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Article

How COVID-19 Pandemic Restrictions Affected Kuwaiti College Students’ Anthropometry, Lifestyle Behaviors, and Dietary Habits

by
Ahmad R. Al-Haifi
1,
Nayef Y. Bumaryoum
1,
Balqees A. Al-Awadhi
1,
Fahad A. Alammar
1,*,
Bader N. Alkhalaf
2 and
Hazzaa M. Al-Hazzaa
3
1
Department of Food and Nutrition Science, College of Health Sciences, The Public Authority for Applied Education & Training, Shuwaikh 70654, Kuwait
2
Department of Environmental Health, College of Health Sciences, The Public Authority for Applied Education & Training, Shuwaikh 70654, Kuwait
3
Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh 11546, Saudi Arabia
*
Author to whom correspondence should be addressed.
Nutrients 2023, 15(22), 4773; https://doi.org/10.3390/nu15224773
Submission received: 25 September 2023 / Revised: 3 November 2023 / Accepted: 10 November 2023 / Published: 13 November 2023

Abstract

:
The COVID-19 pandemic and the measures implemented to control it have led to widespread lifestyle changes globally. While previous studies have explored these effects across different age groups, this research focuses uniquely on college students in Kuwait. A cross-sectional study (N = 1259) was conducted among college students using a validated online questionnaire covering various aspects, including demographics, academic performance, self-reported body weight and height, sleep duration, dietary habits, and physical activity. There were equal proportions of individuals reporting decreased, increased, or no change in body weight, BMI, and dietary habits due to COVID-19, with no significant gender differences observed. A higher decrease (44.3%) than increase (29.2%) occurred due to COVID-19 in the proportion of college students engaging in physical activity. Significant differences were found in the students’ responses to most of the eating behavior questions, concerning the changes attributable to the COVID-19 pandemic restrictions. Multivariable analysis showed significant interaction effects for gender by losing above 9 kg during the last 6 months in age (p = 0.037), total physical activity in METs-min/week (p = 0.048), and cake/donuts intake (p = 0.006). Logistic regression analysis, adjusted for age, revealed that a decrease in BMI was associated with an increase in daily vegetable intake (aOR = 1.531, p = 0.031), whereas increases in BMI were associated with an increased intake of sugar-sweetened drinks equal to or above 4 days/week (aOR = 1.551, p = 0.032) and increased chocolates/candy intake equal to or above 4 days/week (aOR = 1.792, p = 0.037). It was concluded that, in response to a major epidemic, such as COVID-19, college students, as a population, are susceptible to significant changes in lifestyle and eating behaviors that can impact their health and well-being. Future risks for college students’ health can be reduced through appropriate lifestyle interventions.

1. Introduction

The coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization in March 2020 [1]. As of 26 August 2023, it had resulted in a staggering global toll of 6.9 million deaths and 770 million reported cases [1]. To mitigate the rapid spread of the virus and its associated morbidity and mortality rates, governments worldwide swiftly implemented a range of measures, including total or partial lockdowns, quarantines, social distancing mandates, and the closure of schools and workplaces [2].
While the impact of such measures was felt across all age groups, children and adolescents emerged as particularly vulnerable to the mental health challenges brought about by the pandemic [3,4,5]. The disruptions to their usual routines, physical activity, and social interactions, coupled with the stress and uncertainty of the situation, placed students at an increased risk for various psychological issues. It is reasonable to hypothesize that these psychological challenges may have contributed to the changes observed in lifestyle, eating behaviors, and BMI, which are the focus of this research [6]. Numerous studies have reported a surge in negative emotional states among young adults, including heightened levels of anxiety, loneliness, stress, anger, irritability, psychological distress, and depressive symptoms [7,8]. Furthermore, there has been a notable increase in body mass index (BMI) and higher rates of overweight among this demographic [9]. Individuals with pre-existing eating disorders have been especially impacted, with a concerning 41% experiencing a reactivation of their symptoms during lockdowns [8].
Across the globe, the COVID-19 pandemic has influenced many aspects of people’s lives such as their health, body weight, education, social life, and lifestyles behaviors [10,11,12]. Studies conducted in neighboring countries, such as Jordan [9] and Saudi Arabia [13,14], observed similar trends, further emphasizing the regional relevance and importance of this issue. As a consequence of COVID-19, physical activity was impacted with a drastic reduction in exercising, walking, and bicycling for transportation and leisure [15,16]. In addition, as a result of at-home confinement, sedentary behavior frequently replaced time spent in physical activity [16].
College students are generally sociable human beings, and, therefore, the period of social isolation during the COVID-19 lockdowns is considered a major factor that can impact their lifestyle and eating behaviors [12,15,17]. In addition, the closure of universities and the introduction of online teaching definitely disrupted their usual daily routines, added more anxiety and stress to their lives, and may have negatively influenced their mental health and well-being [18]. Hence, it was particularly important to maintain a healthy lifestyle and well-adjusted eating habits during this critical period of the pandemic.
Furthermore, the impacts of COVID-19 on lifestyle behaviors may vary from country to country due to differences in the cultural, social, economic, and types of healthcare systems [11,12,19]. In addition, some recent studies observed gender-related health risk differences as a result of COVID-19 pandemic restrictions [20,21].
In the State of Kuwait, there is limited research examining the impacts of the COVID-19 pandemic on body weight and lifestyle behaviors, including physical activity levels, screen time, sleep, and dietary habits. Therefore, the aim of this study was to evaluate the impact of the COVID-19 pandemic restrictions on self-reported body weight, sleep duration, lifestyle behaviors, eating habits, and academic achievement among college students in Kuwait. Moreover, our study aimed to identify and compare gender differences between male and female students in the measured variables, providing insights into how the pandemic affected each group. Previous research indicated that the pandemic’s effects may vary based on gender [20,21].

2. Materials and Methods

2.1. Sample and Design

This cross-sectional study was conducted in Kuwait over a 4-month period from November 2020 to February 2021. Ethical approval was secured from the Institutional Review Board (IRB) at the College of Health Sciences in Kuwait. The sample size was calculated with the assumption that the population proportion would yield the maximum possible sample size required (proportion = 0.50), with a confidence level of 95% and a margin of error of 4%. An additional 20% of participants were added to account for non-responders or missing data. The total sample size for each gender was calculated to be 480, with 960 students in total.
An online questionnaire was answered by college students attending various colleges across the university (under the Public Authority of Applied Education and Training (PAAET) in Kuwait). The questionnaire was distributed to students electronically, given the restrictions imposed by the pandemic. Participants were provided with clear instructions on how to complete the questionnaire online. The recruitment process involved contacting the colleges’ administrations to post the recruitment letter along with the online questionnaire on the colleges’ internet sites; teachers who were teaching online were asked by the colleges to advise interested students to participate in the survey. Before completing the questionnaire, students were informed of the study objectives and procedures and consented to participate in the study. The inclusion criteria were college students (males and females), above 17 years old, without having any disease that prevents him/her from freely moving, and that the participant was free of any nutritional disorders.

2.2. Questionnaire and Data Collection

The questionnaire was composed of demographic variables (gender and age,) self-reported body weight (kg) and height (cm), marital status, governorate name, the student’s college, the college grade point average (GPA), the high school grade, as well as the lifestyle behaviors items. The lifestyle behaviors questionnaire included questions on physical activity, screen time, sleep duration, and dietary habits. The lifestyle questionnaire was previously validated for adolescents and young people and was previously published [22,23,24,25]. The physical activity questionnaire collected extensive data about the time and frequency of engaging in a variety of activities related to light-, moderate-, and vigorous-intensity physical activities in different domains (leisure-type, sports, transportation like walking, and household activities). Then, the activity was assigned a metabolic equivalent of task (MET) based on the Compendium of Physical Activities. Physical activity then was reported either in minutes per week or as activity energy expenditure in METs-min/week.
Body mass index (BMI) was calculated from weight and height data. Students were also asked about their weight and height both before and during the COVID-19 pandemic. This enabled us to assess changes in BMI and body weight during the pandemic period. The current data used in the present study were part of a prior research project [26].

2.3. Statistical Analysis

Data were entered into an SPSS data file, checked, cleaned, and analyzed using the SPSS program, version 22 (IBM, Chicago, IL, USA). Descriptive statistics were calculated and presented as means and standard deviations (SD) or proportions. Cross tabulation with chi-square tests was used to calculate the proportion (%) of changes due to COVID-19 (before versus during the pandemic) in anthropometric measurements, lifestyle factors, and eating behaviors among the college students relative to gender. We also used multivariable analysis to test the differences in the characteristics of those college students who lost 9 kg or more during the last 6 months of COVID-19 relative to gender (the eating-related items contained a question asking about this issue). Bonferroni tests were used for testing between-subjects’ effects. In addition, logistic regression analysis was used to test the associations of selected demographic and lifestyle behaviors relative to changes in BMI status due to COVID-19 among the college students, while adjusted for age. An alpha level of ≤0.05 was used as the level of significance.

3. Results

The anthropometric characteristics of the participating college students, categorized by gender, are summarized in Table 1. The study included a total of 1259 participants, comprising 54.1% females, with a mean age (SD) of 21.5 (3.1) years. No significant age differences relative to gender were observed (p = 0.133). However, significant gender differences were noted in body weight, height, and body mass index (BMI), with males exhibiting higher values (p < 0.001). Additionally, more than 10% of the participants were married. The prevalence of overweight or obesity stood at 42%, with males having a significantly higher rate than females (p < 0.001).
Table 2 presents the proportions (%) of changes in anthropometric and lifestyle factors among Kuwaiti college students due to COVID-19, categorized by gender. Notably, there were relatively equal proportions of individuals reporting decreased, increased, or no change in body weight, BMI, and dietary habits due to COVID-19, with no significant gender-based differences observed in the proportions of changes (decrease, increase, or no change) in body weight (p = 0.376), BMI (p = 0.417), or dietary habits (p = 0.133). However, more decrease (44.3%) than increase (29.2%) occurred due to COVID-19 in the proportion of Kuwaiti college students engaging in physical activity, with no gender difference (p = 0.767). Table 2 provides a detailed breakdown of these changes.
The proportional changes (%) in eating behaviors among college students resulting from the COVID-19 pandemic and associated restrictions are outlined in Appendix A. As indicated in the table, significant differences were found in the students’ responses to most of the eating behavior questions (26 items) concerning the changes attributable to the COVID-19 pandemic restrictions. However, there were no significant differences in the following questions relative to students’ responses (not included in Table 3): I feel that those around me would like me to eat more (p = 0.224), I throw up after eating foods (p = 0.574), I take more time than others when eating my meals (p = 0.478), I feel that those around me push me to eat (p = 0.582), Foods occupy my time and thinking (p = 0.358), I like to have empty stomach (p = 0.060), and I feel the urge to throw up after eating meals (p = 0.962).
The results of the multivariable analysis, displayed in Table 3, focus on the characteristics of college students who reported losing 9 kg or more during the last 6 months of the COVID-19 pandemic. Significant interaction effects were observed for gender by losing above 9 kg during the last 6 months in age (p = 0.037), total physical activity in METs-min/week (p = 0.048), and cake/donuts intake (p = 0.006). Additionally, the significant, main effects of losing above 9 kg during the last 6 months were noted in several variables including body weight (p < 0.001), BMI (p < 0.001), total physical activity (p < 0.001), moderate-intensity physical activity (p < 0.001), vigorous-intensity physical activity (p < 0.001), as well as intakes of vegetables (p = 0.004), fruits (p < 0.001), sugar-sweetened drinks (p = 0.023), fast foods (p = 0.001), French fries/potato chips (p = 0.006), chocolates/candy (p = 0.003), and energy drinks (p = 0.012). Furthermore, college GPA was also significantly associated with this category (p = 0.010).
Table 4 shows the results of logistic regression analysis, adjusted for age, which explores the relationship between selected demographic and lifestyle behaviors and changes in BMI status due to the COVID-19 pandemic among college students. A decrease in BMI of 53% was associated with an increase in daily vegetable intake (aOR = 1.531, p = 0.031), whereas increases in BMI of 55% and 79% were associated, respectively, with an increased intake of sugar-sweetened drinks equal to or above 4 days/week (aOR = 1.551, p = 0.032) and increased chocolates/candy intake of equal to or above 4 days/week (aOR = 1.792, p = 0.037).

4. Discussion

The COVID-19 pandemic and the subsequent measures, including lockdowns and social distancing, had profound effects on individuals’ lifestyles and behaviors across the globe. While previous research predominantly focused on specific age groups such as children, adolescents, and adults, our study uniquely examined the impact of the COVID-19 pandemic on college students’ body weight, lifestyle behaviors, and eating habits.

4.1. Impact on Body Weight and BMI

Although nearly one-third of the students in our study experienced an increase in body weight and BMI due to the lockdowns and quarantine measures, the overall findings did not show significant differences among those who increased, decreased, or maintained their body weight. However, the COVID-19 lockdown resulted in weight gain among Jordanian children and adolescents [9,27]. Additionally, among Malaysian university students, there was a weight gain of about 3.4 kg after the first month of the COVID-19 lockdown [17]. Similarly, two systematic reviews and meta-analyses examining nearly 100 studies indicated that during the COVID-19 pandemic lockdowns there were increases amounting to 11.1–72.4% in body weight among young adults in these studies [28,29]. It was believed that the main cause of increased body weight among individuals during COVID-19 lockdowns was the move to online education, which involved higher screen time and long sitting hours along with increased food consumption and snacking [17,28,29,30]. Also, with lower physical activity levels, lower diet quality, and more frequent overeating, there was a higher chance of increased BMI [31].

4.2. Changes in Lifestyle Behaviors and Eating Habits

The present findings regarding changes in lifestyle behaviors and eating habits align with those observed in various studies conducted during the pandemic [27,32,33,34]. Furthermore, our research highlights significant changes in eating habits. Increased consumption of unhealthy foods and snacks was prevalent among our participants, which is in line with findings from various international and regional studies [32,33,34]. Moreover, the findings of the current study appeared consistent with similar findings worldwide indicating that the COVID-19 pandemic had profound effects on lifestyle and eating habits. A study carried out on Portuguese university students showed that healthier eating habits were adopted by the students during the lockdown period compared to a typical semester period. Such healthier behaviors included reduced meal delivery, a lower intake of sugar, salt, and fast food, as well as higher engagement in physical activities and more consumption of fruits, vegetables, and legumes [35]. The decreased physical activity levels observed in our study, especially among females, are consistent with global trends during the pandemic [27,32,33,34]. Nevertheless, contrary to many other studies’ findings, studies from Italy [36] and Portugal [10] found a greater adherence to engaging in physical activity during the lockdown period.
The above changes, due to the COVID-19 lockdown, can be attributed to various factors such as increased stress, boredom, and greater access to unhealthy foods at home [37]. The absence of social interaction, especially among young college students, could lead to increased stress, anxiety, and even depression [18]; such feelings of isolation might elicit emotional eating in order to relieve adverse feelings [38].
Notably, our study indicates that most participants reported changes in eating habits, underscoring the widespread impact of the pandemic on dietary behaviors. Lockdown can bring about some healthy eating behaviors. Eating habits of college students from Tabriz (Iran) were characterized by an increase in a regular meal pattern and balanced diet, milk or its products, and egg or meat in the diet, as well as by a reduction in fast food intake, fried food, potato chips, and sugar-sweetened drinks. However, the students reported increases in weight gain, screen and sitting time, and sleep duration, as well as declined physical activity and higher stress or anxiety levels during the COVID-19 pandemic [37]. Similar studies carried out in Italy, Spain, Romania, and Latin America showed some improvement in dietary habits including an increased intake of fruits, vegetables, yogurt, legumes, and eggs during the lockdown period [36,39,40,41].
The findings of the present study do not agree with results found in a study conducted on adults from the UK, which showed a higher number of participants reporting more negative changes in their eating habits, including more frequent snacking, during the COVID-19 confinement compared to the pre-lockdown period [30]. In addition, a Portuguese study, conducted on adults, observed that the majority of the participants consumed more foods rich in fat and salt and sugar-sweetened beverages during the restriction period compared to pre-pandemic [10].

4.3. Sleep Patterns and Academic Achievement

Sleep duration, an essential component of overall health, also experienced alterations during the pandemic. We observed that a substantial number of students reported shifts in their sleep patterns, with many experiencing later bedtimes and wake times. This pattern mirrors the changes in daily routines brought about by remote learning and reduced social commitments, as seen in other studies [32,33]. Despite that, our findings did not show any significant changes in sleep duration relative to a decrease or increase in weight or BMI. However, the interaction of sleep duration, BMI, and lifestyle factors is quite complex, as exhibited in our current study.
Our findings on academic achievement reveal a mixed picture. While some students reported improvements in academic performance due to the flexibility of online learning, others experienced challenges related to motivation and concentration. These variations may be attributed to individual differences in adapting to remote learning environments as well as the overall impact of the pandemic on mental health and stress levels [7,8,34].

4.4. Gender Differences

Aside from the pandemic, it is well recognized that women on average report more physical and mental unhealthy days per year than men [42]. However, reports indicate that women are at a reduced risk of severe disease and death with SARS-CoV-2 infection than men [43,44]. Gender differences in our study show that there were greater changes among females in their body weight, physical activity, and sleep patterns. These gender differences align with the observations made by Al Hourani et al., who noted significant increases in body weight among females [27]. In addition, recent studies observed some differences in gender-related health risks resulting from COVID-19 pandemic restrictions [20,21]. Further, the psychological abuse of women as a type of violence reportedly increased significantly during the lockdown [45].

4.5. Strengths, Limitations, and Future Research

The current research strengths included a large sample of male and female college students from a variety of colleges and the use of a validated lifestyle questionnaire. However, our study is not without limitations. One notable limitation is the use of self-reported data for variables such as body weight and height, which may introduce reporting bias due to a social desirability effect. Additionally, there is a small chance that the sample may not be fully representative of all Kuwaiti college students, although we targeted all college students when recruiting participants.
Future research could involve more objective measures, such as clinical assessments of body composition and the use of accelerometers for the assessment of physical activity, sedentary behaviors, and sleep, to mitigate the limitations associated with self-reported data. Longitudinal studies are also warranted to assess the long-term consequences of the observed lifestyle changes and their impact on the health and well-being of college students.

5. Conclusions

As the result of a major epidemic, such as COVID-19 restrictions, college students appear to be susceptible to significant changes in lifestyle and eating behaviors that can impact their health and well-being. To the best of our knowledge, the current research is the first study that reported about the effects of the COVID-19 pandemic on body weight, lifestyle behaviors, and eating habits among college students in the State of Kuwait using a fairly large and representative sample. The COVID-19 pandemic has profoundly impacted the lives of college students in Kuwait, manifesting in significant changes in anthropometry, lifestyle behaviors, and dietary habits. This study, despite its local focus, contributes to the growing body of literature on the pandemic’s effects, emphasizing the need for tailored interventions and ongoing research. The pandemic’s influence on body weight and BMI is evident, with nearly 30% of college students showing an increase in body weight and BMI. Reduced physical activity levels, dietary changes, disrupted sleep patterns, and variations in academic performance further underscore the comprehensive impact.
Future risks for college students’ health can be reduced through appropriate lifestyle interventions, hence, promoting healthier lifestyle behaviors and dietary habits among college students during crises. These interventions should be multidimensional, addressing not only the physical health but also the psychosocial well-being of students. While our research provides valuable insights into the specific context of Kuwaiti college students, more extensive investigations are warranted to explore the underlying mechanisms and long-term implications of these changes. Collaboration among policymakers, educators, healthcare professionals, and parents is essential to foster a healthier environment for college students amid and beyond the pandemic.

Author Contributions

Conceptualization, A.R.A.-H., H.M.A.-H. and N.Y.B.; methodology, A.R.A.-H., H.M.A.-H. and B.A.A.-A.; software, H.M.A.-H. and B.N.A.; validation, A.R.A.-H., N.Y.B. and B.N.A.; formal analysis, B.A.A.-A. and F.A.A.; investigation, A.R.A.-H., N.Y.B., F.A.A. and B.N.A.; resources, N.Y.B. and B.N.A.; data curation, H.M.A.-H. and B.N.A.; writing—original draft preparation, H.M.A.-H. and F.A.A.; writing—review and editing, A.R.A.-H. and F.A.A.; visualization, A.R.A.-H., H.M.A.-H., N.Y.B. and B.N.A.; supervision, A.R.A.-H. and N.Y.B.; project administration, A.R.A.-H., B.N.A. and N.Y.B. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The Ministry of Education and the Institutional Review Board (IRB) at the College of Health Sciences in Kuwait approved the study protocol (Code: 1-2/2020; 10 September 2020) before starting data collection.

Informed Consent Statement

The Ministry of Education and the Institutional Review Board (IRB) at the College of Health Sciences in Kuwait approved the study protocol before starting data collection. Dr. Ahmad and contributing authors give consent for the above manuscript to be published in Nutrients Special Issue “Body Weight and Food/Eating-Related Behaviors during COVID-19 Pandemic, Traumatic or Stressful Life Events”.

Data Availability Statement

Data are contained within the article.

Acknowledgments

We would like to thank all the participants for taking part in this study.

Conflicts of Interest

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Appendix A

Table A1. Responses to questions related to eating behaviors as a result of changes in body weight due to COVID-19 among Kuwaiti college students.
Table A1. Responses to questions related to eating behaviors as a result of changes in body weight due to COVID-19 among Kuwaiti college students.
VariableResponse ChoiceChange in Weight Due to COVID-19 (%)p-Value
Decreased
N = 432
Increased
N = 344
No Change
N = 483
I am scared of being overweightNever12.516.329.4<0.001
Rarely6.58.414.7
Occasionally19.216.0 14.3
Mostly22.024.717.6
Always39.834.6 24.0
I avoid eating if I am hungryNever27.818.631.10.001
Rarely20.817.220.1
Occasionally26.934.622.8
Mostly19.723.321.7
Always4.96.44.3
I have difficulty stopping eatingNever26.635.849.1<0.001
Rarely17.825.917.4
Occasionally23.817.715.1
Mostly15.813.113.0
Always13.27.65.4
I eat my meals as several small snacksNever39.828.531.70.005
Rarely18.318.917.8
Occasionally21.120.123.4
Mostly12.319.518.4
Always8.613.18.7
I know the calories of my eaten foodsNever51.631.149.3<0.001
Rarely14.414.012.6
Occasionally13.918.912.8
Mostly13.019.215.9
Always7.216.99.3
I avoid carbohydrate-rich foods (like bread, potato, and rice)Never42.433.445.30.003
Rarely16.916.014.7
Occasionally20.620.315.9
Mostly14.619.818.4
Always5.610.55.6
I feel guilty after eatingNever32.232.655.1<0.001
Rarely13.413.412.0
Occasionally18.822.711.0
Mostly16.017.212.2
Always19.714.29.7
I am obsessed with the desire to be thinNever16.420.344.3<0.010
Rarely6.57.68.3
Occasionally13.713.711.6
Mostly15.017.713.9
Always48.440.721.9
I think about burning calories when doing exerciseNever14.616.932.5<0.001
Rarely7.94.46.6
Occasionally12.011.013.5
Mostly24.521.220.3
Always41.046.527.1
People think I am very skinnyNever35.931.126.30.035
Rarely10.612.89.9
Occasionally16.916.015.9
Mostly19.019.822.6
Always17.620.325.3
I am obsessed with the idea that I have fats in my bodyNever14.115.730.6<0.001
Rarely9.06.110.8
Occasionally15.518.316.6
Mostly22.223.318.2
Always39.136.623.8
I avoid foods with sugar Never29.218.033.5<0.001
Rarely18.813.117.2
Occasionally27.827.623.0
Mostly17.625.619.5
Always6.715.76.8
I eat diet foodsNever39.128.241.4<0.001
Rarely16.714.516.8
Occasionally24.121.219.0
Mostly16.223.316.8
Always3.912.86.0
I feel that diet is controlling my lifeNever26.426.537.20.001
Rarely10.911.612.2
Occasionally17.420.116.8
Mostly25.219.519.9
Always20.122.414.1
I can control myself in front of foodsNever20.811.924.20.001
Rarely11.111.910.8
Occasionally25.021.519.7
Mostly26.931.724.6
Always16.223.020.7
I do not feel comfortable after eating sweetsNever30.327.034.20.007
Rarely14.613.415.3
Occasionally22.020.318.2
Mostly13.720.620.1
Always19.418.612.2
I practice certain dietary behaviorsNever43.130.851.1<0.001
Rarely14.613.112.2
Occasionally19.215.714.1
Mostly16.024.114.1
Always7.216.38.5
I enjoy eating new fatty foodsNever5.25.66.80.020
Rarely16.021.814.7
Occasionally21.521.825.5
Mostly25.721.222.2
Always21.814.820.5

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Table 1. Descriptive characteristics of the participating college students.
Table 1. Descriptive characteristics of the participating college students.
VariableAll
N = 1259
Male
N = 577
Female
N = 682
p-Value *
Age (year)21.5 ± 3.121.7 ± 3.121.4 ± 3.10.133
Body weight (kg)69.5 ± 19.778.7 ± 21.261.6 ± 14.3<0.001
Body height (cm)165.9 ± 9.8174.1 ± 6.7158.9 ± 6.0<0.001
Body mass index (kg/m2)25.1 ± 6.325.9 ± 7.024.3 ± 5.5<0.001
Data are means ± standard deviations; * t-test for independent samples for the differences between males and females.
Table 2. Changes (%) in anthropometric and lifestyle factors due to COVID-19 among Kuwaiti college students.
Table 2. Changes (%) in anthropometric and lifestyle factors due to COVID-19 among Kuwaiti college students.
VariableChange (%) *All
N = 1259
Male
N = 577
Female
N = 682
p-Value **
Body weightDecrease34.334.734.00.376
Increase27.326.228.3
No change 38.439.1 37.7
BMIDecrease34.334.734.10.417
Increase27.226.128.2
No change 38.539.237.7
Physical activity levels Decrease44.343.245.20.767
Increase29.229.628.8
No change 26.527.226.0
Dietary habitsDeteriorated27.925.829.60.133
Improved38.941.836.5
No change 33.232.433.9
* The changes indicate from before to during COVID-19. ** Chi-square tests for the differences in proportions between males and females. Explanation: “Deteriorated” indicates that students reported worsening of dietary habits. “Improved” means students reported better dietary habits. “No Change” implies no significant change in dietary habits.
Table 3. Multivariable analysis of the characteristics of those Kuwaiti college students who lost 9 kg or more during the last 6 months of COVID-19 relative to gender (n = 1188).
Table 3. Multivariable analysis of the characteristics of those Kuwaiti college students who lost 9 kg or more during the last 6 months of COVID-19 relative to gender (n = 1188).
VariableGenderLosing ≥ 9 kg during the Last 6 Monthsp-Value *
NeverYes
Age (years)Male21.4 ± 2.922.1 ± 3.3Losing 9 kg: 0.086
Gender: 0.051
Losing 9 kg by gender interaction: 0.037
Female21.4 ± 3.221.4 ± 3.0
All21.4 ± 3.121.7 ± 3.1
Body weight (kg)Male75.5 ± 20.984.7 ± 20.5Losing 9 kg: <0.001
Gender: <0.001
Losing 9 kg by gender interaction: 0.052
Female59.9 ± 13.864.5 ± 14.5
All66.7 ± 18.974.2 ± 20.3
BMI (kg/m2) Male25.1 ± 6.527.6 ± 6.4Losing 9 kg: <0.001
Gender: <0.001
Losing 9 kg by gender interaction: 0.643
Female23.6 ± 5.225.7 ± 5.5
All24.3 ± 5.826.6 ± 6.0
Screen time (hours/day) Male4.6 ± 3.14.9 ± 3.7Losing 9 kg: 0.988
Gender: <0.001
Losing 9 kg by gender interaction: 0.152
Female5.8 ± 3.85.5 ± 4.2
All5.3 ± 3.65.2 ± 4.0
Sleep duration (hours/night) Male7.4 ± 1.67.2 ± 1.6Losing 9 kg: 0.841
Gender: 0.051
Losing 9 kg by gender interaction: 0.228
Female7.4 ± 1.67.5 ± 1.7
All7.4 ± 1.67.4 ± 1.6
Total physical activity (METs-min/week)Male2376.7 ± 2935.72700.9 ± 2832.1Losing 9 kg: <0.001
Gender: <0.001
Losing 9 kg by gender interaction: 0.048
Female1424.7 ± 1876.22350.6 ± 2416.4
All1840.6 ± 2441.82519.2 ± 2627.4
Moderate-intensity physical activity (METs-min/week)Male579.4 ± 892.5720.5 ± 1014.6Losing 9 kg: <0.001
Gender: <0.001
Losing 9 kg by gender interaction: 0.116
Female782.6 ± 1001.41118.8 ± 1442.3
All693.8 ± 960.1927.1 ± 1154.1
Vigorous-intensity physical activity (METs-min/week)Male1797.4 ± 2405.81980.5 ± 2195.4Losing 9 kg: <0.001
Gender: <0.001
Losing 9 kg by gender interaction: 0.078
Female642.1 ± 1233.91231.7 ± 1611.9
All1146.8 ± 1926.01592.1 ± 1949.1
Breakfast intake (day/week)Male4.0 ± 2.73.9 ± 2.7Losing 9 kg: 0.671
Gender: 0.799
Losing 9 kg by gender interaction: 0.090
Female3.8 ± 2.84.2 ± 2.9
All3.9 ± 2.74.0 ± 2.8
Vegetables intake (day/week) Male4.0 ± 2.54.5 ± 2.4Losing 9 kg: 0.004
Gender: 0.992
Losing 9 kg by gender interaction: 0.578
Female4.0 ± 2.54.4 ± 2.6
All4.0 ± 2.54.4 ± 2.5
Fruit intake (day/week) Male3.0 ± 2.33.5 ± 2.5Losing 9 kg: <0.001
Gender: 0.913
Losing 9 kg by gender interaction: 0.927
Female3.0 ± 2.43.5 ± 2.4
All3.0 ± 2.43.5 ± 2.4
Milk/dairy products intake (day/week) Male4.3 ± 2.54.5 ± 2.5Losing 9 kg: 0.514
Gender: 0.225
Losing 9 kg by gender interaction: 0.833
Female4.2 ± 2.64.3 ± 2.5
All4.3 ± 2.54.4 ± 2.5
Sugar-sweetened drink intake (day/week) Male4.0 ± 2.63.7 ± 2.7Losing 9 kg: 0.023
Gender: <0.001
Losing 9 kg by gender interaction: 0.847
Female3.5 ± 2.53.1 ± 26
All3.7 ± 2.63.4 ± 2.7
Fast food intake (day/week) Male3.4 ± 2.13.1 ± 2.1Losing 9 kg: 0.001
Gender: <0.001
Losing 9 kg by gender interaction: 0.381
Female3.1 ± 2.12.6 ± 1.9
All3.2 ± 2.12.8 ± 2.0
French fries/potato chips intake (day/week) Male2.9 ± 2.12.8 ± 2.1Losing 9 kg: 0.006
Gender: 0.434
Losing 9 kg by gender interaction: 0.071
Female3.1 ± 2.22.5 ± 2.0
All3.0 ± 2.12.6 ± 2.1
Cake/donuts intake (day/week) Male2.3 ± 2.12.4 ± 2.1Losing 9 kg: 0.101
Gender: 0.001
Losing 9 kg by gender interaction: 0.006
Female3.1 ± 2.42.5 ± 2.0
All2.7 ± 2.32.5 ± 2.1
Chocolates/candy intake (day/week)Male3.2 ± 2.43.0 ± 2.4Losing 9 kg: 0.003
Gender: 0.002
Losing 9 kg by gender interaction: 0.074
Female3.9 ± 2.43.2 ± 2.3
All3.6 ± 2.43.1 ± 2.3
Energy drinks intake (day/week) Male1.5 ± 2.22.0 ± 2.4Losing 9 kg: 0.012
Gender: 0.002
Losing 9 kg by gender interaction: 0.364
Female1.2 ± 2.11.5 ± 2.3
All1.4 ± 2.11.7 ± 2.3
High school grade (%) Male75.1 ± 8.475.4 ± 9.2Losing 9 kg: 0.369
Gender: 0.171
Losing 9 kg by gender interaction: 0.146
Female75.2 ± 8.973.9 ± 9.1
All75.1 ± 8.774.6 ± 9.2
College GPA Male3.00 ± 0.562.95 ± 0.60Losing 9 kg: 0.010
Gender: 0.054
Losing 9 kg by gender interaction: 0.279
Female3.12 ± 0.612.98 ± 0.61
All3.07 ± 0.602.97 ± 0.61
Data are means and standard deviations. * Wilks’ lambda p values for multivariable tests: age < 0.001; gender < 0.001; losing 9 kg < 0.001; and gender by losing 9 kg interactions <0.001.
Table 4. Logistic regression analysis of lifestyle behaviors relative to changes in BMI status due to COVID-19.
Table 4. Logistic regression analysis of lifestyle behaviors relative to changes in BMI status due to COVID-19.
VariableChanges in BMI Status *
aOR(95% CI)SEEp-Value
Decrease in BMI
Age (younger age = ref)1.0240.967–1.0840.0290.424
Gender (female = ref)0.8910.633–1.2530.11740.506
Marital status (married = ref)1.2570.704–2.2440.2960.439
Screen time (high screen time = ref)1.00
Low screen time0.9900.696–1.4100.1800.957
Sleep duration (sufficient sleep = ref)1.00
Insufficient sleep0.9950.702–1.4120.1780.979
Physical activity (low active = ref)1.00
High active1.0080.721–1.4090.1710.962
Breakfast intake (non-daily intake = ref)1.00
Daily intake1.0380.723–1.4910.1850.838
Vegetables intake (non-daily intake = ref) 1.00
Daily intake1.5311.039–2.2580.1980.031
Fruit intake (non-daily intake = ref) 1.00
Daily intake1.3320.832–2.1350.2400.233
Milk/dairy products intake (non-daily intake = ref)1.00
Daily intake1.0090.693–1.4670.1910.965
Sugar-sweetened drink intake (<4 days/week = ref)1.00
≤ 4 days/week 0.7980.553–1.1500.1870.226
Fast food intake (<4 days/week = ref)1.00
≥4 days/week1.0920.706–1.6890.2230.693
French fries/potato chips intake (<4 days/week = ref)1.00
≥4 days/week0.8020.513–1.2520.2270.331
Cake/donuts intake (<4 days/week = ref)1.00
≥4 days/week0.8740.515–1.4840.2700.618
Chocolates/candy intake (<4 days/week = ref)1.00
≥4 days/week1.2470.777–2.0010.2410.360
Energy drinks intake (<4 days/week = ref)1.00
≥4 days/week0.7380.453–1.2020.2490.222
Increase in BMI
Age (younger age = ref)1.0110.952–1.0740.0310.717
Gender (female = ref)0.8550.600–1.2180.1810.385
Marital status (married = ref)1.6390.867–3.0970.3250.128
Screen time (high screen time = ref)1.00
Low screen time0.8550.593–1.2330.1870.401
Sleep duration (sufficient sleep = ref)1.00
Insufficient sleep1.1840.826–1.5970.1840.357
Physical activity (low active = ref)1.00
High active0.7450.524–1.0580.1790.100
Breakfast intake (non-daily intake = ref)1.00
Daily intake0.8270.572–1.1960.1880.314
Vegetables intake (non-daily intake = ref) 1.00
Daily intake1.1240.757–1.6690.2020.561
Fruit intake (non-daily intake = ref) 1.00
Daily intake0.8510.541–1.3390.2310.486
Milk/dairy products intake (non-daily intake = ref)1.00
Daily intake1.4140.958–2.0880.1990.081
Sugar-sweetened drink intake (<4 days/week = ref)1.00
≥4 days/week 1.5511.039–2.3140.2040.032
Fast food intake (<4 days/week = ref)1.00
≥4 days/week1.3680.845–2.2160.2460.203
French fries/potato chips intake (<4 days/week = ref)1.00
≥4 days/week0.7360.455–1.1910.2460.212
Cake/donuts intake (<4 days/week = ref)1.00
≥4 days/week0.8960.501–1.5990.2950.710
Chocolates/candy intake (<4 days/week = ref)1.00
≥4 days/week1.7921.036–3.1030.2800.037
Energy drinks intake (<4 days/week = ref)1.00
≥4 days/week0.6040.365–1.0020.2580.051
* No change was used as a reference category; aOR = adjusted odds ratio; CI = confidence interval; ref = reference category; SEE = standard error.
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Al-Haifi, A.R.; Bumaryoum, N.Y.; Al-Awadhi, B.A.; Alammar, F.A.; Alkhalaf, B.N.; Al-Hazzaa, H.M. How COVID-19 Pandemic Restrictions Affected Kuwaiti College Students’ Anthropometry, Lifestyle Behaviors, and Dietary Habits. Nutrients 2023, 15, 4773. https://doi.org/10.3390/nu15224773

AMA Style

Al-Haifi AR, Bumaryoum NY, Al-Awadhi BA, Alammar FA, Alkhalaf BN, Al-Hazzaa HM. How COVID-19 Pandemic Restrictions Affected Kuwaiti College Students’ Anthropometry, Lifestyle Behaviors, and Dietary Habits. Nutrients. 2023; 15(22):4773. https://doi.org/10.3390/nu15224773

Chicago/Turabian Style

Al-Haifi, Ahmad R., Nayef Y. Bumaryoum, Balqees A. Al-Awadhi, Fahad A. Alammar, Bader N. Alkhalaf, and Hazzaa M. Al-Hazzaa. 2023. "How COVID-19 Pandemic Restrictions Affected Kuwaiti College Students’ Anthropometry, Lifestyle Behaviors, and Dietary Habits" Nutrients 15, no. 22: 4773. https://doi.org/10.3390/nu15224773

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