The freshman weight gain phenomenon revisited

Exploration of the Dietary and Lifestyle Behaviors and Weight Status and Their Self-Perceptions among Health Sciences University Students in North Lebanon

University students may experience significant environmental changes that exert a negative influence on the quality of their diet and lifestyle. There is scarcity of data concerning the dietary and lifestyle behaviors and weight status of students in the health field in North Lebanon. To investigate these data, a cross-sectional survey was conducted including 369 health sciences students aged 18-25 chosen from four public and private universities in North Lebanon. Data were collected using a standardized interview questionnaire to determine sociodemographic, dietary, and lifestyle behaviors, appetite changes, stress related dietary behaviors, and food cravings, as well as self-perceptions of dietary adequacy, physical activity levels, and weight status. Body mass index was assessed. Results had revealed significant differences in some of the dietary consumption patterns and weight status among seniors compared to juniors. However, the overall prevalence of overweight and obesity recorded 32.2% and the dietary consumption patterns fall below recommended levels. Multivariate regression analysis showed that parental obesity, comfort eating, increased appetite, food cravings, and stressful eating were associated with increased risk of obesity while a healthy diet score was associated with decreased risk. The study's findings call for tailoring culture specific intervention programs which enable students to improve their dietary and lifestyle behaviors and control stress.

Body Composition, Fitness Status, and Health Behaviors Upon Entering College: An Examination of Female College Students From Diverse Populations

Although poor health-related behaviors that impact development of chronic diseases begin much earlier than when actual disease is evident, few studies have examined health behaviors in college students, who may be at an important transitional period where early intervention could prevent development of chronic diseases. The purpose of this study was to examine health-related factors in female college students (N = 61) by race/ethnicity and weight status. We found significant differences in health profiles between non-Hispanic White (White) and African American students, including greater physical fitness and healthier diets among White students. Overweight/obese students had worse health profiles than healthy BMI students. Furthermore, weight status was significantly associated with cardiovascular fitness. This supports a focus on PA promotion for interventions in the period of emerging adulthood, alongside the other healthy behaviors, to elicit improvements in weight status and potential reduction of chronic disease risks.

Impact of exercise changes on body composition during the college years--a five year randomized controlled study

Background

Observational studies have consistently reported severe weight gains during the college years; information about the effect on body composition is scarce, however. Thus, the aim of the study was to determine the effect of exercise changes on body composition during 5 years at university.

Methods

Sixty-one randomly selected male and female dental (DES; 21 ± 3 years., 22 ± 2 kg/m²) and 53 sport (physical education) students (SPS; 20 ± 2 years., 22 ± 3 kg/m²) were accompanied over their 5-year study program. Body mass and body composition as determined via Dual-Energy x-ray-absorptiometry (DXA) at baseline and follow-up were selected as primary study endpoints. Confounding parameters (i.e., nutritional intake, diseases, medication) that may affect study endpoints were determined every two years. Endpoints were log-transformed to stabilize variance and achieve normal distributed values. Paired t-tests and unpaired Welch-t-tests were used to check intra and inter-group differences.

Results

Exercise volume decreased significantly by 33 % (p < .001) in the DES and increased significantly (p < .001) in the SPS group. Both cohorts comparably (p = .214) gained body mass (SPS: 1.9 %, 95 %-CI: 0.3−3.5 %, p = .019 vs. DES: 3.4 %, 1.4−5.5 %, p = .001). However, the increase in the SPS group can be completely attributed to changes in LBM (2.3 %, 1.1−3.5 %, p < 0.001) with no changes of total fat mass (0.6 %, −5.0−6.5 %, p = 0.823), while DES gained total FM and LBM in a proportion of 2:1. Corresponding changes were determined for appendicular skeletal muscle mass and abdominal body-fat. Maximum aerobic capacity increased (p = .076) in the SPS (1.6 %, −0.2−3.3 %) and significantly decreased (p = .004) in the DES (−3.3 %, −5.4 to −1.2 %). Group differences were significant (p < .001). With respect to nutritional intake or physical activity, no relevant changes or group differences were observed.

Conclusion

We conclude that the most deleterious effect on fatness and fitness in young college students was the pronounced decreases in exercise volume and particularly exercise intensity.

Trial registration

NCT00521235; “Effect of Different Working Conditions on Risk Factors in Dentists Versus Trainers. A Combined Cross sectional and Longitudinal Trial with Student and Senior Employees.”; August 24, 2007.

Elearning approaches to prevent weight gain in young adults: A randomized controlled study

OBJECTIVE

Preventing obesity among young adults should be a preferred public health approach given the limited efficacy of treatment interventions. This study examined whether weight gain can be prevented by online approaches using two different behavioral models, one overtly directed at obesity and the other covertly.

METHODS

A three-group parallel randomized controlled intervention was conducted in 2012-2013; 20,975 young adults were allocated a priori to one control and two "treatment" groups. Two treatment groups were offered online courses over 19 weeks on (1) personal weight control ("Not the Ice Cream Van," NTICV) and, (2) political, environmental, and social issues around food ("Goddess Demetra," "GD"). Control group received no contact. The primary outcome was weight change over 40 weeks.

RESULTS

Within-group 40-week weight changes were different between groups (P < 0.001): Control (n = 2,134): +2.0 kg (95% CI = 1.5, 2.3 kg); NTICV (n = 1,810): -1.0 kg (95% CI = -1.3, -0.5); and GD (n = 2,057): -1.35 kg (95% CI = -1.4 to -0.7). Relative risks for weight gain vs.

CONTROL

NTICV = 0.13 kg (95% CI = 0.10, 0.15), P < 0.0001; GD = 0.07 kg (95% CI = 0.05, 0.10), P < 0.0001.

CONCLUSIONS

Both interventions were associated with prevention of the weight gain observed among control subjects. This low-cost intervention could be widely transferable as one tool against the obesity epidemic. Outside the randomized controlled trial setting, it could be enhanced using supporting advertising and social media.

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

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

Predictors of Weight Loss in Young Adults

BACKGROUND

Increased understanding of weight loss among healthy young people in naturalistic settings could inform the development of effective weight control programs. The aim of this study was to describe loss in BMI over 7 years in a population-based sample of healthy young adolescents (mean age 17 years at beginning of follow-up) and identify determinants of BMI loss.

DESIGN AND METHOD

Data were available for 681 participants in the Nicotine Dependence in Teens Study (1999-2012), a longitudinal investigation of adolescents in Montreal (Canada). Loss in BMI was assessed between age 17 and 24 years. Potential predictors of BMI loss including age, sex, mother's education, worry about weight, physical activity, screen time, and cigarette smoking were studied in multivariable logistic regression.

RESULTS

Males and females gained 2.0 and 1.4 BMI units, respectively, on average, between age 17 and 24 years. However, 9% of males and 14% of females experienced a loss in BMI ≥1.0 unit. Female sex and a higher BMI at age 17 were associated with a higher probability of BMI loss, but none of age, mother's education, physical activity, screen time, or cigarette smoking were associated with BMI loss between ages 17 and 24.

CONCLUSIONS

Whereas BMI increased on average between age 17 and 24 years in a population-based sample of healthy young people, 12% of participants experienced a loss in BMI ≥1 unit. Weight loss was highest among the heaviest persons and did not affect the prevalence of underweight. No single behavior at age 17 stands out as associated with predicting BMI loss.

Correlates of University Students' Soft and Energy Drink Consumption According to Gender and Residency

This study assessed personal and environmental correlates of Belgian university students' soft and energy drink consumption and investigated whether these associations were moderated by gender or residency. Four hundred twenty-five university students completed a self-reported on-line questionnaire assessing socio-demographics, health status, soft and energy drink consumption, as well as personal and environmental factors related to soft and energy drink consumption. Multiple linear regression analyses were conducted. Students believing soft drink intake should be minimized (individual subjective norm), finding it less difficult to avoid soft drinks (perceived behavioral control), being convinced they could avoid soft drinks in different situations (self-efficacy), having family and friends who rarely consume soft drinks (modelling), and having stricter family rules about soft drink intake were less likely to consume soft drinks. Students showing stronger behavioral control, having stricter family rules about energy drink intake, and reporting lower energy drink availability were less likely to consume energy drinks. Gender and residency moderated several associations between psychosocial constructs and consumption. Future research should investigate whether interventions focusing on the above personal and environmental correlates can indeed improve university students' beverage choices.

A meta-analysis of weight gain in first year university students: is freshman 15 a myth?

Background

Observational studies report that as students transfer from secondary school to university, there is a tendency to gain weight. This phenomenon is known as the “Freshman 15” in North America, referring to the claim that on average weight gain is 15 lb (6.8 kg) in the first year of university. Studies since 1985 have mostly found weight gains ranging from 1 kg to 6 kg. Our meta-analysis aimed to update the literature on the “Freshman 15” in the first year of university. We also aimed to explore weight gain in only those who gained weight and perform several subgroup analyses. Given adolescent weight gain is highly linked to overweight and obesity in adults, a better understanding of university student weight gain is crucial if we are to combat the rising adult obesity prevalence.

Methods

We conducted a search on six standard electronic databases (including PubMed, Embase, PsycInfo) from 1980 to 2014. Only peer reviewed articles with data from longitudinal studies were included. Screening was performed by two reviewers. The quality of papers was assessed and data extraction was done with a systematic approach.

Results

Thirty two studies were included and 22 studies (5549 students) were included in a pooled mean meta-analysis as they reported standard errors. The overall pooled mean weight gain was 1.36 kg (3lbs) (95 % CI: 1.15 – 1.57) over an average of 5 months. A majority of students, 60.9 %, gained weight during freshman year and these on average gained 3.38 kg (7.5lbs) (95 % CI: 2.85 – 3.92).

Conclusion

Freshman weight gain is an issue with almost two thirds of students gaining weight. Students who gained weight, gained it at rates much faster than in the general population. Despite most universities having some health promotion policies, we denote a consistent weight gain in university students across several countries.

Breast is best: Positive mealtime interactions in breastfeeding mothers from Israel and the United Kingdom

We examined mealtime interactions to assess whether they varied according to maternal body mass index, country and mode of feeding in 41 Israeli and UK mother–infant dyads. Feeding behaviours were coded using the Simple Feeding Element Scale. Significantly, more UK mothers breastfed during the filmed meal compared to Israeli mothers. Mealtime interactions did not vary according to maternal body mass index or country. Women who breastfed (as opposed to those who bottle fed or fed solids) provided fewer distractions during the meal, a more ideal feeding environment and fed more responsively.

Weight gain in freshman college students and perceived health

Background

We determined body weight increase in first year Dutch college students. We had the objective to determine whether the awareness of the unhealthy lifestyle raised concerns and willingness to change habits.

Methods

Body weight, heartbeat, BMI, body fat percentages, and blood pressure values were collected from 1095 students. Comprehensive statistical analysis was performed on the data.

Results

The students had a mean weight gain of 1.1 kg and an average BMI gain of 0.35. Members of a student corps gained significantly more weight (1.6 ± 3.1 kg) than non-members (1.0 ± 2.5 kg), while students who are living independently gained an average of 0.5 kg more than students living with their parents (p < 0.05). Approximately 40% of the students changed their eating patterns and 30.7% of the students consumed more alcohol.

Conclusions

Students experienced hindrance in physical exercise and mental well-being. Students with a high BMI without irregular eating habits were willing to change their lifestyle. However, students who had irregular lifestyles exhibited the lowest willingness to change their eating behaviors and to lose weight. Our study provides insight into means by which adolescents at high risk for weight gain can be approached to improve experienced quality of life.

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Students gained a mean of 1.1 kg in their first three months of college.

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40% of the students changed their eating patterns and 30.7% consumed more alcohol.

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Students with weight gain experienced hindrance in exercise and mental well-being.

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Only students not having irregular eating habits wanted to change their lifestyle.

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To prevent weight gain, gender-specific approaches may be necessary.

[Overweight and obesity in young adults: relevance of job-related changes of exercise on fat, lean body and body mass in students]

Early adulthood is related to changes in lifestyle that negatively affect body weight and health. The aim of the study was to determine the effect of exercise changes on the development of weight and body composition in college students.Sixty-one randomly selected dental (ZMS) and 53 sport students (SLS) were accompanied over 5 years. Body mass, fat and lean body mass (LBM) were determined via DXA-technique. Exercise and physical activity were assessed by questionnaires and interviews.All exercise indices significantly increased in the SLS and significantly decreased in the ZMS. Physical activity slightly increased in both groups. Both cohorts comparably gained body mass, however, the increase in the SLS group can be attributed to LBM-changes with minor changes of fat-mass (2.4 % ± 3.3 % vs. 0.1 ± 1.0 %) whereas ZMS gained fat and LBM in a proportion of 2:1.Maintenance/increase of exercise compensate the negative effects of lifestyle changes on body composition during young adulthood.

Psychosocial moderators of associations between life events and changes in physical activity after leaving high school

OBJECTIVES

To examine 1) associations between life events and changes in leisure-time physical activity (LTPA) in school leavers and 2) whether these associations are moderated by psychosocial factors.

METHODS

Final year students (n=440) from high schools in rural Western Australia completed annual telephone interviews on three occasions; baseline (T1), one-year follow-up (T2; n=440) and two-year follow-up (T3; n=374). LTPA was measured using the Minnesota Leisure-time Physical Activity Questionnaire. Life events included moving out of home, working full-time and studying full-time. Psychosocial factors included enjoyment, self-efficacy, outcome expectations, club membership, and support from family and friends. Mixed linear regression models examined the effect of life events on changes in LTPA from T1 to T2 and T1 to T3.

RESULTS

A decline in LTPA across all time points was observed. Those who continued full-time education had a smaller LTPA decline than those who did not. Those who were not a member of a sporting club at T1 had greater LTPA decline if they worked full-time at T2.

CONCLUSIONS

There is a need for interventions to prevent declines in LTPA among school leavers, especially those who do not enter tertiary education. Encouraging sporting club membership during high school might be important.

Determinants of physical activity and sedentary behaviour in university students: a qualitative study using focus group discussions

Background

College or university is a critical period regarding unhealthy changes in energy related behaviours in students. The first objective of this explorative study was to identify determinants of physical activity and sedentary behaviour in Belgian university students. Secondly, we aimed to collect ideas and recommendations to increase physical activity and decrease sedentary behaviours in university students.

Methods

Using a semi-structured question guide, seven focus group discussions were conducted consisting of 17 male and 29 female university students from a variety of study disciplines, with a mean age of 20.7 ± 1.6 yrs. Using Nvivo9, an inductive thematic approach was used for data analysis.

Results

Students reported that both physical and sedentary activities were influenced by individual factors (e.g. perceived enjoyment, self-discipline, time and convenience), their social networks (e.g. (lack of) parental control, modelling, social support), physical environment (e.g. availability and accessibility, travel time/distance, prices), and macro environment (e.g. media and advertising). Furthermore, the relationships between determinants and university students’ physical activity and sedentary behaviour seemed to be moderated by university characteristics, such as residency, university lifestyle, exams and academic pressure. Recommendations for future physical activity interventions include improving information strategies regarding on-campus sports activities, cheaper and/or more flexible sports subscriptions and formulas, including ‘sports time’ into the curricula, and providing university bicycles around campus. Students also believed that increasing students’ physical activity might decrease their sedentary behaviour at the same time.

Conclusions

The recommendations and ideas discussed in this study may facilitate the development of effective and tailored (multilevel) intervention programs aiming to increase physical activity and decrease sedentary behaviours in university students.

Changes in weight, physical activity, sedentary behaviour and dietary intake during the transition to higher education: a prospective study

Background

The transition to higher education involves a significant life change and might be accompanied with less healthy behaviours. However, the only longitudinal study that spanned the period from high school to college/university was limited to self-reported weight. Other studies assessed objective weight, but only at the start of the first semester at college/university and used retrospective questionnaires to asses health behaviours in high school. This study investigated changes in objectively assessed weight and prospective health behaviours during the transition from high school to college/university in Belgian students and examined which health behaviour changes were related to weight change.

Methods

A sample of 291 students was followed from the final year of high school until the second year of college/university. Body mass index (BMI) and waist circumference were measured objectively. Physical activity, sedentary behaviours and dietary intake were estimated using validated questionnaires. In order to study changes in BMI and health behaviours, 2 × 2 (time × gender) Repeated Measures ANOVA analyses were conducted. A stepwise multiple regression analysis was executed to investigate the association between changes in health behaviours and BMI changes, and the moderating effect of gender.

Results

On average students gained 2.7 kg with a greater increase in boys (boys: 4.2 kg, girls: 1.9 kg). Active transportation and sport participation decreased. Some sedentary behaviours (watching TV/DVD, playing computer games) decreased, while others (internet use, studying) increased. Consumption of different foods decreased, while alcohol consumption increased. A higher decrease in sport participation, a higher increase in internet use and a lower increase in studying were related to a greater increase in BMI. An increase in alcohol consumption only contributed to weight gain in boys, whereas a decrease in fruit/vegetable intake only contributed to weight gain in girls.

Conclusion

We can conclude that the transition to higher education is an at risk period for weight gain and unfavourable changes in health behaviours. Interventions to prevent weight gain in college/university students should therefore already start in high school with a somewhat different focus in boys versus girls.

Predictors of emotional eating during adolescents' transition to college: does body mass index moderate the association between stress and emotional eating?

OBJECTIVE

This study sought to (1) examine perceived stress and resources to cope with stress as predictors of emotional eating during the transition to college and (2) determine whether body mass index (BMI) moderated the emotional eating-stress relationship.

PARTICIPANTS

Participants were 97 college freshmen (73% female; BMI: M = 25.3 kg/m(2), SD = 5.7 kg/m(2)). Research was conducted in September 2012.

METHODS

Participants completed the Perceived Stress Scale, Emotional Eating Scale, and Eating and Appraisal Due to Emotions and Stress Questionnaire during the first month of college. Height and weight were measured objectively.

RESULTS

BMI moderated the relationship between perceived stress and emotional eating. Higher stress predicted greater emotional eating for the lower BMI groups, but not the highest group. Greater resources to cope with stress predicted lower emotional eating.

CONCLUSIONS

Greater perceived stress and poorer resources to cope with stress may contribute to emotional eating during the transition to college. The relationship between perceived stress and emotional eating may vary by BMI.

Weighing the Evidence of Common Beliefs in Obesity Research

Obesity is a topic on which many views are strongly held in the absence of scientific evidence to support those views, and some views are strongly held despite evidence to contradict those views. We refer to the former as "presumptions" and the latter as "myths." Here, we present nine myths and 10 presumptions surrounding the effects of rapid weight loss; setting realistic goals in weight loss therapy; stage of change or readiness to lose weight; physical education classes; breastfeeding; daily self-weighing; genetic contribution to obesity; the "Freshman 15"; food deserts; regularly eating (versus skipping) breakfast; eating close to bedtime; eating more fruits and vegetables; weight cycling (i.e., yo-yo dieting); snacking; built environment; reducing screen time in childhood obesity; portion size; participation in family mealtime; and drinking water as a means of weight loss. For each of these, we describe the belief and present evidence that the belief is widely held or stated, reasons to support the conjecture that the belief might be true, evidence to directly support or refute the belief, and findings from randomized controlled trials, if available. We conclude with a discussion of the implications of these determinations, conjecture on why so many myths and presumptions exist, and suggestions for limiting the spread of these and other unsubstantiated beliefs about the obesity domain.

Calorie-labelling: does it impact on calorie purchase in catering outlets and the views of young adults?

Calorie-labelling of meals has been suggested as an antiobesity measure, but evidence for impact is scarce. It might have a particular value for young adults, when weight gain is most rapid. A systematic literature review and a meta-analysis was performed to assess the effect of calorie-labelling on calories purchased. Seven studies met the inclusion and quality criteria of which six provided data allowing a meta-analysis. Three reported significant changes, all reductions in calories purchased (-38.1 to -12.4 kcal). Meta-analysis showed no overall effect, -5.8 kcal (95% confidence interval (CI)=-19.4 to 7.8 kcal) but a reduction of -124.5 kcal (95% CI=-150.7 to 113.8 kcal) among those who noticed the calorie-labelling (30-60% of customers). A questionnaire, to gauge views on calorie-labelling, was devised and sent to young adults in higher education: 1440 young adults (mean age 20.3 (s.d.=2.9) years) completed the survey. Nearly half (46%) said they would welcome calorie information in catering settings and on alcoholic drinks. Females opposing to calorie-labelling were heavier to those who did not (64.3 kg vs. 61.9 kg, P=0.03; BMI=22.4 kg m(-2) vs. 21.7 kg m(-2), P=0.02). In conclusion, the limited evidence supports a valuable effect from clearly visible calorie-labelling for obesity prevention, and it appears an attractive strategy to many young adults.

Psychometric Evaluation of Dietary Self-Efficacy and Outcome Expectation Scales in Female College Freshmen

Lifestyle interventions commonly measure psychosocial beliefs as precursors to positive behavior change, but often overlook questionnaire validation. This can affect measurement accuracy if the survey has been developed for a different population, as differing behavioral influences may affect instrument validity. The present study aimed to explore psychometric properties of self-efficacy and outcome expectation scales—originally developed for younger children—in a population of female college freshmen ( N = 268). Exploratory principal component analysis was used to investigate underlying data patterns and assess validity of previously published subscales. Composite scores for reliable subscales (Cronbach’s α ≥ .70) were calculated to help characterize self-efficacy and outcome expectation beliefs in this population. The outcome expectation factor structure clearly comprised of positive (α = .81-.90) and negative outcomes (α = .63-.67). The self-efficacy factor structure included themes of motivation and effort (α = .75-.94), but items pertaining to hunger and availability cross-loaded often. Based on cross-loading patterns and low Cronbach’s alpha values, respectively, self-efficacy items regarding barriers to healthy eating and negative outcome expectation items should be refined to improve reliability. Composite scores suggested that eating healthfully was associated with positive outcomes, but self-efficacy to do so was lower. Thus, dietary interventions for college students may be more successful by including skill-building activities to enhance self-efficacy and increase the likelihood of behavior change.

Stress and cardiometabolic manifestations among Saudi students entering universities: a cross-sectional observational study

BACKGROUND

In this observational study, we aimed to see whether transition in Saudi students entering university life could be a breeding stage for cardiometabolic risk factor emergence and clustering.

METHODS

A total of 1878 apparently healthy Saudi students of the Preparatory Year, King Saud University, Riyadh, KSA (1112 men and 766 women) spanning 2 academic years were included. They were divided into 2 groups based on the validated perceived stress test (PST). Anthropometrics were obtained and fasting blood samples were collected for measurement of fasting blood glucose and a lipid profile.

RESULTS

PST score (>27) considered indicative of stress was noted in 44.4% of students. The prevalence of this score was higher in women than in men (49.7% versus 40.7%). The prevalence of obesity, hypertension and dyslipidemia was significantly higher in men than women (p < 0.01), and this was even more apparent among stressed men, who had a significantly higher prevalence of all the above cardiometabolic factors than the non-stressed ones (p < 0.01).

CONCLUSION

Perceived stress is alarmingly high among Saudi students entering universities. This study sheds light on the social responsibility of universities in promoting a healthy lifestyle, particularly in this age group, when exposure to different kinds of stressors may result in body weight and metabolic changes.

Perceived stress scores among Saudi students entering universities: a prospective study during the first year of university life

In this prospective study we wanted to determine whether perceived stress over time among students in the Preparatory Year of King Saud University (KSU) predisposes them to cardiometabolic abnormalities. A total of 110 apparently healthy Saudi students (35 men and 75 women enrolled during the 2010−2011 academic year) were included. Perceived stress was determined at baseline and 1 year later. Anthropometrics were obtained and morning fasting serum glucose, lipid profile and cortisol were measured at both times. Perceived stress was noted among 48.2% of subjects at baseline and was not significantly different after follow-up, with 45.4% scoring high. In men, the prevalence of perceived stress was 48.6% at baseline (13 out of 35) and 37.1% at follow-up (13 out of 35), while in women it was 48% at baseline and 49.3% at follow-up. Interestingly, significant improvements in the blood pressure and lipid profiles, with the exception of HDL-cholesterol, were observed in both men and women, while fasting glucose also improved in women. Serum cortisol was inversely associated to fasting glucose, and total- and LDL-cholesterol (p-values 0.007, 0.04 and 0.04, respectively). These data are opposite to findings in students entering Western universities, in whom increasing stress and a deteriorating cardiometabolic profile have been repeatedly noted. Perceived stress and morning cortisol levels among students of the Preparatory Year in KSU remained constant for both genders over time, yet an improved cardiometabolic profile was observed, suggesting good adaptation among our pre-college students in their first year of university life.

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

Background

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

Methods

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

Results

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

Conclusions

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

Understanding weight management perceptions in first-year college students using the health belief model

OBJECTIVE

To examine weight management barriers, using the Health Belief Model, in first-year college students.

PARTICIPANTS

First-year college students (n = 45), with data collected in April, May, and November 2013.

METHODS

Nominal group technique sessions (n = 8) were conducted.

RESULTS

First-year students recognize benefits to weight management beyond physical attractiveness to quality-of-life domains, including social (eg, bonding opportunities and energy to socially engage) and mental health (eg, stress management). Men believe that weight management is important for career/financial reasons, whereas women voiced that it will allow them to live a full, independent life with a high level of multitasking. Men believed that their barriers were external (eg, campus resources/programs), whereas females perceived their barriers to be internal (eg, poor time management).

CONCLUSIONS

College students are challenged by weight management and want the institution to provide resources, including curriculum, to help them manage their physical activity and nutrition behaviors.

Weight, socio-demographics, and health behaviour related correlates of academic performance in first year university students

Background

This study aimed to examine differences in socio-demographics and health behaviour between Belgian first year university students who attended all final course exams and those who did not. Secondly, this study aimed to identify weight and health behaviour related correlates of academic performance in those students who attended all course exams.

Methods

Anthropometrics of 101 first year university students were measured at both the beginning of the first (T1) and second (T2) semester of the academic year. An on-line health behaviour questionnaire was filled out at T2. As a measure of academic performance student end-of-year Grade Point Averages (GPA) were obtained from the university’s registration office. Independent samples t-tests and chi²-tests were executed to compare students who attended all course exams during the first year of university and students who did not carry through. Uni- and multivariate linear regression analyses were conducted to identify correlates of academic performance in students who attended all course exams during the first year of university.

Results

Students who did not attend all course exams were predominantly male, showed higher increases in waist circumference during the first semester and consumed more French fries than those who attended all final course exams. Being male, lower secondary school grades, increases in weight, Body Mass Index and waist circumference over the first semester, more gaming on weekdays, being on a diet, eating at the student restaurant more frequently, higher soda and French fries consumption, and higher frequency of alcohol use predicted lower GPA’s in first year university students. When controlled for each other, being on a diet and higher frequency of alcohol use remained significant in the multivariate regression model, with frequency of alcohol use being the strongest correlate of GPA.

Conclusions

This study, conducted in Belgian first year university students, showed that academic performance is associated with a wide range of weight and health related behaviours. Future studies should investigate whether interventions aiming at promoting healthy behaviours among students could also have a positive impact on academic performance.

Impact of breakfasts (with or without eggs) on body weight regulation and blood lipids in university students over a 14-week semester

The effects of breakfast type on body weight and blood lipids were evaluated in university freshman. Seventy-three subjects were instructed to consume a breakfast with eggs (Egg Breakfast, EB, n = 39) or without (Non-Egg Breakfast, NEB, n = 34), five times/week for 14 weeks. Breakfast composition, anthropometric measurements and blood lipids were measured at multiple times. During the study, mean weight change was 1.6 ± 5.3 lbs (0.73 ± 2.41 kg), but there was no difference between groups. Both groups consumed similar calories for breakfast at all time-points. The EB group consumed significantly more calories at breakfast from protein, total fat and saturated fat, but significantly fewer calories from carbohydrate at every time-point. Cholesterol consumption at breakfast in the EB group was significantly higher than the NEB group at all time points. Breakfast food choices (other than eggs) were similar between groups. Blood lipids were similar between groups at all time points, indicating that the additional 400 mg/day of dietary cholesterol did not negatively impact blood lipids.

Campus food and beverage purchases are associated with indicators of diet quality in college students living off campus

PURPOSE

To examine the association between college students' dietary patterns and frequency of purchasing food/beverages from campus area venues, purchasing fast food, and bringing food from home.

DESIGN

Cross-sectional Student Health and Wellness Study.

SETTING

One community college and one public university in the Twin Cities, Minnesota.

SUBJECTS

Diverse college students living off campus (n = 1059; 59% nonwhite; mean [SD] age, 22 [5] years).

MEASURES

Participants self-reported sociodemographic characteristics and frequency of purchasing food/beverages around campus, purchasing fast food, and bringing food from home. Campus area purchases included à la carte facilities, vending machines, beverages, and nearby restaurants/stores. Dietary outcomes included breakfast and evening meal consumption (d/wk) and summary variables of fruit and vegetable, dairy, calcium, fiber, added sugar, and fat intake calculated from food frequency screeners.

ANALYSIS

The associations between each purchasing behavior and dietary outcomes were examined using t-tests and linear regression.

RESULTS

Approximately 45% of students purchased food/beverages from at least one campus area venue ≥3 times per week. Frequent food/beverage purchasing around campus was associated with less frequent breakfast consumption and higher fat and added sugar intake, similar to fast-food purchasing. Bringing food from home was associated with healthier dietary patterns.

CONCLUSION

Increasing the healthfulness of campus food environments and promoting healthy food and beverage purchasing around campuses may be an important target for nutrition promotion among college students.

Burn and earn: a randomized controlled trial incentivizing exercise during fall semester for college first-year students

OBJECTIVE

To examine the viability of monetary incentives to increase fitness-center use and maintain/improve the Body Mass Indexes (BMIs) of first-year students over the fall semester.

METHOD

Randomized-controlled trial with no-treatment and incentive conditions involving 117 first-year students. For 12 weeks, students in the incentive condition received monetary payments ranging from $10 to $38.75 for meeting researcher-set fitness-center use goals that were identical across conditions. Fitness-center use was monitored through electronic ID-card check-in and check-out records at the campus fitness center.

RESULTS

63% of incentive-condition participants met the weekly fitness-center use goals on average compared to only 13% of control-condition participants, a significant difference, p<0.001. Goal achievement significantly decreased over time, p<0.01 and at roughly the same rate in the control and incentive conditions, p=0.23. Average BMI increases over the fall semester in the control (24.2 (0.6) to 24.6 (0.6)kg/m(2)) versus incentive condition (23.1 (0.4) to 23.5 (0.4)kg/m(2)) were not significantly different (p=0.70).

CONCLUSION

Weekly monetary incentives resulted in significantly more first-year students meeting weekly fitness-center use goals. However, the increased fitness-center use by the incentive condition did not prevent an increase in BMI during fall semester.

Using Facebook and text messaging to deliver a weight loss program to college students

OBJECTIVE

Between 31 and 35% of the college-aged population is overweight or obese, yet few weight loss trials for this population have been conducted. This study examined the feasibility, acceptability, and initial efficacy of a technology-based 8-week weight loss intervention among college students.

DESIGN AND METHODS

Students (N = 52) were randomly assigned to one of the three arms: Facebook (n = 17); Facebook Plus text messaging and personalized feedback (n = 18); Waiting List control (n = 17), with assessments at 4 weeks and 8 weeks (post-treatment). Participants were 20.47 ± 2.19 years old, 86.45 ± 17.11 kg, with a body mass index of 31.36 ± 5.3 kg/m(2) . Participants were primarily female (86.5%), and the sample was racially diverse (57.7% Caucasian, 30.8% African American, 5.8% Hispanic, and 5.7% other races).

RESULTS

The primary outcome was weight loss after 8 weeks (post-treatment); 96.0% of the participants completed this assessment. At 8 weeks, the Facebook Plus group had significantly greater weight loss (-2.4 ± 2.5 kg) than the Facebook (-0.63 ± 2.4 kg) and Waiting List (-0.24 ± 2.6 kg) (both Ps < 0.05). Weight change at 8 weeks was not significantly different between the Facebook and Waiting List groups.

CONCLUSIONS

Results show preliminary efficacy and acceptability of the two active intervention arms (97.0% found the program helpful, 81.3% found the videos/handouts helpful, and 100% would recommend the program to others). Results indicate the potential for an innovative weight loss intervention that uses technology platforms (Facebook and text messaging) that are frequently used and already integrated into the cultural life of college students.

Impact of glycaemic index and dietary fibre on insulin sensitivity during the refeeding phase of a weight cycle in young healthy men

Previous studies suggest that a low-glycaemic index (LGI) diet may improve insulin sensitivity (IS). As IS has been shown to decrease during refeeding, we hypothesised that an LGI- v. high-GI (HGI) diet might have favourable effects during this phase. In a controlled nutritional intervention study, sixteen healthy men (aged 26·8 (SD 4·1) years, BMI 23·0 (SD 1·7) kg/m2) followed 1 week of overfeeding, 3 weeks of energy restriction and of 2 weeks refeeding at ^50% energy requirement (50% carbohydrates, 35% fat and 15% protein). During refeeding, subjects were divided into two matched groups receiving either high-fibre LGI or lower-fibre HGI foods (GI 40 v. 74, fibre intake 65 (SD 6) v. 27 (SD 4) g/d). Body weight was equally regained in both groups with refeeding (mean regain 70·5 (SD 28·0)% of loss). IS was improved by energy restriction and decreased with refeeding. The decreases in IS were greater in the HGI than in the LGIgroup (group £ time interactions for insulin, homeostasis model assessment of insulin resistance (HOMAIR), Matsuda IS index (MatsudaISI);all P,0·05). Mean interstitial glucose profiles during the day were also higher in the HGI group (DAUCHGI-LGI of continuous interstitial glucose monitoring: 6·6 mmol/l per 14 h, P¼0·04). At the end of refeeding, parameters of IS did not differ from baseline values in either diet group (adiponectin, insulin, HOMAIR, Matsuda ISI, M-value; all P.0·05). In conclusion, nutritional stress imposed by dietary restriction and refeeding reveals a GI/fibre effect in healthy non-obese subjects. LGI foods rich in fibre may improve glucose metabolism during the vulnerable refeeding phase of a weight cycle.

Lower leptin levels are associated with higher risk of weight gain over 2 years in healthy young adults

Complete leptin deficiency is associated with weight gain and extreme obesity, according to studies of animals and of monogenic obesity in humans. It is still a matter of debate whether relative leptin deficiency plays a physiologic role in adiposity regulation in free-living humans. We hypothesized that leptin levels would be associated with subsequent weight changes in healthy normal-weight young adults. Our prospective cohort involved 150 healthy young adults (114 women and 36 men) followed over their years of study at the Université de Sherbrooke. Anthropometric measurements, fasting blood samples, 3-day food diaries, and a physical activity questionnaire were collected at baseline. Leptin levels were measured with radioimmunoassay. Associations between baseline leptin levels and subsequent anthropometric changes were assessed with multivariable linear regression models to account for adiposity at baseline, food intake, and energy expenditure. Over the 2-year follow-up, changes in body mass index (BMI) ranged from -0.8 to +2.6 kg·m(-2) in men (mean BMI change, +0.6 kg·m(-2)) and from -2.5 to +3.7 kg·m(-2) in women (mean BMI change, +0.1 kg·m(-2)). Lower leptin levels at baseline were associated with a higher risk of weight gain in women (r = -0.24; p = 0.01 for change in BMI) and in men (r = -0.27, p = 0.11), even after accounting for baseline BMI, total daily caloric intake, and energy expenditure (p = 0.02). In the subsample measured at 4 years (n = 63), baseline leptin levels were not associated with 4-year weight changes. Lower leptin levels are associated with a higher risk of weight gain over 2 years in healthy young adults.

Evaluating race/ethnicity in moderating baseline cardiometabolic risk and body composition changes in North Carolina first-year college women

The roles of race/ethnicity and geographical region in the context of first-year college weight gain remain largely under-examined. The present study evaluated whether race/ethnicity: (1) at baseline was associated with greater representation in cardiometabolic health risk categories for body mass index, percent body fat, waist circumference, and waist-to-hip ratio in the full sample of 54 Black/African American and 80 White/European American first-year female undergraduates attending a North Carolina state university; and (2) moderated body composition changes between the beginning of the fall and spring semesters among the 83 participants who completed baseline and follow-up visits (N = 39 Black/African Americans). More Black/African Americans than White/European Americans had percent body fat values ≥32% at baseline; a greater proportion of White/European Americans than Black/African Americans had a waist-to-hip ratio >0.80. Among those who completed baseline and follow-up visits, White/European Americans had higher waist-to-hip ratios (unadjusted: p <0.01, adjusted for family income: p < 0.01) and waist circumferences (adjusted for family income: p < 0.05) at both time points. No strong moderating effects of race/ethnicity were detected. Preliminary results suggested that greater consideration of racial/ethnic indicators and potential regional variation in these biometric attributes among first-year college students is warranted.

Resistance training volume, energy balance and weight management: rationale and design of a 9 month trial

The increased prevalence of obesity and the lack of treatment success both argue for the design and evaluation of strategies to prevent the development of overweight and obesity. To date, the role of resistance training (RT) in this regard is largely unexplored. RT may be effective for weight management as a result of increased fat-free mass (FFM), which may result in increased resting metabolic rate and increased physical activity energy expenditure. However, the literature relative to the efficacy of RT protocols recommended for healthy adults to alter the aforementioned parameters is inconsistent or inadequately evaluated. We will conduct a 9 month randomized controlled efficacy trial to compare changes in body composition (fat mass, FFM, % body fat) and energy balance in response to 2 volumes of RT (1 vs. 3 sets vs. non-exercise control) both at the completion of training (9 months) and 1 year later (body composition). This investigation will be conducted in a sample of healthy, normal and overweight, sedentary, young adult men and women; a group at high risk for development of overweight and obesity. Our results will provide information relative to the minimum volume of RT that may be associated with body weight/fat gain which may inform the development of guidelines for RT to prevent weight gain or to alter body composition.

Sweet and salty. An assessment of the snacks and beverages sold in vending machines on US post-secondary institution campuses

This study assessed the nutritional quality of snacks and beverages sold in vending machines. The contents of snack and beverage vending machines in 78 buildings on 11 US post-secondary education campuses were surveyed. Of the 2607 snack machine slots surveyed, the most common snacks vended were salty snacks (e.g., chips, pretzels) and sweets (i.e., candy and candy bars). The 1650 beverage machine slots assessed contained twice as many sugar-sweetened beverages as non-calorie-containing beverages. Only two institutions sold both milk and 100% juice in vending machines. The portion of snacks and beverages sold averaged more than 200 cal. Neither snacks nor beverages were nutrient dense. The majority of snacks were low in fiber and high in calories and fat and almost half were high in sugar. Most beverages were high in calories and sugar. This study's findings suggest that vending machines provide limited healthful choices. Findings from benchmark assessments of components of the food environment, like the vending options reported here, can provide valuable input to campus administrators, health services, food service, and students who want to establish campus policies to promote healthful eating.

The 'freshman 15': trends and predictors in a sample of multiethnic men and women

This study focused on predictors of the 'freshman 15' phenomenon among university students. Participants (N=390) included men and women who identified as African American (32%), Latino American (27%), and European American (41%). Students gained on average 3.2 lbs and 0.5 in BMI from their first through third semesters. Changes in weight and BMI did not differ by gender or racial/ethnic group. Students with lower Scholastic Aptitude Test (SAT) scores were more likely to experience the 'freshman 15'. Results suggest that universities should work with students who may be underprepared for college in order to minimize weight gain.

Wii Health: A Preliminary Study of the Health and Wellness Benefits of Wii Fit on University Students

Objective:

The aim of this preliminary study was to determine the effectiveness of the Nintendo Wii Fit as an occupation to promote weight loss in undergraduate students.

Participants:

Five first-year female students living on campus at a northeastern university in the United States were recruited to participate in this study.

Method:

An A-B single subject design was created where participants were separated into three groups: a typical activity group and two Wii conditions (Wii Fit individually and Wii Fit with another participant). In all conditions, participants recorded their daily food intake and daily number of steps using a pedometer. Body mass index (BMI) and weight were recorded at baseline, at 6 weeks and at 12 weeks (the conclusion of the intervention). At baseline and 12 weeks, motivation and activity level were measured.

Results:

There was a significant change in BMI, weight and motivation for participants in the singles group.

Conclusion:

Although the sample size was very small, the results of this preliminary study suggest that the Wii Fit should be considered by occupational therapists as a potential occupation of weight control in undergraduate students when performed individually.

Lifestyle factors and other health measures in a Canadian university community

With the increasing prevalence of obesity, there is a continuous search for effective obesity-prevention and health-promotion interventions. These interventions should be based on factors that have the potential to influence body weight and health. This study describes various health-related factors in a Canadian university community with the aim of developing more specific obesity interventions. A total of 3143 individuals completed an online questionnaire made up of 3 sections--on physical activity (PA), food habits, and other relevant lifestyle factors. The sampling error was +/-3.3% with a 95% confidence interval. Results showed that 22.9% of students and 37.3% of staff members were either overweight or obese. Students had less desirable eating patterns than staff members in terms of fish, energy drink, and regular milk product intake, and both groups reported undesirable breakfast consumption and quality. Nevertheless, results also showed that a high percentage of individuals in both groups did not meet the recommendations for vegetable, fruit, and fish intake, or PA. Only a few gender differences were observed in eating habits. Soft drink and energy drink consumption was higher and breakfast consumption was lower in men, whereas a higher percentage of women did not meet the recommendations for vegetable, fruit, or fish consumption. Dieting behaviours, disinhibition susceptibility, and moderate-intensity (MIPA) were the 3 lifestyle factors most highly associated with overweight and obesity in both groups. Results also suggest that female students were highly preoccupied with their body weight. This study shows that overweight and obesity are problems in a university community, and that they are associated with many health-related lifestyle behaviours. Although most of the lifestyle factors and health measures examined are similar across groups and genders, some differences call for the development of health-promotion programs with specific targeting strategies.

Are new generations of female college-student populations meeting calcium requirements: comparison of American and Croatian female students

We compared calcium (Ca) sources and intake, as well as multivitamin/mineral supplement use between female students with nutrition/health background and those from general-student-populations. 314 participants 18–37 y, including 57 African-Americans and 54 Caucasian-Americans recruited from Nutrition and/or other Health Sciences departments (NHS), and 100 African-American and 103 Croatian women representing general-student-population (GSP), completed food frequency questionnaire assessing their usual Ca intake and supplement use. NHS populations met recommendations and consumed significantly more Ca, particularly from dairy sources, and were more likely to take supplements than GSP groups, suggesting that health education may influence Ca intake.

Change in diet, physical activity, and body weight among young-adults during the transition from high school to college

Background

The freshmen year of college is likely a critical period for risk of weight gain among young-adults.

Methods

A longitudinal observational study was conducted to examine changes in weight, dietary intake, and other health-related behaviors among first-year college students (n = 186) attending a public University in the western United States. Weight was measured at the beginning and end of fall semester (August – December 2005). Participants completed surveys about dietary intake, physical activity and other health-related behaviors during the last six months of high school (January – June 2005) in August 2005 and during their first semester of college (August – December 2005) in December 2005.

Results

159 students (n = 102 women, 57 men) completed both assessments. The average BMI at the baseline assessment was 23.0 (standard deviation (SD) 3.8). Although the average amount of weight gained during the 15-week study was modest (1.5 kg), 23% of participants gained ≥ 5% of their baseline body weight. Average weight gain among those who gained ≥ 5% of baseline body weight was 4.5 kg. Those who gained ≥ 5% of body weight reported less physical activity during college than high school, were more likely to eat breakfast, and slept more than were those who did not gain ≥ 5% of body weight.

Conclusion

Almost one quarter of students gained a significant amount of weight during their first semester of college. This research provides further support for the implementation of education or other strategies aimed at helping young-adults entering college to achieve or maintain a healthy body weight.