Keywords
Lifestyle behaviours
Obesity
Physicians
Feeding Practice
Workplace
Abstract
Background: The increasing obesity/overweight prevalence among health workers calls for an appraisal of their lifestyle. This study assessed medical practitioners' workhour feeding and lifestyle practices and explored the relationship between these practices and their body mass index (BMI).
Methods: The survey involved 321 medical practitioners selected from 9 northern Nigeria hospitals in 2021. Data collected included biodata, medication history, workhour feeding characteristics, lifestyle behaviours, blood pressure, height, and weight measurements. Data were analyzed using Epi info software (version 7).
Results: Most respondents were male (70.7%). Their mean age was 38±7.4 years. During their last workhours, 84.1% had lunch, 46.4% took sugary drinks, 2.7% brought lunch from home, and 1.3% took nothing. Only 18.7% patronize their hospital canteen weekly. Most reported healthy behaviour towards alcohol (99.7%) and, fruit/vegetable (54.8%) consumption, and smoking (98.4%), but only 22.4% were physically active. Their mean healthy behaviour score and BMI were 2.8±0.7 and 26.1±4.6 kg/m2, respectively. The obesity and overweight rates were 18.4% and 37.7%, respectively. Their source of lunch during workhours, age, sex, years of practice, employment duration, marital status, job category, systolic blood pressure, anti-hypertensive, and antidiabetic medication use were significantly associated with mean BMI. However, only antihypertensive medication use, being married, inadequate fruit/vegetable consumption and workhour sugary drinks consumption predicted obesity. The predictors of overweight/obese were long practice experience (<10y) and use of antihypertensive medications.
Conclusions: Overweight and obesity rates were high. Most were physically inactive. Workhour sugary drink consumption predicted obesity. Effective workplace and community interventions to improve practitioners' lifestyle behaviour and curtail obesity and overweight are needed.
References
World Health Organisation. World Health Organisation, Geeva. 2021 [cited 2023 Dec 2]. Fact sheets: Obesity and overweight. Available from: www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
Ezzati M, Riboli E. Behavioral and dietary risk factors for noncommunicable diseases. N Engl J Med. 2013;369(10):954-64.
Livingstone KM, McNaughton SA. A Health Behavior Score is Associated with Hypertension and Obesity Among Australian Adults. Obesity (Silver Spring). 2017;25(9):1610-1617.
World Health Organisation. Noncommunicable diseases country profiles 2018 [Internet]. Geneva; 2018 [cited 2023 Nov 4]. Available from: https:// apps.who.int/iris
Khaw KT, Bingham S, Welch A, Luben R, Wareham N, Oakes S, et al. Relation between plasma ascorbic acid and mortality in men and women in EPIC-Norfolk prospective study: a prospective population study. The Lancet. 2001;357(9257):657–663.
Khaw KT, Wareham N, Bingham S, Welch A, Luben R, Day N. Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. PLoS Med. 2008 Jan 8;5(1):e12. doi: 10.1371/journal.pmed.0050012. Erratum in: PLoS Med. 2008 Mar 18;5(3):e70.
Adaja TM, Idemudia OJ. Prevalence of overweight and obesity among health-care workers in University of Benin Teaching Hospital, Benin City, Nigeria. Ann Trop Pathol 2018;9:150-4.
Chou CF, Johnson PJ. Health disparities among America's health care providers: evidence from the Integrated Health Interview Series, 1982 to 2004. J Occup Environ Med. 2008;50(6):696-704.
Luckhaupt SE, Cohen MA, Li J, Calvert GM. Prevalence of obesity among U.S. workers and associations with occupational factors. Am. J. Prev. Med. 2014; 46:237–248.
Dankyau M, Shu’aibu JA, Oyebanji AE, Mamven OV. Prevalence and correlates of obesity and overweight in healthcare workers at a tertiary hospital. J Med Trop 2016;18:55-9.
Iwuala SO, Ayankogbe OO, Olatona FA, Olamoyegun MA, OkparaIgwe U, Sabir AA, Fasanmade OA. Obesity among health service providers in Nigeria: danger to long term health worker retention? Pan Afr Med J. 2015;22:1. doi: 10.11604/pamj.2015.22.1.5586.
Kunyahamu MS, Daud A, Jusoh N. Obesity among Health-Care Workers: Which Occupations Are at Higher Risk of Being Obese? Int J Environ Res Public Health. 2021;18(8):4381. doi: 10.3390/ijerph18084381.
Lee DJ, Fleming LE, Gómez-Marín O, LeBlanc WG, Arheart KL, Caban AJ, Christ SL, Chung-Bridges K, Pitman T. Morbidity ranking of U.S. workers employed in 206 occupations: the National Health Interview Survey (NHIS) 1986-1994. J Occup Environ Med. 2006;48(2):117-34.
Younis J, Jiang H, Fan Y, Wang L, Li Z, Jebril M, Ma M, Ma L, Ma M, Hui Z. Prevalence of overweight, obesity, and associated factors among healthcare workers in the Gaza Strip, Palestine: A cross-sectional study. Front Public Health. 2023 Feb 23;11:1129797. doi: 10.3389/fpubh.2023.1129797
Howe M, Leidel A, Krishnan SM, Weber A, Rubenfire M, Jackson EA. Patient-related diet and exercise counseling: do providers' own lifestyle habits matter? Prev Cardiol. 2010;13(4):180-5.
Lobelo F, de Quevedo IG. The Evidence in Support of Physicians and Health Care Providers as Physical Activity Role Models. Am J Lifestyle Med. 2016 Jan;10(1):36-52.
Perry L, Xu X, Gallagher R, Nicholls R, Sibbritt D, Duffield C. Lifestyle Health Behaviors of Nurses and Midwives: The 'Fit for the Future' Study. Int J Environ Res Public Health. 2018;15(5):945. doi: 10.3390/ijerph15050945.
Michael GC, Grema BA, Aliyu I, Suleiman AK, Tanimu ST. Physical activity profile of medical practitioners: A preliminary cross-sectional study in Kano, Northwest Nigeria. Niger J Med 2020;29:693-700.
Kunene SH, Taukobong NP. Dietary habits among health professionals working in a district hospital in KwaZulu-Natal, South Africa. Afr J Prim Health Care Fam Med. 2017;9(1):e1-e5. doi: 10.4102/phcfm.v9i1.1364.
Al Hazmi TM, Alghamdi A, Abdulmajeed I. Eating Habits among Healthcare Providers during Working Hours at National Guard Health Affairs-Riyadh, Saudi Arabia. Int J Med Res Health Sci 2018,;7(9): 1-14. (available from: Eating Habits among Healthcare Providers during Working Hours at National Guard Health Affairs-Riyadh, Saudi Arabia (ijmrhs.com)
Nsiah-Asamoah1 CNA, Amoasi D. Setorglo J. Dietary practices of health professionals during working hours in a tertiary referral teaching hospital in Ghana: a neglected vulnerable group. Eur J Nutr Food Saf. 2021; 13(5): 82-97
Lemaire JB, Wallace JE, Dinsmore K, Lewin AM, Ghali WA, Roberts D. Physician nutrition and cognition during work hours: effect of a nutrition based intervention. BMC Health Serv Res. 2010 ;10:241. doi: 10.1186/1472-6963-10-241.
Winston J, Johnson C, Wilson S. Barriers to healthy eating by National Health Service (NHS) hospital doctors in the hospital setting: results of a cross-sectional survey. BMC Research Notes 2008; 1:69 doi:10.1186/1756-0500-1-69
Faugier J, Lancaster J, Pickles D, Dobson K. Barriers to healthy eating in the nursing profession: Part 1. Nurs Stand. 2001;15(36):33-6.
Faugier J, Lancaster J, Pickles D, Dobson K. Barriers to healthy eating in the nursing profession: Part 2. Nurs Stand. 2001;15(37):33-5.
Araoye MO. Sample size determination. Research methodology with statistics for health and social sciences. 2nd edition. Ilorin: Nathadex Publishers. 2004; p. 115-20.
Gopinath B, Flood VM, Burlutsky G, Mitchell P. Combined influence of health behaviors on total and cause-specific mortality. Arch Intern Med 2010; 170:1605–1607.
Gopinath B, Liew G, Flood VM, Joachim N, Burlutsky G, Mitchell P. Combined influence of poor health behaviours on the prevalence and 15-year incidence of age-related macular degeneration Scientific Reports 2017; 7: 4359 | DOI:10.1038/s41598-017-04697-3
Meriwether RA, McMahon PM, Islam N, Steinmann WC. Physical Activity AssessmentValidation of a Clinical Assessment Tool. Am J Prev Med. 2006; 31(6):484–491.
Iloh G. Amadi AN, Okafor GOC, Ikwudinma AO, Odu FU, Godswill-Uko EU. Adherence to Lifestyle Modifications among Adult Hypertensive Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in Resource-poor Environment of Eastern Nigeria. Br J Med Med Res. 2014;4(18):3478–3490.
Adeloye D, Auta A, Fawibe A, Gadanya M, Ezeigwe N, Mpazanje RG, Dewan MT, Omoyele C, Alemu W, Harhay MO, Adewole IF. Current prevalence pattern of tobacco smoking in Nigeria: a systematic review and meta-analysis. BMC Public Health. 2019 Dec 21;19(1):1719. doi: 10.1186/s12889-019-8010-8.
Ressel GW; NHLBI. NHLBI releases new high blood pressure guidelines. Am Fam Physician. 2003;68(2):376-379
World Health Organization. (2016, June) Obesity and overweight. World Health Organization, Geneva. http://www.who.int/mediacentre/ factsheets/fs311/en/. (20 Nov 2023)
World Health Organisation. (2018). Noncommunicable diseases country profiles 2018. Available at Noncommunicable diseases country profiles 2018 (who.int) (20 Nov 2023).
Ma X, Chen Q, Pu Y, Guo M, Jiang Z, Huang W, Long Y, Xu Y. Skipping breakfast is associated with overweight and obesity: A systematic review and meta-analysis. Obes Res Clin Pract. 2020;14(1):1-8. doi: 10.1016/j.orcp.2019.12.002.
Arnotti K, Bamber M. Fruit and Vegetable Consumption in Overweight or Obese Individuals: A Meta-Analysis. West J Nurs Res. 2020 Apr;42(4):306-314.
Sarna L, Bialous SA, Nandy K, Antonio AL, Yang Q. Changes in smoking prevalences among health care professionals from 2003 to 2010-2011. JAMA. 2014 Jan 8;311(2):197-9.
Al Shahrani AS, Almudaiheem NR, Bakhsh EM, Sarhan NT, Aldossari FS, Bin Huzeim BA. Understanding Smoking Behavior among Physicians in Riyadh, Saudi Arabia: A Cross-Sectional Study. Tob Use Insights. 2021;14:1179173X211006652.
Sotiropoulos A, Gikas A, Spanou E, Dimitrelos D, Karakostas F, Skliros E, Apostolou O, Politakis P, Pappas S. Smoking habits and associated factors among Greek physicians. Public Health. 2007;121(5):333-40.
Mizher IY, Fawaqa SI, Sweileh WM. Prevalence and personal attitudes towards tobacco smoking among Palestinian healthcare professionals: a cross-sectional study. Addict Sci Clin Pract. 2018;13(1):17. doi: 10.1186/s13722-018-0119-z.
World Health Organisation. (2021, June 9). Fact sheets: Obesity and overweight. World Health Organisation, Geneva. www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (30 Nov 2023)
Guo X, Gong S, Chen Y, Hou X, Sun T, Wen J, Wang Z, He J, Sun X, Wang S, Feng X, Tian X. Lifestyle behaviors and stress are risk factors for overweight and obesity in healthcare workers: a cross-sectional survey. BMC Public Health. 2023 Sep 14;23(1):1791. doi: 10.1186/s12889-023-16673-w.
Chukwuonye II, Ohagwu KA, Ogah OS, John C, Oviasu E, Anyabolu EN, et al. Prevalence of overweight and obesity in Nigeria: Systematic review and meta-analysis of population-based studies. PLOS Glob Public Health. 2022 Jun 10;2(6):e0000515. doi: 10.1371/journal.pgph.0000515.
Frank E, Segura C. Health practices of Canadian physicians. Can Fam Physician. 2009; 55(8):810-811
McHill AW, Wright KP Jr. Role of sleep and circadian disruption on energy expenditure and in metabolic predisposition to human obesity and metabolic disease. Obes Rev. 2017;18 (Suppl 1):15-24.
Rouhani MH, Haghighatdoost F, Surkan PJ, Azadbakht L. Associations between dietary energy density and obesity: A systematic review and meta-analysis of observational studies. Nutrition. 2016;32(10):1037-47
Hassapidou M, Papadopoulou SK, Vlahavas G, Kapantais E, Kaklamanou D, Pagkalos I, et al. Association of physical activity and sedentary lifestyle patterns with obesity and cardiometabolic comorbidities in Greek adults: data from the National Epidemiological Survey. Hormones (Athens). 201312(2):265-74.
Banwat ME, Chingle MP, Lar LA, Dami N, Zoakah AI. Pattern of obesity among chief executives of public and private organizations in Jos, Plateau state, Nigeria. Niger J Basic Clin Sci 2012;9:18-22.
Tzotzas T, Vlahavas G, Papadopoulou SK, Kapantais E, Kaklamanou D, Hassapidou M. Marital status and educational level associated to obesity in Greek adults: data from the National Epidemiological Survey. BMC Public Health. 2010 Nov 26;10:732.
Hulsegge G, van Mechelen W, Paagman H, Proper KI, Anema JR. The moderating role of lifestyle, age, and years working in shifts in the relationship between shift work and being overweight. Int Arch Occup Environ Health. 2020;93(6):697–705.