Problematic smartphone usage, prevalence and patterns among university students: A systematic review

Background In the last decade, smartphones have become an indispensable part of our daily life. However, little is known of when smartphone usage becomes problematic and how it can affect mental and physical health. Therefore, this paper aims to analyse to which extent university students suffer from problematic smartphone usage (PSU) and if there are recognisable patterns or predictive factors. Methods This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. To identify eligible primary research studies, a pre-defined search strategy was carried out in four databases, including Cochrane databases, CHINAL Plus, MEDLINE, and PubMed. The obtained literature was screened using inclusion and exclusion criteria and critically appraised with the AXIS tool resulting in 11 peer-reviewed studies in English. Results The prevalence of PSU in university students varied between 36.5% and 67%, with a mean of 52%. Across the literature, PSU was significantly associated with mental health problems like depression, and anxiety. Furthermore, smartphone overuse can lead to physical problems (e.g., neck pain or eye strain) and negatively influence university students' academic performance and sleep quality. Our results suggest that the duration spends on the phone is a potential predictive factor for PSU. Limitations Most studies in this systematic review are cross-sectional; therefore, no causal explanations can be given. Moreover, the measurement scales used are based on self-reported answers, which carry the risk of recall bias. Conclusion This study demonstrates that PSU is very common and needs to be considered in the population group of university students. More longitudinal studies are required in order to identify causal relationships between PSU and possible predictive factors.</p

A healthful plant-based diet is associated with lower type 2 diabetes risk via improved metabolic state and organ function: A prospective cohort study

BackgroundPlant-based diets are becoming increasingly popular due to favourable environmental footprints and have been associated with lower risk of type 2 diabetes (T2DM). Here, we investigated the potential mechanisms to explain the lower T2DM risk observed among individuals following plant-based diets.MethodsProspective data from the UK Biobank, a cohort study of participants aged 40 to 69 years at baseline, was evaluated. Associations between healthful and unhealthful plant-based indices (hPDI and uPDI) and T2DM risk were analysed by multivariable Cox regression models, followed by causal mediation analyses to investigate which cardiometabolic risk factors explained the observed associations.ResultsOf 113,097 study participants 2,628 developed T2DM over 12 years of follow-up. Participants with the highest hPDI scores (Quartile 4) had a 24% lower T2DM risk compared to those with the lowest scores (Quartile 1) [Hazard Ratio (HR): 0.76, 95% Confidence Interval (CI): 0.68-0.85]. This association was mediated by a lower BMI (proportion mediated: 28%), lower waist circumference (28%), and lower concentrations of HBA1c (11%), triglycerides (9%), alanine aminotransferase (5%), gamma glutamyl transferase (4%), C-reactive protein (4%), insulin-like growth factor 1 (4%), cystatin C (4%) and urate (4%). Higher uPDI scores were associated with a 37% higher T2DM risk [HR: 1.37, 95% CI:1.22- 1.53], with higher waist circumference (proportion mediated: 17%), BMI (7%), and higher concentrations of triglycerides (13%) potentially playing mediating roles.ConclusionHealthful plant-based diets may protect against T2DM via lower body fatness, but also via normoglycaemia, lower basal inflammation as well as improved kidney and liver function