Relationship between Physical Activities with Body Mass Index (BMI), among first year and second year medical students of Faculty of Medicine Session.

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Relationship between Physical Activities with Body Mass Index (BMI), among first year and second year medical students of Faculty of Medicine Session 2015/2016 UKM BY LAB 2

ACKNOWLEDGEMENT A high appreciation to: 1. all lecturers of Department of Community Health especially Prof. Madya Dr. Azmi bin Mohd Tamil 2. our facilitator, Dr. Norfazillah Ab Manan ; and 3. all members of Lab 2

Abstract

This study is aimed to determine the relationship between gender, race, type of exercise, duration of exercise, frequency of exercise and BMI level, among the first and second year students session 2015/2016 in UKM Medical Faculty. Hypothesis of our research are, male students have higher BMI compared to female students, Malay students have a higher BMI compared to other races, students who carry out vigorous physical activities, exercised at longer duration and at higher frequency have lower BMI compared to the one that does not. Cross-sectional study was used with random sampling of sample size of 100 respondents. The descriptive and analytic analysis was applied using Microsoft Excel and SPSS version 17.0 which was presented in number, percentage and mean. Chi-square test was used to determine the relationship between the frequency and duration of physical activities with BMI level.

Preface-Introduction Body Mass Index (BMI) A simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults.

Preface-Background Respondent 100 students from first and second year medical students Location UKM Cheras Campus

Literature review

Tanzania Journal of Health Research Females had significantly higher prevalence of overweight than males throughout adolescence. Rosnah MY and Mohd RH, Sharifah NSAR Malays and Indians adolescents are likely to be overweight/obese meanwhile, Chinese are likely to be underweight. American Journal Of Health although nearly half of the overweight population currently meet the physical activity guidelines, these data indicate that the reported physical activity behaviours have not resulted in achieving normal weight status. Those who maintained a healthy weight were consistently more likely to engage in vigorous physical activity.

http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1448495/ It is found that those who does physical activity 3 or more times a week tend to have a healthy BMI compared to those who does physical activity less than 3 times a week, who have a slightly unhealthy BMI and those who does not do physical activity at all has unhealthy BMI. http://jama.jamanetwork.com/article.aspx?articleid=197256 As cited by the book (Exercise Physiology, 2013, Sharon A. Plowman, Denise L. Smith) increased in duration of physical activity is positively associated with a reduction in the total fat in a dose-response relationship, that is the more calories expended in exercise, the greater the fat loss, thus a lower BMI. Less than 150 min per week of exercise will result in minimal weight loss. Exercise between 150 to 225 min per week result in modest weight loss (2-3 kg) whereas 225-420 min per week of exercise results in 5-7.5 kg of weight loss over months or years of activity. Obviously there is a dose-response relationship operating in that higher doses can potentially provide larger losses from initial weight.

The Relationship between Physical Activity and Body Mass Index: Issues in Model Specification the duration of exercise is that matters in lowering or maintaining the BMI of undergraduate-college students. Such a finding is, however, not surprising since a student who has just started exercising and another who has been doing so for a longer period of time should not be expected to gain the same benefits in weight reduction or maintenance. The Journal of the American Medical Association Significant weight loss and improved cardiorespiratory fitness were achieved from the high duration exercise compared to the other two classification.

PROBLEM FRAMEWORK Ideal Body Mass Index types of physical activity frequency of physical activity duration of physical activity demographic pattern gender, age, race

OBJECTIVEs 1. To determine the relationship between gender and BMI 2. To determine the relationship between types of exercise and BMI 3. To determine the relationship between duration of exercise and BMI 4. To determine the relationship between frequency of exercise and BMI 5. To determine the relationship between race and BMI

hypothesis Female students are likely to have higher BMI than male students Chinese students are likely to have lower BMI compared to non-Chinese students. Students whom do vigorous exercise will achieve lower BMI. Students whom do moderate exercise will achieve lower BMI. Students who exercised in longer duration for vigorous exercise will be more likely to achieve ideal BMI. Students who exercised in longer duration for moderate exercise will be more likely to achieve ideal BMI. Moderate exercise more than four times a week will help students to achieve ideal BMI Students who do vigorous exercise more than three times a week will have ideal BMI

METHODOLOGY CROSS-SECTIONAL STUDY Measures the relationship of variables ( manipulated and responding) in a defined population at particular time. Often used to assess the prevalence of acute or chronic conditions, or to answer questions about the causes of disease or the results of intervention.

STUDY FIELD UKM Cheras Campus CONVENIENT SAMPLING 100 preclinical medical students in Pre-clinical building (HUKM) starting from 19- 23 October 2014 QUESTIONNAIRE Self administered

Operational definition 1) Body mass index High : ≥ 25 kg/m^2 Low : < 25kg/m2 Ideal : 18.0-22.9kg/m2 Non ideal : >22.9kg/m2 & <18.0kg/m2

Source: Adapted from WHO 1995, WHO 2000 and WHO 2004.

2) Gender 5) Duration of activity Male long duration Female short duration 3) Race Chinese non-Chinese 4) Frequency of Activity conducted High duration low duration

Table 2 : International Physical Activity Questionnaire Scoring Protocol Source: IPAQ PHYSICAL ACTIVITY LEVELS (Based On Revised IPAQ Categories November 2005) DATE OF LAST REVISION: November 22, 2010

questionnaires Gender Race Physical activity Duration of activity conducted Frequency of activity conducted Types of activities

RESULT DESCRIPTIVE ANALYSIS

RESPONDENT : GENDER

RACES

Classification of bmi - ideal and non-ideal

Vigorous activity

Frequency of vigorous activity

Duration of vigorous activity

Moderate activity

Frequency of moderate activity

Duration of moderate activity

Result analytic analysis

Null hypothesis : there is no significant association between gender and bmi By using student t-test, t = 1.185 p = 0.239 p > 0.05 ; insignificant. Null hypothesis is not rejected. Conclusion: There is no significant association between gender and BMI. gender N Mean Std. Deviation T value P value BMI male 39 21.8715 3.47646 1.185 0.239 female 61 20.9694 3.85461  

chinese and non chinese Null hypothesis : there is no significant association between races (Chinese and non-chinese) and BMI. By using student t-test, t = 2.733 p = 0.007 p < 0.05 ; significant. Null hypothesis is rejected. Conclusion: There is significant association between races (Chinese and non- chinese) and BMI. Chinese students have lower bmi than the non-chinese students   chinese and non chinese N Mean Std. Deviation BMI chinese 34 19.9486 2.39368 non chinese 66 22.0283 4.08369

Null hypothesis : there is no significant association between vigorous activity and BMI. By using student t-test, t = 0.929 p = 0.355 p > 0.05; insignificant. Null hypothesis is not rejected. Conclusion: There is no significant association between vigorous activity and BMI.   vigorous activity N Mean Std. Deviation BMI vigorous 56 21.6278 3.58923 non vigorous 44 20.9310 3.88677

Null hypothesis : there is no significant association between moderate activity and BMI. By using student t-test, t = 2.574 p = 0.012 p < 0.05 ;significant. Null hypothesis is rejected. Conclusion: There is significant association between moderate activity and BMI. Student whom do moderate activity will achieve lower BMI.   moderate activity N Mean Std. Deviation BMI moderate 31 22.7109 4.22701 non moderate 69 20.6968 3.31509

frequency of vigorous activity Null hypothesis : there is no significant association between frequency of vigorous and BMI.   BMI classification frequency of vigorous activity Total   3 or more less than 3 x2 P value ideal n non ideal ideal 32 27.9% 25 29.1% 57 57.0%  2.704a 0.100 non ideal 17 21.1% 26 21.9% 43 43.0% 49 49.0% 51 51.0% 100 100.0% By using Chi-Square Test, x2 = 2.704 p = 0. 1 p > 0.05 ; insignificant. Null hypothesis is not rejected. Conclusion: There is no significant association between frequency of vigorous and BMI.

Null hypothesis : there is no significant association between frequency of moderate activity and BMI.  BMI classification  frequency of activity (moderate) Total   4 or more Less than 4 times x2 P value ideal n non ideal ideal 17 17.7% 40 39.3% 57 57.0% 0.86 0.770 non ideal 14 13.3% 29 29.7% 43 43.0% 31 31.0% 69 69.0% 100 100.0% By using Chi-Square Test, x2 = 0.86 p = 0.770 p > 0.05 ; insignificant Null hypothesis is not rejected. Conclusion: There is no significant association between frequency of moderate activity and BMI.

duration of vigorous activity Null hypothesis : there is no significant association between duration of vigorous activity and BMI.    BMI classification duration of vigorous activity Total 60 minutes or more Less than 60 minutes x2 P value ideal n non ideal ideal 21 18.8% 36 38.2% 57 57.0% 0.885 0.347 non ideal 12 14.2% 31 28.8% 43 43% 33 33.0% 67 67.0% 100 100.0% By using Chi-Square Test, x2 = 0.885 p = 0.347 p > 0.05 ; insignificant Null hypothesis is not rejected. Conclusion: There is no significant association between duration of vigorous activity and BMI.

duration of moderate activity Null hypothesis : there is no significant association between duration of moderate activity and BMI.    BMI classification duration of moderate activity Total 90 minutes or more Less than 90 minutes x2 P value ideal n non ideal ideal 7 6.3% 50 50.7% 57 57.0% 0.222 0.637 non ideal 4 4.7% 39 38.3% 43 43.0% 11 11.0% 89 89.0% 100 100.0% By using Chi-Square Test, x2 = 0.222 p = 0.637 p > 0.05 ; insignificant Null hypothesis is not rejected. Conclusion: There is no significant association between duration of moderate activity and BMI.

Discussion

Moderate activity and bmi Race and BMI There is significant association between races (Chinese and non-chinese) and BMI. Chinese students have lower bmi than the non-chinese students. Our study is also supported by study conducted by Rosnah MY, Mohd RH, Sharifah NSAR in Anthropometry dimensions of older Malaysians: comparisons of age, gender and ethnicity. Asian Soc Sci 5:133-140 Moderate activity and bmi There is significant association between moderate activity and BMI. Student whom do moderate activity will achieve lower BMI. Our study is also supported by study conducted by Spees CK, Health Sciences and Medical Dietetics in Differences in amounts and types of physical activity by obesity status in US adults.

Gender and BMI There is no significant association between body mass index between male and female students This is because research is conducted only among first and second medical students in ukm which are small sample size and not randomised. it is supported by article written by Fernando Araújo et al. entitled Gender- related associations of increased BMI with clinical and laboratory (2007).

Type of physical activity and BMI There is no significant association between types of physical activity and BMI among 1st and 2nd year medical students. This is because our study is conducted in small population which is 100 respondents and a small age gap between respondents.

Duration of physical activity and BMI there is no significant association between duration of physical activity with BMI. longer or shorter duration of physical activity done by the students will have no effect on their BMI This is supported by previous study done by Chetna et al (2012) which suggests there is no correlation between duration of physical activity and BMI

Frequency of physical activity and BMI There is no significant association between frequency of physical activity with BMI among 1st and 2nd year medical students. This is because our study is conducted in small population which is 100 respondents.

Limitation and Suggestion No. Limitation Suggestion 1. Small sample size will reduce the accuracy of the final outcomes Increase the sample size 2. The cross sectional study by conducting self report measure questionnaire longitudinal study is the most accurate and significate result outcomes 3. Reliability and validity of self-reported: underestimate their weight and overestimate their height Use more direct methods to measure height and weight 4. Small age gap between the respondents Wider age gap of more than 6 years would be preferable to show significant changes in BMI