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1 Česká kinantropologie 2014, vol. 18, no. 3, p The relationship between lifestyle change of undergraduates and the incidence of overweight and obesity* Alena Buková, Klaudia Zusková, Ivan Uher, Mirianna Brtková & Rastislav FeČ Pavol Jozef Šafárik University in Košice, Institute of Physical Education and Sport, Slovakia Abstract Addressing the problem of obesity requires a complex holistic approach, respecting its biological, psycho-social and health-related elements. Only 2 5% of all cases of overweight or obesity arise from objective medical reasons. The others are clearly a result of inappropriate lifestyle. The transition from secondary school to university represents one of the milestones for lifestyle changes in adolescents. In our research, which is part of the VEGA grant Selected obesity risk factors and their physical prevention, No. 1/1343/12, we focused on the prevalence of overweight and obesity in male and female undergraduates, with respect on their study programme, lifestyle satisfaction and physical activity. We investigated overweight and obesity using the Body Mass Index (BMI) method. The results obtained, via the questionnaire method, from a sample of 939 female and 691 male students of two universities showed negative correlation between increased BMI values and undergraduate lifestyle satisfaction. The negative relation with physical activity, particularly with doing exercise and sports, was not significant. Diet, physical activity and sleep regime are reported to be the most frequent items that undergraduates would like to change to live a healthier lifestyle. Key words: adolescents, Body mass index (BMI), physical activity, undergraduates, type of higher education, satisfaction, lifestyle. Introduction Lifestyle encompasses the attribute of individuality, but it is based on the way of life that reflects the specifics of relationship and level of individualities living in a community. It reflects the values and interests of the individual (Hodaň, 2005). At the turn of the millennium, obesity has become the most common metabolic disease, due to changes in life conditions and lifestyle (Hainer et al., 2004). The seriousness of the present state has also been pointed out by WHO (1). The prevalence of obesity has doubled after year In year 2008, 1.5 billion adults (over 20 years of age) were ˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉˉ * The research is part of the VEGA 1/1343/12 grant Selected obesity risk factors and physical prevention. 57

2 reported overweight, of which 200 mil. men and 300 mil. women suffered from obesity. 65% of the world s population live in countries where overweight and obesity cause more deaths than underweight. It is alarming that in 2010 overweight was identified in more than 43 mil. children under 5. The national prevalence of obesity is monitored using data from the National Health and Nutrition Examination Survey. Obesity among adolescents aged increased from 5.0 % to 18.4 % during the periods since and (Fryar et al., 2012). WHO (2) further draws attention to the decrease in traditional risk factors such as hygiene, malnutrition and water, whereas there is a sharp increase in risks like tobacco followed by lack of exercise and overweight. Thus, WHO points to the need to prevent overweight and obesity. Addressing the problem of obesity requires a comprehensive holistic approach that will respect, and take into consideration their biological, psycho-social and health-related aspects. A fundamental remedy for this state appears to be increasing the volume of regular physical activity (PA), and establishing an active healthy lifestyle, particularly among children and youth (Bouchard et al., 2006). Over the last two decades, a decline in carrying out PA has been documented, regardless of gender and age (Bunc, 2008, 2010; Pullmannová & Švický, 2012; Streštíková, 2012). Brtková et al. (1992, 2008) points to the negative trends in the lifestyle of undergraduates, namely a decreased amount of hours devoted to PA, increase in the proportion of body fat and decrease in their functional ability. The impact of intrapersonal and interpersonal characteristics on healthy lifestyle, health-related behaviour, as well as risk-taking behaviour of adolescents is reflected in the current models of health (Neyer & Lehnart, 2006). Family influence on human psyche is strong. It stimulates formation of one s personality in a positive, but attenuating way. (Határ & Lohinová, 2005). Whether the parents did, or still do sports, plays an important role in creating the lifestyle of children and youth, in terms of the conative aspect of their attitude towards sporting activities (Medeková, 2006; Zusková, 2006). Exercise as a form of PA, has an effect not only on weight reduction, but also on improving many psychical symptoms, such as helping depression, reducing anxiety, increasing self-esteem and positive reinforcement of the psyche in coping with stress (Cepková, 2011; Křivohlavý, 2009). In a research carried out on undergraduates (Zusková et al., 2012), significant correlation had been found between increased BMI values and the reported reasons for participation in a weight-loss program, and those were body shaping and improving lifestyle. Hošek (2007), based on theoretical analysis, refers to the hypothetical relationship between psycho-social functions of PA and the quality of life. The first area involved, is affiliation and socialisation, the second is strengthening natural and cultural unity of the human and the environment; third comes the area of entertainment. Here it should be pointed out that in the long term, for maintaining one s sporting activity (from a more complex prospective), health is not number one motivating factor (Stelter, 2005). The study by Stempelová & Topoľská (2010) shows, that the respondents have very low awareness of responsibility for their health, and they are unable to properly interiorise their healthy lifestyle knowledge, even if it is sufficiently extensive. The observed time-scheduling of activities refers to their lack of capacity in making better use of leisure time for health there is obvious negligence towards exercise, sports, healthy diet, rest and sleep at the expense of labour. 58

3 Relationship between physical activity and subjective well-being in undergraduates was studied by Pašková (2010). Dependence has been reported between the respondents level of sporting activity and the frequency of experiencing particular emotions, as well as life satisfaction. Valois et al. (2004), in their American study also confirmed the link between perceived life satisfaction, as according Brief Multidimensional Student Life Satisfaction Scale (BMSLSS), and PA-related behaviour (sports, exercise and physical education) in adolescents. Gajdošová & Orosová (2012) point to conscientiousness as an important personality-related factor in relation to the frequency of physical activity. The period of late-adolescence, during their transition from secondary school to college, represents one of the milestones in the changing lifestyle of adolescents. Eliminating the trend of prevailing occurence of overweight and obesity is necessary, not only in terms of quality of life, but also as a preventive measure. A more interdisciplinary approach can help to identify the determining interaction between PA and biopsycho-social factors in undergraduates with overweight and obesity. Aim Via an interdisciplinary approach, reveal the relationship between overweight (obesity), physical activity and lifestyle satisfaction of adolescents during their transition from secondary school to college, and thus point out the possibilities of preventing obesity. Methods The cross-sectional research group consisted of first-year undergraduates from two different universities, humanities and natural sciences-oriented and technical-oriented. The number of women was 939, with the average age of (sd = 2.8), and the number of men was 691, average age of (sd = 3.6). Data were obtained using the questionnaire method and via somatic measurements of body height (cm), weight (kg) using an anthropometer and OMRON Body Composition Monitor BF551 scale, from which Body Mass Index (BMI) was calculated. BMI values were categorized into levels according WHO (< 18.5 underweight, 18.5 to optimum weight, 25 to overweight, 30 to st grade obesity, nd grade obesity, > 40 3rd grade obesity). The questionnaire was completed by students in September 2012, the beginning of winter term. The following questions were chosen from the questionnaire battery: Are you satisfied with your lifestyle? (7-point scale), What would you like to change on your lifestyle? (semi-closed question) and Do your parents keep principles of a healthy lifestyle? (closed question), Have you been regularly exercising or doing sports in the past 6 months? (closed question). The data were processed using STATISTICA 6.0 programme. In addition to the basic mathematical-statistic characteristics, as an indicator we also used standard deviation, the Mann-Whitney U-test for comparing data across gender, the Spearman correlation and the Chi-quadrat. Statistical significance of the results was determined at α <

4 Results BMI N = 939 FACULTY Table 1 BMI levels in the female students group LF PF FF PrF FVS HF BER SJF FU EKF SVF LF FEI Total Under weight (n) % Normal range (n) % Over weight (n) % Obesity (n) % Total (n) % Legend: LF Fac. of Medicine, PF Fac. of Natur. Sciences, FF Philosoph. Fac., PrF Fac. of Law, FVS Fac. of Public Admin., HF Fac. of Metallurgy, BER Fac. of Mining, Ecology, Process contr. & Geotechnol., SJF Fac. of Mechanical Engin., FU Fac. of Arts, EKF Fac. of Economics, SVF Fac. of Civil Engin., LF Fac. of Aviation, FEI Fac. of Electr. Engin. & IT. Tables 1 and 2 show the representation of gender at selected faculties of universities, and their different levels of BMI. BMI values, compared to other more exact methods, indicate the risk of obesity in individuals. Comparison of the group of 939 female and 691 male undergraduates indicated no significant differences in average BMI values measured in women (standard deviation 3.76) compared to men (standard deviation 3.86). A total of 68% females (Table 1) and 61% male students (Table 2) remain within standard values, underweight was reported in 14% of female and 3% of male students. From among female students, 14% are classified overweight and 3% of them are obese. In the group of male students, 29.5% are overweight and 4.92% suffer from obesity. It is obvious that the occurence of obesity is comparable in both groups, while underweight and overweight vary. More critically increased values were found in the female group. When assessing overweight, we have to take into account that sporty individuals with above-average muscle structure, which is more typical for men, also tend to be included in the overweight group. We also tend to believe that active weight modification is more widespread with women. 60

5 BMI N = 691 FACULTY Table 2 BMI levels in the male students group LF PF FF PRF FVS HF BER SjF FU EKF SVF LF FEI Total Under weight (n) % Normal range (n) % Over weight (n) % Obesity (n) % Total (n) % Legend: see Table 1 Both male and female students expressed their lifestyle satisfaction (Table 3) on a 7-degree scale alike, without any statistically significant difference. Women achieved an average gross score of 4.29 (standard deviation 1.17) and the males scored a gross average of 4.77 (standard deviation 1.31). Overall, we can say that a mostly positive assessment of their lifestyle prevails among male students, although it is 2 degrees short of a full consent. That represents a certain reserve in the ability to increase their satisfaction. This question is partly answered by the figures 1 and 2. The negative relationship between lifestyle satisfaction and increased BMI values was confirmed significant in both female (Spearman R = 0.149) and male (Spearman R = 0.146) student groups. Table 3 Degree of lifestyle satisfaction in male and female students 1 (not at all) Scale of lifestyle satisfaction (absolutely yes) Gender F M F M F M F M F M F M F M Number (n) Number % Legend: F females, M males 61

6 In terms of lifestyle changes (Fig. 1), in females physical activity is ranking first (68%), followed by diet (55%) and their drink regime ranking third (40%). Similarly, in males (Fig. 1) diet is ranking first (44%), followed by physical activity (40%) and sleep (30%). As much as 32% of women respondents considered changes in their sleep regime. Addictive substances did not prove to be key factors requiring change. Diet, physical activity, sleep and drink regime are presented as inadequate factors of lifestyle in adolescents at the start of their university studies. In terms of compliance with healthy living standards at their parents, we found a similar opinion in both male and female students. The initial answer options Yes, Mostly Yes, No, Mostly No were eventually merged into two polarities of YES and NO. In the group of males as many as 275 reported their positive attitude to the parents lifestyle, which makes up 34%, while in women it was 40% (475 respondents). A mostly negative opinion of their parents lifestyle was expressed by 60% of female students (706 respondents) and 66% males (533 respondents). It overall implies that undergraduates of both sexes evaluate the lifestyle of their parents mostly negatively. Figure 1 What male and female student would like to change about their lifestyle 62

7 Table 4 Relationship between BMI levels and frequency of exercise and sports in students Frequency of exercise and sport during the week don t do any irregularly regularly 1x regularly 2x regularly 3x Total BMI level Gender M F M F M F M F M F M F Underweight (n) % Standard (n) % Overweight (n) % Obesity (n) % Total (n) % Legend: M men, F females Following complex processing of results, there are no statistically significant differences between male and female students in the weekly frequency of doing sports and exercise in the last half year. Compared to 30% of males exercising regularly 3-times a week, only 11% of female students do so. Irregular activity is reported by 56% females, but only 32% male students. The contingency tables express the link between doing exercise, sports and the BMI values in female and male undergraduates (Table 4). The tables show obvious tendency towards irregular exercise in overweight and obese male and female undergraduates. As many as 37% female and 18% male undergraduates, with a BMI index falling within the standard interval, do sports or exercise only irregularly. We confirmed no significant relationship between doing exercise, sports and the BMI index. Discussion Our results of BMI mean values of in female (standard deviation 3.76) and in male students (standard deviation 3.86) largely correspond with the research results at Slovak university students by Hrčka et al. (2011). Average values were in women and in men. In research by Žídek (2009), the average index was in men, and it was 20.8 in women according Bartík et al. (2004). Our BMI results correspond with the findings by Ležovič et al. (2010), Štovčíková (2010), in favour of higher values in men. In the research, we found a significantly larger representation of males in the range of overweight and obesity, whereas there was a higher prevalence of underweight females. A critical incidence of underweight female undergraduates was also reported by Gádošiová (2003), who further pointed out the potential impact of poor eating 63

8 habits as well as media influence via broadcasting latest fashion trends as for personal appearance. Moreover, we tend to believe that active modification of weight is more widespread among women. Similarly, the results by Burke (2009) suggest a lower proportion of overweight among female students. When assessing the incidence of overweight and class I obesity, we have to take into account though the fact that this group usually includes sporting individuals with above-average musculature, and that is something more typical for men. It is important to follow the BMI trend in undergraduates because of its increased values in the upper grades (Bobrík & Benko, 2006), and its increasing age-related trend in both genders (Ležovič et al., 2010; Zusková et al., 2012). Lifestyle changes significantly at entering university. Adolescents become independent. Students become responsible for their daily routine, diet and content of their time schedule. Negative correlation between lifetime satisfaction and higher BMI values points to the possibility to address this issue via implementing more physical activity in the form of sports. This fact is further reflected in the variables physical activity and diet, and requires changes in lifestyle. A significant fact seems to be the need for sleep regime change, obviously a demand associated with the time spent studying, and social life causing further deficit. Inactivity of the people is like a vicious circle in their individual development, and its consequences are transferred further to the next generations. In this context, Antala (2012) refers to the fact that physically inactive children run into a greater risk of becoming obese and ill. The result is 5.3 million premature deaths per year worldwide. The circle is coming to a full thanks to the children of inactive parents who are much less likely to be motivated to become physically active, which, as a result, can on average shorten their life by 5 years. The global project Designed to move aims to support physical activity by children, the youth and adults. Physical activity is considered an important investment into the future individually, but also at a national level. Inactivity causes 9% (range ) of premature mortality, or more than 5.3 million of the 57 million deaths that occurred worldwide in If inactivity were not eliminated, but decreased instead by 10% or 25%, more than and more than 1.3 million deaths, respectively, could be averted every year. We estimate that elimination of physical inactivity would increase the life expectancy of the world s population by 0.68 (range ) years (Lee et al., 2012). Although no significant relationship between doing exercise or sports, and the BMI index was proved, the results falling within the range of standard BMI, frequency of exercise and doing sports for both sexes indicate the highest representation of those doing sports or exercise regularly, 3-times a week. Moreover, the highest representation of those considering their frequency of exercise and doing sports irregular in this range, may also include the ones that vary the number of training units within the week. Conclusion The prevalence of obesity in both male and female undergraduate groups in our research is comparable, while underweight and overweight vary. More critically increased bodyweight values occured in men, opposed to a greater number of underweight females. Negative correlation between lifestyle satisfaction and increased BMI values was confirmed significantly in both male and female undergraduate groups. Overall, though, we can say that a mostly positive assessment of lifestyle prevails among the students, although it is 2 degrees short of a full consent. Both genders of undergraduates evaluate 64

9 the lifestyle of their parents mostly negatively. We confirmed no significant relationship between doing exercise or sports, and lower BMI values. What we further found interesting was the increased incidence of both male and female students with BMI index values within the standard, in relation to the irregularity of exercise. Monitoring BMI should not be an end in itself. BMI should be monitored in undergraduates with respect to their entering university, and further during university study intervention and the associated lifestyle. Lack of physical activity, dissatisfaction with the diet and the sleep regime provide space for improving a health-related lifestyle. Also, their negative assessment of the lifestyle of parents serves as a stimulus towards introducing preventive measures in the adult population, who represent, or will represent, the values for their children s health. As Valois et al. (2004) pointed out, future research should consider measures of life satisfaction as a component of comprehensive assessments of adolescent physical activity behaviours in fieldwork, research, and program evaluation. References ANTALA, B. (2013) Stvorený k pohybu. Phys. Educ. Sport, 23(1), p BARTÍK, P., ADAMČÁK, Š. & ROZIM, R. (2004) Hodnotenie telesnej zdatnosti a pohybovej výkonnosti študentiek PF UMB v Banskej Bystrici. Banská Bystrica: Univerzita Mateja Bela v Banskej Bystrici. BOBRÍK, M. & BENKO, Ľ. (2006) Vzťah medzi somatometrickými ukazovateľmi a telesnou zdatnosťou u poslucháčov FCHPT STU v rokoch In: Pohyb a zdravie 3. Ročník (p ). Trenčín: Trenčianska univerzita A. Dubčeka v Trenčíne. BRTKOVÁ, M. et al. (1992) Relationships between somatic parameters, physical fitness and plasma lipids and lipoproteins in university students. VI. ICHPER European Congress, Prague, Czechoslovakia, July Proceedings Physical Activity for Better Life Style in a New Europe (p ). Prague: Faculty of Physical Education and Sports, Charles University. BRTKOVÁ, M. et al. (2008) Lipids profile of university undergraduate students with various levels of physical activity. 5th International scientific conference on kinesiology: kinesiology research trends and applications: proceedings book: Zagreb, Croatia, 2008 (p ). Zagreb: Faculty of Kinesiology, University of Zagreb. BOUCHARD, C. et al. (2006) Physical activity and health. Champaign, IL: Human Kinetics. BUNC, V. (2008) Nadváha a obezita dětí životní styl jako příčina a dủsledek. Česká kinantropologie, 12(3), p BUNC, V. (2010). Aktivní styl jako prostředek ovlivnení nadváhy a obezity dětí chlapcủ. Česká kinantropologie, 14(3), p BURKE, J. D. et al. (2009) The University of New Hampsire s Young Adult Health risk Screening Initiative. Journal of American Dietetic Association, 109(10), p CEPKOVÁ, A. (2011) Physical fitness and mental health of students of university. Present and future research in the science of human movement: 12th international scientific conference of sport kinetics 2011 (p ). Cracow: University School of Physical Education. FRYAR, CH. D., CARROLL, M. D. & OGDEN, C. L. (2012) Prevalence of Obesity Among Children and Adolescents: US, Trends Through Retrieved from: GAJDOŠOVÁ, B. & OROSOVÁ, O. (2012) Intrapersonálne faktory a fyzická aktivita pubescentov. In: Rekreačný sport, zdravie, kvalita života (p ). Košice: UPJŠ. GÁDOŠIOVÁ, D. (2003) Stav telesnej zdatnosti študentov EU v Bratislave. In: Telesná výchova, šport, výskum na univerzitách (p ). Bratislava: STU v Bratislave. HAINER, V. et al. (2004) Základy klinické obezitologie. Praha: Grada Publishing. HATÁR, C. & LOHINOVÁ, N. (2005) Vplyv rodiny na deviantné správanie detí a mládeže. Rodina na prelome tisícročia zborník príspevkov z medzinárodnej konferencie (p ). Nitra: UKF. 65

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