Search Results (6,432)

Background/Objectives: Emotional eating (EE) is an emerging public health concern among university students, a population exposed to heightened academic demands, psychosocial stressors, and lifestyle changes that may promote maladaptive coping behaviors. EE has been linked to psychological distress, particularly depressive and anxiety symptoms, as well as sociodemographic, lifestyle, and anthropometric factors; however, findings remain heterogeneous and insufficiently integrated within comprehensive analytical frameworks. This study aimed to examine the association between EE and depressive and anxiety symptoms in university students, while assessing the independent contributions of sociodemographic, academic, lifestyle, and anthropometric determinants. Methods: A cross-sectional survey was performed among 1279 university students from 10 regions in Greece. Sociodemographic, academic, lifestyle, and anthropometric data were collected using validated instruments and standardized procedures. Depressive and anxiety symptoms were assessed by the use of the Beck Depression Inventory-II (BDI-II) and the six-item State-Trait Anxiety Inventory (STAI-6), respectively. EE was evaluated utilizing the EE subscale of the Three-Factor Eating Questionnaire–Revised 18 (TFEQ-R18). Multivariable ordinal logistic regression models were applied to examine independent associations. Results: In fully adjusted models, depressive and anxiety symptoms were the strongest correlates of higher EE levels, each associated with more than twofold increased odds. Female sex, Greek nationality, rural residence, enrollment in biomedical sciences, later academic years, and regular smoking were also positively associated with EE. Higher physical activity was inversely associated with EE levels. Overweight, obesity, and increased waist circumference and waist-to-hip ratio were consistently linked to higher EE, with several associations exceeding twofold increased odds. Conclusions: EE in university students is strongly associated with psychological distress and clusters with adverse lifestyle and anthropometric characteristics. These findings support the need for integrated interventions targeting mental health, lifestyle behaviors, and obesity-related risk factors. Longitudinal studies are warranted to clarify causal pathways and underlying mechanisms. Full article

Background/Objectives: Infertility is a multifactorial condition influenced by both medical factors and lifestyle-related determinants, including diet quality and nutritional supplementation. However, it is unclear which dietary patterns are optimal for women requiring assisted reproductive technology (ART). This study had two main objectives: (1) to assess dietary habits and the prevalence of nutritional supplementation among women with fertility disorders preparing for in vitro fertilization (IVF); (2) to develop, based primarily on a review of the scientific literature, a nutritional protocol to support women undergoing assisted reproductive procedures. Methods: A cross-sectional study was conducted among 61 women undergoing IVF treatment. Diet quality was assessed using the original ProFertiMed score (food-based score). Data regarding supplementation practices, anthropometric characteristics, and the number of IVF attempts were collected using a structured questionnaire. Statistical analyses (Chi-square test) were performed to evaluate associations between diet quality, supplementation practices, and clinical outcomes. Results: Only 8% of the respondents demonstrated a high level of dietary adherence according to the ProFertiMed score, suggesting that nutritional intervention should be implemented in the remaining 92% of women. Dietary supplement use was highly prevalent (95%), with participants taking a mean of 7 ± 4 supplements (range: 1–17). No statistically significant association was observed between diet quality assessed using the ProFertiMed score and the number of IVF attempts (Chi-square test, p = 0.85). Conclusions: The ProFertiMed score appears to be a promising tool for assessing diet-related factors in the context of assisted reproduction and may be particularly valuable when applied at the time of female infertility diagnosis, allowing for the early identification and modification of dietary factors that may affect reproductive outcomes. The proposed protocol, which is primarily based on the scientific literature, outlines key aspects of supportive nutritional management that may contribute to preconception preparation; however, its potential impact on IVF outcomes has not yet been empirically confirmed and should be evaluated in future studies. Therefore, further refinement and validation are required before its implementation in clinical practice. Full article

Background: Fasting plasma glucose, glycated hemoglobin (HbA1c), and oral glucose tolerance testing remain central to the diagnosis and monitoring of dysglycemia, but they mainly reflect the average glycemic exposure or discrete time-point measurements and may not capture intraday and interday glucose fluctuations. Glycemic variability (GV) has been associated with oxidative stress, endothelial dysfunction, inflammation, and diabetes-related complications, although much of the evidence derives from experimental, clinical, and diabetes-care settings rather than occupational cohorts. Aim: This narrative review examines the physiological basis, measurement, and potential occupational relevance of GV and continuous glucose monitoring (CGM) in working populations. Methods: Literature was narratively selected from biomedical databases, major guidelines, consensus statements, and occupational-health sources, prioritizing reviews, clinical guidelines, cohort studies, mechanistic studies, and CGM studies. No systematic search, risk-of-bias assessment, or quantitative synthesis was performed. Main findings: CGM is an established technology in selected diabetes-care contexts and provides metrics such as coefficient of variation, time in range, time above range, and time below range. Its use in occupational medicine, however, remains investigational outside selected clinical circumstances. Work-related factors such as shift work, circadian disruption, sleep loss, psychosocial stress, irregular meal timing, sedentary behavior, and variable physical workload may influence glucose regulation, but direct evidence linking these exposures to CGM-measured GV in workers remains limited. Implications: Potential applications include research on occupational determinants of metabolic health, monitoring of workplace lifestyle interventions, and individualized management of workers with diabetes in safety-sensitive roles, provided that consent, confidentiality, clinical follow-up, equity, and data-governance safeguards are ensured. Conclusions: GV assessment may complement traditional metabolic markers in selected occupational-health contexts, but routine CGM-based surveillance of general worker populations is not currently supported by sufficient evidence. Further longitudinal and interventional studies are required. Full article

Background. Behavioral procrastination has been increasingly recognized as a maladaptive self-regulatory pattern associated with unhealthy lifestyle behaviors, psychological stress, and adverse cardiometabolic profiles. However, its relationship with accelerated cardiovascular aging remains poorly understood. This study aimed to evaluate the association between behavioral procrastination and heart age acceleration in a large occupational cohort of Spanish workers. Methods. A multicenter cross-sectional study was conducted including 92,184 actively employed Spanish workers undergoing routine occupational health examinations between 2021 and 2024. Behavioral procrastination was assessed using the Pure Procrastination Scale-9 (PPS-9). Estimated heart age and heart age acceleration were calculated using a cardiovascular risk-factor-based algorithm. Multivariable linear and logistic regression analyses were performed to evaluate associations between procrastination score, continuous heart age acceleration, and accelerated cardiovascular aging phenotypes after adjustment for demographic, lifestyle, anthropometric, and cardiometabolic variables. Restricted cubic spline analyses and sex-stratified analyses were additionally conducted. Results. Higher procrastination levels were associated with progressively worse cardiometabolic and cardiovascular aging profiles. Mean heart age acceleration increased from −3.1 ± 6.0 years in participants with very low procrastination to 14.0 ± 6.4 years in those with very high/chronic procrastination (p < 0.001). The prevalence of accelerated cardiovascular aging (>0 years) increased from 27.2% to 94.2% across increasing procrastination categories, whereas severe accelerated cardiovascular aging (≥10 years) increased from 1.7% to 75.6% (both p < 0.001). In fully adjusted multivariable analyses, each 5-point increase in PPS-9 score was associated with a 0.50-year increase in heart age acceleration (B = 0.50; 95% CI 0.48–0.52; p < 0.001). Participants with very high/chronic procrastination exhibited significantly higher odds of accelerated cardiovascular aging (OR 1.89; 95% CI 1.65–2.18) and severe accelerated cardiovascular aging (OR 2.51; 95% CI 2.16–2.92). Associations were significantly stronger among women (p-interaction < 0.001). Findings remained robust in sensitivity analyses excluding participants with diabetes mellitus. Conclusions. Behavioral procrastination was associated with higher estimated heart age acceleration and less favorable cardiovascular aging profiles in this large occupational cohort. Higher procrastination severity was consistently related to greater estimated heart age acceleration and a higher prevalence of cardiovascular aging phenotypes, even after extensive multivariable adjustment. These findings indicate that higher procrastination levels were associated with less favorable cardiovascular aging profiles beyond traditional biomedical risk factors. However, given the cross-sectional design, no conclusions regarding causality or temporality can be drawn. Full article

Background: Vitamin D is involved not only in calcium–phosphate homeostasis but also in immune and endothelial regulation. Vitamin D deficiency has been suggested to worsen disease activity in systemic lupus erythematosus (SLE). Environmental and lifestyle factors, including seasonal sun exposure, smoking, diet, and supplementation, may influence vitamin D status and disease manifestations. This study aimed to evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] levels, disease activity, and anti-double-stranded DNA (anti-dsDNA) antibody titers in patients with SLE, taking selected lifestyle and environmental factors into account. Methods: Serum 25(OH)D concentrations, SLE disease activity assessed by the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score, and anti-dsDNA antibody titers were measured in patients with SLE and healthy controls. Blood samples were collected during sunny (April–September) and non-sunny (October–March) months. Information on vitamin D supplementation, smoking status, and dietary habits was obtained using a structured questionnaire. Associations between vitamin D status, disease activity, anti-dsDNA seropositivity, season of blood collection, supplementation, smoking, and diet were analyzed statistically. Results: Patients with SLE had significantly higher mean serum 25(OH)D levels than controls, mainly due to frequent vitamin D supplementation. No significant associations were observed between serum 25(OH)D levels and SLEDAI-2K scores or anti-dsDNA antibody positivity. Seasonality, smoking status, and adherence to special diets were not significantly related to disease activity or anti-dsDNA seropositivity. Vitamin D supplementation was strongly associated with sufficient 25(OH)D levels but did not translate into reduced disease activity or lower anti-dsDNA prevalence. Conclusions: Serum 25(OH)D concentration was not associated with clinical or immunological activity of SLE in this cross-sectional study, despite effective correction of deficiency through supplementation. These findings likely reflect the heterogeneity of SLE and the limitations of single time-point assessments, although regular monitoring and individualized vitamin D supplementation may still be considered in SLE care, particularly in the context of recommended photoprotection. Full article

Sleep is a multidimensional health domain influenced by behavioural, psychological, and lifestyle factors. However, multinational evidence integrating insomnia severity and multiple sleep outcomes within the Mediterranean lifestyle framework remains limited. This study examined correlates of insomnia severity and key sleep outcomes in adults from Mediterranean and neighbouring countries participating in the MEDIET4ALL survey. Data were collected from 4010 adults (59.5% female) across 10 countries using a standardized multilingual e-survey. Insomnia severity was assessed as primary outcome using the Insomnia Severity Index (ISI), while sleep characteristics were assessed using sleep duration, sleep latency, sleep efficiency, and subjective sleep quality. Regression analyses examined sociodemographic, health-related, Mediterranean dietary, movement-related, psychological, and social correlates. Exploratory statistical indirect association analyses involving life satisfaction were also conducted. Insomnia severity showed the highest explained variance among sleep outcomes (adjusted R² ≈ 0.29). Higher insomnia severity was associated with female sex, higher body mass index, and greater depression, anxiety, and stress (β ≈ 0.15–0.17), whereas lower insomnia severity was associated with older age, better self-reported health status, higher life satisfaction, and greater adherence to Mediterranean dietary consumption patterns (β ≈ −0.04 to −0.11). Models for secondary sleep outcomes explained more modest variance and should be interpreted as exploratory. Across these outcomes, psychological well-being and distress showed the most consistent associations, while Mediterranean dietary dimensions and social participation showed smaller and outcome-specific associations. Exploratory indirect association analyses showed small but statistically significant indirect associations involving life satisfaction between Mediterranean dietary dimensions, social participation, and selected sleep outcomes, particularly sleep quality and insomnia severity. The findings confirm and contextualize established associations between sleep, psychological well-being, distress, Mediterranean lifestyle-related behaviours, and regional context within a large multinational sample. Psychological well-being and distress emerged as the most consistent correlates. Insomnia severity was the most robustly explained sleep outcome, whereas secondary sleep dimensions reflected more modest exploratory correlational profiles. Full article

Urban natural spaces are increasingly promoted as a strategy to strengthen resilience against chronic lifestyle-related diseases associated with urbanization. Among these, urban blue spaces have gained attention for their mitigative, restorative, and instorative health benefits, making their design for health promotion a growing priority in public health and urban planning. This study investigates outdoor gyms (OGs) and their role in promoting physical activity in coastal San Diego, USA. Users’ behavior was examined by employing the System for Observing Play and Recreation in Communities and the Blue Health Behavioral Assessment Tool. Supplementary, an online survey was used to further examine visitors’ perceptions towards the OGs of our study area and which design characteristics might affect their use. Systematic observation showed that OGs accounted for 28% of vigorous physical activity onsite, suggesting they function as a co-equal component of the physical activity affordance mix. Community members viewed the gyms as cost-effective and valuable additions to the blue space, while noting that design characteristics influence their use. Ocean views, proximity to amenities, and the availability of accessible equipment emerged as key enabling factors. These findings offer actionable insights for local stakeholders and underscore the importance of community co-design in realizing the health potential of urban blue spaces. Full article

Background: Low high-density lipoprotein cholesterol (HDL-C) is an established marker of cardiovascular risk. However, HDL-C levels may change over time in relation to metabolic status, lifestyle factors, and medication use, and the cardiovascular implications of longitudinal HDL-C changes remain incompletely understood. Methods: We conducted a retrospective cohort study using the JMDC Claims Database, including 3,387,924 adults who underwent at least two health checkups between 2005 and 2021. Participants were categorized into four groups based on HDL-C changes between two time points: persistently low, low to normal, normal to low, and persistently normal. The primary outcome was incident composite cardiovascular disease (CVD), including myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation. Cox proportional hazards models were used to estimate hazard ratios (HRs) with adjustment for demographic and clinical covariates. Results: During a mean follow-up of 4.3 years, persistently low HDL-C was associated with the highest risk of composite CVD compared with persistently normal HDL-C (HR 1.15, 95% CI 1.12–1.19). Both Low-to-Normal and Normal-to-Low groups also showed elevated risks (HR 1.10, 95% CI 1.06–1.14; HR 1.14, 95% CI 1.10–1.19, respectively). The strongest association was observed for myocardial infarction, whereas the association with stroke was modest and less consistent after full adjustment. Conclusions: Longitudinal changes in HDL-C were associated with cardiovascular risk after adjustment for cardiometabolic factors and medication use. Persistently low HDL-C conferred the greatest risk, and serial HDL-C patterns may provide additional information for cardiovascular risk assessment beyond a single baseline measurement. Full article

Cancer and atherosclerotic cardiovascular disease (ASCVD) represent two of the leading causes of death worldwide. Increasingly, these two are being recognized as biologically related conditions rather than entirely segregated disease states. In addition to traditional risk factors such as aging, smoking, and obesity, chronic inflammation may be a key factor connecting the two illnesses. Endothelial dysfunction, oxidative stress, plaque progression, and thrombosis are all facilitated by inflammatory signaling in ASCVD. Similar pathways are known to contribute to cancer growth and invasion. Emerging epidemiologic data demonstrate increased cancer incidence among patients with cardiovascular disease, while cancer survivors and recipients of cardiotoxic therapies exhibit accelerated vascular disease. This narrative review aims to describe the bidirectional relationship between ASCVD and cancer. Targeting shared pathways using statins, colchicine, canakinumab, IL-6 inhibition, and lifestyle modification may provide dual benefits. Future biomarker-guided trials with integrated cardiovascular and oncologic endpoints are needed to clarify causality and optimize prevention and management. Full article

Background/Objectives: Nutrition during childhood and adolescence is a key determinant of long-term health, influencing metabolic homeostasis, neurocognitive development, and immune system maturation. Globalization and technological advances have reshaped food production and consumption, increasing the availability of ultra-processed foods (UPF) of low nutritional quality. This study aimed to investigate the relationship between parental factors, namely food literacy, perceived barriers and enablers, dietary attitudes, and healthy eating behaviors, and the consumption of discretionary UPF among children and adolescents living in 5 Mediterranean countries. Methods: This cross-sectional study was based on a survey completed by 2011 parents of children and adolescents aged 6–17 years from 5 Mediterranean countries, who reported on their children’s dietary and lifestyle habits. Adherence to the Mediterranean diet was assessed through the KIDMED index. Parental food literacy was measured using the Short Food Literacy Questionnaire (SFLQ). Perceived barriers and enablers were assessed based on the Theory of Planned Behavior, and parents’ attitudes toward their child’s diet were evaluated using the Healthy-Eating Attitudes Questionnaire (HEAQ). Finally, the Theory of Internet Use Related to Health (TIUH) questionnaire was used to assess parents’ tendencies related to health information use online. Results: Higher perceived barriers and enablers were significantly associated with lower discretionary UPF consumption across all models. Parental food literacy (SFLQ) showed a positive association with discretionary UPF consumption, remaining significant in the fully adjusted model, although with reduced magnitude. Healthy-eating attitudes (HEAQ) were initially positively associated with discretionary UPF intake but lost statistical significance after full adjustment. Regarding health-related internet use (TIUH), the Health Information dimension showed a strong positive association with discretionary UPF consumption, while other dimensions (Consciousness and Beliefs) showed inconsistent and non-significant associations in the fully adjusted model. Conclusions: Children’s consumption of discretionary UPF is shaped by several interrelated factors, such as family environment, eating patterns, and parents’ perceptions, rather than solely by knowledge or attitudes. Full article

Energy-related carbon emissions in the residential sector have emerged as a critical focal point in global climate change mitigation efforts, given the sector’s significant contribution to overall carbon footprints and its close ties to daily human activities. This study presents a systematic bibliometric analysis of energy-related carbon emissions in the residential sector over the last four years (2023–2026), aiming to unravel the latest trends, driving factors, and potential implications for sustainable development, with a particular focus on major carbon-emitting countries and regions, such as China and the United States. By integrating national statistical data, household energy consumption surveys, and relevant policy documents, the analysis first quantifies the temporal and spatial variations in residential carbon emissions across different regions and urban–rural divides. Subsequently, it delves into the key determinants influencing these emissions, including changes in energy consumption patterns (such as the penetration of clean energy sources), household income levels, demographic shifts, and the implementation of energy efficiency measures. Furthermore, this analysis explores the intricate relationships between residential energy choices, carbon emissions, and broader socioeconomic contexts, shedding light on the challenges and opportunities in transitioning toward low-carbon residential lifestyles. The findings are anticipated to provide valuable insights for policymakers, researchers, and stakeholders involved in formulating targeted strategies to curb residential carbon emissions and promote the adoption of sustainable energy practices in the household domain. Full article

Background: The available evidence highlights that low back pain (LBP) can be categorized into neuropathic or nociceptive pain, according to mechanical- or lesion/disease-related issues. Both types of pain are associated with increased psychological and sleep problems and well-being. However, little is known about how a specific type of LBP pain (neuropathic vs. nociceptive) has an impact on these lifestyle factors. Therefore, the main purpose of the study was to examine the differences in depression and anxiety symptoms, quality of life (QoL) and quality of sleep in patients with LBP. Materials and Methods: In this cross-sectional study, we included 150 patients [mean ± standard deviation (SD) age: 46.54 ± 13.36 years; height: 178.06 ± 10.80 cm; weight: 85.26 ± 15.53 kg; body mass index (BMI): 26.77 ± 3.63 kg/m²; 45.0% women] from three centers in Bosnia and Herzegovina and Croatia between July and October 2025. All patients suffered from chronic LBP confirmed by computerized tomography (CT). The classification of pain was conducted using the Leeds Assessment of Neuropathic Symptoms and Signs (LANNS), the Douleur Neuropathique 4 (DN4) and the PainDETECT (PD-Q) questionnaires. Positive scores in all three questionnaires denoted neuropathic pain. Factors of depression (Beck’s Depression Inventory), anxiety [Hamilton Anxiety Rating Scale (HARS)], QoL (SF-36 scale) and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were also collected. Results: After adjusting for sociodemographic covariates, neuropathic patients reported higher depression [F_1,149 = 7.790, p = 0.006, partial eta squared (ηp²) = 0.051] and anxiety level scores (F_1,149 = 8.140, p = 0.005, ηp² = 0.053), lower QoL (F_1,149 = 19.088, p < 0.001, ηp² = 0.116) and poorer sleep quality (F_1,149 = 19.654, p < 0.001, ηp² = 0.119). Conclusions: In summary, this study shows that neuropathic patients with LBP are more depressed and anxious, and have lower levels of QoL and poorer sleep quality, in comparison to nociceptive patients. The findings suggest that these lifestyle factors need to be considered when establishing the appropriate rehabilitation and management of LBP. Full article

The skin, as the body’s largest organ, reflects overall health and is shaped by factors such as diet, habits, work environment, and lifestyle. A Wood’s lamp offers significant advantages for assessing skin health. Our study leveraged Wood’s lamp to evaluate facial skin hydration and the impact of a diet rich in water, fruits, and vegetables. Conducted with 14 women, the study included the assessment of skin hydration levels. Remarkable improvements were observed in 13 participants, including enhanced skin hydration, reduced surface lesions, and better-regulated sebum levels. Full article

Background: Osteoporosis is increasingly understood as a complex population health condition shaped by interacting behavioral, metabolic, pharmacological, and healthcare system determinants rather than isolated skeletal risk factors. However, comparative studies integrating these dimensions across distinct healthcare and sociocultural settings remain scarce. We aimed to characterize cross-national differences in osteoporosis-related risk clustering between Romanian and Tunisian adults using an integrative multidimensional framework. Methods: We performed a comparative cross-sectional analysis of harmonized data from two pharmacy-based studies conducted in Romania and Tunisia, including adults aged ≥ 40 years (n = 349). Osteoporosis-related knowledge, lifestyle and metabolic risk factors, pharmacological exposures, preventive behaviors, and treatment patterns were assessed. Multivariable regression and mediation analyses were used to identify independent predictors of screening uptake and to evaluate the relationship between knowledge and preventive behavior. An exploratory cumulative preventive deficit score was used to estimate overall preventive burden within the pharmacy-based study sample. Results: Romanian participants demonstrated significantly higher osteoporosis knowledge than Tunisian participants (8.90 ± 2.20 vs. 7.83 ± 2.99; p < 0.001); however, knowledge was not independently associated with Dual-Energy X-ray Absorptiometry (DXA) uptake and did not mediate country-related differences in screening behavior. Compared with the Romanian cohort, the Tunisian cohort exhibited lower DXA screening rates (11.2% vs. 22.8%; p = 0.005), lower vitamin D supplementation (11.9% vs. 38.6%; p < 0.001), greater sedentary behavior, and a significantly higher cumulative preventive deficit burden (3.39 ± 1.08 vs. 2.77 ± 1.26; p < 0.001). Medication-related osteoporosis risk was also greater in Tunisia, particularly due to markedly higher corticosteroid exposure (7.5% vs. 0.5%; p = 0.002). Despite this less favorable preventive profile, the treatment gap among participants with diagnosed osteoporosis was significantly lower in Tunisia than in Romania (4.8% vs. 42.9%; p = 0.003). Conclusions: Distinct but convergent osteoporosis-related risk patterns were identified across the two populations, suggesting that osteoporosis vulnerability emerges through context-specific clustering of behavioral, pharmacological, and healthcare-access determinants rather than through isolated risk factors alone. The dissociation between knowledge and preventive behavior highlights the limited impact of awareness-based strategies when structural barriers remain unaddressed. These findings support a shift toward integrated, population-tailored osteoporosis prevention models that incorporate healthcare-system, medication-related, and behavioral determinants, in addition to conventional educational approaches. Full article

Background: The increasing prevalence of diabetes mellitus and metabolic risk factors among young adults has become a major public health concern. University students are particularly vulnerable to unhealthy lifestyle changes, including sedentary behavior, insufficient physical activity, and academic stress, all of which may be associated with an elevated risk of metabolic disorders. Objective: This study aimed to examine the associations of academic stress, physical activity, and sedentary behavior with diabetes risk among university students. Methods: A cross-sectional analytical study was conducted among 264 university students recruited through an online survey. Academic stress was assessed using a six-item Likert-scale instrument, while diabetes risk was evaluated using a composite score derived from indicators adapted from the modified Finnish Diabetes Risk Score (modified FINDRISC). Statistical analyses included descriptive statistics, Cronbach’s alpha reliability testing, exploratory factor analysis (EFA), Spearman’s correlation analysis, and multivariable logistic regression. Results: The academic stress instrument demonstrated good internal consistency (Cronbach’s alpha = 0.85). Exploratory factor analysis supported the construct validity of the instrument, with all six items loading substantially on a common academic stress factor. Correlation analysis revealed that academic stress was positively associated with sedentary behavior and diabetes risk, whereas physical activity was negatively associated with diabetes risk. Multivariable logistic regression showed that academic stress was significantly associated with an increased risk of diabetes (adjusted odds ratio [aOR] = 1.18, 95% confidence interval [CI]: 1.02–1.36; p = 0.028). Moderate-to-vigorous physical activity was associated with a lower risk of diabetes (aOR = 0.74, 95% CI: 0.60–0.92; p = 0.011), while longer sitting duration was associated with an increased risk of diabetes. Conclusions: Academic stress, sedentary behavior, and physical activity were significantly associated with diabetes risk among university students. These findings highlight the importance of developing university-based health promotion programs that integrate stress management, physical activity promotion, and sedentary behavior reduction to support the prevention of metabolic risk factors in young adults. Full article