Lifestyle behaviors, attitudes, and psychological well-being among undergraduate students

Background. Noncommunicable diseases are rising in Pakistan, driven by poor diet, physical inactivity, and smoking. This study aimed to evaluate undergraduate students’ lifestyle behaviors, their attitudes toward lifestyle medicine, and the associations between these behaviors and psychological well-being. Methods. A cross-sectional online survey was conducted between June 2023 and March 2024 among 725 undergraduate students (18–25 years) from healthcare and non-healthcare programs in Pakistan. Data on dietary habits and psychological well-being were collected using the traditional balanced Pakistani diet (TBPD) adherence scale and the Urdu-adapted Hedonic and Eudaimonic Motives for Activities-Revised (HEMA-R) scale, while physical activity, smoking, and alcohol consumption were assessed using self-reported items. Associations between lifestyle behaviors and psychological well-being were examined using univariable and multivariable logistic regression, adjusting for age, gender, academic discipline, and paternal education. Results. Among participants, 49.9% reported high TBPD adherence, 38.6% met recommended physical activity levels, and 87.7% were non-smokers. High TBPD adherence was associated with higher eudaimonic (adjOR 3.12, 95% CI: 1.82–5.36) and overall well-being (adjOR 2.41, 95% CI: 1.45–4.01). Physically active students were also more likely to report higher eudaimonic (adjOR 1.92, 95% CI: 1.11–3.32) and overall well-being (adjOR 1.76, 95% CI: 1.10–2.81). Current smoking was associated with lower combined well-being (adjOR 0.49, 95% CI: 0.27–0.91). Sociodemographic factors, including gender and academic discipline, were not independently associated with well-being. Most students recognized healthcare professionals as role models and counselors, indicating potential avenues for lifestyle medicine education. Conclusion. Adherence to a healthy diet and engagement in physical activity are positively associated with psychological well-being among undergraduate students. These findings highlight the relevance of lifestyle medicine principles in educational curricula, without implying causality.