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Exploring the Impact of Osteopathic Medical School on Body Composition: A 4-Year Longitudinal Study
Steinberg, R. [1]
Donoghue, J. [10]

Journal: Journal of Osteopathic Medicine Date: 2023/12, 123(12):Pages: A89-A90. doi: Subito , type of study: longitudinal study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2023-2000/html)

Keywords:

longitudinal study [28]
medical students [402]
osteopathic medicine [1540]
physical health [1]
USA [1086]

Abstract:

Statement of Significance: Medical school poses various obstacles, most notably being the extensive time spent studying. A 4-year study done on medical students found that muscular endurance and aerobic capacity decreased significantly from 1st to 4th year [1]. Although fitness and metabolic data has been studied, literature is scarce regarding body composition. Addressing this gap in the literature can initiate discussions on interventions to enhance the physical health of future osteopathic physicians. To analyze changes in body composition in osteopathic medical students over 4 years of medical school Research Methods: This prospective longitudinal study was IRB approved, and all subjects signed written consent prior to participating. Dual x-ray absorptiometry (GE Lunar iDXA) was used to assess body fat percentage (BF%), Body Fat Mass (BFM), lean body mass (LBM), visceral fat, and Body Mass Index (BMI). Inclusion criteria was incoming first year medical students with no contraindication to a DXA scan. Exclusion criteria utilized contraindications to DXA scans based on the American College of Radiology (ACR) guidelines. Participants were scanned in August prior to their first year, and then in May prior to graduation in their 4th year. 120 students (60 men and 60 women, age 23.4±3.8) signed consent and were scanned prior to their first year. A paired t-test was used to analyze all outcome measures and assess for statistical significance. Significance was accepted at p< 0.05. Being the osteopathic (DO) philosophy promotes the unity and wellbeing of an individual’s mind, body, and spirit, DO schools should ensure that the physical health of their students does not decline while in school. By examining this overlooked aspect of osteopathic medical education, we hope to promote the implementation of interventions that encourage the wellness of our future osteopathic physicians. This may better prepare students to incorporate the principles of mind, body, and spirit into the treatment of their future patients. Data Analysis: Out of the 120 subjects that were initially enrolled, 37 completed the study. Follow-up data was not able to be collected from all subjects due to the COVID-19 lockdown of 2020. These 37 subjects consisted of 19 men and 18 women (age 22.71±3.0). Although the study was open to all individuals, it is important to note that all of the subjects in this study identified as their biological sex. Of the 37 subjects that completed the study, 40.5% were Caucasian, 35.1% were Asian, 21.6% were Indian, and 2.7% were African American. The results found that there was a significant increase in body weight (66.11±13.22 kg to 68.21±14.80 kg, p<.001), LBM (46.58±11.50 kg to 48.04±11.92 kg, p<.001), BMI (23.00±2.79 to 23.60±3.30, p=.009), and visceral fat (.23±21 kg to .29±.30 kg, p=.018). There was no significant difference in BFM (p=.220) or BF% (p=.839). By gender, biological males were noted to have a significant increase in body weight (73.66±12.87 kg to 76.99±14.20 kg, p<.001), BFM (15.92±6.68 kg to 17.50±8.06 kg, p=.024), LBM (54.71±8.95 kg to 56.45±9.57 kg, p=.004), and BMI (23.9±2.84 to 24.70±2.48, p= .002). Males had no significant difference in BF% (p=.176) or visceral fat (p=.065). In biological women, there was a significant increase in LBM (37.99±6.58 kg to 39.16±6.41 kg, p= .011) and a significant increase in visceral fat (.09±.12 kg to .14±.13 kg, p= .032). There was no significant difference in body weight (p=.314), BF% (p=.154), BFM (p=.533), or BMI (p=.514). Conclusion: Due to the academic demands placed on medical students, it is hypothesized that they would endure negative changes in body composition over their 4 years of school. However, our data revealed that students at our institution had a significant increase in LBM, and no significant change in BFM or BF%. Body weight and BMI did increase significantly, but this can be attributed to the noted increase in LBM. The only negative finding in our data was the significant increase in visceral fat, but this may be representative of age-related bias. Even by gender, neither men nor women had a significant increase in BF%, and both gained LBM. Although the data was generally positive, the limitation of selection bias must be acknowledged. Recruiting subjects for a body composition study will typically attract individuals who are active and discourage those who are not. Future research should collect similar data with the entirety of a medical school class to address this limitation. The institution where this data was collected has programs in place such as “Fit Physicians”, which aims to encourage movement in medical students. Being previous studies have noted negative changes in fitness data in medical schools without such initiatives, it is evident that osteopathic medical schools should be advocating for the implementation of similar programs. In addition to the physical health benefits they provide, these programs may better prepare students to embrace the osteopathic philosophy by effectively incorporating physical activity counseling into their future practice. Studies have shown that physicians who are physically active themselves are more likely to integrate physical activity counseling into treatment plans[2]. In conclusion, 4 years of osteopathic medical school did not lead to negative changes in body composition in our study. Future studies should aim to examine body composition within a more expansive cohort encompassing multiple geographic medical schools.

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