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*Corresponding Author: Brindaban B, Prof, Dept of Transfusion Medicine, TMSS Medical College, Bogra, Bangladesh.
Citation: Brindaban (2023), Nutrtional Knowledge and Dietary Habit of Medical Students: A Systematic Review, J. General Medicine and Clinical Practice. 6(5); DOI:10.31579/2639-4162/099
Copyright: © 2023, Brindaban B. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 24 June 2023 | Accepted: 06 July 2023 | Published: 20 July 2023
Keywords: infection; diabetes mellitus; periodontitis
Background: There is a general perception amongst the common masses that the medical students have a greater knowledge about the dietary habits and healthy lifestyle. Here we present a systemic review that aims to evaluate nutritional knowledge, eating habits and overall satisfaction regarding nutritional education of medical students.
Methodology: A literature search was done between October 1, and December 1, 2019 with the help of computer-based search of MEDLINE, PubMed, Scopus and allied health Literature. Medical term related headings were used in the execution of PubMed and MEDLINE searches, for such, medical student nutrition, nutritional knowledge etc. The search was restricted to studies published since 2012.
Findings: 34 studies were selected which included quantitative studies, qualitative studies, and curriculum initiatives from India, Pakistan, Malaysia, Ghana, Lithuania, Iran, Albania but in rich countries UAE, Saudi Arabia including in western ones (Canada, USA, etc.). Our analysis showed decreased level of satisfaction regarding nutritional education and also, medical students susceptible to irregular dietary habits and unhealthy lifestyle.
Conclusion: It is evident that their knowledge regarding nutrition and balanced diet has an impact on their lifestyle and dietary practices. Besides, their curriculum should be revised and awareness on healthful practices should be encouraged to adopt a healthy lifestyle that will promote individual health as well as of the society.
Diet pattern of young adults has become an important issue of research worldwide. In recent times, with the increasing burden caused by the lifestyle diseases on the health sector, there has been a renewed interest in the relationship between food and health.1 Cultural transition, social changes, westernization, family environment, exposure to mass media, and globalization all have a significant impact on eating attitudes and behaviors among young people.2 More specifically, these characteristics can mold the eating habits and establish a certain food culture during adolescent years, which ultimately may lead to a strong or a poor diet in adulthood.3 College students are in the emerging adulthood period, which is critical as because these young people establish independence to adopt life-long patterns of health and behavior. It is the time when they may get accustomed with unhealthy lifestyle characteristics and increased risk of obesity and chronic diseases.4,5 There is a general perception amongst the common masses that the students of health sciences have a greater knowledge about the correct dietary habits and healthy lifestyle as compared with non-medical students. This is significant as they are the future physicians and the students who personally adopt a healthy lifestyle are likely to positively influence their patients. However, studies have shown that medical and paramedical students especially who stay in hostels away from their home are susceptible to irregular dietary habits, lack of exercise, and addiction.1 Risk factors for the development of serious chronic diseases in later life can be altered by adaptation of healthy lifestyle, behavior or health hazards during adolescence and young adulthood.6Previous studies about barriers to healthy eating and physical activity showed that the most frequently reported barriers to healthy eating were the lack of time and stress, which is associated with poor diets and inactivity, convenience and lower cost of less nutritious fast food, lack of availability and high cost of healthier food, taste preferences (e.g. for fast foods) and lack of nutritional knowledge and skills.2 These poor eating habits acquired during this period can lead to serious diseases later in life.7 Literature suggests that those medical students who do not adopt healthy lifestyle, fails to provide effective health care to community in future as well.8 Delivering knowledge about health amongst medical students is essential because in addition to requiring it for themselves, as future physicians they shall promote health awareness and wellness amongst societies.6,9 This study was aimed to evaluate nutritional knowledge, eating habits and overall satisfaction regarding nutrition education of medical students.
Search strategy and selection criteria: This systematic review critically synthesizes literature on nutritional education and dietary pattern provided to medical students. To make sure that all relevant studies were included, a literature search was conducted between October 1 and December 1 2019 using computerized searches, ancestry searches, and hand searching of journal articles. This same search technique was used once more on March 10, 2020 to find any pertinent research that has been released since October 1, 2019. Computer-based search of MEDLINE, PubMed, Scopus and allied health Literature was conducted to find out both quantitative and qualitative studies on dietary pattern and nutritional education of medical students. The studies included quantitative studies, qualitative studies, and curriculum initiatives from India, Pakistan, Malaysia, Ghana, Lithuania, Iran, and Albania but in rich countries UAE, Saudi Arabia including western ones Canada, USA, etc. Medical terms were used for PubMed and MEDLINE searches. Search terms related to medical students included “nutrition in medical education” and “undergraduate medical nutrition education”, “dietary pattern”, “dietary habit”. Search terms for the topic of interest included “nutrition”, “knowledge”, “skills”, “nutrition counseling”, “confidence”, “nutrition care”, or “nutrition education”, “diet”, “food habit”. Google Scholar was used to obtain additional articles identified by journal hand searching. Studies published since 2012 were the only ones allowed in the search. Included studies are those study that are related to medical nutrition education, published after 2012 if they met any of the following criteria: examined any aspect of recently graduated or current medical students’ dietary pattern, nutrition knowledge, attitudes, skills, or confidence in nutrition or nutrition counseling; evaluated nutrition curriculum initiatives for medical students; or assessed current medical students’ perceptions of nutrition education.
Data analysis: The outcomes of every database search were imported into EndNote. Prior to screening, duplicate entries were eliminated. Data were extracted by using a table. Author, year, country, aim, research design, sample, participants, and relevant findings were among the data retrieved. Results that were pertinent to the inclusion criteria included information on students' eating habits, nutritional knowledge, attitudes, skills, and confidence in their ability to provide nutrition care, as well as their perceptions of the nutrition education they received during their medical education. Another researcher used the full-text study to cross-check the retrieved data from all included studies to guarantee accuracy.
Research in context:
Evidence before this study: Adequate nutrition is of great importance for every individual. Unbalanced diet is a modifiable risk factor for cardiovascular disease, cancer, diabetes etc. and so on. Usually, doctors are considered the one to apply nutrition knowledge among the patients to protect them from chronic disease and other health conditions. Many oversees literature are available online. All of them have established the fact that the diet pattern of medical students has to be improved, followed by minimizing the gap between the nutrition knowledge and attitudes necessary for the doctor to provide effective care to the patients. We did a systematic review of studies published since 2012 that investigated dietary pattern and nutrition education provided to medical students to come up with a new idea to approach the evidence-practice gap in medical nutrition education
Added value of this study: It has been a matter of argument in the past that although the doctor has a little influence over the myriad structural causes of diet related disease, poorly trained medical personnel can be itself as one structural risk factor. Hence, it is of concern that medical students should follow a balanced diet pattern and healthy lifestyle along with sufficient knowledge and skills to provide necessary health-care to the population. Through comparing with previous published articles we came to the conclusion that nutrition knowledge and training is a must to include into the curriculum and steps should be taken to incorporate student engagement having nutritional balanced food.
Implications of all the evidence available: Despite the centrality of nutrition to a healthy lifestyle, medical students are not supported to provide high-quality, effective nutrition care. To ensure graduating medical students are supported throughout their education to provide optimal nutrition care to patients, health awareness programs and training on nutritional education should be arranged for the promotion of balanced diet and healthy lifestyle among the medical students. A curriculum initiative is an important part of alleviating students’ knowledge and skills on proper nutrition. Also, students’ engagement in cooking and food preparation and availability of low-cost healthier food in the school campus has to be ensured. Counseling sessions, seminars on time management, stress relaxation and meditation workshops have to be arranged from the authority time to time. Moreover, outdoor recreational activities for all academic years should be arranged for having a healthy lifestyle.
Research in context:
The importance and benefits of healthy food cannot be over-emphasized. Food provides the body with necessary amount of energy, vitamins, minerals and antioxidant which are involved in processes that promote neuronal survival35, by synthesizing neurotransmitters responsible for the efficient flow of information across synapses all over the body. Research has provided exciting evidence for influence of dietary factors not only in building the body or preventing disease but also on specific molecular systems and mental function.36 Any imbalance in the micronutrients can lead to alteration in brain function, impaired memory, minimizing ability to solve problem, also may lead to chronic diseases.37
A study by Badiger et al showed that 5.7% of subjects were underweight, 85.2% of subjects had a normal BMI and 9.1% were overweight7 which is consistent with the results found in the study conducted at West Bengal by Sarkar et al wherein the prevalence of normal BMI was 72.7%, the proportion of underweight and overweight were 16% and 11.4% respectively.38
A study carried out among medical students in Lithuania cited that their diet was not balanced, consuming insufficient vegetable fats and fish products, fruits and vegetables and thus their food may lack in vitamins and dietary fibers or nutrition.10
In the study conducted by Yadav et al it was found that 214 (53.5%) were vegetarians and 186 (46.5%) consumed a mixed diet.13 Sharma et al in their study found that 50.5% of the subjects were vegetarian and 49.5% were non-vegetarian (N=200).39 A study conducted among 1000 healthy young female students aged 11-28 years in Mysore by Omidvar et al found that there were 332 (33.7%) vegetarians, 88 (8.9%) regular non-vegetarians and 564 (57.3%) were occasional nonvegetarians.40
In Maharastra, India, 2014, 75% of the participating students had only 1–2 portions per day.1 The same goes with medical students in California, 2017 which shows only 10% of students met recommendations for daily fruit and vegetable intake.17
In a similar study carried out amongst 207 undergraduate students at the University of Hail, Saudi Arabia in 2017, only 11.1
This survey provided a unique insight into both healthful and unhealthful dietary practices among the medical undergraduates. However, it is evidenced that their knowledge regarding nutrition and balanced diet has an impact on their lifestyle and dietary practices. Besides, their curriculum should be revised and awareness on healthful practices should be encouraged to adopt a healthy lifestyle that promotes individual health as well as of the society.
No funding was associated with this study.
Nil
This survey provided a unique insight into both healthful and unhealthful dietary practices among the medical undergraduates. However, it is evidenced that their knowledge regarding nutrition and balanced diet has an impact on their lifestyle and dietary practices. Besides, their curriculum should be revised and awareness on healthful practices should be encouraged to adopt a healthy lifestyle that promotes individual health as well as of the society.
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