THE PREVALENCE OF OVERWEIGHT AND OBESITY AMONG FRESH UNDREGRADUATES OF THE EBONYI STATE UNIVERSITY AND FEDRAL UNIVERSITY OF TECHNOLOGY OWERRI, SOUTH-EAST NIGERIA.

ABSTRACT

This study investigates the prevalence of overweight and obesity among fresh undergraduates of Ebonyi State University (EBSU) and Federal University of Technology Owerri (FUTO) in South-East Nigeria. The objectives include assessing socio-demographic characteristics, determining nutritional status through anthropometry, evaluating health status via blood pressure measurement, and analyzing lifestyle patterns and dietary habits to understand their association with overweight and obesity.

The general objective is to ascertain the prevalence of overweight and obesity among fresh undergraduates of EBSU and FUTO. Specific objectives include investigating socio-demographic characteristics, assessing nutritional status, evaluating health status, determining prevalence rates of obesity and overweight, analyzing lifestyle patterns, evaluating dietary habits, and exploring the relationship between lifestyle, dietary habits, overweight, and obesity. A descriptive cross-sectional study design was employed, targeting fresh undergraduates aged 18-25 years from EBSU and FUTO. Both male and female students were included in the study. Sample size was determined using Araoye's formula, resulting in a sample size of 330 for both universities. Data were collected using a questionnaire adapted from previous studies.

Anthropometric measurements such as body mass index (BMI), hip circumference, waist circumference, height, and weight were calculated and graded using reference classification. Statistical analysis involved calculating means, standard deviations, frequencies, and percentages. T-tests, chi-square tests, and Pearson correlation were used to analyze the data, with significance set at P<0.05. The study revealed a high prevalence of overweight and obesity among first-year undergraduates, with 35.5% overweight and 12.4% obese. Socio-demographic characteristics showed that most students were young adults aged 18-22 years, with a significant portion receiving over 20,000 naira per month. High consumption of pastries was noted among students. Blood pressure measurements indicated a concerning prevalence of pre-hypertension. Significant relationships were observed between BMI status and frequency of fruit consumption, meals missed, alcohol consumption, cigarette intake, and siesta, suggesting that unhealthy dietary habits contribute to overweight and obesity.

The study highlights a concerning prevalence of overweight and obesity among fresh undergraduates, posing risks for cardiovascular diseases. There is a need for further research focusing on this demographic in Nigeria, with emphasis on nutrition education during orientation to promote healthy dietary habits.

It was recommended that further research should be conducted on first-year undergraduates to better understand the prevalence of overweight and obesity. Also, tertiary institutions should integrate nutrition education into orientation programs using food models and diagrams to improve students' knowledge of good nutrition.

TABLE OF CONTENTS

CHAPTER 1

INTRODUCTION

BACKGROUND INFORMATION

1.1       Statement of Problem

1.2       Objective of the Study

1.2.1        General Objective

1.2.2    Specific Objectives

1.3       Significance of Study

CHAPTER 2

LITERATURE REVIEW

2.1       OVER-WEIGHT AND OBESITY

2.1.1    Classification of Overweight and Obesity

2.1.2    Causes of Overweight and Obesity

2.1.3    Risk Factors Associated With Overweight and Obesity

2.1.4    Anthropometric Techniques in the Assessment of Obesity and Overweight

2.2       Prevalence of Overweight and Obesity among Undergraduates and Different Population Groups

2.3       Dietary Habits and Patterns

2.3.1    Dietary Assessment Tools

2.4       Physical Activity and Lifestyle Pattern

2.5       Blood Pressure           

2.6       Management of Obesity

2.6.1    Preventive Measures

CHAPTER 3

MATERIALS AND METHODS

3.1       Study Design

3.2       Area of Study

3.3       Population of the Study

3.4       Sampling and Sampling Techniques

3.4.1    Sample Size

3.4.2    Sampling Procedure

 3.5      Preliminary Activities

3.5.1    Preliminary Visits

3.5.2    Informed Consent

3.5.3    Training of Research Assistants

3.6       Data Collection

3.6.2    Anthropometry Measurements

3.6.2.1 Body Weight

3.6.2.2 Height

3.6.2.3 Skinfold Thickness (SFT)

3.6.2.4 Waist Circumference

3.6.2.5 Hip Circumference

3.6.2.6 Waist Hip Ratios (WHR)

3.6.2.7 Body Mass Index (BMI)

3.7              Blood Pressure Determination

3.8       Data Analysis

3.9       Statistical Analysis

CHAPTER 4

RESULT AND DISCUSSIONS

4.1       Socio-Demographic Data of Students

4.2:      Dietary Habits of Students

4.3:      Lifestyle Pattern of the Students

4.4:      Food Consumption Pattern of the Students

4.5:      Anthropometric Assessment and Prevalence of Overweight /Obesity among Students

4.6:      Health Status of the Students Using Blood Pressure Measurement

4.7:      Nutritional Status of Students

4.8:      Relationship between BMI, Dietary Habit and Lifestyle Pattern of the Students

CHAPTER 5

CONCLUSION AND RECOMMENDATION

5.1       Conclusion

5.2       Recommendation

References

Appendix I: Qualitative 24 Hour Dietary Recall

Appendix II: 24 Hour Dietary Recall

Appendix III: Research Questionnaire

LIST OF TABLES

Table 2.1: Who BMI Classification for Adults

Table 4.1a: Socio-demographic data of students

Table 4.1b: Socio-demographic data of students

Table 4.2a: Dietary habits of the students     

Table 4.2b : Dietary habits of the students

Table 4.2c: Dietary habits of the students

Table 4.2d: Distribution of students according to sources of foods and favourite foods

Table 4.2e: Dietary habits of the students

Table 4.2f: Dietary habits of the students

Table 4.2g: Distribution of students according to factors that determine your choice of food and problems encountered in eating pattern

Tables 4.3: Lifestyle pattern of the students

Table 4.4: Food consumption pattern of students

Table 4.4a: 24 Hour dietary recall

Table 4.4b: 24 Hour dietary recall

Table 4.4c: 24 Hour dietary recall

Table 4.5: Prevalence of overweight /obesity among students using different anthropometric indices

Table 4.6: Health status of the students using blood pressure measurement

Tables 4.7: Mean anthropometry measurement of the students

Table 4.8a: Relationship between BMI and dietary habits of the students

Table 4.8b: Relationship between BMI and lifestyle pattern of the students           

Table 4.8c: Relationship between BMI and blood pressure of the students

CHAPTER ONE

INTRODUCTION

BACKGROUND INFORMATION

Globally, the burden of non-communicable disease has rapidly increased. In the year 2001, non-communicable disease accounted for 60 percent (60%) of the 56.5% million deaths worldwide and 46% of the global burden of disease (Haddad, 2003). There is also rising prevalence of overweight and obesity in both developing and developed countries (Haidar and Cosman, 2011).

Obesity and overweight have both been described as anomalous accumulation of excessive body fat which may be harmful to health, It is also defined by body mass index (BMI) and further evaluated in terms of fat distribution via waist-hip ratio and total cardio-vascular risk factors (Sweeting, 2007). There is no single cause to explain all cases of obesity and overweight but most studies implicate imbalance in the amounts of calories consumed and those expended, energy breakdown is said to be less than energy buildup. The disruption of the normal satiety feedback mechanisms, hyper insulinism, insulin resistance, and genetics are some of the bio physiological causes of obesity and overweight (Codogno et al., 2010).

Body Mass Index (BMI) is an important anthropometric index that is commonly used for body fat storage status assessment and is used for body fat determination (Paknahad, 2008). Another indicator is the waist circumference or abdominal adiposity, which is associated with excess abdominal fat and total body fat (Zimmet, 2005). Abdominal adiposity is defined as a waist circumference of ≥ 102 cm for men and ≥ 88 cm for women (Zimmet, 2005).

Undergraduates have been described as university students who have not yet obtained first bachelor degree (Chinn and Rona, 2001). Young adults in the age group (18-25) years are often the neglected group in any health or nutrition education as compared to children and adults (Louis, 2002). When these young adults leave home and adjust to independent living, good dietary habits gained from home decline (Zimmet, 2005). Young people, have special nutrients needs for growth and maintenance of biochemical activities and have been shown not to meet the dietary recommendation for their age.Thus globally, there is evidence that approximately two (2) billion people are suffering from hidden hunger which has devastating effects and significantly contributes to the global burden of disease (Bonnie et al., 2004).

The prevalence of overweight and obesity among children and adolescents has increased significantly in the developed countries during the past two decades (Chinn and Rona, 2001; Louis, 2002) and similar trends are being observed even in the developing world. The World Health Organisation (WHO) estimated that by 2005, at least 1.6 billion and 400million people aged above 15 years were overweight and obese respectively (WHO, 2006). It further projected that by 2015, these statistics will increase to 2.3 billion for overweight and 700 million for obesity unless drastic measures are taken (WHO, 2006).  Reports show that the issue of childhood and adolescence obesity in third world countries requires public health attention (WHO, 2010; Ziraba, 2009).  In Nigeria a study carried out in 2008, reported a prevalence of 3.2% for overweight and 0.5% for obesity among adolescents in Osun state (Gores, 2008).

One of the population groups vulnerable to the problems of obesity and overweight are university students due to factors such as increased energy needs by age, increased consumption of foods rich in fat and calories, decreased physical activity, and emotional changes (mainly anxiety and depression) that stimulate food intake (Carretero et al., 2010). Additionally, the school context in which they spend most of the day may have unfavorable conditions that make it difficult to adopt and maintain healthy habits (Lloyd-Richardson., 2009).   Several studies showed that risk factors for weight gain in school age are strongly linked to low physical activity and family environmental factors such as parents’ education, job, number of family members, etc (Nwobodo, 2014). In a previous review (Pengpid and Peltzer, 2014), the following factors were identified to be associated with overweight and obesity among university students or (young) adults: socio-demographic factors: gender; social factors: capital; dietary behaviours: skipping breakfast more often; and health risk behaviour: frequent alcohol use; mental health and childhood abuse.  Some studies observed that first year university students have significant weight gain, Vella-Zarb and Elgar (20009)  followed by ongoing slow but steady increase in weight (Gores, 2008). Ukegbu et al (2016) reported that the prevalence of obesity was 33.7% among fresh university students in a previous study and this was significantly higher than students in other levels.

 For all countries, current evidence suggests that the underlying determinants of non communicable disease are largely the same (Haddad, 2003). These include increased consumption of energy-dense, nutrient poor foods that are high in fat, sugar and salt, reduced level of physical activity, and of particular concern are the increasingly unhealthy diets and reduced physical activity of children and adolescents (Haddad, 2003).

 It is against this backdrop that this research investigated the prevalence of obesity and overweight among fresh undergraduates of the Ebonyi state university and federal university of technology in south-east Nigeria.

1.1 STATEMENT OF PROBLEM

In a previous study (Ukegbu et al., 2016), the prevalence of obesity was 33.7% among fresh undergraduates and it was significantly higher than students in other levels. FAO/WHO/UNU (2001) reported the prevalence of obesity among young adults to be 25%. Some studies observed that first year university students have significant weight gain, Vella-Zarb and Elgar (20009)  followed by ongoing slow but steady increase in weight (Gores, 2008). Young adults in the age group (18-25) years are often the neglected group in any health or nutrition education as compared to children and adults (Hains et al., 2006). When these young adults leave home and adjust to independent living, good dietary habits gained from home decline (Hains et al., 2006). Young people, have special nutrients needs for growth and maintenance of biochemical activities and have been shown not to meet the dietary recommendation for their age ((Hains et al., 2006).

 Young adults who are obese, are more likely to have clustering of cardiovascular disease risk factors such as; dyslipidemia, hypertension, increase in left ventricular mass, type 2 diabetes mellitus and elevated fasting and post-load insulin levels (Damerath et al., 2003). There is need to provide accurate data for nutrition educators and policy makers in order to reduce non-communicable diseases such as obesity, overweight and chronic diseases (Mason, 2004).

1.2 OBJECTIVE OF THE  STUDY

1.2.2        General objective

The general objective of the study is to ascertain the prevalence of overweight and obesity among fresh undregraduates of the Ebonyi state university and fedral university of technology Owerri, South-East Nigeria.

1.2.2 Specific objectives

The specific objectives o f this study are to:

i.            investigate their socio demographic characteristics

ii.            determine their nutritional status using anthropometry

iii.            assess their health status using blood pressure measurement

iv.            assess the prevalence of obesity and overweight among the subject

v.            determine their lifestyle pattern

vi.            evaluate their dietary habits and food consumption pattern

vii.            determine the relationship between lifestyle, dietary habit, overweight and obesity.

1.3 SIGNIFICANCE OF STUDY

This study is intended to be a primary source of dietary habit information for policy makers, nutrition educators, and health providers, in dealing with dietary problems of students to make wise decisions or take actions to improve their health, and to determine health risk, ideal weight, target heart rate etc.

Findings from this study will create awareness, document BMI trend among fresh undergraduates. In addition, it will provide basis for assessment of nutritional and health programme and form the frame work for effective health policy guidelines for the Nutritionist, Dietitcians, Home economists in educating students in  south eastern Nigeria and other part of the country on healthy feeding habits. It will also suggest to them plans for maintaining normal body mass index (BMI) through adjustment in dietary pattern.

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