Diet behavior of Employees at a Medical Sciences University in Tehran , Iran : Iran Health Day 2015

Worldwide, the burden of communicable disease and maternal, neonatal, and nutritional disorders declined between 1990 and 2013, whereas the burden of non-communicable disease (NCD) increased.1,2 A sustainable development goal is a global framework to reduce premature deaths from NCDs by one-third. Nutrition-related NCD is important because remarkable transformations of food systems have resulted in a rapid increase on NCDs in lowand middle-income countries.3 Diet plays an important role in NCDs such as cardiovascular disease,2,4-13 diabetes,2,5,8,12 cancer,2,12,14 mental disorders,15-17 and chronic obstructive pulmonary disease.18 Unhealthy diet is a increases the risk of NCDs and provide an opportunity to intervene perfect, appropriately, and synergistically on more than one risk behavior concurrently to prevent NCDs as a whole.12 It has been recommended that the workplace is an appropriate filed to evaluate lifestyle intervention such as promotion of a healthy diet because many adults, regardless of socio-economic status, lifestyle, and risk profile can be targeted at once.9 Globalization of the food supply has increased the need to strengthen food safety. For this reason, the World Health Organization (WHO) is promoting efforts to improve food safety by making the theme of World Health Day 2015 “improve food safety from farm to plate (always and everywhere).”19 The first step to promoting a healthy diet in a given society is to assess diet behavior; thus, the present study assessed the diet behavior of employees at a medical sciences university in Tehran on Health Day 2015. http://ijtmgh.com Int J Travel Med Glob Health. 2016 Sep;4(3):92-95 doi 10.20286/ijtmgh-040305 TMGH IInternational Journal of Travel Medicine and Global Health J


Introduction
Worldwide, the burden of communicable disease and maternal, neonatal, and nutritional disorders declined between 1990 and 2013, whereas the burden of non-communicable disease (NCD) increased. 1,2A sustainable development goal is a global framework to reduce premature deaths from NCDs by one-third.Nutrition-related NCD is important because remarkable transformations of food systems have resulted in a rapid increase on NCDs in low-and middle-income countries. 3iet plays an important role in NCDs such as cardiovascular disease, 2,4-13 diabetes, 2,5,8,12 cancer, 2,12,14 mental disorders, [15][16][17] and chronic obstructive pulmonary disease. 18Unhealthy diet is a increases the risk of NCDs and provide an opportunity to intervene perfect, appropriately, and synergistically on more than one risk behavior concurrently to prevent NCDs as a whole. 12It has been recommended that the workplace is an appropriate filed to evaluate lifestyle intervention such as promotion of a healthy diet because many adults, regardless of socio-economic status, lifestyle, and risk profile can be targeted at once. 9 Globalization of the food supply has increased the need to strengthen food safety.For this reason, the World Health Organization (WHO) is promoting efforts to improve food safety by making the theme of World Health Day 2015 "improve food safety from farm to plate (always and everywhere)." 19 The first step to promoting a healthy diet in a given society is to assess diet behavior; thus, the present study assessed the diet behavior of employees at a medical sciences university in Tehran on Health Day 2015.

Methods
This cross-sectional study was carried out from April 21, 2015 to April 27, 2015 (Iranian Health Week) at a medical university in Tehran.The De Morgan table was used to calculate the sufficient number of cases as 364 and nonprobability sampling used.The subjects were employees of the university who completed demographic and diet behavior questionnaires.Demographic questionnaire consisted of variables such as age, gender, educational level, weight and height.
The diet behavior questionnaire included questions about the consumption of sugar and sweets, bread, cereals, and similar foods, fruits, vegetables, dairy products, proteins such as meat, fish, chicken, eggs and nuts and whether or not the subject read food product labels and ate breakfast.This questionnaire was the Persian version of the health-promoting lifestyle profile (HPLP) validated by Zeidi et al. 20 The questionnaire contained nine questions, with possible responses of 1 (never), 2 (sometimes), 3 (often) and 4 (routinely).The highest score on the diet behavior questionnaire was 36 and the lowest was 9. A higher score indicates better diet behavior.

Statistical Analysis
The data was analyzed using SPSS version 22. P value lower than .05was considered significant for all analyses.Normal distribution was tested by one-sample Kolmogorov-Smirnov test.The independent samples t test and its non-parametric equivalent were used to compare age, body mass index (BMI) and diet behavior score by gender and educational level.
The diet behavior questionnaire scores and age were significantly higher in female subjects whereas the BMI was significantly higher in males (Table 3).
Although there was no significant relationship between education level and diet behavior questionnaire score, age and BMI were found to be significantly higher in employees who had a high school diploma or fewer years of education (Table 4).

Discussion
The results showed that only 58% of participants had a normal BMI and that the diet behavior scores were higher for females.There was no significant relationship between diet behavior score and education level.Kim et al 21 reported that education and gender are significant determinants of health-promoting lifestyles among Arabs and Koreans in the United Arab Emirates.Fincham et al 22 showed that demographic variables such as gender could explain a health-promoting lifestyle.Shaheen et al studied healthpromoting behavior at a university in Jordan.The mean (±SD) score of HPLP nutrition subscale of students was 20.66 (±4.37) which was lower than for the subjects of the present study.They also found that gender could be a determinant of a health-promoting lifestyle. 23ohammadian and Mousavi studied the lifestyles of university students in Kashan, Iran and found a significant relationship between gender and the nutritional status of subjects. 24Geok et al 25 asked student nurses in Malaysia to complete the HPLP and found that the spiritual growth, interpersonal relations and stress management had highest score respectively while the physical activity, health responsibility and nutrition had lowest score respectively.Hwang et al 26 studied predictors of health behavior in Korean blue-collar workers and showed that education level was a significant predictor.Shafieyan et al studied the lifestyle of patients referred to health care centers in Ilam, Iran in 2014.They reported the mean (±SD) of the HPLP nutrition scale to be 26.35(±3.47) for hypertensive patients and 26.65 (±3.74) for the control group.There was no significant difference between the hypertensive and control groups. 27This result is compatible with the findings of the present study.Mahdipour et al studied the effect of educational intervention on a health-promoting lifestyle and reported that although nutrition was one dimension of lifestyle, its score did not change significantly after educational intervention. 28afabakhsh et al 29 examined the effect of health-promoting programs on patient lifestyle after coronary artery bypass surgery and found that the HPLP nutrition subscale score increased significantly after intervention in the experimental group (19.7±0.135versus 31.3±0.258).The HPLP nutrition subscale score of these patients before intervention was lower than that of the present study, although the score was higher after intervention.
Chen et al found an association between breakfast eating habits and health-promoting lifestyle on suboptimal health status in Southern China and showed that 90% of samples had a normal BMI and 19.6% of participants reported "scarce" breakfast eating habits.They found a significant association between breakfast eating habits and healthy lifestyle. 30In the present study, 57.7% of personnel always ate breakfast and 58% had a normal BMI.Inal et al 31 found that only 26.6% of subjects ate breakfast as a family and 57.8% ate breakfast at home.They reported that 68% of mothers had a normal BMI.These results are somewhat compatible with the results of the present study.

Conclusion
The present study showed that, although diet is an important factor in NCDs, diet behavior was not compatible with a healthy diet.The results indicate that females paid more attention to a healthy diet.Eating breakfast daily is important and other healthy diet behaviors must be encouraged.

Table 1 .
Demographics and Diet Behavior Score of Participants

Table 2 .
Gender, Educational Level and Weight of Participants

Table 3 .
Comparison of Age, BMI and Diet Behavior Score by Gender

Table 4 .
Comparison of Age, BMI and Diet Behavior Score by