Risk factors of colorectal cancer: the comparison of selected nutritional behaviors of medical and non-medical students

The study conducted shows that students expose themselves to colorectal cancer risk factors through their diet. The study was participated by students of various universities in Bialystok, Poland—students of: dietetics at the Medical University of Bialystok, of other faculties of the Medical University of Bialystok, the Bialystok University of Technology and the University of Bialystok. Products that may increase the risk of developing colorectal cancer were most frequently consumed by students of non-medical universities. The highest percentage of respondents was obtained from students of the University of Bialystok. They consumed processed meat, red meat and fast-food meals more frequently. In contrast, products that may reduce the risk of colorectal cancer were most often consumed by dietetics students who ate vegetables, whole grains, fatty fish more frequently.

The quality of eating habits was reflected in the analysis of the respondents’ BMI. It has been abundantly evidenced that excessive body weight is a factor that increases the risk of developing colorectal cancer [4]. Based on the WHO classification of BMI values, this study showed that every fifth student was overweight, with the highest percentage of students with excess body weight was found among people studying at non-medical universities. Misiarz et al. also demonstrated a lower percentage of people with BMI ≥ 25 among medical students (28.7%) compared to non-medical students (37.9%) [23]. These results might be due to greater health awareness of people studying medical science.

According to the WCRF’s findings on modifiable risk factors for colorectal cancer, there is strongly convincing evidence available to prove that the consumption of processed and red meat is related to increased risk of colorectal cancer [4]. Another type of products not recommended for consumption in terms of maintaining good health status is fast food due to the amount and origin of fats and low nutritional value offering high energy.

This study showed a statistically significant correlation between the frequency of consumption of foods increasing the risk of colorectal cancer and the respondents’ university. Products such as ham, bacon, sausages and canned meats were consumed daily by a quarter of SUB and SMUB students and only 2% of dietetics students. The type of university did not matter in this aspect, but the field of study did. Different results regarding the percentage of nutritional studies were obtained by the author examining the students of dietetics [24]. Cured meats, which belong to this type of food, were consumed by 66% of the study respondents every day [24]. Dydjow-Bednek et al. noted that 10% of medical students consumed smoked meat products several times a week, and 18% did not eat them at all [25]. Similarly, the said study showed that 17.33% of students of other fields at MUB and 22.92% of students of dietetics gave up eating processed meat.

According to our study, the percentage of students of non-medical faculties (BUT—48.39%, UB—35.19%) consuming red meat several times a week or every day was higher than that of medical students (dietetics and other faculties of the MUB—25%). The research conducted by Misiarz et al. presented the opposite results, with a slightly higher percentage of medical students (62.8%), compared to non-medical students (59.4%), confirming the similar frequency of red meat consumption [23]. High consumption of red meat among non-medical students has also been demonstrated in other studies, where almost half of the respondents—46%—consumed pork several times a week [26,27,28]. Onal et al. showed high frequency of red meat consumption among medical students at the university in Istanbul, with 78.2% of respondents eating it several times a week [29].

According to the authors' own research, the highest number of students who did not eat fast-food products like French fries, pizza or burgers studied at the Medical University of Bialystok (MUB 16%, dietetics 14.58%) and the University of Bialystok (14.81%). Among BUT students, such people constituted only less than 2%. Similar results, excluding University of Bialystok students, were observed by Misiarz et al.—medical faculties (18.1%) and non-medical (2.8%), and Grochowska-Niedworok et al.—medical faculties (10.85%) and non-medical faculties (5.25%) [23, 30]. In turn, in a study by Kowalcze et al., a small percentage of dietetics students refrained from eating this type of food (7%) [24].

In addition, consumption of sweets and sweetened drinks between meals may in-crease the risk of developing colorectal cancer. Most of the respondents had a habit of reaching for various types of snacks. Our own research showed a statistically significant relationship in the frequency of their consumption. Numerous researchers surveying students from different universities received a high percentage of affirmative answers to question about consumption of the above-mentioned products between meals [26, 27]. Mahfouz et al. showed that snack consumption in Jazan University participants was 87% in medical college and 90.6% in non-medical college [31]. Foods such as cookies, cakes, chocolates, chips, sticks, etc. were chosen by students of the MUB: non-nutrition-related faculties—53.33% and dietetics—44.44%. This correlation was statistically relevant. Similar results were obtained by Kowalcze et al.: 46% of dietetics students chose unhealthy snacks [24]. This study shows that more than half of students of dietetics (62.5%) did not consume such drinks as Coca-Cola, Pepsi, Sprite, Fanta, orangeade or lemonade. Kowalcze et al. noted similar results among future nutritionists (57%) [24]. However, among the other students of medical faculties (MUB—37.33%) and students of the University of Bialystok (UB—33.33%), only every third person did not consume sweet drinks. Respondents of the Bialystok University of Technology fared the least favorably, as only every fifth person (20.97%) did not drink Coca-Cola and similar products. Mahfouz et al. showed that 14.9% of medical students and 13.3% of non-medical students resigned from drinking soft drinks [31]. In the research conducted by Misiarz et al. the right behavior in this respect among students was significantly lower, as 23.35% of medical students and 9.56% of non-medical students declared that they did not drink carbonated drinks [30].

Products containing dietary fiber, according to the WCRF, are highly likely to re-duce the risk of colorectal cancer. Rich sources of fiber include vegetables, fruit, whole grains and legumes. The WCRF suggests a relationship between their consumption and colorectal cancer prevention. Furthermore, dairy products have been proven to pro-vide effective protection against colorectal cancer [4].

According to general health-related recommendations, people should consume more than 3 servings of vegetables daily. In our study, it was found that the highest number of people who consumed the required amount were students of dietetics, although they constituted only less than half of the studied group (43.75%). Far fewer respondents from other faculties and universities met the norm—14.67% of students of other faculties of the MUB, 8.06% of the BUT and 12.96% of the UB, which proves very poor eating habits. Slightly better results were obtained by Misiarz et al. who observed that 3–4 portions of vegetables a day were consumed by 31.25% of students of medical faculties and 21.84% of non-medical students [30]. The recommended daily intake of fruit, which is 1–2 portions, was consumed by a large group of students participating in the study: 73–86%. The result was satisfactory and the percentage distribution was similar between the groups. On the other hand, Misiarz et al. noted that 1–2 servings of fruit daily were consumed by only 15.44% of medical students and 11.13% of non-medical students [30]. Medina et al. showed that students do not follow dietary guidelines regarding fruit consumption—only 29% of students had adequate eating habits in this respect [32].

The highest percentage of dietetics students consumed legumes very often, as every fifth person in this group declared choosing legumes several times a week or daily, while almost none of the students of non-medical universities declared such frequent consumption of legumes (3–4%). Slightly better results were obtained by Misiarz et al., with 16% of respondents from non-medical universities consuming legumes several times a week [23]. Onal et al. reported that 20% of medical students consumed legumes several times a week or every day [29]. Kowalcze et al. showed a similar percentage of dietetics students consuming legumes several times a week or every day—22% [23].

According to the obtained results, medical students most often consumed whole grains daily, while non-medical students consumed them only several times a month. More precisely, 2/3 of the students of dietetics and 1/3 of other faculties of the MUB ate whole grain products every day. In contrast, people studying at the BUT and the UB consumed these products every day to a lesser extent: 14.52% and 18.52%, respectively. Misiarz et al. obtained similar results when comparing the frequency of consumption of whole grains with the type of university. Significantly fewer non-medical students consumed dark bread and groats every day (groats—3.68% medical, 2.57% non-medical; dark bread—30.88% medical, 14.85% non-medical) [30]. In turn, Kow-alcze et al. found that a low percentage of respondents from the faculty of dietetics consumed whole grain bread and groats every day—17% and 4%, respectively [24].

Our research showed that students consumed fish mostly several times a month (70–87%). More non-medical (87%) than medical students (70–75%) consumed fish with the said frequency. The highest rate of “several times a week” response was demonstrated by dietetics students—16.67%, and in the studies by Kowalcze et al.—11% [30]. Misiarz et al. reported that a greater percentage of medical students (40.81%) vs. non-medical students (31.91%) ate 1–2 portions of fish per week [30].

The study presented here revealed that one third of medical students and one fourth of non-medical ones drank milk every day. In contrast, more students in Gizan chose milk every day (67.5%—medical; 55.9%—non medical), but with a predominance of medical students, according to the study by Mahfouz et al. [31]. In our re-search, fermented milk drinks were chosen by more dietetics students (35%) each day than by students the other faculties of the MUB (15%) or non-medical students (BUT—11%, UB—7%). Kowalcze et al. showed that the above-mentioned products were consumed by 47% of students of dietetics from Siedlce [24]. In the study by Misiarz et al., milk and fermented milk drinks were chosen each day by more medical vs. non-medical students (milk: 12.13%—medical, 9.14%—non-medical; fermented milk drinks: 21.69%—medical, 12.99%—non-medical) [30].

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