Evidence map›Paper›PMID 41199285›Full record

ArticleBMC public health2025

An unhealthy lifestyle and incident activity-limiting neck and back problems in university students: the Sustainable UNiversity Life (SUN) study.

Clara Onell, Martin Asker, Helene Wiberg, Pierre Côté, Fred Johansson, Tobias Sundberg, Klara Edlund, Eva Skillgate

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Clara OnellDepartment of Health Promoting Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Box 5605, Stockholm, 114 86, Sweden. clara.onell@shh.se.
Martin AskerDepartment of Health Promoting Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Box 5605, Stockholm, 114 86, Sweden.
Helene WibergDepartment of Health Promoting Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Box 5605, Stockholm, 114 86, Sweden.
Pierre CôtéInstitute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada.
Fred JohanssonDepartment of Health Promoting Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Box 5605, Stockholm, 114 86, Sweden.
Tobias SundbergDepartment of Health Promoting Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Box 5605, Stockholm, 114 86, Sweden.
Klara EdlundDivision of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Eva SkillgateDepartment of Health Promoting Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Box 5605, Stockholm, 114 86, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeck and back pain are common musculoskeletal conditions in university students and associated with unhealthy lifestyle behaviors such as physical inactivity, unhealthy dietary habits, smoking and risky alcohol use. Cohort studies have investigated the effect of a healthy lifestyle including several lifestyle behaviors on the risk and prognosis for neck and back pain. Studies of an association between an unhealthy lifestyle and musculoskeletal conditions in university students are lacking. This study aimed to assess the association between an unhealthy lifestyle and incident activity-limiting neck/back problems (ALNBP) in university students.

methodsParticipants enrolled in the Sustainable UNiversity Life (SUN) study who did not report baseline ALNBP in the past three months were included (n = 3492). The baseline web-survey assessed unhealthy lifestyle behaviors (physical inactivity, high sitting time, meal skipping and risky use of alcohol, tobacco, and illicit drugs) with valid instruments and single-item questions. Participants with ≥ 3 unhealthy lifestyle behaviors were categorized as exposed to an unhealthy lifestyle. Responses to web-based follow-up surveys every third month until first reporting ALNBP or to the end of the one-year follow-up were used. The outcome ALNBP was defined as reporting limitations in daily activities due to a neck, low back and/or midback problem the past three months, assessed with a modified version of the Nordic Musculoskeletal Questionnaire. Crude and adjusted Cox regression models were built to assess the association between an unhealthy lifestyle and incident ALNBP, reported as a hazard rate ratio (HRR) with a 95% confidence interval (CI).

resultsSixty percent of the participants were women, and the mean age was 24.5 ± 6.0 years. A total of 574 participants (16%) were exposed to an unhealthy lifestyle at baseline. Having an unhealthy lifestyle generated an adjusted HRR of 1.35 (95% CI 1.12, 1.63) for incident ALNBP, compared to not having an unhealthy lifestyle.

conclusionsAn unhealthy lifestyle, categorized as ≥ 3 unhealthy lifestyle behaviors, is associated with incident ALNBP in university students.

Indexed as

Back PainLife StyleNeck PainStudentsAdultFemaleHumansIncidenceMaleRisk FactorsSurveys and QuestionnairesUniversitiesYoung AdultBack painHigh sitting timeMeal skippingNeck painPhysical inactivityRisky alcohol useRisky illicit drug useRisky tobacco useStudents

Identifiers

PMID41199285
PMCPMC12590823

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.