Original Article

Healthy Lifestyle Habits Among Students at the University of Seville, Spain

Please cite this article as follows: Llorent-Bedmar V, Torres-Zaragoza L, Navarro-Granados M, Ballesteros-Moscosio MA. Healthy lifestyle habits among students at the university of seville, spain. J Educ Community Health. 2022; 9(4):208-214. doi:10.34172/jech.2022.2016

Introduction

There is currently a growing interest in the study of healthy lifestyle habits given their innumerable benefits (1,2), which include proper cognitive development, improved memory and attention, higher levels of self-esteem, and higher rates of physical and mental health (3).

Unhealthy habits can have negative consequences not only on academic performance (3) but also on physical and psychological well-being,(4) which can lead to students’ dropping out of university and a lower quality of life (5).

The institutional promotion of actions that encourage the adoption of healthy lifestyle habits will result in more beneficial routines and habits and so promote the physical and mental well-being of students (6,7).This is truly important since the adoption of certain harmful lifestyle habits can last throughout adulthood if they are not resolved (8).

Students tend to adopt less healthy lifestyles at the start of their university careers as a consequence of the numerous changes in their environment (1) such as changes in their reference groups (family and friends) and new social relationships (e.g., the stress induced by social pressure, competition, and the like), which can lead to health problems such as lack of sleep and reduced psychological well-being (9,10).

In terms of sleep habits, a high percentage of university students in the United States do not get the minimum eight hours of sleep per night required to perform their daily activities properly (11). Numerous studies suggested that poor sleep habits have a negative effect on cognitive performance in students (12). The adoption of good sleep habits is the key driver of improved academic performance in university students (13).

A large proportion of university students have unhealthy eating habits (14), which are further exacerbated during exam periods (15) since stress accounts for the negative effect on eating habits in students (16).

Several studies have found that women are more aware of their diets, which leads them to adopt healthier eating habits (14).However, women also reported being more easily and frequently driven by their emotional state when eating by choosing products high in sugar and calories unlike men (17).

In this regard, recent research has reported gender differences in healthy lifestyle habits among university students. Men tended to have better sleep habits (18) and were physically more active than women (7).

Another factor that affects the adoption of healthy lifestyle habits is the student’s field of study. According to recent research findings, students in health-related areas have higher levels of physical activity than engineering and law students (7).

Parental figures play an essential role in the transmission of certain healthy lifestyle habits during childhood and their subsequent development in adulthood (19). It is also worth noting that the higher the educational and socioeconomic level of the parents, the healthier the lifestyle habits the university student will adopt (10).

Studies conducted in Spanish universities have demonstrated that university students do not have healthy eating habits and do not meet the minimum physical activity requirements(20,21). This led us to study the perceptions of students at the University of Seville of their lifestyle habits during term time and also during exam periods. We also explored the effect of different socio-demographic variables (e.g., gender, work situation, shift (pattern of attendance), and so on) on the practice of healthy lifestyle habits. Hence, the present study aimed to enhance the students’ understanding of healthy lifestyles at the University of Seville in order to develop and implement educational policies that educate and advise them regarding the adoption of healthier habits to improve their quality of life.

The main objective of this study was to analyze the perceptions of students at the University of Seville of their lifestyle habits. To this end, the following specific objectives were determined:

• To examine students’ perceptions of lifestyle habits according to the stage of the academic year: term time or exam period.

• To identify differences in students’ perceptions of their lifestyle habits according to gender, the field of study, shift (morning/afternoon), work situation, and parents’ level of education.

Materials and Methods

This study used a descriptive-analytic method with a non-experimental (ex post facto) design (22).

Descriptive and inferential statistics were used through SPSS software, version 27. For the descriptive statistics, means and standard deviation were used. For the inferential statistics, the Kolmogorov-Smirnov test was first applied to check that the sample was normally distributed, followed by the non-parametric Kruskal-Wallis H test for more than two independent samples and the Mann-Whitney U-test for two independent samples, respectively. In addition, effect sizes were calculated using the squared correlation coefficient (23).

The study population included all undergraduate students (N = 48 039) enrolled at the University of Seville during the 2019-2020 academic year (24). To calculate the sample, the formula for infinite populations ( > 10 000 subjects) was used: n = z² P*Q/E². With a margin of error of 3.3% for a 97% confidence interval, a total of 1.478 students were obtained. Simple random sampling was used with proportional allocation according to sex and field of study. The inclusion criterion for the sample included being over 18 years old, being undergraduate students from the 1st to the 4th year or to the 5th or the 6th in specific degrees such as medicine, architecture, and pharmacy, and studying at the University of Seville. Students with Master’s degrees, Ph. D students, as well as students who had enrolled the educational programs before the academic year 2014-2015 were excluded from the study (Table 1).

The questionnaires were completed both online, using Google Forms, and in person. Students voluntarily participated in the study by completing the questionnaire. Anonymity and confidentiality in responses were preserved at all times. The questionnaire was previously approved by the Ethical Committee of the Socio-educational Research in Action Group (HUM-929).

A specific questionnaire was designed for the present study. It had two main dimensions: Healthy lifestyle habits during the examination period and healthy lifestyle habits during the rest of the academic year. It consisted of a total of 30 items rating on a five-point Likert-type response scale (1 = never; 2 = almost never; 3 = sometimes; 4 = almost always; and 5 = always). Reliability was calculated using Cronbach’s alpha internal consistency coefficient as well as obtaining values close to unity for the questionnaire as a whole (0.943) and its two constituent dimensions (a. α = 0.953 and b. α = 0.960).

Exploratory factor analysis with the Principal Component method was used to evaluate the construct validity after checking sampling adequacy with the Kaiser-Meyer-Olkin test and Bartlett’s test of sphericity (N = 1.478). Both dimensions enjoyed adequate measures of sampling adequacy, rejecting the sphericity hypothesis with optimal statistical significance in all cases (P = 0.001). In addition, item saturation was achieved on factors with a value above 0.4 (25).

Results

Term Time (Excluding Exam P)

Application of the U-test revealed statistically significant differences according to the gender of the respondents for certain items on this dimension (Table 2). Large effect sizes indicated that women consider their diet to be healthy and eat according to their emotional state, while intermediate effect sizes suggested that those attending classes in the morning adopt healthier habits than those attending the afternoon classes.

Differences According to Work Situation, Education Level of the Mother, and Year of Course

Application of the H-test revealed statistically significant differences according to the above-mentioned dimensions, with an intermediate effect size (Table 3).

Examination Periods

The U-test was applied to check more specifically differences arising according to the exam period or term time. As Table 4 depicts, the sharpest differences were observed in the consumption of sugary products and considering their diet to be healthy in exam period and term period, respectively.

Non-significant Differences

According to Table 4, no significant differences were observed in the practice of healthy habits between the exam period and term time with respect to the average mark of the student (P = 0.835 and P = 0.135, respectively) or the educational level of the father (P = 0.648 and P = 0.677, respectively).

Table 5 indicates that significant differences were found in students’ practices of healthy habits in terms of the field of study, but the effect size was not important.

Discussion

This study aimed to analyze the perceptions of students at the University of Seville of their lifestyle habits. It was found that a high percentage of students report maintaining healthy lifestyle habits. For example, they considered their diets to be healthy, ate at least four meals a day, drank at least 2 L of water a day, ate five pieces of fruit and vegetables, and did not usually skip meals. They also exercised at least three times a week and slept a minimum of seven hours a night. This differs from the findings of other studies conducted in Spain (20), Lebanon (26), and Chile (14).

Nevertheless, the students practiced a number of unhealthy eating habits over the course of the academic year, which is consistent with previous studies (15).These students consumed high-calorie and sugary products, engaged in emotional eating, and ate fast/processed food on a weekly basis.

During exam periods, university students adopted a less healthy set of eating habits than at other times of the academic year, consuming more high-sugar products, and fast and processed food. These results are consistent with research conducted in Belgian and Greek universities (15,27).

It was observed that female students considered their diet to be healthier, as reported by (14), although in the present study, interestingly, the same female students reported emotional eating to a greater extent compared to males.

Men reported more physical activity and having less difficulty falling asleep. These results have also been found in previous research, with men reporting better quality of sleep and physical activity habits than women (18).

Statistically significant differences were found in the students’ adoption of certain eating and sleeping habits according to their shift. Specifically, those enrolled in morning classes reported better eating habits, eating four meals a day, and skipping fewer meals than students enrolled in afternoon classes. These results seem to be consistent with other research in which university students who get up later tended to skip breakfast and adopted poorer lifestyle habits (28).

Moreover, students enrolled in the afternoon shift reported greater difficulties in falling asleep at night. Those who worked at the same time also reported sleeping less than seven hours a night and having more difficulty staying awake during the day than those who only studied and were not looking for work.

In addition, students whose mothers had no education reported eating more fast/processed food than those whose mothers had a Ph.D degree. This is consistent with research by Schmidt who found that the education level of both parents played a critical role in the adoption of healthy lifestyle habits by students(10). In the present study, however, we did not find significant differences in the adoption of certain lifestyle habits according to the education level of the father. It would be interesting to explore the reasons for these differences in future research.

Finally, it is worth highlighting the perception of final-year (fourth year) students who were more likely than first-year students to consider their diet to be healthy. Other authors found that medical students at more advanced levels of their education, specifically those in the third and fourth years as opposed to the second year, displayed healthier lifestyle habits (29).In contrast, others found no significant differences according to the level of their course (30).

While numerous research studies have highlighted the relationship between the practice of certain healthy lifestyle habits and academic achievement (2), this study found no significant differences between the adoption of healthy lifestyle habits and the average marks of the student.

Although this study found significant differences in the practice of lifestyle habits according to the general field of study in which the student was enrolled, the effect size was not significant. While several studies have shown that there is no relationship between lifestyle habits and the student’s field of study (7), other research indicated that those fields of study with components that are proximate to particular lifestyle habits such as nutrition, health, physical activity, and sport sciences did have a positive effect on students when it comes to adopting healthy lifestyles (31).

When interpreting the results, it should be borne in mind that this study does not observe or focus on healthy lifestyle habits but rather on the students’ perception of their adherence to them. Nevertheless, the obtained results have important implications for the promotion of health among university students.

Conclusion

We consider that students at the University of Seville maintain healthy lifestyle habits in general although with shortcomings in the practice of certain habits, especially during exam periods. The evidence from this study highlights the importance of developing and implementing educational policies aimed at promoting and advising on healthy lifestyles among students at the University of Seville. Such policies would be especially useful before the start of exam periods when we observed that certain habits deteriorated.

Acknowledgments

We would like to extend our heartfelt thanks to the participants of this study. We also would like to thank the Socio-educational Research in Action Group (HUM929) for the approval of our research ethics application.

Author Contributions

Conceptualization: María Navarro-Granados, Lucía Torres-Zaragoza, Vicente Llorent-Bedmar.

Data curation: María Navarro-Granados, Lucía Torres-Zaragoza, Miguel Ángel Ballesteros-Moscosio.

Formal Analysis: María Navarro-Granados, Lucía Torres-Zaragoza

Funding acquisition: Vicente Llorent-Bedmar.

Investigation: María Navarro-Granados, Lucía Torres-Zaragoza, Vicente Llorent-Bedmar.

Methodology: María Navarro-Granados, Lucía Torres-Zaragoza, Vicente Llorent-Bedmar.

Project administration: Vicente Llorent-Bedmar.

Supervision: Vicente Llorent-Bedmar.

Writing – original draft: María Navarro-Granados, Lucía Torres-Zaragoza, Vicente Llorent-Bedmar, Miguel Ángel Ballesteros-Moscosio.

Writing – review & editing: María Navarro-Granados, Lucía Torres-Zaragoza.

Conflict of Interests

There was no conflict of interests in this study.

Ethical Permissions

Anonymity and confidentiality in responses were preserved at all times. The questionnaire was previously approved by the Ethical Committee of the Socio-educational Research in Action Group (HUM929).

Funding/Support

This study has been written under the framework of the Research Plan of the University of Seville (VPPI-US-2020).

References

1. Çetinkaya S, Sert H. Healthy lifestyle behaviors of university students and related factors. Acta Paul Enferm 2021; 34:eAPE02942. doi: 10.37689/acta-ape/2021AO02942 [Crossref] [ Google Scholar]
2. Chalapud-Narváez LM, Molano-Tobar NJ, Roldán González E. [Healthy lifestyles in teachers and college students]. Retos 2022(44):477-84. doi: 10.47197/retos.v44i0.89342 [Crossref]
3. Naveed S, Lakka T, Haapala EA. An overview on the associations between health behaviors and brain health in children and adolescents with special reference to diet quality. Int J Environ Res Public Health 2020; 17(3):953. doi: 10.3390/ijerph17030953 [Crossref] [ Google Scholar]
4. Uddin R, Burton NW, Khan A. Combined effects of physical inactivity and sedentary behaviour on psychological distress among university-based young adults: a one-year prospective study. Psychiatr Q 2020; 91(1):191-202. doi: 10.1007/s11126-019-09697-2 [Crossref] [ Google Scholar]
5. Fernández-Rodríguez C, Soto-López T, Cuesta M. Needs and demands for psychological care in university students. Psicothema 2019; 31(4):414-21. doi: 10.7334/psicothema2019.78 [Crossref] [ Google Scholar]
6. Pierre Enriquez J, Hernández-Santana A. Influence of educational interventions on nutrition and sustainability in Ecuadorian university students residing in Honduras. La Granja 2021; 34(2):80-90. doi: 10.17163/lgr.n34.2021.05 [Crossref] [ Google Scholar]
7. Núñez-Rocha GM, López-Botello CK, Salinas-Martínez AM, Arroyo-Acevedo HV, Martínez-Villarreal RT, Ávila-Ortiz MN. Lifestyle, quality of life, and health promotion needs in Mexican university students: important differences by sex and academic discipline. Int J Environ Res Public Health 2020; 17(21):8024. doi: 10.3390/ijerph17218024 [Crossref] [ Google Scholar]
8. Cabanas-Sánchez V, García-Cervantes L, Esteban-Gonzalo L, Girela-Rejón MJ, Castro-Piñero J, Veiga Ó L. Social correlates of sedentary behavior in young people: the UP&DOWN study. J Sport Health Sci 2020; 9(2):189-96. doi: 10.1016/j.jshs.2019.03.005 [Crossref] [ Google Scholar]
9. Çivitci A. The moderating role of positive and negative affect on the relationship between perceived social support and stress in college students. Educ Sci Theory Pract 2015; 15(3):565-73. doi: 10.12738/estp.2015.3.2553 [Crossref] [ Google Scholar]
10. Schmidt M. Predictors of self-rated health and lifestyle behaviours in Swedish university students. Glob J Health Sci 2012; 4(4):1-14. doi: 10.5539/gjhs.v4n4p1 [Crossref] [ Google Scholar]
11. Gilbert SP, Weaver CC. Sleep quality and academic performance in university students: a wake-up call for college psychologists. J College Stud Psychother 2010; 24(4):295-306. doi: 10.1080/87568225.2010.509245 [Crossref] [ Google Scholar]
12. Gomes AA, Tavares J, de Azevedo MH. Sleep and academic performance in undergraduates: a multi-measure, multi-predictor approach. Chronobiol Int 2011; 28(9):786-801. doi: 10.3109/07420528.2011.606518 [Crossref] [ Google Scholar]
13. Chiang YC, Arendt SW. Benefits of sleep for undergraduate students’ academic performance. J Hosp Tour Educ 2017; 29(2):61-70. doi: 10.1080/10963758.2017.1297713 [Crossref] [ Google Scholar]
14. Nazar G, Stiepovic J, Bustos C. Latent class analysis of lifestyle behavior among Chilean university students. Int J Health Promot Educ 2019; 57(2):98-111. doi: 10.1080/14635240.2018.1552534 [Crossref] [ Google Scholar]
15. Costarelli V, Patsai A. Academic examination stress increases disordered eating symptomatology in female university students. Eat Weight Disord 2012; 17(3):e164-9. doi: 10.1007/bf03325343 [Crossref] [ Google Scholar]
16. Antonopoulou M, Mantzorou M, Serdari A, Bonotis K, Vasios G, Pavlidou E. Evaluating Mediterranean diet adherence in university student populations: Does this dietary pattern affect students’ academic performance and mental health?. Int J Health Plann Manage 2020; 35(1):5-21. doi: 10.1002/hpm.2881 [Crossref] [ Google Scholar]
17. Alalwan TA, Hilal SJ, Mahdi AM, Ahmed MA, Mandeel QA. Emotional eating behavior among University of Bahrain students: a cross-sectional study. Arab J Basic Appl Sci 2019; 26(1):424-32. doi: 10.1080/25765299.2019.1655836 [Crossref] [ Google Scholar]
18. Montagni I, Qchiqach S, Pereira E, Tully PJ, Tzourio C. Sex-specific associations between sleep and mental health in university students: a large cross-sectional study. J Am Coll Health 2020; 68(3):278-85. doi: 10.1080/07448481.2018.1546183 [Crossref] [ Google Scholar]
19. Mollborn S, Lawrence E, Krueger PM. Developing health lifestyle pathways and social inequalities across early childhood. Popul Res Policy Rev 2021; 40(5):1085-117. doi: 10.1007/s11113-020-09615-6 [Crossref] [ Google Scholar]
20. Moreno-Gómez C, Romaguera-Bosch D, Tauler-Riera P, Bennasar-Veny M, Pericas-Beltran J, Martinez-Andreu S. Clustering of lifestyle factors in Spanish university students: the relationship between smoking, alcohol consumption, physical activity and diet quality. Public Health Nutr 2012; 15(11):2131-9. doi: 10.1017/s1368980012000080 [Crossref] [ Google Scholar]
21. Varela-Mato V, Cancela JM, Ayan C, Martín V, Molina A. Lifestyle and health among Spanish university students: differences by gender and academic discipline. Int J Environ Res Public Health 2012; 9(8):2728-41. doi: 10.3390/ijerph9082728 [Crossref] [ Google Scholar]
22. Nardi PM. Doing Survey Research: A Guide to Quantitative Methods. UK: Taylor & Francis; 2018.
23. Tomczak M, Tomczak E. The need to report effect size estimates revisited An overview of some recommended measures of effect size. Trends Sport Sci 2014; 1(21):19-25. [ Google Scholar]
24. Vicegerencia de Organización. Anuario Estadístico 2020-2021. Universidad de Sevilla; 2021. Available from: http://servicio.us.es/splanestu/WS/Anuarios.html.
25. Floyd FJ, Widaman KF. Factor analysis in the development and refinement of clinical assessment instruments. Psychol Assess 1995; 7(3):286-99. doi: 10.1037/1040-3590.7.3.286 [Crossref] [ Google Scholar]
26. Assaf I, Brieteh F, Tfaily M, El-Baida M, Kadry S, Balusamy B. Students university healthy lifestyle practice: quantitative analysis. Health Inf Sci Syst 2019; 7(1):7. doi: 10.1007/s13755-019-0068-2 [Crossref] [ Google Scholar]
27. Michels N, Man T, Vinck B, Verbeyst L. Dietary changes and its psychosocial moderators during the university examination period. Eur J Nutr 2020; 59(1):273-86. doi: 10.1007/s00394-019-01906-9 [Crossref] [ Google Scholar]
28. Fujino H, Okunari T, Kato Y, Kobashi H, Tarutani T, Miyano N, et al. Proposal to enhance university students’ motivation to switch to a morning-oriented lifestyle with a community approach. In: Meiselwitz G, ed. Social Computing and Social Media Participation, User Experience, Consumer Experience, and Applications of Social Computing. Cham: Springer; 2020. p. 511-25. 10.1007/978-3-030-49576-3_37.
29. Nasir U, Butt AF, Choudry S. A study to evaluate the lifestyle of medical students in Lahore, Pakistan. Cureus 2019; 11(3):e4328. doi: 10.7759/cureus.4328 [Crossref] [ Google Scholar]
30. Navarro-González I, López-Nicolás R, Rodríguez-Tadeo A, Ros-Berruezo G, Martínez-Marín M, Doménech-Asensi G. Adherence to the Mediterranean diet by nursing students of Murcia (Spain). Nutr Hosp 2014; 30(1):165-72. doi: 10.3305/nh.2014.30.1.7413 [Crossref] [ Google Scholar]
31. Fortino A, Vargas M, Berta E, Cuneo F, Ávila O. [Assessment of dietary consumption patterns and physical activity of students from three university degree programs with respect to dietary guidelines for the Argentine population]. Rev Chil Nutr 2020; 47(6):906-15. doi: 10.4067/s0717-75182020000600906 [Crossref] [ Google Scholar]