Clustering of Lifestyle Risk Factors in British University Students: A Longitudinal Study of Health Risk throughout the Course of Undergraduate Study

Introduction: Research examining the clustering of lifestyle risk factors (LRFS) associated with noncommunicable diseases (NCDs) amongst British university students is limited to only a few cross-sectional studies. Aims: The thesis aimed to contribute novel insights into the clustering of a comprehensive range of LRFs in a British undergraduate sample by: estimating the prevalence of a comprehensive range of LRFs; exploring whether LRFs cluster in a diverse sample of students; examining sociodemographic differences in the prevalence of individual LRFs and cluster membership; and exploring stability and change in patterns of LRFs demonstrated by students across the duration of a tradition three-year undergraduate degree. Method: A self-report ‘Student Health and Lifestyle Questionnaire’ was used to survey the prevalence of 15 LRFs on an annual basis amongst students enrolled at a single British university over a period of three academic years. Latent Class Analysis and Latent Transition Analysis were used to identify distinct clusters within the data and to examine stability and change in cluster membership respectively. Results: Three latent classes were detected in both study one (S1) and study two (S2) (i.e. High-Risk, Poor Lifestyle (S1), Higher-Risk (S2); Moderate-Risk, Active (S1, S2); Low-Risk, Moderate Lifestyle (S1), Moderate Risk, Inactive (S2)). Findings suggest students typically demonstrate the same pattern of LRFs throughout their time at university. Females of Black, Mixed or Other ethnicity, and Males of White ethnicity were identified as higher-risk groups. Conclusions: LRFs associated with NCDs were found to cluster in the sample surveyed. Findings suggest that students will likely demonstrate the same pattern of LRFs throughout their time at university. Interventions encouraging the adoption of healthier eating behaviours and more active lifestyles would positively impact the health of most university student. Interventions addressing the LRFs of the highest-risk students should be prioritised.