Exploratory assessment of the correlates of lifestyle medicine among Spanish university students: UNILIFE-M study

BACKGROUND: University students are at a key life stage in their lives for the development of health-related behaviors, yet few studies have explored their overall lifestyle using multidimensional tools. The present exploratory study aimed to assess lifestyle through the Short Multidimensional Inventory Lifestyle Evaluation for University Students (U-SMILE) and to determine its sociodemographic and health correlates in a sample of Spanish university students. METHODS: This cross-sectional analysis was based on baseline data collected at Universidad Loyola Andalucía (Spain) as part of the UNIversity students' LIFEstyle behaviors and Mental health (UNILIFE-M) multicenter project during the 2024 academic year. A total of 671 first-year students (median age = 18 years, 50.1% female) completed validated self-report questionnaires assessing lifestyle behaviors, sociodemographic variables, body mass index (BMI), and diagnosed health conditions. Lifestyle was evaluated using the U-SMILE. Descriptive statistics and robust linear models were applied to identify associated factors. RESULTS: The median overall U-SMILE score was 69.0 points (interquartile range [IQR] = 64-73). Older students (> 18 years old) presented lower scores (unstandardized beta coefficient [B] = -1.59; p = 0.006), as did those enrolled in non-health science degrees (B = -1.47; p = 0.005), single students (B =-1.40; p = 0.013), and those with a mental disorder (B = -2.79; p = 0.001). Heterosexual students scored higher than non-heterosexual peers (B = 2.49; p = 0.007), and students with normal weight showed better results than underweight participants (B = 2.08; p = 0.020). Domain-specific analyses revealed that males scored higher in physical activity, sleep, and social support, whereas females performed better in stress management. Students residing outside university accommodation generally achieved higher domain scores. CONCLUSIONS: These exploratory findings suggest that lifestyle, as measured by the U-SMILE, is associated with several sociodemographic and health-related characteristics in Spanish university students. Lower scores were associated with older age, enrolment in non-health science degrees, underweight status, non-heterosexual orientation, single marital status, and the presence of a diagnosed mental disorder. Sex, BMI status, accommodation, and employment status were associated with specific lifestyle domains.