Top

BMC Public Health

Published in:

Open Access 01-12-2018 | Research article

Socioeconomic, demographic and lifestyle-related factors associated with unhealthy diet: a cross-sectional study of university students

Authors: Roberto Martinez-Lacoba, Isabel Pardo-Garcia, Elisa Amo-Saus, Francisco Escribano-Sotos

Published in: BMC Public Health | Issue 1/2018

Abstract

Background

Food habits are important to promote and maintain good health throughout life, and unhealthy diet is a modifiable and preventable risk factor. University students are a key group of adults among whom to promote healthy lifestyles. The aim of this study is to determine the factors associated with unhealthy diet in a sample of university students.

Methods

An electronic cross-sectional survey was conducted with university students (n=593) from inland Spain, during the 2016-2017 academic year. The survey collected information on the participants’ food habits using an annual food frequency questionnaire. We also collected socioeconomic and demographic data and lifestyle-related information. A multivariate logistic regression was used for analysis.

Results

The multivariate logistic regression revealed that the factors associated with an unhealthy diet were: being male, being underweight compared to the reference category (normal weight), having a mother of low socioeconomic status, the family home not being in the university city and, finally, studying a non health-related course

Conclusion

Among students of the University of Castilla-La Mancha, being male, being underweight, the family home not being in the university city, having a mother of low socioeconomic status, and, finally, not studying a health-related course are the factors associated with a lower quality diet. Following a healthy diet is key in reducing the health costs of non-communicable diseases, and ensuring an acceptable long-term quality of life in populations.

Available only for authorised users

World Health Organization, Food and Agriculture Organization of the United Nations. Diet, Nutrition and the Prevention of Chronic Diseases. In: Report of a Joint WHO/FAO Expert Consultation. Series 916. Geneva: World Health Organization; 2003. http://apps.who.int/iris/bitstream/10665/42665/1/WHO_TRS_916.pdf.

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2224–60. https://doi.org/10.1016/S0140-6736(12)61766-8.CrossRefPubMedPubMedCentral

Mayer-Fulkes DA. A Survey of Macro Damages from Non-Communicable Chronic Diseases: Another Challenge for Global Governance. Glob Econ J. 2011;11. https://doi.org/10.2202/1524-5861.1725.

Muka T, Imo D, Jaspers L, Colpani V, Chaker L, van der Lee SJ, et al. The global impact of non-communicable diseases on healthcare spending and national income: a systematic review. Eur J Epidemiol. 2015;30:251–77. https://doi.org/10.1007/s10654-014-9984-2.CrossRefPubMed

Bloom DE, Cafiero E, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, et al. The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum; 2011. http://apps.who.int/medicinedocs/documents/s18806en/s18806en.pdf

Drewnowski A, Darmon N. The economics of obesity: dietary energy density and energy cost. Am J Clin Nutr. 2005;82(Suppl):265S–73S.CrossRefPubMed

Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr. 2013;17:2769–82. https://doi.org/10.1017/S1368980013003169.CrossRefPubMed

Estruch R, Ros E, Salas-Salvadó J, Covas M-I, Corella D, Arós F, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. N Engl J Med. 2013;368:1279–90. https://doi.org/10.1056/NEJMoa1200303.CrossRefPubMed

Martinez-Gonzalez MA, Bes-Rastrollo M, Serra-Majem L, Lairon D, Estruch R, Trichopoulou A. Mediterranean food pattern and the primary prevention of chronic disease: Recent developments. Nutr Rev. 2009;67(Suppl 1):111–6. https://doi.org/10.1111/j.1753-4887.2009.00172.x.CrossRef

10.

Di Carlo A, Baldereschi M, Inzitari D. Eating the Mediterranean Style: A Tasty Way for Stroke Prevention. Agric Agric Sci Procedia. 2016;8:762–8. https://doi.org/10.1016/j.aaspro.2016.02.063.CrossRef

11.

Lock K, Smith RD, Dangour AD, Keogh-Brown M, Pigatto G, Hawkes C, et al. Health, agricultural, and economic effects of adoption of healthy diet recommendations. Lancet. 2010;376:1699–709. https://doi.org/10.1016/S0140-6736(10)61352-9.CrossRefPubMed

12.

Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011;14:2274–84. https://doi.org/10.1017/S1368980011002515.CrossRefPubMed

13.

UNESCO. Representative List of the Intangible Cultural Heritage of Humanity. 2010. https://ich.unesco.org/en/RL/mediterranean-diet-00884. Accessed 15 Jan 2018.

14.

Wang T, Heianza Y, Sun D, Huang T, Ma W, Rimm EB, et al. Improving adherence to healthy dietary patterns, genetic risk, and long term weight gain: gene-diet interaction analysis in two prospective cohort studies. BMJ. 2018;360:j5644. https://doi.org/10.1136/bmj.j5644.CrossRefPubMedPubMedCentral

15.

Wade AT, Davis CR, Dyer KA, Hodgson JM, Woodman RJ, Keage HAD, et al. Including pork in the Mediterranean diet for an Australian population: Protocol for a randomised controlled trial assessing cardiovascular risk and cognitive function. Nutr J. 2017;16:1–19. https://doi.org/10.1186/s12937-017-0306-x.CrossRef

16.

Chourdakis M, Tzellos T, Papazisis G, Toulis K, Kouvelas D. Eating habits, health attitudes and obesity indices among medical students in northern Greece. Appetite. 2010;55:722–5. https://doi.org/10.1016/j.appet.2010.08.013.CrossRefPubMed

17.

Sánchez-Ojeda MA, De Luna-Bertos E. Hábitos de vida saludable en la población universitaria. Nutr Hosp. 2015;31:1910–9. https://doi.org/10.3305/nh.2015.31.5.8608.CrossRefPubMed

18.

Neslişah R, Emine AY. Energy and nutrient intake and food patterns among Turkish university students. Nutr Res Pract. 2011;5:117–23. https://doi.org/10.4162/nrp.2011.5.2.117.CrossRefPubMedPubMedCentral

19.

Horodyska K, Luszczynska A, Hayes CB, O’Shea MP, Langøien LJ, Roos G, et al. Implementation conditions for diet and physical activity interventions and policies: An umbrella review. BMC Public Health. 2015;15. https://doi.org/10.1186/s12889-015-2585-5.

20.

García-Meseguer MJ, Burriel FC, García CV, Serrano-Urrea R. Adherence to Mediterranean diet in a Spanish university population. Appetite. 2014;78:156–64. https://doi.org/10.1016/j.appet.2014.03.020.CrossRefPubMed

21.

Irazusta Astiazaran A, Ruiz Litago F, Gil Orozco S, Gil Goikouria FJ, Irazusta AJ. Hábitos de vida de los estudiantes de enfermería [Habits of life in nursing students]. Zainak. 2005;27:99–107.

22.

Papadaki A, Hondros G, Scott JA, Kapsokefalou M. Eating habits of University students living at, or away from home in Greece. Appetite. 2007;49:169–76. https://doi.org/10.1016/j.appet.2007.01.008.CrossRefPubMed

23.

Fabián C, Pagán I, Ríos JL, Betancourt J, Cruz SY, González AM, et al. Dietary Patterns and their Association with Socio- demographic Characteristics and Perceived Academic Stress of College Students in Puerto Rico. P R Health Sci J. 2013;32:36–43.

24.

Moreno-Gómez C, Romaguera-Bosch D, Tauler-Riera P, Bennasar-Veny M, Pericas-Beltran J, Martinez-Andreu S, et al. Clustering of lifestyle factors in Spanish university students: the relationship between smoking, alcohol consumption, physical activity and diet quality. Public Health Nutr. 2012;15:2131–9. https://doi.org/10.1017/S1368980012000080.CrossRefPubMed

25.

Arguello M, Bautista Y, Carvajal J, De Castro K, Díaz D, Escobar M, et al. Estilos de vida en estudiantes del área de la salud de Bucaramanga. Rev Psicol Univ Antioquía. 2009;1:27–41 http://aprendeenlinea.udea.edu.co/revistas/index.php/psicologia/article/view/10019.

26.

Sofi F, Dinu M, Pagliai G, Marcucci R, Sofi F, Dinu M, et al. Validation of a literature-based adherence score to Mediterranean diet: the MEDI-LITE score. Int J Food Sci Nutr. 2017;68:757–62. https://doi.org/10.1080/09637486.2017.1287884.CrossRefPubMed

27.

SurveyMonkey. SurveyMonkey: Free online survey software & questionnaire tool. 2012 www.surveymonkey.com. http://www.surveymonkey.com/.

28.

Vioque J, Navarrete-Muñoz E-M, Gimenez-Monzó D, García-de-la-Hera GF, Young IS, et al. Reproducibility and validity of a food frequency questionnaire among pregnant women in a Mediterranean area. Nutr J. 2013;12 http://www.nutritionj.com/content/12/1/26.

29.

Willet WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, et al. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol. 1985;122:51–65.CrossRef

30.

Martin-Moreno JM, Boyle P, Gorgojo L, Maisonneuve P, Fernandez-Rodriguez JC, Salvini S, et al. Development and validation of a food frequency questionnaire in Spain. Int J Epidemiol. 1993;22:512–9. https://doi.org/10.1093/ije/22.3.512.CrossRefPubMed

31.

Ruiz Moreno E, Del Pozo de la Calle S, Cuadrado Vives C, Valero Gaspar T, Ávila Torres JM, Belmonte Cortés S, et al. Encuesta de nutrición de la Comunidad de Madrid. Madrid: Fundación Española de Nutrición y Consejería de sanidad de la Comunidad de Madrid; 2014.

32.

Red BEDCA. Agencia Española de Seguridad Alimentaria y Nutrición. Base de Datos Española de Composición de Alimentos. 2010; http://www.bedca.net/. Accessed 7 Oct 2017.

33.

Domingo-Salvany A, Bacigalupe A, Carrasco JM, Espelt A, Ferrando J, Borrell C. Propuestas de clase social neoweberiana y neomarxista a partir de la Clasificación Nacional de Ocupaciones 2011. Gac Sanit. 2013;27:263–72. https://doi.org/10.1016/j.gaceta.2012.12.009.CrossRefPubMed

34.

Ozen AE, Bibiloni MDM, Murcia MA, Pons A, Tur JA. Adherence to the Mediterranean diet and consumption of functional foods among the Balearic Islands’ adolescent population. Public Health Nutr. 2015;18:659–68. https://doi.org/10.1017/S1368980014000809.CrossRefPubMed

35.

Martínez E, Llull R, del Mar Bibiloni M, Pons A, Tur JA. Adherence to the mediterranean dietary pattern among balearic islands adolescents. Br J Nutr. 2010;103:1657–64. https://doi.org/10.1017/S0007114509993576.CrossRefPubMed

36.

World Health Organization. Body mass index - BMI. 2017. http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. Accessed 26 Nov 2017.

37.

Grupo Colaborativo de la Sociedad Española de Nutrición Comunitaria. Guías alimentarias para la población española; la nueva pirámide de la alimentación saludable. Nutr Hosp. 2016;33(Suplemento 8):1–48. https://doi.org/10.20960/nh.827.CrossRef

38.

World Health Organization. Global Recommendations on Physical Activity for Health. Geneva: World Health Organization; 2010. http://www.who.int/dietphysicalactivity/factsheet_recommendations/en/

39.

Tognon G, Hebestreit A, Lanfer A, Moreno LA, Pala V, Siani A, et al. Mediterranean diet, overweight and body composition in children from eight European countries: Cross-sectional and prospective results from the IDEFICS study. Nutr Metab Cardiovasc Dis. 2014;24:205–13. https://doi.org/10.1016/j.numecd.2013.04.013.CrossRefPubMed

40.

van Buuren S, Groothuis-Oudshoorn K. Mice: Multivariate Imputation by Chained Equations in R. J Stat Softw. 2011;45. https://doi.org/10.18637/jss.v045.i03.

41.

Pedersen AB, Mikkelsen EM, Cronin-Fenton D, Kristensen NR, Pham TM, Pedersen L, et al. Missing data and multiple imputation in clinical epidemiological research. Clin Epidemiol. 2017;9:157–66.CrossRefPubMedPubMedCentral

42.

Sterne JAC, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338(b:2393):157–60.

43.

Mangiafico SS. An R Companion for the Handbook of Biological Statistics, version 1.3.2. 2015. rcompanion.org/documents/RCompanionBioStatistics.pdf.

44.

RStudio Team. RStudio: Integrated Development for R. 2015. http://www.rstudio.com/.

45.

Microsoft. Excel 2016. 2016. https://products.office.com/es-es/excel.

46.

Kimokoti RW, Millen BE. Diet, the Global Obesity Epidemic, and Prevention. J Am Diet Assoc. 2011;111:1137–40. https://doi.org/10.1016/j.jada.2011.05.016.CrossRefPubMed

47.

OECD. Health at a Glance 2017: OECD Indicators. Paris: OECD Publishing; 2017.

48.

Slawson DL, Fitzgerald N, Morgan KT. Position of the Academy of Nutrition and Dietetics: The Role of Nutrition in Health Promotion and Chronic Disease Prevention. J Acad Nutr Diet. 2013;113:972–9.CrossRefPubMed

49.

Al-Rethaiaa AS, Fahmy A-EA, Al-Shwaiyat NM. Obesity and eating habits among college students in Saudi Arabia: a cross sectional study. Nutr J. 2010;9. https://doi.org/10.1186/1475-2891-9-39.

50.

Amaral D, Hernández N, Basabe N, Roncadio AM, Pablo R, Arroyo M. Satisfacción corporal y calidad de la dieta en estudiantes universitarias del País Vasco. Endocrinol y Nutr. 2012;59:239–45. https://doi.org/10.1016/j.endonu.2012.01.007.CrossRef

51.

Arroyo Izaga M, Rocandio Pablo AM, Ansotegui Alday L, Pascual Apalauza E, Salces Beti I, Rebato OE. Calidad de la dieta, sobrepeso y obesidad en estudiantes universitarios. Nutr Hosp. 2006;21:673–9.PubMed

52.

Cervera Burriel F, Serrano Urrea R, Vico García C, Milla Tobarra M, García Meseguer MJ. Hábitos alimentarios y evaluación nutricional en una población universitaria. Nutr Hosp. 2013;28:438–46. https://doi.org/10.3305/nh.2013.28.2.6303.CrossRefPubMed

53.

Satalic Z, Colic Baric I, Keser I. Diet quality in Croatian university students: Energy, macronutrient and micronutrient intakes according to gender. Int J Food Sci Nutr. 2007;58:398–410. https://doi.org/10.1080/09637480701252393.CrossRefPubMed

54.

Soriano JM, Moltó JC, Mañes J. Dietary Intake and Food Pattern Among University. Nutr Res. 2000;20:1249–58.CrossRef

55.

Hall L, Tejada-Tayabas LM, Monárrez-Espino J. Breakfast Skipping, Anxiety, Exercise, and Soda Consumption are Associated with Diet Quality in Mexican College Students. Ecol Food Nutr. 2017;56:218–37. https://doi.org/10.1080/03670244.2017.1299010.CrossRefPubMed

56.

Leon-Munoz LM, Guallar-Castillon P, Graciani A, Lopez-Garcia E, Mesas AE, Aguilera MT, et al. Adherence to the Mediterranean Diet Pattern Has Declined in Spanish Adults. J Nutr. 2012;142:1843–50. https://doi.org/10.3945/jn.112.164616.CrossRefPubMed

57.

Patino-Alonso MC, Recio-Rodríguez JI, Belio JFM, Colominas-Garrido R, Lema-Bartolomé J, Arranz AG, et al. Factors associated with Adherence to the Mediterranean Diet in the Adult Population. J Acad Nutr Diet. 2014;114:583–9. https://doi.org/10.1016/j.jand.2013.07.038.CrossRefPubMed

58.

Hu EA, Toledo E, Diez-Espino J, Estruch R, Corella D, Salas-Salvado J, et al. Lifestyles and Risk Factors Associated with Adherence to the Mediterranean Diet: A Baseline Assessment of the PREDIMED Trial. PLoS One. 2013;8:e60166. https://doi.org/10.1371/journal.pone.0060166.CrossRefPubMedPubMedCentral

59.

Darmon N, Drewnowski A. Does social class predict diet quality? Am J Clin Nutr. 2008;87:1107–17.CrossRef

60.

Fransen HP, Boer JMA, Beulens JWJ, De Wit GA, Bueno-HB, Hoekstra J, et al. Associations between lifestyle factors and an unhealthy diet. Eur J Public Health. 2017;27:274–8. https://doi.org/10.1093/eurpub/ckw190.CrossRefPubMed

61.

Livingstone K, Olstad D, Leech R, Ball K, Meertens B, Potter J, et al. Socioeconomic Inequities in Diet Quality and Nutrient Intakes among Australian Adults: Findings from a Nationally Representative Cross-Sectional Study. Nutrients. 2017;9:1092. https://doi.org/10.3390/nu9101092.CrossRefPubMedCentral

62.

Mullie P, Clarys P, Hulens M, Vansant G. Dietary patterns and socioeconomic position. Eur J Clin Nutr. 2010;64:231–8. https://doi.org/10.1038/ejcn.2009.145.CrossRefPubMed

63.

Backholer K, Spencer E, Gearon E, Magliano DJ, McNaughton SA, Shaw JE, et al. The association between socio-economic position and diet quality in Australian adults. Public Health Nutr. 2016;19:477–85. https://doi.org/10.1017/S1368980015001470.CrossRefPubMed

64.

Nilsen SM, Krokstad S, Holmen TL, Westin S. Adolescents’ health-related dietary patterns by parental socio-economic position, the Nord-Trøndelag health study (HUNT). Eur J Public Health. 2010;20:299–305. https://doi.org/10.1093/eurpub/ckp137.CrossRefPubMed

65.

Thorpe MG, Kestin M, Riddell LJ, Keast RSJ, Sarah A. Diet quality in young adults and its association with food-related behaviours. Public Health Nutr. 2013;17:1767–75. https://doi.org/10.1017/S1368980013001924.CrossRefPubMed

66.

Pérez-Gallardo L, Mingo Gómez T, Bayona Marzo I, Ferrer Pascual MÁ, Márquez Calle E, Ramírez Domínguez R, et al. Calidad de la dieta en estudiantes universitarios con distinto perfil académico. Nutr Hosp. 2015;31:2230–9. https://doi.org/10.3305/nh.2015.31.5.8614.CrossRefPubMed

67.

Rizo-Baeza M, González-Brauer N, Cortés E. Calidad de la dieta y estilos de vida en estudiantes de Ciencias de la Salud. Nutr Hosp. 2014;29:153–7. https://doi.org/10.3305/nh.2014.29.1.6761.CrossRefPubMed

68.

Heerman WJ, Jackson N, Hargreaves M, Mulvaney SA, Schlundt D, Wallston KA, et al. Clusters of Healthy and Unhealthy Eating Behaviors Are Associated With Body Mass Index Among Adults. J Nutr Educ Behav. 2017;49:415–21.e1. https://doi.org/10.1016/j.jneb.2017.02.001.CrossRefPubMedPubMedCentral

69.

Freedman LS, Schatzkin A, Midthune D, Kipnis V. Dealing with dietary measurement error in nutritional cohort studies. J Natl Cancer Inst. 2011;103:1086–92. https://doi.org/10.1093/jnci/djr189.CrossRefPubMedPubMedCentral

70.

Nikolaou CK, Hankey CR, Lean MEJ. Accuracy of on-line self-reported weights and heights by young adults. Eur J Public Health. 2017;27:898–903.CrossRefPubMed

71.

Willett W. Nutritional epidemiology. Oxford: Oxford University Press; 1998.CrossRef

72.

Rhee JJ, Sampson L, Cho E, Hughes MD, Hu FB, Willett WC. Comparison of methods to account for implausible reporting of energy intake in epidemiologic studies. Am J Epidemiol. 2015;181:225–33. https://doi.org/10.1093/aje/kwu308.CrossRefPubMedPubMedCentral

Title: Socioeconomic, demographic and lifestyle-related factors associated with unhealthy diet: a cross-sectional study of university students
Authors: Roberto Martinez-Lacoba
Isabel Pardo-Garcia
Elisa Amo-Saus
Francisco Escribano-Sotos
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-018-6149-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Socioeconomic, demographic and lifestyle-related factors associated with unhealthy diet: a cross-sectional study of university students

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2018

Effectiveness and safety of electronic cigarettes among sole and dual user vapers in Kuantan and Pekan, Malaysia: a six-month observational study

Bi-directional association between sleep and outdoor active play among 10–13 year olds

Association between time preference, present-bias and physical activity: implications for designing behavior change interventions

Disparities in severe shigellosis among adults — Foodborne diseases active surveillance network, 2002–2014

Bathing adaptations in the homes of older adults (BATH-OUT): results of a feasibility randomised controlled trial (RCT)

Assessing the acceptability of incentivising HPV vaccination consent form return as a means of increasing uptake