Self-organization of healthy lifestyle by students in moscow bi-region

. The study aims to reveal factors facilitating healthy lifestyle of modern students. This article presents the ﬁndings obtained in the case study “Our health” carried out in Moscow bi-region in October 2019. A group of researchers from Plekhanov Russian University of Economics surveyed students using online questionnaire method (N=2600). According to the ﬁndings, the widely-recognized health promotion activities are regular exercise, Sport classes at university, mental exercise, walks in the fresh air, listening to music. Some unconventional activities, for instance, walking upstairs, dancing and spending time on a hobby, also gained approval. The respondents showed little concern with oriental health-promoting activities and healing methods. Basically, most students prefer dynamic exercise to static one. Young adults rarely visit doctors or use medication. The respondents are not concerned much about their mental health, and thus, rarely apply for professional psychological help. The majority of the respondents value long and steady relations and speak against casual sexual relations, which proves their awareness on sexually transmitted disease prevention. In conclusion, we need to draw attention to certain discrepancy between intended value-based orientation towards healthy lifestyle and its translation into action.


Introduction
In the modern world, anthropogenic and environmental risks are increasingly growing, which, in turn, affects significantly the number and nature of stresses humans are suffering from. 1 Corresponding author: belyaev2011@mail.ru Currently, health concerns are associated with survival and preservation of the human as a distinct species [7, c. 183]. Population health is a crucial demographic factor, constituting a significant part of the human capital, and thus, shaping the country's future. A number of scholars express concerns about health deterioration in Russia, especially among children and adolescents, due to numerous factors related to political, economic, socio-psychological and environmental situation [2, p. 107; 10, p. 79]. In such context, health maintenance is seen as one of the most important objectives of the country's social policy. It is healthy lifestyle that primarily facilitates health preservation and health maintenance. Medical experts believe that health status is 50% dependent on lifestyle, the other factors affecting health are as follows: environment -20%, genetics -20%, healthcare standards -10% [8]. Scholars understand the term "healthy lifestyle" in a broad or narrow sense. Adherents of a philosophical and sociological approach offer an ultimately broad understanding of healthy lifestyle and see it as an integral part of public life [11,12]. Most researchers tend to associate healthy lifestyle with living habits that work on health maintenance and disease prevention [2,4,5,6]. As a rule, diseases are pluricausal by nature and can occur due to various factors. But first and foremost, diseases occur due to imbalance between qualities of an individual, i.e. strong personality, on the one hand, and a disease agent, on the other [8, p. 3]. People often create unfavorable environment, which cannot provide healthy lifestyle. Therefore, the key ingredients of healthy lifestyle are quitting bad habits, exercise and a healthy diet.
All healthy lifestyle adherents take quitting bad habits as a starting point on their way to healthy life -it is what they decide on when enrolling in wellness schemes. Both mental and physical activities produce positive impacts on the nervous system, CVS (cardiovascular system) the whole body function and work performance [3, p.177]. It is generally recognized that unhealthy diets can lead to a number of diseases, and thus, nutrition-related issues can be prevented by selecting a balanced diet for immune system reinforcement [1, p.105].

Materials and methods
We found it worth attention to explore health-promoting activities where modern students are willingly engaged for disease prevention and health promotion reasons. In this article, we present findings obtained in the 2019 case study "Our health" when we interviewed students from Moscow and Moscow region (N=2600). The study was initiated and guided by Professor Ekaterina Kargapolova. The benchmarking survey did not aim at representative sampling, and thus, the findings can be applied only to the aggregate data of the survey or used as a reference source. Nevertheless, the obtained data not only provide a significant amount of information to think over, but also enable to make valid conclusions. Data processing and analysis were performed using SPSS 17.0.

Results and discussion
Physical activity is one of the main components of healthy lifestyle. Motor activity delays aging and improves longevity. The first eight options given in Table 1 reflect certain aspects of physical activity (Table 1). Engagement in sporting activities, including Sport classes at university, was chosen as one of the most popular dynamic activities for disease prevention -57,6% of the respondents go in for sports "always", while 52,6% do sports "often". We assume that the detected trend results from several reasons -first, students have to attend Sport classes, as Sport is a core subject at Russian universities, second, active promotion of sporting activities in mass culture brought benefits [9, c. 198]. Engagement in mental exercise ranked among top five activities: 45.1% of the respondents always train brain by performing mental exercise and 34.7% often do it. The number of those who never engage in mental work is statistically insignificant. We explain the data by the fact that students are actively involved in learning, as a result, they continuously experience mental stresses. Unexpectedly, rather a popular choice was climbing up the stairs instead of using a lift -actually, the majority of the respondents prefer walking upstairs and do it always (25.4%) or often (31%). Such a choice can be explained by the design structure of Moscow universities where the number of floors is no mere than 10, besides, there are fewer lifts than needed and it may take too long to get into the lift, therefore, students see walking up the stairs as a non-competitive choice.
Equally enthusiastic the respondents feel about fitness workouts (38,8% attend gyms on the regular basis), stretching exercises (34,3% of regular users) and doing their daily exercise in the mornings and evenings (28,7%). All these types of sporting activities are socially recognized as tools used for prevention of diseases associated with sedentary lifestyle. However, according to the survey, there are certain constraints for making gym attendance a daily habit. The thing is that gym membership is rather costly, and thus, hardly affordable to a number of students. Another constraint is lack of spare time given busy schedule at universities.
The respondents also expressed enthusiasm about walking in the fresh air: they enjoy everyday outdoor walks (37.5%) or regular ones (36.6%). We take the data as a positive trend; actually, walking in green areas is extremely helpful for your body suffering from sedentary lifestyle; when going on foot we train muscles, improve eyesight and enhance blood vascular and respiratory systems. The choices "cold exposure training", "massage", "sauna/baths" proved less popular and received almost similar number of devoted fans. 24.9% of the respondents regularly go to baths and saunas, 22.5% enjoy regular sessions of massage, while 24.5% never use this service. Every fourth respondent has massage done only when needed despite the fact that every second student suffers from postural disorder [9, p.42]. Cold exposure training is basically unpopular among young adults. Only every fifth practices it regularly, however, 36.9% never experiment with cold hardening.
Noteworthily, the statistically significant number of the respondents do not see yoga, breathing exercises and meditation as main priorities for health preservation. Modern students feel largely skeptical about meditation. 7,1% of the respondents think of it as a waste of time as far as health care is concerned, 43,1% never did yoga, 29,1% never did breathing exercises. Seemingly, such practices as yoga or breathing exercises must be highly demanded given a number of affordable online courses. Nevertheless, oriental practices gain little popularity among modern students and we tend to explain this by sedentary lifestyle of most students who spend hours at their desks before their laptops, and thus, prioritize dynamic leisure activities over static ones. Basing on the statistical data, we come to a conclusion that modern students underestimate traditional time-tested oriental health maintenance and healing methods.
"Listening to music" was recognized as an alternative static activity for disease prevention by the majority of the respondents. The option "always" was chosen by 58,1% of the surveyed, while 21,4% chose "often". Therefore, "listening to music" ranked second among all the offered disease prevention activities, following right after the favorite "mental exercise". You can listen to music anywhere, at home, at work or at university, when travelling to work or university and any gadget provides the service, which makes this practice widely used. Therapeutic effects of classical music found evidence in academic medicine, and thus, actively exploited by sanatorium-resort care [8].
According to the survey, jogging is one of the least practiced health promotion activities, though medical experts almost unanimously recognize its significant benefits [5, p.192]. Only 12% of the respondents "always" go jogging, 17,9% do it "often", 28,7% take it up from time to time, nearly 20% practice this activity when they feel need for it, 20,4% never do it. A statistically insignificant number of the surveyed admitted irrelevance of jogging for health preservation. Taking into account the fast pace of life in a megapolis and a number of associated stresses, just few students are able to save time for jogging.
Homeopathy also gained little approval. It is never practiced by 35,5% of the respondents, 17,4% find homeopathy irrelevant for health preservation, though until recently homeopathy was part of academic medical care in the Russian Federation and it is still practiced by many families [8].
Exercise for better eyesight, though strongly recommended for high school juniors and seniors, is still far from being a well-spread health-promoting exercise. As the survey shows, students know this method of vision correction, though it is regularly practiced only by 24,4% of the respondents, slightly over 23% use it sometimes or when needed, 24,7% never train eyes. The results are rather predictable given the short-term effect of the training; it definitely helps relieve eyestrain but for a short period [5, p. 154].
Earlier ambulation is not a common practice -only one third of the respondents always or often see a doctor on the first symptoms of a disease; the 8-th never does this. Thus, nearly 65% of the surveyed disregard timely diagnosis, which might be explained by lack of time and casual attitudes of young people towards health issues. However, every third student undergoes periodic health examination, which is a conditionally mandate procedure.
The large majority of the respondents made their choice for long and steady sexual relations and against casual relationships. Actually, measures of sexually transmitted disease prevention turned out to be the most popular practice. 67% of the respondents reject casual relations and 73.6% value long-term relations with the same sexual partner. Such results suggest the respondents' awareness of the risks associated with casual sexual relations.
Psychological counselling, which is widely recognized in Europe and the US, has not become a regular practice among Russian students. 15.8% of the respondents sometimes see psychologists or psychotherapists and 20.5% ask for psychological help only when needed. Regarding psychological counselling, the options "always", "often", "do not take it as a health preservation measure" received almost the same appraisal -9.2%, 8.3% and 9.0% respectively. Evidently, even young adults from the capital city do not yet take their mental health as seriously as physical one.
Only every 8-th respondent expands knowledge in health-related matters and nearly the same number of the surveyed do not associate health education with health preservation instruments. Such attitudes can stem from understanding a gap between theory and practice.
On the contrary, hobbies and leisure activities are very popular among students: choice "always" about using a hobby for health preservation accounts for 35,9% of the aggregate data, choice "often" accounts for 25,3%. We assume that a hobby is so popular not because of its knock-on effect on health preservation but rather because of satisfaction and pleasure gained during the process. This is in line with assumptions about main priorities of young adults who prefer pleasure-giving activities to useful ones for the long run.
Every third student receives regular health resort treatment and travels to the seaside, which is recognized as a helpful health preservation measure. A small minority (14,2%) never uses such practices. Such attitudes can be explained by several reasons: first, health resorts are rather costly, second, the majority of health resort visitors are seniors, third, most young adults enjoy excursion tours for new knowledge and new impressions.
Activity holidays, hikes and travels received almost identical appraisal: 50,5% enjoy regular activity holidays, 51,3% go hiking and 47% travel on the regular basis. We assume that the respondents might draw little distinction between these three types of activities.
As expected, dancing became one of the most popular choices: 37.5% of the respondents rank dancing among their regular activities. 5,2% of the surveyed find few associations between dancing and health preservation matters. Dancing courses have recently been actively promoted on television and in the Internet with the focus on its potential benefits for muscle training, back posture shaping and gracefulness formation. Apart from that, everyone can go dancing at home by using video tutorials or at university by attending dancing clubs.
Noteworthily, a break from using electronic devices is seen as a form of health promotion and disease prevention: 13,8% of the respondents choose "always" when giving their opinion on the issue, 18,2% often put aside their gadgets to have a break and relax. However, the number of the choices goes up when the respondents make choices for occasional refusals of using gadgets: 33,5% sometimes arrange time off online activities, 20,2% are ready to stop using devices only when it is needed. The data suggests several assumptions: first, the respondents are clearly aware of negative health-related effects from permanent exposure to electronic devices [6], although only a minority of the respondents are ready to stop using electronic gadgets continuously.
According to the survey, cosmetic procedures such as cosmetic operations, facial massage and beauty injections gained little approval from the respondents. Nearly 12% deny any use in visiting a cosmetologist for health preservation, only every fifth uses cosmetology services and nearly 20% never visit cosmetologists. 42,7% are against beauty injections and 28,1% show skepticism about cosmetic operations. We associate the survey results with several factors: first, young adults are definitely not target users of cosmetic services, second, the respondents are well-informed about loopholes in the law and insufficient compliance monitoring in this field, in particular, cosmetic procedures and cosmetic medication. Information about use of stem cells (which is medically meaningless) in production of beauty injections affects badly the image of the latter.
Two final questions in the questionnaire were about use of chemical and natural pharmaceutical products. We find it rather reassuring that the majority of the respondents take pharmaceutical drugs only when it is needed (25,8% made this choice with regard to chemical drugs and 28,2% to natural medication). This option is definitely the most adequate when it comes to use of pharmaceutical products. The choices in favor of natural medication outnumber the ones for chemical counterparts by nearly 3%, which does not seem well-reasoned enough as most pharmaceutical products are biochemical. Noteworthily, over 10% of the respondents found the both practices useless for health preservation, which is hardly interpretable. The respondents might mean use of over-the-counter drugs, which is at best ineffective, and at worst harmful for health.

Conclusions
Summing up, the study revealed core health preservation measures prioritized by students from Moscow and Moscow region. Their major priorities are as follows: mental exercise, listening to