Food Selection Under Stress Among Undergraduate Students in Riyadh, Saudi Arabia

Overweight and Obesity Is Associated with Higher Risk of Perceived Stress and Poor Sleep Quality in Young Adults

Background and Objectives: Overweight and obesity are growing public health challenges, particularly concerning young adults. University life presents a unique set of stressors that may influence weight management alongside sleep quality. In this cross-sectional study, we aimed to investigate the association between overweight or obesity, stress, and sleep quality in a large sample of Greek university students. Materials and Methods: The study recruited 2116 active students from across various Greek universities. Participants completed questionnaires on sociodemographics, academic performance, and physical activity levels using the International Physical Activity Questionnaire (IPAQ). Stress and sleep quality were assessed using the Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Body weight and height were directly measured to calculate Body Mass Index (BMI). Results: Our analysis of 2116 Greek university students revealed significant associations between various factors and overweight/obesity. Compared to their rural counterparts, young adults in urban areas had an 88% higher prevalence of overweight/obesity (p = 0.0056). Regular smokers were twice as likely to be overweight or obese (p = 0.0012). Notably, those with low physical activity levels displayed a more than two-fold increased risk (p = 0.0008) compared to those with moderate or high activity levels. Similarly, students with moderate or high perceived stress levels had a more than two-fold prevalence of overweight/obesity compared to those with low stress (p = 0.0005). Inadequate sleep quality was also associated with an 86% higher risk of overweight/obesity (p = 0.0007). Interestingly, good academic performance showed a 57% greater prevalence of overweight/obesity compared to very good/excellent performance (p = 0.0103). Conclusions: Our findings reveal that perceived stress and poor sleep quality are significant risk factors for overweight and obesity in this young adult population.

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.

Severity of acne, stress, and food habits of medical students at Taif University, Saudi Arabia

BACKGROUND

Stress and food habits seem to be associated with acne, but no study has been reported from in Taif, Saudi Arabia. The aim of this study was to determine the association between the severity of acne, stress, and food habits of undergraduate medical students.

MATERIALS AND METHODS

A cross-sectional study was conducted among 585 undergraduate medical students. Data was collected on students' demographics, academic year, and level. The Global Acne Grading System (GAGS) was utilized for a clinical evaluation of acne severity and an assessment of the presence and location of acne lesions. To assess respondents' stress, the Perceived Stress Scale (PSS) was employed, and adolescent food habits checklist (AFHC) assessed the food habits. To test for statistical significance, Chi-squared test was used for qualitative data, whereas Mann-Whitney U test and, Kruskal-Wallis tests were performed for quantitative variables.

RESULTS

The mean age of students was 21.16 ± 1.81 years, 53.5% were female and 53.8% were in the preclerkship academic level. Of these, 9.7%, 78.5%, and 11.8% had low, moderate, and high stress levels. The overall prevalence of acne was 88.2%; Mild, moderate, severe and very severe acne were present among 59%, 23.9%, 3.9% and 1.4% of students respectively. Female students had a significant higher percent of severe acne and students in preclerk ship years had significant higher mean AFHC scores. Students with severe stress had a significant higher mean GAGS score and lower mean AFHC scores. A significant positive correlation was found between GAGS scores and PSS.

CONCLUSION

The high rates of stress and acne of the study's participants demand that medical students be given greater attention with regard to dermatology and psychiatric diseases.

Relationship between hedonic hunger and subjectively assessed sleep quality and perceived stress among university students: A cross-sectional study

Purpose

This study examined the relationship between hedonic hunger (HH), sleep quality, and stress levels among university students in the United Arab Emirates and the Kingdom of Bahrain.

Methods

We used a cross-sectional design with participants (N = 565) recruited via convenience sampling. Data were collected with a self-administered, standardized, and validated online questionnaire. HH was assessed with the Palatable Eating Motives Scale (PEMS) and Power of Food Scale (PFS), sleep quality and sleep components were assessed with the Pittsburgh Sleep Quality Index (PSQI), stress was evaluated with the Perceived Stress Scale (PSS), and physical activity was examined with the International Physical Activity Questionnaire. Descriptive and analytical statistics were used to assess the relationship between HH and sleep quality and perceived stress.

Results

There were positive associations between total PSQI scores and total PEMS (β = 0.14, 95% confidence interval [CI]: 0.06-0.25, P = 0.001) and PFS (β = 0.21, 95% CI: 0.45-1.04, P < 0.001). The likelihood of poor sleep quality increased by 8% (odds ratio [OR] = 1.08, P = 0.020) and 43% (OR = 1.43, P < 0.001) for each one-unit increase in PEMS and PFS scores, respectively. We also found positive associations between PSS scores and total PEMS (β = 0.19, 95% CI: 0.26-0.63, P < 0.001) and PFS (β = 0.23, 95% CI: 1.04-2.22, P < 0.001) scores.

Conclusion

Reducing HH and stress levels may help to enhance sleep quality among university students. Conversely, improving sleep quality and reducing stress levels could improve HH in this population.

Gender-Based Differences in the Consumption of Food Rich in Fibre and Its Relationship with Perceived Mood Status: A Cross-Sectional Study

It is unclear whether gender-based differences in dietary fibre intake exist in the relationship between daily fibre consumption and the prevalence of mood disorders. This study aims to examine the effects of dietary fibre consumption on mood status between genders in Saudi Arabia. A total of 359 Saudi participants completed the survey. The data showed that women consumed 14 g fibre/day and had a mild depression score, while men consumed 12 g/day and had very severe stress. The consumption of low-to-moderate servings of fruit or very low servings of nuts and seeds was associated with stress in men. Moderate levels of depression among women were likely to occur with low-to-moderate servings of nuts and seeds. Moderate-to-high stress levels among women appeared to be associated with low-to-moderate servings of vegetables, while depressed men consumed vegetables in low-to-moderate servings. However, anxious women who experienced mild levels consumed low-to-moderate servings of vegetables, and those with a mild-to-moderate level of anxiety consumed low-to-moderate servings of bread, whole grains, and cereals. The preliminary results showed that the consumption of 12 g fibre/day is not enough to relieve stress among men, while 14 g/day reduces the level of depression to mild among women. Fibre-rich foods, e.g., vegetables, nuts and seeds, fruit, bread, cereals and legumes, lower the degree of negative moods, but this is not only attributed to fibre, as there are other influential nutrients.

Association Between Perceived Levels of Stress and Self-Reported Food Preferences Among Males and Females: A Stated Preference Approach Based on the China Health and Nutrition Survey

Objective

Stress is a major public health challenge and is associated with undesirable eating behavior. This cross-sectional study aimed to explore whether there is an association between perceived level of stress and food preference among Chinese adults.

Study Design

Perceived level of stress was measured using the Chinese version of the 14-item Perceived Stress Scale, whereas self-reported food preferences were investigated by means of five food classification questions, including questions regarding the consumption of fast food, salty snacks, fruit, vegetables, and soft/sugary drinks.

Methods

The data were collected from the 2015 China Health and Nutrition Survey. Information of 8,216 adults (≥18 years) on perceived level of stress, self-reported food preferences, and other important covariates was available and analyzed.

Results

Perceived level of stress was negatively associated with a preference for fruit (β = −0.58, 95% CI: −0.81 to −0.34, p < 0.0001) and vegetables (β = −1.13, 95% CI: −1.41 to −0.85, p < 0.0001), while it was positively associated with a preference for fast food (β = 0.36, 95% CI: 0.08–0.64, p = 0.011) and soft/sugary drinks (β = 0.48, 95% CI: 0.30–0.66, p < 0.0001) after adjusting for potential confounders. No association between a preference for salty snacks and perceived level of stress was found in either men or women.

Conclusions

The present population-based study reported strong associations between perceived level of stress and self-reported food preferences among Chinese adults. Sex differences related to this association were also worthy of attention.

Perceived severity of COVID-19, social support, and pandemic-related stress associated with lifestyle changes among undergraduate students in Indonesia

Introduction:

COVID-19 affects lifestyles, including those of undergraduate students who are one of the most vulnerable populations. This study aimed to describe changes in lifestyle-related behaviors and assess the correlation between the perceived risk of COVID-19, social support, perceived stress, and lifestyle changes among undergraduate students during the pandemic.

Design and methods:

A total of 547 students from 32 provinces in Indonesia completed online questionnaires comprising four measures: perceived risk of COVID-19, the Lifestyle-related Behavior Questionnaire, the Multidimensional Scale of Perceived Social Support, and the Pandemic-related Perceived Stress Scale.

Results:

Undergraduate students who lived with their families had healthier lifestyles than students who lived alone ( p = 0.007). Furthermore, The Pearson’s correlation showed a significant correlation between lifestyle changes with perceived severity ( r = 0.107; p < 0.05), social support ( r = 0.237; p < 0.001and pandemic-related stress ( r = −0.304, p < 0.001). Higher perceived severity of COVID-19 and social support were associated with a healthier lifestyle, whereas increased stress correlated with a less healthy lifestyle.

Conclusion:

Psychological factors correlated with lifestyle changes of Indonesian undergraduate students during the pandemic. Therefore, psychological aspects should be more considered by relatives and institutions to ensure healthier lifestyles of students.

Stress eating: an online survey of eating behaviours, comfort foods, and healthy food substitutes in German adults

BACKGROUND

In many people, stress is associated with changes in eating behaviour. Food products consumed during stress (comfort foods) are often unhealthy. It is rather unknown what comfort foods are consumed in Germany and what healthier food products are considered as alternatives to support stress-eaters in making healthier food choices.

METHODS

This online survey was conducted in spring 2021 throughout Germany. Participants were digitally recruited by newsletters, homepages, social media, and mailing lists. The survey included a standardized questionnaire with items concerning e.g. sociodemography, stress, and nutrition. Comfort foods were pre-selected through literature search and food substitutes were defined and discussed by experts. Analyses examined comfort food consumption and substitute preferences dependent on sex, age, body mass index (BMI), and being a self-identified stress-eater. The statistical analysis was performed using R.

RESULTS

Survey participants were mostly female (80.6%, 994/1234), had a mean age of 31.4 ± 12.8 years and a mean BMI of 23.4 ± 4.3 kg/m². Participants stated, that the two favourite comfort foods were chocolate (consumed often/very often by 48.3%, 596/1234) and coffee (consumed often/very often by 45.9%, 566/1234). Regarding food substitutes, the most frequently named alternative food for chocolate and cookies was fresh fruits (for chocolate: 74.4%, 815/1096, for cookies: 62.6%, 565/902). Tea without added sugar (64.4%, 541/840) was the preferred substitute for coffee. Almost 50% of participants (48.1%, 594/1234) identified themselves as stress-eaters, of which 68.9% (408/592) stated to eat (very) often more than usual in subjective stress situations.

CONCLUSIONS

The results from this work suggest that specific comfort foods and substitutes are preferred by the participants in stressful situations. This knowledge about food choices and substitutes should be investigated in further studies to improve eating behaviour in stressful situations.

TRIAL REGISTRATION

The survey was registered in the German Register of Clinical Studies (Registration number: DRKS00023984 ).

Plant-based dietary indices and stress in female college students: a cross-sectional study

Only a few studies have investigated the association between psychological stress and the healthfulness of plant-based diets while accounting for variances in age groups and regions. In light of this, this study aimed to identify the food groups that contribute the most to the relationship between the healthfulness of plant-based diets and psychological stress in female students in Saudi Arabia. This cross-sectional study, which included 401 female college students aged 19-35 years, collected data on blood, anthropometric indices, the perceived stress scale-10 (PSS-10) and diet using the Saudi food frequency questionnaire. An overall plant-based diet index (PDI), healthy PDI, and an unhealthy PDI (uPDI) were defined. Multiple linear regression analyses were applied to examine the associations between PSS-10 and PDI and hPDI and uPDI. No associations between the PSS-10 score and the overall PDI or uPDI scores were found; however, a six-point higher hPDI score was associated with a 0·16-point lower PSS-10 score (95 % CI, -0·24, -0·08) after controlling for lifestyle factors. Moreover, adjustments for healthy food groups, including vegetables and fruits, attenuated the association between the hPDI and PSS-10. In conclusion, healthy plant-based diets are associated with lower psychological stress in young Saudi women. This finding highlights the importance, especially for female students, of following diets that are not only plant-based but are also healthy and rich in fruits and vegetables.

Prevalence and Predictors of Emotional Eating among Healthy Young Saudi Women during the COVID-19 Pandemic

Emotional eating (EE) is prevalent among women and is associated with obesity. The coronavirus 2019 (COVID-19) pandemic and mandatory quarantine increased the risk of mental symptoms and, inferentially, emotional eating (EE). We investigated the EE prevalence and predictors during this pandemic. Overall, 638 women, ages 18-39, completed an online survey incorporating the Emotional Eating Scale, Perceived Stress Scale, Generalized Anxiety Disorder-7 Scale, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index, and Global Physical Activity Questionnaire. We asked about nutrition and collected data on weight, height, and pandemic responses. Most respondents (47.2%) reported low EE; 40.4% were "moderate" and 12.4% "high" emotional eaters; 42.8% reported depression, 27% anxiety, 71% moderate stress, and 12.5% severe stress. The main EE indicators/predictors were fat intake (β = 0.192, p = 0.004), number of meals (β = 0.187, p < 0.001), sugar consumption (β = 0.150, p < 0.001), body mass index (β = 0.149, p < 0.001), stress (β = 0.143, p = 0.004), energy intake (β = 0.134, p = 0.04), and fast food intake frequency (β = 0.111, p < 0.01). EE score correlated negatively with increased family income (β = -0.081, p = 0.049). Higher stress correlated with worse sleep, less sleep, and less physical activity. Emotional eating is common among young Saudi women during the pandemic. We recommend healthy food choices and increased physical activity to improve sleep and mitigate stress.

Association between the Inflammatory Potential of Diet and Stress among Female College Students

A pro-inflammatory diet may have an adverse influence on stress and inflammatory biomarker levels among college students. The dietary inflammatory index (DII^®) is a tool used to assess the inflammatory potential of a diet. However, evidence for the association between DII and stress is limited. We examined the association between energy-adjusted DII (E-DII^TM), high sensitivity-C-reactive protein [hs-CRP], and stress among female college students. This cross-sectional study included 401 randomly selected female students, aged 19–35 years. Data collection included blood, anthropometric measurements, a healthy-history questionnaire, the perceived stress scale (PSS-10), the Saudi food frequency questionnaire (FFQ), and E-DII. Multiple linear regression analyses were used to examine the association between FFQ-derived E-DII score, hs-CRP, and PSS. A higher E-DII score per 1SD (1.8) was associated with a 2.4-times higher PSS score (95% CI: 1.8, 3.1). Higher hs-CRP per 1SD (3.3 mg/L) was associated with a 0.9 (95% CI: 0.7–1.1) times higher PSS score, independent of lifestyle and dietary factors. Our findings indicate that pro-inflammatory diets were highly prevalent among Saudi college students and were associated with higher stress levels. Consideration of the role of stress and focusing on anti-inflammatory foods may be key for healthier dietary habits.

Association Between Sleep Quality and Physical Activity in Saudi Arabian University Students

BACKGROUND

Many studies have documented a strong association between poor sleep quality and physical inactivity. This study evaluates the association between poor sleep quality and physical inactivity among Jazan University students in Saudi Arabia.

METHODS

An observational cross-sectional study was conducted among undergraduate students at Jazan University. Cluster random sampling was used to select 440 students. The Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire (IPAQ), and Depression Anxiety Stress Scales (DASS) were utilized for data collection.

RESULTS

According to the PSQI results, the majority of respondents (63.9%; n = 281) reported having poor sleep quality. The majority of students (62.7%; n = 276) were also physically inactive. Based on DASS-21 criteria, the majority of students (53.4%) were stressed. Sleep quality differed significantly according to participants' physical activity status (p = 0.0090). Among physically active participants, 43.9% reported having good sleep quality. Sleep duration, daytime dysfunctions, and global PSQI differed significantly according to levels of physical activity (p < 0.05 for all). Univariate analysis revealed that being physically active was significantly associated with good sleep quality (OR = 1.70, 95% CI 1.14-2.54, p < 0.001). Multivariate logistic regression models also demonstrated a significant association between physical activity and good sleep quality (OR = 1.72, 95% CI 1.15-2.56, p = 0.008).

CONCLUSION

The majority of Jazan University students had poor sleep quality and were physically inactive. Evidence-based prevention and therapeutic strategies are needed to promote physical activity among university students.