BACKGROUND: Healthy lifestyles, consisting of healthy eating habits and active lifestyle, are known to be protective factors promoting physical health and psychological wellbeing. University students may be considered a population at risk for unhealthy lifestyles due to factors like the evolution towards sedentarism, nutrition transition and high incidence of stressful situations (e.g. Cuijpers et al., 2018)
AIMS: 1) to analyse lifestyles habits, perceived stress and nutritional vulnerability of University students through a multidimensional and multidisciplinary approach; 2) To evaluate efficacy of a healthy life
style counselling intervention in promoting healthy lifestyles and wellbeing in Sapienza University students.
METHODS: the proposed research will be conducted in 2 phases:
Phase 1: cross-sectional study with 2 aims: a) evaluating, in first year course students, eating habits (in terms of adherence to the Mediterranean Diet, MD), physical activity, nutritional status, nutritional literacy, perceived stress, eating self-efficacy, , psychological wellbeing and the relationship between these variables; b) selecting students with high perceived stress and unhealthy lifestyles to admit to the following phase.
Phase 2: students will be admitted to a RCT study comparing a treatment-as-usual protocol (standard nutritional and exercise advice) to a health counselling protocol that add a health coaching to the standard protocol.
EXPECTED RESULTS: We expect that 1) sedentary lifestyles and unhealthy eating habits are assocated to higher BMI and lower nutritional literacy; 2) unhealthy eating habits are associated to greater perceived stress; 3) eating self-efficacy in the social and emotional domains mediate the relationship between perceived stress and unhealthy eating habits. We also expect that both interventions delivered in phase 2 improve nutritional status and physical activity but this improvement is significantly bigger in the health counselling group.
A few studies have investigated vulnerability of University students and, to the best of our knowledge, they never looked to metabolic, lifestyle, psychological and social aspects at the same time. A multidimensional evaluation of vulnerability may give important information to increase the knowledge on this problem and to shed light upon a better management of it.
Nowadays, in Italy, we are witnessing to a gradual drifting from the MD towards a Westernised diet as a result of the nutritional transition process and the increased sedentarism. Despite the improvement in health care and the increase of life expectancy, the lower adherence to MD may represent a risk for the potential rising of NCDs incidence and prevalence and the related worsening of the quality of life. This will bring to a significant and unsustainable increase of direct and indirect health and social costs.
On the contrary a solid and growing scientific evidence supports the role of a healthy lifestyle to preserve health, to promote the individual and social well-being, to avoid the occurrence of NCDs.
Moreover, the actual unhealthy lifestyle increases vulnerability to NCDs in the general population and/or in categories of subjects exposed to specific stressors (e.g. University students). As assessed by the National Bioethics Advisory Commission (NBAC) observation ¿vulnerability is sensitive to context, and individuals may be vulnerable in one situation but not in another.
Vulnerability can predispose to maladaptive coping behaviours, to unaware and uninformed adhesion to fake eating and/or to eccentric social models, to the acceptance of unrealistic body image models, possibly leading to eating disorders and/or to addictive behaviors such as alcohol and drug abuse, gambling, etc.
Finally, it is well known that the acquisition/recovery of a healthy lifestyle is much more achievable and appropriate in young age since the improvement of an unheathy lifestyle in later life or in individuals suffering from chronic degenerative diseases is unlikely and unrealistic.
In this study a comprehensive evaluation of nutritional status (considering eating and motor habits, body composition, energy and nutrient balance, mental health and psychological wellbeing) will be performed in a global and integrated model.
Statistical analises will be conducted for identifying a combination of variables, that are easy to measure and predictive of high nutritional, physiological and psychological maladjustment and that may be used in the future for assessing nutritional vulnerability in university student population accessing Sapienza University.
To the best of our knowledge, no intervention study has been conducted aimed at the prevention/reduction of nutritional vulnerability in University students. Sapienza University students population represents a very important setting (it is the biggest University in Europe) for documenting the impact of nutritional vulnerability on health status and to verify the efficacy of health coaching in this situation. The analysis of sustainability and transferability of the results on the adult population of Sapienza may represent an additional strength of the study.
References
Apolone G, Mosconi P (1998). J Clin Epidem, 51(11), 1025¿1036. https://doi.org/10.1016/S0895-4356(98)00094-8
Armstrong S, Oomen-Early J (2009). J Am Coll Health, 57(5), 521¿526. https://doi.org/10.3200/JACH.57.5.521-526
Cohen S et al (1983). J Health Soc Behav, 24, 386-396.
Eshetu F et al (2018). Educ Res Rev, 13(15), 570¿581.
Hayes AF (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression¿Based Approach. New York, NY: The Guilford Press.
Iani L et al (2015). Front Psychol, 6. https://doi.org/10.3389/fpsyg.2015.00433
Janssen I et al (2000). J Appl Phys, 89(1), 81¿88. https://doi.org/10.1152/jappl.2000.89.1.81
Kushner RF (1992). J Am Coll Nutr, 11(2), 199¿209.
Lombardo C et al (2011). Eat Weight Dis: EWD, 16(3), e188-198. https://doi.org/10.1007/BF03325131
Lombardo C et al, (2020). Eat Weight Dis, 1¿9. https://doi.org/10.1007/s40519-020-00854-2
Lombardo C et al (2016). Eat Behav, 22, 182¿187. https://doi.org/10.1016/j.eatbeh.2016.06.003
Mannocci A et al (2010). It J Publ Health, 7(4), Article 4. https://doi.org/10.2427/5694
McGorry PD et al (2011). Curr Op Psych, 24(4), 301¿306. https://doi.org/10.1097/YCO.0b013e3283477a09
Nogueira MJ et al (2017). J Am Psych Nur Ass, 23(3), 215¿222. https://doi.org/10.1177/1078390317695261
Prunas A et al (2012). Eur Psych, 27(8), 591¿597. https://doi.org/10.1016/j.eurpsy.2010.12.006