Diet quality and cardiovascular outcomes: A systematic review and meta-analysis of cohort studies.

AIMS: To evaluate relationships between diet quality and cardiovascular outcomes. METHODS: Six databases were searched for studies published between January 2007 and October 2021. Eligible studies included cohort studies that assessed the relationship between a priori diet quality and cardiovascular disease mortality and morbidity in adults. The Academy of Nutrition and Dietetics Checklist was used to assess the risk of bias. Study characteristics and outcomes were extracted from eligible studies using standardised processes. Data were summarised using risk ratios for cardiovascular disease incidence and mortality with difference compared for highest versus lowest diet quality synthesised in meta-analyses using a random effects model. RESULTS: Of the 4780 studies identified, 159 studies (n = 6 272 676 adults) were included. Meta-analyses identified a significantly lower cardiovascular disease incidence (n = 42 studies, relative risk 0.83, 95% CI 0.82-0.84, p < 0.001) and mortality risk (n = 49 studies, relative risk 0.83, 95% CI 0.82-0.84, p < 0.001) among those with highest versus lowest diet quality. In sensitivity analyses of a high number of pooled studies (≥13 studies) the Mediterranean style diet patterns and adherence to the heart healthy diet guidelines were significantly associated with a risk reduction of 15% and 14% for cardiovascular disease incidence and 17% and 20% for cardiovascular disease mortality respectively (p < 0.05). CONCLUSIONS: Higher diet quality is associated with lower incidence and risk of mortality for cardiovascular disease however, significant study heterogeneity was identified for these relationships.

How is online self-reported weight compared with image-captured weight? A comparative study using data from an online longitudinal study of young adults.

BACKGROUND: Accurate anthropometric measurement is important within epidemiological studies and clinical practice. Traditionally, self-reported weight is validated against in-person weight measurement. OBJECTIVES: This study aimed to 1) determine the comparison of online self-reported weight against images of weight captured on scales in a young adult sample, 2) compare this across body mass index (BMI), gender, country, and age groups, and 3) explore demographics of those who did/did not provide a weight image. METHODS: Cross-sectional analysis of baseline data from a 12-mo longitudinal study of young adults in Australia and the UK was conducted. Data were collected by online survey via Prolific research recruitment platform. Self-reported weight and sociodemographics (for example, age, gender) were collected for the whole sample (n = 512), and images of weight for a subset (n = 311). Tests included Wilcoxon signed-rank test to evaluate differences between measures, Pearson correlation to explore the strength of the linear relationship, and Bland-Altman plots to evaluate agreement. RESULTS: Self-reported weight [median (interquartile range), 92.5 kg (76.7-112.0)] and image-captured weight [93.8 kg (78.8-112.8)] were significantly different (z = -6.76, P < 0.001), but strongly correlated (r = 0.983, P < 0.001). In the Bland-Altman plot [mean difference -0.99 kg (-10.83, 8.84)], most values were within limits of agreement (2 standard deviation). Correlations remained high across BMI, gender, country, and age groups (r > 0.870, P < 0.002). Participants with BMI in ranges 30-34.9 and 35-39.9 kg/m2 were less likely to provide an image. CONCLUSIONS: This study demonstrates the method concordance of image-based collection methods with self-reported weight in online research.

Changes in physical activity, diet, sleep, and mental well-being when starting university: A qualitative exploration of Australian student experiences.

Objective: To explore young adult's experiences of how starting university influenced their physical activity, diet, sleep, and mental well-being, and barriers and enablers to health behavior change. Participants: University students aged 18-25 years. Methods: Three focus groups were conducted in November 2019. Inductive thematic approach was utilized to identify themes. Results: Students (female: n = 13, male: n = 2, other gender identity: n = 1, 21.2 (1.6) years) reported mental well-being, physical activity levels, diet quality and sleep health were negatively affected. Stress, study demands, university timetabling, not prioritizing physical activity, cost and availability of healthy foods, and difficulty falling asleep were key barriers. Health behavior change interventions aiming to support mental well-being need to include both information and support features. Conclusions: There is a significant opportunity to improve the transition to university for young adults. Findings highlight areas to target in future interventions to improve physical activity, diet, and sleep of university students.

Effectiveness and reporting of nutrition interventions in cardiac rehabilitation programmes: a systematic review.

AIMS: Dietary modification is essential for the secondary prevention of cardiovascular disease. However, there are limited published evidence syntheses to guide practice in the cardiac rehabilitation (CR) setting. This systematic review's objective was to assess effectiveness and reporting of nutrition interventions to optimize dietary intake in adults attending CR. METHODS AND RESULTS: Randomized controlled trials (RCTs) of nutrition interventions within CR were eligible for inclusion and had to have measured change in dietary intake. MEDLINE, Embase, Emcare, PsycINFO, CINAHL, Scopus, and The Cochrane Library were searched from 2000 to June 2020, limited to publications in English. Evidence from included RCTs was synthesized descriptively. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. This review is registered on PROSPERO; CRD42020188723. Of 13 048 unique articles identified, 11 were eligible. Randomized controlled trials were conducted in 10 different countries, included 1542 participants, and evaluated 29 distinct dietary intake outcomes. Five studies reported statistically significant changes in diet across 13 outcomes. Most nutrition interventions were not reported in a manner that allowed replication in clinical practice or future research. CONCLUSION: There is a gap in research testing high-quality nutrition interventions in CR settings. Findings should be interpreted in the light of limitations, given the overall body of evidence was heterogenous across outcomes and study quality; 6 of 11 studies were conducted more than 10 years old. Future research should investigate strategies to optimize and maintain nutrition improvements for patients attending CR. REGISTRATION: PROSPERO; CRD42020188723.

Health behavior interventions for university students measuring mental health outcomes: A scoping review.

Introduction: Many university students have poor mental health, and co-occurring health risk behaviors. Targeting health behavior change in this population may improve mental health outcomes. This scoping review describes the extent and range of randomized controlled trials (RCT) evaluating interventions targeting health risk behaviors and measuring a mental health outcome, among university students. Methods: Six electronic databases were searched for RCTs published until the 18th May 2021. Eligible RCTs included university students, evaluated interventions that promoted health behavior change (i.e., dietary intake, physical activity, sedentary behavior, alcohol and drug use, smoking, and sleep), and measured a mental health-related outcome. Results: Fifty-nine RCTs met the inclusion criteria that were published from 2000 to 2021, and over half (n = 33) were conducted in the United States. Interventions evaluated within the RCTs (n = 92) predominantly targeted changes to dietary intake (n = 41 interventions), physical activity (n = 39), or alcohol intake (n = 35). Most interventions targeted one (n = 51) or two (n = 27) health behaviors only. Included RCTs considered mental ill health outcomes (n = 24), psychological wellbeing outcomes (n = 20), or both (n = 15). Discussion: This scoping review identified a moderate volume of experimental research investigating the impact of health behavior interventions on university students' mental health. There is scope for further research examining health behavior interventions targeting university students, particularly interventions taking a multi-behavioral approach.

Designing an online intervention for adults with addictive eating: a qualitative integrated knowledge translation approach.

INTRODUCTION: Codesign is a meaningful end-user engagement in research design. The integrated knowledge translation (IKT) framework involves adopting a collaborative research approach to produce and apply knowledge to address real-world needs, resulting in useful and useable recommendations that will more likely be applied in policy and practice. In the field of food addiction (FA), there are limited treatment options that have been reported to show improvements in FA symptoms. OBJECTIVES: The primary aim of this paper is to describe the step-by-step codesign and refinement of a complex intervention delivered via telehealth for adults with FA using an IKT approach. The secondary aim is to describe our intervention in detail according to the TIDieR checklist. DESIGN: This study applies the IKT process and describes the codesign and refinement of an intervention through a series of online meetings, workshops and interviews. PARTICIPANTS: This study included researchers, clinicians, consumers and health professionals. PRIMARY OUTCOME MEASURE: The primary outcome was a refined intervention for use in adults with symptoms of FA for a research trial. RESULTS: A total of six female health professionals and five consumers (n=4 female) with lived overeating experience participated in two interviews lasting 60 min each. This process resulted in the identification of eight barriers and three facilitators to providing and receiving treatment for FA, eight components needed or missing from current treatments, telehealth as a feasible delivery platform, and refinement of key elements to ensure the intervention met the needs of both health professionals and possible patients. CONCLUSION: Using an IKT approach allowed for a range of viewpoints and enabled multiple professions and disciplines to engage in a semiformalised way to bring expertise to formulate a possible intervention for FA. Mapping the intervention plan to the TIDieR checklist for complex interventions, allowed for detailed description of the intervention and the identification of a number of areas that needed to be refined before development of the finalised intervention protocol.

On-campus food purchasing behaviours and satisfaction of Australian university students.

ISSUE ADDRESSED: Many university students have unhealthy dietary intake. The food environment on university campuses is a potentially important contributor to students' diet. This study aimed to describe on-campus food purchasing behaviours; satisfaction with the cost and availability of foods and beverages on-campus; and preferences for the on-campus food environment, in a sample of Australian university students. METHODS: An online cross-sectional survey of 409 students at the University of Newcastle, Australia was conducted in 2017-2018. The survey assessed on-campus purchasing behaviours (frequency of purchase and expenditure), satisfaction with the cost and availability of foods, preferences for the on-campus food environment, and socio-demographics (eg age, domestic/international student). Results are reported as basic descriptive statistics. RESULTS: The majority of students (94%) purchased food or beverages on-campus, with 59% purchasing at least once per week. Satisfaction with the availability of foods was low (35.8% satisfied with the types of main meals available, and 48.5% for snacks); however, 72.8% were satisfied with types of beverages available. The majority of students were not satisfied with the cost of food and beverages (<40%). The top-rated preferences for changes to the on-campus food environment were healthier options, higher quality food, and cheaper food. CONCLUSION: Overall, the findings demonstrate strong support from students for healthier and cheaper food to be made available on-campus. SO WHAT?: There are two main factors of concern with regard to university food environments; the healthiness of food and beverage options and their cost. These should be key considerations of any future strategies aiming to improve university food environments.

Is There an Association between Health Risk Behaviours and Academic Achievement among University Students?

University students have high rates of health risk behaviours, and these may be predictive of academic success. This cross-sectional study aimed to determine the association between individual and multiple health risk behaviours and academic achievement in a sample of Australian university students. Data from the University of Newcastle Student Healthy Lifestyle Survey 2019 were used. Health risk behaviours (diet, physical activity, sitting time, sleep, alcohol consumption, smoking) were assessed, and total number of risk factors calculated. Academic achievement was assessed using self-reported grade point average (GPA). The association between health risk behaviours and GPA was explored using linear regression, adjusted for socio-demographic and student characteristics. The sample included 1543 students (mean age 25.0 ± 7.9 years, 70.6% female). Lower GPA was associated with not meeting fruit consumption recommendations (ß = -0.203), consuming >1 cup of soft drink/week (ß = -0.307), having takeaway foods ≥1 time/week (ß = -0.130), not consuming breakfast daily (ß = -0.261), not meeting sleep recommendations (ß = -0.163), exceeding single occasion alcohol consumption risk (ß = -0.277), smoking (ß = -0.393), and having a higher number of risk factors (ß = -0.105). This study identified modest associations between GPA and health risk behaviours, suggesting that further research is warranted into whether strategies to improve university students' health could modestly improve their academic achievement.

eHealth interventions targeting nutrition, physical activity, sedentary behavior, or obesity in adults: A scoping review of systematic reviews.

A vast body of evidence regarding eHealth interventions for nutrition, physical activity, sedentary behavior, and obesity exists. This scoping review of systematic reviews aimed to evaluate the current level of evidence in this growing field. Seven electronic databases were searched for systematic reviews published until October 27, 2019. The systematic reviews must have included adult participants only and have evaluated eHealth behavioral interventions with the primary aim of changing nutrition, physical activity, and sedentary behavior or treating or preventing overweight and obesity. One hundred and six systematic reviews, published from 2006 to 2019, were included. Almost all (n = 98) reviews evaluated the efficacy of interventions. Over half (n = 61) included interventions focused on physical activity, followed by treatment of obesity (n = 28), nutrition (n = 22), prevention of obesity (n = 18), and sedentary behavior (n = 6). Many reviews (n = 46) evaluated one type of eHealth intervention only, while 60 included two or more types. Most reviews (n = 67) were rated as being of critically low methodological quality. This scoping review identified an increasing volume of systematic reviews evaluating eHealth interventions. It highlights several evidence gaps (e.g., evaluation of other outcomes, such as reach, engagement, or cost effectiveness), guiding future research efforts in this area.

University Students Purchasing Food on Campus More Frequently Consume More Energy-Dense, Nutrient-Poor Foods: A Cross-Sectional Survey.

University food environments are typically dominated by unhealthy food choices. The aim was to investigate associations between on-campus food purchasing behaviours and dietary intake in an Australian university student sample. An online cross-sectional survey was conducted in 2017-2018 with students (n = 362, 71.0% female, mean age 27.5 ± 10.5 years) from the University of Newcastle, Australia. On-campus food purchasing behaviours (purchasing frequency and weekly expenditure), dietary intake (diet quality and percentage energy/day from energy-dense, nutrient-poor (EDNP) foods) and sociodemographic and student characteristics (e.g., time spent on campus) were measured. Linear regression was used to explore associations between food purchasing behaviours and dietary intake, adjusted for potential confounders. Mean percentage energy/day from EDNP foods was 31.7 ± 14.4. Mean diet quality score was 32.6 ± 10.2 out of 73. Higher percentage energy/day from EDNP foods was associated with higher weekly expenditure (ß = 0.203, p < 0.001) and more frequent purchase (ß = 18.041, p < 0.001 for ≥4 times a week vs. never) of food/drinks on campus. Diet quality was not significantly associated with purchase frequency or expenditure (p > 0.05). Findings are supportive of changes being made to university food environments, as a strategy to improve dietary intake among university students.

Effectiveness of interventions and behaviour change techniques for improving physical activity in young adults: A systematic review and meta-analysis.

Physical activity (PA) participation declines from adolescence to young adulthood. This review evaluates the effectiveness of interventions aiming to improve PA among healthy young adults (17-35 years), and the effectiveness of the behaviour change techniques (BCTs) used. Six electronic databases were searched up to December 2019, for randomized controlled trials aiming to achieve PA behaviour change among young adults. In total, 66 RCTs were included. Meta-analyses for moderate-vigorous PA (n = 11 studies), steps (n = 5 studies) and total PA (MET min/week, n = 11 studies) identified that intervention participants compared with control significantly increased PA at time points up to 3 months and >3 months. Narrative synthesis identified that 34 RCTs (52%) reported significant between group differences favouring the intervention for one or more PA outcome. BCTs with the highest effectiveness were material reward, valued self-identity and habit formation. However, the overall test of significance demonstrated no significant relationship between type or number of BCTs and effectiveness. This review identified interventions that improve steps, moderate-vigorous and total PA in young adults in the shorter-term, and BCTs associated with greater effectiveness. Further research is needed to determine strategies to achieve longer-term effectiveness of PA interventions in young adults.

Recruiting and retaining young adults: what can we learn from behavioural interventions targeting nutrition, physical activity and/or obesity? A systematic review of the literature.

OBJECTIVE: To describe strategies used to recruit and retain young adults in nutrition, physical activity and/or obesity intervention studies, and quantify the success and efficiency of these strategies. DESIGN: A systematic review was conducted. The search included six electronic databases to identify randomised controlled trials (RCT) published up to 6 December 2019 that evaluated nutrition, physical activity and/or obesity interventions in young adults (17-35 years). Recruitment was considered successful if the pre-determined sample size goal was met. Retention was considered acceptable if ≥80 % retained for ≤6-month follow-up or ≥70 % for >6-month follow-up. RESULTS: From 21 582 manuscripts identified, 107 RCT were included. Universities were the most common recruitment setting used in eighty-four studies (79 %). Less than half (46 %) of the studies provided sufficient information to evaluate whether individual recruitment strategies met sample size goals, with 77 % successfully achieving recruitment targets. Reporting for retention was slightly better with 69 % of studies providing sufficient information to determine whether individual retention strategies achieved adequate retention rates. Of these, 65 % had adequate retention. CONCLUSIONS: This review highlights poor reporting of recruitment and retention information across trials. Findings may not be applicable outside a university setting. Guidance on how to improve reporting practices to optimise recruitment and retention strategies within young adults could assist researchers in improving outcomes.

Efficacy of dietary interventions in individuals with substance use disorders for illicit substances or illicit use of pharmaceutical substances: A systematic review.

BACKGROUND: Disordered eating habits, poor dietary intake and nutritional status, and altered body composition are highly prevalent among individuals with substance use disorders. This systematic review aimed to evaluate the efficacy of dietary interventions in adults with substance use disorders for illicit substances or illicit use of pharmaceutical substances. METHODS: Eight scientific databases were searched using predetermined text word and subject heading (MeSH) searches for experimental studies published up to March 2020 that evaluated interventions aiming to improve dietary intake in adults with substance use disorders for illicit substances or illicit use of pharmaceutical substances, which included dietary intake outcomes. RESULTS: Of 9299 articles identified, five studies were included. Three studies (60%) were conducted in outpatient/community clinic settings and two studies (40%) were conducted in inpatient/residential treatment centres. Dietary interventions ranged in duration from 5 weeks to 24 months. These included education and behaviour change advice for nutrition and other lifestyle behaviours (n = 3 studies), nutrition education and provision of healthy food choices within the residential treatment centre (n = 1 study), and polyunsaturated fatty acid supplementation (n = 1 study). Three studies (60%) reported small but significant change in one or more dietary outcome at post-intervention, including reductions in sweets, fast food or caffeine intake, as well as increases in fruit and vegetable intake. CONCLUSIONS: This review has identified a small number of studies, despite the strong evidence that dietary intervention is needed in substance use rehabilitation. More research is needed to determine the most effective intervention approaches for this group, including robust study designs.

Latent Class Analysis of Multiple Health Risk Behaviors among Australian University Students and Associations with Psychological Distress.

University students have high rates of health risk behaviors and psychological distress. This study explores patterns of health behaviors among a sample of Australian university students, and determines whether patterns of health behaviors are associated with psychological distress and demographic characteristics. Cross-sectional data from the University of Newcastle Student Healthy Lifestyle Survey 2019 were analyzed. Fruit and vegetable intake, sugar-sweetened beverage intake, physical activity, sitting time, smoking, alcohol intake, drug use, sleep and psychological distress were assessed. Latent class analysis (LCA) was used to identify patterns of health risk behaviors, and latent class regression to explore associations between psychological distress and demographic characteristics with health behavior classes. Analysis included 1965 students (mean age 25.8 ± 8.6 years, 70.7% female). Three patterns of health behaviors were identified: healthier (48.6%), moderate (40.2%) and unhealthy (11.2%) lifestyle classes. Students in the moderate and unhealthy lifestyle classes had higher odds of moderate (OR 1.43 and 2.37) and high/very high psychological distress risk (OR 2.71 and 11.69). Students in the unhealthy and moderate lifestyle classes had a higher odds of being male, younger, enrolled in transition to university and English language courses, Aboriginal or Torres Strait Islander descent and to report some financial difficulty. Study findings may be used to inform the design of mental health interventions for university students that target key health risk behaviors.

Correction to: Effectiveness of gender-targeted versus gender-neutral interventions aimed at improving dietary intake, physical activity and/or overweight/obesity in young adults (aged 17-35 years): a systematic review and meta-analysis.

An amendment to this paper has been published and can be accessed via the original article.

Effectiveness of gender-targeted versus gender-neutral interventions aimed at improving dietary intake, physical activity and/or overweight/obesity in young adults (aged 17-35 years): a systematic review and meta-analysis.

BACKGROUND: Young adulthood has become synonymous with the development of poor lifestyle behaviours associated with an increased risk of preventable chronic disease in later years. Interventions aiming to improve health behaviours may be more engaging and effective if they are targeted to males or females than interventions with a gender-neutral approach. This review will examine the outcome effectiveness of gender-targeted and gender-neutral interventions targeting nutrition, physical activity or overweight/obesity in young adults (17-35 years). METHODS: Six electronic databases were searched for randomised controlled trials (RCTs) published up to December 2019 that evaluated nutrition, physical activity and/or overweight/obesity interventions in young adults (17-35 years). An effective intervention was one where the change in one or more primary outcome was positive and statistically significantly different from baseline, compared with control, or if no control comparator, compared with another active intervention. Effectiveness of outcomes was compared between gender-targeted and gender-neutral studies. RESULTS: In total 21,582 manuscripts were identified and 107 RCTs were included; 30 gender-targeted studies (28%) and 77 gender-neutral (72%). Most gender-targeted studies were female targeted (n = 22, 73%). Primary outcome/s were adiposity (n = 36, 34%), nutrition (n = 29, 27%), physical activity (n = 28, 26%), or a combination of (n = 14, 14%). A greater proportion of gender-targeted than gender-neutral studies were effective in improving nutrition (n = 6, 100% and n = 17, 74% of studies respectively) and physical activity outcomes (n = 6, 86% and n = 14, 67% respectively), where as a greater proportion of gender-neutral studies were effective in improving adiposity outcomes (n = 13, 59% and n = 5, 36% respectively). None of these differences were statistically significant. Meta-analyses for weight found no significant differences between gender-targeted and gender-neutral studies for weight loss or weight gain prevention studies. Meta-analysis for fruit and vegetable intake demonstrated a significantly greater increase in intervention participants in gender-targeted studies of +158 g/day for > 3 months. CONCLUSIONS: Although differences in outcome effectiveness were identified between gender-targeted and gender-neutral studies, these were not significantly different. This is likely due to an insufficient number of studies to detect a difference. The meta-analysis for fruit and vegetable intake findings should be interpreted with caution due to including only two gender-targeted studies. The findings collectively are suggestive of a potential difference requiring further investigation. To truly determine the effectiveness of gender-targeted interventions, well-designed RCTs comparing gender-targeted interventions with gender-neutral and control are needed. REGISTRATION: This systematic review is a secondary analysis of studies included in a systematic review examining the effectiveness of interventions targeting nutrition, physical activity, or overweight/obesity in young adults, for which a predefined protocol was registered with PROSPERO (CRD42017075795).

Effectiveness of Nutrition Interventions in Vending Machines to Encourage the Purchase and Consumption of Healthier Food and Drinks in the University Setting: A Systematic Review.

University food environments typically offer an abundance of unhealthy foods, including through vending machines. This review evaluated the effectiveness of nutrition interventions in vending machines in the university setting. Ten databases were searched for experimental studies published up to July 2019, evaluating nutrition interventions that aimed to encourage the purchase or consumption of healthier foods and drinks in vending machines in the university setting. In total, 401 articles were identified, and 13 studies were included. Studies were pre-post test (n = 7, 54%), randomized controlled trials (RCTs) (n = 5, 38%), and non-randomized controlled trial (n = 1, 8%). Most studies were from the USA (n = 10, 77%) and were published between 2014 and 2018 (n = 9, 69%). Eight interventions (62%) reported positive change in outcomes, including increased number/proportion of sales or revenue from healthier items (n = 6), improved adherence to guidelines for the ratio of healthy/unhealthy products available (n = 1), and improved consumer perception of items available (n = 1). Effective interventions involved the promotion, reduced pricing, increased availability, and/or optimized product placement of healthier items within vending machines. Strategies to improve the nutritional quality of food and drinks in vending machines are warranted. This may be achieved by making healthier options more available and promoting them; however, more robust intervention studies are needed to determine effectiveness.

Which behaviour change techniques within interventions to prevent weight gain and/or initiate weight loss improve adiposity outcomes in young adults? A systematic review and meta-analysis of randomized controlled trials.

Young adulthood is associated with the highest rate of weight gain compared with any other adult age group. This review evaluates the effectiveness of interventions with adiposity outcomes among young adults and identifies which behaviour change techniques (BCTs) are most effective. BCT utilization was assessed using Michie's 93-item BCT Taxonomy v1. Six electronic databases were searched for randomized controlled trials assessing change in adiposity in young adults (17-35 years) until December 2019; identifying 21,582 articles. Fifty-one studies were included. Meta-analyses for weight (n=19 studies), body mass index (BMI) (n=20 studies), and waist circumference (n=10 studies) demonstrated no significant between-group differences at ≤3 or >3 months. There were no differences between interventions focusing on weight loss or weight-gain prevention. Narrative synthesis showed significant between-group differences in weight change, favouring the intervention in 14/43 (33%) studies. In studies assessing BMI and waist circumference, this was 31% (11/36) and 25% (4/16). Two BCTs had a percentage effectiveness ratio >50% in weight loss interventions; social support (unspecified) and self-monitoring behaviour, and one in weight-gain prevention interventions; and goal-setting (outcome). Findings demonstrate initial potential for these types of BCTs and can help build cumulative evidence towards delivering effective, cost-efficient, and replicable interventions.

Lifestyle behaviors and related health risk factors in a sample of Australian university students.

Objective: To describe lifestyle behaviors (fruit and vegetable intake, alcohol intake, physical activity, sitting time, smoking, drug use, sleep, sexual health) and health risk factors (body mass index, food insecurity, mental health) in a sample of Australian university students. Participants: 3,077 students from the University of Newcastle (UON), Australia (mean age 27.1 ± 9.8 years, 69.4% female) were surveyed in September-October 2017. Methods: Cross-sectional self-report survey, the UON Student Healthy Lifestyle Survey 2017. Results: Participants with unhealthy lifestyle behaviors included; 89.5% not meeting vegetable recommendations, 50.3% exceeding lifetime risk guidelines for alcohol intake, and 38.1% insufficiently physically active. Rates of health risk factors included; 39.6% overweight/obese, 37.6% high or very high risk of psychological distress, and 22.0% food insecure. Conclusions: Rates of unhealthy lifestyle behaviors and related health risk factors were high within the study population, highlighting the importance of ongoing monitoring and prioritization of effective strategies to improve university student health.