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Social and Psychological Factors Affecting Eating Habits among University Students in a Malaysian Medical School: A...

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Social & Psychological Factors Affecting Eating Habits among University Students in a
Malaysian Medical School: A Cross-sectional Study
Kurubaran Ganasegeran1, Sami AR Al-Dubai1, Ahmad AM Qureshi2, Al-Abed AA Al-Abed3, Rizal AM3, Syed M Aljunid3,4
1International Medical School, Management and Science University, University Drive, Off Persiaran Olahraga, Section 13, 40100 Shah Alam, Selangor, Malaysia.
2Community Medicine & Public Health, Cyberjaya University College of Medical Sciences, No 3410, Jalan Teknokrat 3, Cyber 4, 63000 Cyberjaya, Selangor, Malaysia.
3Community Health Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, 56000, Cheras, Kuala Lumpur, Malaysia.
4 United Nations University-International Institute for Global Health, Jalan Yaacob Latiff, 56000, Kuala Lumpur, Malaysia.

Poor eating habit is a major public health concern among Study Design: Cross-sectional
young adults who experience transition into a university Study Sample and Location: Universal sampling of 132 pre-clinical medical students
life (Nelson et al, 2008). from a Malaysian private university.
The triad of social, environmental and psychological Instruments: Self-administered questionnaire which included items on socio-
domains stimulates the adoption of unhealthy eating habits demography, anthropometry, eating habits & psychosocial factors. Psychological
among university students. factors was assessed by the Validated 6 item Compulsive Eating Scale (Kagan &
This study aimed to assess patterns of eating habit and its Squires, 1984).
associated factors, with particular focus on psychological
determinants among medical students in a Malaysian Ethical issue: Approval from ethics committee of MSU. Information sheet and
university. assurance of confidentiality. Consent.
Statistical Analysis: SPSS 16. Descriptive,bivariate & multivariate analysis. T-test,
ANOVA, Multiple Hierarchical Linear Regression. Items on eating habits and
psychological factors were summed, total score for each part was obtained.

Figure 1: Psychological factors affecting eating habits


Socio-demographics Eating habits & Psychological
among respondents (n=132)
Mean (SD) age of the factors
respondents was 22.7 (2.4) 57.6% had regular meals 120
100
years and (the age) ranged from 43.9% took daily breakfast
80
18 to 30 years. Other socio- 81.8% consume vegetables 60
demographics are in Table 1. 73.5% consume fried food 40
(Table 2) 20
Yes
Table 1: Selected Socio-Demographics of 80.3% ate because of 0
No
Respondents (n=132) feeling happy (Figure 1) Eat Feel Eat so Eat Eat Eat
because of completely much until because of because of because of
Characteristics N (%) feeling out of stomach feeling feeling feeling
Gender
Table 2: Eating Habits among lonely control hurts upset or bored happy
Male 39 (29.5) Respondents (n=132) when it nervous
Female 93 (70.5) (* three or more times) comes to
food
Age Characteristics N (%) This study exhibited significant
18-21 51 (38.6) Regular meals 76 (57.6) Table 3: Association between eating association between eating habits
22 81 (61.4) habits score & categorical variables with smoking & alcohol
Daily breakfast 58 (43.9)
Ethnicity consumption. Sakamaki et al.,
Malay 81 (61.4) Frequency of daily 53 (40.2) Categorical Mean (SD) P Value
Variable (2005) found similar findings among
Chinese 3 (2.3) meals*
Chinese university students.
Indian 42 (31.8) Frequency of having 56 (42.4) Age
University life can be a stressful
Others 6 (4.5) snacks (per week)* 18-21 5.86 (1.87) 0.01
22 6.68 (1.66) experience for many students
Living Arrangement Weekly consumption of 108 (81.8) (Gower et al., 2007). A stressful
Alone 47 (35.6) vegetables & legumes* Smoking
individual tend to eat more as a way
With Family 85 (64.4) Yes 4.86 (1.57) 0.02
Weekly consumption of 64 (48.5) of coping with stress (Torres et al.,
Monthly Household No 6.45 (1.76)
fruits* 2007).
Income (RM) Alcohol
Weekly consumption of A possible new innovation in this
3000 78 (59.1) Yes 4.25 (2.06) 0.02
fried food study was the association between
3001-4999 22 (16.7) No 6.43 (1.74)
Less than twice 35 (26.5) eating habits and psychological
5000 32 (24.2)
Twice or more 97 (73.5) factors (Table 4).
Mother Working 56 (42.4)
Consumption of fast food Table 4: Association between eating
Smoking 7 (5.3) Often 28 (21.2) habits score & psychological factors
Alcohol 4 (3.0) Rarely 104 (78.8)
Regular Exercise 103 (78.0) Daily meals with friends 107 (81.1) Psychological factors Yes No P value
& family Mean(SD) Mean(SD)
BMI
Underweight (<18.5) 30 (22.7) Type of food consumed Eat because of feeling lonely 5.95(1.78) 6.75(1.70) 0.01
Normal (18.5-22.9) 70 (53.0) Mainly meat 25 (18.9)
Mainly vegetables 7 (5.3) Eat so much until stomach hurts 6.06(1.76) 6.72(1.74) 0.03
Pre-obese (23.0-27.4) 22 (16.7)
Obese Class I (27.5- 10 (7.6) Carbohydrate (rice,bread) 20 (15.2) Eat because of feeling upset or 6.07(1.75) 6.69(1.77) 0.04
24.9) Variety of food in balance 80 (60.6) nervous
Water intake (liters/day) Eat because of feeling bored 5.91(1.67) 7.02(1.74) <0.01
<2 79 (59.8)
2 53 (40.2)
Table 5: Results of hierarchical multiple linear regression; factors associated with
eating habits score (n=132) Step 1; Step 2
Social & psychological factors were important determinants of eating habits. B Beta P value B Beta P value
Most of the students in this study had healthy eating habits except in frequency 22 years old 0.675 0.238 0.006 0.629 0.222 0.009
of meals, fruit consumption, water intake & consumption of fried food. Being Alcohol 1.514 0.146 0.139 2.090 0.202 0.037
the most vulnerable group, university students have adopted unhealthy eating Eat because of feeling 0.931 0.258 0.009
habits due to reduced availability, affordability & accessibility of healthy diet in happy
university campuses & surrounding food outlets. With the paradigm shift
towards industrialization & cultural change globally, information on healthy diet
has become scarce in many developing & developed nations. Understanding the
context of multi-factorial causes affecting eating habits in this study may be a 1.Nelson MC, Story M, Larson NI, Neumark-Sztainer D, Lytle LA: Emerging adulthood and college-aged
foundation to initiate healthy food promotional activities. Blended with youth: An overlooked age for weight-related behavior change. Obes 2008, 16(10):2205-2211.
different socio-cultural & psychological attributes across different regions, a 2.Kagan DM, Squires RL: Compulsive eating, dieting, stress & hostility among college students. J Coll Stud
Pers 1984, 25(3):213-220
unified healthy eating policy should be drafted, being potentially amalgamated 3.Sakamaki R, Toyama K, Amamoto R, Liu CJ, Shinfuku N: Nutritional knowledge, food habits and health
& practiced in all regions including developing & developed nations. attitude of Chinese university students: a cross sectional study. Nutr J 2005, 4(4), 2891-2894.
4.Galore SR, Walker C, Chandler A: Brief communication:Dietary habits of first year medical students as
determined by computer software analysis of three-day food records. J Am Coll Nutr 1993, 12:571-520.
5. Gower B, Hand CE, Crooks ZK: The relationship between stress & eating in college-aged students.
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Undergrad Res J Human Sci 2008, 7: ISBN1-929083-13-0.

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