Stress, Health Risk Behaviors, and Weight Status Among Community College Students

Overall diet quality, food groups and mental health disorders among Brazilians older than 15 years old: Brazilian National Health Survey - 2019

BACKGROUND

Adherence to a nutrient-dense diet can have an impact on depression and other mental health issues. Little is known whether this is attributed to some or all components and how these differ in a country that is known to have a vast diversity of nutrient-dense foods. The aim was to examine whether there is a relationship between individual food groups with depression and other mental health disorders.

METHODS

Data was from 89,955 Brazilians from the National Health Survey. Mental health and diet were accessed using a screener questionnaire. Descriptive statistics and regression analyses were calculated.

RESULTS

Persons living with depression had significantly lower diet scores for vegetables/fruits (β = -0.08, 95 % CI -0.13, -0.02), grains/roots (β = -0.05; 95%CI (-0.07, -0.03)), beans (β = -0.03; 95%CI (-0.04, -0.01)) and higher scores for sweetened beverages (β = 0.04; 95%CI (0.01, 0.07)), sweets and sugars (β = 0.03; 95%CI (0.01, 0.05) and high fat/sodium products (β = 0.04; 9%CI (0.01, 0.07). Individuals living with other mental disorders showed lower scores for grains/roots (β = -0.03; 95%CI (-0.06, -0.01)) and higher scores for sweets and sugars (β = 0.06; 95%CI (0.03, 0.09)) and high fat/sodium products (β = 0.05; 95%CI (0.01, 0.09)).

CONCLUSION

People with mental health disorders are more likely to have an unhealthy diet. Relationships were slightly stronger with depression in particular food groups as other mental disorders. Further studies are needed to help in the prevention of these disorders.

Patterns of Health-Risk Behaviours and Their Associations With Anxiety and Depression Among Chinese Young Adults by Gender: A Latent Class Analysis

This study investigated gender differences in health-risk behaviour patterns among young adults and assessed the associations of anxiety and depression with these patterns. A cross-sectional survey was conducted with 1740 young Chinese adults aged 18-24 years. Latent class analysis (LCA) and multinomial logistic regression were conducted to identify the clusters of health-risk behaviours and their associations with anxiety and depression. Three common patterns were found for both genders: physical inactivity, substance use, and insufficient fruit intake (5.7% for males [M] and 11.6% for females [F]); a sedentary lifestyle only (48.4% for M and 48.9% for F); and a sedentary lifestyle, substance use, and an unhealthy diet (7.6% for M and 20.0% for F). Additionally, two additional unique patterns were found: physical inactivity and unhealthy diet in males (38.3%) and physical inactivity and insufficient fruit intake in females (19.6%). Sociodemographic variables exert different effects on health-risk behaviour patterns as a function of gender. Lower anxiety levels (odds ratio [OR]: 0.892; 95% confidence interval [CI]: 0.823-0.966) and greater depression levels (OR: 1.074; 95% CI: 1.008-1.143) were associated with a sedentary lifestyle, substance use, and unhealthy diet class only in female young adults compared with a sedentary-only class. These findings underscore the need for the implementation of targeted interventions based on gender differences.

Postponing sleep after a stressful day: Patterns of stress, bedtime procrastination, and sleep outcomes in a daily diary approach

Sleep problems and stress are common among students and are associated with negative effects on academic performance as well as mental and physical health risks, but studies exploring mediating factors between stress and sleep on a daily basis are scarce. This study aimed to investigate the relationship of daily stress, Bedtime procrastination (BP) (i.e., postponing bedtime without external reasons), and sleep outcomes controlling for trait factors such as self-control. N = 96 students at a German university (M = 22.2 years, SD = 4.0) wore a sleep-tracking wearable (Fitbit Charge HR) for two weeks to assess sleep duration and to calculate the gap between the intended time to go to sleep and the objectively measured time of falling asleep. Stress, intended time to go to sleep, and sleep quality were assessed via daily diaries. Established questionnaires were used to measure trait self-control, trait BP, and smartphone addiction. Multilevel analyses indicated that more stress experienced during the day was associated with more BP (b = 2.32, p = 0.008), shorter sleep duration (b = -3.46, p = 0.003), and lower sleep quality (b = 1.03, p = 0.005) after controlling for several trait factors. The association of daily stress with sleep outcomes (quality and duration) was partly mediated by BP. Our findings indicate that BP might be one factor that contributes to stress-linked decreases in sleep duration and quality. Potential reasons for stress-related later time to fall asleep-like higher physiological arousal or stress-related worries-should be investigated in future studies.

Eating Attitudes, Stress, Anxiety, and Depression in Dietetic Students and Association with Body Mass Index and Body Fat Percent: A Cross-Sectional Study

University students face challenges impacting psychology and dietary choices. The present work examined the association between eating attitudes, stress, anxiety, and depression to body mass index (BMI) and body fat percentage in Dietetics students. Respondents completed the Eating Attitudes Test-26 (EAT-26), the Depression Anxiety Stress Scales (DASS), a validated Food Frequency Questionnaire, and the Hellenic Physical Activity Questionnaire (HPAQ). Anthropometry and a bioimpedance analysis were performed. The EAT-26 score was 11 (8-16) and the DASS score was 20 (11-36) (medians and interquartile ranges). Disordered eating was detected in 20% of men and 15% of women. Depressive symptomatology was detected in 30% of males and 23% of females, anxiety in 35% of males and 40% of females, and stress in 29% of males and 35% of females. EAT-26 and DASS scores were highly correlated (r = 0. 0.221, p = 0.001). The EAT-26 oral control subscale (B = 0.430, SE = 0.184, p = 0.026) was positively correlated with BMI in men in the models, adjusted for age, physical activity, and Mediterranean Diet Score, while no association was documented for % body fat. The DASS depression score was not related to BMI in multi-adjusted models. In conclusion, disordered eating, depression, stress, and anxiety are present in this sample of university students. The relationship between disordered eating and BMI needs consideration in programs targeting overweight or underweight in Dietetics students.

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.

Preventable incidence cases from non-communicable diseases attributable to insufficient physical activity in Chile

OBJECTIVES

Lack of sufficient physical activity (PA) has been associated with an increased risk of several non-communicable diseases (NCDs) and all-cause mortality. This study aimed to estimate the number of preventable incidence cases of NCDs attributable to insufficient PA in the Chilean population.

STUDY DESIGN

Comparative risk assessment modelling study.

METHODS

This study examined data from 5834 participants aged ≥20 years from the Chilean National Survey (2016-2017). PA was assessed by the Global Physical Activity Questionnaire (GPAQ), and metabolic equivalent of tasks (METs) were assigned according to PA intensity. Estimated incidence cases of NCDs in Chile in 2019 were obtained from the Global Burden of Disease study. Relative risks for breast cancer, colon cancer, ischaemic heart disease, diabetes and stroke were obtained from a published meta-analysis and applied to the prevalence of insufficient PA estimates through the potential impact fraction equation.

RESULTS

High levels of PA (≥8000 MET-min/week) could potentially avoid more than 22,000 (64.6 %) incidence NCD cases, ranging from 498 (10.1 %) preventable cases of breast cancer to 5629 (14.7 %) cases of diabetes. Other modelled scenarios also showed to reduce the incidence cases of all five NCDs but to a lesser extent; where at least PA recommendation was achieved, preventable NCDs were reduced by 6522 cases (18.7 %), and where a 10 % relative reduction in insufficient PA level in the population was achieved, preventable NCDs were reduced by 651 (1.8 %) cases.

CONCLUSIONS

The study results provide estimates for the incidence cases of preventable NCDs attributable to insufficient PA, highlighting the important role of PA in NCD prevention in Chile.

Adolescent sources of stress, stress levels, and associations between stress and changes in weight outcomes at the time of COVID-19 related school closure in March 2020

Objective

Stress is associated with weight changes, yet how level and sources of stress relate to this association is poorly understood. This mixed methods study examined associations between adolescent stress at the COVID-19 pandemic onset and standardized BMI (BMIz) over a three-month period. Methods: Participants (N = 197, mean age 13.66 ± 1.43 years, 85% Hispanic, 56% female) were recruited from a charter school in Texas to participate in a healthy lifestyle intervention during physical education class. We calculated BMIz using height and weight measurements taken December 2019 and the week of COVID-19 school closures in March 2020. We measured stress in March 2020 with the 4-item Perceived Stress Scale. We ran a multiple linear regression model controlling for baseline BMIz (December 2019), age, sex, intervention condition, and assessed the interaction between baseline BMIz and PSS-4 score on BMIz change.

Results

Overall, our sample had an average PSS-4 score of seven and mean BMIz decrease of 0.04 over the three-month period. We observed a significant interaction between PSS-4 score and baseline BMIz. At lower baseline BMIz scores, higher PSS-4 scores were associated with decreases in BMIz over time. There was no significant association at higher baseline BMIz scores. COVID-19 pandemic-related concerns and school performance were the two primary stressors reported.

Conclusions

The relation between stress and weight changes differed based on starting weight status. Future interventions should consider the influence of external stressors on intervention adherence and outcomes.

Breaking the Link Between Negative Emotion and Unhealthy Eating: the Role of Emotion Regulation

Stressful experiences frequently lead to increased consumption of unhealthy foods, high in sugar and fat yet low in nutrients. Can emotion regulation help break this link? In a laboratory experiment (N = 200), participants were encouraged to ruminate on a current, distressing personal problem, followed by instruction to use a specific emotion regulation strategy for managing feelings around that problem (challenge appraisal, relaxation/distraction, imagined social support, no-instruction control). Participants then spent 15 min on an anagram task in which 80% of items were unsolvable-a frustrating situation offering a second, implicit opportunity to use the regulation strategy. During the anagram task they had free access to a snack basket containing various options. Analyses revealed significant differences among regulation conditions in consumption of candy versus healthy snack options; challenge appraisal led to the healthiest snack choices, imagined social support to the least healthy snack choices.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-023-00190-5.

The association of current exclusive e-cigarette use and dual use of e-cigarettes and cigarettes with psychological distress among U.S. adults

This observational study examines the association of current e-cigarette use and dual use of e-cigarettes and cigarettes (dual use) with psychological distress among U.S. adults. We differentiate dual use based on the smoking frequency and compare the relationship between dual use and psychological distress to that of exclusive cigarette smoking with the same smoking frequency. Using data from the 2015-2018 National Health Interview Surveys, we analyzed adults aged 18+ (N = 55,780) who currently use e-cigarettes or/and cigarettes and have no history of using other tobacco products, and adults who never used any tobacco. Multinomial logistic regression models estimate the association of current e-cigarette use and dual use with psychological distress severity (no/mild, moderate, and severe).In the sample, 15.3% and 2.9% of adults experienced moderate and severe psychological distress. Compared to never tobacco users, current exclusive e-cigarette users and dual users who smoke daily had higher odds of moderate and severe psychological distress. Dual users who smoke nondaily had higher odds of moderate, but not severe psychological distress than never tobacco users. Compared to exclusive daily smokers, dual users with daily smoking had higher odds of moderate and severe psychological distress. Compared to exclusive nondaily smokers, dual users with nondaily smoking had higher odds of moderate but not severe psychological distress. Our findings suggest that exclusive e-cigarette use is associated with psychological distress severity. Dual use is associated with higher odds of psychological distress severity compared to never tobacco users and exclusive cigarette smoking, and this association differs by smoking frequency.

Sexual Minority College Undergraduate Students Have Worse Health-Related Quality of Life, Diet Quality, and Weight Dissatisfaction Than Their Heterosexual Peers

OBJECTIVE

Assess the health-related quality of life (HRQOL), diet quality (DQ), and weight dissatisfaction in sexual minority (SM) undergraduates.

METHODS

Undergraduates (n = 690) at 2 universities completed a survey assessing HRQOL, body mass index, DQ, and weight dissatisfaction. A multivariate analysis of covariance assessed HRQOL between SM and heterosexual students. Chi-square tests and independent t tests measured weight dissatisfaction and DQ. P < 0.05 was considered statistically significant.

RESULTS

Significant differences in HRQOL were observed (F[6,584] = 8.89; P < 0.001; Wilk's Λ = 0.916; partial η2 = 0.084). Sexual minority students experienced more days per month feeling sad/blue/depressed (12.0 ± 9.7 vs 6.3 ± 7.8 days; P < 0.001) and worried/tense/anxious (18.1 ± 10.2 vs 10.9 ± 9.8 days; P < 0.001); and fewer days feeling healthy and full of energy (6.8 ± 6.5 vs 11.4 ± 8.7 days; P < 0.001). Sexual minority students consumed more sugar (14.4 ± 7.9 g vs 10.2 ± 7.1 g; P = 0.020), had higher body mass indexes (25.8 ± 6.1 vs 24.4 ± 4.8; P = 0.005), and were less satisfied with their weight (30.7% vs 44.0%; P = 0.001).

CONCLUSIONS AND IMPLICATIONS

Sexual minority undergraduates experience similar health disparities as other SM populations and have indicators of poorer DQ.

An 8-Week Peer Health Coaching Intervention among College Students: A Pilot Randomized Study

This study explored the effects of an 8-week peer coaching program on physical activity (PA), diet, sleep, social isolation, and mental health among college students in the United States. A total of 52 college students were recruited and randomized to the coaching (n = 28) or the control group (n = 24). The coaching group met with a trained peer health coach once a week for 8 weeks focusing on self-selected wellness domains. Coaching techniques included reflective listening, motivational interviews, and goal setting. The control group received a wellness handbook. PA, self-efficacy for eating healthy foods, quality of sleep, social isolation, positive affect and well-being, anxiety, and cognitive function were measured. No interaction effects between time and group were significant for the overall intervention group (all p > 0.05), while the main effects of group difference on moderate PA and total PA were significant (p < 0.05). Goal-specific analysis showed that, compared to the control group, those who had a PA goal significantly increased vigorous PA Metabolic Equivalent of Task (METs) (p < 0.05). The vigorous METs for the PA goal group increased from 1013.33 (SD = 1055.12) to 1578.67 (SD = 1354.09); the control group decreased from 1012.94 (SD = 1322.943) to 682.11 (SD = 754.89); having a stress goal significantly predicted a higher post-coaching positive affect and well-being, controlling the pre-score and other demographic factors: B = 0.37 and p < 0.05. Peer coaching showed a promising effect on improving PA and positive affect and well-being among college students.

Community-Based Participatory Research: Partnering with College Students to Develop a Tailored, Wellness-Focused Intervention for University Campuses

College students face unique challenges with leading healthful lifestyles. Using a community-based participatory research approach, college student research partners at two land-grant universities collected data and developed a tailored intervention to improve the well-being of college students. To inform the design of the program, college students were trained to conduct a needs assessment that included a campus-wide survey on the health behaviors of college students, environmental audits of health policies and food pantries on campus, and stakeholder interviews with campus health professionals. Outcomes of the needs assessment data highlighted university students ranked their health as "good" but nutrition health as "fair/poor." Low or very low food security was self-reported by 36.9% of participants and had an overall diet quality score of 47.6 ± 10.1 out of 100. Health professional interview data indicated campuses provide healthful resources to students, but students are not aware those resources exist. Utilizing the needs assessment data previously mentioned, the nominal group technique was then used for student research partners to collaboratively determine the best intervention approaches and develop a wellness program. Student partners identified (1) education, (2) sharing of campus resources, and (3) incentives as important areas of intervention. Using the data collected, the student research partners developed a program titled, The College Cooking Connection, to address health-related quality of life in college students. Using a community-based participatory research approach to program planning, educators and researchers have a greater likelihood of addressing the current needs of the population they are targeting and developing a successful intervention to meet those health concerns. This study aims to partner with young adult university students to understand the college environment and allow the target community to be involved with the development of intervention programs for their campus.

Trait mindfulness and mind-body health in students: The role of gender, race, and ethnicity

Objective: Trait mindfulness is associated with well-being in college students, yet it is unclear whether these associations are consistent across demographics. Participants: Undergraduate students (n = 534; 33% nonwhite; Apr2018-Sep2019). Methods: A cross-sectional online survey was performed. Pearson correlations tested the relationship between specific facets of trait mindfulness and four domains of mind-body health: stress, well-being, cognitive functioning, and health behaviors. Gender, race, and ethnicity were tested as moderators. Results: In general, higher trait mindfulness is consistently associated with better mind-body health across demographics. However, in men, some health behavior variables correlated more strongly with mindfulness. Among Black students, the relationship between Non-Reactivity and some outcome variables was null or counterintuitive. In Asian students, several predicted associations were significantly stronger. Conclusion: Trait mindfulness corresponds to mind-body health in college students, but relationships may not be universal. Future research is needed to replicate these findings and to examine possible demographic differences in response to mindfulness training.

Factors associated with perceived stress in Middle Eastern university students

Objective: University students face high levels of stress-related factors, such as an unfamiliar environment, challenging workload, and uncertainty about their ability to succeed. Participants: A total of 370 students in Qatar who consented to participate between February 2017 and February 2018. Methods: This cross-sectional study assessed perceived stress [using a validated 4-point perceived stress scale (PSS-4)], as well as diet, exercise, body mass index, sleep, and life satisfaction. Results: Among students aged 18-39 (mean = 20.1 ± 3.0 years), PSS-4 scores varied between 0 and 16 (mean = 7.4 ± 3.4). Elevated stress was significantly associated with female sex, country of origin, residing off-campus, eating when bored, lack of self-discipline, disturbed sleep, and low levels of life satisfaction. Furthermore, students with PSS-4 scores above the median level were 2.3 times likelier to report difficulty concentrating on academic work. Conclusion: Elevated stress levels are present in university students in Qatar. Strengthening coping skills may improve health and academic performance.

Development of the College Student Acute Stress Scale (CSASS)

PURPOSE

The purpose of this study is to develop and validate the College Student Acute Stress Scale, a measure of acute stress specific to college students.

DESIGN AND METHODS

A total sample of 440 young adults from a university in the northeast United States were surveyed across three separate research studies. Exploratory principal component analysis, internal consistency reliability, convergent and divergent validity, and test-retest reliability analyses were performed.

FINDINGS

Evidence of convergent and divergent validity were obtained, and adequate internal consistency and test-retest reliability were identified.

PRACTICE IMPLICATIONS

This study provides evidence for the validity and reliability of a self-report measure of college students' acute stress experiences.

Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD)

Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.

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.

Skipping Breakfast and Incidence of Frequent Alcohol Drinking in University Students in Japan: A Retrospective Cohort Study

Frequency of alcohol drinking is a potential predictor of binge drinking of alcohol, a serious social problem for university students. Although previous studies have identified skipping breakfast as a predictor of various health-compromising behaviors and cardiometabolic diseases, few studies have assessed the association between skipping breakfast and the incidence of frequent alcohol drinking. This retrospective cohort study included 17,380 male and 8799 female university students aged 18–22 years admitted to Osaka universities between 2004 and 2015. The association between breakfast frequency (eating every day, skipping occasionally, and skipping often/usually) and the incidence of frequent alcohol drinking, defined as drinking ≥4 days/week, was assessed using multivariable-adjusted Cox proportional hazards models. During the median observational period of 3.0 years, 878 (5.1%) men and 190 (2.2%) women engaged in frequent alcohol drinking. Skipping breakfast was significantly associated with the incidence of frequent alcohol drinking (adjusted hazard ratios [95% confidence interval] of eating every day, skipping occasionally, and skipping often/usually: 1.00 [reference], 1.02 [0.84–1.25], and 1.48 [1.17–1.88] in men; 1.00 [reference], 1.60 [1.03–2.49], and 3.14 [1.88–5.24] in women, respectively). University students who skipped breakfast were at a higher risk of frequent alcohol drinking than those who ate breakfast every day.

Chronic stress, behavioral tendencies, and determinants of health behaviors in nurses: a mixed-methods approach

BACKGROUND

Nurses experience high, and often chronic, levels of occupational stress. As high-quality care requires a healthy workforce, individualized stress-alleviating interventions for nurses are needed. This study explored barriers and resources associated with health behaviors in nurses with different stress levels and work-related behavioral tendencies and identified health behavior determinants based on the Health Action Process Approach (HAPA) model.

METHODS

Applying a mixed methods transformative triangulation design, n = 43 nurses filled out chronic stress (SSCS) and work-related behavior and experience patterns (German acronym AVEM) questionnaires, and participated in semi-structured interviews. With content analysis, categories of health behavior-related barriers and resources emerged. Behavior determinants (self-efficacy, outcome expectancies), health behavior, and barriers and resources were quantified via frequency and magnitude coding and interrelated with SSCS and AVEM scores to link level of health behavior with potential influencing factors. Nonparametric tests explored differences in quantified variables for SSCS and AVEM scores and 4-step-hierarchical regression analysis identified predictors for health behavior.

RESULTS

Eighty-four percent of the nurses were chronically stressed while 49% exhibited unhealthy behavioral tendencies at the workplace. 16 personal and organizational themes (six resources, ten barriers) influenced health behaviors. Stress was associated with resource frequency (p = .027) and current health behaviors (p = .07). Self-efficacy significantly explained variance in health behaviors (p = .003).

CONCLUSION

Health promotion related barriers and resources should be considered in designing nurse health promotion campaigns. Practitioners need to individualize and tailor interventions toward stress and behavioral experiences for sustainable effects on adherence and health.

Agreement of measures between measured body adiposity and calculated indices of fatness in sedentary and active male and female students

Study aim: Our study was undertaken to analyze agreement between measured body fat and different indices of fatness in students of both sexes and with different physical activity.

Materials and methods: A total of 330 students not engaged in regular physical activity (150 males and 180 females) and 356 students (180 males and 176 females) engaged in regular physical activity due to their study program (5–7 h/week) were recruited. In all participants body adiposity was measured from skinfold thickness. In addition, calculated indices of fatness based on waist (WC) and hip circumference (HC), such as abdominal volume index (AVI), body adiposity index (BAI) and relative fat mass (RFM) were calculated.

Results: The analysis of Bland-Altman plots revealed that agreement between measured and calculated body fat was found for RFM and BAI in sedentary and active men and for BAI in sedentary women, but not for measured body fat and RFM in sedentary women and for RFM and BAI in active women.

Discussion: Our study showed that in young adult Poles of both sexes and with different physical activity, the calculated obesity rates should be used with caution, especially in women, as an indicator of total body fat.

Effects of Exercise in Improving Cardiometabolic Risk Factors in Overweight Children: A Systematic Review and Meta-Analysis

This meta-analysis aims to evaluate the effects of exercise in improving cardiometabolic risk factors in overweight children and adolescents until the adolescent age, which is 18 years. A systemic search was conducted using the electronic databases PubMed/Medline, Cochrane Library, and Google Scholar, from inception to 29 June 2021. All statistical analyses were conducted in Review Manager 5.4.1. All studies meeting the inclusion criteria were selected. A random-effect model was used to pool the studies, and the results are reported in the odds ratio (OR) and corresponding 95% Confidence interval (CI). Twelve randomized control trials were selected for meta-analysis. Significant results were obtained for BMI in children after the interventions (0.38 95% CI 0.14, 0.62; p = 0.002; I² = 65%). LDL level was also found significantly reduced (0.41 95% CI 0.01, 0.82; p = 0.05; I² = 83%). Other factors such as HDL level, blood pressure, blood glucose level, body weight, and waist circumference were also analyzed. We found that exercise interventions significantly improved several cardiometabolic risk factors such as BMI, LDL level, BP, and blood glucose level. However, no significant effect on HDL concentration, waist circumference, and body weight were found. Long-term interventions are needed to attain improvement in all cardiometabolic risk factors.

Associations between college/university campus characteristics and student body mass index

Background

Campus environments are associated with undergraduate weight. However, few studies have examined campus type and geographic location in relation to student weight. This article aimed to identify college/university students with elevated BMIs by campus type and region.

Methods

Linear mixed effects regression models were fit to data from the American College Health Association-National College Health Assessment II. Analyses tested associations between campus type/region and student self-reported BMI.

Results

The sample included 404,987 students from 445 schools with mean BMI 24.9 ± 5.8. Across all school types/regions, BMI confidence intervals included overweight values. Two-year and public school students had higher BMIs compared to four-year and private school students, respectively. Students in the Midwest had higher BMIs compared to students in the Northeast. In the South only, Minority Serving Institution (MSI) students had higher BMIs compared to non-MSI students.

Conclusion

Healthy weight maintenance programs should be made available to undergraduate students.

Stressors and level of stress among different nursing positions and the associations with hyperlipidemia, hyperglycemia, and hypertension: a national questionnaire survey

BACKGROUND

Nurses are faced with varying job stressors depending on their positions and duties. Few previous studies have compared job stress and related chronic conditions among different nursing positions. The objectives were to compare job stressors among clinical registered nurses, nurse practitioners, and head nurses and explore the impact of job stressors and stress level on hyperlipidemia, hyperglycemia, and hypertension.

METHODS

Secondary data extracted from a survey of health-care workers conducted from May to July 2014 across 113 hospitals in Taiwan was used. This analysis included 17,152 clinical registered nurses, 1438 nurse practitioners, and 2406 head nurses. Socio-demographic characteristics, job stressors, stress levels, and hyperlipidemia, hyperglycemia, and hypertension variables were extracted.

RESULTS

Perceived stressors differed among clinical registered nurses, nurse practitioners, and head nurses, but overall stress level did not. Nurse practitioners and head nurses showed significantly higher prevalence of hyperlipidemia, hyperglycemia, and hypertension than clinical registered nurses. Higher stress levels, age, body mass index, work hours, and caring for family members were positively associated with hyperlipidemia, hyperglycemia, and hypertension. After adjustment for these variables, risk of hyperlipidemia, hyperglycemia, and hypertension did not differ across the nursing positions.

CONCLUSIONS

Although stressors vary by different nursing positions, overall stress level does not. Hyperlipidemia, hyperglycemia, and hypertension are related to stress level, age, body mass index, weekly working hours, and caring for family members. Hence, alleviating job stress and avoiding long working hours are likely to reduce the risk of hyperlipidemia, hyperglycemia, and hypertension in nurses.

The Relationship Between Perceived Age Discrimination in the Healthcare System and Health: An Examination of a Multi-Path Model in a National Sample of Israelis Over the Age of 50

OBJECTIVES

The present study aims to examine possible pathways that potentially account for the relationship between perceived age discrimination in healthcare settings (as one form of ageism) and health outcomes.

METHODS

We relied on 1570 complete surveys, which constitute a representative national sample of adults aged 50 and above in Israel.

RESULTS

We found a direct link between perceived age discrimination and health outcomes. This link was partially mediated by self-perceptions of aging and subsequently by health behaviors (e.g., eating vegetables) and preventive health behaviors (e.g., medical check-ups). The link between perceived age discrimination and health behaviors was moderated by age, thus, particularly detrimental for older people over the age of 65 as compared with those between the ages of 50 and 65.

DISCUSSION

This study adds to the literature as it examines comprehensive mechanisms to account for the path between perceived age discrimination and health status. Our findings point to the unique aspects associated with perceived age discrimination, which potentially make older people more susceptible to its negative effects.

Brief Alcohol Screening and Intervention for Community College Students (BASICCS): Feasibility and preliminary efficacy of web-conferencing BASICCS and supporting automated text messages

Objective: The Brief Alcohol Screening and Intervention for College Students (BASICS; Dimeff et al., 1999) is an evidence-based approach to reduce high-risk drinking and associated harms; however, implementation may present challenges for community colleges (CCs) that have limited budgets and mostly non-residential students. We examined feasibility, acceptability, and efficacy of BASICS for CC students (BASICCS) delivered remotely via web-conferencing with supporting automated text messages. Method: Participants included 142 CC students who reported exceeding National Institute on Alcohol Abuse and Alcoholism (NIAAA's) weekly low-risk drinking recommendations and/or heavy episodic drinking (HED). Participants were randomized to BASICCS or assessment-only control (AOC) and completed 1- and 3-month follow-up assessments. Results: Most students liked the personalized information in the program and found the web-conferencing platform useful, however intervention completion rate was 56%. Significant differences were found between BASICCS and AOC. At 1-month, individuals in BASICCS had 33% fewer alcohol consequences than those in AOC. At 3-month follow-up, individuals in BASICCS had lower estimated peak blood alcohol concentration, 29% fewer drinks per week, 62% fewer episodes of HED, and 24% fewer consequences than those in AOC. Conclusions: BASICCS showed evidence of being acceptable and the technology proved feasible, although the intervention completion rate in the non-treatment-seeking volunteer sample was modest. Preliminary evidence does suggest BASICCS shows promise in reducing alcohol use and consequences. Technology-based platforms could be a viable prevention solution for CC students. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Lifestyle behaviors trend and their relationship with fear level of COVID-19: Cross-sectional study in Saudi Arabia

INTRODUCTION

COVID-19 pandemic cautionary measures have affected the daily life of people around the globe. Further, understanding the complete lifestyle behaviors profile can help healthcare providers in designing effective interventions and assessing overall health impact on risk of disease development. Thus, this study aims to assess the complete spectrum of lifestyle behaviors (physical activity, sedentary behavior, sleep, distress, social support, dietary habits, and smoking) prevalence and its association with fear of COVID-19 in people living in Saudi Arabia.

METHODS

Self-administered survey consisted of seven sections was used to collect data on fear of COVID-19 using Fear of COVID-19 Scale (FCV-19S), physical activity and sedentary behavior using the Global Physical Activity Questionnaire (GPAQ), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), psychosocial distress using Kessler Psychological Distress Scale (K-10), social support using the MOS social support survey, and dietary habits using a short version of food frequency questionnaire (FFQ). The online survey was distributed via social media platforms during lockdown period of COVID-19 pandemic (May-June 2020). Each section consisted of validated questionnaire examining one of aforementioned lifestyle behaviors. Associations were analyzed using multiple linear regression.

RESULTS

A total of 669 individuals attempted to complete the online survey, 554 participants completed at least 2 sections of the survey (82.8%), and 41.3% (n = 276) completed the whole online survey. The majority of the sample were female (83%), not smokers (86.5%), had sufficient sleep duration (7.5 hrs ± 2.1), and only indicated mild level of distress (21.4 ± 8.9); they also reported high level of sedentary behavior (7.7 hrs ± 4.5), poor sleep quality (5.4 ± 2.4), were not engaged in healthy eating habits, and moderate level of perceived social support (62.0% ± 27). Only physical activity results indicated that about half of the sample were engaged in moderate to vigorous level of physical activity (54.3%). Further, being female (β = 0.12; 95% CI: 0.45, 2.94) and married (β = 0.13; 95% CI: 0.3, 2.63) were associated with fear of COVID-19 level (β = 0.21; 95% IC: 0.05, 0.19) with a confidence interval level of 95%. In addition, distress was associated with fear.

CONCLUSION

The trend of lifestyle behaviors measured during lockdown period changed from previously published rates. Future research needs to establish the short-term and long-term effect of lifestyle behaviors complete profile on physical and mental health.

Tobacco consumption in Chilean university students and associations with anthropometry, eating habits and sleep quality multicentric study

Tobacco Consumption (TC) is one of the main causes of the deterioration of health; however, there are few studies linking its consumption with diet and nutrition among university students. The objective of this study is to test the association of smoking with anthropometry, diet and sleep quality among Chilean university students. Cross-sectional study. University students (n = 1454) from the North, South and Central parts of Chile were evaluated. A self-assessment survey was used to evaluate healthy and unhealthy eating habits. Nutritional status was evaluated by Body Mass Index (BMI). Two surveys were used to assess sleep quality: the Questionnaire of Insomnia and the Epworth Scale. Finally, participants were consulted about Tobacco Consumption: 30% of the students consume tobacco and have a higher score in unhealthy food consumption, less frequent weekly breakfast consumption (< 0.01), lower daily fruit (< 0.01) and vegetables (< 0.05) consumption, higher alcohol consumption (< 0.05) and daily junk food consumption (< 0.05) compared to non-consuming students. Men who consume tobacco present greater insomnia (< 0.001), sleep latency (< 0.001) and daytime sleepiness (< 0.05) compared to non-consumers; and women who consume tobacco have a higher weight (< 0.001) and BMI (< 0.01). When performing logistic regression, tobacco consumption is positively associated with major alcohol consumption (< 0.001), whereas fish (< 0.05) and vegetable (< 0.05) consumption was negatively associated. In conclusion, students of both sexes who smoke have more unfavorable health factors and a poorer quality of life.

Differences between Active and Semi-Active Students Regarding the Parameters of Body Composition Using Bioimpedance and Magnetic Bioresonance Technologies

The aim of the study was to identify differences in obesity-related parameters between active sports students and semi-active or sedentary students, differentiated by sex, in order to optimize health. The study sample included 286 students, of which the male experimental sample consisted of 86 active sports students, age X ± SD 21.25 ± 0.32 years; height X ± SD 181.08 ± 3.52 cm; control group consisting of 89 semi-active students aged X ± SD 21.07 ± 0.1.13 years; height X ± SD 182.11 ± 1.32. The female experimental sample includes 57 active sports students, age X ± SD 21.02 ± 0.92 years; height X ± SD 167.48 ± 1.34 cm; the control group includes 54 semi-active students aged X ± SD 21.57 ± 0.1.98 years; height X ± SD 168.42 ± 1.76. The study used a thalliometer, Tanita Health Ware software and Quantum Resonance Magnetic Analyzer equipment to investigate height (cm), Body Mass Index (BMI), muscle mass (kg, %), as well as the obesity analysis report, and componential analysis of body and nourishment. The differences registered between the samples of active and semi-active sports subjects were predominantly statistically significant for p < 0.05. The differences registered between the samples of active and semi-active sports subjects were predominantly statistically significant for p < 0.05. The most important parameters regarding obesity and body composition that registered significant differences between the two male groups were in favor of the group of active athletes: triglyceride content of abnormal coefficient 0.844 (CI95% 0.590–1.099), abnormal lipid metabolism coefficient 0.798 (CI95% 1.091–0.504), obesity degree of body (ODB %) 10.290 (CI95% 6.610–13.970), BMI 2.326 (CI95% 1.527–3.126), body fat (kg) 2.042 (CI95% 0.918–3.166), muscle volume (kg) 2.565 (CI95% 1.100–4.031), Lean body weight (kg) 2.841 (CI95% 5.265–0.418). In the case of female samples, the group of active sportswomen registered the biggest differences compared to the group of students who were significantly active in the parameters: abnormal lipid metabolism coefficient 1.063 (CI95% 1.380–0.746), triglyceride content of abnormal coefficient 0.807 (CI95% 0.437–1.178), obesity degree of body (ODB%) 8.082 (CI95% 2.983–13.181), BMI 2.285 (CI95% 1.247–3.324), body fat (kg) 2.586 (CI95% 0.905–4.267), muscle volume (kg) 2.570 (CI95% 0.154–4.985), lean body weight (kg) 4.118 (CI95% 1.160–7.077). The results of the study directly facilitate the understanding of the complexity of the impact of obesity on multiple parameters of body composition and health.

Stress and eating behaviours in healthy adults: a systematic review and meta-analysis

Stress leads to detrimental health outcomes through direct biological and indirect behavioural changes. Stress can lead to disruption to normal eating behaviours, although the strength of these associations is unknown. This is the first meta-analysis to determine the strength of the stress-eating relationship in healthy adults and to explore the impact of potential moderators. Studies included had a clearly defined measure of stress (i.e., any noxious event or episode in one's environment with the exclusion of emotional distress) that was linked to non-disordered eating. Key terms were searched in Medline, PsycInfo and Ovid databases (23,104 studies identified). 54 studies (combined N = 119,820) were retained in the meta-analysis. A small, positive effect size was found for the stress-overall food intake relationship (Hedges' g = 0.114). Stress was associated with increased consumption of unhealthy foods (Hedges' g = 0.116) but decreased consumption of healthy foods (Hedges' g = -0.111). Only one significant moderator (restraint on stress-unhealthy eating) was identified. This meta-analysis identified the magnitude of the effect of stress on eating behaviour outcomes. Significant heterogeneity was observed that was not explained by the moderators examined. Further research on moderators of the stress-eating relationship is required and should distinguish effects for healthy versus unhealthy eating.

Associations between health-related quality of life and health behaviors in Australian nursing students

Health-related quality of life (HRQoL) is being increasingly studied as an indicator of wellbeing. This study evaluated the HRQoL of nursing students and relationships between lifestyle behaviors including smoking, diet, alcohol intake and physical activity. A cross-sectional study was conducted in 2018 using the Short-Form 12V2 to measure the HRQoL of 475 students from both regional and metropolitan universities in Queensland, Australia. z-scores were aggregated into a Physical Composite Score (PCS) and a Mental Composite Score (MCS). Multivariate linear regression was used to explore the associations. Nursing students (94.5% female) had lower HRQoL scores relative to the general Australian population. Students enrolled at the regional university, with higher income; higher intakes of vitamin A, calcium, and iodine; and more physical activity had a higher Mental Composite Score, but those with health conditions and high intakes of meat, fat, carbohydrates, and sugar reported lower Physical Composite Score compared to their counterparts. Skipping breakfast, physical inactivity, and alcohol score were inversely associated with HRQoL. This study highlights the need for strategies to address the poor lifestyle and HRQoL in nursing students to support their physical and mental health.

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.

Mindfulness-based intervention helps preclinical medical students to contain stress, maintain mindfulness and improve academic success

BACKGROUND

Stress among students is on the rise during early medical school and has been implicated in poor academic performance. Several methods are being discussed to efficiently reduce stress, among them mindfulness-based interventions. We therefore set out to assess how stress, mindfulness, and academic performance are connected and if an intervention on mindfulness based stress reduction could alleviate stress among medical students and improve their academic achievements.

METHODS

A non-randomized controlled trial including 143 medical students in their preclinical years was performed in 2019. The students completed two surveys - one in the first, the other in the third term - recording perceived stress and mindfulness via validated scales (PSS-10 and MAAS). In between both, 41 students participated in a voluntary mindfulness-based intervention including six two-hours courses. 86 students served as controls. Scholarly success was assessed via the scores achieved in six exams written during the observation period.

RESULTS

Stress was inversely related with mindfulness and with the results of the most challenging exam. The intervention on mindfulness based stress reduction helped to contain stress and maintain mindfulness during the observation period and this effect lasted for at least six months beyond completion of the intervention. In contrast, beneficial effects on scholarly success were transient and only detectable at completion of the intervention.

CONCLUSION

Our observation of short- and intermediate term effects resulting from six individual interventions on mindfulness based stress reduction is encouraging and calls for alternative strategies to induce long-lasting impacts.

Mindful Attention and Eating Expectancies among College Students with Obesity and a History of Trauma Exposure

Objectives

Trauma exposure and obesity are highly prevalent among college students and both are associated with disordered eating. There is a need to understand psychological factors that may be related to maladaptive eating behavior among college students with obesity and a history of trauma exposure.

Methods

Participants included 139 college students with obesity (defined as a BMI ≥ 30) and a history of trauma exposure (76.3% females; M _age = 25.4 years, SD = 8.07). The current study conducted three separate two-step hierarchical regressions examining mindful attention, and its relation to eating expectancies (expectancies of eating to help manage negative affect, expectancies of eating to alleviate boredom, and expectancies of eating to lead to feeling out of control).

Results

Results indicated that lower levels of mindful attention were related to greater levels of expectancies of eating to help manage negative affect (b = -4.16, SE = 1.08, p = .023, CI_95% = -7.72, -0.60, sr² = .04), expectancies of eating to alleviate boredom (b = -1.09, SE = 0.39, p = .006, CI_95% = -1.86, -0.32, sr² = .06), and expectancies of eating to lead to feeling out of control (b = -1.62, SE = 0.40, p < .001, CI_95% = -2.41, -0.83, sr² = .11). Results were observed over, and above variance accounted for by sex (assigned at birth), body mass index (BMI), and posttraumatic stress disorder (PTSD) symptom severity.

Conclusions

Overall, the results from the present investigation suggest the potential importance and need for future research in the role of mindful attention in relation to several distinct eating expectancies associated with maladaptive eating.

Associations of Skipping Breakfast, Lunch, and Dinner with Weight Gain and Overweight/Obesity in University Students: A Retrospective Cohort Study

Although multiple studies have identified skipping breakfast as a risk factor for weight gain, there is limited evidence on the clinical impact of skipping lunch and dinner on weight gain. This retrospective cohort study including 17,573 male and 8860 female university students at a national university in Japan, assessed the association of the frequency of breakfast, lunch, and dinner with the incidence of weight gain (≥10%) and overweight/obesity (body mass index ≥ 25 kg/m²), using annual participant health checkup data. Within the observation period of 3.0 ± 0.9 years, the incidence of ≥10% weight gain was observed in 1896 (10.8%) men and 1518 (17.1%) women, respectively. Skipping dinner was identified as a significant predictor of weight gain in multivariable-adjusted Poisson regression models for both men and women (skipping ≥ occasionally vs. eating every day, adjusted incidence rate ratios, 1.42 (95% confidence interval: 1.02–1.98) and 1.67 (1.33–2.09) in male and female students, respectively), whereas skipping breakfast and lunch were not. Similarly, skipping dinner, not breakfast or lunch, was associated with overweight/obesity (1.74 (1.07–2.84) and 1.68 (1.02–2.78) in men and women, respectively). In conclusion, skipping dinner predicted the incidence of weight gain and overweight/obesity in university students.

Stress, coping, and preventing contagion during the SARS-COV2 epidemic in a sample of Mexican adults

Given the lack of an effective treatment for COVID-19, it is essential to explore the psychological variables involved in the development and maintenance of preventive behaviors during the current epidemic. In this study, we analyze the predictive value of perceived stress (measured with the Perceived Stress Scale) and coping styles (measured with the Extreme Risks Coping Scale) for adhering to infection prevention behavior in a sample of 1132 Mexican adults aged between 18 and 84. A logistic regression analysis showed that Active Coping and Cognition-Focused Coping, in addition to age and being a student, proved to be predictors of adhering to SARS COV2 preventive behaviors ( R2 = 0.282). The findings from this study can be used to design strategies to promote potentially effective epidemic mitigation behaviors.

Perspectives on youth-onset nonalcoholic fatty liver disease

BACKGROUND

The prevalence and incidence of youth-onset nonalcoholic fatty liver disease (NAFLD) far exceeds other paediatric chronic liver diseases and represents a considerable public health issue globally.

METHODS

Here, we performed a narrative review of current knowledge regarding the epidemiology of paediatric NAFLD, selected concepts in pathogenesis, comorbidities, diagnosis, and management, and issues related to the transition to adulthood.

RESULTS

Paediatric NAFLD has become increasingly more prevalent, especially in certain subgroups, such as children with obesity and certain races/ethnicities. The pathophysiology of paediatric NAFLD is complex and multifactorial, driven by an interaction of environmental and genetic factors. Once developed, NAFLD in childhood is associated with type 2 diabetes, hypertension, increased cardiovascular disease risk, and end-stage liver disease. This predicts an increased burden of morbidity and mortality in adolescents and young adults. Early screening and diagnosis are therefore crucial, and the development of noninvasive biomarkers remains an active area of investigation. Currently, treatment strategies are focused on lifestyle changes, but there is also research interest in pharmacological and surgical options. In the transition from paediatric to adult care, there are several potential challenges/barriers to treatment and research is needed to understand how best to support patients during this time.

CONCLUSIONS

Our understanding of the epidemiology and pathophysiology of paediatric NAFLD has increased considerably over recent decades, but several critical knowledge gaps remain and must be addressed in order to better mitigate the short-term and long-term risks of youth-onset NAFLD.

Happy prenatal relationships, healthy postpartum mothers: a prospective study of relationship satisfaction, postpartum stress, and health

OBJECTIVE

Major life transitions, such as the arrival of a new baby, can be stressful, and therefore, costly to one's health. Being in a satisfying romantic relationship has been previously linked with better health, perhaps because it provides access to a bank of psychosocial resources. The objective of the present research was two-fold. First, we examined whether prenatal relationship satisfaction benefitted mothers' postpartum health. Second, we examined whether this association was mediated by reduced postpartum stress. Design: Pregnant women (N = 431) were drawn from a larger prospective pregnancy and birth cohort study. Main Outcome Measures: Participants reported on their relationship satisfaction, perceived stress, and perceived health at two time points: 24-26 weeks of gestation and 6 months postpartum. Results: Greater prenatal romantic satisfaction predicted enhanced perceived postpartum health, and reduced perceived postpartum stress appeared to mediate this link. Conclusion: This research demonstrates that greater prenatal relationship satisfaction is associated with better postpartum health and provides evidence for one potential mechanism for this link: the reduction of perceived postpartum stress. Thus, assessments of women's prenatal relationship satisfaction may help identify those who are at higher risk of experiencing poor postpartum health. Implications for interventions are discussed.

Assessing the Mental Health of Brazilian Students Involved in Risky Behaviors

Adolescence, which is the transition from childhood to adulthood, is marked by emotional sensitivity and inconsistency and may be affected by mental health problems. In order to fill the gap related to the risky behaviors in students in Brazil, our cross-sectional study aimed to analyze the relationship between risky behaviors and indicators of mental health of Brazilian students. We used the data from the National School Health Survey to analyze the relationship between risk behaviors and three symptoms of mental health issues: feeling of being alone, number of close friends, and trouble sleeping due to worries. The sample consisted of 102,072 students in Brazil (48.3% boys and 51.7% girls), aged between 11 to 19 years. The risk behaviors evaluated were substance use, sedentary lifestyle, sexual behavior, and suffering violence and bullying. We have performed a multivariate analysis based on the Poisson regression model, and the measure of effect used was the prevalence ratio (PR) with confidence intervals (CI) of 95%. Our results showed that students with symptoms of mental health issues were involved in risky behaviors, including drug use and unsafe sex. Thus, mental illness outcomes may be associated with risky behaviors, or mental health may be impaired by them. Given these findings, in-school programs focused on improving mental health outcomes should be developed.

Risk in childhood family environments and loneliness in college students: Implications for health

Objective: To investigate associations between risk in family environments and health-relevant outcomes in college and the role of loneliness. Participants: College students at a state university (N = 360). Methods: We utilized linear regression to examine relationships between risk in family environments and loneliness, perceived stress, affect, and self-rated health. We tested for indirect effects of risk in family environments on outcomes through loneliness Results: Analyses showed that risk in family environments associated with loneliness (β = 0.12 t[358] = 2.22, p = .03, R² change = .02), perceived social stress (β = 0.20, t[357] = 3.88, p < 0.001, R² change = .04), negative and positive affect (β = 2.44, t[357] = 3.95, p < .001, R² change = .04), and (β = -0.18 t[357]= -3.44, p = .001, R² change = .03 respectively), and self-rated health (β = 0.19, t[359] = 4.57, p < .001, R² change = .10). Significant indirect effects were observed for risk in early family on all outcomes through loneliness. Conclusion: These findings provide initial evidence that risk in childhood family environments may negatively affect health by increasing loneliness in college students.

Determinants of eating behaviours in Australian university students: A cross-sectional analysis

AIM

This study aimed to explore clustering among individual eating behaviours in a sample of Australian university students, and explore associations between clustered eating behaviours and demographic characteristics.

METHODS

A cross-sectional analysis of data from the University of Newcastle (UON) Student Healthy Lifestyle Survey 2017 was conducted. Measures included eating behaviours (eg, vegetables, energy-dense nutrient poor [EDNP] food intakes) assessed using short diet questions, and demographic characteristics (eg, age, undergraduate/postgraduate student). Factor analysis was used to explore clustering of individual eating behaviours (ie, identify factors). Linear regression models were used to explore associations between eating behaviour factors identified and demographic characteristics.

RESULTS

A total of 3062 students (70% female; 56% aged 17-24 years) were included in the analysis. The six eating behaviour factors identified (characterised by higher consumption of the named foods/drinks) were; EDNP snack foods, meat and takeaway foods, fruit and vegetables, sugary drinks, breakfast, and breads and cereals. A higher fruit and vegetable factor score was associated with being female (P < .001), and a higher meat and takeaway foods factor score was associated with being male (P < .001) and of younger age (P < .001).

CONCLUSIONS

Nutrient-rich foods clustered together and EDNP foods clustered together, that is, the identified factors represent either nutrient-rich or EDNP foods. Interventions in the university setting should target students with the poorest eating behaviours, including males and younger students.

Are Psychological Distress and Resilience Associated with Dietary Intake Among Australian University Students?

University students report unhealthy diets and experience poorer mental health than the general population. This study explores the association between psychological distress and resilience with dietary intake in a sample of Australian university students. Cross-sectional data from the University of Newcastle Student Healthy Lifestyle Survey 2017 were analysed. Psychological distress (Kessler Scale), resilience (Brief Resilience Scale) and fruit, vegetable, soft drink, takeaway food and breakfast intakes (short diet questions) were assessed. Socio-demographic (e.g., gender), student (e.g., undergraduate/postgraduate) and health characteristics (e.g., physical activity) were captured. Multivariate linear regression models explored associations between psychological distress and resilience with dietary intake, with adjustment for potential confounders. Analysis included 2710 students (mean age 26.9 ± 9.5 years, 30.4% male). In adjusted models, lower psychological distress was associated with higher fruit (β = -0.37, p = 0.001) and vegetable (β = -0.37, p < 0.001) serves/day, more frequent breakfast consumption (p < 0.001) and less frequent soft drink and takeaway food consumption (p < 0.001). Higher resilience was associated with higher fruit (β = 0.03, p = 0.022) and vegetable (β = 0.06, p < 0.001) serves/day, more frequent breakfast consumption (p = 0.005), and less frequent soft drink (p < 0.001) and takeaway food consumption (p = 0.001). These results highlight a potential link between psychological distress and resilience with diet, and that further research in this area is warranted.

The association between sedentary behaviour and indicators of stress: a systematic review

BACKGROUND

Emerging evidence shows sedentary behaviour may be associated with mental health outcomes. Yet, the strength of the evidence linking sedentary behaviour and stress is still unclear. This study aimed to synthesise evidence regarding associations between time spent in sedentary behaviour and stress in adults.

METHODS

A systematic search was conducted (January 1990 - September 2019). Following PRISMA guidelines, an evaluation of methodological quality, and best-evidence synthesis of associations between time in sedentary behaviour (including sitting time, TV viewing, computer use) and stress were presented. Twenty-six studies reporting on data from n = 72,795 people (age 18-98y, 62.7% women) were included.

RESULTS

Across the studies (n = 2 strong-, n = 10 moderate- and n = 14 weak-quality), there was insufficient evidence that overall time spent in sedentary behaviour and sitting time were associated with stress, particularly when using self-report measures of sedentary behaviour or stress. There was strong evidence of no association between TV viewing, or computer use and stress. Amongst studies using objective measures of sedentary behaviour and/or stress there was also strong evidence of no association.

CONCLUSION

Although previous research suggested sedentary behaviour may be linked to mental health outcomes such as depression and anxiety, the evidence for an association between various types of sedentary behaviour and stress is limited in quality, and associations are either inconsistent or null. High-quality longitudinal/interventional research is required to confirm findings and determine the direction of associations between different contexts (i.e. purpose) and domains (i.e. leisure, occupational, transport) of sedentary behaviour and stress.

Trends and disparities in urinary BPA concentrations among U.S. emerging adults

BACKGROUND

Emerging adulthood (ages 18-25 years) is a key turning point in the life course characterized by particularly poor eating behaviors (e.g., low in fruits and vegetables, and high in fast food) and weight gain. Emerging adults are also prime consumers of personal care and other consumer products that may result in differential exposures to environmental contaminants, such as Bisphenol A (BPA), compared to adults aged 26+ years. This is of concern given BPA has been associated with adverse health outcomes such as obesity, metabolic disorders, miscarriage, infertility and breast cancer. However, no research has examined exposure to BPA among emerging adults.

OBJECTIVE

To assess trends of exposure to urinary BPA among a representative sample of emerging adults compared to adults aged 26+ years. Secondarily, we aimed to identify differential associations between BPA concentrations and sociodemographic characteristics and BMI by age group.

METHODS

This study uses National Health and Examination Surveys (NHANES) over 2003-2014 to test differences in BPA concentrations comparing emerging adults to adults aged 26+ years. Generalized linear models predicting log BPA by age group and sex, race/ethnicity, education, income, and food security status, and generalized linear models predicting BMI by log BPA, both age group and age as a continuous variable, sex, race/ethnicity, education, income, and food security status were conducted. Interactions with age group (i.e., age group x sex) were examined for the mutually adjusted models. All models controlled for survey year, month, and time of day, and were run with, and without, an adjustment for urinary creatinine.

RESULTS

In models adjusted, and not adjusted, for urinary creatinine, emerging adults had a higher log BPA concentration than adults aged 26+ years (β=0.153, p=0.004; β=0.544, p<0.001), and a significantly steeper decline in BPA concentration between 2003-2004 and 2013-2014 than adults aged 26+ years (ß=-0.051, p=0.002; ß=-0.071, p=0.001). Males' log BPA concentration were lower than that for females when urinary creatinine was included in the model, and higher when urinary creatinine was excluded from the model (ß=-0.188, p<0.001; β=0.203, p<0.001). Higher income was significantly associated with lower log BPA concentration (ß=-0.220, p<0.001; ß=-0.166, p<0.001). A significant interaction between emerging adult age group and food security status was observed, which was associated with higher BPA exposures. Log BPA concentration was associated with BMI only when urinary creatinine was excluded from the models (urinary creatinine included: β=0.031, p=0.747; β=0.022, p=0.815, urinary creatinine excluded: β=0.528, p<0.001; β=0.552, p<0.001).

CONCLUSION

Findings indicate that emerging adults had higher BPA exposures than adults aged 26+ years in 2003-2004, and that emerging adults' exposure level has decreased faster than that of adults aged 26+ years. There were suggestions that the BPA concentration of emerging adults in 2013-2014 was lower than that for adults aged 26+ years, and that BPA exposure is associated with higher BMI. Our results highlight the need for additional research to identify the sources and routes of exposure to BPA and BPA replacements among emerging adults and to better characterize the variability in exposure. Intervention studies are needed to assist emerging adults in limiting their exposure to BPA, and potentially also the BPA alternatives.

Stress Management and Health Promotion in a Sample of Women With Intimate Partner Violence: A Randomized Controlled Trial

The aim of the present study was to investigate the effectiveness of a stress management program regarding mitigating psychological repercussions in women who experience intimate partner violence (IPV). This randomized controlled trial took place from January 2015 to June 2015, in Attica, Greece. A total of 60 women were randomly assigned into an intervention and control group, with the intervention group ( n = 30) receiving stress management and a lifestyle program. Self-reported measures were used to assess stress, depression and anxiety levels, daily routine, severity of abuse, self-esteem, health locus of control, and self-efficacy. Statistical analysis showed a significant improvement in measures of stress, depression, anxiety, self-esteem, and self-efficacy in the intervention group. Daily routine and physical exercise also improved. Based on these findings, we strongly encourage health professionals to advise women experiencing current and past IPV to adopt stress management techniques to their daily program, as a further means of empowerment.