Determinants of health-related lifestyles among university students

Aims: The aim of this study was to investigate students' health-related lifestyles and to identify barriers and social determinants of healthier lifestyles. Methods: An online survey, two focus groups and three in-depth interviews across 2014/2015. A stratified by school size and random sample (n = 468) of university students answered a 67-item questionnaire comprising six scales: Rapid Assessment of Physical Activity, Rapid Eating and Activity Assessment for Patients-Short Version, CAGE, Fagerstrom Test for Nicotine Dependence, Warwick-Edinburgh Mental Wellbeing Scale short version, and ad hoc scale for drug use/misuse. Stratified by gender, (2) tests were run to test associations/estimate risks and three multivariate Logistic Regression models were adjusted. A thematic approach guided the analysis of qualitative data. Results: A total of 60% of the respondents were insufficiently physically active, 47% had an unbalanced diet and 30% had low mental wellbeing. Alcohol drinkers versus abstinent were almost equally distributed. A total of 42% of alcohol drinkers reported getting drunk at least once a month. Smokers accounted for 16% of the respondents. Identified risk factors for suboptimal physical activity were as follows: being a woman, not using the university gym and smoking. Risk factors for unbalanced diet were low mental wellbeing and drug use. Poor mental wellbeing was predicted by unbalanced diet, not feeling like shopping and cooking frequently, and a lack of help-seeking behaviour in cases of distress. Qualitative analysis revealed seven thematic categories: transition to new life, university environment and systems, finances, academic pressure, health promotion on campus and recommendations. Conclusion: This study provides robust evidence that the health-related lifestyles of the student population are worrying and suggests that the trend in chronic diseases associated with unhealthy lifestyles sustained over years might be unlikely to change in future generations. University students' health-related lifestyle is a concern. Nine out of the identified 10 predictors of problematic physical activity, nutrition and mental wellbeing, were environmental/societal or institutional barriers. Universities must expand corporate responsibilities to include the promotion of health as part of their core values.