ABSTRACT
This study assessed the prevalence of overweight and obesity among first year undergraduates in two tertiary institutions in Nigeria (University of Nigeria Nsukka and Nnamdi Azikiwe University). Samples of 330 undergraduates (18->25 years) were randomly selected from the two Universities. Data were collected with the aid of a structured questionnaire, while anthropometric and blood pressure measurements were taken usingstandard procedures. Data were analyzed using frequencies, percentages and Chi-square test and using SPSS Version 20.0.Results showed that 43.6% of the students were within the age of 22-25 years; 60% were females, while 40% were males. About 39.1% were given >N20, 000 as monthly allowance. About half (56.1%) ate three times a day, 51.7% and 40.8% skipped breakfast and lunch, respectively. About 69.7% consumed pastries twice a week and biscuit was the commonest (37.8%). About 64.3% consumed carbonated soft drinks, 40% preferred alcoholic beverages, while 28.6% smoked cigarettes. Life style pattern showed that 60.6% and 34.8% engaged in jumping and walking/trekking, respectively. The prevalence of overweight and obesity among the students was 38.8% and 11.2%, respectively. About 48.5% and 19.1% were pre-hypertensive using SBP and DBP, respectively. Frequency of consumption of pastries (x2=20.626; p=0.014), consumption of alcoholic beverages (x2=5.373; p=0.049), smoking of cigarette (x2=37.480; p=0.001) and having high systolic blood pressure (x2=20.626; p=0.014) were significantly related with being overweight and obese.Public health strategies to prevent overweight and obesity by encouraging good dietary habits and lifestyle pattern such as exercise should begin with schools and extend to the entire community.
TABLE OF CONTENTS
Title
page i
Certification ii
Dedication iii
Acknowledgement iv
Table
of contents v
List
of tables ix
Abstract xi
CHAPTER ONE: INTRODUCTION 1
1.0 Introduction 1
1.1 Background information 1
1.2 Statement of problem 3
1.3 Objective 4
1.4 Specific objectives 4
1.5 Significance
of the study 5
CHAPTER TWO: LITERATURE REVIEW 6
2.0 Literature review 6
2.1 Research on overweight and obesity 6
2.2 Classification of
obesity 8
2.2.1 Ways of measuring body fat 8
Body
mass index (BMI) 8
Body
volume index (BVI) 9
Body fat percentage 9
Skin-fold thickness 10
Waist circumference 11
Hip circumference 11
Waist-hip ratio 12
2.2.2 Causes of obesity 12
2.2.3 Consequences of obesity 14
2.3 Management of obesity 16
2.3.1 Preventive measures 16
2.3.2 Dietary intake 17
2.3.3 Control of obesity 19
CHAPTER THREE: MATERIALS
AND METHODS 21
3.0 Materials and
methods 21
3.1 Study design 21
3.2 Area of study 21
3.3 Population of the
study 21
3.4 Sampling and
sampling techniques 22
3.4.1 Sample size 22
3.4.2 Sampling procedure 23
3.5 Preliminary
activities 23
3.5.1 Preliminary visits 23
3.5.2 Training of research
assistants 23
3.6 Data collection 24
3.6.1 Questionnaire
administration 24
3.6.2 Anthropometric
measurements 24
3.6.3 Blood pressure
determination 26
3.6.4 Dietary intake
assessment 26
3.7 Statistical
analysis 27
CHAPTER FOUR
RESULTS AND DISCUSSION 28
4.1 Socio-demographic
characteristics of the students 28
4.2
Dietary habits of the students 31
4.3 Lifestyle patternof the students 40
4.4 Qualitative 24 hour
recall
of foods consumed by the students 42
4.5 Food consumption pattern of students 45
4.6 Comparism of anthropometric parameters
between
male and female students 48
4.7 Prevalence of obesity using different
anthropometric
indices 50
4.8 Systolic and diastolic blood pressure
classification
of the respondents 54
4.9 Mean blood pressure measurement of the
students 55
4.10 Relationship between BMI, dietary habit
and
lifestyle pattern of the students 56
CHAPTER FIVE
CONCLUSION AND
RECOMMENDATION 61
5.1 Conclusion 61
5.2 Recommendation 61
REFERENCES 62
APPENDIX:
QUESTIONNAIRE 78
LIST OF TABLES
Table 2.1 BMI Classification of overweight and obesity 8
Table
4.1a Socio-demographic
characteristics of the students 28
Table
4.1b Socio-demographic
characteristics of the students 30
Table
4.2a Dietary habits of the
students 32
Table
4.2b Dietary habits of the students 34
Table
4.2c Dietary habits of the
students 38
Table
4.2d Dietary habit of the students 36
Table
4.2e Distribution of the students
according to
their favourite foods and source 37
Table
4.2f Determinants of food choice
and problems
associated with eating pattern 39
Table
4.3 Lifestyle pattern of the
students 41
Table
4.4a Qualitative 24 hour recall of
foods consumed by the students 43
Table 4.4b Qualitative
24 hour recall of foods consumed by the students 44
Table
4.4c Qualitative 24 hour recall of
foods consumed by the students 45
Table
4.5 Percentage of food groups
consumption by the students 46
Table
4.6 Comparism of anthropometric
parameters
between male and female students 50
Table
4.7 Prevalence of obesity using
different anthropometric indices 51
Table
4.8 Systolic and diastolic blood
pressure classification of the students 54
Table
4.9 Comparism of mean blood
pressure measurement of the students 55
Table
4.10a Relationship between BMI,
dietary habit
and lifestyle pattern of the students 57
Table
4.10b Relationship between BMI,
dietary habit
and lifestyle pattern of the students 59
Table
4.10c Relationship between BMI,
dietary habit
and lifestyle pattern of the students 60
CHAPTER ONE
1.0 INTRODUCTION
1.1 BACKGROUND
INFORMATION
Although interests in and funding to treat
obesity have increased, its prevalence has not yet decreased (Jain, 2005).
Clinical evidence of obesity can be dated as far back as Greek and Roman times
but little scientific progress was made towards understanding the condition
until the 20th century (James, 2005). Weight that is higher than
what is described as a healthy weight for a given height is described as
overweight (Freedman et al., 2013). Olusanya
(2008) defined obesity as an abnormal accumulation of fat in the adipose tissue
throughout the body. It is the most common nutritional disorder in infants,
children, young adults and adults in affluent societies (Olusanya, 2008). Obesity
is a medical condition in which excess body fat has accumulated to the extent
that it may have an adverse effect on health (WHO, 2000). It is defined by Body
Mass Index(BMI) and further evaluated in terms of fat distribution through the
waist-hip ratio and total cardiovascular risk factors (Sweeting, 2007). The
World Health Organization (WHO) classifies adults as overweight when Body Mass
Index (BMI) is 25 -29.9 kg/m2, obese when BMI is
>30 kg/m2, and have abdominal obesity when waist circumference (WC) is > 94 cm
for men and >80 cm for women, and Waist –to-Hip Ratio (WHR) is> 0.90 in
men and > 0.85 in women (WHO, 2006).Obesity is becoming more prevalent in many African and other developing
countries with nutritional transition as a result of urbanization, adoption of
western lifestyles and demographic transition being implicated for the upsurge
(Ojofeitimi et al., 2007). There is a
general misconception in Nigeria that obesity is a sign of affluence (Adeyemo et al.,2003). Ojofeitimi and Adeyeye (2007)
found that 21.2% of their respondents (young adults) were obese, while, Kadiri
and Salako (2007) also found obesity in 21% and 28% of males and females
respectively in a study of 146 middle-aged Nigerians.
Young adults in the age group (18-25 years)
are often the neglected group in any health or nutrition sector as compared to
children and adults (Haines 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). Overweight and obesity have been considered a
serious health problem in young adults worldwide (WHO, 2000). Both developed
and developing countries are experiencing increasingrates of overweight and
obesity. Overweight and obesity are the fifth leading risk for global deaths;
at least 2-8 million adults die each year as a result of being overweight or
obese (WHO,2012). Overweight and obesity are linked to more deaths worldwide
than underweight. For example, 65% of the world’s population live in countries
were overweight and obesity kill more people than underweight (this include the
high income and most middle-income countries) (WHO, 2012).The rate of obesity
has tripled in developing countries over the past 20 years as they rapidly
become more urbanized, with increased consumption of high calorie foods and
adoption of a more sedentary lifestyle (Haidar et al., 2011; Popkin et al.,
2012). Some studies observed that first year university students in Dutch have
significant weight gain (Vella Zarb et
al., 2009) followed by ongoing slow but steady increase in weight (Gores,
2008).
Undergraduates have been described as
university students who have not yet obtained first bachelor degree (Webster,
1995; World English Dictionary, 2011). Studies among university students in
developing countries show high prevalence of overweight and obesity: Africa
(Nigeria: 10% (Nwachukwu et al.,
2010); Egypt: 25.3%–59.4% (Abolfotouh et
al., 2007; Bakr et al., 2012),
South Africa: 10.8%–24% (Cilliers et al.,
2006; Bodiba et al., 2008); Asia
(Bangladesh: 20.8% (Sultana et al.,
2011); China: 2.9%–14.3% (Sakamaki et
al., 2005); Malaysia: 20%–30.1% (Go Palakrishnan et al., 2012; Boo et al.,
2010), Thailand: 31% (Banwell et al.,
2009), Pakistan: 13%–52.6% (Chaudhry et
al., 2012; Hingorgo et al.,2009),
and India: 11%–37.5% (Seo et al., 2009;
Balhara et al., 2012; Bhongir et al., 2011; Pengpid et al., 2014); Latin America (Colombia:
12.4%–16.7% (Vargas et al., 2008);
Mexico: 31.6% (Trujillo et al., 2010),
the Middle and Near East (Saudi females: 47.9% (Al Qauhiz et al., 2010), Oman: 28.2% (Al-Kilani et al., 2012).
Possible reasons for over-eating these days
include: cheaper foods (relative to income), more varied foods; supermarkets,
advertising and promotion of foods; more snack foods, over-eating because of
anxiety for example, work stress or depression, and irregular meal times etc
(Haslam and James, 2005). Obesity is a leading preventable cause of death
worldwide, with increasing prevalence in adults and children and authorities
view it as one of the most serious public health problems of the 21st
century (Barness et al., 2007).
Food intake has been associated with obesity
not only in terms of the volume of food ingested but also in terms of the
composition and quality of diet (Hanley et
al., 2000). Furthermore, eating habits have also changed and current habits
include low consumption of fruits, green vegetables, and milk; increasing
consumption of snacks, sweets, and soft drinks; and skipping breakfast; these
eating habits result in continuous increase in adiposity (Hanley et al., 2000). Eating habits in addition
to environmental differentials represent the most dominant determinant in
increasing the tendency of overweight and obesity among students (Nicklas et al., 2001) and a modification in the
eating habits may be singleton tactic strategy to a more appropriate weight
control (Triches and Giugliani, 2005).
1.2 STATEMENT OF PROBLEM
Childhood and adolescent obesity is becoming
an increasingly large problem in the society (Anderson and Musalger, 2006). The
epidemic of obesity and associated diseases poses a serious public health
challenge worldwide (Anderson and Musalger, 2006). A major concern is the
dramatic and continuing increase in the prevalence of overweight and obesity in
the young adults (Bruss et al., 2010).
The prevalence of obesity among adolescents aged 12 to 19 years increased from
5.0% to 18.1% (NationalCentre for Chronic Disease Prevention and Health
Promotion, 2008)
A previous study conducted by Ukegbu et al (2016) reported that the
prevalence of obesity was higher among fresh undergraduates with a percentage
of 33.7% than other levels. This rise is attributed to drastic changes in the
lifestyle of undergraduates (Haslam and James, 2005). Upon leaving home, the
dietary habits of the average Nigerian undergraduate changes from natural
traditional foods to high-calorie foods which are relatively cheap and heavily
promoted (Nwachukwu et al., 2010).
More recent research has found that in addition to changes in physical activity
and caloric intake (medical health); emotional, social, and psychological
(mental health) factors must be addressed in order to provide effective
treatment to overweight and obese adolescents and youths (Braet, 2005; Cook et al., 2005). In order to promote this
holistic approach to obesity treatment, it is necessary to examine the existing
evidence and compile it in a format that is easily accessed as well as
informative for use by those in the
health care professions (Triches and Giugliani, 2005).
1.3 OBJECTIVE
To assess the prevalence of overweight and
obesity among first year undergraduates in two tertiary institutions in Nigeria
(University of Nigeria Nsukka and Nnamdi Azikiwe University).
1.4 SPECIFIC OBJECTIVES
The specific objectives of this study are:
i. To
ascertain the socio demographic characteristics of the subjects.
ii. To
assess their dietary habits and food consumption pattern.
iii. To
assess their lifestyle pattern.
iv. To
evaluate their nutritional status using anthropometric measurement.
v. To
determine the prevalence of overweight and obesity among the subjects.
vi. To
assess their health status using blood pressure measurement.
vii. To determine the relationship between
dietary habit, lifestyle pattern, overweight and obesity.
1.5 SIGNIFICANCE OF THE STUDY
It
is important to note that there has been a nutritional transition in food
choices during the past years from the typical Mediterranean diet into the
western fast food pattern. This study is therefore useful in hospitals and
health care centres as well as the ministry of health as a whole.
It
will act as a source of information for nutritionists, dieticians, home
economists etc by providing information as regards the dietary pattern and
overall nutritional status of fresh undergraduates. The findings in this study
will go a long way in assisting health policy makers and other stakeholders in
coming up with strategies aimed at reducing the burden of obesity in the
country.
Click “DOWNLOAD NOW” below to get the complete Projects
FOR QUICK HELP CHAT WITH US NOW!
+(234) 0814 780 1594
Login To Comment