A prospective study of weight gain during the college freshman and sophomore years

Interplay between actual and perceived weight on mental health among Canadian Indigenous post-secondary students

OBJECTIVES

Research increasingly focuses on the mental health implications of both actual and perceived weight, particularly among post-secondary students. Considering their unique socio-cultural context and the frequent oversight in research, this study examines these implications specifically among Canadian Indigenous post-secondary students. Recent evidence indicates that students with normal weight may also experience increased mental health risks due to negative weight perceptions. Therefore, this study explores the independent and combined effects of actual and perceived weight on the mental health of this group.

PARTICIPANTS AND METHODS

This study utilized data from the 2017 Aboriginal Peoples Survey, a nationally representative sample of First Nations peoples living off-reserve, Métis, and Inuit. The focus was on Canadian Indigenous post-secondary students aged 19-34 years (n = 1,518). Logistic regression models, stratified by sex, were employed to analyze the data.

RESULTS

Perceptions of being overweight were linked to a higher risk of mood and anxiety disorders, poor self-rated mental health, and suicidal ideation among female students. This pattern was less evident among male students. Notably, female students who were overweight and perceived themselves as such were more likely to report poor mental health across all four indicators examined. In contrast, male students exhibited a less clear pattern. Diverging from recent studies, the findings indicated less robust mental health disparities among students with normal weight who perceived themselves as overweight, potentially due to the insufficient cell size of this category among Indigenous post-secondary students.

CONCLUSIONS

The study highlights the complex interplay between actual and perceived weight and its impact on mental health, particularly among female Indigenous post-secondary students.

Addressing nutritional issues and eating behaviours among university students: a narrative review

University life is a critical period for establishing healthy eating habits and attitudes. However, university students are at risk of developing poor eating habits due to various factors, including economic conditions, academic stress and lack of information about nutritional concepts. Poor diet quality leads to malnutrition or overnutrition, increasing the risk of preventable diseases. Food environments on university campuses also play a significant role in shaping the dietary habits of students, with the availability of and accessibility to healthy food options being important factors influencing food choices and overall diet quality. Disordered eating habits and body dissatisfaction are prevalent among university students and can lead to eating disorders. Income and living arrangements also influence dietary habits, with low household income and living alone being associated with unhealthy eating habits. This study is a narrative review that aimed to address nutritional issues and eating behaviours, specifically among university students. We investigated the eating behaviours of university students, including their dietary patterns, food choices and food environments. The objective of this review was to provide insights into the nutritional issues and eating behaviours of university students, with the aim of identifying target areas for intervention to improve the overall health and wellbeing among college students. University food environments need to be restructured to promote healthy eating, including the availability, accessibility, affordability and labelling of healthy foods, and policies to limit the availability of unhealthy foods and drinks on campus.

Lessons learned: Implementing and adapting a multimedia campaign to promote heart health to college students

Objective: This one-year pilot study investigated the effectiveness of a multimedia campaign, Heart Healthy U (HHU), to increase awareness about the link between unhealthy behaviors and risk for heart disease among emerging adults on a college campus. This paper describes the implementation of HHU. Participants: The HHU campaign was implemented from the Fall of 2019 through Spring 2020 and during this time there were approximately 15,043 enrolled students at the south eastern U.S. college campus. Methods: The HHU campaign employed print (e.g., banners, posters, and yard signs) and electronic formats (e.g., email, Instagram). We designed the methods across three phases: (1) relationship building and formative research, (2) campaign development, and (3) the Heart Healthy U campaign launch. Results: The HHU encountered challenges when the novel coronavirus (COVID-19 or SARS-co-V2) interrupted campus life, however we relied on the electronic formats to reach students during the state-wide lockdown/quarantine mandates. In addition, there were two changes to the HHU health messages. First, we updated the health messages to illustrate that eating healthy and engaging in physical activity supports immune function. Next, we developed new health messages to address effects of physical isolation and anxiety by promoting psychological well-being during this historic public health crisis. Conclusions: We asked whether a multimedia campaign on a college campus could encourage emerging adults to consume fruits and vegetables and engage in physical activity according to the federally-recommended guidelines. It is essential that interventions intended to reach today's emerging adults be presented in formats that they use (e.g., social media platforms), supported by campus administrators, and endorsed by peer influencers. In conclusion, more intervention studies are needed to counter the unhealthy social norm behaviors common to college campus life that increase heart disease risk, particularly among marginalized populations.

Associations between health issues and food consumption with overweight and obesity in three university students minorities

Objective: To determine the presence of overweight and obesity among minorities, and the factors contributing to this weight disparity. Participants: The study comprises 3405 students including nonwhite, international, and first-generation college students. Methods: An online cross-sectional survey collected data on demographics, height, weight, self-health perception, overall sleep quality, progress in school, and food consumption. Three logistic regressions tested abnormal weight associations with health issues and food consumption. Results: Being 31 years-old or older, perception of health and consumption of ultra-processed food was significant with abnormal weight (BMI > 25). Only nonwhite and international students were correlated with ultra-processed and fast-food consumption respectively. Conclusion: Each minority presented vulnerabilities to high percentages of weights exceeding the appropriate rates of BMI. The high consumption of fast and ultra-processed foods makes it important to consider factors related to health perception in each minority group.

Health behavior changes associated with weight gain among first-year international students studying at an American university

Objectives: To characterize the health behaviors and outcomes of first-year international students (FYIS) studying in the U.S. Participants and methods: Three different cohorts of FYIS from a large midwestern university in the U.S. completed three laboratory visits between August and March. The study began in 2017 and ended in March 2020. Anthropometrics, acculturative stress, eating behaviors, sleep, physical activity, and eating habits were assessed. Results: Fifty-four students completed the study. Females had a significant increase in percent body fat (p = .036) and a decrease in sleep quality (p = .006) at the final visit vs. baseline, and uncontrolled (p = .006) and emotional (p < .001) eating behaviors were higher. FYIS who gained more than the median 1.2 kg over the study period experienced higher acculturative stress (p = .004) and a decline in sleep quality (p = .003). Conclusion: Reducing acculturative stress and improving sleep quality should be explored as interventions to protect against undesirable changes in adiposity among FYIS.

Body Dissatisfaction, Eating Styles, Weight-Related Behaviors, and Health among Young Women in the United States

Body dissatisfaction is a common condition that poses health behavior risks, such as the use of maladaptive eating styles instead of adaptive eating styles. Few studies have simultaneously examined both adaptive and maladaptive eating styles and their association with body dissatisfaction in a comprehensive manner. To address this gap, this study examined how body dissatisfaction is related to an array of adaptive and maladaptive eating styles, weight-related behaviors, and health status as well as the associations of health status, BMI, and weight-related behaviors with body dissatisfaction in 261 young adult women. Maladaptive eating styles, such as emotional eating, tended to rise in tandem with body dissatisfaction, differing significantly among body-dissatisfaction levels with medium to large effect sizes. For adaptive eating styles, as body dissatisfaction increased, compensatory restraint increased, intuitive eating declined, and mindful eating did not differ. Weight-related dietary, physical activity, and sleep behaviors did not differ by body dissatisfaction level. BMI increased and health status decreased as body dissatisfaction increased. Binary logistic regression revealed those who were body-dissatisfied had significantly lower health status, higher BMIs, and did not differ on weight-related behaviors. Study findings suggest strategies to improve health-promotion interventions aiming to increase body satisfaction.

UniStArt: A 12-Month Prospective Observational Study of Body Weight, Dietary Intake, and Physical Activity Levels in Australian First-Year University Students

Background: Students in the United States gain weight significantly during their first year of university, however limited data are available for Australian students. Methods: This 12-month observational study was conducted to monitor monthly body weight and composition, as well as quarterly eating behaviours, dietary intake, physical activity, sedentary behaviours, and basal metabolic rate changes amongst first-year Australian university students. Participants were first-year university students over 18 years. Results: Twenty-two first-year university students (5 males and 17 females) completed the study. Female students gained weight significantly at two, three, and four-months (+0.9 kg; +1.5 kg; +1.1 kg, p < 0.05). Female waist circumference (2.5 cm increase at three-months, p = 0.012), and body fat also increased (+0.9%, p = 0.026 at three-months). Intakes of sugar, saturated fat (both >10% of total energy), and sodium exceeded recommended levels (>2000 mg) at 12-months. Greater sedentary behaviours were observed amongst male students throughout the study (p <0.05). Conclusions: Female students are at risk of unfavourable changes in body composition during the first year of university, while males are at risk of increased sedentary behaviours. High intakes of saturated fat, sugars, and sodium warrant future interventions in such a vulnerable group.

Differences in health behaviors related to overweight/obesity by race/ethnicity in a diverse urban commuter college

Objective: To examine health behaviors associated with overweight/obesity by race/ethnicity at a diverse urban college. Participants: 270 undergraduates (77.0% female; 26.7% non-Hispanic white) and median body mass index (BMI) of 23.1 kg/m². Methods: A questionnaire about health-related behaviors as part of the "Get Fruved" project was used to measure health behaviors (sugar sweetened beverage (SSB), fruit and vegetable consumption, physical activity, stress, and sleep) by race/ethnicity. Multivariable logistic regression was used to assess the adjusted odds of engaging in positive health-related behaviors. Results: Non-Hispanic black and Hispanic students were 64% and 59% less likely to consume lower amounts of SSB. Hispanic students were 83% and 81% less likely to meet vegetable and fruit recommendations. Non-Hispanic black and other (including biracial) had reduced odds of meeting vegetable recommendations (AOR = 0.18 and 0.28). Conclusions: Disparities in SSB, fruit, and vegetable consumption represent potential intervention targets to improve health behaviors among racial/ethnic minorities.

Eating behaviors associated with weight gain among university students worldwide and treatment interventions: A systematic review

Introduction: Emerging adulthood has been described as a period of risk for body weight gain. Several studies have indicated that the positive or negative health behaviors established during this stage, tend to prevail the rest of life. However, there are discrepancies in published studies on weight change in freshmen and there are disagreements on weight gain predictors. The present study reviewed the literature with the aim of knowing the eating behaviors associated with weight gain in university students. Method: A systematic search was conducted in three databases according to the PRISMA method during the months of February to November 2020. Results: 20 articles were included in the review. The main behaviors associated with weight gain were the consumption of sugary drinks, alcohol consumption, low consumption of vegetables and fruits, frequent self-consumption, eating unhealthy and low levels of food regulation.

Exercise preferences among emerging adults: Do men and women want different things?

The purpose of this study was to examine exercise preferences of college students (CS), and explore potential gender differences to inform interventions. Participants (N = 187, 18-25 years) completed an online survey. Descriptive statistics were conducted to characterize preferences for exercise type and mode of delivery, followed by χ² tests to assess potential gender differences. CS preferred a combination of moderate intensity cardio and strength training. Most CS preferred exercising on their own with guidance from a program. Men preferred intense strength training at higher rates than women (p < .001). Findings can inform tailored recruitment messaging and lifestyle interventions for this high-risk population.

Factors Associated with Underweight, Overweight, and Eating Disorders in Young Korean Women: A Population-Based Study

Both underweight (UW) and overweight (OW) conditions are problematic in young women. The aim of this study was to examine the factors associated with extreme weight status and eating disorders (EDs) in young Korean women. A total of 808 women (mean age 22.3 ± 3.4 years) participated, including 144 with UW [Body Mass Index (BMI) < 18.5kg/m2], 364 with NW, and 137 with OW or obesity (BMI ≥ 25kg/m2), and 63 patients with anorexia nervosa (AN) and 100 with bulimia nervosa (BN). Participants completed questionnaires regarding nutrients consumed, eating behaviors, health behaviors, body image, and obsessive-compulsive symptoms with face to face interviews. The associations between the status of participants and the data were analyzed with NW group as a reference. OW status was associated with overeating and with frequent eating. UW status was associated with less frequent overeating and with longer sleep duration. AN status was associated with less frequent consumption of alcohol. BN status was associated with a larger discrepancy between the ideal and current body shape. Both OW status and BN were associated with more obsessive-compulsive symptoms. The results suggested that certain dietary, health, and psychological factors are associated with extreme weight conditions and EDs.

Loss Aversion and Health Behaviors: Results from Two Incentivized Economic Experiments

Experimental research in health economics has analyzed the effects of economic preference parameters such as risk attitude and time preference on the probability of adopting risky health behaviors. However, the existing evidence is mixed and previous research often fails to include controls for other determinants of health behaviors such as personality traits. The aim of this research is to analyze the relationships between an incentivized measure of loss aversion and three health behaviors: smoking, binge drinking, and engaging in physical activity. Loss aversion is a preference measure that has been derived from prospect theory as an alternative approach to analyze decision-making under risk, such as the decision to invest in health capital, and has never been used in an analysis of the determinants of health behaviors before. Using two experimental samples of college students in the Republic of Korea and the United States of America, and controlling for Big Five personality traits and a host of individual-level control variables, there are no statistically significant relationships between loss aversion and the three aforementioned health behaviors, but relationships for Big Five conscientiousness, extraversion, agreeableness, and neuroticism. A candidate explanation might be lack of domain independence for loss aversion. Differences between the Korean and the US samples indicate the possibility of intercultural differences.

Muscular Strength, Power, and Endurance Adaptations after Two Different University Fitness Classes

Physical activity (PA) classes help college students add weekly PA, which can help improve health and maintain body weight. Traditional weight training (TWT) can improve strength and aerobic capacity. High-intensity functional training such as CrossFit^® (CF) provides time-efficient workouts with both muscle strengthening and aerobic exercises. Limited research has compared these classes for college students. We examined changes in muscular strength, power, and endurance as well as body composition. Participants were 85 healthy college students enrolled in TWT (n = 36, age 22.6 ± 4.1 years, 72.2% male) or CF (n = 49, age 21.8 ± 3.2 years, 55.1% male) classes meeting twice/wk for 8 weeks between October 2017 and May 2018. Baseline and posttest measurements included a vertical jump, grip strength, a 2 min push-up test, a 1 min squat test, height, weight, and a bioelectrical impedance analysis. Although no significant group × time interactions were found, there was a significant main effect of time for push-ups and squats (both p < 0.001). Participants enjoyed the classes and most planned to continue. Both classes improved muscular endurance although no significant differences were found between them. Activity classes provide college students with an option for increasing their weekly PA and help maintain body composition. Future research should examine the benefits from longer or more frequent classes.

Changes over time in the relationship between weight, body fat, motivation, impulsivity and eating behaviour

BACKGROUND

University students are at a greater risk of gaining weight compared to others. We explored associations between changes in weight and a set of dispositional constructs related to eating behaviour: motivation, impulsivity, social comparison, and eating styles. We predicted that increases in controlled motivation, impulsivity, uncontrolled eating, emotional eating, and physical appearance comparison would be related to increased weight and body fat.

METHODS

First year students at a British university completed baseline (n = 196) and three-month (n = 163) measures of impulsivity, physical appearance comparison, motivation for following a healthy diet, eating styles, weight and body fat. Baseline-follow-up changes in these constructs were computed and subjected to cluster analysis.

RESULTS

Four participant groups were identified according to similarities in the way these constructs evolved over time. The Losing and Gaining groups tended to show opposing changes in key variables (physical appearance comparison, uncontrolled eating, motivation, weight, and percentage of body fat). Interestingly, two groups showed no change in weight and body fat but evidenced unique changes in key variables, indicating that individuals can have different psychological profiles but still maintain their weight.

CONCLUSIONS

The study highlighted how stable weight maintenance arises from sets of interdependent constructs rather than variables in isolation, as well as emphasizing a need to take a person-centred approach to examining those at risk of weight gain and in developing interventions.

Effects of campus food insecurity on obesogenic behaviors in college students

This study sampled college students at a medium-sized university to explore the prevalence of food insecurity, as well as frequency of multiple coping behaviors. Participants: The research team randomly sampled 25% of all students attending at least one on-campus class in October 2017, obtaining a response rate of 14.9% (n = 547). Methods: Using a previously validated instrument, the research team launched an online version of the survey. All students in the sample received an e-mail link to the survey. Results: Students with lower food security seem to be more likely to engage in potentially obesogenic coping behaviors, such as purchasing cheap, processed foods, and overeating when food is plentiful. Comments: Improved access to nutritious food could decrease risk for overweight and obesity in college students. Respondents most commonly identified increased education and skill development as most helpful to improve their food situation.

Exploration of changes in health-related behaviours among Saudi Arabian undergraduates in the UK

This project is an exploratory survey of the ways in which living in the UK has affected the health-related behaviours of Saudi Arabian undergraduate students. The study identifies changes in exercise behaviours, dietary and smoking habits and experiences of stress after their move to the UK. In addition, it identifies what the students perceive to be the drivers of these changes. To achieve this, an online questionnaire was developed collecting quantitative data. This was distributed via Facebook groups specifically for Saudi students in the UK. The results demonstrate that a majority of Saudi Arabian undergraduates felt that their behaviours had become healthier since their move to the UK, mainly as a result of a more active lifestyle, derived from reduced reliance on cars, increased daily walking, and a heightened focus on health promoted by their independence, the availability of healthy foods and exposure to a more health-promoting culture. Although these results are based on a relatively small sample, they are surprising since they contradict previous studies on international students, which have generally found negative lifestyle changes during their studies, including increased stress, poorer dietary habits and a decline in physical activity. Although the exploratory nature of the study means that concrete recommendations cannot be made, it nonetheless offers an impetus for further research into how Saudi Arabian students may be encouraged to adopt healthier lifestyles while studying in the UK.

Variability of Sleep and Relations to Body Weight Among First-Year College Students

BACKGROUND

Existing research suggests that greater sleep variability may increase risk for weight gain. College often marks a transition to a less consistent daily schedule, which may adversely impact sleep routines and further increase risk for weight gain. The current study is among the first to explore relations between nighttime sleep variability and daytime sleep (napping) and body weight among first-year college students.

METHODS

Using daily diary methods, first-year college students (N = 307; 84.7% female) self-reported their sleep for seven days. Several indices were created to capture sleep variability for reported bedtime, wake time, and sleep duration, including weekday versus weekend differences (WvW), day to day differences (D2D), and overall standard deviation (SD). Napping was also assessed. Based on body mass index (BMI), individuals were categorized as underweight, healthy weight, overweight, and obese.

RESULTS

Across indices, students' sleep varied over an hour on average across the week. Hierarchical regressions revealed that greater differences in wake time D2D, wake time SD, and sleep duration WvW were all associated with higher BMI, after accounting for gender, depressive symptoms, and sleep duration. Longer napping was also associated with higher BMI, using the same covariates. Finally, greater sleep variability was reported by overweight and obese than healthy weight individuals.

CONCLUSION

These findings suggest that sleep variability, particularly wake times and napping may be important modifiable sleep behaviors to investigate in future studies. More longitudinal research is needed to explore relations between multiple facets of sleep variability and weight gain, including possible mechanisms.

Freshmen weight and body composition change determinants: A scoping review

Scoping review of freshmen weight and body composition change determinants in order to inform practice, policymaking, and research that improve health and well-being. Methods: A systematic search of the literature identified potential sources. Duplicates were removed before a title and abstract review. A full-text review was then conducted on the remaining sources. Retained sources were then reviewed systematically before synthesis. Results: Eighty-five sources were synthesized. Variation in study design, measurement, reporting, and analyses of determinants, in particular dietary characteristics and physical activity, complicate comparisons. Dietary characteristics and physical activity appear to influence freshmen weight and body composition changes, while evidence indicates alcohol consumption is associated with deleterious weight and body composition changes. Conclusions: Design, measurement, analyses, and reporting can be improved considerably to better examine relationship between body composition changes and determinants in order to provide insight into, and inform, interventions and policies to benefit students' health and well-being.

The association between fitness and obesity in diverse multi-ethnic college students

We examined differences and associations between physical fitness and behavioral factors with obesity in a multi-ethnic student population. Participants: Study population included non-Hispanic whites (NHW, n = 1,454); Hispanics (n = 1,436) and Asians (n = 1,016) at a metropolitan university from Fall 2006 to Fall 2013. Methods: Analyses of Variance and regression analyses, utilizing cross-sectional data, measured the association between fitness, and behavior with obesity. Results: BMI differences (p < .05) were observed between NHW (23.17 ± 3.67), Hispanics (24.32 ± 3.67), and Asians (22.92 ± 4.12). Fitness parameters, relative VO₂ max, % body fat, and total fitness score were significantly (p < .0001) associated with obesity. Stress was strongly significantly associated with obesity in Hispanics (p < .001) and somewhat in NHW. Conclusions: Obesity disparities persist in college. Physical fitness and stress management interventions should be targeted towards Hispanic and NHW college students, which may curb current and/or adult-onset obesity.

Testing a One-Item Risk Measure to Predict Alameda Seven Health Behaviors in the Republic of Korea

The college years provide an important window of opportunity for the implementation of preventive efforts, especially with respect to smoking, problematic drinking, and obesity. Targeting of individuals at high risk of adopting those health behaviors might increase the effectiveness of those efforts, yet little is known about possible criteria for targeting and their ability to predict the adoption of risky health behaviors. Human capital theory predicts that more risk-averse individuals are more likely to invest in their health capital and should therefore be less likely to engage in risky health behaviors. Building on this theoretical prediction, this study uses a simple one-item measure of risk attitude and examines its ability to predict the Alameda Seven health behaviors in a sample of college students in the Republic of Korea. Unlike previous research, it also controls for personality traits and cognitive ability. Experimental data were gathered and analyzed using regression analysis. The risk measure predicted the probability of smoking and reporting higher stress levels, with no correlations found for the other health behaviors, suggesting that replication studies using larger samples should be carried out to analyze if these findings persist.

Using self-determination theory to understand eating behaviors and weight change in emerging adults

INTRODUCTION

College may be a time when emerging adults establish eating patterns that influence future weight trajectories. Self-determination theory (SDT) suggests that satisfaction of basic psychological needs (autonomy, competence, relatedness) supports autonomous regulation of behavior, which is associated with healthier behaviors. When needs are frustrated, individuals feel as though their behaviors are controlled by others, which is associated with unhealthy behaviors. This study used SDT to examine a model for associated body satisfaction, eating/weight control behaviors, and weight change.

METHODS

Using a cross-sectional design, undergraduates (N = 875; 57% women; Age_M = 20 ± 1.4 yrs.; BMI_M = 24.3 ± 4.4) completed measures of need satisfaction and frustration, behavioral regulation of healthy weight, body satisfaction, eating/weight control behaviors, and weight change in their first semester of college.

RESULTS

Structural equation modeling showed that need satisfaction was positively associated with greater autonomous regulation, which was positively associated with greater body satisfaction and fruit/vegetable intake. Conversely, greater need frustration was associated with greater controlled regulation, which was associated with lower body satisfaction. Participants who had greater body satisfaction engaged in fewer unhealthy weight control behaviors. Engaging in more unhealthy behaviors was associated with greater weight gain during the first semester of college, whereas fruit and vegetable intake was not associated with weight change. The associations were stronger for women than men, particularly for the relationships between body satisfaction and unhealthy weight control behaviors and increased weight gain.

CONCLUSIONS

The model was generally supported, suggesting that psychological need satisfaction and autonomous motivation in college students may facilitate greater body satisfaction and healthier eating behaviors. Future longitudinal research is needed to clarify the factors that influence health behaviors and weight gain in college students.

Health of Youth in Transition in Hong Kong

This study aimed to examine the impact of individual (level of vigorous physical activity (VPA) and frequency of using sports and recreation facilities), interpersonal (perceived social cohesion (PSC)), and neighborhood environmental (availability of sports and recreation facilities) factors on youths’ health in transition in Hong Kong. A sample of 508 individuals aged 17–23 years from all Hong Kong council districts randomly completed validated questionnaires by telephone survey. Of 508,302 individuals with complete data pertaining to address geocoding were selected for further analyses. Overall, more than half of them (56.3%) used sports and recreation facilities once per month or less. Structural equation modeling was used to examine the relationship among the studies’ constructs. The results indicated that the proposed model sufficiently fitted the data (χ² (24) = 32.23, p < 0.12; CFI = 0.977; SRMR = 0.051; RMSEA = 0.034 (90% CI = 0.000 to 0.061). However, two items of PSC were sequentially removed due to their low standardized factor loadings (<0.3). A structural model was reinserted into data analyses, and the modified model fitted the data well as indicated by fit indices (χ² (11) = 15.29, p < 0.17; CFI = 0.987; SRMR = 0.054; RMSEA = 0.036 (90% CI = 0.000 to 0.075). Only VPA (β = 0.27, p = 0.0005) and PSC (β = 0.12, p = 0.048) were significantly related to perceived health at an individual level. To promote youth health, the Hong Kong government may work with the business sector, community groups, or education institutions to develop community programs to keep youths active (especially VPA) and to build more cohesive, trustful relationships among youths in the neighborhood.

Socioeconomic Determinants of the Anthropometric Characteristics and Motor Abilities of Polish Male University Students: A Cross-Sectional Study Conducted in 2000-2018

Aim: The aim of this study was to determine the relationships between socioeconomic factors, anthropometric characteristics and motor abilities of male university students. Materials and Methods: The study was conducted from 2000 to 2018 on 2691 male university students aged 19.98 ± 1.05 years, who were randomly selected from students attending obligatory physical education (PE) classes. The participants’ body mass and height were measured, and students participated in 13 motor ability tests that assessed their speed/agility, flexibility, strength and endurance abilities. Multiple independent samples were compared with the Kruskal–Wallis test or the mean-ranks post-hoc test when significant differences were observed in the participants’ motor abilities. Results: Factors such as the place of permanent residence, students’ monthly budget, and mother’s and father’s educational background, significantly (p < 0.05) influenced the body mass, BMI and motor abilities of first-year university students. The participants’ motor abilities (speed/agility, flexibility—partly, strength, strength endurance, and endurance) were most frequently and most significantly determined by their monthly budgets, and were least frequently and least significantly determined by their place of permanent residence. Conclusions: The students’ body height, BMI and motor abilities generally increased with a rise in population in the place of permanent residence, monthly budget, and the parents’ educational attainment.

Development of an Instrument Measuring Perceived Environmental Healthfulness: Behavior Environment Perception Survey (BEPS)

OBJECTIVE

To create a tool to measure college students' perception of the healthfulness of their environment.

DESIGN

(1) Item generation, (2) cognitive interview testing and exploratory factor analysis, (3) item refinement/modification, (4) factor structure validation, and (5) criterion validation.

SETTING

Ten college campuses.

PARTICIPANTS

Time point 1 (n = 120 cognitive interviews; n = 922 factor analysis); time point 2 (n = 2,676), convenience sample of undergraduate students.

MAIN OUTCOME MEASURES

Cognitive interviews and survey data were used to assess perceptions about the environment.

ANALYSIS

Exploratory factor analysis, structural equation confirmatory factor analysis, correlations, and regressions.

RESULTS

Item generation resulted in 93 items. Items were eliminated based on cognitive interviews, exploratory factor analysis of pilot data, and elimination of cross-loading or weak loading items. In confirmatory analyses, a 21-item, 5-factor structure was the best fit for the data (χ² = 3,286.77, degrees of freedom = 189; comparative fit index = 0.840; root-mean-square error of approximation = 0.078). Environmental factors include physical activity (α = 0.68, 4 items), healthful eating (α = 0.86, 5 items), mental health (α = 0.85, 5 items), barriers to healthful eating (α = 0.70, 4 items), and peer influences (α = 0.73, 3 items). There were significant associations between scales and validation criteria (P < .05).

CONCLUSIONS AND IMPLICATIONS

The Behavior Environment Perception Survey is a novel instrument measuring perceptions of the healthfulness of the campus environment. Strengths include a development process involving 10 different universities, strong psychometric properties, and breadth of constructs.

Changes in Weight Status and the Intestinal Microbiota Among College Freshman, Aged 18 Years

PURPOSE

The transition to college is a vulnerable period for weight gain and the onset of obesity. Gut microbes differ in obese compared with lean individuals, but gut microbiota in adolescent-aged college freshmen during a known period of weight gain have never been studied. This pre-post observational pilot study assessed associations between intestinal microbiota changes and weight-related outcomes in healthy adolescent college freshmen living in on-campus dormitories at Arizona State University (n = 39).

METHODS

We measured anthropometrics (waist circumference [WC], height, weight, and body mass index [BMI]) and collected fecal samples at the beginning and end of the 2015-2016 academic year. Fold changes in species-level microbes across time were measured by quantitative real-time polymerase chain reaction and used in correlation and multivariate regression analyses.

RESULTS

A total of 24 female and 15 male adolescents (aged 18.54 ± .67 years) participated in this study. Over the academic year, BMI and WC increased by .97±1.28 kg/m² and 2.64±4.90 cm, respectively. Correlation analyses indicated a significant negative association between Akkermansia muciniphila and both percentage WC change and percentage BMI change (r = -.66, p < .01; and r = -.33, p = .04, respectively). Multivariate regression analysis controlling for sociodemographics showed a significant association between A. muciniphila and percentage WC change, but not percentage BMI change (R² = .53, p < .01; and R² = .24, p = .15, respectively).

CONCLUSIONS

As this was the first study in a university-based adolescent population to show a relationship between A. muciniphila and weight-related outcomes, further research is needed to explore these findings.

A systematic review of the methodology used to study weight change among young adults attending college

INTRODUCTION

Young adulthood is a sensitive developmental period that is high-risk for weight gain. Ample research has focused on weight gain among college students; however meta-analyses report <2 kg pooled estimates of weight gain, which is in the range of normal weight fluctuation, and there is disagreement in the literature regarding common predictors of weight gain. These limitations pose a major barrier to targeted obesity prevention efforts. The present study reviewed the literature assessing college weight gain with a focus on three methodological factors that could contribute to variability in the literature: 1) use of an evidence-supported definition of weight gain (>2 kg or ≥3%); 2) weight measurement protocols; and 3) including weight/BMI in analyses of predictors of weight change.

METHODS

Three databases were systematically searched. Studies were included in the review if the primary goal was to determine magnitude of weight change and/or test predictors of weight change during the academic year, and they reported weight at 2+ time points.

RESULTS

A total of 81 studies were included in the review. Most studies (90%; 73/81) did not use an evidence-supported definition of weight gain. Studies that used an evidence-supported definition reported estimates of gain among students who gained weight to be beyond the range of normal weight fluctuation (4.0-7.5 kg), and occurred in a subset (<32%) of participants. Studies that did not use an evidence-supported definition reported weight gain to be 2.0-4.5 kg, and occurred in the majority >50% of students. Most studies that measured height and weight (71%; 42/59) did not use a fasting protocol and the majority (63%; 37/59) did not conduct measurements at the same time of day. A higher percentage of studies that used a standardized measurement protocol reported weight change >2 kg (44% vs 20%). A lower percentage of studies that used a standardized measurement protocol had substantial variability in weight change estimates (50% vs 69%). The majority of studies that tested predictors of weight gain (74%; 42/57) included weight/BMI as a covariate in analyses.

CONCLUSIONS

The body of literature examining weight change among college students suffers from limitations that may have contributed to overestimations in the percent of students who gain weight, and simultaneous underestimations of the magnitude of weight gain among those who gain weight. Weight gain may be limited to approximately 30% of students in a sample, and weight gain among this subset of students may be substantial (>4 kg). Going forward, use of both an evidence-supported weight gain definition and fasting measurement protocol will likely enhance accuracy in characterizing weight gain among college students, as well as improve researchers' ability to detect important predictors of weight gain.

Similarity in meal plan use among first-year roommates

OBJECTIVE

To examine if first-year roommates made similar meal plan decisions.

METHODS

Residence information for 1186 first-year students (N = 593 roommate pairs) and 559 floormates was obtained for the 2015-2016 academic year. Linear generalized estimating equations (GEEs) were used to examine if the number of meals students used over the semester was higher if their roommate used their meal plan more frequently. A logistic GEE examined joint meal plan usage between students and roommates for each month of the semester. To determine if residence, rather than roommate, explained the results, a simulation was conducted by randomly assigning the floormates to a same-sex roommate.

RESULTS

The number of meals students used in spring was higher if the students' roommate had used more meals in spring, even after controlling for the number of meals students used in fall (Female: β = 0.07, 99% CI = 0.00, 0.13; Male: β = 0.10, 99% CI = 0.02, 0.18). Students were more likely to use a meal with their roommate if they were on the same meal plan (Female: OR = 1.61, 99% CI = 1.27, 2.04; Male: OR = 1.57, 99% CI = 1.09, 2.25), and less likely after the first month of being roommates (Female: OR = 0.57-0.25; Male: OR = 0.50-0.22; p < 0.001). The simulation analysis indicated these findings were not due to shared residence.

DISCUSSION

Students' meal plan choices were associated with their roommates' meal plan choices. Roommates' joint meal plan usage was highest at the start of the year. Strategic roommate pairings may result in students using their meal plan more. Further research should determine the extent of roommate influence on students' diet.

Relation of self-weighing to future weight gain and onset of disordered eating symptoms

OBJECTIVE

Frequent self-weighing is recommended in weight loss interventions and may prevent weight gain. However, concerns regarding the associations between self-weighing and eating disorders have been expressed and the relations between self-weighing and weight gain/eating pathology have not been examined prospectively. We tested whether (a) frequency of baseline self-weighing in college students with weight concerns predicted weight change over 2-year follow-up, (b) this relation was moderated by eating disorder symptoms, and (c) self-weighing predicted future eating disorder symptoms.

METHOD

Data were merged from two trials evaluating obesity/eating disorder prevention programs in 762 students (Mage = 18.7; 86% women). Participants reported how often they weighed themselves at baseline; body mass index (BMI) and eating disorder symptoms were assessed over 2-year follow-up.

RESULTS

Baseline self-weighing predicted weight gain, with more frequent weighers experiencing greater gains (i.e., +0.8 of BMI) over follow-up. This relation was moderated by the frequency of binge eating but not weight/shape concerns or compensatory behaviors; the combination of more frequent self-weighing and binge eating was associated with greatest weight gain (+1.6 of BMI). More frequent weighers also reported higher onset of compensatory behaviors, relative to non-self-weighers (odds ratio = 3.90, 95% confidence interval [1.76, 8.75]).

CONCLUSIONS

Young adults who weighed themselves more frequently had greater weight gain than those who self-weighed less frequently, especially those who engaged in binge eating, and were at risk for future unhealthy compensatory behaviors. Findings suggest that frequent self-weighing may have negative effects for some young adults, and that relations between self-weighing and weight control outcomes require further investigation. (PsycINFO Database Record

Prevalence and correlates of food insecurity among U.S. college students: a multi-institutional study

Background

College students may be vulnerable to food insecurity due to limited financial resources, decreased buying power of federal aid, and rising costs of tuition, housing, and food. This study assessed the prevalence of food insecurity and its sociodemographic, health, academic, and food pantry correlates among first-year college students in the United States.

Methods

A cross-sectional study was conducted among first-year students (n = 855) across eight U.S. universities. Food security status was assessed using the U.S. Department of Agriculture Adult Food Security Survey Module. Cohen’s Perceived Stress Scale, Pittsburgh Sleep Quality Index, and Eating Attitudes Test-26 were used to assess perceived stress, sleep quality, and disordered eating behaviors, respectively. Participants self-reported their grade point average (GPA) and completed questions related to meal plan enrollment and utilization of on-campus food pantries.

Results

Of participating students, 19% were food-insecure, and an additional 25.3% were at risk of food insecurity. Students who identified as a racial minority, lived off-campus, received a Pell grant, reported a parental education of high school or less, and did not participate in a meal plan were more likely to be food-insecure. Multivariate logistic regression models adjusted for sociodemographic characteristics and meal plan enrollment indicated that food-insecure students had significantly higher odds of poor sleep quality (OR = 2.32, 95% CI: 1.43–3.76), high stress (OR = 4.65, 95% CI: 2.66–8.11), disordered eating behaviors (OR = 2.49, 95% CI: 1.20–4.90), and a GPA < 3.0 (OR = 1.91, 95% CI: 1.19–3.07) compared to food-secure students. Finally, while half of the students (56.4%) with an on-campus pantry were aware of its existence, only 22.2% of food-insecure students endorsed utilizing the pantry for food acquisition.

Conclusions

Food insecurity among first-year college students is highly prevalent and has implications for academic performance and health outcomes. Higher education institutions should screen for food insecurity and implement policy and programmatic initiatives to promote a healthier college experience. Campus food pantries may be useful as short-term relief; however, its limited use by students suggest the need for additional solutions with a rights-based approach to food insecurity.

Trial Registration

Retrospectively registered on ClinicalTrials.gov, NCT02941497.

The Impact of Step Recommendations on Body Composition and Physical Activity Patterns in College Freshman Women: A Randomized Trial

PURPOSE

Transitioning from high school to college generally results in reduced physical activity and weight gain at a rate that is higher than the general population. The purpose of this study was to examine the effects of three progressively higher step recommendations over 24 weeks on changes in body weight and body composition.

METHODS

Ninety-two freshmen college women wore a multifunction pedometer for 24 weeks after being randomly assigned to a daily step level: 10,000, 12,500, or 15,000. Pedometer data were downloaded every two weeks and participants were counseled on meeting their step recommendation. Body weight and body composition were assessed at baseline and 24 weeks. Body composition was assessed by dual X-ray absorptiometry.

RESULTS

On average, women took 10,786 ± 1501, 12,650 ± 2001, and 13,762 ± 2098 steps per day for the 10,000-, 12,500-, and 15,000-step groups, respectively (F = 15.48, P < 0.0001). Participants gained 1.4 ± 2.6, 1.8 ± 2.1, and 1.4 ± 2.1 kg for the 10,000-, 12,500-, and 15,000-step groups, respectively (F = 37.74, P < 0.0001). Weight gain was not significantly different between groups (F = 0.18, P=0.8385). There was also no difference in fat weight gain (F = 0.41, P=0.7954).

DISCUSSION

A step recommendation beyond 10,000 does not prevent weight or fat gain over the first year of college. Future research should focus on either intensity of physical activity or the addition of dietary interventions to prevent weight gain during the first year of college.

Diet, physical activity and screen time but not body mass index are associated with the gut microbiome of a diverse cohort of college students living in university housing: a cross-sectional study

BACKGROUND

Modifiable lifestyle factors (e.g. dietary intake and physical activity) are important contributors to weight gain during college. The purpose of this study was to evaluate whether associations exist between body mass index, physical activity, screen time, dietary consumption (fat, protein, carbohydrates, and fiber), and gut microbial diversity during the first year of college. Racially/ethnically diverse college students (n = 82; 61.0% non-white) at a large Southwestern university completed self-reported physical activity and 24-h recall dietary assessments, height and weight measurements, and provided one fecal sample for gut microbiome analysis. Fecal microbial community composition was assessed with Illumina MiSeq next-generation sequencing of PCR amplified 16S rRNA genes. Post-hoc analyses compared microbial diversity by groups of high and low physical activity and fiber intake using QIIME and LEfSe bioinformatics software.

RESULTS

No statistically significant differences were observed between body mass index and gut microbiome abundance and diversity. Median daily consumption of dietary fiber was 11.2 (7.6, 14.9) g/d, while the median self-reported moderate-to-vigorous physical activity (MVPA) was 55.7 (27.9, 79.3) min/d and screen time 195.0 (195.0, 315.0) min/d. Microbial analysis by LEfSe identified Paraprevotellaceae, Lachnospiraceae, and Lachnospira as important phylotypes in college students reporting greater MVPA, while Enterobacteriaceae and Enterobacteriales were more enriched among students reporting less MVPA (p < 0.05). Barnesiellaceae, Alphaproteobacteria, and Ruminococcus were more abundant taxa among those consuming less than the median fiber intake (p < 0.05). Post-hoc analyses comparing weighted UniFrac distance metrics based on combined categories of high and low MVPA and fiber revealed that clustering distances between members of the high MVPA-low fiber group were significantly smaller when compared to distances between members of all other MVPA-fiber groups (p < 0.0001).

CONCLUSIONS

Habitual fiber consumption and MVPA behaviors help explain the differential abundance of specific microbial taxa and overall gut microbial diversity differences in first-year college students.

Preferences, personality and health behaviors: results from an explorative economic experiment

This research note analyzes the relationship between experimentally elicited, incentivized economic preference parameters, personality traits, and three health behaviors: smoking, drinking, and physical activity. While there is a strand of economic research that uses proxy measures of risk and time preference that are not derived from an incentivized experiment and personality traits at the same time, and a considerably smaller one that uses experimentally elicited measures of risk and time preference only, the innovation of my work is to use experimentally elicited, incentivized preference measures and personality traits at the same time to explain a range of health behaviors. Findings presented in this paper suggest that personality traits seem to be more important determinants of health behaviors than economic preference parameters, and that Big Five personality traits, especially Agreeableness, seem to be more important determinants than the Grit score developed by Duckworth et al. (J Pers Soc Psychol 92(6):1087, 2007). When also controlling for a host of personality traits, risk preference is not related to the analyzed behaviors, but time preference is negatively related to smoking. When controlling for economic preferences and Big Five personality traits, the Grit score is unrelated to the analyzed health behaviors. Big Five openness is negatively related to the probability of engaging in physical activity, while Big Five agreeableness is negatively related to the probability of both drinking and binge drinking, but also to the probability of engaging in physical activity. Big Five neuroticism is negatively related to the probability of binge drinking.

Multilevel Structural Equation Modeling of Students' Dietary Intentions/Behaviors, BMI, and the Healthfulness of Convenience Stores

Background: When dietary behaviors are habitual, intentions are low, and environmental cues, such as the consumer food environment, might guide behavior. How might intentions to eat healthily and ultimately actual dietary behaviors, be influenced by the consumer food environment (including the availability and affordability of healthy foods) in convenience stores? This study will determine pathways between the healthfulness of convenience stores and college students’ dietary intentions/behaviors, and body mass index (BMI). Methods: Through multilevel structural equation modeling, a comparison was made of students’ healthful meal intentions (HMI); intake (fruits/vegetables, %kcal/fat, sugar-sweetened beverages (SSBs) and whole-grains); and measured BMI; as well as the healthfulness of convenience stores (fruits/vegetables availability/quality, healthy food availability/affordability). Data was collected on 1401 students and 41 convenience stores across 13 US college campuses. Results: Controlling for gender, HMI was negatively associated with SSBs (β = −0.859) and %kcal/fat (β = −1.057) and positively with whole-grains (β = 0.186) and fruits/vegetables intake (β = 0.267); %Kcal/fat was positively (β = 0.098) and fruits/vegetables intake (β = −0.055) negatively associated with BMI. Campus level, fruits/vegetables availability were positively associated to HMI (β = 0.214, β = 0.129) and directly/negatively to BMI (β = −2.657, β = −1.124). Conclusions: HMI modifies dietary behaviors, with energy from fat and fruit/vegetable intake the most predictive of weight. Availability of fruit/vegetables in convenience stores make it easier for young adults to eat well.

Disordered Eating Among a Diverse Sample of First-Year College Students

OBJECTIVE

A cross-sectional study of first-year college students was conducted to identify the prevalence and predictors of disordered eating (DE).

METHODS

College freshmen students, aged 18 years, (n = 106) completed the Eating Disorder Examination Questionnaire (EDE-Q) and a supplemental survey. A subset of the sample (n = 77) underwent measurements of height, weight, and body composition. DE was defined as an elevated (3) weight, shape, eating concern, or dietary restraint EDE-Q subscale score.

RESULTS

The sample, consisting of 56.6%, 15.1%, 11.3%, and 11.3% Latino/a, Asian, African American, and Caucasian students, respectively (37% male), reported a 31.1% prevalence of DE. The current desire to lose weight was the strongest predictor of DE (odds ratio = 15.3; 95% confidence interval = 2.8, 82.5). Other variables linked to DE or elevated EDE-Q subscale scores included body mass index (BMI) 25.0 kg/m², vegetarianism, weight loss in the past year, female gender, and eating breakfast < 5 d/wk. Participants with BMI 25.0 kg/m² and the current desire to lose weight (n = 23) or following a vegetarian diet (n = 5) exhibited the highest prevalence of DE (78.3% and 80.0%, respectively). A higher proportion of Latinas reported binge episodes compared to female Caucasian, Asian, and African American students (36.4% vs. 0.0%, 6.7%, and 28.6%, respectively, p = 0.056, χ² = 7.6). Males, versus females, were more likely to report excessive exercise (56.4% vs. 37.3%, p = 0.056, χ² = 3.6).

CONCLUSIONS

This study adds to the current body of literature on DE by providing a diverse sample and potentially novel predictors and risk factors for DE.

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

This study assessed food choice priorities (FCP) and associations with consumption of fruits and vegetables (FV), fiber, added sugars from non-beverage sources, and sugar-sweetened beverages (SSB) among college students. Freshmen from eight U.S. universities (N = 1149) completed the Food Choice Priorities Survey, designed for college students to provide a way to determine the factors of greatest importance regarding food choices, and the NCI Dietary Screener Questionnaire. Changes in FCP and dietary intake from fall 2015 to spring 2016 were assessed. Multiple regression models examined associations between FCP and log-transformed dietary intake, controlling for sex, age, race, and BMI. Participant characteristics and FCP associations were also assessed. FCP importance changed across the freshmen year and significantly predicted dietary intake. The most important FCP were price, busy daily life and preferences, and healthy aesthetic. Students who endorsed healthy aesthetic factors (health, effect on physical appearance, freshness/quality/in season) as important for food choice, consumed more FV and fiber and less added sugar and SSB. Busy daily life and preferences (taste, convenience, routine, ability to feel full) predicted lower FV, higher added sugar, and higher SSB consumption. Price predicted lower FV, higher SSB, and more added sugar while the advertising environment was positively associated with SSB intake. FCP and demographic factors explained between 2%–17% of the variance in dietary intake across models. The strongest relationship was between healthy aesthetic factors and SSB (B = −0.37, p < 0.01). Self-rated importance of factors influencing food choice are related to dietary intake among students. Interventions that shift identified FCP may positively impact students’ diet quality especially considering that some FCP increase in importance across the first year of college.

Racial/ethnic differences in body weight perception among U.S. college students

OBJECTIVE

To examine racial/ethnic differences in weight perception by sex among U.S. college students.

PARTICIPANTS

a national sample (N = 70,267) of college students selected from 2- and 4-year postsecondary institutions (N = 62) during the Fall semester from 2011 to 2014.

METHODS

This is a secondary data analysis using 4 years of American College Health Association-National College Health Assessment IIb data. Sex-stratified multinomial logistic regression was performed to investigate racial/ethnic differences in body weight perception.

RESULTS

Compared with non-Hispanic whites, non-Hispanic black men and women were more likely to underestimate their body weight (p < .01). Asian men and women were more likely to overestimate their body weight than non-Hispanic whites (p < .001).

CONCLUSIONS

Weight-related interventions should take into account racial/ethnic differences in body weight perception.

First-Year University Students Who Self-Select into Health Studies Have More Desirable Health Measures and Behaviors at Baseline but Experience Similar Changes Compared to Non-Self-Selected Students

Studies demonstrate that first-year university students are at high risk for weight gain. These reports typically rely on self-selected participants. The purpose of this study was to explore if students who chose to participate in a health-based research study had more desirable health measures and behaviors than students who completed health assessments as part of a first-year seminar course. Health measures included blood pressure (BP), body mass index (BMI), and percent body fat. Health behaviors included dietary patterns (Starting the Conversation questionnaire) and alcohol use (Alcohol Use Disorders Identification Test-Consumption). A total of 191 (77% female) participants completed testing in the self-selected “Health Study” group, whereas 73 of the 91 students (80%, 55% female) enrolled in the “Seminar” allowed their data to be used for research purposes. Baseline measures favored Health Study participants, including but not limited to fewer participants with undesirable BMI (≥25.0 kg/m²; males and females) and a smaller percentage of participants with undesirable BP (systolic ≥120 mmHg and/or diastolic ≥80 mmHg; females only). Differences in dietary behaviors at baseline were inconsistent, but Seminar students engaged in more problematic alcohol-use behaviors. While both groups experienced undesirable changes in health measures over time, the degree of change did not differ between groups. Changes in health behaviors over time typically resulted in undesirable changes in the Seminar group, but the magnitude of change over time did not differ between groups. Thus, results from first-year university students who self-select into health studies likely underestimate the seriousness of undesirable health measures and behaviors but may accurately reflect the degree of change over time.

Stress and psychological constructs related to eating behavior are associated with anthropometry and body composition in young adults

BACKGROUND

The transition to college is associated with weight gain, but the relation between eating behavior indicators and anthropometric outcomes during this period remains unclear.

OBJECTIVE

We aimed to evaluate sex differences in stress, emotional eating, tendency to overeat, and restrained eating behavior, and determine whether the psycho-behavioral constructs assessed immediately prior to starting college are associated with anthropometry and adiposity at the start of college, and with first-semester weight gain.

METHODS

A prospective study administered the Three Factor Eating Questionnaire (TFEQ), Satter Eating Competence Inventory, and Perceived Stress Scale (PSS) to 264 participants one month before college. Body composition was assessed via dual energy X-ray absorptiometry (DXA) at the start of college, and anthropometry (weight, height, waist circumference [WC]) was collected at the beginning and end of the first semester. Ordinary least squares regression tested the cross-sectional association of baseline psychological and behavioral scales with baseline DXA and anthropometry, and the longitudinal association with change in anthropometry.

RESULTS

Among 264 participants, 91% (241) had baseline data, and 66% (173) completed follow-up. In sex-adjusted linear regression models, baseline TFEQ disinhibited and emotional (DE; EE) eating sub-scales were positively associated with baseline weight (P = 0.003; DE, P = 0.014; EE), body mass index (BMI, P = 0.002; DE, P = 0.001; EE), WC (P = 0.004; DE, P = 0.006; EE) and DXA fat mass index (P = 0.023; DE, P = 0.014; EE). Baseline PSS was positively associated with subsequent changes in weight and WC among males only (P_interaction = 0.0268 and 0.0017 for weight and WC, respectively).

CONCLUSION

College freshmen with questionnaire scores indicating a greater tendency to overeat in response to external cues and emotions tended to have greater weight, BMI, and WC at the start of college. Males with higher perceived stress at college entrance subsequently gained significantly more weight in the first semester, but no such relation was evident in females.

College Freshmen Students' Perspectives on Weight Gain Prevention in the Digital Age: Web-Based Survey

BACKGROUND

College freshmen are highly vulnerable to experiencing weight gain, and this phenomenon is associated with an increased risk of chronic diseases and mortality in older adulthood. Technology offers an attractive and scalable way to deliver behavioral weight gain prevention interventions for this population. Weight gain prevention programs that harness the appeal and widespread reach of Web-based technologies (electronic health or eHealth) are increasingly being evaluated in college students. Yet, few of these interventions are informed by college students' perspectives on weight gain prevention and related lifestyle behaviors.

OBJECTIVE

The objective of this study was to assess college freshmen students' concern about weight gain and associated topics, as well as their interest in and delivery medium preferences for eHealth programs focused on these topics.

METHODS

Web-based surveys that addressed college freshmen students' (convenience sample of N=50) perspectives on weight gain prevention were administered at the beginning and end of the fall 2015 semester as part of a longitudinal investigation of health-related issues and experiences in first semester college freshmen. Data on weight gain prevention-related concerns and corresponding interest in eHealth programs targeting topics of potential concern, as well as preferred program delivery medium and current technology use were gathered and analyzed using descriptive statistics.

RESULTS

A considerable proportion of the freshmen sample expressed concern about weight gain (74%, 37/50) and both traditional (healthy diet: 86%, 43/50; physical activity: 64%, 32/50) and less frequently addressed (stress: 82%, 41/50; sleep: 74%, 37/50; anxiety and depression: 60%, 30/50) associated topics within the context of behavioral weight gain prevention. The proportion of students who reported interest in eHealth promotion programs targeting these topics was also generally high (ranging from 52% [26/50] for stress management to 70% [35/50] for eating a healthy diet and staying physically active). Email was the most frequently used electronic platform, with 96% (48/50) of students reporting current use of it. Email was also the most frequently cited preferred eHealth delivery platform, with 86% (43/50) of students selecting it. Facebook was preferred by the second greatest proportion of students (40%, 20/50).

CONCLUSIONS

Most college freshmen have concerns about an array of weight gain prevention topics and are generally open to the possibility of receiving eHealth interventions designed to address their concerns, preferably via email compared with popular social media platforms. These preliminary findings offer a foundation to build upon when it comes to future descriptive investigations focused on behavioral weight gain prevention among college freshmen in the digital age.

Daily self-weighing and weight gain prevention: a longitudinal study of college-aged women

Daily self-weighing has been suggested as an important factor for weight loss maintenance among samples with obesity. This study is a secondary analysis that examined daily self-weighing in association with weight and body composition outcomes over 2 years among young women with vulnerability for weight gain. Women (N = 294) of varying weight status completed self-weighing frequency questionnaires and weight was measured in the clinic at baseline, 6 months, 1, and 2 years; DXA scans were completed at baseline, 6 months and 2 years. Multilevel models examined the relationship between daily self-weighing (at any point in the study) and trajectories of BMI and body fat percentage. Daily self-weighing was associated with significant declines in BMI and body fat percent over time. Future research is needed to examine causal relations between daily self-weighing and weight gain prevention. Nonetheless, these data extend the possibility that daily self-weighing may be important for prevention of unwanted weight gain.

An Examination of Family, Healthcare Professionals, and Peer Advice on Physical Activity Behaviors among Adolescents at High Risk for Type 2 Diabetes

Studies have shown that many college students do not meet the recommended daily physical activity (PA) levels, and about 22% of these students are overweight. Given that engaging in PA is a protective behavior against many chronic conditions, it is imperative to understand what sources of information/advice to engage in PA is most influential. Hence, the purpose of this study was to examine the relative impact of different sources of advice regarding exercise and PA on actual PA engagement among obese/overweight adolescents. Using data from 319 overweight/obese college students, multivariate regression analyses were conducted to examine which source of advice (from parents, peers, or healthcare provider) to engage in PA was associated with PA behavior among these adolescents. Influence of type 2 diabetes (T2D) family history on PA behavior was also examined. Moderate and vigorous PA behavior was more likely among obese/overweight adolescents who received advice to exercise or engage in PA from their peers (B = 200.85, β = 0.193, p = 0.001; B = 121.19, β = 0.145, p = 0.014). Overweight/obese adolescents with a T2D family history were more likely to walk compared with those without a T2D family history (χ² = 12.97, p = 0.000). Findings suggest that although healthcare professionals advise obese/overweight adolescents, those who received advice regarding PA behavior from their peers were more likely to heed the advice and exercise/engage in PA. In essence, intervention efforts should focus on employing peer ambassadors to counsel other adolescents on the importance of PA.

Effect of a Counseling Session Bolstered by Text Messaging on Self-Selected Health Behaviors in College Students: A Preliminary Randomized Controlled Trial

Background

The college experience is often the first time when young adults live independently and make their own lifestyle choices. These choices affect dietary behaviors, exercise habits, techniques to deal with stress, and decisions on sleep time, all of which direct the trajectory of future health. There is a need for effective strategies that will encourage healthy lifestyle choices in young adults attending college.

Objective

This preliminary randomized controlled trial tested the effect of coaching and text messages (short message service, SMS) on self-selected health behaviors in the domains of diet, exercise, stress, and sleep. A second analysis measured the ripple effect of the intervention on health behaviors not specifically selected as a goal by participants.

Methods

Full-time students aged 18-30 years were recruited by word of mouth and campuswide advertisements (flyers, posters, mailings, university website) at a small university in western Pennsylvania from January to May 2015. Exclusions included pregnancy, eating disorders, chronic medical diagnoses, and prescription medications other than birth control. Of 60 participants, 30 were randomized to receive a single face-to-face meeting with a health coach to review results of behavioral questionnaires and to set a health behavior goal for the 8-week study period. The face-to-face meeting was followed by SMS text messages designed to encourage achievement of the behavioral goal. A total of 30 control subjects underwent the same health and behavioral assessments at intake and program end but did not receive coaching or SMS text messages.

Results

The texting app showed that 87.31% (2187/2505) of messages were viewed by intervention participants. Furthermore, 28 of the 30 intervention participants and all 30 control participants provided outcome data. Among intervention participants, 22 of 30 (73%) showed improvement in health behavior goal attainment, with the whole group (n=30) showing a mean improvement of 88% (95% CI 39-136). Mean improvement in any behavioral domains was not seen in the control group. Intervention participants also increased their exercise significantly compared with controls, regardless of their self-selected goal category. The increased exercise was paralleled by significantly lower fasting glucose levels.

Conclusions

The health coaching session plus tailored SMS text messages improved self-selected health behaviors with a modest ripple effect to include unselected health behaviors.

Trial Registration

Clinicaltrials.gov NCT02476604; https://clinicaltrials.gov/ct2/show/NCT02476604 (Archived by WebCite at http://www.webcitation.org/6qAAryS5t)

Longitudinal changes in anthropometry and body composition in university freshmen

OBJECTIVE

We investigated predictors of weight gain in college freshmen.

PARTICIPANTS

A longitudinal cohort study followed a representative sample of freshmen (N = 264) from 8/2011 to 6/2012.

METHODS

Repeated measurements of anthropometry, dual-energy X-ray absorptiometry (DXA), physical activity, and diet were collected. We investigated predictors of 9-month weight gain using regression models.

RESULTS

172 participants completed follow-up: 75% gained >0.5 kg. Mean weight change was +2.3 kg (SD 3.2) and +2.0 kg (SD 3.2) and mean adiposity change was +1.3% (SD 1.6) and +0.7% (SD 2.2) in men and women, respectively. In participants gaining >0.5 kg, weight increased 5.6% and body fat increased 1.6%. Anthropometric change in men occurred in the first semester, while women increased in both semesters. Leaner DXA-defined body composition at baseline was consistently associated with greater weight gain (p-values 0.029-0.049).

CONCLUSIONS

Freshman weight gain is common and reflects increased adiposity. Leaner body composition at the beginning of college predicted greater weight gain in men and women during the first year of college.

Breakfast Skipping, Anxiety, Exercise, and Soda Consumption are Associated with Diet Quality in Mexican College Students

ABSTEACT Despite the reported poor dietary habits and risk of weight gain in college students, they remain understudied in Mexico. Mexican college students are in a rapidly changing economic environment; a shift from a traditional, homemade cuisine to a diet more heavily influenced by an industrialized culture seems to be occurring, potentially affecting the quality of their dietary intake. A health and nutrition survey was conducted among 450 Mexican college students to study the relationship between sociodemographic factors and diet quality. Dietary data were used to build macro- and micronutrient scores, dichotomized as low and normal quality. Adjusted odds (OR [95% CI]) were computed to determine the probability of low dietary quality. Breakfast skipping (5.3 [1.2, 22.7]) and risk of anxiety (2.3 [1.3, 4.4]) were associated with a greater risk of low macronutrient quality, and caloric intake < 1,800 kcal (5.8 [3.5, 9.7]), breakfast skipping (3.7 [1.4, 10.3]), vigorous exercise ≤ 1 h/wk (2.6 [1.3, 5.2]), and soda consumption > 250 mL/d (2.0 [1.2, 3.3]) with low micronutrient quality.

Examining the Weight Trajectory of College Students

OBJECTIVE

To examine the weight trajectory of students over 4 years of college.

METHODS

Anthropometric assessments were completed at the beginning and end of students' freshman year and the end of senior year to calculate body mass index. Questionnaires assessing weight-related behaviors were completed in senior year.

RESULTS

Of the original 117 students, 86 remained in the study for 4 years. Body mass index was significantly higher at the end of senior year (mean, 24.84; SD, 4.46) vs the beginning of freshman year (mean, 23.59; SD, 4.01; t[85] = 5.61; P < .001). Weight was significantly higher at the end of senior year (mean, 71.32 kg; SD, 15.60) vs the beginning of freshman year (mean, 66.94 kg; SD, 14.02; t[85] = 6.60; P < .001). Students' mean weight gain was 4.38 kg and the sample increased from 23% to 41% overweight/obese. No significant associations were found between BMI and lifestyle factors.

CONCLUSIONS AND IMPLICATIONS

This study suggests that students gain weight throughout college, which highlights the need for weight control interventions to target more than just freshman college students.