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

Assessing Lifestyle in a Large Cohort of Undergraduate Students: Significance of Stress, Exercise and Nutrition

BACKGROUND/OBJECTIVES

Lifestyle (in particular, nutrition and exercise) determines present and future youths' health. The goal of the present study was to identify specific student groups who deserve precise lifestyle improvement interventions, tailored to their characteristics.

METHODS

An anonymous web-based questionnaire to assess lifestyle was posted on the websites of two main Italian Academic Institutions, and 9423 students voluntarily participated. A personalised immediate report was provided to improve compliance/motivation. We assessed age, sex, affiliation, anthropometrics, lifestyle components (nutrition, exercise, sedentariness, stress perception, smoking, alcohol, sleep), and the desire to be helped with lifestyle improvement. Cluster analysis was performed to identify healthy lifestyle groups among the students.

RESULTS

In total, 6976 subjects [age: 21 (20, 23) yrs; 3665 female, 3300 male] completed the questionnaire and were included. Of these students, 73.9% expressed the need for lifestyle improvement help, particularly for becoming physically active (66.7%), managing stress (58.7%), and improving nutrition (52.7%). We unveil three clusters of subjects, each corresponding to a distinct lifestyle pattern. The clusters are differentiated by exercise level and perceptions of stress/fatigue/somatic symptoms (cluster 1: 74.8% meet international exercise guidelines (IEGs), 67.4% have high stress perception, 49.1% drink 1-3 glasses of wine/beer per week, and 63.3% drink 0-1 glass of spirits per week; cluster 2: 75.6% meet IEGs, 75.7% have low/medium levels of stress perception, and 65.8% have low alcohol consumption; cluster 3: 72.5% do not meet IEGs, 77.6% have high stress perception, and 67.5% have low alcohol consumption). More active students present lower stress/somatic symptoms perception. Interestingly, the AHA diet score (nutrition quality) was not in the ideal range in any cluster (nevertheless, obesity was not of concern), being worst in cluster 3, characterized by higher stress perception (59.7% had poor nutrition quality). Those who were physically active but showed a high stress/fatigue perception were used to drinking alcohol.

CONCLUSIONS

Students desire help to improve their lifestyle, and this approach might help identify specific student groups to whom LIs in Academic Institutions can be tailored to foster well-being and promote health.

Unhealthy Eating Habits and Determinants of Diet Quality in Primary Healthcare Professionals in Poland: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

The aim of this work was to understand the factors influencing the prevalence of dietary behaviors, as well as determinants of unhealthy eating and diet quality among primary care physicians and nurses in Poland.

METHODS

A cross-sectional study involving 161 doctors and 331 nurses was conducted in the years 2020-2022 in primary healthcare settings.

RESULTS

Unhealthy eating habits affected GPs aged 40-54 years (42.9%), females (64.3%), those of normal body weight (67.9%), representing private medical practice (67.9%), who had over 20 years of work experience (42.8%). Similarly, among the group of nurses, unhealthy eating habits were reported in subjects aged 40-54 (46.5%), individuals with normal body weights (49.5%), those with one chronic disease (38.4%), representing public medical practice (63.6%), with over 20 years of work experience (40.4%), seeing ≤100 patients during the work week (84.8%). The univariable logistic regression analyses for unhealthy dietary habits showed that overweight GPs had lower odds of unhealthy eating habits (OR = 0.35; 95% CI: 0.11-1.08; p < 0.05). Among the nurses, the odds of unhealthy eating habits increased with the number of years of work. Nurses with 10-20 years of work experience had 1.23 times greater odds of unhealthy eating habits, while people working for more than 20 years had 1.81 times greater odds of unhealthy eating habits than individuals working for a period shorter than ten years (OR = 1.23; 95% CI: 0.68-2.23; p > 0.05 vs. OR = 1.81; 95% CI: p < 0.05). The multivariable logistic regression analysis did not show statistically significant results.

CONCLUSIONS

These issues should be addressed when planning educational activities aimed at supporting healthcare professionals in implementing lifestyle changes.

Determinants of Weight Status and Body, Health and Life Satisfaction in Young Adults

Health behaviors include behavioral patterns and habits that relate to health maintenance, restoration and improvement. They do not only affect the physical condition; they are also associated with life satisfaction. In our study, we focused on young adulthood, a specific lifespan period for establishing long-term health behavior patterns. The aim of the present study was to investigate depressive symptoms, lifestyle and eating behaviors and delineate their associations with overweight/obesity and body, health and life satisfaction in young adults in Poland. We enrolled 800 students (81.4% females and 18.6% males). Diet, physical activity, depressive symptoms, eating behaviors and body, health and life satisfaction were assessed. Multivariate logistic regression models were employed. Almost half of the participants in our study had at least mild symptoms of depression. Symptoms of depression significantly reduced the odds of satisfaction with body, health and life, whereas physical activity increased them. Overweight/obesity significantly reduced the odds of body and health satisfaction. In women, a history of depression and emotional eating increased the odds of being overweight/obese. The results of our study may contribute to the development of educational programs and intervention strategies for young adults.

Dietary Behavior and Determinants of Diet Quality among Primary Health Care Patients in Poland

BACKGROUND

The aim of the present research was to determine the factors influencing the prevalence of eating behaviors, diet quality, and unhealthy eating among primary healthcare patients in Poland.

METHODS

The cross-sectional study included 896 adult primary care patients in Łódź. The study was conducted from January 2020 to December 2021 among thirty-four primary healthcare facilities. A survey recorded the sociodemographic data of the respondents as well as data regarding their health condition and diet.

RESULTS

The majority of the respondents (57.6%) had average dietary habits, while 40% had unhealthy eating habits. The univariable logistic regression found that primary care patients with medium/secondary education had a 1.5 times greater risk of unhealthy eating habits, and those with post-secondary vocational education had a 1.75 times greater risk of unhealthy eating habits than those with higher education (OR = 1.46; 95% CI: 1.08-1.97, p ≤ 0.01, and OR = 1.75; 95% CI: 1.04-2.94, p ≤ 0.05). The multivariable logistic regression confirmed that the level of education had a significant impact on dietary habits: for medium/secondary education, OR = 1.40; 95% CI: 1.03-1.91 (p ≤ 0.01); for post-secondary vocational education, OR = 1.69; 95% CI: 1.0-2.85 (p ≤ 0.05).

CONCLUSIONS

The education level was significantly correlated with the prevalence of unhealthy eating behaviors in the studied population. This factor should be considered in the promotion of healthy eating behaviors and nutritional counseling interventions conducted by family physicians in primary health care.

Weight biases, body image and obesity risk knowledge in the groups of nursing students from Poland and Nigeria

Each population may have its own specific characteristics and cultural differences, which can affect perceptions of one's body, obesity, and the development of weight-related biases. The goal of our study is to (I) examine weight biases among incoming nursing students from two distinct cultures; (II) determine whether the cultural differences may be reflected in the levels of fat phobia, attitudes, and behaviors related to overweight and obesity; (III) adapt the Fat Phobia Scale and translate it into Polish. The study includes 119 Nigerian students and 120 Polish students. The following tools are used-ORK-10, ATOP, BAOP, BES and FPh. The results indicates that Nigerian students have significantly (p < 0.01) less knowledge about the risks associated with overweight and obesity. In contrast, they have a significantly (p < 0.01) more positive body image than the Polish students. Among Nigerian students, men have more positive body image in comparison to women (p = 0.01). An inverse relationship is observed in the group of Polish students, among whom women had a more positive body image than men did (p = 0.01). There are no statistically significant differences in fatphobic attitudes among the studied groups. It has been observed, that culture may be related to weight biases.

Diet Inflammatory Index among Regularly Physically Active Young Women and Men

Recently, special attention has been paid to the relationship between diet and inflammation in the body. A factor that influences both diet and inflammation is physical activity. The aim of this study was to assess the inflammatory potential of the diets of young people engaging in regular physical activity. The participants were physical education students (n = 141 men and n = 151 women). The measurements included basic anthropometric parameters and a 4-day nutritional history from which the dietary inflammatory index (DII) was calculated. The average DII for female students was 2.09 ± 1.52, and that for male students was 0.21 ± 1.69. Consumption of all macro- and micronutrients was significantly higher among women and men with the lowest DII value (corresponding to an anti-inflammatory diet). The female and male students consuming anti-inflammatory diets were characterized by greater lean body mass (LBM), and, for the male students, a lower body fat content, compared to those whose diets were pro-inflammatory. Young and regularly physically active people are also exposed to the pro-inflammatory nature of their diets, whose long-term effects may lead to health problems.

The Importance of Adverse Childhood Experiences in Depressive Symptoms and Their Biological Consequences in Healthy Adults: Results of a Polish University Student Study

Adverse childhood experiences (ACEs) have a long-lasting effect on both physical and mental health. The aim of this study was to assess the consequences of ACEs and experienced stress on depression and the role of biological disturbances in this relationship in a student population. Potential participants filled out a screening questionnaire; 60 of 126 students met the inclusion criteria and were tested for the severity of stress and depressive symptoms, ACEs, dietary habits, and serum concentrations of biological markers. Depressive symptoms were related to a younger age (p = 0.012), a higher severity of stress (p = 0.001), ACEs (p = 0.007), and lower triglyceride (p = 0.01) and cortisol concentrations (p = 0.01). An inverse relationship between the triglyceride concentration and emotional abuse (R = -0.38) and emotional neglect (R = -0.33) was found. Occludin was positively associated with physical abuse (R = 0.31). Cortisol was inversely associated with emotional abuse (R = -0.35). Emotional neglect was associated with lipopolysaccharide binding protein (R = 0.38) and insulin levels (R = -0.31). The most promising multi-panel of biomarkers for recognizing mood symptoms included triglycerides, tight junction protein 1, and cortisol (cut-offs of ≤ 95.5 mg/dL, 0.72 ng/mL, and 134.63 ng/mL, respectively). This study confirmed the association between ACEs and depressive symptoms and the importance of psychological stress in developing mood disorders. ACEs could affect biological dysregulation. Some of the biological markers could be helpful in early detection of depression.

Mediating Roles of Psychological Distress, Insomnia, and Body Image Concerns in the Association Between Exercise Addiction and Eating Disorders

Purpose

Exercising can promote good health. However, excessive exercising may have downsides. This study examined the association between exercise addiction and eating disorders and whether the identified association was mediated by psychological distress, insomnia (including sleep quality), and body image concern.

Methods

A total of 2088 adolescents (mean age of 15.3 years) participated in this cross-sectional study by questions assessing exercise addiction, eating disorders, psychological distress, insomnia, sleep quality, and body image concern.

Results

There were significantly positive relationships between the variables (r=0.12-0.54, p<0.01) with effect sizes from small to large. The four potential mediators (ie, insomnia, sleep quality, psychological distress, and body image concern), individually and in total, significantly mediated the association between exercise addiction and eating disorders.

Conclusion

The findings suggest that exercise addiction in adolescents may influence eating disorders through multiple pathways, such as insomnia, psychological distress, and body image concerns. Future research should examine these relationships longitudinally and use gathered information to inform intervention development. Clinicians and healthcare workers are encouraged to assess exercise addiction when treating individuals with eating disorders.

Improvement of Dietary Habits among German Medical Students by Attending a Nationwide Online Lecture Series on Nutrition and Planetary Health ("Eat This!")

Nutrition is a major influential factor in optimizing human health and environmental sustainability. Medical students often do not follow national dietary guideline recommendations. Raising awareness of a healthy lifestyle is important as physicians with healthy lifestyle behaviors are more likely to counsel on nutrition. Our study aims to evaluate a Germany-wide online lecture series on nutritional medicine, "Eat This!". Before and after the course, 520 medical students who participated and 64 who did not participate in the course (comparison group) filled out an online survey. To assess the students' dietary habits, a validated FFQ was used. According to this questionnaire, only 31% of the lecture participants consumed enough fruits and 24% consumed enough vegetables, while almost half of the students exceeded the recommended maximum amount of crisps and sweets. After attending the lecture series, guideline adherence with respect to fruits and vegetables showed a significant increase, as did awareness of healthy nutrition and percentage of students with low-risk lifestyle habits. Our results show that low-threshold approaches, such as "Eat This!", can positively influence the dietary behaviors and lifestyle habits of medical students. This can help future doctors fulfill their role in the fight against the global burden of non-communicable diseases.

Food Literacy Scale: Validation through Exploratory and Confirmatory Factor Analysis in a Sample of Portuguese University Students

Eating behaviors and healthy food choices are associated with food literacy, and they have a huge impact on one's health status. For that reason, to increase food literacy is a way to effectively help individuals make appropriate choices that help maintain health and diminish the incidence of non-communicable diseases. The objective of this work was to test and validate a scale to assess food literacy. The validation was conducted on a sample of 924 Portuguese university students. The scale was composed of 50 items, which were submitted to exploratory and confirmatory factors analysis. The final validated scale corresponded to a second-order model with a global factor called "Food literacy", which retained 26 items distributed by three factors: F1-literacy about the nutritional composition of foods (10 items), F2-literacy about labelling and food choices (7 items), and F3-literacy about healthy eating practices (9 items). The internal consistency of the scale is very high, with an alpha higher than 0.9, and the Pierson correlations between the three factors and the global are also higher than 0.9. In conclusion, the present scale has been validated and can therefore be utilized to measure food literacy.

How do students cope with stress during remote learning due to COVID-19 pandemic? Biological and psychological factors-protocol of the study

Introduction: The COVID-19 pandemic negatively affected the mental health of the Polish population. Students are the group with a high risk of developing mood disorders. The scientific data suggest the usefulness of biological substances as potential biomarkers of psychiatric disorders. Saliva is non-invasive, quick to obtain material and a promising fluid for measuring stress and depression severity. In this paper, we present the protocol of our study, which aims to assess the utility of concentrations of biological fluids as potential biomarkers of the stress response and risk of developing depression and anxiety disorders among students of Lublin.

Materials and methods: Total number of 80 students were included in the study. Participants were asked to collect saliva samples simultaneously with responding to the questionnaires concerning their mental state. Afterwards, the samples were examined with an ELISA test to assess the level of fibroblast growth factor (FGF-2), cortisol and chromogranin A (CgA). The relationship between biomarkers and severity of stress, depression, anxiety will be examined.

Results: Cortisol on its own is not a good material to investigate the stress reaction in saliva due to its variable levels among people during stressful situations. Scientific data indicate the usefulness of other biomarkers or their combination to indicate the potential risk of developing depression and/or anxiety.

Conclusions: Introducing objective tests, helpful for mood symptoms recognition, would improve the prevention and diagnosis of psychiatric disorders in vulnerable populations.

The Risk of T2DM in College Women: The Predictive Power of Financial versus Residential Status in a Cross-Sectional Pilot Study in Turkey

Aim: This study aimed to investigate the relationships between dietary habits, income levels and type 2 diabetes mellitus (T2DM) risk in Turkish female university students who are living with their family or in the dormitory. Materials and Methods: This work was a cross-sectional pilot study conducted during December 2016–January 2017 in Istanbul Yeni Yuzyıl University. A survey was administered to 100 female students, 60 living with their family and 40 in dormitories. Income level was determined based on TURKSTAT 2015 percentiles. T2DM risk was determined using the Finnish Diabetes Association Type 2 Diabetes Risk Assessment Form (FINDRISC). Food frequency questionnaire and 24 h dietary recall results were analyzed by the diet analysis software Beslenme Bilgi Sistemi (BeBiS), specially developed for Turkey. Results: Results indicated inadequacies and imbalanced nutrition among female college students overall. Notably, there was a statistically significant higher diet quality for the students living with their families compared to those living in dormitories. Income level was consistently positively associated with better nutritional outcomes, while negatively associated with T2DM risk, but interestingly, only in the case of students living in the dormitory and not for those living with family. Conclusions: Our findings indicated that financial status, rather than living in the dormitory versus with family, is positively associated with increased T2DM risk as assessed via FINDRISC among Turkish female college students. This study’s results indicate a potential need for educational programs and nutritional support for students, particularly those living away from family.