Use of table sugar and non-caloric sweeteners in Brazil: associated factors and changes across a decade.

This study evaluated changes in the use of sweeteners over one decade and the relationship between socio-demographics, diet and weight status with the type of sweetener. Data came from the Brazilian National Dietary Surveys of 2008-2009 and 2017-2018, including ≥ 10-year-old individuals (n 32 749; n 44 744, respectively, after excluding pregnant and lactating women). The use of table sugar, non-caloric sweeteners (NCS), both or none was reported through a specific question. Food consumption was assessed using two non-consecutive food records (2008-2009) and 24-h recalls (2017-2018). For the last survey, means of energy, macro and micronutrient intake, food groups' contribution (%) to daily energy intake and age- and energy-adjusted nutrient intake were estimated according to the type of sweetener used. Differences in means and proportions across the categories of sweeteners used were evaluated based on the 95 % CI. All analyses were stratified by sex and considered sample design and weights. Over 10 years, the use of table sugar decreased by 8 %, while the habit of not using any sweetener increased almost three times, and the use of NCS remained stable. Larger reductions in the use of table sugar were observed in the highest income level and among men. Regardless of sex, compared with NCS users, table sugar users had greater mean intake of energy, carbohydrates and added sugar and lower micronutrient intake means. Although table sugar is still the most used sweetener, the increased choice of 'no sweetener' is noteworthy in Brazil.

Association of household composition with dietary patterns among adolescents in Brazil.

The present study identified dietary patterns (DP) and analyse their association with household composition. This is a cross-sectional school-based study, with a nationally representative sample of Brazilian adolescent students, aged 11-19 years, with data from National School Health Survey (n 102 072). Food consumption was obtained through the weekly frequency of consumption of food markers, and the confirmatory factor analysis was applied to examine the latent variables 'Healthy' (beans, legumes/vegetables and fresh fruit/fruit salad) and 'Unhealthy' (ultra-processed foods, sweets, soft drinks and snacks) DP. The association between household composition and DP was estimated considering lives with both parents as reference category. Among adolescents aged 11-14 years, adherence to healthy DP was lower for boys who lived only with mother (ß = -2·1), and boys (ß = -4·9) and girls (ß = -4·5) who lived without any parents. Adherence to unhealthy DP was higher among boys (ß = 7·6) and girls (ß = 6·0) who lived only with mother, and boys (ß = 4·6) and girls (ß = 5·3) who lived only with father. For older adolescents (aged 15-19 years), adherence to the unhealthy DP was higher among boys who lived only with mother (ß = 3·9) or only with father (ß = 5·3) and girls who lived only with mother (ß = 6·3). Adherence to healthy DP was lower among girls who lived only with father (ß = -9·0). Thus, adolescents who lived in single-parent households had lower adherence to healthy DP and greater adherence to unhealthy DP. Among younger adolescents of both sexes, living without any parent contributed to lower adherence to healthy DP.

Effect of the dietary inflammatory potential on the trajectory of body adiposity in a Brazilian cohort of university students.

OBJECTIVES: University students are vulnerable to unhealthy eating habits that characterize a proinflammatory diet. This study aimed to estimate the dietary inflammatory index (DII) and its association with the trajectory of body adiposity markers in university students. METHODS: The study analyzed data from 685 students entering a Brazilian public university in 2016 and 2017 and followed until 2018. DII was estimated from 39 dietary parameters obtained by 24-h dietary recall. Body adiposity was assessed by anthropometric markers and the percentage of body fat. Linear mixed-effects models were used to estimate the trajectory of adiposity markers according to DII tertiles. RESULTS: After adjustment for confounding variables, at baseline, DII showed a positive association with increased percentage of body fat among men (ß = 0.52; 95% CI: 0.01; 1.03) and waist-to-height ratio (WHtR; ß = 0.15; 95% CI: 0.12; 0.18) and among women with all body adiposity markers: BMI (ß = 0.68; 95% CI: 0.30; 1.05), percentage of body fat (ß = 1.43; 95% CI: 0.74; 2.11), WC (ß = 1.15; 95% CI: 0.41; 1.89) and WHtR (ß = 0.13; 95% CI:0,10; 0.16). The rate of change of the outcome variables over time was not associated with DII at baseline. CONCLUSIONS: The diet of university students in this Brazilian cohort study was characterized as proinflammatory and it was associated with body adiposity markers.

Cesarean birth and risk of obesity from birth to adolescence: A cohort study.

BACKGROUND: Recent studies have shown associations between cesarean birth and overweight. However, very few studies have evaluated weight gain or adiposity throughout life, and the majority are restricted to analysis during childhood. The purpose of this study was to analyze the effect of cesarean birth on obesity risk from birth to adolescence. METHODS: The study sample was drawn from live births that occurred in 1999 and 2000 in Mato Grosso-Brazil. Participants were evaluated once when they were between 0 and 5 years of age and again after approximately 10 years (2009-2011). To measure the association between cesarean birth and obesity (Body Mass Index/age >+2 z-scores), we used generalized estimation equations (GEE) with binomial distribution and log-binomial models for repeated measures, controlled by the following confounding factors: weight and length at birth, sex, gestational age, breastfeeding, maternal age and schooling, economic class in childhood, and maternal smoking during pregnancy. The exposure-time interaction term was evaluated to verify differences in the change in the risk of obesity over time. RESULTS: 56.8% of children in the sample were born by cesarean birth. Children born by cesarean had a higher risk of obesity from birth through adolescence (RR = 1.22, 95% CI = 1.02; 1.46), even after adjusting for covariates, when compared with those born vaginally. However, the time-exposure interaction term was not significant, which indicates that there was no increased risk of obesity over time. CONCLUSION: Cesarean birth was positively associated with obesity from birth to adolescence, with a persistent risk in the period evaluated.

Incidence of depressive symptoms and its association with sociodemographic factors and lifestyle-related behaviors among Brazilian university students.

Entering university brings on changes in lifestyle and psychological stress and has been associated with increased risk of 1988 in college students. This study aimed to investigate the incidence of depressive symptoms and associated sociodemographic and lifestyle factors among university students. A dynamic cohort of freshmen was followed up for three years, starting at their entry to university (baseline) and then annually. A structured auto administered questionnaire was applied to obtain information on age, sex, economic class, living situation, smoking and drinking, sedentary and sleep behaviors, and change in physical activity after university admission. Depressive symptoms were assessed using the Patient Health Questionaire-9. Incidence and incidence rate of depressive symptoms were calculated. Poisson Regression with robust variance was used to identify risk factors associated to these disorders. A total of 1,034 students without depressive symptoms at baseline were investigated. The overall incidence of depressive symptoms was 28.3% and the incidence rate (IR) was 2.12, being greater for females (2.75) than males (1.65). The IR decreased over time for both males (from 2.61 to 0.41) and females (from 4.25 to 0.54). A greater risk of depressive symptoms was observed for younger male students compared to those ≥20 years old (IRRadj = 1.64) and for women who reported concomitant use of alcohol and tobacco compared to those that reported no smoking and no alcohol consumption. For both males (IRRadj = 2.80) and females (IRRadj = 1.91), severe stress level was associated with greater risk of depressive symptoms when compared to mild stress level. Depressive Symptoms occurred more significantly in females, in the early years of undergraduate course, in males <20 years old, and among those with high stress level. Understanding the possible causes of depression is essential to promote mental health and well-being among college student.

Skipping breakfast is associated with the presence of cardiometabolic risk factors in adolescents: Study of Cardiovascular Risks in Adolescents - ERICA.

Breakfast is considered as the most important meal of the day. The habit of skipping this meal in adolescence tends to remain until adulthood and has been associated with cardiometabolic risk factors. The present study estimated the prevalence of skipping breakfast and its association with cardiometabolic risk factors. This is a cross-sectional study with data from the Study of Cardiovascular Risks in Adolescents (ERICA), with a nationally representative sample of 36 956 Brazilian adolescents, aged 12-17 years, enrolled in public and private schools. The outcomes were excess body weight (BMI), central obesity (waist circumference and waist:height ratio), lipid profile (total cholesterol (TC), LDL-cholesterol, HDL-cholesterol and TAG) and glycidic profile (fasting glycaemia, fasting insulin and glycated Hb). The association between skipping breakfast and each outcome was estimated using multiple Poisson regression models (prevalence ratio (PR) and 95 % CI). Prevalence of skipping breakfast was 68·7 % and, after adjustments, it was associated with excess body weight (PR = 1·30; 95 % CI 1·18, 1·43), central obesity both by waist circumference (PR = 1·27; 95 % CI 1·00, 1·61) and by waist:height ratio (PR = 1·32; 95 % CI 1·13, 1·54) and high fasting glucose levels (PR = 1·54; 95 % CI 1·09, 2·18), fasting insulin (PR = 1·64; 95 % CI 1·21, 2·22), glycated Hb (PR = 1·16; 95 % CI 1·03, 1·31) and total cholesterol (PR = 1·14; 95 % CI 1·02, 1·27). Skipping breakfast was associated with cardiometabolic risk factors in adolescence. In this context, the school environment is an ideal space to promote healthy eating habits, favouring the implementation of food and nutrition education activities to make adolescents aware of the importance of consuming breakfast daily.

Poor sleep quality, excessive daytime sleepiness and association with mental health in college students.

AIM: To estimate the prevalence of poor sleep quality and excessive daytime sleepiness (EDS) among college students and to analyse their association with aspects of mental health. SUBJECTS AND METHODS: A cross-sectional study carried out with 1113 college students, enrolled in full-time courses at a public university in the Mid-West region of Brazil. Data were collected through a self-administered questionnaire with questions about demographics, socioeconomics, mental health, sleep quality, and EDS. Measurements of weight and height were taken to assess weight status using the body mass index. Multivariate logistic regression models were used to estimate the associations between perceived stress (classified as light, moderate, and high) and presence of depressive symptoms with poor sleep quality and presence of EDS. RESULTS: High prevalence of poor sleep quality (65.5%) and EDS (55%) was observed. In the adjusted models, poor sleep quality was significantly associated with moderate and high perceived stress and presence of depressive symptoms. For EDS, there was also a significant association with moderate and high perceived stress and presence of depressive symptoms. CONCLUSIONS: High prevalence of poor sleep quality and EDS was found among college students. Perceived stress and presence of depressive symptoms were significantly associated with both evaluated outcomes.

Prevalence of disordered eating behaviors and associated factors in Brazilian university students.

BACKGROUND: University students may be a vulnerable group to adopt unhealthy behaviors, including changes in eating behavior. Assessment of factors associated with the prevalence of disordered eating behaviors in this population may facilitate the early identification of their predictors, thus allowing fast interventions. AIM: To analyze the prevalence of disordered eating behaviors (DEB) and associated factors in Brazilian university students. METHODS: Cross-sectional study of male and female students aged 16-25 years, enrolled in full-time degree program at a public university in the mid-west of Brazil. Disordered eating behaviors in the last three months (binge eating, purging, and food restriction), through an adapted version of the instrument developed by Hay, was evaluated and the association with demographic and socioeconomic characteristics, including lifestyle, body image, perceived stress, depressive symptoms, and excess weight, was analyzed. A hierarchical analysis model was performed to determine the relative importance of factors on the prevalence of DEB. RESULTS: A total of 1608 university students were evaluated (50.7% male). Prevalence of DEB was 4.4% for binge eating, 2.5% for purging and 9.1% for food restriction, all of which were higher among women (7.0%, 4.4%, and 13.5%) compared with men (1.8%, 0,6%, and 4.9%, respectively). The factors that remained significantly associated with these behaviors were female sex, smoking, consumption of alcoholic beverages, dissatisfaction with body image, excess weight, high perceived stress, and presence of self-reported depressive symptoms. CONCLUSION: Factors associated with DEB signal that intervention is required to create synergy between individual and population-level interventions in lifestyle behaviors.

Adult food consumption by household composition: an analysis of the first National Dietary Survey, Brazil, 2008-2009.

OBJECTIVE: To evaluate differences in food consumption of Brazilian adults according to the presence of children and adolescents in the household. DESIGN: Averages of two non-consecutive days of food records from the first Brazilian National Dietary Survey were analysed and classified into eighteen food groups according to nutritional characteristics and use in diet. We compared the mean percentage contribution to total daily energy intake of each food group according to three groups of household composition: adults living alone or with other adults (32·7 %), adults living with children (35·6 %) and adults living with adolescents (31·7 %). SETTING: Brazilian nationwide survey, 2008-2009. PARTICIPANTS: Adults aged 20-59 years (n 6312; 52·1 % female). RESULTS: Women living alone or with other adults had higher consumption of vegetables, milk and other drinks, and lower consumption of beans and rice, compared with those living with children or adolescents. Men living alone or with other adults had higher consumption of sweets & desserts and vegetables, and lower consumption of beans, compared with those living with children or adolescents. According to household income, adults in the highest tertile who lived with children or adolescents presented a mixed consumption of healthy and unhealthy foods, whereas their counterparts in the first income tertile presented a marked consumption of foods considered traditional of the Brazilian population. CONCLUSIONS: There are differences in food consumption based on the presence of children and adolescents in the household, with greater variation according to gender and household income.

Socio-economic and demographic characteristics associated with risk behaviour patterns for chronic non-communicable diseases in Brazil: data from the National Health Survey, 2013.

OBJECTIVE: To identify risk behaviour patterns for chronic non-communicable diseases (NCD) in the Brazilian population and to investigate associated socio-economic and demographic factors. DESIGN: Factor analysis was used to identify patterns considering the following risk behaviours: consumption of soft drinks/artificial juice, sweet foods, red meat with apparent fat, chicken skin; inadequate consumption of fruits and vegetables; alcohol abuse; smoking; absence of physical activity during leisure time; and time spent watching television. The χ 2 test was used to compare ratios. All analyses accounted for weighting factors and the study's complex sampling design effect. The socio-economic and demographic variables evaluated were gender, age, schooling level and macro region of residence. SETTING: National Health Survey, a household survey with national representation, conducted in 2013 in Brazil.ParticipantsIndividuals (n 60202) aged 18 years or over. RESULTS: Four risk behaviour patterns were identified: 'Physical inactivity in leisure time and Inadequate consumption of fruits and vegetables', 'Saturated fat', 'Alcohol and Smoking' and 'Sedentary behaviour and Sugar', explaining 52·01 % of the total variance. Overall, greater adherence to 'Saturated fat' and 'Alcohol and Smoking' patterns was observed among men and those with lower education level. The 'Sedentary behaviour and Sugar' and 'Physical inactivity in leisure time and Inadequate consumption of fruits and vegetables' patterns had greater adherence among younger individuals, and the first was associated with higher education whereas the second with less education among individuals residing in the North and Northeast regions. CONCLUSIONS: Risk behaviour patterns for NCD were heterogeneous, reflecting the socio-economic and demographic differences in Brazil.

Cut-off points of anthropometric markers associated with hypertension in the Brazilian population: National Health Survey, 2013.

OBJECTIVE: To identify cut-off points for waist circumference (WC), waist-to-height ratio (WHtR) and BMI associated with hypertension in the Brazilian adult and elderly population. DESIGN: Cross-sectional study. The receiver-operating characteristic (ROC) curve was used to determine the cut-off points of WC, WHtR and BMI in the prediction of hypertension. Those who had systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and those who reported use of antihypertensive medication were considered hypertensive. SETTING: Brazil.ParticipantsParticipants from the National Health Survey, the Brazilian household-based survey conducted in 2013, of both sexes and age ≥20 years. RESULTS: Cut-off points for WC and WHtR increased with age in both sexes. WC cut-off limits ranged between 88·0 and 95·9 cm in men and between 85·0 and 93·2 cm in women. For WHtR, cut-off scores ranged from 0·51 to 0·58 for men and from 0·53 to 0·61 for women. Additionally, the area under the ROC curve (AUC) for all age and sex groups was greater than 0·60 while the lower limit of the AUC 95 % CI for both WC and WHtR was not less than 0·50. The performance of BMI was similar to that of indicators of fat location. CONCLUSIONS: All analysed anthropometric indicators had similar performance in identifying hypertension in the Brazilian population.

How many meals and snacks do Brazilians eat a day? Findings from the 2017-2018 Brazilian National Dietary Survey.

The habit of eating specific meals has been addressed in several studies, but the evaluation of meal patterns has received less attention. This study aimed to describe the meal patterns of the Brazilian population. A complex sampling design was used to select the 46,164 ≥ 10-year-old individuals examined in the Brazilian National Dietary Survey. Food consumption was assessed by two non-consecutive 24-hour recalls applied throughout a one-week period. The exploratory data analysis approach was used to determine the meal patterns, i.e., how individuals combined the main meals (breakfast, lunch, dinner) and snacks (morning, afternoon, evening/night) throughout the day. The most common meal patterns were three main meals + one snack, reported by 25.1% of the individuals, and three main meals + two snacks (24.6%). Other meal patterns identified were: three main meals + three snacks (18.5%); three main meals and no snacks (10.9%); one or two main meals + two snacks (7.4%); one or two main meals + one snack (6.9%); one or two main meals + three snacks (4.2%); and one or two main meals and no snacks (2.3%). Meal patterns varied according to gender and age group, and on typical versus atypical food consumption days. We found that eight patterns characterized the daily meal consumption in Brazil. Furthermore, around 80% of the population had three main meals every day and about 13% did not report having any snacks. The characterization of meal habits is important for tailoring and targeting health promotion actions.

The interaction of the FTO gene and age interferes with macronutrient and vitamin intake in women with morbid obesity.

Fat mass and obesity-related (FTO) gene single nucleotide polymorphisms (SNPs) interferes with food preferences that impact macronutrient intake. Few studies have investigated the relationship of this polymorphisms with the intake of micronutrients. Moreover, studies have shown multiple micronutrient deficiencies in patients with obesity. This work evaluated the effect of the FTO rs9939609 gene polymorphism on dietary nutritional quality and food intake of macronutrients and vitamins in of women with obesity candidates for metabolic surgery. The study included 106 women (24 to 60 years old) with BMIs of 36.1 to 64.8 kg/m2. A food frequency questionnaire validated for the local population was applied to obtain information about food intake. The Index of Nutritional Quality (INQ) was used to assess the adequacy of macronutrient and vitamin intake. Energy, protein and lipid intakes were higher in carriers of the A allele compared to TT in the younger age groups but were similar in the class of subjects aged ≥45 years. The INQ for protein was higher in carriers of the A allele than in carriers of the TT allele. The INQs for protein, carbohydrate, vitamins B2, B3 and B6 decreased, whereas the INQ for vitamin C increased with advancing age. The INQ for vitamin A was lower in AA than in TT, regardless of age, whereas vitamin E was higher in younger AA than in older AA. The INQ for vitamin B9 was higher in younger women than in older women. In conclusion, the FTO gene contributed to the intake of more energy, protein and lipids and interfered with the intake of vitamins B9, A and E. With the exception of vitamin A, the effect of the genotype was attenuated with ageing.

Adherence to school meals and co-occurrence of the healthy and unhealthy food markers among Brazilian adolescents.

The aim of this study was to analyze the association between adherence to school meals and the co-occurrence of the regular consumption of healthy and unhealthy eating markers among Brazilian adolescents. Data from 67,881 adolescents in Brazilian public schools who participated in the 2015 National School Health Survey, were used. From the 7-day FFQ, the dependent variable was constructed, co-occurrence of regular consumption (≥ 5x/week) of healthy and unhealthy food markers, which was categorized as regular consumption of none, one or two, or three eating markers. We performed an ordinal logistic regression with adjustment for sociodemographic, eating habits outside of school, and school characteristics variables. The prevalence of the co-occurrence of the regular consumption of three healthy eating markers was 14.5%, and that of three unhealthy markers was 4.9%. High adherence to school meals (every day) was positively associated with regular consumption of healthy eating markers and inversely associated with regular consumption of unhealthy eating markers. The school meals provided by PNAE contribute to the promotion of healthy eating habits among Brazilian adolescents.

Snacking habits of Brazilian adolescents: Brazilian National Dietary Survey, 2017-2018.

This study was aimed at describing the snack consumption among Brazilian adolescents. The Brazilian National Dietary Survey (2017-2018) is a nationwide representative cross-sectional study that collected food consumption data from 8264 adolescents (10 to 19 years old); data from one 24-h recall were used, in which all foods and beverages consumed throughout the day prior to the interview were described along with the amount, unit of measurement, time, place and occasion of consumption (breakfast, lunch, dinner or snack). Snacks were classified as follows: (a) Morning snack: "Snacks" consumed between 6 AM and 12 PM; (b) Afternoon snack: "Snacks" consumed between 1 PM and 5 PM; (c) Evening snack: "Snacks" consumed between 6 PM and 5 AM. Individuals were categorised according to the number of "Snacks" per day (zero, one, two or three or more). Among the evaluated adolescents, 52.8% were female and 23.0% were overweight. The consumption of at least one snack per day was mentioned by 88.2% of the adolescents, with an average of 2.33 snacks per day. An afternoon snack was consumed by 70.0% of the adolescents. Snack consumption was related to higher mean daily energy intake and a greater contribution of carbohydrates, added sugar and trans fat to the total daily energy intake. 'Cookies & Crackers' and 'Fast Foods' were the groups that contributed the most to the energy intake provided by snacks, showing, therefore, that less healthy foods were relevant components of the snacks consumed. For their important contribution to food intake, snacking habits deserve attention among the topics covered in dietary guidelines.

Skipping breakfast associated with socioeconomic and lifestyle factors in Brazilian adolescents.

The aim is to estimate the prevalence and evaluate the association of socioeconomic and lifestyle factors with skipping breakfast among Brazilian adolescent students. A cross-sectional study carried out with adolescent ninth-graders from Brazilian public and private schools participating in the 2015 National School Health Survey. The prevalence of skipping breakfast (less than five days/week) and its respective 95% confidence intervals were estimated and stratified by gender according to demographic, socioeconomic, and lifestyle factors, self-perceived body image, and attitudes towards weight. A three-block hierarchical Poisson regression, considering the complex sample design. The prevalence of skipping breakfast was 35.6%, higher among girls than boys. In both genders, skipping breakfast was positively associated with the highest socioeconomic level, morning school shift, paid work, regular consumption of alcoholic beverages, living only with the mother, the father or neither, the irregular consumption of school food and meals with parents, considering oneself too fat/fat and trying to lose weight. In general, skipping breakfast was associated with socioeconomic factors and lifestyle behaviors harmful to health among adolescent students.

Food Insecurity and Associated Factors in Brazilian Undergraduates during the COVID-19 Pandemic.

Undergraduates may face challenges to assure food security, related to economic and mental distress, especially during the COVID-19 pandemic. This study aimed to assess food insecurity and its associated factors in undergraduates during the COVID-19 pandemic. An online cross-sectional study was conducted from August 2020 to February 2021 with 4775 undergraduates from all Brazilian regions. The questionnaire contained socio-economic variables, the validated Brazilian food insecurity scale, and the ESQUADA scale to assess diet quality. The median age of the students was 22.0 years, and 48.0% reported income decreasing with the pandemic. Food insecurity was present in 38.6% of the students, 4.5% with severe food insecurity and 7.7% moderate. Logistic regressions showed students with brown and black skin color/race presented the highest OR for food insecurity; both income and weight increase or reduction during the pandemic was also associated with a higher OR for food insecurity, and better diet quality was associated with decreased OR for food insecurity. Our study showed a considerable presence of food insecurity in undergraduates. Policy for this population must be directed to the most vulnerable: those with brown and black skin color/race, who changed income during the pandemic, and those presented with difficulties maintaining weight and with poor diet quality.

Association of dietary patterns with blood pressure and body adiposity in adolescents: a systematic review.

This paper aimed to systematically review the results of observational studies that investigated the association of dietary patterns with blood pressure and body adiposity markers in adolescents. Articles were searched in July 2020 in PubMed, Scopus, Web of Science, and Scientific Electronic Library Online (SciELO). Of the 3408 studies found, 24 fulfilled the inclusion criteria and were considered in this review. Almost all studies (n = 23) identified at least one unhealthy pattern, predominantly characterized as consumption of confectionery, refined grains, sweets, sweetened drinks, red meats, and processed meats. Fourteen of the twenty-four studies found a significant association between any dietary pattern and blood pressure and/or body adiposity markers. There was a positive association of dietary patterns - characterized by the consumption of foods rich in sodium, animal fat, refined carbohydrates, and low in fiber - with increased blood pressure and body adiposity. Our findings highlight the importance of studies with this scope, whose results can support the surveillance of adolescent's health. However, considering the limited number of studies that found a significant association and their limitations, the present results should be interpreted carefully. More prospective studies are needed to determine how adherence to dietary patterns could influence blood pressure and body adiposity markers in the long term.

Lifestyle-related behaviors and depressive symptoms in college students.

This study sought to examine the association between lifestyle-related behaviors and depressive symptoms among college students. This cross-sectional study analyzed baseline data of a dynamic-cohort study from a public university in Central-Western Brazil, in all 21 undergraduate full-time courses. Students up to 25 years old who were enrolled for the first time in a university were included in the study, except pregnant and/or nursing women. All students who met the eligibility criteria were invited to participate in the study. From a total of 1,212 eligible students, 1,038 were included (85.6%). All participants answered a self-administered questionnaire on smoking, alcohol consumption, screen time, sleep duration, and meal patterns. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Multivariate Poisson regression models stratified by sex were used to estimate the associations. Depressive symptoms was observed in 31.6% (males 23.6%; females 39.9%; p-value chi-square test = 0.01) of the students. Smoking, drinking spirits, and having irregular meal habits were directly associated with depressive symptoms in both males and females. The co-occurrence of two risk behaviors (men: aPR = 2.23, 95%CI: 1.25; 3.99; women: aPR = 1.54, 95%CI: 1.03; 2.30) and three or more risk behaviors (men: aPR = 3.42, 95%CI: 1.90; 6.16; women: aPR = 2.09, 95%CI: 1.39; 3.15) increased the occurrence of depressive symptoms among the students. Lifestyle-related unhealthy behaviors were associated with an increased occurrence of depressive symptoms among college students. These findings suggest the need of interventions encouraging changes in lifestyle to promote mental health and to improve the quality of life in this group.