Anthropometric status and dietary habits of registered nurses, enrolled nurses and enrolled nursing auxilliaries workng at a private hospital in Pietermaritzburg, KwaZulu-Natal.

Masters Degree. University of KwaZulu-Natal, Pietermaritzburg.

The prevalence of overweight and obesity has been increasing over the years, particularly in South Africa (SA). A major contributor to this is poor lifestyle choices such as unhealthy diets and sedentary lifestyles. The rise in overweight and obesity is alarming as both are major risk factors for non-communicable diseases (NCDs). Overweight and obesity are also becoming more prevalent among healthcare professionals, specifically nurses. However, nurses are expected to lead by example and should be role models to the patients they care for. Nurses are the backbone of healthcare facilities and being overweight or obese impacts both on themselves and on their patients. Factors contributing to overweight and obesity among nurses include consuming meals late, eating during stressful periods, low physical activity levels and working shifts. Aim: This study aimed to investigate the anthropometric status and dietary habits of registered nurses (RNs), enrolled nurses (ENs) and enrolled nursing auxiliaries (ENAs) working at a private hospital in Pietermaritzburg (PMB), KwaZulu-Natal (KZN). Objectives: (i) to determine the anthropometric status of RNs, ENs and ENAs working at a private hospital in PMB, KZN; (ii) to determine the dietary habits of RNs, ENs and ENAs working at a private hospital in PMB, KZN; (iii) to determine the factors contributing to the anthropometric status and dietary habits of RNs, ENs and ENAs working at a private hospital in PMB, KZN; (iv) to determine the prevalence of NCDs among RNs, ENs and ENAs working at a private hospital in PMB, KZN. Method: A cross-sectional descriptive study was conducted on RNs, ENs and ENAs working at a private hospital in PMB, KZN. A self-administered questionnaire was developed to obtain data on demographic characteristics, lifestyle factors, body image and weight and eating habits. Anthropometric status was determined using selected anthropometric indices including weight, height, body mass index (BMI) and waist circumference (WC). Dietary habits was assessed using a food frequency questionnaire (FFQ) and a single 24-hour recall. The 24-hour recall was analysed using the Medical Research Council (MRC) Food Finder software programme version 1.0. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 22. Results: The study sample consisted of 130 nurses; 40.8% (n=53) were RNs, 36.9% (n=48) were ENs, 2.3% (n=3) were midwives, 19.2% (n=25) were ENAs and one was a clinical nurse specialist in the neonatal intensive care unit (NICU). A significant number of the participants were either overweight (25.4%; n=33) or obese class I (29.2%; n=38) (p<0.0005). Most participants did not smoke (82.3%; n=107) or consume alcohol (59.2%; n=77). Only 50% (n=65) of participants exercised. A significant number (63.1%; n=82) indicated that they were not satisfied with their body shape/size and did not feel that they were at a healthy body weight (60%; n=78). The majority of participants underestimated their BMI using the Stunkard figure rating scale (76.9%; n=100). The majority of participants stated they had tried to lose weight before (64.6%; n=84). The most common weight loss methods were cutting down on fast foods/takeaways (67.9%; n=57) (p=0.001) and exercising (63.1%; n=53). A significant number of nurses agreed that they were role models to their patients (70.8%; n=92) and believed it was important for a nurse to have an ideal body weight (92.3%; n=120). The majority of participants skipped meals (83.8%; n=109) with the only significantly skipped meal being breakfast (63.3%; n=69). A significant number of participants prepared their own meals at home (84.6%; n=110). Participants significantly agreed that time [M (mean)=3.98; p<0.0005], cost (M=3.26; p=0.021), emotions/stress (M=3.61; p<0.0005) and convenience (M=3.38; p<0.0005) were factors that influenced their meal choices. There was significant agreement that a lack of time to prepare meals (M=3.69; p<0.0005), lack of time to eat at work (M=4.04; p<0.0005), emotions/stress (M=3.30; p<0.0010) and healthy food not being available to buy at work (M=3.22; p<0.0036), were factors preventing nurses from eating healthily. The most common food item bought at the hospital cafeteria was pies (21.5%; n=17). Fruit (52.3%; n=68), sweets (34.6%; n=45) and sugar-sweetened soft drinks (32.3%; n=42) were consumed at least once a day. The mean BMI for females (33.6 kg/m2) was significantly higher than that for males (28.1 kg/m2) (p=0.043). Most male participants had a WC above 94 cm (63.6%; n=7), while the majority of females (88.2%; n=105) had a WC above 80 cm. The mean BMI for non-smokers (BMI=33.8 kg/m2) was significantly higher than that of smokers (29.6 kg/m2) (p=0.030). A higher BMI was associated with less snacking. The mean BMI for those who skipped supper (36.3 kg/m2) was significantly higher than for those who ate supper (32.0 kg/m2) (p=0.013). The mean BMI for those who skipped meals (33.8 kg/m2) was significantly higher than for those who did not skip meals (29.6 kg/m2) (p=0.005). The FFQ showed that the starches most frequently consumed were brown and white bread/rolls, white rice, phutu (crumbly maize meal porridge) and potatoes without skin. Sweets, chips (crisps), biscuits and chocolates were also frequently eaten. In the meat, poultry, fish, eggs and meat substitutes group, eggs, processed meats and chicken cuts with skin were frequently (n=65) of participants exercised. A significant number (63.1%; n=82) indicated that they were not satisfied with their body shape/size and did not feel that they were at a healthy body weight (60%; n=78). The majority of participants underestimated their BMI using the Stunkard figure rating scale (76.9%; n=100). The majority of participants stated they had tried to lose weight before (64.6%; n=84). The most common weight loss methods were cutting down on fast foods/takeaways (67.9%; n=57) (p=0.001) and exercising (63.1%; n=53). A significant number of nurses agreed that they were role models to their patients (70.8%; n=92) and believed it was important for a nurse to have an ideal body weight (92.3%; n=120). The majority of participants skipped meals (83.8%; n=109) with the only significantly skipped meal being breakfast (63.3%; n=69). A significant number of participants prepared their own meals at home (84.6%; n=110). Participants significantly agreed that time [M (mean)=3.98; p<0.0005], cost (M=3.26; p=0.021), emotions/stress (M=3.61; p<0.0005) and convenience (M=3.38; p<0.0005) were factors that influenced their meal choices. There was significant agreement that a lack of time to prepare meals (M=3.69; p<0.0005), lack of time to eat at work (M=4.04; p<0.0005), emotions/stress (M=3.30; p<0.0010) and healthy food not being available to buy at work (M=3.22; p<0.0036), were factors preventing nurses from eating healthily. The most common food item bought at the hospital cafeteria was pies (21.5%; n=17). Fruit (52.3%; n=68), sweets (34.6%; n=45) and sugar-sweetened soft drinks (32.3%; n=42) were consumed at least once a day. The mean BMI for females (33.6 kg/m2) was significantly higher than that for males (28.1 kg/m2) (p=0.043). Most male participants had a WC above 94 cm (63.6%; n=7), while the majority of females (88.2%; n=105) had a WC above 80 cm. The mean BMI for non-smokers (BMI=33.8 kg/m2) was significantly higher than that of smokers (29.6 kg/m2) (p=0.030). A higher BMI was associated with less snacking. The mean BMI for those who skipped supper (36.3 kg/m2) was significantly higher than for those who ate supper (32.0 kg/m2) (p=0.013). The mean BMI for those who skipped meals (33.8 kg/m2) was significantly higher than for those who did not skip meals (29.6 kg/m2) (p=0.005). The FFQ showed that the starches most frequently consumed were brown and white bread/rolls, white rice, phutu (crumbly maize meal porridge) and potatoes without skin. Sweets, chips (crisps), biscuits and chocolates were also frequently eaten. In the meat, poultry, fish, eggs and meat substitutes group, eggs, processed meats and chicken cuts with skin were frequently consumed. The fruit and vegetables most frequently consumed were non-starchy vegetables, fresh fruit and fruit juice. Full cream milk, sunflower oil, tub/soft margarine and cheddar cheese were the dairy and fats eaten most often. Tea and water were consumed more often than sugar-sweetened beverages. Overall, the most frequently consumed foods were full cream milk, sunflower oil, tea, white sugar, fresh fruit, brown sugar, brown bread/rolls, tub/soft margarine, sweets and white bread/rolls. Conclusion: There was a high prevalence of overweight and obesity among the participants. According to WC, the majority of nurses had an increased risk for metabolic complications. However, most participants were not diagnosed with a NCD. Factors associated with a high BMI included being female, not smoking, skipping meals, skipping supper, less snacking and cost of meals. Nurses consumed both healthy and unhealthy foods. Overall, there was a higher intake of carbohydrates and protein and a lower intake of dietary fibre. Despite the many hours that they spend caring for patients, nurses should also pay attention to their own health and well-being. Nurses should be supported in their efforts to achieve and maintain a healthy weight and lead a healthy lifestyle.