Keywords: Exercise; Lifestyle; Medical school; Malaysia; Nutrition; Physical Activity; Preclinical
Although behaviors of students are considered a temporary part of college life; however, unhealthy habits picked up at this stage can persist in adult life [4]. Therefore, university and college years represent an important opportunity to students for learning about healthy lifestyle and enhancing nutritional awareness. Medical students can learn and derive the most benefit of a healthy lifestyle, by virtue of the nature of their studies [5]. It is presumed that medical students have substantial knowledge about physical activity and its benefits and, as health care professionals-to-be, they will have an influence on their patients' attitude towards the need for a regular physical activity program and an ethical obligation to prescribe suitable exercises. It is well known that there is a direct correlation between physical activity level in medical students and the medical advice they provide to their patients [6-9]. However, there is no evidence to indicate that this knowledge translates into practice in terms of maintaining good health. The structure of medical education itself is likely to cause disruption to students' health habits [10]. Staying physically-active during medical school is one of the hardest things to do; as with busy schedules, medical students may not find the time to exercise regularly. Numerous studies on physical activity level have produced different results, often presenting a sharp contrast between medical students' knowledge about the benefits of regular physical activity and its application in everyday life [11-16]. Angyan et al. [16] reported that medical students had low physical activity levels as a result of high workload and less free time.
The purpose of this study was to acquire a quantitative account for the physical activity levels of preclinical medical students at the University of Malaya Medical Centre and to learn about the influencing factors on such activities. Also, it was of interest to acquire data on student nutrition to reveal information on the prevalent lifestyle of these students.
Item |
No. |
% |
Gender Male Female |
150 100 |
60.0 40.0 |
Age* £ 20 >20 |
119 131 |
47.6 52.4 |
Year of study 1 2 3 |
125 68 57 |
50.0 27.2 22.8 |
Ethnic background Malay Chinese Indians Others |
120 100 20 10 |
48.0 40.0 8.0 4.0 |
Province / Region Peninsular None Peninsular N.S.** |
221 20 9 |
88.4 8.0 3.6 |
Living on campus Yes No |
225 25 |
90.0 10.0 |
No. of brothers or sisters 0-3 4-6 >6 |
154 82 14 |
61.6 32.8 5.6 |
Position in family The only First Middle Last |
7 89 60 94 |
2.8 35.6 24.0 37.6 |
Any of parents work? Yes No |
204 46 |
81.6 18.4 |
Any siblings at UM? Not at all Yes In medical Yes in Other colleges |
235 4 11 |
94 1.6 4.4 |
** N.S. - not specified.
Item
|
No. |
% |
Do you eat on campus? Yes No
|
223 27 |
89.2 10.8 |
How many meals do you eat/day? 1-2 3 > 3
|
34 156 60 |
13.6 62.4 24.0 |
Do you think your nutrition is proper? Yes No
|
158 92 |
63.2 36.8 |
Do you take any supplements? Yes No
|
126 124 |
50.4 49.6 |
Body Mass Index (BMI)* Underweight (<18.5) Normal (18.5-22.9) Pre-obese (23-27.4) Obese class I (27.5-34.9)
|
42 160 43 5 |
16.8 64.0 17.2 2.0 |
Additional questions that pertain to physical activity of students are shown in Table 4. Students reported that the main reason for them to exercise is to have proper health (53%), followed by being physically fit (29%), and 12% just exercised for fun. The rest of the students indicated other reasons for exercising such as: utilizing free time, interest in sport, building stomata and relief of tension. The main motivating reasons for students to exercise were those of: appearance (39%), health (29%), friends (16%), and self-interest (9%). As to the types of preferred exercise/game/sport, students reported a variety of physical activities with jogging on top of such. Students pointed out a variety of positive feelings after exercising and others indicated tiredness, in contrast. As for the students who did not exercise, having either no time and/or feeling lazy were the only reasons given – 62 and 38%, respectively.
Question
|
Yes No. (%) |
No No. (%) |
Does any of your parents exercise? (n=250)
|
190 (76.0)
|
60 (24.0) |
Do you exercise? (n=250)
|
189 (75.6) |
61 (24.4) |
If you do not presently exercise, have you ever exercised? (n=60)
|
52 (86.7) |
8 (13.3) |
Even you do not currently exercise, would you like to exercise? (n=61)
|
50 (82.0) |
11 (18.0) |
Do you prefer to exercise alone? (n=189 - exercising participants)
|
69 (36.7) |
119 (63.3) |
Do you exercise on campus? (n=189 - exercising participants)
|
159 (84.1) |
30 (15.9) |
Are facilities sufficient on campus? (n=159 - exercising on campus)
|
118 (74.7) |
40 (25.3) |
Did you exercise prior to being in medical school? (n=189 - exercising participants)
|
179 (94.7) |
10 (5.3) |
Do you exercise with a coach or under a professional advice? (n=189 - exercising participants)
|
40 (21.2) |
149 (78.8) |
Are you committed to exercising? (n=188 - exercising participants)
|
111 (59.0) |
77 (41) |
Do you exercise during your menstrual cycle? (n=71 - exercising females)
|
48 (67.6) |
23 (32.4) |
Do you represent UM/State-National sporting club/country? (n=250)
|
25 (10%) |
225 (90%) |
Were you recognized for your sporting activities? (n=250)
|
62 (24.8) |
188 (75.2) |
Item
|
No. |
% |
Why do you exercise? (n=189) Proper health Physically fit For fun Others |
100 54 22 13 |
52.9 28.6 11.6 6.9 |
Why you don't exercise? (n=61) No time Laziness |
38 23 |
62.3 37.7 |
Type(s) of exercise/games/sports you prefer* (n=189) Jogging Badminton Swimming Football Basketball Tennis Walking Others |
51 37 29 28 22 22 13 39 |
27.0 19.6 15.4 14.8 11.6 11.6 6.9 20.6 |
How do you feel after exercise? * (n=189) Refreshed Tired Relaxed Energetic Fulfilled |
77 75 59 46 44 |
40.7 39.6 31.2 24.3 23.2 |
What motivates you to exercise? (n=189) Appearance Health Friends Self esteem Others |
73 55 30 17 14 |
38.6 29.1 15.9 9.0 7.4 |
Majority of the respondents in this study were physically active (76%), which is in agreement with a similar finding from research work conducted by the Malaysian Ministry of health [22]. In this study, male participants were more physically-active compared to females, a finding in support by previous results of similar studies [23-27]. The participants were almost in the same age range (21.1±1.2) years. Results showed no effect of student age on physical activity levels. Other studies showed that during the transition to college, exercise and fitness levels usually decrease and that they are unlikely to improve as students get older [28- 30]. The current study did not reveal any major difference in the year of study on the physical activity level of students. This can be explained on the basis that scholastic duties of all the participants were similar as they were in their preclinical stage.
The composition of the sample represented the ethnic distribution in Malaysia [31]; in particular, Malays and other Bumiputera (native) groups comprised the majority of the distribution, followed by Chinese and Indians. There was no association between the physical activity level and ethnic background. About 90% of the participants were from provinces of peninsular Malaysia and those participants were of the highest percentage in all the physical activity level groups. Unlike a previous study which showed that level of physical activity was significantly higher in students living on campus compared to
Variable |
Physical Activity (Minutes/Week) |
P value |
|||||||
None n=61 |
30-60 n=99 |
90-120 n= 70 |
>120 n=20 |
||||||
No. |
% |
No. |
% |
No. |
% |
No. |
% |
||
Gender Male Female |
32 29 |
52.5 47.5 |
47 52 |
47.5 52.5 |
53 17 |
75.7 24.3 |
18 2 |
90.0 10.0 |
<0.001 |
Age £20 ³20 |
26 35 |
42.6 57.4 |
50 49 |
50.5 49.5 |
34 36 |
48.6 51.4 |
9 11 |
45.0 55.0 |
0.796 |
Year of Study 1 2 3 |
26 20 15 |
42.6 32.8 24.6 |
52 28 19 |
52.5 28.3 19.2 |
37 17 16 |
52.9 24.3 22.9 |
10 3 7 |
50.0 15.0 35.0 |
0.550 |
Ethnic Background Malay Chinese Indians Others |
31 25 3 2 |
50.8 41.0 4.9 3.3 |
50 39 7 3 |
50.5 39.4 7.1 3.0 |
27 32 6 5 |
38.6 45.7 8.6 7.1 |
12 4 4 0 |
60.0 20.0 20.0 0.0 |
0.212 |
Province/Region Peninsular None Peninsular N.S.* |
51 6 4 |
83.6 9.8 6.6 |
90 6 3 |
90.9 6.1 3.0 |
61 7 2 |
87.1 10.0 2.9 |
19 1 0 |
95.0 5.0 0.0 |
0.672 |
Living on campus Yes No |
57 4 |
93.4 6.5 |
89 10 |
89.9 10.1 |
61 9 |
87.1 12.9 |
18 2 |
90.0 10.0 |
0.696 |
No. of brothers and sisters 0-3 4-6 >6 |
35 23 3 |
57.4 37.7 4.9 |
61 31 7 |
61.6 31.3 7.1 |
45 22 3 |
64.3 31.4 4.3 |
13 6 1 |
65.0 3.0 5.0 |
0.955 |
Position in family 1 2 3 4 5 ³ 6 |
24 13 14 6 1 3 |
39.3 21.3 23.0 9.8 1.6 4.9 |
37 31 15 5 6 5 |
37.4 31.3 15.2 5.1 6.1 5.1 |
25 19 11 6 4 5 |
35.7 27.1 15.7 8.6 5.7 7.1 |
10 4 3 1 1 1 |
50.0 20.0 15.0 5.0 5.0 5.0 |
0.928 |
Any of parents work Yes No |
44 17 |
72.1 27.9 |
83 16 |
83.8 16.2 |
61 9 |
87.1 12.9 |
16 4 |
80.0 20.0 |
0.142 |
Any sibling in UM Yes No |
0 61 |
0.0 100.0 |
8 91 |
8.1 91.9 |
2 68 |
2.9 97.1 |
5 15 |
25.0 75.0 |
<0.001 |
Parents exercising Yes No |
1 60 |
1.6 98.4 |
99 0 |
100.0 0.0 |
70 0 |
100.0 0.0 |
20 0 |
100.0 0.0 |
<0.001 |
The majority of participants in the four physical activity categories were from those dined on campus - 95, 90, 86 and 80% for none, low, medium and high physical activity levels,
Variable |
Physical Activity (Minutes/Week) |
P value |
|||||||
None n=61 |
30-60 n=99 |
90-120 n= 70 |
>120 n=20 |
||||||
No. |
% |
No. |
% |
No. |
% |
No. |
% |
||
Eating on campus Yes No |
58 3 |
95.1 4.9 |
89 10 |
89.9 10.1 |
60 10 |
85.7 14.3 |
16 4 |
80.0 20.0 |
0.181 |
No. of meals eaten/day 1-2 3 >3 |
11 41 9 |
18.0 67.2 14.8 |
16 62 21 |
16.2 62.6 21.2 |
5 45 20 |
7.1 61.3 28.6 |
2 8 10 |
10.0 40.0 50.0 |
0.022 |
Perceived nutrition as proper Yes No |
37 24 |
60.7 39.3 |
64 35 |
64.6 35.4 |
45 25 |
64.3 35.7 |
12 8 |
60.0 40.0 |
0.944 |
Taking supplements Yes No |
24 37 |
39.3 60.7 |
50 49 |
50.5 49.5 |
41 29 |
58.6 41.4 |
11 9 |
55.0 45.0 |
0.170 |
Body Mass Index (BMI)* Underweight Normal Overweight Obese |
13 34 12 2 |
21.3 55.7 19.7 3.3 |
19 65 13 2 |
19.2 65.7 13.1 2.0 |
7 48 14 1 |
10.0 68.6 20.0 1.4 |
3 13 4 0 |
15.0 65.0 20.0 0.0 |
0.683 |
All students with non- exercising parents were also physicallyinactive, whereas 99.5% of participants with exercising parents were exercising at different activity levels. There was a significant difference between physical activity and having at least one parent who exercised (P< 0.001). This association was supported by studies which revealed that families engaged in physical activity were important predictor factor of physical inactivity of adolescents [38-39]. Our findings revealed that more than 80% of inactive participants were exercising before joining medical school and expressed the desire to exercise. They explained their recent inactivity by the nature of medical school studies. Those who were engaged in physical activities preferred exercising in groups (63.3%) and explained that having friends and socializing were their motivation factors. Many studies supported the importance of socializing as an encouraging factor for exercising [40-46]. There was no significant difference between the physical activity level and the place of exercising. Most of the students who exercised on campus (74.7%) felt satisfied with its facilities, and the remainder of students felt that their campus lacked a satisfactory number of courts and instruments. Enjoying proper health and being physically-fit were the most motivating factors for students to exercise. Lack of time and being lazy were the major barriers for students who were not exercising, an observation that was supported by many studies showing the same results [47-49].
Data of this study revealed the status of physical activity of preclinical medical students at the University of Malaya, Malaysia, and add to other studies in the pertinent literature on this subject. Percentages of exercising and non-exercising students – as well as the levels of physical activity were expressed. Factors and conditions that influence student physical activity were explored and associations were detected. Considering that nowadays medical students will be the future medical doctors, emphasizing the significance of a healthy lifestyle for proper health of these doctors and their patients is of extreme importance. It needs to be stressed that it is of many benefits to any society that all segments of its population follow healthy dietary guidelines and be engaged in regular physical activity programs and routines.
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