Comparison of Meal Patterns Across Common Racial Groups in the UK and the USA, Examining Associations with Weight Status and Diet Quality: a Secondary Analysis of NDNS and NHANES Datasets

Prevalence of adverse cardiometabolic health markers in UK undergraduate university students: an observational cohort study

OBJECTIVES

The prevalence of adverse cardiometabolic health markers has increased substantially in UK young adults, and university students now make up a significant proportion of this population. Their health-related behaviours are poorer than age-matched normative data, and students' anthropometric outcomes deteriorate during their university career. The influence of university on cardiometabolic health markers is unclear, and men and students of Minoritised Ethnicity are often under-represented in student health research. This study aimed to determine the prevalence of adverse cardiometabolic health markers in undergraduate university students and assess differences between genders, ethnic groups and year of study.

DESIGN

Observational cohort study.

SETTING

A higher education institution in Nottingham, UK.

PARTICIPANTS

Three independent cohorts of undergraduate university students (total n=1,299) completed five physiological tests and provided demographic information. One-way ANOVAs assessed differences between year of study and ethnic groups, and paired samples t-tests assessed differences between genders.

MAIN OUTCOME MEASURES

Body mass index (BMI), waist circumference, waist to hip ratio (WHR), waist to height ratio (WHtR), blood pressure (BP) and glycated haemoglobin concentrations (HbA1c).

RESULTS

34.5% had overweight or obesity, 7.6% had a 'very high' waist circumference, 11.0% had a high WHR, 25.5% had a high WHtR, 12.7% were classified as hypertensive and 3.0% had an HbA1c ≥42 mmol/mol, indicating impaired glucose regulation. Differences between year groups were present for diastolic BP and HbA1c (p<0.01). Gender and ethnic group differences (p<0.05) were present for all variables other than BMI (gender) and diastolic BP (gender and ethnic group).

CONCLUSION

Overall, these data demonstrate the prevalence of adverse cardiometabolic health markers in UK undergraduate university students, highlighting differences between year groups, genders and ethnic groups. These findings should be considered when developing strategies to promote healthy lifestyles in higher education.

Identifying characteristics of UK university students at risk of developing adverse markers of health and related behaviours across one year at university: a latent transition approach

INTRODUCTION

University students are a population notorious for developing adverse markers of health and related behaviours that can have negative consequences for current and future health status. However, there is a dearth of literature devoted to identifying students at greater risk of developing poorer health-related outcomes. The current study aimed to identify characteristics of UK university students at risk of developing adverse markers of health and related behaviours across one year at university.

METHODS

Four hundred and thirty-eight students completed an online self-report survey to assess markers of health and related behaviours in term one (October) and term three (April) in one of three academic years (2021-22, 2022-23, and 2023-24). Latent Profile Transition analysis was employed to generate health-related profiles and assess transitions over time.

RESULTS

Four latent profiles were detected, largely influenced by physical activity behaviours and psychological markers. The majority of students were identified in profiles considered as less healthy and remained in those profiles over time. Women and trans and gender diverse (TGD) students, and students in their second year at university were at greatest risk of being in, and remaining in, less healthful profiles.

CONCLUSIONS

Most students identify and remain in less healthful profiles throughout the academic year. Students that transition between profiles are more likely to transition to less healthful profiles. Work to develop bespoke interventions aimed at students with higher-risk demographic characteristics should now be prioritised.

Sleep Duration, Dietary Inflammatory Potential, and Obesity in Relation to Colorectal Cancer Incidence in the Multiethnic Cohort

BACKGROUND/OBJECTIVES

Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide. Sleep duration, diet, and obesity have each been identified as modifiable risk factors linked to CRC. However, their joint effect on CRC incidence is underexplored. This study investigated the association between sleep duration and CRC incidence and explored the joint effects of sleep duration, a pro-inflammatory diet, and obesity on CRC incidence in the Multiethnic Cohort (MEC).

METHODS

This prospective cohort study analyzed 193,027 participants from Hawaii and California enrolled in the MEC between 1993 and 1996. Sleep duration was self-reported and categorized as short (≤6 h), normal (7-8 h), or long (≥9 h). Diet was self-reported via FFQ and inflammatory potential was assessed using the energy-adjusted Dietary Inflammatory Index (E-DII). CRC cases were identified via cancer registries. Cox proportional hazards models estimated the hazard ratios (HRs) for CRC risk.

RESULTS

After 23.8 years of follow-up, 5825 CRC cases were identified. A pro-inflammatory diet combined with suboptimal sleep increased CRC risk by 12% (short sleep duration, aHR: 1.12; 95% CI: 1.02-1.24) and 22% (long sleep duration, aHR: 1.22, 95% CI: 1.05-1.43). Furthermore, long sleep duration was associated with a 10% increase in CRC risk (aHR: 1.10; 95% CI: 1.01-1.22) compared with normal sleep, while short sleep showed no significant association overall. Obese individuals with short or long sleep had significantly higher CRC risk (short sleep aHR: 1.35; 95% CI: 1.21-1.51; long sleep aHR: 1.36; 95% CI: 1.14-1.64) compared with non-obese individuals with corresponding sleep durations.

CONCLUSIONS

Long sleep duration and a combination of suboptimal sleep duration and a pro-inflammatory dietary pattern or obesity amplifies the risk.

What factors influence sustainable and healthy diet consumption? A review and synthesis of literature within the university setting and beyond

Globally, typical dietary patterns are neither healthy nor sustainable. Recognizing the key role of dietary change in reducing noncommunicable disease risk and addressing environmental degradation, it is crucial to understand how to shift individuals toward a sustainable and healthy diet (SHD). In this literature review, we introduced the concept of a SHD and outlined the dietary behaviors necessary to transition toward SHD consumption; we reviewed the literature on factors that may influence sustainable (and unsustainable) dietary behaviors in adults; and we developed a novel scoring system to rank factors by priority for targeting in future research. Given the significant potential to promote a sustainable and healthy dietary transition on the university campus-where factors that may impact dietary behaviors can be targeted at all levels of influence (i.e., individual, interpersonal, environmental, policy)-we narrowed our focus to this setting throughout. Aided by our novel scoring system, we identified conscious habitual eating, product price, food availability/accessibility, product convenience, self-regulation skills, knowledge of animal ethics/welfare, food promotion, and eating norms as important modifiable factors that may influence university students' dietary behaviors. When scored without consideration for the university population, these factors were also ranked as highest priority, as was modified portion sizes. Our findings offer insight into factors that may warrant attention in future research aimed at promoting SHDs. In particular, the high-priority factors identified from our synthesis of the literature could help guide the development of more personalized dietary behavioral interventions within the university setting and beyond.