Exploring the Relationships between Eating Behaviours, Body Mass Index, Perceived Stress, and Dysmenorrhea among University Students in Malaysia
Abstract
This study employed a cross-sectional design to investigate the interrelationships among eating behaviours (emotional, restrained, and external), Body Mass Index (BMI), perceived stress, and dysmenorrhea among university students. A total of 190 students from three higher education institutions in Kota Kinabalu were recruited via convenience sampling. Data collection was conducted using a self-administered questionnaire comprising sections on sociodemographic background, eating behaviours (DEBQ questionnaire), stress levels (PSS-10 instrument), dysmenorrhoea (WaLIDD score), and anthropometric measurements. Relationships among the variables were analysed using Pearson’s correlation test. The findings showed that most students exhibited external eating behaviours (55.3%), followed by restrained eating (32.1%) and emotional eating (12.6%), with mean±SD scores of 3.16±0.57, 2.84±0.83, and 2.63±0.73, respectively. Most students had a normal weight (60.5%), reported medium stress (80.5%), and experienced moderate dysmenorrhea (51.1%), with corresponding means of 22.31±4.40 kg/m² for BMI, 20.89±4.96 for perceived stress, and 5.93±2.59 for dysmenorrhea severity. The restrained eating was significantly correlated with BMI (r=0.320, p<0.001). No significant correlations were observed between BMI and emotional or external eating (p>0.05). Emotional and external eating behaviours were significantly correlated with perceived stress (r=0.227; r=0.183) and dysmenorrhoea severity (r=0.223; r=0.288), with all associations significant at p<0.05. In conclusion, the exploratory findings highlight interrelated associations among eating behaviours, BMI, perceived stress, and dysmenorrhea. The results suggest potential interactions between eating patterns and body composition, with menstrual discomfort and psychological stress possibly influencing eating behaviours. These findings underscore the need for integrated university-based programmes that promote mindful eating, stress management, and menstrual health to enhance students’ well-being and academic performance.
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References
Abreu-Sánchez A, Parra-Fernández ML, Onieva-Zafra MD, Ramos-Pichardo JD, Fernández-Martínez E. 2020. Type of dysmenorrhea, menstrual characteristics and symptoms in nursing students in Southern Spain. Healthcare 8(3):302. https://doi.org/10.3390/healthcare8030302
Abubakar U, Zulkarnain AI, Samri F, Hisham SR, Alias A, Ishak M, Sugiman H, Ghozali T. 2020. Use of complementary and alternative therapies for the treatment of dysmenorrhea among undergraduate pharmacy students in Malaysia: A cross-sectional study. BMC Complement. Med. Ther 20(1):285. https://doi.org/10.1186/s12906-020-03082-4
Al-Dubai SAR. 2015. The validated Malay version of the 10-item Perceived Stress Scale (PSS-10). Malays J Med Sci. https://doi.org/10.13140/RG.2.1.2749.5127
Aslan I, Ochnik D, Çınar O. 2020. Exploring perceived stress among students in Turkey during the COVID-19 PandemicInt. J. Environ. Res Public Health 17(23):8961. https://doi.org/10.3390/ijerph17238961
Azli MS, Rahim KHM, Hasan H, Ikram EHK. 2024. Body image, eating behaviour, and physical activity among students at national defence University of Malaysia. J Gizi Pangan 19(Supp.2):163–172. https://doi.org/10.25182/jgp.2024.19.supp.2.163-172
Azli NS, Zawawi AM, Ibrahim NS, Mohamed Zukri S, Mohd Fauzi NZ, Suhaimi F. 2021. The prevalence and factors affecting primary dymenorrhea among female students. JQMA 17(2):79–88
Bakro Mohamad R, Farrukh MJ, Rajagopal M, Kristina SA, Ramatillah DL, Ming LC, Paneerselvam GS, Hadi MA. 2023. Assessment of prevalence, knowledge and health-related practices of dysmenorrhea among Malaysian women in Kuala Lumpur: A cross-sectional survey. Ann Med 55(2):2281655. https://doi.org/10.1080/07853890.2023.2281655
Benbaibeche H, Saidi H, Bounihi A, Koceir EA. 2023. Emotional and external eating styles associated with obesity. J Eat Disord 11(1):67. https://doi.org/10.1186/s40337-023-00797-w
Blondin SA, Mueller MP, Bakun PJ, Choumenkovitch SF, Tucker KL, Economos CD. 2015. Cross-sectional associations between empirically-derived dietary patterns and indicators of disease risk among university students. Nutr 8(1):3. https://doi.org/10.3390/nu8010003
Brechan I, Kvalem IL. 2015. Relationship between body dissatisfaction and disordered eating: Mediating role of self-esteem and depression. Eat Behav 17:49–58. http://dx.doi.org/10.1016/j.eatbeh.2014.12.008
Chao AM, Jastreboff AM, White MA, Grilo CM, Sinha R. 2017. Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight. Obesity 25(4):713–720. https://doi.org/10.1002/oby.21790
Choi J. 2020. Impact of stress levels on eating behaviors among college students. Nutr 12(5):1241. https://doi.org/10.3390/nu12051241
Daniel WW. 1999. Biostatistics: A Foundation for Analysis in the Health Sciences. New York (USA): John Wiley & Sons
Elran-Barak R, Sztainer M, Goldschmidt AB, Crow SJ, Peterson CB, Hill LL, Crosby RD, Powers P, Mitchell JE, Le Grange D. 2015. Dietary restriction behaviors and binge eating in anorexia nervosa, bulimia nervosa and binge eating disorder: Trans-diagnostic examination of the restraint model. Eat Behav 18:192–196. https://doi.org/10.1016/j.eatbeh.2015.05.012
Gill T. 2014. Managing and Preventing Obesity. Sawaton (UK): Woodhead Publishing
Gorczyca AM, Sjaarda LA, Mitchell EM, Perkins NJ, Schliep KC, Wactawski‐Wende J, Mumford SL. 2016. Changes in macronutrient, micronutrient, and food group intakes throughout the menstrual cycle in healthy, premenopausal women. Eur J Nutr 55(3):1181–1188. https://doi.org/10.1007/s00394-015-0931-0
Graves BS, Hall ME, Dias-Karch C, Haischer MH, Apter C. 2021. Gender differences in perceived stress and coping among college students. Plos One 16(8):e0255634. https://doi.org/10.1371/journal.pone.0255634
Jaiprakash H, Myint KN, Chai L, Nasir BM. 2016. Prevalence of dysmenorrhea and its sequel among medical students in a Malaysian University. Br J Med Med Res 16(9):1–8. http://dx.doi.org/10.9734/BJMMR/2016/25135
Kowalkowska J, Hamulka J, Wadolowska L, Górnicka M, Czarniecka-Skubina E, Gutkowska K. 2024. Restrained eating and disinhibited eating: Association with diet quality and body weight status among adolescents. Nutr 16(21):3601. https://doi.org/10.3390/nu16213601
Laessle R, Hilterscheid E. 2019. Stress-induced release of eating-related hormones in young women classified as restrained and unrestrained eaters. Neuropsychobiology 78(1):27–30. https://doi.org/10.1159/000498866
Ling J, Zahry NR. 2021. Relationships among perceived stress, emotional eating, and dietary intake in college students: Eating self-regulation as a mediator. Appetite 163:105215. https://doi.org/10.1016/j.appet.2021.105215
Mohammad Radzi KNM, Ibrahim MA, Saad N, Nazori MNM, Shamsuddin AS 2022. Academic stress and emotional eating behaviour among IIUM students. J Allied Health Sci 6(3):2693–2701. https://doi.org/10.31436/ijahs.v6i3.795
Ning CH, Vasanthi RK, Muniandy Y. 2020. A study on the prevalence of dysmenorrhea and its relationship with physical activity among young adults. Int J Health Res 10(10):39−45.
Ragavi M, Muthu MP. 2024. Factors affecting eating behavior and impact of nutrition education on the eating behaviour of adolescents (17–19 years). Nutr Food Sci 55(2). https://doi.org/10.1108/nfs-03-2024-0076
Sen LC, Jahan I, Salekin N, Shourove JH, Rahman M, Uddin MJ, Zhang C, Hamer DH, Islam GR. 2024. Food craving, vitamin A, and menstrual disorders: A comprehensive study on university female students. Plos One 19(9):e0310995. https://doi.org/10.1371/journal.pone.0310995
Sinha R, Gu P, Hart R, Guarnaccia JB. 2019. Food craving, cortisol and ghrelin responses in modeling highly palatable snack intake in the laboratory. Physiol Behav 208:112563. https://doi.org/10.1016/j.physbeh.2019.112563
Sogari G, Velez-Argumedo C, Gómez MI, Mora C. 2018. College students and eating habits: A study using an ecological model for healthy behavior. Nutr 10(12):1823. https://doi.org/10.3390/nu10121823
Souza LBD, Martins KA, Cordeiro MM, Rodrigues YDS, Rafacho BPM, Bomfim RA. 2018. Do food intake and food cravings change during the menstrual cycle of young women? Rev Bras Ginecol Obstet 40(11):686–692. https://doi.org/10.1055/s-0038-1675831
Štefan L, Čule M, Milinović I, Juranko D, Sporiš, G. 2017. The relationship between lifestyle factors and body composition in young adults. Int J Environ Res Public Health 14(8):893. http://dx.doi.org/10.3390/ijerph14080893
Stoliker BE, Lafreniere KD. 2015. The influence of perceived stress, loneliness, and learning burnout on university students' educational experience. Coll Stud J 49(1):146–160.
Subramaniam K, Low WY, Chinna K, Chin KF, Krishnaswamy S. 2017. Psychometric properties of the Malay version of the Dutch Eating Behaviour Questionnaire (DEBQ) in a sample of Malaysian adults attending a health care facility. Malays J Med Sci 24(4):64–73. https://doi.org/10.21315/mjms2017.24.4.8
Teherán AA, Piñeros LG, Pulido F, Mejía Guatibonza MC. 2018. WaLIDD score, a new tool to diagnose dysmenorrhea and predict medical leave in university students. Int J Womens Health 10:35–45. https://doi.org/10.2147/IJWH.S143510
Ulhaq ND, Amalia DP, Rafa KD, Rizkiya I, Astuti YD, Febriyanti F, Alrahmah S, Widayati KA. 2023. Correlation between stress and eating behaviour in college students: A longitudinal study. HAYATI Journal of Biosciences 30(1):88–94. https://doi.org/10.4308/hjb.30.1.88-94
[WHO] World Health Organization. 2010. Everyday actions for better health–WHO recommendations. A healthy lifestyle-WHO recommendations. https://www.who.int/europe/news-room/fact-sheets/item/a-healthy-lifestyle---who-recommendations [Accessed 10th March 2024]
Wong, YN, Aris N. 2024. Effects of examination on perceived stress, eating behaviours and nutritional status. Transactions on Science and Technology 11:4–2.
Yong C, Liu H, Yang Q, Luo J, Ouyang Y, Sun M, Xi Y, Xiang C, Lin Q. 2021. The Relationship between restrained eating, body image, and dietary intake among university students in China: A Cross-Sectional Study. Nutr 13(3):990. https://doi.org/10.3390/nu13030990
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