College kids need to change unhealthy ways

A new study from Northwestern Medicine® and Northeastern Illinois University found that the majority of college students are engaging in unhealthy behaviors that could increase their risk of cancer later on. Racial minority students could be at an even greater risk, especially African Americans and Native Americans.

A shocking 95 percent of college students fail to eat the recommended amount of fruit and vegetables (five or more servings a day), and more than 60 percent report not getting enough physical activity (three or more days of vigorous exercise for at least 20 minutes or five or more days of moderate exercise for at least 30 minutes a week).

"Changing unhealthy behaviors in college students now could be a way to reduce the risk of cancer as well as other diseases later in life," said Brian Hitsman, principal investigator of the study.

Hitsman is an assistant professor in preventive medicine-behavioral medicine and psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine and a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

Published online May 5 in the journal Preventive Medicine, the study is the first to evaluate cancer risk behaviors and conditions in college students and how they vary by race and ethnicity. Data for the study comes from the fall 2010 wave of the National College Health Assessment, a self-reported survey of a diverse group of more than 30,000 college students in the United States.

The majority of all college students surveyed reported low fruit and vegetable consumption and low physical activity. Other unhealthy behaviors or conditions -- alcohol binge drinking, tobacco use and obesity/being overweight -- appear to cluster differently among college students depending on their race, the scientists found.

For example, tobacco use and alcohol binge drinking seem to go hand in hand for all subgroups except black students. For black students, tobacco use co-occurred with being overweight/obese.

"Tobacco use and obesity are two health issues that have been vying in the last five years for first place as the major health problem in the United States," said Joseph Kang, lead author of the study and assistant professor in preventive medicine-biostatistics at Feinberg. "It's frightening that those behaviors seem to co-occur in black students."

Native Americans were the only racial group in which there were students who engaged in all five unhealthy behaviors/conditions (alcohol binge drinking, tobacco use, insufficient fruit and vegetable consumption, low physical activity and obesity/being overweight). The finding was surprising and even more frightening than the profile for tobacco use and obesity in black students, Kang said.

Understanding cancer risk behavior clustering by race and ethnicity is critical given that the number of new cases is projected to increase by 45 percent by 2030 and surpass heart disease as the leading causes of death in the United States. (American Society of Clinical Oncology, 2014. The state of cancer care in America, 2014: a report by the American Society of Clinical Oncology. J. Oncol. Pract. 10, 119-142.). If left unaddressed in college students, there is potential for cancer rates to escalate even higher.

"There are major cancer disparities both in terms of risk, morbidity and mortality with racial and ethnic minorities in the United States," Hitsman said. "In this study, we see some of these behavioral risk factors already starting in young adulthood. Future research should monitor the persistence of cancer risk behavior clustering by race and ethnicity."

Other key results from the study broken down by race/ethnicity:

• White students reported the highest prevalence of binge drinking (37.5 percent).
• Asian students reported the highest rate of physical inactivity (74.6 percent).
• Black students had the highest prevalence of insufficient fruit/vegetable intake (98.1 percent) but the lowest rates of tobacco use (13.6 percent) and binge drinking (17.1 percent).
• Native American students had the highest rate of being overweight/obesity (51.4 percent).
• Students who choose not to report their race/ethnicity (2.4 percent of the sample) reported the highest rate of tobacco use (27.9 percent).