Weekend-Weekday Differences in Adherence to the Mediterranean Diet among Spanish University Students

Luis M Béjar, Luis M Béjar

Abstract

Daily routines may influence eating patterns; however, differences in intake on weekdays and at weekends have rarely been explored. Furthermore, these differences have not been analyzed among university students (a particularly interesting group among the younger generations). The aim of the study was to evaluate weekend−weekday variation in the Mediterranean diet among Spanish university students, while investigating the potential influence of age, gender, studies, body mass index, smoking status and physical activity status. A repeated-measurement 28-day cross-sectional observational study with self-reported dietary intake collected using the e12HR app was conducted. There were 361 participants: average age 20.6 years; 72.9% women; 58.2% students of Pharmacy; average BMI 21.9 kg/m2; 91.4% nonsmokers; 77.6% performed ≥150 min/week of physical activity. Outcome measurements were adherence to the Mediterranean diet (AMD) index and percentage of participants meeting recommendations for each food group on weekdays and at weekends. In all subgroups, Spanish university students’ global diet was associated with low AMD, with poorer diet quality (>12% reductions in mean scores of AMD index and >26% reductions in adequate adherence scores (≥9)) at weekends. In conclusion, weekend health behaviors of Spanish university students displayed less favorable eating behavior, making the weekend an important target for public health interventions aiming to improve dietary intake.

Keywords: Mediterranean diet; feeding behavior; food; information technology; mobile applications; nutrition assessment; smartphone; university.

Conflict of interest statement

The author declares no conflict of interests.

Figures

Figure 1
Figure 1
Screenshots from the e-12HR app.

References

    1. WHO Global Strategy on Diet, Physical Activity and Health. 2004. [(accessed on 14 June 2022)]. Available online: .
    1. Gotsis E., Anagnostis P., Mariolis A., Vlachou A., Katsiki N., Karagiannis A. Health benefits of the Mediterranean Diet: An update of research over the last 5 years. Angiology. 2015;66:304–318. doi: 10.1177/0003319714532169.
    1. Ventriglio A., Sancassiani F., Contu M.P., Latorre M., Di Slavatore M., Fornaro M., Bhugra D. Mediterranean Diet and its Benefits on Health and Mental Health: A Literature Review. Clin. Pract. Epidemiol. Ment. Health. 2020;16:156–164. doi: 10.2174/1745017902016010156.
    1. Lăcătușu C.M., Grigorescu E.D., Floria M., Onofriescu A., Mihai B.M. The Mediterranean Diet: From an Environment-Driven Food Culture to an Emerging Medical Prescription. Int. J. Environ. Res. Public Health. 2019;16:942. doi: 10.3390/ijerph16060942.
    1. Katz D.L., Meller S. Can we say what diet is best for health? Annu. Rev. Public Health. 2014;35:83–103. doi: 10.1146/annurev-publhealth-032013-182351.
    1. Dernini S., Berry E.M., Serra-Majem L., La Vecchia C., Capone R., Medina F.X., Aranceta-Bartrina J., Belahsen R., Burlingame B., Calabrese G., et al. Med Diet 4.0: The Mediterranean diet with four sustainable benefits. Public Health Nutr. 2017;20:1322–1330. doi: 10.1017/S1368980016003177.
    1. Karam J., Bibiloni M.D.M., Serhan M., Tur J.A. Adherence to Mediterranean Diet among Lebanese University Students. Nutrients. 2021;13:1264. doi: 10.3390/nu13041264.
    1. Berry E.M. Sustainable Food Systems and the Mediterranean Diet. Nutrients. 2019;11:2229. doi: 10.3390/nu11092229.
    1. Dernini S., Berry E.M. Mediterranean Diet: From a Healthy Diet to a Sustainable Dietary Pattern. Front. Nutr. 2015;7:15. doi: 10.3389/fnut.2015.00015.
    1. Berry E.M., Dernini S., Burlingame B., Meybeck A., Conforti P. Food security and sustainability: Can one exist without the other? Public Health Nutr. 2015;18:2293–2302. doi: 10.1017/S136898001500021X.
    1. Burlingame B., Dernini S. Sustainable Diets and Biodiversity. Food and Agriculture Organization of the United Nations (FAO); Rome, Italy: 2012. p. 309.
    1. Lacirignola C., Capone R. Mediterranean Food Consumption Patterns Diet, Environment, Society, Economy and Health. Food and Agriculture Organization of the United Nations (FAO); Rome, Italy: 2015. p. 77.
    1. Burlingame B., Dernini S. Sustainable diets: The Mediterranean diet as an example. Public Health Nutr. 2011;14:2285–2287. doi: 10.1017/S1368980011002527.
    1. McCarthy S. Weekly patterns, diet quality and energy balance. Physiol. Behav. 2014;134:55–59. doi: 10.1016/j.physbeh.2014.02.046.
    1. Nordman M., Matthiessen J., Biltoft-Jensen A., Ritz C., Hjorth M.F. Weekly variation in diet and physical activity among 4-75-year-old Danes. Public Health Nutr. 2020;23:1350–1361. doi: 10.1017/S1368980019003707.
    1. Cullen K.W., Lara K.M., de Moor C. Children’s dietary fat intake and fat practices vary by meal and day. J. Am. Diet Assoc. 2002;102:1773–1778. doi: 10.1016/S0002-8223(02)90380-9.
    1. Hart C.N., Raynor H.A., Osterholt K.M., Jelalian E., Wing R.R. Eating and activity habits of overweight children on weekdays and weekends. Int. J. Pediatr. Obes. 2011;6:467–742. doi: 10.3109/17477166.2011.590204.
    1. Brazendale K., Rayan S., Eisenstein D., Blankenship M., Rey A., Garcia J., Odahowski C.L., Leon A. Obesogenic Behaviors of Rural Children on School and Nonschool Days. Child Obes. 2021;17:483–492. doi: 10.1089/chi.2021.0084.
    1. Hoffmann D.A., Marx J.M., Burmeister J.M., Musher-Eizenman D.R. Friday Night Is Pizza Night: A Comparison of Children’s Dietary Intake and Maternal Perceptions and Feeding Goals on Weekdays and Weekends. Int. J. Environ. Res. Public Health. 2018;11:720. doi: 10.3390/ijerph15040720.
    1. Rothausen B.W., Matthiessen J., Hoppe C., Brockhoff P.B., Andersen L.F., Tetens I. Differences in Danish children’s diet quality on weekdays v. weekend days. Public Health Nutr. 2012;15:1653–1660. doi: 10.1017/S1368980012002674.
    1. Rothausen B.W., Matthiessen J., Andersen L.F., Brockhoff P.B., Tetens I. Dietary patterns on weekdays and weekend days in 4-14-year-old Danish children. Br. J. Nutr. 2013;109:1704–1713. doi: 10.1017/S0007114512003662.
    1. Rockell J.E., Parnell W.R., Wilson N.C., Skidmore P.M., Regan A. Nutrients and foods consumed by New Zealand children on schooldays and non-schooldays. Public Health Nutr. 2011;14:203–208. doi: 10.1017/S136898001000193X.
    1. Svensson A., Larsson C., Eiben G., Lanfer A., Pala V., Hebestreit A., Huybrechts I., Fernández-Alvira J.M., Russo P., Koni A.C., et al. European children’s sugar intake on weekdays versus weekends: The IDEFICS study. Eur. J. Clin. Nutr. 2014;68:822–828. doi: 10.1038/ejcn.2014.87.
    1. Lachapelle D., Gamache C., Brodeur J.M., Sévigny J. Frequency of food consumption in children: Weekdays versus weekends. J. Can. Dent. Assoc. 1989;55:61e5.
    1. Dutch D.C., Golley R.K., Johnson B.J. Diet Quality of Australian Children and Adolescents on Weekdays versus Weekend Days: A Secondary Analysis of the National Nutrition and Physical Activity Survey 2011–2012. Nutrients. 2021;13:4128. doi: 10.3390/nu13114128.
    1. Hanson K.L., Olson C.M. School meals participation and weekday dietary quality were associated after controlling for weekend eating among U.S. school children aged 6 to 17 years. J. Nutr. 2013;143:714–721. doi: 10.3945/jn.112.170548.
    1. Kim M.J. Comparison of food and nutrient intake between weekday and weekend for elementary and middle school students by gender in Busan and some parts of Kyungsangnamdo. J. Nutr. Health. 2013;46:332–345. doi: 10.4163/jnh.2013.46.4.332.
    1. Smith K.L., Straker L.M., Kerr D.A., Smith A.J. Overweight adolescents eat what? And when? Analysis of consumption patterns to guide dietary message development for intervention. J. Hum. Nutr. Diet. 2015;28:80–93. doi: 10.1111/jhn.12263.
    1. Haines P.S., Hama M.Y., Guilkey D.K., Popkin B.M. Weekend eating in the United States is linked with greater energy, fat, and alcohol intake. Obes. Res. 2003;11:945–949. doi: 10.1038/oby.2003.130.
    1. Monteiro L.S., Hassan B.K., Estima C.C.P., Souza A.M., Verly E., Sichieri R., Pereira R.A. Food Consumption According to the Days of the Week-National Food Survey, 2008–2009. Rev. Saude Publica. 2017;51:93. doi: 10.11606/S1518-8787.2017051006053.
    1. Yang P.H.W., Black J.L., Barr S.I., Vatanparast H. A temporal analysis of Canadian dietary choices using the Canadian Community Health Survey Cycle 2.2: Does nutrient intake and diet quality vary on weekends versus weekdays. FASEB J. 2013;27:354. doi: 10.1096/fasebj.27.1_supplement.354.5.
    1. An R. Weekend-weekday differences in diet among U.S. adults, 2003–2012. Ann. Epidemiol. 2016;26:57–65. doi: 10.1016/j.annepidem.2015.10.010.
    1. Racette S.B., Weiss E.P., Schechtman K.B., Steger-May K., Villareal D.T., Obert K.A., Holloszy J.O. Influence of weekend lifestyle patterns on body weight. Obesity. 2008;16:1826–1830. doi: 10.1038/oby.2008.320.
    1. Jahns L., Conrad Z., Johnson L.K., Scheett A.J., Stote K.S., Raatz S.K. Diet Quality Is Lower and Energy Intake Is Higher on Weekends Compared with Weekdays in Midlife Women: A 1-Year Cohort Study. J. Acad. Nutr. Diet. 2017;117:1080–1086. doi: 10.1016/j.jand.2017.01.012.
    1. Yang P.H., Black J.L., Barr S.I., Vatanparast H. Examining differences in nutrient intake and dietary quality on weekdays versus weekend days in Canada. Appl. Physiol. Nutr. Metab. 2014;39:1413–1417. doi: 10.1139/apnm-2014-0110.
    1. Rhodes D.G., Cleveland L.E., Murayi T., Moshfegh A.J. The effect of weekend eating on nutrient intakes and dietary patterns. FASEB J. 2007;21:835. doi: 10.1096/fasebj.21.6.A1064-c.
    1. Hartline-Grafton H.L., Rose D., Johnson C.C., Rice J.C., Webber L.S. The influence of weekday eating patterns on energy intake and BMI among female elementary school personnel. Obesity. 2010;18:736–742. doi: 10.1038/oby.2009.249.
    1. Yahia N., Achkar A., Abdallah A., Rizk S. Eating habits and obesity among Lebanese university students. Nutr. J. 2008;7:32. doi: 10.1186/1475-2891-7-32.
    1. Béjar L.M., Sharp B.N., García-Perea M.D. The e-EPIDEMIOLOGY Mobile Phone App for Dietary Intake Assessment: Comparison with a Food Frequency Questionnaire. JMIR Res. Protoc. 2016;5:e208. doi: 10.2196/resprot.5782.
    1. Béjar L.M., Vázquez-Limón E. Is there any alternative to traditional food frequency questionnaire for evaluating habitual dietary intake? Nutr. Hosp. 2017;34:880–888. doi: 10.20960/nh.650.
    1. Béjar L.M. First evaluation steps of a new method for dietary intake estimation regarding a list of key food groups in adults and in different sociodemographic and health-related behaviour strata. Public Health Nutr. 2017;20:2660–2669. doi: 10.1017/S1368980017001641.
    1. Béjar L.M., Reyes Ó.A., García-Perea M.D. Electronic 12-Hour Dietary Recall (e-12HR): Comparison of a Mobile Phone App for Dietary Intake Assessment with a Food Frequency Questionnaire and Four Dietary Records. JMIR Mhealth Uhealth. 2018;6:e10409. doi: 10.2196/10409.
    1. Béjar L.M., García-Perea M.D., Reyes Ó.A., Vázquez-Limón E. Relative Validity of a Method Based on a Smartphone App (Electronic 12-Hour Dietary Recall) to Estimate Habitual Dietary Intake in Adults. JMIR Mhealth Uhealth. 2019;7:e11531. doi: 10.2196/11531.
    1. Knudsen V.K., Hatch E.E., Cueto H., Tucker K.L., Wise L., Christensen T., Mikkelsen E.M. Relative validity of a semi-quantitative, web-based FFQ used in the ‘Snart Forældre’ cohort—A Danish study of diet and fertility. Public Health Nutr. 2016;19:1027–1034. doi: 10.1017/S1368980015002189.
    1. Medin A.C., Astrup H., Kåsin B.M., Andersen L.F. Evaluation of a web-based food record for children using direct unobtrusive lunch observations: A validation study. J. Med. Internet Res. 2015;17:e273. doi: 10.2196/jmir.5031.
    1. Rodríguez I.T., Ballart J.F., Pastor G.C., Jordà E.B., Val V.A. Validation of a short questionnaire on frequency of dietary intake: Reproducibility and validity. Nutr. Hosp. 2008;23:242–252.
    1. Forster H., Fallaize R., Gallagher C., O’Donovan C.B., Woolhead C., Walsh M.C., Macready A.L., Lovegrove J.A., Mathers J.C., Gibney M.J., et al. Online dietary intake estimation: The Food4Me food frequency questionnaire. J. Med. Internet Res. 2014;16:e150. doi: 10.2196/jmir.3105.
    1. Svensson A., Larsson C. A mobile phone app for dietary intake assessment in adolescents: An evaluation study. JMIR Mhealth Uhealth. 2015;3:e93. doi: 10.2196/mhealth.4804.
    1. Hongu N., Pope B.T., Bilgiç P., Orr B.J., Suzuki A., Kim A.S., Merchant N.C., Roe D.J. Usability of a smartphone food picture app for assisting 24-hour dietary recall: A pilot study. Nutr. Res. Pract. 2015;9:207–212. doi: 10.4162/nrp.2015.9.2.207.
    1. Monteagudo C., Mariscal-Arcas M., Rivas A., Lorenzo-Tovar M.L., Tur J.A., Olea-Serrano F. Proposal of a Mediterranean Diet Serving Score. PLoS ONE. 2015;10:e0128594. doi: 10.1371/journal.pone.0128594.
    1. Vasiloglou M.F., Lu Y., Stathopoulou T., Papathanail I., Fäh D., Ghosh A., Baumann M., Mougiakakou S. Assessing Mediterranean Diet Adherence with the Smartphone: The Medipiatto Project. Nutrients. 2020;12:3763. doi: 10.3390/nu12123763.
    1. Duan Y.P., Wienert J., Hu C., Si G.Y., Lippke S. Web-Based Intervention for Physical Activity and Fruit and Vegetable Intake Among Chinese University Students: A Randomized Controlled Trial. J. Med. Internet Res. 2017;19:e106. doi: 10.2196/jmir.7152.
    1. García-Meseguer M.J., Burriel F.C., García C.V., Serrano-Urrea R. Adherence to Mediterranean diet in a Spanish university population. Appetite. 2014;78:156–164. doi: 10.1016/j.appet.2014.03.020.
    1. Solera A., Gamero A. Healthy habits in university students of health sciences and other branches of knowledge: A comparative study. Rev. Esp. Nutr. Hum. Diet. 2019;23:271–282.
    1. Cancela-Carral J.M., Ayán-Pérez C. Prevalence and relationship between physical activity and abnormal eating attitudes in Spanish women university students in Health and Education Sciences. Rev. Esp. Salud Publica. 2011;85:499–505. doi: 10.1590/S1135-57272011000500009.
    1. Ramón-Arbués E., Granada-López J.M., Martínez-Abadía B., Echániz-Serrano E., Antón-Solanas I., Jerue B.A. Factors Related to Diet Quality: A Cross-Sectional Study of 1055 University Students. Nutrients. 2021;13:3512. doi: 10.3390/nu13103512.
    1. Telleria-Aramburu N., Bermúdez-Marín N., Rocandio A.M., Telletxea S., Basabe N., Rebato E., Arroyo-Izaga M. Nutritional quality and carbon footprint of university students’ diets: Results from the EHU12/24 study. Public Health Nutr. 2022;25:183–195. doi: 10.1017/S1368980021002640.
    1. López-Moreno M., Garcés-Rimón M., Miguel M., Iglesias-López M.T. Adherence to Mediterranean Diet, Alcohol Consumption and Emotional Eating in Spanish University Students. Nutrients. 2021;13:3174. doi: 10.3390/nu13093174.
    1. Cobo-Cuenca A.I., Garrido-Miguel M., Soriano-Cano A., Ferri-Morales A., Martínez-Vizcaíno V., Martín-Espinosa N.M. Adherence to the Mediterranean Diet and Its Association with Body Composition and Physical Fitness in Spanish University Students. Nutrients. 2019;11:2830. doi: 10.3390/nu11112830.
    1. Willett W. Nutritional Epidemiology. 3rd ed. Oxford University Press; New York, NY, USA: 2013. p. 552.
    1. Rutishauser I.H. Dietary intake measurements. Public Health Nutr. 2005;8:1100–1107. doi: 10.1079/PHN2005798.
    1. Tucker K.L., Smith C.E., Lai C.Q., Ordovas J.M. Quantifying diet for nutrigenomic studies. Annu. Rev. Nutr. 2013;33:349–371. doi: 10.1146/annurev-nutr-072610-145203.
    1. Gibson R. Principles of Nutritional Assessment. 2nd ed. Oxford University Press; New York, NY, USA: 2005. p. 908.
    1. Martín-Moreno J.M., Gorgojo L. Assessment of dietary intake at the population level through individual questionnaires: Meth-odological shadows and lights. Rev. Esp. Salud Publica. 2007;81:507–518. doi: 10.1590/s1135-57272007000500007.
    1. Dhurandhar N.V., Schoeller D., Brown A.W., Heymsfield S.B., Thomas D., Sørensen T.I., Speakman J.R., Jeansonne M., Allison D.B., Energy Balance Measurement Working Group Energy balance measurement: When something is not better than nothing. Int. J. Obes. 2015;39:1109–1113. doi: 10.1038/ijo.2014.199.
    1. Illner A.K., Freisling H., Boeing H., Huybrechts I., Crispim S.P., Slimani N. Review and evaluation of innovative technologies for measuring diet in nutritional epidemiology. Int. J. Epidemiol. 2012;41:1187–1203. doi: 10.1093/ije/dys105.
    1. Steele R. An overview of the state of the art of automated capture of dietary intake information. Crit. Rev. Food Sci. Nutr. 2015;55:1929–1938. doi: 10.1080/10408398.2013.765828.
    1. Hassannejad H., Matrella G., Ciampolini P., De Munari I., Mordonini M., Cagnoni S. Automatic diet monitoring: A review of computer vision and wearable sensor-based methods. Int. J. Food Sci. Nutr. 2017;68:656–670. doi: 10.1080/09637486.2017.1283683.
    1. Thong Y.J., Nguyen T., Zhang Q., Karunanithi M., Yu L. Predicting food nutrition facts using pocket-size near-infrared sensor. Annu. Int. Conf. IEEE Eng. Med. Biol. Soc. 2017;2017:742–745. doi: 10.1109/EMBC.2017.8036931.
    1. Carroll R.J., Midthune D., Subar A.F., Shumakovich M., Freedman L.S., Thompson F.E., Kipnis V. Taking advantage of the strengths of 2 different dietary assessment instruments to improve intake estimates for nutritional epidemiology. Am. J. Epidemiol. 2012;175:340–347. doi: 10.1093/aje/kwr317.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit