Promoting a Healthy Lifestyle through Mindfulness in University Students: A Randomized Controlled Trial

Consistency between definitions and measurement of mindfulness in eating and physical activity behavior: a scoping review

Mindfulness (i.e., relating to one's internal and external awareness with non-evaluative attitudes) is increasingly applied as a determinant and strategy to change dietary and physical activity behaviours in the general adult population. However, current applications of mindfulness lack methodological standardisation, thereby limiting its comparison. The aim of this study was to examine currently applied conceptual definitions of mindfulness regarding their elements, their measurement, and the consistency between the defined elements and their measurement.Using scoping review methodology, we searched PubMed, PsycINFO, and Web of Science databases for peer-reviewed literature. Definitions were analyzed using an inductive content analysis approach. Consistency between defined elements and measurement was scored on an index. Across 57 records, less than half defined mindfulness as specific to a disposition, state, or action. One third described mindfulness as an attentional process without attitudinal elements. An additional 30% mentioned non-judgment as the singular attitudinal element underlying mindfulness. Empirical articles (n = 45) predominantly assessed dispositional mindfulness as a single score and frequently lacked measurement of defined attitudinal elements or measured elements that were not defined. To advance the systematic investigation of mindfulness, we present a conceptual model describing the measurement selection based on explicitly defined attentional and attitudinal mindfulness elements.

A call for mindfulness-based interventions for cannabis-use disorders

Cannabis use is being increasingly liberalized worldwide, and an increasing prevalence of cannabis-use disorder (CUD) is observed. The few current therapeutic options for CUD are only modestly effective. Mindfulness-based interventions offer promising prospects for the management of substance-use disorders. However, despite proliferating literature on mindfulness and substance use, few studies have explored mindfulness in terms of cannabis use and CUD. There are many possibilities for the implementation of mindfulness-based interventions for cannabis use reduction, especially for younger users, who are more vulnerable to cannabis-related harms. Accordingly, large controlled trials are needed to reliably assess the potential of such interventions.

Prevalence and correlates of generalized anxiety disorder and perceived stress among Sudanese medical students

BACKGROUND

Generalized Anxiety Disorder (GAD) causes significant disturbance in an individual's well-being and activity. Whereby, interfering with the dynamic progress in life. Also, anxiety is a product of stress and a major predictor of academic performance. This study aimed to assess the prevalence of Generalized Anxiety Disorder (GAD), measure levels of anxiety and perceived stress, evaluate the academic profile, identify lifestyle characteristics, and explore the relationship between these factors.

METHODS

In this cross-sectional study, 340 Sudanese medical students filled out online questionnaires, composed of the sociodemographic and lifestyle characteristics, academic profile, Generalized Anxiety Disorder-2 scale (GAD-2), and Perceived Stress Scale-10 (PSS-10). Descriptive and inferential statistics were applied using Statistical Package for Social Science (SPSS) Version 20.0 for data analysis.

RESULTS

Of 340 medical students, 3.8% of them were diagnosed with GAD, while 29.1% scored ≥ 3 in GAD-2, indicating a possible diagnosis. The study found that 9.7% of the participants used addictive substances, with 42% of them having high GAD-2 scores. Moreover, high anxiety levels were associated with high-stress scores (p-value = 0.000). Also, high GAD-2 scores were significantly associated with students who spent less than 10,000 SDG (18 USD) weekly, spent more time on entertainment using smart devices (p-value = 0.004), and had an unhealthy diet (p-value = 0.004). Low anxiety levels were associated with better sleep quality (p-value = 0.00), satisfaction with religious practices (p-value = 0.00), and increased leisure/hobby time (p-value = 0.018). High-stress levels were observed in females (p-value = 0.035), those with lower academic performance satisfaction levels, and increased hours of smart device usage for entertainment (p-value = 0.001). Reduced stress levels were associated with being ≥ 23 years old, increased leisure/hobby time (p-value = 0.002), satisfaction with religious practices [F(3, 166.6) = 10.8, p-value = 0.00)], and having a healthy diet (p-value = 0.006).

CONCLUSION

The low prevalence of GAD corresponded with previous literature, but 29.1% of medical students had a high probability of having GAD. The study emphasizes on providing accessible mental health services for medical students and interventions addressing modifiable risk factors.

Mindfulness to improve the mental health of university students. A systematic review and meta-analysis

Objectives

This systematic review and meta-analysis was to analyze the effects of a mindfulness program on mental health in university students.

Methods

A systematic review was conducted using the databases Pubmed, Scopus, Web of Science and CINAHL. The selected studies had to incorporate a mindfulness intervention in university students. The methodological quality of the collected articles was evaluated using the PEDro scale.

Results

We initially identified 321 studies, of which 21 were included in this review. The interventions focused on mindfulness with durations ranging from 8 weeks to 3 months. The results demonstrated significant effects of a mindfulness intervention on mental health in university students.

Conclusion

This systematic review and meta-analysis found that mindfulness is effective for improving the mental health of college students.

Systematic Review Registration

identifier: CRD42023441453.

Self-care behaviors, drinking, and smoking to cope with psychological distress during COVID-19 among Chinese college students: the role of resilience

OBJECTIVE

College students are vulnerable to psychological distress during COVID-19 due to pandemic-related stressors. In response to psychological distress, college students engage in various coping behaviors, such as self-care behaviors and substance use. The transactional model of stress and coping depicts a cognitive appraisal process in the stress-coping association. Psychological resilience is an essential factor for the cognitive appraisal. This study aimed to investigate the mediation effects of resilience on psycho-behavioral health in response to COVID-19 stressors.

DESIGN

Longitudinal data were collected from 1,225 Chinese college students via web-based anonymous surveys at wave 1 (T1, between Jan 31 and Feb 11, 2020) and wave 2 (T2, between Mar 20 and Apr 3, 2020).

MAIN OUTCOME MEASURES

Participants reported their COVID-19 stressors (T1), resilience (T1), psychological distress (depression and anxiety; T2), and coping behaviors (self-care behaviors, drinking, and smoking; T2). Path analysis was used for data analyses.

RESULTS

Resilience mediated the association between COVID-19 stressors and psychological distress. Resilience together with psychological distress mediated the association of COVID-19 stressors with self-care behaviors or drinking.

CONCLUSIONS

Resilience appears to offer protection that promotes psycho-behavioral health in college students in the face of COVID-19 stressors. Interventions for college students should attend to resilience.

Associations between mind-body practice engagement and diet quality: Exploring the mediating roles of eating behaviour traits and regulation styles for eating behaviours in the PREDISE study

While engaging in Mind-Body Practices (MBPs) may be related to better diet quality, its association with eating behaviours is unclear. This cross-sectional study explores whether eating behaviour traits and regulation style of eating behaviours mediate the association between MBP engagement and diet quality. A total of 418 women and 482 men, aged between 18 and 65 years and recruited as part of the PREDISE study cohort, reported whether they currently practice one or more MBP (e.g., yoga or meditation). Canadian Healthy Eating Index (C-HEI) was calculated from three 24h dietary recalls. Intuitive Eating Scale (IES-2), and Regulation of Eating Behaviour Scale were completed online. Mann-Whitney tests were conducted to compare C-HEI scores of individuals who currently engage in MBPs (practitioners) to those who do not (non-practitioners). Multiple regression analyses and bootstrapping were performed to test whether eating behaviours and regulation style of eating behaviours mediate the association between MBPs and diet quality. Overall, 88 women and 43 men were practitioners. They had higher C-HEI scores than non-practitioners (62.9 ± 13.0 vs. 55.6 ± 14.3; p = 0.001). Parallel mediation model showed significant indirect effects of the IES-2 subscale relating to Body-Food Choice Congruence (β = 1.57, SE = 0.41, 95% CI: 0.86, 2.43), self-determined motivation (β = 1.51, SE = 0.39, 95% CI:0.81, 2.32) and non-self-determined motivation (β = 0.39, SE = 0.21, 95% CI: 0.03, 0.85) on the association between practitioner status and C-HEI. These findings suggest that the current practice of MBPs is associated with better diet quality, mainly through practitioners' higher intuitive eating skills and more self-determined regulation of eating behaviours. Further studies should investigate the potential impacts of MBPs on the development and maintenance of positive eating habits.

A Network Analysis of Multiple Preconception Health Behaviors in Chinese Women

BACKGROUND

A healthy preconception lifestyle, consisting of multiple health behaviors, is crucial for preventing adverse health outcomes in mothers and offspring. Although knowledge about the pattern of inter-behavior relations may provide insights for nudging multiple health behavior changes, this has not been adequately explored in the existing literature. Adopting a network perspective, the present study conceptualized multiple health behaviors as a behavior network (i.e., behaviors as nodes, inter-behavior relations as edges) and utilized network analysis to investigate the pattern of interrelations of preconception health behaviors in a large sample of Chinese women.

METHOD

We used the data of a population-based cohort study in China to estimate the behavior network. An analytic sample included 41,127 Chinese women who were surveyed about their adoptions of multiple health behaviors during the preconception period.

RESULTS

Network analysis revealed a relatively dense behavior network and visualized the network structure of multiple preconception health behaviors. Subsequent centrality analysis identified three central behaviors (i.e., avoiding second- or third-hand smoke, reducing psychosocial stress, and reducing alcohol) that had distinctively stronger connections to other behaviors.

CONCLUSIONS

Preconception health behaviors were strongly interconnected, and certain behaviors had stronger influences than others within the behavior network. Our findings highlight the strong inter-relatedness of preconception health behaviors. This study also encourages targeting the three central behaviors in preconception lifestyle promotions because this may bring more secondary improvements on other non-targeted behaviors and thereby achieve comprehensive lifestyle change.

The effect of Tabata-style functional high-intensity interval training on cardiometabolic health and physical activity in female university students

Introduction: The increasing prevalence of metabolic syndrome and physical inactivity enhances exposure to cardiometabolic risk factors in university students. High-intensity interval training (HIIT) improved cardiometabolic health in clinical adults but the evidence in the university setting is limited. Furthermore, few studies examined the effect of low-volume HIIT on habitual physical activity (PA). Therefore, the primary aim of this study was to evaluate the efficacy of 12-week Tabata-style functional HIIT for improving multiple cardiometabolic health outcomes and habitual PA. We also investigated whether changes in habitual PA over the intervention period had an impact on exercise-induced health outcomes. Methods: 122 female freshmen were randomized into the Tabata group (n = 60) and the control (n = 62). The Tabata training protocol involved 8 × 20 s maximal repeated functional exercises followed by 10 s rest with a frequency of 3 times per week for 12 weeks. Body composition, maximal oxygen uptake (VO_2max), blood pressure (BP), blood lipids, fasting glucose and insulin, C-reactive protein and PA were objectively measured using standardized methods. Dietary intake was measured using a valid food frequency questionnaire. All variables were measured pre- and post-intervention. Results: Mixed linear modelling results showed that there were large intervention effects on VO_2max (p < 0.001, d = 2.53, 95% CI: 2.03 to 3.00 for relative VO_2max; p < 0.001, d = 2.24, 95% CI: 1.76 to 2.68 for absolute VO_2max), resting heart rate (p < 0.001, d = -1.82, 95% CI: -2.23 to -1.37), systolic BP (p < 0.001, d = -1.24, 95% CI: -1.63 to -0.84), moderate-to-vigorous intensity physical activity (MVPA) (p < 0.001, d = 2.31, 95% CI: 1.83 to 2.77), total PA (p < 0.001, d = 1.98, 95% CI: 1.53 to 2.41); moderate effects on %BF (p < 0.001, d = -1.15, 95% CI: -1.53 to -0.75), FM (p < 0.001, d = -1.08, 95% CI: -1.46 to -0.69), high-density lipoprotein (HDL) (p < 0.001, d = 1.04, 95% CI: 0.65 to 1.42), total cholesterol (p = 0.001, d = -0.64, 95% CI: -1.00 to -0.26); small effects on BMI (p = 0.011, d = -0.48, 95% CI: -0.84 to 0.11), WC (p = 0.043, d = -0.37, 95% CI: -0.74 to -0.01), low-density lipoprotein (p = 0.003, d = -0.57, 95% CI: -0.93 to -0.19), HOMA-IR (p = 0.026, d = -0.42, 95% CI: -0.78 to -0.05) and fasting insulin (p = 0.035, d = -0.40, 95% CI: -0.76 to -0.03). Regression analysis showed that only the percentage change of HDL was associated with the change of MVPA (b = 0.326, p = 0.015) and TPA (b = 0.480, p = 0.001). Conclusion: From the findings of the study we can conclude that 12-week low-volume Tabata-style functional HIIT was highly effective for university female students to improve cardiorespiratory fitness, body fat, some cardiometabolic health outcomes and habitual PA.

Mindfulness-Based Movement Intervention to Improve Sleep Quality: A Meta-Analysis and Moderator Analysis of Randomized Clinical Trials

(1) Background: Given that the most effective dose, optimal type, and most beneficial population for improving sleep with mindfulness-based movement (MBM) remains unknown, we conducted a systematic review and meta-analysis with moderator analysis of randomized controlled trials (RCTs) to assess these effects. (2) Methods: Three electronic databases (PubMed, Web of Science, and EBSCO) were systematically searched for RCTs published through August 2021 for analysis. The risk of bias of the included studies was assessed with Review Manager 5.3, and the meta-analysis was performed in Stata 16.0. (3) Results: A meta-analysis of 61 RCTs with 2697 participants showed that MBM significantly improved sleep quality compared to controls (SMD = −0.794; 95% CI: −0.794 to −0.994, p < 0.001, I2 = 90.7%). Moderator analysis showed that a long-term MBM (SMD = −0.829; 95% CI: 0.945 to 0.712; p < 0.001) had a larger effect size on sleep than a short-term MBM (SMD = −0.714; 95% CI: 0.784 to 0.644; p < 0.001). Practicing at least twice per week (SMD = −0.793; 95% CI: −0.868 to −0.718; p < 0.001) was more effective compared to practicing once per week (SMD = −0.687; 95% CI: −0.804 to −0.570; p < 0.001). Studies with a total intervention time of more than 24 h also revealed better sleep quality improvement (SMD = −0.759; 95% CI: −0.865 to −0.653; p < 0.001). In addition, the healthy population and older adults gained more from MBM than the patients and younger adults. (4) Conclusions: MBM can effectively improve subjective sleep quality, and the optimal intervention dose of MBM can be utilized in future intervention studies to treat or improve sleep disturbance (MBM more than twice a week for more than three months, with a total intervention time of more than 24 h).

Age, skin color, self-rated health, and depression associated with co-occurrence of obesogenic behaviors in university students: a cross-sectional study

BACKGROUND

The university context plays an important role in the health-disease process since students are potentially vulnerable to obesogenic behaviors that can influence long-term health.

OBJECTIVE

To estimate the prevalence of and factors associated with the co-occurrence of obesogenic behaviors among university students.

DESIGN AND SETTING

This was a cross-sectional study at a Brazilian public university.

METHODS

This study was conducted with all university students in the first and second semesters of 2019 at Universidade Federal de Ouro Preto, Minas Gerais, Brazil. Data were collected between April and September 2019, using a self-administered questionnaire. The outcome was the co-occurrence of obesogenic behaviors, measured as the sum of three risk behaviors: inadequate eating practices, leisure-time physical inactivity, and sedentary behavior. A Venn diagram was used to evaluate the simultaneous occurrence of risk behaviors. Pearson's chi-square test and multivariate logistic regression were used for statistical analyses.

RESULTS

A total of 351 students participated in the study. Inadequate eating practices constituted the most prevalent isolated risk behavior (80.6%), which was also the most prevalent when combined with sedentary behavior (23.6%). University students aged 20 years or younger, with non-white skin color, poor self-rated health, and symptoms of depression had increased chances of simultaneous occurrence of obesogenic behaviors.

CONCLUSION

These findings highlight the importance of developing and implementing actions to reduce combined obesogenic behaviors in the university environment. Institutions should focus on creating an environment that promotes health-protective behaviors such as physical activity and healthy eating.

Adherence to preventive behaviors among college students during COVID-19 pandemic in China: The role of health beliefs and COVID-19 stressors

Before herd immunity is reached, preventive practices still play an important role in controlling the COVID-19 pandemic. Adherence to preventive behaviors could be determined by individuals' health beliefs, which would be influenced by antecedent factors such as previous exposure to pandemic stressors. Applying the health belief model (HBM), this study aims to examine the mediation association among COVID-19 stressors, HBM constructs, and preventive behaviors. Longitudinal data were collected from 1225 Chinese college students using web-based surveys at wave 1 (w1; between January 31 and February 11, 2020) and wave 2 (w2; between March 20 and April 3, 2020). Participants reported their COVID-19 stressors (w1), five HBM constructs (w2), and preventive behaviors (w1 and w2). Paired t-tests suggested that social distancing and self-quarantine behaviors decreased while precautionary behaviors increased from w1 to w2. Path analysis indicated that two HBM constructs (perceived barriers and self-efficacy) mediated the association between COVID-19 stressors and precautionary behaviors. These findings suggested that tailored prevention intervention for college students should attend to perceived barriers and self-efficacy. Individuals who exposed to multiple pandemic stressors merit particular attention and intervention should account for their early pandemic stress experiences.

Physical Activity Level, Mediterranean Diet Adherence, and Emotional Intelligence as a Function of Family Functioning in Elementary School Students

(1) Background: Family is considered as one of the most important elements for the transmission of healthy habits that improve the lives of students. For this reason, the present study aims to describe the degree of family functionality, emotional intelligence, Mediterranean diet adherence, and extra-curricular physical activity engagement. A further aim is to perform a correlational analysis between these variables. (2) Methods: To this end, an ad hoc questionnaire was used, alongside the APGAR, KIDMED, and Trait Meta Mood Scale (TMMS-24). (3) Results: Finally, the data suggest that a high percentage of students need to improve their diet. Further, students reporting severe family dysfunction showed worse outcomes. Thus, levels of emotional clarity were lower when family functionality was poor. Poor diet quality was also associated with lower emotional attention, with Mediterranean diet adherence being positively related to emotional clarity and repair, as well as normal family functionality. (4) Conclusions: Boys showed higher levels of adherence to the Mediterranean diet adherence, while girls reported higher family functionality. Thus, compliance with the minimum recommendations for physical activity engagement was associated with adequate adherence to the Mediterranean diet. The importance of diet for obtaining an optimal physical condition, adequate emotional state, and family functionality is highlighted.