Associations between food insecurity and diet quality among graduate students and postdoctoral trainees in the health sciences at a private university in Boston: A cross-sectional study

Abstract

BackgroundFood insecurity is a pivotal determinant of health outcomes. Little evidence exists on the association between food insecurity and health behaviors and outcomes, including diet quality, among graduate students or postdoctoral trainees. ObjectiveExamine the association between food insecurity and diet quality among graduate students and postdoctoral trainees at three health-focused graduate schools (public health, medical, and dental medicine) within Harvard University. MethodsBetween April-June 2023, 1,287 graduate students and 458 postdoctoral trainees at the health-focused schools within Harvard University completed a web-based survey. The primary exposure was food security status, assessed using the U.S. Household Food Security Survey Module. The primary outcome was diet quality, measured using the 30-day Prime Diet Quality Score screener (ranges from 0 to 126, with higher scores indicating healthier diets). The associations between food insecurity and diet quality were examined using multivariable regression models, adjusting for sociodemographic covariates. ResultsAmong graduate students, compared to those with high food security, diet quality was significantly lower among those experiencing marginal food security (β=-4.7, 95%CI=-6.5, -2.9), low food security (β=-5.4, 95%CI=-7.6, -3.3) and very low food security (β=-4.4, 95%CI=-7.4, -1.4). Poor diet quality included lower intake frequencies of vegetables, fruits, beans/peas/soy products, nuts/seeds, poultry, fish, low-fat dairy, and liquid oils, and higher intake frequencies of refined grains/baked products, sugar-sweetened beverages, and fried foods. Among postdoctoral trainees, compared to those with high food security, diet quality was significantly lower among those experiencing low food security (β=-5.1, 95%CI=-8.8, -1.4) and very low food security (β=-5.2, 95% CI=-10.2, -0.2). Poor diet quality included lower intake frequencies of dark green leafy vegetables, other fruits, and whole grains. ConclusionsGraduate students and postdoctoral trainees who experienced degrees of food insecurity reported lower diet quality. These observations underscore the need for policies and interventions to simultaneously reduce food insecurity and improve diet quality.