College students' interpretations of food security questions: results from cognitive interviews

Food Insecurity, MyPlate Recognition, and Meal Preparation Confidence Among College Food Pantry Users

OBJECTIVE

This study examined college students' food security status, Choose MyPlate familiarity, and confidence in preparing healthy meals using food pantry ingredients.

METHODS

A sample of 354 student users of a college food pantry in the US southeastern region were surveyed before using the food pantry for the first time.

RESULTS

Of the respondents, 81.3% were food insecure, and 47% of the overall sample experienced very low food security. About one-third (37.3%) recognized MyPlate; of those, 89.4% stated intention to use MyPlate knowledge making pantry selections. Students familiar with MyPlate (P = 0.003) and intending to use MyPlate when making food selections (P = 0.02) exhibited greater confidence. Differences were not observed on the basis of food security status.

CONCLUSIONS AND IMPLICATIONS

These findings suggest that familiarity with simple nutritional guidelines such as MyPlate may improve students' intended food pantry selections and healthy meal selection confidence.

Research trends and gaps concerning food insecurity in college students in the United States: a scoping review

OBJECTIVE

This scoping review explores the broad body of peer-reviewed research measuring food insecurity in post-secondary students in the U.S. to identify trends and gaps to inform future research.

METHODS

Three search engines (PubMed, Web of Science, and CINHAL Full Text) were systematically searched for articles reporting on food security status in U.S. college students.

RESULTS

One-hundred and sixty studies met inclusion criteria. Emerging high-risk student characteristics include gender non-conforming (GNC) and non-binary, financial independence in college, and pregnant and parenting students. Emerging correlates include lack of transportation, anxiety, and eating disorders.

CONCLUSIONS

Prevalence data can be used by colleges to advocate for services and programs. Additional multi-institutional cohort, longitudinal and qualitative studies are needed to identify timely interventions and effective solutions. A new "rights-based" approach to food security solutions that includes nutrition and food literacy for all students is needed.

Advancing college food security: priority research gaps

Despite over a decade of both quantitative and qualitative studies, food insecurity among US college/university students remains a pervasive problem within higher education. The purpose of this perspective piece was to highlight research gaps in the area of college food insecurity and provide rationale for the research community to focus on these gaps going forward. A group of food insecurity researchers from a variety of higher education institutions across the United States identified five thematic areas of research gaps: screening and estimates of food insecurity; longitudinal changes in food insecurity; impact of food insecurity on broader health and academic outcomes; evaluation of impact, sustainability and cost effectiveness of existing programmes and initiatives; and state and federal policies and programmes. Within these thematic areas, nineteen specific research gaps were identified that have limited or no peer-reviewed, published research. These research gaps result in a limited understanding of the magnitude, severity and persistence of college food insecurity, the negative short- and long-term impacts of food insecurity on health, academic performance and overall college experience, and effective solutions and policies to prevent or meaningfully address food insecurity among college students. Research in these identified priority areas may help accelerate action and interdisciplinary collaboration to alleviate food insecurity among college students and play a critical role in informing the development or refinement of programmes and services that better support college student food security needs.

Visceral sensitivity, hunger responsiveness, and satiety responsiveness: Associations between facets of gastrointestinal interoception and disordered eating profiles in an undergraduate sample

This preregistered study examined associations between empirically derived profiles of disordered eating in a diverse nonclinical sample and three facets of gastrointestinal (GI) interoception (visceral sensitivity, hunger responsiveness, satiety responsiveness). University students (n = 591; 53.3% women; 23.0% Hispanic) completed the Visceral Sensitivity Index, Adult Eating Behavior Questionnaire, and Eating Pathology Symptom Inventory. Latent profile analysis was conducted in Mplus v8.3 with four behavioral indicators (restricting, binge eating, excessive exercise, purging [binary]). Facets of GI interoception predicting odds of disordered eating profile membership compared to an asymptomatic group were evaluated. Five profiles were identified. Facets of GI interoception differentially predicted odds of membership in disordered eating profiles. However, higher scores on all three facets of GI interoception were associated with increased odds of membership in a high disordered eating profile. The relationship between distinct facets of GI interoception and specific disordered eating patterns appears nuanced, though individuals displaying a range of disordered eating behaviors may exhibit broad GI interoceptive dysfunction. Findings are consistent with the recent emphasis on idiographic treatment approaches for disordered eating and may have implications for screening among university students. Prospective longitudinal work and extension to clinical samples is needed.

Systematic investigation of inadequate food access at a large southeastern land grant university

Over the past decade, the impact of low food security on student well-being and academic performance has become a growing concern at institutions of higher education across the U.S. This mixed methods study adds to the growing body of evidence on the association between student socio-demographic and economic characteristics and food security. An online survey covering food access, student well-being, and housing security was sent to 35,337 undergraduate and graduate students at a large southeastern land grant university. A total of 2,116 complete responses were received; a 6% response rate. The survey responses also included 176 written statements by students. The survey found that 16% of both undergraduate and graduate students had low or very low food security, as defined by a modified USDA food security measure. The socio-demographic and economic characteristics that were linked to a higher likelihood of low food security included: having a GPA of less than 3.0, having a disability, being an international student, being a first-generation student, being a transfer student, going into debt to pay for food, being a Black or African American student, having poor mental health, having uncertain living arrangements, and having no medical insurance. Recommendations for enhancing student access to food, housing, and mental health services are discussed.

Factors associated with food security of Texas Woman's University freshmen

OBJECTIVE

To investigate what factors are associated with food insecurity (FI) among freshman students and identify potential solutions.

PARTICIPANTS

73 freshman students.

METHODS

Cross-sectional, Internet survey-based study. Fisher's Exact tests examined factors associated with food security (FS); Cohen's Kappa assessed the agreement between FI scores and self-assessment; thematic analysis used Nvivo 12.

RESULTS

FI was 54.2% among the diverse students (65% non-white). Factors associated with FS included mother with a college degree (p = .018); father employed full-time (p < .001); identifying one's family financial situation as better than others (p = < .001); not obtaining personal student loans (p = 0.022). Students with FI tended to overestimate their FS status. Suggested solutions for FI included: improved finances, improved food accessibility, improved cooking skills.

CONCLUSIONS

Future interventions should target freshmen who obtain personal student loans or have parents with less than a college degree or unstable employment status. (148).

Struggling with the basics: food and housing insecurity among college students across twenty-two colleges and universities

OBJECTIVES

To quantify the number and type of students failing to secure basic needs.

PARTICIPANTS

Students attending 22 postsecondary schools in the United States in Fall 2019.

METHODS

The Adult Food Security Module and part of the #RealCollege Survey were used to measure food and housing insecurity, respectively. Logistic and linear regression models were used to assess the relationship between selected factors and basic needs insecurities.

RESULTS

Participants (n = 22,153) were classified as 44.1% and 52.3% food insecure and housing insecure, respectively. Homeless students or those who experienced childhood food insecurity were at the greatest odds of college food insecurity. Year in school was the largest contributor to being housing insecure, with PhD or EdD students being 1,157% more likely to experience housing insecurity compared to freshmen.

CONCLUSIONS

High prevalence of basic needs insecurities remain. Current campus initiatives may be insufficient, calling for a more holistic approach at the campus, state, and national levels.

Evaluation of food security status, psychological well-being, and stress on BMI and diet-related behaviors among a sample of college students

OBJECTIVES

The purpose of this study was to evaluate food insecurity on body mass index (BMI) and diet-related behaviors among college students and whether psychological well-being (PWB) and stress levels mediate this relationship.

STUDY DESIGN

This was a cross-sectional study.

METHODS

Data from 1439 students from the American College Health Association National College Health Assessment III (Fall 2020) were used. Food security status was evaluated by the USDA Six-Item Short Form. PWB was measured using the Diener Flourishing Scale. Diet-related behaviors included the average servings of fruits, vegetables, and sugar-sweetened beverages consumed per day. Stress was measured by self-reported levels. Regression model analysis evaluated the influence of food security status, PWB, and stress levels on BMI. PWB and stress were also tested as mediators in the relationship between food insecurity and BMI.

RESULTS

Among our sample of college students, 44.54% (n = 641) were food insecure, and 55.46% (n = 798) were food secure. Multiple regression analysis showed that higher food insecurity, older age, full-time enrollment status, and fifth-year student status were positively associated with a higher BMI score (P < 0.05). Results from mediation models revealed that PWB, but not stress, mediated the relationship between food security and BMI among Black/African American students. Regarding diet-related behaviors, high stress levels mediated the relationship between food insecurity and sugar-sweetened beverage intake among students.

CONCLUSIONS

Food insecurity appears to influence BMI in college students. This relationship seems to be mediated by disrupted PWB and a higher intake of sugar-sweetened beverages due to stress.

Household food insecurity in South Africa from 1999 to 2021: a metrics perspective

OBJECTIVE

To review and synthesize studies on household food security in South Africa.

DESIGN

Systematic mapping review of metrics (methodological review).

SETTING

Electronic databases, including EBSCOHost, Scopus and Web of Science, were searched for studies and reports on household food security in South Africa, reporting household food security published between 1999 and 2021. Searching, selecting and reporting were performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement.

PARTICIPANTS

South African households.

RESULTS

Forty-eight articles reporting on six national surveys (one repeated annually since 2002) and forty sub-national studies meeting the inclusion criteria were selected. Various metrics, with different recall periods and ways of categorizing food security levels, were identified. Surveys that used similar metrics showed that the percentage of South African households that have experienced food insecurity and hunger has decreased over the review period yet remains concerning. However, the multitude of metrics used to assess the different components and levels of food security limits the comparability of the results to evaluate the scope and scale of the problem.

CONCLUSIONS

There is growing support for developing multi-variable approaches for food security research in sub-Saharan Africa. Future research should focus on finding the most appropriate combination of complementary metrics that would allow comparable data while holistically capturing food security and providing insight into the causes and consequences.

Measuring Food Security among American Indian and Alaska Native Adults: Validity Evidence Supports the Use of the US Department of Agriculture Module

BACKGROUND

Inequities in access, availability, and affordability of nutritious foods produced by settler colonialism contribute to high rates of food insecurity among American Indian and Alaska Native (AI/AN) households. Efforts to understand the influences of food security programming among AI/AN individuals in the United States are constrained by the absence of validity evidence for food security assessments for this population.

OBJECTIVE

This study assessed whether AI/AN adult responses on the Food Security Survey Module provide an accurate assessment of food security prevalence, especially when compared with other racial and ethnic groups.

DESIGN

A correlational design with the cross-sectional 2019 National Health Interview Survey was used to address the research objective.

PARTICIPANTS AND SETTING

The 2019 National Health Interview Survey contains a sample (N = 30,052) representative of the resident civilian noninstitutionalized population.

MAIN OUTCOME MEASURES

The primary outcome was food security, as characterized by the 10-item US Department of Agriculture Adult Food Security Survey Module. The module evaluates whether insufficient finances result in perceived food shortages and a reduction in the quantity and/or quality of food intake during the prior 30 days.

STATISTICAL ANALYSES PERFORMED

Data were analyzed by racial and ethnic subsamples to assess scale dimensionality (confirmatory factor analysis), Item Response Theory item analysis, differential item functioning, and external validity (χ2 tests).

RESULTS

Results supported the use of the 10-item module for racial and ethnic groups. However, differential item functioning effect sizes exceeded criteria for the Asian, AI/AN, and Hispanic respondents when compared with White respondents. Food security was not significantly related to all expected correlates in the AI/AN subsample.

CONCLUSIONS

Compelling evidence is presented for validity of the FSSM scores in determining food security status of AI/AN adults. Qualitative inquiry that explores how culture influences the way food security is conceptualized and experienced is warranted.

Home-prepared meals among college students at-risk for food insecurity: A mixed-methods study

The ability to prepare meals at home is an important life skill with potential to improve dietary quality and reduce costs and thus may be particularly important for college students with food insecurity. However, heavy time demands, limited financial resources, and therefore other barriers such as lack of motivation to follow a healthy diet may constrain meal preparation skills. To gain greater insight into this issue, we conducted a mixed-methods study. The quantitative component assessed relationships among food security, motivation, and meal preparation skills. The qualitative component used focus groups to more closely consider college students' perceptions, values, and barriers surrounding preparing meals at home, including current practices, desired future practices, and the ways in which the campus could support their efforts. The survey (n = 226) assessed food security, meal preparation skills, and motivation (i.e., perceived ability and willingness) to consume a healthy diet. Ten focus groups (n = 60) discussed food choice, meal preparation practices, and ways in which the campus could help students develop meal preparation skills. Students with food insecurity had lower meal preparation skills and lower perceived ability to consume a healthy diet. However, a) willingness to consume a healthy diet and b) the impact of both willingness and perceived ability did not differ by food security status. Focus group data indicated that in-person and online cooking classes, information cards in the food pantry, and incentives (e.g., kitchen equipment and vouchers from local grocery stores) were popular ideas for improving home-meal preparation. A greater understanding of meal preparation skills and their interconnectedness to food choice and the campus environment may inform effective ways to support the ability and willingness of college students with food insecurity to prepare meals at home.

Examining food security among minority student groups, with particular attention on diversity and inclusion

Objective: To identify signs of food insecurity (FI) and coping strategies among university students from three minority groups. Participants: Participants consisted of 3155 university students: 25.58% first-generation, 16.86% nonwhite, and 4.63% international. Methods: Students answered a questionnaire composed of the 2-item Hunger Vital Sign for food security, and questions about demographics, food campus resources, and coping strategies. Results: Among the three minorities, most students (53-57%) reported being food insecure. The food insecurity status was associated with being a senior, or graduate student, having participated in high school food programs, and use of university food resources in all minority groups. Also, a variation in the use of coping strategies to obtain food was reported among minority groups. Conclusion: There is a need to articulate minorities' awareness and use of the university's nutritional resources to face the high rates of FI. Campus initiatives should focus on the reality of underserved populations.

The Role of Campus Food Pantries in the Food Security Safety Net: On-Going or Emergency Use at a Midwest Campus Pantry

Food pantries are an integral part of the food security safety net and were designed to distribute emergency food to alleviate short-term hunger. Given many rely on assistance long-term, food pantries may no longer meet the nutritional needs of the typical food pantry user. Less is known about the extent college students use campus food pantries and whether they seek ongoing food support. A comprehensive analysis of food pantry use, including reach, awareness, and student satisfaction was conducted using a cross-sectional campus survey, a student satisfaction survey, and observational data from pantry logs collected from August 2020 to May 2022. During the first year of operation, 20.6% of students were aware of the pantry, 3.1% of students were reached, and student satisfaction was high. About half of users visited once, while 15.4% visited 8 or more times during an academic year. On average, students that visited more had a larger span of use (6.5 months), visited more frequently (2 weeks between visits), and were more likely to be graduate students and older. While most students used the pantry in the short-term, chronic use of the pantry increased from year 1 to year 2. This suggests need may be growing and additional policies or programs are warranted to support students with chronic food needs.

Persistent and Episodic Food Insecurity and Associated Coping Strategies Among College Students

OBJECTIVE

To determine the rates of episodic and persistent food insecurity among college students and whether coping strategies employed differs on the basis of food security status.

DESIGN

Online cross-sectional survey administered in March 2021.

SETTING

A large Midwestern university.

PARTICIPANTS

A random sample of students (n = 5,000) were invited to participate via email with a response rate of 20% (n = 888).

MAIN OUTCOME MEASURES

Food insecurity was assessed using the 10-item US Department of Agriculture Adult Food Security Survey Module. Food acquisition and management coping strategies were measured using modified questionnaires.

ANALYSIS

Pearson's chi-squared tests, 1-way ANOVAs, and post hoc analyses were conducted to examine associations of sociodemographic factors and coping strategies with food security status. Linear regression models were used to estimate the association between the coping strategies scale and subscales with food insecurity status.

RESULTS

The food insecurity rate was 22%, with 11% and 10% of students experiencing episodic and persistent food insecurity, respectively. Coping strategies varied significantly by food security status (P < 0.001), with students facing persistent food insecurity employing coping strategies most frequently.

CONCLUSIONS AND IMPLICATIONS

Future research is needed to better understand the persistent nature of food insecurity and coping strategies to develop tailored policies and programs for the college student population.

Online Food Security Discussion Before and During the COVID-19 Pandemic in Native Hawaiian and Pacific Islander Community Groups and Organizations: Content Analysis of Facebook Posts

Background

The Native Hawaiian and Pacific Islander (NHPI) population experiences disproportionately higher rates of food insecurity, which is a risk factor for cardiometabolic diseases such as cardiovascular disease, type 2 diabetes, obesity, and hypertension, when compared to white individuals. Novel and effective approaches that address food insecurity are needed for the NHPI population, particularly in areas of the continental United States, which is a popular migration area for many NHPI families. Social media may serve as an opportune setting to reduce food insecurity and thus the risk factors for cardiometabolic diseases among NHPI people; however, it is unclear if and how food insecurity is discussed in online communities targeting NHPI individuals.

Objective

The objective of this study was to characterize the quantity, nature, and audience engagement of messages related to food insecurity posted online in community groups and organizations that target NHPI audiences.

Methods

Publicly accessible Facebook pages and groups focused on serving NHPI community members living in the states of Washington or Oregon served as the data source. Facebook posts between March and June 2019 (before the COVID-19 pandemic) and from March to June 2020 (during the COVID-19 pandemic) that were related to food security were identified using a set of 36 related keywords. Data on the post and any user engagement (ie, comments, shares, or digital reactions) were extracted for all relevant posts. A content analytical approach was used to identify and quantify the nature of the identified posts and any related comments. The codes resulting from the content analysis were described and compared by year, page type, and engagement.

Results

Of the 1314 nonduplicated posts in the 7 relevant Facebook groups and pages, 88 were related to food security (8 in 2019 and 80 in 2020). The nature of posts was broadly classified into literature-based codes, food assistance (the most common), perspectives of food insecurity, community gratitude and support, and macrolevel contexts. Among the 88 posts, 74% (n=65) had some form of engagement, and posts reflecting community gratitude and support or culture had more engagement than others (mean 19.9, 95% CI 11.2-28.5 vs mean 6.1, 95% CI 1.7-10.4; and mean 26.8, 95% CI 12.7-40.9 vs mean 5.3, 95% CI 3.0-7.7, respectively).

Conclusions

Food security–related posts in publicly accessible Facebook groups targeting NHPI individuals living in Washington and Oregon largely focused on food assistance, although cultural values of gratitude, maintaining NHPI culture, and supporting children were also reflected. Future work should capitalize on social media as a potential avenue to reach a unique cultural group in the United States experiencing inequitably high rates of food insecurity and risk of cardiometabolic diseases.

Differences in Measured and Self-Categorized Food Security Status and Related Coping Strategies among College Students

Qualitative studies suggest that college students with food insecurity (FI) experience stigma and misinterpret some of the USDA Adult Food Security Survey Module (AFSSM) questions, leading to misclassification of food security (FS) status. We aimed to evaluate differences in AFSSM-measured FS status and self-categorized FS status (based on USDA descriptions of the four FS levels) among college students, and to identify differences in the coping strategies and BMI of these students. Data were collected cross-sectionally from a convenience sample via web-based, self-reported surveys. Measured FS, self-categorized FS, coping strategies, and self-reported BMI were key variables of interest. Participants were 1003 undergraduate and graduate students (22.2 ± 4.6 years; 65.7% female). Of the participants measured as food insecure (40.0%), 57.8% self-categorized as food secure (MFI-SFS) and 42.2% self-categorized as food insecure (MFI-SFI). Significantly more MFI-SFI participants were AFSSM-categorized as having very low FS when compared to MFI-SFS participants (71.6% vs. 46.6%, p < 0.05). MFI-SFI participants reported significantly higher BMI (M = 24.7, SD ± 6.0 kg/m2) and coping strategies scores (M = 49.8, SD ± 7.5) when compared to MFI-SFS participants (M = 23.1, SD ± 3.6 kg/m2; M = 46.9, SD ± 7.5, respectively, p ≤ 0.01). Assessment of and interventions to address FI among college students should consider the potential influence of self-perception and students’ interpretation of survey questions.

Risk of Food Insecurity in Young Adulthood and Longitudinal Changes in Cardiometabolic Health: Evidence from the National Longitudinal Study of Adolescent to Adult Health

BACKGROUND

Studies have demonstrated relations between food insecurity, the lack of access to enough nutritious food, and greater risk of diet-sensitive chronic diseases. However, most prior evidence relies on cross-sectional studies and self-reported disease.

OBJECTIVES

The objective was to assess the longitudinal relation between risk of food insecurity in young adulthood and changes in diet-sensitive cardiometabolic health outcomes across 10 y among non-Hispanic white, non-Hispanic black, American Indian or Alaska Native, and Hispanic adults.

METHODS

Data from the fourth and fifth waves (n = 3992) of the National Longitudinal Study of Adolescent to Adult Health were used. Measures included risk of food insecurity, body weight, diabetes, and sociodemographic characteristics. Body weight and diabetes were assessed with direct measures. Mixed-effects models assessed the association of risk of food insecurity with BMI, obesity, and diabetes while accounting for sociodemographic characteristics and the complex survey design.

RESULTS

Risk of food insecurity was associated with increases in BMI as well as incidence of obesity and diabetes from young to middle adulthood in unadjusted and adjusted models (all P < 0.01). In models stratified by race and ethnicity, the relations of risk of food insecurity with body weight outcomes and diabetes varied.

CONCLUSIONS

Risk of food insecurity in young adulthood was related to BMI and obesity during young and middle adulthood but not in changes over time. Risk of food insecurity in young adulthood related to an increased incidence of diabetes in middle adulthood. However, the relations among specific racial and ethnic groups were unclear. Estimates of the relation between food insecurity and cardiometabolic health outcomes within racial and ethnic groups experiencing the highest prevalence of these conditions should be refined.

Nutritional Concerns among Female International Volunteers Based on the Income and Development Status of Their Country of Service

This study aimed to determine the prevalence of female athlete triad risk factors among female international volunteers based on the development and income status of their country of service. A total of 2164 past volunteers completed a retrospective survey. Countries’ income and development statuses were coded using the respective annual United Nations World Economic Situations and Prospects reports. Independent t-tests, ANOVAs, and Pearson’s Chi-Squared tests were used to assess group differences; corresponding odds ratios were calculated. Volunteers in nondeveloped (OR = 2.25, CI = 1.85–2.75) and non-high-income (OR = 2.17, CI = 1.75–2.70) countries had over twice the odds of experiencing secondary amenorrhea. More volunteers who served in nondeveloped countries reported an increase in exercise while serving (p = 0.005). Those who served in a nondeveloped (OR = 1.52, CI = 1.16–1.98) or non-high-income (OR = 1.45, CI = 1.08–1.94) country had higher odds of weight loss. However, volunteers serving in nondeveloped (OR = 0.52, CI = 0.44–0.63) and non-high-income (OR = 0.50, CI = 0.4–0.61) countries were less likely to report food insecurity compared to those in developed and high-income countries. Bone mineral density was within the expected range regardless of income and development status. Female volunteers who served in nondeveloped and non-high-income countries experienced higher odds of secondary amenorrhea, which was likely influenced by an increase in exercise and higher odds of weight loss.

A Decade of College Student Hunger: What We Know and Where We Need to Go

The first article on college food insecurity, published in 2009, sparked conversation on the dark secret many students face while seeking a college degree; they do not have secure access to food. Over 10 years later, numerous investigators around the globe have reported on the heightened prevalence of college food insecurity, the correlates that increase risk, and the detrimental outcomes associated with not having a secure source of food. In this manuscript, we describe the decade of research devoted to college food insecurity and provide direction for research, programs, and policies moving forward. Replicable and valid data collection methods must be utilized, campus-based program evaluation implemented and disseminated, and evidence-based policies supported to achieve realistic goals of warding off hunger and food insecurity on college campuses as well as improve the lives of individuals after post-secondary education. Collectively, stakeholders on college campuses as well as off-campus advocates can be the catalyst to creating a nutritionally secure environment and it is imperative that food insecurity be prevented on college campuses to ensure college students are able to achieve degree attainment.

Food Insecurity is Related to Disordered Eating Behaviors Among College Students

OBJECTIVE

To determine the association between food insecurity and disordered eating behaviors (DEBs) in undergraduate college students.

METHODS

Cross-sectional data of college students (n = 533) were collected from February to April 2020. Food security was measured with the US Department of Agriculture's Adult Food Security Survey Module. Disordered eating behaviors were measured with the Eating Disorder Examination Questionnaire. Associations were examined statistically with Pearson chi-square tests of independence and general linear regression models.

RESULTS

Across all food security ranges, linear trends detailed significant associations between food insecurity and global DEBs (β = 0.17; P < 0.001), eating concern (β = 0.27; P < 0.001), shape concern (β = 0.17; P = 0.001), and weight concern (β = 0.21; P < 0.001), but not restraint (β = 0.10; P = 0.08).

CONCLUSIONS AND IMPLICATIONS

Food insecurity was consistently related to DEBs. Future research may consider longitudinally examining this relationship, as food insecurity and DEBs may be associated with worse health outcomes among vulnerable college students.

Technical Assistance is Related to Improvements in the Food Pantry Consumer Nutrition Environment

OBJECTIVE

To assess changes in food pantries' consumer nutrition environment (CNE) after the provision of technical assistance.

DESIGN

Pre-post study with 2 phases.

SETTING

Staff completed observational assessments using the Nutrition Environment Food Pantry Assessment Tool (NEFPAT) at food pantries in an initial pilot phase. Then, staff conducted NEFPAT observations at pantries in Illinois statewide.

PARTICIPANTS

In the pilot phase, 6 staff assessed 28 pantries. In the statewide phase, 35 staff assessed 119 pantries.

INTERVENTION

After completing an initial NEFPAT at each pantry, technical assistance was provided by staff to support changes in the pantries' CNE before another NEFPAT observation was completed.

MAIN OUTCOME MEASURE

Changes in the CNE, as assessed with the NEFPAT, when comparing preassessment and postassessment.

ANALYSIS

Score differences were evaluated with paired t tests.

RESULTS

In the pilot phase, among 23 pantries with preassessment and postassessment data, 2 objectives on the NEFPAT observation increased significantly. In the statewide phase, among 66 pantries with preassessment and postassessment data, most NEFPAT objectives and the overall NEFPAT score (22.12 ± 8.16 vs 28.20 ± 7.14, P < 0.001) significantly increased.

CONCLUSIONS AND IMPLICATIONS

Technical assistance provided by Supplemental Nutrition Assistance Program Education implementing staff were related to improvements in the CNE of food pantries in Illinois. Future work should evaluate the association of these CNE changes with changes in behavior among pantry patrons.

The Association Between Food Insecurity and Dietary Outcomes in University Students: A Systematic Review

BACKGROUND

University students may experience a high prevalence of food insecurity. The impacts of food insecurity on dietary intake and meal patterns of students have not been fully researched.

OBJECTIVE

This systematic review aimed to examine the association between food insecurity and dietary outcomes among university students.

METHODS

Nine electronic databases and gray literature were searched from their inception to July 2020. Studies that reported dietary outcomes in both food-secure and -insecure students or the association between food insecurity and dietary outcomes among current students in tertiary education settings in any country were included. All study designs were eligible for inclusion, except qualitative studies. Two reviewers completed the screening, data extraction, and quality assessment independently. Study quality was assessed using the Joanna Briggs Institute appraisal tools.

RESULTS

Sixteen studies were included in the final qualitative synthesis of this review. Most studies were cross-sectional designs and of fair quality. The prevalence of food insecurity among university students ranged from 21% to 82% across studies. Lower intakes of healthy foods (eg, fruits, vegetables, and whole grains) and higher intakes of unhealthy foods (eg, fast foods, added sugars, and sugar-sweetened beverages) were observed in food-insecure students, and studies with the most representative samples of the student body found these trends. Some food-insecure students consumed breakfast and evening meals less frequently than food-secure students but the evidence was limited. Validated food security and dietary assessment tools were inconsistently used to assess diet quality among students with differing food security status. The heterogeneity of student sampling and data collection may contribute to inconsistent findings.

CONCLUSION

Poorer dietary outcomes were found in university students with food insecurity compared with food-secure students, but statistical significance was only observed in a small number of studies. Future longitudinal studies using food security and dietary assessment tools validated in this population are recommended to confirm the observed associations between food insecurity and diet quality among university students.

'Spending all this time stressing and worrying and calculating': marginal food security and student life at a Diverse Urban University

OBJECTIVE

Food security status is a continuum ranging from high to very low food security. While marginal food security falls next to high food security on the spectrum, new quantitative research indicates marginal food security status is associated with negative health outcomes and poor academic performance among college students. Qualitative research focusing on college students experiencing marginal food security has not been conducted. The current study aims to qualitatively explore experiences of college students with marginal food security and to identify themes to better understand and provide context regarding how marginal food security impacts students.

DESIGN

Students were recruited for semi-structured interviews with questions designed to study the challenges associated with students' food situations. All interviews were recorded and transcribed with themes identified via an inductive approach.

SETTING

A large public university on the US west coast.

PARTICIPANTS

Thirty college students.

RESULTS

Key themes that emerged: purchasing cheap unhealthy foods, insufficient time to prepare and eat meals on a regular basis, stress and anxiety around the inability to eat healthy food and future health issues, self-perception of health when eating poorly along with physical symptoms and low academic motivation by not fully participating in their courses due to few healthy food options or missing meals.

CONCLUSION

Marginal food security can potentially diminish students' health and their capacity to learn and succeed in their coursework. The results emphasise that students experiencing marginal food security should not be grouped with students experiencing high food security.

Mental Health of Students Reporting Food Insecurity during the Transition to University

Purpose: The present study examined differences in mental health and well-being between students with and without suspected food insecurity during their transition to university.Methods: We drew on existing data from 4 samples of first-year undergraduates enrolled at 3 large universities in 3 provinces (Alberta n = 199, Québec n = 299, and Ontario n = 461 and n = 510). Students completed online surveys assessing a wide range of health-related behaviours and indicators, and students were classified as food secure or insecure based on their responses to screening questions.Results: Mental health (depression, anxiety, low satisfaction with life) was consistently poorer in students classified as food insecure across all samples. The magnitude of mental health deficit was comparable to socioeconomic disadvantage associated with food insecurity.Conclusions: Students experiencing food insecurity are disproportionately launching their university careers with poorer mental health, revealing a critical point of intervention for these socioeconomically higher-risk students.

College student sleep quality and mental and physical health are associated with food insecurity in a multi-campus study

Objective:

To assess the relationship between food insecurity, sleep quality, and days with mental and physical health issues among college students.

Design:

An online survey was administered. Food insecurity was assessed using the ten-item Adult Food Security Survey Module. Sleep was measured using the nineteen-item Pittsburgh Sleep Quality Index (PSQI). Mental health and physical health were measured using three items from the Healthy Days Core Module. Multivariate logistic regression was conducted to assess the relationship between food insecurity, sleep quality, and days with poor mental and physical health.

Setting:

Twenty-two higher education institutions.

Participants:

College students (n 17 686) enrolled at one of twenty-two participating universities.

Results:

Compared with food-secure students, those classified as food insecure (43·4 %) had higher PSQI scores indicating poorer sleep quality (P < 0·0001) and reported more days with poor mental (P < 0·0001) and physical (P < 0·0001) health as well as days when mental and physical health prevented them from completing daily activities (P < 0·0001). Food-insecure students had higher adjusted odds of having poor sleep quality (adjusted OR (AOR): 1·13; 95 % CI 1·12, 1·14), days with poor physical health (AOR: 1·01; 95 % CI 1·01, 1·02), days with poor mental health (AOR: 1·03; 95 % CI 1·02, 1·03) and days when poor mental or physical health prevented them from completing daily activities (AOR: 1·03; 95 % CI 1·02, 1·04).

Conclusions:

College students report high food insecurity which is associated with poor mental and physical health, and sleep quality. Multi-level policy changes and campus wellness programmes are needed to prevent food insecurity and improve student health-related outcomes.