Non‐Communicable Disease, Metabolic and Lifestyle Risk Factor Profiles in South African University Students: A Latent Class Analysis

Abstract

Background: Cardiovascular disease, chronic respiratory diseases, diabetes and cancer (referred to as NCD4), the four main groups of non-communicable diseases (NCDs) and common mental disorders (CMDs) are key NCDs with shared risk factors, often established in youth. University students, known for their unhealthy lifestyles, represent a critical population for early intervention. However, few studies have examined their NCD risk profile. Aim: To assess self-reported NCD4, CMDs, metabolic and lifestyle risk factor prevalence and the latent risk profiles present in a South African university student population. Methods: = 3252). Latent class analysis (LCA) identified naturally occurring subgroups based on NCDs, metabolic and lifestyle risk factor patterns. Results: Most participants had a median age of 21, were women (59.7%), undergraduates (76.5%) and attended non-medical faculties (82.2%). The overall NCD prevalence was 52.5%. Chronic respiratory diseases (34.7%), CMDs (31.2%), raised body mass index (35.4%) and various lifestyle risk factors were prevalent. LCA identified three latent risk profiles. Although poor nutrition and alcohol use were common across groups, stress-related factors (psychological distress, poor sleep and CMDs) differentiated the moderate- (28.7%) and higher risk (14.8%) groups from the lower risk group (56.5%), with increased substance use uniquely marking the higher risk group. NCDs and lifestyle risk factor prevalence and profiles differed according to gender. Conclusion: The characteristics of the latent risk profiles and NCD distribution identified in this study position university students as an 'early-risk' population. Co-occurring stress-related factors and increased substance use characterised the higher risk group, whereas poor diet was common across profiles. Despite limitations, these findings highlight specific modifiable risk factors that can be addressed in this low-resource setting by combining population-level nutrition strategies with targeted, multi-behavioural interventions focusing on stress-related factors and substance use to improve student health.