http://doi.org/ 10.33698/NRF0092 – Suresh K.Sharma, Jasbir Kaur, Jasveen Kaur, Jasmine Kaur, Kirandeep Kaur
Abstract : Healthy eating in childhood and adolescence is important for proper growth and development. Dietary patterns developed during adolescence may contribute to obesity and eating disorders and may increase the risk for several important chronic diseases later in life.1 A descriptive study was conducted to assess the dietary pattern and biophysical profile among 200 female nursing students aged 17-25 years in College of Nursing, Dayanand Medical College & Hospital (DMCH), Ludhiana. Findings of the study revealed that 43.5% of the subjects were skipping their meal and among them 33% were substituting their meal with junk food Fasting was practiced by only 24% subjects. The study has shown that 66.5% of the total subjects were consuming junk food. All the subjects were consuming one or other type of snack in between the meals. Fruits & nutritional supplement was consumed by only 22% & 39.5% subjects respectively. Majority of the subjects were consuming mixed nutrient supplements. It was found that only few subjects i.e. 4 (2%) had systolic BP>130mm of Hg and only 2 (1 %) showed diastolic BP>90 mm of Hg. Sixty one (30.5%) subjects were having altered Body Mass Index [39 (19.5%) underweight & 22 (11 %) overweight], and there were 15 (7.5%) subjects who were found to have Waist to Hip Ratio (WHR) >85. Based on these findings, a retrospective approach to this study is recommended with a larger sample so as to know the cause of altered Body Mass Index, Waist to Hip Ratio and altered dietary pattern among the nursing students. There by preventive approach can be recommended.
Key words :
Adolescent Girls, Body Mass Index, Waist to Hip Ratio, Obesity, Dietary Pattern.
Correspondence at :
Suresh K. Sharma
Lecturer,
College of Nursing, DMCH, Ludhiana
Introduction
Obesity is a major health hazard all over the world and is becoming a major health threat. There are a number of health hazards associated with obesity, including diabetes, hyper tension, cardiovascular disease, ar thritis, anesthesia risk, respiratory problems, breast cancer, menstrual abnormalities, ovarian dysfunction along with poor social image and rejection.2
Over the past few decades, the food and home environments have changed tremendously. Environmental influences that affect eating behaviors include the changing nature of the food supply and increased reliance on foods consumed away from home.2 Changes in fast food and soft drink consumption, may explain the increasing prevalence of overweight in adolescents.3 Being overweight as an adolescent is associated with being overweight as an adult.4 In adolescents, poor nutritional intake can have an adverse effect on educational performance, productivity and well beings.5 According to a 2005 study on adolescents by Augustine and Poojara, with excessive consumption of processed foods and high fat diets obesity is on the rise. The high popularity of junk foods and carbonated beverages were likely to precipitate obesity.6 Zafar (2007) conducted a descriptive study on 483 medical students at Lahore medical & dental college, Lahore in which he summarized that of the population studied 21.3% were underweight, 52% were normal weight, 20.5% as overweight, and 6.2% were obese. He stated that those with either higher BMI or central adiposity distribution are potential candidates of increased risk of hypertension and cardiovascular disease.2
The purpose of present study was to evaluate the dietary pattern and biophysical profile as predictors of health risk for being overweight among the nursing students.
Objective
To assess the dietary pattern and biophysical profile among nursing students.
Materials and Methods
The study was conducted in College of Nursing, DMCH, Ludhiana during months of Jan-Feb 2008. It is situated in old DMC campus, Civil Lines, near Dandi Swami Mandir. This institute is offering General Nursing and Midwifery (G.N.M.), B.Sc. Nursing, Post Basic B.Sc. Nursing courses. In the present study a total of 200 unmarried female nursing students between the age group of 17-25 years, residing in hostel of college were selected by simple random sampling.
A semi structured interview schedule was developed as data collection tool for assessing health status and dietary pattern. Three Blood Pressure measurements of selected students were taken at 5 minutes intervals in lying position. Waist circumference was measured using a measuring tape over the unclothed abdomen, with measurements made half way between the lower border of the ribs and the highest point of iliac crest (at the umbilicus level) in the standing position. Hip circumference was measured over light clothing at the widest point over the buttocks. Interaction with each individual was completed with height and weight measurements. Weight was measured after removal of shoes and height was measured without shoes in the standing position with the shoulders in the relaxed position. BMI was calculated as weight (in kg) divided by height squared (in m2) & it was classified according to the classification given by American National Institutes of Health and National Heart, Lung and Blood Institute, 1998.
Classification BMI
the most common substitutes for the meals skipped whereas only 3.5% of subjects
Underweight <18.5
Normal 18.5-24.9
Overweight 25-29.9
Obesity, class I 30-34.9
Obesity, class II 35-39.9
Extreme obesity, >40 class III ®
The WHR was calculated as waist circumference divided by hip circumference & it was classified according to WHO classification.
Classification WHR
Low risk <0.80
Moderate risk 0.80-0.84
High risk >0.85
The research tool was validated by consulting experts from the fields of nursing, nursing research, pediatrics, and nutrition regarding the content and language used in the tool and necessary changes were made. The data was analyzed using both descriptive and inferential statistics.
Results
Table 1 discusses the dietary pattern of the study subjects. Out of all the participants, 50.5% of the subjects were vegetarian and 49.5% were non-vegetarian. It was found that 56.5% of the subjects were consuming 3 meals regularly, while 43.5% skipped meals, either due to the food not being tasty (38%) or shortage of time (4%). Junk food (20.5%) and snacks (20%) were consumed fruits as substitute. About three – fourth (76%) of the subjects did not practice fasting, 11.5% were occasional fasters, 6.5% practiced fasting 1 weekly.
Table 1: Dietary pattern of subjects
N=200
Variables f (%)
Eating habits
Vegetarian 101 (50.5)
Non-vegetarian 99 (49.5)
Meal regularity
Taking all three meals 113(56.5) Skipping meals with 065 (32.5) substitute
Skipping meals without 22 (11.0) substitute
Reason for skipping meals
| Food not tasty | 66 (33.0) |
| Shortage of time | 08 (04.0) |
| Health factors | 02 (01.0) |
| Skipped meal substitute
Junk food |
*
41 (20.5) |
| Snacks | 40(20.0) |
| Beverages | 14 (07.0) |
| Fruits | 07 (03.5) |
| Fasting | |
| Not at all | 152 (76.0) |
| Occasionally | 23 (11.5) |
| Weekly | 13 (06.5) |
| Once a while | 07 (03.5) |
| Monthly | 04(02.0) |
| Twice a week | 01(00.5) |
* Many subjects take more than one skipped meal substitute
Table 2 presents the snacks and junk food consumption pattern among the
subjects. The study shows that more than half (66.5%) of the total subjects consume junk food.
Table 2 : Snacks & junk food consumption pattern among subjects N=200 Variables f (%)
Junk food consumption
Yes 133 (66.5)
No 67 (33.5)
| Type of snack | |
| Biscuits | 76 (38.0) |
| Namkeen | 62 (31.0) |
| Samosa | 30 (15.0) |
| Sandwich | 26 (13.0) |
| Bread pakora | 21 (10.5) |
| Mathi | 09 (04.5) |
| Any other | 07 (03.5) |
| Quantity of snack
One |
156 (78.0) |
| Three & above | 20 (10.0) |
| Two | 14 (07.0) |
| Frequency of snack | |
| Alternative day | 55 (27.5) |
| Daily | 45 (22.5) |
| Weekly | 33 (16.5) |
| Occasionally | 57 (28.5) |
*Many subjects consume more than one snack at a time.
Figure 1 shows fruit consumption pattern among subjects which reveals that the majority of the subjects (98%) are the consumers of fruits while only (2%) of the subjects do not consume fruits at all. But only 22% of subjects were taking fruits daily addition 89% of the total, take seasonal fruits whereas only 9% take fruits other than the seasonal fruits.
Figure 1: Fruit consumption pattern among subjects
Table 3 highlights nutrient supplement consumption among subjects. It shows that 102 (51%) of the total subjects did not take any supplements while 98 (49%) were taking nutrient supplementation. Out of them 39.5% of subjects were daily taking nutrient supplements. One fourth ie 59 (29%) of the total subjects were taking mixed supplementation.
|
Table 3: Nutrient supplement consumption among subjects N=200 Supplementation f (%)
Table 4, presents the beverage consumption pattern among the subjects. It depicts that 90% of the subjects were
consuming tea, 51 % were taking soft drinks, 23.5% had coffee, while only 0.5% of subjects had alcoholic beverages.
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Table 4 : Beverages consumption pattern among subjects N=200 Beverages* f (%) Quantity (ml)
*Many subjects consume more than one beverage.
Table 5 depicts the biophysical
Two third (69.5%) of the subjects had attributes of the subjects which shows that 86.5% of the subjects had systolic blood pressure between 110-130 mm of Hg, 11.5% had <110 mm of HG and only 2% had systolic blood pressure >130 mm of Hg. However, 69.5% of the subjects were found to have diastolic blood pressure in the range 70-90 mm of Hg, 29.5% had <70 mm of Hg and 1% showed the diastolic blood pressure >90 mm of Hg.
normal BMI ranging from 18.50-24.99 kg/m2, 19.5% were underweight (i.e. <18.50 kg/m2), followed by 11 % of the subjects who were overweight having BMI>25 kg/m2.
Waist to Hip ratio of 70.5% of the subjects was <0.80 whereas 22% had Waist to Hip ratio in the range 0.80-0.84 and only 7.5% of the subjects showed Waist to Hip ratio >0.85.
Table 5 : Biophysical measurement among subjects N=200
| Variable | f (%) | Range | Mean±S.D. |
| Systolic BP (mm of Hg) | – | 97.33-143.33 | 117.77±7.16 |
| <110 | 23 (11.5) | ||
| 110-130 | 173 (86.5) | ||
| >130 | 04 (02.0) | ||
| Diastolic BP (mm of Hg) | – | 58.00- 93.33 | 73.86±6.67 |
| <70 | 59 (29.5) | ||
| 70-90 | 139 (69.5) | ||
| >90 | 02 (01.0) | ||
| Weight (Kg) | – | 38.50- 87.00 | 53.35±7.74 |
| Height (meters) | 1.45- 01.72 | 1.56±0.06 | |
| Body Mass Index | 15.82- 33.98 | 21. 09±3 .09 | |
| <18.50 | 39 (19.5) | ||
| 18.50-24.99 | 139 (69.5) | ||
| ³25 | 22 (11.0) | ||
| Waist to Hip ratio | – – 0.77±0.07 | ||
| <0.80 | 141 (70.5) | ||
| 0.80-0.84 | 44 (22.0) | ||
| ³ 0.85 | 15 (07.5) | ||
Discussion
There have been very few studies undertaken to assess the dietary pattern & biophysical profile of nursing students.
In the present study findings revealed that there. were more vegetarians (50.5%) followed by (49.5%) non-vegetarians. Most subjects (56.5%) were taking all 3 meals regularly, but 45.5% were skipping their meals. Only 32.5% of the subjects who skipped meals were taking substitutes in place of the skipped meals. The most common consumed foods were junk food (20.5%), snack foods (20%), beverages (7%) whereas only (3.5%) of subjects were taking fruits in place of regular meals which ideally should be more as it is a healthy practice to have fruits as meal substitute. This indicates that the majority of adolescent girls in the present study prefer to eat junk food. The most common junk foods consumed were biscuits (38%); namkeen (31 %); samosas, bread pakora, mathi, and others being consumed less frequently. A study by Ravi & Truman’s (2002)7 study also found that junk foods and carbonated beverages are on the rise among adolescents.
Fruit consumption pattern among subjects was also explored. 98% of subjects consume fruits and 89% of them consume seasonal fruits. However only 22% of subjects consume fr uits daily while 18% of the students consumed fruits twice a month when they visited their home. However 2-3 servings of fruit should be consumed daily as per food parameter guidelines.
Consumption of seven categories of beverages was also explored among the subjects. Subjects’ were found to consume tea (90%), juice (55.5%), soft drinks (51%), coffee (23.5%), alcohol (0.05%), and any other beverages (5.5%). The present study found that 51 % of the subjects consumed soft drinks and that 22 (11%) of the subjects had a BMI >25; out of them 14 consumed soft drinks ranging from 200-600 ml per day, while 8 did not consume soft drinks.
Systolic blood pressure was >130 mm Hg in 2% of subjects while 1 % showed the diastolic blood pressure >90 mm Hg.
The present study found that 69.5% of the subjects had a normal BMI, 19.5% of the students had a BMI<18.5%, and 11% of the students had a BMI > 25. It was found that 70.5% of the subjects had WHR <0.8, 22% of subjects had WHR of 0.80-O.84 and 7.5% of subjects had WHR >0.85. A study on 3rd year medical students also found that 23% of female students had BMI ³ 25, and central obesity was present in 21.7% of female students. (Bertsias, 2003)8.
Conclusion
Out of the total 200 subjects almost equal numbers of subjects were vegetarian and non-vegetarian. Nearly half 87 (43.5%) of the subjects were having meal irregularity. Nearly one fourth of the total subjects i.e. 48 (24%) of the total subjects were practicing fasting. Two third i.e. 133 (66.5%) of subjects were consuming junk food ; 102 (51%) subjects showed the intake of soft drinks, however majority 180 (90%) were found to consume tea. A significant finding shows that out of all the overweight subjects, more than half (54.5%) subjects were still consuming junk food and one third (63.6%) subjects were consuming soft drinks The biophysical profile of all the subjects were assessed and the measurements clearly depicted that 22 (11%) of the subjects had Body Mass Index (BMI) greater than equal to 25, 15 (7.5%) of the subjects had Waist to Hip ratio (WHR) greater than equal to 0.85 which shows that a significant number of students are at a risk of developing coronary artery disease. So, a retrospective approach to this study is recommended with a larger sample so as to know the cause of altered Body Mass Index, Waist to Hip Ratio and altered dietary pattern among the nursing students. Therefore, a preventive approach can be recommended.
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