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Determination of Salivary Cortisol Levels and Nutrition, Smoking and Physical Activity Status of University Students during the Exam Period

Yıl 2024, Cilt: 14 Sayı: 3, 594 - 604, 30.09.2024
https://doi.org/10.31020/mutftd.1508807

Öz

Objective: The aim of this study is to determine the salivary cortisol levels and nutrition, smoking and physical activity status of university students during the exam period.
Method: This study was conducted at Bayburt University Faculty of Health Sciences during the 2023-2024 final exam period. A questionnaire determined the demographic characteristics, dietary and physical activity behaviors, while anthropometric measurements were taken and nutritional status was evaluated. ELISA analyzed the cortisol hormone levels in saliva samples taken before and after the final exam.
Results: The study was conducted on 120 volunteer students between the ages of 18-25 who had no clinical health problems. In the study, a significant difference was found between the students' salivary cortisol levels before and after the exam (p<0.05). Cortisol levels were found to be lower in male students (n=60) than in female students (n=60) (p<0.05). Cortisol levels were found to be higher in smokers than in non-smokers (p<0.05) Exam anxiety was found to be higher in female students (p<0.05). No significant change was observed in terms of physical activity, nutritional behaviors or food preferences during the exam period (p>0.05).
Conclusion: One of the important stress factors for students is the exam period. It is important to examine the effects on nutrition, physical activity and smoking during this period. Cortisol levels are an important marker for such studies and are thought to contribute to the evaluation of the effectiveness of stress prevention strategies.

Etik Beyan

Ethics committee approval (16.12.2022/Decision No. 332/13) and institutional permission were obtained before the study. Participants were informed about the study in line with the Declaration of Helsinki, and their consent was obtained for the Informed Consent Form. The study included voluntary participants. Every stage of the study adhered to research and publication ethics.

Kaynakça

  • 1. Hukkanen J, Jacob P, Benowitz NL. Metabolism and disposition kinetics of nicotine. Pharmacol Rev 2005;57:79–115.
  • 2. Kirkham PA, et al. Macrophage phagocytosis of apoptotic neutrophils is compromised by matrix proteins modified by cigarette smoke and lipid peroxidation products. Biochem Biophys Res Commun 2004;318:32–37.
  • 3. Docheva MH, Kirkova DM, Stoyanova LS. Summary of Regulatory Methods and Procedures for Determination of Harmful and Potentially Harmful Components in Tobacco Smoke. Contrib Tob Nicotine Res 2024;33:112–135.
  • 4. Kopa PN, Pawliczak R. Effect of smoking on gene expression profile – overall mechanism, impact on respiratory system function, and reference to electronic cigarettes. Toxicol Mech Methods 2018;28:397–409.
  • 5. Fucito LM, Palmer AM, Baldassarri SRA new perspective on mitigating lung cancer risks through smoking cessation and reduction. JNCI: Journal of the National Cancer Institute vol 2024;116:782–785.
  • 6. Oguz S, Camcı G, Kazan M. The Prevalence of Cigarette Smoking and Knowing Status for Diseases Caused by Smoking among University Students. Van Med J 2018;25:332–337.
  • 7. Lanier CA, Nicholson T, Duncan D. Drug Use and Mental Well Being among a Sample of Undergraduate and Graduate College Students. J. Drug Educ 2001;31:239–248 .
  • 8. Organization WH WHO Global Report on Trends in Prevalence of Tobacco Use 2000–2030. World Health Organization 2024.
  • 9. Parrott AC. Does cigarette smoking cause stress? Am Psychol 1999;54:817 .
  • 10. Lee JH, et al. Acute stress enhances memory and preference for smoking-related associations in smokers. Nicotine Tob Res 2024;26:333–341.
  • 11. Husain K, et al. Chronic ethanol and nicotine interaction on rat tissue antioxidant defense system. Alcohol 2001;25:89–97.
  • 12. Kirbaş ZÖ, Bayraktar B, Aktaş EO. Salivary apelin hormone response and dysfunctional attitudes in adolescents in Türkiye: a relational screening model. BMC Psychol 2024;12:64.
  • 13. Kirbas ZO, Bayraktar B, Odabasi Aktas E. Investigation of the relationship of cardiac troponin I and cortisol hormone levels with some variables in children: Relational screening model. Med Sci 2024;13:310–4.
  • 14. Bayraktar B. Endocrine System, in Physiology for Health Sciences. Akademisyen Kitabevi, 2020.
  • 15. Patel VK, et al. Cortisol as a target for treating mental disorders: a promising avenue for therapy. Mini Rev Med Chem 2024;24:588–600.
  • 16. Gilbert D, et al. Effects of exam stress on mood, cortisol, and immune functioning: Influences of neuroticism and smoker-non-smoker status. Personal Individ Differ 1996;21:235–246.
  • 17. Zunhammer M, Eichhammer P, Busch V. Sleep quality during exam stress: the role of alcohol, caffeine and nicotine. PloS One 2014;9:e109490.
  • 18. Seiffge‐Krenke I, et al. Stress With Parents and Peers: How Adolescents From Six Nations Cope With Relationship Stress. J Res Adolesc 2013;23:103–117.
  • 19. Sarubbi De Rearte E, Castaldo R I. Factores causales del estrés en los estudiantes universitarios. In V Congreso Internacional de Investigación y práctica profesional en psicología XX Jornadas de Investigación Noveno Encuentro de Investigadores en Psicología del MERCOSUR. Facultad de Psicología-Universidad de Buenos Aires, 2013.
  • 20. Lattimore P, Caswell N. Differential effects of active and passive stress on food intake in restrained and unrestrained eaters. Appetite 2004;42:167–173.
  • 21. Chezhian C, et al. Exploring factors that influence smoking initiation and cessation among current smokers. J Clin Diagn Res JCDR 2015;9:LC08 .
  • 22. Lacey K, et al. A prospective study of neuroendocrine and immune alterations associated with the stress of an oral academic examination among graduate students. Psychoneuroendocrinology 2000;25:339–356.
  • 23. Weekes N, et al. Examination stress as an ecological inducer of cortisol and psychological responses to stress in undergraduate students. Stress 2006;9:199–206.
  • 24. Špiljak B, et al. Perceived Stress, Salivary Cortisol, and Temperament Traits among Students of Dental Medicine: A Prospective and Interventional Study. Behav Sci 2024;14:289.
  • 25. Murphy L, et al. Academic stress differentially influences perceived stress, salivary cortisol, and immunoglobulin-A in undergraduate students. Stress 2010;13:366–371.
  • 26. Singh, R et al. Effect of examınatıon stress on mood, performance and cortısol levels ın medıcal students. Indian J Physiol Pharmacol 2012;56:48-55.
  • 27. Macht M, Haupt C, Ellgring H. The perceived function of eating is changed during examination stress: a field study. Eat Behav 2005;6:109–112.
  • 28. Misra R, McKean M. College students’ academic stress and its relation to their anxiety, time management, and leisure satisfaction. Am J Health Stud 2000;16:41.
  • 29. Özğan H, Balkar B. The Reasons of Stress Perceived by Students of Education Faculty in The Classroom and Personal Variables’ Effect on Stress. Electron J Soc Sci 2008;7.
  • 30. Honglin C et al. Stress among Shanghai University Students: The Need for Social Work Support. J Soc Work 2009;9:323–344.
  • 31. Schick MR, et al. Effects of Ovarian Hormone Levels on Stress, Cigarette Craving, and Smoking in a Laboratory Relapse Paradigm Among Females Who Smoke Daily. Nicotine Tob Res 2024;26:392–396.
  • 32. Porcelli B, et al. Association between stressful life events and autoimmune diseases: A systematic review and meta-analysis of retrospective case–control studies. Autoimmun Rev 2016;15:325–334.
  • 33. Naja F, Hamadeh R. Nutrition amid the COVID-19 pandemic: a multi-level framework for action. Eur J Clin Nutr 2020;74:1117–1121.
  • 34. Caso D, et al. Unhealthy eating and academic stress: The moderating effect of eating style and BMI. Health Psychol Open 2020;7:205510292097527.
  • 35. Gümüş AB, Yardımcı H, Keser A. Evaluation of Nutritional Situations according to Anxiety Score of Students Prepared for Exam. J Duzce Univ Health Sci Inst 2018;8:22–28.
  • 36. Rehman F, et al. Pattern and Associated Factors of Exam Anxiety among Students of Private Medical College Pakistan. PJMHS 2020;14:669–71.
  • 37. Eller T, et al. Symptoms of anxiety and depression in Estonian medical students with sleep problems. Depress Anxiety 2006;23: 250–256.
  • 38. Uney R, Erim BR. The effects of regular physical exercise on violent behavior, coping with stress and self-confidence in male prisoners of a closed prison/Kapali cezaevindeki kalan erkek mahkumlarda duzenli fiziksel egzersizin siddet davranisi, stresle bas etme ve ozguven uzerine etkileri. Anadolu Psikiyatri Derg 2019;20:619–627.
  • 39. Oğuz S, et al. Effects of Progressive Muscle Relaxation Exercises on Stress, Sleep Quality and Exercises Capacity in Young Adults. J Health Sci Prof 2019;6:534–544.
  • 40. Durmaz A, Gün Ç. Relationship Between Healthy Lifestyle Behaviors In Midwifery Students And The Exams. OPUS Int J Soc Res 2018;9:15–15.
  • 41. Savcı FDS, Öztürk UFM, Arıkan FDH. Physical activity levels of university students. Arch Turk Soc Cardiol 2006;34:166–172.
  • 42. Yildiz A, Tarakci D, Karantay Mutluay F. The Relationship between Body Composition and Physical Activity Level in the Young Adults: Pilot Study. Sağlık Bilim Ve Meslekleri Derg 2015;2:297.
  • 43. Ölçücü B, et al. The Relationship Between Depression, Anxiety and Physical Activity Level Among University Students. Int J Educ Sci 2015;2015:294–303.
  • 44. Yıldırım İ, et al. The Correlation Between Physical Activities and Depression Status Among itThe University Students. Niğde Univ J Phys Educ Sport Sci 2015;9:32–39.

Sınav Döneminde Üniversite Öğrencilerinin Tükürük Kortizol Düzeyleri İle Beslenme, Sigara İçme, Fiziksel Aktivite Durumlarının Belirlenmesi

Yıl 2024, Cilt: 14 Sayı: 3, 594 - 604, 30.09.2024
https://doi.org/10.31020/mutftd.1508807

Öz

Amaç: Bu çalışmanın amacı, sınav döneminde üniversite öğrencilerinin tükürük kortizol düzeyleri ıle beslenme, sigara ıçme fiziksel aktivite durumlarının belirlenmesidir.
Yöntem: Bu çalışma Bayburt Üniversitesi Sağlık Bilimleri Fakültesi'nde 2023-2024 final sınav döneminde yürütülmüştür. Bir anket ile katılımcıların demografik özellikleri, beslenme ve fiziksel aktivite davranışları belirlenirken, antropometrik ölçümler alınmış ve beslenme durumları değerlendirilmiştir. Final sınavından önce ve sonra alınan tükürük örneklerinde kortizol hormonu seviyeleri ELISA ile analiz edilmiştir.
Bulgular: Çalışma, klinik olarak herhangi bir sağlık problemi bulunmayan 18-25 yaş aralığındaki toplam 120 gönüllü öğrenci üzerinde yürütülmüştür. Çalışmada, öğrencilerin sınav öncesi ve sonrası tükürük kortizol düzeyleri arasında anlamlı bir fark bulunmuştur (p<0.05). Kortizol düzeyleri erkek öğrencilerde (n=60) kız öğrencilerden (n=60) daha düşük bulunmuştur (p<0.05). Sigara içenlerin kortizol düzeyleri içmeyenlere göre yüksek bulunmuştur (p<0.05). Sınav kaygısı kız öğrencilerde daha yüksek bulunmuştur (p<0.05). Sınav döneminde fiziksel aktivite, beslenme davranışları veya besin tercihleri açısından anlamlı bir değişiklik gözlenmemiştir (p>0.05).
Sonuç: Öğrencilerin için önemli stress etmenlerinden birisi olan sınav dönemidir. Bu dönemde beslenme, fiziksel aktivite ve sigara kullanımı üzerindeki etkilerinin incelenmesi önemlidir. Kortizol seviyeleri bu tür çalışmalar için önemli bir belirteçtir ve stres önleme stratejilerinin etkinliğinin değerlendirilmesine katkı sağlayacağı düşünülmektedir.

Kaynakça

  • 1. Hukkanen J, Jacob P, Benowitz NL. Metabolism and disposition kinetics of nicotine. Pharmacol Rev 2005;57:79–115.
  • 2. Kirkham PA, et al. Macrophage phagocytosis of apoptotic neutrophils is compromised by matrix proteins modified by cigarette smoke and lipid peroxidation products. Biochem Biophys Res Commun 2004;318:32–37.
  • 3. Docheva MH, Kirkova DM, Stoyanova LS. Summary of Regulatory Methods and Procedures for Determination of Harmful and Potentially Harmful Components in Tobacco Smoke. Contrib Tob Nicotine Res 2024;33:112–135.
  • 4. Kopa PN, Pawliczak R. Effect of smoking on gene expression profile – overall mechanism, impact on respiratory system function, and reference to electronic cigarettes. Toxicol Mech Methods 2018;28:397–409.
  • 5. Fucito LM, Palmer AM, Baldassarri SRA new perspective on mitigating lung cancer risks through smoking cessation and reduction. JNCI: Journal of the National Cancer Institute vol 2024;116:782–785.
  • 6. Oguz S, Camcı G, Kazan M. The Prevalence of Cigarette Smoking and Knowing Status for Diseases Caused by Smoking among University Students. Van Med J 2018;25:332–337.
  • 7. Lanier CA, Nicholson T, Duncan D. Drug Use and Mental Well Being among a Sample of Undergraduate and Graduate College Students. J. Drug Educ 2001;31:239–248 .
  • 8. Organization WH WHO Global Report on Trends in Prevalence of Tobacco Use 2000–2030. World Health Organization 2024.
  • 9. Parrott AC. Does cigarette smoking cause stress? Am Psychol 1999;54:817 .
  • 10. Lee JH, et al. Acute stress enhances memory and preference for smoking-related associations in smokers. Nicotine Tob Res 2024;26:333–341.
  • 11. Husain K, et al. Chronic ethanol and nicotine interaction on rat tissue antioxidant defense system. Alcohol 2001;25:89–97.
  • 12. Kirbaş ZÖ, Bayraktar B, Aktaş EO. Salivary apelin hormone response and dysfunctional attitudes in adolescents in Türkiye: a relational screening model. BMC Psychol 2024;12:64.
  • 13. Kirbas ZO, Bayraktar B, Odabasi Aktas E. Investigation of the relationship of cardiac troponin I and cortisol hormone levels with some variables in children: Relational screening model. Med Sci 2024;13:310–4.
  • 14. Bayraktar B. Endocrine System, in Physiology for Health Sciences. Akademisyen Kitabevi, 2020.
  • 15. Patel VK, et al. Cortisol as a target for treating mental disorders: a promising avenue for therapy. Mini Rev Med Chem 2024;24:588–600.
  • 16. Gilbert D, et al. Effects of exam stress on mood, cortisol, and immune functioning: Influences of neuroticism and smoker-non-smoker status. Personal Individ Differ 1996;21:235–246.
  • 17. Zunhammer M, Eichhammer P, Busch V. Sleep quality during exam stress: the role of alcohol, caffeine and nicotine. PloS One 2014;9:e109490.
  • 18. Seiffge‐Krenke I, et al. Stress With Parents and Peers: How Adolescents From Six Nations Cope With Relationship Stress. J Res Adolesc 2013;23:103–117.
  • 19. Sarubbi De Rearte E, Castaldo R I. Factores causales del estrés en los estudiantes universitarios. In V Congreso Internacional de Investigación y práctica profesional en psicología XX Jornadas de Investigación Noveno Encuentro de Investigadores en Psicología del MERCOSUR. Facultad de Psicología-Universidad de Buenos Aires, 2013.
  • 20. Lattimore P, Caswell N. Differential effects of active and passive stress on food intake in restrained and unrestrained eaters. Appetite 2004;42:167–173.
  • 21. Chezhian C, et al. Exploring factors that influence smoking initiation and cessation among current smokers. J Clin Diagn Res JCDR 2015;9:LC08 .
  • 22. Lacey K, et al. A prospective study of neuroendocrine and immune alterations associated with the stress of an oral academic examination among graduate students. Psychoneuroendocrinology 2000;25:339–356.
  • 23. Weekes N, et al. Examination stress as an ecological inducer of cortisol and psychological responses to stress in undergraduate students. Stress 2006;9:199–206.
  • 24. Špiljak B, et al. Perceived Stress, Salivary Cortisol, and Temperament Traits among Students of Dental Medicine: A Prospective and Interventional Study. Behav Sci 2024;14:289.
  • 25. Murphy L, et al. Academic stress differentially influences perceived stress, salivary cortisol, and immunoglobulin-A in undergraduate students. Stress 2010;13:366–371.
  • 26. Singh, R et al. Effect of examınatıon stress on mood, performance and cortısol levels ın medıcal students. Indian J Physiol Pharmacol 2012;56:48-55.
  • 27. Macht M, Haupt C, Ellgring H. The perceived function of eating is changed during examination stress: a field study. Eat Behav 2005;6:109–112.
  • 28. Misra R, McKean M. College students’ academic stress and its relation to their anxiety, time management, and leisure satisfaction. Am J Health Stud 2000;16:41.
  • 29. Özğan H, Balkar B. The Reasons of Stress Perceived by Students of Education Faculty in The Classroom and Personal Variables’ Effect on Stress. Electron J Soc Sci 2008;7.
  • 30. Honglin C et al. Stress among Shanghai University Students: The Need for Social Work Support. J Soc Work 2009;9:323–344.
  • 31. Schick MR, et al. Effects of Ovarian Hormone Levels on Stress, Cigarette Craving, and Smoking in a Laboratory Relapse Paradigm Among Females Who Smoke Daily. Nicotine Tob Res 2024;26:392–396.
  • 32. Porcelli B, et al. Association between stressful life events and autoimmune diseases: A systematic review and meta-analysis of retrospective case–control studies. Autoimmun Rev 2016;15:325–334.
  • 33. Naja F, Hamadeh R. Nutrition amid the COVID-19 pandemic: a multi-level framework for action. Eur J Clin Nutr 2020;74:1117–1121.
  • 34. Caso D, et al. Unhealthy eating and academic stress: The moderating effect of eating style and BMI. Health Psychol Open 2020;7:205510292097527.
  • 35. Gümüş AB, Yardımcı H, Keser A. Evaluation of Nutritional Situations according to Anxiety Score of Students Prepared for Exam. J Duzce Univ Health Sci Inst 2018;8:22–28.
  • 36. Rehman F, et al. Pattern and Associated Factors of Exam Anxiety among Students of Private Medical College Pakistan. PJMHS 2020;14:669–71.
  • 37. Eller T, et al. Symptoms of anxiety and depression in Estonian medical students with sleep problems. Depress Anxiety 2006;23: 250–256.
  • 38. Uney R, Erim BR. The effects of regular physical exercise on violent behavior, coping with stress and self-confidence in male prisoners of a closed prison/Kapali cezaevindeki kalan erkek mahkumlarda duzenli fiziksel egzersizin siddet davranisi, stresle bas etme ve ozguven uzerine etkileri. Anadolu Psikiyatri Derg 2019;20:619–627.
  • 39. Oğuz S, et al. Effects of Progressive Muscle Relaxation Exercises on Stress, Sleep Quality and Exercises Capacity in Young Adults. J Health Sci Prof 2019;6:534–544.
  • 40. Durmaz A, Gün Ç. Relationship Between Healthy Lifestyle Behaviors In Midwifery Students And The Exams. OPUS Int J Soc Res 2018;9:15–15.
  • 41. Savcı FDS, Öztürk UFM, Arıkan FDH. Physical activity levels of university students. Arch Turk Soc Cardiol 2006;34:166–172.
  • 42. Yildiz A, Tarakci D, Karantay Mutluay F. The Relationship between Body Composition and Physical Activity Level in the Young Adults: Pilot Study. Sağlık Bilim Ve Meslekleri Derg 2015;2:297.
  • 43. Ölçücü B, et al. The Relationship Between Depression, Anxiety and Physical Activity Level Among University Students. Int J Educ Sci 2015;2015:294–303.
  • 44. Yıldırım İ, et al. The Correlation Between Physical Activities and Depression Status Among itThe University Students. Niğde Univ J Phys Educ Sport Sci 2015;9:32–39.
Toplam 44 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Spor ve Beslenme
Bölüm Araştırma Makalesi
Yazarlar

Tuğçe Orkun Erkılıç 0000-0003-2395-7561

Bülent Bayraktar 0000-0002-2335-9089

Ali Ozan Erkılıç 0000-0001-8602-2419

Gülbahar Böyük Özcan 0000-0002-3453-2967

Yayımlanma Tarihi 30 Eylül 2024
Gönderilme Tarihi 2 Temmuz 2024
Kabul Tarihi 4 Ağustos 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 14 Sayı: 3

Kaynak Göster

APA Orkun Erkılıç, T., Bayraktar, B., Erkılıç, A. O., Böyük Özcan, G. (2024). Determination of Salivary Cortisol Levels and Nutrition, Smoking and Physical Activity Status of University Students during the Exam Period. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi Ve Folklorik Tıp Dergisi, 14(3), 594-604. https://doi.org/10.31020/mutftd.1508807
AMA Orkun Erkılıç T, Bayraktar B, Erkılıç AO, Böyük Özcan G. Determination of Salivary Cortisol Levels and Nutrition, Smoking and Physical Activity Status of University Students during the Exam Period. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi. Eylül 2024;14(3):594-604. doi:10.31020/mutftd.1508807
Chicago Orkun Erkılıç, Tuğçe, Bülent Bayraktar, Ali Ozan Erkılıç, ve Gülbahar Böyük Özcan. “Determination of Salivary Cortisol Levels and Nutrition, Smoking and Physical Activity Status of University Students During the Exam Period”. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi Ve Folklorik Tıp Dergisi 14, sy. 3 (Eylül 2024): 594-604. https://doi.org/10.31020/mutftd.1508807.
EndNote Orkun Erkılıç T, Bayraktar B, Erkılıç AO, Böyük Özcan G (01 Eylül 2024) Determination of Salivary Cortisol Levels and Nutrition, Smoking and Physical Activity Status of University Students during the Exam Period. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi 14 3 594–604.
IEEE T. Orkun Erkılıç, B. Bayraktar, A. O. Erkılıç, ve G. Böyük Özcan, “Determination of Salivary Cortisol Levels and Nutrition, Smoking and Physical Activity Status of University Students during the Exam Period”, Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi, c. 14, sy. 3, ss. 594–604, 2024, doi: 10.31020/mutftd.1508807.
ISNAD Orkun Erkılıç, Tuğçe vd. “Determination of Salivary Cortisol Levels and Nutrition, Smoking and Physical Activity Status of University Students During the Exam Period”. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi 14/3 (Eylül 2024), 594-604. https://doi.org/10.31020/mutftd.1508807.
JAMA Orkun Erkılıç T, Bayraktar B, Erkılıç AO, Böyük Özcan G. Determination of Salivary Cortisol Levels and Nutrition, Smoking and Physical Activity Status of University Students during the Exam Period. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi. 2024;14:594–604.
MLA Orkun Erkılıç, Tuğçe vd. “Determination of Salivary Cortisol Levels and Nutrition, Smoking and Physical Activity Status of University Students During the Exam Period”. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi Ve Folklorik Tıp Dergisi, c. 14, sy. 3, 2024, ss. 594-0, doi:10.31020/mutftd.1508807.
Vancouver Orkun Erkılıç T, Bayraktar B, Erkılıç AO, Böyük Özcan G. Determination of Salivary Cortisol Levels and Nutrition, Smoking and Physical Activity Status of University Students during the Exam Period. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi. 2024;14(3):594-60.
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