Associations Between Modifiable Health Behaviors and Obesity Among U.S. College Students: An Analysis of the ACHA-NCHA Data

Abstract

Purpose

To examine the individual and combined effects of modifiable health behaviors—physical activity, healthy diet, smoking, and alcohol consumption—on obesity among U.S. college students.

Design

Cross-sectional.

Setting

Data from the 2018 American College Health Association-National College Health Assessment surveys.

Sample

Data included 91,535 undergraduate students.

Measures

Modifiable health behaviors included self-reported physical activity, diet, smoking, and alcohol use. Weight-related measures included perceived weight status, weight control intentions, weight loss behaviors, and BMI (obesity defined as BMI ≥30).

Analysis

Weighted and adjusted logistic regression models estimated associations between individual behaviors, the number of guidelines met, and obesity.

Results

Non-adherence to guidelines for moderate-intensity physical activity, vigorous-intensity physical activity, muscle-strengthening activities, and healthy diet significantly increased obesity odds (OR = 1.14, 1.53, 1.45, and 1.46, respectively). Non-adherence to alcohol guidelines was associated with lower obesity odds (OR = 0.78). Cigarette smoking was not significantly associated with obesity after covariate adjustments. Meeting more guidelines was linked to healthier BMI and weight perceptions. Males were more likely to meet physical activity and alcohol guidelines, whereas females adhered more to dietary and smoking guidelines.

Conclusions

Interventions targeting multiple health behaviors are needed to reduce obesity among college students.

Keywords

college students modifiable health behaviors weight-related outcomes body mass index health behavior guidelines

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