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Dietary and lifestyle habits among university students at different academic years

Narmeen Jamal Al-Awwad, Hiba Fathi Al-Sayyed, Zeinah Abu Zeinah, Reema Fayez
Tayyem

PII: S2405-4577(21)00221-7
DOI: https://doi.org/10.1016/j.clnesp.2021.06.010
Reference: CLNESP 1023

To appear in: Clinical Nutrition ESPEN

Received Date: 15 December 2020

Revised Date: 5 June 2021
Accepted Date: 10 June 2021

Please cite this article as: Al-Awwad NJ, Al-Sayyed HF, Zeinah ZA, Tayyem RF, Dietary and lifestyle
habits among university students at different academic years, Clinical Nutrition ESPEN, https://
doi.org/10.1016/j.clnesp.2021.06.010.

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 Dietary and lifestyle habits among university students at different academic

years

Narmeen Jamal Al-Awwad a, * , Hiba Fathi Al-Sayyed b , Zeinah Abu Zeinah b, Reema

Fayez Tayyem c

a
Department of Clinical Nutrition and Dietetics, Faculty of Applied Health Sciences,

The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan

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b
Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of

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Petra, P.O. Box 961343 Amman 11196 Jordan

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Department of Human Nutrition, College of Health Sciences, Qatar University,
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P.O.Box: 2713 Doha-Qatar
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* Corresponding author. P.O. Box 330127, Zarqa 13133, Jordan

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E-mail addresses: narmeen@hu.edu.jo (N.J. Al-Awwad), halsayyed@uop.edu.jo (H.F.

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Al-Sayyed), zeinah.abuzeinah@uop.edu.jo (Z. Abu Zeinah),

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reema.tayyem@qu.edu.qa (R.F. Tayyem)

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 Dietary and lifestyle habits among university students at different academic

years

Abstract

Background/aims: College serves as a transitionary period into adulthood where

students begin making independent dietary and lifestyle choices and begin forming

possibly detrimental habits. Such habits may persist into adulthood and negatively

affect their long-term health and risk of disease. This study aimed at exploring the

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dietary and lifestyle habits among the Hashemite University students at different

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academic years.

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Methods: A cross-sectional design was used to study dietary and lifestyle habits as
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well as the occurrence of obesity among a convenient sample of undergraduate
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students at the Hashemite University during the academic year 2015-2016. Five
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hundred and forty students (184 males: 356 females) were enrolled in this study.

Bodyweight and height were measured and body mass index was calculated. Personal
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information, dietary habits and physical activity data were collected using constructed
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questionnaires.
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Results: Around 36% of the students were overweight and obese. The percentage of

overweight among the freshmen was about 31% and 26.5% among the seniors.

Additionally, 8.6% of freshmen and 16.3% of seniors were found to be obese. One-

third (30.2%) of the study sample was hookah smokers, while 15.4% were cigarette

smokers. The students showed similar physical activity levels in the four academic

years. The majority of students at different academic levels consumed fruits 1-2 times

/week and 5 times cereals, grains, and starchy vegetables/day.

Conclusion: Our results show that approximately one-third of students are overweight

or obese, and practicing unhealthy dietary and lifestyle habits. This indicates a need to

address this problem, possibly through implementing a nutrition and health education

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programs at the university in addition to improving the quality of food available on

campus.

Keywords: Dietary habits; Lifestyle; Physical activity; BMI; Academic years

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1. Introduction

For many students, the period of the transition from school life to college or

university is a critical period where they begin making their own food decisions [1–3].

Health habits developed during this period of life may persist into adulthood [2,4].

This is particularly important in the global context of increasing trends in obesity and

non-communicable disease, where over the recent decades the prevalence of obesity

[5,6] and chronic diseases [7] in Arab countries have been increasing at a worrying

rate. In Jordan, age-adjusted odds of obesity almost doubled between 2009 and 2017

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[8] and estimated mean body mass index (BMI) in 2016 was 28.5 kg/m2 [9].

This is further highlighted in the results of studies from universities in Arab

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countries on the rates of overweight and obesity among students. A study in Saudi
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Arabia found that 21.8% of the students were overweight and 15.7% were obese [5].

One in Jordan found that 30.5% of male and 19.1% of female students were
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overweight while about 6.7 % of male and 5.3 % of female students were obese [10].
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Another in Kuwait found that 30.6% of students were overweight and 19.8% were

obese [11].
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Several studies reported poor health habits among university students. Their
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diet is typically characterized by an increased consumption of sugar-sweetened

beverages [12] and fast foods [13] which provides excessive amounts of fat,

cholesterol, and sodium [2,13,14]. Their diet is also characterized by low consumption

of milk and dairy products [13] and fruits and vegetables [1,2,13,14]. Other unhealthy

practices in this age group include skipping meals [10], physical inactivity, and a high

prevalence of smoking [1,2,13,14]. All of the aforementioned characteristics of

university students’ lifestyle places them at an increased risk for overweight and

obesity in addition to several other chronic diseases such as type 2 diabetes and heart

diseases later in life [6,12,15].

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 It is well established that overweight and obesity at a younger age are strong

predictors of obesity in adulthood [16]. This further enhances the importance of

identifying and correcting these detrimental health habits as early as possible [15,17],

particularly among males who were more likely to be overweight or

obese [5,6,15,17] and in freshman year where weight gain is a likely outcome [3].

The main objective of this study was to evaluate the dietary habits, physical

activity patterns and the prevalence of overweight and obesity among undergraduate

students at different academic levels in the Hashemite University in Jordan.

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2. Materials and methods

2.1. Study design

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To meet the aim of this study, a cross-sectional design was used to investigate
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the dietary and lifestyle habits of the students as well as the prevalence of obesity
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among a conveniently selected sample at the Hashemite University during the

academic year 2015-2016. The study protocol was approved by the Ethics Committee
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of the Hashemite University (IRB No. 1/1/2014/ 2015).

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2.2. The Study Sample

Five hundred and forty apparently healthy, undergraduate students from

different faculties and academic years (freshmen, sophomores, juniors, and seniors) in
the Hashemite University were recruited. The age range of the students participating

in the study was 18- 25 years. Students who suffered from any diseases known to

negatively affect nutritional status were excluded, such as liver cirrhosis, renal failure,

diabetes mellitus and heart failure. Similarly, students who had acute or chronic

infections or those on special diets were excluded from the study. Furthermore,

female students who were pregnant or lactating during the study were excluded. All
participants provided informed written consent before participation.

2.3. Anthropometric measurements

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 Bodyweight and height were measured by trained dietitians at the nutritional

assessment clinic of the Department of Clinical Nutrition and Dietetics at the

Hashemite University. Height was measured in a standing position without shoes to

the nearest 0.1 cm using a calibrated stadiometer (Seca, Germany). Bodyweight was

measured to the nearest 0.1 kg with participants wearing minimal clothing and

barefoot, using a calibrated digital Tanita scale (Tanita Corp., USA). Body fat

percentage was measured using the same scale used for measuring bodyweight.

Additionally, waist circumference was measured using a standard tape to the nearest 1

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cm. [18]. Body mass index (BMI) was calculated by dividing the weight (in kg) by

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height (in meters squared) [18]. Consequently, students were classified as

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underweight for a BMI of <18.5 kg/m2, normal for a BMI of 18.5-24.9 kg/m2,
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overweight for a BMI of 25-29.9 kg/m2, and obese if their BMI was greater than 30
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kg/m2 [18].
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2.4. Data Collection

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A package of 3 questionnaires was used for collecting data; the questionnaires

were composed of:

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1. A personal information questionnaire which asked about: age, sex,

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marital status, academic year (freshmen, sophomores, juniors and seniors),

major of study, smoking status, anthropometric measurements (weight, height,

body fat percentage in addition to waist circumference).

2. A dietary habits questionnaire included questions about the number

of main meals eaten, if any main meals were skipped, and the number of

snacks was used in the present study. In addition, the questionnaire asked

about the consumption frequency of several food groups: fruits, vegetables,

cereals and starchy vegetables, dairy products, white meat (poultry and fish),
red meat, and legumes. The frequencies were classified as less than once a

week, 1-2 times weekly, 3-4 times weekly, 5-6 times weekly, once daily, twice
daily, 3 times daily, 4 times daily and 5 times daily.

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 3. A validated physical activity recall (PAR) questionnaire which had

been developed by Sallis et al (1985) was used in this study to evaluate

the level of physical activity for each participant [19]. Students were

asked to recall their usual weekly physical activity in terms of

intensity, type and duration. The structured PAR questionnaire is

designed to collect data regarding various intensity levels of physical

activity as well as the frequency and duration of each type of the

performed physical activity. The number of hours spent sleeping in

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addition to the duration, intensity, and type of physical activity were

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assessed and converted into metabolic equivalents (METs). That is

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time spent in sleep (1 MET), light activity (1.5 METs), moderate
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activity (4 METs), hard activity (6 METs), and very hard activity (10
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METs). The activity participants engaged in for the past 7 days were
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multiplied by their related MET values and then summed. Finally, an

estimate of Total Physical Activity MET-minutes/week was calculated

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and transformed into categories: inactive, minimally active and Health

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Enhancing Physical Activity (HEPA) active. Scoring into these

categories was performed according to the standard scoring protocol of

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the International Physical Activity Questionnaire [20].

2.5. Statistical analysis

The data was coded, entered, and analyzed using the Statistical Package for
Social Sciences (IBM SPSS, version 20). The values of height, bodyweight, BMI,

waist circumference, and body fat percent were represented as mean value ± SD. This

data was analyzed using a t-test to compare male to female outcomes. Analysis of

variance (ANOVA) was performed to examine differences in physical activity and the

anthropometric measurements of the students in their different academic years. The

number of meals consumed, skipped meals, number of snacks per day, and

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consumption frequency of food groups based on academic year were analyzed using

Chi-square. Statistical significance was reported at P < 0.05 level.

3. Results

3.1. Socio-demographic characteristics of the students

The total number of students who participated in this study was 540 students.

Table 1 highlights the demographic and lifestyle characteristics of the study

participants. Students were distributed across the different academic years as follows:

128 freshmen (23.7%), 135 sophomores (25.0%), 130 juniors (24.1%) and 147

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seniors (27.2%). The number of male students was 184 (34.1%) distributed across the

different academic years as follows: 46 freshmen (35.9%), 44 sophomores (32.6%),

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44 juniors (33.8%) and 50 seniors (33.6%). The number of female students was 356
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(65.9%) distributed across the different academic years as follows: 82 freshmen
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(64.1%), 91 sophomores (67.4%), 86 juniors (66.2%) and 97 seniors (66.4%). With

regards to BMI, 44 students (8.1%) were underweight, 301 students (55.7%) had a
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normal BMI, 142 students were overweight (26.3%) and 53 students were obese

(9.8%). A significant difference (P<0.05) was found in the prevalence of obesity

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between the students according to academic year. One third (30.5%) of freshmen was
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overweight and 8.6% were obese, while 26.5% of seniors were overweight and 16.3

% were obese. About 15% of students smoked cigarettes, with no significant

differences between the different academic years. With regards to hookah smoking, a
significant difference (P<0.05) was found between the students in their different

academic years. The total number of hookah smokers was 163 (30.2%), in which 37

(28.9%) were freshmen, 27 (20.0%) were sophomores, 45 (34.6%) were juniors and

54 (36.7%) were seniors.

In regard to physical activity levels, the vast majority of the students were considered

to be HEPA active (89.4%) while 10.4 % were minimally active and 0.2% was

inactive. No significant differences were detected between academic year and

physical activity levels (Table 1).

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3.2. Age, physical activity and the anthropometric characteristicsof the students

Age, physical activity and the anthropometric characteristics of the students

based on gender and academic year are shown in Table 2. The total physical activity

MET-min/week was not significantly different between the academic years. There

were also no significant differences between males and females.

No significant differences in height, weight, body fat percent and waist circumference

were noticed between students in their different academic years. However, significant

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differences were found between male and female students regarding these variables.

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BMI was not significantly different between student in their different academic years,

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but it was significantly different (P<0.05) between male and female students in
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freshman (25.3 ± 4.7 and 23.4 ± 4.2) and senior year (26.7±4.9 and 22.9± 4.4),
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respectively.
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3.3. Number of meals intake, skipped meals and number of snacks per day

No significant differences were detected in the number of meals eaten per day,

skipped meals and number of snacks per day between the different academic years as

shown in table 3.

3.4. Consumption frequency of food groups based by university year

Table 4 shows the significant differences between students in their different

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academic years regarding their consumption of the fruits and the cereals food groups.

However, no significant differences were detected in the food groups: vegetables,

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dairy products, red meat, white meat (poultry and fish) and legumes between students
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in their different academic years.
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4. Discussion

Freshman year is an important transitionary period into adulthood, where

studies have found that weight gain is a likely outcome [3], usually as a result of a

change in eating behavior, shifting towards an increase in unhealthy food items like

fast food, snack foods, and sugar-sweetened beverages [12,21]. This study aimed to

compare the nutritional habits, physical activity and the prevalence of overweight and

obesity among the Hashemite University students at different academic years.

The total numbers of males and females students who participated in the

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current study were 184 (34.1%) and 356 (65.9%), respectively, which is similar to the

ratio of male to female students (1:3) at the Hashemite University. In this study, the

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average BMI of the participants was higher in males than females across all four
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academic years, with statistically significant differences in first and fourth-year

students. Similar results were reported by other studies in the region and globally
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[2,15,22]. A study in Finland mentioned that 41% of male compared to 23% of female
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students were overweight or obese [21], another in Greece found 58.8% of males were

overweight or obese compared to 41.2% of females [2]. A study by Ahmed et al.

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(2015) in the UAE found 34.6% of male students were overweight and obese
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compared to 21.5% of females [22].

In this study, 63.9% of participants had underweight and normal BMI while

36.1% were overweight and obese. The highest percentage of overweight was found

among freshmen (30.5%) however the highest percentage of obesity was found in

seniors (16.3%). The high rate of overweight and obesity in freshmen can be

attributed to the change in dietary habits of the students compared to their dietary

habits at their high school period [23]. A German study found that 65.3% of the

students mentioned a change in their eating behavior since enrollment in university

[24].

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 Students in the fourth academic year may have gained extra weight through

their educational period in the University. This could be due to their consumption of

fast food at the university restaurants. The rates of overweight and obesity in our

study were similar to that reported from a study on students in Jordan University [25].

The rates were higher than those previously documented among the Hashemite

University students [10], and Mutah University in Jordan [26]. They were also higher

than what studies in Egypt [27] and Lebanon [15] reported. The rates, however, were

lower than that reported by studies on males in Kuwait [28] and Saudi Arabia [5].

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The majority of students in this study (47.8%) reported eating two meals daily.

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Half of freshmen, 51.1% of sophomores, 47.3% of juniors and 43.1% seniors only

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consumed 2 meals, something that is consistent with findings from other studies in the

region. One such study on Saudi college male students found that students usually eat
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two meals daily [5]. A study conducted in Lebanon also found similar results [29].
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This could be attributed to the long hours most of the students spend outside their

homes [5]. Our study found that dinner was the most commonly skipped meal in
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49.3% of freshmen 41.9% of sophomores 42.1% of juniors and 44.0% of seniors,

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something that can be associated with overweight/ obesity [16].

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With regards to fruit and vegetable consumption, the majority of students

consume less than the recommended 3 servings of vegetables 2 servings of fruits daily

[30]. Our study found that 77.3% of freshmen, 73.3% of sophomores, 75.0% of

juniors and, 79.5% of seniors consume vegetables once a day or less. In addition,
75.1% of freshmen, 74.8% of sophomores, 82.0% of juniors, and 85.6% of seniors

consume fruits once a day or less. These findings are consistent with global studies

that report a decrease in fruit and vegetable consumption among university students

regardless of gender [12,21,31]. Furthermore, only 18.8 % of freshmen, 17% of

sophomores, 17.1% of juniors, and 15.10% of seniors consume dairy products 2 or

more times daily, which is likely to be below the recommended 3 servings of dairy
products daily [32]. These findings match reports that university students, in general,

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tend to consume higher amounts of fast food rich in calories and fats [14], due to the

palatability, accessibility, and convenience of this type of food [15].

Although, freshmen and seniors showed the higher rates of overweight and

obesity respectively, the dietary profile of those students shows that 25.2% of

overweight and 31.5% of obese students consumed cereals, grains, and starchy

vegetables five times a day. Meanwhile, 42.2% of sophomores and 50.8% of juniors

consumed cereals, grains, and starchy vegetables five times a day. The daily

consumption of meat in this study is less than what was found by Alibabic et al.

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(2014) who found that 54.67% of students consumed meat or meat products daily in

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the University of Bihac, Bosnia and Herzegovina [13], while in our study 13.1% and

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21.1% of students reported eating red and white meat respectively at least once a day.

Eating habits demonstrated that the majority of students at different academic levels
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consumed 1-2 times fruits per week and 5 times cereals, grains and starchy vegetables
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on daily basis.
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Although the differences between students in different academic years was

statistically significant, the average body fat % in both males and females was within
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the normal limits and similar results were obtained in previous studies [10,15].
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The prevalence of cigarette and hookah smoking reported in our study (15.4%

and 30.2 % of students respectively) was lower than reported among other universities

in Jordan (28.6 % for cigarettes and 36.8% for hookah) [33].

According to the standard scoring protocol of the International Physical

Activity Questionnaire [20], 89.4% of students’ activity scores are considered HEPA

active, inconsistent with other studies findings that university students were less likely

to meet their physical activity requirements [1]. It is likely that the adherence of

overweight and obese students to their current physical activity requirements is

insufficient for maintaining, or reaching a healthy bodyweight. Several studies

showed an inverse relationship between level of physical activity and overweight

and/or obesity [1,13,15].

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 Our study confirms the global observations that the trend of unhealthy lifestyle

and poor dietary habits among university students is increasing. This trend can be

attributed to numerous factors including peer pressure, being away from home for a

considerable number of hours, the pressure of studying, accessibility of fast foods, and

the limited choices of other foods on campus, in addition to the influence of

traditional and social media [10]. Other factors may include a low level of nutrition

knowledge [14].

5. Conclusions

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Our results show that approximately a third of students that participated in the

study are overweight or obese, and engage in poor dietary and lifestyle habits.

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Consequently, it is recommended that the university should adopt and implement
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nutrition and health education programs to reduce the prevalence of overweight and

obesity and improve students' eating habits, in addition to increasing their physical
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activity levels, especially among first and fourth year students. The university should
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seek to provide more healthy food options on campus for people to purchase in

tandem with the educational programs.

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Acknowledgments

The authors would like to express their gratitude to administrators of the

Hashemite University for granting the funding required to conduct this study. Special

thanks to dietitians Lina Massemi and Reham Rhateb for their help. Also, we would

like to express our deepest grattitude to all students who participated in this study.

Author contribution

Narmeen Jamal Al-Awwad: Conceptualization; Methodology; Software;

Supervision; Validation; Writing-original draft; Data curation; Investigation; Project

administration. Hiba Fathi Al-Sayyed: Writing-original draft; Visualization. Zeineh

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Abu Zeinah: Visualization; Writing- review & editing. Reema Fayez Tayyem:

Conceptualization; Methodology; Software; Supervision.

Funding

This research was funded by The Hashemite University.

Data availability statement

The authors confirm that the data supporting the findings of this study are

available within the article.

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Declaration of competing interest

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The authors declare that they have no conflict of interest.
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[25] Suleiman AA, Alboqai OK, Yasein N, El-Qudah JM, Bataineh MF, Obeidat

BA. Prevalence of and factors associated with overweight and obesity among

Jordan University students. J Biol Sci. 2009;9(7):738–45.

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[26] Alkhawaldeh O. Health promoting lifestyles of Jordanian university students.

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Int J Adv Nurs Stud. 2013;3(1):27–31.

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[27] Genena DM, Salama AA. Obesity and Eating Habits among University
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Students in Alexandria, Egypt: A Cross Sectional Study. World J Nutr Heal.
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2017;5(3):62–8.
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[28] Al-Isa AN. Dietary and socio-economic factors associated with obesity among

Kuwaiti college men. Br J Nutr. 1999;82(5):369–74.

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[29] El-Kassas G, Itani L, El Ali Z. Obesity Risk Factors among Beirut Arab
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University Students in Tripoli- Lebanon. J Nutr Food Sci. 2015;05(06).

[30] Wallace TC, Bailey RL, Blumberg JB, Burton-Freeman B, Chen C y. O,

Crowe-White KM, et al. Fruits, vegetables, and health: A comprehensive

narrative, umbrella review of the science and recommendations for enhanced

public policy to improve intake [Internet]. Vol. 60, Critical Reviews in Food

Science and Nutrition. Taylor and Francis Inc.; 2020 [cited 2021 Feb 1]. p.

2174–211. Available from:

https://www.tandfonline.com/action/journalInformation?journalCode=bfsn20

[31] Breitenbach Z, Raposa B, Szabó Z, Polyák É, Szűcs Z, Kubányi J, et al.

19
 Examination of Hungarian college students’ eating habits, physical activity and

body composition. Eur J Integr Med. 2016;8:13–7.

[32] US Department of Agriculture. Dairy | MyPlate [Internet]. [cited 2021 Feb 3].

Available from: https://www.myplate.gov/eat-healthy/dairy

[33] World Bank. Jordan: Overview of Tobacco Use, Tobacco Control Legislation,

and Taxation [Internet]. 2015. Available from:

http://documents1.worldbank.org/curated/en/809891561045747696/pdf/Jordan-

f
Overview-of-Tobacco-Use-Tobacco-Control-Legislation-and-Taxation.pdf

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20
Table 1

Demographic and lifestyle characteristics of the students at different academic years

University Year
Demographic and Pearson

f
oo
N (%)
lifestyle Chi-

r
-p
characteristics 1 2 3 4 Square Total

re
lP
Gender Male 46 (35.9%) 44 (32.6%) 44 (33.8%) 50 (33.6%) 184 (34.1%)
0.954

na
ur
Female 82 ( 64.1%)
Jo 91 (67.4%) 86 (66.2%) 97 (66.4%) 356 (65.9%)

Marital status Married 1 (0.8%) 0 (0.0%) 1 (0.8%) 4 (2.7% 0.303 6 (1.1%)

Single 127 (99.2%) 135 (100.0%) 128 (98.5%) 142 (96.6%) 532 (98.5%)

Divorced 0 (0.0%) 0 (0.0%) 1 (0.8%) 1 (0.7%) 2 (0.4%)

1
Occupation Yes 8 (6.3%) 9 (6.7%) 13 (10.0%) 16 (11.0%) 0.405 46 (8.5%)

No 120 (93.8%) 126 (93.3%) 117 (90.0%) 130 (89.0%) 493 (91.5%)

Physical Activity Inactive* 0 (0.0%) 0 (0.0%) 0 (0.0%) 1 (0.7%) 0.612 1 (0.2%)

f
oo
Levels
Minimally Active¥ 15 (11.7%) 10 (7.4%) 14 (10.8%) 17 (11.6%) 56 (10.4%)

r
-p
HEPA Activeᶲ

re
113 (88.3%) 125 (92.6%) 116 (89.2%) 129 (87.8%) 483 (89.4%)

lP
BMI Underweight 9 (7.0%) 6 (4.4%) 15 (11.5%) 14 (9.5%) 0.005 44 (8.1%)

na
Normal
ur
69 (53.9%) 94 (69.6%) 68 (52.3%) 70 (47.6%) 301 (55.7%)
Jo
Overweight 39 (30.5%) 27 (20.0%) 37 (28.5%) 39 (26.5%) 142 (26.3%)

Obese 11 (8.6%) 8 (5.9%) 10 (7.7%) 24 (16.3%) 53 (9.8%)

Smoking Yes 18 (14.1%) 19 (14.1%) 21 (16.2%) 25 (17.0%) 0.720 83 (15.4%)

2
 No 110 (85.9%) 116 (85.9%) 109 (83.8%) 122 (83.0%) 457 (84.6%)

Hookah smoking Yes 37 (28.9%) 27 (20.0%) 45 (34.6%) 54 (36.7%) 0.041 163 (30.2%)

No 91 (71.1%) 108 (80.0%) 85 (65.3%) 93 (63.3%) 377 (69.1%)

f
oo
* Inactive: less than 600 MET-mins/week
¥

r
Minimally active: 600 -3000 MET-mins/week.

-p
ᶲ
HEPA active: more than 3000 MET-mins/week.

re
lP
na
ur
Jo

3
Table 2

Physical activity and the anthropometric measurments of the male and female students (Mean± SD) according to their academic year

Physical activity and

University Year p-

f
the anthropometric

oo
value¥
characteristics 1 2 3 4

r
-p
Age (years) Male 19.1 d ± 1.5 19.7 c ± 0.7 20.5 b ± 0.7 21.6 a ± 1.0 0.001

re
lP
Female 18.6 d ± 0.7 19.7 c ± 1.1 20.1 b ± 2.4 21.3 a ± 1.3 0.001

na
Total 18.8 d±1.1 19.7 c ± 1.0 20.2 b ± 2.0 21.4 a ± 1.2 0.001

P-value* 0.013
ur 0.945 0.301 0.217
Jo
Total Physical Activity Male 19327.0 ±
17476.4± 15461.4 14525.5 ± 19268.6 14576.7 ±12180.0 0. 369
(MET-min/week) 14845.1

Female 17093.5 ±13023.0 18406.2 ±10909.3 17757.2 ±10537.5 17334.7 ±11388.4 0.880

Total 17896.2 ± 16396.7 ±

18103.1 ± 12523.5 16663.4 ± 14116.7 0.616
13689.9 11695.3

1
 P-value* 0.378 0.688 0.218 0.176

Male 175.3 ± 6.3 173.5 ± 6.8 172.4 ± 5.6 174.7 ± 7.4 0.165

Female 161.1 ± 4.9 158.4 ± 12.0 160.0 ± 5.3 159.8 ± 4.4 0.140
Height (cm)
Total 166.2 ± 8.8 163.4 ± 12.8 164.2 ± 7.9 164.9 ± 9.0 0.122

f
oo
P-value* 0.001 0.001 0.001 0.001

r
Male 77.9 ± 16.4 74.4 ± 15.0 74.0 ± 16.4 82.0 ± 17.9 0.091

-p
re
Female 60.6 ± 10.5 57.3 ± 9.9 59.8 ± 15.5 58.7 ± 12.0 0.317
Bodyweight (kg)

lP
Total 66.9 ± 15.3 62.9 ± 14.3 64.8 ± 17.2 66.6 ± 18.0 0.161

na
P-value* 0.001 0.001 0.001 0.001

Male 25.3 ± 4.7

ur 24.7 ± 4.6 25.0 ± 4.9 26.7 ± 4.9 0.168
Jo
Female 23.4 ± 4.2 23.1 ± 5.8 23.2 ± 5.3 22.9 ± 4.4 0.940
BMI
Total 24.1 ± 4.4 23.6 ± 5.5 23.8 ± 5.2 24.2 ± 4.9 0.768

P-value* 0.021 0.133 0.067 0.001

Male 17.4 ± 7.6 17.3 ± 7.1 17.4 ± 7.8 20.8 ± 8.6 0.072
Fat (%)
Female 26.0 ± 7.9 23.7 ± 9.3 24.3 ± 10.0 24.4 ± 8.7 0.390

2
 Total 22.9 ± 8.8 21.6 ± 9.1 21.9 ± 9.9 23.2 ± 8.8 0.400

P-value* 0.001 0.001 0.001 0.019

Male 88.7 ± 11.7 83.8 ± 10.5 81.9 ± 17.8 88.4 ±16.9 0.082

Waist circumference Female 73.7 ± 9.0 72.2 ± 10.0 74.4 ±12.6 73.8 ± 9.4 0.513

f
oo
(cm) Total 79.1 ± 12.4 75.8 ± 11.5 76.7 ± 14.7 78.7 ± 14.2 0.136

r
-p
P-value* 0.001 0.001 0.008 0.001

re
¥
Means with different superscripts within the same row are significantly different (p< 0.05)

lP
* Each variable is significantly different between males and females within the same academic year if p-value < 0.05

na
ur
Jo

3
Table 3

Number of meals intake, skipped meals and number of snacks per day based on academic years

academic year

f
1 2 3 4 p- Total

r oo
N % N % N % N % value N %

-p
re
One meal 10 7.8% 21 15.6% 16 12.4% 18 12.5% 65 12.1%

lP
Two meals 64 50.0% 69 51.1% 61 47.3% 62 43.1% 256 47.8%
Numbers of

na
Three meals 46 35.9% 40 29.6% 45 34.9% 59 41.0% 0.482 190 35.4%
main meals
More than 3 meals 8
ur
6.3% 5 3.7% 7 5.4% 5 3.5% 25 4.7%
Jo
Total 536 100.0%

Breakfast 21 28.0% 25 26.9% 24 31.6% 21 25.0% 91 27.7%

Lunch 5 6.7% 8 8.6% 4 5.3% 8 9.5% 25 7.6%

Skipped meal 0.901
Dinner 37 49.3% 39 41.9% 32 42.1% 37 44.0% 145 44.2%

Breakfast and lunch 2 2.7% 1 1.1% 1 1.3% 2 2.4% 6 1.8%

1
 Breakfast and Dinner 9 12.0% 18 19.4% 12 15.8% 16 19.0% 55 16.8%

Lunch and dinner 1 1.3% 2 2.2% 3 3.9% 0 0.0% 6 1.8%

Total 328 100.0%

One meal 41 32.0% 44 32.6% 49 38.3% 50 35.0% 184 34.5%

f
oo
Two meals 52 40.6% 48 35.6% 43 33.6% 47 32.9% 190 35.6%

r
Numbers of Three meals 19 14.8% 17 12.6% 15 11.7% 24 16.8% 75 14.0%

-p
0.859

re
snacks More than 3 meals 9 7.0% 18 13.3% 13 10.2% 16 11.2% 56 10.5%

lP
Don't eat it 7 5.5% 8 5.9% 8 6.3% 6 4.2% 29 5.4%

na
Total 534 100.0%

ur
Jo

2
Table 4.

Consumption frequency of food groups based by university year

University year

1 2 3 4
p-value
N % N % N % N %

<once a week 13 10.2% 19 14.1% 15 11.7% 13 8.9%

1-2 weekly 39 30.5% 38 28.1% 43 33.6% 48 32.9%

3-4 weekly 27 21.1% 26 19.3% 25 19.5% 32 21.9%

f
oo
5-6 weekly 7 5.5% 10 7.4% 7 5.5% 17 11.6%

Fruits Once a day 10 7.8% 8 5.9% 15 11.7% 15 10.3% 0.050

r
2 daily

3 daily
23

5
-p
18.0%

3.9%
15

15
11.1%

11.1%
10

5
7.8%

3.9%
9

8
6.2%

5.5%
re
4 daily 2 1.6% 1 .7% 6 4.7% 4 2.7%
lP

5 daily 2 1.6% 3 2.2% 2 1.6% 0 0.0%

<once a week 19 14.8% 18 13.3% 15 11.7% 14 9.6%

na

1-2 weekly 28 21.9% 25 18.5% 35 27.3% 35 24.0%

ur

3-4 weekly 26 20.3% 24 17.8% 23 18.0% 32 21.9%

5-6 weekly 14 10.9% 20 14.8% 6 4.7% 15 10.3%

Jo

Vegetables Once a day 12 9.4% 12 8.9% 17 13.3% 20 13.7% 0.463

2 daily 15 11.7% 16 11.9% 12 9.4% 12 8.2%

3 daily 7 5.5% 13 9.6% 14 10.9% 7 4.8%

4 daily 6 4.7% 7 5.2% 4 3.1% 8 5.5%

5 daily 1 .8% 0 0.0% 2 1.6% 3 2.1%

<once a week 0 0.0% 1 0.7% 0 0.0% 1 0.7%

1-2 weekly 7 5.5% 9 6.7% 2 1.6% 10 6.8%

Cereals, grains
3-4 weekly 6 4.7% 6 4.4% 5 3.9% 14 9.6%
and starchy 0.001
5-6 weekly 8 6.3% 4 3.0% 9 7.0% 6 4.1%
vegetables
Once a day 7 5.5% 4 3.0% 3 2.3% 9 6.2%

2 daily 18 14.2% 10 7.4% 11 8.6% 15 10.3%

1
 3 daily 28 22.0% 11 8.1% 9 7.0% 22 15.1%

4 daily 21 16.5% 33 24.4% 24 18.8% 23 15.8%

5 daily 32 25.2% 57 42.2% 65 50.8% 46 31.5%

<once a week 22 17.2% 20 14.8% 17 13.3% 19 13.0%

1-2 weekly 26 20.3% 34 25.2% 27 21.1% 37 25.3%

3-4 weekly 25 19.5% 17 12.6% 31 24.2% 26 17.8%

5-6 weekly 19 14.8% 22 16.3% 16 12.5% 18 12.3%

Dairy Products Once a day 12 9.4% 19 14.1% 15 11.7% 24 16.4% 0.671

2 daily 17 13.3% 12 8.9% 14 10.9% 14 9.6%

f
3 daily 7 5.5% 8 5.9% 3 2.3% 6 4.1%

oo
4 daily 0 0.0% 2 1.5% 3 2.3% 1 0.7%

r
5 daily 0 0.0% 1 .7% 2 1.6% 1 0.7%

<once a week 51
-p
40.2% 35 25.9% 41 32.0% 42 28.8%
re
1-2 weekly 37 29.1% 54 40.0% 35 27.3% 44 30.1%
lP

3-4 weekly 18 14.2% 14 10.4% 24 18.8% 26 17.8%

5-6 weekly 7 5.5% 10 7.4% 12 9.4% 15 10.3%

na

Red Meat Once a day 7 5.5% 10 7.4% 7 5.5% 12 8.2% 0.351

ur

2 daily 5 3.9% 4 3.0% 5 3.9% 4 2.7%

3 daily 2 1.6% 4 3.0% 3 2.3% 0 0.0%

Jo

4 daily 0 0.0% 2 1.5% 1 0.8% 2 1.4%

5 daily 0 0.0% 2 1.5% 0 0.0% 1 0.7%

<once a week 25 19.5% 21 15.6% 15 11.7% 13 8.9%

1-2 weekly 32 25.0% 24 17.8% 36 28.1% 39 26.7%

3-4 weekly 34 26.6% 31 23.0% 37 28.9% 44 30.1%

5-6 weekly 14 10.9% 24 17.8% 13 10.2% 21 14.4%

White Meat Once a day 13 10.2% 11 8.1% 11 8.6% 11 7.5% 0.180

2 daily 3 2.3% 3 2.2% 4 3.1% 5 3.4%

3 daily 6 4.7% 12 8.9% 11 8.6% 7 4.8%

4 daily 1 0.8% 5 3.7% 1 0.8% 3 2.1%

5 daily 0 0.0% 4 3.0% 0 0.0% 3 2.1%

2
 <once a week 40 31.3% 37 27.8% 37 28.9% 45 30.8%

1-2 weekly 41 32.0% 41 30.8% 43 33.6% 49 33.6%

3-4 weekly 27 21.1% 27 20.3% 30 23.4% 27 18.5%

5-6 weekly 9 7.0% 12 9.0% 8 6.3% 9 6.2%

Legumes Once a day 3 2.3% 7 5.3% 6 4.7% 13 8.9% 0.182

2 daily 5 3.9% 3 2.3% 1 0.8% 1 0.7%

3 daily 1 0.8% 4 3.0% 0 0.0% 0 0.0%

4 daily 0 0.0% 1 .8% 3 2.3% 0 0.0%

5 daily 2 1.6% 1 .8% 0 0.0% 2 1.4%

f
r oo
-p
re
lP
na
ur
Jo