Health status, hematological profiles, and health-related behaviors among first-year university students in Thailand: implications for health promoting university development

Background University students face health risks during the transition to higher education, including unhealthy lifestyles, psychological stress, and malnutrition. This study assessed health status, hematological profiles, and health-related behaviors among first-year university students. Methods A cross-sectional study was conducted among first-year students at Rangsit University, Thailand. Health screening records of 3,220 students were analyzed, while health-related behaviors were assessed using an online questionnaire completed by 156 students. BMI was classified according to the World Health Organization Asia-Pacific criteria. Differences by sex and BMI group were assessed using the Mann–Whitney U and Kruskal–Wallis H tests, respectively. Associations between BMI and hematological parameters were initially assessed using Spearman's ρ, followed by multivariable linear regression adjusted for age and sex. Results Among 3,220 students (70.7% female), 32.9% were overweight or obese and 26.6% were underweight. Anemia affected 26.1% and was more common in females than males (34.3% vs. 6.5%). Males had higher BMI, blood pressure, hemoglobin, and hematocrit, whereas females had higher white blood cell and platelet counts (all p < 0.01). Among questionnaire respondents, 99.3% had unhealthy dietary practices, 44.5% had high or very high stress, and 41.9% consumed alcohol. Males reported higher regular physical activity than females ( p = 0.004). BMI was positively associated with hemoglobin, hematocrit, white blood cell count, and platelet count, with the strongest correlation for white blood cell count (ρ = 0.267, p < 0.001). After adjustment for age and sex, BMI remained positively associated with all four hematological parameters (all p < 0.001), with the strongest standardized association for white blood cell count (β = 0.326). Conclusion First-year students face substantial health challenges, including the double burden of malnutrition, anemia, unhealthy dietary practices, and elevated stress. Early health screening and integrated health promotion strategies may help address these challenges in university settings.