UNIVERSITY OF AGRICULTURE, FAISALABAD

National Institute of Food Science &Technology

Faculty of Food, Nutrition & Home Sciences
(SYNOPSIS FOR M.Sc. (Hons.) HUMAN NUTRITION & DIETETICS)

TITLE: INVESTIGATING THE IMPACT OF IRREGULAR MEAL AND

DIETARY PATTERNS ON WEIGHT GAIN AND OBESITY
IN UNIVERSITY TEACHERS

Name of Student : Ayesha Fatima

Registration No. : 2016-ag-7301

Abstract
Obesity and overweight are two disorders that are common in today’s world and are the main
reason of many other diseases like diabetes, high blood pressure and heart disease. Their
prevalence is increasing rapidly in both developing and developed countries. These are caused by
various factors like increased calories, salt and sugar intake and low physical activity. Moreover,
irregular meal and dietary patterns further worsen the situation. University teachers have to stay
most of their time engaged in either teaching and research consequently, it is assumed that they
are unable to follow regular meal patterns. Meal patterns also influence body weight either
positively or negatively. Irregular meal patterns cause energy imbalance that is main reason for
obesity. Different dietary patterns like fruits or vegetables, meat and dairy and others contribute
towards obesity and overweight. The objective of this study is to investigate the impact of
irregular meal and dietary patterns on weight gain and obesity in university teachers. This study
will be performed by developing a questionnaire including different domains like
sociodemographic, anthropometric, dietary intake assessment and physical activity level.
Appropriate statistical analysis will be used to analyze data.

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 UNIVERSITY OF AGRICULTURE, FAISALABAD
National Institute of Food Science &Technology
Faculty of Food, Nutrition & Home Sciences
(SYNOPSIS FOR M.Sc. (Hons.) HUMAN NUTRITION & DIETETICS)

I. TITLE: INVESTIGATING THE IMPACT OF IRREGULAR MEAL

AND DIETARY PATTERNS ON WEIGHT GAIN AND
OBESITY IN UNIVERSITY TEACHERS

II. a) Date of Admission : 28-10-2020

b) Date of Initiation : 10-11-2021
c) Probable Duration : 4-6 months

III. PERSONNEL

a) Name of student : Ayesha Fatima

b) Registration. No. : 2016-ag-7301

IV. SUPERVISORY COMMITTEE

i. Supervisor : Dr. Mian Kamran Sharif

ii. Member : Dr. Muhammad Issa khan
iii. Member : Dr . Beenish Israr

V. INTRODUCTION
Obesity is a leading medical disorder in which excess fat has stored in the body to the
extent that it causes negative effects on health, leading towards low quality of life, low life
expectancy, poor mental health and causing more health problems in the body. Obesity is a
condition in which weight is higher than normal. Overweight is indicated as BMI more than 24.5
and obesity is BMI more than 30. Fat cells in the body increase due to obesity. It is a major but
avoidable reason of death worldwide, its prevalence is rapidly increasing in children and adults,
and it is considered as the most critical and serious public health problems of the 21st century.
Obese adults worldwide are 13 percent, and 39% are overweight. Obesity rate has tripled since
1975. Over 340 million adolescents and children are overweight and obese. More than 10% of
population in the world is obese. In Pakistan 20.8% of population is overweight and 4.8% is

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obese. Obesity is increasing rapidly in both developing and developed countries (Ekuni et al.,
2013).
If we talk about factors that contribute towards obesity they include increased calories,
fat, salt, and sugar intake, decreased physical activity, energy imbalance, eating disorders,
emotional factors, poor sleep, poor dietary habits and meal patterns (Gazibara et al., 2013).
Stress is also a trigger for obesity and overweight and leads towards unhealthy dietary patterns
and increased energy intake. Some medications and health situations also cause obesity such as
thyroid, PCOS etc. Primary causes of obesity include no physical activity, poor diet and
increased food intake. Changes in dietary habits and lifestyle patterns are linked with rapid
increase in obesity. Genetic, physiological and environmental factors also affect on obesity
prevalence. Nutrition transition has played important role towards obesity and overweight,
people of different countries has increased their intake of fast foods, sugar, drinks and lowered
their intake of fruits, vegetables and other fiber rich foods, moreover people have become
physically less active and adopted sedentary lifestyle (Mesas et al., 2012).
Obesity is leading cause of many metabolic diseases like diabetes, hypertension and heart
disease, some type of cancers and even death (Otaki et al., 2017). Various breathing problems
are also associated with obesity such as asthma and sleep apnea. Mental illness is also somehow
linked with obesity because it causes anxiety, depression and poor social life. Obesity and
overweight have increased global burden of diseases. As a person’s BMI increases the risk of
getting non communicable diseases also increases. Obesity doubles the risk of getting diseases as
compared to people having normal weight. Common indicators for obesity are BMI for general
obesity and WC for central obesity. According to global disease burden study (GBD) conducted
in 2017 high BMI is ranked at number 4 th as a risk factor of mortality (Jia et al., 2020).
Overweight and obesity are identified as the fifth major risk factor for mortality worldwide, 2.8
million adults deaths worldwide are due to obesity or overweight every year (Wang et al., 2021).
Meal patterns are identified as a major factor that has affect on BMI. There is a negative
association between body weight status and meal frequency. If we talk about the term meal
pattern that is often used to define eating patterns of individuals on the stage of a specific meal,
involving a major meal (breakfast, lunch or dinner) and a smaller meal (supper or snack).
Individuals consume different combinations of food rather than single food as meal. There are
three structures according to which meals are defined. First one is meal patterns that include

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regularity, spacing, frequency, timing and skipping of meals. Second one is format of meal like
which combination of meal and sequence is being followed and nutrient content. Third one is
context either you are eating alone or with family. Different approaches are used to measure and
record meals such as FFQ, 24-h dietary recall and food diary (Leech et al., 2015).
A dietary pattern is described as various types of foods and drinks included in the diet
and proportion in which they are consumed. Evidences suggest that people consuming more
fruits and vegetables, whole grains, legumes, lower consumption of processed meat and taking
low fat dairy products have lower risk of being overweight and obese. Energy dense foods
consumption rather than nutrient dense foods leads towards more rapid weight gain. Eating
rapidly and eating before bed is linked with faster weight gain. Different type of factors
including sociodemographic profile, eating habits, lifestyle affect dietary patterns. Sleep patterns
also affect the diet quality and energy intake and ultimately obesity. Individuals who work for
long hours in a day have very little time for physical exercise, and have irregular dietary habits
ultimately gain weight (Guinter et al., 2019).
Energy imbalance is a condition that occurs when you consume less or more calories than
your daily need and ultimately results in weight gain and loss. It is often considered as the main
cause of weight loss and weight gain and is affected by eating habits, meal and dietary patterns.
It is often caused by unhealthy lifestyle, eating habits, poor dietary intake and low physical
activity. Eating rapidly is linked with increased energy intake, satiety rate and ultimately leads to
overweight and obesity, eating until we are full is also associated with eating more amount of
food than our need and leads towards obesity. There is a positive relationship between eating
quickly and high BMI. Regular vs irregular eating pattern can be identified by observing the
eating habits over the days. Regular eating patterns leads toward low energy intake and irregular
on the other hand leads toward high energy intake (Berg and Forslund, 2015).
Regular eating helps in maintaining weight and controls overweight and obesity and has
positive health consequences. A better understanding of meal timing and eating frequency is
required for rapid increase in obesity over the past decade. Decrease intake of fats, sugar,
processed foods and regular engagement with physical activity is correlated with lower
probability of obesity and overweight. Plenty of work and studies have been conducted to knock
out the obesity and overweight and decrease its prevalence but a little work has done to fight

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obesity and overweight by following regular meal patterns and implementing good dietary
habits. Following are study objectives:
 To measure the predominance of obesity among university teachers through a self-
administrated questionnaire
 To assess the association between obesity and irregular meal and dietary patterns
 To evaluate health consequences related to obesity and irregular meal patterns

VI. REVIEW OF LITERATURE

Obesity has emerged as pandemic. Both developing and developed countries are equally
affected by obesity. Various genetic, physiological, and diet related factors contribute towards
obesity. Overweight and obesity are greatest problems that affect lifestyle and causes different
diseases and mainly caused by eating habits and poor dietary patterns. Physical activity level is
another factor that contributes towards weight gain. Demographic, socioeconomic and work
stress related factors have impact on overweight and obesity (Ito et al., 2019).
To estimate the links between dietary patterns and obesity risk a research was performed
in east China. In this study 2560 subjects of age 45–60 years were included, to assess dietary
intake FFQ was used. Standardized methods were performed for doing anthropometric
measurements. Multivariate logistic regression analysis was used to analyze data. Animal food,
fast-food, high-salt and conventional Chinese patterns were isolated. Outcomes indicated that
animal food patterns were related with more risk of abdominal obesity, while the conventional
Chinese patterns were linked with a lesser risk of abdominal obesity and overweight (Shu et al.,
2015).
This survey was performed over a sample of 416 undergraduate students, of age 18–26
years old, from colleges of Health Sciences in the Kingdom of Saudi Arabia at Jazan University.
Students were given a questionnaire to fill about their eating habits and dietary patterns. SPSS
statistical analysis was used for data analyzation. To determine relationship between obesity and
eating patterns multivariate logistics regression model was used. The incidence of corpulence
and obesity was (20%) and (15%), respectively. Conclusions indicated that prevalence of obesity
and overweight was very high and linked with eating habits of individuals (Syed et al., 2020).
This study was performed on 8652 adults of age 20-70 years. Data regarding Socio-
demographic profile, dietary habits, and previous medical history was collected by developing a
questionnaire. Anthropometric measurements were taken. Binary logistics regression test was

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used for data analyzation. The general obesity was 25.9 percent and abdominal obesity was 45.3
percent. Consumption of fast food, carbonated drinks and high fat dairy products was directly
linked with abdominal obesity, while intake of low fat dairy products was inversely linked
(Ardekani et al., 2019).
To compare and evaluate eating patterns of university students this study was conducted
in Chile. Data was collected by a food habits survey by developing a self-assessment
questionnaire. To assess healthy and unhealthy eating habits questions related to dietary intake
including fast food consumption, fruits and vegetables consumption, salt and sugar intake, and
physical activity level were asked. Anthropometric measurements were done by taking weight
and height of participants. Data was analyzed by statistics. Results showed that lower intake of
healthy foods was linked with high rates of obesity and healthy eating patterns were linked with
good body weight status and lower risk of obesity and overweight (Crovetto et al., 2018).
To determine association between obesity and dietary patterns this study was performed
between the period of 2010 and 2012. This study included 1613 adults living in Zhejiang
Province of China. 24-h food recall procedure was used to measure dietary patterns. Relationship
among dietary patterns and obesity was determined. Almost five diet patterns cereal, animal,
plant food, high protein food, poultry, and beverage were included. Results concluded that
animal, cereal, beverage and plant food diet patterns might be linked with greater risk of obesity.
Animal, plant food and cereal dietary patterns might be related with high odds of weight gain as
a result from increased intake of energy by taking more fat and protein, and a beverage dietary
pattern may be related with high risk of obesity due to increased intake of energy and
carbohydrate (Zou et al., 2017).
In a study, 500 subjects aged greater than 18 years were involved. Anthropometric data,
physical activity and dietary habits were measured. Association between general obesity (GO)
and abdominal obesity (AO) was determined using SES and multiple logistic regression analysis
for food choices. Individuals consuming two or more servings of fruit daily were having lower
rate of obesity. Two or more servings of dairy products daily were linked with decline in general
and abdominal obesity. Five or more servings of beans, legumes and nuts in a week were linked
with decrease in general obesity and abdominal obesity. Specific food groups like fruits,
vegetables and low fat dairy products with greater intake were linked with lower chances of
obesity (Tutunchi et al., 2019).

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 Another study was conducted over 9 nine lean healthy women aged 18–42 years. They
took part in a experimental trial comprising of three phases for the period of 42 days. Participants
visited the laboratory at the start and end of segment three and one. Subjects consumed similar
things as normal in segment 1 (14 days). In phase 2 participants resumed their normal diet. In
phase 3 subjects went along with the substitute pattern of meal to that obeyed in phase 1.
Throughout irregular period when subjects were taking 9, 3 and 6 meals/day they noted their
food intake for three days. There was lower postprandial energy expenditure due to irregular
meal frequency than regular meal frequency, while there was no notable change between the
mean energy intake of two. For longer time decreased thermic effect of food due to irregular
meal frequency became a reason of weight gain (Farshchi et al., 2004).
357 male students of age in the middle of 18-25 years were selected from the college of
health sciences at Qassim university. Eating habits were measured by a self-reported
questionnaire. BMI, visceral fat level and body fat percent were measured. SPSS statistical
software was used for data analyzation. Results suggested that approximately 22% of the
students were overweight and 16% were obese. In 55.19% participants total body fat was more
than its normal limit and 22% of them have high visceral fat level. Eating habits that were most
observed were taking two main meals per day as well as breakfast, fried food consumption and
frequent snacks. Fruits and vegetables intake, excluding dates, was very low among students (Al-
rethaiaa et al., 2010).
In a study, 7958 adults were involved, diet related behaviors were measured in five
different areas (intra-meal fluid consumption, meal-to-sleep time, fatty foods consumption, meal
patterns and eating time) with the help of a pretested questionnaire. Individuals having irregular
meal pattern were 21% at risk of being obese/overweight, 24% were at the risk to be
abdominally overweight/obese, and 22 % more liable to be abdominally obese in comparison
with those who had a consistent meal pattern. Entities taking more intra-meal drinking had
bigger probabilities of overweight and obesity than those with normal intra-meal drinking. There
was no meaningful relationship noted between eating rate, meal-to-sleep interval and general or
abdominal obesity (Saneei et al., 2016).
A research was performed to examine the relationship among dietary patterns, metabolic
phenotype and obesity. Adults aged over 45 years were included. Criteria that is used to define
metabolic syndrome was used to determine phenotype and further was categorized for obesity.

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 Dietary patterns were assessed using various methods. Findings indicated that 20% of
Australians were obese and metabolically unhealthy. Increased intake of processed and refined
foods and higher consumption of unhealthier dietary patterns was associated with obesity and
unhealthy metabolic profile and vice versa for the healthy dietary patterns (Bell et al., 2015).

VII. MATERIAL AND METHODS

i. Data Collection
Data will be collected by developing a questionnaire to collect information about their
dietary habits and meal patterns and anthropometric measurements will be performed. 24-h
dietary recall and FFQ will be used to collect data about person's dietary intake (Yahia et al,
2008).
a) Participants
This study will be conducted in different universities situated at the Faisalabad.
b) Inclusion criteria
Teachers having BMI more than 24.9 will be included in this study.
c) Exclusion criteria
Teachers from different universities having BMI less than 24.9 will not be included in this
study.
ii. Questionnaire
A detailed self-administrated questionnaire will be used for data collection.
a) Sociodemographic
Age, gender, designation, family, marital status and other such sociodemographic
information will be collected (Wang et al., 2021).
b) Anthropometric measurements
Weight and height of individuals will be measured following the protocol in a comfortable
environment. Body mass index (BMI) will be determined as weight in Kgs divided by height in
meter square. Based on BMI they will be classified into underweight, overweight, and obese.
Waist circumference will be quantified to asses central obesity. Body frame will be measured by
taking wrist measurements and height of individuals (Jia et al., 2020).
c) Physical signs and symptoms

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 Participants will be asked questions about their physical signs and symptoms related to
obesity and overweight. Body shape questionnaire (BSQ) will be used to assess physical signs
and symptoms (Beechy et al., 2012).

d) Family and medical history

Individuals will be asked about their family and personal disease history. Any self-reported
disease and span of disease occurrence will be noted. Individuals will be asked about taking any
supplements and specific medications (Musaiger et al., 2016).
e) Lifestyle related questions
Lifestyle related questions like smoking, exercise, sleep schedule, skipping meals and other
habits will be asked (Sanlier et al., 2015) (Doo and Wang, 2020).
f) Assessment of dietary habits
Different domains will be covered to assess the dietary habits of individuals including eating
rate, meal patterns, intra meal fluid consumption, meal to sleep period and fatty food intake.
Detailed information will be gathered regarding each domain, and response will be recorded. To
calculate meal patterns subjects will be questioned about meal frequency (Main meals and
Snacks). For eating rate subjects will be asked about chewing rate and how much time they are
spending over dinner and lunch, intra-meal fluid intake will be recorded by asking about water
and fluid consumption within and before and after meals. Meal to sleep period will be assessed
by calculating interval between lunch and dinner and going to bed, for fatty food intake fried
food consumption will be asked (Parks and McCrory, 2005) (Saneei et al., 2016).
g) Assessment of dietary intake
Data regarding food intake, consumption, portion size, frequency and regularity will be
collected (Mansouri et al., 2020).
h) Assessment of physical activity
General physical activity questionnaire will be used to assess individuals’ activity level
(Saneei et al., 2016).
iii. Statistical Analysis
Statistical analysis will be performed to analyze data (Montgomery, 2017).

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