Akinyemi O, Adelekan O, Omokhodion O, Nurudeen Ola B, Tanna R, Akingbule A, Utomi, Fasokun M, Violet O, Chioma , Bezold M. Impact of Obeity on college student academic performance: A comparison between the United States and Nigeria. HPHR. 2022;63. 10.54111/0001/KKK4
Obesity is a global health concern, with the prevalence increasing worldwide. In the USA, the prevalence increased from 30.5% to 42.4% among adults from 2000-2018, while in Nigeria, 14.3% of adults were obese in 2020. The rising prevalence of obesity is associated with an increased risk of chronic medical conditions and their complications, leading to increased morbidity, mortality, and healthcare costs. Obesity is no longer solely an adult problem; it now affects children and adolescents. This study aims to compare the impact of obesity on academic performance among college students in the United States and Nigeria.
This was a cross-sectional study that recruited randomly selected students of Western Illinois University (WIU), Macomb, IL, USA, between August 15, 2019, and December 15, 2019, and Afe Babalola University (ABUAD), Ado-Ekiti, Nigeria, between June 2020 and July 2020. The primary aim was to compare academic performance measured by the cumulative grade point average (CGPA) between obese and propensity score-matched controls with normal body mass index (BMI) in the two colleges. In addition, in the two colleges, students were matched for age, gender, race/ethnicity, and level of schooling.
A total of 709 and 405 students from WIU and ABUAD were included in the study. Females constituted the majority of students in both schools. The prevalence of obesity was higher among WIU students (30.30%) than ABUAD students (10.62%). The WIU study showed no significant difference in mean CGPA between the obese and matched controls (3.70 ± 0.17 versus 3.73 ± 0.17, p=0.19). Similarly, in the ABUAD study, there was no significant difference in mean CGPA between obese and matched controls (4.05± 0.61 versus 4.19± 0.62, p=0.21).
In conclusion, our study suggests that obesity does not significantly influence academic performance among college students in the United States and Nigeria. Thus, it is unlikely that obesity alone is a predictor of poor academic performance. Instead, other factors may be responsible for any observed academic performance differences between obese and non-obese students in tertiary institutions.
The global prevalence of obesity has tripled since 1975, with an estimated 2 billion people, about 30% of the world population, being overweight or obese1,2. In the United States, the prevalence of obesity increased from 30.5% to 42.4% between 2000 and 20183, with projections that about 50% of adult Americans will be obese by 20304. Moreover, overweight and obesity are no longer restricted to high-income countries. However, they are now rising in low- and middle-income countries, including Nigeria, where 14.3% of adults were obese in 20205. The obesity epidemic has also spread to children and adolescents in recent decades6.
Studies have reported mixed findings regarding the association between obesity and academic performance, with some suggesting a negative association in childhood. For example, a Chinese study found that childhood obesity was associated with poor academic performance, potentially due to deficits in working memory skills7. However, other studies have found no significant correlation between obesity and academic performance8, including a Nigerian study that concluded that overweight/obesity is not common in Nigeria and that no significant association exists between obesity indices and academic performance in the medical students studied9.
The relationship between obesity and academic performance is a subject of research interest, but studies show inconsistent results, potentially influenced by the measures used to quantify academic performance. While some studies found a negative association between obesity and academic performance, others found no effect10–12. Differences in measurement and analysis methods may account for the inconsistency in findings. This study determine the independent association between obesity and academic performance among college students in the United States and Nigeria.
This cross-sectional study investigated the association between obesity and academic performance in two colleges on different continents. We collected data using a self-administered online questionnaire. Graduate students and first-semester students were excluded. The sample was selected using a simple random sampling technique, and the institutional review boards approved the study in both colleges
The study was conducted at Western Illinois University (WIU) in Macomb, Illinois, and Afe Babalola University (ABUAD) in Ado-Ekiti, Nigeria. WIU is a rural university with a population of about 7,000, while ABUAD is located in the capital city of Ekiti State and has a population of 8,500.
The primary outcome of this study is college students’ academic performance. We evaluated the academic performance using the Cumulative Grade Point Average (CGPA) and determined the association between obesity and CGPA by comparing the CGPA among study respondents and a propensity score generated control group of students with normal BMI (BMI between 18.4 and 24.9 kg/m2).
In this study, we considered several covariates, including age, sex, ethnicity, year in school, and maternal education level. Age was stratified into three categories: 18-20, 21-24, and ≥ 25 years. We categorized respondent ethnicity as Non-Hispanic White, Non-Hispanic Black, Hispanic, and Others at WIU. In contrast, at ABUAD, we categorized ethnicity as Yoruba, Hausa, Igbo, and Others, representing the major ethnic groups in Nigeria.
Propensity score matching is a non-randomized method to evaluate outcome differences between groups, particularly when randomization is not feasible. Since simple random sampling was inadequate for sufficient randomization, we used propensity score matching to ensure that student characteristics such as age, sex, race/ethnicity, school year, and maternal education level (for ABUAD students) were evenly distributed between the control group and self-reported obese students.
Categorical variables were presented as frequencies and percentages, and continuous variables as mean and standard deviations. We utilized nearest neighbor propensity-score matching in a 1:1 ratio without replacement, with a caliper width set to 0.02 times the standard deviation of the propensity score to compare the CGPA of obese and non-obese college students with self-reported normal BMI. We adjusted for age, sex, race/ethnicity, school year, and maternal education (ABUAD students) in the model. Statistical significance was set at a 2-tailed p-value <0.05. All analyses were performed using STATA 16 (StataCorp, College Station, TX).
In this cross-sectional study, we analyzed the bio-demographical characteristics of 709 college students at WIU, Macomb, IL, USA, and 405 students at ABUAD. 58.39% of the WIU students and 74.07% of the ABUAD students were below 21. Females were the majority of the respondents at both schools: 60.93% at WIU and 63.70% at ABUAD. Most of the students at WIU were non-Hispanic whites (77.43%), while all the students at ABUAD were non-Hispanic Blacks. Students were evenly distributed across different school years in both schools. Almost all the students from ABUAD had mothers with tertiary education, as high as 73.83%, and advanced education at 16.30%. The prevalence of obesity was 30.32% and 10.62% among student respondents at WIU and ABUAD, respectively. The average CGPA at WIU was 3.73 ± 0.16 on a scale of 4, while at ABUAD; it was 4.09 ± 0.70 on a scale of 5.
Table 2 displays the propensity score matching results among WIU student respondents, matched for age, year in school, race, and sex. No significant difference was found in the CGPA of obese students compared to non-obese controls (3.70 ± 0.17 vs. 3.73 ± 0.17, p=0.19). Similarly, Table 3 shows the results of matching among ABUAD students, matched for age, level of schooling, ethnicity, sex, and highest maternal education level, with no significant difference found between the CGPA of obese students and their non-obese controls (4.05 ± 0.61 vs. 4.19 ± 0.62, p=0.21).
Table 1: Bio-demographical Characteristics of College Students (WIU & ABUAD)
CGPA, cumulative grade point average. *CGPA is on a grade of 4 in WIU and 5 at ABUAD,
Table 2: Bivariate analysis showing association between self-reported obesity and cumulative grade point average among WIU students following propensity score matching.
*CGPA, cumulative grade point average
Table 3: Bivariate analysis showing association between self-reported obesity and cumulative grade point average among ABUAD students following propensity score matching.
*CGPA, cumulative grade point average
This study aimed to investigate the association between obesity and academic performance among college students. With the global rise of obesity affecting individuals of all ages and income levels, it is crucial to determine its influence on adolescents and young adults. We also sought to explore potential geographical differences in the relationship between obesity and college students’ academic performance.
We surveyed students from ABUAD (Nigeria) and Western Illinois University (United States).The majority of the Nigerian students were of African descent and while most of the WIU students were non-Hispanic whites. Most respondents from both schools were under 21, and two-thirds were female. This similarity in the proportion of female college students may reflect ongoing efforts to educate the girl-child in Nigeria13, despite women being more likely to enroll in tertiary education in the US14.
The prevalence of obesity was 30.32% among respondents at WIU, which is higher than the obesity rate among young adults in the US (19.5%) 15. At ABUAD, the prevalence was 10.6%, similar to findings in previous studies on obesity prevalence in Nigeria16. The higher prevalence at WIU indicates the rising trend of obesity among adolescents worldwide.
A global review showed that obesity was more prevalent among the poor in high-income countries and more common among the wealthy in mid and low-income countries17. The prevalence of obesity in ABUAD, a Nigerian university for the elite, was surprisingly lower than in the general population in Nigeria. The increase in obesity in low- and mid-income countries may be due to westernization and adoption of high-income country lifestyle habits. As low-income countries approach the population characteristics of high-income countries, their health statistics may follow a similar trend.
Obesity did not appear to significantly influence students’ academic performance, as measured by the cumulative grade point average (CGPA) in the present study. After matching for age, sex, year in school, race, or ethnicity in both schools, there was no difference in the CGPA between obese students and the control group with normal BMI. Previous evidence on the association between obesity and academic performance has been conflicting. A systematic review of 34 studies shows an uncertain association between children and adolescents in the majority (55.9%)18. Other studies have shown a negative association between obesity and academic performance in adolescents19, while another study among medical students in Nigeria found no association between obesity and academic performance. The discrepancies in study findings may be due to age-related differences in the study populations and the measures of academic performance used.
This study examined the impact of obesity on college students’ academic performance as measured by cumulative grade point average (CGPA). Despite no statistically significant difference in mean CGPA between obese and control groups, it is noteworthy that overall academic performance was higher among ABUAD students than WIU students, where obesity was more prevalent. This suggests that while obesity may have an uncertain association with academic performance, other factors likely influences academic achievement among college students.
The public health significance of the study is that it provides evidence that obesity may not be an independent predictor of poor academic performance among college students. This information may inform public health policies aimed at reducing the burden of obesity and related chronic medical conditions among college students. It also highlights the need for further research to identify other factors that may affect academic performance among obese college students, which could aid in developing targeted interventions to improve academic outcomes in this population.
Several factors could explain the absence of an association between obesity and college student academic performance as measured by GPA in the present study. The study’s sample size and demographic characteristics might have influenced the results, despite the use of propensity score matching to minimize these effects. Additionally, variables of interest such as self-reported BMI or GPA may have introduced bias or inaccuracies. Other unaccounted factors that can affect obesity and academic performance, such as physical and mental health, sleep patterns, diet, exercise, stress, and engagement in academic activities, might have also played a role. The study’s duration may be inadequate to capture the true association between the two variables. Moreover, the complex relationship between obesity and academic performance, influenced by genetic, personality, and environmental factors, suggests that caution is necessary when interpreting the study’s findings. Additionally, the current study’s sample consisted of college students who met the requirements for admission, which may introduce a selection bias and limit generalizability to the broader population. Further research that addresses these limitations with larger and more diverse samples, better measures, and comprehensive control of confounding factors could advance our understanding of this association.
The global prevalence of obesity is escalating, including in mid and low-income countries and this phenomenon is also observed among adolescents. Although the relationship between obesity and academic performance remains unclear, other variables may influence this association. Therefore, further research is warranted to elucidate the complex interplay between these factors.
Dr. Oluwasegun Akinyemi earned his Bachelor of Medicine/Bachelor of Surgery degree at Obafemi Awolowo University in Nigeria. He then completed his residency in Obstetrics and Gynecology and became a fellow of the Nigerian Postgraduate Medical College in 2017. Dr. Akinyemi went on to earn a Master of Science in Public Health at Western Illinois University in 2020 and currently serves as a Research Associate at the Department of Surgery Outcomes Research Center, Howard University College of Medicine.
With a research focus on disparities in access to quality health care for women and minority populations, Dr. Akinyemi investigates the impact of social determinants of health and chronic conditions, such as obesity, diabetes, and hypertension, on health outcomes across different disciplines such as surgery, obstetrics and gynecology, internal medicine and public health in minority and immigrant communities. He is dedicated to not only identifying these disparities, but also to designing targeted intervention studies that aim to improve them. He is currently pursuing a Ph.D. in Health Policy and Management at the University of Maryland School of Public Health in College Park, Maryland, USA.
Dr. Oluseyi Adelekan earned his Bachelor of Medicine/Bachelor of Surgery degree at Ladoke Akintola University of Technology in Nigeria. He completed his residency in Obstetrics and Gynecology, becoming a fellow of the West African College of Surgeons in 2019. Dr. Adelekan went on to obtain a Master of Science in Physiology from Afe Babalola University, Ado Ekiti, in 2022.
Currently, He is a lecturer and consultant at Afe Babalola University in Ado Ekiti, Nigeria. His research interests encompass maternal and child health, reproductive endocrinology, and infertility. Dr. Adelekan is dedicated to assisting couples in achieving pregnancy, maintaining a healthy pregnancy, and experiencing stress-free deliveries.
Dr. Ofure Omokhodion earned her Bachelor of Medicine/Bachelor of Surgery degree from Obafemi Awolowo University in Nigeria. She then obtained a Master’s degree in Public Health from the Johns Hopkins Bloomberg School of Public Health in Baltimore, USA, in 2015. Following her Master’s, Dr. Omokhodion completed her residency training in Obstetrics and Gynecology at the University College Hospital in Nigeria, becoming a fellow of the West African College of Surgeons in 2020.
Currently, she works as a virtual medical scribe at Central Ohio Primary Care in Ohio, USA. Her research interests encompass maternal obesity, contraception, indigenous health, and health inequities. Driven by her passion for women’s health, she serves as a research assistant at Medical Education Programs in Canada, where she participates in numerous research projects and health education campaigns designed to benefit Indigenous women.
Dr. Nurudeen Ola Bello earned his Bachelor of Medicine/Bachelor of Surgery degree from the University of Ilorin in Nigeria. He completed his residency training in Obstetrics and Gynecology, becoming a fellow of the West African College of Surgeons in 2018. Dr. Bello has held positions as a Lecturer 1/Consultant Obstetrician Gynecologist at Afe Babalola University in Ado-Ekiti, Nigeria.
He is currently the Head of the Department of Obstetrics and Gynecology at the State Specialist Hospital in Oshogbo, Nigeria. His research interests focus on the impact of micronutrients and free radicals in disease development, particularly during pregnancy and its effects on feto-maternal outcomes.
Dr. Resham Tanna is a recent alumna of Spartan Health Sciences University in Saint Lucia. She actively engages in volunteer work within underserved communities, concentrating on women’s health issues. Dr. Tanna’s research interests encompass Women’s Health, Global Health, and Public Health.
Dr. Akinwale Akingbule began his medical career in Nigeria, where he practiced as a physician for four years. He then moved to the United States to pursue a Master’s degree in Public Health at Western Illinois University. After completing his degree, Dr. Akingbule took on a role as a Health Educator at the University of Illinois Extension Urbana Champaign.
In this position, he focused on obesity and chronic disease prevention across five counties, utilizing his medical expertise and passion for public health to drive community initiatives that led to policy changes in schools and the broader community. Dr. Akingbule is ECFMG certified and currently works as a mid-level provider in a primary care setting in Branson, Missouri. He is dedicated to preventing chronic diseases and promoting behavioral changes that contribute to improved management of chronic conditions.
Awele Utomi completed his Bachelor of Science degree in Biology & Chemistry in 2019 at Howard University, Washington, D.C, USA. He went on to earn a Master of Science in Bioethics from Columbia University in New York City in 2020. As a second-year medical student at Howard University College of Medicine, Awele is passionate about addressing and combating mental health disparities among minority populations, utilizing innovative approaches such as music and mindfulness techniques.
Dr. Mojisola Esther Fasokun earned her Bachelor of Medicine/Bachelor of Surgery degree from Obafemi Awolowo University in Nigeria. She is recently completed a Master of Public Health with a concentration in Epidemiology at the University of Alabama at Birmingham. Dr. Fasokun is also gaining practical experience through her internship with the RURAL Heart and Lung Study.
As a Student Research Assistant, Dr. Fasokun works at both the University of Alabama at Birmingham’s Neurology Chair Office and the Institute for Informatics (General Medicine). Her research interests center on the epidemiology of infectious and chronic diseases, as well as maternal and child health in economically disadvantaged rural communities in the United States. She focuses on risk factors such as poverty, race/ethnicity composition, and population sizes, while also striving to understand and develop interventions aimed at addressing health disparities across the country. Dr. Fasokun is eager to commence her Ph.D. program in Epidemiology.
Dr. Omajugho Abimbola Violet is a recent graduate of Afe Babalola University and is currently pursuing an internship.
Sixtus-Iheanacho Sandra Chioma is presently a student at the Afe Babalola University.
Maureen P. Bezold (Ph.D., Virginia Tech) is an associate professor of public health and the graduate coordinator for the Department of Health Sciences and Social Work at Western Illinois University (WIU) where she has taught for 12 years. Prior to joining WIU, Dr. Bezold earned her MPH from the University of Wisconsin – La Crosse and worked as public health emergency preparedness professional at the City of Milwaukee Health Department. Dr. Bezold has served on the American Public Health Association (APHA) Governing Council for two terms and has served as the co-program planner for the Health Administration Section for two years. She continues to be active in the organization. Dr. Bezold is also a member of the Illinois Public Health Association (IPHA) and has served as a program planner for the emergency preparedness and response section. Her current research interests include emergency preparedness and access to services for medically underserved rural communities and for the disability community.