Prevalence and predictors of binge eating disorder symptoms among a sample of university students in Bangladesh: A cross-sectional survey

Background and Aims

There is a dearth of information about binge eating disorder (BED) among Bangladeshi university students, who may be more susceptible to BED due to the rise in unhealthy lifestyles and food habits. Therefore, the purpose of this study was to assess the prevalence and associated factors of BED symptoms among Bangladeshi university students.

Methods

Students (N = 525) from three public universities in Bangladesh participated in this cross-sectional study between November 2022 and March 2023. Face-to-face interviews were conducted using a structured paper-based questionnaire that included two validated survey tools; the binge eating disorder screener and the patient health questionnaire-9. To identify the factors associated with BED symptoms, multiple logistic regression analysis was conducted, with sociodemographic and behavioral information (e.g., age, sex, smoking status, etc.) considered as covariates.

Results

The prevalence of BED symptoms among participants (mean age 21.28 years, 50.3% male and 49.7% female) was 20.6%. Male students had a 2.28 times higher likelihood of having BED symptoms compared to female counterparts (adjusted odds ratio [AOR] = 2.28; 95% CI: 1.33-3.89). Older students (AOR = 3.56, 95% CI: 1.80-7.05), students who were overweight or obese (AOR = 3.32, 95% CI: 1.87-5.89), and students reporting higher depressive symptoms (AOR = 2.69, 95% CI: 1.66-4.35) were at greater risk for developing BED compared to their respective counterparts.

Conclusions

This study provides new insights into the prevalence of BED symptoms and its contributing factors among Bangladeshi students. Approximately 1-in-5 university students reported having BED symptoms. University students who are older, overweight, or obese, and who report depressive symptoms may be at greatest risk. Future longitudinal studies are needed to determine the causal factors underlying BED. Findings from this study can assist policymakers and public health professionals in developing effective and targeted strategies to mitigate the risks associated with BED among Bangladeshi university students.

Exposure to secondhand smoke is associated with poor sleep quality among non-smoking university students in Bangladesh: a cross-sectional survey

Although secondhand smoke (SHS) exposure is predominant in Bangladesh, the adverse effect of SHS exposure on health-related behaviors, such as sleep quality, have remained an under-investigated area of the country's public health landscape. Therefore, the purpose of this study was to examine the association between SHS exposure and poor sleep quality among non-smoking university students in Bangladesh. A cross-sectional survey was carried out between May and September 2022. SHS exposure (main predictor variable) and other covariates (e.g., age, sex, etc.) were measured using a self-reported questionnaire and sleep quality (outcome variable) was measured via the Pittsburgh Sleep Quality Index. Multiple logistic regression models investigated the association between SHS exposure and poor sleep quality. The study included 390 students (mean age: 22 years, 53.8% male). Approximately 41.8% of the participants reported SHS exposure, and 50.5% had poor sleep quality. Students exposed to SHS were more likely to have poor sleep quality compared to their counterparts (AOR = 1.61; 95% CI 1.01, 2.58). Subgroup analysis revealed poor sleep quality was 2-times higher among male students exposed to SHS than those male students without SHS exposure (AOR = 2.03; 95% CI 1.05, 3.93). No association was found in female students. Findings from this study warrant increased awareness and public health initiatives on the implications of SHS on health behaviors, such as sleep quality, in non-smoking Bangladeshi university students.

Food neophobia and its association with sociodemographic factors and food preferences among Bangladeshi university students: Evidence from a cross-sectional study

Food neophobia, described as a reluctance to eat and or avoid new food, is a personality trait that affects food choice. Despite its potential influence on an individual's food intake, food neophobia has been poorly investigated in Bangladesh. This cross-sectional study was designed to evaluate food neophobia and its association with sociodemographic factors and food preferences in a sample of Bangladeshi university students. Five hundred students from five public universities completed the structured surveys. Food neophobia was assessed by a 10-item validated food neophobia scale with some minor modifications based on study settings. A multiple linear regression model was used to observe the factors associated with food neophobia. The mean food neophobia score among study participants was 37.45 (SD: 13.39, Range: 13-67). According to the adjusted statistical model, being female (regression coefficient, β = 2.73), having higher monthly family income (β = -6.64), being underweight (β = 4.68), being overweight (β = -4.63), having any food allergy (β = 9.09), and a history of sickness after eating a new food item (β = 5.16) were significantly associated with food neophobia amongst the participants. The participants' liking of various food items such as vegetables were significantly correlated with food neophobia scores. Nutrition education policies and programs are of importance to address the students' food neophobia during their tertiary education so that they maintain lifelong healthy dietary habits and consume a variety of foods to improve their physical health and well-being.

Association between Nutrition Literacy and Bangladeshi Adults' Healthy Eating Behaviors: Evidence from the Nutrition Literacy Study 2021

This study investigated the association between healthy eating behaviors and nutrition literacy in a sample of Bangladeshi adults. A cross-sectional survey was conducted among 400 adults from two districts of Bangladesh (Dhaka and Chattogram). Data were generated by in-person interviews using a structured questionnaire. The Nutrition Literacy Scale and National Dietary Guidelines for Bangladesh were used to assess nutrition literacy and healthy eating behaviors, respectively. Multiple linear regression models were used to observe the association. The mean score for healthy eating behavior was 21.8 (SD = 4.8, Range: 5−33) on a scale of 34. A moderate positive correlation was found between nutrition literacy and healthy eating behavior of participants (r = 0.28, p < 0.001). The adjusted regression model showed that a 1 unit increase in nutrition literacy reflected an increase in the healthy eating behavior score of participants by 0.22 units (β = 0.223, p < 0.001). Findings showed an association between nutrition literacy and eating behaviors in Bangladeshi adults. Future research could be carried out to establish a causal relationship that may help inform the necessity of educational interventions for Bangladeshi adults to assist with meeting national nutrition-related targets.

Prevalence and factors associated with dietary supplement use among Bangladeshi public university students: A cross-sectional study

INTRODUCTION

The usage of dietary supplement (DS) such as vitamins, minerals, and fish oil has expanded, but there is limited data on their use by sub-populations such as university students. The study was aimed to investigate the prevalence of DS use among Bangladeshi university students and its associated factors.

METHODS

A cross-sectional survey of 390 students was conducted from two public universities from Barishal Division in Bangladesh using a structured questionnaire with 72 questions divided into five sections: sociodemographic, knowledge, opinions, and attitudes, types of DS, reasons and sources for using DS, and adverse reactions after taking DS. Descriptive statistics and logistic regression were utilized to estimate the results.

RESULTS

Among all the students, 15.6% students were using DS where only 7.7% of them used DS according to physicians' recommendation. Additionally, students used DS for general health and well-being, weight gaining and as a source of energy for physical and sporting activities, etc. The use of DS was significantly associated with female sex (AOR = 5.44, 95% CI: 2.18-13.52), ≥25 years age (AOR = 0.08, 95% CI: 0.01-0.67), underweight (AOR = 5.86, 95% CI: 1.95-17.62), having major illness (AOR = 6.99, 95% CI: 1.98-24.70) and good knowledge of DS (AOR = 2.64, 95% CI: 1.23-5.64).

CONCLUSION

This study provides new findings on DS use and its correlates in Bangladeshi students which may be used by the policymakers to improve DS usage among students. Adaptation of an appropriate program is recommended to educate students on proper and safer ways of using DS.

Assessment of Food Safety Knowledge, Attitudes and Practices of Food Service Staff in Bangladeshi Hospitals: A Cross-Sectional Study

Food safety knowledge, attitudes and practices among hospital food service staff are crucial in the prevention of foodborne disease outbreaks, as hospitalized patients are more vulnerable to potential hazards. This study, therefore, sought to assess the food safety knowledge, attitudes and practices of food service staff in Bangladeshi hospitals. A cross-sectional study was conducted among 191 food service staff from seven different hospitals in Dhaka and Chattogram from October 2021 to March 2022 using pretested questionnaires. Multiple linear regression was used to identify the factors associated with the food safety knowledge, attitudes and practices. The findings showed moderate knowledge but high levels of attitudes and practices of food safety among hospital food handlers. Food safety knowledge was significantly higher among males, participants from private hospitals and participants working in a hospital that had a food service supervisor and dietitian in charge of food service operations. Moreover, participants from private hospitals and participants working in a hospital that had a food service supervisor and dietitian in charge of food service operations had more positive attitudes and better practices regarding food safety. Hospital management should consider these factors for enhancing food handlers’ knowledge and increase training and supervision on food safety practices to reduce foodborne diseases and outbreaks.

The Association Between Bangladeshi Adults' Demographics, Personal Beliefs, and Nutrition Literacy: Evidence From a Cross-Sectional Survey

Background

Poverty and health illiteracy, combined with inappropriate systems to track disease and infection rates, contribute to children-and-mothers' poor adherence to nutrient-rich foods intake in Bangladesh. Although risk factors for child and pregnant women malnutrition have been explored, the relationship between Bangladeshi adults' nutrition literacy and their demographics and personal beliefs remains unknown. The purpose of this study was to examine the association between adults' nutrition literacy, demographics and personal beliefs in a large sample of Bangladeshi adults.

Methods

Four hundred adults from two districts (Dhaka and Chattogram) of Bangladesh participated in a cross-sectional survey. Data were collected by interviews using a structured questionnaire containing the Nutrition Literacy Scale. Multiple linear regression models were employed to analyze associations between nutrition literacy and related factors.

Results

The mean nutrition literacy score was 21.6 (SD: 3.7; range: 11-32) on a scale of 32. Multiple linear regression revealed that being a businessman (β = 1.66, p = 0.013) or private employee (β = 1.08, p = 0.030), having a higher family income (β = 1.17, p = 0.009), and a higher educational level were positively associated with higher nutrition literacy scores compared to their counterparts. Participants who had ever completed a nutrition-related course (β = 4.95, p < 0.001), and who perceived themselves as having a need for accessing nutrition-related information were positively associated with the higher nutrition literacy compared to their counterparts.

Conclusion

Findings from this study suggest the need for an integrated response plan involving educational interventions and accessible dietary plans targeting adult populations to enhance their nutritional literacy.

Knowledge, attitudes, and preventive practices toward the COVID-19 pandemic: an online survey among Bangladeshi residents

AIM

The novel coronavirus (SARS-CoV-2) has rapidly infected people worldwide, leading to a massive public reaction. Peoples' knowledge, attitudes, and practices (KAP) toward COVID-19 are the most important for the control and prevention of the infectious disease pandemic. This study aimed to assess the knowledge, attitude, and preventive practices (KAP) toward the COVID-19 among Bangladeshi residents during the lockdown situation.

SUBJECTS AND METHODS

An online-based cross-sectional survey was conducted among 1765 Bangladeshi adults through the social media networks of the authors.

RESULTS

The respondents were older than 18 years, with an average age of 24.88 years (SD 6.30). Approximately 15% of our participants received online training. The mean knowledge score was 14.49 (SD 1.8, range 0-17), and the overall correct response rate on this knowledge test was 85%. Approximately 67.2% scored well (above the mean 4.5, range 1-5) regarding the practices. To avoid the infection, 96.6% wore masks outside the home, and 98.7% washed their hands with soap when they came back. COVID-19 knowledge score was significantly associated with a lower odds of (OR 0.87, 95% CI 0.79-0.92) negative attitudes. Again, the awareness score was associated with a lower likelihood of (OR 0.94, 95% CI 0.87-0.98) poor practices.

CONCLUSION

Online health education programs focusing on young people, housewives, and people with less education may potentially improve the attitudes and practices to control the COVID-19 pandemic in the long term in such a low-resource setting.

Eating habits and lifestyle changes among higher studies students post-lockdown in Bangladesh: A web-based cross-sectional study

BACKGROUND

The Coronavirus is still exhibiting cases in Bangladesh thus educational institutes are still ceased over one year, it becomes burdens to students at post lockdown period.

OBJECTIVES

Identifying the changes in eating habits and lifestyles including, physical activity, sleeping hours, and sleep quality after the cancellation of lockdown than the period of restrictions.

METHODS

A quasi-experimental cross-sectional study was conducted among 394 students in Bangladesh using a structured questionnaire from February 3, 2021, to February 13, 2021.

RESULTS

Consuming homemade foods drops by 8.63% at post lockdown than lockdown period. At post lockdown, 26.67% of students gained weight whereas 47.46% of respondents never engaged in any physical works. There has been a significant correlation between weight gain and physical activities (p = 0.007). Not continuing the academic activities from home was significantly associated with weight changes (AOR = 1.73; 95% CI: 1.01, 2.95), meals per day (AOR = 3.25; 95% CI: 1.79, 5.92), screen time for entertainment (AOR = 3.08; 95% CI: 1.78, 5.33), sleeping hours (AOR = 2.23; 95% CI: 1.30, 3.83), and sleep quality (AOR = 2.38; 95% CI: 1.35, 4.23) whereas female gender was related to meals per day (AOR = 1.77; 95% CI: 1.06, 2.95) and sleep quality (AOR = 1.76; 95% CI: 1.09, 2.85). However, 43.91% of respondents never felt any sleep disturbances. The rates of students who always experienced mentally tired, resentment, and sadness at post lockdown was lower than lockdown period. All of these changes were significant (p < 0.000) in terms of the lockdown situation.

CONCLUSIONS

This study shows notable changes in eating habits and lifestyles after lockdown which may indicate the tendency to adopt normal life than restrictions.

Handwashing with soap: A concern for overuse of water amidst the COVID-19 pandemic in Bangladesh

Handwashing is one of the vital public health measures. It helps to prevent the spread of the COVID-19 pandemic. However, water overuse during hand scrubbing with soap keeping the tap on may put enormous pressure on the already overstretched groundwater resources and households' economic well-being. Therefore, this study aimed to determine the overuse of water while scrubbing hands with soap for handwashing when the tap is on amid the COVID-19 pandemic in Bangladesh. Sociodemographic data were collected using a web-based survey tool among 1980 participants and an experiment was conducted among 126 participants to estimate the overuse of water during hand scrubbing while the tap is on. A total of 80% of the participants washed their hands regularly after returning home from outside. About 57.3% of participants did not turn off their tap throughout the handwashing process. A single participant, who kept his tap on throughout the handwashing process, overused approximately 1.7 L of water per handwash and 14.9 L of water per day. Hand scrubbing with soap keeping the tap on, raised the overuse of water 13-fold during this pandemic compared to the non-pandemic situation which cost an extra 225.0 BDT (2.7$) per day for 1980 participants. Minimize the speed of tap, using automatic taps, and using taps operated by legs might be an effective solution to reduce the water overuse. Furthermore, behavioral change interventions are needed to aware people turn off the tap during hand scrubbing with soap.

Determinants of household food security and dietary diversity during the COVID-19 pandemic in Bangladesh

OBJECTIVES

The study aimed to determine the associated factors of household food security (HFS) and household dietary diversity (HDD) during the COVID-19 pandemic in Bangladesh.

DESIGN

Both online survey and face-to-face interviews were employed in this cross-sectional study. The Household Food Security Scale and Household Dietary Diversity Score were used to access HFS and HDD, respectively. The HDD scores were derived from a 24-h recall of food intake from 12 groups.

SETTING

Bangladesh.

PARTICIPANTS

A total sample of 1876 households were recruited.

RESULTS

The overall mean scores of HFS and HDD were 31·86 (sd 2·52) and 6·22 (sd 5·49), respectively. Being a rural resident, having no formal education, occupation of household head other than government job and low monthly income were potential determinants of lower HFS and HDD. Approximately 45 % and 61 % of Bangladeshi households did not get the same quantity and same type of food, respectively, as they got before the pandemic. Over 10 % of respondents reported that they lost their job or had to close their businesses, and income reduction was reported by over 70 % of household income earners during the COVID-19 pandemic, which in turn was negatively associated with HFS and HDD.

CONCLUSION

Household socio-economic variables and COVID-19 effects on occupation and income are potential predictors of lower HFS and HDD scores. HFS and HDD deserve more attention during this pandemic particularly with reference to low-earning households and the households whose earning persons' occupation has been negatively impacted during the COVID-19 pandemic.

Depressive symptoms associated with loneliness and physical activities among graduate university students in Bangladesh: findings from a cross-sectional pilot study

In low-resource settings like Bangladesh, there is a dearth of research on the mental health of university students. This pilot study aimed to identify the prevalence of depressive symptoms, loneliness, and physical activities as well as the associated factors of depressive symptoms among graduate students in a public university of Bangladesh.

This cross-sectional study was carried out among 323 graduate students between February 2019 and May 2019. By the convenience sampling technique, data were collected by a pretested, structured questionnaire. Depressive symptoms were assessed by the validated Patient Health Questionnaire-9 (PHQ-9) tool with a cut-off score of ≥10 vs. less; University of California, Los Angeles (UCLA) loneliness scale was applied to assess loneliness, International Physical Activity Questionnaire (IPAQ) scale was used to measure physical activity level.

The overall prevalence of depressive symptoms was 52% and about 43% of participants felt most lonely. About 32.8% of students were involved in low physical activity. Being female, from lower income families, having poor academic performance, experiencing shorter sleep time, lower physical activity, and being lonely were potential risk factors for depressive symptoms among graduate university students. A positive correlation was found between loneliness and depressive symptoms of students (r = 0.367, p < 0.001).

The higher prevalence of depressive symptoms among Bangladeshi graduate university students suggests the need for situation analysis, confirmatory clinical diagnosis, in-depth qualitative explorations, and large-scale surveys to explore the burden of such disorders and design appropriate low-intensity interventions like implementing student counselling service, offering mental assistance or other mental health support program in the country.