Movement and Dietary Behaviours and Mental Health among University Students: The Health@NUS Study

Introduction University is a crucial time when students face mounting pressures on their mental health and are establishing health behaviours that may persist in later life. This study investigated the associations between movement and dietary behaviours and mental health among university students. It further explored the potential role of sex differences in these associations. Methods This cross-sectional study used data (2020–2022) from the Health@NUS prospective cohort study. Six behaviours—moderate-to-vigorous physical activity (MVPA), sedentary time, sleep duration, and intake of fruit, vegetables, and unhealthy food—were assessed and classified as either healthy or unhealthy based on established recommendations. Mental health was measured using the 6-item Kessler Psychological Distress scale and the 5-item World Health Organization Well-being Index. Multivariable linear regression was used to investigate the associations between the behaviours and mental health, and to evaluate effect modification by sex. Results Among 773 students (mean age 22.7 years, 56.8% female), 23.3% practiced 4–6 healthy behaviours; 14.1% and 37.7% reported high distress and poor well-being, respectively. Compared to students engaging in 0–1 healthy behaviour, those engaging in 2 or more healthy behaviours reported less distress and greater well-being. Students who practiced 4–6 behaviours reported lowest distress (females: -1.51, 95% CI -2.75, -0.27; males: -1.72, 95% CI -3.06, -0.39) and the best well-being (females: 10.66, 95% CI 6.04, 15.23; males: 9.98, 95% CI 6.04, 15.23). For individual behaviours, more sleep and less intake of unhealthy foods were associated with less distress, whereas more MVPA and sleep were associated with better well-being. Additionally, among female students, less sedentary time and unhealthy food intake were associated with better well-being. Conclusions The more healthy movement and dietary behaviours that students practiced, the better their reported mental health outcomes. The type of behaviour and sex also appear to play a role. These findings highlight the need for interventions addressing both lifestyle behaviours and mental health in students concurrently, potentially using sex-tailored strategies.