Food Insecurity Is Associated with Increased Risk of Obesity in US College Students.

Aseel El Zein,Wenjun Zhou,Anne E Mathews,Geoffrey W Greene,Melissa D Olfert,Karla P Shelnutt,Tanya M Horacek,Sarah E Colby

doi:10.1093/cdn/nzaa120

Abstract

ABSTRACTBackgroundFood insecurity affects millions of Americans and college students are especially vulnerable. Little is known about the relation of food insecurity with weight status and dietary intake during this critical phase of emerging adulthood.ObjectivesWe aimed to examine the sex-specific associations of food insecurity with obesity and dietary intake among college students. The study also explored these associations by meal plan (MP) enrollment.MethodsThis cross-sectional study included 683 second-year students at 8 universities in the United States. Food security status and dietary intake were assessed using the USDA Adult Food Security Survey and the Dietary Screener Questionnaire, respectively. On-site anthropometrics were measured by researchers.ResultsThe prevalence of food insecurity at the universities ranged from 19.0% to 34.1% with a mean of 25.4% for the entire sample. Compared with high food security, marginal food security and food insecurity were associated with 3.16 (95% CI: 1.55, 6.46) and 5.13 (95% CI: 2.63, 10.00) times increased odds of obesity, respectively, exhibiting a dose–response relation. Food insecurity remained a significant predictor of obesity among both sexes after adjusting for sociodemographic variables. Food-insecure (FI) students had a significantly lower intake of fruits and vegetables and higher intake of added sugars than food-secure (FS) students. Obesity rate and added sugars consumption were higher among FI students with MPs than among FI students lacking MPs and FS students regardless of MP status. Among students with MPs, FS students had a higher intake of fruits and vegetables than FI students.ConclusionsFood insecurity was associated with obesity and poor dietary intake among both sexes. Although MP subsidies may be a reasoned approach to combat food insecurity, it should be coupled with efforts to assist students in making healthy food choices.Registered at clinicaltrials.gov as NCT02941497.

Highlights

Reducing obesity in college students may be possible if specific economic stressors are identified and addressed by applicable social policies
The purposes of this study were to examine the sex-specific associations between food insecurity and obesity among college students and to compare the differences in dietary intake between FS and FI students
An exploratory aim of this study was to assess the differences in weight status and dietary intake by meal plan (MP) enrollment

Summary

Introduction

Reducing obesity in college students may be possible if specific economic stressors are identified and addressed by applicable social policies. Prior research has identified food insecurity, defined as limited access to adequate and safe foods [1], as one of the stressors linked to obesity and associated comorbidities in adults [1,2,3]. Food-insecure (FI) individuals may react differently to having limited finances for nutritionally balanced foods, it is common for dietary quality to decline when food is scarce [5]. This is supported by the inverse relation between energy density and cost of foods [5, 6]. Objectives: We aimed to examine the sex-specific associations of food insecurity with obesity and dietary intake among college students.

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Conclusion