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Nutritional Deficiencies among Adolescents: Challenges for 

Healthcare System 
 

Adeela Rehman  
 

Fatima Jinnah Women University, The Mall, Rawalpindi, Pakistan   
 

 

Abstract 
 

The individual’s behavior, education and knowledge about nutrition are important factors 

to be considered in healthy living. The study aimed to explore gender differences in 

awareness about nutritional deficiencies among university students. Six public and 

private universities of twin cities (Rawalpindi and Islamabad) were selected to collect 

data through a formal questionnaire survey. The research covered issues related to the 

awareness of well-being and health risks, perception and attitude towards health and 

nutrition, prevalence and knowledge about nutritional food and healthy lifestyle. The 

data was analyzed by using different statistical tests and the results of the study 

demonstrated a significant difference between male and female students regarding the 

awareness and knowledge of well-being and health risks behavior. The findings of the 

study indicated that female students have more awareness of health-related matters like 

nutritional value of food, perception of their physical social health status, avoiding health 

risk behavior and adopting healthy lifestyle for enhanced wellbeing. Although female 

students do not have breakfast and generally go to university with empty stomachs, 

which adversely affects their health as well as diminish their activities, they are more 

aware of the foods which are more nutritious and better for health. On the other hand, 

male students are involved in some risky health behaviors such as smoking and dietary 

irregularities. The male students were more frequently involved in health risk behavior 

like smoking, drinking, eating out etc. It has been recommended from the study that 

comprehensive health educational programs should be incorporated into educational 

institutions to promote optimistic health seeking behavior among students.  

 

Introduction 
 

Nutrition is defined as the way the body processes and uses the essence of nutrients 

that the body needs for growth, repair and preservation of cells. Carbohydrates, 

vitamins, minerals and fats are the essential nutrients for a healthy body (Alters & Schiff, 

2011).  One of the simplest and most effective ways of improving health is to follow an 

adequate diet that satisfies the nutritional needs and a good supply of fresh clean water. 

Proper food high in nutrients is important for physically and mentally healthy living.  

 

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Health and nutrition problems are the effect of unsatisfactory food intake, severe and 

repeated infections or the combination of the two, and are closely connected with 

inadequate health service and unhealthy environment. In Pakistan, there is a significant 

difference in the economic status, lifestyle and nutrition between urban and rural 

populations, and between male and female children. The study conducted by Anwar & 

Awan (2003) comparing the nutritional status of rural and urban school children in 

Faisalabad District indicated that girls are often neglected by their families regarding 

health status as food of higher quality is given to male children. The reason for 

malnourishment of female family members in both urban and rural areas is illiteracy and 

poverty: girls are given less food than boys and families spend less money on girls' 

healthcare. Hospital records show that more boys than girls are brought in for treatment, 

while girls are usually admitted only when an illness has become critical.  

 

Gender differences exist in the preferences of eating places.  The study by Driskell, 

Meckna & Scales (2006) indicates that male students show a decided preference for 

eating lunch at fast food places as compared to female students. At fast food places 

mostly males prefer to take burgers and carbonated drinks, which do not have such 

nutritional values that are required for their health.  

 

The research by Tirodimos et al (2009) conducted on nutritional and health habits of 

university students in Thessaloniki, the second largest city in Greece, provides further 

insights into the differences.  The purpose of the study was to assess the eating habits 

and some health-related behaviors. The analysis of the data collected from 300 

students indicates that the percentage of female students’ awareness of health 

practices and nutritional eating habits was higher than the percentage of male students: 

66.7% and 61.8%, respectively. Another research, conducted by Yahia et al (2008) on 

eating habits of Lebanese university students, indicates that female students show 

better and healthier eating habits than male students. 53.3 % of female students have a 

proper breakfast daily as compared to 52.1% of male students.  

Boys consume significantly more products from the grain and meat groups than girls. 

While the average daily intake of fiber and micronutrients is significantly low for both 

boys and girls, there are significant gender differences in nutrient intake, with boys 

consuming greater energy, protein, carbohydrate, calcium, iron, phosphorus, and 

sodium than girls (Galloway, 2007). The research conducted by Liebman et al (2003)  

into gender differences in selected dietary intakes and eating behaviors in rural 

communities of Wyoming, Montana, and Idaho  indicates that women report higher 

intakes of fruits, vegetables (except for potatoes), and high-fiber cereals, but lower 

intakes of milk and sweetened beverages such as soft drinks in comparison with d men. 

The result of the study showed that the diets of female respondents were more nutrient 

and likely to be higher in dietary fiber. Women were generally seen to prefer food 

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prepared at home, with low fat and sufficient protein level. The overall gender 

differences in dietary intakes and eating behaviors were consistent among both male 

and female respondents of the study.  

Another research conducted by Deshpande et al (2009) highlighted poor eating habits 

young generation because of taking more independent eating decisions. By doing so 

they do not focus on the timing, quality and type of food they are choosing, ignoring the 

nutritional requirements of the body.  

Method 

Objectives of the study: 

 To find out gender differences in nutritional awareness and eating habits among 

university students.  

 To explore the choices of nutritional food among students.  

Research Design 

In order to find out gender differences in health seeking behavior among university 

students in the twin cities, the present research applies quantitative approach.  

Tool  

The semi structured questionnaire was developed for the purpose of this research. The 

questionnaire was based on open-ended, close-ended, matrix as well as contingency 

questions. The questionnaire was filled by the students of different public and private 

universities in Rawalpindi and Islamabad.   

Language of Instrument Instruction 

The questionnaire was prepared in the English language because the students can 

understand English very well.  

 Research Locale  

The study area for this research was public and private universities in Rawalpindi and 

Islamabad.  

 

 

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Sample Size 

Four hundred students were selected as respondents of the study. The overall sample 

consisted of 175 males and 225 females.  

Sampling Technique  

This research was based on a probability as well as non-probability sampling technique. 

The universities were selected randomly and then sampled proportionately. The desired 

number of students was established using a convenient sampling technique, the study 

was conducted on the specified sample group.  

Results  
 

Table 1: Demographics characteristics of the respondents  
 

Sex  Age Group   Frequency  Percentage  

 

 

Male 

18-20 52 30 

21-23 88 50 

24-26 31 18 

27-30 4 2 

 

Female  

18-20 55 25 

21-23 132 59 

24-26 33 14 

27-30 5 2 

 Education    

Male Bachelors 72 41 

Masters 103 59 

Above Masters 0 0 

Female  Bachelors 148 66 

Masters 66 29 

Above Masters 11 6 

 Marital Status    

Male  Single 164 94 

Married 11 6 

Female  Single 215 96 

Married 10 4 

 Family system    

Male Nuclear 145 64 

Joint 74 33 

 Extended 6 3 

Female  Nuclear 73 42 

Joint 92 53 

 Extended 10 5 

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The above table indicates that 30% of the males belong to the 18to-20-age group as 

compared to 25% of the females, while 50% of the male are between 21-23 years old 

as compared to 59% of the females. It further indicated that 18% of the males are aged 

24-26 and 14% of the females belong to this age category, while 2% of both males and 

females are aged 27-30.  

 

The table also indicates that 41% of the male respondents have education up to the 

bachelor level as compared to 66% of the females, while 59% of male respondent have 

a master degree as compared to 29% of the females. Only 5% of the female 

respondents have higher degrees than master. Regarding the marital status of the 

respondents, it is indicated that 94% of the male respondents were unmarried as 

compared to 96% of the females. 64% of the males belong to nuclear families as 

compared to 42% of female respondents belonging to the same type of family.  

 

Table 2: Eating timing of the respondents by gender with relation to their level of 
education  
 

Sex  Education Level  Hungry  

% (f) 

When free  

% (f) 

Any time 

% (f)  

Proper time  

% (f) 

Total  

% (f) 

Male  Bachelor  35(25) 30(22) 19(14) 15(11)      (72) 

Master  34(35) 14(15) 24(25) 27(28)      (103) 

Above Master  0 0 0 0         0 

 Total       

Female  Bachelor  42(62) 15(22) 24(36) 19(28)         (148) 

Master  62(41) 7(5) 15(10) 15(10)          (66) 

Above Master  9(1) 37(5)  54(6)         (11)  

 Total       

Chi-Square: 8.72 (M), 25.348 (F)    DF: 3 (M), 6(F)   Significance Level (SL): 0.041 (M), 0.000(F) 

Lambda:0.099         Standard error: .026               t value: .3.959    SL: .000 

 

The above table indicates that 35% of the males having education up to the bachelor 

level take their food when they are hungry while the rest of the male students take food 

when they have free time or at any time. Whereas 62% of the female students having 

master education take food when hungry and the rest of the female students take food 

at proper times, in their free time or at any time. The chi-square value indicates an 

insignificant difference between eating times of both male and female respondents.   

 

 
 
 
 
 

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Table 3: Level of education and eating timings among students.  
 

Sex  Education Level  Hungry  

% (f) 

When free  

% (f) 

Any time 

% (f)  

Proper time  

% (f) 

Total  

% (f) 

Male  Bachelor  35(25) 30(22) 19(14) 15(11)      (72) 

Masters  34(35) 14(15) 24(25) 27(28)      (103) 

Above Masters  0 0 0 0         0 

Female  Bachelor  42(62) 15(22) 24(36) 19(28)         (148) 

Masters  62(41) 7(5) 15(10) 15(10)          (66) 

Above Masters  9(1) 37(5)  54(6)         (11)  

Chi-Square: 8.72 (M), 25.348 (F)    DF: 3 (M), 6(F)   Significance Level (SL): 0.041 (M), 0.000(F) 

Lambda:0.099         Standard error: .026               t value: .3.959    SL: .000 

 

 

Table 4:  Gender differences in prevalence of overeating among students (n=400) 

 

Respondents Overeating 

 Yes  No   Total  

Male  

Female 

               Total  

56(99) 

51 (122)  

55 (221) 

43(76) 

45(103) 

45(179) 

44(175) 

56(225) 

100(400) 

Chi-Square: .220       DF: 1                Significance Level (SL): 0.063 

Lambda:0.000           Standard error: .009               t value: .633       SL:.527 

 

The table indicates gender differences in the habit of overeating among university 

students. The chi-square value shows an insignificant difference among male and 

female students regarding overeating, with both and male and female respondents 

having the habit of overeating.  

 

 
Table 5: Gender differences in causes of overeating among students  
 

Respondents Reasons of Overeating 

 Passions  Excitement Stress Anxiety  Lack of time 

management    

Study 

pressure 

Total  

Male  

Female 

Total  

21(37) 

14 (31)  

  25(68) 

22 (39) 

  30  (67) 

39(106) 

6(11) 

7(16) 

10(27) 

7(12) 

4(10) 

8(22) 

4(8) 

2(6) 

6(14) 

7(13) 

9(20) 

 12(33) 

44(120) 

56(150) 

100(270) 

Chi-Square: .220       DF: 1                Significance Level (SL): 0.053 

 

 

The results indicate that the majority of both male and female students overeat due to 

excitement in terms of their activities, achievements or other event. The chi-square 

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values indicate significant differences between the male and female reasons for 

overeating.  

 

 
Table 6: Habit of intake of proper breakfast among students by gender  
 

Respondents Take proper breakfast  

 Yes  No   Total  

Male  

Female 

               Total  

66(115) 

47 (106)  

 55 (221) 

34(60) 

53(119) 

45(179) 

44(175) 

56(225) 

100(400) 

Chi-Square: 13.77      DF: 1                Significance Level (SL): 0.000 

Lambda: 

 

The table indicates that 66% of the male respondents have a proper breakfast, whereas 

53 % of the female do not have a proper breakfast. The chi-square value indicates a 

significant difference between male and female breakfast intakes.  

 

Table 7: Food choices of the respondents by gender 

 

Food group  Sex  N  Mean  SD 

Fruit & 

vegetables  

Male  175 5.06 1.61 

Female  225 5.29 1.86 

Dairy products  Male  175 16.58 5.27 

Female  225 16.22 4.55 

T value -1.35              DF: 398                  Significance Level (SL): 0.005 

 

 

The mean of male and female students choosing the food groups points at some 

differences between their foods choices. The test value also indicates differences at 

0.005 level of significance.   

 

Discussion 

 

The findings of the study indicate that a difference exists between health seeking 

behavior of male and female university students. The results of the study point out that 

the majority of the students belong to the age group of 21-23 and are unmarried. Most 

of the students are at their master level of education having different socioeconomic 

backgrounds.  The results of the study indicate that 60% of the female students prefer 

to take their food at home while a smaller number of the male students take their food at 

home. The remaining proportion of male and female respondents sometimes take their 

food at the university café, fast food places or other restaurant.  

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After gaining information about the nutritional value of the food, the researcher asked 

questions related to sources of vitamins. The answers indicated that the majority of the 

female respondents fulfill their vitamin requirements by food, whereas some of the 

females and the majority of the males take vitamin tablets and/or supplements. The 

difference between the sources of vitamin intakes used by the two gender groups may 

be caused by the lack of nutritional awareness among male respondents, as females 

tend to be more conscious about their health issues and aware of the importance of 

proper nutrition practices.  This observation can be supported by the research into 

gender differences in wellbeing conducted by Babu, Balakrishnan & Ramani (2007) in 

South India, which indicates that females are more nutrition conscious than males.  

 

Another research by Stock et al. (2001) indicates that female students have more 

knowledge and better intake of nutritional foods than male students. The results of that 

study show that almost one-quarter of respondents (35.6% females and 19.8% males: 

p< 0.001) take a keen interest in healthy nutritional food and related programs.  

 

Further the present study show that a higher percentage of males overeat due to some 

passion, excitement, physical hard work, depression and work pressure.  Females may 

have better management skills to cope with these problems, which leads to less 

prevalent overeating among them.  

 

The data also suggests that the female intake of a proper breakfast is lower than the 

male intake of breakfast. Females do not have breakfast due to their habits and 

sometimes a lack of time in the morning, which may exert a negative effect on their 

health. Their performance at university can be weak due to their empty stomachs since 

they had their last meal the previous night. This also leads to a nutritional deficiency 

among women.  

 

Conclusion 

 

The results of the investigation show that there is a difference between nutritional 

knowledge, nutritional deficiencies and eating habits of male and female university 

students. Although females do not eat a proper breakfast, they have more knowledge 

about nutritional food than male students. The findings of the study also suggest that 

despite their preferences for fulfilling nutritional requirements from natural sources, 

females show nutritional deficiencies resulting from not taking the required amount and 

quality of food on time. The deficiencies do not only affect their own health, but also 

increase the burden for the healthcare system, due to the accelerating number of 

diseases.  

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In order to reduce the burden that falls on the healthcare delivery system, it is 

recommended that health education programs should be incorporated into the curricula 

of educational institutions at all levels. Nutrition should be a long-term national goal and 

not a short-term political one. 

 

 

References  

 

Alters, S., & Schiff, W. (2011). Essential concepts for healthy living update. Jones & 

Bartlett Learning. 

Anwer, I., & Awan, J. A. (2003). Nutritional status comparison of rural with urban school 

children in Faisalabad District, Pakistan. Rural Remote Health. Jan-Jun 2003, 3(1), 

130. PMID: 15877486.  

Babu, R., Balakrishnan, R., & Ramani, R. (2007). Gender differences in U.S.H.A well 

being among Irulas of Nilgiris District, Tamil Nadu, South India. In Batra, P., 

Malhorta, S., & Yadava, A. (Eds). Health Psychology, Delhi: Commonwealth 

Publishers. 

Deshpande, S., Basil, M. D., & Basil, D. Z. (2009). Factors influencing healthy eating 

habits among college students: An application of the health belief model. Health 

Marketing Quarterly, 26(2), 145-164. 

Driskell, J. A., Meckna, B. R., & Scales, N. E. (2006). Differences exist in the eating 

habits of university men and women at fast-food restaurants. Nutrition 

Research, 26(10), 524-530. 

Galloway, T. (2007). Gender differences in growth and nutrition in a sample of rural 

Ontario schoolchildren. American Journal of Human Biology: The Official Journal of 

the Human Biology Association, 19(6), 774-788. 

Liebman, M., Propst, K., Moore, S. A., Pelican, S., Holmes, B., Wardlaw, M. K., ... & 

Dunnagan, T. (2003). Gender differences in selected dietary intakes and eating 

behaviors in rural communities in Wyoming, Montana, and Idaho. Nutrition 

Research, 23(8), 991-1002. 

Stock, C., Wille, L., & Krämer, A. (2001). Gender-specific health behaviors of German 

university students predict the interest in campus health promotion. Health 

Promotion International, 16(2), 145-154. 

Tirodimos, I., Georgouvia, I., Savvala, T. N., Karanika, E., & Noukari, D. (2009). Healthy 

lifestyle habits among Greek university students: differences by sex and faculty of 

study. EMHJ-Eastern Mediterranean Health Journal, 15(3), 722-728. 

Yahia, N., Achkar, A., Abdallah, A., & Rizk, S. (2008). Eating habits and obesity among 

Lebanese university students. Nutrition Journal, 7(1), 32-39. 

 

 

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Author Note 

 

Dr.  Adeela Rehman, PhD in Sociology from International Islamic University, Malaysia, 

Master in Gender Studies from Fatima Jinnah Women University, Rawalpindi. Currently 

working as Assistant Professor at Department of Sociology, Fatima Jinnah Women 

University, Pakistan. In recognition of her teaching excellence in research in the field of 

gender and sociology she has awarded numerous national and international awards 

one of them is “Rosina C. Chia Teaching of Excellence Award 2015” presented by 

Global Partners in Education USA on 12th Day of May 2015. She worked at The 

University of Texas, Austin USA as visiting faculty in 2013 for one semester. Her 

research areas are; medical/health sociology, culture and gender issues on which she 

has presented at a number of national and international conferences and seminars as 

presenter and as guest speaker in the USA, Malaysia, China, Singapore, Thailand, 

Indonesia and Turkey.  Being a Gender Expert and a Medical Sociologist, she is 

interested in studying women’s health issues and problems with reference to the 

healthcare system of Pakistan.  She also received a number of awards for her 

professional activities and always volunteers for various academic and non-academic 

activities. Member of various social and research oriented national and international 

associations.  

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