UNBALANCED NUTRITION - LEADING FACTOR OF EXCESSIVE BODY WEIGHT AND ARTERIAL HYPERTENSION OF MEDICAL STUDENTS

Full Text

Relevance.

Today, eating habits and the associated early onset of overweight is becoming an epidemic problem, as the World Health Organization notes in its report. Experts believe that none of the countries in the region, given the current dynamics, will be able to achieve a positive result in the fight against obesity by 2025.

A total of 55% of Russians of different ages have overweight. However, the majority consider their diet to be healthy - this contradicts official statistics, which indicates the illiteracy of the population in matters of nutrition. Nutritional misconceptions are defined by persistent eating disorders that lead to changes in food intake or digestion, physical or psychological dysfunction, manifested in various forms, such as underweight, overweight and obesity.

Eating behavior is a set of human habits associated with eating under normal and stressful conditions. Eating disorders usually begin during adolescence and early adulthood, during a life stage associated with stressful events, such as leaving home for educational institutions. It should also be noted that there is a trend towards an increase in the total academic load (mastering new disciplines, studying theoretical material, etc.), which requires perseverance for a long period of time, which entails skipping meals, followed by an excess of the energy value of the diet over daily energy costs due to increasing the amount of fats, proteins, easily digestible carbohydrates, sugar and salt.

The eating habits of students are of interest because the greatest increase in overweight and obesity occurs at ages 18–29, according to the Behavioral Risk Factors Surveillance System. Thus, studying the nutrition of students is essential to prevent diseases associated with eating habits in later life.

Target.

To study the prevalence of overweight and obesity among students of the Voronezh State Medical University. N. N. Burdenko by an objective assessment of the anthropometric indicators of students, followed by the calculation of BMI, measurement of blood pressure as a dependent factor on body weight, and analysis of the questionnaire "Attitude towards healthy eating" with the determination of the respondents' awareness of proper nutrition. Evaluate the relationship between nutrition, body weight and BP values.

Materials and methods.

The study was performed on the basis of the Voronezh State Medical University. N. N. Burdenko, which was attended by 162 student volunteers aged 18 to 25 years, among whom female prevailed (121 participants - 74.7%) over male (41 participants - 25.3%).

All respondents were asked to fill out an anonymous online questionnaire "Attitudes towards healthy eating", consisting of 21 questions to study participants' awareness of proper nutrition.

The research program, in addition to the survey, included the study of anthropometric indicators of physical development, determination of blood pressure, pulse and saturation. Height and weight were measured using a measuring tape and a scale, followed by a calculation of body mass index, which is weight in kilograms divided by the square of height in meters. Groups were formed according to BMI (WHO, 2004): underweight (BMI <18.5 kg/m²); normal (18.5–24.9 kg/m²); overweight (25.0–29.9 kg/m²) and obese (≥30 kg/m²). The body mass index is needed to assess the nutritional status of students.

Determination of heart rate and systemic blood pressure was carried out using an electronic tonometer in subjects according to the measurement rules: in a calm atmosphere and sitting position, on the left and right hand with two successive blood pressure recordings, the interval between which was 5 minutes. Based on the criteria for assessing the value of blood pressure, groups were also formed: with high normal blood pressure (130-139 mm Hg), AH of the 1st degree (140-159 mm Hg), AH of the 2nd degree (160- 179 mm Hg), 3rd degree hypertension (≥180 mm Hg).

Statistical analysis and processing of the data obtained were carried out at the Department of Medical Prevention during the autumn semester of 2022 using pivot tables in the Microsoft Excel system.

Results.

In the course of the work, it was found that the BMI is in the range from 15.6 to 36.2 kg / m², while the average value is normal and is 21.3 kg / m². However, a fifth of the surveyed have deviations towards overweight. After analyzing the data, we can draw the following conclusions that among 162 medical students, 32 people are overweight (19.8%), of which 2 people are obesity of the first degree (1.23%), 3 people are obesity of the second degree (1 .85%). It should be noted that 23 (14.2%) students were found to be underweight.

Similar descriptive activities were carried out with respect to students' blood pressure values. Among the participants in the study, the occurrence of SBP above 130 mm Hg. Art. was detected in 35 people (21.6%), of which 13 (8.02%) had high normal blood pressure, i.e. not exceeding 139 mm Hg. Art. The 1st degree AH group included 17 students (10.5%), whose blood pressure was in the range from 140 to 159 mm Hg. Art., and 5 others - in the group of hypertension of the 2nd degree (3.08%) with a pressure of 160 to 179 mm Hg. Art.

Compliance with the diet has a significant impact on the appearance of excess weight. Based on the statistical analysis of the survey “Attitude towards healthy eating”, it turned out that out of 162 respondents, 17.3% consider their current state of health to be poor, they often get sick, are discouraged and are not at all cheerful. Some of the respondents (33.5%) believe that proper nutrition is mainly eating high-quality and natural products, allowing the use of fatty and sweet foods.

The main principles of proper nutrition, which are observed by the majority of the surveyed, are: the use of raw vegetables and fruits that enhance intestinal motility and contain vitamins (66.7%); the use of soups and broths, tk. they contain substances ready for absorption (61.6%); do not overeat (49.1%); thoroughly chew food (42.1%). They never have breakfast - 13% of the respondents, the rest of the students eat tea (coffee), sandwiches and sweets (58.6%) for breakfast. 49.4% of students eat vegetables and fruits every day or every other day, 45.7% of respondents eat dairy or sour-milk products; the majority - 66.7% do not eat enough fish; never eat porridge - 13% of respondents; add salt to food - 38.9%; harmful foods are found in the diet of 96.3% of students. Their diet is not considered varied - 34% of respondents, the number of meals equal to 1-2 times a day, 32.7% of students of a medical institution. 19.8% of respondents do not strive to eat right. In their opinion, there are many reasons that interfere with observing the principles of a balanced diet: lack of time to prepare healthy food (66.7%); lack of money (43.2%); no motivation (27.2%).

Some students, based on the survey, currently have nutrition-related illnesses. The most common of them are: diseases of the digestive system (27.8%), obesity or overweight (17.3%). The study found 15 people (9.26%) who at this stage are both overweight and high blood pressure, which increases the risk of adverse complications in the future. Thus, comparing the obtained characteristics, the dynamics of blood pressure from BMI was confirmed. 

Discussion.

Disruption in the balance of eating behavior during study in the student period predisposes this age group to health problems in the future. Therefore, the main goal of a specific statistical review was to show current data on the prevalence of overweight associated with nutritional status and to identify the relationship of elevated blood pressure among students of VSMU. N. N. Burdenko. The advantage of the work lies in the high number of patients examined, which increases the accuracy of the results.

The systematic bias and limitation of the study is related to: first, response bias, there is potential for socially desirable feedback from participants - students may tend to underestimate symptoms; secondly, the influence of environmental factors on the objective measurement of blood pressure; third, the indicators in the current study were chosen based on similar studies using the same indicators. Although, as far as we know, there is no "gold standard" in relation to the assessment of eating behavior.

Summary of the main result of the study. The number of students with overweight and obesity out of 162 surveyed is 32 people (19.8%), which, according to the results of the survey, is associated with ignorance, lack of desire, time and financial component to lead a balanced and proper eating behavior. 19.8% of respondents do not make attempts to improve nutrition. 15 people (9.26%) are overweight and obese (≥25 kg/m²) with high SBP (≥130 mmHg), which indicates about the relationship between these factors.

Conclusion.

VSMU students N. N. Burdenko demonstrate inadequate eating habits associated with insufficient consumption of fruits, vegetables and fish in favor of high-calorie meals, sugary snacks and carbonated drinks.

Eating right in the age of information technology is difficult. The sharp increase in refined high-calorie products, their availability limited the motivation of students to choose food products in accordance with their usefulness.

Foods high in animal fat and simple carbohydrates have been shown to contribute to addiction-like deficits in brain reward function and can lead to overeating and obesity. And unbalanced nutrition, overweight, obesity, high blood pressure numbers are risk factors for the occurrence of chronic NCDs in students studying at V.I. N.N. Burdenko. Adopting proper eating behaviors and a healthy lifestyle is important for the people who will become future health workers, for their health and the health of future generations.

To solve this issue, it is necessary to carry out full-scale activities aimed at increasing knowledge in the field of healthy nutrition, encourage students to eat foods rich in protein, complex carbohydrates, vitamins and microelements, with sufficient fiber content in their diet. Starting now, the number of people suffering from chronic noncommunicable diseases will decrease in the future. 

 

 

 

 

 

 

 

 

 

 

 

 

About the authors

Tatyana Valerievna Ponkratova

Voronezh State Medical University named after N.N. Burdenko

Author for correspondence.
Email: Tanushkapon@mail.ru
ORCID iD: 0000-0001-8634-4119
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia

Karolina Aleksandrovna Ryzhikh

Voronezh State Medical University named after N.N. Burdenko

Email: karolinka-2000@mail.ru
ORCID iD: 0000-0003-2567-9200
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia

Irina Vladimirovna Kochetkova

Voronezh State Medical University named after N.N. Burdenko

Email: iri4217@yandex.ru
ORCID iD: 0000-0002-8545-6255
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia

Elena Anatolyevna Fursova

Voronezh State Medical University named after N.N. Burdenko

Email: Fursova_elena_76@mail.ru
ORCID iD: 0000-0002-9459-7033
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia

References