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Research Article
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Vegetarianism among Jordan University Students
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Ahmad A. Suleiman,
Omar K. Alboqai,
Sameer Kofahi,
Adib A. Aughsteen
and
Khader El Masri
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ABSTRACT
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To determine the prevalence rate and reasons of vegetarianism
as well as its relationship with selected demographic and lifestyle characteristics
among Jordan University students. A cross-sectional survey was carried
out at Jordan University, Amman, Jordan from March to September 2005.
The survey included 1209 students aged 17-28 years. A multistage stratified
sampling technique was used to recruit the participants from different
majors at Jordan University. A self-administered questionnaire included
information about demographic, lifestyle characteristics and vegetarian
status. The response rate was 80.6%. The overall prevalence of vegetarianism
among university students was 23.9%. Vegetarianism was statistically significant
(p< 0.05) with being female, younger age, lower family monthly income,
nonsmoker, physically active, vitamin-mineral supplement user and normal
BMI. The main important reasons for being vegetarian were weight control
39.2% and economic reasons 35.8%. A significant proportion of Jordan University
students are interested in vegetarianism because of weight control and
economic reasons. Vegetarians are more likely to be: females, younger
age, with lower family monthly income, nonsmokers, physically active,
vitamin-mineral supplement users and with normal BMI.
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INTRODUCTION
During the last century, the majority of the world population consumed a largely
plant-based diet mainly due to a limited availability of foods (Willett,
1999). The industrial revolution was accompanied by increased production
and availability of food, particularly from animal sources which may resulted
in a global public health challenges caused by various types of transitions
such as epidemiologic, nutritional, demographic and socioeconomic transitions
(Popkin, 1998). In developed countries and some developing
countries such as middle-eastern countries particularly, Jordan, epidemiologic
transition is characterized by an increase in Non-Communicable Diseases (NCD),
such as cardiovascular diseases (CVD), diabetes mellitus and obesity. Also,
nutritional deficiency diseases are prevalent in Jordan such as nutritional
anemia and osteoporosis (Alwan, 1997; Alwan
and Kharabsheh, 2006; MOH, 2006).
Currently, there are an increasing proportion of people in developed countries
interested in plant based diets (ADA, 2003; Worsley
and Skrzypiec, 1998; Perry et al., 2002;
Larsson et al., 2001; Spencer
et al., 2007). Vegetarianism is a dietary pattern that is characterized
by the consumption of plant foods and the avoidance of some or all animal products.
Some vegetarians eat no animal products (vegans), whereas others eat both dairy
products and eggs (lacto-ovo-vegetarians). Many self-identified vegetarians
also eat some meat, particularly fish and chicken (semi-vegetarians) (White
and Frank, 1994; Key et al., 2006, 1999).
Several studies have found the prevalence of vegetarianism among adults and
youth in Western cultures to be 2.5-7% (ADA, 2003; Robinson,
2001), whereas among college students in USA the prevalence varied from
2 to 20.9% (Spencer et al., 2007; Kim
et al., 1997; Klopp et al., 2003).
Several epidemiologic studies and scientific reports demonstrated that appropriately
planned vegetarian diets are healthful, nutritionally adequate and can provide
certain health benefits in the prevention and treatment of certain diseases
and, hence, could lower morbidity and mortality (ADA, 3003;
Key et al., 1999; US Department
of Health and Human Services, 2005). Several epidemiological studies in
Western populations have indicated that vegetarians have been found to be better
educated, of female gender, of younger age, with lower household income, less
likely to smoke, physically active, more likely to use vitamin-mineral supplements
and with normal or lower BMI (Larsson et al., 2001;
Spencer et al., 2007; White
and Frank, 1994; Perry et al., 2001; Bedford
and Barr, 2005; Baines et al., 2007; White
et al., 1999).
Several studies have indicated a variety of reasons for adopting a vegetarian
diet including health concerns, animal welfare, ethical and ecological reasons,
economic reasons, sensory and taste preferences and weight control reasons (ADA,
2003; Robinson, 2001; Klopp
et al., 2003).
Since four decades, Jordan has witnessed a dramatic lifestyle changes due to
modernization which led to changes in food habits from plant based diets to
diets from both plant and animal sources. Since three decades, there was an
increase in the prevalence of chronic diseases in Jordan (Alwan,
1997; Alwan and Kharabsheh, 2006; MOH,
2006), which may be attributed to an increase in the consumption of foods
from animal sources. Also, nutritional deficiency diseases are prevalent in
Jordan (Alwan, 1997; Alwan and Kharabsheh,
2006; MOH, 2006). There is a lack of scientific research
about vegetarianism in Jordan. Therefore, this study was conducted to determine
the prevalence and reasons of vegetarianism and their relationship with selected
demographic and lifestyle characteristics among Jordan university students.
MATERIALS AND METHODS
A cross-sectional survey on vegetarianism was conducted on 1500 students
attending Jordan University between March 2005 and September 2005. Jordan
University is a large sized and a public university consists of eleven
faculties, located in Amman the capital of Jordan. A multistage stratified
sampling technique was used to recruit the participants of the study which
was approved by the deanship of student affairs. At the first stage of
selection five faculties (Medicine, Dentistry, Agriculture, Science and
Humanities) were selected using a systematic random sampling technique.
At the second stage of selection one class from first, second, third and
fourth years in each faculty were randomly selected. Classes were visited
by the research team to clarify the purposes of the study, the students
showed their willingness to participate in the study. Then a schedule
for the next visit was given to fill the questionnaire. At the second
visit an informed consent was obtained from each participant and a self
administered questionnaire was filled by the students in the presence
of a member of the research team. A total of 1209 students aged 17 to
28 years (791 females and 418 males) completed the study. Students were
excluded from the study due to: unwillingness to participate (n = 123),
handing in incomplete questionnaires (n = 66) and non-attendance of class
(n = 102). Thus the response rate for sample respondents was 80.6% (1209/1500).
Statistical analysis were carried out on 1209 participants.
A pre-tested questionnaire consisted of two sections. The first section
of the questionnaire included general demographic information such as
age, sex, family monthly income, as well as information about selected
lifestyle characteristics such as smoking status, physical activity, vitamin-mineral
supplement use and body weight and height. Age was categorized as, 17-20
years and 21-28 years. Sex was categorized as males and females. Family
monthly income, in Jordanian Dinar (JD), was categorized as <300, 300-500
and >500 JD. Smoking status was categorized as never, former or current
smoker. Physical activity was assessed by asking subjects how many times
per week they exercised enough to work up a sweat. Subjects were classified
as active if they exercised to a sweat three or more times per week. Subjects
were classified as physically inactive if they did not exercise to a sweat
with a frequency less than three times per week. Vitamin-mineral supplement
use was assessed by asking the participant about use of vitamin-mineral
supplement during the last year. Weight and height were self-reported
by subjects. The Body Mass Index (BMI) was computed using the widely accepted
method of weight (kg) divided by the square of height (m2).
BMI was classified, based on (WHO, 1997) into three categories: normal
(BMI = 18.5-24.9 kg m-2), overweight (BMI = 25-29.9 kg m-2)
and obese (BMI = 30 kg m-2).
The second section of the questionnaire included a series of questions
about vegetarianism. To identify vegetarians, all students were asked
on the survey to respond to the question Are you a vegetarian? (1) Yes;
(2) No. Of those who answered yes, they were also asked to respond to
additional questions. The first was as a vegetarian, do you eat any of
the following? (1) eggs; (2) dairy food (such as milk, cheese); (3) chicken
and (4) fish. Students who checked no to all four were categorized as
vegan; while those who checked yes that they ate dairy foods were considered
lacto-vegetarian and those who checked yes that they ate eggs and dairy
products were considered lacto-ovo vegetarian. Students who checked yes
to either chicken or fish were considered semi-vegetarians. Self-reported
vegetarians were also asked to answer what are your main reason(s) for
eating a vegetarian diet? and to restrict their answers to the followings:
(1) for health reasons; (2) for economic reasons; (3) for weight control;
(4) dislike red meat and (5) for animal welfare.
Data entry and statistical analysis were performed using the Statistical
Package for the Social Science (SPSS) program, for windows (version 11.5,
SPSS Inc., Chicago, Illinois). Frequency and range checks were performed
initially to detect errors in the data entry. Detected errors were corrected
by rechecking the original data forms. Descriptive statistics such as
Mean ± SD were used to summarize the quantitative variables. Proportions
and percentages were used to summarize category variables. Chi-square
test (χ2) examined the relation between demographic, lifestyle
characteristics and vegetarianism. The p-values≤ 0.05 were considered
for statistical significance. Also, percentages were used to determine
the prevalence rate of vegetarianism and reasons of vegetarianism among
Jordan University students.
RESULTS
The study sample included a total of 1209 students, of this number 34.6%
(n = 418) were males and 65.4% (n = 791) were females. The female to male
ratio was (1.9:1.0). The mean age for all subjects was 20.3 ± 1.5
years (range = 17 to 28 years). Nearly 62% of the students were between
the ages of 17-20 years. Most (83.6%) were of normal weight. More than
one quarter of students (25.6%) had a low level of family monthly income.
Approximately, 18% of students were current smokers. Approximately, 28%
of students were physically active compared with 72% of students who were
physically inactive. Overall, the prevalence of vegetarianism in the sample
was 23.9% (n = 289).
Table 1 shows the prevalence of vegetarianism among
Jordan university students. The overall prevalence of vegan, lacto-ovo-vegetarian
and semi-vegetarian was 1.8, 10.7 and 11.4%, respectively. Among males,
the prevalence of vegan, lacto-ovo-vegetarian and semi-vegetarian was
1.2, 7.9 and 8.4%, respectively. Regarding females, the prevalence of
vegan, lacto-ovo-vegetarian and semi-vegetarian was 2.1, 12.1, 13.0%,
respectively. The prevalence of lacto-ovo-vegetarian and semi-vegetarian
is significantly higher (p = 0.02) among females than among males.
Table 2 shows selected demographic and lifestyle characteristics
associated with vegetarianism among Jordan university students. Sex was
significantly (p = 0.000) associated with vegetarianism. Females (27.3%)
were more likely to be vegetarian than males (17.5%). Age was also significantly
(p = 0.005) associated with vegetarianism. Students with an age group
between 17-20 years (26.8%) were more likely to be vegetarian than students
with an age group between 21-28 years (19.0%). There is a significantly
(p = 0) decreasing pattern in being vegetarian with increasing family
monthly income. Approximately, more than one third (36.1%) of students
with incomes of <300 JD were vegetarians compared with 26.4% of vegetarian
students with incomes between 300 and 500 JD and 18.2% of vegetarian students
with incomes more than 500 JD. Smoking was significantly (p = 0.01) associated
with vegetarianism. Non-smokers (25.8%) were more likely to be vegetarians
than current smokers (18.3%) or former smokers (12.2%). In addition to
that, physical activity was significantly (p = 0.005) associated with
vegetarianism. Physically active students (31.4%) were more likely to
be vegetarians than physically inactive students (21.8%). Also, vitamin-mineral
supplement use was significantly (p = 0) associated with vegetarianism.
Vitamin-mineral supplement users (31.2%) were more likely to be vegetarians
than non-users of vitamin-mineral supplements (21.6%). Data analysis showed
that vegetarianism was significantly (p = 0.041) associated with a normal
BMI. Students with a normal BMI (24.9%) were more likely to be vegetarians
than overweight (21.1%) or obese (10.0%) subjects.
Reasons for vegetarianism were: for weight control (39.2%), for economic
reasons (35.8%), for health reasons (16.5%), dislike red meat (6.8%) and
animal welfare (1.7%).
Table 1: |
Prevalence of vegetarianism among Jordan University students |
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Table 2: |
Selected demographic and lifestyle characteristics associated
with vegetarianism among Jordan university students |
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JD: Jordanian Dinar |
Table 3: |
Reasons given by students for becoming a vegetarian |
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aLose weight or keep from gaining weight;
bPrevention of cardiovascular diseases, cancer, diabetes
and obesity |
There was no statistical significance (p>0.05) between males and females
regarding reasons for being a vegetarian as shown in Table
3.
DISCUSSION
To our knowledge this the first study conducted in Jordan about vegetarianism.
The study found that the overall prevalence of vegetarianism among Jordan University
students was 23.9%. The percentage of semi-vegetarians was 11.4%; the percentage
of lacto-ovo-vegetarians was 10.7% and the percentage of vegans was 1.8% as
shown in Table 1. Several studies conducted worldwide reported
that overall prevalence of vegetarianism varied from 2 to 20.9% in USA (ADA,
2003; Perry et al., 2002; Spencer
et al., 2007; Kim et al., 1997; Klopp
et al., 2003; White et al., 1999;
Barr and Chapman, 2002), from 3 to 7% in UK (Robinson,
2001; Gilbody et al., 1999), 4% in Canada
(ADA, 2003), 15.6% in Sweden (Larsson
et al., 2001) and from 5 to 34% in Australia (Worsley
and Skrzypiec, 1998; Baines et al., 2007).
Results of present study as well as other studies indicate that the overall
prevalence of vegetarianism is different from country to country which
may be due to several factors such as beliefs, economic status, cultures
and food availability.
In addition, study findings indicate that vegetarianism is significantly associated
with being female, younger age, low family monthly income, nonsmoker, physically
active, vitamin-mineral supplement user and normal BMI as shown in Table
2. These findings are consistent with several studies (Larsson
et al., 2001; Spencer et al., 2007;
White and Frank, 1994; Perry et
al., 2001; Bedford and Barr, 2005; Baines
et al., 2007; White et al., 1999).
Present study results show that vegetarianism among university students
is a female phenomenon. This may be due to the fact that females are more
concerned about their body shape and weight control than males. Also,
females overall appear to be more concerned about the financial and moral
aspects of meat consumption. The study also showed that vegetarianism
is more common among young students which may be due to the fact that
young students are more educated; health conscious and more likely to
seek healthy behaviours. Regarding the study finding that students with
low family monthly income are more likely to be vegetarians, it could
be pointed out that, this may be due to the high cost of food from animal
sources. Furthermore, a dramatic increase in food prices occurring currently
worldwide, including Jordan, had lead to a decrease in purchasing power
of food which affected a higher proportion of Jordanian people and resulted
in converting them from middle class to lower class.
Also, results of this study indicated that vegetarianism was significantly
associated with health conscious behaviours such as nonsmokers, physically active,
vitamin-mineral supplement users and normal BMI. These findings are consistent
with Larsson et al. (2001), Spencer
et al. (2007), Frank (1994), Perry et al.
(2001), Bedford and Barr (2005), Baines
et al. (2007) and White et al. (1999).
Results of this study (Table 3) indicated that the most common
reasons for being vegetarian were weight control (39.2%), followed by economic
reasons (35.8%) and health reasons (16.5%) such as, prevention of CVD, cancer,
diabetes and obesity. Several studies in developed countries reported that the
most common reasons of vegetarianism were health and weight control reasons
(Worsley and Skrzypiec, 1998; Perry
et al., 2002; Larsson et al., 2001;
Spencer et al., 2007; Kim
et al., 1997; Klopp et al., 2003;
Perry et al., 2001; Bedford
and Barr, 2005; Baines et al., 2007; White
et al., 1999; Barr and Chapman, 2002; Gilbody
et al., 1999), which is consistent with the results of this study,
whereas economic reasons were found as the most common reasons for being vegetarian
by studies conducted in developing countries (Worsley and
Skrzypiec, 1998; Baines et al., 2007). Study
findings show that the overall prevalence, reasons and lifestyle factors of
vegetarianism are mostly consistent with findings from other studies in developed
countries (Perry et al., 2002;
Larsson et al., 2001; Spencer et al.,
2007; Kim et al., 1997; Klopp
et al., 2003; Perry et al., 2001;
White et al., 1999; Barr
and Chapman, 2002).
This may indicate that health policy makers in Jordan as in developed
countries are encouraging plans to combat chronic diseases and their predisposing
factors through health education. The study recommends that more efforts
has to be devoted to nutrition education programs through government and
private nutrition clinics for dietary planning and consultations to help
in preventing and treating chronic diseases, as well as to get the best
health benefits of vegetarianism and to avoid its deficiencies. An appropriately
planned vegetarian diet is considered to be nutritionally adequate for
all stages of the life cycle as well as for prevention and treatment of
chronic diseases which may reduce the high economic cost of treatment
of chronic diseases. In addition, vegetarianism will lead to a decreased
consumption of foods from animal sources which are highly costly. Furthermore,
due to the existing food crisis worldwide, particularly in Jordan, it
is predicted that a large proportion of middle class Jordanians will adopt
a plant based diet as before, but it should be appropriately planned to
be adequate.
The study was limited by the self-reporting of vegetarianism and the
cross-sectional design of the study. Also, the study was performed in
a single university and therefore the sample may not be representative
of the total population of university students in Jordan. It is highly
recommended that a study on vegetarianism with a larger sample representing
all Jordanian university students, as well as at the national level, be
conducted in the near future.
In conclusion, a significant proportion of Jordan university students
are interested in vegetarianism because of weight control and economic
reasons. Vegetarians are more likely to be: females, younger age, with
lower family monthly income, nonsmokers, physically active, vitamin-mineral
supplement users and with normal BMI.
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