Department of Psychology, University of Kansas, United States of America; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, United States of America.
Department of Psychology, University of Kansas, United States of America; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, United States of America.
Eat Behav. 2019 Dec;35:101333. doi: 10.1016/j.eatbeh.2019.101333. Epub 2019 Aug 23.
Young adulthood is a sensitive developmental period that is high-risk for weight gain. Ample research has focused on weight gain among college students; however meta-analyses report <2 kg pooled estimates of weight gain, which is in the range of normal weight fluctuation, and there is disagreement in the literature regarding common predictors of weight gain. These limitations pose a major barrier to targeted obesity prevention efforts. The present study reviewed the literature assessing college weight gain with a focus on three methodological factors that could contribute to variability in the literature: 1) use of an evidence-supported definition of weight gain (>2 kg or ≥3%); 2) weight measurement protocols; and 3) including weight/BMI in analyses of predictors of weight change.
Three databases were systematically searched. Studies were included in the review if the primary goal was to determine magnitude of weight change and/or test predictors of weight change during the academic year, and they reported weight at 2+ time points.
A total of 81 studies were included in the review. Most studies (90%; 73/81) did not use an evidence-supported definition of weight gain. Studies that used an evidence-supported definition reported estimates of gain among students who gained weight to be beyond the range of normal weight fluctuation (4.0-7.5 kg), and occurred in a subset (<32%) of participants. Studies that did not use an evidence-supported definition reported weight gain to be 2.0-4.5 kg, and occurred in the majority >50% of students. Most studies that measured height and weight (71%; 42/59) did not use a fasting protocol and the majority (63%; 37/59) did not conduct measurements at the same time of day. A higher percentage of studies that used a standardized measurement protocol reported weight change >2 kg (44% vs 20%). A lower percentage of studies that used a standardized measurement protocol had substantial variability in weight change estimates (50% vs 69%). The majority of studies that tested predictors of weight gain (74%; 42/57) included weight/BMI as a covariate in analyses.
The body of literature examining weight change among college students suffers from limitations that may have contributed to overestimations in the percent of students who gain weight, and simultaneous underestimations of the magnitude of weight gain among those who gain weight. Weight gain may be limited to approximately 30% of students in a sample, and weight gain among this subset of students may be substantial (>4 kg). Going forward, use of both an evidence-supported weight gain definition and fasting measurement protocol will likely enhance accuracy in characterizing weight gain among college students, as well as improve researchers' ability to detect important predictors of weight gain.
青年期是一个容易体重增加的高风险敏感发育期。大量研究集中在大学生体重增加上；然而，荟萃分析报告的体重增加的汇总估计值<2kg，处于正常体重波动范围内，并且文献中对于体重增加的常见预测因素存在分歧。这些局限性对有针对性的肥胖预防工作构成了重大障碍。本研究回顾了评估大学生体重增加的文献，重点关注可能导致文献中变异性的三个方法学因素：1）使用证据支持的体重增加定义（>2kg 或≥3%）；2）体重测量方案；3）在分析体重变化的预测因素时纳入体重/ BMI。
系统地检索了三个数据库。如果主要目标是确定学术年期间体重变化的幅度和/或测试体重变化的预测因素，并且报告了 2 个及以上时间点的体重，则研究将被纳入综述。
共有 81 项研究被纳入综述。大多数研究（90%；73/81）没有使用证据支持的体重增加定义。使用证据支持的定义的研究报告称，体重增加的学生的增加幅度超出了正常体重波动范围（4.0-7.5kg），并且发生在<32%的参与者中。没有使用证据支持的定义的研究报告称体重增加为 2.0-4.5kg，并且发生在大多数学生（>50%）中。大多数测量身高和体重的研究（71%；42/59）没有使用禁食方案，大多数研究（63%；37/59）没有在同一天的同一时间进行测量。使用标准化测量方案的研究报告体重变化>2kg 的比例更高（44%比 20%）。使用标准化测量方案的研究报告体重变化估计值的变异性较小（50%比 69%）。大多数测试体重增加预测因素的研究（74%；42/57）在分析中纳入了体重/ BMI 作为协变量。
检查大学生体重变化的文献存在局限性，这些局限性可能导致高估体重增加的学生比例，同时低估体重增加的学生体重增加幅度。体重增加可能仅限于样本中的大约 30%的学生，并且这部分学生的体重增加幅度可能很大（>4kg）。未来，使用证据支持的体重增加定义和禁食测量方案可能会提高描述大学生体重增加的准确性，并提高研究人员检测体重增加重要预测因素的能力。
