In their qualitative study about obesity in young people, King, et al, found that GP's perceived there were significant barriers to patient compliance with advice on food intake and exercise.1 By contrast, healthcare students are a group who may be more likely to comply with advice on healthy eating. In December 2006 we conducted a cross-sectional, confidential questionnaire survey to assess the attitudes and behaviour of healthcare students towards eating five or more portions of fruit and vegetables per day.
Three hundred questionnaires were distributed in a lecture for first year healthcare students at St George's, University of London. Two hundred and twelve students responded giving a response rate of 71% (212/300). The mean age of responders was 22 years old and ranged from 18–54 years old. They described their ethnicity as white British; 49% (104/211), Indian; 14% (30/211), and 37% (77/211), were from other ethnicities. The students were studying medicine; 44% (93/211), physiotherapy; 16% (34/211), biomedicine; 13% (27/211), nursing; 9% (19/211), diagnostic radiography; 13% (27/211) and therapeutic radiography; 5% (11/211).
Although 61% (128/211) of responders said that they tried to eat ‘5 a day’, we found that only 17% (35/210) reported actually eating five or more portions of fruit and vegetables on the previous day. This is identical to the 2005 Health Survey for England in which the rate for five-a-day consumption of 16–24 year olds was also 17%.2 In our population we found no difference in fruit and vegetable consumption between men and women, but British white students and postgraduate students were more likely to eat ‘5 a day’ than the remainder. Therefore, 22% (23/104) of British white students ate five or more portions the day before compared with 12% (11/105) of students of other ethnicities (P = 0.023) and 26% (12/46) of postgraduates ate five a day compared with 14% (22/162) of undergraduates (P = 0.043).
Through asking the students to answer how many items of a given fruit or vegetable would constitute a single portion we also found that many healthcare students did not have a good understanding of portion size. For instance, only 11% (23/203) were able to guess the correct number of apricots that make up a single portion of fruit (the answer is three). Half (105/210) of the students also felt that there is not enough promotion of ‘5 a day’.
We found over 80% of this group of UK healthcare students failed to eat five portions of fruit and vegetables daily. As King, et al, imply, it is scarcely surprising if GPs feel they have an uphill struggle to change the behaviour of many of their obese patients!
- © British Journal of General Practice, 2007.