Clusters of lifestyle behavioral risk factors and their associations with depressive symptoms and stress: evidence from students at a university in Finland.

BACKGROUND: No previous research of university students in Finland assessed lifestyle behavioral risk factors (BRFs), grouped students into clusters, appraised the relationships of the clusters with their mental well-being, whilst controlling for confounders. The current study undertook this task. METHODS: Students at the University of Turku (n = 1177, aged 22.96 ± 5.2 years) completed an online questionnaire that tapped information on sociodemographic variables (age, sex, income sufficiency, accommodation during the semester), four BRFs [problematic alcohol consumption, smoking, food consumption habits, moderate-to-vigorous physical activity (MVPA)], as well as depressive symptoms and stress. Two-step cluster analysis of the BRFs using log-likelihood distance measure categorized students into well-defined clusters. Two regression models appraised the associations between cluster membership and depressive symptoms and stress, controlling for sex, income sufficiency and accommodation during the semester. RESULTS: Slightly more than half the study participants (56.8%) had always/mostly sufficient income and 33% lived with parents/partner. Cluster analysis of BRFs identified three distinct student clusters, namely Cluster 1 (Healthy Group), Cluster 2 (Smokers), and Cluster 3 (Nonsmokers but Problematic Drinkers). Age, sex and MVPA were not different across the clusters, but Clusters 1 and 3 comprised significantly more respondents with always/mostly sufficient income and lived with their parents/partner during the semester. All members in Clusters 1 and 3 were non-smokers, while all Cluster 2 members comprised occasional/daily smokers. Problematic drinking was significantly different between clusters (Cluster 1 = 0%, Cluster 2 = 54%, Cluster 3 = 100%). Cluster 3 exhibited significantly healthier nutrition habits than both other clusters. Regression analysis showed: (1) males and those with sufficient income were significantly less likely to report depressive symptoms or stress; (2) those living with parents/partner were significantly less likely to experience depressive symptoms; (3) compared to Cluster 1, students in the two other clusters were significantly more likely to report higher depressive symptoms; and (4) only students in Cluster 2 were more likely to report higher stress. CONCLUSIONS: BRFs cluster together, however, such clustering is not a clear-cut, all-or-none phenomenon. Students with BRFs consistently exhibited higher levels of depressive symptoms and stress. Educational and motivational interventions should target at-risk individuals including those with insufficient income or living with roommates or alone.

Are behavioural risk factors clusters associated with self-reported health complaints? University students in Finland.

OBJECTIVES: No previous research of university students in Finland assessed lifestyle behavioural risk factors (BRFs) and categorized students into clusters, explored the associations of the clusters with self-reported health complaints (HCs), whilst controlling for potential confounders. The current study undertook this task. METHODS: Students at the University of Turku (1,177) completed an online well-being questionnaire that assessed socio-demographic variables, 5 BRFs - problematic alcohol consumption, smoking, illicit drug use, food consumption habits, moderate-to-vigorous physical activity (MVPA), and 22 HCs. A food frequency questionnaire assessed students' consumption of a range of foods, and a dietary guideline adherence score was computed based on WHO dietary recommendations for Europe. Three separate regression models appraised the associations between the cluster membership and HCs factors, adjusting for sex, income sufficiency and self-rated health. RESULTS: Mean age was 23 ± 5.2 years, 77% had never smoked and 79% never used illicit drug/s. Factor analysis of HCs resulted in four-factors (psychological, circulatory/breathing, gastro-intestinal, pains/aches); cluster analysis of BRFs identified two distinctive student clusters. Cluster 1 represented more healthy students who never smoked/used illicit drugs, had no problematic drinking, and undertook MVPA on 4.42 ± 3.36 days/week. As for cluster 2 students, half the cluster smoked occasionally/daily, used illicit drug/s, and > 50% had problematic drinking and students undertook MVPA on 4.02 ± 3.12 days/week. More cluster 2 students adhered to healthy eating recommendations, but the difference was not significant between clusters. Regression analysis revealed that females, those with sufficient income, and with excellent/very good self-rated general health were significantly less likely to report all four HCs. Cluster 2 students were significantly more likely to report psychological complaints, circulatory/breathing and gastro-intestinal complaints. There was no significant association between BRFs clusters and pains/aches factor. CONCLUSIONS: Risk taking students with less healthy lifestyles and behaviour were consistently associated with poorer psychological and somatic health.