Fruit and vegetable intakes, associated characteristics and perceptions of current and future availability in Dutch university students

Exploring reasons for high levels of food insecurity and low fruit and vegetable consumption among university students post-COVID-19

High rates of food insecurity and low consumption of fruit and vegetables among university students have been observed prior to the COVID-19 pandemic and intensified during the pandemic. This study aimed to investigate food insecurity among university students and its associations with sociodemographic factors, fruit and vegetable consumption behaviours, and preferred campus programs to address these issues. A convenience sample of 237 Australian university students completed a cross-sectional online survey from October to December 2022. Food insecurity was assessed using the 10-item US Adult Food Security Module, applying the Canadian classification scheme. Sociodemographic variables, fruit and vegetable consumption behaviours, and perceptions of fruit and vegetable access and their affordability were included in the survey. Students were also asked to select the most suitable program(s) and provide reasons for their choice using open-ended questions. Approximately half of respondents (46.4%) were identified as food insecure. The proportion of students meeting the recommended intake of vegetables as specified in the Australian Dietary Guidelines was very low (5.1%) compared with fruit (46.2%). Low fruit consumption was significantly associated with food insecurity (OR = 1.81; 95%CI 1.03, 3.18, p = 0.038). Factors such as the perceived lower accessibility and higher price of fruit and vegetables were significantly associated with higher odds of food insecurity. In terms of potential programs, a free fruit and vegetable campaign was the most popular program, with affordability and physical access being the most frequently cited reasons. These findings suggest that food insecurity is associated with low fruit and vegetable consumption in university students. Therefore, transforming campus food environments and developing food policies at the university level must be considered to address food and nutrition security in university students.

Lifestyle Elements for Improving Mental and Physical Health in Japanese University Students: Subjective Sleep Quality is a Common Key Factor

This study aimed to reveal the key lifestyle elements that improve physical and mental health in university students by focusing on physical activity, nutrition, and sleep. This cross-sectional study was conducted between October 2021 and December 2021. The participants were 290 first-year students (mean age, 18.63 ± .63 years; age range, 18 to 23; 198 female). The outcomes were daily step counts measured using accelerometers, dietary intake by nutrient category, sleep duration, subjective sleep quality, exercise frequency and duration by exercise type, screen time, depression level, and subjective fatigue by body part. Depression and subjective eye fatigue represent mental and physical health outcomes. Subjective sleep quality predicted depression (β = -1.22, P < .001) and eye fatigue (β = -.23, P < .01) in the path analysis. Participants with higher subjective sleep quality performed more frequent aerobic exercise (P < .01), longer session times of physical relaxation exercise (P < .05), and shorter screen time (P < .05). Subjective sleep quality could be a key factor for high mental and physical health. Furthermore, performing aerobic and relaxation exercises and reducing screen time are important for improving the subjective sleep quality.

The influence of diet quality on health-related quality of life in undergraduates

Objective: Explore the relationship between fruit and vegetable (FV) intake and health-related quality of life (HRQOL) in undergraduates. Participants: Undergraduates (N = 655). Methods: Using the Centers for Disease Control's Healthy Days Core Module and National Cancer Institute's (NCI) FV screener, differences in HRQOL between students who had consumed above the sample's average FV intake and their counterparts were evaluated. Multiple regression analyses assessed behaviors that predicted HRQOL. Results: Differences existed between HRQOL of students who consumed above average FV (M = 2.2 1.3) and peers, F(9,602) = 509, p < 0.001, Wilk's Δ = 0.116, partial n2 = 0.884. Predictors explained 30.0% of the variance in days per month feeling healthy (r2 = 0.29, F(4, 549) = 58.6, p < 0.001): perceived stress (β = 0.46, p < 0.001), body mass index (BMI) (β = 0.11, p < 0.01), FV intake (β = 0.16, p < 0.001), and sleep duration (β = 0.08, p < 0.05). Conclusions: FV intake and modifiable behaviors influenced HRQOL, suggesting that multifaceted interventions could improve HRQOL in this population.

Changes in diet quality across life transitions from adolescence to early adulthood: a latent growth analysis

Background

Adolescence to early adulthood is a period of multiple education-, employment- and family-related life transitions. Changing resources and food environments within the context of these transitions could contribute to significant changes in diet, which persist into later adulthood. This study investigated diet quality trajectories from age 15 to 31 years and changes in diet quality associated with life transitions, by sex.

Methods

Data from the Project EAT (Eating and Activity in Teens and Young Adults) study were used to examine diet quality among a longitudinal cohort (n=2,524) across four waves (mean ages of 15, 19, 25 and 31 years). Diet quality was evaluated using the DASH (Dietary Approaches to Stop Hypertension) index. Life transitions were assessed by changes in life circumstances between pairs of waves, including leaving the parental home, leaving full-time education, beginning full-time employment, cohabitating with a partner, and becoming a parent. Average within-person changes in DASH scores were analysed by sex-specific latent growth models, incorporating underlying growth trajectories, five life transitions and baseline socio-demographic characteristics.

Results

Both sexes followed a quadratic trajectory of DASH scores, showing decreases in diet quality from waves 1 to 2 followed by increases until wave 4. Compared to females, males had worse diet quality at wave 1, and this sex difference widened at wave 4. Leaving the parental home between waves 1 and 2 was associated with transient decreases in diet quality at wave 2 only for males. For females, cohabitating with a partner and becoming a parent between waves 3 and 4 were respectively related to decreases and increases in diet quality at wave 4. Leaving full-time education and starting full-time employment respectively had long-term negative and positive associations with diet quality for both sexes.

Conclusions

Diet quality remained suboptimal throughout adolescence but to some extent improved across early adulthood. A sex-sensitive approach in public health policy is welcome for addressing sex differences in diet quality and dietary changes associated with family-related life transitions. Targeted dietary interventions are beneficial for young people who leave their parental home early or who do not enter into a structured school or workplace environment.

The campus food environment and postsecondary student diet: a systematic review

Objective: Examine the impact of the campus food environment on postsecondary students' dietary behaviors (e.g., dietary intake) and food purchasing. Participants: Students currently attending a postsecondary institution, all ages and geographic locations included. Methods: A systematic search from January 2000-October 2022 was conducted in six databases using postsecondary education, food environment, and diet related keywords. Results: In total, 25 quantitative and 10 qualitative studies were extracted. All quantitative studies that conducted statistical analyses (n = 15) reported a statistically significant relationship between the campus food environment and dietary intake, including both positive and negative effects. All qualitative studies (n = 10) discussed students' experience of the campus food environment influencing their diet. Conclusions: This review found moderate evidence that the campus food environment has an impact on postsecondary students' dietary behaviors. A campus environment that has healthy foods accessible, affordable, and acceptable for postsecondary students may have a beneficial impact on students' dietary intake.

Fruit and Vegetable Consumption Patterns and Risk of Chronic Diseases of Lifestyle among University Students in Kenya

This study assesses the fruit and vegetable consumption patterns and risk factors for chronic diseases of lifestyle (CDL) among young adults attending Kenyatta University, Kenya. Four hundred and twenty-three young adults aged 19–30 years participated in the cross-sectional study. Males were 75.0% less likely to be overweight than females (OR = 0.25; 0.13–0.47). The mean overall consumption of fruit and/or vegetables amounted to 3.6 servings in a typical day. Eight in ten participants consumed lower amounts of fruits and vegetables than recommended by the WHO. At least one combined risk factor of CDL was observed among 91.3% of the young adults. About 8.7% of the participants were classified as low risk for CDL (having none of the five risk factors), 48.9% had one risk factor, 32.9% had two risk factors, 8.5% had three risk factors, while 0.9% had four risk factors. A significant relationship between daily fruit consumption and waist circumference was observed. These findings show the dire need to develop public health nutrition activities aimed at increasing the intake of fruit and vegetables and sensitizing young adults, and the general population, to the risk factors of CDL.

Snacking pattern of college students in Saudi Arabia: a cross-sectional study

BACKGROUND

Although unhealthy snack foods are commonly consumed by college students, snacking patterns among college students have not been comprehensively examined in Saudi Arabia. In our study, we aimed to investigate snacking patterns among Saudi college students and to assess sociodemographic data that affect adherence to these snacking patterns.

METHODS

Between January 2021 and March 2021 in Jeddah, Saudi Arabia, an online survey was conducted with 662 college students from a Saudi university. The survey included sociodemographic questions and a short food frequency questionnaire (FFQ) regarding the consumption of common snack foods. Snacking patterns were generated from the FFQ using the factor analysis method.

RESULTS

Factor analyses generated seven snacking patterns, which explained 64.5% of the variance in snacking. Students in their early academic years (1-3 years) had a higher score for the convenience snack and fast-food pattern (0.22 ± 0.48 and 0.31 ± 0.52, respectively) than senior students (4-6 years) (P = 0.03 and 0.04, respectively). Healthy snacks patterns were higher among students at higher income levels (P = 0.006) and active students (P < 0.001) than among students at low- or mid-income levels and inactive students. Higher adherence to the beverages pattern was observed among male students (P = 0.03), active students (P = 0.01), and students with obesity than their counterparts (P = 0.02). The dairy products pattern was higher among male students (P = 0.04), students at higher income levels (P = 0.04), and students with obesity (P = 0.03) than their counterparts.

CONCLUSIONS

Most snacking patterns identified among the study participants were considered unhealthy. Adherence to healthy snacks is influenced by physical activity and family income. These findings may be helpful in the future for developing adequate nutrition education programs that promote health by adhering to healthy snack choices in this critical age group. Further studies are needed to confirm these findings and to investigate snacking patterns among other age groups in Saudi Arabia.

How Does the University Food Environment Impact Student Dietary Behaviors? A Systematic Review

The food environment has been implicated in creating an obesogenic generation; and while previous research has focused on population-wide initiatives, the university population resides in a research gap. To explore detailed components of the university food environment and what shaped dietary behaviors, we retrieved literature from the following databases: ScienceDirect, Scopus, PubMed, Medline, and EMBASE. Eleven studies were identified for qualitative content analysis and study quality assessment identified most of the studies as of good quality (n 8) and some as of fair quality (n 3). The certainty of evidence remained at a low level for all (n 11) studies due to the cross-sectional, observational nature of studies. Three major themes emerged: (1) food environment, (2) student perceptions (SPs), and (3) dietary outcome (DO). In a university food environment, the taste of food was paramount for the food choices of students, followed by the availability of food and the price of food. When university students perceive and choose foods and beverages, they sometimes regard unhealthy foods and beverages as healthy options. The diet quality of university students is more susceptible to living arrangements and socioeconomic status, but higher salt, fat, and added sugar consumption generally resulted in poorer quality of diet on campus. Future research could use novel methods to explore a wider range and deeper level of students' dietary behavior determinants in university food environments.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier: CRD42021283562.

Eating Behavior during First-Year College Students, including Eating Disorders-RUVIC-RUNEAT-TCA Project. Protocol of an Observational Multicentric Study

(1) Introduction: Changes in eating behavior and eating disorders are especially common in young people, especially teenage and college women. The first year of college is a critical period, as students acquire freedoms that can lead to poor eating habits. During this first year, students usually gain weight. The aims of this project are to analyze the risk of developing eating disorders, the composition and dietary intake and the changes in the body composition of two groups of college students (independent from the family nucleus or still living within the family) in the first year of college. (2) Material and Methods: Multicentric prospective observational study protocol in which first-year students at the Universidad Europea del Atlántico and Universitat de Vic-Universitat Central de Catalunya voluntarily took part in the study. The students will be divided into two groups, independent and those residing in the family home, and the evolution of both groups will be compared at the beginning and at the end of the school year by performing anthropometric measurements, tests on lifestyle and eating habits (Test of Adherence to the Mediterranean Diet, MEDAS-14; Emotional Eater Questionnaire, EEQ), validated questionnaires on eating disorders (Eating Attitude Test, EAT26; Teen Figure Drawing Scales; SCOFF, Eating Behavior Test; Bulimia Investigatory Test Edinburgh, BITE) and their intake will be evaluated through 72 h dietary records. (3) Discussion: Determining the risk of suffering eating disorders of alimentary behavior, knowing eating consumption, perception of the corporal image and body composition through the first year of college will be decisive in establishing alimentary education strategies to prevent possible eating disorders in young students.

Daily experiences of hangover severity and food consumption in young adults

OBJECTIVES

Our aim was to determine whether alcohol hangover is associated with eating unhealthy foods (hot chips, soft drink) or healthy foods (fruit, vegetables).

DESIGN

Daily diary study across 13 days (micro-longitudinal design).

METHODS

We examined a sample of 605 young adults (71% women; ages 17-25; mean age 19.91 [SD 1.86] years) who completed daily diaries in the university community and reported drinking alcohol at least twice during the 13-day study period. Each day, participants reported on their hangover severity, their consumption of fruit, vegetables, hot chips (French fries), and soft drink, and their alcohol consumption from the previous day. Linear mixed models were used to examine within-person associations between hangover severity and food consumption, by gender. Exploratory models also controlled for previous day alcohol consumption to acknowledge potential variability in hangover susceptibility.

RESULTS

On days when participants reported higher severity of hangovers, they reported consuming more hot chips (β = .09, p = .001), more soft drink (β = .08, p = .001) and less fruit (β = -.06, p = .05). In our exploratory model controlling for previous day alcohol consumption, the predictive effect of hangover severity on hot chips remained (β = .08, p = .009) and significant interaction effects were observed between gender and previous day alcohol consumption on fruit (β = -.03, p = .003) and vegetable (β = -.03, p = .03) servings.

CONCLUSIONS

Higher hangover severity may lead to greater intake of some unhealthy foods such as hot chips, an effect that may not be reduceable to those associated with alcohol consumption per se. Interventions that target excessive drinking primarily, but also emphasize the importance of a healthy diet, should be considered for this population.

Markets in Municipal Code: The Case of Michigan Cities

Food’s place on the urban, municipal agenda has become an increasing focus in the emergent fields of food policy and food planning, whose leaders argue that food needs to be more explicitly added to the urban agenda. Yet, public food markets are a food system activity that municipal governments have been long engaged in. Reports from leading health, planning, and food organizations assert that farmers markets—the dominant form of public retail food markets in the US today—should be explicitly included in zoning and other municipal codes to ensure that they can be created and sustained. Despite their popularity as a local sustainable food system and healthy food access strategy, it is unclear whether markets have been codified through municipalities’ planning and policy instruments, and research has largely not addressed this topic. This study aims to elicit whether markets have been codified into law, focusing on US municipal charters, codes and zoning ordinances, using Michigan, an upper Midwest state, as a case. After analyzing municipal documents to determine whether and where markets have been codified into law in ninety Michigan cities, this study concludes that markets are highly underrepresented in municipal policy, rarely defined in code, and mostly absent from zoning ordinances, even among those cities with currently operating markets. Market presence in code is, however, associated with the presence of historically operated markets. These findings raise questions about why markets are missing from codified food policy and what risks this poses to the future of markets. They also highlight the need to better document the market sector and underline the importance of including historic perspectives when examining the efficacy of current food policy efforts.

Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk

Health behaviors of higher education students can be negatively influenced by stressful events. The global COVID-19 pandemic presents a unique opportunity to characterize and compare health behaviors across multiple countries and to examine how these behaviors are shaped by the pandemic experience. Undergraduate and graduate students enrolled in universities in China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands and the United States (USA) were recruited into this cross-sectional study. Eligible students filled out an online survey comprised of validated tools for assessing sleep quality and duration, dietary risk, alcohol misuse and physical activity between late April and the end of May 2020. Health behaviors were fairly consistent across countries, and all countries reported poor sleep quality. However, during the survey period, the COVID-19 pandemic influenced the health behaviors of students in European countries and the USA more negatively than Asian countries, which could be attributed to the differences in pandemic time course and caseloads. Students who experienced a decline in sleep quality during the COVID-19 pandemic had higher dietary risk scores than students who did not experience a change in sleep quality (p = 0.001). Improved sleep quality was associated with less sitting time (p = 0.010). Addressing sleep issues among higher education students is a pressing concern, especially during stressful events. These results support the importance of making education and behavior-based sleep programming available for higher education students in order to benefit students' overall health.

A free-produce stand on campus: impact on fruit and vegetable intake in Dutch university students

OBJECTIVE

To investigate the effects of providing free fruit and snack vegetables at a university on students' fruit intake, snack vegetable intake and total vegetable intake.

DESIGN

Free fruit and raw snack vegetables (e.g. bite-sized tomatoes) were provided in a stand in the form of a miniature wooden house located in the central hall of the university's main building, which students regularly pass through on their way to lectures and the cafeteria. Three interventions tested with a pre-test/post-test design were performed. In these three interventions, small changes to the appearance of the stand were made, such as placing potted plants around it. Demographic characteristics and fruit and vegetable intakes were assessed with questionnaires.

SETTING

A Dutch university of applied science.

PARTICIPANTS

Intervention 1 included 124 students; Intervention 2 included ninety-two students; Intervention 3 included 237 students.

RESULTS

Longitudinal linear regression analyses showed that post-test snack vegetable intake was consistently higher compared with pre-test. In the three interventions, post-test snack vegetable intakes were between 11 and 14 g/d higher than at the pre-test, which is comparable to three bite-sized tomatoes. No differences in fruit intake or total vegetable intake were found. Subgroup analyses showed that, in all three interventions, students with the lowest pre-test fruit intake and total vegetable intake reported the largest increase in fruit intake and snack vegetable intake after the interventions.

CONCLUSIONS

Providing free fruit and vegetables to students at their university might be beneficial for those with low habitual intakes.

Vegetable Consumption and Factors Associated with Increased Intake among College Students: A Scoping Review of the Last 10 Years

Vegetable consumption is a predictor for improved health outcomes, such as reduced obesity and likelihood of food-related noncommunicable diseases. Young adults are a key population, being in a transitional stage-of-life: Habits gained here are taken through the lifespan. This review establishes insight into the consumption of vegetables among young adults during their college/university years, and factors associated with increased consumption. Seventy-one papers were extracted, published between January 2009 and October 2018. Search terms related to consumption; vegetables; and college/university setting and sample. A diverse range of definitions, guidelines, and study approaches were observed. Findings identify that the majority of students do not consume World Health Organization recommendations. Being female was the most frequent predictor of higher intake of vegetables, and no consumption patterns were identified by countries. Living at family home; body mass index; happiness and stress level; perceived importance of healthy eating; socioeconomic level; breakfast consumption; stage of study; openness to new experiences; sleep pattern; nutrition knowledge; activity level; alcohol usage; and energy intake were identified as influential factors. Public policies and new strategies to encourage vegetable consumption among college students are indispensable, especially targeting subgroups with even lower intakes, such as males and those living outside family home.