= 83 (%)
Out of 303 university students, 226 (74.6%) reported eating meals regularly on a daily basis with 42.6% (129 out of 303) practising consuming breakfast daily. The majority (52.5%) consumed three meals per day, while 101 (33.3%) of university students consumed less than three meals and 43 (14.2%) more than three meals. Many of the participants had a habit of snacking regularly and consumed fried food at least 3–5 times per week (82.2%, 60.7%, respectively). Only 23.4% (71 out of 303) and 9.2% (28 out of 303) of participants consumed vegetables and fruits every day, respectively, which is relatively low.
Table 3 compares eating habits between the non-overweight/obese populations with that of overweight/obese. The number of regular daily meals differed significantly between these two groups ( P = 0.011).
Factors (eating habits) associated with overweight/obesity
Variable | = 303 (%) | Non-overweight/obese = 216 (%) | Overweight/obese = 87 (%) | statistics (df) | -value |
---|---|---|---|---|---|
Eat meals regularly on daily basis | |||||
Yes | 226 (74.6) | 165 (76.4) | 61 (70.1) | 1.29 (1) | 0.256 |
No | 77 (25.4) | 51 (23.6) | 26 (29.9) | ||
Number of regular meals | |||||
< 3 meals/day | 101 (33.3) | 71 (32.9) | 30 (34.5) | 9.00 (2) | 0.011 |
3 meals/day | 159 (52.5) | 122 (56.5) | 37 (42.5) | ||
> 3 meals/day | 43 (14.2) | 23 (10.6) | 20 (23.0) | ||
Eat breakfast every day | |||||
Yes | 129 (42.6) | 95 (44.0) | 34 (39.1) | 0.61 (1) | 0.435 |
No | 174 (57.4) | 121 (56.0) | 53 (60.9) | ||
Snack in between regular meals | |||||
Yes | 249 (82.2) | 183 (84.7) | 66 (75.9) | 3.32 (1) | 0.068 |
No | 54 (17.8) | 33 (15.3) | 21 (24.1) | ||
How often do you eat vegetables | |||||
Everyday | 71 (23.4) | 52 (24.11) | 19 (21.8) | 0.24 (2) | 0.886 |
3–5 times per week | 130 (42.9) | 91 (42.1) | 39 (44.8) | ||
Rarely | 102 (33.7) | 73 (33.8) | 29 (33.3) | ||
How often do you eat fruits | |||||
Everyday | 28 (9.2) | 24 (11.1) | 4 (4.6) | 3.26 (2) | 0.196 |
3–5 times per week | 127 (41.9) | 90 (41.7) | 37 (42.5) | ||
Rarely | 148 (48.8) | 102 (47.2) | 46 (52.9) | ||
How often do you fried food | |||||
Everyday | 62 (20.5) | 47 (21.8) | 15 (17.2) | 3.62 (2) | 0.164 |
3–5 times per week | 184 (60.7) | 124 (57.4) | 60 (69.0) | ||
Rarely | 57 (18.8) | 45 (20.8) | 12 (13.8) | ||
Daily water intake | |||||
< 2 L | 128 (42.2) | 88 (40.7) | 40 (46.0) | ||
≥2 L | 175 (57.8) | 128 (59.3) | 47 (54.0) | 0.70 (1) | 0.404 |
Most students (80.5%) would sometimes prepare/cook their meals, but very few (24.1%) would eat a variety of food (rice, meat, vegetables and fruits) as required for a balanced diet. The frequency of eating at restaurants, fast food stores, and cafés was relatively low, where many reported going to these places less than three times weekly (60.4%, 89.4%, 94.1%, respectively). However, all three practices were significantly ( P < 0.05) associated with BMI status, where a higher proportion of nonoverweight/obese population (43.5%) eat out more frequently, while more of the overweight/obese population visited fast food stores (17.2%) and cafés (10.3%) more frequently ( Table 4 ).
Factors (lifestyle practices) associated with overweight/obesity
Variable | = 303 (%) | Non-overweight/obese = 216 (%) | Overweight/obese = 87 (%) | statistics (df) | -value |
---|---|---|---|---|---|
Do you bring lunch to school | |||||
Yes | 34 (11.2) | 21 (9.7) | 13 (14.9) | 1.70 (1) | 0.193 |
No | 269 (88.8) | 195 (90.3) | 74 (85.1) | ||
Where do you get lunch on a typical school day | |||||
I don’t eat my lunch | 15 (5.5) | 12 (6.1) | 3 (4.1) | 1.86 (3) | 0.601 |
I go home during lunch times | 45 (16.5) | 30 (15.2) | 15 (20.3) | ||
I eat/buy lunch at campus cafeteria | 139 (51.1) | 100 (50.5) | 39 (52.7) | ||
I eat lunch at restaurants in town | 73 (26.8) | 56 (28.3) | 7 (23.0) | ||
Do you prepare/cook your own meals | |||||
Always | 26 (8.6) | 21 (9.7) | 5 (5.7) | 1.78 (2) | 0.412 |
Sometimes | 244 (80.5) | 170 (78.7) | 74 (85.1) | ||
Never | 33 (10.9) | 25 (11.6) | 8 (9.2) | ||
What do you usually eat when you had to prepare/cook your own meals | |||||
Rice, meat, vegetables and fruits | 73 (24.1) | 55 (25.5) | 18 (20.7) | 2.46 (3) | 0.483 |
Rice and meat/vegetables | 104 (34.3) | 71 (32.9) | 33 (37.9) | ||
Meat/vegetables/Fruits only | 22 ( 7.3) | 18 ( 8.3) | 4 ( 4.6) | ||
Instant noodles/any noodles | 104 (34.3) | 72 (33.3) | 32 (36.8) | ||
How often do you eat out in restaurants | |||||
< 3 times per week | 183 (60.4) | 122 (56.5) | 61 (70.1) | 4.82 (1) | 0.028 |
3 or more times per week | 120 (39.6) | 94 (43.5) | 26 (29.9) | ||
How often do you eat fast foods (McD, KFC, Jollibee, Sugarbun, Burger King) | |||||
< 3 times per week | 271 (89.4) | 199 (92.1) | 72 (82.8) | 5.77 (1) | 0.016 |
3 or more times per week | 32 (10.6) | 17 ( 7.9) | 15 (17.2) | ||
How often do you visit cafés (Starbucks, Coffee Bean, Gloria Jeans) | |||||
< 3 times per week | 285 (94.1) | 207 (95.8) | 78 (89.7) | 4.24 (1) | 0.040 |
3 or more times per week | 18 ( 5.9) | 9 ( 4.2) | 9 (10.3) | ||
How often do you order food takeaways/deliveries | |||||
< 3 times per week | 232 (76.6) | 167 (77.3) | 65 (74.7) | 0.23 (1) | 0.629 |
3 or more times per week | 71 (23.4) | 49 (22.7) | 22 (25.3) | ||
How often do you eat with your family at home | |||||
< 3 times per week | 84 (27.7) | 58 (26.9) | 26 (29.9) | 0.23 (1) | 0.629 |
3 or more times per week | 219 (72.3) | 158 (73.1) | 61 (70.1) | ||
Do you choose food that cost less over healthy/nutritious food or the other way round | |||||
Healthy/nutritious food | 125 (41.3) | 97 (44.9) | 28 (32.2) | 4.14 (1) | 0.042 |
Food that costs less | 178 (58.7) | 119 (55.1) | 59 (67.8) | ||
Do you eat more when feeling stressed | |||||
Yes | 214 (70.6) | 152 (70.4) | 62 (71.3) | 0.02 (1) | 0.877 |
No | 89 (29.4) | 64 (29.6) | 25 (28.7) | ||
How often do you exercise | |||||
Everyday | 10 (3.3) | 8 (3.7) | 2 (2.3) | 0.68 (3) | 0.877 |
3–4 times per week | 67 (22.1) | 49 (22.7) | 18 (20.7) | ||
Once or twice per week | 111 (36.6) | 77 (35.6) | 34 (39.1) | ||
Rarely | 115 (38.0) | 82 (38.0) | 33 (37.9) | ||
Do you walk around campus | |||||
Yes | 238 (78.5) | 171 (79.2) | 67 (77.0) | 0.17 (1) | 0.679 |
No | 65 (21.5) | 45 (20.8) | 20 (23.0) |
Most students (72.3%) ate with family at home at least three times weekly. As much as 58.7% (178 out of 303) of all participants preferred eating cheap food over healthy/nutritious food. This was significantly ( P = 0.042) true for the overweight/obese population (67.8%). The majority (70.6%) ate more when feeling stressed. Regarding physical activity, 78.5% (238 out of 303) walked around the campus when going to classes. However, for the frequency of weekly exercise, only ten students (3.3%) exercised daily, while others exercised three to four times per week (22.1%), one to two times (36.6%), or rarely exercised (38.0%).
The majority of students were aware of the food pyramid (96.4%) and the concept of balanced nutrition (96.0%) ( Table 5 ). Although the majority 82.5%) were concerned about body size and physical appearance, slightly less than half (47.9%) had tried dieting. The main reason for dieting (34.7%) (those who never dieted were questioned why they think other people dieted) was to be strong and healthy.
Knowledge and views on dieting, balanced nutrition and self-body image by gender
Variable | = 303 (%) | Male = 83 (%) | Female = 220 (%) |
---|---|---|---|
Do you know the ‘Food Pyramid’ | |||
Yes | 292 (96.4) | 78 (94.0) | 214 (97.3) |
No | 11 (3.6) | 5 (6.0) | 6 (2.7) |
What is a balanced nutrition | |||
A diet consisting of mainly meat | 2 (0.7) | 0 (0.0) | 2 (0.9) |
A diet consisting of mainly fruits and vegetables | 8 (2.6) | 2 (2.4) | 6 (2.7) |
A diet consisting of meat, vegetables and other variety of foods | 291 (96.0) | 80 (96.4) | 211 (95.9) |
Others | 2 (0.7) | 1 (1.2) | 1 (0.7) |
Are you concerned about your body size and physical appearance | |||
Yes | 250 (82.5) | 66 (79.5) | 184 (83.6) |
No | 53 (17.5) | 17 (20.5) | 36 (16.4) |
Have you tried dieting before | |||
Yes | 145 (47.9) | 34 (41.0) | 111 (50.5) |
No | 158 (52.1) | 49 (59.0) | 109 (49.5) |
Reasons for dieting | |||
To be strong and healthy | 105 (34.7) | 36 (43.4) | 69 (31.4) |
To be slim/thin and confident | 90 (29.7) | 19 (22.9) | 71 (32.3) |
To look beautiful in clothes | 24 (7.9) | 9 (10.8) | 15 (6.8) |
To maintain my weight | 84 (27.7) | 19 (22.9) | 65 (29.5) |
In this study, 28.8% of participants were overweight or obese, and 10.6% of the populations were obese. Although this percentage is lower when compared to the Bruneian adult obesity rate of 27.2% reported in the 2011 National Health and Nutritional Status Survey ( 2 ), the university obesity rate can still be worrying considering the younger age of participants.
The prevalence of overweight/obesity was similar among male and female students with a difference of only 0.3% ( Table 2 ). This finding is different from the study conducted in the International Medical University of Malaysia ( 12 ), where male university students were more overweight/obese (15.3% more).
Eating regular meals with daily breakfast is considered healthy eating behaviour. Several studies concluded that the habit of skipping breakfast was associated with weight gain and a higher BMI value ( 13 , 14 ). In this study, although most participants ate meals regularly, more than half did not eat breakfast daily. This result is similar to the findings of a Malaysian study ( 6 ) where 56.1% reported not consuming daily breakfast. It is possible that meal skipping caused frequent snacking as the majority of the participants admitted to snacking between regular meals. An association between daily meals frequency and BMI status was identified from our study where a higher proportion of overweight/obese participants (23.0%) consumed more than three meals daily ( Table 3 ).
Hakim et al. ( 15 ) emphasised that skipping meals leads to more eating throughout the day including frequent snacking, which can subsequently result in weight gain. Minimal intake of daily fruits and vegetables combined with increased fried food consumption is common among university students ( 6 , 12 , 15 ). Such a trend was also observed among our participants ( Table 3 ).
The phenomenon of nutrition transition is emerging globally in which diets are shifting away from home food intake to dependence on outdoor processed food that is high in fats, salt and sugar ( 16 ). The majority of our respondents prefer eating lunch in the campus cafeteria (51.1%) instead of bringing lunch from home (11.2%), indicating their reliance on outside food. Furthermore, they resorted to eating instant noodles when required to cook their meals, while few would eat a balanced meal including a variety of food (i.e., rice, meat, vegetables and fruits).
The frequency of visits to fast food restaurants and cafés were significantly higher in the overweight/obese population, suggesting consumption of more food that is high in fat, salt and sugar. Hakim et al. ( 15 ) believed that increasing accessibility to fast food stores is closely linked to overweight or obesity as there is an associated risk of consuming high energy food, sweetened drinks and fatty food but low intake of nutritious food. Fast food is a quick and cheap choice for university students, especially when the time is limited and there is a large university workload. The majority of the respondents preferred cheap food to healthy/nutritious food, especially among the overweight/obese population ( P = 0.042).
It is important to keep a balance between energy intake and energy expenditure, as disruption of this balance can lead to obesity ( 14 , 17 ). Physical activity is also an important determining factor of weight status. A combination of low physical activity with poor dietary habits increases the risk of overweight or obesity ( 17 ). In this study, most participants adopted the habit of walking around the campus, but only 25.4% (77 out of 303) of participants engaged in physical exercises at least three times per week. According to the WHO guidelines ( 18 ), physical activity of moderate intensity for at least 150 minutes throughout the week (equivalent to 30 min/day for five days) is recommended for ages 18–64 years. The majority of the participants did not meet these requirements.
Although some of the reported eating patterns were unhealthy, the majority of students had good knowledge of the food pyramid and balanced nutrition. Due to stress, heavy workload and lack of time, university students tend to make poor food choices ( 7 ). Hence, it is challenging for them to adhere to the food pyramid.
This study reported that female participants were more concerned about physical size and appearance, and slightly more females tried dieting compared to males. Similar results were also seen in a previous study ( 9 ), where being overweight was more of a fear among female students.
This study was subject to a number of limitations. As a list of the names of all attending students was not available, convenience sampling was used instead of random sampling, hence limiting the validity of the data. However, the response rate of those approached to participate in the study was high (95.3%). Although self-reported height values could be under- or overestimated by participants, some studies ( 19 , 20 ) had shown that BMI calculations based on self-reported data were still able to classify most of the population into the correct BMI categories.
The BMI classification used in this study was based on the WHO international cut-off values. However, considering the WHO Asian BMI cut-off values, the prevalence of overweight/obesity among students may be underestimated.
In regard to the questionnaires, no quantitative data (such as daily food portions, calorie intake, and duration of daily exercises) was available to identify the association between the lifestyle practices and BMI status of university students. In addition, the type of food and snacks that university students tend to eat on a daily basis were not identified. Psychological factors associated with overweight/obesity leading to students’ desire for weight loss practices were also not explored.
The prevalence of overweight/obesity among this population of university students was 28.8% and affected males and females equally (28.9% versus 28.6%). A higher proportion of females were concerned about body size and physical appearance; hence dieting was more common among them. Although most university students reported having good knowledge of the food pyramid and balanced nutrition, the majority did not adhere to and practiced such healthy eating habits. Most of them skipped breakfast, snacked frequently, consumed fried food often and had a low intake of daily fruits and vegetables.
The transition from home food to increased reliance on outside food such as fast food common among the respondents especially among the overweight/obese population. Physical activity was low among students and less than WHO recommended levels. Therefore, the university should provide a multi-disciplinary team to support nutrition and physical activity programmes to increase the awareness among the university students ( 21 ). Physical activity programmes in the campus may have a positive impact on the student’s behaviour towards exercise.
Conflict of Interest
The authors declare no conflict of interest in this study.
Authors’ Contributions
Conception and design: TCY, SRA, DKSQ
Analysis and interpretation of the data: TCY, SRA, DKSQ
Drafting of the article: TCY, SRA, DKSQ
Critical revision of the article for important intellectual content: TCY, SRA, DKSQ
Final approval of the article: TCY, SRA, DKSQ
Provision of study materials or patients: TCY
Statistical expertise: TCY, SRA, DKSQ
Administrative, technical, or logistic support: SRA, DKSQ
Collection and assembly of data: TCY
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