INTRODUCTION:
Scholars have found that the factors and forces that help create and explain the basic relationship or association between physical activities and body mass index (BMI) are far more complex and multifaceted than sports idealists have often believed or assumed. The relationship between physical activities and BMI is not, for the most part, a direct, causal one. It can vary dramatically depending upon the type of physical activity, duration of physical activity, the diet pattern that they follow in their daily life, awareness about their health, and the relationship between physical activities
on BMI. Indeed, for some groups under certain conditions, physical activities and food intake can be detrimental, functioning as a risk factor for causing overweight. This variability is the second basic insight of the field and has led to an ongoing scholarly effort to isolate and evaluate the causal factors that account for the correlation between physical activities and food intake on overweight1.
A comprehensive examination and assessment of the limitations and variability of the physical activities and BMI relationship are crucial if we are to understand how to best utilize and explore sports programming and participation for better health. Nevertheless, some of these researchers recognized that playing video games is fun and more beneficial. Although the percentage of those agreeing is relatively lower than those who disagreed, evidence nowadays is mixed had come with various changes in the latest video games that have become increasingly virtual, realistic, diverse and more social. For us, it is quite balanced between the positive and negative effects of playing video games2.
In conjunction with that, we will carry out research on the effect of physical activities on BMI among medical school students of Universiti Sultan Zainal Abidin (UniSZA). As we know, the medical degree is very challenging with almost most of the student’s time spent on studying and attending classes. So the evidence will be collected from the medical students of UniSZA regarding their perspective and benefit of doing physical activities and their BMI.
Recently, students find it difficult to take part and get involved in sports at the same time coping with all the assignments, classes and exams in their schools. Therefore, students become negligent about the importance of physical activities in their daily life for the past few decades especially medical students. They fall in dilemma and assume that doing physical activity in their leisure time could waste their time, and energy without concern about their health status.
We are going to observe and understand the students’ BMI by doing physical activities. Besides, we will identify the obstacles and challenges faced by the students to balance their time after physical activities.
Based on Petros C. Dinas et al., physical activity is defined as the total of the daily movements produced by skeletal muscles causing energy expenditure including programmed exercise. The waist-to-hip ratio is calculated as the ratio of the smallest diameter of the waist (waist circumference) and the circumference of the largest diameter of the hips (hip circumference). Waist circumference is a surrogate for abdominal obesity and is an independent risk factor for cardiovascular disease. Waist-to-hip ratios >1 in men and >0.85 in women indicate a greater risk for disease3. However, BMI and waist-to-hip ratio cannot describe the body composition and therefore they should be used by taking into consideration this limitation. According to Jean-Philippe Chaput et al., (2011), in the field of obesity research, physical exercise has been considered a well-known way which helps to burn calories. When physical exercise is properly managed, it contributes to the enhancement of energy and macronutrient balance regulation and also to total body functioning4. Physical exercise in water is a possibility to try to increase the physical and mental health of obese persons without the risk of injuries5. Aerobic activities in the water are effective to improve aerobic fitness and the effect on body composition has been demonstrated to be similar to weight-bearing aerobic exercise on land6. Aqua jogging is a specific form of exercise which consists of simulated running in deep water. In sports, aqua jogging is used as low-impact training, for example, in the rehabilitation phase after an injury7.
The dramatic increase in childhood obesity in recent years is paralleled by decreased physical activity as well as cardiorespiratory fitness levels, which is also attributed to increased insulin resistance and diabetes-associated risk factors in children and adolescents. As observed in adults, an increasing body of evidence suggests that acute physical activity and chronic exercise have a beneficial effect on reductions in insulin resistance through multiple adaptations such as improved insulin sensitivity and glucose uptake of skeletal muscles and body composition changes in overweight children and adolescents8. According to studies demonstrated by George A. Kelley, both aerobic and resistance types of exercise alone (without weight loss or calorie restriction) resulted in significant improvement in insulin sensitivity, suggesting that exercise alone is an effective therapeutic strategy for reducing insulin resistance in overweight and obese children and adolescents9. However, future studies are required to explore the optimal dose of exercise and efficacious modality to elicit meaningful reductions in insulin resistance in youth.
The authors evaluated the effect of physical activities on BMI among medical students. Accordingly, screened the socio-demographic status. Assessed involvement of medical students in physical activities. Determined BMI among medical students. Finally, correlated the physical activities with BMI.
METHODOLOGY:
The study design used for this research is a cross-sectional study. This study design was used because of its advantages, especially in the aspect of cost-effectiveness. Adding to that, the required amount of resources to conduct this study is very minimal. Therefore, a cross-sectional study design is best conducted to determine the prevalence and is very useful in identifying any association so that the research conducted can be more precisely followed up using a cross-sectional study design.
The location of the study is based in the Medical Campus of UniSZA, Kuala Terengganu. The faculty involved in this research is the Faculty of Medicine. The number of elements for the target population is 120. The independent variables are the factors that will be studied in the research. The dependent variables include body mass index. The body mass index of the subject will be considered based on the correlation with physical activity participation. The questionnaire will be distributed to the medical students of UniSZA that has been evaluated in the interview.
RESULTS:
Socio-demographic characteristics among students in medical faculty at UniSZA:
Table 1- Summarizes the socio-demographic characteristics of medical students in UniSZA (n=120)
|
Variables |
Frequency (%) |
|
MBBS students Year 1 Year 2 |
60 (50%) 60 (50%) |
|
Gender Female Male |
86(71.7%) 34(28.3%) |
|
Race Malay Chinese Indian |
92(76.7%) 7(5.8%) 21(17.5%) |
|
Economic status Low income Middle-class income High income |
4(3.3%) 91(75.8%) 25(20.8%) |
|
Parental education status Diploma, pre-university, equivalent and others Lower than a diploma, pre-university |
85(70.8%) 35(29.2%) |
The youngest adult involved in this study is Year 1 whose age ranges from 19-20 and the eldest adult is from Year 2 who is 21-22 years old. About 28.3% of the respondents are male and 71.7% of respondents are females. The major race of the respondents is Malay (76.7%), followed by Indians (17.5%) and finally Chinese (5.8%). In the economic status aspect, most of the respondents are from middle-class income (75.8%), followed by high income (20.8%) and then low income (3.3%). 70.8% of the respondent’s parents hold a diploma/pre-university, equivalent and higher level of academic status where else 29.2% of the respondent’s parents have an academic status lower than diploma and pre-university as depicted in Tab 1. Nevertheless, the type of physical activities involved as well as time spent are portrayed in Tab 2 and 3 respectively. Finally, discussed through the questionnaire about the BMI category among different races and gender (Tab 4 and 5) of medical students. Tab 6 explains BMI category among medical students involved in physical activities. These parameters are correlated and ultimately arrived to a postulation about the effect of physical activity on BMI with reference to type of activity, gender, race etc.
Sports participation among students in the medical faculty of UniSZA:
Table 2- Type of Sports participation among MBBS students in UniSZA. (n=120)
|
Types of sports engaged in |
frequency (%) |
|
Gym |
43 (35.83) |
|
Jogging |
25 (20.83) |
|
Badminton |
18 (15.00) |
|
Futsal |
20 (16.67) |
|
Swimming |
2 (1.67) |
|
Cycling |
9 (7.50) |
|
Walking (including walking to class) |
45 (37.5) |
Table 3: Time spent doing sports among MBBS students in UniSZA. (n=120)
|
Time spent doing sports |
frequency (%) |
|
None |
58 (48.33) |
|
< 1 hour |
20 (16.67) |
|
1 – 2 hours |
26 (21.67) |
|
2 – 3 hours |
16 (13.33) |
Table 4-BMI category among different races of medical students
|
BMI Category |
Malay |
Chinese |
Indian |
Total |
|
Underweight |
9 |
0 |
1 |
10 |
|
Normal |
58 |
7 |
18 |
83 |
|
Overweight |
15 |
0 |
2 |
17 |
|
Obese |
10 |
0 |
0 |
10 |
|
Total |
92 |
7 |
21 |
120 |
Table 5-BMI category among different gender of medical students
|
BMI Category |
Male |
Female |
Total |
|
Underweight |
1 |
9 |
10 |
|
Normal |
24 |
59 |
83 |
|
Overweight |
7 |
10 |
17 |
|
Obese |
2 |
8 |
10 |
|
Total |
34 |
86 |
120 |
Table 6-BMI category among medical students with physical activities.
|
BMI Category |
Exercise |
No Exercise |
Total |
|
Underweight |
0 |
10 |
10 |
|
Normal |
56 |
27 |
83 |
|
Overweight |
5 |
12 |
17 |
|
Obese |
1 |
9 |
10 |
|
total |
62 |
58 |
120 |
DISCUSSION:
The terms obesity and overweight can sometimes be confusing. According to WHO, obesity is defined as a condition of abnormal or excessive fat accumulation in adipose tissue all over the body. Obesity can lead to the extent that health may be impaired. While overweight is described as excessive weight that may be from extra muscle, bone, or water as well as from having too much fat. Both terms mean the weight is higher than their ideal body weight which is thought to be healthy for their height. One of the most commonly used indices of relative weight to classify obesity in our study is BMI based on WHO expert consultation10.
Obesity can be divided into general obesity and central obesity. General obesity is defined as BMI ≥ 27 kg/m2. Abdominal obesity is also known as central obesity which reflects an increase in visceral fat. Prevalence of abdominal obesity is defined as a waist circumference ≥90cm for men and ≥ 80cm for women according to the WHO classification for the Asian population11.
The problem of obesity in Malaysia is arising involving all ethnicities and localities. The prevalence concept of obesity can be applied by measuring generalized obesity and abdominal obesity. Abdominal obesity poses a major challenge to health worldwide and is associated with cardiovascular risk. There have been few studies on obesity in the Malaysian population12-14.
According to the finding, the relationship between physical activities on BMI among medical students of UniSZA has received much attention owing to the increasing prevalence of students who are overweight and obese. From the study we have conducted, we learnt that many factors contribute to the BMI of a medical student. In our study, we study the influence between physical activities on obesity among medical students of UniSZA.
Around 120 students from Year 1 and Year 2 participated in this study. We found out 6 students from Year 1 and 4 students from Year 2 are obese with a BMI of more than 30 kg/m². 6 students from Year 1 and 11 students from Year 2 are at risk of getting obese. 45 students from Year 1 and 38 students from Year 2 are having a normal BMI which is between 18.5 to 24.99 kg/m². 3 students from Year 1 and 7 students from Year 2 are underweight, meaning having a BMI of less than 18.5 kg/m².
All the students who are categorized as obese are not doing any physical activities which causes them to have a very high BMI. Those who are categorized as overweight are people who are at high risk of getting obese. Some students still do exercise but not having a normal range of BMI15. Contrary to the above, apart from physical activity, food intake also contributes to a student’s BMI. This is because not only the factor of exercise contributes to having high BMI but food intake is also affecting BMI. The amount and frequency of food intake affect someone’s BMI16.
Most of the students prefer eating carbohydrates and fast food which is the major contributor for someone to having a high BMI. Those who are obese or overweight prefer or like to eat those types of food. Besides that, medical students prefer eating fast food because less time is needed to prepare and is easily available since most students are busy with their studies.
They also prefer eating more frequently, like more than 4 times per day. Study shows that the higher the frequency of taking the meal, the higher the BMI of the students. They are not following the food pyramid in their daily food intake. A high intake of carbohydrates and fatty food and less intake of fruits and vegetables leads to a higher BMI and increases the risk of getting obesity17. Even though most of them are aware of obesity and its consequences, there are still people who neglect and not taking it seriously.
More than half the number of students have a normal BMI. Most of them exercise regularly and are concerned about their daily food intake which makes them have an ideal BMI. Even though some of them not involving much in physical activities, they can maintain an ideal BMI by taking proper and healthy food by following the food pyramid18.
Susana Maria Coelho Guimarães Vale et al., (2010)19 had cross-sectional questionnaire-based research with the objective to examine the association between objectively measured physical activity (PA) and BMI in preschool children. The study comprised 281 children (55.9% boys) aged from 4 to 6 years. PA was measured by an accelerometer. Children were categorized as non-overweight (NOW) and overweight/obese (OW). Total and moderate intensity PA was not associated with BMI. They observed that a higher proportion of OW children were classified as low-vigorous PA compared to their NOW peers (43.9 versus 32.1%, resp.,). The data suggest that vigorous PA may play a key role in obesity development already at preschool age.
A few students are underweight. It might be due to less food intake by the students. Or else the high metabolic rate of a student also contributes to having a less BMI. According to Trishnee Bhurosy and Rajesh Jeewon (2014)20, the prevalence of obesity has been increasing since 1981 for both genders; female BMI is greater than that of males, except in European countries; lower BMI trends are more prevalent in African and ASEAN countries. As economic transition advances, they predicted that the current mean BMI trends depicted in developing nations will surpass even the maximum mean BMI values reported in developed countries. Such an increase in overweight can be attributed to significant alterations in eating habits and physical activity levels caused by socioeconomic influences21,22. Rather than focusing on obesity as an individual behavioral chronic state, current scientific evidence indicates the consideration of a multidisciplinary approach targeting the immediate environment of the obese individual to broader socioeconomic contexts. For such a venture to be fruitful in developing nations, the incentives at several levels of organizations, the media, and educational institutions along with changes in food policies and distribution will need to be provided to low-income populations.
In general, our research revealed that only 35% of the MBBS students from UniSZA are doing physical activities. Students who are overweight and obese does not involve in any kind of physical activity but students who are having normal BMI involve themselves actively in physical activities. It shows that there is a relationship between physical activities and BMI. However, there is no significant association between gender and the overall period of involved with BMI. In conclusion, based on this study physical activities are not only the factor that influences the BMI, but there are other metabolic factors as well such as diet pattern, occupation, lifestyle etc. Physical activities are one of the major factors that prevent obesity among students.
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Received on 08.10.2022 Modified on 19.11.2022
Accepted on 16.12.2022 © RJPT All right reserved
Research J. Pharm. and Tech 2023; 16(1):200-204.
DOI: 10.52711/0974-360X.2023.00037