Introduction
Youth is the time when a person develops various healthy and unhealthy habits that will follow him throughout his life [1-2]. The World Health Organization (WHO) estimates that nearly two-thirds of premature deaths and one-third of the burden of disease in adulthood are linked to inappropriate behaviors or lifestyles that began in youth. About 27-39% of cancers can be prevented only by improving eating habits and physical activity [3-5]. Optimal nutrition, physical activity, and sleep levels have been shown to be important for academic achievement [6-8]. There is solid evidence that the main health behaviors related to the health status and quality of life of young people are the daily consumption of fruits and vegetables, physical activity, avoiding sedentary behavior and abstinence from alcohol and tobacco [9-10].
Physical activity is a key determinant of energy consumption and therefore fundamental for energy balance and weight control [11]. Participating in physical activity is also important for ensuring good mental health [ 12 ]. Intense and frequent physical activity is thought to be associated with lower levels of stress and fatigue in young people [13]. Studies have shown that there is a positive association between high levels of physical activity, healthy food consumption, good health and health-related quality of life [14-15]. A lifestyle that promotes health among young people has become a major focus of research at the global level. The life of college students is a transitional period; therefore, they can be offered good opportunities to establish health-promoting lifestyles. To see also : How Lady Gaga and mother Cynthia Germanotta are promoting mental health in the workplace. This research aims to assess youth lifestyle domains in terms of dietary habits and physical activity and to reveal risk factors associated with lifestyle domains.
Materials & Methods
A cross-sectional study was conducted in junior colleges in Bhubaneswar, India. The total duration of the research was from October 2019 to September 2021. This may interest you : Michigan’s largest health system is sending mixed messages on abortion. The research participants were young people going to college.
The sample size was 636. The sampling technique was a two-stage stratified sampling method. First, one college from each of the five administrative regions (East, West, North, South and Central zones) of Bhubaneswar was selected by lottery method to obtain a representative sample. From each faculty, 128 students were randomly selected from the list of students.
Young students who gave written informed consent were included in the study. Students who were ill with physical impairments and were not present on the day of data collection were excluded.
Permission to conduct the study was obtained from the Institutional Ethics Committee (IEC) of Kalinga Institute of Medical Sciences (KIMS), with ref. no. approvals: KIMS/KIIT/IEC/87/2019 from September 6, 2019, before the start of the study.
A pre-designed, pre-tested, semi-structured questionnaire was prepared based on previous similar research articles in the Department of Community Medicine, KIMS, and was used to collect socio-demographic data and relevant variables using UNICEF’s findings from the National Adolescent Attitudes Survey on Healthy Lifestyles and skills questionnaire (2018) [16] and the step-by-step approach to the “Noncommunicable Disease Risk Factor Survey”, WHO questionnaire (2009) [17]. The questionnaire was divided into three parts:
1) socio-demographic profile (the modified Kuppuswamy 2019 scale [18] was used to assess socio-economic status);
2) eating habits (e.g. breakfast habits, number of meals per day, frequency of consumption of green leafy vegetables, tendency to fast food, etc.);
Data were entered into Microsoft Excel 2019 (Microsoft® Corp., Redmond, USA), and data cleaning was performed to remove typographical errors and harmonize the dataset. SPSS version 20.0 (IBM, Inc., Armonk, USA) was used for analysis.
Results
In the current study, a total of 636 participants (476 females and 160 males) were randomly selected from five selected colleges (randomly selected from each of the five administrative regions of Bhubaneswar Municipal Corporation according to pre-specified inclusion and exclusion criteria).
Of the 636 students, the majority of 83.1% were in the age group of 15-17 years with an average age of 17. Read also : Executive order on the protection of access to reproductive health services.6±1.22 years. The maximum age was 23 years, and the minimum age was 15 years.
In the current study, the majority (74.8%) of participants were female and 25.2% were male. There were 56.4% from the basic family, and then 37.6% from the joint family. In the current study, the largest number (60.5%) of the participants belonged to the upper middle socio-economic class according to the modified Kuppuswamy socio-economic scale [18] (Table 1).
In this study, of the 424 (66.7%) participants who always ate breakfast regularly, 68.8% were men and 66.0% were women. Of the 349 (54.9%) participants who had >2 meals per day, 54.4% were female, while 56.2% were male. Here 287 (45.1%) of them had <2 meals/day, of which 45.6% were women and 43.8% men, but the observed difference was not statistically significant (Table 2).
Of the 184 (28.9%) participants who were not on a non-vegetarian diet, 33.4% were female, while only 15.6% were male. This difference in food preference between males and females was found to be statistically significant with a p-value of 0.002.
In this study, 237 (37.3%) participants ate green leafy vegetables daily, of which 39.3% were women, while 31.2% were men. This difference in preference for green leafy vegetables between male and female adolescents was found to be statistically significant with a p-value of 0.019.
Of the 201 (31.6%) of the total number of participants who consumed dairy products more than twice a week, 33.1% were men and 31.1% were women. Of the 180 (28.3%) participants who consumed dairy products daily, 25% were female, while 38.1% were male. This difference in dairy preference between male and female participants was statistically significant with a p-value of 0.004 (Table 3).
Of the 281 (44.2%) participants who preferred junk food (high-energy, low-nutrient, and/or fat) more than twice a week, 45.2% were women, while 41.2% were men. This difference was not statistically significant with a p-value of 0.763 (Figure 1).
In this study, of the 247 (38.8%) participants who preferred to eat fast food, 37.6% were female, while 42.5% were male. Of the 213 (33.5%) who prefer sweets (candies/chocolate), 37.2% were women, while only 22.5% were men. This gender difference in fast food preference was found to be statistically significant with a p-value of 0.001 (Figure 2).
In the current study, of the 243 (42%) participants who spent 30 minutes to one hour exercising daily, 43.4% were women, while 37.4% were men. Of the 133 (23%) who spent one to two hours a day exercising, 23.6% were women and 20.9% were men. This gender difference was found to be statistically significant with a p-value of 0.003. Of the 208 (35.9%) participants who preferred walking as their main form of exercise, 40.2% were female and 22.3% were male. This difference was found to be statistically significant with a p-value <0.0001.
In the current study, of the 309 (48.6%) participants who played badminton, 56.1% were female and 26.2% were male. Of the 151 (23.7%) those who did not play any of the following outdoor games, 25.4% were female, while 18.8% were male. This difference in their gaming habits was found to be statistically significant with a p-value <0.0001 (Table 4).
Discussion
In the current study, of the 636 students, the majority (83.1%) were in the age group of 15 to 17 years. Most of the participants belonged to the early adolescent age group. The average age of the participants was 17.6±1.22 years. In the current study, the majority (74.8%) of participants were female and 25.2% were male. These findings were in contrast to the study conducted by Elsabagh et al. [4], where 66% of the participants were aged between 19-21 years and 34% were younger than 19 years, with a mean age of 19.26±1.17 years.
In the current study, the maximum number (60.5%) of the participants belonged to the upper middle socio-economic class, while in the study by Kulkarni [19], 70% of the youth belonged to the higher socio-economic status according to the modified Prashad classification, which was almost similar to the findings our studies.
In the current study, of the 66.7% of participants who always ate breakfast regularly, 68.8% were male and 66.0% were female. This finding shows that an almost equal proportion of women and men always consumed breakfast. This finding was inconsistent with the study by Musaiger et al. [20], where 56.7% of men ate breakfast regularly compared to 47.6% of women. Similarly, in a study conducted by Kulkarni [ 19 ], the habit of skipping breakfast was more common among females (37.09%) compared to males (24.14%).
In the current study, of the 54.9% of participants who had >2 meals per day, 54.4% were female, while 56.2% were male. Here 45.1% of them had <2 meals/day, of which 45.6% were women and only 43.8% were men; while in the study by Ganesan et al. [1], 94.7% of women had more than two meals per day while 90.6% of men had less than two meals per day, which was contrary to the findings of our study.
In the current study, 37.3% of participants ate green leafy vegetables daily, of which 39.3% were women, while only 31.2% were men. Of the 50.3% of participants who ate green leafy vegetables more than twice a week, 60% were men, while 47% were women. Likewise, in a study by Musaiger et al. [20], 51.9% of women ate vegetables more than four times per week, compared to 40.4% of male participants. In a study by Ganesan et al. [1], 36.2% of male participants ate green leafy vegetables compared to 33.5% of female participants, which did not agree with the findings of our study, where it was evident that more women consumed green leafy vegetables.
Of the 31.6% of total participants who consumed dairy products more than twice a week, 33.1% were men, while 31.1% were women. Of the 28.3% of participants who consumed dairy products daily, 25% were women, while 38.1% were men (p-value 0.004). This difference is mainly due to cultural influences; while in the study of Musaiger et al. [20], 75.3% of male participants consumed dairy products more than four times per week compared to 58.3% of female participants. This finding was in contrast to the findings of our study.
In this study, more men preferred to eat fast food than women. In a study by Musaiger et al. [20], more women (90.4%) consume fast food compared to 80.9% of men. Similarly, in a study conducted by Kulkarni [19], 46.5% of men consumed fast food more than five times a week compared to women (37.1%). The higher consumption of unhealthy food by men could be attributed to men receiving pocket money more often. In a study by Ganesan et al. [1], 64% of women prefer to eat fast food compared to 54.8% of men. This finding was in contrast to the findings of our study. Of the 33.5% who preferred sweets (candies/chocolate), 37.2% were women, while only 22.5% were men. Similarly, in the study by Musaiger et al. [20], 85% of women prefer sugary canned drinks compared to 70.2% of men, and 65.2% of women prefer sweets compared to 64% of men. Therefore, this finding was also similar to the findings of our study, where more women had a greater preference for a variety of unhealthy foods.
In the current study, of the 42% of participants who spent 30 minutes to one hour exercising daily, 43.4% were female, while 37.4% were male (p-value 0.003). Of the 23% who spent one to two hours a day exercising, 23.6% were women and 20.9% were men. In the study by Evangeline et al. [21], 97.6% of men spend more time on exercise compared to 2.4% of women, which is in contrast to the results of our study.
Of the 35.9% of participants who prefer walking as their main form of exercise, 40.2% were women and only 22.3% were men; while, in the study by Evangeline et al. [21], 97.6% of men prefer walking as their main form of exercise compared to 2.4% of women, which is in contrast to the findings of our study.
Of the 23.7% who did not play any of the following outdoor games, 25.4% were women and 18.8% were men; while, in the study by Evangeline et al. [ 21 ], 97.6% of males were involved in outdoor games compared to 2.4% of females, which contradicts the findings of our study. In the current study, women are less involved in outdoor games. This can be attributed to the fact that women are more conservative and are more involved in household chores than men.
Our study has several limitations. First, the instrument used to assess health-related lifestyle and health risk behaviors was a self-administered questionnaire; therefore, a social desirability bias may have occurred. Second, since this study was conducted in an educational institution, it may not be representative of the entire community. Young people who left school missed participation in the research. Finally, being a cross-sectional study, it limits the temporal association of risk factors with lifestyle behaviors.
Conclusions
The main findings of this study showed that most young people follow a proper meal routine and engage in regular physical exercise. However, compared to eating junk food, the participants consumed much less green leafy vegetables. This would prove harmful to their health. A healthy lifestyle is very important to promote good health. Since young people play an important role in developing and shaping healthy lifestyles and behaviors, it is very important that healthy behaviors are promoted from an early age.
After understanding the findings of the study, it is recommended that young people increase their consumption of green leafy vegetables. Since there has been an increased consumption of fast food by the youth, most likely due to the easily accessible fast food centers located near the university campus, therefore, the sale of fast food should be banned inside the university campus and should be replaced with a variety of healthier and tastier foods in canteen of the faculty. This needs to be done in order to promote healthy eating habits. Together with the teaching institute, this study could be conducted at the community level to better assess the lifestyle habits of non-college youth.
