Few studies have used a multidimensional approach to describe lifestyle changes among
undergraduate students during the COVID-19 pandemic or have included controls. This study
aimed to evaluate lifestyle behaviors and mental health of undergraduate students and compare
them with an age and sex-matched control group. A cross-sectional web survey using snowball
sampling was conducted several months after the beginning of COVID-19 pandemic in Spain. A
sample of 221 students was recruited. The main outcome was the total SMILE-C score. Students
showed a better SMILE-C score than controls (79.8 + 8.1 vs. 77.2 + 8.3; p < 0.001), although these
differences disappeared after controlling for covariates. While groups did not differ in the screenings
of depression and alcohol abuse, students reported lower rates of anxiety (28.5% vs. 37.1%; p = 0.042).
A lower number of cohabitants, poorer self-perceived health and positive screening for depression
and anxiety, or for depression only were independently associated (p < 0.05) with unhealthier lifestyles
in both groups. History of mental illness and financial difficulties were predictors of unhealthier
lifestyles for students, whereas totally/moderate changes in substance abuse and stress management
(p < 0.05) were predictors for the members of the control group. Several months after the pandemic,
undergraduate students and other young adults had similar lifestyles
