generally assumed that the medicos have better knowledge about healthy life style and dietary practices when compared to their peer age group undergoing other courses. However there is no evidence to indicate that the knowledge which has been gained is translated into practice⁸. Also medical students have been shown to exhibit early risk factors for chronic diseases.⁹ This study is designed to assess the awareness of body mass index and life style including physical activity, food habits and personal history among first year medical college students at a rural medical college in Kerala.

MATERIAL AND METHODS

The study was done at PK Das Institute of Medical Science, Vaniamkulam, Ottapalam, Kerala, 134 first year medical college students were enrolled. The study was conducted between December2017 to May 2018. A written consent was obtained from the entire student. A structured questionnaire was given to all the participants. Results obtained was tabulated and expressed in percentage.

Table 1: Awareness about body mass index

 

Table 2: Physical activity

 

Table 3: Food habits

 

Table 4: Personal history

Table: Awareness about lipid profile and associated risk factors

RESULTS

A detail analysis of the questionnaire was done, the results were tabulated under five divisions as awareness about body mass index (BMI) ,physical activity, food habits ,personal history and awareness  about lipid profile and associated risk factors. From Table-1, awareness about BMI 71.61% of the Students were not aware about BMI, out of the 28.39% who were aware about BMI only 14.9% knew their own BMI. All of the 14.9% of the students had calculated their BMI using the standard formula Weight in kg /height in m² as per WHO guidelines for Asia Pacific region^8,9 Further out of the students  who  knew their BMI 20% were underweight, 35% were overweight and 15% were obese.  The next analysis was based on the physical activity (Table-2), 49.2% were not doing any type of  physical activity .Out of the 50.7% doing physical activity 39.7% were doing physical activity daily,22% were doing physical activity thrice a week,23.5 percentage did physical activity twice weekly and 14.6% did  physical activity once a week. Of the students who do physical activity 35% did play games, 30% were walking, 20% did running and 15% did other types of physical activity. The next analysis was based on food habits table-3, 80.59% of the students did not know their daily calorie requirement, 5. 22% of the students felt they were undernourished,94.02% of the students were   non-vegetarian, out of which 64% of the students were regularly consuming non-vegetarian food.43.31% have said that they consume fruits and vegetables regularly.88.05% of the students have told that they consume fat rich foods and 88% said they were not consuming fast-food. Table-4 was based on personal history, 2.9% said that they consume alcohol and was occasional .Onlyone student that is 0.74% said was a smoker. The last table were questions based on the risk factors of obesity .14.7% of the students said that there was obesity in their family.35.77% of the student said that their family members had history of elevated lipid levels.23.88% of the students were not aware of the components of lipid profile.98% did say that obesity was a risk factor for diseases .Only 5.9 % of the students have checked their lipid profile.

 

DISCUSSION

Body mass index is the simplest and the most widely used parameter for measuring obesity.⁹ It is a known fact that obesity is becoming an epidemic awareness about BMI is very much needed as medical student as the study showed that 71.61%were not aware BMI, of the 14.9% who knew their BMI 20% were underweight, 35% were overweight and15% were obese. The study conducted by Jayaraj etal has already shown the increase in obesity among the medical college student in Kerala.¹⁰ 20% of the student are underweight which is also a serious concern. Physical activity is one of the major factors contributing to control obesity in he study nearly 50%of the student do not do any physical activity. Previous studies done to evaluate the physical activity, diet and fitness status revealed that the physical condition and nutritional habit of the student attribute towards health promotion and illness prevention^11,12 This study showed that 39.75%were regularly doing physical activity, that is daily.  The rest of the students were not doing enough physical activity that is thirty minutes of moderate physical activity five days a week which is the latest guidelines. Further when the different types of physical activity was asked 35% said that they were playing games,30% said they go walking,20% said they went for running and 15% they said other types of physical activity. The food habits play a pivotal role in maintaining health and preventing illness, around 80.59% of students were not aware of the daily calorie required by them.64% of the students were  non-vegetarians. Of the non-vegetarians ,94.02% were regular in consuming non-vegetarian food.56.71% of the students do not consume fruits and vegetables regularly.88.5% of the respondents said that they consume fat rich food regularly. Only 11.9 % of the students said they consume fast food regularly which is a good healthy trend. Balanced diet according to ICMR guidelines should be followed, sensitization on the same should be made available in the curriculum .Good eating habits helps in maintaining good health and prevent illness.^8,12,13, Tobacco and alcohol abuse is a major public health and social issue, medical students also face the issue.^14,15 In this study only 2.9% consumed alcohol and were occasional drinkers. Only one student that is 0.74% said was a smoker .In addition to social and health problem the medical course is very stressful, pushing students to addiction mainly tobacco and alcohol abuse. Regular counseling sessions for students should be made mandatory. Family history of obesity and knowing family members with elevated cholesterol levels can be helpful in preventing morbidity and mortality.14% of the students said that there was family history of obesity.35.77%said that there was family history of elevated cholesterol levels.98.5% were of the view that obesity is a risk factor for various diseases.76% of the respondents told that they knew about the components of lipid profile but only 5.97% have checked their lipid profile.   The results of this study has thrown clarity and added an evidence that material knowledge is not been transferred to practical implications. As medical students our study has thrown light for the need of skill based learning .As the study has indicated maintaining BMI with good life style including adequate physical activity, good eating habits, early screening for obesity related risk factors among medical students is need of the hour for medical students.

 

CONCLUSION

As future physicians and health care providers it is very important for medical college students to have good physical health and fitness .This study has shown  71 .61 % of students are unaware about  BMI,49.2% do not do any physical  activity,80%  do not know their calorie requirement and only 5.9%  are knowing their lipid  profile.  Policy makers and curriculum designers should lay importance on hands on skills rather than to have material knowledge imparted. Practical sessions should include anthropometry, calculation of BMI and calorie requirement. Nutrition should be added as a practical session. De-stressing activities and yoga can be added as a part of the curriculum.

REFERENCES

1. The United Nations Population Funds (UNFA) State of the world’s Population Report –Nov 2014
2. World Population Prospects  : The 2017 Review UN Department of Economic and Social Welfare
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4. National health Survey India -3  (NHFS -3)2005 -06,Sep2007
5. Executive Summary, Clinical Guidelines on the Identification on Treatment of Overweight and Obesity in Adults. The Evidence Report, National Heart, Lung and Blood Institute. September 1998
6. World Health Organization: Preventing and managing the global epidemic. Geneva,3-5 June 1997 and Geneva,WHO;1998 Document
7. Srinivas K etal A study of stress and autonomic nervous function in first year undergraduate Medical Students. Indian J Physiol Pharmacol 2006;50:257 -64
8. S.V Saranya etal Dietary habits and physical activity among medical students of a teaching hospital in South India-A descriptive Analysis Tropical J Med Res 2016;19:172-7
9. World Health Organization(WHO) Obesity and overweight fact sheet from the WHO-2011
10. Jayaraj etal Prevalence of Overweight and Obesity among students of Medical College in South India : A Pilot Study   Indian J of Clinical Practice Vol 25,No.4 Sept 2014
11. Greenlee P  etal Successful modification of medical students cardiovascular risk factors Am J Prev  Med 1992;8;43-52
12. Liang MT etal Do Medical students knowledge and attitude about health and exercise effect their physical fitness  J Am Osteopath Assoc 1993 Oct;93(10) 1020 -4 ;1028-32      
13. Sandhyavani Javalkar etal  Food habits and fast food preferences among medical college students    In Journal of Multidisciplinary Research and Development Oct 2015;Vol 2;10;556-559
14. Nidhi Goel  etal  Alcohol and Tobacco use among undergraduate and post graduate medical student: a multicentric cross –sectional study Cent Asian J Global Health 2015;491);187
15. Avi Sing etal  A cross sectional study on tobacco and alcohol abuse among medical college students                                                 Int J Community Med Public Health 2017 Sep4(9); 3372-3375.