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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