title: The influence of academic examinations on energy and nutrient intake in male university students.
abstract: BACKGROUND
  Taking examinations is central to student experience at University and may cause psychological stress. Although stress is recognised to impact on food intake, the effects of undertaking examinations on students' dietary intake have not been well characterised. The purpose of this study was to assess how students' energy and nutrient intake may alter during examination periods.
  
  
  METHODS
  The study design was a within-subject comparison of students' energy and nutrient intake during an examination period contrasted with that outside an examination period (baseline). A total of 20 male students from the University of Sheffield completed an automated photographic 4-d dietary record alongside four 24-h recalls in each time period. Daily energy and nutrient intake was estimated for each student by time period and change in energy and nutrient intake calculated. Intakes at baseline were compared to UK dietary recommendations. Cluster analysis categorised students according to their change in energy intake between baseline and the examination period. Non-parametric statistical tests identified differences by cluster.
  
  
  RESULTS
  Baseline intakes did not meet recommendations for energy, non-milk extrinsic sugars, non-starch polysaccharide and sodium. Three defined clusters of students were identified: Cluster D who decreased daily energy intake by 12.06 MJ (n = 5), Cluster S who had similar energy intakes (n = 13) and Cluster I who substantially increased energy intake by 6.37 MJ (n = 2) between baseline and examination period. There were statistically significant differences (all p < 0.05) in change in intake of protein, carbohydrate, calcium and sodium between clusters. Cluster D recorded greater energy, carbohydrate and protein intakes than Cluster I at baseline.
  
  
  CONCLUSIONS
  The majority of students were dietary resilient. Students who demonstrated hypophagia in the examination period had a high energy and nutrient intake at baseline, conversely those who showed hyperphagia had a low energy and nutrient intake. These patterns require confirmation in studies including women, but if confirmed, there is need to address some students' poor food choice especially during examinations.
authors.affiliation: Department of Oncology, Human Nutrition Unit, Medical School, University of Sheffield, Sheffield, S102RX, UK. m.e.barker@sheffield.ac.uk.
authors.forename: Margo E
authors.initials: ME
authors.lastname: Barker
authors.affiliation: Department of Oncology, Human Nutrition Unit, Medical School, University of Sheffield, Sheffield, S102RX, UK.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Blain
authors.affiliation: Corporate Information and Computing Service, University of Sheffield, Sheffield, UK.
authors.forename: Jean M
authors.initials: JM
authors.lastname: Russell
mesh_terms: D000293:Adolescent; D000328:Adult; D002136:Calcium, Dietary / Q000008:administration & dosage; D002755:Choice Behavior; D004032:Diet; D015930:Diet Records; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D004521:Educational Measurement; D002149:Energy Intake; D005247:Feeding Behavior; D005518:Food Preferences; D006801:Humans; D008297:Male; D011939:Mental Recall; D018977:Micronutrients / Q000008:administration & dosage*; D015596:Nutrition Assessment; D012982:Sodium, Dietary / Q000008:administration & dosage; D013334:Students; D014495:Universities; D055815:Young Adult
chemical_list: D002136:Calcium, Dietary; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D018977:Micronutrients; D012982:Sodium, Dietary