Anxiety and depression symptoms in relation to body mass index, fruit and vegetable intake, and physical activity among nutrition students in Peru: a cross-sectional study

Abstract

Background Anxiety and depression are common among university students and may negatively affect their wellbeing and academic performance. However, evidence regarding their co-occurrence and their relationship with BMI and lifestyle-related factors in Peruvian students remains limited. This study aimed to analyze the association between anxiety, depression, BMI, and lifestyle-related factors among nutrition students at a private university in northern Peru. Methods A cross-sectional study was conducted with 405 university students. Anxiety and depressive symptoms were assessed using the Generalized Anxiety Disorder-2 (GAD-2) and the Patient Health Questionnaire-2 (PHQ-2). A cut-off score of ≥3 was used to identify clinically relevant symptoms. Data were collected on body mass index (BMI), sleep duration, physical activity (PA), and fruit and vegetable (F/V) consumption. Associations were evaluated using Poisson regression models with robust variance to estimate prevalence ratios (PR) and 95% confidence intervals (95% CI). Results The prevalence of anxiety and depression symptoms was 57.3 and 26.4%, respectively. Anxiety symptoms was significantly associated with depression (aPR = 4.53; 95% CI: 2.63–7.80). Compared with normal weight, overweight and obesity were associated with a higher prevalence of anxiety (overweight: aPR = 1.22; 95% CI: 1.01–1.48; obesity: aPR = 1.43; 95% CI: 1.10–1.87) and depression (overweight: aPR = 1.27; 95% CI: 1.00–1.62; obesity: aPR = 1.61; 95% CI: 1.12–2.32). Engaging in PA ≥ 5 times per week was associated with a lower prevalence of depression (aPR = 0.35; 95% CI: 0.14–0.85), whereas consuming <5 servings/day of F/V was associated with a higher prevalence of depression (aPR = 1.52; 95% CI: 1.14–2.02). Conclusion Anxiety and depression symptoms were highly prevalent and strongly interrelated. Excess body weight, low PA, and low F/V consumption were associated with poorer mental health indicators, highlighting the importance of integrated health-promotion strategies among university students.