Experiences in healthy dieting of male college students with obesity in Korea.

OBJECTIVES: The purpose of this study was to describe and understand experiences of healthy dieting in male college students with obesity.
METHODS: The interview data were collected from nine male students and analyzed by using descriptive phenomenology of Colaizzi. The procedural steps described the phenomenon of interest, collected participants' descriptions of the phenomenon, extracted the meaning of significant statements, organized the meanings into clusters, wrote exhaustive descriptions, and then incorporated data into an exhaustive description.
RESULTS: The findings in 246 restatements, 47 constructed meanings, 31 themes, eight theme clusters, and four categories were deduced. The four categories were "Uneasiness at interpersonal relationships", "Developing durability in dieting strategies", "Practicing healthy diets based on information", and "Perceived on healthy diets as a whole health support strategies".
CONCLUSION: This study described experiences in healthy dieting of male college students who were discharged from military services. These findings have important implications for understanding healthy dieting in young men and must be considered in developing health promotion in youth.

Introduction

Recently, concerns about disease prevention and health promotion have led to trying to resolve problems of obesity. Health problems of obesity have been impacted by socioeconomic development [1]. Especially, obesity has been a preceding factor of cardiovascular diseases, chronic conditions, and cancers [2]. Therefore, our society has a new view that obesity itself is a disease.

According to Korean Health Statistics, the percentage of obese adults has been increasing. A 2011 survey showed that 31.9% adults among the total population were obese [3]. In particular, a body mass index (BMI) > 30 kg/m2 was seen in the greatest percentage of young men among all of the population. This revealed that obesity leads to a risk of disease in a young population. It was reported that domestic young people had a high subjective perception on obesity, but physical activity was continuously low [3].

Korean literature on healthy dieting activities for young college adults reviews practices on dieting [4,5], lifestyle [6], and motivation [7]. Psychosocial factors on dieting practices were identified. Regardless of sex, dieting has been a concern for young people, but preceding literature usually focused on dieting practices for female college students. A related article reported that female’ healthy dieting was the process of developing self-competence by a qualitative approach [8].

In addition, literature from abroad reported the relation of physical fitness and academic achievement [9] and adiposity and metabolic risk factors [10]. Qualitative reports referred to determinants of weight control behaviors [11], psychosocial and environmental determinants [12], and barriers and enablers [13]. Therefore, we knew it was mainly due to activity of diet and moving that was contributed by psychosocial effects.

In the case of male college students, an increase of weight reflected a risk of metabolic syndrome [14], and higher BMI, higher levels of blood pressure and cholesterol [15].

From these perspectives, this paper focused on male college students. The aim of this paper was to describe experiences of healthy dieting from their perspective.

Materials and methods

Design

Colaizzi's descriptive phenomenology, a qualitative exploratory design, was used for this study [16]. Colaizzi's method has been used for identifying common characteristics in health dieting experiences of participants.

Participants

To measure fatness, body mass index (BMI) proposed by World Health Organization was applied [17]. So, the participants were male college students with a BMI range > 25 kg/m2. The general characteristics of participants are presented in Table 1.

Table 1

General characteristics of participants.

		Number of participants
Discharge from military service	Yes	5
	No	4
Major field	Human science	4
	Natural science	2
	Engineering	3
Housing	One's own house	5
	Self-boarding students	2
	Dormitory	2
Cohabitation	Families	5
	Friends	2
	Live alone	2
Rate of change in body weight (%)		10.03 ± 4.01
Age (y)		24.23 ± 1.92

Data collection

Interview questions started with, “What your experiences on healthy dieting were?” and then according to their responses, Kvale's interview method was timely applied [18].

These interviews performed about two to three times/participant. One mean time duration was 45 minutes. Then, recorded data were transcribed through repeated listening. Through these processes, vague meanings were identified.

Data analysis

Audio recording and observations were transcribed verbatim. Based on Colaizzi’ methods, data analysis were performed by the following.

Step 1: After repeated listening, record data were transcribed verbatim.

Step 2: Among the statement, related phenomenon of the study spelled out and identified 246 significant statements.

Step 3: Significant statements were summarized restatements by participants' language.

Step 4: From the 246 restatements, 47 meanings were extracted. These extracted meanings were compared to the original statement by identifying participants' experiences for validity. This process was progressed by a professor for objective validity.

Step 5: Thirty-one themes were identified from previous extracted meanings. Then, eight theme clusters and four categories were organized.

Step 6: Tried to write an exhaustive description by relating themes to interested phenomenon.

Step 7: For constructing essential structure, there was a return to participants for validation of the description. Nine participants identified their each description and agreed extracted themes.

Ethical issue

This study received institution ethics approval from Pukyung Natinoal University Committee (IRB No:1041386-20131205-HR-003-04). Students who were intended to participate in this study were given a brief verbal explanation of the research. They were given a copy of consent to sign to prove that their vocal sounds were recorded. They were told their participation was free and they had the right to be involved or to withdraw participation at any time. Finally, students were offered a gift as recompense for their participation.

Results

Since the analyzing process have continued by Colaizzi' method, thirty-one themes consisted in seven theme clusters, and the theme clusters were integrated to three categories as following (Table 2).

Table 2

Categorizing by Colaizzi's methods.

	Categories	Theme clusters	Themes
1	Uneasiness at interpersonal relationships	Perceived on disconnected self	Being introversive
			Being anyone else
		Follow up intrapersonal satisfaction	Satisfied with selfish lifestyle
			Disconnected by misanthropy
2	Developing durability in dieting strategies	Minimizing stress on dieting	Practicing by plan of life
			Detecting body conditions when enjoying activities
			Controlling minds with positive
			Applying dances as exercises
			Focusing on self with weights exercise
		Developing interesting diet motives	Watched the body with open dieting
			Finding methods of recognized healthy dieting
			Exercising with friends
			Having diets with chatting
3	Practicing healthy diet based on information	Practicing daily exercises based on dieting	Increasing the time of exercise based on activities
			Using the campus athletic facilities
			Following the natural trail
		Converted diets based on nutriment	Taking breakfast daily
			Keeping the diet – amounts that do not feel a sense of satisfaction
			Decreasing times of eating out
			Having low sodium diets
			Restrained on alcoholic drinks
			Checking the accounting by the menu
			Limiting the time of dinner
			Cutting down the intakes of carbohydrates
4	Perceived on healthy diets as a whole health support strategy	Considered weight changes as pre-index for health	Changing the amounts of sweat in activities
			Increased vitality
			Increased muscle mass
			Increasing quality of sleep
		Perceived as a short cut for social adaptive	Restoring the romantic relationship
			Having various activities in groups
			Perceiving on factors of employment

Uneasiness at interpersonal relationships

Participants felt a dislike to reveal their obese body image. Therefore participants' activity level is low and they feel lonely. As time goes on, their lifestyle is limited and they are disconnected from social life. Finally, they are indulged in with a computer-centered life, imbalanced diets, and are led to physical weakness.

Perception on disconnected self

“At home, I lie down and rest rather than sitting down. I have been use computer daily rather than social activity. Because my friends live away, I have expensive money for meeting them. So I rarely get along them.”(Participant 3)

Follow up intrapersonal satisfaction

“96 kg, 168 cm, I am obesity but I have not concern about people, I have self-oriented life. So, I satisfied with game or another. I perceived that I have not important anything else except me. Therefore, I like eating, I ate full freely.” (Participant 2)

Developing durability in dieting strategies

The participants had obesity-related health problems. About theses stressors, they tried to overcome obesity. They perceived the importance of physical activities and exercise to be low. In particular, they were aware of the importance of practicing dieting activities daily, through internet health news. In the process of dieting, participants were helped by friends and family members. They realized that dieting activities are difficult to practice consistently.

Their strategies for developing dieting were to minimize the stress on dieting and develop interesting dieting motives.

Minimizing stress on dieting

“My thought for effective dieting, I have few of stress. Because of stressors, we tend to have overeating and drinking. So my physical condition will be repeated as obese as before.”(Participant 1)

Developing interesting diet motives

“I have taken lecture on ‘dance sports’. Anyway, I have more chances for moving body in the lecture. It was very fun and pleasure. So this was a reason for continence. ” (Participant 5)

Practicing healthy diet based on information

Participants dieted and exercised in daily life. They developed a variety of methods for increasing activities and selecting healthy foods. These processes were undertaken gradually. They changed their life gradually with regards to exercise, nutrition, sleeping time, and limiting favorable foods.

Practicing daily exercises based on dieting

“I always practice running for participating the international marathon. I have practiced two hours after school daily. Finally, I run an entire marathon.” (Participant 4)

Converted diets based on nutriment

“I have a low carbohydrate diet. My diet menu had been changed for health. So I rejected salty foods and snacks. I restricted myself to two meals a day.” (Participant 5)

Self awareness of healthy diet strategy

In the past, participants have not perceived their overweight seriously in aspects of health. However, practicing dieting, they realized that body weight itself is an important factor for health. They realized also that changed weight led to self-confidence in social relations.

Considered weight change as a pre-index for health

“As I have overweight, I sweated profusely. Before I have heating senses of body and face, but now, I would controlled my hot flush.” (Participant 1)

Perceived as a short cut for socially adapting

“After dieting, I had lots of self confidence. Girls told me that L became handsome. That makes me feel great.” (Participant 4)

Discussion

The participants' experiences of healthy dieting revealed “uneasiness at interpersonal relationships”, “developing durability in dieting strategies”, “practicing healthy diets based on information” and “perception on healthy diets as a whole health support strategy”. These theme clusters correlated with each other and consisted of experiences in healthy dieting.

Firstly, male college students' healthy dieting experience “uneasiness at interpersonal relationships”, reveals a disconnected social life and intrapersonal satisfaction. Their only activity is walking to school and they recognized deficits of activity. The self-oriented behavior led to rapid obesity. This resulted in them feeling neglected. From related reports, the activities of male college students had focused on control of health status than weight reduction, but non-obese and high fat female students diminished daily concerns of health [17,19,20]. These results were different from those of females. In this study, the participants tried dieting for the purpose of health and social relationships.

The second theme category, “developing durability in dieting strategies” revealed an experience that dieting practices have good effects. The participants tried to find their own ways. They stated they had better self-fitting strategies for diets. Another article reported on health supplements used by obese people for controlling body weights [20]. However, participants of this study intended to be active and had reasonable methods for themselves. They focused on daily life and reality. Their strategies included to have pleasure and to pursue personal incentives for dieting. In this respect, preceding research reported that motives and control of minds were important factors for dieting strategies [12]. The experience of “practicing healthy diet based on information” was consisted with ‘practicing daily exercises’ and ‘nutrients based diets’. They considered health and weight control through a variety of information. The final theme category, “perceived on healthy diets as a whole health support strategy” was an experience considering health practices having lots of opportunities to socially adapt.

This paper provides a look at healthy dieting experiences of male college students through a phenomenological approach. Therefore, the daily healthy diet and social activities could be included in the healthy diet program. This intervention research is required to promote health and social relations and adaptives.

Conflicts of interest

The author has no conflicts of interest to declare.