Nutritional and Physical Activity Levels

of University Female Students

Author: Zoe Leow
Student ID Number: 215072199
Word Count: 15148 words

Introduction

2
Leading risk factors for chronic disease are insufficient and physical
activity and inadequate nutritional intake (McGinnis 1992). University students
are an important group to as they have future societal roles, and also little is
known about their eating and physical activity habits (Leslie et al. 1999). It is
imperative to initiate healthy and active lifestyles during youth as these habits
tend to form during childhood to early adulthood (McGinnis 1992). Female
university students in particular have barriers preventing them from achieving
healthy lifestyles, such as time, body image, safety and lower socioeconomic
status (Better Health Channel 2008). Therefore, the purpose of this study is to
determine the physical activity levels and nutritional intake of university female
students. Measurements employed to estimate the nutritional intake of the
students include the short food frequency questionnaire (SFFQ) and 3-Day
weighed food intake Record (3DWFIR). The physical activity active Australia
questionnaire, 3-Day Bouchard physical activity diary, and anthropometric
assessments measured their physical activity and body fat percentage.
Participants and Methods
In order to determine and compare the food intake and activity of female
students at Deakin University, 134 female university participants aged 18-24,
undertook various assessments. The methods used to collect the data included a
short food frequency questionnaire, a 3-day food record, a 3-day physical activity
diary, a physical activity assessment questionnaire and anthropometric
assessments.
Short Food Frequency Questionnaire (SSFQ):
Subjects were asked to indicate the frequency and amount of dairy items
listed on the SFFQ they had consumed over the past three months (Angus et al.
1989). Total calcium intake was estimated by multiplying the serves of dairy
foods per day and the amount that each food contributed. The overall result for
on-dairy sources had an additional 40 percent of calcium added from dairy
products.
Three-day Food Record (3DWFIR):
Subjects recorded their intake of food and drinks over three days (Gibson
2005). All consumed foods were weighed using scales (Gibson 2005).
Condiments that are eaten several times a day in conjunction with main meals
(eg. margarine, sugar or milk) were weighed separately at the beginning and end
of each day. If there is a portion of the meal that was uneaten, or is inedible, then
it was specifically recorded and weighed, in order to obtain the actual weight of
edible food.

Three-day Physical Activity Diary:

Subjects provided a detailed account of their daily activities and the

duration of each activity in a three-day physical activity dairy (Bouchard et al.
1983). To determine each individuals total energy expenditure, the Schofield
equation was employed. Equations varied for each gender and specific age
groups (Bouchard et al. 1983).
Physical Activity Assessment Questionnaire:
Subjects answered a set of questions relating to any physical activities
that they did within a week (Australian Institute of Health and Welfare 2003).
These include any physical activity that excludes household chores, gardening or
yard work. The responses were then tabulated to calculate the three
interpretations of sufficient physical activity.
Anthropometry:
Anthropometric assessments estimated the subjects body fat percentage,
based on weight and height, circumferences, skinfolds, and bioelectrical
impedance (Durnin et al. 1974, Lukaski et al. 1985). Body mass was determined
by a weighing scale, and height was measured by the mastoid process (Jebb
1993). Waist circumference was measured around the natural waist. Mid-upperarm circumference was measured halfway between the acromion process and
the top of the olecranon process (Durnin et al. 1974). Skinfolds were measured
by the Slim Guide caliper, which was used on the bicep, triceps, subscapular, and
iliac crest skinfolds (Durnin et al. 1974)

Results
Results were found for calcium intake, macronutrient and micronutrient
intake, energy balance, physical activity and anthropometric measures of 134
female students. Statistical analysis of the techniques used included
examinations of descriptive statistics (mean, standard deviation) as well as a
paired T-test to determine if there was a significant difference in the results that
were obtained.
Calcium intake
Table 1 summarizes the participants calcium intake, and Graph 1
represents the comparison between the two techniques. The average calcium
intake via FFQ and the 3-day food record was 719.2 and 673.3 mg/day
respectively.
Statistical analyses included descriptive statistics to determine if there
was a significant difference in average calcium intake between the two
techniques, as well as a chi-square test to establish the correlation between
calcium intake from the SFFQ and the 3DWFIR.
The generated paired t-test between the techniques was p<0.245, thus
the difference between the FFQ and the 3-day record is not significant. The Chisquare test generated p<0.0001, showing that a significant relationship exists,
meaning both techniques are reliable. Graph 2 shows that there is a moderate,
positive, but not significant, correlation between the two techniques (r=0.429,
p=0.0003).

Calcium Intake
Food Frequency
Questionnaire
(mg/d)
3-day food record
(mg/d)

N
=
10
8

Mean SD

Minimum

719.2
323.8

65.0

Maximu
m
1654.0

10
8

673.3
423.1

0.0

2231.0

Serves of dairy/d
10
2.0 3.0
0.0
18.0
(FFQ)
8
Table 1: Calcium intake of the participants using the FFQ and 3-day food record.

5
1800
1600
1400
1200
1000
Calcium intabe by 3DFR (mg/day)
800
600
400
200
0

r = 0.429
p=
f(x) = 0.33x + 498.35
0.0003

500 1000 1500 2000 2500

Calcium intake by FFQ (mg/day)

Graph 1: Comparison between FFQ and 3-day food record using the Pearsons correlation
test.

Macro and Micronutrient Intake

Tables 2 and 3 summarize the estimated risk of nutrient inadequacy and
nutrient intakes respectively. The average mean percentage for energy coming
from fat, carbohydrates, protein and alcohol were 31.6%, 41.35%, 21.30%, and
0.91% respectively. The average mean percentage for calcium, iron, folate,
vitamin C, zinc, and energy intake in kJ were 673.32, 11.76, 356.74, 107.65,
10.61, and 7427.10 respectively. By using the EAR cut-point method and full
probability approach, it was found that participants were at risk of inadequate
calcium, folate, vitamin C, zinc and iron intake. Table 2 shows that the
percentages of participants that are at risk of this inadequacy, in respect to the
following micronutrients, are 62.04%, 45.37%, 9.26%, 31.48%, and 53.41%.

Micronutrie
nt
Inadequacy
Calcium
Folate
Vitamin C
Zinc
Iron

Number at
Risk

% At risk

Methods
used

67

62.04%

49
10
34
57

45.37%
9.26%
31.48%
53.41%

EAR cut-point
method

Full
Probability
Approach
Table 2: Percentage of female class population at risk of deficiency of various nutrients
using EAR cut point method and probability approach.
Nutrient
Intake from
food record
Calcium
(mg)

N=

Mean SD

Median

Minimum

Maximum

108

673.32
423.06

596.00

0.00

2241.00

6
Iron (mg)

108

Folate (mg)

108

Vitamin C

108

Zinc

108

% Fat

108

%
Carbohydrat
es
% Protein

108

11.76
7.36
356.74
187.29
107.65
89.41
10.61
8.08
31.60
8.23
41.35
10.13

10.00

2.00

46.00

331.00

48.00

962.00

90.00

12.00

557.00

9.00

1.00

50.00

33.00

10.00

56.00

42.50

9.00

69.00

108

21.30
20.00
10.00
45.00
6.90
% Alcohol
108
0.91 2.67
0.00
0.00
18.00
Energy (kJ/d)
108
7427.10
7072.50
482.00
18925.00
2704.99
Table 3: Descriptive statistics of nutrient intake (mg) of participants; statistics include
mean, SD, median, and minimum and maximum values of the intake of various
nutrients.

Energy balance
Table 4 presents the participants energy intake and expenditure. As can
be seen in Table 4, the average energy intake data collected from two different
methods, food diary and activity diary, are vastly different, being 5911 and 1929
respectively. This difference is due toAdditionally, the energy balance attained
a negative value of -766.
Energy Balance
Energy Intake (kJ/d)
Food Diary
Energy Expenditure (kJ/d)
Activity Diary
Energy Balance

N=
107

Mean SD
5911.5
6040.7
108
1929.9
2818.8
108
-766.05
4492.49
Table 4: Mean and standard deviation of 107 and 108 participants for energy intake and
expenditure respectively, and energy balance of participants.

Physical Activity
Table 5 and Graph 2 represent the energy expenditure of the participants
and the comparison between the Active Australia Survey (AAS) and the 3-day
activity record methods respectively (Australian Bureau of Statistics 2013). AAS

7
showed that participants expanded an average of 1929 kJ over a week, whilst
the 3-day Activity Record revealed it was an average of 8193 kJ. Over 80% of
students met the National Physical Activity Guidelines, which classifies as 150
to 300 minutes of moderate intensity physical activity per day (The Department
of Health 2014). This is much higher than the population data for women aged
18 to 24, of which only 32.7% met the guidelines (Australian Bureau of
Statistics 2013). Graph 2 shows that the comparison of the methods used to
estimate expenditure has a weak correlation with no significance (r=0052,
p=0.597). The calculated paired t-test between the two was p<0.002, clarifying
that the averages are significantly different.
Physical
N=
Activity
Expenditure
(kJ)
Active
108
Australia
Survey
(AAS)
3-day
108
Activity
Record
Table 5: Energy expenditure of the
day Activity Record.

Mean SD

Minimum

Maximum

1929.9
2818.8

124

13064

8193.3
3672.8

124

13064

participants via the Active Australia Survey and 3-

30000
25000

r = 0.052
p=
0.597

20000

EE using 3DD (KJ/d) 15000

10000

f(x) = - 0.01x + 8196.62

5000
0

5000

10000

15000

EE using AAS (KJ/d)

Graph 2: Correlation between energy expenditure via AAS vs 3-day Record using the
Pearsons correlation test.

Anthropometric Data
Table 6 and Graph 3 represent the anthropometric measurements of the
participants. The average for BMI was 22.4%. The percentage of fat measured
by skinfolds and BIA were 25.4% and 26.4% respectively. Graph 3 displays a
comparison of the means of the techniques used, which showed that there was
a strong, positive and significant correlation between BIA and skinfold
estimation of body fat (r=0.696, p=0.005). This means that both these
techniques are reliable for estimating body fat percentage. The generated
paired t-test was p=0.059, which shows that there was no significance between
the two methods.

8
Anthropometry

N
Mean
Minim
Maximum
=
SD
um
Height (cm)
10
163.6
149.0
183.0
8
7.5
Weight (kg)
10
60.1 9.9
35.0
97.0
8
Body Mass Index
10
22.4 3.1
14.4
33.6
(BMI)
8
Waist Cir. (cm)
10
73.9 9.5
31.0
109.0
8
% Fat Skinfolds
10
25.4 5.9
14.4
33.6
8
% Fat BIA
10
26.4 6.6
6.0
45.0
8
Table 6: Anthropometric measurements of 108 female participants, including statistical
analysis such as mean, standard deviation, minimum, and maximum data.
40
35

f(x) = 0.62x + 9.16

30
25

Fat % (Sum of four skinfolds) 20

15
10
5
0

5 10 15 20 25 30 35 40 45 50

Fat % (BIA)
Graph 3: comparison between the two % body fat techniques, skinfold test and BIA.

Discussion
The results revealed that a significant amount of participants had
inadequate micronutrient intake, and adequate macronutrient intake, physical
activity levels, body fat, BMI and waist circumference results according to the

9
WHO guidelines (WHO 2009). Significant correlations between the techniques
were observed in Graphs 1 and 3, whereas Graph 2 had a weak correlation.
Nutritional Intake
The 3-day food record has the advantage of only being used over a
specific period (3 days) (Nowson et al. 1995). However, it is time consuming for
the assessor who is coordinating the results, and those who manage the
database of results (Nowson et al. 1995). This is so as they need to be proficient
in using various instruments for the measurements, and a specific set of
mathematical and software skills are needed (Nowson et al. 1995). Moreover,
participants might have altered their intake during the assessment by increasing
their physical activity due to bias or social desirability (Willet et al. 2011). The
results gathered in this study showed that the energy intake average was lower
than normal, which could be due to participants underestimating their food
intake (Nowson et al. 1995, Willet et al. 2011). The fact that since they are
undertaking studies related to nutrition, they are inclined to be more health
conscious can also be considered (Devera-Sales et al. 1999).
The main concerns from these results include, 62.04% of participants who
have inadequate calcium intake, making them prone to osteoporosis, and
45.37% of participants who have inadequate folate intake, which in the longterm leads to anaemia (Commonwealth of Australian and New Zealand
Government 2006).
The results showed that the participants intakes for Calcium, energy,
Folate, Zinc, Iron and Vitamin C were 673.3-719.2mg/d, 1929-5911kJ/d,
356.74mg/d, 10.61mg/d, 11.76mg/d, and 107.65mg/d respectively. In comparison
to the NRVs, in which the recommended intakes (EAR) for Calcium, energy,
Folate, Zinc, Iron and Vitamin C are 840mg/d, 8200-11100kJ/d, 320mg/d,
6.5mg/d, 8mg/d, and 30mg/d respectively, it can be deduced that most
participants had inadequate Calcium and energy intake (Australian Bureau of
Statistics 2007-20080).
The recommended contribution from protein, fat and carbohydrates are
16.1, 32.8 and 48.4% respectively (National Health and Medical Research Council
2013). Compared to the results in this study, the recommendations for fat and
carbohydrates were only slightly higher the participants intake. As for alcohol
intake, the recommended contribution to energy intake from the NRV is below
5%, whereas the NNS recommends 2.0% (Bingham et al. 1994). In this study, the
alcohol intake of participants met this recommendation, at an average of 0.91%.
By comparing the Food Frequency Questionnaire (FFQ) and 24-hour recall survey,
we found that the FFQ could better identify subjects who consumed less than
800mg/d, concluding that it is a reliable method to use in population based
studies of all age groups and both genders (Bingham et al. 1994).

10

Physical Activity and Energy Expenditure Assessment

The results in this study suggest that there are a few participants who
significantly expand more energy than the others, thus causing a skew in the
distribution, average and range, as can be seen in Table 5. Limitations may be
caused by the techniques used to measure the results. The physical activity diary
measures a wide variety of activities, compared to the AAS, which specifically
measures moderate-vigorous activity over a time frame of seven days,
considering the frequency and duration (Ainsworth B.E. et al. 2000). However, it
does not measure activity that is done outside of workouts, such as gardening
(Ainsworth B.E. et al. 2000).
As for the negative value obtained for energy balance, if this result is
maintained in the long term, it can result in weight loss, muscle breakdown and
fatigue (Sallis J.F. 2000). Nonetheless, this measurement was only recorded over
three days, thus it may not be entirely accurate and reliable (Sallis J.F. 2000).
Moreover, participants tend to underestimate their food intake and overestimate
their physical activity, therefore it is not an accurate or sustainable
representation of the participants eating and exercising habits (Sallis J.F. 2000).
According to the Department of Health and Ageing, performing 30 minutes
of physical activity under moderate intensity for 5-7 days is recommended in
order to achieve health benefits (Department of Health 2014). In terms of energy
expenditure, the sufficient value is ~480kJ (The Department of Health 2014).
From the results, it can be seen that approximately 80% participants were
sufficiently active over a week. Compared to the general population, 56.6% of
women, aged 18-29 years old, were sufficiently active, whilst 45.5% were
sufficiently active over a week (Brown 2000). Participants in this study might be
more likely to be physically active as they belong to a younger age group, and
might be more conscious of their health (Devera-Sales 1999).
The two techniques used to measure physical activity, AAS and Activity
diary, had a weak correlation. This means that they are not accurate means of
measuring physical activity.

11

Anthropometric Assessment
This study found that the average BMI was 22.4. The recommended BMI
range by the World Health Organisation is 18.5-29.9 (WHO 2009). Therefore, we
can conclude that majority of participants were in the normal weight range. In
comparison to the general population, 57.1% are of normal weight, 7.2% are
underweight, 20.8% are overweight, and 14.9% are obese (Australian Bureau of
Statistics 2013).
The waist circumference average was 73.9cm. According to the WHO,
people who have a waist circumference of 80cm and above have an increased
risk of developing chronic diseases later in life (WHO 2009). The average body
fat percentage determined by skinfolds and BIA were 25.4% and 26.4%
respectively. Another study found similar results, stating that 23.4%-26.5% is the
average (Durnin J. & Womersley J. 1974). From this, we can establish that
majority of participants in this study are within the recommended levels of BMI,
waist circumference and body fat percentage. A reason for this phenomenon
could again be due to the health-related course the participants are studying,
being more likely to incorporate what they learn into their own lifestyle (DeveraSales 1999).
The difference between techniques used to measure body fat percentage,
BIA and skinfold measurement, is that BIA uses an electrical instrument to
measure the entire body, whereas the
skinfold uses callipers, which is manually measured at four specific sites
(Womersley J. & Durnin JVGA 1977). While both techniques are very different,
they both showed a strong, positive significant correlation when compared as
shown in Graph 3. Therefore, both can measure body fat percentage accurately.
Conclusion
To conclude, a majority of the female university students accomplished the
physical activity and anthropometric recommendations set by Commonwealth
Department of Health and Ageing and World Health Organisation, however the
nutrition recommendations and guidelines were not met by a significant margin
of participants. Techniques such as the FFQ, food record method, and
anthropometric method showed significant correlations, meaning they can all be
relied on. As for the physical activity assessment methods, the physical activity
diary had a weak correlation. This indicates that this study had limitations, and
therefore the results should be considered with caution. Overall, we were able to
achieve the aim of determining the students physical activity levels and
nutritional intake, and the results suggest that in order to meet the listed
guidelines and recommendations, they should increase their consumption of
vitamins and energy intake.

12

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