Health behavior of nursing students is often inadequate in terms of dietary, physical activity, smoking and alcohol drinking habits. The results concerning students BMI correspond with studies of the German general population, where 68.2% of adults aged 18 up to 29 years had normal ranged weight
. However, the prevalence of overweight female nursing students (24.3%) exceeded that of females of the general population (17.2%). The prevalence of smokers and never smokers were comparable to findings of a representative health study in Germany (DEGS). It identified a prevalence of 40% smokers and 45.5% never smokers among women aged between 18 and 29 years
Results of DEGS stated additionally, that at-risk drinking is most common in adults aged between 19 and 29 years old, which represent the surveyed study population
. Alcohol consumption correspondents with findings of the national drug affinity study
. However, the increase of at-risk alcohol consumption within the population of female nursing students between 2008 and 2013 is concerning. The alcohol intake was on average about 9 g per day which is nearly twice as high compared with 2008. Moreover, it is twice as high as the average alcohol consumption of 16 and 17 years old girls of German general population
All these points of inadequate health behavior do not reflect the requirements of health promotion and seems somewhat contradictory to successful health care education. These students will play an important role model in primary health care settings having a great potential to promote healthy choices through direct contact to patients
. Practicing a healthy lifestyle seems to be related with counseling and screening of patients: The Women Physicians’ Health Study reported that physicians were more likely to screen their patients for cholesterol or counsel for tobacco cessation when eating less fat or being nonsmokers themselves
. In addition, health professionals are considered more motivating and authentic when they demonstrate a healthy lifestyle themselves
. Counseling therefore is an effective treatment strategy against tobacco use. It leads to increasing abstinence among adolescent smokers
. The question remains wether the students are adequately informed about their ability to influence patients and if they estimate correctly their self efficacy. A different approach in lecturing seems to be required to improve consequences of health promotion curriculum to counseling skills and health behavior
[24, 25]. An evaluation of an online tobacco cessation course demonstrates that the individual ability and skill in counseling patients improves outcomes significantly
Nationwide surveys indicated a decreasing trend in the prevalence of smoking in young adults: 43.1% in 2008 vs. 36.8% in 2011
. In the present 5-year comparison, this trend could not be found in female nursing students. Similarly, nationwide surveys indicated a decreasing trend in risky alcohol consumption in young adults. Quite the contrary shows this 5-year comparison: more female nursing students tend to drink alcohol on a risky level.
The World Health Organization recommends exercising moderately for at least 150 minutes or to exercise intensively for at least 75 minutes per week.
. Nationwide surveys showed that 30.2% of young adults meet this recommendation
. The findings of this study confirm a comparable percentage of female nursing students fulfilling this recommendation. Given the increasing prevalence of obesity between 2008 and 2013 but constantly high intensity of practiced physical activities, further investigation should focus on dietary habits
Most of the nursing students were female in both surveys, what is representative for that setting. The Global Health Professions Student Survey showed similar gender differences in nursing education sites all over the world with an average of 70% females
This survey has some limitations. First, the results may have just restricted validity due to estimation per self report. Studies showed, that the correlation between self reported and objective measures of body weight, height and physical activity is low and varies individually
[31, 32]. Meanwhile the estimation of smoked cigarettes in self reports is mostly correct the validation of self reported consumption of alcoholic beverages in liter still has to be performed
. Even though, the use of questionnaires for assessing health behavior is a well established method
. It leads to high response rates, like achieved in this survey with hundred percent return, and provides numerous information in short time.
Another limitation is the missing analysis of possible relationships between smoking, alcohol and weight status. In the evaluation of the data from 2008 a cluster-analysis had been integrated by Lindeman et al.
. The results show a share of 35.7% smokers in the alcohol high-risk group. Similar group specificities may exist within the data 2013 and should be investigated in further analysis.