Lifestyle habits and health behaviors in first-year medical students. A longitudinal analysis across the academic year

Background: Despite being educated in a health-oriented environment, medical students are vulnerable to developing unhealthy habits that may compromise their well-being and future professional effectiveness. This study aimed to assess changes in lifestyle behaviors and psychological well-being among first-year medical students over one academic year. Methods: A longitudinal observational study was conducted on a cohort of 189 first-year medical students at Link Campus University (Rome, Italy). Assessments were performed at the beginning and end of the academic year (November 2024–June 2025). A total of 87 students completed all surveys. Measures included self-reported anthropometric data, the Mediterranean Diet Adherence Screener (MEDAS), International Physical Activity Questionnaire (IPAQ), Volition in Exercise Questionnaire (VEQ-I), Perceived Stress Scale (PSS-10), WHO5 Well-Being Index, and the Psychological General Well-Being Index (PGWBIS). Statistical analyses included paired t-tests or Wilcoxon signed-rank tests, and correlation analyses using Spearman’s coefficients. Results: Of the total of sample, 102 students were female (65%) and 55 were male (35%), with median age was 19.8 years old. At follow-up, a statistically significant increase in BMI was observed ( p = 0.009). No significant changes were found in physical activity levels or Mediterranean diet adherence. However, volitional facilitation for physical activity significantly declined ( p = 0.020), indicating reduced motivation. Psychological well-being worsened across the academic year, with increased perceived stress ( p < 0.001), and decreased WHO5 ( p = 0.046) and PGWBIS scores ( p = 0.055). Significant correlations were found between psychological well-being and both physical activity and diet adherence. Conclusions: Over the course of one academic year, medical students reported moderate levels of perceived stress and average emotional and psychological well-being. Despite increasing psychological strain, students maintained a stable core of eating behaviors, suggesting a remarkably resilient and structured dietary pattern. Nevertheless, they exhibited a predictable decline in psychological well-being during examination periods, accompanied by a reduction in motivation for physical activity and modest weight gain. Overall, these findings underscore the importance of targeted interventions within medical education to promote and sustain healthy lifestyle behaviors during the early stages of academic training.