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Higher academic stress is longitudinally associated with less favorable eating-related patterns, nutritional and somatic indicators, higher depressive symptoms, and altered cortisol dynamics in university students.

This study protocol hypothesizes that within-semester academic stress in university students is associated with adverse changes in eating patterns, nutritional status, somatic health, depressive symptoms, and stress-related physiological markers (lower cortisol awakening response, higher salivary alpha-amylase). The study uses a longitudinal, observational design with repeated measures across three assessment cycles in a convenience sample of undergraduate students.

Last updated: Jul 10, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Longitudinal associations of academic stress with eating related patterns, nutrition, somatic indicators, and depressive symptoms in university students: A study protocol.

observational

Rojas-Cárdenas P, Nazar G, Castillo-Navarrete JL · PloS one (2026)

Participants: N/A
Duration: One academic semester (three assessment cycles)
Intervention: Not applicable (observational study; no intervention tested)
Outcome: Eating-related patterns, nutritional indicators, somatic indicators (heart rate, oxygen saturation, sleep metrics), depressive symptoms, salivary cortisol dynamics (CAR, AUCi, AUCg), salivary alpha-amylase levels, and blood biomarkers (lipid profile, glucose, albumin, globulin, total proteins)
Effect Size: N/A
Population: Undergraduate students (2nd to 4th year) enrolled in the Faculty of Medicine, University of Concepción, Chile

Result:

PubMed: 42412896DOI: 10.1371/journal.pone.0352779

Mechanism Graph

Academic stress activates the HPA-axis and sympathetic nervous system
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This leads to altered cortisol dynamics (lower CAR, lower AUCi, higher AUCg) and higher salivary alpha-amylase
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Chronic stress influences eating behaviors and nutritional patterns
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Result: Increased depressive symptoms and adverse somatic indicators

Limitations

  • ⚠Observational design cannot establish causality, only associations
  • ⚠Convenience sample from a single faculty may limit generalizability
  • ⚠Feasibility-based sample size may reduce statistical power

Frequently Asked Questions

What is the main hypothesis of this study?▼

The study hypothesizes that higher academic stress is longitudinally associated with less favorable eating patterns, poorer nutritional and somatic health, higher depressive symptoms, and altered cortisol dynamics (lower CAR, lower AUCi, higher AUCg) and higher salivary alpha-amylase.

How will academic stress be measured?▼

Academic stress will be assessed using standardized questionnaires administered via electronic surveys (REDCap), along with perceived stress measures.

What biological samples are collected?▼

Saliva samples are collected twice per week during each assessment cycle to measure cortisol dynamics and salivary alpha-amylase. Peripheral blood samples are taken at baseline and end of semester for lipid profile, glucose, albumin, globulin, and total proteins.

Is this study an intervention or observational?▼

This is a longitudinal, observational, nonexperimental study. No intervention is tested; it examines natural associations over an academic semester.

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References

  1. 1.Rojas-Cárdenas P, Nazar G, Castillo-Navarrete JL. "Longitudinal associations of academic stress with eating related patterns, nutrition, somatic indicators, and depressive symptoms in university students: A study protocol.." PloS one, 2026. PMID: 42412896 DOI: 10.1371/journal.pone.0352779
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.