Food Choice Priorities Change Over Time and Predict Dietary Intake at the End of the First Year of College Among Students in the U.S

Undergraduates' knowledge, attitudes, and behaviours associated with fad diets

PURPOSE

We aimed to determine undergraduate students' use and knowledge of fad diets as well as examine how appealing students found these diets given the goal of rapid weight loss and/or improved health. Twenty-three students from a Midwestern university (mean age = 19.2, mean BMI = 27.35, 69.6% female) were recruited through new student orientations for this qualitative study. Approximately 52% of participants identified as White, 30% as Black, 13% as Asian, and 4% as multi-racial.

METHODS

Knowledge and opinions about fad diets were collected via focus groups and individual interviews. Coding of transcripts was conducted by hand using the constant comparative method and data were analysed based on grounded theory.

RESULTS

Two primary themes emerged: very negative views of fad diets and the importance of healthy eating. Although few participants had tried fad diets, they thought these diets: 1) did not lead to sustained weight loss, 2) were associated with disappointment and health issues, and 3) were money-making schemes delivered heavily through social media. Participants also valued healthy eating.

CONCLUSION

Experimental studies are needed to examine how healthy eating among university students can be supported through credible sources, accurate information, and established connections via innovative social media platforms.

Behavioural determinants of healthy and environmentally friendly diets in French university students

Although encouraging the shift toward sustainable diets in young adults is a major challenge to preserve population and planet health, the precursors of sustainable diets in this population remain unknown. This study aimed to identify the behavioural determinants of healthier and more environmentally friendly diets among university students. A sample of 582 French university students reported their food consumption using an online 125-item food frequency questionnaire. The nutritional quality (adherence to French recommendations, sPNNS-GS2) and the greenhouse gas emissions (GHGE) of students' diets were calculated for an isocaloric diet. Behavioural determinants were measured based on a literature review and classified into the Capability, Opportunity, Motivation Behaviour (COM-B) framework. Linear models, adjusted for socioeconomic characteristics, were run to identify the most prominent behavioural predictors of nutritional quality and GHGE of students' diets. Higher cooking skills (β = 0.38, p = 0.01) and health motives (β = 0.91, p < 0.001) were associated with higher nutritional quality. Greater environmental knowledge was linked to lower GHGE (β = -0.07, p = 0.002), while health and weight control motives were associated with higher GHGE (β = 0.26, p = 0.02 and β = 0.39, p < 0.001). Enhancing cooking skills and environmental knowledge could enable healthy and environmentally friendly diets, but health-based motives can act as a lever and as a barrier.

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.

Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students

BACKGROUND

Promoting healthy and sustainable diets is increasingly important and the Mediterranean Diet (MD) has been recognized as an appropriate example that can be adapted to different countries. Considering that the college years are the time when US young adults are most likely to adopt unhealthy eating habits, the present study assessed adherence to the MD and the sustainability of dietary behaviors in a nationally representative sample of US university students, aiming to identify crucial levers for improving their eating behaviors.

METHODS

MD adherence and the adoption of healthy and sustainable dietary patterns were assessed through the KIDMED and the Sustainable-HEalthy-Diet (SHED Index questionnaires, respectively, administered through an online survey that also included sociodemographic and behavioral questions. Non-parametric and logistic regression analyses were performed.

RESULTS

A sample of 1485 participants (median (IQR) age 21.0 (19.0-22.0); 59% women) correctly completed the survey. A medium adherence to the MD was the most prevalent (47%). According to multivariate logistic regression analysis, the likelihood of being more compliant with the MD increased when meeting physical activity recommendations, having a high SHED Index score, having the willingness to purchase and eat healthy and sustainable dishes, eating ultra-processed plant-based meat alternatives foods daily, and regularly attending the university canteen.

CONCLUSIONS

Encouraging dietary patterns rich in plant-based foods and with a moderate intake of animal products is crucial to increasing the adoption of healthy and sustainable diets, and university dining services represent a suitable setting to build a supportive environment that educates students on human and planetary health.

Persistent and Changing Food Insecurity Among Students at a Midwestern University is Associated With Behavioral and Mental Health Outcomes

PURPOSE

To assess associations between persistent and changing food insecurity and behavioral and mental health outcomes in college students.

DESIGN

Online surveys conducted November 2018 and March 2019 (freshman year), and March 2020 (sophomore year) were used to assess food insecurity, which was then used to create 4 food security transitions: persistent food insecurity, emergent food insecurity, emergent food security, and persistent food security.

SETTING

Large Midwestern university.

SAMPLE

593 students completing all 3 surveys.

MEASURES

Dietary intake and behavioral and mental health outcomes (eating disorders, anxiety, depression, sleep quality) were assessed using validated instruments.

ANALYSIS

Associations between food security transitions and dietary intake, behavioral, and mental health outcomes were examined using generalized linear models.

RESULTS

Compared to persistent food security, emergent and persistent food insecurity was associated with lower (7% and 13% respectively) intake of fruits and vegetables combined; persistent food insecurity was associated with 17% lower intake of fruits, 6% lower intake of fiber and 10% higher intake of added sugar from beverages. Compared to persistent food secure students, eating disorder symptom risk was higher for emergent food insecure (OR = 7.61, 95% CI: 3.32, 17.48), and persistent food insecure (OR = 6.60, 95% CI: 2.60, 16.72) students; emergent (OR = 2.05, 95% CI: 1.14, 3.71) and persistent (OR = 2.55, 95% CI: 1.34, 4.87) food insecure students had higher odds of poor sleep quality, and persistent food insecure, emergent food insecure, and emergent food secure students had higher odds of anxiety and depression (OR range 2.35-2.85).

CONCLUSION

Food security transitions were associated with aspects of low diet quality and poorer behavioral and mental health outcomes among college students.

Gastrointestinal distress, State and Trait anxiety, and dietary intake among college students during the COVID-19 pandemic

OBJECTIVE

This study examined the impact of State and Trait anxiety and dietary intake on college students' gastrointestinal symptoms during the COVID-19 pandemic.

PARTICIPANTS

A total of 455 students, aged 18-23, from two residential colleges in the midwestern United States participated in the study during April 2021.

METHODS

An online questionnaire that included the National Cancer Institute Dietary Screener, State-Trait Inventory for Cognitive and Somatic Anxiety, and an adapted version of the Gastrointestinal Symptoms Questionnaire was used. Stepwise multiple regression analyses and Spearman rho correlation coefficients were used to analyze the data.

RESULTS

High rates of State-somatic, State-cognitive, and Trait-somatic anxiety were present in our study population. These anxiety subscales and dietary intake predicted 26% and 3.8% of the GI symptoms variance, respectively.

CONCLUSION

State-anxiety and Trait-somatic anxiety are large factors in predicting GI symptoms compared to dietary intake. College students could seek anxiety-reducing techniques to ease GI symptoms.

The rewards US university students associate with campus dining halls and food choices

Objective: To understand the rewards university students associate with two key decisions shaping food choices. Participants: Thirty-eight university students. Methods: In this exploratory research, we conducted focus groups to identify the rewards students associated with choosing to eat at the campus dining hall and their specific food choices within that venue. We also obtained feedback on reward nomenclatures identified via a content analysis of health and business literature. Results: Students primarily chose the dining hall due to its convenience, foods offered, and the social aspects of the venue. Rewards associated with food choice included freshness, customization, variety, local foods, healthy foods, convenience, and portion size. Nomenclatures were relevant and meaningful. Conclusions: These students associate food choice decisions with rewards. Universities should consider whether dining halls and menu items link healthy foods to the rewards prioritized by students. Reward nomenclatures may be useful for researchers investigating the drivers of food choice.

The influence of diet quality on health-related quality of life in undergraduates

Objective: Explore the relationship between fruit and vegetable (FV) intake and health-related quality of life (HRQOL) in undergraduates. Participants: Undergraduates (N = 655). Methods: Using the Centers for Disease Control's Healthy Days Core Module and National Cancer Institute's (NCI) FV screener, differences in HRQOL between students who had consumed above the sample's average FV intake and their counterparts were evaluated. Multiple regression analyses assessed behaviors that predicted HRQOL. Results: Differences existed between HRQOL of students who consumed above average FV (M = 2.2 1.3) and peers, F(9,602) = 509, p < 0.001, Wilk's Δ = 0.116, partial n2 = 0.884. Predictors explained 30.0% of the variance in days per month feeling healthy (r2 = 0.29, F(4, 549) = 58.6, p < 0.001): perceived stress (β = 0.46, p < 0.001), body mass index (BMI) (β = 0.11, p < 0.01), FV intake (β = 0.16, p < 0.001), and sleep duration (β = 0.08, p < 0.05). Conclusions: FV intake and modifiable behaviors influenced HRQOL, suggesting that multifaceted interventions could improve HRQOL in this population.

Are Future Doctors Prepared to Address Patients' Nutritional Needs? Cooking and Nutritional Knowledge and Habits in Medical Students

Background. Many diseases are linked to lifestyle in the United States, yet physicians receive little training in nutrition. Medical students' prior knowledge of nutrition and cooking is unknown. Objective. To determine incoming medical students' prior nutrition knowledge, culinary skills, and nutrition habits. Methods. A dual-methods study of first-year medical students. Cross-sectional survey assessing prior knowledge, self-efficacy, and previous education of cooking and nutrition. Interviews of second-year medical students explored cooking and nutrition in greater depth. Results. A total of 142 first-year medical students participated; 16% had taken a nutrition course, with majority (66%) learning outside classroom settings. Students had a mean score of 87% on the Nutritional Knowledge Questionnaire versus comparison group (64.9%). Mean cooking and food skills score were lower than comparison scores. Overall, students did not meet guidelines for fiber, fruit, vegetables, and whole grains. Interviews with second-year students revealed most learned to cook from their families; all believed it important for physicians to have this knowledge. Conclusions. Medical students were knowledgeable about nutrition, but typically self-taught. They were not as confident or skilled in cooking, and mostly learned from their family. They expressed interest in learning more about nutrition and cooking.

Understanding changes in eating behavior during the transition to university from a self-determination theory perspective: a systematic review

Objective: The objective of this systematic review was to understand how and why eating behavior changes during the transition to university, and interpret findings from a self-determination theory perspective (Ryan & Deci, 2000). Methods: We searched six databases and identified 51 articles with findings involving changes in eating behavior during the transition to university. Results: During this transition, students eat less food, less healthy, and less regularly. These changes are mostly among students who move into a university residence or off-campus housing, with few changes in eating behavior among students who continue living at home. Yet, incoming students with food skills and experience living independently seem less likely to experience these changes. Conclusions: The university context offers challenges to eating healthy. Students' satisfaction of psychological needs may explain observed changes in habits, self-regulation, and motivation.

Nutritional intake and metabolic parameters of Japanese university students with and without obesity: Sex-specific differences

OBJECTIVE

To establish effective methods of obesity prevention among young adults, we analyzed the relationship between obesity-related food intake and metabolic factors in Japanese university students.

METHODS

We performed a cross-sectional analysis of nutrient intake information and metabolic parameters among 1,206 Gifu University students categorized by body mass index.

RESULTS

The overweight/obesity rate was significantly higher in males. Additionally, among males, the intake of protein, potassium, magnesium, phosphorus, iron, zinc, all lipids/fats, and all metabolic parameters including blood sugar, hemoglobin A1c, uric acid, alanine aminotransferase, aspartate aminotransferase, low-density lipoprotein, high-density lipoprotein, triglycerides, and blood pressure significantly differed between the obese and non-obese groups. However, the same comparison among females revealed no significant differences in nutrient intake and significant differences in only half of the parameters. Among males, energy intake from protein and fat was significantly higher in the obese group, while the percentage of total energy intake from carbohydrates and fat was lower and higher, respectively, among females in the obese group.

CONCLUSIONS

Overeating of protein and fat in males and unbalanced nutrition in females are sex-specific characteristics of Japanese university students with obesity, and metabolic abnormalities in students with obesity are more remarkable in males than in females.

What's to Eat and Drink on Campus? Public and Planetary Health, Public Higher Education, and the Public Good

Public higher education institutions (PHEIs) have a unique and important role in responding to the public and planetary health crisis-they are centers of research on public and planetary health and of learning for young people, and have a public good mission. Yet, PHEI campus food environments are predominantly unhealthy and environmentally unsustainable, and associated with unhealthy food choices and unhealthy students. PHEIs are addressing high levels of student food insecurity (FI) that disproportionately affect the most vulnerable groups. Yet, because student FI is measured as individual access to adequate quantities of food, campus responses to FI often overlook unhealthy food environments. These environments result from neoliberal PHEI business policies that prioritize short-term revenue and encourage superfluous consumption, and unhealthy, environmentally harmful diets. PHEIs need to move beyond neoliberalism to honor their public good mission, including prioritizing health, the environment, and equity, in decisions about food on campus. My goal in this perspective is to encourage inclusive campus discussion about why this change is required to adequately respond to the crisis of student, public, and planetary health, and about how to begin.

Adolescent Knowledge, Attitudes and Practices of Healthy Eating: Findings of Qualitative Interviews among Hong Kong Families

To tackle unhealthy eating among adolescents, it is crucial to understand the dietary knowledge, attitudes, and practices (KAP) on which adolescent eating habits are based. This qualitative study identifies the gaps in KAP by exploring what Chinese adolescents know, perceive, and practice regarding healthy eating to better inform targeted interventions for this important health problem. Parent–adolescent dyads were purposively sampled based on, for example, the dietary intake, age, and gender of the adolescent and household income, and each completed a 30 to 60 min interview. Twelve themes were synthesized: knowledge: (1) dietary recommendations, (2) health outcomes of healthy eating, (3) nutrition content in food, and (4) access to healthy meals; attitudes: (5) outcome expectation for healthy eating, (6) food preferences, and (7) self-efficacy regarding adopting healthy eating; and practices: (8) going grocery shopping for healthy food, (9) eating home-prepared meals. (10) eating out in restaurants or consuming takeaway food, (11) fruit and vegetable consumption, and (12) snacking, perceived unhealthy eating to be low risk, made unhealthy choices regarding snacking and eating out, and had insufficient fruit and vegetable intake. Programs should emphasize the positive short-term health outcomes of healthy eating and empower adolescents to acquire food preparation skills to sustain healthy eating habits.

Life of a vegetarian college student: Health, lifestyle, and environmental perceptions

Objective To examine health behavior and environmental perception differences among vegetarian and nonvegetarian students. Participants: First-year university students (n = 1078) from eight United States universities. Methods: Data were obtained from base 2015 and followup 2016 assessments. Vegetarians and nonvegetarians were compared for anthropometrics, lifestyle behaviors, and campus environmental perceptions (CEPS). Results: Vegetarians had smaller waist circumference, lower systolic blood pressure, higher fruit and vegetable consumption, lower percentage of energy obtained from fat, and higher perceived stress. Vegetarians expressed a lower rating of perceptions of health policies on campus. Conclusion: A clear difference in indicators of physical health does not appear, however, vegetarian students show positive dietary patterns which can promote positive health outcomes. Further, vegetarians had lower perceptions of health policies on campus. Results can be used by administrators to ensure policies are in place to support health of students as currently vegetarian students see limitations in the environmental health policies.

Dietary Intake of Adult Residents in Luxembourg Taking Part in Two Cross-Sectional Studies-ORISCAV-LUX (2007-2008) and ORISCAV-LUX 2 (2016-2017)

Background: A balanced diet is an important lifestyle component and has been associated with a reduced risk of chronic diseases. Objectives: To assess dietary intake of adult residents in Luxembourg taking part in two population-based cross-sectional studies (ORISCAV-LUX, 2007–2008 and ORISCAV-LUX 2, 2016–2017). Methods: Dietary intake of the study participants (1242 in 2007/08 and 1326 in 2016/17), 25–69 years old, were evaluated using food-frequency questionnaires (134 items in 2007/2008 and 174 items in 2016/2017) according to the French ANSES-CIQUAL food composition database. Both food-group- and nutrient-based analyses were conducted. Results: Dietary patterns in ORISCAV-LUX 2, 2016–2017, were characterized by an increase in the estimated marginal means (EMM) of the intake of energy, total fat, saturated fatty acids, alcohol, and decreased EMM of total carbohydrates, magnesium, and calcium compared to 2007/08. We also observed an increased EMM of the intake of protein-rich food items and ready-to-eat foods/fast foods, together with a decreased intake of grains, dairy products, and vegetables (all p-values <0.05, linear mixed models). The intake of most micronutrients was stable or slightly increased in ORISCAV-LUX 2 vs. ORISCAV-LUX, except for the drop in magnesium and calcium, and generally met recommendations, in particular, EFSA population reference intakes (PRI), except for vitamin D. Conclusions: Though most micronutrient recommendations were met, nutrient consumption in terms of high energy, total fat, and sodium, as well as low carbohydrates, were not aligned with recommendations for balanced eating.

Brief, effective experience to increase first-year medical students' nutrition awareness

Background: Wellness is an important concept for medical students to learn, both for their own health and for their patients. Since nutrition is an essential part of one's wellness that can positively or negatively impact one's health, it is important for medical students to learn approaches to nutritional wellness. Studies have shown that physicians' nutrition attitudes and clinical practices are positively correlated with their dietary practices.Objective: Here, we describe a brief nutrition-based education experience for first-year students offered at the start of the medical school curriculum that is designed to increase their nutrition awareness.Design: The nutrition experience involved five components: 1) having students complete three 24-hour food recalls; 2) comparing their recalls to nutrient standards; 3) emphasizing strategies that include simple, nutritionally sound food choices and preparation; 4) surveying students on their implementation of personal healthy nutritional strategies; and 5) requesting future recommendations for modifying the educational experience.Results: Most students' diets did not meet the recommended dietary levels for several nutrients, and these deficiencies corresponded to specific food group inadequacies. Forty percent of the students responded to a three-month follow-up survey. Of these students, 46% implemented one of the presented strategies to improve their food intake. Most changes included the addition or deletion of a particular food. Seventy-three percent recommended repeating the program in the future.Conclusions: We demonstrate that a brief 2.5-hour nutrition wellness experience can increase nutrition awareness and promote dietary change in incoming medical students. Many felt that the experience was valuable and recommended offering a similar experience to future classes.

Fruit and vegetable consumption in relation to primary headaches: the MEPHASOUS study

BACKGROUND

Fruit and vegetable consumption may beneficially affect the odds of primary headaches due to their antioxidant contents. However, no study has examined the association between fruit and vegetable consumption and primary headaches among university students.

AIM

To assess the relation between fruit and vegetable intakes and primary headaches among Iranian university students.

METHODS

Overall, 83,214 university students with an age range of ≥ 18 years participated in the present study. Dietary intakes and also data on confounding variables were collected using validated questionnaires. Data on dietary intakes were collected using a validated dietary habits questionnaire. We used the International Classification of Headache Disorders-3 (ICHD-3) criteria to define primary headaches.

RESULTS

Fruit consumption was negatively associated with primary headaches; such that after controlling for potential confounders, greater intake of fruits was associated with 30% lower odds of primary headaches (OR: 0.70, 95% CI 0.58-0.84). Such an inverse association was also found for vegetable consumption. In the fully adjusted model, students in the top category of vegetable consumption were 16% less likely to have primary headaches compared with those in the bottom category (OR: 0.84, 95% CI 0.74-0.95). Subgroup analysis revealed that fruit consumption was inversely associated with primary headaches in females, unlike males, and vegetable consumption was inversely associated with these headaches in males, as opposed to females. Moreover, fruit and vegetable consumption was related to lower odds of primary headaches in normal-weight students.

CONCLUSION

Fruit and vegetable intakes were associated with reduced odds of primary headaches.

LEVEL OF EVIDENCE

Level III, cross-sectional analytic studies.

College Students' Views on Functional, Interactive and Critical Nutrition Literacy: A Qualitative Study

This research aimed to uncover how the nutrition literacy domains (functional, interactive, critical) influence the dietary decisions of young adults in college. For this qualitative study, undergraduate college students aged 18-24 years old (n = 24) were recruited to participate in focus groups. The focus group transcripts were independently coded for primary and secondary themes using a grounded theory approach and a basic thematic analysis. Four focus groups with 5-7 participants per group were conducted. The three domains of nutrition literacy emerged in the focus groups with two themes per domain. Themes within functional nutrition literacy included 'food enhances or inhibits good health' and 'components of a healthy diet'; themes within interactive nutrition literacy included 'navigating the college food environment' and 'awareness of food marketing on dietary behavior'; themes within critical nutrition literacy included 'critical appraisal of nutrition information' and 'awareness of societal barriers to good health'. Understanding how the different nutrition literacy domains relate to college students' food choices can inform future researchers on how to appropriately assess nutrition literacy and design programs aimed at improving dietary behaviors of college students.

Breakfast consumption is inversely associated with primary headaches in university students: The MEPHASOUS study

OBJECTIVE

This study was conducted to examine the association between breakfast consumption pattern and primary headaches in a large population of university students.

METHODS

This cross-sectional study was done on the MEPHASOUS dataset that contained the information of 83,677 university students, aged ≥18 years, from 28 provinces of Iran. Dietary intakes and breakfast consumption pattern were assessed using a validated self-administered dietary habits questionnaire. Primary headaches were determined according to the International Classification of Headache Disorders-3 (ICHD-3) criteria. Binary logistic regression in different adjusted models was used to assess the association between breakfast consumption and primary headaches.

RESULTS

The mean age of participants was 21.50 ± 4.01. Primary headaches were prevalent among 9% of university students. A significant inverse association was seen between breakfast consumption and odds of primary headaches [odds ratio (OR): 0.57, 95 % confidence interval (CI): 0.51-0.62]. This association remained significant even after taking potential confounders into account; such that students who consumed breakfast frequently had 26 % lower odds of primary headaches compared with those who consumed it <1 day/week (OR: 0.74, 95 % CI: 0.65-0.85). Moreover, such a significant inverse association was observed in female students (OR: 0.54, 95 % CI: 0.49-0.61) as well as those with BMI < 25 kg/m² (OR: 0.68, 95 % CI: 0.58-0.79). However, it became non-significant in male students and those with overweight or obesity.

CONCLUSION

We found that frequent breakfast consumption is associated with a decreased odds of primary headaches in female students and those with BMI < 25 kg/m². Further prospective studies are needed to confirm our findings.

Exploring the association between mental wellbeing, health-related quality of life, family affluence and food choice in adolescents

Young people choose energy-dense, nutrient-poor diets, yet understanding of potential determinants is limited. Associations between food choices, mental wellbeing, health-related quality of life (HRQoL) and family affluence were explored to identify targets for intervention to promote dietary health and wellbeing in young people. Adolescents were recruited via post-primary schools in the UK and surveyed at two time-points when aged 13-14 years and 15-16 years. The questionnaire enquired about mental wellbeing using the Short Warwick-Edinburgh Mental Wellbeing Scale, HRQoL using the KIDSCREEN-10, socio-economic status using the Family Affluence Scale and food choice by Food Frequency Questionnaire (FFQ). With missing and anomalous cases excluded, the sample comprised 1208 cases. Factor analysis on the FFQ indicated five food choice factors: 'Junk Food'; 'Meat'; 'Healthy Protein'; 'Fruit/Vegetables'; 'Bread/Dairy'. Multivariate regression analysis indicated that frequent consumption of Junk Food was associated with being male and lower mental wellbeing. Frequent Meat intake was associated with being male and with lower HRQoL. Frequent choice of Bread/Dairy foods was more common among males and associated with higher wellbeing and greater affluence. Those who consumed Fruit/Vegetables frequently were more likely to be female, have higher HRQoL, higher mental wellbeing, and greater family affluence. These direct associations endured between time points. The dietary factors were not mutually exclusive. Those who frequently chose Junk Food were less likely to choose Fruit/Vegetables. Frequent choice of Meat was associated with more frequent choice of Junk Food and Healthy Protein. Intervention to improve dietary and psychological health in young people should target males, those in less affluent households, seek to reduce consumption of 'junk' food, and increase fruit and vegetable intake.

Beyond Body Weight: Design and Validation of Psycho-Behavioural Living and Eating for Health Segments (LEHS) Profiles for Social Marketing

Obesity, sedentary behaviour, and poor dietary habits amongst young adults are growing concerns, with this age group being in a worse state of health and nutrition than adolescents and adults. This paper presents the procedures for establishing a new instrument for defining behaviours in relation to healthy lifestyle and food choices amongst young adults (Living and Eating for Health Segments: LEHS). The aim of this paper is to outline the instrument design protocol for external validation and to permit replication in other studies. The instrument design process used a multi-step social marketing instrument design method. This approach has previously been used in designing valid and reliable measures in marketing and consumer research, including social marketing. The protocol established six psycho-behavioural LEHS profiles for young adults. These profiles are: Lifestyle Mavens (15.4%), Aspirational Healthy Eaters (27.5%), Balanced-all Rounders (21.4%), Health Conscious (21.1%), Contemplating Another Day (11.2%), and Blissfully Unconcerned (3.4%). Each of these profiles provided insights into psycho-behavioural characteristics that can be used in designing apposite social media social marketing campaigns.

Sugar-sweetened beverages consumption in relation to hypertension among Iranian university students: the MEPHASOUS study

PURPOSE

This study aimed to assess the link between sugar-sweetened beverages (SSBs) consumption and hypertension among a large population in the Middle East.

METHODS

In this cross-sectional study (a part of Mental and Physical Health Assessment of University Student: MEPHASOUS study), 66,634 university students from all provinces of Iran, aged ≥ 18 years, were included. A self-administered dietary habits questionnaire was used to assess SSBs consumption as well as other dietary intakes. Participants were categorized based on three levels of SSB consumption: < 1 time/wk, 1-3 times/wk, and ≤ 3 times/wk. Hypertension was defined as systolic blood pressure (SBP) of ≥ 140 and diastolic blood pressure of ≥ 90.

RESULTS

Compared with those in the bottom category, students in the top category of SSBs consumption were more likely to have hypertension (OR 1.71, 95% CI 1.54-1.90). This association remained significant even after adjusting for confounding variables; such that participants in the highest category of SSBs consumption had 2.17 times greater odds of hypertension compared with those in the lowest category (OR 2.17, 95% CI 1.91-2.47). Stratified analysis based on gender and BMI status revealed such significant association in men (OR 2.12, 95% CI 1.79-2.50) and women (OR 2.03, 95% CI 1.67-2.48), and in all categories of BMI including students with underweight (OR 2.53, 95% CI 1.81-3.52), normal-weight (OR 2.13, 95% CI 1.81-2.51), overweight (OR 2.14, 95% CI 1.58-2.89) and obesity (OR 1.59, 95% CI 1.00-2.53).

CONCLUSION

Our results support previous findings indicating a significant positive association between SSBs consumption and hypertension.

LEVEL OF EVIDENCE

Level III, cross-sectional analytic studies.

Promoting Wellness Through Mobile Health Technology in a College Student Population: Protocol Development and Pilot Study

Background

The health and well-being of college students has garnered widespread attention and concern in recent years. At the same time, the expansion and evaluation of digital technologies has grown in recent years for different target populations.

Objective

This protocol aims to describe a pilot feasibility study on wearables to assess student interest and to gather baseline data from college freshmen, for the academic year 2019 to 2020.

Methods

All full-time college freshmen residing in a single residence hall were eligible to participate. Study invitations were sent by post and email 5 weeks prior to move-in. Web-based enrollment and in-person attendance at study orientation sessions were mandatory. We provided the incoming freshmen with a wearable and study app. Wearable data and weekly survey data will be collected through the study app and analyzed. We have collected demographic, enrollment, and attrition data and the number and type of support requests from students.

Results

The planning phase of the WearDuke initiative was completed in 2018 to 2019, and the pilot study was launched in July 2019. Of the 175 students invited, 120 enrolled and 114 started the study; 107 students remained active participants till the end of the fall semester. For Apple Watch participants (the majority of study population), weekly survey completion rates ranged from 70% (74/106) to 96% (95/99).

Conclusions

Halfway through the pilot, we noticed that the initiative has been received positively by the students with minimal attrition. The short- and long-term benefits may be substantial for students, the campus, the utilization of health services, and long-term health.

International Registered Report Identifier (IRRID)

DERR1-10.2196/16474

Language of Health of Young Australian Adults: A Qualitative Exploration of Perceptions of Health, Wellbeing and Health Promotion via Online Conversations

Young adults (YA) are in a critical stage of life for the encouragement of healthy behaviours such as healthy eating and exercising. This research explored Australian YA values and perceptions related to health, healthy behaviours and health promotion efforts. This qualitative analysis involved n = 166, Australian 18–24 year-olds recruited through a market research field house. Participants (63% currently studying at tertiary level) engaged in a facilitated in-depth online conversation around health and healthy eating over four weeks. Leximancer^TM and manual inductive thematic coding were utilised for analysis via the lens of emerging adulthood and health communication theories. Health was seen as multi-faceted, with particular importance placed on mental health and exercise. Some participants focussed on physical appearance, often fuelled by comparison to others. Many believed that at their age and health status, adopting health-enhancing behaviours without short-term tangible benefits was not a priority. Participants did not prioritise health-enhancing behaviours due to barriers such as a perceived lack of money, knowledge and time often due to studying or working and perceived effort. Strategies they proposed to encourage healthy eating included: incentivising healthy food; quick and affordable healthy recipes; and communicating the short-term tangible benefits of healthy behaviours. There is a need for focussed health messaging that address the needs and desires of YA and directly address the barriers they face.

Dairy Consumption in Relation to Hypertension Among a Large Population of University Students: The MEPHASOUS Study

BACKGROUND

Hypertension is a chronic condition that its prevalence is increasing at an alarming rate. Findings on the association between dairy consumption and hypertension are conflicting and few data are available in the Middle East.

AIM

To assess the association between dairy consumption and hypertension among a large population of university students.

MATERIALS AND METHODS

The current study was performed in the framework of the Mental and Physical Health Assessment of University Student (MEPHASOUS) project. Overall, 67,011 university students with complete information were included in the statistical analysis. To assess dairy consumption, a self-administered dietary habits questionnaire was employed. Blood pressure was measured using a standard protocol. The systolic/diastolic blood pressure of ≥140/90 mmHg was considered hypertension.

RESULTS

Hypertension was prevalent among 6.9% of students. A significant inverse association was found between dairy consumption and the odds of hypertension; such that after taking potential confounders into account, individuals in the highest levels of dairy consumption had 85% lower odds for having hypertension compared with those in the lowest levels (odds ratio (OR): 0.15, 95% confidence interval (CI): 0.13-0.18). Such an inverse association was also seen among males (OR: 0.14, 95% CI: 0.11-0.18) and females (OR: 0.16, 95% CI: 0.12-0.21), normal-weight students (OR: 0.15, 95% CI: 0.12-0.18) and those with overweight or obesity (OR: 0.15, 95% CI: 0.11-0.21), and individuals with (OR: 0.13, 95% CI: 0.11-0.16) and without (OR: 0.24, 95% CI: 0.17-0.35) family history of hypertension.

CONCLUSION

Our results support the previous findings on the inverse association between dairy consumption and hypertension among university students.