Evaluation of dietary habits and assessment of cardiovascular disease risk factors among Greek university students

Assessment of Knowledge and Attitude of Medical Students Towards Nutrition and Health: A Cross-Sectional Study

INTRODUCTION

Students' health and well-being generally depend on their nutritional intake. Medical students, in particular, must be physically and mentally fit to perform better academically and to treat their patients holistically. Consuming a nutritious diet and maintaining good health requires an adequate understanding of nutrition and related diseases. Thus, this study used a validated general nutrition knowledge questionnaire to evaluate nutritional knowledge and aimed to assess medical students' knowledge and attitudes about health and nutrition-related diseases.

METHODOLOGY

A cross-sectional study was conducted on 123 medical students between July 2023 and June 2024. A general nutrition knowledge questionnaire was used for the online survey, which consisted of questions on nutrition knowledge, individual dietary choices, thoughts about expert advice and awareness about health problems and diseases related to weight management and diet. The responses obtained were put in an Excel (Microsoft, Redmond, WA, USA) spreadsheet, and the data obtained was transformed into bar graphs and pie charts by using SPSS version 20 (IBM Corp., Armonk, NY, USA). For the statistical analysis of data, percentages were calculated.

RESULTS

The mean age of the study participants was 18.56 ± 1.16 years. The gender-wise distribution of participants shows around 47.7% (50) male and 57.3% (66) female. 39.8% of students answered correctly the precise requirement of macronutrients. 21.1% of students were unsure about the content of added sugar, salt and fibre requirements. The majority of students made healthy dietary choices, while many students were unaware of the expert's advice and diet-related diseases.

CONCLUSION

It was discovered in the current study that students' general understanding of a nutritious diet was good, but they lacked knowledge regarding the nutrient content. Students showed a sufficient level of understanding of the healthy food selections, but they were not aware of the healthy cooking methods. Students were unaware of the advice given to the patients, while awareness of nutrition-related diseases was acceptable. Inadequate understanding and lack of awareness are attributed to the limited nutrition-related curriculum in medical schools.

Higher adherence to the Mediterranean Diet is associated with better academic achievement in Spanish university students: A multicenter cross-sectional study

The objective was to assess the association of the overall score and different items of the Mediterranean Diet Adherence Screener (MEDAS) questionnaire with academic achievement in Spanish university students. We hypothesized that university students with greater adherence to the Mediterranean Diet (MedDiet) would have better academic achievement. A cross-sectional study was performed involving 266 first-year students from the University of Castilla-La Mancha, Spain, during the 2017-2018 academic year. Adherence to the Mediterranean diet was evaluated with the 14-item MEDAS questionnaire. As an indicator variable for academic achievement, the average marks of the examinations required for access to Spanish universities were used. A total of 63 participants (23.6%) adhered to MedDiet recommendations. Analysis of covariance models showed that participants with higher adherence to the MedDiet had significantly higher scores on academic achievement than their peers with low adherence (P < .001) after controlling for potential confounders. Additionally, the evaluation of each item of the MEDAS questionnaire showed that a diet rich in olive oil, vegetables, fruits, legumes, fish and shellfish, and a low consumption of sweets and carbonated beverages were positively associated with academic achievement; nevertheless, wine intake was inversely associated. This study showed that Spanish university students had a low prevalence of good adherence to the MedDiet. Additionally, our results suggested that higher adherence to the MedDiet is associated with better academic achievement in Spanish university students. From a public health perspective and because of low adherence, it is important to continue to focus on promoting adherence to the MedDiet as part of a healthy lifestyle pattern to improve the academic performance of young university students.

Eating Attitudes, Stress, Anxiety, and Depression in Dietetic Students and Association with Body Mass Index and Body Fat Percent: A Cross-Sectional Study

University students face challenges impacting psychology and dietary choices. The present work examined the association between eating attitudes, stress, anxiety, and depression to body mass index (BMI) and body fat percentage in Dietetics students. Respondents completed the Eating Attitudes Test-26 (EAT-26), the Depression Anxiety Stress Scales (DASS), a validated Food Frequency Questionnaire, and the Hellenic Physical Activity Questionnaire (HPAQ). Anthropometry and a bioimpedance analysis were performed. The EAT-26 score was 11 (8-16) and the DASS score was 20 (11-36) (medians and interquartile ranges). Disordered eating was detected in 20% of men and 15% of women. Depressive symptomatology was detected in 30% of males and 23% of females, anxiety in 35% of males and 40% of females, and stress in 29% of males and 35% of females. EAT-26 and DASS scores were highly correlated (r = 0. 0.221, p = 0.001). The EAT-26 oral control subscale (B = 0.430, SE = 0.184, p = 0.026) was positively correlated with BMI in men in the models, adjusted for age, physical activity, and Mediterranean Diet Score, while no association was documented for % body fat. The DASS depression score was not related to BMI in multi-adjusted models. In conclusion, disordered eating, depression, stress, and anxiety are present in this sample of university students. The relationship between disordered eating and BMI needs consideration in programs targeting overweight or underweight in Dietetics students.

Why don't college freshmen meet the US dietary guidelines for added sugar, refined grains, sodium, and saturated fat?

OBJECTIVE

The objective of the study was to evaluate how well college students meet U.S. dietary guidelines by examining the mean intakes of nutrients to limit (sodium, sugar, refined grains, and saturated fat), and what factors lead to exceeding the dietary recommendations.

PARTICIPANTS

Participants were first-year undergraduate students (N = 269).

METHODS

Diet was assessed using a DHQ-III and estimated with food source composition tables. Multivariable logistic regression analysis was used to model variables associated with exceeding the recommendations. One-sample t-tests were performed to compare the cohort with national intakes.

RESULTS

One-third met added sugar guidelines; only 4% met daily refined grains requirements, Fewer than half met saturated fat guidelines, and slightly over half met recommended sodium guidelines. Level of physical activity, race/ethnicity, and living on campus were the important predictors for exceeding recommended intakes.

CONCLUSIONS

Most students do not adhere to the U.S. dietary guidelines for nutrients to limit.

Psychometric evaluation and invariance of the Spanish version of the Block Fat Screener (BFS-E) in university students

Introduction

University students constantly face a number of health challenges related to an unhealthy diet, characterized by a high intake of saturated fats.

Objective

This study aimed to analyze the psychometric properties of the Spanish version of the Block Fat Screener (BFS-E) food frequency questionnaire in a university population.

Methods

An observational analytical study of instrumental type was carried out in 5608 Peruvian university students. Based on the Block Fat Screener questionnaire, a back-translation and cultural adaptation process was carried out. The validity of the questionnaire was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), hypothesizing a unidimensional structure. For the determination of reliability, the alpha coefficients were considered; likewise, the ω and H coefficients were used to evaluate the construct. The model explained 63% of the cumulative variance.

Results

The CFA confirmed the unidimensionality of the 16-item questionnaire with appropriate goodness-of-fit indicators; therefore, which model of the Peruvian version adequately fits the observed data. The values of the reliability coefficients were higher than 0.90, with ordinal α = 0.94, ω = 0.94, and H = 0.95.

Conclusion

The Spanish version of the Block Fat Screener food frequency questionnaire presents adequate psychometric properties and is therefore a valid scale to quickly measure fat intake in university students in a Latin American context.

Changing trends of the disease burden of non-rheumatic valvular heart disease in China from 1990 to 2019 and its predictions: Findings from global burden of disease study

Objective

China has an increasing burden of non-rheumatic valvular heart disease (NRVHD) as the aging of the population is deepening. The aim was to assess the age and sex-specific prevalence and DALYs of NRVHD in China from 1990 to 2019 and to predict the burden in the next 25 years.

Methods

The Global Burden of Disease Study (2019) was used to extract the data of age- and sex-specific incidence, mortality, and disability-adjusted life years (DALYs) of NRVHD in China, 1990-2019. We estimated the annual percentage change (EAPC) to access the temporal trends of the disease burden of NRVHD. The R package called Nordpred was used to perform an age-period-cohort analysis to predict the prevalence of NRVHD in the next 25 years.

Results

The number of incident cases of NRVHD increased from 93.16 thousand in 1990 to 325.05 thousand in 2019. Overall upward trends were observed in the age-standardized incidence rate (ASIR) from 1990 to 2019. Significant temporal trends in mortality and DALYs of NRVHD were observed. High systolic blood pressure, high sodium diet, and lead exposure were the main driving forces for NRVHD. In the next 25 years, the number of new cases and deaths of NRVHD should continue to increase to 390.64 thousand and 10.0 thousand, respectively. The ASIR should show an upward trend, while the ASMR should show a downward trend among men and women.

Conclusion

In China, the overall rates of NRVHD have increased over the past 30 years, and there has been a substantial increase in the burden of NRVHD due to population growth and aging and will continue to increase in the next 25 years. Our results can help shape a multifactorial approach and public policy to reduce the NRVHD burden throughout China.

Immune fitness and lifestyle habits of Saudi medical students: a cross sectional study

Introduction

Immune function reaches an optimum level in young adults. However, young adults are more likely to adopt potentially harmful habits that may pose a risk to their long-term health and immune fitness, and which eventually may put a substantial burden on the healthcare system. This study aimed to assess the status of medical students' immune fitness, using the immune status questionnaire (ISQ) and exploring the association with the commonly adopted lifestyle habits hypothesized to have an impact on immune functions.

Methods

A descriptive, cross-sectional study was conducted among preclinical students attending the medical school of King Abdulaziz University. An online self-reported questionnaire was used to assess the immune status (ISQ), perceived (momentary) immune fitness, general health, lifestyle habits and students' perception of these lifestyle-associated impacts on immune fitness. Descriptive, Spearman's correlation and stepwise linear regression analyses were performed.

Results

In a pooled sample of 211 participants, the overall ISQ score was 6.00 ± 5.0 with statistically significant abnormally lower scores in females (ISQ 5.00 ± 5.0, p < 0.001). 49.29% of respondents experienced poor immune fitness as measured by the ISQ (<6). The ISQ score was significantly correlated with fast and fatty food consumption (p = 0.003), daytime sleepiness (p = 0.001), and BMI subgroups (p = 0.028) negatively and positively correlated with adherence to a program of exercise (p = 0.005). A total of 41.23% of participants who reported a normal immune health, rated at ≥6 were graded below 6 on the ISQ score. Only 62.6% of students were able to correctly identify the effects of fast and fatty food consumption on immune fitness.

Conclusion

Poor immune fitness was common among medical students in KAU and associated significantly with their adopted lifestyle habits. Although, other factors can be significant contributors, biased immune health perception and lack of awareness of these lifestyle-associated impacts on immune fitness and general health may hinder the adoption of healthier habits. Immune biomarkers should be implemented in future work.

Mediterranean Diet, a Posteriori Dietary Patterns, Time-Related Meal Patterns and Adiposity: Results from a Cross-Sectional Study in University Students

The transition to university is connected to potentially obesogenic dietary changes. Our aim was to assess the relation of Mediterranean diet adherence, and a posteriori dietary and meal patterns with adiposity in Greek students at the University of the Peloponnese. A total of 346 students (269 women) participated. Anthropometry was performed, and a food frequency questionnaire was administered. The MedDietScore was higher in women and was not linearly related to adiposity. Principal component analysis revealed six patterns: (1) legumes/vegetables/fruits/tea/dairy/whole grains, (2) juice/sodas/liquid calories, (3) olive oil/fats, (4) meat/poultry/fish, (5) alcohol/eggs/dairy and (6) fast foods/sweets. Patterns 4 and 6 were related to overweight/obesity probability (OR = 1.5, 95% CI: 0.995-2.538 and OR = 2.5, 95% CI: 1.07-6.06, respectively) and higher waist circumference (men). Men "early eaters" (breakfast/morning/afternoon snack) had a higher MedDietScore and lower overweight probability (OR = 0.47, 95% CI: 0.220-1.020). Poor meal and dietary patterns relate to overweight and central obesity, which is important for targeted health promotion programs.

Eating Behaviors, Depressive Symptoms and Lifestyle in University Students in Poland

Young adulthood is the period from the late teens through the twenties and is associated with life transitions that could contribute to the development of obesity. Targeting this group will be critical to reversing the obesity epidemic. The aim of the study was to investigate the eating behaviors and lifestyle of healthcare students in Poland. We enrolled 227 students in the study. Convenience sampling was employed. Diet (Food Frequency Questionnaire), physical activity (International Physical Activity Questionnaire), depressive symptoms (Beck Depression Inventory), impulsivity (Barratt Impulsivity Scale), and eating behaviors (Three-Factor Eating Questionnaire) were assessed. One in three students exhibited depressive symptoms, one in four showed low levels of physical activity. More than 40% of the students did not consume vegetables at least once a day, and more than half did not consume fruit. Only approximately 50% of the students ate fish several times a month. There was an association between high scores of specific eating behaviors and body weight, adherence to the Mediterranean diet, and consumption of specific product groups (sweets, alcohol). The results of our study are expected to contribute to a better understanding of dietary habits and overweight/obesity in university students, and support the development of programs to promote healthy lifestyles in that population.

Nutrition knowledge among university students in the UK: a cross-sectional study

OBJECTIVE

To investigate nutrition knowledge (NK) in university students, potential factors affecting knowledge and predictors of good NK.

DESIGN

A cross-sectional study was conducted in 2017-2018. The revised General Nutrition Knowledge Questionnaire was administered online to assess overall NK and subsections of knowledge (dietary recommendations, nutrient sources of foods, healthy food choices and diet-disease relationships). The Kruskal-Wallis test was used to compare overall NK scores according to sex, age, ethnicity, field of study, studying status, living arrangement, being on a special diet and perceived health. Logistic regression was performed to identify which of these factors were associated with a good level of NK (defined as having an overall NK score above the median score of the sample population).

SETTING

Two London-based universities.

PARTICIPANTS

One hundred and ninety students from various academic disciplines.

RESULTS

The highest NK scores were found in the healthy food choices (10 out of 13 points) and the lowest in the nutrient sources of foods section (25 out of 36 points). Overall NK score was 64 out of 88 points, with 46·8 % students reaching a good level of knowledge. Knowledge scores significantly differed according to age, field of study, ethnicity and perceived health. Having good NK was positively associated with age (OR = 1·05, (95 % CI 1·00, 1·1), P < 0·05), White ethnicity (OR = 3·27, (95 % CI 1·68, 6·35), P < 0·001) and health rating as very good or excellent (OR = 4·71, (95 % CI 1·95, 11·4), P < 0·05).

CONCLUSIONS

Future health-promoting interventions should focus on increasing knowledge of specific nutrition areas and consider the personal and academic factors affecting NK in university students.

On-campus food purchasing behaviours and satisfaction of Australian university students

ISSUE ADDRESSED

Many university students have unhealthy dietary intake. The food environment on university campuses is a potentially important contributor to students' diet. This study aimed to describe on-campus food purchasing behaviours; satisfaction with the cost and availability of foods and beverages on-campus; and preferences for the on-campus food environment, in a sample of Australian university students.

METHODS

An online cross-sectional survey of 409 students at the University of Newcastle, Australia was conducted in 2017-2018. The survey assessed on-campus purchasing behaviours (frequency of purchase and expenditure), satisfaction with the cost and availability of foods, preferences for the on-campus food environment, and socio-demographics (eg age, domestic/international student). Results are reported as basic descriptive statistics.

RESULTS

The majority of students (94%) purchased food or beverages on-campus, with 59% purchasing at least once per week. Satisfaction with the availability of foods was low (35.8% satisfied with the types of main meals available, and 48.5% for snacks); however, 72.8% were satisfied with types of beverages available. The majority of students were not satisfied with the cost of food and beverages (<40%). The top-rated preferences for changes to the on-campus food environment were healthier options, higher quality food, and cheaper food.

CONCLUSION

Overall, the findings demonstrate strong support from students for healthier and cheaper food to be made available on-campus. SO WHAT?: There are two main factors of concern with regard to university food environments; the healthiness of food and beverage options and their cost. These should be key considerations of any future strategies aiming to improve university food environments.

Consumers' Perceptions of Healthy Food Availability in Online Food Delivery Applications (OFD Apps) and Its Association With Food Choices Among Public University Students in Malaysia

This retrospective cross-sectional study was conducted to study consumers' perceptions of healthy food availability in online food delivery applications (OFD apps) among public university students in Malaysia and its association with their food choices. A total of 290 subjects aged 19–29 years old were recruited from 20 public universities in Malaysia via snowball sampling. Data was collected through an online questionnaire which consisted of socio-demographic status, use of OFD apps (most frequently used brand, usage frequency, food choice, and expenditure per transaction), factors affecting food choice in OFD apps, consumers' perceptions of healthy food availability in OFD apps and recommendation for improvements. The most frequently used apps among the subjects was Food Panda (46.6%), however, majority of the subjects in this study (41.4%) rarely used OFD apps. Also, most of the subjects ordered unhealthy food (77.6%) and spent up to RM15–RM19 for each transaction (43.1%). There was no significant difference between the use of OFD apps and gender (p > 0.05). Among the five food choice motives, “price and convenience” motive was the most influencing food choice factor in OFD apps. Majority of the subjects (76.9%) had a negative perception of healthy food availability (variety, price, and quality of healthy food) in OFD apps. No significant association was found between consumers' perceptions of healthy food availability in OFD apps and their food choices made in OFD apps among the subjects in this study (p > 0.05). Also, majority (85.9%) responded they are keen to purchase healthy foods through OFD apps if they are given an option. However, most Malaysian public university students perceived that there were not much variety of healthy food, of good quality and affordable price, available in OFD apps. This finding suggests that the online food environment in Malaysia are perceived as unhealthy. Future studies can explore the online food environment particularly its impact on community health and well-being. Public health professionals and policymakers need to address the online food environment issues as part of the obesogenic food environment in Malaysia especially when OFD is one of the most convenient service in this country.

Nutritional quality and carbon footprint of university students' diets: results from the EHU12/24 study

Objective:

To evaluate diets in terms of nutritional characteristics and quality from the perspectives of health, greenhouse gas emissions (GHGE) and possible associations with each other in a representative sample of students at a public university.

Design:

Cross-sectional. Dietary intake was evaluated with a validated FFQ, and diet quality was assessed through the Healthy Eating Index (HEI-2010) and MedDietScore (MDS). GHGE data were obtained from the literature. In addition, sex, socio-economic status (SES) and body fat (BF) status were analysed as covariates.

Setting:

Basque Autonomous Community, Spain.

Participants:

Totally, 26 165 healthy adults aged 18–28 years.

Results:

Student diets were characterised by low consumption of carbohydrates (38·72 % of total energy intake (TEI)) and a high intake of lipids (39·08 % of TEI). Over half of the participants had low dietary quality. The low-emitting diets were more likely to be consumed by subjects with low HEI-2010 scores (β: 0·039 kg eCO₂/1000 kcal/d) and high MDS scores (β: −0·023 kg eCO₂/1000 kcal/d), after controlling for sex, SES and BF status. Both the low-emitting and healthy diets were more likely to be consumed by women and by those with normal BF percentage.

Conclusions:

UPV/EHU university students’ diets were characterised by moderate quality from a nutritional perspective and moderate variation in the size of carbon footprints. In this population, diets of the highest quality were not always those with the lowest diet-related GHGE; this relationship depended in part on the constructs and scoring criteria of diet quality indices used.

Health Status, Behaviors, and Beliefs of Health Sciences Students and Staff at Kuwait University: Toward Maximizing the Health of Future Health Professionals and Their Patients

Health professionals who engage in healthy lifestyle behaviors are more likely to promote their patients’ health. We evaluated health status, behaviors, and beliefs of students (future health professionals) and staff in four health sciences faculties, Kuwait University. In total, 600 students and 231 staff participated in this descriptive cross-sectional study. Questionnaire surveys were used to evaluate lifestyle-related practices and participants’ beliefs about these practices, in addition to health-related objective measures, e.g., heart rate, blood pressure, and body mass index. Overweight/obesity was prevalent among the participants (staff, 68.7%, students, 48.1%; p < 0.001); 57% of staff had suboptimal resting blood pressures. About half of the participants reported being moderately physically active (staff, 44.8%, students, 52.6%; p < 0.05), and most reported moderate/high stress (staff, 88.8%, students, 90.9%; p > 0.05). Only 25.1% of staff and 27.9% of students reported at least 8 h sleep nightly (p > 0.05). Staff reported healthier dietary practices than students (p-value range < 0.001–0.02). Overall, the participants had sub-optimal health indices. A marked gap existed between participants’ beliefs about healthy lifestyle practices and their actual health status. Healthy lifestyle programs are needed on campus with respect to diet, exercise, and stress management. As emerging health professionals, students in health sciences faculties, Kuwait University, need exposure to a health-promoting environment including healthy staff as role models.

Exploring the links between unhealthy eating behaviour and heavy alcohol use in the social, emotional and cultural lives of young adults (aged 18-25): A qualitative research study

Alcohol use peaks in early adulthood and can contribute both directly and indirectly to unhealthy weight gain. This is the first qualitative study to explore the links between unhealthy eating behaviour and heavy alcohol use in the social, emotional and cultural lives of young adults. We conducted 45 in-depth interviews with 18-25-year-olds in North-East England to inform development of a dual-focused intervention to reduce health risk due to excess weight gain and alcohol use. Data were analysed thematically, following the principles of constant comparison, resulting in three intersecting themes: (1) how food and alcohol consumption currently link together for this population group; (2) influences upon linked eating and drinking behaviours and (3) young adults' feelings and concerns about linked eating and drinking behaviours. Socio-cultural, physical and emotional links between food and alcohol consumption were an unquestioned norm among young adults. Eating patterns linked to alcohol use were not tied only to hunger, but also to sociability, traditions and identity. Young adults conceptualised and calculated risks to weight, appearance and social status, rather than to long-term health. This study is the first to evidence the deeply interconnected nature of food and alcohol consumption for many young adults. Findings have important implications for intervention development, UK public health policy and practice, and point to a need for similar research in other countries.

The EHU12/24 cohort: survey design, instruments and participants

The EHU12/24 (code of a survey from the University of the Basque Country/Euskal Herriko Unibertsitatea, UPV/EHU) study was designed to investigate the risk factors of overweight/obesity-related lifestyles, particularly those associated with diet, their psychosocial influences and the interactions among these factors. This observational cohort study was carried out according to a standardised protocol and involved a representative sample of the UPV/EHU student population. Anthropometric measurements, direct behavioural determinants, such as physical activity and diet, and indirect determinants, such as social/psychological factors, are considered. In this paper, we present the survey design, instruments, measurements and related quality management. We describe the study sample in terms of its socio-economic and demographic factors and knowledge area and summarise the methodology used to collect the data and obtain the anthropometric measurements. The participants were 603 students (59·5 % female) aged 18-28 years. The crude participation proportion was 53·5 %. Regarding the knowledge area, the lowest response proportions were obtained from the Health Sciences (38·6 %) compared with the Non-Health Sciences (48·3 %) (P = 0·003). The mean age was 20·9 years, and 83·1 % of the sample were from Basque Country. Regarding the socio-economic characteristics, there were significant differences by sex and knowledge area in most studied variables. Moreover, the Health Sciences students were more likely younger, from outside Basque Country, to have parents with university degrees and to have a higher social status. In conclusion, the EHU12/24 cohort provides valuable data for analysing the complexity and multidimensionality of obesity in university students.

Feasibility and Preliminary Efficacy of the Eating Advice to Students (EATS) Brief Web-Based Nutrition Intervention for Young Adult University Students: A Pilot Randomized Controlled Trial

Young adult university students are a priority population for nutrition intervention. This study assessed the feasibility and preliminary efficacy of the EATS (Eating Advice to Students) brief (i.e., single use) web-based nutrition intervention for young adult university students. A 3-month pilot randomized controlled trial (RCT) was conducted with 124 students aged 17–35 from the University of Newcastle, Australia. Participants were randomized to EATS (n = 62) or attention control (n = 62). EATS aimed to improve four target eating behaviors (vegetables, fruit, discretionary foods, breakfast). Primary outcomes were feasibility (recruitment, retention, usage, program acceptability). Recruitment and retention numbers were recorded, the program acceptability was assessed by a process evaluation survey and the website usage was objectively tracked. Preliminary efficacy was assessed via changes in diet quality (primary), fruit, vegetables, discretionary foods and breakfast intake, measured using Food Frequency Questionnaire. Recruitment was completed in five weeks. Retention was 73% (90/124) at 3-months. Intervention participants used EATS 1.5 ± 1.0 times. Satisfaction with EATS was rated at 4.04 ± 0.74 (maximum five). Intervention participants significantly decreased the percentage energy/day from discretionary foods compared with control (−4.8%, 95%CI −8.6, −1.1, p = 0.012, d = −0.34). No significant between-group differences were observed for diet quality, fruit, vegetable or breakfast intakes. EATS demonstrated high feasibility, particularly for reach and acceptability. The university setting and a brief web-based intervention show promise in engaging young adults to improve their eating behaviors.

Associations of Anthropometric Characteristics, Dietary Habits, and Aerobic Capacity With Cardiovascular Risk Factors of Health-Science Students

The aim of this cross-sectional study was to study the relative importance of dietary habits and aerobic capacity in parameters related to cardiovascular risk in 271 female and 95 male health-science students (mean age = 19.1 ± 1.4 years). In females, fatty-meat consumption predicted triglycerides (β = .649, p < .001) and high-density lipoprotein (HDL; β = -.242, p = .001) and low-density lipoprotein (LDL; β = .373, p < .001) cholesterol levels. Consumption of nuts, legumes, and complex carbohydrates predicted triglyceride (β = -.099, p = .074), HDL (β = .231, p = .001), and LDL (β = -.155, p = .025) levels, respectively. Aerobic capacity (β = -.245, p < .001) and fatty-meat intake (β = .230, p < .001) predicted diastolic blood pressure (BP); body mass index (BMI) predicted systolic BP (β = .340, p < .001). In males, body fat percentage was the strongest predictor of triglycerides (β = .348, p = .004), cholesterol (β = .366, p = .006), HDL (β = -.378, p = .004), and LDL (β = .271, p = .043) levels. Aerobic capacity (β = -.263, p = .013) and fatty-meat consumption (β = .334, p = .005) independently predicted triglyceride levels. Nut (β = -.286, p = .013) and fatty-meat intake (β = .361, p = .002) predicted systolic BP, while BMI predicted diastolic BP (β = .209, p = .045). As health sciences students, these participants are future health professionals; targeting such populations is important for chronic disease prevention.

Food insecurity and Mediterranean diet adherence among Greek university students

AIM

To assess Mediterranean diet (MD) adherence and food insecurity (FI) among university students in Greece.

METHODS AND RESULTS

A non-probability sample of 236 students was recruited from Athens and Thessaloniki during 2016. FI was assessed with the Household Food Insecurity Access Scale and MD adherence with the MEDAS questionnaire. Mean MEDAS score of the sample was 6.4 ± 1.9, with women demonstrating greater MD adherence compared to men (p = 0.016) and Dietetics students exhibiting increased score compared to the rest (p ≤ 0.001). A low proportion of participants were food-secure (17.8%), 45.3% were severely food-insecure, 22.0% experienced moderate FI and the remaining 14.8% had low FI. Participants studying in the city they grew up exhibited lower FI compared to those studying in other cities (p = 0.009), while, additionally, a trend was noted for increased FI among students with an unemployed family member (p = 0.05). Students working night shifts had lower MD adherence and increased FI compared to the rest (p = 0.004 and p = 0.003, respectively). The same pattern was observed among participants who smoked (p = 0.003 for MD adherence and p = 0.009 for FI, respectively). Multivariate regression analyses did not reveal any connections between FI categories, waist circumference or BMI, but showed an inverse relationship between severe FI and MD adherence.

CONCLUSIONS

The majority of the surveyed university students from Greece demonstrate some degree of FI, with a great proportion being severely food-insecure. Increased FI is inversely associated with MD adherence.

Evaluation of adherence to Mediterranean diet in medical students at Kocaeli University, Turkey

Introduction This study was conducted to evaluate the eating habits of medical students at Kocaeli University in northwest Turkey in terms of their ability to apply their academic knowledge regarding healthy lifestyles to their own lives using the Mediterranean Diet Quality Index (KIDMED). Methods In this cross-sectional study, a questionnaire including demographic information and the KIDMED index was administered to 354 medical school students (206 first-year and 148 third-year students). The students' sex, body mass index, KIDMED score, place of residence, smoking habit, media screen time, and regular exercising variables were evaluated. Results The KIDMED score was -2 to 8 (3.8 ± 1.9) among all students, -1 to 8 (3.9 ± 2.0) among first-year students, and -1 to 8 (3.6 ± 1.9) among third-year students. In total, 59.1% of females and 40.9% of males among first-year students showed moderate adherence to the Mediterranean diet, and female students showed better adherence to the Mediterranean diet than males among third-year students. Conclusion Medical students at Kocaeli University in Turkey showed inadequate application of their academic knowledge about healthy living to their own lives.

Fiber Patterns in Young Adults Living in Different Environments (USA, Spain, and Tunisia). Anthropometric and Lifestyle Characteristics

Benefits of dietary fiber go beyond its effect on chronic diseases associated with development. Consequently, the pattern of fiber intake has been considered an indicator for diet quality. Young adults are especially vulnerable to a food environment that drives an increase in chronic diseases linked to economic development. The aim of this work was to characterize patterns of fiber intake among university students. A cross-sectional study was conducted on a sample of 730 students enrolled at the University of Castilla-La Mancha (Spain), the University of Carthage (Tunisia), and Florida International University (USA). Mean age was 21.2. Food consumption was self-reported in two 24-h recalls. Mean dietary fiber intake was 17.8 g, not reaching the adequate intake. Contrary to expectations, American participants were the highest consumers (p < 0.001), and also exhibited the highest BMI. Cereals, legumes, vegetables and fruit were the main food sources of fiber. Fiber from appetizers, prepared and precooked meals, sauces, spices and condiments accounted for 16.7% in American participants, 7.4% in Spanish participants and 2.6% in Tunisian participants. Total fiber intake increased with energy intake but did not depend on smoking habits and physical activity in any country. It is essential to improve consumers’ interpretation of guidelines on fiber intake.

Level of nutrition knowledge and its association with fat consumption among college students

BACKGROUND

Intake of saturated fat, trans fat, and cholesterol has been associated with increased risk of coronary heart disease. The aim of this study was to explore whether increased nutrition knowledge is associated with a reduction in the consumption of unhealthy fats in a sample of university students.

METHODS

A sample of 231 students, with a mean age of 20 years, was recruited from university campus during spring 2012. Students completed a validated questionnaire related to students' demographic, nutrition knowledge, and daily fat consumption. Weight, height, and waist circumference were measured. Data were analyzed using one-way ANOVA, chi-square, and student's t-test.

RESULTS

Results indicate that female students have greater nutrition knowledge than male students (the mean nutrition score for women was 5 points higher than that of men (P = 0.01)). Nutrition knowledge was negatively correlated with fat and cholesterol intake. Students who consumed more than 35 % calories from fat or >300 mg of cholesterol daily had lower mean nutrition scores than those students with lower fat or cholesterol intake (8 points lower and 7.9 points lower, respectively). Using linear regression for nutrition scores on estimated saturated fat intake and cholesterol intake (controlling for gender, height, weight, age, and dieting), nutrition scores were negatively associated with saturated fat intake (-0.15, P <0.0001) and cholesterol intake (-1.38, P <0.0001).

CONCLUSION

Students with greater nutritional knowledge consumed less unhealthy fats and cholesterol. This finding magnifies the role of nutrition education as a potential tool in health campaigns to promote healthy eating patterns among college students. Results of this pilot study can inform the design of future nutrition education intervention studies to assess the efficacy of nutrition knowledge on pattern of fat consumption among college students.

The relationship between dietary intake and energy availability, eating attitudes and cognitive restraint in students enrolled in undergraduate nutrition degrees

The aim of this research was to explore the relationship of total energy and macronutrient intake, energy balance and energy availability to eating attitudes and cognitive restraint in students enrolled in undergraduate nutrition degrees. Energy and micronutrient intake was assessed in 63 students (n = 50 nutrition, and n = 13 occupation therapy degrees; n = 51 females, n = 12 males) using three 24-h dietary recalls. Energy requirements were calculated based on measured resting metabolic rate, estimated exercise energy expenditure, and dietary induced thermogenesis. Body composition was assessed using dual energy x-ray absorptiometry. Eating attitudes and cognitive restraint were measured using previously validated tools. Eighteen percent of nutrition students were classified as having low energy availability (<30 kcal kgFFM^-1d^-1) and 38% were in negative energy balance. Eating attitudes and cognitive restraint were not associated with total energy or macronutrient intake. However, female nutrition students with high cognitive restraint had greater exercise energy expenditure and thus lower energy availability than those with low cognitive restraint (371 (302) kcal d^-1 compared to 145 (206) kcal d^-1, P < 0.01, and 35 (7) kcal d^-1 compared to 41 (10) kcal d^-1 of fat free mass, P = 0.005). Additionally, in females, disordered eating attitudes and cognitive restraint negatively correlated with energy availability (r_s = -0.37, P = 0.02 and r_s = -0.51, P < 0.01 respectively). There were no differences in outcomes between nutrition and non-nutrition students. The current study suggests that those students with disordered eating attitudes and cognitive restraint may be controlling their energy balance through exercise, as opposed to restricting food intake.

Nutritional value of foods sold in vending machines in a UK University: Formative, cross-sectional research to inform an environmental intervention

Vending machine use has been associated with low dietary quality among children but there is limited evidence on its role in food habits of University students. We aimed to examine the nutritional value of foods sold in vending machines in a UK University and conduct formative research to investigate differences in food intake and body weight by vending machine use among 137 University students. The nutrient content of snacks and beverages available at nine campus vending machines was assessed by direct observation in May 2014. Participants (mean age 22.5 years; 54% males) subsequently completed a self-administered questionnaire to assess vending machine behaviours and food intake. Self-reported weight and height were collected. Vending machine snacks were generally high in sugar, fat and saturated fat, whereas most beverages were high in sugar. Seventy three participants (53.3%) used vending machines more than once per week and 82.2% (n 60) of vending machine users used them to snack between meals. Vending machine accessibility was positively correlated with vending machine use (r = 0.209, P = 0.015). Vending machine users, compared to non-users, reported a significantly higher weekly consumption of savoury snacks (5.2 vs. 2.8, P = 0.014), fruit juice (6.5 vs. 4.3, P = 0.035), soft drinks (5.1 vs. 1.9, P = 0.006), meat products (8.3 vs. 5.6, P = 0.029) and microwave meals (2.0 vs. 1.3, P = 0.020). No between-group differences were found in body weight. Most foods available from vending machines in this UK University were of low nutritional quality. In this sample of University students, vending machine users displayed several unfavourable dietary behaviours, compared to non-users. Findings can be used to inform the development of an environmental intervention that will focus on vending machines to improve dietary behaviours in University students in the UK.

Assessment of weight status, dietary habits and beliefs, physical activity, and nutritional knowledge among university students

AIMS

The purpose of this study was to assess weight status, dietary habits, physical activity, dietary beliefs, and nutrition knowledge among a sample of students from Central Michigan University.

METHODS

A cross-sectional survey was conducted among a sample of undergraduate students in Fall 2011 and Spring 2012 at Central Michigan University. Participating students completed an online questionnaire that included questions related to their eating habits, physical activity and lifestyle, dietary beliefs, and nutritional knowledge. Weight, height, and waist circumference were measured. Percentage body fat and visceral fat score were determined using a Tanita body composition analyser (SC-331S).

RESULTS

Outcomes of this study indicated that 78% of female students were within the healthy weight range compared to 52% of male students. Visceral body fat and waist circumference scores were higher in males than in females. Most students showed 'satisfactory' dietary habits. Almost half of the students reported drinking two glasses of milk and consuming two cups of fruits and vegetables daily. Physical activity and lifestyle score indicated that most of the students were not physically active. Only 7% of students reported having a very active lifestyle, and 4% had quite good nutritional knowledge.

CONCLUSION

The majority of students, particularly females, were within the healthy body weight range. Students' dietary habits were satisfactory. However, physical activity, students' knowledge of healthy and unhealthy diet habits, and nutritional knowledge needed improvement. Developing gender-specific programmes for promoting healthy lifestyle behaviours among students is recommended.

Determinants of eating behaviour in university students: a qualitative study using focus group discussions

Background

College or university is a critical period regarding unhealthy changes in eating behaviours in students. Therefore, the purpose of this study was to explore which factors influence Belgian (European) university students’ eating behaviour, using a qualitative research design. Furthermore, we aimed to collect ideas and recommendations in order to facilitate the development of effective and tailored intervention programs aiming to improve healthy eating behaviours in university students.

Methods

Using a semi-structured question guide, five focus group discussions have been conducted consisting of 14 male and 21 female university students from a variety of study disciplines, with a mean age of 20.6 ± 1.7 yrs. Using Nvivo9, an inductive thematic approach was used for data analysis.

Results

After the transition from secondary school to university, when independency increases, students are continuously challenged to make healthful food choices. Students reported to be influenced by individual factors (e.g. taste preferences, self-discipline, time and convenience), their social networks (e.g. (lack of) parental control, friends and peers), physical environment (e.g. availability and accessibility, appeal and prices of food products), and macro environment (e.g. media and advertising). Furthermore, the relationships between determinants and university students’ eating behaviour seemed to be moderated by university characteristics, such as residency, student societies, university lifestyle and exams. Recommendations for university administrators and researchers include providing information and advice to enhance healthy food choices and preparation (e.g. via social media), enhancing self-discipline and self-control, developing time management skills, enhancing social support, and modifying the subjective as well as the objective campus food environment by e.g. making healthy foods price-beneficial and by providing vending machines with more healthy products.

Conclusions

This is the first European study examining perceived determinants of eating behaviour in university students and collecting ideas and recommendations for healthy eating interventions in a university specific setting. University characteristics (residency, exams, etc.) influence the relationships between individual as well as social environmental determinants and university students’ eating behaviour, and should therefore be taken into account when designing effective and tailored multilevel intervention programs aiming to improve healthy eating behaviours in university students.