Food consumption patterns, physical activity and overweight and obesity among undergraduates of a private university in Nigeria

Journal Pre-proof Food Consumption Patterns, Physical Activity and Overweight and Obesity among Undergraduates of a Private University in Nigeria Olariike Oyindasola Kayode, Quadri K. Alabi PII:

S2352-9393(20)30004-X

DOI:

https://doi.org/10.1016/j.yclnex.2020.01.001

Reference:

YCLNEX 126

To appear in:

Clinical Nutrition Experimental

Received Date: 27 August 2019 Revised Date:

25 December 2019

Accepted Date: 14 January 2020

Please cite this article as: Kayode OO, Alabi QK, Food Consumption Patterns, Physical Activity and Overweight and Obesity among Undergraduates of a Private University in Nigeria, Clinical Nutrition Experimental, https://doi.org/10.1016/j.yclnex.2020.01.001. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2020 Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.

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Food Consumption Patterns, Physical Activity and Overweight and Obesity among Undergraduates of a Private University in Nigeria.

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Olariike Oyindasola, Kayode1*, Quadri K. Alabi2**

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Department of Public Health, Adeleke University, Ede, Nigeria

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Department of Physiology, Adeleke University, Ede, Nigeria

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Corresponding Authors:

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*O.O Kayode; Department of Public Health, Adeleke University, Ede, PMB 250, Nigeria; Email: [email protected]

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**Q.K. Alabi; Department of Physiology, Adeleke University, Ede, PMB 250, Nigeria; Email: [email protected]

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ABSTRACT

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Background: Non Communicable Diseases which is strongly associated with overweight and

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obesity have overtaken communicable diseases as the leading causes of morbidity and mortality.

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The changing disease pattern has been attributed to nutrition transition and inadequate exercise.

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This study was carried out to assess the food consumption pattern, physical activity and

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overweight and obesity among undergraduates of Adeleke University, Ede Osun State, Nigeria.

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Methods: Cross-sectional study. Undergraduate students, from a stratified random sample of

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Adeleke University in Ede, Osun State, Nigeria (n 268) aged 15-26 were used for the study.

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Pretested, structured self-administered questionnaires and anthropometric measurements were

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obtained from the participants.

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Results: Mean age of respondents was 19.8 ± 1.3 years, with a higher proportion being females

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(172; 64.2%). Body mass index (BMI) showed that 2.2% were underweight, 57.5% had a normal

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weight, 31% were overweight while 9.3% were obese. 56.7% of the respondents engage in

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physical activity always, and 35.8% of the respondents seldom engage in physical activity.

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Majority of the respondents consumed snacks daily. Using Chi square there was no association

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between cereals consumption and BMI (x2 = 5.415, P-value = 0.144). There was an association

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between intakes of vegetables and BMI (x2 =18.342, P-value = <0.001) and there was no

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association between animal food and BMI (x2= 0.031 p-value = 0.999)

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Conclusion: Since consuming a diet high in vegetable is associated with low BMI, Nutrition

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Education with emphasis on vegetable consumption is recommended.

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Keywords: Dietary pattern, Physical activity, BMI and Undergraduates

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1.0

INTRODUCTION

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The increasing westernisation, urbanisation and mechanisation occurring in most

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countries around the world is associated with changes in the diet towards one of high fat, high

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energy-dense foods and a sedentary lifestyle.1,2 This shift is also associated with the current rapid

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changes in childhood and adult obesity. Even in many low income countries, obesity is now

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rapidly increasing, and often coexists in the same population with chronic undernutrition.2 The

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nutrition transition in developing countries leads to dietary intakes of micronutrient-poor,

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energy-dense foods, which may be important determinants of overweight/obesity and important

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for child development.3

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Overweight and obesity has reached epidemic proportions globally. Increasing

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prevalence of obesity, seen both in the developed and developing countries, is primarily

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driven by imbalanced diets and sedentary lifestyles. Sedentary lifestyle that is characterized

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by physical inactivity has been associated with adiposity and increased weight gain.

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The World Health Organization defines overweight and obesity as follows: Overweight is

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a BMI greater than or equal to 25; and Obesity is a BMI greater than or equal to 30. BMI

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provides the most useful population- level measure of overweight and obesity as it is the same

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for both sexes and for all ages of adults.

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Unhealthy dietary habits characterized by the consumption of fast foods, drinking of

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sugar sweetened beverages, low fruits and vegetables intakes contributes to the increasing trend

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of overweight and obesity. Snacking and fast food consumption have being identified as a

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contributory factor to the development of childhood overweight and obesity in Nigeria.4 Studies

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have shown that youths are particularly vulnerable to poor eating habits and are said to be in the

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habit of eating “junks”.5 It has been shown that adolescence leaving their parents and living away

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from home to attend college experience numerous health- related behavioral changes, which

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includes adoption of unhealthy dietary habits.6-8 These adopted habits are mostly attributed to

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drastic changes in the environment and resources available, frequent exposure to unhealthy foods

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and habits.9

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Nutrition-related health problems such as overweight and obesity in adolescents are

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increasingly significant causes of disability and premature death both in developed and

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developing countries including Nigeria.10 According to World Health Organization estimates, in

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2016, more than 1.9billion adults (aged 18 years and older were overweight), of these over 650

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million adults were obese.11 Studies have examined lifestyles (dietary habits and Physical

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activity) and association with nutritional status.12,13 These studies have focused on secondary

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school students and have excluded young adults in tertiary institution.

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The identification of food consumption pattern and physical activity of undergraduates is

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an important strategy for promoting balanced nutrition and reducing the disability associated

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with excess weight gain. Hence this study was carried out to assess food consumption patterns,

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physical activity of undergraduates of Adeleke University, Ede Osun State focusing primarily on

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weight status.

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2.0

METHODOLOGY

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2.1

Study Design The study applied a cross-sectional, descriptive design

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2.2

Study area

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The study was carried out in Adeleke University, Ede, located in Ede North Local

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Government Area of Osun State, Nigeria. Adeleke University is a private faith-based University

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located in a serene and nature friendly atmosphere of 520 acres of land in the historical town of

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Ede, State of Osun, South –Western part of Nigeria. As a higher institution that is based on the

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Seventh-day Adventist philosophy of education, it forms part of the over 100 worldwide

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institutions run by the Seventh-day Church. All the students (with the exception of married

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students) are accommodated in the University’s hostels and served food in the University

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cafeteria. Students are not permitted to cook in their hostels.

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2.3

The study population included undergraduate students of Adeleke University Ede.

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101 102

Study population

2.3.1

Inclusion criteria The undergraduate students attending the University who agreed to participate in the

study and signed the consent form.

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2.3.2

Exclusion criteria

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The undergraduate students excluded from the study were those who were pregnant (for

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females), on any form of medication, acutely ill or with known chronic diseases. Postgraduate

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students were also excluded

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2.4

Sample size determination Sample size (n = 268) was determined using the Fischer formula (n = z2pq/d2)14 as the

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population from which the sample size was drawn was more than 3,000.

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2.5

This study applied stratified random sampling method

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Sampling Technique

2.6

Research Instrument and Data Collection Method

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A pretested structured 87- item food frequency questionnaire (FFQ) was used to elicit

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information on food consumption pattern of respondents. The FFQ composed of 87 food items

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and the frequency of consumption was represented by 8 categories, namely: daily (once a day,

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twice or more times a day), weekly (once a week, two to four times a week), monthly (once in a

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month, one to three times a month), yearly (Once a year) and never. Information on socio

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demographic characteristics and habits (which include physical activity, consumption of in-

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between meals, Snacking), were obtained using self- administered questionnaires to respondents.

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Each questionnaire was coded with a unique number representing each respondent.

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Anthropometric measurements were taken with the respondents wearing light clothes and no

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shoes. Anthropometric classification was performed by the calculation of the body mass index

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(BMI), calculated by weight (kg)/height (m2), using the height and weight values provided by the 6

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respondents. BMI was classified according to the cut-off point established by the World Health

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Organization.15

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2.7

Data analysis

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Data analysis was performed using SPSS statistical package. The data collected was also

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analyzed using simple description analysis such as percentages and frequency counts. Statistical

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significance was set at p < 0.05.

132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148

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3.0

RESULTS

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Table 1 depicts the socio-demographic profile of the study subjects.

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The result in table 1 shows that most of the respondents 184 (68.7%) were within the 15 –

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20 year age group while 84 (31.3%) were within the 21 – 26 year age group. The mean age of

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respondents was 19.75 ± 1.32 year. Over half of the respondents 172 (64.2%) were females and

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most of the respondents 220 (82.1%) were Christians. Widely held percentage of the respondents

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184(68.7%) were Yoruba ethnic group. Majority of the respondents 125 (46.6%) were 200 Level

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students (Table 1).

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3.2

Food Consumption Pattern

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The frequency of consumption of specified food, snacks, fruits and vegetables are shown

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in Table 2. Only 48(18%) consumed fruits on a daily basis while 68(25.4%) consumed vegetable

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daily. The Majority, 180 (67.2%) of the 268 respondents that responded to the question on

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snacking reported eating snacks every day (mostly once a day). Only 54(20.1%) of the

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respondents reported taking swallow every night. Snacks has the highest number of times of

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consumption per week followed by rice (Table 2).

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3.3

Physical Activity Level of Respondents

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Larger percentage 152(56.7%) of the respondents engage in physical activity. However,

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96(35.8%) seldom engage in physical activity and 20(7.4%) reported not engaging in any form

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of physical activity.

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3.4

Body Mass Index of Respondents

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The Body Mass Index of the respondents showed that 6(2.2%) were underweight (BMI

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less than 18.5kg/m2), 154(57.5%) were normal weight (BMI between the range of 18.5

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24.9kg/m2), 83(31%) were overweight (BMI within the range 25 – 29.9kg/m2) and 25(9.3%)

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were obese (BMI greater than 30kg/m2) (Table 3).

173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194

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4.0

DISCUSSION

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Larger proportion (68.7%) of the respondents were within the age range 15 – 20 yrs

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which implies that most of them were adolescents. Also majority (64.2%) were females while

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(35.8%) were males. Besides, higher proportion of the respondents 125 (46.6%) were 200 Level

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students.

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High prevalence of snacking (67.2%) reported in the study is at variance with the very

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high prevalence of snacking (92.4%) reported in a study by Chung et al.16 among female college

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students Seoul, South Korea. Another study by Olumaikaye et al.4 among adolescents in Osun

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state reported prevalence of snacking to be 33%. The finding in this study clearly illustrates that

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snacks consumption among undergraduates is high, and this implies that consumption of refine

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foods is high compare to starchy roots and tubers that are high in fiber and B vitamins.

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The proportion of respondents that eat fruits (31.7%) and vegetable (32.8%) less than

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three times in a week in this study varies well with the findings in a study by Ganasegeran et al.17

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who reported consumption of fruits less than thrice in a week by 73.5% of respondents.

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Ogunkunle and Oludele18 also reported frequent consumption of fruits and vegetables to be

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30.2% and 29.2% respectively. The low frequency of fruits and vegetables observe in this study

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may influence the high prevalence of overweight and obesity among the respondents because the

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energy contents of most fruits and vegetables are very minimal compared to other nutrients.

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Fruits and vegetables are essential for the supply of micronutrients such as vitamins and

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minerals.

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The physical activity of the respondents indicates that about 56.7% were frequently

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involved in jogging, skipping, running and playing football while 35.8% seldom engage in

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physical activity. To promote and maintain healthy living, individuals should perform vigorous-

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intensity physical activity for a minimum of 20 minutes three days per week, or moderate-

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intensity physical activity for a minimum of 30 minutes five days per week.19

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Findings from this study showed that 31% of respondents were overweight and 9.3%

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were obese; this result correlates with the study carried out in Nigeria by Chukwuonye et al.20 in

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the study, the prevalence of overweight individuals ranged from 20.3% - 35.1% while the

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prevalence of obesity ranged from 8.1% - 22.2%. The high prevalence of overweight and obesity

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can also be attributed to high rate of snacking and low frequent consumption of fruit and

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vegetable.

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The findings on relationship between food consumption pattern and BMI indicates that

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there is significant relationship between vegetable consumption and BMI (x2 = 16.031 and p-

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value = 0.001) while there exists no significance difference between cereals consumption and

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BMI. Furthermore, from the study there is no significant difference between physical activity

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and BMI (x2 = 8.916 and p-value = 0.710). The results of the study varies with Alkhatani et al.21

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who reported that relationship exist between physical activity level and BMI of students and the

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relationship was significant (p = 0.048).

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This finding agrees and confirms several studies conclusion that overweight and obesity

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is strongly associated with the fruit and vegetable consumption and frequency of its

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consumption.22-24. Several literature have attributed the high prevalence over weight and obesity

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among people to the rising level of other non-communicable disease condition such as diabetes,

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hypertension, certain form of cancer, arthritis, kidney problems and metabolic syndrome in

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general.

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Limitations in this study included the use of BMI, since BMI is not only an accurate

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measure for adiposity, waist circumference and waist – to –hip ratios should be incorporated in

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future research. It is also recommended that physical activity patterns of undergraduates be

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examined. Also future study should be conducted on both private and government university

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obese students for large comparison of data

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5.0

CONCLUSION

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This study demonstrated high prevalence of overweight and obesity and also high rate of

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snacking among the respondents. Since the study population are future leaders of tomorrow,

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nutrition education that focus on increase consumption of fruits and vegetable and limit intake of

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snacks should be given to them to promote good health and also reduce the incidence of NCDs in

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adulthood.

250 251 252 253 254 255 256 257 258 259 260 261

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262 263 264 265

Declaration

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Acknowledgement

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Nil

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Funding

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The research was solely funded by the authors

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Conflict of interest

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The authors of this manuscript declare no conflict of interest.

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Authors’ Contribution

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O.O. conceptualized the idea, organized the data, performed data analysis and wrote the draft of

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the manuscript. QK reviewed the conceptual basis, edited and reviewed the results, and

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contributing to writing and editing of the final version of the manuscript.

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Ethical Standards Disclosure

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This study was conducted according to the guidelines laid down in the Declaration of Helsinki

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and all procedures involving human subjects were approved by the Ethic Review Board of

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Institute of Public Health, Adeleke University. Written informed consent was obtained from all

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subjects.

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3. Troesch B., Biesalski HK., Bos R et al. (2015). Increased intake of foods with high

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4. Olumakaiye MF., Ogbimi GF., Ogunba BO et al. (2010). Snacking as a Contributor to

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6. Strong KA., Parks SL., Anderson E et al. (2008). Weight gain prevention: Identifying

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Dietetic Association, 108(10), 1708–1715. https://doi.org/10.1016/j. jada.2008.07.007

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8. Wengreen HJ & Moncur C (2009). Change in diet, physical activity, and body weight

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10. World Health Organization. (2015). Obesity and overweight. Accessed 5th July, 2016. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/ 11. Boyle MA., & Holben DH. (2006). Community Nutrition in Action 4th Eds. Belmont USA: Thomson Higher Education

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12. Eberechukwu LE., Eyam, ES., & Nsan E (2013). Effect of Lifestyle (eating habits and

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physical activities) on Weight gain of Rural and Urban Secondary School Adolosescents

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in Cross River States, Nigeria. Journal of Biology,Agriculture and Healthcare Vol 3 (7) ,

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13. Adebusoye MS., Fasan T., Owolabi AJ et al. (2014). Food Consumption and Nutritional

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Status of Young Adolescents in Urban LG as of Oyo state, Nigeria. From Cambridge

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publication: http://cambridgepubng.com /admin/images/pdf_ Retrieved May 6, 2015

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14. WHO (1995). Expert Committee on Physical Status: the use and interpretation of

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Anthropometry Physical status: the use and interpretation of anthropometry: Report of a

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WHO expert committee. WHO (Technical report series; 854) World Health Organization.

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15. Chung HT, Song MK, Park MH et al. (2003). A study of anthropometric indices and

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eating habits of female college students. J. Comm. Nutr. 5(1):21-28

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18. Haskell WL, Lee IM, Pate RR, et al (2007). Physical activity and public health: Updated

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19. Chukwuonye II, Chuku A, John C et al. (2013) Prevalence of overweight and obesity in adult Nigerians - a systematic review. Diabetes Metab Syndr Obes 6: 43-47

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22. Mushtaq MU., Gull S., Mushtaq K et al. (2011). Dietary Behaviors, Physical Activity and

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of Behavioral Nutrition and Physical Activity Vol 8 (130) , pp 1 - 13.

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23. Mozaffarian D., Hao T., Rimm EB et al. (2011). Changes in Diet and Lifestyle and Long-

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term Weight gain in Women and Men. New England Journal of Medicine Vol 364 (25),

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pp 2392 - 2404.

349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 16

364 365 366

Table 1: Socio-demographic profile of subjects.

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Variables

368

Age Group (in years)

369

15 – 20

184

68.7

370

21 – 26

84

31.3

371

Mean Age+SD (years)

372

Gender

373

Male

96

35.8

374

Female

172

64.2

375

Level of Student

376

100

43

16.0

377

200

125

46.6

378

300

52

19.4

379

400

48

17.9

380

Ethnicity

381

Yoruba

184

68.7

382

Igbo

52

19.4

383

Hausa

32

11.9

384

Religion

385

Christianity

220

82.1

386

Islam

45

16.8

387

Traditional

3

1.1

388

Field of studies

389

Health Sciences

99

36.9

390

Business and social Sciences

82

30.6

391

Sciences

15

5.6

392

Law

38

14.2

393

Art

14

5.2

Frequency (N = 268)

Percent (%)

19.75 + 1.32 years

17

394

Engineering

20

7.5

395 396 397

Table 2: Consumption of specified foods, fruits and vegetables per week Frequency of Consumption (N=268)

398 399

Food Items

400

Consumed

401

Rice

402

Yam

403

Never

1–2

3–4

5 or more

% Total

times

times

times

a

76(28.4%)

82(30.6%)

110(41%)

100

34(12.7%)

112(41.8%)

76(28.3%)

46(17.2%)

100

Sweet potatoes

107(40%)

73(27.2%)

51(19%)

37(13.8%)

100

404

Beans

24(8.9%)

116(43.3%)

81(30.2%)

47(17.5%)

100

405

Fish

28(10.4%)

46(17.2%)

89(33.2%)

105(39.2%)

100

406

Meat

36(13.4%)

54(20.1%)

96(35.8%)

82(30.6%)

100

407

Fruits

-

85(31.7%)

135(50.3%)

48 (18%)

100

408

Vegetables

-

88(32.8%)

112(41.8%)

68(25.4%)

100

409

Snacks

-

30(11.2%)

58(21.6%)

180(67.2%)

100a

-

410 411 412 413 414 415 416 417 18

as

418 419 420

Table 3: Body Mass Index of Respondents

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VARIABLES

FREQUENCY (n=268)

PERCENT

422

Less than 18.5kg/m2

6

(2.2)

423

18.5 – 24.9kg/m2

154

(57.5)

424

25- 29.9 kg/m2

83

(31)

425

Greater than 30kg/m2

25

(9.3)

426 427 428 429 430 431 432 433 434 435 436 437 438 439

19

440 441 442 443

Figure Legend Fig 1: Body Mass Index of Respondents

444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459

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Conflict of interest The authors of this manuscript declare no conflict of interest.