Association between academic stress during exam period, dietary behavior and bowel symptoms among medical students in Saudi Arabia

Background: The study evaluated the levels of academic stress in medical students and investigated its association with eating habits and bowel symptoms. Methods: Two hundred and ninety seven medical students participated in the study. Medical students from all five years of study were recruited using a stratified random sampling technique. A well-structured questionnaire containing three sections on stress levels, eating habits, and bowel symptoms was self-administered. Student ttest and ANOVA were used to quantify the association between variables. Results: The medical students showed high levels of stress accounting for low (2%), moderate (72%), and highstress levels (26%) during exams. Men showed higher stress levels than women. The levels of stress were similar in distribution across all years of study. Poor dietary habits were noted among the medical students. Around 66% reported skipping breakfast, and 69% consumed frequent unhealthy snacks. Reduced consumption of fruits less than three times per week (61.5%) and drinking water less than 2 L per day (82.3%) was noted. Mean dietary scores worsened as the stress levels increased (p = 0.007). Similarly, higher PAC-SYM scores were associated with higher stress levels (p < 0.001). Women showed more severe constipation symptoms than men (8.83 +/- 8.0 2; 5.68 +/- 5.87; p < 0.001). Conclusions: Alarming levels of academic stress were noted during the exam period. There is an urgent need to frame multidisciplinary strategies involving behavior modification, nutrition education and a special focus on stress reduction programs for the medical students.