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The Effects of Sleep Quality and Resilience on Perceived Stress, Dietary Behaviors, and Alcohol Misuse: A Mediation-Moderation Analysis of Higher Education Students from Asia, Europe, and North America during the COVID-19 Pandemic

Du C 1 , Zan MCH 2 , Cho MJ 3 , Fenton JI 1 , Hsiao PY 4 , Hsiao R 5 Show all authors , Keaver L 6 , Lai CC 7 , Lee H 8 , Ludy MJ 9 , Shen W 9 , Swee WCS 2 , Thrivikraman J 3 , Tseng KW 7 , Tseng WC 7 , Doak S 6 , Folk SYL 1 , Tucker RM 1

Affiliations 

  • 1 Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
  • 2 Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia
  • 3 Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands
  • 4 Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA
  • 5 Department of Kinesiology, Health, and Sport Science, Indiana University of Pennsylvania, Indiana, PA 15705, USA
  • 6 Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland
  • 7 Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan
  • 8 Department of Human Services, Bowling Green State University, Bowling Green, OH 43403, USA
  • 9 Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA
Nutrients, 2021 Jan 29;13(2).
PMID: 33572863 DOI: 10.3390/nu13020442

Abstract

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has increased the already high levels of stress that higher education students experience. Stress influences health behaviors, including those related to dietary behaviors, alcohol, and sleep; yet the effects of stress can be mitigated by resilience. To date, past research studying the connections between dietary behaviors, alcohol misuse, sleep, and resilience commonly investigated singular relationships between two of the constructs. The aim of the current study was to explore the relationships between these constructs in a more holistic manner using mediation and moderation analyses.

METHODS: Higher education students from China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands, and the United States were enrolled in a cross-sectional study from April to May 2020, which was during the beginning of the COVID-19 pandemic for most participants. An online survey, using validated tools, was distributed to assess perceived stress, dietary behaviors, alcohol misuse, sleep quality and duration, and resilience.

RESULTS: 2254 students completed the study. Results indicated that sleep quality mediated the relationship between perceived stress and dietary behaviors as well as the relationship between perceived stress and alcohol misuse. Further, increased resilience reduced the strength of the relationship between perceived stress and dietary behaviors but not alcohol misuse.

CONCLUSION: Based on these results, higher education students are likely to benefit from sleep education and resilience training, especially during stressful events.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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