Breakfast consumption is inversely associated with primary headaches in university students: The MEPHASOUS study.

OBJECTIVE: This study was conducted to examine the association between breakfast consumption pattern and primary headaches in a large population of university students. METHODS: This cross-sectional study was done on the MEPHASOUS dataset that contained the information of 83,677 university students, aged ≥18 years, from 28 provinces of Iran. Dietary intakes and breakfast consumption pattern were assessed using a validated self-administered dietary habits questionnaire. Primary headaches were determined according to the International Classification of Headache Disorders-3 (ICHD-3) criteria. Binary logistic regression in different adjusted models was used to assess the association between breakfast consumption and primary headaches. RESULTS: The mean age of participants was 21.50 ± 4.01. Primary headaches were prevalent among 9% of university students. A significant inverse association was seen between breakfast consumption and odds of primary headaches [odds ratio (OR): 0.57, 95 % confidence interval (CI): 0.51-0.62]. This association remained significant even after taking potential confounders into account; such that students who consumed breakfast frequently had 26 % lower odds of primary headaches compared with those who consumed it <1 day/week (OR: 0.74, 95 % CI: 0.65-0.85). Moreover, such a significant inverse association was observed in female students (OR: 0.54, 95 % CI: 0.49-0.61) as well as those with BMI < 25 kg/m2 (OR: 0.68, 95 % CI: 0.58-0.79). However, it became non-significant in male students and those with overweight or obesity. CONCLUSION: We found that frequent breakfast consumption is associated with a decreased odds of primary headaches in female students and those with BMI < 25 kg/m2. Further prospective studies are needed to confirm our findings.

Prevalence of smoking and its association with health-related behaviours among Iranian university students: a large-scale study.

BACKGROUND: The prevalence of smoking and contributing factors among Iranian university students has been paid little attention. AIMS: The aim of this study was to assess the prevalence of smoking in Iranian university students and its association with health-related behaviours. METHODS: This cross-sectional study was carried out on a sample of 82 806 Iranian university students admitted in 2012-2013. Information on demographic characteristics and health-related behaviours, including physical activity, sleep pattern, use of electronic devices and dietary habits, were collected using a standardized questionnaire. Weight and height were measured using a standard protocol and body mass index calculated. Smokers were defined as students who smoked ≥ 1 cigarette per week. RESULTS: Smoking was prevalent among 6.0% of university students (males 6.6%, females 5.6%). Moderate physical activity was inversely associated with odds of smoking. A significant positive association was also found between obesity and odds of being a smoker. Higher intake of fruits and dairy products were associated with lower odds of smoking. However, intake of vegetables, fast foods and carbonated beverages was positively associated with smoking. Breakfast consumption was also associated with greater odds of being a smoker. CONCLUSIONS: Demographic characteristics and health-related behaviours, including marital status, occupation, economic status, sleep pattern, physical activity, use of electronic devices and dietary intake, were significantly associated with smoking.

Prevalence of Ever Self-Reported Asthma and Associated Factors among University Students in Iran: A Population-Based Study.

BACKGROUND: Asthma is a chronic inflammatory airway disease with regressive episodic symptoms. This study aimed to assess the prevalence of asthma ever (lifetime prevalence of asthma) and the associated factors among newly entered students in public universities in Iran. METHODS: This population-based cross-sectional study was part of the "Mental and Physical Health Assessment of University Students in Iran." The target population included all newly admitted students (N = 151,671) in 74 public universities in 28 provinces (out of the 31 provinces) in Iran. STATA version 12 was used for calculating the descriptive statistics. Univariate and multivariate logistic regression models were employed to identify relationships between asthma and socioeconomic variables. The level of significance was set at 95% confidence interval. RESULTS: Of a total of 79,277 participants, 55.23% (n = 43,785) and 44.77% (n = 35,492) were female and male, respectively. The prevalence of ever asthma among studied student was 1.89%. Of all the participants with asthma, 88.43% (85.49%-90.84%) were nonsmokers. More than 20% of the subjects were physically inactive. The respondents who revealed smoking >10 cigarettes/week were about 1.22 (1.036-1.437) times more likely to suffer from asthma disease (0.017), as compared with those who were not smoking. CONCLUSIONS: Our study provides valuable information about the prevalence of asthma ever symptoms among university students in Iran. In fact, the results of this study can fill information gaps concerning the affected groups in Iran, and even worldwide.

Dairy Consumption in Relation to Hypertension Among a Large Population of University Students: The MEPHASOUS Study.

BACKGROUND: Hypertension is a chronic condition that its prevalence is increasing at an alarming rate. Findings on the association between dairy consumption and hypertension are conflicting and few data are available in the Middle East. AIM: To assess the association between dairy consumption and hypertension among a large population of university students. MATERIALS AND METHODS: The current study was performed in the framework of the Mental and Physical Health Assessment of University Student (MEPHASOUS) project. Overall, 67,011 university students with complete information were included in the statistical analysis. To assess dairy consumption, a self-administered dietary habits questionnaire was employed. Blood pressure was measured using a standard protocol. The systolic/diastolic blood pressure of ≥140/90 mmHg was considered hypertension. RESULTS: Hypertension was prevalent among 6.9% of students. A significant inverse association was found between dairy consumption and the odds of hypertension; such that after taking potential confounders into account, individuals in the highest levels of dairy consumption had 85% lower odds for having hypertension compared with those in the lowest levels (odds ratio (OR): 0.15, 95% confidence interval (CI): 0.13-0.18). Such an inverse association was also seen among males (OR: 0.14, 95% CI: 0.11-0.18) and females (OR: 0.16, 95% CI: 0.12-0.21), normal-weight students (OR: 0.15, 95% CI: 0.12-0.18) and those with overweight or obesity (OR: 0.15, 95% CI: 0.11-0.21), and individuals with (OR: 0.13, 95% CI: 0.11-0.16) and without (OR: 0.24, 95% CI: 0.17-0.35) family history of hypertension. CONCLUSION: Our results support the previous findings on the inverse association between dairy consumption and hypertension among university students.

Dairy consumption in relation to primary headaches among a large population of university students: The MEPHASOUS study.

AIM: To investigate the association between dairy consumption and primary headaches among a large population of university students. METHODS: Totally, 83,622 university students aged 18 years or older were included in the current cross-sectional study. Dietary intakes were assessed using a validated self-administered dietary habits questionnaire. Primary headaches were determined according to the International Classification of Headache Disorders-3 (ICHD-3) criteria. RESULTS: Totally, 9 % of participants suffered from primary headaches. A significant inverse association was observed between dairy consumption and odds of primary headaches (OR: 0.67, 95 % CI: 0.60-0.74). Such inverse association remained significant when potential confounders including demographic variables, physical activity, dietary factors, and BMI were taken into account; such that individuals in the highest category of dairy consumption were 19 % less likely to have primary headaches compared with those in the lowest category (OR: 0.81, 95 % CI: 0.72-0.92). Such an inverse association was also observed in women (OR: 0.79, 95 % CI: 0.68-0.93), but not in men. Stratified analysis based on body mass index revealed a significant inverse association between dairy consumption and primary headaches either in normal-weight individuals or those with overweight or obesity. CONCLUSION: We found that dairy consumption was inversely associated with primary headaches among university students.

The relationship between lifestyle and anthropometric factors with the sleep characteristics among university students in Iran: the MEPHASOUS study.

BACKGROUND: Healthy sleep habits have an important role in normal cognitive function, emotional performance, and well-being. The aims of this study were to describe the characteristics of sleep among university students in Iran. In addition, we assessed the relationship between lifestyle and anthropometric factors with the sleep characteristics. METHODS: This population-based cross-sectional study was conducted using the data of "Mental and Physical Health Assessment of University Students in Iran" survey 2012-2013. This survey was conducted on newly admitted students in 74 public universities in 28 provinces. The participants were younger adults. Univariate and multivariate logistic regression models were utilized to recognize associated factors with sleep pattern and range. RESULT: Of total 78,848 students who completed the survey, 54.64% (n = 43,079) were females. The average age of the students was 21.53 ± 4.08 and 21.54 ± 3.99 among males and females, respectively. More than 90% (n = 70,923), were non-smokers. Out of the total respondents, 40.56% (n = 31,756) had irregular sleep pattern. Male students were less likely to have irregular sleep pattern than female students. CONCLUSION: Our findings indicated that irregular sleep pattern is associated with overweight and obesity. So, these results underscore the need to educate students on importance of healthy sleep pattern and duration on health conditions.

Breakfast consumption pattern and its association with overweight and obesity among university students: a population-based study.

PURPOSE: To determine the association between breakfast consumption habit and overweight and obesity in a sample of Iranian university students. METHODS: A sample of 78,905 university students, aged 18 years or older, was recruited from 28 provinces in Iran to assess breakfast consumption pattern. Breakfast consumption habit was evaluated using a pre-tested questionnaire. Weight and height were measured using standard protocol and then body mass index (BMI) was calculated. Overweight (obesity included) and obesity were defined as BMI ≥ 25 and BMI ≥ 30 kg/m2, respectively. RESULTS: Mean age of participants was 21.50 ± 4.01. After controlling for potential confounders, participants who ate breakfast > 4 days/week had 15% lower risk of overweight compared with those who ate < 1 day/week (OR: 0.85, 95% CI 0.78-0.92). Such significant association was also seen in female students (OR: 0.82, 95% CI 0.72-0.93); however, it was marginally significant in male ones (OR: 0.89, 95% CI 0.79-1.00). In addition, a significant inverse association was found between breakfast consumption and obesity (OR: 0.74, 95% CI 0.64-0.85) such that after adjusting for potential confounders, students who consumed breakfast > 4 days/week were 33% less likely to be obese compared with those who consumed it < 1 day/week (OR: 0.67, 95% CI 0.57-0.78). Such significant inverse association was also seen in either gender. CONCLUSIONS: Breakfast consumption was inversely associated with odds of overweight and obesity in university students. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive studies.

Sugar-sweetened beverages consumption in relation to hypertension among Iranian university students: the MEPHASOUS study.

PURPOSE: This study aimed to assess the link between sugar-sweetened beverages (SSBs) consumption and hypertension among a large population in the Middle East. METHODS: In this cross-sectional study (a part of Mental and Physical Health Assessment of University Student: MEPHASOUS study), 66,634 university students from all provinces of Iran, aged ≥ 18 years, were included. A self-administered dietary habits questionnaire was used to assess SSBs consumption as well as other dietary intakes. Participants were categorized based on three levels of SSB consumption: < 1 time/wk, 1-3 times/wk, and ≤ 3 times/wk. Hypertension was defined as systolic blood pressure (SBP) of ≥ 140 and diastolic blood pressure of ≥ 90. RESULTS: Compared with those in the bottom category, students in the top category of SSBs consumption were more likely to have hypertension (OR 1.71, 95% CI 1.54-1.90). This association remained significant even after adjusting for confounding variables; such that participants in the highest category of SSBs consumption had 2.17 times greater odds of hypertension compared with those in the lowest category (OR 2.17, 95% CI 1.91-2.47). Stratified analysis based on gender and BMI status revealed such significant association in men (OR 2.12, 95% CI 1.79-2.50) and women (OR 2.03, 95% CI 1.67-2.48), and in all categories of BMI including students with underweight (OR 2.53, 95% CI 1.81-3.52), normal-weight (OR 2.13, 95% CI 1.81-2.51), overweight (OR 2.14, 95% CI 1.58-2.89) and obesity (OR 1.59, 95% CI 1.00-2.53). CONCLUSION: Our results support previous findings indicating a significant positive association between SSBs consumption and hypertension. LEVEL OF EVIDENCE: Level III, cross-sectional analytic studies.

Assessing the Functions of Non-Suicidal Self-Injury: Factor Analysis of Functional Assessment of Self-Mutilation among Adolescents.

Objective: The aim of this cross sectional study was to assess the factor analysis of Functional Assessment of Self-Mutilation (FASM) among Iranian adolescents with non-suicidal self-injury. Method: In this study, 646 high school students, with the mean age of 16.55 ± 0.7, were selected using a multistage cluster sampling method; they completed FASM and the demographic form. Data were analyzed using the descriptive statistics, chi-square (χ2), independent sample t test, MANOVA, and confirmatory factor analyses (CFA). Results: Of the participants, 178 reported at least 1 episode of NSSI during the previous year. The mean age of the participants when they first harmed themselves was 14.64 (±1.71). Most of them reported to engage in NSSI impulsively (39.32%) and experienced little (31.5%) or moderate physical pain (31.5%) There were no significant differences between males and females in severity of NSSI, frequency of NSSI, thinking about NSSI prior to engaging in the act, and age of onset. The results of the confirmatory factor analysis supported the 4-factor model of NSSI functions suggested by Nock and Prinstine [Χ2/df = 1.84; RMSEA = 0.07; GFI = 0.82; AGFI = 0.77]. The most frequent function for engaging in NSSI was Automatic Negative Reinforcement. Conclusion: Findings of this study supported the structural validity of the FASM; thus, this tool can be useful in treatment and research contexts as a measure of NSSI functions. Moreover, this study found that adolescents engage in non-suicidal self-injury because of 4 distinct reinforcement processes. The study findings have important implications for the assessment and treatment of NSSI.

Risk and protective factors for substance use among Iranian university students: a national study.

BACKGROUND: Substance use is a major mental health concern among university students. It may result in behavioral and academic problems, psychiatric disorders, and infectious diseases. Thus, this study investigated the risk and protective factors of substance use among Iranian university students. METHODS: This was a cross-sectional study. A number of 7330 students were selected from 30 universities in Iran. The participants completed a researcher-designed questionnaire. It measured life time, previous year and previous month's substance use, demographic characteristics, and a body of risk and protective factors including, religious beliefs, self-esteem, stress and psychological pressure, sensation seeking, attention seeking, anger and aggression, depression and anxiety, parents' positive attitude towards substance use, lack of intimacy between family members, plus substance use, smoking cigarettes or hookah, alcohol consumption, and prescribed medications use by their family members, easy access to illegal drugs, peers' positive attitude towards substance use, peers' drug use, perceived prevalence of substance use among students, and negative attitude toward university. The data were analyzed using descriptive statistics and multivariate logistic regression analysis. RESULTS: Participants' anger and aggression, depression and anxiety, participants' positive attitude towards substances, low level of religious beliefs, peers and family member's substance use, and parent's positive attitude towards substance significantly and strongly predicted using cigarette/hookah, alcohol, hard drugs, and prescribed medications. Having a negative attitude toward university significantly predicted using all types of substance (except for prescribed medications). Low self-esteem predicted using cigarette/hookah, and alcohol use. Perceived availability of illegal drugs predicted hard drugs and prescribed medications' consumption. Finally, peers' positive attitude toward drugs anticipated cigarette/hookah use. CONCLUSION: Prevention programs are most needed among Iranian students. They should be comprehensive in nature and focus on students' psychoeducation about substances and their related negative consequences, plus promotion of students' life skills, and integrate family- and peer-based preventive interventions.

The Psychometric Properties of the Persian Version of the Contamination Cognition Scale (CCS).

Objective: In recent years, many researchers have been searching for effective cognitive factors in the development of obsessive-compulsive disorder (OCD). One of the scales designed to measure this characteristic is the contamination cognition scale (CCS) that evaluates 2 dimensions: overestimating the likelihood and severity of contamination. The aim of the present study was to evaluate the psychometric properties of the Persian version of CCS. Method : The study population of this descriptive psychometric study included students of Shahed University. A total of 490 students were selected via cluster sampling and completed the CCS. CCS was translated and back- translated before given to the students. The Obsessive Beliefs Questionnaire (OBQ) and the Padua Inventory (PI) were used. To assess the evidence for the validity of the scale, the exploratory and confirmatory factor analyses were used. The gathered data were analyzed by SPSS-22 and Amos-22 software. Results: The results of the confirmatory factor analysis (CFA) showed that one-factor model did not have adequate fitness (RMSEA>.05). Therefore, to explore the factors of this scale, exploratory factor analysis (EFA) was used, and it revealed 3 factors (public equipment, food, and restroom) for each of the dimensions (likelihood and severity). CFA by AMOS-22 confirmed the three-factor model (GFI, CFI, and NFI>.95; RMSEA<.05). Furthermore, the results supported criteria validity of CCS with the PI total score (0.56- 0.47, p<0.001) and PI-contamination subscale (0.71-0.75, p<0.001). Also, the correlation between CCS and responsibility/threat subscale of the OBQ was significant (0.47- 0.49, p<0.001) The Cronbach's alpha for likelihood dimensions total was 0.93 and it was 0.94 for severity dimension total. The composite reliability was 0.95 for the likelihood dimension and 0.96 for severity dimension of CCS. Also, the test-retest reliability after a 4-week interval was confirmed (likelihood: r = 0.78; severity: r = 0.81, p<.001). Conclusion: The results indicated that one-factor model of CCS did not have adequate fitness, but three-factor model was confirmed in both dimensions (likelihood and severity). According to the results of the present study, the reliability and validity of the Persian version of CCS were acceptable.

Iranian university students lifestyle and health status survey: study profile.

BACKGROUND: The physical health assessment of university students in Iran is a national large scale assessment examining health behaviors among tertiary education students. Understanding risky health behaviors which are the major sources of global mortality and morbidity in adulthood is the key objective of this assessment. METHODS: In academic year of 2012-2013, newly admitted students (N = 151,671) at 74 governmental eligible universities that had health center from 28 provinces were invited to participate in the health assessment program. The physical health behaviors of the students were evaluated by using questionnaire. The test-retest reliability method was applied to estimate the reliability of physical health questionnaire. After filling out the questionnaires, students were led to the examination room for the measurement of height, weight and blood pressure. RESULTS: From the total study population, 84,298 student's ages between 18 and 29 years old, were participated in the health assessment. The mean response proportion was 63%. The mean age of students was 21.5 ± 4.01, with 49.20% percent being <20 years old. 32.31% were between 20 and 24 years, 13.44% between 25 and 29 years, 69% of the participants were undergraduate 34.9% were master's students, and 2.9% were Ph.D. students. The mean BMI for total students was 22.5 ± 4.0 and regarding to gender, the mean BMI for male and female were 23.0 ± 4.1 and 22.2 ± 3.8 respectively. CONCLUSION: Analysis of student's findings will generate multiple studies which report different aspects of physical health of Iranian university students who constitute a large proportion of young adult aged 18-29 years in the country. This assessment also provides opportunity to compare Iranian student's behavioral patterns with the behavioral pattern of students worldwide.