ABSTRACT:

Objective:

To compare the prevalence of excess of body weight between the surveys conducted in the years 2010, 2012 and 2014, in college students from the same institution.

Methods:

Three cross-sectional surveys were carried out in representative samples of students of a public institution. The excess of body weight was estimated by the body mass index and compared between the surveys, using the χ² test for linear trend, in each of the categories: sociodemographic, link with the university and health-related behaviors.

Results:

There were 1,069, 1,074 and 1,031 participants in the surveys in 2010, 2012 and 2014, respectively. Between surveys, the prevalence of overweight increased in men (2010: 30.1%; 2014: 36.4%), but not in women. There was an increased prevalence of excess body weight for the categories of sociodemographic variables link with the university and health-related behaviors in men and women.

Conclusion:

An increasing prevalence of excess body weight in college students was observed in the surveys. The conduction of interventions aimed at maintaining body weight is essential in order to avoid possible diseases associated with the concentrations of fat in inadequate levels.

Keywords:
Overweight; Obesity; Students; Cross-Sectional Studies; Longitudinal Studies

INTRODUCTION

Excess body weight (EBW) is a serious public health problem and is a risk factor for the emergence of chronic non-communicable diseases (NCDs)¹1. Luppino FS, Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67(3): 220-9. DOI: 10.1001/archgenpsychiatry.2010.2
https://doi.org/10.1001/archgenpsychiatr... ^,22. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003; 348(17): 1625-38. DOI: 10.1056/NEJMoa021423
https://doi.org/10.1056/NEJMoa021423... ^,33. Adams KF, Schatzkin A, Harris TB, Kipnis V, Mouw T, Ballard-Barbash R, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med 2006; 355(8): 763-78. DOI: 10.1056/NEJMoa055643
https://doi.org/10.1056/NEJMoa055643... . EBW is associated with psychological disorders such as depression¹1. Luppino FS, Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67(3): 220-9. DOI: 10.1001/archgenpsychiatry.2010.2
https://doi.org/10.1001/archgenpsychiatr... and increases the risks of mortality due to cancer²2. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003; 348(17): 1625-38. DOI: 10.1056/NEJMoa021423
https://doi.org/10.1056/NEJMoa021423... and other causes³.

In developed and developing countries, prevalence of EBW has increased in both young people and adults⁴4. Low S, Chin MC, Deurenberg-Yap M. Review on epidemic of obesity. Ann Acad Med Singapore 2009; 38(1): 57-9.. It is estimated that, by 2030, the worldwide concentration of people with EBW could be of 3.38 billion⁵5. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond) 2008; 32(9): 1431-7. DOI: 10.1038/ijo.2008.102
https://doi.org/10.1038/ijo.2008.102... . In Brazil, in 2002 and 2003, this occurrence in men was of 50.4%; in 2008, and in 2009, it increased to 62.5%. For women, between 2008-2009, it was of 64.9% - an increase of approximately 10% compared to 2002-2003⁶6. Brasil. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: antropometria e estado nutricional de crianças, adolescentes e adultos no Brasil. Rio de Janeiro 2010. [Internet]. Disponível em: http://www.ibge.gov.br/home/ (Acessado em 15 de outubro de 2010).
http://www.ibge.gov.br/home/... . Over time, this has also been verified in children and adolescents⁶6. Brasil. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: antropometria e estado nutricional de crianças, adolescentes e adultos no Brasil. Rio de Janeiro 2010. [Internet]. Disponível em: http://www.ibge.gov.br/home/ (Acessado em 15 de outubro de 2010).
http://www.ibge.gov.br/home/... .

As for the group in the transition phase from adolescence to adulthood (university students), studies pointed to a high prevalence of EBW in undergraduates from universities in Brazil⁷7. Costa LCF, Vasconcelos FAG. Prevalence and factors associated with nutritional status among female university students in Florianópolis, SC. Rev Bras Cineantropom Desempenho Hum 2013; 15(3): 326-37. DOI: 10.5007/1980-0037.2013v15n3p326
https://doi.org/10.5007/1980-0037.2013v1... ^,88. Fontes AC, Pontes LM, Vianna RP. Prevalência e fatores associados ao sobrepeso e obesidade em estudantes universitários, Paraíba, Brasil. Coleção Pesquisa Educação Física 2012; 11(2): 149-58., the United States⁹9. Sira N, Pawlak R. Prevalence of overweight and obesity, and dieting attitudes among Caucasian and African American college students in Eastern North Carolina: a cross-sectional survey. Nutr Res Pract 2010; 4(1): 36-42. DOI: 10.4162/nrp.2010.4.1.36
https://doi.org/10.4162/nrp.2010.4.1.36... and Portugal¹⁰10. Brandão MP, Pimentel FL, Silva CC, Cardoso MF. Factores de risco cardiovascular numa população universitária portuguesa. Rev Port Cardiol 2008; 27(1): 7-25.. This situation was observed among men and physical activity practitioners¹¹11. Nelson TF, Gortmaker SL, Subramanian SV, Cheung L, Wechsler H. Disparities in overweight and obesity among US college students. Am J Health Behav 2007; 31(4): 363-73. DOI: 10.5555/ajhb.2007.31.4.363
https://doi.org/10.5555/ajhb.2007.31.4.3... .

Information on the prevalence and factors associated with EBW in Brazilian university students is limited, since studies, to date, have been limited to the participation of new students entering university⁷7. Costa LCF, Vasconcelos FAG. Prevalence and factors associated with nutritional status among female university students in Florianópolis, SC. Rev Bras Cineantropom Desempenho Hum 2013; 15(3): 326-37. DOI: 10.5007/1980-0037.2013v15n3p326
https://doi.org/10.5007/1980-0037.2013v1... ^,1212. Madureira AS, Corseuil HX, Pelegrini A, Petroski EL. Associação entre estágios de mudança de comportamento relacionados à atividade física e estado nutricional em universitários. Cad Saúde Pública 2009; 25(10): 2139-46. DOI: 10.1590/S0102-311X2009001000005
https://doi.org/10.1590/S0102-311X200900... and women⁷7. Costa LCF, Vasconcelos FAG. Prevalence and factors associated with nutritional status among female university students in Florianópolis, SC. Rev Bras Cineantropom Desempenho Hum 2013; 15(3): 326-37. DOI: 10.5007/1980-0037.2013v15n3p326
https://doi.org/10.5007/1980-0037.2013v1... , as well as not having national coverage⁷7. Costa LCF, Vasconcelos FAG. Prevalence and factors associated with nutritional status among female university students in Florianópolis, SC. Rev Bras Cineantropom Desempenho Hum 2013; 15(3): 326-37. DOI: 10.5007/1980-0037.2013v15n3p326
https://doi.org/10.5007/1980-0037.2013v1... ^,88. Fontes AC, Pontes LM, Vianna RP. Prevalência e fatores associados ao sobrepeso e obesidade em estudantes universitários, Paraíba, Brasil. Coleção Pesquisa Educação Física 2012; 11(2): 149-58.^,1212. Madureira AS, Corseuil HX, Pelegrini A, Petroski EL. Associação entre estágios de mudança de comportamento relacionados à atividade física e estado nutricional em universitários. Cad Saúde Pública 2009; 25(10): 2139-46. DOI: 10.1590/S0102-311X2009001000005
https://doi.org/10.1590/S0102-311X200900... . In addition, the predominance of cross-sectional studies⁷7. Costa LCF, Vasconcelos FAG. Prevalence and factors associated with nutritional status among female university students in Florianópolis, SC. Rev Bras Cineantropom Desempenho Hum 2013; 15(3): 326-37. DOI: 10.5007/1980-0037.2013v15n3p326
https://doi.org/10.5007/1980-0037.2013v1... ^,88. Fontes AC, Pontes LM, Vianna RP. Prevalência e fatores associados ao sobrepeso e obesidade em estudantes universitários, Paraíba, Brasil. Coleção Pesquisa Educação Física 2012; 11(2): 149-58.^,1212. Madureira AS, Corseuil HX, Pelegrini A, Petroski EL. Associação entre estágios de mudança de comportamento relacionados à atividade física e estado nutricional em universitários. Cad Saúde Pública 2009; 25(10): 2139-46. DOI: 10.1590/S0102-311X2009001000005
https://doi.org/10.1590/S0102-311X200900... makes it difficult to identify possible temporal trends.

Consistent with the need for research on EBW in this group, it is important to consider the increase in enrollment in higher education¹³13. Brasil. Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (INEP). Censo da educação superior 2010: divulgação dos principais resultados do Censo da Educação Superior 2010. Ministério da Educação 2011. [Internet]. Disponível em: http://download.inep.gov.br/educacao_superior/censo_superior/documentos/2010/divulgacao_censo_2010.pdf (Acessado em 14 de julho de 2012).
http://download.inep.gov.br/educacao_sup... . With the exception of the South and Southeastern regions of the country, between 2001 and 2010, access to universities became more comprehensive for Brazilians, with the highest enrollment growth being in the Northeast, from 15.2% to 19.3%¹³13. Brasil. Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (INEP). Censo da educação superior 2010: divulgação dos principais resultados do Censo da Educação Superior 2010. Ministério da Educação 2011. [Internet]. Disponível em: http://download.inep.gov.br/educacao_superior/censo_superior/documentos/2010/divulgacao_censo_2010.pdf (Acessado em 14 de julho de 2012).
http://download.inep.gov.br/educacao_sup... . Considering the above, as well as the need to monitor the prevalence of EBW in this group, especially due to the negative impact of this biological marker on health, this study aimed to compare the prevalence of EBW between the surveys conducted in the years 2010, 2012 and 2014, with university students of the same institution.

METHODS

The data in this study were derived from the Monitoring of Health Indicators and Quality of Life of Academics (Monitoramento dos Indicadores de Saúde e Qualidade de Vida de Acadêmicos - MONISA) Research, held at a university in the state of Bahia. The methodological details of this study were presented in a previous publication¹⁴14. Sousa TF, Fonseca SA, José HP, Nahas MV. Estudo MONISA: características e aspectos metodológicos. Rev Bras Epidemiol 2012; 15(4): 904-7. DOI: 10.1590/S1415-790X2012000400020
https://doi.org/10.1590/S1415-790X201200... .

The target population was university students enrolled in the second semester of undergraduate courses in the years 2010, 2012 and 2014. E-learning students were excluded, as well those with special enrollment conditions and those entering the institution in the second semester, totaling: in 2010, 5,461 students; in 2012, 5,767; and in 2014, 5,244. In all three surveys, the sample estimates were similar for the adopted parameters (prevalence: 50%; relative error: 3 percentage points, or p.p.; 95% confidence interval; increase of 20 and 15% for losses and refusals). The estimated samples, in the years 2010, 2012 and 2014, were 1,232, 1,243 and 1,223, respectively.

The sample was stratified according to the distribution of the target population in the courses, time of classes and years of entry into the institution. In 2010, 30 courses were included. In 2012, four courses were added to these, resulting in 34 courses. In 2014, the Language Studies courses with qualification in Spanish and with qualification in English were fused into one single “Language Studies course”, making 33 courses. The daytime (morning and evening) and night class periods were considered.

In each of the three surveys, the years of entry into the university were organized into four categories (considering the minimum time for completion of most courses in eight semesters):

In each stratum, the university students were randomly selected, with the help of the registration list, in alphabetical order, using the Research Randomizer software.

In all three surveys, the team responsible for data collection received training in the months of July and August. These teams in each survey were composed of students not participating in the sample and by teachers of the institution, 6 in 2010, 27 in 2012 and 39 in 2014.

The university students selected were searched in the institution in up to three attempts, at different days and times; data collection was carried out between September and November in the year of each survey, before or during classes, according to the convenience of the individuals selected. There was no replacement for those who were not found or refused to participate.

The information was obtained through the Health Indicators and Quality of Life of Academics (ISAQ-A) questionnaire, developed for application in research with university students and previously validated regarding face and content, as well as tested for its levels of reproducibility¹⁵15. Sousa TF, Fonseca SA, José HP, Nahas MV. Validade e reprodutibilidade do questionário indicadores de saúde e qualidade de vida de acadêmicos (ISAQ-A). Arq Ciênc Esp 2013; 1(1): 21-30.. The questionnaires were applied individually or collectively (up to 40 students), being filled by the students themselves in the classroom. The same conditions were guaranteed during collection with only one student or in groups: guidelines were given for the filling of the questionnaires and a member of the team was available to resolve any doubts at the time of collection.

OUTCOME VARIABLE

EBW was estimated by the body mass index (BMI), using the measures of body mass and height included in the ISAQ-A questionnaire and classified according to the criteria established by the World Health Organization (WHO)¹⁶16. World Health Organization (WHO). Obesity: preventing and managing the global epidemic: report on a WHO expert consultation on obesity 3-5. Geneva: WHO; 1997. for adults aged 18 years or older, in BMI ≥ 25 kg/m², through the following equation: body mass divided by height squared. University students aged under 18 years were classified according to Cole et al.¹⁷17. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320(7244): 1240-3.

The analysis of reproducibility of the height and body mass reported, with an interval of one week, was previously published¹⁵15. Sousa TF, Fonseca SA, José HP, Nahas MV. Validade e reprodutibilidade do questionário indicadores de saúde e qualidade de vida de acadêmicos (ISAQ-A). Arq Ciênc Esp 2013; 1(1): 21-30.. The values obtained were considered satisfactory (height in meters, mean difference of - 0.002, 95%CI - 0.006 - 0.003; body mass in kilograms, mean difference of 0.36, 95%CI - 0.19 - 0.91), according to the plotting of the Bland-Altman scatter plot.

The levels of concurrent validity of the measures of body mass and stature reported in relation to the measurements showed satisfactory agreement for use in the classification of EBW in this group for use in epidemiological studies¹⁸18. Sousa TF, Barbosa AR. Validade das medidas referidas da massa corporal e estatura em universitários. ABCS Health Sci 2016; 41(2): 71-7. DOI: 10.7322/abcshs.v41i2.872
https://doi.org/10.7322/abcshs.v41i2.872... , with Kappa values of 0.76 for men and 0.74 for women.¹⁸18. Sousa TF, Barbosa AR. Validade das medidas referidas da massa corporal e estatura em universitários. ABCS Health Sci 2016; 41(2): 71-7. DOI: 10.7322/abcshs.v41i2.872
https://doi.org/10.7322/abcshs.v41i2.872... .

EXPLORATORY VARIABLES

The independent, sociodemographic variables were: sex; age group in tertiles (1^st tertile, 17 to 20 years, 2^nd tertile, 21 to 23 years, and 3^rd tertile, 24 years or more); marital status (no spouse and spouse). The variables related to the bond with the university were the period of classes (night and day) and years of exposure to the university, being:

The variables referring to health-related behaviors were:

• physical activities during leisure, classified as active (university students who reported practicing physical activity in at least one day of a typical week) and inactive (those who did not practice physical activity, but were interested in doing it, and those who did not practice but had no interest);

The information was tabulated in EpiData 3.1 and the analyzes were performed in the Statistical Package for Social Sciences (SPSS) version 15.0. Descriptive analyzes of the absolute and relative frequencies, mean and standard deviation were used. To compare the prevalence of EBW between the surveys, for each independent variable, the χ² test was used for linear trend. All analyzes were stratified by sex. The level of significance was 5%.

The design of the MONISA study was approved by the local research ethics committee, under protocol no. 382/2010. Participants signed the informed consent and had their identification information kept confidential.

RESULTS

A total of 1,069, 1,074 and 1,031 university students participated in the surveys in 2010, 2012 and 2014, respectively. The mean age of men was 23.8 years (± 5.5) in 2010, 23.6 years (± 6.5) in 2012, and 24.3 years (± 6.5) in 2014. The mean age of women was 23.3 years (± 5.0) in 2010, 23.6 years (± 6.6) in 2012, and 23.1 years (± 4.9) in 2014. Sociodemographic characteristics, information on the bond with the university and on the health-related behaviors of men and women are presented in Table 1. In the three surveys, there was a greater participation of women (2010: 54.7%, 2012: 54.9%, 2014: 52.5%).

The prevalence of EBW in university students in each survey is shown in Figure 1. There was an increase in the prevalence of EBW in men (p < 0.05), specifically between 2012 and 2014, but not in women.

The comparison between the prevalence of EBW between the surveys, according to the independent variables, is presented in Table 2. In men, there was an increase among the investigations for university students in the lowest age group, in the night period, in their first year of exposure to the university, which reported fruit consumption of up to four days a week, fatty meat and fatty chicken consumption, of soft drink consumption in up to four days a week, as well as being physically active during leisure.

For females (Table 2), over time, the increase in the prevalence of EBW occurred for those in the highest age tertile, who had a spouse, who studied in the daytime with four years and more of exposure to the university, who reported consuming fruits on five or more days of the week, who reported not ingesting chicken with fat and who did not engage in physical activity during leisure.

DISCUSSION

The prevalence of EBW has generally increased over time in men and not in women. In both groups, this increase was evidenced in different categories of sociodemographic characteristics and bond with the university, as well as health-related behaviors.

The males analyzed in this study had an increase in EBW similar to Harvard undergraduates¹¹11. Nelson TF, Gortmaker SL, Subramanian SV, Cheung L, Wechsler H. Disparities in overweight and obesity among US college students. Am J Health Behav 2007; 31(4): 363-73. DOI: 10.5555/ajhb.2007.31.4.363
https://doi.org/10.5555/ajhb.2007.31.4.3... , during the years of the investigations, and it appears that this follows the trend estimated in the surveillance of risk and protection factors for chronic diseases by phone survey (VIGITEL)¹⁹19. Brasil. Ministério da Saúde. VIGITEL 2006. Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 Estados brasileiros e no Distrito Federal em 2006. Brasília: Ministério da Saúde; 2007. 90 p.^,2020. Brasil. Ministério da Saúde. VIGITEL 2014. Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 Estados brasileiros e no Distrito Federal em 2014. Brasília: Ministério da Saúde; 2015. 152 p.. However, in this study, there were no differences in the prevalence of EBW among women, which did not occur for the female students of Havard¹¹11. Nelson TF, Gortmaker SL, Subramanian SV, Cheung L, Wechsler H. Disparities in overweight and obesity among US college students. Am J Health Behav 2007; 31(4): 363-73. DOI: 10.5555/ajhb.2007.31.4.363
https://doi.org/10.5555/ajhb.2007.31.4.3... . It is important to consider the interval between the surveys: the largest interval in the present study was four years; at Harvard, it was seven years¹¹11. Nelson TF, Gortmaker SL, Subramanian SV, Cheung L, Wechsler H. Disparities in overweight and obesity among US college students. Am J Health Behav 2007; 31(4): 363-73. DOI: 10.5555/ajhb.2007.31.4.363
https://doi.org/10.5555/ajhb.2007.31.4.3... - which may have contributed to the identification of differences between the prevalence of EBW among women.

The results showed the increase in the prevalence of EBW over time in males of the lowest age group and the first year of exposure to university. The occurrence of EBW among the categories of university exposure time in Harvard students was verified for those in the fifth year, from 28.7% in 1993 to 37.2% in 1999¹¹11. Nelson TF, Gortmaker SL, Subramanian SV, Cheung L, Wechsler H. Disparities in overweight and obesity among US college students. Am J Health Behav 2007; 31(4): 363-73. DOI: 10.5555/ajhb.2007.31.4.363
https://doi.org/10.5555/ajhb.2007.31.4.3... . In this study, the difference between the prevalence observed for the youngest men and the first year of university exposure may represent a trend in the increase on EBW in adolescence¹³13. Brasil. Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (INEP). Censo da educação superior 2010: divulgação dos principais resultados do Censo da Educação Superior 2010. Ministério da Educação 2011. [Internet]. Disponível em: http://download.inep.gov.br/educacao_superior/censo_superior/documentos/2010/divulgacao_censo_2010.pdf (Acessado em 14 de julho de 2012).
http://download.inep.gov.br/educacao_sup... , and thus, university students have entered with a higher EBW each year. In addition, it is important to consider the occurrence of BMI increase in the first few months of university, as verified in Canadian university students²¹21. Edmonds MJ, Ferreira KJ, Nikiforuk EA, Finnie AK, Leavey SH, Duncan AM, et al. Body weight and percent body fat increase during the transition from high school to university in females. J Acad Nutr Diet 2008; 108(6): 1033-7. DOI: 10.1016/j.jada.2008.03.002
https://doi.org/10.1016/j.jada.2008.03.0... .

For women, the increase in the prevalence of EBW (2010 to 2014) occurred for those in the highest age group and with four years or more of exposure to the university. Adult women from the Brazilian capitals, aged 24 to 54 years, also presented higher prevalence of EBW in 2014²⁰20. Brasil. Ministério da Saúde. VIGITEL 2014. Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 Estados brasileiros e no Distrito Federal em 2014. Brasília: Ministério da Saúde; 2015. 152 p., when compared to 2006¹⁹19. Brasil. Ministério da Saúde. VIGITEL 2006. Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 Estados brasileiros e no Distrito Federal em 2006. Brasília: Ministério da Saúde; 2007. 90 p.. In a meta-analysis, it was verified that, at the end of the university period, there was an increase of 1.55 kg in body weight, and 1.17% in fat percentage. This accumulation was higher than at the beginning²²22. Fedewa MV, Das BM, Evans EM, Dishman RK. Change in weight and adiposity in college students: a systematic review and meta-analysis. Am J Prev Med 2014; 47(5): 641-52. DOI: 10.1016/j.amepre.2014.07.035
https://doi.org/10.1016/j.amepre.2014.07... , which possibly explains the results shown here for females.

In relation to the females with a spouse, a predominance of EBW was evidenced over the years of the surveys. Studies have indicated that the same occurs with married adults of both sexes, regardless of age²³23. Janghorbani M, Amini M, Rezvanian H, Gouya MM, Delavari A, Alikhani S, et al. Association of body mass index and abdominal obesity with marital status in adults. Arch Iranian Med 2008; 11(3): 274-81. DOI: 08113/AIM.008
https://doi.org/08113/AIM.008... ^,2424. 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; 10: 732. DOI: 10.1186/1471-2458-10-732
https://doi.org/10.1186/1471-2458-10-732... , schooling and health-related behaviors²³23. Janghorbani M, Amini M, Rezvanian H, Gouya MM, Delavari A, Alikhani S, et al. Association of body mass index and abdominal obesity with marital status in adults. Arch Iranian Med 2008; 11(3): 274-81. DOI: 08113/AIM.008
https://doi.org/08113/AIM.008... . In relation to married women, this may represent less involvement in behaviors related to maintaining body weight, such as physical activity in leisure²³23. Janghorbani M, Amini M, Rezvanian H, Gouya MM, Delavari A, Alikhani S, et al. Association of body mass index and abdominal obesity with marital status in adults. Arch Iranian Med 2008; 11(3): 274-81. DOI: 08113/AIM.008
https://doi.org/08113/AIM.008... .

The results showed that the prevalence of EBW in men who studied at night increased during the surveys; however, in women, the fact was evidenced for the daytime period. Students attending night classes are usually engaged in occupational activities that require little energy expenditure and which favor an inadequate diet during the day²⁵25. Nahas MV, Barros MV, Bem MF, Oliveira ES, Loch MR. Estilo de vida e indicadores de saúde dos jovens catarinenses. Relatório da pesquisa desenvolvida pelo Núcleo de Pesquisa em Atividade Física e Saúde com amostra representativa dos estudantes de 15 a 19 anos matriculados nas escolas estaduais do ensino médio em Santa Catarina. Florianópolis: Universidade Federal de Santa Catarina; 2005.. The characteristics related to the higher prevalence of EBW in university students attending night classes are not conclusive⁸8. Fontes AC, Pontes LM, Vianna RP. Prevalência e fatores associados ao sobrepeso e obesidade em estudantes universitários, Paraíba, Brasil. Coleção Pesquisa Educação Física 2012; 11(2): 149-58.^,2626. Silva DA, Quadros TM, Gordia AP, Petroski EL. Associação do sobrepeso com variáveis sócio-demográficas e estilo de vida em universitários. Ciênc Saúde Colet 2011; 16(11): 4473-79. DOI: 10.1590/S1413-81232011001200020
https://doi.org/10.1590/S1413-8123201100... , which raises the need for scientific research on the occurrence of EBW in students of different periods.

Regarding health-related behaviors, such as eating habits and the practice of physical activities, these components have a direct impact on maintaining body weight²⁷27. Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK, et al. American college of sports medicine position stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2009; 41(2): 459-71. DOI: 10.1249/MSS.0b013e3181949333
https://doi.org/10.1249/MSS.0b013e318194... . In the present study, the increase in the prevalence of EBW was verified in men who reported the consumption of meat and chicken with fat and the irregular intake of fruits. Studies have shown that inadequate feeding may be positively related to increased body weight⁸8. Fontes AC, Pontes LM, Vianna RP. Prevalência e fatores associados ao sobrepeso e obesidade em estudantes universitários, Paraíba, Brasil. Coleção Pesquisa Educação Física 2012; 11(2): 149-58.^,2828. Menezes IH, Neutzing MB, Taddei JA. Risk factors for overweight and obesity in adolescents of a Brazilian University: a case-control study. Nutr Hosp 2009; 24(1): 17-24..

The results showed that the prevalence of EBW for males who are active during leisure increased between the surveys; however, for females, this occurred for those who reported being inactive during leisure. One possibility to explain this is that college students with EBW, seeking to control their weight, may become more active than their peers with normal weight¹²12. Madureira AS, Corseuil HX, Pelegrini A, Petroski EL. Associação entre estágios de mudança de comportamento relacionados à atividade física e estado nutricional em universitários. Cad Saúde Pública 2009; 25(10): 2139-46. DOI: 10.1590/S0102-311X2009001000005
https://doi.org/10.1590/S0102-311X200900... ; another hypothesis is that men who are active during leisure may have practiced modalities that favor the increase of muscle mass, resulting in classification as EBW²⁹29. Sousa TF. Atividades físicas praticadas no lazer por universitários de uma instituição pública do Nordeste do Brasil. Rev Bras Ativ Fís Saúde 2012; 17(2): 125-31.. The increase in the prevalence of EBW in women who are inactive during leisure may be related to the female habits, which characterize them with a higher prevalence of physical inactivity during leisure, thus, with greater possibilities of presenting EBW.

The article presents limitations that should be mentioned. First, the overlap of subjects among the surveys, which was of approximately 7% between the investigations every two years (2010 and 2012; 2012 and 2014) and 3% between 2010 and 2014. The second limitation is related to the use of a questionnaire for the investigation of health-related behaviors, in view of the possible memory bias; on the other hand, the variables employed in this study presented satisfactory levels of reproducibility¹⁵15. Sousa TF, Fonseca SA, José HP, Nahas MV. Validade e reprodutibilidade do questionário indicadores de saúde e qualidade de vida de acadêmicos (ISAQ-A). Arq Ciênc Esp 2013; 1(1): 21-30.. Although the use of reported measures of body mass and height for BMI estimation may be seen as a limitation, some validation studies of these measures have shown the possibility of use in epidemiological surveys with university students¹⁸18. Sousa TF, Barbosa AR. Validade das medidas referidas da massa corporal e estatura em universitários. ABCS Health Sci 2016; 41(2): 71-7. DOI: 10.7322/abcshs.v41i2.872
https://doi.org/10.7322/abcshs.v41i2.872... ^,3030. Savane FR, Navarrete-Muñoz EM, Hera MG, Gimenez-Monzo D, Gonzalez-Palacios S, Valera-Gran D, et al. Validez del peso y talla auto-referido en población universitaria y factores asociados a las discrepancias entre valores declarados y medidos. Nutr Hosp 2013; 28(5): 1633-8. DOI: 10.3305/nh.2013.28.5.6671
https://doi.org/10.3305/nh.2013.28.5.667... .

Among the strengths of this study are its methodological rigor, using a simple random selection process, in a stratified sample that is proportional to the different characteristics of the bond to the university. The short period of data collection may have avoided possible seasonal academic interference, such as the finals period. Finally, the monitoring aspect contributes to the surveillance of this information in university students.

CONCLUSION

The information from this study allow the conclusion that there has been an increase in the prevalence of EBW over the years between men and women. The estimates herein have pointed to this increase among men:

In females, this increase was shown for women who:

The implementation of interventions focused on the maintenance of body weight in university students is essential, as it may prevent the emergence of diseases associated with fat concentrations at inadequate levels.

References

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