Eat,Sleep,Work,Play: Associations of Weight Status and Health-Related Behaviors among Young Adult College Students

Abstract

Purpose.

To examine relationships of sleep, eating, and exercise behaviors; work time pressures; and sociodemographic characteristics by weight status (healthy weight [body mass index or BMI < 25] vs. overweight [BMI ≥ 25]) of young adults.

Design.

Cross-sectional.

Setting.

Nine U.S. universities.

Subjects.

Enrolled college students (N = 1252; 18–24 years; 80% white; 59% female).

Measures.

Survey included the Pittsburgh Sleep Quality Index (PSQI), Three-Factor Eating Questionnaire (TFEQ), Satter Eating Competence Inventory (ecSI), National Cancer Institute Fruit/Vegetable Screener, International Physical Activity Questionnaire, Work Time Pressure items, and sociodemographic characteristics.

Analysis.

Chi-square and t-tests determined significant bivariate associations of sociodemographics, sleep behaviors, eating behaviors, physical activity behavior, and work time pressures with weight status (i.e., healthy vs. overweight/obese). Statistically significant bivariate associations with weight status were then entered into a multivariate logistic regression model that estimated associations with being overweight/obese.

Results.

Sex (female), race (nonwhite), older age, higher Global PSQI score, lower ecSI total score, and higher TFEQ Emotional Eating Scale score were significantly (p < .05) associated with overweight/obesity in bivariate analyses. Multivariate logistic regression analysis showed that sex (female; odds ratio [OR] = 2.05, confidence interval [CI] = 1.54–2.74), older age (OR = 1.35, CI= 1.21–1.50), higher Global PSQI score (OR = 1.07, CI = 1.01–1.13), and lower ecSI score (OR = .96, CI = .94–.98), were significantly (p < .05) associated with overweight/obesity.

Conclusion.

Findings suggest that obesity prevention interventions for college students should include an education component to emphasize the importance of overall sleep quality and improving eating competence.

Keywords

Young Adults Health Behaviors Weight Sleep Eating Prevention Research Manuscript format: research Research purpose: modeling/relationship testing Study design: nonexperimental Outcome measure: behavioral Setting: school Health focus: weight control Strategy: skill building/behavior change Target population age: adults Target population circumstances: education/income level,race/ethnicity

References

Yach

Stuckler

Brownell

. Epidemiologic and economic consequences of the global epidemics of obesity and diabetes. Nat Med. 2006;12:62–66.

Bray

. Medical consequences of obesity. J Clin Endocrinol Metab. 2004;89(6):2583–2589.

Williamson

Kahn

Remington

Anda

. The 10-year incidence of overweight and major weight gain in US adults. Arch Intern Med. 1990;150:665–672.

Truesdale

Stevens

Lewis

. Changes in risk factors for cardiovascular disease by baseline weight in young adults who maintain or gain weight over 15 years: The CARDIA study. Int J Obes. 2006;30:1397–1407.

Guo

Huang

Maynard

. Body mass index during childhood, adolescence and young adulthood in relation to adult overweight and adiposity: The Fels Longitudinal Study. Int J Obes. 2000;24:1628–1635.

Stamatakis

Brownson

. Sleep duration and obesity-related risk factors in the rural Midwest. Prev Med. 2008;46:439–444.

Baranowski

Cullen

Basen-Engquist

. Transitions out of high school: Time of increased cancer risk? Prev Med. 1997;26:694–703.

Bray

Born

. Transition to university and vigorous physical activity: Implications for health and well-being. J Am Coll Health. 2004;52:181–188.

Lund

Reider

Whiting

Richard

. Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health. 2010;46:124–132.

10.

Strong

Parks

Anderson

. Weight gain prevention: Identifying theory-based targets for health behavior change in young adults. J Am Diet Assoc. 2008;108:1708–1715.

11.

Jeffery

Drewnowski

Epstein

. Long-term maintenance of weight loss: Current studies. Health Psychol. 2000;19(suppl):5–16.

12.

Franz

VanWormer

Crain

. Weight-loss outcomes: A systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc. 2007;107:1755–1767.

13.

Neumark-Sztainer

Wall

Story

Standish

. Dieting and unhealthy weight control behaviors during adolescence: Associations with 10-year changes in body mass index. J Adolesc Health. 2012;50:80–86.

14.

Haines

Neumark-Sztainer

Wall

Story

. Personal, behavioral, and environmental risk and protective factors for adolescent overweight. Obesity. 2007;15:2748–2760.

15.

Haines

Kleinman

Rifas-Shiman

. Examination of shared risk and protective factors for overweight and disordered eating among adolescents. Arch Pediatr Adolesc Med. 2010;164:336–343.

16.

Center for Disease Control and Prevention . QuickStats. MMWR. 2005;54:933.

17.

Hasler

Buysse

Klaghofer

. The association between short sleep duration and obesity in young adults: A 13-year prospective study. Sleep. 2004;27:661–666.

18.

Satter

. Eating competence: Definition and evidence for the Satter Eating Competence model. J Nutr Educ Behav. 2007;39(S5):S142–S153.

19.

Stranges

Cappuccio

Kandala

N-B

. Cross-sectional versus prospective associations of sleep duration with changes in relative weight and body fat distribution: The Whitehall II study. Am J Epidemiol. 2008;167:321–329.

20.

Vioque

Torres

Quiles

. Time spent watching television, sleep duration, and obesity in adults living in Valencia, Spain. Int J Obes Relat Metab Disord. 2000;24:1683–1688.

21.

Mathews

. Assessing Sleep Quality in Young Adult College Students, Aged 18–24 in Relation to Quality of Life and Anthropometrics [master's thesis]. Orono, Me: University of Maine; 2010.

22.

Sleep and sleep disorders . Washington, DC: Center for Disease Control and Prevention. Available at: http://www.cdc.gov/features/sleep/. Accessed March 1, 2013.

23.

Karlsson

Persson

L-O

Sjostrom

Sullivan

. Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women: Results from the Swedish Obese Subjects (SOS) study. Int J Obes. 2000;24:1715–1725.

24.

Satter

. Satter eating competence: Nutrition education with the Satter eating competence model. J Nutr Educ Behav. 2007;39(suppl 5):189–194.

25.

Shoff

Nuss

Horacek

. Sleep quality is associated with eating behavior in 18–24 year old college students. J Nutr Educ Behav. 2009;41:S8–S9.

26.

Brunner

Chandola

Marmot

. Prospective effect of job strain on general and central obesity in the Whitehall II study. Am J Epidemiol. 2007;165:828–837.

27.

About BMI for adults . Washington, DC: Center for Disease Control and Prevention. Available at: http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html. Accessed November 10, 2011.

28.

Buysee

Reynolds

Monk

. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatr Res. 1989;28:193–213.

29.

Grandner

Kripke

Yoon

Youngstedt

. Criterion validity of the Pittsburgh Sleep Quality Index: Investigation in a non-clinical sample. Sleep Biol Rhythms. 2006;4:129–136.

30.

de Lauzon

Romon

Deschamps

. The Three-Factor Eating Questionnaire-R18 is able to distinguish among different eating patterns in a general population. J Nutr Educ Behav. 2004;134:2372–2380.

31.

Lohse

Satter

Horacek

. Measuring eating competence: Psychometeric properties and validity of the ecSatter Inventory. J Nutr Educ Behav. 2007;39(S5):S145–S166.

32.

Thompson

Subar

Smith

. Fruit and vegetable assessment: Performance of 2 new short instruments and a food frequency questionnaire. J Am Diet Assoc. 2002;102:1764–1772.

33.

Booth

. Assessment of physical activity: An international perspective. Res Q Exerc Sport. 2000;71:s114–s120.

34.

Patel

. Short sleep duration and weight gain: A systematic review. Obesity. 2008;16:643–653.

35.

McKnight-Eily

Eaton

Lowry

. Relationships between hours of sleep and health-risk behaviors in US adolescent students. Prev Med. 2011;53:271–273.

36.

Wheaton

Perry

Chapman

. Relationship between body mass index and perceived insufficient sleep among US adults: An analysis of 2008 BRFSS data. BMC Public Health. 2011;11:295.

37.

Redline

Clark

Graham

. Risk factors for sleep disordered breathing in children: Associations with obesity, race, and respiratory problems. Am J Respir Crit Care Med. 1999;159:1527–1532.

38.

Vorona

Winn

Babineau

. Overweight and obese patients in a primary care population report less sleep than patients with a normal body mass index. Arch Intern Med. 2005;165:25–30.

39.

Chen

Beydoun

Wang

. Is sleep duration associated with childhood obesity: A systematic review and meta-analysis. Obesity. 2008;16:265–274.

40.

Gupta

Mueller

Chan

Meininger

. Is obesity associated with poor sleep quality in adolescents? Am J Human Biol. 2002;14:762–768.

41.

Shlisky

Hartman

Kris-Etherton

. Partial sleep deprivation and energy balance in adults: An emerging issue for consideration by dietetics practioners. J Acad Nutr and Diet. 2012;112:1785–1797.

42.

Psota

Lohse

West

. Association between eating competence and cardiovascular disease biomarkers. J Nutr Educ Behav. 2007;39:S171–S178.

43.

Lohse

Psota

Estruch

. Eating competence of elderly Spanish adults is associated with a healthy diet and a favorable cardiovascular disease risk profile. J Nutr. 2010;140:1322–1327.

44.

Stotts

Lohse

. Reliability of the ecSatter Inventory as a tool to measure eating competence. J Nutr Educ Behav. 2007;39:S167–S170.

45.

Brown

Larsen

Nyland

Eggett

. Eating competence of college student in an introductory nutrition course. J Nutr Educ Behav. 2013;45:269–273.

46.

Dour

Horacek

Schembre

. Process evaluation of Project WebHealth: A non-dieting web-based intervention for obesity prevention in college students. J Nutr Educ Behav. 2013;45:288–295.

47.

Lohse

Bailey

Krall

. Diet quality is related to eating competence in cross-sectional sample of low-income females surveyed in pennsylvania. Appetite. 2012;58:645–650.

48.

Lohse

Arnold

Wamboldt

. Evaluation of About Being Active, an online lesson about physical activity shows that perception of being physically active is higher in eating competent low-income women. BMC Women's Health. 2013;13:12.

49.

Greene

White

Hoerr

. Impact of an online healthful eating and physical actiity program for college students. Am J Health Promot. 2012;27:47–58.

50.

Hoek

. Incidence, prevalence and mortality of anorexia and other eating disorders. Curr Opin Pyschiatr. 2007;19:389–394.

51.

Neumark-Sztainer

Wall

Larson

. Dieting and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study. J Am Diet Assoc. 2011;111:1004–1011.

52.

Ganley

. Emotion and eating in obesity: A review of the literature. Int J Eat Disord. 2006;8:343–361.

53.

Bennett

Greene

Schwartz-Barcott

. Perceptions of emotional eating behavior: A qualitative study of college students. Appetite. 2013;60:187–192.

54.

Prochaska

Redding

Evers

. Health Behavior and Health Education: Theory, Research and Practice: The Transtheoretical Model and Stages of Change. 4th ed. San Francisco, Calif: Jossey-Bass Inc; 2008.

55.

Lallukka

Lahelma

Rahkonen

. Associations of job strain and working overtime with adverse health behaviors and obesity: Evidence from the Whitehall II Study, Helsinki Health Study, and the Japenese Civil Servants Study. Soc Sci Med. 2008;66:1681–1698.

56.

Adams

Matthews

Ebbeling

. The effect of social desirability and social approval on self-reports of physical activity. Am J Epidemiol. 2005;161:389–398.

57.

Herbert

Clemow

. Gender differences in social desirability and social approval bias in dietary self-report. Am J Epidemiol. 1997;146:1046–1055.

58.

Larson

Neumark-Sztainer

Story

. Identifying correlates of young adults' weight behavior: Survey development. Am J Health Behav. 2011;35:712–725.

59.

Krall

Lohse

. Interviews with low-income Pennsylvanians verify a need to enhance eating competence. J Am Diet Assoc. 2009;109:468–473.

60.

Ball

Brown

Crawford

. Who does not gain weight: Prevalence and predictors of weight maintenance in young women. Int J Obes Relat Metab Disord. 2002;26:1570–1580.

61.

Hoffman

Policastro

Quick

Lee

. Changes in body weight and fat mass of men and women in the first year of college: A study of the “Freshman 15”. J Am Coll Health. 2006;55:41–50.

62.

Matvienko

Lewis

Schafer

. A college nutrition science course as an intervention to prevent weight gain in female college freshman. J Nutr Educ. 2001;33:95–101.

63.

Leslie

Sparling

Owen

. University campus setting and the promotion of physical activity in young adults: Lessons from research in Australia and the USA. Health Educ. 2001;101:116–125.

64.

Hivert

M-F

Langlois

M-F

Berard

. Prevention of weight gain in young adults through a seminar-based intervention program. Int J Obes. 2007;31:1262–1269.

65.

Ferrara

. The college experience: Physical activity, nutrition and implications for intervention and future research. J Exerc Physiol. 2009;12:23–35.