Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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On Sep 2018




Prof. Somashekhar Nimbalkar

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Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
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Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : June | Volume : 16 | Issue : 6 | Page : OC11 - OC17 Full Version

Evaluation of Knowledge, Attitudes, and Practices Related to Dietary Supplements Intake among College Students: A Cross-sectional Study


Published: June 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/44287.16428
Hadeel ALi Ghazzawi, Enas Salem Abu Hazem, Adam Tawfiq Amawi

1. Associate Professor, Department of Nutrition and Food Science, Agriculture School, Amman, Jordan. 2. Master, Department of Nutrition and Food Technology, School of Agriculture, University of Jordan, Amman, Jordan. 3. PhD Scholar, Department of Physical Education, School of Sport Science, University of Jordan, Amman, Jordan.

Correspondence Address :
Hadeel ALi Ghazzawi,
Associate Professor, Department of Nutrition and Food Science,
Agriculture School, Amman, Jordan.
E-mail: h.ghazzawi@ju.edu.jo

Abstract

Introduction: Food intake has been connected to health status for a long time. There are some products that are used to boost the nutrient density of the food intake, such as dietary supplements (DS). DS can defined as a concentrated source of nutrients with a nutritional or physiological effect that adds further nutritional value to the normal diet.

Aim: This study investigated the intake of DS among students at the University of Jordan (JU) in Amman, as well as consumer’s Knowledge, Attitudes and Practices (KAP) regarding DS according to gender, Body Mass Index (BMI), science and humanities, and academic year streams.

Materials and Methods: A descriptive cross-sectional questionnaire-based study was conducted over three months on 381 students selected by using convenient sampling method from the JU from different faculties including freshmen students and senior students between April and May 2018. The KAP was used to assess awareness of the study group on the topic. The questionnaire was divided into two parts, part I included questions related to participant’s socio-demographic characteristics and part II included 11 questions for assessing KAP related to DS. Face to face interview technique was used for data collection. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) program (version 22.0). Pearson’s chi-square test for independence was used for the qualitative variables to detect the relationship between gender, BMI, faculty (humanities or science) and academic year and the corresponding KAP toward DS. p-value less than 0.05 was considered as statistically significant.

Results: The results showed that the overall percentage of student’s knowledge of DS is only 13.65%, which indicates lack of knowledge in regard to DS. It was found that the percentage of intake of DS at least one per week among students was approximately 42%, which is considered relatively high. Regarding the results of the present study, there were statistically significant differences in faculty (p=0.001**) and BMI subdivisions (p=0.03*) in term of previous knowledge. Science facultie’s students had more information than humanities about the risks of DS (p=0.008*). Nearly (80%) of science and humanities faculties’ students have not received any training or attended in any health campaign about DS. Most of the students trusted the information that comes from health care professionals (65%). One third of DS users consumed them for no certain purpose (34%). Pharmacies were the most common source to buy supplements (87%). Furthermore, vitamin D and iron were the most frequently reported DS type used, while herbal supplements, omega 6, omega 9, multi minerals were the least common DS among participants.

Conclusion: It can be concluded from results of this study that there was a relative high prevalence of DS consumption among JU students and students in general lacked knowledge about DS.

Keywords

Awareness, Body mass index, Socio-demographic domain

Adequate and appropriate diet plays a key role in prevention of disease and maintenance of good health. A well balanced diet ensures a sufficient amount of nutrients, minerals and vitamins (1). Diet intake style has changed widely in many parts of the world including the Middle Eastern (ME) countries (2). In Jordan, the changes in life pattern and socioeconomic status has led to nutrition transition (3). Frequent eating of fast foods and meals away from home has increased by time. All these factors have led to the tendency to pay more attention to complementary medicine (4). The DS are the most common subgroup of Complementary and Alternative Medicines (CAM); a group of varied medical and health care products that are not usually considered as a part of conventional medicines (4).

Micronutrients (vitamins and minerals), herbals (botanical products) and complementary nutritionals like amino acids are all considered to be DS (5). DS are defined as products that are purposed to supply the diet; they are not drugs and, therefore, are not intended to diagnose, prevent or treat diseases (6). These supplements can be found in many forms, such as tablets, capsules, softgels, gelcaps, liquids or powders (7).

DS consumption has reached more than half of adults which means a rise in consumption over time in the United States [US], of which more than two-thirds use Multi-Vitamin/Multi-Mineral Supplements (MVMS). Hence, 70% of older adults in the US reported using one or more DS (8). Currently, DS are consumed in both developed and developing countries (9). Supplement market size was of US $96 billion in 2012 and was expected to rise to approximately US $104 billion globally (9). The estimated number of supplement products raised from 4000 products in 1994 to more than 55,000 products in 2012 (10).

Nutrition and health in the world face challenges as a result of new shifts in the food system, especially in low and middle income countries. Understanding the changing history of the food system and how it relates to dietary changes and transitions is very important (7). Changes in food policy are seen as a major option for improving nutrition, but they will not be enough without shifting nutrition our culture (7). Growing prevalence rates of non communicable diseases, which are increasingly becoming major mortality causes, result from nutrition transition (11). Nutrition knowledge plays a significant role in raising public awareness and consequently improves the health of the community (12). DS is different from meal replacement; in which meal replacement therapy is an alternative strategy.

Jordan Food and Drug Administration (JFDA) was established in 2003, as an independent public sector institution. The main responsibilities of JFDA include ensuring the safety and quality of food and its suitability for human consumption, and the effectiveness, quality and safety of medicine and related materials through the application of controlled systems based on the science and international standards (13). As per the researcher’s knowledge, there was no single study that conducted KAP regarding DS on Jordanian people in general to assess awareness towards DS using KAP model.

Therefore, the aim of this study was to determine the prevalence of usage of DS among a group of students from both genders, different BMI, both science and humanities faculties at the JU, and from different academic year levels and as well as to assess the level of awareness of DS using KAP procedure and determine whether they are aware of any potential risks of DS or potential interactions with other medicaments. Furthermore, this research aimed at supply background information on this subject in Jordan to guide further research. The results of this study could provide baseline data for policy makers and researchers towards more thorough education and integration of nutrition and health in the courses that are taught in the universities. The outcomes of this study will help the health sectors to take a step towards the college population in regards to their dietary supplement knowledge and intakes.

Material and Methods

A descriptive, cross-sectional, questionnaire-based study was conducted on a selected sample from JU students during the period between April and May 2018.

This study was approved by a Committee of Graduated Studies at the Department of Nutrition and Food Technology. Total 381 students were included in the study.

Sample size calculation: The sample size was determined using the Raosoft online calculator (14). The total population of bachelor’s degree students in JU according to the admission and registration unit was approximately 35800 in 2018. Proportionate stratified random sampling; the total number of students in humanities and science faculties was approximately 17200 and 18600 students, respectively was used. Therefore, in order to achieve a confidence level of 95% and a 5% margin of error and taking into consideration the Raosoft calculator, the sample size was determined to be 381. Since the proportion of humanities faculties was about 48%, we took 183 samples that represented these faculties, and taking into consideration that females form about 60% of the faculties’ population. Hence the sample taken from these faculties consisted of 110 female and 73 male students. Regarding the science faculties, the proportion was 52% and so, the sample from these faculties consisted of 198 students, divided between females and males in proportion of 60% and 40%, respectively, so that the sample from the science faculties consisted of 119 female and 79 male students.

Inclusion criteria: The inclusion criteria for participants were: students at JU, who were Jordanian nationals and between 18-24 years of age, undergraduate (bachelor not postgraduate) students.

Exclusion criteria: The exclusion criteria for the participants were: pregnant or lactating females, and students of nutrition and food sciences, because they may have a good background about DS.

Students of JU come from different backgrounds and cultures. Therefore, in order to avoid background influence, non-Jordanian students were excluded. A written consent was obtained from all participants reserving their right to withdraw from the study at any time.

Students were asked to respond to the questionnaire after signing the consent form. A brief overview of the research and its goals was provided to the participants. The questionnaire was answered by students under the researcher supervision.

The Assessment Tool

Knowledge, Attitudes and Practices (KAP) questionnaire was used to assess awareness of the study group on the topic. KAP is one of the modern strategies of studies and is an (an educational diagnosis of the society and assesses the awareness of a particular group of any given subject. The questionnaire in this study has been adapted from a study carried out in United Arab Emirates (UAE) and validated by qualitative adaptive questions to adapt them to the Jordanian student’s community, because the UAE community is close to a certain degree of Jordanian society (15). In order to preserve the source, the questionnaire was prepared in both Arabic and English as the original source, and used to collect information from the participants.

The questionnaire used for collecting data to meet the purpose of the study was divided into two parts. These parts included questions related to participant’s socio-demographic characteristics and 11 questions assessing consumer’s KAP related to DS.

Part I: Socio-demographic and lifestyle characters: This part included age (year), gender, height (cm), weight (kg), academic year level (from first to sixth year) and faculty; humanities faculties included arts, business, Shari’a, educational sciences, law, physical education, arts and design, Prince Al-Hussein bin Abdullah II faculty of international studies, foreign languages, archaeology and tourism), whereas science faculties included (science, agriculture, engineering and technology, King Abdullah II faculty of information technology and health.

Part II: Knowledge, attitudes and practices about dietary supplements: This part was divided into two sections; the first section contained six questions, two questions for each knowledge, attitude and practice. These evaluations were studied in relation to gender, BMI, faculties and academic years. The second section had five multiple-choice questions about several topics, such as the source that is considered as the most credible for information about DS, reasons of consumption and frequency of ingesting DS.

Face to face interview technique was used for data collection and the questionnaire was completed by the researcher. Measurements were taken for weight by digital balance which was calibrated regularly, and taking into account weight of clothing worn, and for height by measuring meter after taking off the shoes. Body mass index was calculated using this equation: BMI=weight in kilograms divided by squared height in meters. Sample members with BMI <18.5 were considered underweight, those with BMI ≥18.5-24.9 were considered in the normal weight range, those with BMI ≥25.0-29.9 were classified overweight, and finally those with BMI ≥30.0 were considered as obese (16).

Validity and Reliability

Regarding validity and reliability, the following assessments were carried out:

1. Pilot study: It was conducted on 15 students, among individuals who shared characteristics similar to those that were included in the study. They were asked to respond to the questionnaire, and asked whether everything was clear and if they had any idea or suggestion. The questionnaire was then revised and modified accordingly. Questionnaire forms completed by the pilot study were not included in the study.

2. Content validity: Three questions were added at the end of the pilot study questionnaire. These questions had the same meaning as three questions in the first section of the second part in the questionnaire, but in other words that can be fit with the Jordanian community more. The participants were asked to answer them. Then, they were revised with the original questions if they have the same answers. This step was taken to insure that the two similar questions had the same response, thereby determining whether a measure is measuring the concept that the researcher thinks is being measured.

3. Translation: An expert checked the translation of the questionnaire in Arabic and English languages to make sure that both versions gave the same meaning.

Statistical Analysis

Data was coded and entered into the computer, where statistical analysis was performed using the SPSS program (version 22.0). Pearson’s chi-square test for independence was used for the qualitative variables. It was applied to detect the relationship between gender, BMI, faculty (humanities or science) and academic year and the corresponding KAP toward DS. The results for categorical variables were presented as frequency (n) and percentages (%). An alpha level of 0.05 was set to assess statistical significance.

Results

The study sample consisted of 381 students from the JU. The distribution of the sample according to demographic characteristics was shown in (Table/Fig 1). Female students constituted the highest percentage 229 (60.10%) about 250 (66%) students were in the normal BMI category, while the lowest category was that of obese students with a frequency of 14 (3.67%).

The category 20-23 years for age variable had the highest number of subjects 256 (67.19%), while the age category above 23 years was the lowest 20 (5.25%). Science faculty’s students were 199 (52.23%), while humanities faculty’s students had a percentage of (47.77%). The highest category for academic year variable was (2nd year) with 133 (29.66%) students, while the lowest category was (fifth year and above with a frequency of 35 (9.19%).

In (Table/Fig 3) the percentage for knowledge was highest 207 (54.33%) for the grade of 50% of knowledge while the lowest percentage was 52 (13.65%) for students who answer the two questions and have full knowledge that is (100%).

The percentage for the question: Which source/sources would you consider as the most trustworthy i.e., you are most likely to believe the information coming from this source? was highest 248 (65.09%) for health care professionals, while the lowest percentage was 4 (1.05%) for TV or journal advertisements (Table/Fig 4).

The highest percentage for the question “In the long term, is it more effective to get a nutrient from?” was 194 (50.92%) for both food and DS, while the lowest percentage was 7 (1.84%) for supplements.

In addition, 244 (64.04%) of the samples members consumed DS as prescribed by doctor, while the lowest percentage was 56 (14.70%) for answer daily to improve my health. The percentage for the question about the purpose of using a nutritional supplement product was 129 (33.86%) for all of the above, while the lowest percentage was 22 (5.77%) for to meet increased energy demands of the body. Finally, most of the students prefer to buy DS from the pharmacy 331 (86.88%), whereas only a very little percentage of students buy them from other sources such as peddlers 7 (1.84%).

In (Table/Fig 5) there were statistically significant differences only between gender variables and using DS in addition to looking for a professional medical help to take DS (p-value=0.022*) and (p-value= 0.004*) respectively.

There were statistically significant differences between the belief in the possibility of interactions of DS with drugs, foods or drinks and gender variable p-value <0.001**.

There were significant differences only between faculty variables and knowing what are the DS and the belief that DS are always safe to use, p-value <0.001** and p-value=0.008* respectively (Table/Fig 6).

In (Table/Fig 7) there was a statistically significant difference between knowledge about dietary supplements and BMI variables p-value =0.030.

In (Table/Fig 8) there were no statistically significant differences between all parameters and the academic year level.

Discussion

The consumption of DS according to this study was common among the students of the JU, 41.99% admitted the use of DS at least one per week. The reason for this could be multifactorial. At this stage of adult life, they might use DS for experimentation and exploration and as a result of their desire to try new things, such as substitutional forms of medicine and health promoting activities, as well as the belief in the need of using these supplements (17). Additionally, university students may be interested in body image or have weak levels of body satisfaction (18). This discontent may cause those young adults to use DS in an effort to enhance physical appearance. This study’s findings were consistent with those of previous studies that showed a high rate of consumption, such as a study conducted in the UAE which showed that the percentage of use of DS was 39% and an Indian study that unveiled a usage percentage of 49.6% among university students (15),(19). Another older study conducted in the JU showed that the usage of vitamin mineral supplements among students was only 27.4% (20). This lower usage can be explained by the fact that their study included vitamin and mineral supplements only, another interpretation might be that the DS take among JU students has increased with time due to the rapid development in marketing of these products. Attractive information about DS is widespread from sources such as magazines, internet and television commercials. They can be easily bought from drug stores, supermarkets and many other sources. This along with the wide variety in the prices for each product might be additional factors helping DS spread significantly. They are called Over The Counter (OTC) product due to their availability without prescription.

There were statistically significant differences in DS consumption between males and females with respect to their attitude toward DS (p=0.022*) in the present study. One explanation is that females are more interested in beauty such as taking vitamin E for hair and skin health (21). This result is in contrast to another study which was conducted in Japan and showed no differences in this aspect (18). In the same field, there were no significant differences in the DS consumption that can be relied on age, academic year and BMI variables. This result is opposite to a recently conducted study which showed that there are statistically significant differences (p≤0.001)** in DS use due to academic year and BMI (p=0.004)** which might be due to the same age and background factors (22).

With regard to one of the most important goals of research, it was found that there were no statistically significant differences between the percentages of DS use in humanities and science faculties. However, science faculty’s students showed a higher level of knowledge about DS than that of humanities faculty’s students (p<0.001**), it may be because science faculty’s students taking some courses that related to health and food. Different discoveries recommended that there were factually critical contrasts in the knowledge of health sciences and non health science’s students relating to the medical advantages and security of these enhancements and their sorts (23). These differences may be attributed to those students from health science’s faculties had better knowledge regarding DS and were more likely to attend a health workshop or campaign on DS than those who were not from health sciences’ faculties (15).

Only 13.7% of all students had a knowledge score of 100%, while about 32% of them had no knowledge about DS, this showed that the knowledge about DS was inadequate in students of both science and humanities faculties, because they might learn about diet and DS generally. This indicated that further seminars and courses on nutrition and health in regard to different aspects such as DS should be held at universities to raise the awareness among students of their health (23),(24) .

About 65% of the students considered health care professionals as the most trustworthy source to believe the information coming from, which is a good indication of reducing the wrong data that may come from other sources. On the other hand, about 18% of the students trusted information received from internet which is not a small proportion. Therefore, it must be emphasized that students should use reliable sites and pages to obtain health information from them. A study was conducted in UAE, it has been found that most of the information pertaining to DS intake was obtained from healthcare providers (62%) followed by internet (14%), relatives/friends (7.5%) then product information (4%) (15). Another study conducted in Saudi Arabia reported that around 70% of the participants received information either from doctors or pharmacists (20). These results are near to the finding of this study, which gives an evidence of the similarity of the culture of these communities with Jordan. Another study that conducted at a rural population indicated that internet had the highest percentage of reported use (58.6%), followed by family/friends (57.1%), books/magazines (40.8%), physicians/nurses (37.9%), pharmacists (21.5%) and TV programs (18.6%) (9).

Furthermore, regarding the purpose of using DS in the present study, the highest percentage was 33.86% for all of the above answer while the lowest percentage was 5.77% for the purpose of meeting increased energy demands of the body. A study on 339 participants showed that the reasons for DS consumption were: to keep up great wellbeing (40.1%) and guarantee satisfactory nourishment consumption (36.9%), while others consumed supplements to forestall sickness (10%), to improve appearance and get more fit (3.9%) (19). However, another study showed that the major reported reason for supplement intake was enhancing appearance (47.7%) (25). A previous Jordanian study addressed that the participants are prone to consume DS as a kind of treatment On the other hand, 54% of the underweight individuals are DS users, while only 4% of obese individuals are ingesting DS (20).

It is significant that clients get the message that DS are planned to ready to eat food, however are not substitutes for a sound eating routine and way of life to keep up great wellbeing and guarantee satisfactory nourishment (23),(24). Additionally, supplements can’t supplant medicine or treatment to treat medical sickness. An enhancement alone won’t really fix or treat a medical issue (15). Two thirds of the consumers used DS only according to the physician prescription, which benefit to reduce the risk of chronic use of supplements. A survey reported that most respondents indicated that they consume DS daily or almost daily (71.1%), occasionally (13.8%), weekly (11.1%) and monthly (4%) (9).

These results differ from a Jordanian study held in JU, which showed that multivitamins and multi-vitamins multi-minerals were the most common type then vitamin C, and B12 (20). Another study reported that it was popularity for using multivitamins, vitamin C and vitamin B complex, then followed by vitamin A, iron, folic acid, protein powders, and herbal teas (19).

Limitation(s)

This study had some limitations. For example, it was based on cross-sectional data, which does not allow for ascertainment of temporality. It could only provide a snapshot of KAP study participants relating to DS at the time of the investigation. It wasn’t longitudinal, so data about changes between knowledge and attitudes which depend on the academic year level could not be obtained. Furthermore, attitudinal variables are often precursors to dietary behaviours and intakes. On the other hand, studies conducted on students cannot be generalized to the whole society.

Conclusion

Considering the conditions of this study and the outcomes, it can be concluded that there was a relatively high prevalence of DS consumption among JU students; it was found to be associated with gender, but not with science or humanities faculties. BMI and academic year level. Students, in general lacked knowledge about DS, requiring rapid intervention by health education among students to increase awareness about DS taking into consideration their speed prevalence. Furthermore, previous knowledge about the term DS was statistically significant with faculty and BMI and not statistically significant with gender and academic year level. Science faculties students had more information about safety of DS which is not affected by gender, BMI and academic year level. It is very important to highlight the importance of increasing the awareness and knowledge, attitudes and practice among humanities schools and obese population. In addition, delivering education through courses and workshops helps to improve student’s nutritional KAP and adults should be encouraged to obtain their nutrient requirements by taking higher amounts of fruit and vegetables rather than ingesting DS, because this field is incompletely understood and have complex interactions.

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DOI and Others

DOI: 10.7860/JCDR/2022/44287.16428

Date of Submission: Mar 09, 2020
Date of Peer Review: May 05, 2020
Date of Acceptance: Aug 27, 2021
Date of Publishing: Jun 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? No
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Mar 11, 2022
• Manual Googling: Jul 29, 2021
• iThenticate Software: May 03, 2022 (24%)

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