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ASSESSMENT OF DIETARY HABITS AND LIFESTYLE OF THE MEDICAL STUDENTS OF AGARTALA GOVERNMENT MEDICAL COLLEGE

INTRODUCTION: Medical students represent a significant community investment and promoting their health preserves this investment. This study aims assessing the dietary habits and risky lifestyle behavior among the MBBS students. MATERIALS AND METHOD: A cross-sectional study was conducted among MBBS students of all four professional years of Agartala Government Medical College, Tripura, selecting in total 200 students (50 students from each year) through stratified random sampling method. Data was collected via a self-administered questionnaire and analyzed on SPSS (version 21) data sheet. RESULTS: The study population constitutes 64% male and 36% female students with mean age 20.77±1.18 years. The mean BMI for males was 22.7±2.98 and for females 21.9±3.25, whereas 18.5% of all respondents were overweight. 11% of study population used to take food away from home/ mess more than 5 times a week. Also 69.5% of all students and 86.5% of the overweight students take junk food more than 5 times a week; about 2.5% students were smokers and 6.5% of students take alcohol. CONCLUSION: This study showed that more consumption of fast food and fatty food, academic stress and more prevalence to Pre-hypertension are the major lifestyle risky behavior among the MBBS students of this institute.

Adoption of poor health behaviors during young adulthood can increase the risk of several chronic diseases including obesity, type 2 diabetes, cardiovascular disease, and bone or joint complications. 7 This suggests that the period between the end of high school and the end of college is a critical time to intervene and educate young adults on the importance of developing and maintaining healthy behaviors. 8 The university and college arenas represent the final opportunity for the health and nutrition education of a large number of students from the educator's perspective. A number of jurisdictions have attempted to undertake preventive programs to encourage physician health. 9,10,11 In addition, several medical schools have recognized that prevention of physician health problems should begin in the medical school and medical students should be given information and provided with tools to maintain good health along with their clinical studies. 12,13 Considering above viewpoints, this study was carried to assess the dietary habits and lifestyle behavior among the MBBS students of Agartala Government Medical College, in order to contribute to the development of health promotion programs designed specifically for them.

MATERIALS AND METHODS:
This cross-sectional epidemiological study was conducted from 28 th June to 26 th July 2012 on 200 MBBS students to study the nutritional assessment of medical students. Using a stratified random sampling, 50 students were randomly selected from each year as strata. Only those students (male and female) were selected who gave the consent to participate in the study. Data was collected by a team of 18 MBBS students of 6 th semesters posted in the department of Community medicine.
Minimum requirement of sample size for the study is 100 MBBS students from Agartala Govt. Medical College, Agartala. Annual intake in AGMC, Agartala is 100 students and we take the fifty students form each year for our study. Our study target was 200 students for more precise information regarding our objectives and equal distribution for each stratum.
A questionnaire was supplied to the students. Both, verbal and written consents were taken before including a student in the study. Strict confidentiality was maintained about the analyzed data. After filling up the questionnaire, students were examined by research group for height and weight. A general physical examination was also done to find out any underlying disease.
The questionnaire consisted of three different types of questions. The first group of questions was meant to calculate the daily calories intake. Students were asked to recall the food items and their amounts consumed in last 24 hours. The food items and their amounts were compared with the standard calorific value chart published by the National Institute of Nutrition. As medical students constitute sedentary worker group, their daily calories intake was compared with the standard intake for this group and inferences were made.
The second group included questions on general food habits of medical students. Students were asked to report the food items they consumed generally and their frequency of consumption in a week. The third group of questions was meant to assess lifestyle of the students. Students were asked whether they did exercise or not and the duration of exercise in a week. This was compared with World Health Organization guidelines which emphasize on moderate level exercise for at least 150 minutes per week. Students were also asked about other aspects of lifestyle like sleep, outing, computer usage, religious activities and tobacco and alcohol consumption.

Materials Used:
  2 It is also found that out of the total 200 students 12% were underweight, 69.5% healthy and 18.5% were overweight according to their BMI status as showed in Table 2. Table 3 shows the dietary habits of the students according to their BMI status. It was found that out of those students who had healthy weight, 87.8% of them took meal away from home <5 times a week and 10. 8% of overweight students took meal away from home >5 times a week. 75.5% of all the students took fruits and vegetables >5 times a week which is a good habit among the students. But 43.5% of the students have been observed to take fatty foods (e. g., fatty meat, cheese, fried food, butter, whole milk, ice cream or egg etc.) and 69. 5% of the students to take junk foods (e. g. samosa, puri, burger, pizza, sweets etc.) ≥5 time a week; whereas 94% of them were taking supplementary vitamins and minerals other than their daily routine food.
Various lifestyle habits have been shown on Table 4 according to the BMI status of the students, which reveals 125 out of 200 students were engaged in any or other sports, fitness or recreational activities. Most of them (101 out of 200) took sleep 7 to 8 hours a day, which is adequate. Also, 139 participants reported use of computer and 132 students watched television 1 hour or less in a day. Out of total 200 participants, 58, 53 and 36 students reported studying 1 hour or less, 2 hours and 3 hours a day respectively. Similarly 60, 43 and 46 students out of the total 200 mentioned hours spend in shopping by them is 1 hour or less, 1 to 2 hours and 2 to 4 hours a day respectively.
Out of the 200 participants 5 mentioned about smoking or taking tobacco, whereas 13 mentioned taking alcohol.

DISCUSSION:
Our study reveals that 18.5% students (n=37) are overweight (21.1% male respondents and 13.9% female respondents). According to our study 12% students are under weight and among the underweight students in this study 10.2% are male and 15.3% female. We have also seen that males are more (21.1%) overweight than the females (13.9%). In our study 75.5% of the study subjects have taken fruits and green vegetables more than 5 times in a week. It has also been found that 43.5% of all students (48.6% of overweight students) take fatty foods more than 5 times in a week, somewhat higher by normal weight students (41%). Junk foods are taken by 69.5% of total students and by 86.5% overweight students as compared to 66.9% normal weight students >5 times a week.
Approximately 2.5% are smokers in our study population and 6.5% students take alcohol. Whereas, only 62.5% students are found to be engaged with regular physical exercise and only 19.5% students have slept 8 hours or more in a day.
Our study findings are more or less similar to the findings of the study conducted by Gopalakrishnan S et al 14 where 21.1% of the total respondents were overweight and 14.8% were underweight. A higher proportion of smokers was found in their study which is 14%, as compared to our present study.
In a similar study conducted by Anne O. Carter1 et al, 15 they found that 14% of all students were underweight. In their study also they showed that males were likely to be more obese than female students (59.5% vs. 40.5%), which is consistent with our current study results. Smoking was reported among 3% of the students, almost similar to our study. Shaimaa B. Abdelaziz et al 16 in a similar study showed that 30.5% of their study subjects consumed fruits and vegetables more than 5 times a week, which is quite less than our study findings. But in contrast to our study results, 74.6% of their study subjects took fatty foods more than 5 times a week. It may be due to difference in the nutritional pattern of our country and the gulf countries. In their study, they have also found among their study participants 10% were smokers and 25.3% were taking alcohol occasionally, which is quite higher than what we have found in the present study.
A possible explanation for the findings can be cultural variation between the countries. Shaimaa B. Abdelaziz et al 16 in their study have also found that 37.6% of the students used to take sleep 8 hours or more in a day which is quite less in case of our study participants, This may be due to the busy schedules of the students here.
Results similar to our study regarding regular physical exercise and alcohol consumption by the medical students were also shown by Kurubaran Ganasegeran et al 17 and Mahasti Alizadeh et al, 18 in their respective studies.

Variables
Male (