Weekend–Weekday Differences in Adherence to the Mediterranean Diet among Spanish University Students

Abstract

Daily routines may influence eating patterns; however, differences in intake on weekdays and at weekends have rarely been explored. Furthermore, these differences have not been analyzed among university students (a particularly interesting group among the younger generations). The aim of the study was to evaluate weekend–weekday variation in the Mediterranean diet among Spanish university students, while investigating the potential influence of age, gender, studies, body mass index, smoking status and physical activity status. A repeated-measurement 28-day cross-sectional observational study with self-reported dietary intake collected using the e12HR app was conducted. There were 361 participants: average age 20.6 years; 72.9% women; 58.2% students of Pharmacy; average BMI 21.9 kg/m2; 91.4% nonsmokers; 77.6% performed ≥150 min/week of physical activity. Outcome measurements were adherence to the Mediterranean diet (AMD) index and percentage of participants meeting recommendations for each food group on weekdays and at weekends. In all subgroups, Spanish university students’ global diet was associated with low AMD, with poorer diet quality (>12% reductions in mean scores of AMD index and >26% reductions in adequate adherence scores (≥9)) at weekends. In conclusion, weekend health behaviors of Spanish university students displayed less favorable eating behavior, making the weekend an important target for public health interventions aiming to improve dietary intake.

Evaluation of an Application for Mobile Telephones (e-12HR) to Increase Adherence to the Mediterranean Diet in University Students: A Controlled, Randomized and Multicentric Study

“…(2) Among the younger generations, university students constitute a prominent subgroup since in the 2019/2020 academic year, there were 1309,762 undergraduate students enrolled in Spanish universities [ 34 ]. (3) University students are a population at high risk for having unhealthy habits [ 35 ] (with low AMD index [ 25 ]) as they choose their own food, are very receptive to trends in diet such as slimming diets, skipped meals or consuming snacks, soft drinks, and other new products [ 36 ]. (4) University students lead an unhealthy lifestyle and are at risk of preserving these habits throughout adulthood, which represents a great inconvenience for these individuals, especially for students of the Health Sciences [ 37 ].…”

“…However, in the case of recommendations on frequency of consumption, some modifications had to be made in order to adapt them to the characteristics of e-12HR [ 25 ] ( Table 1 ).…”

“…However, for food groups calculated on a daily basis, the procedure was as follows: every seven days, for each specific food group, the number of standard portions registered daily throughout this period were added all together first, and the result was then divided by seven. For the food groups calculated on a daily basis with scores greater than 1, the scoring rules were as follows [ 19 , 25 ]:…”

“…The sample size was estimated a priori, considering the main result variable. Assuming a standard deviation of 2.9 points in AMD index and a dropout rate of 17.8% throughout the duration of the study—28 days—(from a previous study using e-12HR [ 25 ]), a power of 0.8 and an alpha risk of 0.05 in a bilateral test, 161 participants were necessary in each group in order to detect an increase of 1 point in ADM index in the IG compared to the CG.…”

“…The main hypothesis of this study was that the use of e-12HR with the two new functionalities (hereafter referred to as ‘feedback’ e-12HR) among Spanish university students (a group with low AMD index and one of the groups of the younger generations that is abandoning the MD [ 25 ]), could have an influence on improving AMD index. To the best knowledge of the research team, this has been the first study that has evaluated an application for mobile telephones to increase AMD among university students.…”