ABSTRACT
This study was carried out to assess the activity pattern, food intake, and prevalence of abdominal obesity among undergraduate students in Michael Okpara University of Agriculture, Umudike, Abia State. Questionnaires were distributed to 288 systematically selected undergraduates from the 12 colleges in Michael Okpara University of Agriculture, which included information on sociodemographic and socioeconomic characteristics, physical activity pattern, food frequency pattern, 24-hour dietary recall and anthropometric measurements. Data were analyzed using frequencies, percentages, mean and standard deviations. T-test was used to compare differences in anthropometric measurements between males and females. Chi-square was used for categorical variables, while Pearson correlation was used to determine the relationship between dietary diversity, waist circumference and waist-to-hip ratio. The result showed that more females (57.6%) than males (42.4) participated in the study. Some (48.3%) of the students were between 16-20 years of age, a further (44.4% and 5.9%) were between 21-24 and 25-28 years of age respectively with (1.4%) between 28-32 years of age. In terms of physical activity, less than half (48.4%) of the male students had high physical activity pattern when compared with their female counterparts (35.5%). Less than half (47.6%) of the female undergraduates had low physical activity pattern compared to their male counterparts (36.9%). In assessing the students’ risk to abdominal obesity, the result shows that majority (92.7%) of the undergraduates were normal while few (7.3%) of them had substantially increased risk of abdominal obesity. More females (9.6%) than their male counterparts (4.1%) had substantially increased risk of abdominal obesity. The result of this study indicates that undergraduates should engage more in physical activities and improve their dietary habits to achieve a healthy lifestyle. Lecturers, school guidance counselors should put more effort in motivating students to change their dietary practices and adopt healthy food choices as part of their lifestyle changes.
TABLE OF CONTENTS
CERTIFICATION i
DEDICATION ii
ACKNOWLEDGMENT iii
TABLE OF CONTENTS iv
LIST OF TABLES viii
ABSTRACT x
CHAPTER 1
1.0 INTRODUCTION 1
1.1 Background of study 1
1.2 Statement of problem 3
1.3 Objective of the study 4
1.3.1 General objective 4
1.3.2 Specific objectives 4
1.4 Significance of study 5
CHAPTER 2
2.0 LITERATURE REVIEW 6
2.1 Physical activity 6
2.1.1 Dimensions of physical activity 10
2.2 Eating behavior and factors influencing it 11
2.2.1 Fast food preferences 11
2.2.2 Canteen food consumption 13
2.2.3 Beverage consumption 14
2.2.4 Fruits and vegetable consumption 15
2.2.5 Snacking 17
2.3 FACTORS INFLUENCING FOOD CHOICES AMONG UNDERGRADUATES 17
2.3.1 Food taste 17
2.3.2 Stress 18
2.3.3 Past food habits 19
2.3.4 Knowledge and perception about nutritional benefit 19
2.3.5 Food taboo 19
2.3.6 Influence of peers 20
2.3.7 Campus culture and style 20
2.3.8 Availability and affordability of fresh raw food 21
2.3.9 Body image perception 21
2.4 Dietary pattern among university students 22
CHAPTER 3
3.0 MATERIALS AND METHODS 24
3.1 Study design 24
3.2 Area of study 24
3.3 Sample size and population 24
3.4 Data collection 25
3.4.1 Questionnaire 25
3.4.2 Interview 26
3.4.3 Anthropometric measurement 26
3.4.4 Weight measurement 26
3.4.5 Height measurement 26
3.4.6 Waist circumference 26
3.4.7 Hip circumference 27
3.4.8 Body mass index 27
3.4.9 Waist-to-hip ratio 27
3.5 Data analysis 28
3.6 Statistical analysis 28
CHAPTER 4
4.0 RESULTS AND DISCUSSION 29
4.1 Background information of the undergraduates 29
4.2 Socioeconomic characteristics of the undergraduates and their parents 31
4.3 Physical activity pattern of the undergraduates 33
4.4 Dietary habits of the undergraduates 35
4.5 Anthropometric characteristics of the undergraduates 43
4.6 Relationship between dietary habits and abdominal obesity 47
CHAPTER 5
5.0 CONCLUSION AND RECOMMENDATION 49
5.1 Conclusion 49
5.2 Recommendation 49
References 51
Appendix
LIST OF TABLES
Table 4.1 Background information of the undergraduates 30
Table 4.2 Socio-economic characteristics of the undergraduates and their parents 32
Table 4.3 Mean physical activity patterns of the undergraduates 33
Table 4.4 Physical activity pattern of the undergraduates by gender 34
Table 4.5 Frequency of food consumption pattern of the undergraduates 36
Table 4.6 Frequency of food consumption of the undergraduates contd. 38
Table 4.7 Frequency of food consumption of the undergraduates contd. 40
Table 4.8 Dietary diversity of the undergraduates 41
Table 4.9 Body mass index (BMI) of the undergraduates by gender 42
Table 4.10 Waist circumference of the undergraduates by gender 43
Table 4.11 Waist-to-hip ratio of the undergraduates by gender 44
Table 4.12 Relationship between dietary diversity, waist circumference and waist-hip-ratio of the students 46
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND OF STUDY
Abdominal obesity is socially acceptable among Nigerians and therefore is not usually recognized as a health risk (Iloh et al., 2012). It is a medical problem in which excess fat has accumulated in the abdomen to the extent that it may have an adverse effect on health and/or increase medical problems (Iloh et al., 2012). It was once thought as the health problem of affluent advanced countries but now exists in Nigeria in varying prevalence ranges and has been described as a time bomb for future explosion in the frequency of dysmetabolic syndrome (Abubakar et al., 2008). Globally, in the past, abdominal obesity was viewed as a sign of wealth and prosperity (Chukwuonye et al., 2013). However, in the present, public perceptions of healthy body shape and weight have changed significantly since the beginning of the epidemic of obesity (Ziraba et al., 2009). Normal adiposity of the abdomen (flat abdomen) is viewed as the ideal abdominal adiposity in western societies in contrast to the perception in traditional Nigerian societies where protruding abdomen (abdominal obesity) is culturally perceived as a symbol of good health and wealth (Okeke et al. 2006).
Obesity is defined using waist circumference (WC) criterion as an excess of adipose tissues resulting in waist circumference ≥102cm (40 inches) and ≥88cm (35 inches) for men and women respectively (Iloh et al., 2012). Similarly, according to The European Food Information Council, (TEFIC) (2006) abdominal overweight refers to the waist circumference between 94-101cm and 80-87cm for men and women respectively. Many methods of estimating abdominal obesity have been developed and include imaging techniques such as computed tomography scan and magnetic resonance imaging. Although, the imaging methods are the major standard for assessing abdominal adiposity, they are expensive for large scale epidemiological studies (Iloh et al., 2012). Waist circumference is therefore one of the most popular measure of abdominal adiposity and the simplest anthropometric indices of abdominal obesity (Abubakar et al., 2008). The validity of WC as a measure of abdominal obesity is further supported by its association with obesity-related risk factors (Wahrenberg et al., 2005) and a crucial correlate of metabolic syndrome (Tokin, 2004). The waist circumference therefore provides an easy method of describing pattern of abdominal adiposity even if the body mass index is about right (Janssen et al. 2004). The metabolic and structural changes in obese individuals are most often seen in abdominal obesity and have consistently been related to increased risk of coronary heart disease in men and women (Fezeu et al., 2007).
The prevalence of obesity as defined by waist circumference in the developing nations such as Nigeria is changing (Siminnialayi et al., 2008). The prevalence of obesity has almost doubled over the last 30 years globally (Gores, 2008). According to the World Health Organization report of 2015, more than 1.9 billion adults (18 years and older) were overweight and, among them, over 650 million were obese (WHO, 2014). Overweight and obesity are a threat to the public health as they increase the likelihood of non-communicable diseases, such as diabetes, hypertension, coronary heart disease, stroke, certain cancers, obstructive sleep apnoea, and osteoarthritis and negatively affect reproductive performance (WHO, 2014).
However, ongoing nutritional, socio-economic and demographic, lifestyle and epidemiologic changes in Nigeria have contributed to the burden of abdominal obesity and its metabolic co-morbidities (Iloh et al., 2012). The prevalence of abdominal obesity has been reported in Nigeria (Iloh et al., 2012) and other parts of the world such as United States of America, South Korea (Park et al., 2003) and Cotonou, Benin Republic (Ntandou et al., 2014). In Nigeria, a prevalence of 50.8% was reported among geriatric hypertensives in Amurie Omanze, Imo state (Iloh et al., 2012); 21.7% was reported in selected rural and urban communities of Abia state, Nigeria; 31.7% was reported in Okirika, Rivers State, Nigeria (Chukwuonye et al., 2013); 16.9% was reported in Port Harcourt, Nigeria (Siminnialayi et al., 2008). Abdominal obesity occurring in adult population over a prolonged period may constitute a strong risk factor for cardio-metabolic and diverse chronic medical conditions. The waist circumference anthropometry therefore, provides guidelines on the identification, evaluation and treatment of adults who are abdominally obese.
According to the International Diabetes Federation (IDF), abdominal obesity is a major independent risk factor for atherosclerotic cardiovascular diseases and appears to interact with or amplify the effects of other cardio-metabolic risk factors under the umbrella term of metabolic syndrome (Alberti et al., 2006). Research from African countries shows that overweight and obesity have been increasing rapidly over the past twenty-five years, particularly in the urban settings (Amugsi et al., 2017). If this is not controlled, it may take epidemic proportions in the very near future (Ziraba et al., 2009). This study focuses on the activity pattern, dietary habits and prevalence of abdominal obesity among undergraduates in Michael Okpara University of Agriculture, Umudike, Abia State.
1.2 STATEMENT OF PROBLEM
In many developing countries, obesity and obesity-related morbidity are becoming a problem of increasing importance. Urbanization and economic development have led to a nutritional transition characterized by a shift to diets of higher energy content and/or to the reduction of physical activity, resulting in changes in individuals’ body composition (Pasquet et al., 2003).
Obesity has become a growing global public health problem, owing to its high prevalence and substantial morbidity and mortality. Obesity and abdominal obesity are associated with an increased risk of multiple chronic diseases, including diabetes, cardiovascular disease (CVD), hypercholesterolemia, asthma and cancer (Lindstrom et al., 2003). As mentioned above, obesity has rapidly been established as a public health problem. Hence, in 2013, the American Medical Association (AMA) called for physicians to focus on obesity. Although many studies have focused on overweight/obesity and abdominal obesity, there are still noticeable ethical and geographical differences that exist.
1.3 OBJECTIVE OF THE STUDY
The general objective of this study was to assess the activity pattern, food intake, and prevalence of abdominal obesity among undergraduate students in Michael Okpara University of Agriculture, Umudike, Abia State.
SPECIFIC OBJECTIVES
The specific objectives include to:
1. determine the personal and socio-economic characteristics of the students
2. study the activity pattern of the students
3. ascertain the dietary habits of the students
4. evaluate the anthropometric status of the students
5. assess the rate of abdominal obesity among the students
6. examine the relationship between the dietary habits, waist circumference and waist-to-hip ratio among the students.
1.4 SIGNIFICANCE OF THE STUDY
Eating behavior can affect long term health and predispose one to risk of chronic diseases, cardiovascular diseases, metabolic syndrome and osteoporosis. Cancer may increase as a result of unhealthy nutrition. The result of this study could help school guidance and counselors and lecturers in counseling those students who indulge in poor dietary practices. This will help undergraduates become more conscious on what diet they consume. It would also motivate students to change their unhealthy dietary practices and adopt healthy food choices as part of their lifestyle changes.
University students have also been considered an important target for the promotion of healthy lifestyles of the adult population and various studies have shown that there is a global increased attention on investigating the nutritional knowledge and eating habits indices of university students. Thus, this study will help to increase emphases on the need to promote healthy eating habits among university students in order to achieve healthy lifestyles.
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