|Year : 2018 | Volume
| Issue : 1 | Page : 35-40
Weight status and related factors in medical students of King Khalid University, Saudi Arabia
Ali Al Bshabshe1, Mushabab A Al-Ghamdi2, Masoud I Elkhalifa2, Mohammad T Ahmad3, Ibrahim A Eljack2, Yara M Assiri4, Bashayer Fahad4, Sara A Hadi4, Rahaf S.O Bukhari4, Mubarak Al Saif4, Yazeed Alqahtani4, Hossien M.M Al Qahtani4, Mohammed Alshehri4, Abdulelah Alqahtani4
1 Internal Medicine Department, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
2 Internal Medicine Department, College of Medicine, University of Bisha, Bisha, Kingdom of Saudi Arabia
3 Medical Education Department, College of Medicine, King Khalid University, Kingdom of Saudi Arabia
4 King Khalid University, Abha, Kingdom of Saudi Arabia
|Date of Submission||14-Jul-2018|
|Date of Decision||01-Jan-2019|
|Date of Acceptance||08-Jan-2019|
|Date of Web Publication||13-Mar-2020|
Dr. Ali Al Bshabshe
Internal Medicine Department, College of Medicine, King Khalid University, Abha
Kingdom of Saudi Arabia
Source of Support: None, Conflict of Interest: None
Introduction and Objective: The purpose of this study was to find out the prevalence of obesity and related factors among students of College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia. Materials and Methods: A total of 560 medical students of different levels participated in this cross-sectional study. The study was conducted in the period between January 2016 and January 2017. The data were collected through a validated, self-administered questionnaire. Weight and height readings were taken using a calibrated manual scale. Results: Out of 560 respondents, 54.8% were females, whereas 45.2% were males. Mean ± standard deviation was 22.05 ± 1.8. The body mass index was calculated from the weight (kg) and height (m2) of the participants. Underweight was found in 16% of the participants, normoweight in 55%, overweight in 21%, and obese in 8%. Conclusion: The prevalence of overweight and obesity was found to be high among medical students of College of Medicine, King Khalid University, particularly among female students. There is a need for a program to promote healthy eating and exercise among the students.
Keywords: Medical students, obesity, overweight, prevalence
|How to cite this article:|
Al Bshabshe A, Al-Ghamdi MA, Elkhalifa MI, Ahmad MT, Eljack IA, Assiri YM, Fahad B, Hadi SA, Bukhari RS, Al Saif M, Alqahtani Y, Al Qahtani HM, Alshehri M, Alqahtani A. Weight status and related factors in medical students of King Khalid University, Saudi Arabia. Saudi J Obesity 2018;6:35-40
|How to cite this URL:|
Al Bshabshe A, Al-Ghamdi MA, Elkhalifa MI, Ahmad MT, Eljack IA, Assiri YM, Fahad B, Hadi SA, Bukhari RS, Al Saif M, Alqahtani Y, Al Qahtani HM, Alshehri M, Alqahtani A. Weight status and related factors in medical students of King Khalid University, Saudi Arabia. Saudi J Obesity [serial online] 2018 [cited 2020 Oct 20];6:35-40. Available from: https://www.saudijobesity.com/text.asp?2018/6/1/35/280264
| Introduction|| |
Obesity has been recognized as a public health problem and global epidemic. Obesity has been established as a risk factor for serious illnesses such as diabetes, cancer, and cardiovascular diseases.,, Saudi Arabia has one of the highest prevalence rates of overweight and obesity, which present as a big challenge to public health in the country. Doctors are seen as role models for health behavior. To promote a healthy lifestyle among their populations, doctors themselves ought to practice healthy behavior and appear fit and healthy. Medical students are healthcare professionals in the making. With this context in mind, we were interested in knowing the dietary habits, physical activity levels, weight status, etc., of medical students in our setting.
Obesity has been defined by the World Health Organization (WHO) as “abnormal or excessive fat accumulation that may impair health.” A person can be classified as overweight when the body mass index (BMI) is 25 kg/m2 or more and obese when BMI is 30 kg/m2 or more.
According to the WHO, global obesity has nearly tripled since 1975. More than 1.9 billion adults aged 18 years and older were overweight; of these, 650 million were obese. Moreover, of adults aged 18 years and older, 39% were overweight and 13% were obese. The available data indicate that the prevalence of overweight and obesity is increasing, and by 2030, most of the population worldwide will be either overweight or obese. Most of the world’s population live in countries where overweight and obesity kill more individuals than underweight.
Many factors are responsible for the development of overweight and obesity, including nutritional culture, eating habits, types of dietary components, physical inactivity, family history, and genetic predisposition. The prevalence of overweight and obesity is significantly high in the Kingdom of Saudi Arabia among individuals from different age and occupation groups, at different locations in the country, and between males and females. The main risk factors for overweight and obesity in the Kingdom of Saudi Arabia include family history, dietary pattern and eating habits, genetic factors, marital status, and lack of physical activities. In addition to these factors, the prevalence of overweight and obesity was reported to be higher in illiterate, high-income individuals residing in urban communities. It was found that an excessive intake of sugar-sweetened beverages, particularly carbonated soft drinks, is a main contributor to the global epidemic of overweight and obesity.
In a national survey conducted in 2013, obesity was found in 24.1% of men and 33.5% in females. The study also found that compared to males, females developed obesity at a younger age and amongst them those married or previously married were at an even greater risk of obesity. Overall, about 28.7% or 3.6 million Saudis of 15 years or older were found to be obese.
According to the National Epidemiological Survey, Saudi Arabia, the findings of which were featured in a research published in 1996, there is a progressive increase in BMI with age for both genders, reaching a maximum at the 5th decade, and BMI was found to be higher in females than in males. However, the prevalence of overweight was higher in males than in females (29% vs. 27%), whereas the prevalence of obesity was higher in females than in males (24% vs. 16%). The mean BMI was reported to be significantly higher in females than males of the same age group. Some gender variation was observed among individuals in different regions, as the prevalence of overweight was reported to be higher in males in all regions, except for the southern region, where the difference was not significant. Moreover, the prevalence of obesity was found to be significantly high in females throughout the country.
Medical students are a special group, as most of them possess at least basic information about healthy behaviors and obesity as a risk factor for diseases. As future physicians, they are expected to be role models for the society. In the Kingdom of Saudi Arabia, there is a shift from consumption of traditional foods to consumption of fast foods, particularly among those living in cities. Medical students are prone to develop overweight and obesity because of their inactive lifestyles. Many studies showed that the prevalence of overweight and obesity in medical students is significantly high in many countries,,,,, including the Kingdom of Saudi Arabia.,,, This study aimed to determine the prevalence of overweight and obesity in medical students of College of Medicine, King Khalid University, and to study the association between weight status and dietary habits in relation to their eating habits and nutritional preferences
| Materials and methods|| |
This cross-sectional study included 560 medical students at different levels of medical training enrolled at King Khalid University, Abha City. This city is situated at high altitude (more than 2000 m above sea level) and is located in the southern region of the Kingdom of Saudi Arabia. Abha has a mild climate conducive for outdoor activity all round the year unlike other major cities in the Kingdom such as Riyadh, Jeddah, Dammam, and Jazan. The study was performed for 1 year from January 2016 to January 2017. This research was approved by the ethical research committee of the College of Medicine, King Khalid University.
Data were collected through a validated (Cronbach’s alpha = 0.94), and self-administered questionnaire that included demographic information and questions related to eating habits, physical activity, and availability of financial resources. BMI was calculated using the results of measurement of height (m2) and weight (kg). BMI, which is defined as an individual’s weight in kilograms divided by the square of height in meters (kg/m2), is used to classify overweight and obesity. The WHO defines overweight and obesity as abnormal or excessive fat accumulation that may impair health, with a BMI greater than or equal to 25 and a BMI greater than or equal to 30 indicating overweight and obesity, respectively. Trained staff members took the height/weight using the advanced machinery.
Data entry, processing, analysis, and storage were performed using SPSS version 23 (IBM Corp, Armonk, New York, USA). Descriptive statistics [mean, standard deviation (SD), frequencies, and percentages] were calculated for the obtained data. To measure whether there was any significant difference among the variables of interest, Chi-square test was used. Level of significance was taken as 5%.
| Results|| |
Out of 560 respondents, 54.8% were females, whereas 45.2% were males. Mean ± SD was 22.05 ± 1.8. A total of 73.9% were single, 20.2% were married, whereas 5.9% were widowed or divorcees. As classified according to the scale mentioned in the questionnaire, 44.5% were poor, 53% were medium, whereas 2.5% were rich [Table 1].
The BMI was calculated from the weight (kg) and height (m2) of the participants as discussed earlier. Underweight was found in 16% of the participants, normoweight in 55%, overweight in 21%, and obese in 8% [Figure 1].
BMI was compared with income, regularity of meals, and number of main meals as depicted in [Table 2]. No significant difference was observed.
BMI was compared with the frequency of vegetable consumption, fruit consumption, and fried food consumption. We observed a significant relation of BMI with frequency of vegetable consumption (P value 0.036), whereas frequency of fried food consumption was also found to be significant (P value 0.049) [Table 3].
There was a highly significant difference when BMI was compared with gender, with a female preponderance (P value 0.001), whereas there was no significance observed when BMI was compared with exercise [Table 4].
| Discussion|| |
This study showed that of the participants, 16% were underweight, 55% were normoweight, 21% were overweight, and 8% were obese, which is almost similar to the results of Al Shahrani et al. who reported a prevalence rate of 28% for overweight. However, they reported a prevalence rate of 20% for obesity, which is higher than that in our study (8%). The prevalence rate of obesity in this study (8%) was in partial agreement with that reported by Saeed et al. (13.7%). Moreover, in both the studies, the prevalence was much higher in male participants. Another study that included female nursing students showed a prevalence rate of 19%, 9%, and 6% for obesity, severe obesity (BMI > 35 kg/m2), and underweight, respectively, which is in contrast with the results of our study. This contradiction may be related to different social and eating habits. A Nigerian study that included university students reported that overweight and obesity were more common in female students than in male students (prevalence rate of 10% and 5.1% vs. 4.6% and 1.3%, respectively). However, in our study, underweight was more prevalent in male students than in female students and the Obesity was more prevalent in females students compare to male students. Yadav et al. assessed BMI in undergraduate medical students of the Medical College of Haryana and found that of the students, 22.3% were overweight, 3.1% were obese, and only 1.5% were underweight, which is in partial agreement with our study.In another study conducted among medical students in Northern Border University, Saudi Arabia, the prevalence of obesity was found to be 8.4% and overweight 21.7%.
In another study of Saudi Board residents of Aseer region, it was found that overweight and obesity was 36% and 23.2%, respectively, which is much higher than our findings. This points to the need for timely interventions to prevent development of overweight and obesity especially among medical students.
Although most students (70.5%) were knowledgeable about the components of a healthy diet and the roles that healthy diet and exercise play in preventing and controlling obesity, most of them did not practice healthy nutritional habits, and almost half of the students (49.1%) never exercised, with most doing it either rarely or irregularly and for a short duration.
Like other similar studies, fried food consumption was found to be significantly associated with high BMI. However, the significance was not as high as seen in other studies., An explanation of this could be the absence of genetic background, which interacts with fried food consumption, leading to the development of obesity.
| Limitations of the study|| |
This work was limited by sample size, which might be limiting to generalize our result; also it was performed in one geographical location, which makes the conclusion hard to be applied in all different geographical location in the country or internationally. Larger studies will be needed to evaluate the prevalence and finding the risk factors for overweight and obesity in medical student nationally and internationally.
| Conclusion|| |
The prevalence of overweight and obesity is high in medical students of College of Medicine, King Khalid University, particularly among female students. Development and implementation of an effective health promotion program for students is a priority.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Medanic D, Pucarin-Cvetkovic J. Obesity—A public health problem and challenge. Acta Med Croat 2012;66:347e55.
Garg SK, Maurer H, Reed K, Selagamsetty R. Diabetes and cancer: Two diseases with obesity as a common risk factor. Diab Obes Metab 2014;16:97-110.
Akil L, Ahmad HA. Relationships between obesity and cardiovascular diseases in four southern states and Colorado. J Health Care Poor Underserved 2011; 22(4 Suppl):61.
Mathew B, Francis L, Kayalar A, Cone J. Obesity: Effects on cardiovascular disease and its diagnosis. J Am Board Fam Med 2008;21:562-8.
DeNicola E, Aburizaiza OS, Siddique A, Khwaja H, Carpenter DO. Obesity and public health in the Kingdom of Saudi Arabia. Rev Environ Health 2015;30:191-205.
While AE. Promoting healthy behaviours—Do we need to practice what we preach?. London J Prim Care 2015;7:112-4.
Lobelo F, de Quevedo IG. The evidence in support of physicians and health care providers as physical activity role models. Am J Lifestyle Med 2016;10:36-52.
Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond) 2008;32:1431-7.
Alqarni SSM. A review of prevalence of obesity in Saudi Arabia. J Obes Eat Disord 2016;2:2.
al-Nuaim AR, al-Rubeaan K, al-Mazrou Y, al-Attas O, al-Daghari N, Khoja T. High prevalence of overweight and obesity in Saudi Arabia. Int J Obes Relat Metab Disord 1996;20:547-52.
Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: A systematic review. Am J Clin Nutr 2006;84:274-88.
Deotale MK, Ranganathan U, Akarte SV. Prevalence of overweight and obesity among medical students and their knowledge, attitude and practices about obesity. Int J Sci Rep 2015;1:74-9.
Nor Afiah MZ, Suriani I, Abdul Hakim MS, Simmadorai R, Nor Shahida Akhma MN. Influence of eating behaviours and psychosocial factors on overweight and obesity among medical students in a public university in Malaysia. Int J Public Health Clin Res 2014;1:151-9.
Manojan KK, Benny PV, Bindu A. Prevalence of obesity and overweight among medical students based on New Asia-Pacific BMI guideline. Int J Prevent Therap Med 2014;2:15-7.
Boo NY, Chia GJQ, Wong LC, Chew RM, Chong W, Loo RCN. The prevalence of obesity among clinical students in a Malaysian medical school. Singapore Med J 2010;51:126.
Yeasmin R, Choudhuryn S, Parveen S, Nahar N, Begum K, Akhter F. Assessment of overweight, obesity and metabolic variables among students of a private medical college in Dhaka City. Bangladesh. J Med Sci 2015;14:53-8.
Olusanya JO, Omotayo OA. Prevalence of obesity among undergraduate students of Tai Solarin University of Education, Ijagun, Ijebu-Ode. Pak J Nutr 2011;10:940-6.
Al-Qahtani MH. Dietary habits of Saudi medical students at University of Dammam. Int J Health Sci (Qassim) 2016;10:353-62.
Saeed E, Assiri AM, Awad Eljack I, Aljasser AS, Alhuzimi AM, Assiri AA et al.
Obesity and associated risk factors among students of health colleges of King Saud University, Saudi Arabia: A cross-sectional study. J Pak Med Assoc 2017;67:355-9.
Al Shahrani MM, Chandramohan S. A cross-sectional study on prevalence of obesity and its association with dietary habits among college students in Abha, Saudi Arabia. Int J Community Med Public Health 2017;4:1406-12.
Banu S, Mobarak SA. Prevalence of obesity among nursing students at College of Applied Medical Sciences, Wadi Al Dawasir. SCIREA J Clin Med 2016;1:220-30.
Yadav SS, Saini P, Khan ZA, Bachloo T, Kumar R, Singh J. Assessment of body mass index among undergraduate medical students—A cross-sectional study from the Medical College of Haryana. Int J Med Sci Public Health 2016;5:705-8.
Mehmood Y, Al-Swailmi FK, Al-Enazi SA. Frequency of obesity and comorbidities in medical students. Pak J Med Sci 2016;32:1528.
Alzahrani AA, Al-Khaldi YM, Alsamghan AS. Prevalence of obesity among Saudi board residents in Aseer Region, Saudi Arabia. Saudi J Obes 2016;4:13.
Al-Rethaiaa AS, Fahmy AE, Al-Shwaiyat NM. Obesity and eating habits among college students in Saudi Arabia: A cross sectional study. Nutr J 2010;9:39.
Qi Q, Chu AY, Kang JH, Huang J, Rose LM, Jensen MK et al.
Fried food consumption, genetic risk, and body mass index: Gene-diet interaction analysis in three US cohort studies. BMJ 2014;348:g1610.
[Table 1], [Table 2], [Table 3], [Table 4]