The study sample comprised of 1,020 university students (response rate = 57%) where 65% were between the age of 18 to 21, and the remaining were over 21 years old. The proportion of female students was 64% and male students 36%., and majority were living off-campus (89%) and in single houses (77%). First class students with grade point average above 3.9 was at 11%. About one third (30%) were either overweight or obese. Regarding sleeping duration, 70% slept less than seven hours per day, and 40% reported more than 8 hours of daily sedentary activity. Running or jogging (58%) was the most common sport activity, followed by aerobic dance (41%), racquet sport (24%), ball-related sports (23%), and water sport (21%) (see Table 1).
Table 1
Sample characteristics of University students (n = 1,020)
| Frequency (Percentage) |
Age groups | |
18 years old | 111 (11%) |
19 to 21 years old | 549 (54%) |
More than 21 years old | 360 (35%) |
Gender | |
Male | 363 (36%) |
Female | 657 (64%) |
Body Mass Index (BMI) | |
Normal weight | 561 (55%) |
Underweight | 155 (15%) |
Overweight | 194 (19%) |
Obese | 110 (11%) |
Grade point average (GPA) (Range 1 to 5) | |
> 3.9 (First class) | 110 (11%) |
3.2 to 3.9 (Upper second class) | 465 (45%) |
≤ 3.2 (Lower second and third class) | 445 (44%) |
Living arrangement | |
On-campus | 113 (11%) |
Off-campus | 907 (89%) |
Housing type | |
Single house | 784 (77%) |
Townhouse | 170 (17%) |
Apartment | 66 (6.5%) |
Sedentary duration (hours) | |
≤ 3 hours | 236 (23%) |
4 to 8 hours | 381 (37%) |
> 8 hours | 403 (40%) |
Sleeping duration (hours) | |
≤ 7 hours | 710 (70%) |
> 7 hours | 310 (30%) |
Type of sport activities | |
Running/Jogging | 587 (58%) |
Cycling | 177 (17%) |
Aerobic dance | 416 (41%) |
Ball-related sport | 231 (23%) |
Racquet sport | 243 (24%) |
Athletics | 63 (6.2%) |
Water sport | 211 (21%) |
Fight sport | 145 (14%) |
Figure 1 presents the gender-stratified prevalence of poor mental wellbeing and health-risk behaviors among the sample of university students. The overall prevalence of poor mental wellbeing was 30% where female students (33.6%) reported significantly higher than male students (23.4%) (p < 0.001). Eating excessive snack was the most prevalent health-risk behavior for both female (92.4%) and male (84.8%) students. Female students were reportedly less physically active (46.4%) and had higher proportion of alcohol drinkers (4.6%) than male students. Whereas, smoking among male students (27.0%) were significantly higher than female students (5.8%) (p < 0.001).
Tables 2 and 3 demonstrate the final adjusted multiple logistic regression models for factors related to poor mental wellbeing and health-risk behaviors. After adjusting for confounders, poor mental wellbeing was significantly more likely among female (OR = 2.00, 95%CI: 1.41, 2.85), smoking (OR = 2.17, 95%CI: 1.39, 3.38), being overweight (OR = 1.85, 95%CI: 1.12, 2.77) or obese (OR = 1.77, 95%CI: 1.08, 2.98), consume excessive sweet drinks (OR = 1.58, 95%CI: 1.07, 2.38), and participate in fight sports (OR = 2.74, 95%CI: 1.73, 4.37). Students who did water sports were significantly less likely to experience poor mental wellbeing (OR = 0.28, 95%CI: 0.18, 0.44).
Table 2
Multiple logistic regression results on factors related to health-risk behaviors and mental wellbeing (n = 1020)
| Smoking | Alcohol | Physically inactive | Poor mental wellbeing |
Factors | OR | 95% CI | p-value | OR | 95% CI | p-value | OR | 95% CI | p-value | OR | 95% CI | p-value |
Gender (Ref: Male) | 1.00 | - | - | 1.00 | - | - | 1.00 | - | - | 1.00 | - | - |
Female | 0.13 | 0.08, 0.21 | < 0.001 | 34.6 | 7.35, 226 | < 0.001 | 1.90 | 1.37, 2.65 | < 0.001 | 2.00 | 1.41, 2.85 | < 0.001 |
BMI (Ref: Normal) | 1.00 | - | - | - | - | - | 1.00 | - | - | 1.00 | - | - |
Underweight | 0.44 | 0.14, 1.11 | 0.11 | - | - | - | 1.38 | 0.92, 2.06 | 0.12 | 1.08 | 0.71, 1.65 | 0.7 |
Overweight | 2.18 | 1.29, 3.70 | 0.004 | - | - | - | 1.81 | 1.23, 2.66 | 0.003 | 1.85 | 1.23, 2.77 | 0.003 |
Obese | 3.04 | 1.56, 5.83 | < 0.001 | - | - | - | 0.69 | 0.43, 1.09 | 0.11 | 1.77 | 1.08, 2.89 | 0.024 |
Sleep duration (Ref: >7 hours) | 1.00 | - | - | - | - | - | - | - | - | - | - | - |
≤ 7 hours | 1.46 | 1.07, 2.00 | 0.018 | - | - | - | - | - | - | - | - | - |
Health-risk behaviors (Ref: No) | 1.00 | - | - | 1.00 | - | - | 1.00 | - | - | 1.00 | - | - |
Smoking | - | - | - | 23.9 | 4.77, 124 | < 0.001 | 1.90 | 1.25, 2.91 | 0.003 | 2.17 | 1.39, 3.38 | < 0.001 |
Alcohol intake | - | - | - | - | - | - | 0.26 | 0.08, 0.66 | 0.009 | - | - | - |
High sugar intake | - | - | - | - | - | - | - | - | - | 1.58 | 1.07, 2.38 | 0.025 |
High snack intake | 2.81 | 1.34, 6.46 | 0.010 | - | - | - | 0.47 | 0.30, 0.75 | 0.002 | - | - | - |
Poor mental wellbeing | 3.08 | 1.93, 4.97 | < 0.001 | - | - | - | - | - | - | - | - | - |
Physically inactive | 1.75 | 1.10, 2.78 | 0.018 | - | - | - | - | - | - | - | - | - |
Types of sport (Ref: No) | 1.00 | - | - | - | - | - | 1.00 | - | - | 1.00 | - | - |
Running/Jogging | - | - | - | - | - | - | 0.42 | 0.32, 0.56 | < 0.001 | - | - | - |
Cycling | - | - | - | - | - | - | - | - | - | - | - | - |
Aerobic dance | 0.57 | 0.35, 0.93 | 0.026 | - | - | - | 0.46 | 0.34, 0.61 | < 0.001 | - | - | - |
Ball-related sport | 0.38 | 0.19, 0.71 | 0.003 | - | - | - | 0.53 | 0.36, 0.77 | 0.001 | - | - | - |
Racquet sport | 0.22 | 0.10, 0.46 | < 0.001 | 9.67 | 3.32, 31.7 | < 0.001 | - | - | - | - | - | - |
Water sport | 3.55 | 1.99, 6.38 | < 0.001 | - | - | - | - | - | - | 0.28 | 0.18, 0.44 | < 0.001 |
Fight sport | 4.55 | 2.56, 8.18 | < 0.001 | 4.16 | 1.34, 13.2 | 0.014 | - | - | - | 2.74 | 1.73, 4.37 | < 0.001 |
H-L Goodness of fit test | 11.9 (3) | 3.7 (8) | 9.4 (8) | 18.9 (8) |
P-value | 0.076 | 0.879 | 0.599 | 0.152 |
McFadden R-square | 0.275 | 0.564 | 0.126 | 0.119 |
OR = Odds ratio CI = Confidence interval Ref = Reference group H-L = Hosmer and Lemesho |
Table 3
Multiple logistic regression results on factors related to health-risk behaviors (n = 1020) [continue]
| High salt intake | High sugar intake | High snack intake | Poor diet |
Factors | OR | 95% CI | p-value | OR | 95% CI | p-value | OR | 95% CI | p-value | OR | 95% CI | p-value |
BMI (Ref: Normal) | - | - | - | 1.00 | - | - | 1.00 | - | - | 1.00 | - | - |
Underweight | - | - | - | 4.44 | 2.28, 9.59 | < 0.001 | 1.06 | 0.51, 2.40 | 0.9 | 4.25 | 2.81, 6.46 | < 0.001 |
Overweight | - | - | - | 1.01 | 0.64, 1.63 | > 0.9 | 1.09 | 0.61, 2.03 | 0.8 | 1.40 | 0.94, 2.08 | 0.100 |
Obese | - | - | - | 4.63 | 2.28, 10.4 | < 0.001 | 0.24 | 0.13, 0.46 | < 0.001 | 2.63 | 1.64, 4.20 | < 0.001 |
Sleep duration (Ref: >7 hrs) | 1.00 | - | - | - | - | - | - | - | - | - | - | - |
≤ 7 hours | 1.38 | 1.04, 1.84 | 0.025 | - | - | - | - | - | - | - | - | - |
Health-risk behaviors (Ref: No) | - | - | - | 1.00 | - | - | 1.00 | - | - | 1.00 | - | - |
Smoking | - | - | - | 1.73 | 1.01, 3.07 | 0.054 | 2.89 | 1.41, 6.50 | 0.006 | - | - | - |
Alcohol intake | - | - | - | - | - | - | 0.16 | 0.06, 0.53 | < 0.001 | 3.00 | 1.39, 6.91 | 0.007 |
High snack intake | 1.91 | 1.24, 2.99 | 0.004 | 4.31 | 2.66, 7.01 | < 0.001 | | | | - | - | - |
High salt intake | - | - | - | 2.01 | 1.40, 2.88 | < 0.001 | 1.77 | 1.13, 2.80 | 0.013 | - | - | - |
High sugar drink | 1.88 | 1.33, 2.66 | < 0.001 | - | - | - | 5.22 | 3.21, 8.52 | < 0.001 | - | - | - |
Poor mental wellbeing | - | - | - | 1.76 | 1.17, 2.69 | 0.008 | - | - | - | - | - | - |
Types of sport (Ref: No) | 1.00 | - | - | 1.00 | - | - | - | - | - | 1.00 | - | - |
Running/Jogging | - | - | - | 0.36 | 0.24, 0.53 | < 0.001 | - | - | - | 1.83 | 1.33, 2.51 | < 0.001 |
Cycling | - | - | - | - | - | - | - | - | - | 1.70 | 1.16, 2.48 | 0.006 |
Aerobic dance | 0.77 | 0.59, 1.01 | 0.056 | 1.51 | 1.03, 2.23 | 0.036 | - | - | - | - | - | - |
Ball-related sport | - | - | - | - | - | - | - | - | - | 3.56 | 2.51, 5.08 | < 0.001 |
Racquet sport | - | - | - | 2.89 | 1.78, 4.86 | < 0.001 | - | - | - | - | - | - |
Fight sport | - | - | - | - | - | - | - | - | - | 1.72 | 1.11, 2.65 | 0.015 |
H-L Goodness of fit test | 12.6 (8) | 15.9 (8) | 7.4 (8) | 7.2 (8) |
P-value | 0.126 | 0.331 | 0.405 | 0.282 |
McFadden R-square | 0.064 | 0.166 | 0.151 | 0.149 |
OR = Odds ratio CI = Confidence interval Ref = Reference group H-L = Hosmer and Lemeshow |
In the final adjusted logistic regression model, there was significantly increased odds of physical inactivity among female (OR = 1.90, 95%CI: 1.37, 2.65), being overweight (OR = 1.81, 95%CI: 1.23, 2.66), and smoking (OR = 1.90, 1.25, 2.91). Whereas, significantly decreased odds of physical inactivity among alcohol drinkers (OR = 0.26, 95%CI: 0.08, 0.66), consume excessive sweet drinks (OR = 0.47, 95%CI: 0.30, 0.75), and participated in running/jogging (OR = 0.42, 95%CI: 0.32, 0.56), aerobic dance (OR = 0.46, 95%CI: 0.34, 0.61) or ball-related sports (OR = 0.53, 95%CI: 0.36, 0.77).
In the final adjusted model, there was significantly higher odds of smoking among those who were overweight (OR = 2.18, 95%CI: 1.29, 3.70) or obese (OR = 3.04, 95%CI: 1.56, 5.83), sleep less than 7 hours per day (OR = 1.46, 95%CI: 1.07, 2.00), consume excessive snack (OR = 2.81, 95%CI: 1.34, 6.46), experience poor mental wellbeing (3.08, 95%CI: 1.93, 4.97), physically inactive (OR = 1.75, 95%CI: 1.10, 2.78), and participated in water sport (OR = 3.55, 95%CI: 1.99, 6.38) and fight sport (OR = 4.55, 95%CI: 2.56, 8.18). Whereas, there was significantly lower odds of smoking among female, and those who participated in aerobic dance, ball-related sport or racquet sport.
In the final adjusted model, female (OR = 34.6,95%CI: 7.35, 226.0), smoking (OR = 23.9, 95%CI: 4.77, 124.0), and participated in racquet sport (OR = 9.67, 95%CI: 3.32, 31.7) or fight sport (OR = 4.55, 95%CI: 2.56, 8.18) was associated with increased odds of alcohol consumption. Whereas, significant higher odds of poor diet intake was associated with being underweight (OR = 4.25, 95%CI: 2.81, 6.46) or obese (OR = 2.63, 95%CI: 1.64, 4.20), consume alcohol (OR = 3.00, 95%CI: 1.39, 6.91), and participated in running/jogging, cycling, ball-related sports, or fight sport.
Significant higher odds of excessive sugar intake was associated with being underweight (OR = 4.44, 95%CI: 2.28, 9.59) or obese (OR = 4.63, 2.28, 10.4), smoking (OR = 1.73, 95%CI: 1.01, 3.07), excessive snack intake (OR = 4.31, 95%CI: 2.66, 7.01) and salt intake (OR = 2.01, 95%CI: 1.40, 2.88), and participated in aerobic dance (OR = 1.51, 95%CI: 1.03, 2.23) or racquet sport (OR = 2.89, 95%CI: 1.78, 4.86). Those who participate in running/jogging had lower odds of excessive sugar intake.
Excessive snack intake were significantly more likely among smoker, and those who consumed high salt and high sugar intake. Students who were obese and alcohol drinker were less likely to consume excessive snacks. Meanwhile, excessive salt intake were significantly more likely among those who sleep less than 7 hours per day, consume high snack and high sugar intake, however, less likely for those doing aerobic dance exercise.