Use of Ripple Effects Mapping to assess student-perceived benefits of undergraduate research and learning objective attainment with Irish nutrition students.

Ripple Effects Mapping (REM) is a qualitative data analysis approach that combines mind mapping with inductive analysis to condense data obtained from group interviews. One benefit of REM is the ability to identify unintended outcomes, or "ripples," of the intervention of interest. Ripples are visually represented by a mind map created during the REM session. Mind maps connect related concepts, typically with the main concept in the center of the map and supporting ideas radiating from a central node. This project applied REM to undergraduate course evaluation. The purpose of this study was threefold: to use REM to identify undergraduate student-perceived benefits of research projects, to assess whether REM could be used to confirm achievement of course learning objectives, and to compare the themes identified from the mind mapping component of REM to those identified by inductive analysis. Mind maps were generated with Xmind (Xmind Ltd., Hong Kong) during online sessions by two groups of students, those who completed a "mandatory" research project (n = 11) and those who chose to participate in an additional "optional" research project (n = 9). There was considerable overlap in identified themes between mind mapping and inductive analysis, with skills, relationships, career direction, and unexpected benefits identified by both techniques. Mind mapping identified several additional themes. Findings from both approaches were compared to course learning objectives, and both confirmed that all objectives were met. In situations where time is a limiting factor, mind mapping could be superior to the complete REM approach for course learning objective assessments.NEW & NOTEWORTHY This study used Ripple Effects Mapping (REM) to identify undergraduate student-perceived benefits of research projects, to assess whether REM could confirm achievement of course learning objectives for a research project-based course, and to compare themes identified from the mind mapping component of REM to those identified by inductive analysis. Mind mapping confirmed achievement of course objectives and may be a better choice compared to inductive reasoning when time is limited.

Comparing mental health and well-being of US undergraduate and graduate students during the early stages of the COVID-19 pandemic.

Objective: This study explored how COVID-related mental health and well-being varied between undergraduate and graduate students. Relationships with physical health behaviors were also examined. Participants: Undergraduate (n = 897) and graduate (n = 314) students were recruited from three US universities between mid-April and late-May 2020. Methods: Participants in this cross-sectional survey self-reported perceived stress, financial stress, resilience, repetitive negative thinking, mood, anxiety, diet, sleep, and physical activity using validated instruments. Results: Undergraduate students reported more perceived stress, more repetitive negative thinking, less positive mood, and less support from professors than graduate students. Perceived stress, repetitive negative thinking, negative mood, and anxiety increased among all students (p < .05 for all). Correlations between mental health outcomes and physical health behaviors were weak to moderate (r = .08 to .49). Conclusions: College students, particularly undergraduates, perceived negative mental health impacts during COVID. Creative approaches for meeting student needs are necessary.

Reply to Kuo et al. Comment on "Du et al. Gender Differences in the Relationships between Perceived Stress, Eating Behaviors, Sleep, Dietary Risk, and Body Mass Index. Nutrients 2022, 14, 1045".

We thank Kuo et al. for their comments [...].

Gender Differences in the Relationships between Perceived Stress, Eating Behaviors, Sleep, Dietary Risk, and Body Mass Index.

BACKGROUND: Obesity is a growing epidemic among university students, and the high levels of stress reported by this population could contribute to this issue. Singular relationships between perceived stress; engagement in restrained, uncontrolled, and emotional eating; sleep; dietary risk; and body mass index (BMI) have been reported in the current body of literature; however, these constructs interact with each other, and the complex relationships among them are infrequently examined. Therefore, the aim of the present study was to explore the complex relationships between these constructs using mediation and moderation analyses stratified by gender. METHODS: A cross-sectional study, enrolling university students from the United States (U.S.), the Netherlands, South Korea, Malaysia, Ireland, Ghana, and China, was conducted between October 2020 and January 2021 during the COVID-19 pandemic. Perceived stress; maladaptive eating behaviors including restrained, uncontrolled, and emotional eating; sleep duration and quality; dietary risk; and BMI were assessed using validated questionnaires, which were distributed through an online platform. RESULTS: A total of 1392 students completed the online survey (379 male, 973 female, and 40 who self-identified as "other"). Uncontrolled and emotional eating mediated the relationship between perceived stress and dietary risk for both males and females; higher sleep quality weakened this relationship among female students but not males. Emotional eating mediated the relationship between perceived stress and BMI for both males and females, but higher sleep quality weakened this relationship only among females. CONCLUSIONS: Our findings suggest that students in higher education are likely to benefit from interventions to reduce uncontrolled and emotional eating. Programs that improve sleep quality, especially during highly stressful periods, may be helpful.

Relationships between Dairy and Calcium Intake and Mental Health Measures of Higher Education Students in the United States: Outcomes from Moderation Analyses.

BACKGROUND: The prevalence of mental health concerns among university students in the United States (U.S.) continues to increase, while current treatments, including medication and counseling, present shortcomings. Higher dairy and calcium intakes are associated with protective effects on mental health; however, previous studies have focused on investigating singular relationships between dairy and calcium intakes and mental health measures. A more complex exploration of these relationships is warranted to better examine whether increasing dairy and calcium intakes could serve as an intervention to improve mental health. The present study sought to further characterize the relationships between dairy and calcium intake, perceived stress, and a variety of mental health measures using linear regression and moderation analyses. METHODS: The present cross-sectional study involved students studying at three large U.S. universities, and data collection occurred from April to May 2020 when students were learning remotely due to the COVID-19 pandemic. An online survey comprising validated tools was distributed among students to assess dairy and calcium intake, perceived stress, anxiety, negative and positive moods, rumination, and resilience, sleep quality and duration, dietary risk, and physical activity. RESULTS: A total of 1233 students completed the study. Higher dairy and calcium intake was coincident with lower perceived stress and higher positive mood scores, while higher calcium intake was also coincident with lower anxiety, rumination, and higher resilience scores. Additionally, as calcium intake increased, the relationship between perceived stress and anxiety and the relationship between perceived stress and negative mood weakened. Dairy intake did not have this effect. CONCLUSIONS: Based on the results, and considering that calcium is a shortfall nutrient, universities should consider initiating programs and public health campaigns to promote dairy and calcium intake among this population.

Insufficient Sleep and Poor Sleep Quality Completely Mediate the Relationship between Financial Stress and Dietary Risk among Higher Education Students.

The coronavirus disease 2019 (COVID-19) pandemic worsened financial stress for higher education students in the U.S. Financial stress is associated with poor dietary behaviors; however, factors that might influence this relationship are not well characterized. The present cross-sectional study investigated the associations between financial stress and dietary intake and dietary risk scores among higher education students (undergraduate and graduate students) in the U.S. and examined whether poor sleep quality and short sleep duration mediated the relationship between financial stress and dietary risk score. Validated tools were used to assess financial stress, sleep quality, sleep duration, dietary intake, and dietary risk. A total of 1280 students from three large U.S. universities completed the study. Results indicated that higher financial stress was associated with lower vegetable, fruit, fiber, and calcium intake, higher added sugar intake from sugar sweetened beverages, and higher dietary risk score. Further, the positive relationship between financial stress and dietary risk score was completely mediated by poor sleep quality among students who reported poor sleep quality and by short sleep duration among students who slept less than 7 h per night. These findings suggest that students might benefit from both financial management training and sleep education services to reduce undesirable dietary behaviors.

The Effects of Sleep Quality and Resilience on Perceived Stress, Dietary Behaviors, and Alcohol Misuse: A Mediation-Moderation Analysis of Higher Education Students from Asia, Europe, and North America during the COVID-19 Pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has increased the already high levels of stress that higher education students experience. Stress influences health behaviors, including those related to dietary behaviors, alcohol, and sleep; yet the effects of stress can be mitigated by resilience. To date, past research studying the connections between dietary behaviors, alcohol misuse, sleep, and resilience commonly investigated singular relationships between two of the constructs. The aim of the current study was to explore the relationships between these constructs in a more holistic manner using mediation and moderation analyses. METHODS: Higher education students from China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands, and the United States were enrolled in a cross-sectional study from April to May 2020, which was during the beginning of the COVID-19 pandemic for most participants. An online survey, using validated tools, was distributed to assess perceived stress, dietary behaviors, alcohol misuse, sleep quality and duration, and resilience. RESULTS: 2254 students completed the study. Results indicated that sleep quality mediated the relationship between perceived stress and dietary behaviors as well as the relationship between perceived stress and alcohol misuse. Further, increased resilience reduced the strength of the relationship between perceived stress and dietary behaviors but not alcohol misuse. CONCLUSION: Based on these results, higher education students are likely to benefit from sleep education and resilience training, especially during stressful events.

Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk.

Health behaviors of higher education students can be negatively influenced by stressful events. The global COVID-19 pandemic presents a unique opportunity to characterize and compare health behaviors across multiple countries and to examine how these behaviors are shaped by the pandemic experience. Undergraduate and graduate students enrolled in universities in China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands and the United States (USA) were recruited into this cross-sectional study. Eligible students filled out an online survey comprised of validated tools for assessing sleep quality and duration, dietary risk, alcohol misuse and physical activity between late April and the end of May 2020. Health behaviors were fairly consistent across countries, and all countries reported poor sleep quality. However, during the survey period, the COVID-19 pandemic influenced the health behaviors of students in European countries and the USA more negatively than Asian countries, which could be attributed to the differences in pandemic time course and caseloads. Students who experienced a decline in sleep quality during the COVID-19 pandemic had higher dietary risk scores than students who did not experience a change in sleep quality (p = 0.001). Improved sleep quality was associated with less sitting time (p = 0.010). Addressing sleep issues among higher education students is a pressing concern, especially during stressful events. These results support the importance of making education and behavior-based sleep programming available for higher education students in order to benefit students' overall health.

Increased Resilience Weakens the Relationship between Perceived Stress and Anxiety on Sleep Quality: A Moderated Mediation Analysis of Higher Education Students from 7 Countries.

High levels of perceived stress and anxiety among university students are a global concern and are known to negatively influence sleep. However, few studies have explored how stress response styles, like psychological resilience and rumination, might alter these relationships. Using validated tools, perceived stress, anxiety, stress response styles, and sleep behaviors of undergraduate and graduate students from seven countries during the height of the COVID-19 pandemic were characterized in order to examine the relationships between these factors using mediation and moderation analyses. Students enrolled in universities in China, Ireland, Malaysia, Taiwan, South Korea, the Netherlands, and the United States were recruited in May 2020. A total of 2254 students completed this cross-sectional study. Perceived stress and anxiety were negatively associated with sleep quality through the mediation of rumination. Increased psychological resilience weakened the relationships between perceived stress and anxiety on sleep quality. The majority of students reported that COVID-19 negatively influenced their mental health and sleep quality but not sleep duration. Based on these results, university students would likely benefit from sleep education and mental health promotion programs that include trainings to increase psychological resilience and reduce rumination, particularly during times of increased stress.

A Humanities-Based Explanation for the Effects of Emotional Eating and Perceived Stress on Food Choice Motives during the COVID-19 Pandemic.

Perceived stress affects emotional eating and food choices. However, the extent to which stress associates with food choice motives is not completely understood. This study assessed whether emotional eating mediates the associations between perceived stress levels and food choice motives (i.e., health, mood, convenience, natural content, price, sensory appeal, familiarities, weight control, and ethical concerns) during the Coronavirus Disease 2019 pandemic. A total of 800 respondents were surveyed in the United States in June 2020. Their perceived stress, emotional eating, and food choice motives were assessed by the Perceived Stress Scale, Dutch Eating Behavior Questionnaire, and Food Choice Questionnaire, respectively. Moderate to high levels of perceived stress were experienced by the majority (73.6%) of respondents. Perceived stress was significantly correlated with emotional eating (r = 0.26) as well as five out of nine food choice motives: mood (r = 0.32), convenience (r = 0.28), natural content (r = -0.14), price (r = 0.27), and familiarity (r = 0.15). Emotional eating was significantly correlated with four out of nine food choice motives: mood (r = 0.27), convenience (r = 0.23), price (r = 0.16), and familiarity (r = 0.16). The mediation analyses showed that emotional eating mediates the associations between perceived stress and five food choices motives: mood, convenience, sensory appeal, price, and familiarity. Findings were interpreted using theories and concepts from the humanities, specifically, folklore studies, ritual studies, and symbolic anthropology.

Animated Case Study Videos: A Creative Approach for Exploring Health in the High School to College Transition.

While the college years present an ideal time for chronic disease prevention, students often do not seek services or perceive themselves to be at health risk. Researchers at Bowling Green State University have been exploring the health patterns of first-year university students for several years, initially as a health-based research study (August 2012 to May 2016) and currently through a first-year seminar course for students transitioning from high school to college (August 2016 to present). This article describes the evolution of data sharing techniques from passively presented paper feedback sheets (focusing on individual health assessments) to highly interactive classroom discussions stemming from viewings of animated case study videos (designed based on whole group themes). Qualitative feedback from students and faculty has been positive, suggesting that animated case study videos are an effective strategy for engaging students in critical thinking about physical and mental health concerns affecting their peer group. Practical recommendations for using animated case studies in diverse educational settings are provided.

Weight gain in first-semester university students: Positive sleep and diet practices associated with protective effects.

For university students, alterations in sleep and diet quality are common, and the propensity for weight gain is well established. The role of sleep duration during periods of rapid weight gain is understudied. This study explored the relationships between sleep duration, diet patterns, and body composition in first-year university students. Data collection occurred during the beginning of the fall (August) and spring semesters (January). Anthropometric measures included weight, height, and percent body fat (%BF). Survey questions assessed sleep and diet quality. As a group, participants (N = 60) gained weight (1.8 ±â€¯2.1 kg) over the 4.5-month period of study. Hierarchical cluster analysis (HCA) identified three groups based on weight change between baseline and follow-up visits. Group 1 ("maintainers") (N = 21) gained 0.1 ±â€¯1.3 kg, group 2 ("modest gainers") (N = 24) gained 2.0 ±â€¯1.7 kg, and group 3 ("major gainers") (N = 15) gained 3.8 ±â€¯1.8 kg. No differences in weight, body mass index (BMI), %BF, or average sleep duration existed between clusters at baseline. Minimal differences in baseline dietary behaviors between groups were noted other than maintainers used more fat, e.g., butter, to season vegetables, bread, and potatoes compared to modest gainers (p = .010). At follow-up, sleep duration significantly decreased from baseline among major gainers (7.1 ±â€¯0.7 vs. 6.8 ±â€¯0.7 h, p = .017) while sleep duration increased from baseline among maintainers (7.3 ±â€¯0.9 vs. 7.6 ±â€¯1.0 h, p = .048). Sleep duration at follow-up was significantly shorter among major gainers compared to maintainers (p = .016). Total diet scores for maintainers and modest gainers improved between visits (p = .038 and 0.002, respectively) but did not change among major gainers. Combining sleep and diet education may increase the effectiveness of interventions designed to mitigate weight gain in this high-risk population.

Comparison of Body Composition Measurements in Lean Female Athletes.

This study compared body composition measurements in lean female athletes. The primary objective was to compare the accuracy of percent body fat (%BF) determined by bioelectrical impedance analysis (BIA), air-displacement plethysmography (ADP), and underwater weighing (UWW) in female Division I cheerleaders (n = 10 bases, 6 back-spots, and 12 flyers) from two universities. The secondary objective was to compare health risk predicted by %BF to body mass index (BMI) categorizations. UWW was considered the gold standard for assessing %BF. Pearson correlation coefficients were used to determine associations between methods. Repeated measures analysis of variance was used to identify differences in %BF by method. BIA, ADP, and UWW were highly correlated (r ≥ .828, p < .001 for all). However, %BF by BIA (20.0 ± 5.2%) and ADP (19.3 ± 6.0%) was higher than %BF by UWW (15.9 ± 4.1%, p < .001). Health risk was predicted less often when classified based on very lean (risky low) %BF levels by BIA and ADP than UWW (7.1%, 3.6%, and 21.4%, respectively). This finding suggests that, similar to female track-and-field athletes who also exhibit lean muscular physiques, %BF is overestimated by BIA and ADP in female cheerleaders and health risk associated with low %BF is underestimated when compared to UWW. In contrast, BMI was not associated with %BF by any method and no participants were classified as underweight by this measure. Thus, BMI should not be used to predict health risk in lean female athletes, such as collegiate cheerleaders.

First-Year University Students Who Self-Select into Health Studies Have More Desirable Health Measures and Behaviors at Baseline but Experience Similar Changes Compared to Non-Self-Selected Students.

Studies demonstrate that first-year university students are at high risk for weight gain. These reports typically rely on self-selected participants. The purpose of this study was to explore if students who chose to participate in a health-based research study had more desirable health measures and behaviors than students who completed health assessments as part of a first-year seminar course. Health measures included blood pressure (BP), body mass index (BMI), and percent body fat. Health behaviors included dietary patterns (Starting the Conversation questionnaire) and alcohol use (Alcohol Use Disorders Identification Test-Consumption). A total of 191 (77% female) participants completed testing in the self-selected "Health Study" group, whereas 73 of the 91 students (80%, 55% female) enrolled in the "Seminar" allowed their data to be used for research purposes. Baseline measures favored Health Study participants, including but not limited to fewer participants with undesirable BMI (≥25.0 kg/m²; males and females) and a smaller percentage of participants with undesirable BP (systolic ≥120 mmHg and/or diastolic ≥80 mmHg; females only). Differences in dietary behaviors at baseline were inconsistent, but Seminar students engaged in more problematic alcohol-use behaviors. While both groups experienced undesirable changes in health measures over time, the degree of change did not differ between groups. Changes in health behaviors over time typically resulted in undesirable changes in the Seminar group, but the magnitude of change over time did not differ between groups. Thus, results from first-year university students who self-select into health studies likely underestimate the seriousness of undesirable health measures and behaviors but may accurately reflect the degree of change over time.

Relationship Between Body Fat and Physical Fitness in Army ROTC Cadets.

The Army Physical Fitness Test (APFT), including timed push-ups, sit-ups, and run, assesses physical performance for the Army. Percent body fat is estimated using height and circumference measurements. The objectives of the study were to (a) compare the accuracy of height and circumference measurements to other, more accepted, body fat assessment methods and (b) determine the relationships between body composition and APFT results. Participants included Reserve Officer Training Corps (ROTC) cadets (n = 11 males, 2 females, 21.6 ± 3.5 years) from a midwestern university). At one visit, percent body fat was assessed using height and circumference measurements, air-displacement plethysmography, and bioelectrical impedance analysis. APFT results were provided by the ROTC director. All assessment methods for percent body fat were strongly associated (r ≥ 0.7, p < 0.01), implying that height and circumference measurement is a practical tool to estimate percent body fat of ROTC cadets. Total APFT score was not associated with any body fat assessment method. Push-up number was negatively associated with percent body fat by all assessment methods (r ≥ -0.8, p = 0.001), although run time was positively associated (r ≥ 0.6, p < 0.05). This suggests that percent body fat may be an important variable in determining or improving cardiovascular and muscular endurance, but not APFT performance.

Validation of Self-Reported Anthropometrics in Female College Freshmen.

Most investigations concerning the validity of self-reported anthropometrics focus on weight, height, and body mass index. This study extends those investigations by exploring the impact of self-reporting bias on the disease risk indicators of waist circumference and body fat percentage. Female college freshmen (n=128) self-reported weight and height, then underwent measurements for weight, height, waist circumference, and body fat percentage. Self-reporting bias was defined as self-reported minus directly-assessed anthropometric value. Despite no differences in self-reported versus directly-assessed weight or height for the total group, students with high waist circumference and excess fat under-reported their weight by 2.3±4.4 lb (p<0.05). Self-reporting bias was negatively correlated with waist circumference (r=-0.362; p<0.001) and body fat percentage (r=-0.317; p<0.001). Although many female college freshmen accurately represent their weight, those with excess fat and waist circumference under-reported their weight. This may lead to missed opportunities for risk identification, prevention, and intervention.

Changes in taste preference and steps taken after sleep curtailment.

A substantial proportion of the population does not achieve the recommended amount of sleep. Previous work demonstrates that sleep alterations perturb energy balance by disrupting appetite hormones, increasing energy intake, and decreasing physical activity. This study explored the influence of sleep duration on taste perception as well as effects on dietary intake and physical activity. Participants (n=24 habitual short sleepers and n=27 habitual long sleepers, 82.4% female, 88.2% white, 25.2±7.7years) completed two randomized taste visits; one following short sleep duration (≤7h) and one following long sleep duration (>7h). Taste perception measures included sweet and salt detection thresholds (ascending 3-alternative, forced-choice method), as well as sweet preference (Monell 2-series, forced-choice, paired-comparison, tracking method). Steps and sleep were tracked via FitBit, an activity monitoring device. Dietary intake was assessed using 24-hour recalls and analyzed using Nutritionist Pro. Habitual long-sleepers had a higher sweet taste preference (p=0.042) and took fewer steps (p=0.036) following sleep curtailment compared to the night where they slept >7h but did not experience changes in dietary intake or detection thresholds. Habitual short-sleepers did not experience changes in taste perception, activity, or dietary intake following sleep alteration. Habitual long-sleepers may be at greater risk of gaining weight when typical sleep patterns are disrupted.