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Open AccessArticle

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

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Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
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Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia
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Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands
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Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA
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Department of Kinesiology, Health, and Sport Science, Indiana University of Pennsylvania, Indiana, PA 15705, USA
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Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland
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Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan
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Department of Human Services, Bowling Green State University, Bowling Green, OH 43403, USA
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Department of Public & Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA
*
Author to whom correspondence should be addressed.
Clocks & Sleep 2021, 3(1), 12-30; https://doi.org/10.3390/clockssleep3010002
Received: 6 December 2020 / Revised: 9 January 2021 / Accepted: 11 January 2021 / Published: 15 January 2021
(This article belongs to the Special Issue Role of Sleep and Circadian Rhythms in Health)
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. View Full-Text
Keywords: sleep; dietary risk; physical activity; alcohol misuse; COVID-19; undergraduate and graduate students sleep; dietary risk; physical activity; alcohol misuse; COVID-19; undergraduate and graduate students
MDPI and ACS Style

Du, C.; Zan, M.C.H.; Cho, M.J.; Fenton, J.I.; Hsiao, P.Y.; Hsiao, R.; Keaver, L.; Lai, C.-C.; Lee, H.; Ludy, M.-J.; Shen, W.; Swee, W.C.S.; Thrivikraman, J.; Tseng, K.-W.; Tseng, W.-C.; Almotwa, J.; Feldpausch, C.E.; Folk, S.Y.L.; Gadd, S.; Wang, L.; Wang, W.; Zhang, X.; Tucker, R.M. Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk. Clocks & Sleep 2021, 3, 12-30. https://doi.org/10.3390/clockssleep3010002

AMA Style

Du C, Zan MCH, Cho MJ, Fenton JI, Hsiao PY, Hsiao R, Keaver L, Lai C-C, Lee H, Ludy M-J, Shen W, Swee WCS, Thrivikraman J, Tseng K-W, Tseng W-C, Almotwa J, Feldpausch CE, Folk SYL, Gadd S, Wang L, Wang W, Zhang X, Tucker RM. Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk. Clocks & Sleep. 2021; 3(1):12-30. https://doi.org/10.3390/clockssleep3010002

Chicago/Turabian Style

Du, Chen; Zan, Megan C.H.; Cho, Min J.; Fenton, Jenifer I.; Hsiao, Pao Y.; Hsiao, Richard; Keaver, Laura; Lai, Chang-Chi; Lee, HeeSoon; Ludy, Mary-Jon; Shen, Wan; Swee, Winnie C.S.; Thrivikraman, Jyothi; Tseng, Kuo-Wei; Tseng, Wei-Chin; Almotwa, Juman; Feldpausch, Clare E.; Folk, Sara Y.L.; Gadd, Suzannah; Wang, Linyutong; Wang, Wenyan; Zhang, Xinyi; Tucker, Robin M. 2021. "Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk" Clocks & Sleep 3, no. 1: 12-30. https://doi.org/10.3390/clockssleep3010002

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