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PhilSPEN Online Journal of Parenteral and Enteral Nutrition

(Article 46 | POJ_0041.html) Issue )

Thesis Abstract

PREDISPOSING FACTORS THAT AFFECT/INFLUENCE OVERWEIGHT AND OBESITY AMONG EMPLOYEES IN SAN LAZARO HOSPITAL, MANILA

Abstract | Introduction | Methodology | Results | Conclusion | Recommendation | ___ |Back to Articles Page

Submitted: December 2008

AUTHOR: CONSUELO C. SABIO

INSTITUTION WHERE THESIS WAS DONE: Philippine Women's University, Metro-Manila, Philippines

ABSTRACT: | Back

Purpose of the Study
The study primarily aimed to determine the predisposing factors that affect overweight and obesity among employees in San Lazaro Hospital, Metro Manila. Specifically, this study assessed the quality and quantity of food intake, physical activities and lifestyle practices of the selected participants from the three services of San Lazaro Hospital: the Administrative, Medical and Nursing. Based on the results; a recommendation on the management to address the problems of overweight and obesity in the institution was developed.

Methodology
The descriptive analytical research method was used with the pre-tested questionnaire as the major instrument in gathering data on nutrition. Different variables were used in the study. Weight was measured using the calibrated detecto. Height was measured using the microtoise, The BMI (Body Mass Index) was used to determine overweight and obesity by dividing the individual's weight in kilogram by the square of his/her height in meters squared (BMI = kg/m2 ). WHR was used to calculate the ratio of circumference of waist and hips which can assess fat distribution. Food frequency questionnaire was used to know how often and in what amount of foods are consumed by the participants while the 24 hour food recall was used to assess the amount of selected nutrients. Food intake was transformed into nutrients using FCT + Menu Eval Software by the FNRI. Physical Activity patterns were also analyzed by percentage distribution with the following category: light, moderate and vigorous activity (Canada's Physical Activity Guide, 2002) There were 212 out of 770 participants randomly selected for this study. Pearson's r coefficient of correlation, percentage and mean, One-way ANOVA and Tukey Methods were used as statistical tools.

Results

  1. Profile of the Participants - Majority of the participants were females whose age ranged from 40 to 59 years old and 75% of them are married. In terms of Family Medical History, more than half of the participants have hypertension (68%) while the others were having cardiovascular disease (30%), stroke (27%), and hyperlipidemia/ hypocholesterolemia (30%). The selected participants have a different salary grade ranging from Php6, 100 - 26,200.
  2. Nutritional Status - Nearly half of the participants from the three services were overweight based on the WHO Guidelines, but in Asia-Pacific Guidelines, more than half of them were overweight. Forty eight per cent (48%) among males have normal WC. 17% have low WC (measured at 35 inches or 88 cm) and almost 11 % have high WC. While in females, nearly 21 % have high WC and 37% have normal WC. In terms of WHR, results indicate that 50.5% of the participants have a low WHR ( .88) , or classified as a femoral gynoid "pear shaped" where the fat store more in the buttocks, thighs and hips.
  3. Quality and quantity of food intake - 24 hour Food Recall  -
    1.  The mean· intake for energy consumption is 1468.1 Skcal in the Administrative Service; 954.37 kcal in the Medical Service and 1103.17 kcal in the Nursing Service. The % adequacy for Energy intake in the three Services ranged from 43-87%.
    2. The mean intake for carbohydrate consumption was 195 g. in the Administrative; 218 g. in Medical and 202 g. in the Nursing Service. The % adequacy for the carbohydrates of the three services ranged from 64-94.7%.
    3. The mean intake for the consumption of protein is 61 g. in Administrative, 68g in Medical and 88g for Nursing. The % adequacy for protein in the three services ranged from 55-103%.
    4. The mean intake for the consumption of fat was 28 g. in the Administrative Service, 27 g. in Medical and 29 g. in Nursing. The % adequacy for fat in the three services ranged from 45-87%.
    5. The mean intake for the consumption of Sodium was 258 mg. in the Administrative Service, 418 mg. in the Medical and 310 mg. in the Nursing Service. The % adequacy for sodium ranged from 51 to 83.6%.
    6. Eighty nine per cent (89%) from the Administrative Service have a hearty appetite in food, so as the participants from the Nursing Service with 98% and the Medical Service, 97%.
  4. Physical Activity - Most of the participants (90-94%) were engaged in light physical activities; however, comparing the three services, the staff in the Nursing Service had done more moderate and vigorous activities, than the other two services of SLH (Medical and Administrative).
  5. Lifestyle Factors and Biochemical Markers –
    1. Most of the participants were non-smokers ranging from 64-73% and 14-31 % for current smokers.
    2. Majority of the SLH selected employees go to fastfood chains for a meal: Administrative (54 %), Medical (88.2%), Nursing SeNice (92 %).
    3. Eight per cent (8%) from the participants have hypothyroidism and only 1 % had rheumatoid arthritis.
    4. Among the three services, the Administrative Service (31.03%) had the highest cholesterol level but most participants (73-97%) have normal high density lipoprotein, also known as the good cholesterol. The triglyceride is also within the normal range. Results also showed that the three services have achieved a normal range of low density lipoprotein or "bad cholesterol". Half of the population or participants in the study have. a normal blood pressure (50- 58%).
  6. Relationships between of risk factors to overweight and obesity
    1. There was a highly positive correlation of Actual Weight, Waist Hip Ratio, Waist Circumference and Hips Circumference with the level of overweight and obesity at P0.01 level.
    2. In the Physical Activity, sports like volleyball, swimming and basketball are positively correlated with the level of overweight and obesity at P0.01 level. Ahighly positive correlation was seen in gymnastic while negative correlation of fast swimming and fast dancing with overweight and obesity.
    3. For the dietary intake, fat has a positive correlation with overweight and obesity at P0.05 level but carbohydrates, sodium and kilocalories were negatively correlated. No significant result was seen in protein.
    4. There was a significant difference on the responses of the respondents by groups in the food preference questionnaire in assessing their dietary risk of cardiovascular diseases. Results also revealed that the food preference of the respondents has a greater effect on experiencing cardiovascular diseases that included obesity, insulin resistance, hypertension and elevated cholesterol.

Conclusion

  1. In BMI WHO results, the Administrative Service had the highest percentage of overweight among the three services (45.97%). In the obese classification, the Medical Service was the highest (8.82%). Following the BMI Asia-Pacific results, the Medical Service had the highest overweight rate (55.88%). Among obese, the highest percentage was in the Administrative (22.98%) followed by the Medical (17.64%) and Nursing (9.89%).
  2. In WHR results, the selected SLH participants were classified as femoral gynoid or "pear shaped" type of obesity
  3. The selected SLH participants have low prevalence of dyslipidemias The observed rise in the prevalence of such diseases like hypertension and obesity may be due. to physiologic factors, meaning it is within the intestine, the adipose tissues, and the brain which sense the inflow of dietary nutrient, their distribution and metabolism and/or storage. The three services were having a normal cholesterol level whether it would be a Total Cholesterol, HDL and LDL.
  4. The following factors are positively influencing the occurrence of overweight and obesity among study participants:
    1. Lack or very light physical activity. Only 20% of the participants were doing vigorous activities like aerobics, jogging, basketball, fast swimming and fast dancing. Exercise promotes the oxidation of fat by increasing lean body mass in proportion to fat, restoring muscle tone, good posture and feeling of well being.
    2. Majority of the selected participants (52-92%) were fastfood eaters. Fastfood exposed the participants to high-calorie, high-fat foods that are readily available, relatively inexpensive, heavily advertised and wonderfully delicious that can contribute a major cause in the development of obesity.
    3. Fourteen to thirty one percent (14-31%) of the participants were current smokers and 11-39% of them drink alcohol. Smoking and body weight are inversely related and smokers frequently gain weight when giving up the habit. Alcohol intake is associated with increased risk of abdominal fat.

Recommendations

  1. The creation of Overweight and Obesity Club for San Lazaro Hospital as a nutrition support program is something to look forward to for all the employees with a BMI of 25-30 kg/m2. This is to build more opportunities for physical activity at work site. This will be initiated by the researcher.
  2. The development and implementation of a proposed hospital-based nutrition education program to guide Dietitians in its commitment of providing holistic health care and wellness service to the overweight and obese patients but also to other patients as well. (e.g. counseling sessions, food diary,· weigh-ins and Proposed Hospital Based Education Program).
  3. Further research is suggested on the Physical Activity and energy expenditure as well as Dietary Intake data and its contribution to overweight and obesity.
     

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