Prevalence and Correlates of Overweight and Obesity among Medical Students in Ipoh, Malaysia

Sandheep Sugathan, Davinder Singh Bagh

Department of Public Health, Universiti Kuala Lumpur, Royal College of Medicine Perak (UniKL-RCMP)

Abstract

Overweight and obesity are the fifth leading risk factors of deaths  globally. At least 2.8 million adults die each year due to the consequences of being overweight or obese.

The present study was carried out to know the prevalence of overweight and obesity among medical students in UniKL Royal College of Medicine, Perak, Malaysia and its association with physical activity and nutritional behaviour. Questionnaires were administered to the selected 250 students, out of which 150 were from pre-clinical years and 100 were from clinical years.  

Prevalence of overweight and obesity among medical students were 11.2 % and 2.8% respectively and the prevalence of underweight was 17.2%. Overweight and obesity were significantly higher among males as compared to females. Overweight and obese individuals were found to be engaging in physical activity for more than 60 minutes per week. The study found that despite 86% of the participants not being in the overweight or obese category, their nutritional practices and physical activity need to be improved.

Keywords: , , , ,

Introduction

Overweight and obesity are defined as abnormal or excessive fat accumulation in the body that may impair health.  Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity among adults. It is defined as a person’s weight in kilograms divided by the square of his height in meters (kg/m2).  The WHO definition of overweight is a BMI greater than or equal to 25 and the definition of obesity is a BMI greater than or equal to 30.  Overweight and obesity are the fifth leading risk factors for global deaths.  At least 2.8 million adults die each year as a result of being overweight or obese. In addition, 44% of the diabetes burden, 23% of the ischaemic heart disease burden and between 7% and 41% of certain cancer burdens are attributable to overweight and obesity.1

Data from the years 1996, 2003 and 2006 show that there has been a rise in both overweight (20.7%, 26.7% and 29.1%) and obesity (5.5%, 12.2%, 12.3% and 14.0%) among adults.2  A population-based cross-sectional study conducted in all states of Malaysia in 2004 found that 6.5% of youth aged 15 – 19 were obese.  The prevalence of obesity was higher among boys than among girls and slightly higher in urban areas (12%) than in rural areas (11.3%).3

Objectives

  1. To study the prevalence of overweight and obesity among medical students in UniKL Royal College of Medicine Perak (UniKL RCMP)
  2. To study the factors associated with overweight and obesity among the students. 

Methodology

 This was a cross-sectional study carried out between October 2012 and January 2013, among 250 medical students; 150 from pre-clinical and 100 from clinical years.

Sample size was calculated as 250, assuming the prevalence of overweight and obesity as 20% based on previous studies.  Data Collection was done using a self-administered questionnaire.  In addition to demographic details, practice of physical activity and questions related to nutritional behaviour were enquired.  Height and weight of all students were measured and body mass index (BMI) calculated.  SPSS version 17 was used for data entry and analysis.  Obesity and overweight and its association with physical activity and nutritional behaviour were analyzed using proportions and Chi square test. Level of statistical significance was fixed at 0.05.  The research protocol was approved by the coordinator of research of the Faculty of Medicine at UniKL Royal College of Medicine Perak. Informed consent was obtained from all participants.  Confidentiality of personal information was strictly maintained.

Results

Table 1. Distribution of the study subjects according to age and sex

Table 1. Distribution of the study subjects according to age and sex

Out of 250 students who participated in the study, 81 (32.4%) were males and 169 (67.6%) were females.  The study participants constituted 150 students from pre clinical years (1st and 2nd years) and 100 students from clinical years (3rd and 4th years).  Age and Gender distributions of the study subjects are shown in Table 1.

Table 2. Overweight and obesity among the medical students

Table 2. Overweight and obesity among the medical students

Mean age of the medical students who participated in this study was 20.38 years with mean age for males 20.64 years and mean age for females 20.26 years. In the present research, prevalence of overweight and obesity among medical students according to WHO criteria were 11.2% and 2.8 % respectively (Table 2).  Prevalence of underweight among the study subjects was 17.2%.

Table 3.  Analysis for the correlates of overweight and obesity

Table 3. Analysis for the correlates of overweight and obesity

Analysis was done to identify factors associated with overweight and obesity (Table 3). Overweight and obesity were significantly higher among males as compared to females (p-value <0.05).  There was a significant positive correlation between overweight / obesity and duration of physical activity.  Overweight and obese students were found to be doing exercise for more than 60 minutes duration per week.  There was no significant association between overweight / obesity and factors such as age, phase of study, ethnicity or diet category. 

Discussion

In this study, even though 80% of respondents were doing physical activity, none of the respondents were meeting the current physical activity recommendations (i.e., 150 minutes per week or more of moderate or vigorous physical activity).  The highest duration of physical activity done by a medical student was only 100 minutes per week.  The high percentage of respondents who were not meeting this physical activity recommendation is similar to the pattern seen in national studies conducted in the general population, which have shown lower adherence rates.  This result is not unexpected, given that the respondents were medical students who have very limited time to do long durations of physical activity due to their hectic schedule, especially during the clinical years.  Despite the low physical activity level reported by the respondents, only less than one quarter was overweight or obese.  The lower prevalence of overweight and obesity might be due to the frequent physical activity that they did even though for short durations.

A study conducted on prevalence of overweight and obesity among the medical students from AIMST University in Malaysia showed a prevalence of pre-obesity (BMI 25 – 29.9) and obesity as 15.9% and 5.2% respectively.4  Boo NY et al conducted a study to determine the prevalence of  obesity  among  medical  students  in  a  private  medical school  in  Malaysia  and  found that  30.1%  of  the students were overweight or obese, Malays and Indians were more obese than the Chinese and unlike the national data, a significantly  higher  proportion  of  the  male  students  were found to be overweight.5  This was found to be similar to our study findings.

A  study  conducted  in  West  Bengal  in  India  among undergraduate  medical  students  showed  that  overall prevalence  of  overweight was  17.5%  and  prevalence  of  obesity was 3.4%.6   Another similar study by Chhabra et al. reported a prevalence of 11.7% overweight and 2% obesity among medical students of Delhi.7  In a study conducted in Kelantan  by  the  Department  of  Medicine,  University  Sains Malaysia, the overall prevalence  of  overweight  and  obesity  were  21.3%  and  4.5% respectively.8  In the present study, male  medical  students were more obese and overweight  than females, whereas studies  from other parts of the world  showed that female medical students were more obese and overweight than males.

There was a significant positive correlation between overweight / obesity and duration of physical activity.  Overweight and obese students were found to be doing exercise for more than 60 minutes duration per week.  This may be due to the fact that those who were overweight or obese become more health conscious and start doing exercise for longer duration.

Conclusions

The prevalence of overweight among medical students was 11.2% while prevalence of obesity was 2.8%.  Overweight and obesity were significantly higher among males as compared to females (p-value <0.05).  Those who were overweight and obese were engaging in exercise for more than 60 minutes duration per week.

Out of 250 participants, 60.8% were following healthy dietary practices while 39.2% were following unhealthy dietary practices.   Association between nutritional practices and BMI category among the study subjects was not significant.  In conclusion, we found that in spite of the fact that 68.8 % of the participants were in the normal BMI category, their nutritional practices and physical activity still need to be improved.  Being in the medical school did not appear to convert the knowledge gained into healthy practices.

Referrences

  1. WHO fact sheet on Overweight and Obesity – Available  from: http://www.who.int/mediacentre/factsheets/fs311/en/
  2. Khambalia AZ, Seen LS. Trends in overweight and obese adults in Malaysia (1996-2009): a systematic review. Obes Rev. 2010 Jun;11(6):403–12.
  3. Health of Adolescents in Malaysia. WHO Western pacific region publication. Accessed from http://www.wpro.who.int/topics/adolescent_health/malaysia_fs.pdf
  4. Gopalakrishnan S, Ganeshkumar P, Prakash MVS, Christopher, Amalraj V. Prevalence of overweight/obesity among the medical students, Malaysia. Med J Malaysia. 2012 Aug;67(4):442–4.
  5. Boo NY, Chia GJQ, Wong LC, Chew RM, Chong W, Loo RCN. The prevalence of obesity among clinical students in a Malaysian medical school. Singapore Med J. 2010 Feb;51(2):126–32.
  6. Gupta S, Ray TG, Saha I. Overweight, obesity and influence of stress on body weight among undergraduate medical students. Indian J Community Med. 2009 Jul;34(3):255–7.
  7. Chhabra  P,  Grover  VL,  Aggarwal  K,  Kanan  AT.  Nutritional  Status  and Blood Pressure of Medical Students in Delhi. Ind J Comm Med 2006; 31:248-5.
  8. Mohamad WB, Mokhtar N, Mafauzy M, Mustaffa BE, Musalmah M. Prevalance of obesity and overweight in northeastern peninsular Malaysia and their relationship with cardiovascular risk factors. Southeast Asian J Trop Med Public Health. 1996 Jun;27(2):339–42.

Author Information

  1. Sandheep Sugathan, Senior Lecturer in Public Health, Department of Public Health, Universiti Kuala Lumpur, Royal College of Medicine Perak (UniKL-RCMP)
  2. Davinder Singh Bagh, Associate professor in Public Health, Department of Public Health, Universiti Kuala Lumpur, Royal College of Medicine Perak (UniKL-RCMP)

Acknowledgement

The researchers express their sincere gratitude to Prof. Dr. Osman Ali, Dean and Professor of Public Health, RCMP for his full support and motivation to conduct this research. We express our gratitude to Siti Nabila A, Siti Amirah A.A, Mas Azlin M, Hani Fatina A.S and Norain Syazzira O.J who were actively involved  in data collection for this research.

Conflict of Interest: None Declared

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