REVIEW ARTICLES
Analysis of sedentary lifestyle among college students
Leianny Rodrigues dos SantosI; Emmanuel Calisto da Costa BritoII; José Cláudio Garcia Lira NetoIII; Lívio Eduardo Pereira AlvesIV; Lunara Rocha Antunes AlvesV; Roberto Wagner Júnior Freire de FreitasVI
INursing Student. Federal University of Piauí. Amílcar Ferreira Sobral Campus. Floriano, Piauí, Brasil. E-mail: leianny.rs@hotmail.com.
IINursing Student. Graduating Student in Nursing. Federal University of Piauí. Amílcar Ferreira Sobral Campus. Floriano, Piauí, Brasil. E-mail: emmanuelbrito13@hotmail.com.
IIINursing Student. Federal University of Piauí. Amílcar Ferreira Sobral Campus. Floriano, Piauí, Brasil. E-mail: zecklira@hotmail.com.
IVNursing Student. Federal University of Piauí. Amílcar Ferreira Sobral Campus. Floriano, Piauí, Brasil. E-mail: liviopa@hotmail.com.
VNursing Student. Federal University of Piauí. Amílcar Ferreira Sobral Campus. Floriano, Piauí, Brasil. E-mail: lunara.antunes@hotmail.com.
VIPhD in Nursing. Adjunct Professor of Federal University of Piauí. Amílcar Ferreira Sobral Campus. Floriano, Piauí, Brasil. E-mail: robertowjff@globo.com.
ABSTRACT: This investigation aimed at analyzing prevalence of sedentary lifestyle in a population of college students from a higher education institution in the state of Piauí, Brazil. This cross-sectional study was carried out in April-May, 2011 with 101 students of both sexes. For data collection we applied a structured form covering socio-demographic aspects, anthropometric measurements, blood glucose level, waist circumference, physical activity, consumption of alcohol and tobacco. Data were statistically analyzed and the Chi-square test was used for association of variables. Sedentary lifestyle was outstanding in 78(77.2%) of the sample. We identified statistically significant association between males and alcohol consumption, smoking and alcohol consumption, and between waist circumference and Body Mass Index. Intervention studies should be encouraged with the young population to help bring down chronic diseases in adulthood.
Keywords: Sedentary lifestyle; young adult; students; nursing.
INTRODUCTION
This research was based on the possibility of, through analysis of sedentary lifestyle in university students, design strategies of education and health promotion, in order to ensure satisfactory quality of life for students. It is important to point out that the sooner physical inactivity is identified, greater the chances of an effective intervention.
Reducing sedentary lifestyle will contribute to reduce many health problems both in young people and in future elderly that, despite the increase in life expectancy, are increasingly adopting a sedentary lifestyle1.
It is undeniable that, among health professionals, nurses are able to develop important activities in regard to sedentary lifestyle in young people, whether on diagnostic evaluation, through epidemiological studies, or on educational measures in health, through the dissemination, awareness and training of young people for regular physical activity, or on intervention measures, through studies that may try to change high-risk lifestyle.
Considering the above, the objective of this study was to analyze the prevalence of sedentary lifestyle in a population of university students in a higher education institution of Piauí, Brazil.
LITERATURE REVIEW
Sedentary lifestyle is an issue that has been widely discussed in the Brazilian media, whether in newspapers, magazines or internet. Researchers define physical inactivity when the person does not perform a minimum amount of daily movement (at least between 25 and 35 minutes), which produces an energy expenditure >10% of what usually happens to perform daily activities. This can be measured by the duration and type of activity performed. These activities include outdoor games, housework, climbing stairs, walking, using a bicycle to exercise2.
According to Brazilian Ministry of Health, the practice of physical activity is considered sufficient when performed at least 30 minutes of light or moderate intensity activity on five or more days of the week, or when performed at least 20 daily minutes of vigorous intensity physical activity in three or more days a weeks3.
Regarding to epidemiological data, a recent survey involving 292,553 Brazilians revealed that approximately one fifth of the population 59,096 (20.2%) reported not practicing any physical activity4.
It is natural to think that sedentary indices are only focused on adult and elderly people, which is actually a big mistake. Renowned researchers claim that the sedentary lifestyle is extremely widespread in the daily lives of young people, especially on college students. To illustrate this statement, we highlight two recent investigations conducted internationally. The first occurred at the University of Aveiro, Portugal, and found that about 123 (80%) of the students were sedentary5. And the second, at the University of Cartagena, Colombia, revealed that 193 (64.1%) of the sample was physically inactive6.
Considering that in Brazil, every year, around 112,000 students enroll in the federal universities, it is believed that if there was an incentive to the practice of regular physical activity, these youth are more likely to become healthy adults7.
Given the epidemiological data described above, it is seen that the problem of physical inactivity does exist and should be further explored. The benefits of regular physical activity should be clear to the population, and it should be noted that individuals who are more physically active have lower rates of all-cause mortality, coronary heart disease, hypertension, stroke, diabetes, metabolic syndrome, colon cancer, breast cancer, and depression8.
METODOLOGY
This is a descriptive, cross-sectional study, with quantitative approach and was held in a Federal Institution of Higher Education (FIHE) of Piauí’s South-Central region.
The population consisted of college students of four courses, both sexes. The following inclusion criteria were used: be over 18 years old, be duly enrolled in selected FIHE and participate in all stages of the research. Students who had been diagnosed with type 2 diabetes mellitus confirmed or other chronic diseases that could interfere directly with the weight and height, and those which had some restraint on the occasion of obtaining anthropometric measurements were excluded, as well as pregnant women. For convenience, the sample involved 101 college students, being stratified as follows: Nursing Course 26 (25.7%), Business Administration Course 26 (25.7%), Pedagogy Course 24 (23.8%) and Biological Sciences Course 25 (24.8%).
Data collection occurred during the months of April and May 2011 and consisted of a few steps. Initially the researchers - nurses, students of undergraduate nursing course and scientific initiation scholars – went to classrooms to explain the research project, its objectives and methodology. Then, after students showed interest in participating in the study, they signed an Informed Consent Form.
The second stage of the research was to collect data. Data were collected using a structured questionnaire covering, among others, the following items: age, sex, course, attended period, anthropometric measurements (weight, height, BMI and waist circumference), plus lifestyle and clinical variables (practice of physical activity, alcohol consumption, smoking, and blood glucose).
Data related to weight were obtained with subjects standing barefoot and wearing light clothing, using a 0.1 kg accuracy portable digital scale with the ability to record 120 kg, automatic display triggered with the touch of the feet positioned on the plan floor.
Height was assessed using a 0.5 cm accuracy tape, fixed on a smooth wall. Height measurements were taken with students standing barefoot, on their back, with feet together and parallel, standing erect and looking forward, with the support of a ruler that was placed over participants’ heads, to ensure measurement accuracy. BMI was defined as the ratio between the weight of the student and the square of your height and the values considered normal were between 18.5 to 25.0 kg / m2, according to the World Health Organization (WHO)9.
To check the waist circumference it was used a 0.1 cm accuracy measuring tape, with a scale of 0 to 150 cm. For the effectuation of the measure, the subject was requested to stand upright and then it was measured between the last rib and the iliac crest. Furthermore, to identify the value, we considered the recommendations that determine the condition of obesity when waist circumference reaches value >102 cm for men and >88 cm for women.
In this study, participants who practiced physical activities for less than 30 minutes and less frequently than three times per week were classified as sedentary2. Regarding to alcohol consumption and smoking, individuals who reported routine consumption of drugs were considered drinkers and smokers.
For obtaining the blood glucose level, it was necessary to collect a drop of blood of subjects, through a bite taken on the tip of a fingernail (after disinfection with 70% alcohol) with a suitable disposable needle for this purpose. The blood glucose reading was performed using a glucometer, and suitable test strips. The values were analyzed according to the recommendations of Ministry of Health10.
It is noteworthy that, initially, the data were stored in a database, processed using Epi Info version 3.5.2 and organized into tables. Statistical measures of quantitative variables were calculated: mean and standard deviation. For the association between the physical activity variables and sex, course, attended period, alcoholism, smoking, waist circumference, BMI and blood glucose, we used the chi-square test and values were considered significant when p <0.05. On the ethical aspects of research, it is noteworthy that this was done with the approval of the Federal University of Piauí Research Ethics Committee (opinion under number 0016.0.045.000-11), seeking to meet the requirements of the National Health Council, with regards to the implementation of research involving human beings, pursuant to Resolution No. 196/96 of the Ministry of Health11.
RESULTS AND DISCUSSION
Most academics, 72 (71.3%) were female. The age range was 18-39 years and the average age of students was 21.4 years. Similarly, searches in literature can prove that the female gender is the one that has greater participation in health researches. One reason that can justify this majority is the fact that women are more concerned with their health compared to men12.
With regard to the mean age at this study, authors have found similar average in college students (20.5 ± 1.8 years) 13, indicating that the higher education students are mostly young. Regarding courses that participated in the investigation, 26 (25.7%) were doing Nursing Course, 25 (24.8%) Biological Sciences Course, 26 (25.7%) Business Administration Course and 24 (23.8%) Education Course. As regards the stages in each course, 63 (62.4%) were found at 1st year (semesters I and II), 18 (17.8%) at 2nd year (semesters II and III) and 20 (19.8% ) in the 3rd year (semesters IV and V).
Sedentary lifestyle, the main focus of this study, was detected in 78 (77.2%) of undergraduate students. Moreover, when associated with several variables, prevailed in females, 59 (81.9%), p = 0.066, the new students - 50 (79.4%), p = 0.788, and doing Biological Sciences Course - 21 (84.0%), p = 0.648, as shown in Table 1.
The prevalence of sedentary lifestyle in this study may be lower or higher compared to results of other investigations. To illustrate this assertion, two researches can be highlighted. The first reflects a study conducted at the Federal University of Santa Catarina, Brazil, with 762 participants, in which 105 (13.8%) had a sedentary lifestyle7. Finally, the second investigation, this time held at the University of Aveiro, Portugal, identified 123 (80%) sedentary college students5. Based on these comparisons we can conclude that the level of sedentary lifestyle may differ from one location to another, depending on the methodology of the study, as well as the socioeconomic and cultural factors involved in the study population.
Regarding gender issue, two studies, one national and one international investigated the sedentary lifestyle in college students and found a higher prevalence of physical inactivity in females. The first, studied the stages of behavior change related to college students physical activity, and found that when compared to men - 314 (62.7%), 276 (76.5%) women had a sedentary lifestyle14. The second study accomplished with 301 students in the city of Cartagena, Colombia, revealed that 139 (67.5%) of women had a sedentary lifestyle6.
With regard to the frequency of physical activity during the years of course on college, this research revealed results contrary to a study conducted with undergraduate students in Paraíba state, which shows the decrease in the frequency of physical activity from high to moderate, and moderate to low, as the time of admission to graduation increases15. The sedentary lifestyle detected in this study had a high prevalence in the first academic year of the course, in which 50 (79.4%) said they did not do any exercise, while the 2nd and 3rd year obtained the respective values of physical inactivity, 13 (72.2%) and 15 (75.0%). Another survey with Physical Education students also showed controversies to our study. Most students reported having a high level of physical activity, but as the course progressed, there was a reduction in levels of physical activity and quality of life in this population16.
The level of physical activity related to course, obtained in this study showed that Biological Sciences and Education Course students were those who achieved higher levels of physical inactivity, 21 (84.0%) and 19 (79.2%), respectively. The Business Administration Course students were the most physically 8 (30.8%) active and this data might be explained considering that the course has a student body composed mostly by males. Furthermore, other studies have found a significant relationship between male and physical activity.
A research conducted at the University of Pernambuco with 253 students noted that the Physical Education Course is the one with the highest rate of physically active academics - 131 (51.6%). In contrast, the School of Medicine showed lower percentages of physical activity 22 (8.8%)17. A good explanation for these findings is that academics of Physical Education Course have regular physical activity in their curriculum. However, a worrisome fact was found in other health courses. How can we accept that these students, who have been trained to promote health, have a high percentage of physical inactivity? One of the reasons is that health related courses are mostly full-time, thus decreasing the availability of these academics to the practice of physical activities.
In daily habits analysis, 49 (48.5%) and 5 (5%) of the students reported routine use of alcohol and tobacco, respectively. Regarding the anthropometric measures, 25 (24.7%) of the sample was overweight and 3 (2.9%) with high values of waist circumference.
Regarding the clinical variable, blood glucose, 2 (2%) subjects had values above 140 mg / dL.
Finally, by associating sedentary lifestyle with variables described above, it was observed higher rates of physical inactivity among alcoholics (p = 0.378), smokers (p = 0.266) and those with a large waist circumference (p = 0.456 ). The data are summarized in Table 2.
Concerning smoking, in this research, it was observed that 5 (100%) students who reported being smokers were sedentary. Regarding the association between physical inactivity and smoking, due to the paucity of recent national studies with college students it was not possible to determine whether these variables are related and, either, what is the magnitude of this relationship.
With regard to the association between physical inactivity and alcohol consumption, this study revealed that 39 (79.6%) students who consume alcohol were sedentary, this percentage was higher than that found in a research conducted in Sergipe, 27 (12.5 %)18.
Furthermore, it was found that the drug consumption was present in higher percentages in males (21.8%, p = 0.000). This finding, when confronted with the national literature, is higher, 24 (18.3%), than the study conducted in the State of Alagoas19 and lower when compared to international literature 46 (88.4%), in a study conducted in Venezuela14.
Referring to intersections, this research conformed statistically significant relationship between alcohol consumption and tobacco use (p = 0.024). Similar relationship was found in research conducted with 1,359 students from a public university of Colombia (OR = 4.6)20.
The study also found the relationship between the waist circumference and high BMI (p = 0.009). Similar relationship with university students in Mexico, showed that, among women with high values of waist circumference, 69 (65%) of them were with BMI ≥ 25,0Kg / m2, which features overweight21.
Finally, statistically significant associations were found between male gender and alcohol consumption (p = 0.000), smoking and alcohol consumption (p = 0.024) and waist circumference and BMI (p = 0.009).
CONCLUSION
The conclusion of this research is that there is a high level of sedentary lifestyle among young university population, given that the majority, 78 (77.2%) did not practice regular physical activity. Moreover, it is clear that males, despite exercising more, make more use of tobacco and alcoholic beverages regularly, compared to women.
Finally, it is emphasized that there is a relationship between the use of tobacco and alcohol use, as well as between measures of waist circumference and body mass index.
Educational measures, public health policies and intervention studies should be developed for young people with the aim of encouraging healthy lifestyle, specifically the practice of physical activities to prevent chronic diseases in adult and long-lived age.
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