Prevalence and correlates of lifestyle behavior, anxiety and depression in Chinese college freshman: A cross-sectional survey

Objectives: First-year college students had exposure to unhealthy lifestyle behaviors that correlate with a high prevalence of anxiety and depression. Regarding to the modifiable lifestyle behaviors factors, this study investigated the prevalence and correlation of multiple lifestyle behaviors, anxiety and depression in a sample of Chinese first-year college students. Methods: Cross-sectional data were extracted from Residents eHealth app of health lifestyle behaviors survey from September to October 2019. Anxiety, depression, eating regular meals, consumption of snacks in-between meals, consumption of fruit, dessert and sugar-sweetened beverages, smoking and secondhand smoke exposure, consuming alcohol, physical activity, sedentary time were assessed by self-report. Socio-demographic including age, gender, education, family income, religion, and health condition were captured. Logistic regression was used to explore the association of multiple lifestyle behaviors, anxiety and depression. Results: Totally 1,017 participants were included in the study. The prevalence of anxiety and depression (from mild to severe) were 40.3% and 45.3%, respectively. In multivariable analyses, religion (believe in Buddhism, OR = 2.438, 95%CI: 1.097–5.421; believe in Christian, OR = 5.886, 95%CI: 1.604–21.597), gender (Female, OR = 1.405, 95%CI: 1.001–1.971), secondhand smoke exposure (OR = 1.089, 95%CI: 1.001–1.184), and eating regular meals (OR = 0.513, 95%CI: 0.346–0.759) were associated with anxiety. Family income (OR = 0.732, 95%CI: 0.596–0.898), eating regular meals (OR = 0.641, 95%CI: 0.415–0.990), frequency of breakfast (OR = 0.813, 95%CI: 0.690–0.959), with a chronic disease (OR = 1.902, 95%CI: 1.335–2.712), and consumption of nocturnal snack (OR = 1.337, 95%CI: 1.108–1.612) were associated with depression. Conclusions: These results highlighted the need for early lifestyle behavior intervention, especially modifying diet patterns considering the background of religion, health condition, and social-economic status in first-year college students to improve their mental health