Policy, Theory, and Social Issue

International Quarterly of
Community Health Education
Knowledge as Determinant of Healthy-Eating 0(0) 1–12
! The Author(s) 2020
Among Male Postgraduate Public Health Article reuse guidelines:
sagepub.com/journals-permissions
Students in a Nigerian Tertiary Institution DOI: 10.1177/0272684X20972895
journals.sagepub.com/home/qch

Samuel Oluwasogo Dada1, Oyediran Emmanuel Oyewole1, and

Adeyimika Titilayo Desmennu1

Abstract
Unhealthy eating, which is quite prevalent among the adult population globally, is a major risk factor for Non-Communicable Diseases.
Men have the tendency to visit food vendors without recourse to body nutrients requirement, health and expectations as potential
change agents. The study was thus designed to investigate the knowledge and practices of healthy eating among male public health
students in a Nigerian tertiary institution. Data was collected from 161 consenting respondents. Knowledge of healthy eating was
assessed on a 25-point knowledge scale; score
19 was rated good, <19
12 fair and <12 poor. Practices of healthy eating were
assessed using a 34-point practice scale; score
26 was rated good and <26 poor. Patterns of eating was determined using food
frequency questionnaire; descriptive and inferential statistics were carried out at a¼0.05. Respondents’ age was 28.9  5.5 years; they
were mostly Christian (87.0%), Yoruba (69.6%) and 21.1% were married. Their body mass index was 23.1  3.1kg/m2, monthly income
ranged between N5000 and N300,000, 2.5% smoked tobacco/cigarette and 28.0% consumed alcohol. Good knowledge was observed
among 52.2% of the respondents, 37.9% had good healthy eating practices, 49.7% did not eat breakfast everyday while only 13.7%
consumed fruits and vegetables daily. The most reported factors influencing choice of food included health maintenance and food
availability. Respondents’ knowledge and practices relating to healthy eating was significant. Knowledge of healthy eating was average
and practice was poor among the study population. Strategic health education and behaviour change communication could motivate
male students for healthy eating.

Keywords
healthy eating, non-communicable disease, food choice, male MPH students

Introduction
A healthy diet is a pillar to wellbeing throughout the lifespan;
it supports normal growth, development and aging, maintain
healthful body weight, reduces chronic disease risk and pro-
motes overall health and wellbeing.1 Healthy eating includes
consumption of fat-free or low-fat dairy products while
avoiding trans-fat and saturated fats; the consumption of
fishes rich in Omega-3 fatty acids avoiding red meat.
According to the National Institute of Health,2 healthy
eating also requires the consumption of fruits, legumes,
whole grains and vegetables and reducing intake of food
high in salt, sugar, palm and coconut oils. This also implies,
consuming the right quantities of foods from all food groups
in order to ensure appropriate nourishment and proper func-
tioning, dependent on lifestyle and activity levels.1,3
The intake of healthy diet throughout the life course will
help prevents malnutrition in all its form as well as range of
Non-Communicable Diseases (NCDs).4 Studies have shown
that, of the 57 million global deaths in 2008, 36 million, or
63%, were due to NCDs; principally cardiovascular diseases,
diabetes, cancers and chronic respiratory diseases.5
Inadequate consumption of fruit and vegetables increases
the risk for cardiovascular diseases and several cancers,
high salt consumption is an important determinant of high
blood pressure, cardiovascular risk and increases the risk of
1
Department of Health Promotion and Education, Faculty of Public Health,
College of Medicine, University of Ibadan, Ibadan, Nigeria
Corresponding Author:
Adeyimika Titilayo Desmennu, Department of Health Promotion and Education,
Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan,
Nigeria.
Email: adeyimikades@hotmail.com
2 International Quarterly of Community Health Education 0(0)
stomach cancer; high consumption of saturated fats and
trans-fatty acids is linked to heart disease. Additionally, a
range of dietary factors have been linked with diabetes
while red and processed meat consumption is linked with
some cancers.6–8 Excessive energy intakes have been estab-
lished to leads to overweight, obesity and a range of health
problems, including NCDs.7,9
There have been a number of barriers to healthy eating.
This includes lack of knowledge or education about healthy
eating, lack of knowledge or education around food prepa-
ration, poor accessibility to affordable food, inconsistent or
unclear food labelling and the marketing of high fat high
sugar foods to children and youths.10
Gender difference in food consumption is related to social
norms and cultural belief like motives and behaviours. Some
foods are labelled masculine, some are seen as feminine. For
instance, the consumption of meat symbolizes a masculine
diet while the consumption of vegetables and fruits represents
a feminine one.11 Men have been reported to have a higher
energy intake and the higher percentage of the energy in men
diets is found to be derived from animal products. Men diet
is usually characterized by meat, bread and alcohol.11,12
With regard to eating habits, a large number of reports
indicate that in general, women are more aware about diet,
health-diet relationship implications and also embrace sug-
gested dietary changes to a greater degree than men.13–17
Men usually talk about eating as habitual, routine, and as
necessary activity to fuel their bodies. Despite their aware-
ness of healthy eating guidelines, they often show scepticism
and resistance to nutrition education messages, and frequent-
ly perceive eating healthy foods as monotonous and unsat-
isfying.18 Studies has also shown that men give lower priority
to health compared to other considerations, such as taste and
convenience, in making their food choices.19–21
Nowadays, most of the students, especially the males,
have been seen to prefer the intake of fast foods, fried
foods, processed foods and soft drinks to choosing food
choice based on body nutrients’ requirement and health.
Men are seen to concentrate more on work and other life
activities than diet and health, hence, the need to assess
their knowledge and practices relating to healthy eating so
as to have baseline evidence to guide appropriate interven-
tion targeting the male population.
Investigation on the knowledge and practice relating to
healthy eating among the male postgraduate students is a
concern because this population, being a subset of young
adult in the society, are potential or are already heads of
families. As a role model in the home, men eating behaviour
will influence his wife and children with far reaching health
consequences throughout their lifetime.
In understanding human behaviours especially as it relates
to concepts of health promotion and education, there are
factors that could predispose an individual to the behaviour
being investigated, factors that could reinforce the behaviour
and those that could enable an individual to either start or
continue in it. Thus, analysing a behaviour in this context
would assist in reaching definite solutions to problems orig-
inating from individual behaviours and long-term prevention
of such. Using the PRECEDE-PROCEED Model as was
postulated by Green Lawrence;22 the predisposing (anteced-
ent) factors provides the rationale for the behaviour. They
refer to those intrinsic factors that are unique to the research
participants and make them liable of practicing healthy
eating. These include but not limited to knowledge, values,
beliefs, norms, attitudes, perceptions and present health con-
dition (presence of absence of disease conditions). Enabling
Factors influences the motives, aspirations, and decisions of
an individual. These factors could be level of education,
financial resources, time, accessible markets, and price of
food, ability to make food purchase, perceived health
status (indicated by BMI, alcohol consumption and physical
activities), government policies and academic class schedule.
Reinforcing Factor are the feedback or influence of the sig-
nificant order or people e.g. peers, siblings, co-students,
social support group, social media and mass media that influ-
ence the continuance or discontinuance of a particular behav-
iour. These factors are profiled in this study in order to have
a proper perspective with respect to the subject matter.
Methodology
Study Design
This study adopted a descriptive cross-sectional design using
a pretested semi-structured self-administered questionnaire.
Study Site
The study was carried out in the Faculty of Public Health,
College of Medicine, University of Ibadan, Nigeria, which
was founded in 2002 as the first Faculty of Public Health
in Nigeria. The Department of Preventive and Social
Medicine of the then faculty of Clinical sciences
metamorphosed into Faculty of Public Health. The Faculty
currently has six departments and one institute which include
Epidemiology and Medical Statistics, Health Promotion and
Education, Health Policy and Management, Environmental
Health Sciences, Human Nutrition, Community Medicine
and Institute of Child Health. Being the foremost and leading
Faculty of public health in Nigeria, carrying this study out at
this location will provide a baseline and recommendations
that could be adopted by the other schools of Public
Health in the country.
Study Population and Sampling Procedure
The study population were consenting male postgraduate
public health students of the Faculty of Public Health,
University of Ibadan. As at the time of this study, there
were one hundred and eighty-three (183) students in this
category.
Dada et al. 3

Instrument for Data Collection Table 1. Socio-Demographic Information of Respondents.

Data was collected using a validated, self-administered, semi- Socio-Demographic N ¼ 161

structured questionnaires. The instrument consisted of Variables Responses %
five (5) sections which elicited information on socio- Age (in years) 20–24 15.5
demographics of the respondents, knowledge of respondents 25–29 49.7
on knowledge relating to healthy eating, practices relating to 30–34 21.7
healthy eating, patterns of eating of respondents, measure- 35–39 5.0
ment of basic anthropometric data for BMI assessment and 40–44 2.5
factors responsible for choice of food among them. 45–49 3.1
50–54 2.5
Religion Christianity 87.0
Data Collection, Management and Analysis Islam 12.4
A trained research assistant administered (handed-out) the Atheism 0.6
questionnaires after obtaining a written informed consent Marital status Single 78.9
from respondents. The administered questionnaires were Married 21.1
Level of study MPH I 52.2
subsequently checked for completeness and errors were cor-
MPH II 47.8
rected. Furthermore, the data were carefully coded, entered
Departments Epidemiology and 21.1
into the statistical software and analysed using descriptive Medical Statistics
statistics including frequencies and means. Inferential statis- Health Promotion and 17.4
tics such as Chi-square test measured significant difference Education
between knowledge and practices relating to healthy eating Health Policy and 14.9
among the study population at ¼ 0.05. Management
Respondents’ knowledge of healthy eating was measured Community Medicine 9.9
on a 13-items and 25-point knowledge scale. Knowledge Human Nutrition 3.1
Environmental Health 26.1
Score (KS) of <12 was rated as poor knowledge, KS of
sciences

12<19 was considered Fair Knowledge and KS
19 was
Institute of Child health 7.5
rated as good knowledge. A 17-item and 34-point practice Ethnic group Yoruba 69.6
scale that was developed after reviewing of relevant litera- Hausa/Fulani 5.6
tures was used to examine the practices of respondents Igbo 13.0
towards healthy eating. A practice score <26 (<75%) repre- Niger-Delta 7.4
sent poor practice while a score
26 (
75%) represent a
a
Others 4.4
good practice towards healthy eating among the respondents. How do you obtain Bought 11.2
Food frequency questionnaire was used to determine pat- your daily food Cooked 40.4
Both 48.4
terns of eating.
Do you know how Yes 93.8
Chi square test was conducted to assess the relationship
to cook your food No 6.2
between knowledge and practice relating to healthy eating. It Alcohol intake Yes 28.0
was also used to assess the association of selected variables No 72.0
including level of study, marital status and practices relating Smoking tobacco/cigarette Yes 2.5
to healthy eating. No 97.5
Exercise/physical activities Yes 86.3
Ethical Consideration No 13.7
a
Ethical approval was obtained from the University of Others¼ Igala, Tiv and Ebira.
Ibadan/University College Hospital (UI/UCH) Ethics
Review Committee to ensure the study meets all the princi- The mean age of the respondents was 28.9  5.5 years.
ples and national guidelines in research involving human Majority, (87.0%) of the respondents were Christians and
participants. 78.9% of the respondents were single. The table also shows
the departmental distribution of the respondents with most
(26.1%) from Environmental Health Sciences. Most of the
Results respondents 112(69.6%) were of the Yoruba ethnicity .
Monthly income of respondents ranged between N5000 and
Sociodemographic Characteristics of the Respondents
N300,000. Their height ranged between 1.54 m and 2.00 m,
The respondents’ socio-demographics is as shown in Table 1. while their weight was between 45.0 kg and 109.0 kg. The
Overall, a total of 161 male Master of Public Health (MPH) mean Body Mass Index (BMI) in Kilograms per meters
students of University of Ibadan took part in the study. square of the respondents was 23.11  3.1 and it ranged
4 International Quarterly of Community Health Education 0(0)

between 15.9 kg/m2 and 32.5 kg/m2. Majority, (67.1%) of the Practices Relating to Healthy Eating Among Male MPH
respondents had normal body weight. With regards to daily Students
food consumption, majority of the respondents (48.4%)
The respondents’ practices relating to healthy eating were
either self - cooked or bought their foods. Some of the
presented in Table 4. About two-third (65.2%) of the
respondents (40.4%) cooked their daily food, a few
respondents practised regular intake of fruits and vegetables,
(11.2%) of them bought their daily food from food vendors.
77.0% ate breakfast that is rich in energy, proteins and vita-
Also, majority, (93.8%) of the respondents knew how to
mins every day, 60.2% practised intake of light food for
cook. Of all the respondents, 45(28.0%) take alcohol while dinner but just about one-fifth, 18.0% of the respondents
only, 2.5% of the respondents’ smoke tobacco/cigarette. have ever consulted a nutritionist/dietician before. Two-
Physical activities/exercise were practised by 139(86.3%) of third of the respondents, 66.5%, did not eat snacks between
the respondents. meals, 27.3% of the respondents consumed soft drinks at
least once per day, 41.0% of the respondents consumed
fried food more than three times a week, 31.1% consumed
Respondents’ Knowledge of Healthy Eating high fat meat more than three times a week. Majority of the
Most (52.2%), of the respondents had good knowledge of respondents 81.4%, regularly ate food rich in Calcium and
healthy eating as reflected in their scores (Figure 1); their Iron. Some of the respondents 42.2% consumed dairy prod-
knowledge score ranged from 3.0 and 25.0 with a mean ucts (milk, yogurt, cheese, ice-cream) while about one-fifth
score of 17.8  4.1. Table 2 presents information on the
knowledge relating to healthy eating among the respondents.
Table 2. Respondents’ Knowledge of Healthy Eating.
Majority of the respondent (97.5%) reported that healthy
eating is a necessity for all and not just for a section of the N¼161
population. Respondents listed importance of healthy eating Knowledge variables Responses %
as; ‘eating healthy food helps to live healthy for sustaining Knowledge of definition of Correct 80.0
(40.4%), for growth and development (42.9%), prevention of health eating Wrong 5.1
disease (29.2%) and to build body immunity (23.0%). Other No response 14.9
responses are shown in the same table. Also, majority Necessity of healthy eating Yes 97.6
(90.7%) of the respondents reported that food intake has to everybody No 1.2
effect on health. Additionally, 79.5% respondents correctly No response 1.2
Importance of eating Correct 81.2
stated the six classes of food that constituted a healthy diet.
healthy food No response 18.8
Majority of the respondents (93.2%) reported that unhealthy Food intake is related to Yes 90.7
eating contributes to onset of NCDs. Variables constituting health status No 8.1
the knowledge score and some examples of healthy foods No response 1.2
mentioned by respondents included rice, beans, fruits and Six classes of food that Correct 79.5
vegetables, whole grains amala, egusi (melon soup), vegeta- constitute a healthy diet Incomplete correct response 16.2
bles, fish and meat; the distribution and other information No response 4.3
related to healthy eating is shown in Table 3. Does unhealthy eating Yes 93.2
contribute to any No 6.2
NCD? No response 0.6
Food sources of vitamina Fruits 91.9
60.0%
Vegetables 65.2
52.2%
Palm oil 2.5
50.0% Sunlight 1.9
39.1% Examples of healthy fooda Rice, beans and vegetables 50.3
40.0% Fruits and vegetables 50.3
Amala, Egusi and vegetables 7.5
30.0% Pounded yam and vegetables 14.9
Whole grain 4.3
20.0% The NCDs at risk due to Cancer 39.8
unhealthy eatinga Hypertension and stroke 47.8
8.7%
10.0% Diabetes 52.8
Heart diseases 16.8
0.0% Obesity 34.2
Good Fair Poor Risks of intake of Junk Correct 67.0
foods No response 33.0
a
Figure 1. Respondents’ General Knowledge of Healthy Eating. Multiple responses present.
Dada et al. 5

Table 3. Components of the knowledge score. Table 4. Respondents’ Practices Relating to Healthy Eating.

Knowledge variables Responses % N ¼ 161

Essential micronutrients required by men Correct 73.3 Practices statement/variables Responses %

No response 26.7
Calcium rich foods Correct 73.9 Regular intake of fruits and vegetables Yes 65.2
No responses 26.1 No 34.8
Zinc rich foods Correct 59.9 Eating of breakfast rich in energy, pro- Yes 77.0
No response 40.1 tein and vitamin everyday
General knowledge score Good 52.2 No 23.0
Fair 39.1 Intake of light food for dinner Yes 60.2
Poor 8.7 No 39.8
Ever consulted a nutritionist/ dietician Yes 18.0
Average knowledge score (KS) ¼ 17.84.1. before?
Minimum KS ¼ 3.0. No 82.0
Maximum KS ¼ 25.0. I take snacks between meals Yes 33.5
No 66.5
23.0% enjoyed eating food high in fat and 6.8% take alco- I consume fried food more than three Yes 41.0
holic drinks to complement their meal daily. times a week
No 59.0
Patterns of Eating Among Respondents I consume high fat meat more than Yes 31.1
three times a week
The respondents’ patterns of eating based on their frequency No 68.9
per week are presented in Table 6. Many of the respondents Regular intake of food rich in calcium Yes 81.4
50.3% ate breakfast every day, 37.9% ate lunch every day and iron
while 78.3% of them take dinner/supper every day. About No 18.6
one-third (26.7%) of the respondents skip their meal up to Regular consumption of soft drinks at Yes 27.3
least once per day
three times a week, 23.0% ate snacks every day and only
No 72.7
5.0% did not take soft drinks (Coca-Cola products, Malta,
Regular consumption of dairy products Yes 42.2
fruits juice) at least one in a week. Flour products (bread, (milk, yogurt cheese, ice-cream) No 57.8
cakes, biscuits, doughnut, noodles) were taken up to three I enjoy eating food high in fat Yes 23.0
times a week by about one-third (28.6%) of the respondents. No 77.0
About 18% of the respondents consumed vegetables daily I take food rich in vitamin daily Yes 72.7
and all of them reportedly consumed fruits at least once in No 27.3
a week while only 13.7% ate fruits every day. Other I like to eat food high in sugar Yes 41.0
responses with regards to pattern of healthy eating are as No 59.0
shown in the table. My egg intake is more than three times Yes 39.1
a week
No 60.9
Factors Influencing Choice of Food Among the I eat beans at least twice a week Yes 68.3
Respondents No 31.7
I take alcoholic drinks to complement Yes 6.8
The respondents’ factors responsible for choice of food are
my daily meal
presented in Table 7. Almost all (96.9%) of the respondents No 93.2
reported that their choice of food was to maintain their
health. Although more than half (54.0%) of the respondents’ Total practice score.
As shown in Table 5, majority of the respondents (60.9%) scored low on a
choice of food was not for weight control, many (54.0%) of 34-point practice scale while 39.1% had good practice score relating to healthy
them made their choice of food to add weight. Majority, 139 eating. The mean practice score was 22.6  5.7 while the lowest and higher
(86.3%) of the respondents reported that their choice of food practice score were 8.0 and 34.0, respectively.
was because of personal desire to be physically fit. Many
(64.0%) of the respondents did not choose food-based doc-
tor’s or any health worker’s advice, neither was it based on
Association Between Dependent and Independent
advice from dietitian 107(66.5%). Other factors influencing
choice of foods included respondent’s background (64.6%), Variables Influencing Healthy Eating
prevention of overweight and obesity (65.2%), level of Data in Tables 8 and 9 showed the association between
income (81.4%), taste of food (80.7%), convenience respondents’ practice of healthy eating (dependent variable)
(82.6%), pleasure derived from the food (70.2%), food avail- and some socio-demographic characteristics (independent
ability (87.6%) and food accessibility (85.1%). variables) and factors influencing food choices. There was
6 International Quarterly of Community Health Education 0(0)

an association between practices and respondent’s knowledge Discussion

of healthy eating in which practice of healthy eating
increased with increase in knowledge score (50.0%) Socio-Demographic Profile of Male Postgraduate Students
(p ¼ 0.003). Other associated factors are as shown in the of Public Health of University
tables.
The data collected showed that male MPH students of uni-
versity of Ibadan were within the age range of 20–52, major-
Profile of Factors Influencing Food Choices in Association ity of them being single. Most of the respondents are of the
Yoruba ethnicity as expected because the University of
With Practices of Healthy Eating Ibadan where the study was conducted is the capital city of
In profiling predictors for healthy eating practices, a binary Oyo-state which is in South-western part of Nigeria where
logistic regression of the significant factors influencing food Yoruba is the major ethnic group. Most of the respondents
choices was carried out. The result indicated that, education- were Christians and have a normal body weight. About half
al exposure and respondents desire to get fit were significant of the respondents knew how to cook their daily food and
and could be said to be predictors for healthy eating. This is obtain same by cooking. Also, majority of the respondents
as shown in Table 10. did not drink alcohol and nearly all the respondents do not
smoke cigarette. Nearly all the respondents practised physi-
cal activity/exercise and their training in Public Health sug-
gests that they are probably more informed and
Table 5. Total Practice Score.
knowledgeable than most people in the general population
Practice score (PS) N (%) as far as healthy living and healthy eating is concern but the
findings from this study revealed that they do not practice
Poor practice (PS < 26) 100 (62.1)
healthy eating. This means that the knowledge and informa-
Good practice (PS
26) 61 (37.9)
tion they have on healthy eating did not translate into
Total 161 (100)
healthy eating practices. It is pertinent to note that religion,
Average practice score ¼ 22.6  5.7. marital status and ethnicity were not equitably distributed in
Minimum practice score ¼ 8.0. this study population because good majority of the respond-
Maximum practice score ¼ 34.0.
ents were Christians, Singles and Yoruba.

Table 6. Respondents’ Patterns of Eating in a Week.

N ¼ 161
Frequency per week

Once Twice Three times Four times Everyday None

Variables % % % % % %

Breakfast 5.0 14.9 12.4 17.4 50.3 0.0

Lunch 6.2 9.3 23.6 19.9 37.9 3.1
Dinner 1.9 1.2 5.6 10.6 78.3 2.5
Meal skipping 17.4 19.3 26.7 9.3 18.3 9.3
Snacking 19.9 21.1 17.4 9.9 23.0 8.7
Soft drinks intake (Coca-Cola products, 39.1 22.4 14.3 13.0 6.2 5.0
Malta, fruit juice)
Intake of flour products (Bread, cakes, 13.0 13.0 28.6 25.5 18.0 1.9
biscuit, doughnut, noodles)
Vegetable intake 11.2 11.8 32.9 21.1 18.0 4.3
Intake of fruits 18.0 29.8 23.0 15.5 13.7 0.0
Consumption of dairy products (milk, 27.3 22.4 21.1 11.8 12.4 5.0
yogurt, butter, cheese, ice-cream)
Red meats consumption 18.6 18.6 24.8 21.7 12.4 3.7
Eggs intake 12.4 29.8 28.6 21.7 5.0 2.5
Intake of beans 16.1 21.7 27.3 21.1 8.7 5.0
Intake of brown rice, corn and oat 24.8 9.9 22.4 29.8 8.1 5.0
Consumption of wheat-based products 54.7 14.3 8.7 6.8 2.5 13.0
Water intake 1.9 0.6 0.6 3.1 93.8 0.0
Patronage of food vendors 31.7 14.3 18.6 16.1 10.6 8.7
Dada et al. 7

Knowledge Relating to Healthy Eating that has reported good nutrition knowledge among students
with health-related disciplines,23,24 this study also revealed
The study revealed a high level of knowledge of healthy
that male MPH students have good knowledge on healthy
eating; most of the respondents have good knowledge
eating and this is because education exposes people to differ-
scores. Although, literature is scarce on men’s knowledge
ent sources of information which makes them more
of healthy eating, several are available on knowledge of
enlightened.25
nutrition and dietary habit. There have been various studies
Some of the respondents defined healthy eating as con-
suming the right quantities of food from all food groups in
Table 7. Respondents’ Factors Identified for Choice of Food. order to ensure individual body is appropriately nourished,
this definition is in consonance with National Health Service,
N ¼ 161 UK3 definition on healthy eating. In responding to the
importance of healthy eating, some respondents stated it
Variablesa No. %
helps to maintain a healthy weight and rich in sources of
To maintain health 156 96.9 dietary fibres, this supported the importance of healthy
To reduce weight 74 46.0 eating as stated by World Cancer Research Fund.8 The
To add weight 74 46.0 good knowledge of healthy eating by male MPH students
To get or feel fit 139 86.3 suggest that the lessons and education they receive in class
Based on advice from doctor/health worker 57 35.4 with a view in obtaining a Master degree in Public Health
Advice from dietician 54 33.5
actually have an impact on their knowledge about Healthy
Level of education exposure 136 84.5
lifestyle and healthy eating.
Family background 104 64.6
To prevent overweight/obesity 105 65.2 Also, in this study, the null hypothesis which showed no
Based on my level of income 131 81.4 statistical significant difference between respondents’ knowl-
Based on taste of food 130 80.7 edge and practices relating to healthy eating was rejected.
Based on cost of food 133 82.6 This showed a difference between respondents’ knowledge
Based on convenience 139 86.3 and practices relating to healthy eating. This findings was
Based on pleasure 113 70.2 in contrast to the report by Aung et al.26 who stated knowl-
Food availability 141 87.6 edge to be significantly associated with healthy eating prac-
Food accessibility 137 85.1 tice but the study was in accordance to a finding by Kigaru
Cultural practices 78 48.4 et al.27 who found that Nutrition knowledge had no signifi-
Taboo 42 26.1
cant relationship with dietary practices. This is an indication
Preferences 135 83.9
for the need for male students to translate their knowledge of
Parent educational level 56 34.8
healthy eating to practice.
a
Multiple responses.

Table 8. Percentage Distribution of Practice Related to Healthy Eating by Selected Respondents Characteristics.

Practices relating to healthy eating

X2-value
Respondents’ characteristics Poor (%) Good (%) Total Df (p value)

Total 100 (62.1) 61 (37.9) 161

Knowledge
Poor 12 (85.7) 2 (14.3) 14 (100.0) 2 11.733**
(0.003) *
Fair 46 (73.0) 17 (27.0) 63 (100.0)
Good 42 (50.0) 42 (50.0) 84 (100.0)
Total 100 (62.1) 61 (37.9) 161 (100.0)
Level of study
MPH 1 55 (65.5) 29 (34.5) 84 (100.0) 1 0.845**
(0.358)
MPH II 45 (58.4) 32 (41.6) 77 (100.0)
Marital status
Single 81 (63.8) 46 (36.2) 127 (100.0) 1 0.711**
(0.399)
Married 19 (55.9) 15 (44.1) 34 (100.0)
**Chi square test statistic was used.
*Significant (p < 0.05).
8 International Quarterly of Community Health Education 0(0)

Table 9. Relationship Between Factors Influencing Choice of Food and Table 10. Logistic Regression Analysis Between Significant Factors and
Practices of Healthy Eating. Practices Relating to Healthy Eating.

Practices relating to 95% Confidence interval

healthy eating
Factors p-value Odd ratio Lower Upper
Poor Good
Factors practice practice Total Df X2 P-value To get fit -
Yes 0.019 0.438 0.220 0.874
Total 100 (62.1) 61(37.9) 161 No
To maintain Health - Education exposure-
Yes 95 (60.9) 61 (39.1) 1 3.128 0.770 Yes 0.012 5.131 1.438 18.316
No 5 (100.0) 0 (0.0) No
To reduce weigh- Level of income-
Yes 46 (62.2) 28 (37.8) 0.000 0.990 Yes 0.453 0.651 0.212 1.998
No 54 (62.1) 33 (37.9) No
To get fit- Cost of food-
Yes 60 (72.) 23 (27.7) 7.541* 0.006 Yes 0.579 0.708 0.208 2.401
No 40 (51.3) 38 (48.7) No
Doctor’s advice- Food availability-
Yes 34 (59.6) 23 (40.4) 0.307 0.579 Yes 0.210 0.488 0.159 1.499
No 66 (64.1) 37 (35.9) No
Dietician’s advice-
Yes 29 (53.7) 25 (46.3) 2.441 0.118
No 71 (66.4) 36 (33.6)
Education exposure- Practices Relating to Healthy Eating
Yes 78 (57.4) 58 (42.6) 8.429* 0.004 Although, various studies have been conducted among the
No 22 (88.0) 3 (12.0) general population, female population and the adolescent
Family background- relating to healthy eating, only a few specifically focused on
Yes 66 (63.5) 38 (36.5) 0.227 0.633
men, especially among those in the Public Health field. This
No 34 (59.6) 23 (40.4)
To prevent overweight-
study revealed that majority of the respondents did not have
Yes 61 (58.1) 44 (41.9) 2.069 0.150 good practices towards healthy eating. This is worrisome
No 39 (69.6) 17 (30.4) because male postgraduate public health students who are
Level of income- potential fathers and public health professional are meant
Yes 87 (66.4) 44 (33.6) 5.525* 0.019 to be role models in the area of healthy eating practices
No 13 (43.3) 17 (56.7) because their practice will affect the food choice of their
Taste of food- wife, children and even their children’s friends in school.
Yes 82 (63.1) 48 (63.9) 0.267 0.605 The reason for these poor practices relating to healthy
No 18 (58.1) 13 (41.9) eating may be because, majority of the study population
Cost of food-
are young men who do not still care about health or healthy
Yes 88 (66.2) 45 (33.8) 5.340* 0.021
lifestyle. Similar evidence has shown that elderly people gen-
No 12 (42.9) 16 (57.1)
Convenience- erally consumed more fruits and vegetables than do younger
Yes 90 (64.7) 49 (35.3) 2.284 0.131 people. As people age, they tend to care more about eating
No 10 (47.6) 11 (52.4) healthily since benefits of healthy eating gets more apparent
Pleasure for food- and noticeable then.28
Yes 74 (65.5) 39 (34.8) 1.834 0.176 The poor eating practice among the respondents can also
No 26 (54.2) 22 (45.8) be explained by the change in human lifestyle all over the
Food availability- world, especially in recent years, the lifestyles have rapidly
Yes 92 (65.2) 49 (34.8) 4.745* 0.029 been industrialized. This has caused change in diets and
No 8 (40.0) 12 (60.0) food.29 It may also be due to rapid increase in the number
Food accessibility-
of restaurants and in the people tendency to eat fast food and
Yes 89 (65.0) 48 (35.0) 3.176 0.075
No 11 (45.8) 13 (54.2)
fast food consumption has continued to be on the increase
among the young people.30 The results of this finding also
*Significant (p < 0.05). supported the findings by Nmor et al.31 that students in
Dada et al.
southern part of Nigeria have fairly good eating habit.
Despite the fact that the study population for this study are
individual with high educational attainment, they still did not
have good practice towards healthy eating, this go contrary
to the position by Roos et al.32 and Sobal18 that healthy food
choice are commonly expressed by high educational male
than by blue collar workers such as carpenters or drivers.
This evidence shows that educational level or being a
Public Health professional may not necessarily be sufficient
to initiate practice of healthy eating.
There was no statistical difference between marital status,
level of study and practices relating to healthy eating. This
means, been married or single does not translate to eating a
healthy food and level of study has no relationship with
practices of healthy eating. Hence, there is the need for
male students to take a conscious effort in practicing healthy
eating
Patterns of Eating
Almost all, 78.3% of the respondents ate dinners on a daily
basis. However, breakfast which has been said to be the most
important daily meal was not taken every day by 49.7% of
the respondent. This is in line with the findings by Hakim
et al.33 who reported that breakfast skipping among male
students is higher and the need for an intervention to
ensure majority of men takes breakfast every day. This was
also in line with findings by Ogechi and Justina34 who
reported high prevalence of breakfast skipping among under-
graduate’ students in tertiary institutions in Abia state
Nigeria. The reason for the skipping of breakfast may be
due to lack of adequate time to cook. The side effects of
not taken breakfast have been reported to negatively
impact weight, hormonal health, memory, cognition and
mood. According to a study reported in the British Journal
of Nutrition,35 it was noted that when breakfast is not taken,
energy reduced and physical activity level decline. Skipping
breakfast may also trigger bad eating habits throughout the
day as cravings ensue and quick-fix fast foods are often
sought. Intake of breakfast is important because it boosts
the metabolism and increases body energy throughout the
day. According to a report by the National Institute of
Health,2 not eating breakfast increases the risk of
Hypoglycaemia or low blood sugar. This condition can
bring on physical symptoms such as shakiness, dizziness,
weakness, headache, tingling and rapid heart rate. The fact
that most respondents in this study did not take breakfast
every day was in line with a fact by Goh et al.36 who said, fast
food may be more attractive and convenient for busy stu-
dents, who may find it more convenient to skip a healthy
breakfast and instead have a less healthy snack later on.
9
About one-tenth, 6.2% of the respondent did not take
water every day and 1.9% of the respondents reported
intake of water only once a week. This is alarming because
water is an important food class that is needed for body
metabolism which is needed to be taken adequately and reg-
ularly. Not drinking enough water can causes dehydration
which might result in droopy skin, the inability to focus,
dizziness, confusion, lack of strength and headache. Also,
10.6% of the respondents patronises food vendors every
day while 80.7% of the respondents patronises food vendors
at least once a week. This shows that most male postgraduate
public health students ate more of food prepared outside
their respective homes. The food they bought from vendors
may not have been prepared under hygienic condition which
predisposes them to be at risk of food borne diseases and
food poison. A reason for the high percentage of patronage
of food vendors may be due to busy lecture schedules and the
need to meet some timelines therefore, time for preparing and
cooking food by the individual is used for other academic
and personal affairs.
The prevalence of daily consumption of snacks (23.0%)
among the respondents is lower compared to what was
reported in a study among employee of the Federal Airport
Authority of Nigeria in an urban population in Nigeria by
Abidoye et al.37 who reported 84.3% prevalence and 49.9%
was also reported by Awosan et al.38 in a study among trad-
ers in Sokoto Central market, Sokoto Nigeria, snacking pat-
terns was shown to have effects on body weight. The lower
prevalence compared to the one cited may be due to the fact
that the study was carried out among a population group of
Public Health students. Their training in Public Health may
have given them some awareness on the negative impact of
snack food consumption.
Most of the respondents skip their meal; about one-third
of the respondents skip their meal with resultant adverse
effects on proper growth and development.39 This may be
because of tight lecture schedules. This high prevalence of
meal skipping was similar to the findings by Oladunni and
Sanusi40 which investigated the nutritional status and dietary
patterns of male athletes in Ibadan, South western Nigeria,
which reported that 72.0% male athletes usually skip their
meal. This is also in line with the study by Waly et al.41 that
among young Omani athletes, about 55.0% took less than
three meals per day.
Only a little more than one-fifth of the respondent eats
snacks every day, this is in variance with the high prevalence
of snacking (92.4%) reported in a study by Chung et al.42
among female college students in South Korea but it is in
agreement with a study by Olumakaiye et al.43 among ado-
lescents in Osun state, Nigeria. Contrary to the high con-
sumption of soft drinks (Coca-cola products, Malta, fruit
10
juice) at least once in a week among the study participants in
this study, Arulogun et al.30 reported a lower consumption of
soft drinks in a study among a younger population
(Undergraduates of university of Ibadan, Nigeria). This dif-
ference might be due to more work schedule or more class
workload among the study population which may encourage
them to take soft drinks that is readily available to satisfy
body glucose need.
The low proportion of participants that ate fruits and
vegetables at least three times in a week is contrary to a
study by Awosan et al.38 among traders in Sokoto central
market, Sokoto Nigeria where the participants had high pro-
portion that eats fruits and vegetables. Majority of the
respondents consume fast foods on a weekly basis with dif-
ference in number of times per week. The percentage of those
who consume fast food every day in this study is lower than
the percentage reported in a study by Olumakaiye et al.44 but
greater than the percentage reported by Arulogun and
Owolabi.30 The types of fast food commonly consumed by
majority of the respondents were flour-based products as
similarly documented by Olumakaiye et al.44 Majority of
the respondents patronised food vendors at least once a
week and Payne and Hahn45 concluded that eating out is
not all bad but the major concern is how often people con-
sume those foods and the nutritional make up of such foods.
Majority of the respondents takes water regularly and on a
daily basis.
Profiling Factors Responsible for Choice of Food
The factors identified to influence choice of food were; to
maintain good health, to feel/get fit, based on level of edu-
cation exposure, family background, based on income level,
cost of food, taste and colour of food, pleasure, food avail-
ability, accessibility, food preference and to prevent over-
weight and obesity. The result of this finding was in term
with factors responsible for choice of food as highlighted
by Food Standard Agency 200946 and 2007.47 Also, factors
such as taste of food, cost of food and convenience as
reported in this study were in line with factors responsible
for choice of food reported in another study.48 Factors such
as the cost of food as reported in this study was in line with
what was reported by Goh et al.36 that most people do not
take healthy food because healthy food is usually more
expensive than fast foods and unhealthy snacks, thus
making the healthier choice the more difficult one for tight-
budgeted students. The respondents also in a specific term
did not identify factors such as to live longer, to support
sporting goals, for physical appearance, sexual attractiveness
as highlighted in a similar study among the male popula-
tion.49 Although, majority of the respondents did not
choose their food based on taboo or cultural practice/
belief, rather the study revealed that level of education expo-
sure influence choice of food. This might be because educa-
tion has been consistently found to keeping people informed.
International Quarterly of Community Health Education 0(0)
Thus, a profile of the factors revealed educational exposure
and intention to get fit as predictors of healthy eating out of
all the associated factors discussed above.
Conclusion
The study assessed the knowledge and practices related to
healthy eating among male public health students of
University of Ibadan while identifying factors that could
influence these. It can be concluded that the level of knowl-
edge was good while the practices was poor. A profile of
factors that could influence health eating practices included
desire to get fit, educational exposure, level of income, cost of
food and food availability. It could further be said that desire
to get fit and educational exposure could predict the practice
of healthy eating. Although, knowledge seems not to result in
good practices relating to healthy eating; the findings suggest
that nutritional education, opportunities to knowledge of
healthy eating and the importance of practices relating to
healthy eating among male students should be explored
and adopted. Furthermore, the inability to take the appro-
priate portion of healthy foods such as fruits and vegetables
per day can be addressed through social marketing in which
fruits and vegetables are made available at an affordable
price, acceptably presented and readily available, in order
to prevent the inevitable consequences of poor eating practi-
ces because of its health consequence.
Implications and Contribution
The findings from this study could inform strategic health
promotion and education programming for populations
that are usually understudied – Men. Intervention strategies
would target reducing prevalence of non-communicable dis-
ease among specific populations exploring different settings
for health promotion. A workable strategy could target behav-
iour change and this could be facilitated through the under-
standing various concepts and factors that could enable,
reinforce and facilitate the adoption of the proposed healthy
behaviour. A successful implementation of such would have
great implication for healthy public policy with regard to
healthy eating. Such interventions should be tailored to suit
the peculiarity of each population and workplaces.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, author-
ship, and/or publication of this article.
ORCID iD
Adeyimika Titilayo Desmennu https://orcid.org/0000-0003-1667-
7422
Dada et al.
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International Quarterly of Community Health Education 0(0)
Author Biographies
Samuel Oluwasogo Dada is a result-driven public health pro-
fessional and researcher, monitoring and evaluation special-
ist with four years’ experience in Health Promotion and
Education, Health Systems, on-field qualitative and quanti-
tative research and programs’ monitoring and evaluation. He
is passionate about self-development and continuous profes-
sional growth.
Oyediran Emmanuel Oyewole is currently an associate pro-
fessor of Public Health Nutrition and Education in the
Department of Health Promotion and Education, Faculty
of Public Health, College of Medicine, University of
Ibadan, Ibadan, Nigeria. His areas of research focus include
public health nutrition education and training, reproductive
health, gender issues in nutrition, especially from the male
perspective and community organisation for health and
development using health promoting settings. He has pub-
lished more than 75 research articles and co-authored two
books in these areas of research interest. He has won indi-
vidual and joint research grants and has collaborated with
the private sectors on health related researches. He has trav-
elled globally to present papers at international fora and
conferences.
Adeyimika Titilayo Desmennu is a lecturer and researcher in
the Department of Health Promotion and Education,faculty
of Public Health, University of Ibadan with demonstrated
history in academic and translational research. She is expe-
rienced in diverse areas of public health and has built exper-
tise in planning, implementation and evaluation of health
interventions among at risk population. Her interest is in
Maternal Child and Adolescent Health, Health Promotion
Programming for behavioural change, Public Health
Nutrition, Health Innovations, and Entrepreneurial skill
development.