Longitudinal study: lifestyle and cardiovascular health in health science students

Influence of the COVID-19 Pandemic on the Lifestyles of Health Sciences University Students in Spain: A Longitudinal Study

The COVID-19 pandemic has significantly impacted daily activities worldwide. University students may have experienced substantial changes in daily living as a result of restrictions on university attendance. The return to normalcy may take a long time, and understanding the influence that shifts in daily routines have had on the lifestyles of university students may inform approaches to support overall well-being. We analyzed changes in the lifestyles of students enrolled at a health sciences university during the COVID-19 pandemic. This longitudinal study took place at the Faculty of Medicine and Nursing in the University of the Basque Country in Spain, and the final sample consisted of 113 nursing students, 109 medical students, and 45 physiotherapy students. Our results demonstrate changes in lifestyles of university students during the pandemic. MedDiet adherence scores and the percentage of students with high adherence increased during the pandemic. This increase was due to the increased consumption of vegetables and nuts. In terms of physical activity, the practice of moderate and intense physical activity was maintained. These results provide important information for both public health authorities and educational institutions to guide strategies to maintain the well-being of students and enhance opportunities for young adults to lead a healthy lifestyle.

Dietary fibre intake in childhood or adolescence and subsequent health outcomes: A systematic review of prospective observational studies

AIM

To determine whether higher fibre intakes during childhood or adolescence effect a broad range of intermediate markers of cardiometabolic risk or other health related issues.

MATERIALS AND METHODS

We used online searches up to January 2020 and manual searches to identify prospective observational studies reporting on childhood or adolescent intakes of dietary fibre, vegetables, fruit and refined or whole grains. Outcomes measured later in life were body weight, blood lipids, blood pressure, glycaemia, bone health, cognition, growth and bowel habits. Potential age-specific ranges for dietary fibre were extrapolated from published adult data.

RESULTS

We identified 45 publications reporting on 44 354 participants from 30 cohort studies. Mean age at dietary assessment varied from 1 to 19.3 years. Follow-up duration varied from 4 months to 27 years. Although well-conducted studies reported improvements in body weight, blood lipids and glycaemia, the diverse nature of studies precluded meta analysis. The quality of evidence was very low to low given the limited data available per outcome and the inability to synthesize results from multiple studies. Potential dietary fibre intake begins at 13-16 g a day for 2-year-olds and increases until the age of 10 years, when values are comparable with an adult range of 25-30 g a day.

CONCLUSIONS

Given the inconsistency in findings from cohort studies other than an absence of detrimental effects, it seems appropriate that recommendations regarding childhood fibre intake are extrapolated from relevant adult data.

Identification of Body Composition, Dietary Patterns and Its Associated Factors in Medical University Students in China

This study aimed to measure the body composition, dietary patterns and its associated factors in medical students. A cross-sectional study was conducted among 695 students studying at Nanjing medical university, China. Data regarding dietary intake factors was collected by a validated food frequency questionnaire. Principle component analysis and multivariate linear regressions were used. Body composition including BMI and visceral fats index of the males were significantly higher (P < .05) than females. While body fats percentage and fats mass index/free fat mass index (FMI/FFMI) ratio of females was significantly higher (P < .05) than males. Three dietary patterns were identified: western dietary pattern, meat pattern, and vegetables and fruits pattern. The western pattern was having an independent negative association (P < .05) with age and financial status, while positive association (P < .05) with sleeping duration and FMI/FFMI ratio. Vegetables and fruits patterns was having positive association with physical exercise and while negative association with FMI/FFMI ratio. Meat pattern was having positive association with educational levels and sleeping duration, while negative association with physical exercise and FMI/FFMI ratio. In conclusion, medical students adopted less healthy dietary patterns as compared to healthy dietary patterns, which were found to be more associated with some adverse dietary and lifestyle behavior outcomes.

Physical Activity, Physical Fitness, Body Composition, and Nutrition Are Associated with Bone Status in University Students

Understanding the modifiable factors that improve and maximize peak bone mass at an early age is necessary to design more effective intervention programs to prevent osteoporosis. To identify these modifiable factors, we analyzed the relationship of physical activity (PA), physical fitness, body composition, and dietary intake with bone stiffness index (SI), measured by quantitative ultrasonometry in young university students (18–21 years). Moderate-to-vigorous PA (MVPA) was the strongest predictor of SI (β = 0.184; p = 0.035). SI was most closely related with very vigorous PA in males (β = 0.288; p = 0.040) and with the number of steps/day in females (β = 0.319; p = 0.002). An association between thigh muscle and SI was consistent in both sexes (β = 0.328; p < 0.001). Additionally, extension maximal force was a bone SI predictor factor in females (β = 0.263; p = 0.016) independent of thigh muscle perimeter. Calcium intake was the only nutrition parameter that had a positive relationship with SI (R = 0.217; p = 0.022). However, it was not included as a predictor for SI in our regression models. This study identifies predictors of bone status in each sex and indicates that muscle and bone interrelate with PA and fitness in young adults.

Changes in consumption of added sugars from age 13 to 30 years: a systematic review and meta-analysis of longitudinal studies

Added sugar intake during adolescence has been associated with weight gain and cardiometabolic risk factors. Moreover, dietary habits may persist into adulthood, increasing chronic disease risk in later life. This systematic review investigated changes in intake of added sugars between the ages of 13 and 30 years. Literature databases were searched for longitudinal studies of diet during adolescence or early adulthood. Retrieved articles were screened for studies including multiple measures of intake of sugars or sugary foods from cohort participants between the ages of 13 and 30. Data were analysed using random-effects meta-analysis, by the three main nutrient and food group categories identified (PROSPERO: CRD42015030126). Twenty-four papers reported longitudinal data on intake of added sugar or sucrose (n = 6), sugar-sweetened beverages (SSBs) (n = 20) and/or confectionery (n = 9). Meta-analysis showed a non-significant per year of age decrease in added sugar or sucrose intake (-0.15% total energy intake (95%CI -0.41; 0.12)), a decrease in confectionery consumption (-0.20 servings/week (95%CI -0.41; -0.001)) and a non-significant decrease in SSB consumption (-0.15 servings/week (95%CI -0.32; 0.02)). Taken together, the overall decrease in added sugar intake observed from adolescence to early adulthood may suggest opportunities for intervention to further improve dietary choices within this age range.

Change in diet in the period from adolescence to early adulthood: a systematic scoping review of longitudinal studies

BACKGROUND

Late adolescence to early adulthood is a period of lifestyle change and personal development which may influence dietary behaviour. Understanding dietary trajectories across this age range may help in targeting interventions appropriately. This scoping review aimed to assess how longitudinal change in diet is conceptualised and measured between the ages of 13 to 30.

METHODS

We searched Medline, SCOPUS, Embase, PsycInfo (EBSCO), ASSIA, Sportdiscus, and Web of Science Core Collection (January 2016) using search terms combining diet outcomes, longitudinal methods and indicators of adolescent or young adult age. Titles and abstracts were screened and data extracted following published guidelines for scoping reviews. Data were analysed to summarize key data on each study and map availability of longitudinal data on macronutrients and food groups by age of study participants.

RESULTS

We identified 98 papers reporting on 40 studies. Longitudinal dietary data were available on intake of energy, key macronutrients and several food groups, but this data had significant gaps and limitations. Most studies provided only two or three waves of data within the age range of interest and few studies reported data collected beyond the early twenties. A range of dietary assessment methods were used, with greater use of less comprehensive dietary assessment methods among studies reporting food group intakes.

CONCLUSION

Despite limited availability of longitudinal data to aid understanding of dietary trajectories across this age range, this scoping review identified areas with scope for further evidence synthesis. We identified a paucity of longitudinal data continuing into the mid and late twenties, variability in (quality of) dietary assessment methods, and a large variety of macronutrients and food groups studied. Advances in dietary assessment methodologies as well as increased use of social media may facilitate new data collection to further understanding of changing diet across this life stage.