Movement and dietary behaviours and mental health among university students: the Health@NUS study.

introductionUniversity years represent a crucial period in a student's life, with mounting pressures on mental health and the formation of lifestyle habits that may endure into adulthood. This study examined the associations between movement and dietary behaviours and mental health among university students. It further explored potential sex-specific differences in these associations.

methodsThis cross-sectional study used data (2020-2022) from the Health@NUS prospective cohort study. Six behaviours-moderate-to-vigorous physical activity (MVPA), sedentary behaviour, sleep duration, and intake of fruit, vegetables, and unhealthy food-were assessed and categorised as either healthy or unhealthy based on established guidelines. Mental health was measured using the 6-item Kessler Psychological Distress Scale and the 5-item World Health Organisation Well-Being Index. Multivariable linear regression was used to analyse the associations between the behaviours and mental health, and to evaluate effect modification by sex.

resultsAmong 773 students (mean age 22.7 years, 56.8% female), 23.3% engaged in 4-6 healthy behaviours; 14.1% and 37.7% reported high distress and poor well-being, respectively. Compared to students engaging in 0-1 healthy behaviours, those engaging in 2 or more healthy behaviours reported less distress and greater well-being. Students who engaged in 4-6 behaviours reported the lowest distress (females: -1.51, 95% CI -2.75, -0.27; males: -1.72, 95% CI -3.06, -0.39) and the best well-being (females: 10.66, 95% CI 6.04, 15.23; males: 9.98, 95% CI 6.04, 15.23). For individual behaviours, adequate sleep and less intake of unhealthy foods were associated with both less distress and better mental well-being, whereas sufficient MVPA and less sedentary behaviour were associated with better well-being. Additionally, among female students, less sedentary behaviour and unhealthy food intake were associated with better well-being.

conclusionsThe more healthy movement and dietary behaviours that students engaged in, the better their reported mental health outcomes. The type of behaviour and sex also appear to play a role. These findings highlight the need for interventions addressing both lifestyle behaviours and mental health in university students, potentially using sex-tailored strategies. CLINICAL TRIAL NUMBER: NCT05154227 (registered on 16 September 2021; https://www. CLINICALTRIALS: gov/).