Original Article

Lifestyle behavior of budding health care professionals:

A cross‑sectional descriptive study
Suresh K. Sharma1, Shiv K. Mudgal1, Kalpana Thakur1, Rakhi Gaur1,
Pradeep Aggarwal2
College of Nursing, 2Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh,
1

Uttarakhand, India

A bstract
Background: College life is a crucial period and at this age, students are more likely to get involved in unhealthy lifestyle behavior
like poor dietary habits, physical inactivity, and use of substances, etc. Objectives: Study objectives were to determine the lifestyle
behavior of budding healthcare professions and to determine the association of bio‑physical profiles with their personal profile,
activity, sleep, and dietary pattern. Settings and Design: The current study adopted a cross‑sectional design and carried out during
May - June 2019 among 284 participants of tertiary care institute. Methods and Material: Participants were selected through a
proportionate stratified sampling technique. Self‑structured questionnaire and Likert scale were used to assess the lifestyle behavior
of participants. Descriptive and inferential statistics were used for data analysis. Results: Majority of participants (70.7%) preferred
junk food as a substitute of meal. Significant number (68.3%) of students did not exercise regularly and 30.9% have disturbed sleep
pattern. One‑third of them (34.5%) were in pre‑hypertensive stage and alarming number of them having unacceptable body mass
index (BMI) (24.7%) and waist hip ratio (28.5%). Increased BMI was significantly associated with male gender (P = 0.01) and sleep
deprivation (P = 0.03). Significantly more male participants were hypertensive and pre‑hypertensive (P = 0.001). Conclusions: Study
data indicated that having knowledge regarding health is not enough to ensure that health professionals will follow healthy lifestyle
and it is important to motivate budding health care professionals to practice healthy lifestyle with an aim of health promotion and
prevention of diseases.

Keywords: Biophysical profile, budding health care professionals, dietary pattern, lifestyle behavior

Introduction to lifestyle. In recent decades, most of the people followed

unhealthy lifestyle behavior and therefore, the burden of
Lifestyle behavior is a way of living that can be determined various non‑communicable illnesses like hypertension, obesity,
through healthy or unhealthy practices. Healthy lifestyle behavior metabolic diseases, and cardiovascular diseases have increased
is a way that includes physical activity, balanced diet, avoidance in the country.[2]
of substances use, and stress management.[1] As per World
Health Organization (WHO) report, ~60% of contributing It has been estimated that by 2020, these illnesses
factors to health and quality of life of individuals are related (non‑communicable) will be accountable for seven out of every
ten deaths in developing nations.[3] Further, another paper has
Address for correspondence: Dr. Suresh K Sharma,
documented that chronic illnesses are beginning to hit the young
College of Nursing, AIIMS, Rishikesh, Uttarakhand ‑ 249 203, population instead of only being restricted to adults.[4] Obesity,
India. E‑mail: [email protected] the fifth leading cause of death around the globe is increasing at

Received: 28‑03‑2020 Revised: 08‑06‑2020

Accepted: 19-06-2020 Published: 30-07-2020 This is an open access journal, and articles are distributed under the terms of the Creative
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remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is
Access this article online given and the new creations are licensed under the identical terms.
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How to cite this article: Sharma SK, Mudgal SK, Thakur K, Gaur R,
DOI: Aggarwal P. Lifestyle behavior of budding health care professionals:
10.4103/jfmpc.jfmpc_491_20 A cross-sectional descriptive study. J Family Med Prim Care
2020;9:3525-31.

© 2020 Journal of Family Medicine and Primary Care | Published by Wolters Kluwer ‑ Medknow 3525
 Sharma, et al.: Lifestyle behaviour of budding health care professionals

an alarming pace and physical inactivity and poor eating pattern were taken on the first day after interview. However, three blood
are among the main‑related factors for the obesity epidemic.[5] pressure readings are taken at the same time for three consecutive
days using a single standardized android sphygmomanometer.
The transition from school to college is a crucial period because The average time taken to administer the tool and recording
students in this phase face enormous challenges which include measurements was 45 min.
adapting to new social environments and lifestyle changes.[6]
During this age, students are more susceptible to adapt and Sample size was calculated by using formula,=N/1+Ne2; where
practice unhealthy lifestyles like poor dietary habits, use of N = Population size (620), absolute error of 5%, confidence
substances, physical inactivity, etc.[7] Studies carried out among interval as 95%, and minimum estimated sample size needed was
medical and nursing students reported that even though 276 approximately. An overall sample of 284 participants was
budding healthcare professionals are well informed about the selected, consideration 15% non‑response rate.[13] Participants
significance of practicing unhealthy lifestyle but still they did were selected by using proportionate stratified sampling
not follow the suggested guidelines for health lifestyle.[8] Healthy technique from each batch of the medical and nursing students.
lifestyle plays a vital role in maintaining good health. Daily
exercise routine and good dietary patterns have been reported Data collection measures
as having promised benefits for psychological and physical A self‑structured questionnaire was used for data collection,
fitness and good academic performance.[7,8] Therefore, assessing which was validated by seven experts and was found reliable
the lifestyle of university students is crucial for developing in pilot try‑out (r = 0.83). Questionnaire consisted; four
tailored health promotion actions aimed at enhancing students’ sections (a) Demographic profile (age, gender, academic
quality of life. discipline, and monthly income of family); (b) personal
profile (history of substance abuse, exercise/activity, and sleep
Medical field is a challenging and stressful profession and pattern.); (c) biophysical profile (body mass index, waist to hip
participants who are studying at universities tend to develop
ratio, and blood pressure.) and (d) dietary pattern (eating habits,
unhealthy lifestyle behavior.[9,10] Inadequate exercise routine,
main meals of the day, meal regularity, and reasons for skipping
inadequate sleep, and poor dietary habits by budding healthcare
meals, skipped meals substitute, practice of fast, and frequency
professionals cannot be ignored. Lifestyle behavior practiced by
of eating outside the mess).
college students is gaining an increased attention in developing
countries like India because lifestyle is an element, which has
Body mass index (BMI) was calculated based on the
a significant impact on quality of life.[11] Lifestyle behavior of
measured weight and height of the participants and the
college students or young adults has become an interesting
waist to hip ratio was calculated after measuring waist and
research area around the globe.
hip circumferences. The participants were categorized as
underweight (<18.5), normal (18.524.99), and overweight
Various studies[11‑13] carried out in United States of America (USA)
(≥25) based on the WHO BMI chart while based on WHR;
and European countries had investigated the lifestyle behaviors
they were categorized in acceptable (0.9 or less in men and
of college students specially their dietary habits; physical activity,
0.85 or less for women) and unacceptable range. Furthermore,
and sleep pattern that helped in forming further guidelines to
blood pressure was measured on three consecutive days with
promote healthy behaviors. However, there is limited literature
the same instrument and participants were categorized as
on lifestyle behaviors among college students particularly
normal (≤120/80 mm Hg), pre‑hypertension (121139/8189
budding health care professionals, which comprise the highly
mm Hg), and hypertension (≥140/90 mm Hg).
educated chunk of adolescents in India. Thus present study is a
modest attempt to increase our knowledge on lifestyle behaviors
among budding health care professionals and enhancing
Ethical permission
our understanding about healthy or unhealthy behavior that Ethical clearance was obtained from the Institutional Ethics
significantly affect students’ present and future health. Committee wide letter no. ECR/736/Inst/UK/2015/RR/18 on
12-04-2019. Data were collected after getting formal permission
Material and Methods from the concerned authorities. A written informed consent was
taken from each student after explaining purpose of the study.
Study design and sample size
A cross‑sectional descriptive study was conducted among nursing Statistical analysis
and medical students from tertiary care institute from May - Descriptive and inferential statistics were used for analysis of
June 2019. Study aimed to determine the lifestyle behavior of data with SPSS version 23.0 as per the study objectives and
budding health care professions and to determine the association hypothesis. In descriptive analysis, calculations were done by
of bio‑physical profiles with their personal profile, activity, using frequency, percentage, mean, and standard deviation; and
sleep, and dietary pattern. There was 100% response rate as for inferential statistics, Chi‑square was used to find association
study participants were face‑to‑face interviewed and single of participants’ BMI and blood pressure with demographic
measurement of height, weight, waist, and hip circumference variables.

Journal of Family Medicine and Primary Care 3526 Volume 9 : Issue 7 : July 2020
 Sharma, et al.: Lifestyle behaviour of budding health care professionals

Results friends among 71.4% participants and for 42% it was due to
study and stress [Table 1].
A total of 284 budding health care professionals between
the ages, 17-25 were included in this study, of which 64.4% The dietary pattern of participants revealed that for 62.3%
belonged to 20-22 years and 57.7% were females. The sample were non‑vegetarian and rest 37.7% were vegetarian. Majority
was constituted of participants from the academic year first to of participant (74.6%) reported dinner and breakfast as the
fourth. Little more than half (52.8%) of participants’ family main meal of the day. Majority of participants (63%) had three
monthly income was rupees 44,480 or above. Personal profile meals pattern, while 28.9% skipped meal with substitute and
of participants revealed that very few participants 11 (3.9%) 8.1% skipped meal without substitute. The main reasons of
had habits of bidi/cigarette smoking and only 3 participants skipping meal were lack taste of food (58.1%), shortage of
smoke more than 10 bidi/cigarette per day, while 23 (8.1%) time (37.1%), and health/other factors (13.3%). Majority of
consumed alcohol and among them majority (15 participants) participants (70.7%) preferred junk food and beverages as
drunk alcohol occasionally. Furthermore, it was found that 31.7% substitute for skipped meal, followed by fruits/juice (57.3%),
of participants exercised daily followed by 41.5% who exercised while 39% preferred snacks (homemade preparation, dry
occasionally and 26.8% did not exercise. Out of all, the most fruits, biscuits, namkeen). Further, more than half of the
common pattern of exercise was walking (85.1%) followed by participants (55.3%) reported occasional eating out followed by
jogging (59.1%) and other sports (46.7%) while only 20.7% had weekly (40.8%) and very few eat outside daily (3.9%). Very few
practice of yoga. Furthermore, 30.7% of them did exercise for participants did fast weekly (5.3%); while about one third of
less than 15 minutes, while 25.5% did more than 45 minutes. them practice fast occasionally (33.5%) [Table 1].
In regards to sleep pattern, 69% had a routine of sleeping for
6-8 h, whereas 30.9% reported sleep deprivation and the reason Based on participants’ BMI values, 75.4% of the participants
for inadequate sleep were the use of mobile phone, media, and were in category of normal weight, and 12% and 12.7%

Table 1: Physical activity, substance abuse, sleep, dietary pattern of the participants (n=284)
Physical activity & substance abuse sleep pattern f (%) Dietary pattern f (%)
Exercise/workout routine Eating pattern
No exercise 76 (26.8) Non-vegetarian 177 (62.3)
occasionally 118 (41.5) Vegetarian 107 (37.7)
Daily 90 (31.7)
Specific type of exercise* (n=208) Main meal of the day
Yoga 43 (20.7) Dinner & breakfast 212 (74.6)
Walking 177 (85.1) Breakfast 14 (4.9)
Jogging 123 (59.1) Lunch 28 (9.9)
Other (sports) 97 (46.7) Dinner 13 (4.6)
Lunch & dinner 17 (5.9)
Duration of exercise in minutes (n=208)
<15 min 64 (30.7) Meal regularity
16-45 min 91 (43.8) Three meals regularly 179 (63.0)
>45 min 53 (25.5) Skipping meal with substitute 82 (28.9)
Skipping without substitute 23 (8.1)
Substance abuse (n=34) Reason for skipping meals*
Smoking 11 (3.9) Food not tasty 61 (58.1)
Alcohol consumption 23 (8.1) Shortage of time 39 (37.1)
Health factors 11 (10.5)
Others 09 (2.8)
Number and amount of substances abuse(n=34) Substitute for skipped meals*
>10 bidi/cigarette per day Junk food & beverages 44 (70.7)
>250 ml/sitting 3 (27.3) Fruits/juices 47 (57.3)
8 (34.8) Snacks** 32 (39.0)
Duration of sleep Practice of fast
<6 h 58 (20.4) Not at all 174 (61.3)
6-8 h 196 (69.0) Occasionally 95 (33.5)
>8 h 30 (10.6) Weekly 15 (5.3)
Reasons for disturbed sleep*(n=88) How often you eat outside
Use of mobile or media
Chat with friends 52 (59.1)
Study 11 (12.3) Daily 11 (3.9)
Stress 16 (18.1) Weekly 116 (40.8)
21 (23.9) Occasionally 157 (55.3)
*Multiple responses **Homemade preparation, dry fruits, etc.

Journal of Family Medicine and Primary Care 3527 Volume 9 : Issue 7 : July 2020
 Sharma, et al.: Lifestyle behaviour of budding health care professionals

were in overweight and under‑weight category. For waist to more number of males were pre‑hypertensive or hypertensive
hip ratio, 28.5% participants were in unacceptable range. as compared to their female counterparts (P = 0.001); while
About average systolic/diastolic BP (as it was measured three blood pressure of participants was not found to be associated
consecutive days), more than one‑third (34.5%) participants with exercise pattern, duration of sleep, eating habits, and meal
were in pre‑hypertensive category and 1.5% were suffering regularity (P > 0.05) [Table 3].
from hypertension.
Discussion
Table 2 depicts an association of BMI with selected parameters
of participants, that is, gender, exercise pattern, duration In this study, about two‑third of the participants were 20-22 years
of sleep, eating habits, and meal regularity. It was found old and more than half of them were females. Further, 52.8%
that increased BMI was found in participants with male participants’ family monthly income was Rs. 44, 418, or above.
gender (P = 0.01) and sleep deprivation (P = 0.03); while exercise Similar findings have been reported for other related studies[14‑16]
patterns, eating habits, and meal regularity were not found to which found that most budding health care professionals were
be associated with BMI (P > 0.05). Surprisingly, significantly female and belong to 20-23 years of age group.

Table 2: Association of BMI with gender, physical activity, sleep, and dietary pattern of participants(n=284)
Demographic variables BMI
<18.5 f (%) 18.524.9 f (%) ≥25 f (%) χ2/P
Gender 8.82/0.01*
07 (5.8) 97 (80.8) 16 (13.3)
Male
29 (17.7) 117 (71.3) 18 (11.0)
Female
Exercise routine 1.17/0.88
11 (14.5) 58 (76.3) 07 (9.2)
No exercise
15 (12.7) 87 (73.7) 16 (13.6)
Occasionally
10 (9.0) 69 (76.8) 11 (12.2)
Daily
Duration of sleep 10.34/0.03*
04 (6.9) 42 (72.4) 12 (20.7)
<6 h
01 (3.3) 26 (86.7) 03 (10.0)
6-8 h
31 (15.8) 146 (74.5) 19 (9.7)
>8 h
Eating habits 0.83/ 0.65
16 (14.9) 79 (73.8) 12 (11.2)
Vegetarian
20 (11.3) 135 (76.3) 22 (12.4)
Non-vegetarian
Meal regularity 0.82/0.93
25 (13.9) 133 (74.3) 21 (11.8)
Three meals regularly
09 (11.0) 63 (76.8) 10 (12.2)
Skipping with substitute
02 (8.7) 18 (78.3) 03 (13)
Skipping without substitute
* Chi-square statistical analysis with significance at P<0.05

Table 3: Association of BP with gender, physical activity, sleep, and dietary pattern of participants n=284
Demographic variables Blood pressure
Normal f (%) Pre-HTN f (%) HTN f (%) χ2/P
Gender 59.8/0.00*
Male 46 (38.3) 71 (59.2) 03 (2.5)
Female 136 (82.9) 27 (16.5) 01 (0.6)
Exercise routine 4.77/0.31
No exercise 55 (72.4) 21 (27.6) 00 (0)
Occasionally 75 (63.6) 41 (34.7) 02 (1.7)
Daily 52 (57.8) 36 (40.0) 02 (2.2)
Duration of sleep 8.19/0.08
<6 h 36 (62.1) 21 (36.2) 01 (1.7)
6-8 h 16 (53.3) 12 (40.0) 02 (6.7)
>8 h 130 (66.3) 65 (33.2) 01 (0.5)
Eating habits 2.01/0.36
Vegetarian 74 (69.2) 32 (29.9) 01 (0.9)
Non-vegetarian 108 (61.0) 66 (37.3) 03 (1.7)
Meal regularity 2.40/0.66
Three meals regularly 119 (66.5) 58 (32.4) 02 (1.1)
Skipping with substitute 50 (61) 30 (36.6) 02 (2.4)
Skipping without substitute 13 (56.5) 10 (43.5) 00 (0)
* Chi-square statistical analysis with significance at P<0.05

Journal of Family Medicine and Primary Care 3528 Volume 9 : Issue 7 : July 2020
 Sharma, et al.: Lifestyle behaviour of budding health care professionals

In the present study 11 (3.9%) participants had reported a shows 13.2% of participants were overweight, respectively,
habit of smoking, while 23 (8.1%) were alcoholic. Few studies while 31.22% participants were having abnormal waist to hip
revealed ~ 58% of medical students had a habit of smoking ratio in a study.[26] Surprisingly, more than one‑third of the
which is consistent with the results of the current study.[17,18] participants (36%) were found pre‑hypertensive (34.5%) and
Some studies reported drinking alcohol among 6-10% of medical hypertensive (1.5%). This was similar to study[27] done where
students which is similar to the present study.[18,19] Whereas, prevalence of pre‑hypertension and hypertension were reported
various studies[17,19‑21] reported that there are more common by 36% of college students.
practice of smoking and drinking among medical students. These
findings could be explained by the fact that college students do Present study reported statistical significant association between
not worry about their health status, think themselves relatively biophysical profile of students, with selected demographic
young and risk‑free.[17,19] variables (gender and duration of sleep). These findings
resemble to another studies which concluded that demographic
Further, findings of our study revealed that less than one characteristics have significant relationship with biophysical
third (31.7%) of students exercised daily and among the profile.[15,24,26]
majority (85.1%) had considered walk as a main physical
activity. Our findings indicated that a significant number of Lifestyle behaviors in adolescent or young adulthood may have
participants exercised less than 15 min per day. These findings an influence on diseases related to lifestyle in the future. The
were similar to previous studies, which reported lack of being diseases among adults can be prevented from identifying the
physically active on a daily basis was more prevalent among practices and rectifying them at an early stage. Increasing the
study participants.[14,21] awareness of healthy lifestyle behaviors to maintain normal
biophysical profile among the college students is therefore
In the present study, 30.9% participants reported sleep essential and primary health care physicians play crucial role by
deprivation and the reason for inadequate sleep were the use of becoming a role model and practicing healthy lifestyle before
mobile phone, media, and friends among 71.4% participants and advising to others. This article will definitely provide an idea
for 42% participants reported that it was due to study and stress.
to primary health care physicians regarding unhealthy lifestyle
These results are in line with other studies[16,22,23], which reported
practices among budding professionals in medical field and they
the use of mobile and stress were the major factors for disturbed
can take innovative steps so that they refrain from unhealthy
sleep pattern among budding health care professionals. Study
lifestyle and can become future ambassador for patients to
shows that disturb sleep pattern may result in depression, anxiety,
adopt healthy lifestyle practices.
improper interpersonal relationship, poor academic performance,
and more vulnerability to substance abuse.[16,22] Therefore,
reorganization, appropriate counseling, better planning, and Conclusion
support is needed and should be provided to students who are Present study findings show that budding health care
suffering from disturb sleep pattern.
professionals are into unhealthy lifestyle, where a significant
number of professionals are practicing unhealthy dietary habits,
Breakfast is generally considered the major meal of the day as
sleep deprivation, and inadequate physical activity. Few of
it gives an energetic start and maintains energy level for body’s
them also reported habits of alcohol use and smoking. Further,
function throughout the day. Present study reports impressive
a significant number of participants are overweight, have
findings that majority of the participants (63%) were taking
unacceptable WHR, and either hypertensive/pre‑hypertensive.
three meals per day and this is in line with a study carried out
Our results highlight the requirement of further research to
by Sharma et al.[24]. Dinner and breakfast were considered as the
explore the barriers and potential promoters to adopt healthy
main meal of the day by almost 74.6% which is similar to other
lifestyle behaviors at the medical universities. Moreover, it is
study findings, where 68% respondents reported breakfast as
needed to plan and implement health promotion programs to
their important meal.[25] Current study result shows that 28.9%
motivate budding healthcare professionals to engage in regular
participants skipped their meal with substitute and out of them
70.7% participants take junk food and beverage as a substitute exercise, maintain normal weight, and practice healthy dietary
for their skipped meal. These finding are in resemblance with pattern with the aim of health promotion and prevention of
another similar study[24] where 32.5% participants skipped their diseases at university level. Finally, coordinated efforts including
meal with substitute and majority of them preferred junk food the individual, social, and administration levels are required to
and bakery items. create an environment where healthy lifestyle behavior flourishes
and become a routine pattern.
With regards to BMI, waist to hip ratio and blood pressure of
study participants revealed that 12.7% and 12% of students Recommendations
were underweight and overweight, respectively, while 28.5% of On the basis of the findings of the study results, it can be
students were in unacceptable range of WHR. Study findings recommended that plan and implement health promotion
are in line with studies carried out by Fernandez et al.[15] which programs to motivate budding healthcare professionals to engage

Journal of Family Medicine and Primary Care 3529 Volume 9 : Issue 7 : July 2020
 Sharma, et al.: Lifestyle behaviour of budding health care professionals

in regular exercise, maintain normal weight, and practice healthy Across sectional study.Nutr J2010;9:39.
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9. Laska MN, Pasch KE, Lust K, Story M, Ehlinger E. Latent class
influence the biophysical profile of the sample. Furthermore,
analysis of lifestyle characteristics and health risk behaviors
this is a single centric study and tool used was based on more among college youth. PrevSci2009;10:376‑86.
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Declaration of patient consent 11. American College Health Association National College
Health Assessment Spring 2006 reference group data
The authors certify that they have obtained all appropriate report (abridged).J Am Col Health2007;55:195‑206.
patient consent forms. In the form the patient(s) has/have 12. Steptoe A, Wardle J, Cui W, Bellisle F, Zotti AM, Baranyai R,
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