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Eating habits and obesity and their relationship with certain socio-demographic
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 Journal of American Science 2013;9(8) http://www.jofamericanscience.org

Eating habits and obesity and their relationship with certain socio-demographic characteristics among Saudi
Nursing Students at the University of Dammam

Al-Mahmoud, Sana Abdulkareem

Management & Leadership, University of Dammam – College of Nursing, Kingdom of Saudi Arabia
Sana98saudi@yahoo.com

Abstract: Obesity is a global and substantial public health crisis in developed world. Overweight and obesity are
increasingly being observed among the young. This growing rate represents a pandemic that needs urgent attention
if its potential morbidity, mortality, and economic consequences are to be avoided. The Aim of this study was - to
assess the relationship among certain socio-demographic characteristics, eating habits and overweight or obesity on
a sample of undergraduate nursing students. Design: Cross sectional survey-descriptive correlation study, design
was used to conduct this study. Setting: The study was conducted in College of Nursing University of Dammam.
Subjects: convenient sample consisted of 300 nursing students who accepted to participate in the study .Their ages
ranged from 18 to 22 years. Two tools were used in this study namely: "Structured Interview Sheet", to assess
socio-demographic characteristics, health history & physical examination and Students' weight status based on BMI
categories and percentage body fat. Calculate waist circumference and hip/Waist Ratio. "Life Style Questionnaire"
to assess student’s lifestyle practices including eating habits, meal patterns, physical activity and smoking habit.
Results: The unhealthy eating habit of students was noticed in the intake of fried food (majority reported eating fried
food one or two times/week). Frequent snacking and eating fried food can adversely affect students' health status,
given the abundance of energy dense and high fat ingredients they contain. Physical exercise was practiced at a
lower rate by nursing students; 19.7%.
[Al-Mahmoud, Sana Abdulkareem. Eating habits and obesity and their relationship with certain socio-
demographic characteristics among Saudi Nursing Students at the University of Dammam. J Am Sci
2013;9(8):234-242]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 34

Keywords: Eating habits, obesity, Saudi Nursing Students

1.Introduction: suffer from obesity, 55-59 % of them were females as

The prevalence of overweight and obesity is compared to 40% males, 29% were children & 90%
increasing worldwide at an alarming rate in of obesity due to excessive intake fast snacks by
developed countries. Body weight is a function of youth [5]. Therefore, WHO, Urged governments in
energy balance over an extended period of time [1]. different countries all over the world to set strategies,
Positive energy balance over weeks and months through assessment should be proceeding at the
results in weight gain, whereas negative energy national level to define the extent and the magnitude
balance has the opposite effect. The increase in the of the problem [6]. This study conducted on nursing
prevalence of overweight and obesity cases student because of obesity has a tremendous effect on
worldwide is occurring against a background of a their health & work on the future from such a disease
progressive reduction in the energy expended for can be prevented.
work and occupational activities as well as for the The Center of Disease Control and Prevention
accomplishment of personal tasks and daily (CDC) defines obesity as an excessively high amount
necessities [2]. of body fat or adipose tissue in relation to lean body
Dietary habits of young adults are affected by mass. Body Mass Index (BMI) is a common measure
the fast-food market. As a consequence, overweight expressing the relationship of weight-to-height. BMI
and obesity are increasingly observed among the is a mathematical formula in which a person's body
young. Obesity in combination with unhealthy life weight in kilograms is divided by the square of his or
style, such as smoking and physical inactivity, may her height in meters (wt/(ht)2). Individuals with a
increase the risk of chronic diseases [3]. BMI of 30 or more are considered obese." [7].
Data from the Middle Eastern countries of The World Health Organization has agreed on
Bahrain, Saudi Arabia, Egypt, Jordan, Tunisia, and an international standard for identifying overweight
Lebanon, among others, indicate this same disturbing and obesity in adult populations using the body mass
trend, with alarming levels of obesity often exceeding index (weight=height2) [8].. The majority of current
40% and particularly worse in women than in men studies agree that waist circumference (WC) is
[4]. In Saudi Arabia, study reported that the probably a better indicator of abdominal fatness and
prevalence of obesity nearly 3 million Saudi Arabian

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cardiovascular disease than either body mass index per week. First personal structured interview was to
(BMI) or waist-to-hip ratio (WHR) [9,10]. fill out the questionnaire sheet concerning personal
Significance of the study: characteristics data, assessment of their health
Eating habits in youth sector such as eating condition was to perform the anthropometric
snacks, irregular eating patterns, and lack exercises measurements. Second, students were asked to fill
are considered as indicators of obesity. For college out a questionnaire related to their life styles include
students, life can sometimes seem like one major eating, drinking and smoking habits. The participants
hurdle after another. Facing homework from several were informed to answer a questionnaire and their
classes and sometimes outside employment or identity and answers would be kept confidential. At
internship responsibilities, eating a good lunch, or the completion of the questionnaire, the students were
hitting the gym often falls low on the priorities. thanked for their cooperation.
Assessing students' weight status and eating habits Data collection conducted in two steps; First
will help health educators to develop proper Personal structured interview to fill out the
nutrition-related education programs that promote questionnaire sheet concerning personal characteristics
healthy food choices and good eating habits. data, assessment of their health condition was to
Thus, the aim of this study was to assess the perform the anthropometric measurements. Second,
relationship among certain socio-demographic students were asked to fill out a questionnaire related
characteristics, eating habits and overweight or to their life styles include eating, drinking and smoking
obesity on a sample of undergraduate nursing habits. After filling out the questionnaire,
students. anthropometric measurements, such as weight and
height, percentage body fat and body mass index were
2.Material & Methods done. Weight, percentage body fat and body mass
Research Design index measurements were determined.
Cross sectional survey descriptive design was Body mass index (BMI) was used to assess
used in this study. students' weight status. According to guidelines
Setting: stated by the National Institutes of Health, weight
This study was conducted at College of Nursing, the status was classified into four categories:
University of Dammam. underweight (BMI ≤ 18.5), normal weight (BMI
Subjects: between 18.5 – 24.9), overweight (BMI between 25–
Participants were 300 students who were 29.9), and obese (BMI ≥ 30) [11]. Normal range for
available at the college of Nursing during the time of percentage body fat was considered as follow: 10–
study. Subjects were from first grade (n= 115), 20% for males and 20–30% for females.
second grade (n=94), and third grade (n=91). Statistical analyses
Tools: After data were collected, they were coded
Two tools were developed by the researcher and transferred into especially design formats to be
based on the review of literatures. suitable computer feeding. Statistical analyses were
Tool I: performed using the Statistical Package for Social
"Structured Interview Sheet", to assess socio- Sciences software (version 15.0). Results were
demographic characteristics, health history, physical presented as means ± SD. Correlation and t-test
examination and students' weight status based on were used to test the significance of some related
BMI categories and percentage body fat. Calculate variables in this study. A p-value of (0.05 & 0.01)
waist circumference and hip/waist ratio. levels was used as the cut off value for statistical
Tool II: significance.
"Life Style Questionnaire" to assess student’s
lifestyle practices including eating habits, meal 3.Results
patterns, physical activity and smoking habit. Table (1) represents the participant's socio-
Procedure: demographic characteristics for obese and non obese
Formal permission from the Dean & College nursing students. As regards student age in the
of Nursing academic manager was obtained and studied sample, the mean age of both obese and non
verbal consent was obtained from students to obese students was 20.17 + 1.3; the means of
participate in this study. personal income, weight, & height were (2212 +
Data Collection 2158, 57.2 + 13.6, 156 + 5.6) respectively. This table
Tools I and II were collected from each student also showed that there was statistical significant
individually. The data were collected over a period of difference between the obese and non obese students
4 months from February till May 2010, during this in relation to their ages, personal monthly income,
period, the nursing students were interviewed twice

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buying a meal by themselves, and weight (p= .003, Underweight (BMI ≤ 18.5), ** Normal (BMI
0.045, 0.023, & 0.000) respectively. between 18.5 – 24.9), *** Overweight (BMI between
Based on BMI classification, the study 25–29.9), **** Obese (BMI ≥ 30).
classified student as obese or non obese.

Table (1) Distribution of the studied sample by obesity and socio-demographic factors
Obese Non-Obese Total Test of
Socio-demographic Characteristic (N = 106) % (N = 194) % NO. (300) % Sig.
Age (years)
< 20 39 36.7 82 42.3 121 79.0 0.003*
20 + 67 63.3 112 57.7 179 21.0
(means ± SD) 20.17 + 1.3
Marital status
Single 72 67.9 161 83.0 233 77.7 0.135
Married 34 32.1 33 17.0 67 22.3
Number of children
No child 81 76.4 172 88.7 253 84.4
1 child 15 14.2 12 6.2 27 9.0 0.456
2 children or more 10 9.4 10 5.1 20 6.6
Personal monthly income
(SR/Month):
<1000 53 50.0 90 46.4 143 47.7 0.045*
1000-5000 35 33.0 96 49.5 131 43.7
5000-10,000 12 11.3 6 3.1 18 6.0
> 10,000 6 5.7 2 1.0 8 2.6
(means ± SD) 2212 + 2158
Do you buy your own meals?
Yes 90 84.9 89 45.9 179 59.7 0.023*
No 16 15.1 105 54.1 121 40.3
Height: (cm.)
< 150 16 15.1 25 12.9 41 13.7 0.654
150 – 165 84 79.2 160 82.5 244 81.3
> 165 6 5.7 9 4.6 15 5.0
(means ± SD) 156 + 5.6
Weight: (kg.)
< 50 0 0 104 53.6 124 41.3 0.000*
50 – < 70 60 56.5 90 46.4 150 50.0
70 - < 80 36 34.0 0 0.00 16 5.3
80 – 100 6 5.7 0 0.00 6 2.0
> 100 4 3.8 0 0.00 4 1.4
(means ± SD) 57.2 + 13.6
* P< 0.05

Figure (1) represents the distribution of BMI respectively. It means that total over weight and obese
in Saudi Nursing students, Based on BMI participants were (106) 35.4 % and the rest of
classification, 19.2 % , 6.9 %, 6.5 %, & 2.9 % participants (194) 64.6% were non obese.
represented in BMI 25-<30, 30-<35, 35-<40, & 40+

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Fig.(1) Frequency Distribution of BMI in Saudi Nursing Students

40 38.4%

35

30

25 23.6%

20 19.2%

15

10 6.9% 6.5%
0.3% 2.8%
5

0
<15 15-<20 20-<25 25-<30 30-<35 35-<40 40+

Table (2) represents the health assessment for obese and non obese nursing students. As regards present
assessment, the table shows significant statistical differences between obese and non obese nursing student in relation to;
present medical illness, random blood glucose level (>110 mg/d)l, using diet, exercise, surgical operation and history of
family obesity (p= 0.005, 0.002, 0.011, 0.007, 0.046, & 0.000) respectively.
Table (2) Distribution of the Studied Sample by obesity in relation to their health condition
Obese Non-Obese Test of
Health Condition (N = 106) % (N = 194) % Sig.
1. Present Complaints
Presence of medical illness 0.005*
Yes 56 52.8 9 4.6
No 50 47.2 185 95.4
Systolic Blood Pressure
< 90 mmhg 6 5.7 9 4.6 0.643
90 – 120 mmhg 58 54.7 120 61.9
> 120 mmhg 42 39.6 65 33.5
Diastolic Blood Pressure
< 60 mmhg 8 7.5 14 7.2
60 – 80 mmhg 61 57.5 112 57.7 0.098
> 80 mmhg 37 34.9 68 35.1
Random Blood Glucose Level:
< 70 mg/dl 15 14.2 13 6.7 0.002*
70 – 110 mg/dl 35 33.0 166 85.6
> 110 mg/dl 56 52.8 15 7.7
Have you tried to do anything to have an ideal body weight?
Yes 87 82.1 55 28.4 0.692
No 19 17.9 139 71.6
If YES, what do / did you do:
Diet 18 17.0 39 20.1 0.011*
Exercise 16 15.1 9 4.6 0.007*
Medications / Herbs 15 14.2 54 27.8 0.135
Diet & Exercise 5 4.7 20 10.3 0.000*
Surgery 12 11.3 32 16.5 0.010*
Others 40 37.7 40 20.6 0.453
2. Past history
a. Past history of medical illness
Yes 46 43.4 70 36.1 0.367
No 60 56.6 124 63.9
b. History of surgical operation
Yes 17 16.0 27 13.9 0.046*
No 89 84.0 167 86.1
Family History of:
D.M 68 64.2 56 28.9 0.176
Hypertension 49 46.2 85 43.8 0.087
Obesity 80 75.5 21 10.8 0.000*

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 Journal of American Science 2013;9(8) http://www.jofamericanscience.org

The findings of this study indicated that more underweight. Similarly, the obese students had at the
than half of the students (54.7 %) were of normal same time higher values of percentage body fat
weight as indicated in Figure (2). Based on BMI (30.9%) while normal students reported that had no
classification, the prevalence of overweight and percentage of body fat and that was within the normal
obesity was (24.2% & 10% respectively). In contrast, range (69.1%) (Figure 3).
more than tenth (11.1%) of the students were
Fig.(2) Percentage of Students' Wieght Status Based on BMI Categories

53.5%
60
50
40 25.4%
30 11.1%
10%
20
10
0
Underwieght Normal Overwieght Obese

Underweight (BMI ≤ 18.5), ** Normal (BMI between 18.5 – 24.9), *** Overweight (BMI between 25–29.9),
**** Obese (BMI ≥ 30).
Fig.(3) Percentageof Students' weight status based on WHR categories
and percentage body fat

69.1

70
60
50 30.9
40
30
20
10
0
Normal Obese

Fig.(4) Percentage of Students' weight status based on WC

categories and percentage body fat

75.2
80
70
60
50
40
30
13.7 11.1
20
10
0
No Risk High Risk Extremely High Risk

Regarding percentage of students’ weight status based on waist circumferences and percentage of body fat (Figure
4) illustrates that the students of normal weight had normal percentage of body fat and reported no risk (75.2 %).
while, the obese students had low values of percentage body fat and at high risk (13.7 %) as well as 11..1% had
extremely high risk.

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Table (3): Student's response to questions related to their lifestyle practices

Questions No. %
Do you take your meals regularly?
Always regular 118 39.3
Irregular 182 60.7
How many times do you eat meals per day (apart from snacks)?
One time 19 6.3
Two times 112 37.4
Three times 113 37.6
Four times 43 14.3
More than 4 12 4.0
Eat only snacks 1 0.4
Do you drink beverages?
Yes 205 66.8
No 95 33.2
If yes, what type do you drink? (205)
Diet 32 15.6
Regular 173 84.4
Do you drink coffee / tea?
Yes 225 73.3
No 75 26.7

As regards student's response to questions habits in terms of breakfast intake and meal
related to their lifestyle practices (Table3) presents frequency 39.3% i.e. .students reported eating
eating habits of the students, nearly two thirds breakfast daily or three to four times per week. Most
(60.4%) of the students were taking meals irregularly of students were drink beverages coffee/tea (66.8% &
as compared to students showed healthier eating 73% respectively).

Table (4): Percentage of student's lifestyle practices regarding eating habits

Rarely 1–2 times /week 3–4 times /week Daily Never
Eating Habit as a life style
How often do you eat breakfast? 13.7 15.0 21.5 45.6 4.2
How often do you take snacks apart from regular meals? 14.0 27.0 14.3 36.5 8.2
How often do you eat green, red or yellow coloured vegetables? 22.1 23.8 23.1 23.1 7.2
How often do you eat fruits? 25.4 25.4 25.1 17.9 6.2
How often do you eat fried food? 16.3 35.8 27.4 15.3 5.2
How often do you eat Fast food? 22.5 40.7 18.6 11.4 6.8
How often do you eat with family? 8.5 22.1 19.9 46.9 2.6
How often do you eat with friends? 16.6 18.6 29.0 30.6 5.2
How often do you eat at restaurants? 11.1 32.2 44.0 4.6 8.1

Table 4 represents percentage of student's The unhealthy eating practice was indicated by
lifestyle practices regarding eating habits. More than the fact that more than one third of students (35.8 %) of
one third of students 36.5 % reported eating snacks as the students reported eating fried food one to two times
a part from regular meals per day. Intake of colour per week. Eating daily with friends and family was
vegetables and fruits was uncommon among students. common among students (30.6% & 46.9). About 4.6%
Only 23.1% of the students reported daily intake of were eating daily at restaurants, while 44 % of students
colour vegetables of the students while 17.9% eat at restaurants 3-4 times per week.
reported daily intake of fruits. Table 5 shows that smoking was not common
among students, 96.7% of the students reported that

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 Journal of American Science 2013;9(8) http://www.jofamericanscience.org

they do not smoke, while 1.6 % was smoke them reported by walking, 12.4% by aerobics and
occasionally or current smokers. Regarding Practice (32.4%) practiced regularly 1-2 times/week, while
of exercises, also, this table shows that (47.2%) of the (26.9%) either on daily regular basis or 3-4 times
students were practice exercises, (78.6%) among /week. 14.5% reported rarely.

Table (5): Student's response to questions related to their lifestyle practices (Smoking & Exercises)
Questions No. %
Smoking history:
Current smoker 5 1.6
Never smoke 290 96.7
Smoke occasionally 5 1.6
If you are a current smoker or ex-smoker or smoke occasionally:
Type:
(1) Cigarettes 4 1.3
(2) Hubble-Bubble 4 1.3
(3) Cigar 1 0.6
Number of cigarettes / heads of Hubble-Bubble smoked per day?
1 2 0.7
2 3 1.0
Practice of exercises:
(1) Yes 145 47.2
(2) No 155 52.8
What type of exercise? (145)
(1) Aerobics 18 12.4
(2) Walking 114 78.6
(3) Treadmills / Bike 8 5.5
(4) Swimming 5 3.5
How often? (145)
(1) Daily 38 26.2
(2) 3-4 times /week 39 26.9
(3) 1-2 times / week 47 32.4
(4) Rarely 21 14.5
For how long do you exercise? (145)
(1) 1 Hour 39 26.9
(2) Half an hour 47 32.4
(3) 45 minutes 31 21.4
(4) < than 30 minutes 28 19.3

4.Discussion half of students were of normal weight. This result is

Obesity is an excessive accumulation of body really good image which has be generalized for all
fat and in its gross manifestation posses a real threat nursing students as a leader of the future and will
to health [12]. It is the most prevalent, chronic understand the importance of weight control for
medical condition in developing countries [13]. It is health status while educate any patient suffering from
well established that directly or indirectly obesity is different diseases.
associated with a wide variety of diseases such as On the other hand, the result of this study
non-insulin-dependent diabetes mellitus (NIDDM) represents that 11.1% & 35.4% were underweight &
[14, 15]. overweight or obese respectively. This rate of
In the present study, the frequency students whom need to change life style and food
distribution of height, weight and BMI shows normal habits to promote their weight.
distribution, body mass index was used to assess In terms of eating habits, the present study
weight status. Based on BMI classification of weight data analyses of students' eating habits revealed that
status, findings of this study indicate that more than more than one third of students eat meals regularly

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 Journal of American Science 2013;9(8) http://www.jofamericanscience.org

and the majority of them eat breakfast daily or three more healthy eating patterns thus the better eaters had a
to four times per week. These findings supported in higher level of knowledge about nutrition [21]
some way the study conducted by Yahia et al., Based on the findings of the present study, it can be
revealed that the majority of students eat meals concluded that
regularly and eat breakfast daily or three to four times Saudi Arabian female student community has
per week [16]. been experiencing a nutritional transition in food
Other studies showed that, students usually choices from the typical traditional diet to the fast food
do not follow healthy eating habits. The typical pattern due to the students spent most of their time at
university student diet is high in fat and low in fruits university campus. As a consequence, the dietary habits
and vegetables [3,9,17]. Students often select fast of young adults' female nursing students have been
food due to its palatability, availability and affected; thus, overweight and obesity are increasingly
convenience. A previous survey by the American being observed among the young. As a result of this
Dietetic Association indicated that obesity, or being study, diets were rich in carbohydrates, and deficient in
severely overweight, is a fast-food related issue [16]. fibber. Breakfast was a regular meal for 67.1% of
The Healthy people 2010 objectives include a focus students. In this study, irregularly taking meals and
on nutrition and obesity prevention [18]. beverages, soda or juice were representing 60.7% &
In a recent study, namely the Lebanon Global 66.8% of students. In addition, physical exercise was
Youth Tobacco Survey (GYTS), conducted among practiced significantly lower by female students;
5035 students aged 13–15 years from 50 schools 19.7%.
reported that the prevalence rate of students who
were current cigarette smokers was 8.6% and 33.9% It can be recommended that:
were current water-pipe smokers. The GYTS 1. Increase awareness of students about healthy
indicated that half of students who were current food, complications of overweight or obesity.
smokers expressed their desire to stop smoking [19]. 2. Health education and physical education
In this study, daily intake of snacks was programs in the universities are recommended to
reported by more than half of students as a daily or 3-4 promote healthy life styles and dietary habits.
times intake/w. The unhealthy eating habit of students 3. Physical exercise course has to be added in the
was noticed in the intake of fried food (majority curriculum for nursing students.
reported eating fried food one or two times/w). 4. It is clear that changes must be made to the
Frequent snacking and eating fried food can adversely lifestyle of the Saudi population in order to
affect students' health status, given the abundance of reduce the prevalence of obesity.
energy dense and high fat ingredients they contain.
Unexpectedly, intake of coloured vegetables References
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