Prevalence of multiple behavioral risk factors for chronic diseases in medical students and associations with their academic performance

Abstract

Multiple behavioral risk factors (MBRFs) related to lifestyle have been associated with non-communicable diseases, but there is limited evidence on their prevalence in undergraduate medical students and their association with academic performance. During 1989–2017, data from 1447 medical students of the University of Crete, Greece (mean age 21.8 ± 2.2 years), were analyzed. MBRFs assessed included smoking, high body weight, physical inactivity, risky alcohol consumption and low consumption of fruits and vegetables. Academic performance was based on the grades received in the mandatory Clinical Nutrition course and the overall medical degree (scale of 0–10). Of the sample, 25.8% were smokers, 30.7% had high body weight, and 67.2% had low consumption of fruits and vegetables. Prevalence of having ‘no MBRFs’ and having ‘multiple clustering’ and ‘3+ factors’ was 15.8% and 12.3%, respectively. Men had almost twice the prevalence of multiple clustering compared with women (16.5% vs. 8.4%, p < 0.001). Participants who had none compared with 3+ MBRFs had higher mean grades in the Clinical Nutrition course (6.34 vs. 5.94, p = 0.027, p = 0.003) and overall degree (7.39 vs. 7.22, p = 0.021, p = 0.002). As the number of MBRFs increased (from ‘none’ to ‘1,’ ‘2’ and ‘3+’ factors), the proportion of graduates receiving a distinction also decreased (6.1%, 3.3%, 3.3% and 0.0%, respectively, p = 0.001). Overall, high prevalence of MBRFs was observed in this sample of medical students, while MBRF clustering was prospectively inversely associated with academic performance. These findings highlight the need for preventive lifestyle strategies to improve these students’ behavioral risk factors and academic performance during their studies.