Department of Food Science and Nutrition, College of Life Sciences, Kuwait University, P.O. Box 5969, Safat 13060, Kuwait City, KuwaitKuwait
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This work was carried out to study the perception of 440 female and male first-year Kuwait University students on body weight gain. Students attended 11 colleges of the University, 6 of theoretical-type and 5 science-type colleges. Each college was represented by 40 students of both genders. Freshmen were chosen for this study to reduce the influence of their subsequent studying at different colleges to a minimum. A simple questionnaire that contained a section on demographics and 5 subsections, with 2 statements for each, was utilized in collecting responses from willing students. Correct responses were agreed upon by a panel of nutritionists and trained interviewers administered the questionnaire on a face-to-face basis. Obtained results were recorded and were statistically analyzed, with a set level of p<0.05 for statistical significance. Results showed varied percentages in the numbers of correct answers for 2-4 subsection (14-21%) and that only 5% of students answered all correctly. Demographic factors that significantly influenced responses were: college type on subsection 4(p<0.001), governorate of residence on subsection 3(p<0.01), and number of siblings on subsection 2(p<0.05). Other demographic factors: age, gender nationality father education, mother education and monthly income did not influence responses. With concerns being raised in the literature about the nutrition and lifestyle of university students and, consequently their effect on body weight change, it is recommended that a short course on basics of healthy nutrition and lifestyle should be offered to freshmen across all study disciplines taught in universities. Educational interventions could prove valuable for their stage of study and for the rest of their lives.
Keywords: Attitude; Health; Knowledge; Nutrition; Students; University; Attitude; Health; Knowledge; Nutrition; Students; University
Normal body weight is one of the desired parameter for enjoying good health. It can be attained
and maintained by following a healthy lifestyle that involves following sound nutrition and
being engaged in a regular physical activity program. Excess body weight is mainly because
of storage of fat and this heavier weight is a risk factor for some diseases such as diabetes, hy-
pertension and other cardiovascular diseases – among many others. The status of body weight
of an individual is a reflection of the overall effects of influencing factors, such as genetics,
young and able to acquire knowledge. Promoting a healthy pattern for their nutrition and physi-
of high school with different scholarly interests – thus, they may
choose to join either a theoretical-type or scientific-type colleges accordingly. Students in their
first year at the university may still carry over their active life
from their high school years; then as they progress in their stud-
ies and with mounting academic pressure, their lifestyle would
be modified. Freshmen scored higher in health-promoting life-
style profile than when they were in subsequent study years.1
University students were found to be at risk of eating disorders
and can be vulnerable to disturbance in their body weight and
its perception.2 About 15% of Spanish university students suf-
fered from disturbed eating attitudes and 73% led an inactive
lifestyle. American freshmen gained between 1.5-3.0 kg of
their body weight during the first semester in the university. A
meta-analysis of body weight change in first-year students in the
United States showed that nearly 66% gained an average of 3.5
kg and 10% of them gained nearly 7 kg.
With regard to university students in Kuwait, a study
revealed an alarming finding, which is that nearly 93% of fe-
males and males were either overweight or obese. A study that
involved 1037 female and male first-year students at Kuwait
University detected certain deficiencies in nutritional knowl-
edge; however, 71% felt that their health was good, 66% stated
that their nutrition as being healthy, 77% were satisfied with
their body weight and 56% followed a certain diet to be satis-
fied about their weight. The main perceived barriers to weight
maintenance among university students in Kuwait were not hav-
ing the skills to plan, shop for or time to prepare healthy food.
With such concerns about university students’ attitude and po-
tential changes in their body weight, it was of interest to explore
the perception of students on some aspects of body weight gain.
Without having freshmen to be influenced by the subject matters
they have chosen to study, this work was limited to first-year
students at Kuwait University.
Kuwait University is the main national institution of higher
learning in Kuwait, with a student body of nearly 36,000. Fe-
males account for nearly 2/3 of the total student population of
the University. The University has several colleges, some are
known as theoretical (such as the colleges of law, business ad-
1A Overweight problem is due mainly to genetic and physiological factors
1B Overweight problem is due mainly to loss of self-control Yes
2A Overweight people can lose weight if they are determined Yes
2B Overweight people can lose weight if they have considerable external motivation
3A Weight reduction pills are effective in reducing body weight
3B Those who lost weight because of pills will re-gain their weigh with time Yes
4A Overweight people feel hungry because of their expectation of being hungry
4B Overweight people feel hungry because of stomach contraction and low blood sugar level Yes
5A Overweight problem is related to early childhood and is resistant to change
5B Overweight problem is related to poor dietary habits, which can be simply changed Yes *Agreed upon by a panel of 5 nutritionists.
ministration, arts…etc.) and the others are those known as scien-
tific (such as colleges of science, engineering and petroleum, life
sciences…etc.). Being an urban university, colleges are located
at different sites in the country.
A simple questionnaire that contained a section on demographics
and a section on perceived body weight gain was utilized. The
4 section relating to weight gain consisted of 5 subsections, which
were statements to be answered. Each subsection contained an
aspect of body weight gain with two different statements, to
5 which students were to check either of the statements, i.e., one
answer only (Table 1). A panel of 5 nutritionists agreed on the
correct statements of the questionnaire; thus, such were adopted
and used for analysis of secured data. Responses were collected
6 from a total of 440 first-year students from eleven colleges of
Kuwait University, 40 from each college of the 6 theoretical col-
leges and the 5 science-oriented colleges. Theoretical-type col-
leges were those of: Arts, Business Administration, Education,
Islamic Studies, Law, and Social Sciences. Science-oriented col-
leges were those of: Allied Health Sciences, Engineering and Pe-
troleum, Life Sciences, Medicine, and Science. When students
declared that they are in their first year of study at the University,
8 they were asked to participate in this study at random. Students
who agreed to respond to this survey offered their voluntary con-
sent. Trained personnel were made familiar with the question-
naire first, then they recorded the student answers from those
who were willing to participate.
Data were recorded and analyzed using the IBM Statistical Pack-
age for Social Studies (SPSS) Editor, version 20 (International
Business Machines Corporation, New York, USA) between
February and April 2016. Descriptive analysis were expressed
in terms of percentages. The analysis of variance (ANOVA)
was utilized to detect the significance of any influencing factors
(e.g.; age, gender, college of study…etc.) on student perception
of body weight gain. The level of significance for these tests was
set at p<0.05.
Respondents to the administered questionnaire were 285(65%)
females and 155(35%) males, with an average age of 18.2±0.5
years. The total number of students was 440, of which 240 stud-
ied at theoretical colleges and 200 were from scientific colleg-
es. Demographic data of this study population are presented in
Table 2. The majority (85%) were Kuwaiti nationals, with the
remainder being non-Kuwaitis. Students came from the differ-
ent governorates of Kuwait. As for the educational level of their
fathers, the majority (76%) had university education and higher,
with lesser percentages of 16 with diplomas and 8 for up to high
school level. In contrast to fathers, nearly 46% of the mothers
had a university education or higher – with 31 and 23% who
Gender
Age (y)
Nationality
Governorate of residence
Father education
Mother education
Monthly income (KD)
No. of siblings
Table 2. Demographic data of the theoretical (n=240) and scientific (n=200) college student population (total n=440).
Table 3. Computed correct responses for statements, based on the gender of stu- obtained diplomas and had up to high school education, respec- tively. The majority of students (75%) came from homes with a relatively high monthly income. Most of students had 0-7 sib- lings (84%) and the remainder had 8 or more siblings.
Computed correct responses for the 5 subsections,
based on gender, are shown in Table 3. The overall results
showed that about 2% of students did not get answers to any of
the statements of subsections correctly. Correct answers for 1
to 3 statements ranged between 14-21%, with 39% answering 4
statements correctly. Only 5% of students answered all 5 subsec-
tion statements correctly. Data of further statistical analysis to
reveal influencing factors on the answers of the 5 subsections are
shown in Table 4. The type of college only influenced subsec-
Female 143 142 285 Male 97 58 155
17-18 186 146 332 19-20 54 54 108
Kuwaiti 198 176 374 Non-Kuwaiti 42 24 66
Al-Asima 33 60 93 Al-Ahmadi 12 19 31 Hawalli 74 68 142 Al-Jahraa 40 4 44 Al-Farawania 52 27 79 Mubarak Al-Kabir 29 22 51
Up to high school 7 26 33 Diploma 52 20 72 >University 171 154 335
Up to high school 77 25 102 Diploma 68 67 135 >University 95 108 203
500-1000 7 19 26 1000-1500 27 58 85 1500-2000 106 60 166 >2000 100 63 163
0-3 60 42 102 4-7 127 139 266 8-11 51 19 70 >11 2 0 2
All Wrong Answers 3(1.1) 4(2.6) 7(1.6)
One Correct Answer 53(18.6) 30(19.4) 83(18.9)
Two Correct Answers 40(14.0) 21(13.5) 61(13.9)
Three Correct Answers 65(22.8) 29(18.7) 94(21.4)
Four Correct Answers 108(37.9) 64(41.3) 172(39.1)
All Correct Answers 16(5.6) 7(4.5) 23(5.2)
Total Responses 285 155 440
College type Theoretical 87 153 81 159 Scientific 84 116 84 116
p value 0.219 0.075
Gender Female 112 173 107 178 Male 59 96 58 97
p value 0.800 0.980
Age 17-18 137 194 121 210 19-20 34 75 44 65
p value 0.241 0.145
Nationality Kuwaiti 151 223 148 226 Non-Kuwaiti 20 46 17 49
p value 0.365 0.065
Governorate Al-Asima 36 57 38 55 Al-Ahmadi 9 22 8 23 Hawalli 56 86 49 93 Al-Jahraa 16 28 16 28 Al-Farawania 37 42 34 45 M. Al-Kabir 17 34 20 31
p value 0.529 0.545
Father education < High school 9 24 14 19 Diploma 26 46 30 42 >University 136 199 121 214
p value 0.244 0.564
Mother education <High school 39 63 37 65 Diploma 52 83 53 82 >University 80 123 75 128
p value 0.337 0.731
Mon. income (KD) 500-1000 13 13 11 15 1000-1500 28 57 37 48 1500-2000 67 99 61 105 >2000 78 100 56 107
p value 0.674 0.731
No. of siblings 0-3 34 68 28 74 4-7 104 162 102 164 8-11 32 38 23 37 >11 1 1 2 0
p value 0.883 0.510 *Total number of responses to bothA and B for each subsection is 440. ** Numbers in bold in columns are those of correct answers.
Table 4. Student responses to statements and results of influencing factors based on ANOVA.
tion 4(p<0.001), the governorate of residence influenced subsec-
tion 3(p<0.01), and the number of siblings had an influence on
subsection 2(p<0.04). Other possible influencing factors, such
as: gender, age, nationality, education level of father, education
level of mother, and monthly family income did not have signifi-
cant effects on student answers of any of the 5 subsections of the
questionnaire.
Since the discovery of oil, Kuwait and the rest of the Gulf Coop-
eration Council (GCC) countries have gone through a transition
1A 1B** 2A** 2B 3A 3B** 4A 4B** 5A 5B**
73 167 90 150 75 165 53 147 112 88 61 139
0.367 0.001 0.866
82 203 128 157 85 200 44 111 74 81 51 104
0.932 0.570 0.506
99 232 152 179 100 231 27 82 50 59 36 73
0.339 0.908 0.436
107 267 173 201 116 258 19 47 29 37 20 46
0.409 0.541 0.827
26 67 43 50 27 66 5 26 16 15 7 24 43 99 71 71 49 93 10 34 18 26 14 30 28 51 32 47 26 53 14 37 22 29 13 38
0.014 0.839 0.634
1 32 18 15 7 26 19 53 32 40 25 47 106 229 152 183 104 231
0.399 0.719 0.720
21 81 39 63 23 79 41 94 59 76 42 93 64 139 104 99 71 132
0.089 0.100 0.807
1 25 13 13 8 18 21 64 50 35 25 60 52 114 69 97 57 109 52 111 70 93 46 117
0.089 0.100 0.807
20 82 45 57 26 76 79 187 125 141 92 174 26 44 31 39 17 53 1 1 1 1 1 1
0.157 0.046 0.307
towards urbanization. Most of these countries enjoy economic
affluence and the comfort of modern life. Food supply is abun-
dant and many of the fast food establishments are wide-spread in
this region.9 Increased food consumption and lack of sufficient
level of physical activity among populations of these countries
resulted in an alarming high rate of overweight and obesity.10
Overweight and obesity are considered as a risk factor for many
chronic diseases, thus they constitute a serious threat to pub-
lic health. Many of the nutrition-related diseases in this region; 11 12 such as: diabetes, hypertension,11 and coronary heart disease12
are most prevalent. As all segments of the population are sub-
jected to such societal conditions, it would be natural to expect
that university students are also affected by such circumstances.
The ratio of female to male student enrollment at Ku-
wait University has been nearly 2:1 since 20097 and continues
to be about the same. Our study sample was in close accordance
with such a ratio; thus, it can be considered as representative.
Also, students represented different theoretical-type and sci-
ence-oriented colleges. First-year students were chosen for this
study, so that the influence of their study in subsequent years
would be minimized. Demographic parameters chosen were
those that were expected to be influential on student perception
of body weight gain. Students of this study were: close in age,
represented both genders, mostly Kuwaiti nationals, from dif-
ferent locations in the country, mostly with university-educated
fathers, educated mothers, majority from on the “well-to-do” families, and mostly with up to 7 siblings.
Computed correct responses to the contents of the 5
subsection of the administered questionnaire were generally
low, with only 5% of students answering all 5 correctly. This
was not a surprise, as such could be related to the reported fair
level score of nutrition knowledge and a low level of awareness
about the relationship between nutrition and disease among first-
year Kuwait University.7 Further analysis of the data revealed
that most demographic factors did not prominently influence
student perception on aspects of body weight gain, with the ex-
ception of a few. This could be a function of the personality de-
velopment attained during the transition from high school to the
university environment, in spite of that most Kuwait University
students live at their family homes and commute between them
daily. However, it was expected that students of science-oriented
colleges would have higher percentages of correct answers than
their counterparts at the theoretical-type.
Dimensions of the issue at hand has to do with the glob-
al, including the Eastern Mediterranean Region13 problem of
overweight and obesity, nutritional habits, individual lifestyle,
level of nutrition education, and individual perception of body weight and shape. The World Health Organization (WHO) of
the United Nations considers that body weight gain as one of the
leading global health problems and recommended that promo-
tion of weight loss as one strategy to fight this global overweight 14,15 and obesity epidemic. However, most people who lose weight through lifestyle modifications tend to regain the weight within
several years.16 Thus, there seems to be a need for more proac-
tive and effective strategies to combat this danger. Overweight
and obesity represent a threat to public health for all segments of
society in Kuwait, including: children, adolescents, adults,
and the elderly.20
What became known as the “freshman 15” was coined
in the United States to indicate that students attending their first
year of university or college gain about 15 lb (6.8 kg). This
was found to be significantly more weight than age-matched in-
dividuals who did not attend university or college.23 Students
gained approximately 6 kg after four years of college and over-
weight and obesity increased from 18 to 31% by the end of a
study.24 In the United States, most students move to the univer-
sity campus – where they typically have “all-you-can-eat” meal 7 25 plans and lack of parental supervision.25 Also, during the fresh-
man time period at a university or college, many social forces
act on students to change their feeding, drinking, and sporting
behaviors.26 Many students who were active in sports in high
school, either stopped being active or were less active when they
joined the university.24 Thus, the freshman period at university
or college has been identified as a period of high risk for weight
gain.
This university student body weight gain phenomenon
was also studied in Europe. In Belgium, 68% of students in their
first semester at the university gained an average of 1.0 kg in
weight and 66 showed an increase in body mass index (BMI). In
The Netherlands, students gained an average of 1.1 kg in weight in first 3 months in the university and the weight gain continued
throughout the 4 years of their education, with averages of 6 kg
for males and nearly 2 kg for females. Students with weight gain
experienced hindrance in exercise and mental well-being. Only
those students who did not have irregular eating habits wanted to
change their lifestyle.28 In Spain, female and male students were
found to lead a sedentary lifestyle in their first year at the univer-
sity and as the academic year progressed, dietary habits deviated
much from the healthy Mediterranean-type diet.29 Thus, it was
concluded that university students represent a social group that
is at risk of having inappropriate nutritional habits and lifestyle.
Misperception of self-reported body weight and shape
among university students and other humans seems to be uni-
versal across the globe. This misperception represents a diffi-
culty in view of accurate data collection and in mapping appro-
priate strategies for curbing the obesity problem. In the United
States, 48% of university students who were overweight and
23% of those who were obese perceived themselves as being
in the healthy weight category. Students overestimated their
healthy weight status, while underestimating their overweight
status. Overweight and obese individuals who misperceived
their weight status were less likely to want to lose weight or
have tried to lose weight, as compared to overweight and obese
individuals who perceived their weight accurately. Females and
males who misperceived their weight were also less likely to be
engaged in more physical activity. A nationally representative
sample of 50,240 students of 9-12 grade students in both pub-
lic and private schools - the Youth Risk Behavior Surveillance
Survey (YRBSS) that took place between 2001-2009, showed 17 10,18 19 that adolescents who perceived themselves as overweight had
a stronger intention to lose weight. However, they did not de-
velop better eating or exercise habits. In contrast, normal-weight adolescents, if they perceived themselves as overweight – were
more likely to engage in health-compromising weight loss meth- 21,22 ods. It was concluded that it is critical to transform weight loss
intentions to actual behaviors, in addition to having behavioral 23 32 interventions to combat childhood obesity.32
A study across 7 European countries showed that be-
tween 32-68% of student populations were satisfied about their
body weight, while large proportions were dissatisfied and
were trying to lose weight. Their perceived weight did not al-
ways reflect actual weight status based on the BMI. Females,
in particular, perceived themselves as being overweight, despite
low rates of obesity among them.33 Perception of body image
by Italian university students showed that greater dissatisfac-
tion and higher weight status perception consistency in females
than in males among those examined.34 Studies of body weight
perception among university students were conducted in the Far
East. In Korea, height, weight, and the distribution of obesity
index showed significant differences between female and male
college students. Also, differences were found between gen-
ders about self-perception of body image and in the necessity
for body weight control.35 Percentages of 29 and 26% of both
female and male Korean adolescents misperceived their body
weight status, respectively. Within each misperception, overesti-
mation was higher than underestimation. Weight misperception
was found to be associated with socio-demographic factors such
as gender, age, BMI, place of residence, and maternal education
level.36 Eating behavior, perception of body shape, and physi-
cal status among Japanese university students were studied. Re-
strained, emotional, and external eating habits were higher in
the females than in the males and ideal body shape was lower
than its perception among females. It was concluded that gen-
der differences regarding ideal body shape were related to eat-
ing behavior.37 Prevalence of overweight and obesity among
Japanese and Korean female university students was low. Body
shape perception and ideal body shape were strongly influenced
by socioeconomic factors.38 In Thailand, both female and male
university students significantly under-reported their weights
and over-reported their heights, which showed discrepancies be-
tween perceived and measured (true) data.39
Collectively, studies have shown that misperceptions of
body weight, height, BMI, and body shape of university students
are subjected to a variety of influencing factors. Such factors in- 35,36 36 36 clude: gender, age, place of residence, maternal education 36 37 38 level, eating behavior, and socioeconomic factors. Aspects
of body weight, height, BMI, and body shape are all related to
nutrition and lifestyle. Since university students viewed as a
group that is at risk of having inappropriate nutritional habits
and lifestyle,29 enhancing their self-awareness of these aspects
and about their related health risks would be of an empirical im-
portance. Such can be achieved by interventional programs that
raise the level of nutrition knowledge of adolescents and of their
parents.36 Also, it is critical to transform weight loss intentions
to actual behaviors to combat childhood obesity.32 It was rec-
ommended that a short course on nutrition and nutrition-related
diseases to be conducted across all study disciplines at Kuwait
University.7 As results of this study showed low percentages of
correct answers to the subsections of the administered question-
naire, the previous recommendation for such an educational
course is hereby repeated. Also, since the internet is widely-
available and that university students are among the avid users
of computers, devised and implemented online awareness pro-
grams can prove to be as valuable tools. A study demonstrated
the feasibility of an inexpensive internet-based intervention in
preventing weight gain among college students in the first se-
mester of college.40 Other innovative means of electronic media
communication that can be interactive in nature may prove to be
beneficial to university students
This work was conducted to study the perception of first-year
Kuwait University students at 11 colleges, 6 of the theoretical-
type and 5 of the science-oriented type. Females represented
65% and males represented 35% of a total of 440 students, who
voluntarily responded to an administered questionnaire. Data
of correct answers to questionnaire subsections on body weight
gain were poor to fair, thus indicating a deficit in relevant knowl-
edge. These results necessitate the need to enhance many aspects
of nutrition and lifestyle. It is recommended that a short course
on nutrition and the risks for disease that result from inadequate
or improper nutrition ought to be offered to first-year students
across all disciplines being studies at the university. Develop-
ment of online, and/or other computer-oriented, programs for
enhancing students’ awareness and knowledge can be devised
and implemented. Such programs that are interactive in nature
could prove advantageous, as the internet is widely-available
and nowadays university students are avid users of it. This ap-
proach can be considered as an inexpensive means of nutritional
intervention and should be tried alongside all other means of
education and intervention.
The authors declare that they have no conflicts of interest.