Applied nutritional investigationRelationships between dietary habits and the prevalence of fatigue in medical students
Introduction
Fatigue is best defined as difficulty in the initiating or sustaining voluntary activities [1]. It is a common symptom; large community surveys have reported that up to half of the general adult population complains about fatigue [2], [3], and medical students are no exception [4]. Because fatigue is related to poor academic attainment, such as impaired academic performance [5] and absenteeism [6], [7], [8], the impact of fatigue on medical students should be emphasized.
In children and adolescents, impaired dietary habits, such as skipping breakfast and taking meals irregularly, are correlated with poor school performances [9], [10], [11]. Moreover, participation in a school breakfast program is associated with improvements in school performance and absenteeism [12], [13], [14]. Therefore, improved dietary habits may result in beneficial outcomes in school students.
Although the association between dietary habits and academic performance has been clarified, little is known about the correlation between dietary habits and the prevalence of fatigue in medical students. However, because other lifestyle factors, such as physical inactivity [15], [16], are associated with fatigue, we hypothesized that dietary habits are also related to the prevalence of fatigue. Therefore, the aim of the present study was to determine whether impaired dietary habits, such as skipping breakfast and taking meals irregularly, are associated with the prevalence of fatigue in medical students.
Section snippets
Subjects
The study group included all second-year students who attended an advanced course lecture at Osaka City University Graduate School of Medicine. Twenty-four subjects with medical illnesses, such as depression, chronic nephritis, gastric ulcer, irritable bowel syndrome, bronchial asthma, atopic dermatitis, and seasonal allergic rhinitis, were excluded from the analyses. The present study was approved by the ethics committee of Osaka City University, and all subjects provided their informed
Results
The subjects' baseline characteristics are summarized in Table 1. The prevalence of fatigue among healthy medical students was 16.5%. The mean age and the proportion of women were not different between subjects who were not fatigued and subjects who were fatigued. With respect to lifestyle factors, although mean BMI, nocturnal sleeping hours, smoking habit, drinking habit, and meal regularity were similar between the two groups, completely skipping breakfast everyday and exercising once per
Discussion
These cross-sectional data demonstrate that skipping breakfast and meal irregularity were associated with fatigue in medical students, independent of other factors, such as age, gender, BMI, and sleeping hours. In contrast, BMI, exercise, nocturnal sleeping hours, smoking habit, and drinking habit were not associated with the prevalence of fatigue in medical students. Academic performance, including factors such as school attendance, pleasure in school, pleasure in learning, and lecture
Conclusion
The present results provide evidence that skipping breakfast and meal irregularity are significantly correlated with the prevalence of fatigue among medical students. Teaching proper dietary habits to medical students and their family members may contribute to lowering the incidence of and/or increasing the rates of recovery from fatigue.
Acknowledgments
The authors thank Dr. Luba Wolchuk for editorial help with the manuscript.
References (25)
- et al.
Fatigue in neurological disorders
Lancet
(2004) The epidemiology of self-perceived fatigue among adults
Prev Med
(1986)- et al.
Learning and memorization impairment in childhood chronic fatigue syndrome manifesting as school phobia in Japan
Brain Dev
(2004) - et al.
Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents
J Am Diet Assoc
(2005) - et al.
Development of a fatigue scale
J Psychosom Res
(1993) - et al.
Lifestyle risk factors associated with fatigue in graduate students
J Formos Med Assoc
(2007) - et al.
Family food insufficiency, but not low family income, is positively associated with dysthymia and suicide symptoms in adolescents
J Nutr
(2002) - et al.
Population based study of fatigue and psychological distress
BMJ
(1994) Fatigue and stress in medical students, interns and residents: it's time to act!
CMAJ
(1989)Relationship of subjective chronic fatigue to academic performance
Psychol Rep
(2004)
A follow-up study of chronic fatigue syndrome in children and adolescents: symptom persistence and school absenteeism
Clin Child Psychol Psychiatry
The definition of disabling fatigue in children and adolescents
BMC Fam Pract
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This work was supported by the 21st Century COE Program “Base to Overcome Fatigue,” from the Ministry of Education, Culture, Sports, Science and Technology, the Japanese Government.