Country and Gender-Specific Achievement of Healthy Nutrition and Physical Activity Guidelines: Latent Class Analysis of 6266 University Students in Egypt, Libya, and Palestine

Abstract

Research on healthy behaviour such as physical activity and healthy nutrition and their combination is lacking among university students in Arab countries. The current survey assessed healthy nutrition, and moderate/vigorous physical activity (PA) of 6266 students in Egypt, Libya, and Palestine. We computed a nutrition guideline achievement index using WHO recommendation, as well as the achievement of PA recommendations using guidelines for adults of the American Heart Association guidelines. Latent class regression analysis identified homogenous groups of male and female students, based on their achievements of both guidelines. We examined associations between group membership and achievement of guidelines. A three-class solution model best fitted the data, generating three student Groups: “Healthy Eaters” (7.7% of females, 10.8% of males), “Physically Active” (21.7% of females, 25.8% of males), and “Low Healthy Behaviour” (70.6% of females, 63.4% of males). We did not observe a latent class that exhibited combined healthy behaviours (physically active and healthy eaters), and there were no major differences between countries. We observed a very low rate of healthy nutrition (≈10% of students achieved greater than four of the eight nutrition guidelines), with little gender differences across the countries. About 18–47% of students achieved the PA guidelines, depending on country and gender, more often among males. Few females achieved the PA guidelines, particularly in Libya and Palestine. Culturally adapted multi-behavioural interventions need to encourage healthy lifestyles, nutrition and PA behaviours. National policies need to promote active living while addressing cultural, geographic, and other barriers to young adults’ engagement in PA.

Lifestyle behaviors among undergraduate nursing students: A latent class analysis

“…Our study identifies four latent lifestyle classes suggesting that health behavior types are probably interrelated, as found in previous research examining multiple risk behaviors among undergraduate students (Davoren et al, 2018;El Ansari & Berg-Beckhoff, 2017;Kabir et al, 2018;Nazar et al, 2019 that professors encourage students to get up and move for at least 10 min every 3 hr, as students need to be reminded that movement helps reduce the consequences of a long time sitting (Matsudo et al, 2001;Mussi et al, 2017) Other research suggests that the intensity of the academic schedules (e.g., long classes, multiple courses, and computer use) could contribute to a sedentary profile (Torquato et al, 2016) and contributes to obesity among students (Mussi et al, 2017). Previous findings discuss factors that influence the student's lifestyle.…”

“…LCA is often used in research to identify high-risk behavior patterns in the general populations (Mathur et al, 2014;Patrão, Almeida, Alvim, Chor, & Aquino, 2018;Wienert, Kuhlmann, Storm, Reinwand, & Lippke, 2018). Several studies have examined undergraduate students from different programs and universities around the world, but do not specify whether nursing students were included (Afrashteh, Ghaem, & Abbasi-Ghahramanloo, 2017;Davoren et al, 2018;El Ansari & Berg-Beckhoff, 2017;Kabir et al, 2018;Laska et al, 2009;Luo, Agley, Hendryx, Gassman, & Lohrmann, 2015;Mathur et al, 2014;Nazar et al, 2019;Sanscartier et al, 2018).…”

“…It is important to recognize that health risks are not distributed equally and separately among the students; rather, they tend to occur in clusters in definite population subgroups (Almutairi et al, 2018;Torquato et al, 2016). In the published literature, few studies have assessed the co-occurrence of complex groupings of lifestyle behaviors using LCA technique among nursing students (El Ansari & Berg-Beckhoff, 2017;Han et al, 2019;Hernandez, Blavo & Hardigan, 2010). As future health care practitioners, nursing students serve as role models for healthy lifestyles for clients/ patients.…”

Association of Health Status and Health Behaviors with Weight Satisfaction vs. Body Image Concern: Analysis of 5888 Undergraduates in Egypt, Palestine, and Finland

“…Using students' FFQ responses [40], we computed an objective dietary guideline achievement index, with a maximum of 8 points (8 guidelines), derived from 8 foods: (1) sweets, cookies, and snacks;…”

“…The university environment is important for studies of body image and related variables due to physiological and psychological factors that include identity and role changes, insufficient exercise, cafeteria food, and the availability and ease of snacking on junk food [40,41]. To the best of our knowledge, no comparative research examined such differences among young adult university students across these three culturally different countries, particularly involving both genders.…”