Cross-sectional study of eating behaviours, physical activity and depression in college students in China

Abstract

This study examined the associations of eating behaviours and physical activity (PA) with depressive symptom severity and the mediating role of self-efficacy among college students in Northwest China. A cross-sectional study is performed from 2022 to 2023 across ten colleges in five provinces in Northwest China. Eating behaviours, physical activity, depressive symptom severity, and self-efficacy are assessed using self-developed eating behaviour items, the Physical Activity Rating Scale-3 (PARS-3), the Patient Health Questionnaire-9 (PHQ-9), and the General Self-Efficacy Scale (GSES), respectively. Multivariable linear regression and mediation analyses are performed. The final analysis includes 7,041 participants. Using a PHQ-9 cutoff of ≥10, 8.79% screen positive for probable depression. In the fully adjusted model, frequent breakfast skipping (β = 2.57, 95% CI 2.26-2.88), late-night snacking (β = 2.11, 95% CI 1.63-2.58), irregular meals (β = 4.55, 95% CI 4.05-5.05), and strong preferences for high-calorie (β = 1.43, 95% CI 1.04-1.81), sweet (β = 0.71, 95% CI 0.24-1.19), and spicy foods (β = 1.52, 95% CI 1.22-1.82) are associated with higher PHQ-9 scores, as is frequent alcohol consumption (β = 3.52, 95% CI 2.99-4.04). Higher PA is associated with lower PHQ-9 scores (β = −0.03, 95% CI -0.03 to -0.02). For strong sweet food preference, the indirect effect through self-efficacy is 0.29 (95% CI 0.11-0.48), accounting for 40.22% of the total effect. Specific eating behaviours and PA are associated with depressive symptom severity, and self-efficacy may partly mediate these associations.