Change in weight and adiposity in college students: a systematic review and meta-analysis

The role of vegetarianism, gender, and food choice motivations on vegetable intake among university students

Objective: This study investigated collegians' (N = 466) vegetable consumption as a function of their food choice motivations, gender, and dietary habits. Method: Vegetarians and vegans (veg*ns, n = 94, 60% women), occasional meat eaters (n = 90, 66% women), and omnivores (n = 282, 43% women) completed the Food Choice Questionnaire and reported frequency of vegetable consumption. Results: Veg*ns consumed vegetables more frequently than omnivores and occasional meat eaters. Veg*ns' and occasional meat eaters' food choices were more motivated by natural content, health, and ethics, and less motivated by familiarity compared to omnivores. Women were more motivated than men by weight control. Health concerns predicted vegetable consumption for all dietary groups. Additionally, familiarity predicted veg*ns vegetable consumption, whereas mood, natural content, and convenience predicted omnivores' vegetable consumption. Conclusions: Individual differences in dietary habits and food choice motivations should be considered when designing strategies to promote healthful diets for university students.

University Food Environment Assessment Methods and Their Implications: Protocol for a Systematic Review

BACKGROUND

While the retail food environment has been well studied, research surrounding the university food environment is still emerging. Existing research suggests that university food environments can influence behavioral outcomes such as students' dietary choices, which may be maintained long-term. Despite a growing interest in assessing university food environments, there is no standardized tool for completing this task. How researchers define "healthy" when assessing university food environments needs to be clarified. This paper describes the protocol for systematically reviewing literature involving university food environment assessments.

OBJECTIVE

This paper aimed to describe the protocol for a systematic review of the assessments of university food environments. The review will summarize previously used tools or methods and their implications.

METHODS

Electronic databases, including PubMed (NLM), Cochrane Library (Wiley), Web of Science (Clarivate), APA PsycINFO (EBSCO), CINAHL (Cumulative Index to Nursing & Allied Health) Complete (EBSCO), ProQuest Nursing and Allied Health, and Google Scholar were searched for papers published between 2012 and 2022 using combinations of related medical subject headings terms and keywords. The electronic databases were supplemented by reviewing the reference list for all included papers and systematic reviews returned with our search results. The review will include all study types, including randomized controlled trials, observational studies, and other pre-post designs. Papers that examine at least 1 aspect of the university food environment, such as cafeterias, campus convenience stores, and vending machines, were considered for inclusion. A total of 2 reviewers will independently screen titles and abstracts, complete a full-text review, extract data, and perform a quality assessment of included papers, with a third reviewer resolving any conflicts. The Quality Assessment for Diverse Studies (QuADS) tool was used to determine the methodological quality of selected studies. A narrative and tabular summary of the findings were presented. There will not be a meta-analysis due to the methodological heterogeneity of the included papers.

RESULTS

The initial queries of 4502 records have been executed, and papers have been screened for inclusion. Data extractions were completed in December 2023. The results of the review were accepted for publication in May 2024. The systematic review generated from this protocol will offer evidence for using different assessment tools to examine the campus food environment.

CONCLUSIONS

This systematic review will summarize the tools and methods used to assess university food environments where many emerging adults spend a significant part of their young adult lives. The findings will highlight variations in practice and how "healthy" has been defined globally. This review will provide an understanding of this unique organizational food environment with implications for practice and policy.

TRIAL REGISTRATION

PROSPERO CRD42023398073; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=398073.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/54955.

Eating behaviors associated with weight gain among university students worldwide and treatment interventions: A systematic review

Introduction: Emerging adulthood has been described as a period of risk for body weight gain. Several studies have indicated that the positive or negative health behaviors established during this stage, tend to prevail the rest of life. However, there are discrepancies in published studies on weight change in freshmen and there are disagreements on weight gain predictors. The present study reviewed the literature with the aim of knowing the eating behaviors associated with weight gain in university students. Method: A systematic search was conducted in three databases according to the PRISMA method during the months of February to November 2020. Results: 20 articles were included in the review. The main behaviors associated with weight gain were the consumption of sugary drinks, alcohol consumption, low consumption of vegetables and fruits, frequent self-consumption, eating unhealthy and low levels of food regulation.

Associations of smart device apps with and without a perceived self-efficacy component in a physical activity context with BMI

Smart device apps can be used to promote physical activity, decrease sedentariness, or increase self-efficacy to get active in college students, possibly reducing their obesity risk. This study assessed associations of college students' smart device use with body mass index (BMI), expecting associations between physical activity parameters and self-efficacy with BMI, moderated by app type. In an online survey, app data of a week from student's devices, weight, height, physical activity, and self-efficacy to get active were collected from 120 students. Apps were categorized "physical activity," "physical activity with a self-efficacy component," or "unrelated." Use time of physical activity apps is not associated with BMI, while self-efficacy app time show negative and unrelated app time positive associations. Self-efficacy may be an important component in app design for obesity risk reduction of college students. Test economy was low, which is why future studies need to concentrate on better data extraction methods.

Using structural equation modeling to examine correlations between health-related physical fitness and cell health among Chinese college students

INTRODUCTION

College students' physical fitness is likely to be directly related to their cells' health. However, there is a lack of literature on whether the relationship between cell health and college students' physical fitness is direct or indirect. This study used a structural equation modeling (SEM) approach to investigate the connection between cell health and college students' physical fitness.

METHODS

This cross-sectional study collected data from 838 volunteers (502 males and 336 females, average age of 18.74 ± 1.5 years) who were college students from the Shandong province of China in July 2023. Initially, we obtained anthropometric measurements and conducted physical fitness tests on the students. Then, we performed Pearson correlation analysis and principal component analysis to screen variables and explore potentially influencing factors. Finally, we examined associations between the variables and determined whether there were direct or indirect influences among factors using SEM.

RESULTS

The results revealed a significant correlation between the cell health factor and the muscle strength factor (path coefficient = 0.97; p < 0.001) as well as the fat obesity factor (path coefficient = -0.52; p < 0.001). The cardiovascular factor exhibited a weak correlation with the cell health factor (path coefficient = 0.11; p < 0.01). Moreover, the cardiovascular factor acted as a mediating variable between the muscle strength factor and the cell health factor, with a positive correlation observed between the muscle strength factor and the cell health factor (path coefficient = 0.40; p < 0.001).

CONCLUSION

These findings suggest that cell health is indicative of muscle strength and cardiorespiratory fitness. Our findings demonstrate that assessing the cell health of college students can be a valuable method for evaluating their overall health.

What factors influence sustainable and healthy diet consumption? A review and synthesis of literature within the university setting and beyond

Globally, typical dietary patterns are neither healthy nor sustainable. Recognizing the key role of dietary change in reducing noncommunicable disease risk and addressing environmental degradation, it is crucial to understand how to shift individuals toward a sustainable and healthy diet (SHD). In this literature review, we introduced the concept of a SHD and outlined the dietary behaviors necessary to transition toward SHD consumption; we reviewed the literature on factors that may influence sustainable (and unsustainable) dietary behaviors in adults; and we developed a novel scoring system to rank factors by priority for targeting in future research. Given the significant potential to promote a sustainable and healthy dietary transition on the university campus-where factors that may impact dietary behaviors can be targeted at all levels of influence (i.e., individual, interpersonal, environmental, policy)-we narrowed our focus to this setting throughout. Aided by our novel scoring system, we identified conscious habitual eating, product price, food availability/accessibility, product convenience, self-regulation skills, knowledge of animal ethics/welfare, food promotion, and eating norms as important modifiable factors that may influence university students' dietary behaviors. When scored without consideration for the university population, these factors were also ranked as highest priority, as was modified portion sizes. Our findings offer insight into factors that may warrant attention in future research aimed at promoting SHDs. In particular, the high-priority factors identified from our synthesis of the literature could help guide the development of more personalized dietary behavioral interventions within the university setting and beyond.

Implementation of nutrition and physical activity-related policies and practices on college campuses participating in the Healthier Campus initiative

Objective: To evaluate implementation of nutrition/physical activity-related policies/practices at colleges participating in a healthy campus initiative and campus health leaders' perceptions of policies/practices' support for student health and ease of/barriers to implementation. Participants: Health leaders at colleges participating in the Healthier Campus Initiative (HCI), with completed or ongoing three-year HCI commitments. Methods: Surveys asked which of 41 guidelines were implemented and perceptions around support for student health and ease of/barriers to implementation. Qualitative interviews explored similar domains. Results: Campuses with completed HCI commitments (n = 17) averaged 27.6 guidelines implemented, versus 21.1 on campuses with commitments ongoing (n = 13; p = 0.003). Perceived support for student health and implementation ease varied by guideline. Common implementation barriers included financial costs and time. Interviews largely reinforced these findings. Conclusions: Completion of a campus environmental change initiative may be associated with more health-supporting practices. Campuses may benefit from implementing coordinated policy/practice changes supporting healthy eating and physical activity.

Lifestyle behavior of physiotherapy students from Ecuador upon admission to higher education: a cross-sectional study

Introduction

Admission to university has been identified as a period involving the adoption of unhealthy lifestyle behaviors. However, few studies have addressed the extent of this experience among Latin American university students. The aim of this study was twofold: first, to describe anthropometric variables, body composition, physical activity, sedentary behavior, sleep duration and quality, diet, and alcohol consumption in first-year students entering physiotherapy school at the Universidad de las Americas in Quito, Ecuador; second, to test differences in these variables between sexes.

Methods

A total of 116 students were recruited. Sociodemographic variables, anthropometric indices, body composition, physical activity, sedentary behavior, sleep quality and duration, adherence to 24-hour movement guidelines, physical fitness (i.e., handgrip strength), diet, alcohol consumption, and smoking habits were evaluated.

Results

A total of 50 male (43.1%) and 66 female (56.9%) students were assessed. Overall, the adherence to the 24-hour movement guidelines of the students upon admission to university was 8.6%. Conversely, 86 students (74.1%) did not meet any of the recommendations. Upon admission to university, only 8.6% of the students (female 2.6%; male 6%) met the overall 24-hour movement guidelines. Additionally, 82 students (70.7%) needed changes in diet quality, 81 students (69.8%) had significant sleep disturbances, and 22 students (18.9%) had harmful alcohol consumption. A greater proportion of males met all three 24-h movement recommendations (p = 0.025) than females did. In addition, females reported a greater percentage of occasional smokers (p = 0.025) and a greater prevalence of obesity (p < 0.001), a lower level of physical activity (p < 0.001), and a greater percentage of sleep disturbance (p < 0.001). Conversely, males reported greater waist circumference (p = 0.005), weight (p < 0.001), handgrip strength (p < 0.001), and a greater percentage of harmful alcohol consumption (p < 0.001).

Discussion

Our study showed that upon admission to university, overall adherence to the 24-hour movement guidelines is low among university students. Additionally, a high percentage of students reported unhealthy lifestyle behaviors, with differences according to sex. Our findings could lead to the use of specific sex-specific strategies for the prevention and promotion of movement and lifestyle behaviors during this critical period.

Study protocol for evaluating the current status and needs assessment of health-related characteristics among students at Albert-Ludwigs-University Freiburg

Today, university students face study conditions that increase the risk of sedentary behavior, unhealthy eating, and the likelihood of stress, anxiety, and depression. Although the situation has likely worsened in recent months due to the COVID-19 pandemic, even in the pre-Corona era, several investigations have demonstrated that the students' health behaviors could increase the incidence of metabolic risk factors and non-communicable diseases, however, further and detailed information is needed to develop tailored counter-strategies. Therefore, in the present survey, the current health status of students at the Albert-Ludwigs-Universität Freiburg (ALU) will be recorded by various questionnaires. In addition, barriers that could potentially influence their health behavior will be identified, and information on the use and awareness of existing health services will be obtained in order to derive concrete needs for further health promotion activities. The study is designed as a monocentric and prospective study at the ALU; the survey of students' situation and needs assessments will be conducted in the areas of nutrition, exercise, relaxation and stress reduction, self-management, psychosocial health and socio-demographic correlations via an anonymous and self-administered online questionnaire. Subsequently in two-year intervals, the survey will be repeated. Data will be collected over a period of 4 years. One goal of this survey is to gain more insight into the health situation of university students; another goal is to use the knowledge gained to integrate holistic health measures into the university landscape in a structured and sustainable manner. These health measures will be implemented by using the newly developed student health care management at the ALU (www.sgm.uni-freiburg.de). Every two years, after evaluation of the surveys, the effect of the health measures can be checked and adjusted. Trial registration: ETK: 20-1082; DRKS-ID: DRKS00024088.

Associations between health issues and food consumption with overweight and obesity in three university students minorities

Objective: To determine the presence of overweight and obesity among minorities, and the factors contributing to this weight disparity. Participants: The study comprises 3405 students including nonwhite, international, and first-generation college students. Methods: An online cross-sectional survey collected data on demographics, height, weight, self-health perception, overall sleep quality, progress in school, and food consumption. Three logistic regressions tested abnormal weight associations with health issues and food consumption. Results: Being 31 years-old or older, perception of health and consumption of ultra-processed food was significant with abnormal weight (BMI > 25). Only nonwhite and international students were correlated with ultra-processed and fast-food consumption respectively. Conclusion: Each minority presented vulnerabilities to high percentages of weights exceeding the appropriate rates of BMI. The high consumption of fast and ultra-processed foods makes it important to consider factors related to health perception in each minority group.

Motivational interviewing to promote healthy behaviors for obesity prevention in young adults (MOTIVATE): a pilot randomized controlled trial protocol

BACKGROUND

Obesity is a chronic disease and is an established risk factor for other chronic diseases and mortality. Young adulthood is a period when people may be highly amenable to healthy behavior change, develop lifelong healthy behaviors, and when primary prevention of obesity may be feasible. Interventions in early adulthood have the potential for primary or primordial prevention (i.e., preventing risk factors before disease onset). The primary objective of this study is to determine the feasibility of a 6-month behavioral and educational intervention to promote healthy behaviors for obesity prevention among young adults.

METHODS

This is the study protocol for a pilot randomized controlled trial. Young adults (age 18-29) attending McMaster University, Hamilton, Canada, will be recruited and randomized to either the intervention or control. The intervention will include individual motivational interviewing sessions (online or in-person) with a trained interviewer plus educational materials (based on Canada's food guide and physical activity recommendations). The control group will receive educational materials only. The primary feasibility outcomes that will be evaluated as part of this pilot study include enrollment, retention (≥ 80%), data completion (≥ 80% of weights measured, and surveys completed), and participant satisfaction. Secondary clinical outcomes will include body mass index (BMI) change from baseline to 6 months, physical activity, nutrition risk, health-related quality of life mental health, and economic outcomes. Outcomes will be measured remotely using activity trackers, and online questionnaires at baseline and every 2 months. Risk stratification will be applied at baseline to identify participants at high risk of obesity (e.g., due to family or personal history). Exit questionnaires will collect data on how participants felt about the study and cost analysis will be conducted.

DISCUSSION

Our pilot randomized controlled trial will evaluate the feasibility of an obesity prevention intervention in early adulthood and will inform future larger studies for obesity prevention. The results of this study have the potential to directly contribute to the primary prevention of several types of cancer by testing an intervention that could be scalable to public health, post-secondary education, or primary care settings.

TRIAL REGISTRATION

https://clinicaltrials.gov/ct2/show/NCT05264740 . Registered on March 3, 2022.

Exploring the effects of health behaviors and mental health on students' academic achievement: a cross-sectional study on lebanese university students

BACKGROUND

High academic achievement, an important determinant of future success, is known to be influenced by many factors including dietary behavior, lifestyle and mental health, among others. The objectives of the current study were to explore university students' nutritive habits, daily lifestyle, and mental status, and to scrutinize the associations between these factors and students' academic achievement.

METHODS

A cross-sectional study was conducted among students of a private Lebanese university, using an electronic survey. Diet, eating habits, physical activity, sleep, and smoking were evaluated, and mental health was assessed using a validated Arabic version of the combined Depression, Anxiety, Stress Score (DASS-8). Academic achievement was measured using the Subjective Academic Achievement Scale (SAAS).

RESULTS

A total of 1677 students participated in the questionnaire. The results of a linear regression taking the SAAS score as the dependent variable, showed that students who have a non-scientific versus scientific major (Beta = 0.53), and having breakfast ≥ 4 days per week compared to less than 2 days (Beta = 0.28) were significantly associated with higher SAAS scores. More psychological distress (Beta = - 0.06) and a higher number of days of eating out (Beta = - 0.07) were significantly associated with lower SAAS scores.

CONCLUSIONS

This is the first investigation on a Lebanese university students' academic success in relation to lifestyle and mental profiles. Better academic achievement was demonstrated by students having healthier dietary and lifestyle habits, as well as less distressing mental status. Such results, in light of the compounded and unprecedented crises with which Lebanon has been assailed, suggest the need to focus on promoting healthy habits among students in higher education as a possible driver of better academic success.

Effect of the dietary inflammatory potential on the trajectory of body adiposity in a Brazilian cohort of university students

OBJECTIVES

University students are vulnerable to unhealthy eating habits that characterize a proinflammatory diet. This study aimed to estimate the dietary inflammatory index (DII) and its association with the trajectory of body adiposity markers in university students.

METHODS

The study analyzed data from 685 students entering a Brazilian public university in 2016 and 2017 and followed until 2018. DII was estimated from 39 dietary parameters obtained by 24-h dietary recall. Body adiposity was assessed by anthropometric markers and the percentage of body fat. Linear mixed-effects models were used to estimate the trajectory of adiposity markers according to DII tertiles.

RESULTS

After adjustment for confounding variables, at baseline, DII showed a positive association with increased percentage of body fat among men (β = 0.52; 95% CI: 0.01; 1.03) and waist-to-height ratio (WHtR; β = 0.15; 95% CI: 0.12; 0.18) and among women with all body adiposity markers: BMI (β = 0.68; 95% CI: 0.30; 1.05), percentage of body fat (β = 1.43; 95% CI: 0.74; 2.11), WC (β = 1.15; 95% CI: 0.41; 1.89) and WHtR (β = 0.13; 95% CI:0,10; 0.16). The rate of change of the outcome variables over time was not associated with DII at baseline.

CONCLUSIONS

The diet of university students in this Brazilian cohort study was characterized as proinflammatory and it was associated with body adiposity markers.

Longitudinal weight and body-composition changes in polish undergraduate students of health faculty

Objective: The study investigates the changes in body composition, dietary intake and physical activity of Polish health faculty undergraduates. Methods: 340 university students were measured at the beginning their studies. Subsequent measurements were performed at the beginning of the following academic years. In total, 82 men and 87 women were included in the analysis. The measurements included anthropometric parameters and the amount of consumed nutrients. Using Seven-Day Physical Activity Recall Questionnaire measured students' physical activity. Results: Across three years at university 65.1% of students showed an increase in body mass. Men displayed an increase in body weight (1.6 kg) and waist circumference (4.1 cm). Women's weight changed insignificantly. Participants' energy intake increased statistically significantly after the 1st year and decreased after the 2nd year. In men there was observed decline in energy expenditure between the 1st and 2nd year. Conclusion: Transitory unfavorable changes were observed in students' nutrition and physical activity.

Nutritional quality of snacks and beverages sold through vending machines in a large Hispanic-serving urban college campus in the United States: A cross-sectional study

Students from nutritionally-vulnerable neighborhoods face dietary challenges through built environment of college vending machines. In this cross-sectional study, snacks and beverages sold in vending machines for a 4-week period in a Bronx-based Hispanic-serving college were recorded. Nutritional information was recorded from nutrition labels. Proportion of low- and high-sodium foods, "smart snacks" with a limit of 200 kcal and 200 mg of sodium, and foods with added sugar were recorded. Snacks had significantly higher calories and sodium per serving (227 kcal, 208 mg) than beverages (132 kcal, 90 mg) (t-test, p < 0.001). Almost a third of the snacks (32%) qualified as "smart snacks" for calories and 62% qualified as "smart snacks" for sodium. Beverages contained less than half the number of ingredients as snacks. About 53% of beverages and almost 60% of snacks listed sugar among the first five ingredients. Results underscore the need for colleges to promote less-processed entities with less added sugar.

Dietary Patterns of Competitive Swimmers with Moderate-to-Severe Cerebral Palsy: A 3-Year Longitudinal Evaluation

AIM

To evaluate the longitudinal dietary patterns of three adolescents with moderate-to-severe cerebral palsy (CP) participating in a performance-focused swimming training intervention.

METHOD

Participants were three previously inactive adolescents with CP (15-16 years, GMFCS IV) who had recently (<6 months) enrolled in a swimming training program. Diet quality from diet histories was calculated at 10-time points over 3.25 years using the Dietary Guidelines Index for Children and Adolescents (DGI-CA) and the Healthy Eating Index for Australian Adults (HEIFA-2013). A food group analysis was compared to the Australian Guide to Healthy Eating recommendations. Trends were considered in the context of dietary advice given and the training load.

RESULTS

Longitudinal diet quality scores were consistent and ranged from 40 to 76 (DGI-CA) and 33 to 79 (HEIFA-2013). Food group intake remained stable; participants rarely met the recommendations for fruit, vegetables, dairy, grain, and meat but frequently achieved discretionary serves.

CONCLUSIONS

Participants with moderate-to-severe CP who were enrolled in a performance-focused swimming training intervention and were monitored frequently maintained diet quality throughout a period where it conventionally declined. Scores were higher than the general population and were maintained irrespective of the training load. Participants frequently met food group recommendations for discretionary foods and were comparable to the general population for other food groups.

Chrononutrition behavior during the COVID-19 pandemic and its relationship with body weight among college students

Introduction

Students in colleges are exposed to unhealthy lifestyles and poor dietary choices. They are at risk of being overweight, skipping meals, and developing eating disorders. However, there is a paucity of information on their chrononutrition behavior, which is very important, especially concerning the timing of food consumption across the day. Therefore, the present study aimed to investigate chrononutrition behavior and its potential association with body weight status among college students in Malaysia.

Methods

This cross-sectional study was conducted on 409 college students aged above 18 in Malaysia. The chrononutrition behavior was assessed using the validated Chrononutrition Profile Questionnaire (CP-Q). The questionnaire was distributed using an online platform. Participants self-reported their body weight and height, and the Body Mass Index (BMI) was computed. Data were analyzed using the SPSS software.

Results

A total of 409 participants were recruited, with a mean age of 21.5 ± 2.2 years. The prevalence of underweight, normal, and overweight was 24.7, 49.4, and 25.9%, respectively. The chrononutrition behavior revealed that participants ate breakfast about four times/week (mean 4.27 ± 2.43 days), and only 135 (33.0%) consumed breakfast daily. The largest meal consumed was during lunch (75.8%), and the mean of snacking after the last meal was 3.23 ± 2.01 days. The prevalence of night eating was low, and most participants (70.9) did not wake up at night to eat. The frequency, however, was significantly higher in the underweight group compared to the normal weight group (p < 0.05). We observed a significant association between BMI and eating window, evening latency, evening eating, and night eating. It was found that the underweight had a poor eating window (p < 0.01), poor evening latency (p < 0.01), poor evening eating (p < 0.01), and poor night eating (p < 0.05) compared to those with normal and overweight BMI groups. In contrast to predictions, poor chrononutrition behavior was more likely to predict being underweight compared to normal (p < 0.05).

Conclusion

Underweight young adults are more likely to have poor chrononutrition behavior. The results of the present study suggest that future nutrition education should also focus on the chrononutrition behavior of college students.

Weight Gain, Comorbidities, and Its Associated Factors Among Korean Adults

BACKGROUND

Weight gain in adults is associated with an increased risk of obesity-related diseases and high healthcare costs. However, there have been limited studies on weight gain in Asians. This study investigated the prevalence, comorbidities, and associated factors of weight gain in the Korean population.

METHODS

This is a cross-sectional study of Korean adults aged 19-64 years who participated in the Korea National Health and Nutritional Examination Survey 2016-2019. We used data from 15,514 adults (subjects 1) to analyze the prevalence of weight gain. Finally, after excluding adults with suspicious debilitating conditions among them, 11,477 adults (subjects 2) were used to analyze comorbidities and associated factors. Weight changes and lifestyle factors were assessed using a self-report questionnaire. We analyzed odds ratios and 95% confidence intervals using multivariable logistic regression analysis to examine factors associated with weight gain.

RESULTS

The overall prevalence of weight gain was 25.7% in men and 31.3% in women and decreased significantly with age in both sexes. Weight gain of ≥ 6 kg was evident in 10.5% of men and 9.8% of women and was more pronounced with a higher baseline body mass index (BMI). Most metabolic comorbidities worsened the greater the weight gain. Young age was the strongest associated factor for weight gain. Other factors associated with weight gain were being unmarried, blue-collar job, lower income, and alcohol consumption in men; being married in women; smoking and skipping breakfast in both sexes.

CONCLUSION

Weight gain was much more pronounced in younger adults and at a higher baseline BMI in both sexes. Public education and health policies to prevent unnecessary weight gain should be strengthened by considering the associated harmful factors in Korean adults.

The effect of Baduanjin exercise on health-related physical fitness of college students: A randomized controlled trial

Background

The continuous decline in the physical fitness of college students has become a serious social problem worldwide. Therefore, it is necessary to explore the effective method improving college students' physique. Previous studies have shown that Baduanjin exercise is beneficial in improving sleeping quality, mental health, body flexibility, and body physique. However, the evidence is unclear whether Baduanjin exercise can be recommended as an effective exercise to promote health-related physical fitness of college students.

Methods

A total of 130 college students were recruited and randomly allocated to either the Baduanjin training or the control group at a ratio of 1:1. The students in the Baduanjin training group received a 12-week supervised Baduanjin exercise training intervention with a frequency of 1 h each day and 4 days per week, while those in the control group did not receive any specific exercise intervention and were informed to maintain their original lifestyle for 12 weeks. The outcomes of health-related physical fitness involving measurements of body flexibility, muscular strength, cardiopulmonary fitness, and body endurance were measured at baseline and after the 12-week intervention period. Mixed linear model was used to analyze the effect of the Baduanjin exercise intervention.

Results

Mixed linear model analyses showed that the Baduanjin training group had a significant increase in the composite scores of health-related physical fitness compared to the control group from baseline to 12-week post-intervention with a medium effect size (d = 0.68, P = 0.006). Moreover, there were significant improvements in vital capacity, physical flexibility, 800/1,000 m endurance running, and body composition (measured by body mass index (BMI), fat mass and body fat ratio) at end of 12-week intervention in the Baduanjin training group. No adverse events were observed in this trial.

Conclusion

Regular Baduanjin training may be an effective, safe exercise form to promote the health-related physical fitness of young adults.

Trial registration

Chinese Clinical Trial Registry, ChiCTR-IOR-17013011. http://www.chictr.ogr.cn.

Acute Effects of Virtual Reality Exercise Biking on College Students' Physical Responses

Purpose: Current evidence regarding the use of commercially available immersive virtual reality (VR) headsets and compatible VR exercise apparatus in the promotion of individuals' physical activity (PA) is lacking. This exploratory study investigated the acute effects of a VirZoom VR exercise bike (vBike) on college students' physical responses compared to an exergaming bike (eBike) and a traditional stationary exercise bike (tBike). Method: Forty-eight college students (34 females, X_age = 23.58 ± 3.39; X_BMI = 23.81 ± 3.57) completed three separate 20-minute cycling sessions on the vBike, eBike, and tBike in a counterbalanced order. Outcomes included rating of perceived exertion (RPE), assessed at 4-minute intervals throughout each cycling session, and overall PA, operationalized as pedal revolution counts (PRC) during each session. Results: Linear models indicated significant group differences between exercise modalities for RPE (F (2,138) = 14.76-27.30, all p < .001, η² = 0.17-0.27) and PRC (F (2,138) = 74.862, p < .001, η² = 0.48). Pairwise comparisons revealed that RPE was reported significantly higher at each time point (i.e., 4th minute, 8th minute, 12th minute, 16th minute, and 20th minute) during the tBike session vs. the vBike and eBike sessions (p < .001) and that participants had higher PRC during the vBike session vs. the eBike and tBike sessions (p < .001). Conclusion: A commercially available VR exercise bike would trigger greater overall PA as compared to exergaming and traditional cycling while being perceived less intense. Future intervention studies conducted in real-world settings to determine cause and effect relationship are warranted.

Changes in Physical Health-Related Indexes of Chinese College Students before and after COVID-19 Lockdown

The outbreak of the COVID-19 pandemic has caused negative impacts on people's lifestyles, as well as considerable indirect social impacts, which has even overshadowed the direct impact of virus infection itself. This study is aimed at examining the changes in physical health-related indexes of Chinese college students before and after the COVID-19 lockdown. The data of this study are from the National Physical Health Testing Program, covering 43 college students (male: 22) from a class of a Chinese university. Paired t-tests were performed on the physical health test data separately collected in November 2019 before the COVID-19 pandemic and October 2020 after the COVID-19 lockdown was lifted. As shown by the test results, compared to the prelockdown data, college students had an increased body mass index (BMI) (0.43 (SD 0.94) P = 0.004), decreased vital capacity (VC) (-128.98 (SD 310.13) ml P = 0.009), and lowered performance in the 800/1000 m endurance (-6.21 (SD 8.81) points P < 0.001) and standing long jump tests (-2.44 (SD 7.37) points P = 0.036) after the lockdown, and the differences in these regards all were significant. In addition, for the students in the overweight/obese group, their pre- and postlockdown physical fitness test results were found to have no statistically significant difference (P > 0.05), but the students in the control group showed a significantly increased BMI, as well as significantly decreased vital capacity and performance in the 800/1000 m endurance and standing long jump tests (P < 0.05). The findings of this study are expected to help government departments and policymakers better understand the impacts of school closures and online learning on the physical health of adolescents, while providing a basis for the formulation of measures that are aimed at reversing adolescents' physical health decline.

Social contexts are related to health behaviors: mEMA findings from the SPARC study

Understanding how social context is associated with behaviors can indicate circumstances when behaviors are more likely to occur. In this study 29,995 ecological momentary assessment (EMA) surveys from 805 participants were analyzed to determine the social context of when eating, drinking, physical activity behaviors, and none of those behaviors (not eating, drinking, or being physically active, "none") occurred. Within-person results indicated that participants had lower odds of reporting eating (OR = 0.81) and drinking (OR = 0.79), and higher odds of reporting physical activity behaviors (OR = 1.20) and "none" (OR = 1.11) when they were alone, compared to when they were with friends. Within-person results also indicated that when participants were off-campus they were more physically active (OR = 1.73) and had lower odds of being reported "none"(OR = 0.78) than when they were on campus. Surprisingly, within-person results also suggested participants reported less physical activity on the weekend (OR = 0.78) than during weekdays, and instead had higher odds of reporting "none" (OR = 1.11). Between-person results suggested participants who were alone had higher odds of reporting "none"(OR = 1.64). When stratified by demographics the findings were similar. These findings show that student behaviors are different when they are alone vs. not, and that social context matters when understanding student behaviors. Interventions aimed to improve dietary intake and promote physical activity may be more effective if a social context aspect is included in their design.

Barriers to high school and university students' physical activity: A systematic review

Physical inactivity commonly occurs throughout one's life, particularly during adolescence and young adulthood. Multiple factors can negatively influence participation in physical activity, but there has been no review examining the barriers to physical activity among high school and university students. Therefore, the aim of this systematic review was to summarize evidence of barriers to the practice of physical activity among high school and university students. The literature search was conducted without time limits using five databases, including CINAHL, Cochrane Library, Embase, PubMed, and Scopus. In total, 59 studies (37 with high school students [n = 22,908] and 22 with university students [n = 15,411]) were included. The main barriers identified in high school and university students were lack of time, lack of motivation, and lack of accessible places. These findings may be useful in designing and implementing evidence-informed interventions and programs for physical activity promotion in students.

Associations between college/university campus characteristics and student body mass index

Background

Campus environments are associated with undergraduate weight. However, few studies have examined campus type and geographic location in relation to student weight. This article aimed to identify college/university students with elevated BMIs by campus type and region.

Methods

Linear mixed effects regression models were fit to data from the American College Health Association-National College Health Assessment II. Analyses tested associations between campus type/region and student self-reported BMI.

Results

The sample included 404,987 students from 445 schools with mean BMI 24.9 ± 5.8. Across all school types/regions, BMI confidence intervals included overweight values. Two-year and public school students had higher BMIs compared to four-year and private school students, respectively. Students in the Midwest had higher BMIs compared to students in the Northeast. In the South only, Minority Serving Institution (MSI) students had higher BMIs compared to non-MSI students.

Conclusion

Healthy weight maintenance programs should be made available to undergraduate students.

Emotional eating and cognitive restraint mediate the association between sleep quality and BMI in young adults

This cross-sectional study was designed to investigate whether diet quality and eating behaviors could mediate the association between sleep quality and body mass index (BMI) in young adults. For all participants (n = 925; aged 21.4 ± 2.5 years; 77.8% women) we evaluated: BMI, sleep quality, diet quality, and eating behavior dimensions (emotional eating, cognitive restraint, and uncontrolled eating). Linear regression models were used to test associations between exposure and outcome variables. Path analysis was conducted with all potential mediators and covariates entered at the same time. Results showed that emotional eating (β = 0.04 [95% CI: 0.03; 0.06]), cognitive restraint (β = 0.03 [95% CI: 0.01; 0.04]), uncontrolled eating (β = 0.02 [95% CI: 0.01; 0.04]) and diet quality (β = -0.14 [95% CI: 0.19;-0.08]) were significantly associated with sleep quality. Additionally, BMI was significantly associated with PSQI score (β = 0.09 [95% CI: 0.01; 0.17]), emotional eating (β = 0.89 [95% CI: 0.60; 1.18]), and cognitive restraint (β = 1.37 [95% CI: 1.02; 1.71]). After testing for mediation, results revealed that emotional eating and cognitive restraint evidenced a significant mediating effect on the association between sleep quality and BMI. Additionally, diet quality was significantly associated with emotional eating (β = -0.35 [95% CI: 0.56;-0.13]), cognitive restraint (β = 0.53 [95% CI: 0.27; 0.79]), and uncontrolled eating (β = -0.49 [95% CI: 0.74;-0.25]). In conclusion, young adults with poor sleep quality are more likely to deal with negative emotions with food, which, in turn, could be associated with higher cognitive restraint, becoming a vicious cycle that has a negative impact on body weight. Our results also emphasize the role of eating behaviors as determinants of diet quality, highlighting the importance of considering sleep quality and eating behaviors when designing obesity prevention strategies in this population.

Associations between lifestyle factors and body mass index in African-American community college students

The goal was to examine associations between body mass index (BMI) and lifestyle factors in African American community college students. Methods: Young adults, 18-25, who identified as African American were eligible to participate from 3/17 to 11/17. BMI, body image, discrimination, social roles, emotional and informational support, nutrition knowledge, and physical activity were assessed. Results: Data from 323 students were analyzed. The mean age was 20.1 ± 2.0 years. There were no significant differences between individuals with BMI ≥ 25 and BMI < 25 on social role satisfaction, discrimination, and emotional or informational support. Overweight/obese individuals rated themselves higher on body image than normal weight individuals. The association between ideal body image and BMI sustained after adjusting for various factors. Conclusions: This is a unique population and they have unique needs in weight loss interventions. The strong relationship between body image and BMI suggests that incorporating body image into intervention design may assist in weight loss.

The Eating with Ease Program Improved Veterinary Medical Students' Perceived Ability to Buy, Cook, and Eat Healthy Foods

College students are challenged to consume healthy diets, and veterinary medical students may also have difficulty achieving optimal dietary intake, yet improved well-being is associated with following healthy dietary patterns. Individuals with food literacy-the inter-related knowledge, skills, and behaviors to plan and manage, select, prepare, and eat healthy foods-are better able to meet dietary recommendations. The Eating with Ease program developed and tested a nutrition education/culinary skill-building program to build first- and second-year veterinary medicine students' food literacy and healthy behaviors toward food. The curriculum emphasized health and nutrition, taste, food preparation skills, planning/decision making, and convenience. Students engaged in four 30-minute sessions and communicated through a mobile group messaging application. Pre- and post-program scores on the Eating and Food Literacy Behaviors Questionnaire (EFLBQ) were compared between those who finished the intervention and a control group of graduate students who completed a money management program. The intervention group (n = 23) had a mean age of 24.2 years (SD = 2.6), and the control group (n = 14) had a mean age of 27.1 years (SD = 2.3). Most participants were female (87%, n = 20 and 79%, n = 11 in the intervention and control groups, respectively). After completing the program, the veterinary medical students' mean EFLBQ factor change score for health and nutrition was significantly higher (p = .03) when compared to the control group. These findings suggest that a short, evidence-based nutrition education/culinary skill-building program may improve veterinary medical students' behaviors to choose, prepare and consume healthy foods.

Morphofunctional and Hematological Characteristics of Health in Students from the Northern and Southern Regions of Kazakhstan

The study aimed at investigating morphofunctional and hematological features of the first-year students’ health condition. The health status for a total of 400 first-year students, who arrived for studying from the northern region (North Kazakhstan) and the southern region (Turkestan, Kyzylorda), was estimated during the study. The morphological (BMI, vital lung capacity, etc.) and hematological (the total number of red blood cells, white blood cells, the concentration of hemoglobin in the blood, etc.) indicators of the health status were investigated. By comparing the condition of physical health in students from both regions, a significant difference in main morphofunctional and hematological indices has been established. The functional indicators of the cardiovascular and respiratory systems were higher in students from the southern region, which reflects a good adaptive reaction to studying at a university, as well as new climatic and geographical conditions. Students from the southern region were reported to have lower red blood cell amounts and diagnosed with mild anemia compared to those from the northern region. Therefore, constant monitoring of the health condition among youth is required to develop effective tactics for the students’ smooth adjusting to living in new climatic conditions.

Cardiometabolic, Dietary and Physical Health in Graduate Paramedics during the First 12-Months of Practice - A Longitudinal Study

Objective: Shift work is an established risk factor for poor health yet is necessary for paramedics to provide continuous care to the public. It is unknown how early into a career shift work may begin to impact health. This study sought to identify changes in cardiometabolic health, diet, aerobic capacity, physical activity and health-related quality of life (HRQoL) in graduate paramedics during the first 12-months of their career.Methods: Fifty-six paramedics with no history of regular shift work (28 female, 28 male; median age 24.5, IQR 23-26 years) were recruited for this study. Dietary patterns (food frequency questionnaires) and HRQoL (36-Item Short Form Questionnaire) were assessed at baseline, 6- and 12-months. Body weight, body mass index (BMI) and blood samples (fasting lipids, glucose, insulin and C-reactive protein) were measured at baseline and 12-months to ascertain cardiometabolic health risk. A subset of participants (n = 19; 10 female, 9 male) wore a physical activity monitor for 12 months and completed baseline and 12-month maximal aerobic capacity assessments (V̇O_2max).Results: Body weight and BMI decreased in males and increased in females (-0.7% versus 1.7%, p = 0.02). HRQoL and dietary intake did not change over 12-months, except for a small decrease in fat intake (-1%). Consumption of core/healthy foods was lower than recommended at all timepoints. Biomarkers of cardiometabolic health were within normal range and did not change over 12-months, excepting insulin where a small non-significant increase was seen (+0.5 mIU/L, p = 0.61). Baseline V̇O_2max was 41.4 (37.1-49.1) ml.kg^-1.min^-1, with no change noted at 12-months. Comparison of quarterly physical activity data showed no difference in steps per day (p = 0.47) or moderate to vigorous physical activity (MVPA, p = 0.92) across the 12-months. Paramedics completed less MVPA on day shifts compared to rostered days off (-14.68 minutes, p = 0.04).Conclusions: Dietary patterns, HRQoL, cardiometabolic health, aerobic capacity and physical activity levels did not change meaningfully in the first year of practice. Some dietary behaviors and physical activity levels could be improved and may mitigate health effects of exposure to shift work. Long-term follow-up of this group may aid in developing programs to enhance health for paramedics and other health workers.

A higher dietary restraint is associated with higher BMI: a cross-sectional study in college students

BACKGROUND

College students tend to have eating and lifestyle habits that can lead to weight gain. Paradoxically, weight gain could also lead to calorie restriction, a practice that is common among those who are concerned about their body weight. Thus, the objective of this study was to investigate the association between habits related to overweight and obesity and dietary intake, physical activity, and BMI among college students.

METHODOLOGY

One hundred ninety-two participants (18-26 years; 75% female) were included in this cross-sectional study. Participants completed the 'habits related to overweight and obesity questionnaire' which evaluates five dimensions: the concern about caloric intake, healthy eating, physical activity, alcohol consumption, and eating for psychological well-being. Additionally, anthropometric parameters, dietary intake, and physical activity were evaluated. Linear regression models were used to examine the associations between outcome and exposure variables.

RESULTS

Higher concern about caloric intake was associated with higher BMI (1.05 kg/m² [95%CI: 0.58, 1.51]), but lower energy (-312.2 kcal/day [95%CI: -404.6, -219.8]) and fat intake (-1.88% [95%CI: -2.94, -0.83]). Furthermore, healthy eating was related to better diet quality 0.96 [95%CI: 0.47,1.44] and lower energy intake (-231.4 kcal/day [95%CI: -367.7, -95.2]). Meanwhile, higher scores in the physical activity dimension were associated with better diet quality (0.41 [95%CI: 0.16,0.66]).

CONCLUSIONS

College students with the highest dietary restraint had the greatest BMI and the lowest energy and fat intake. Our results highlight the importance of promoting healthy behaviors among college students.

Association among Neck Circumference and Percent Body Fat with Fasting Blood Glucose in Obese Female College Students

Background: Neck circumference could describe upper-body subcutaneous fat, correlated with obesity and diabetes mellitus.Objective: The purpose of this study was to determine the correlation between percent body fat and neck circumference with fasting blood glucose in obese female college students.Methods: The study was cross-sectional, conducted at Diponegoro University in June-August 2019. 119 participants were female, aged 17-21 years selected using the purposive sampling method. Measurement of waist circumference was used as an indicator of obesity. Percent body fat was measured using Bioelectrical Impedance Analysis (BIA), and neck circumference was measured using a met line. Fasting blood glucose was examined after the subject fasted for 8-12 hours, the amount of blood taken was 5 cc. Data were analyzed with the Rank-Spearman correlation test.Results: As many as 84% of subjects had excess percent body fat. The median neck circumference was 32.5 cm. The median fasting blood glucose was 87 mg / dL. There was a significant correlation between percent body fat with fasting blood glucose (r = 0.231) (p = 0.012). There was no correlation between neck circumference with fasting blood glucose (r = 0.137) (p = 0.137).Conclusion: Percent of body fat had a significant relationship with fasting blood glucose, and the greater the circumference of the neck, the greater fasting blood glucoseKeywords: Obesity, Neck Circumference, Percent Body Fat, Fasting Blood Glucose

Freshmen weight and body composition change determinants: A scoping review

Scoping review of freshmen weight and body composition change determinants in order to inform practice, policymaking, and research that improve health and well-being. Methods: A systematic search of the literature identified potential sources. Duplicates were removed before a title and abstract review. A full-text review was then conducted on the remaining sources. Retained sources were then reviewed systematically before synthesis. Results: Eighty-five sources were synthesized. Variation in study design, measurement, reporting, and analyses of determinants, in particular dietary characteristics and physical activity, complicate comparisons. Dietary characteristics and physical activity appear to influence freshmen weight and body composition changes, while evidence indicates alcohol consumption is associated with deleterious weight and body composition changes. Conclusions: Design, measurement, analyses, and reporting can be improved considerably to better examine relationship between body composition changes and determinants in order to provide insight into, and inform, interventions and policies to benefit students' health and well-being.

Technology-Enhanced Health Promotion for College Students: A Seed Development Project

Obesity is an issue for young adults in the U.S. This population is particularly vulnerable to weight gain as they move from adolescence to young adulthood, especially as they transition from high school to college. Adopting a health promotion approach, a university-based cluster of researchers, community advocates, and a technology partner embarked on a two-year seed development project that focused on development, implementation, and evaluation of a web-based healthy lifestyle intervention for college students. Using a mixed-method design, two convenience samples of residential university students were recruited to participate in a 4-week intervention called Eat, Move, Live, in which they interacted with a newly-created comprehensive website about management of a healthy lifestyle. Participants' post-intervention readiness for change increased by 15% (eating and life balance behaviors) to 23% (moving behaviors). Participants reported increased awareness of eating behaviors, and feelings of engagement in tracking their fruit and vegetable consumption. Findings suggest that technology may be utilized to enhance the effectiveness and efficiency of achieving students' individual goals related to healthy living. These preliminary findings have implications for increasing the development and implementation of technological approaches to health promotion for young adult students.

Food access, dietary acculturation, and food insecurity among international tertiary education students: A scoping review

The number of international students within tertiary education facilities continues to increase globally, but the challenges for this population in achieving a healthy diet in an unfamiliar environment receives insufficient attention. This scoping review aimed to synthesize current literature that investigated dietary changes and food security status of this student population. We followed a five-stage methodological framework developed by Arksey and O'Malley. Six electronic databases were searched. All types of research methods, including qualitative, quantitative, and mixed methods, were considered for inclusion. This review included 30 articles reporting dietary changes and 12 articles reporting food insecurity in international students. The students were able to explore novel foods in their host country without totally abandoning their original diet, thus developing a hybrid diet. Dietary habits oscillated between the new and traditional dietary cultures with many students consuming foods from their new food environment but less so in the long term. Changes in diet may contribute to weight change and some negative health impacts, but none of the included studies investigated the effects on academic performance. Additionally, international students appeared to be more vulnerable to food insecurity, but the contributing factors and impacts of this issue were insufficiently researched. International students often experienced dietary acculturation and faced more challenges in food security than their domestic peers. More specific support should be provided by tertiary institutions and governments to international students including regular culturally appropriate nutrition education programs.

College campuses' influence on student weight and related behaviours: A review of observational and intervention research

Research indicates that most college students are not meeting dietary and physical activity guidelines, and the average student gains an estimated 1.6-3.0 kg during 4 years of study. College administrations are well-positioned to influence student weight-related health behaviours by ensuring that campus environments/policies promote health. However, to date, campus health interventions have largely addressed individual and interpersonal factors rather than environmental/policy-level changes. Using an ecological perspective, this narrative review synthesizes the literature on campus environmental/policy-level factors (e.g., food availability, physical activity requirements) associated with student diet, physical activity and weight, as well as campus interventions to address these factors. Web of Science and PubMed databases were searched between December 2018 and November 2019. Results indicate that campus food environments may contribute to overconsumption and weight gain, and the number of campuses requiring students to participate in physical activity courses is in decline. Eight examples of environmental/policy-level campus interventions are presented: nutrition labels in dining halls, campus-wide healthy choice marketing campaigns, restricted payment methods for à la cart dining, trayless dining, health-themed residence halls, peer health education programmes, active classroom spaces and physical activity course requirements. Implications for research and health promotion programmes/policies in the field of college health are discussed.

First-year college students' weight change is influenced by their randomly assigned roommates' BMI

BACKGROUND

There is ongoing debate about whether friends' greater similarity in Body Mass Index (BMI) than non-friends is due to friend selection, shared environments, or peer influence.

METHODS

First-year college students (n = 104) from a southwestern U.S. university were randomly assigned roommates during the university's housing process, effectively removing friend selection effects. Participant BMI was measured up to four times (T1-T4) across 2015-2016. The influence of roommate baseline BMI (T1) on change in participant BMI over time (T2-T4) was analyzed using a linear mixed effects model adjusted for individual socio-demographics, linear time trends, baseline BMI, and physical clustering of students. A sensitivity analysis examining floormates was also conducted.

RESULTS

Consistent with roommate influence, participants randomized to roommates with a higher BMI gained more weight between times T2 and T4 (β = 0.06; 95% CI = 0.02, 0.10). No shared environment effects (shared campus or floor) were found.

CONCLUSIONS

Randomly assigned roommates influenced each other's weight trajectories. This clarifies that BMI convergence can occur outside of friend selection or shared environments mechanisms.

Gaining "The Quarantine 15:" Perceived versus observed weight changes in college students in the wake of COVID-19

OBJECTIVE

Amidst restrictions to reduce the spread of COVID-19, jokes have surfaced regarding weight gain during the pandemic. The current study documents perceived changes since COVID-19 and compares these to observed longitudinal changes in reported weight, BMI, and how college students described their weight from January to April 2020.

METHOD

Undergraduates (N = 90; 88% female) completed on-line assessments before and after students were required to leave campus due to COVID-19. Time 1 and Time 2 surveys collected demographic information, height, weight, and a Likert-scale rating to describe perceived weight, ranging from 1 = very underweight to 5 = very overweight (weight description). Time 2 surveys added questions for perceived changes since COVID-19 in body weight, eating, physical activity, various forms of screen time, and concerns about weight, shape, and eating.

RESULTS

Time 2 surveys indicated perceived increases in body weight, eating, and screen time, and decreases in physical activity along with increased concerns about weight, shape and eating since COVID-19. Longitudinal data indicated no significant change in weight, body mass index (BMI), or BMI category, but how participants described their weight changed significantly from January to April 2020. Compared to longitudinal changes in BMI category, students' weight description was significantly more likely to fall into a higher category from Time 1 to Time 2.

DISCUSSION

Shifts in how body weight is experienced in the wake of COVID-19 that do not align with observed changes in reported weight may reflect cognitive distortions that could increase risk for disordered eating in some individuals.

Lifestyle behaviors and related health risk factors in a sample of Australian university students

Objective: To describe lifestyle behaviors (fruit and vegetable intake, alcohol intake, physical activity, sitting time, smoking, drug use, sleep, sexual health) and health risk factors (body mass index, food insecurity, mental health) in a sample of Australian university students. Participants: 3,077 students from the University of Newcastle (UON), Australia (mean age 27.1 ± 9.8 years, 69.4% female) were surveyed in September-October 2017. Methods: Cross-sectional self-report survey, the UON Student Healthy Lifestyle Survey 2017. Results: Participants with unhealthy lifestyle behaviors included; 89.5% not meeting vegetable recommendations, 50.3% exceeding lifetime risk guidelines for alcohol intake, and 38.1% insufficiently physically active. Rates of health risk factors included; 39.6% overweight/obese, 37.6% high or very high risk of psychological distress, and 22.0% food insecure. Conclusions: Rates of unhealthy lifestyle behaviors and related health risk factors were high within the study population, highlighting the importance of ongoing monitoring and prioritization of effective strategies to improve university student health.

Evaluating an Interactive Digital Intervention for College Weight Gain Prevention

OBJECTIVE

Pilot a digital interactive intervention for weight gain prevention among college students.

METHODS

One sample pre-post study reporting on initial usability and changes in theoretical constructs (ie, self-efficacy, behavioral capability, elaboration) and program acceptability. Twenty college freshmen (mean age, 18.25 ± 0.72 years) reviewed a digital program providing self-assessment and brief tailored feedback on 8 behaviors that relate to a healthy weight: physical activity, sedentary behavior, and consumption of sugary beverages, high fat snacks, breakfast, fried foods, fruits and vegetables, and pizza.

RESULTS

At posttest, improvements in self-efficacy were found for 5 behaviors (ie, physical activity, high fat snacks, breakfast, fried foods, fruits and vegetables); improvements in behavioral capability were found for 3 behaviors (ie, high fat snacks, fried foods, and fruits and vegetables). Acceptability benchmarks included: positive impression (60%), relevance (95%), and ease of comprehension (75%).

CONCLUSIONS AND IMPLICATIONS

This program demonstrates acceptability for a digital weight gain prevention intervention, with improvements in behavioral mediators of change. Suggestions to simplify messaging and allowing for user control may enhance acceptability and comprehension. There is a need for further testing with larger more diverse populations before broader implementation by universities to address student health.

Effect of a Single Nutritional Intervention Previous to a Critical Period of Fat Gain in University Students with Overweight and Obesity: A Randomized Controlled Trial

BACKGROUND

the present study aimed to investigate the effects of a single nutritional preventive session previous to a critical period linked to fat gain in university students with overweightness and obesity, emulating a nutritional session of a public health system.

METHODS

In this single-blind randomized controlled trial, 23 students met all the criteria to be included (20.91 ± 2.52-year-old; 52.2% women) who were divided into two groups: intervention group (IG) and control group (CG). Fat mass (FM) by dual-energy X-ray absorptiometry (DXA), physical activity by accelerometry, feeding evaluation through three questionnaires, and a set of healthy lifestyle recommendations were evaluated before and after the national holidays (NH).

RESULTS

Our findings showed that FM increased significantly in the CG, but not in the IG (CG = 428.1 g; IG = 321.9 g; Δ = 106.2 g; p = 0.654 [95% CI = -379.57, 591.92]). However, no differences were found during the NH between them (Hedges' g effect size = 0.19; p = 0.654). In addition, no statistical differences were observed between groups in feeding evaluations, the set of recommendations performed, and physical activity.

CONCLUSION

a single preventive session before a critical period, using a similar counselling approach as used in the public health system, might not be enough to promote changes in eating and physical activity patterns and preventing fat gain in overweight/obese university students. Long-term interventions are a must.

Rural-urban differences in college students' cardiovascular risk perceptions

Objective: To examine rural-urban differences in college students' cardiovascular risk perceptions. Participants: College students in rural (n = 61) and urban (n = 57) Kentucky counties were recruited from November 2012 to May 2014. Methods: This was a secondary data analysis of a cross-sectional study examining rural-urban differences in cardiovascular risk factors. Students rated their risk for developing high blood pressure, diabetes, high cholesterol, heart disease, having a stroke, and gaining excess weight. Chi-square and logistic regression were used for data analysis. Results: Rural students had lower odds of perceived high risk for developing high blood pressure compared to urban students (odds ratio (OR): 0.32, 95% CI: 0.11-0.96) after adjusting for race, sex, and body mass index. This association was not observed after adjusting for healthcare access variables. No other significant differences were observed. Conclusions: Efforts to raise perceived risk for developing hypertension among rural college students may be warranted.

Required Health and Wellness Courses: Associations With College Student Physical Activity Behavior and Attitudes

OBJECTIVE

To assess the extent to which college student physical activity behaviors and attitudes are associated with enrollment in required, but self-selected, health and wellness courses.

PARTICIPANTS

Data were analyzed from 1473 undergraduate students (60% women) taking health and wellness courses at a large northeastern university.

METHODS

Demographic characteristics and activity levels at the time of course enrollment were assessed in relation to course selection and activity levels after course completion. One-way analysis of variance tests were used to assess the differences in the characteristics of students enrolling in different types of health and wellness courses, and paired samples t tests were used to assess the differences in physical activity and related attitudes from the time of enrollment to the end of the semester.

RESULTS

Course selection was predicted by demographic characteristics and precourse activity levels. Overall, no significant change in activity levels was observed over the course of one semester, although some effects were observed within certain types of activities.

CONCLUSIONS

When given the option, college students appear to select health and wellness courses that match their current activity levels. These courses do not significantly change the average student's behavior or attitudes about physical activity.

A Systematic Umbrella Review on the Epidemiology of Modifiable Health Influencing Factors and on Health Promoting Interventions Among University Students

Background: Universities represent an important setting for health promotion. The unique collective of university students is of particular relevance since they are the leaders, decision-makers, and parents of tomorrow. In this context, modifiable health influencing factors as well as interventions to prevent these, play a crucial role. Therefore, the present umbrella review aims to (i) provide an overview of review articles addressing epidemiological issues (prevalence and determinants) of modifiable health influencing factors in university students and (ii) to provide an overview of review articles addressing the evidence of interventions to promote/enhance modifiable health influencing factors in university students. Methods: A systematic literature search was performed in the databases PubMed, Cochrane Reviews Library und Web of Science according to the PRISMA guidelines. Only systematic reviews and meta-analyses were included. The AMSTAR-2-Tool was used for the quality assessment. Result: The initial search resulted in 10,726 records of which 81 fulfilled the inclusion criteria, with a further distinction in articles with an epidemiological focus (n = 39) and in articles with interventional approaches (n = 42). Topics of the different review articles ranged from physical activity over mental health, substance use, sleep, diet and nutrition, and media consumption. Many review articles had a specific focus on medical and nursing students and originated from the U.S.A., U.K., or China. Discussion: This umbrella review provides an overview of review articles on the epidemiology of modifiable health influencing factors and on the evidence of interventions targeting these factors among university students. Thereby, experts as well as stakeholders in the field could gain insights into crucial target points for health promotion. It identifies research gaps in terms of study region and groups of students.

Impact of Stress Levels on Eating Behaviors among College Students

Weight gain is a common phenomenon among college students, especially those in their first year of university. Transitioning from high school to the college environment might increase perceived stress levels, thus affecting dietary behaviors and metabolism to promote overweight and obesity. The purpose of this study was to investigate the physical activities and dietary behaviors of college students in the context of their perceived stress levels. In addition, the demographic characteristics of the students were compared to ascertain their impact on dietary behaviors. Self-reported questionnaires were distributed to college students on campus in Korea. Perceived stress was measured by the 10-item Perceived Stress Scale (PSS-10), the scores for which were evaluated by independent t-tests to compare the dietary behaviors of the high- and low-perceived stress groups. Exploratory factor analysis was performed and Cronbach’s alphas were computed to assess the validity and internal consistency of the PSS-10 measurement items. Differences in the physical activities and dietary behaviors of the college students based on demographics such as sex, academic year, and residence type were found. Several dietary behaviors were significantly different between students with low and high perceived stress levels. Students with high perceived stress levels exhibited increased unhealthy dietary behaviors such as ready-prepared meal consumption (p < 0.001). These results suggest that stress management should be offered to college students. In addition, programs should be provided to help first-year students adjust to the college environment in order to promote healthy dietary behaviors.

Participation of Female Emerging Adults in a Theory- and Evidence-Based Behavioral Weight Loss Program

Emerging adults are less likely to participate in and more likely to drop out of behavioral weight loss programs. Thirty-five female emerging adults who dropped out of a behavioral weight loss program, Weight Loss For Life, completed an online survey. Main reasons for dropout relate to insufficient behavioral skills and unique characteristics of emerging adults, especially when in college (e.g., citing working and getting good grades to be more important than losing weight). Most desired >50% of program online, having virtual groups, and using small groups to model desirable behaviors. Around $140 and $180 seemed sufficient to them to encourage participation in all scheduled treatment sessions and reaching overall weight loss goal, respectively. Future behavioral weight loss programs for emerging adults may consider helping develop time management and task management, decision-making that focuses on longer term outcomes, and immediate tangible rewards similar to what college students typically receive after they complete each class assignment.

A systematic review of the methodology used to study weight change among young adults attending college

INTRODUCTION

Young adulthood is a sensitive developmental period that is high-risk for weight gain. Ample research has focused on weight gain among college students; however meta-analyses report <2 kg pooled estimates of weight gain, which is in the range of normal weight fluctuation, and there is disagreement in the literature regarding common predictors of weight gain. These limitations pose a major barrier to targeted obesity prevention efforts. The present study reviewed the literature assessing college weight gain with a focus on three methodological factors that could contribute to variability in the literature: 1) use of an evidence-supported definition of weight gain (>2 kg or ≥3%); 2) weight measurement protocols; and 3) including weight/BMI in analyses of predictors of weight change.

METHODS

Three databases were systematically searched. Studies were included in the review if the primary goal was to determine magnitude of weight change and/or test predictors of weight change during the academic year, and they reported weight at 2+ time points.

RESULTS

A total of 81 studies were included in the review. Most studies (90%; 73/81) did not use an evidence-supported definition of weight gain. Studies that used an evidence-supported definition reported estimates of gain among students who gained weight to be beyond the range of normal weight fluctuation (4.0-7.5 kg), and occurred in a subset (<32%) of participants. Studies that did not use an evidence-supported definition reported weight gain to be 2.0-4.5 kg, and occurred in the majority >50% of students. Most studies that measured height and weight (71%; 42/59) did not use a fasting protocol and the majority (63%; 37/59) did not conduct measurements at the same time of day. A higher percentage of studies that used a standardized measurement protocol reported weight change >2 kg (44% vs 20%). A lower percentage of studies that used a standardized measurement protocol had substantial variability in weight change estimates (50% vs 69%). The majority of studies that tested predictors of weight gain (74%; 42/57) included weight/BMI as a covariate in analyses.

CONCLUSIONS

The body of literature examining weight change among college students suffers from limitations that may have contributed to overestimations in the percent of students who gain weight, and simultaneous underestimations of the magnitude of weight gain among those who gain weight. Weight gain may be limited to approximately 30% of students in a sample, and weight gain among this subset of students may be substantial (>4 kg). Going forward, use of both an evidence-supported weight gain definition and fasting measurement protocol will likely enhance accuracy in characterizing weight gain among college students, as well as improve researchers' ability to detect important predictors of weight gain.

Changes in weight and body composition across five years at university: A prospective observational study

Objectives

The transition from high school to college or university has been shown to be a critical period for weight and fat gain. To date, no European data on weight and fat gain over the full trajectory of college or university are available. Therefore, the purpose of the present study was to investigate weight and fat gain among Belgian university students from freshman through senior year of university.

Methods

In this prospective observational study, a total of 340 university students were measured six times, i.e. at baseline (start of the first academic year) and at the start of the second semester of the first, second, third, fourth and fifth academic year. Objective measurements included body weight, height, body mass index (BMI), fat%, fat mass, fat free mass and waist circumference. Multilevel modelling was used to assess anthropometric changes over time according to sex.

Results

From freshman through senior year of university, individual weight changes ranged from -5.2 to +15.7kg, and respectively 77.4% and 69.3% of students showed increases in BMI and fat%. Stronger increases in weight and BMI were found for males (5.7kg; 1.6kg/m²; both p<0.001) than females (2.2kg; 0.8kg/m²; both p<0.001) over the 4.5 year measuring period. Similarly, waist circumference increased more in males (4.7cm; p<0.001) than in females (1.0cm; p<0.001). In contrast, females (2.5%; p<0.001) showed a higher increase in fat% than males (1.0%; p = 0.019). Across sexes, the highest weight and fat gains were found during the first semester and during the final year of university.

Conclusions

Belgian university students gain a significant amount of body weight and body fat from freshman through senior year of university. Similar to the first semester, more pronounced increases in weight and fat were observed during the final year of university. Interventions aiming at preventing weight gain at university should not only focus on freshmen but also on senior students.

The Association Between Health Conditions, Consciousness, Involvement, and Knowledge and Dietary Supplement Intake among University Students in South Korea

Dietary supplements (DSs) are typically used by the elderly in a population, but younger age groups are increasingly purchasing these products. In consideration of this issue, the present study investigated the DS-related behaviors and general lifestyles of university students in South Korea. The health conditions, consciousness, involvement, and knowledge, as well as the future behavioral intentions, of DS users and non-users were determined and compared. A survey was administered to the respondents, and measurements were adapted and rephrased to suit the Korean context. Results showed that although the behaviors of DS users and non-users were characterized by similar patterns, significant differences in health involvement and future purchase were found between these groups. Health involvement influenced DSs buying intentions in the future, but no significant differences in the other variables were found. The findings suggested that university students take DSs regardless of their expectations about their efficacy and that their knowledge does not affect their intention to purchase such products.