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Nutr J. 2008; 7: 32. Published online 2008 October 30. doi: 10.1186/1475-2891-7-32. | PMCID: PMC2584644 |
Copyright © 2008 Yahia et al; licensee BioMed Central Ltd. Eating habits and obesity among Lebanese university students Najat Yahia, 1 Alice Achkar, 2 Abbass Abdallah, 2 and Sandra Rizk  21Department of Human Environmental Studies, Central Michigan University, USA 2Natural Science Division, Lebanese American University, Beirut, Lebanon Received April 1, 2008; Accepted October 30, 2008. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License ( http://creativecommons.org/licenses/by/2.0), which
permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited. Background In the past year Lebanon has been experiencing a nutritional transition in food
choices from the typical Mediterranean diet to the fast food pattern. As a
consequence, the dietary habits of young adults have been affected; thus,
overweight and obesity are increasingly being observed among the young. The
purpose of this study is to assess the prevalence of overweight and obesity on a
sample of students from the Lebanese American University (in Beirut) and to
examine their eating habits. Methods A cross-sectional survey of 220 students (43.6% male and 56.4% female), aged 20
± 1.9 years, were chosen randomly from the Lebanese American University
(LAU) campus during the fall 2006 semester. Students were asked to fill out a
self-reported questionnaire that included questions on their eating, drinking and
smoking habits. Also, their weight, height, percentage body fat and body mass
index were measured. Body mass index (BMI) was used to assess students' weight
status. Statistical analyses were performed using the Statistical Package for
Social Sciences software (version 13.0) to determine overweight and obesity among
students and to categorize eating habits. Results This study showed that the majority of the students (64.7%) were of normal weight
(49% male students compared to 76.8% female students). The prevalence of
overweight and obesity was more common among male students compared to females
(37.5% and 12.5% vs. 13.6% and 3.2%, respectively). In contrast, 6.4% female
students were underweight as compared to 1% males. Eating habits of the students
showed that the majority (61.4%) reported taking meals regularly. Female students
showed healthier eating habits compared to male students in terms of daily
breakfast intake and meal frequency. 53.3% of female students reported eating
breakfast daily or three to four times per week compared to 52.1% of male
students. There was a significant gender difference in the frequency of meal
intake (P = 0.001). Intake of colored vegetables and fruits was common among
students. A total of 30.5% reported daily intake of colored vegetables with no
gender differences (31.5% females vs. 29.2% males). Alcohol intake and smoking
were not common among students. Conclusion In spite of the overall low prevalence of overweight and obesity in the studied
sample, results indicate that university students would possibly benefit from a
nutrition and health promotion program to reduce the tendency of overweight and
obesity, especially among male students, and to improve students' eating
habits. Lebanon has been experiencing a nutritional transition in food choices during the past
years from the typical Mediterranean diet into the fast food pattern [ 1]. Dietary habits of young adults are affected by the fast-food market. As a
consequence, overweight and obesity are increasingly observed among the young. Obesity
in combination with unhealthy life style, such as smoking and physical inactivity, may
increase the risk of chronic diseases. In this regard, nutritional knowledge may act as
a deterrent against fast-food trend. Thus, universities may contribute significantly in
reducing the prevalence of obesity among the young population through the promotion of
healthy eating habits. Universities may provide an ideal forum for reaching out to a
large number of young adults through nutrition education programs that may positively
influence students' eating habits by advocating for the adoption of healthy food
choices. The purpose of this study was to assess the prevalence of overweight and
obesity in a sample of students from the Lebanese American University and examine their
eating habits. Assessing students' weight status and eating habits will help health
educators to develop proper nutrition-related education programs that promote healthy
food choices and good eating habits. Design and sample The study design was a cross-sectional survey conducted at the Lebanese American
University (LAU) campus during the fall 2006 semester. A sample of 220 students
(43.6% male and 56.4% female), aged 20 ± 1.9 years participated in this
study. Students were recruited randomly by a trained student accompanied by an LAU
professor. The response rate among students was high. Students who agreed to
participate in this study were asked to sign a consent form according to Helsinki
declaration. Data Collection Data collection took place in two steps. The first step was to fill out the
questionnaire and the second step was to perform the anthropometric measurements.
Recruited students were asked to fill out a questionnaire related to their eating,
drinking and smoking habits. The questionnaire was adopted from a previously
published study where authors have standardized its use among university students [ 2]. Prior to questionnaire administration, students were informed by an LAU
professor about the study. They were given instructions on how to fill out the
questionnaire completely and truthfully. After filling out the questionnaire,
anthropometric measurements, such as weight and height, percentage body fat and body
mass index, were done. Weight, percentage body fat and body mass index measurements
were determined using Tanita scale body fat analyzer 300A (BF 300, courtesy of Abbott
Diagnostic Company, Lebanon). As fluctuations in body hydration status may affect
body composition results, conditions for Tanita scale measurements were taken in the
morning (at least three hours after waking up) when students were on an empty
bladder, not having exercise, food or drink for at least three hours before having
the measurements. Students were asked to wipe off the bottom of their feet before
stepping onto the measuring platform, since unclean foot pads may interfere with
conductivity. Height measurements were taken with a secured metal ruler. Students
were asked to take off their shoes for height measurements. Body mass index (BMI) was
used to assess students' weight status. According to guidelines stated by the
National Institutes of Health, weight status was classified into four categories:
underweight (BMI ≤ 18.5), normal weight (BMI between 18.5 –
24.9), overweight (BMI between 25–29.9), and obese (BMI ≥ 30) [ 3]. Normal range for percentage body fat was considered as follow:
10–20% for males and 20–30% for females. Data Analysis Statistical analyses were performed using the Statistical Package for Social Sciences
(version 13.0, SPSS, Inc) software. Analysis of variance (ANOVA) was used to examine
differences in the anthropometric characteristics of students. Results were expressed
as means ± SD (standard deviation). Parametric variables were analyzed using
students' t-test, while chi-squared analyses were conducted for
non-parametric variables. All reported P values were made on the basis of
2-sided tests and compared to a significance level of 5%; differences were considered
statistically significant at P < 0.05. Characteristics of the students' sample and BMI values Characteristics of the participated students are presented in Table 1. A total of 220 students (96 males and 124 females), with a mean age of 20
± 1.9 years, participated in this study. The average weight and height of
the participated students were 67.7± 15.8 kg and 168.0 ± 10.0 cm,
respectively. Mean BMI and percentage body fat were 23.6 ± 4.1 and 23.7
± 8.2, respectively. | Table 1Characteristics of the participants (means ± SD) |
Students' weight status based on BMI categories and percentage body fat The outcome of this study indicated that the majority of the students (64.7%) were of
normal weight (49% of the male students compared to 76.8% of the female students) as
indicated in Table 2. Based on BMI classification, the
prevalence of overweight and obesity was more common among male students compared to
females (37.5% and 12.5% vs. 13.6% and 3.2%, respectively). In contrast, 6.4% female
students were underweight as compared to 1.0% males. Students of normal weight had at
the same time normal percentage of body fat (14.4% males vs. 26.7% females).
Similarly, the obese male students had at the same time higher values of percentage
body fat (24.4%) while the overweight male students had a percentage body fat that
was slightly higher than the normal range (20.1%) (Table 3). In
the underweight category, female students also had a lower percentage of body fat
(16.9%) (Table 3). | Table 2Prevalence of obesity among students based on BMI by gender |
| Table 3Students' percentage body fat by gender |
Students' eating habits Eating habits of the students were compared by gender (Table 4). The majority (61.4%) reported taking meals regularly. Female students
showed healthier eating habits compared to male students in terms of breakfast intake
and meal frequency. 53.3% female students reported eating breakfast daily or three to
four times per week compared to 52.1% male students. There was a significant gender
difference in the frequency of meal intake (P = 0.001). The majority of students
(52.7%) reported eating two meals per day. Among females, 56.5% reported eating two
meals per day as compared to 47.9% males. Intake of colored vegetables and fruits was
common among students. A total of 30.5% of the students reported daily intake of
colored vegetables with no gender differences (31.5% females vs. 29.2% males). 27.3%
of the students reported daily intake of fruits. Male students tend to eat more
fruits daily as compared to females (29.2% vs. 25.8% respectively). Alcohol intake
was not common among students. 25.3% of the studied students did not consume alcohol
at all and the majority (57%) of students reported drinking alcohol rarely whereas
17.2% reported two/three times per week. The unhealthy eating practice was indicated
by the fact that the majority (57.3%) of the students reported eating fried food more
than three times per week. Among females, 54% reported eating fried food daily or
three to four times per week compared to 61.4% males. Daily intake of snacks apart
from regular meals was more common among females than males (55.6% vs. 50%
respectively). Eating daily with friends and family was common among students (42.7%)
with no differences in gender. Smoking was not common among students. 62.4% of the
students reported that they do not smoke, 7.2% were ex-smokers and 30.3% were current
smokers. | Table 4Student's response to questions related to their lifestyle practices including
eating habits, meal patterns, fruits and vegetables intake, fried food, alcohol
consumptions and smoking habit. |
The purpose of this study was to assess the prevalence of overweight and obesity and
examine eating habits in a sample of Lebanese University students. Body mass index was
used to assess weight status. Based on BMI classification of weight status, findings of
this study indicate that the majority of students were of normal weight. Normal weight
was more prevalent among females (76.8%) as compared to males (49%), whereas, overweight
and obesity were more common among male than female students. Students in the normal
weight category had at the same time normal values of percentage body fat. Prevalence of
overweight was 37.5% in males as compared to 13.6% in females. Obesity was more common
among male students than females in the studied population. A total of 12.5% of the
males were obese compared to 3.2% of the females. Moreover, obese students had at the
same time higher values of percentage body fat. The lower rate of obesity among female
students is expected since females are more cautious about their weight status than
males, due to society perceptions which encourage females to be slender. This assumption
was supported by the fact that only 1% of males were underweight as compared to 6.4% of
females in this studied sample. Obviously, pictures of movie stars and models in fashion
magazines and mass media have a strong impact on girls' body shape and image perception [ 4]. University girls see the shape and weight of fashion models as the ideal
body shape and figure to attain. Girls with such strong body weight perception can be at
risk of developing eating disorders [ 5]. Similar findings of prevalence of obesity among male university students
were reported in recent studies [ 6, 7]. In a study conducted among 749 students (68% females and 32% males)
recruited from the State University of the Basque Country, prevalence rate of overweight
and obesity was 25% in males compared to 13.9% in females [ 6]. Another study conducted among 989 medical students (527 men, 462 women) from
the University of Crete reported that approximately 40% male students and 23% female
students had BMI > 25 kg/m 2 [ 7]. High prevalence rate of overweight and obesity was also reported in a study
conducted in Kuwait University among 842 students [ 8], at 32% and 8.9%, respectively. In the United Arab Emirates, a
cross-sectional survey conducted among 300 male students reported that the prevalence
rate of obesity was 35.7% in males and this figure was higher than the rate in females [ 9]. In terms of eating habits, university students usually do not follow healthy
eating habits. The typical university student diet is high in fat and low in fruits and
vegetables [ 10]. Students often select fast food due to its palatability, availability and
convenience. A previous survey by the American Dietetic Association indicated that
obesity, or being severely overweight, is a fast-food related issue [ 11]. The Healthy people 2010 objectives include a focus on nutrition and obesity
prevention [ 12]. In this study, data analyses of students' eating habits revealed that the
majority of students eat meals regularly and eat breakfast daily or three to four times
per week. 52.7% of the students eat meals two times per day. However, there was a
significant gender difference in the frequency of meal intake in the studied sample
( P = 0.001). As expected, intake of colored vegetables and fruits was also
common among students. Alcohol intake and smoking were not common among students. The
majority of students believe that eating meat, vegetables and other foods will provide
them with a balanced diet. 77% male students and 73% female students in this study
agreed that it is important to eat a variety of foods to have a balanced and nutritious
diet. A study conducted at Midwestern University among 105 male and 181 female students,
reported that 94.4% of the students agreed that it is important to eat a variety of
foods for good health [ 13]. In another study, healthful diet was classified as a diet that included more
fruits and vegetables, and less fat [ 14]. Daily intake of snacks was reported by the majority of students. The
unhealthy eating habit of students was noticed in the intake of fried food (majority
reported eating fried food three or four times per 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. Improving students' knowledge about
nutrition and healthy eating habits may promote healthy body weight management among
students and reduce the prevalence of overweight and obesity. A recent study conducted
among college students reported that increased knowledge of dietary guidance,
Dietary Guidelines for Americans 2005, appeared to be positively related to
more healthy eating patterns thus the better eaters had a higher level of knowledge
about nutrition[ 15]. Therefore, developing nutrition education programs that promote healthy
eating habits for university students should be encouraged. Alcohol intake and smoking
were not common in our sample of students. National data on alcohol intake and the
prevalence of smoking among university students in Lebanon are limited. A previous study
conducted among 1850 Lebanese university students reported that the prevalence of
drinking alcohol was found to have increased through the 1990s. However, the author
stated that protective factors, such as belief in God (irrespective of the students'
religion), practice of faith, and family or peer negative attitudes towards excessive
drinking, were associated with less frequent experimentation with alcohol [ 16]. A previous study conducted among 2443 students from 13 public and private
schools in Greater Beirut reported that the prevalence rate of cigarette smoking was
2.5% [ 17]. In a recent study, namely the Lebanon Global Youth Tobacco Survey (GYTS),
conducted among 5035 students aged 13–15 years from 50 schools reported that
the prevalence rate of students who were current cigarette smokers was 8.6% and 33.9%
were current water-pipe smokers. The GYTS indicated that half of students who were
current smokers expressed their desire to stop smoking [ 18]. The findings of this study are limited by the use of a sample of students from just one
university which may not be a representative of all university students in Lebanon.
Furthermore, students attending the Lebanese American University are usually of high
socio-economic standards; therefore, samples from different universities may provide a
more inclusive picture of university students taking into consideration religion and
socio-economic status. However, baseline information about weight status and eating
habits among a sample of university students was certainly obtained from the present
study. Despite the low prevalence of overweight and obesity in the studied university students'
sample, results indicate that university students would benefit from a nutrition and
health promotion program to reduce the tendency of overweight and obesity among
students, particularly males, and to improve students' eating habits. The authors declare that they have no competing interests. NY carried out questionnaire design, manuscript preparation and total coordination of
the study. AA contributed to data analysis. AA contributed in the data collection and
data entry. SR was actively involved in study's implementation and total
coordination of study data collection and analysis. All authors read and approved the
final manuscript. No external funds. Authors funded this study. A special note of appreciation goes to Abbott Pharmaceutical company, namely Mrs.
Doris Salamoun: UPO-Lab Director Manager, Mrs. Myriam Daher: UPO-Assistant Manger,
Mrs. Zeina Oueidate: UPO-Marketing Supervisor and to all Lebanese American University
(LAU) students for their cooperation and to all LAU staff who helped in this
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