Few studies have used a multidimensional approach to describe lifestyle changes among undergraduate students during the COVID-19 pandemic or have included controls. This study aimed to evaluate lifestyle behaviors and mental health of undergraduate students and compare them with an age and sex-matched control group. A cross-sectional web survey using snowball sampling was conducted several months after the beginning of COVID-19 pandemic in Spain. A sample of 221 students was recruited. The main outcome was the total SMILE-C score. Students showed a better SMILE-C score than controls (79.8 + 8.1 vs. 77.2 + 8.3; p < 0.001), although these differences disappeared after controlling for covariates. While groups did not differ in the screenings of depression and alcohol abuse, students reported lower rates of anxiety (28.5% vs. 37.1%; p = 0.042). A lower number of cohabitants, poorer self-perceived health and positive screening for depression and anxiety, or for depression only were independently associated (p < 0.05) with unhealthier lifestyles in both groups. History of mental illness and financial difficulties were predictors of unhealthier lifestyles for students, whereas totally/moderate changes in substance abuse and stress management (p < 0.05) were predictors for the members of the control group. Several months after the pandemic, undergraduate students and other young adults had similar lifestyles.

Universidade Federal do Rio Grande do Sul. Instituto Nacional de Ciência e Tecnologia Translacional em Medicina. Departamento de Psiquiatria. Porto Alegre, Brasil.

McMaster University. Department of Psychiatry and Behavioural Neurosciences. Mood Disorders Program, St. Joseph’s Healthcare. Hamilton, Canada

Instituto de Investigación Sanitaria del Principado de Asturias. Servicio de Salud del Principado de Asturias. Oviedo, Spain

Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.

Universidad de Córdoba. Departamento de Ciencias Morfológicas y Sociosanitarias. Córdoba, Spain.

Universidad de Sevilla. Facultad de Medicina. Departamento de Psiquiatria. Sevilla, Spain

Universidad de Oviedo. Escola de Medicina. Departamento de Psiquiatria. Oviedo, Spain.

Instituto Maimónides de Investigación Biomédica de Córdoba. Córdoba, Spain.

Universitat Politècnica de València. CMT-Motores Térmicos. Valencia, Spain.