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 Joanna Białkowska1, Karolina Osowiecka1,
Paweł Białkowski2, Łukasz Puchała1
1
Collegium Medicum, University of Warmia and Mazury in Olsztyn
2
Voivodal Specialistic Hospital in Olsztyn, Poland

Ocena nawyków żywieniowych i aktywności fizycznej

wśród studentów z północno-wschodniej Polski
Evaluation of eating habits and physical activity among
students from northeastern Poland

Abstract
Subject of research. Proper diet and good habits about food are important
part of health life style. Statistics describing food consumption behaviors show,
that unhealthy behaviors are still popular in general population. Students who be-
came health care professionals should have a high knowledge and good habits in
food consumption as they are expected to improve health status of population.
Lack of knowledge, bad habits and wrong dietary behaviors can be source of misin-
formation and should to be minimized.
Scope. The aim of the study was to compare the eating habits and physical ac-
tivity between medical and non-medical students in relation to factors like gender
and place of residence. In this research students form north-eastern Poland were
examined.
Materials and methods. 527 students were included in the analysis. The study
was carried out using a specially prepared questionnaire. Questions asked about
e.g numbers of meals by day, sweets, vegetables, dairy products consumption. Bad
habits were recognized e.g by asking about bed time eating, and daily physical
exercises. The chi-square test was used to compare the percentage of subgroups.
A p value of < 0.05 was considered to be significant.
Results. 58% students declared that they have a healthy lifestyle, but only
1/5 students ate vegetables and fruits every day. There were no significant differ-
ences in eating habits due to the field of study. Students had insufficient physical
42 J. Białkowska, K. Osowiecka, P. Białkowski, Ł. Puchała

activity, however students living in a city significantly more often exercised daily
at least 30 minutes (p < 0.001) and joined in additional sports activities (p < 0.001)
in comparison with students from village, who admitted to walk everyday more
frequently (p = 0.03). Students of medicine significantly often exercised at least
30 minutes every day (p < 0.001).
Conclusion. The percentage of young people eating a proper diet and having
proper physical activity is still insufficient, so Polish schools should conduct more
education regarding a healthy lifestyle.
Key words: pro-healthy behaviors, diet, physical activity

Streszczenie
Przedmiot badań. Właściwa dieta i prawidłowe nawyki żywieniowe są waż-
nym elementem zdrowego stylu życia. Statystyki opisujące zachowania konsump-
cyjne pokazują, że nadal popularny jest nieprawidłowy styl życia. Studenci, którzy
zostali pracownikami służby zdrowia, powinni nabyć odpowiednią wiedzę i dobre
nawyki w zakresie odżywiania. Oczekuje się, że to oni będą wzorem inicjującym
poprawę stanu zdrowia populacji. Brak świadomości, niewłaściwe nawyki i za-
chowania żywieniowe mogą być przyczyną wielu chorób i dlatego tak ważne są
działania prewencyjne.
Zakres. Celem badania było porównanie nawyków żywieniowych i aktywności
fizycznej studentów kierunków medycznych i niemedycznych w zależności od płci
i miejsca zamieszkania.
Materiały i metody. Do analizy włączono 527 studentów z północno-wschod-
niej Polski. Badanie przeprowadzono za pomocą specjalnie przygotowanego kwe-
stionariusza ankietowego. Pytania dotyczyły m.in. liczby posiłków w ciągu dnia,
słodyczy, warzyw, spożycia produktów mlecznych. Złe nawyki rozpoznawano,
np. pytając o jedzenie przed snem i codzienne ćwiczenia fizyczne. Do porównania
proporcji w podgrupach zastosowano test chi-kwadrat. Za istotną uznano wartość
p < 0.05.
Wyniki. Ponad połowa (58%) studentów zadeklarowała, że prowadzi zdrowy
tryb życia, ale tylko 1/5 z nich codziennie spożywa warzywa i owoce. Nie stwier-
dzono istotnych różnic względem nawyków żywieniowych w zależności od kie-
runku studiów. Pomimo iż aktywność fizyczna studentów nie była wystarczająca,
studenci z miast istotnie częściej ćwiczyli codziennie przez co najmniej 30 minut
(p < 0.001) i uczestniczyli w dodatkowych zajęciach sportowych (p < 0,001) w po-
równaniu ze studentami ze wsi. Studenci medycyny znamiennie częściej wykony-
wali ćwiczenia przez co najmniej 30 minut dziennie (p < 0.001).
Wniosek. Liczba młodych ludzi stosujących prawidłową dietę i aktywność
fizyczną jest wciąż za mała, dlatego w polskich szkołach powinno się prowadzić
odpowiednią edukację z zakresu zdrowego stylu życia.
Słowa kluczowe: zachowania prozdrowotne, dieta, aktywność fizyczna
 Ocena nawyków żywieniowych i aktywności fizycznej wśród studentów... 43

Introduction
Health is one of the care values in Polish society. In CBOS study (Public
Opinion Research Center) [1], 57% of respondents indicated that health is the
most important value in life. Factors, which could influence on protection and
improvement of health are diet, physical activity, prophylactic examinations,
coping with stress, avoiding the psychoactive substances and risky sexual be-
haviors. According to the CBOS study [1], most adults in Poland (64%) claimed
that a healthy lifestyle was popular in the country, while 31% of respondents
did not admit that taking care of their own health is important to them. The
awareness of healthy lifestyle is systematically growing and it was about 45%
from 1993 to 2016. In the report, the proper nutrition was noticed as the most
important factor, which could improve health. 46% of respondents ate a meal
at bedtime at least once a week and in only 9% of cases this was a regular habit.
Less than 1/3 of the respondents (30%) ate less than three meals a day at least
once a week [1]. Whereas Walentukiewicz et al. [2] noted that AWFiS student’s
nutrition model differed from recommended nutrition rules, the other study
proved that there is a correlation between increasing diet knowledge of stu-
dents and consumption frequency of fruits, vegetables, grainy bread, sweets,
sparkling, alcohol or energy drinks [3]. It is the reason that education plays
a significant role and should be develop among young people to have better
control of their health behavior.

Objectives
The aim of the study was to compare the eating habits and physical activi-
ty between medical and non-medical students in relation to factors like gender
and place of residence. We assumed that young people, who claimed that they
have a healthy lifestyle, follow the rules of pro-healthy behavior and medical
students have a higher awareness of their nutrition. Lifestyle was the main
factor in determining health and quality of life.

Materials and methods

527 students were included in the analysis. There were 399 female (76%)
and 128 male (24%). Most of them lived in a city (64%) and studied an area
other than medicine (76%) (Table 1). The participants were selected randomly
and took part in anonymous research after agreement.
44 J. Białkowska, K. Osowiecka, P. Białkowski, Ł. Puchała

Table 1. Characteristics of the study group

Tabela 1. Charakterystyka grupy badanej
Variables N %
All 527 100,0
Age (years) median = 21
Gender
Female 399  75,7
Male 128  24,3
Place of residence
City 336  63,8
Village 191  36,2
Faculty of study
Medicine  91  17,3
Non-medicine 398  75,5
No data  38  7,2

Source: research material.

Źródło: materiał badawczy.

The study was carried out using the prepared questionnaire. Positive Psy-
chometric analysis of Positive Health Behaviours Scale for adults was used to
estimate the health behaviours [4]. The questionnaire contained closedended
and semi-open ended questions about the most important factors affecting
nutrition (number, type, distribution of meals throughout the day) and phys-
ical activity. The study was carried using a group of students from the Uni-
versity of Warmia and Mazury in Olsztyn, Medical University of Gdańsk and
Olsztyn College studying: medicine nursing, physiotherapy, humanities, social
and economic sciences. The study protocol was approved by the Local Eth-
ics Committee of the University of Warmia and Mazury, in Olsztyn, Poland
(582/2018).

Statistical analysis
The chi-square test was used to compare the percentage of student’s health
behaviors in relation to their gender, place of residence and area of study. Sta-
tistical analysis was performed using STATISTICA software (version 13.1)
StatSoft, Poland. A p value of < 0.05 was considered to be significant.
 Ocena nawyków żywieniowych i aktywności fizycznej wśród studentów... 45

Results
Three hundred and four students (58%) declared that they have a healthy
lifestyle. Half of students stated that they eat 4–5 meals daily (51%), always eat
breakfast an hour after wake up (55%) and always eat dinner (56%). Most of
students did not always eat a second breakfast (82%) and supper (59%). Unfor-
tunately less than 1/5 of students eat vegetables (16.5%) and fruits (13.5%) daily
even though most of them like to eat vegetable (91%), soups (77%) and dairy
products (92%). There was no difference between the state of health and fre-
quency of eating vegetables (p = 0.17), fruits (p = 0.95) and dairy products
(p = 0.50). 184 students (35%) stated that they consumed sweets daily and
77% of them declared that they ate chocolate sweets more often. Whereas the
most of students admit not to watch television (66%) and play on computer
(80%), almost everyone (91%) serves on the internet every day and more than
2 or 3 hours a day (84%). The most of students do not exercise daily at least
30 minutes with moderate and vigorous intensity (82%), do not join in addi-
tional sports activities (76%) and do not walk everyday (78%) (Table 2).

Table 2. P
 ositive Health Behaviours Scale, its subscales and statements
(nutrition, physical activity)
Tabela 2. S
 kala pozytywnych zachowań zdrowotnych, jej podskale i oświadczenia
(odżywianie, aktywność fizyczna)
Variables N %
All 527 100,0

I provide a healthy lifestyle Yes 304  57,7

No 223  42,3
NUTRITION
I have at least 4 meals a day with a regular meal
pattern
<4 257  48,8
4–5 270  51,2
I have breakfast every morning
No always 239  45,4
Always 288  54,6
I have second breakfast everyday
No always 434  82,4
Always  93  17,6
I have dinner everyday
No always 233 44,2
46 J. Białkowska, K. Osowiecka, P. Białkowski, Ł. Puchała

Table 2. P
 ositive Health Behaviours Scale... cd.
Variables N %
Always 294 55,8
I have supper everyday
No always 313 59,4
Always 214 40,6
I eat vegetables a least once a day
No always 440 83,5
Always  87 16,5
I eat fruit a least once a day
No always 456 86,5
Always  71 13,5
I like to eat vegetables

Source: research material.

Źródło: materiał badawczy.

In a group of young people, who admitted to leading a healthy lifestyle,

176 students (58%) ate 4–5 meals daily, 197 students (65%) always ate breakfast
an hour after waking up, 74 students (24%) only always ate second breakfast,
181 students (60%) always ate dinner and 126 students (41%) always ate supper.
In the case of young people, who declared that they led a healthy lifestyle, only
66 students (22%) and 59 students (19%) respectively ate vegetables and fruits
daily. Most ate soups (81%) and dairy products (95%). 1/3 of them admitted to
eating sweets daily.
Among students health habits differ significantly between males and
females. More women than men have declared eating breakfast an hour af-
ter wake up (p < 0.001) and eating more vegetables (p = 0.03). On the other
hand, the consumption of supper was more common among men (p < 0.001).
A significant relation between place of residence and amount of daily eaten
meals was observed. Students living in a village more frequent declared eating
4–5 meals daily in comparison to those living in a city, who more often eat
less than 4 meals per day (p = 0.04). A higher percentage of students from a city
than inhabitants of the village admitted to eating vegetables everyday (19.3%
vs 11.5%, p = 0.02). The residence status had significant effect on frequency
of daily sweets consumption. Students living in a city more often declared
to eating sweets everyday (p = 0.03). There was no significant difference in
eating habits between people studying medicine in comparison with students
in other areas of study (p > 0.05) (Table 3).
Table 3. Distribution of the nutrition-related factors in relation to gender, place of residence and faculty of study
Tabela 3. R
 ozkład czynników związanych z odżywianiem w zależności od płci, miejsca zamieszkania i wydziału studiów
Factors Gender Place of residence Faculty of study
test test Non-medi- test
Female Male City Village Medicine
chi2 chi2 cine chi2
N % N % P N % N % P N % N % P
I provide a healthy lifestyle
yes 237 59,4  67 52,3 187 55,7 117 61,3 47 51,6 235 59,0
 0.16 0.21 0.20
no 162 40,6  61 47,7 149 44,3  74 38,7 44 48,4 163 41,0
I have at least 4 meals a day
with a regular meal pattern
<4 193 48,4  64 50,0 175 52,1  82 42,9 43 47,3 196 49,2
 0.75 0.04 0.73
4–5 206 51,6  64 50,0 161 47,9 109 57,1 48 52,7 202 50,8
I have breakfast every
morning
no always 164 41,1  75 58,6 155 46,1  84 44,0 45 49,5 178 44,7
< 0.001 0.63 0.41
always 235 58,9  53 41,4 181 53,9 107 56,0 46 50,5 220 55,3
I have second breakfast
everyday
no always 322 80,7 112 87,5 275 81,8 159 83,2 75 82,4 332 83,4
 0.08 0.69 0.82
always  77 19,3  16 12,5  61 18,2  32 16,8 16 17,6  66 16,6
I have dinner everyday
no always 180 45,1  53 41,4  0.46 141 42,0  92 48,2 0.17 39 42,9 176 44,2 0.81
always 219 54,9  75 58,6 195 58,0  99 51,8 52 57,1 222 55,8
I have supper everyday
no always 258 64,7  55 43,0 209 62,2 104 54,5 57 62,6 229 57,5
< 0.001 0.08 0.37
always 141 35,3  73 57,0 127 37,8  87 45,5 34 37,4 169 42,5
Ocena nawyków żywieniowych i aktywności fizycznej wśród studentów...
47
 48
Table 3. Distribution of the nutrition-related factors... cd.
Factors Gender Place of residence Faculty of study

I eat vegetables a least once

a day
no always 325 81,5 115 89,8 271 80,7 169 88,5 74 81,3 339 85,2
 0.03 0.02 0.36
always  74 18,5  13 10,2  65 19,3  22 11,5 17 18,7  59 14,8
I eat fruit a least once a day
no always 341 85,5 115 89,8 291 86,6 165 86,4 77 84,6 346 86,9
 0.21 0.94 0.56
always  58 14,5  13 10,2  45 13,4  26 13,6 14 15,4  52 13,1
I like to eat vegetables
yes 367 92,0 111 86,7 311 92,6 167 87,4 86 94,5 357 89,7
 0.07 0.05 0.16
no  32  8,0  17 13,3  25  7,4  24 12,6 5  5,5  41 10,3
I like to eat soups
yes 306 76,7 102 79,7 263 78,3 145 75,9 74 81,3 304 76,4
J. Białkowska, K. Osowiecka, P. Białkowski, Ł. Puchała

 0.48 0.53 0.31

no  93 23,3  26 20,3  73 21,7  46 24,1 17 18,7  94 23,6
I eat sweets everyday
yes 141 35,3  43 33,6 129 38,4  55 28,8 39 42,9 129 32,4
0.72 0.03 0.06
no 258 64,7  85 66,4 207 61,6 136 71,2 52 57,1 269 67,6
Kind of sweets I usually eat
chocolate 305 79,2 102 79,7 266 81,8 141 76,6 68 79,1 308 79,6
0.46 0.16 0.91
others  80 20,8  22 17,2  59 18,2  43 23,4 18 20,9  79 20,4
I like to eat dairy products
yes 368 92,2 116 90,6 307 91,9 177 92,7 84 93,3 365 91,7
0.95 0.76 0.61
no  31  7,8  10  7,8  27  8,1  14  7,3  6  6,7  33  8,3

Source: research material.

Źródło: materiał badawczy.
Table 4. D
 istribution of the physical activity-related factors in relation to gender, place of residence and faculty of study
Tabela 4. R
 ozkład czynników związanych z aktywnością fizyczną w zależności od płci, miejsca zamieszkania i wydziału studiów
Factors Gender Place of residence Faculty of study
test test test
Female Male City Village Medicine Non-medicine
chi2 chi2 chi2
N % N % P N % N % P N % N % P
I watch a television everyday
yes 149 37,3  30 23,4 125 37,2  54 28,3 25 27,5 141 35,4
 0.004  0.04  0.15
no 250 62,7  98 76,6 211 62,8 137 71,7 66 72,5 257 64,6

I play on a computer everyday

yes  61 15,3  45 35,2  69 20,5  37 19,4 15 16,5  81 20,4
< 0.001  0.75  0.40
no 338 84,7  83 64,8 267 79,5 154 80,6 76 83,5 317 79,6

I serve on an internet everyday

yes 360 90,2 120 93,8 307 91,4 173 90,6 79 86,8 366 92,0
 0.22  0.76  0.12
no  39  9,8  8  6,2  29  8,6  18  9,4 12 13,2  32  8,0
I watch television/serve
internet no more than 2 or 3
hours a day
yes  71 17,8  12  9,4  49 14,6  34 17,8 13 14,3  66 16,6
 0.02  0.33  0.59
no 328 82,2 116 90,6 287 85,4 157 82,2 78 85,7 332 83,4
Ocena nawyków żywieniowych i aktywności fizycznej wśród studentów...
49
 50
Table 4. D
 istribution of the physical activity-related factors... cd.

Factors Gender Place of residence Faculty of study

I exercise daily at least
30 minutes with moderate
and vigorous intensity
yes  60 15,3  13 11,3  65 22,6  8  5,3 33 41,3  26  7,9
< 0.001 < 0.001 < 0.001
no 331 84,7 102 88,7 222 77,4 144 94,7 47 58,8 303 92,1
I join in additional sports
activities
yes  83 20,8 45 35,2  98 29,2  30 15,7 23 25,3  94 23,6
< 0.001 < 0.001 0.74
no 316 79,2 83 64,8 238 70,8 161 84,3 68 74,7 304 76,4
I walk everyday
J. Białkowska, K. Osowiecka, P. Białkowski, Ł. Puchała

yes  84 21,1 30 23,6  63 18,8  51 26,7 17 18,9 88 22,1
 0.54  0.03 0.50
no 315 78,9 97 76,4 272 81,2 140 73,3 73 81,1 310 77,9

Source: research material.

Źródło: materiał badawczy.
 Ocena nawyków żywieniowych i aktywności fizycznej wśród studentów... 51

The women significant frequently watch a television than men (p = 0.004)

and spend on this activity more than 2 or 3 hours a day whereas men more
often choose playing on a computer (p < 0.001). More women exercise daily at
least 30 minutes but more men join in additional sports activities (p < 0.001).
There is a correlation between physical activity and place of residence. Students
living in a city significantly more often watch a television (p = 0.04), exercise
daily at least 30 minutes (p < 0.001) and join in additional sports activities
(p < 0.001) in comparison with students from village, who admitted to walk
everyday more frequently (p = 0.03). Students of medicine significantly often
exercise at least 30 minutes every day (p < 0.001). There were no significant
differences between activities like: watching tv, serving on the internet, play-
ing computer or walking, joining in additional sports activities due to faculty
of study (Table 4).

Discussion
The holistic model of health showed that lifestyle was the main deter-
minant of health, which is defined as a set of behaviors (habits and activities)
[5]. There are 2 groups of behaviors either positive (pro-health) or negative
(anti-health) effects on human health [6]. The pro-health behaviors such as:
a rational diet, physical activity, effective coping with psychological stress,
using preventive examinations, avoiding psychoactive substances and risky
sexual contacts, promote prevention of civilization diseases [7, 8]. Cardio­
vascular diseases are the main cause of death worldwide [9]. The dietary
goals for prevention of these group of diseases were defined by WHO (World
Health Organization) [10]. Incorrect diet is one of risk factors leading to the
cardiovascular diseases. Some prior published results indicate the impact of
diet in prevention and treatment of cardiovascular diseases [11–13]. The low
level of pro-healthy behaviors and the increase of harmful factors to health
are the direct cause of diseases, disability and premature death, especially in
the young population. Despite the activities promoting health, the level of the
effects of unhealthy habits is prevailing in student groups, because some re-
searches show that anti-health behaviors are becoming more common also
among students [14, 15]. Our study also showed that only more than half of
young people lead a healthy lifestyle. Unfortunately among young respondents,
who declared pro-healthy habits the level of positive behaviors is insufficient
to be truly healthy.
The knowledge of healthy lifestyle among medical students seems to be
particularly important due to their future work. The health education provided
52 J. Białkowska, K. Osowiecka, P. Białkowski, Ł. Puchała

by physicians, physiotherapists, nurses, psychologists, speech therapists is an

important task of modern medicine in the prevention of civilization diseases.
Unfortunately, the results of this analysis did not show a statistically signifi-
cant difference between medical and non-medical students in healthy nutri-
tion, but it was observed that students of medicine significantly often exercise
at least 30 minutes every day.
The workload students have schedules, tests, exams, and relationships
with friends affect behawior towards health. An inadequate diet could be
the cause of many diseases like atherosclerosis, diabetes, hypertension, os-
teoporosis, or tooth decay. There are many theories about how a daily and
balanced meal should look like. Nowadays, it is believed that people should eat
5 meals a day at regular intervals, using the nutritional pyramid. This pyra-
mid shows the recommended proportions of special types of products, which
should be consumed. Some authors also indicated negative nutritional habits
of young people. They noted that students do not eat regularly and quality of
consumed food is not good. The reason of this could be: financial situation,
family traditions and academic schedule [16–19]. The results of our analysis
also showed that nutritional habits among student’s group differed from the
recommended rules of proper diet. Only half of the respondents ate an average
4–5 meals per day and less than 1/5 students ate vegetables and fruits daily.
Many researchers consider that in group of young people living in villages
and small towns there are pro-healthy behaviors observed. Similarly, the re-
sults of our study showed that young people living in the village, significantly
more often consumed meals 4 to 5 a day and significantly less often ate sweets
compared with students from the city. However, people from cities more fre-
quent ate vegetables and salads.
Almost half students did not declare to provide a healthy lifestyle, what
could suggested a need for more nutritional education in this consumer seg-
ment. In our study the students of medicine did not show frequent healthy
nutrition habits in comparison to students in other disciplines. Nutritional
guidelines specify that it is important to eat 4–5 meals a day but our study
showed that students, even those studying medicine, do not eat frequently
enough. Even though students stated they like vegetables but they eat them
infrequently.
In studies conducted by Ślusarska et al. among students of medical fac-
ulties there were manifestations of anti-healing behavior in the field of nutri-
tion: too few meals during the day, uneven distribution, insufficient vegetable
consumption, fruits and products containing fiber, low fish intake, frequent
salting of meals [20].
 Ocena nawyków żywieniowych i aktywności fizycznej wśród studentów... 53

Ekelund et al. [21] showed that physical activity of 60–75 minutes a day
with moderate intensity reduces the increased risk of death associated with
long-term staying in a sitting position. Researchers found that the risk of death
of people, who are sitting > 8 hours a day and who are not active enough,
is 58% higher than in the healthy population. In the meta-analysis of Arem
et al. [22] the largest reduction in mortality was found at moderate physical
activity for 60–75 minutes a day.
In the Lavie study, it was emphasized that the lack of physical activity may
be the greatest health risk in the 21st century. The current guidelines of the
European Cardiac Society [23] for the prevention of cardiovascular disease
emphasized the need for regular physical exercise. Special attention was also
paid to the fact that education regarding the importance of physical activity
should be started already in the pre-school period, because then it brings the
best results. The guidelines set out the minimum physical activity ranges for
both children and adults according to which daily physical activity at school
should last at least 30 minutes, preferably 60 minutes. In adults, regular phys-
ical activity is recommended for all women and men as a permanent element
of a healthy lifestyle, at least 150 minutes per week for moderate activity and at
least 75 minutes per week for intense activity [24].
In our study more women exercised daily at least 30 minutes but more
men joined in additional sports activities. Students living in a city significantly
more often watched a television, exercised daily at least 30 minutes and joined
in additional sports activities in comparison with students from village, who
admitted to walk everyday more frequently. Students of medicine significantly
often exercise at least 30 minutes every day.
According to Mandziuk, the period of study belongs to one of the most
difficult in life young people, related to the change of place of residence, leav-
ing the family and disorganization of everyday life. It is therefore necessary to
strengthen health-oriented activities during this period [25].

Conclusion
Almost half of the students do not declare having a healthy lifestyle,
which suggests a need for more health education in the process of academic
education. The students of medicine did not show frequent healthy nutrition
habits in comparison to students in other disciplines.
Students living in a city significantly more often exercise daily at least
30 minutes and join in additional sports activities in comparison with students
from village, who admitted to walk everyday more frequently.
54 J. Białkowska, K. Osowiecka, P. Białkowski, Ł. Puchała

Students of medicine significantly often exercise at least 30 minutes every

day. This study can be an important source of information to compare chang-
es of eating habits and pro-healthy behaviors. Future study among pharmacy
students can be very interesting. It seems to be very important to engage phar-
macists to improve public health, and for it, they are expected to have higher
knowledge and better percentage of pro-healthy behaviors that general pop-
ulation. Great role of pro-health education, even for health care professionals
have to be underlined.

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