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Dietary Behaviors and Food Insecurity among Houston College Students during the COVID-19 Pandemic

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Title: Dietary Behaviors and Food Insecurity among Houston College Students during the COVID-19 Pandemic
Language: English
Authors: Casley R. Matthews, Augusto X. Rodriguez, Laura S. Kabiri (ORCID 0000-0002-1419-0760), Amanda M. Perkins-Ball, Heidi Y. Perkins, Cassandra S. Diep (ORCID 0000-0001-9262-6171)
Source: Journal of American College Health. 2024 72(8):2661-2667.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 7
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Hunger, COVID-19, Pandemics, College Students, Nutrition, Eating Habits, Food, Student Characteristics, Racial Differences, Ethnicity, Social Class
Geographic Terms: Texas (Houston)
DOI: 10.1080/07448481.2022.2122722
ISSN: 0744-8481
1940-3208
Abstract: Objective: This study assessed the impact of the COVID-19 pandemic on college students' nutrition, including dietary behaviors and food security status. Participants: Participants included 140 students between 18 and 25 years of age, who were enrolled in a college or university in the greater Houston area. Methods: Analyses included descriptive statistics, t tests, and ANOVAs to analyze differences in dietary behaviors by demographic variables, and chi-square tests to assess characteristics associated with food security status. Results: The majority of participants reported changing their diets due to the COVID-19 pandemic. There were no significant differences by demographics. However, there were significant differences in food security status by race/ethnicity and social class. Conclusion: This study identified changes and disparities in college students' dietary behaviors and food security status during the COVID-19 pandemic. Findings help inform future policy, programs, and research to address college students' nutrition during the ongoing COVID-19 pandemic.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1448342
Database: ERIC
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  Value: <anid>AN0180828339;acl01nov.24;2024Nov14.03:52;v2.2.500</anid> <title id="AN0180828339-1">Dietary behaviors and food insecurity among Houston college students during the COVID-19 pandemic </title> <p>Objective: This study assessed the impact of the COVID-19 pandemic on college students' nutrition, including dietary behaviors and food security status. Participants: Participants included 140 students between 18 and 25 years of age, who were enrolled in a college or university in the greater Houston area. Methods: Analyses included descriptive statistics, t tests, and ANOVAs to analyze differences in dietary behaviors by demographic variables, and chi-square tests to assess characteristics associated with food security status. Results: The majority of participants reported changing their diets due to the COVID-19 pandemic. There were no significant differences by demographics. However, there were significant differences in food security status by race/ethnicity and social class. Conclusion: This study identified changes and disparities in college students' dietary behaviors and food security status during the COVID-19 pandemic. Findings help inform future policy, programs, and research to address college students' nutrition during the ongoing COVID-19 pandemic.</p> <p>Keywords: College students; COVID-19; dietary behaviors; food insecurity</p> <hd id="AN0180828339-2">Introduction</hd> <p>Poor nutrition affects people nationwide. In 2010, a poor diet was the leading cause of US morbidity and mortality, accounting for 14% of disability-adjusted life-years.[<reflink idref="bib1" id="ref1">1</reflink>] Improper nutrition can lead to adverse health effects, including an increased risk of heart disease, type II diabetes, obesity, and other chronic illnesses.[<reflink idref="bib2" id="ref2">2</reflink>] Because of its negative effects on health outcomes, improper nutrition must be studied and addressed.</p> <p>Unfortunately, the onset of the COVID-19 pandemic has impacted people's ability to make healthy nutritional decisions.[[<reflink idref="bib3" id="ref3">3</reflink>], [<reflink idref="bib5" id="ref4">5</reflink>], [<reflink idref="bib7" id="ref5">7</reflink>], [<reflink idref="bib9" id="ref6">9</reflink>], [<reflink idref="bib11" id="ref7">11</reflink>]] The pandemic has resulted in barriers to accessing food, such as lockdowns, reduced household incomes, and shifts in consumer purchasing patterns.[<reflink idref="bib3" id="ref8">3</reflink>],[<reflink idref="bib4" id="ref9">4</reflink>],[<reflink idref="bib11" id="ref10">11</reflink>],[<reflink idref="bib13" id="ref11">13</reflink>],[<reflink idref="bib14" id="ref12">14</reflink>] Those who were obese and adhered to unhealthy eating patterns before the pandemic were more likely to negatively change their diets.[[<reflink idref="bib6" id="ref13">6</reflink>], [<reflink idref="bib8" id="ref14">8</reflink>]] Individuals also began consuming more sweet and salty snacks during this time.[<reflink idref="bib5" id="ref15">5</reflink>],[<reflink idref="bib7" id="ref16">7</reflink>],[<reflink idref="bib15" id="ref17">15</reflink>],[<reflink idref="bib16" id="ref18">16</reflink>] However, other research found a positive impact on dietary behaviors, including eating more home-cooked meals, drinking more water, and eating more fruits and vegetables.[<reflink idref="bib8" id="ref19">8</reflink>],[<reflink idref="bib17" id="ref20">17</reflink>]</p> <p>In addition, the COVID-19 pandemic may have worsened people's food security status. According to the US Department of Agriculture (USDA), food insecurity is a social or economic condition that prohibits people from obtaining adequate food.[<reflink idref="bib18" id="ref21">18</reflink>] Food insecurity leads to poor health outcomes, including mental and physical challenges.[<reflink idref="bib19" id="ref22">19</reflink>] Unfortunately, COVID-19 led to higher rates of food insecurity early on in the pandemic.[<reflink idref="bib4" id="ref23">4</reflink>],[<reflink idref="bib9" id="ref24">9</reflink>],[<reflink idref="bib20" id="ref25">20</reflink>] Gunderson et al.[<reflink idref="bib21" id="ref26">21</reflink>] predicted an increase of 17 million food-insecure Americans from 2018, and Morales et al.[<reflink idref="bib22" id="ref27">22</reflink>] reported that the number of food-insecure households rose by 13%. The pandemic exacerbated existing problems, with vulnerable populations experiencing increased food insecurity.[<reflink idref="bib4" id="ref28">4</reflink>],[<reflink idref="bib9" id="ref29">9</reflink>],[<reflink idref="bib13" id="ref30">13</reflink>],[<reflink idref="bib20" id="ref31">20</reflink>],[<reflink idref="bib23" id="ref32">23</reflink>]</p> <p>College marks a significant milestone for many young adults and represents a transition period that may make college students more vulnerable to poor nutritional status. Even before the COVID-19 pandemic, college students exhibited high rates of food insecurity and poor diets.[[<reflink idref="bib24" id="ref33">24</reflink>], [<reflink idref="bib26" id="ref34">26</reflink>]] Students must make food-related choices on their own in a new environment, making healthy nutritional decisions tricky.[<reflink idref="bib27" id="ref35">27</reflink>],[<reflink idref="bib28" id="ref36">28</reflink>] In addition, they may be at risk of unhealthy eating habits because of increased stress, a lack of time to prepare healthy meals, the expense of purchasing healthy foods, and easy access to junk food.[<reflink idref="bib29" id="ref37">29</reflink>] Furthermore, students may face increased difficulty obtaining healthy and sufficient food because they are financially independent but must manage the cost of food with other expensive necessities, such as school supplies, rent, and supporting family members.[<reflink idref="bib24" id="ref38">24</reflink>] College students may also make nutritional decisions based on taste, convenience, and energy value, limiting their likelihood of purchasing healthy foods.[<reflink idref="bib30" id="ref39">30</reflink>] In addition, few students are eligible for food assistance programs.[<reflink idref="bib31" id="ref40">31</reflink>] With 41% of 18- to 24-year olds enrolled in college in 2019, this large population is critical to study.[<reflink idref="bib32" id="ref41">32</reflink>]</p> <p>The impact of the COVID-19 pandemic on nutrition has significant implications for college students' livelihood and well-being. Students were faced with school shutdowns, often forcing them to find alternative housing or move home. Those reliant on on-campus meal plans, pantries, and food programs often lost access to these critical resources. In addition, some students may have experienced increased economic hardships given the lockdowns, making purchasing food more difficult. Racial and ethnic minorities, students who experienced a job change, students with children, students whose parents had lower education levels, and younger students had higher rates of food insecurity.[<reflink idref="bib4" id="ref42">4</reflink>],[<reflink idref="bib20" id="ref43">20</reflink>],[<reflink idref="bib23" id="ref44">23</reflink>],[<reflink idref="bib33" id="ref45">33</reflink>],[<reflink idref="bib34" id="ref46">34</reflink>] Results regarding the impact of obesity, gender, and living situation were mixed.[<reflink idref="bib4" id="ref47">4</reflink>],[<reflink idref="bib20" id="ref48">20</reflink>],[<reflink idref="bib23" id="ref49">23</reflink>],[<reflink idref="bib33" id="ref50">33</reflink>]</p> <p>Although studies have been published on food insecurity among college students during the COVID-19 pandemic, gaps exist in the current knowledge about the impacts of the COVID-19 pandemic on college students' nutrition. For instance, no studies were conducted during fall 2020 when students began to return to campuses.[<reflink idref="bib4" id="ref51">4</reflink>],[<reflink idref="bib20" id="ref52">20</reflink>],[<reflink idref="bib23" id="ref53">23</reflink>],[<reflink idref="bib33" id="ref54">33</reflink>],[<reflink idref="bib34" id="ref55">34</reflink>] Furthermore, only two studies have been conducted, to our knowledge, on dietary changes among college students due to the COVID-19 pandemic in the United States.[<reflink idref="bib11" id="ref56">11</reflink>],[<reflink idref="bib35" id="ref57">35</reflink>] However, one had a small sample size and the other focused specifically on the effects of moving in with family on dietary behaviors.[<reflink idref="bib11" id="ref58">11</reflink>],[<reflink idref="bib35" id="ref59">35</reflink>] In addition, few studies primarily focused on the disparities and determinants of food insecurity and dietary changes among this population. Therefore, the purpose of this study was to assess the effects of the COVID-19 pandemic on college students' nutrition, including dietary behaviors and food insecurity, with a specific focus on disparities in poor nutrition. The authors hypothesized that dietary behaviors would become unhealthier and that certain demographic characteristics would significantly impact one's ability to make healthy dietary choices and maintain high food security status.</p> <hd id="AN0180828339-3">Materials and methods</hd> <p></p> <hd id="AN0180828339-4">Study design and participants</hd> <p>This study used data from the COVID-19 Stress, Physical Activity, and Nutrition Effects on Students (C-SPANES) study, which examined the impact of the COVID-19 pandemic on Houston-area college students' physical activity, diet, and stress. A cross-sectional survey was administered through Qualtrics (Qualtrics, Provo, UT). The lead investigators shared the survey on their online learning management systems (e.g., Canvas courses), through student listservs at their university, and in social media advertisements. They also sent the survey to their colleagues at six other universities to share with their students. The survey remained open for one month (November 2020). Study procedures were approved by the institutional review board at Rice University.</p> <p>Students between 18 and 25 years of age, who were enrolled in a college or university in the greater Houston area, were eligible to participate in the C-SPANES study. There were no exclusions related to level of study (undergraduate vs. graduate). At the end of the survey, students had the opportunity to enter a drawing for one of five $20 gift cards. There were no other incentives for participation, and participants could skip questions or terminate the survey at any time.</p> <hd id="AN0180828339-5">Instrument and measures</hd> <p>The C-SPANES survey was developed by the lead investigators using validated instruments. The survey consisted of 63 items across five sections: demographics, physical activity, diet, food security, and stress. For the current study, the authors focused on items related to demographics, diet, and food security.</p> <hd id="AN0180828339-6">Demographics</hd> <p>Demographics included questions on age, type of college or university (e.g., junior or community college, 4-year public college), race/ethnicity (e.g., Asian, White, Black or African American), gender identity (e.g., man/male/masculine, woman/female/feminine), self-identified socioeconomic status (SES) (e.g., poor, working class), health insurance status, height, and weight. Because of sample size limitations, those who self-identified as Black, Hispanic, or mixed, as well as those who did not answer or preferred not to answer the question about race/ethnicity, were classified as "Other." Those who identified as Middle-Eastern or White were combined into one category labeled "White," which is consistent with the 1997 Office of Management and Budget (OMB) standards on race and ethnicity. Only one participant identified as gender nonconforming. Because of sample size limitations, analyses on gender were restricted to female and male.</p> <p>Living situations immediately before the COVID-19 pandemic, in summer 2020, and at the time of survey completion were also assessed; response options included on campus, off campus with parent/guardian, and off campus without parent/guardian. For this study, the authors also calculated body mass index (BMI) using the standard formula (kg/m<sups>2</sups>) and classified participants as underweight, normal weight, overweight, or obese.[<reflink idref="bib36" id="ref60">36</reflink>] Participants in the underweight or obese categories were further combined into an "unhealthy" weight category.</p> <hd id="AN0180828339-7">Diet and food security status</hd> <p>Diet and food security status were measured using the Block Fruit/Vegetable/Fiber Screener (Block FVF Screener) and the USDA ERS Food Security 6-Item Short Form, respectively. The Block FVF Screener includes 10 items on fat, fiber, fruit, and vegetable intake and has been validated against a full-length, 100-item food frequency questionnaire.[<reflink idref="bib37" id="ref61">37</reflink>] Participants completed the Block FVF Screener items for before the COVID-19 pandemic and during the COVID-19 pandemic. For example, participants indicated how often they ate any fruit, fresh or canned, during an average month before the COVID-19 pandemic, and they indicated how often they ate any fruit, fresh or canned, during an average month during the COVID-19 pandemic. Participants, who answered in a screening question that their dietary behaviors had not changed during the COVID-19 pandemic, were able to skip the Block FVF Screener questions.</p> <p>The Food Security 6-Item Short Form is used in the National College Health Assessment and assesses access to nutritionally adequate and safe foods to meet needs.[<reflink idref="bib38" id="ref62">38</reflink>] Participants were asked to answer the questions based on the COVID-19 pandemic. For example, one item asked, "During the COVID-19 pandemic, did you or other adults in your household ever cut the size of your meals or skip meals because there wasn't enough money for food?" Participants who were classified as having low or very low food security were combined into one group.</p> <hd id="AN0180828339-8">Statistical analyses</hd> <p>The current study included items related to demographics, diet, and food security status. Demographic factors, dietary change, and food security status were analyzed with frequency counts and percentages. The authors used a paired-sample <emph>t</emph> test to assess whether people's fruit and vegetable consumption changed during the pandemic, ANOVAs to determine differences in fruit and vegetable consumption based on demographic factors, and chi-square tests to analyze differences in food security status based on demographic factors. The authors limited their analyses to specific demographic characteristics, including gender, class, BMI classification, race/ethnicity, and living status in fall 2020. There was insufficient variability in the other demographic variables (e.g., age) or they were not hypothesized to be related to nutritional behaviors during the pandemic (e.g., living status before the COVID-19 pandemic). All analyses were conducted using IBM SPSS Statistics for Windows (version 27.0, 2020, IBM Corporation, Armonk, New York, USA), with statistical significance set as <emph>p</emph> <.05.</p> <hd id="AN0180828339-9">Results</hd> <p></p> <hd id="AN0180828339-10">Demographics</hd> <p>A total of 181 participants responded to the survey, but the current analyses were restricted to participants with complete surveys (<emph>n</emph> = 140). The majority of participants were 22 years or younger (91.8%), female (70.2%), middle class (59.5%), insured (98.5%), enrolled at a 4-year private college (90.1%), and considered healthy weight (73.3%). A plurality of participants self-identified as Asian (37.9%). A majority of students (53.8%) lived on campus immediately before the COVID-19 pandemic, compared to 37.4% of students who lived on campus at the time of the survey. Table 1 includes the demographic information of the participants.</p> <p>Table 1. Demographic characteristics of C-SPANES participants (<emph>n</emph> = 140).</p> <p> <ephtml> <table><thead><tr><td>Characteristic</td><td><italic>n</italic> (%)</td></tr></thead><tbody valign="top"><tr><td>Age</td><td /></tr><tr><td> 18</td><td char=".">26 (19.4)</td></tr><tr><td> 19</td><td char=".">28 (20.9)</td></tr><tr><td> 20</td><td char=".">30 (22.4)</td></tr><tr><td> 21</td><td char=".">30 (22.4)</td></tr><tr><td> 22</td><td char=".">9 (6.7)</td></tr><tr><td> 23+</td><td char=".">11 (8.2)</td></tr><tr><td>Type of college/university</td><td /></tr><tr><td> Junior or Community College</td><td char=".">8 (6.1)</td></tr><tr><td> 4-Year public college</td><td char=".">3 (2.3)</td></tr><tr><td> 4-Year private college</td><td char=".">118 (90.1)</td></tr><tr><td> Other</td><td char=".">2 (1.5)</td></tr><tr><td>Gender</td><td /></tr><tr><td> Male</td><td char=".">38 (29.0)</td></tr><tr><td> Female</td><td char=".">92 (70.2)</td></tr><tr><td> Gender nonconforming</td><td char=".">1 (0.8)</td></tr><tr><td>Race/Ethnicity</td><td /></tr><tr><td> Asian</td><td char=".">53 (37.9)</td></tr><tr><td> White</td><td char=".">44 (31.4)</td></tr><tr><td> Other</td><td char=".">43 (30.7)</td></tr><tr><td>Social class</td><td /></tr><tr><td> Working class</td><td char=".">24 (18.3)</td></tr><tr><td> Middle class</td><td char=".">78 (59.5)</td></tr><tr><td> Affluent</td><td char=".">29 (22.1)</td></tr><tr><td>Health insurance</td><td /></tr><tr><td> Yes</td><td char=".">129 (98.5)</td></tr><tr><td> No</td><td char=".">2 (1.5)</td></tr><tr><td>Living situation – before COVID-19 pandemic</td><td /></tr><tr><td> On campus</td><td char=".">70 (53.8)</td></tr><tr><td> Off campus with guardian</td><td char=".">34 (26.2)</td></tr><tr><td> Off campus without guardian</td><td char=".">26 (20.0)</td></tr><tr><td>Living situation – Fall 2020</td><td /></tr><tr><td> On campus</td><td char=".">49 (37.4)</td></tr><tr><td> Off campus with guardian</td><td char=".">44 (33.6)</td></tr><tr><td> Off campus without guardian</td><td char=".">38 (29.0)</td></tr><tr><td>BMI classification</td><td /></tr><tr><td> Normal</td><td char=".">96 (73.3)</td></tr><tr><td> Overweight</td><td char=".">21 (16.0)</td></tr><tr><td> Unhealthy weight</td><td char=".">14 (10.7)</td></tr><tr><td>Dietary change</td><td /></tr><tr><td> Changed</td><td char=".">83 (63.4)</td></tr><tr><td> Did not change</td><td char=".">48 (36.6)</td></tr><tr><td>Food security status</td><td /></tr><tr><td> High/marginal</td><td char=".">112 (85.5)</td></tr><tr><td> Low/very low</td><td char=".">19 (14.5)</td></tr></tbody></table> </ephtml> </p> <hd id="AN0180828339-11">Dietary behaviors</hd> <p>The majority of participants (63.4%) reported changing their diets due to the COVID-19 pandemic. There was a statistically significant decrease in fruit and vegetable consumption during the pandemic [<emph>t</emph>(<reflink idref="bib78" id="ref63">78</reflink>) = 3.798, <emph>p</emph> <.001]. However, there were no significant differences in fruit and vegetable consumption change by living status [<emph>F</emph>(<reflink idref="bib2" id="ref64">2</reflink>,<reflink idref="bib78" id="ref65">78</reflink>) = 2.035, <emph>p</emph> =.138], gender [<emph>F</emph>(<reflink idref="bib1" id="ref66">1</reflink>,<reflink idref="bib77" id="ref67">77</reflink>) = 2.929, <emph>p</emph> =.091], race/ethnicity [<emph>F</emph>(<reflink idref="bib2" id="ref68">2</reflink>,<reflink idref="bib78" id="ref69">78</reflink>) = 0.960, <emph>p</emph> =.390], social class [<emph>F</emph>(<reflink idref="bib2" id="ref70">2</reflink>,<reflink idref="bib78" id="ref71">78</reflink>) = 0.025, <emph>p</emph> =.975], or BMI classification [<emph>F</emph>(<reflink idref="bib2" id="ref72">2</reflink>,<reflink idref="bib78" id="ref73">78</reflink>) = 1.578, <emph>p</emph> =.216].</p> <p>Overall, participants consumed less fruit [<emph>t</emph>(<reflink idref="bib81" id="ref74">81</reflink>) = 2.459, <emph>p</emph> =.016], green salad [<emph>t</emph>(<reflink idref="bib81" id="ref75">81</reflink>) = 4.628, <emph>p</emph> <.001], and any other vegetables [<emph>t</emph>(<reflink idref="bib81" id="ref76">81</reflink>) = 2.412, <emph>p</emph> =.018] during the pandemic. However, their fruit juice [<emph>t</emph>(<reflink idref="bib81" id="ref77">81</reflink>) = 0.890, <emph>p</emph> =.376], vegetable juice [<emph>t</emph>(<reflink idref="bib81" id="ref78">81</reflink>) = 1.810, <emph>p</emph> =.074], potato [<emph>t</emph>(<reflink idref="bib79" id="ref79">79</reflink>) = 0.942, <emph>p</emph> =.349], vegetable soup [<emph>t</emph>(<reflink idref="bib80" id="ref80">80</reflink>) = –1.779, <emph>p</emph> =.079], fiber cereal [<emph>t</emph>(<reflink idref="bib81" id="ref81">81</reflink>) = 0.097, <emph>p</emph> =.923], bean [<emph>t</emph>(<reflink idref="bib81" id="ref82">81</reflink>) = 1.633, <emph>p</emph> =.106], and dark bread [<emph>t</emph>(<reflink idref="bib81" id="ref83">81</reflink>) = 0.914, <emph>p</emph> =.363] consumption did not change. Details are presented in Table 2.</p> <p>Table 2. Changes in fruit, vegetable, and fiber consumption during COVID-19 pandemic (C-SPANES participants, <emph>n</emph> = 140).</p> <p> <ephtml> <table><thead><tr><td>Fruits, vegetables, and grains<sup>a</sup></td><td>Before COVID-19 pandemic</td><td>During COVID-19 pandemic</td><td><italic>t</italic> test</td><td><italic>p</italic> value</td></tr></thead><tbody valign="top"><tr><td>Overall fruits and vegetables<sup>b</sup></td><td char=".">18.53</td><td char=".">16.71</td><td char=".">3.798</td><td char="."><.001</td></tr><tr><td>Fruit juice</td><td char=".">2.06</td><td char=".">1.94</td><td char=".">0.890</td><td char=".">.376</td></tr><tr><td>Fruit</td><td char=".">3.93</td><td char=".">3.56</td><td char=".">2.459</td><td char=".">.016</td></tr><tr><td>Vegetable juice</td><td char=".">1.37</td><td char=".">1.21</td><td char=".">1.810</td><td char=".">.074</td></tr><tr><td>Green salad</td><td char=".">2.87</td><td char=".">2.15</td><td char=".">4.628</td><td char="."><.001</td></tr><tr><td>Potatoes</td><td char=".">2.84</td><td char=".">2.69</td><td char=".">0.942</td><td char=".">.349</td></tr><tr><td>Vegetable soup</td><td char=".">1.63</td><td char=".">1.81</td><td>–1.779</td><td char=".">.079</td></tr><tr><td>Any other vegetables</td><td char=".">3.80</td><td char=".">3.45</td><td char=".">2.412</td><td char=".">.018</td></tr><tr><td>Fiber cereals</td><td char=".">1.63</td><td char=".">1.62</td><td char=".">0.097</td><td char=".">.923</td></tr><tr><td>Beans</td><td char=".">2.22</td><td char=".">2.00</td><td char=".">1.633</td><td char=".">.106</td></tr><tr><td>Dark bread</td><td char=".">2.33</td><td char=".">2.18</td><td char=".">0.914</td><td char=".">.363</td></tr></tbody></table> </ephtml> </p> <p>1 Response categories: less than once per week, about once per week, 2–3 times per week, 4–6 times per week, every day, and 2 or more times per day; scored 0, 1, 2, 3, 4, 5.</p> <p>2 <sups>b</sups>Scores ranged from 0 to 35.</p> <hd id="AN0180828339-12">Food security status</hd> <p>The majority of participants (85.5%) were classified as having high food security status. There was a statistically significant relationship between race/ethnicity and food security status [X<sups>2</sups>(<reflink idref="bib2" id="ref84">2</reflink>, _I_N_i_ = 131) = 11.09, <emph>p</emph> =.004], with White (84.1%) and Asian (96.2%) participants exhibiting higher food security status than those in the other category (70.6%) (Table 3). There was also a statistically significant relationship between social class and food security status [X<sups>2</sups>(<reflink idref="bib2" id="ref85">2</reflink>, _I_N_i_ = 131) = 23.78, <emph>p</emph> <.001], with affluent (96.6%) and middle class (91.0%) participants exhibiting higher food security status than working class participants (54.2%) (Table 4). There was no relationship between food security status and living status [X<sups>2</sups>(<reflink idref="bib2" id="ref86">2</reflink>, _I_N_i_ = 131) = 0.822, <emph>p</emph> =.663], BMI classification [X<sups>2</sups>(<reflink idref="bib2" id="ref87">2</reflink>, _I_N_i_ = 131) = 1.778, <emph>p</emph> =.411], or gender [X<sups>2</sups>(<reflink idref="bib1" id="ref88">1</reflink>, _I_N_i_ = 130) = 0.170, <emph>p</emph> =.680].</p> <p>Table 3. Food security status by race/ethnicity (C-SPANES participants, <emph>n</emph> = 140).</p> <p> <ephtml> <table><thead><tr><td /><td>White</td><td>Asian</td><td>Other</td><td /><td /></tr><tr><td><italic>n</italic></td><td>%</td><td><italic>n</italic></td><td>%</td><td><italic>n</italic></td><td>%</td><td>X<sup>2</sup>(2)</td><td><italic>p</italic> value</td></tr></thead><tbody valign="top"><tr><td>Total</td><td char=".">44</td><td char=".">100</td><td char=".">53</td><td char=".">100</td><td char=".">34</td><td char=".">100</td><td char=".">11.09</td><td char=".">.004</td></tr><tr><td>High/Marginal</td><td char=".">37</td><td char=".">84.1</td><td char=".">51</td><td char=".">96.2</td><td char=".">24</td><td char=".">70.6</td><td /><td /></tr><tr><td>Low</td><td char=".">7</td><td char=".">15.9</td><td char=".">2</td><td char=".">3.8</td><td char=".">10</td><td char=".">29.4</td><td /><td /></tr></tbody></table> </ephtml> </p> <p>Table 4. Food security status by social class (C-SPANES participants, <emph>n</emph> = 140).</p> <p> <ephtml> <table><thead><tr><td /><td>Working class</td><td>Middle class</td><td>Affluent</td><td /><td /></tr><tr><td><italic>n</italic></td><td>%</td><td><italic>n</italic></td><td>%</td><td><italic>n</italic></td><td>%</td><td>X<sup>2</sup>(2)</td><td><italic>p</italic> value</td></tr></thead><tbody valign="top"><tr><td>Total</td><td char=".">24</td><td char=".">100</td><td char=".">78</td><td char=".">100</td><td char=".">29</td><td char=".">100</td><td char=".">23.78</td><td char="."><.001</td></tr><tr><td>High/Marginal</td><td char=".">13</td><td char=".">54.2</td><td char=".">71</td><td char=".">91.0</td><td char=".">28</td><td char=".">96.6</td><td /><td /></tr><tr><td>Low</td><td char=".">11</td><td char=".">45.8</td><td char=".">7</td><td char=".">9.0</td><td char=".">1</td><td char=".">3.4</td><td /><td /></tr></tbody></table> </ephtml> </p> <hd id="AN0180828339-13">Discussion</hd> <p>This study examined changes and disparities in college students' dietary behaviors and food security status during the COVID-19 pandemic. The majority of participants (63.4%) reported changing their diets due to the COVID-19 pandemic. As hypothesized by the authors, dietary behaviors became unhealthier; there was a statistically significant decrease in fruit and vegetable consumption during the pandemic. Specifically, students struggled to eat sufficient fruits, green salad, and other vegetables.</p> <p>The decreased consumption found in the current study is not surprising, given that college students face many challenges in acquiring healthy foods, including them being expensive, inaccessible, and time-consuming to prepare.[[<reflink idref="bib27" id="ref89">27</reflink>], [<reflink idref="bib29" id="ref90">29</reflink>]] In addition, US production of fruits and vegetables may have slightly decreased, especially toward the end of 2020.[<reflink idref="bib39" id="ref91">39</reflink>] A decrease in migrant farm workers, increased difficulty in grocery shopping, and store closures may have impacted students' ability to purchase and consume healthy foods.[<reflink idref="bib5" id="ref92">5</reflink>],[<reflink idref="bib11" id="ref93">11</reflink>],[<reflink idref="bib40" id="ref94">40</reflink>] Finally, people may have changed their purchasing patterns, meaning they were more likely to purchase nonperishable foods in bulk rather than perishable items.[<reflink idref="bib40" id="ref95">40</reflink>] This may be more applicable to students who lived at home or off-campus, although no differences in fruit and vegetable consumption were observed by living status in the current study.[<reflink idref="bib11" id="ref96">11</reflink>],[<reflink idref="bib35" id="ref97">35</reflink>]</p> <p>Although this study suggested decreased fruit and vegetable intake during the COVID-19 pandemic, there were no significant differences based on demographics, which contradicted the authors' original hypothesis. Students from all backgrounds experienced this negative change, regardless of their race/ethnicity, social class, BMI classification, living status in fall 2020, or gender identity. It is possible that these findings reflect a sample size issue and lack of heterogeneity (e.g., majority female, Asian or White) in the sample. Previous studies have shown that female participants were more likely to report changing their diets, either negatively or positively, compared to males.[<reflink idref="bib6" id="ref98">6</reflink>] However, other studies have demonstrated no change in dietary behaviors based on gender.[<reflink idref="bib7" id="ref99">7</reflink>] Studies have also demonstrated that obesity was associated with less fruit and vegetable consumption and worse nutritional choices.[<reflink idref="bib7" id="ref100">7</reflink>],[<reflink idref="bib16" id="ref101">16</reflink>] Finally, two studies suggested that students who lived on their own consumed fewer fruits and vegetables.[<reflink idref="bib16" id="ref102">16</reflink>],[<reflink idref="bib34" id="ref103">34</reflink>] However, research on disparities and determinants of dietary changes are limited. Only one of these studies was conducted in the United States, and only two focused on college students. More research with larger and diverse samples is needed to better understand which college students are at risk for poor nutrition, and higher education institutions should make a concerted effort to improve access to fruits and vegetables on campus.</p> <p>Although the majority of participants were classified as having high food security status, the current study did find that ∼15% of participants were food insecure during the pandemic. This number was lower than the authors originally expected but also higher than the national estimate of food insecurity. Although early estimates of food insecurity in the beginning of the pandemic ranged from 18% to 35%, the 2020 prevalence of food insecurity (10.5%) was unchanged from the 2019 prevalence of food insecurity (10.5%), partly because of government policies, expanded local food programs, and responses by charitable organizations to meet increased needs.[<reflink idref="bib41" id="ref104">41</reflink>],[<reflink idref="bib42" id="ref105">42</reflink>] Pandemic unemployment assistance programs may have also helped students who were unemployed maintain the ability to purchase food if they were not dependent on their parents. However, the current sample had higher rates of food insecurity than national rates. Therefore, more research is needed to understand why rates were higher in the current sample and if additional efforts are needed for college students.</p> <p>Finally, the current study identified disparities in food security status. Non-White and non-Asian participants and working class participants were at risk for lower food security status. This aligns with previous studies that demonstrate that racial and ethnic minorities and low-income students are at increased risk for food insecurity during the COVID-19 pandemic.[<reflink idref="bib4" id="ref106">4</reflink>],[<reflink idref="bib23" id="ref107">23</reflink>],[<reflink idref="bib33" id="ref108">33</reflink>] Lifetime racial discrimination has been associated with a decrease in food security status.[<reflink idref="bib43" id="ref109">43</reflink>] In addition, structural racism may impact the ability of racial and ethnic minorities to access food. Residential segregation means that racial and ethnic minorities end up paying more for healthy foods than White people.[<reflink idref="bib44" id="ref110">44</reflink>] As students returned home or were forced to move off campus due to the pandemic, those from racial and ethnic minority backgrounds might have returned to living situations that made purchasing food more difficult. Students from low socioeconomic backgrounds likely struggled to afford food during the COVID-19 pandemic. As many on campus food resources closed, such as food pantries and dining halls, students were forced to rely on their own funds to purchase food. This study adds to existing literature on college students' food security status during the pandemic and their ability and willingness to consume nutritional foods.</p> <hd id="AN0180828339-14">Limitations</hd> <p>The current study is not without limitations. First, the study included a convenience sample of college students, which may have resulted in selection bias, including sampling bias and volunteer bias, that limited generalizability. For example, the majority of participants were from a 4-year private institution (90.1%). As demographic factors are likely different among student populations depending on the type of institution they attend, this limits generalizability to the university student population at large. Relatedly, because of the sampling method, the authors cannot accurately estimate the reach of the survey and potential response rate, in order to better understand potential for participant bias. For example, the authors shared the survey with colleagues at other universities, most of whom were in a health-related field. This may have resulted in a larger reach of health-related students. Next, the study may have required a larger, more diverse sample of different subgroups to detect some statistical differences. In addition, the data collected in this study were self-reported. This may have resulted in some self-reporting bias, including social desirability and recall bias. However, the instruments used in this study have all been found to be valid and reliable.</p> <p>Finally, this study was cross-sectional, and causality could not be established. More research is needed longitudinally. Despite these limitations, the current study adds to the limited research on US college students and nutrition during the COVID-19 pandemic, and it is one of the first studies to examine dietary changes among college students due to the COVID-19 pandemic in the United States. Further analyses of other variables in the C-SPANES survey, as well as continued follow-up of college students in the greater Houston area, will provide additional opportunities to explore the impact of the ongoing COVID-19 pandemic on physical and mental health among college students.</p> <hd id="AN0180828339-15">Implications and future directions</hd> <p>Given findings from this study, it is necessary to improve access to nutritious foods on campus. Currently, 37 states, including Texas, do not have any food security legislation for college students.[<reflink idref="bib31" id="ref111">31</reflink>] Of states that do have policies in place, a standard solution is hunger-free campus legislation. States with this policy require campuses to meet the food needs of their student populations and encourage schools to set up food pantries and meal donation programs.[<reflink idref="bib31" id="ref112">31</reflink>] Schools that already have these programs in place can reduce the challenges students might face in utilizing them by allowing anyone, regardless of background, to use on-campus food pantries and by making food resources more readily available by extending hours of operation and locating them in more centralized spots across campus.[<reflink idref="bib31" id="ref113">31</reflink>] Schools can encourage fruit and vegetable consumption by offering more of these items in dining halls and reducing their prices.</p> <p>On a national level, information about nutrition programs for students is hard to find. Less than half of college students who are eligible for the Supplemental Nutrition Assistance Program (SNAP) are currently enrolled.[<reflink idref="bib31" id="ref114">31</reflink>] Schools could easily provide information about SNAP eligibility to students via brochures or infographics, especially in areas where students who are food insecure might visit, such as on-campus food pantries. However, while SNAP is accessible to some, it is relatively limited in its scope. Unless a student is a single parent, part of work-study, or a recipient of assistance under a title IV-A program, they are likely ineligible.[<reflink idref="bib31" id="ref115">31</reflink>] In light of the pandemic and the challenges it has brought in accessing food, policymakers should expand who is eligible for SNAP.</p> <p>As one of the first studies to analyze dietary changes among college students during the pandemic, further research is also warranted investigating college students' nutrition, especially dietary behaviors among a more diverse sample, during this period. In addition, more studies would help clarify how nutrition among college students has changed throughout the pandemic. The authors hope to re-administer the C-SPANES study, with an expanded sample size, later on. In addition to the demographics in the current study, including a question about international student status may reveal another at-risk group.[<reflink idref="bib20" id="ref116">20</reflink>] This would help provide insight into the state of students' nutrition during the evolving COVID-19 pandemic.</p> <hd id="AN0180828339-16">Conclusion</hd> <p>The COVID-19 pandemic has negatively impacted college students' nutrition, including decreasing fruit and vegetable consumption. Moreover, racial/ethnic minorities and those from a lower social class were at greater risk for food insecurity. In light of the pandemic, more resources should be made available to students on the national, state, and local levels to increase access to nutritious foods and encourage students to make better dietary choices. In addition, college administrators should continue to monitor the food-needs of their students and commit to ensuring equal access to healthy foods for everyone on campus.</p> <hd id="AN0180828339-17">Acknowledgment</hd> <p>The authors would like to thank all the staff and faculty who distributed the C-SPANES survey and all the students who participated.</p> <hd id="AN0180828339-18">Conflict of interest disclosure</hd> <p>The authors report there are no competing interests to declare. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States and received approval from the Institutional Review Board at Rice University.</p> <hd id="AN0180828339-19">Data availability statement</hd> <p>The data that support the findings of this study are available from the corresponding author, CSD, upon reasonable request.</p> <ref id="AN0180828339-20"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Mokdad AH, Ballestros K, Echko M, The US Burden of Disease Collaborators, et al. The State of US Health, 1990–2016: burden of diseases, injuries, and risk factors among US States. JAMA. 2018; 319 (14): 1444 – 1472. doi: 10.1001/jama.2018.0158</bibtext> </blist> <blist> <bibl id="bib2" idref="ref2" type="bt">2</bibl> <bibtext> Willett W, Stampfer M. Current evidence on health eating. 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Items – Name: Title
  Label: Title
  Group: Ti
  Data: Dietary Behaviors and Food Insecurity among Houston College Students during the COVID-19 Pandemic
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Casley+R%2E+Matthews%22">Casley R. Matthews</searchLink><br /><searchLink fieldCode="AR" term="%22Augusto+X%2E+Rodriguez%22">Augusto X. Rodriguez</searchLink><br /><searchLink fieldCode="AR" term="%22Laura+S%2E+Kabiri%22">Laura S. Kabiri</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-1419-0760">0000-0002-1419-0760</externalLink>)<br /><searchLink fieldCode="AR" term="%22Amanda+M%2E+Perkins-Ball%22">Amanda M. Perkins-Ball</searchLink><br /><searchLink fieldCode="AR" term="%22Heidi+Y%2E+Perkins%22">Heidi Y. Perkins</searchLink><br /><searchLink fieldCode="AR" term="%22Cassandra+S%2E+Diep%22">Cassandra S. Diep</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-9262-6171">0000-0001-9262-6171</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+American+College+Health%22"><i>Journal of American College Health</i></searchLink>. 2024 72(8):2661-2667.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 7
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2024
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Hunger%22">Hunger</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink><br /><searchLink fieldCode="DE" term="%22Pandemics%22">Pandemics</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink><br /><searchLink fieldCode="DE" term="%22Nutrition%22">Nutrition</searchLink><br /><searchLink fieldCode="DE" term="%22Eating+Habits%22">Eating Habits</searchLink><br /><searchLink fieldCode="DE" term="%22Food%22">Food</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Characteristics%22">Student Characteristics</searchLink><br /><searchLink fieldCode="DE" term="%22Racial+Differences%22">Racial Differences</searchLink><br /><searchLink fieldCode="DE" term="%22Ethnicity%22">Ethnicity</searchLink><br /><searchLink fieldCode="DE" term="%22Social+Class%22">Social Class</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Texas+%28Houston%29%22">Texas (Houston)</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/07448481.2022.2122722
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0744-8481<br />1940-3208
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: This study assessed the impact of the COVID-19 pandemic on college students' nutrition, including dietary behaviors and food security status. Participants: Participants included 140 students between 18 and 25 years of age, who were enrolled in a college or university in the greater Houston area. Methods: Analyses included descriptive statistics, t tests, and ANOVAs to analyze differences in dietary behaviors by demographic variables, and chi-square tests to assess characteristics associated with food security status. Results: The majority of participants reported changing their diets due to the COVID-19 pandemic. There were no significant differences by demographics. However, there were significant differences in food security status by race/ethnicity and social class. Conclusion: This study identified changes and disparities in college students' dietary behaviors and food security status during the COVID-19 pandemic. Findings help inform future policy, programs, and research to address college students' nutrition during the ongoing COVID-19 pandemic.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2024
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1448342
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1448342
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/07448481.2022.2122722
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 7
        StartPage: 2661
    Subjects:
      – SubjectFull: Hunger
        Type: general
      – SubjectFull: COVID-19
        Type: general
      – SubjectFull: Pandemics
        Type: general
      – SubjectFull: College Students
        Type: general
      – SubjectFull: Nutrition
        Type: general
      – SubjectFull: Eating Habits
        Type: general
      – SubjectFull: Food
        Type: general
      – SubjectFull: Student Characteristics
        Type: general
      – SubjectFull: Racial Differences
        Type: general
      – SubjectFull: Ethnicity
        Type: general
      – SubjectFull: Social Class
        Type: general
      – SubjectFull: Texas (Houston)
        Type: general
    Titles:
      – TitleFull: Dietary Behaviors and Food Insecurity among Houston College Students during the COVID-19 Pandemic
        Type: main
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          Name:
            NameFull: Casley R. Matthews
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            NameFull: Augusto X. Rodriguez
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            NameFull: Amanda M. Perkins-Ball
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            NameFull: Heidi Y. Perkins
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            NameFull: Cassandra S. Diep
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              Type: published
              Y: 2024
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            – Type: issn-print
              Value: 0744-8481
            – Type: issn-electronic
              Value: 1940-3208
          Numbering:
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              Value: 72
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              Value: 8
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            – TitleFull: Journal of American College Health
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