Prevalence and correlates of food insecurity among U.S. college students: a multi-institutional study

This study investigated the prevalence of food insecurity among first-year college students and explored how it relates to various aspects of their lives. It wasn't an intervention study testing a specific treatment, but rather an observational study looking for connections.

The primary focus was to:

Determine how common food insecurity is among this student population.

Identify sociodemographic characteristics (like race, living situation, financial aid, parental education, meal plan enrollment) that are associated with food insecurity.

Examine the relationship between food insecurity and several key health and academic outcomes:

* **Perceived stress levels:** How stressed students feel.

* **Sleep quality:** How well students sleep.

* **Disordered eating behaviors:** Patterns of eating that might be unhealthy or indicative of an eating disorder.

* **Academic performance:** Measured by Grade Point Average (GPA).

Assess students' awareness and use of on-campus food pantries.

In essence, they tested whether food insecurity was present, who it affected, and what other challenges it was linked to.

The study included **855 first-year college students** from **eight different universities across the United States**.

The participants were specifically:

**First-year students:** This means they were in their initial year of college, typically aged 18-19, and likely experiencing significant life changes related to independence, finances, and academic demands.

**U.S. college students:** The findings are specific to the context of higher education in the United States, which has particular structures for financial aid, meal plans, and living arrangements.

The study did not specify other inclusion/exclusion criteria such as health status, but the focus was on a general population of first-year students.

The researchers used a combination of standardized questionnaires and self-reported data to gather information from the students:

**Food Security Status:** This was the central measure. It was assessed using the **U.S. Department of Agriculture (USDA) Adult Food Security Survey Module**. This is a widely recognized and validated 10-item questionnaire that asks about experiences related to food access, such as worrying about food running out, not being able to afford balanced meals, or cutting meal sizes because of lack of money, over the past 12 months. Based on responses, individuals are categorized as food-secure, marginally food-secure, low food-secure, or very low food-secure. For this study, "food-insecure" likely combined the low and very low categories, and "at risk" likely referred to marginally food-secure.

**Perceived Stress:** Measured using **Cohen's Perceived Stress Scale (PSS)**. This is a 10-item questionnaire that assesses how individuals perceive their life situations as stressful over the past month. Higher scores indicate higher perceived stress.

**Sleep Quality:** Measured using the **Pittsburgh Sleep Quality Index (PSQI)**. This is a self-rated questionnaire that assesses sleep quality and disturbances over a one-month period. It evaluates seven components of sleep (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction). A global score of 5 or greater indicates poor sleep quality.

**Disordered Eating Behaviors:** Measured using the **Eating Attitudes Test-26 (EAT-26)**. This is a 26-item self-report questionnaire designed to screen for symptoms and concerns characteristic of eating disorders. A score of 20 or higher is generally considered a clinical cutoff, suggesting a need for further evaluation.

**Academic Performance:** Students **self-reported their Grade Point Average (GPA)**. This is a common measure of academic achievement, typically on a 4.0 scale in the U.S.

**Sociodemographic Characteristics:** Students self-reported information such as their racial identity, living situation (on-campus vs. off-campus), receipt of a Pell Grant (a federal financial aid program for low-income students), and parental education level.

**Meal Plan Enrollment and Food Pantry Utilization:** Students answered specific questions about whether they were enrolled in a university meal plan and whether they had used on-campus food pantries for food acquisition. They also reported their awareness of these pantries.

All these measures relied on self-report, meaning students provided the information themselves, which is a common approach in large-scale surveys but has certain implications for data accuracy.

This study employed a **cross-sectional observational design**. This means that data was collected from participants at a single point in time, providing a snapshot of the prevalence of food insecurity and its correlates.

**How they ran the study:**

Researchers recruited first-year students from eight U.S. universities. These students completed a series of questionnaires, including the USDA Food Security Survey Module, Cohen's Perceived Stress Scale, Pittsburgh Sleep Quality Index, and Eating Attitudes Test-26, along with questions about their GPA, sociodemographic background, meal plan enrollment, and food pantry use. All data was collected at one specific time point.

**Why this design matters:**

**No Randomization:** In an observational study like this, participants are not randomly assigned to different groups (e.g., a food-secure group vs. a food-insecure group). Instead, they are observed as they naturally exist. This means the researchers did not manipulate any variables or interventions.

**No Blinding:** Blinding (where participants or researchers don't know who is in which group or receiving which intervention) is not applicable here because there was no intervention. Participants knew they were reporting on their own experiences and circumstances.

**No Washout Periods:** Washout periods are used in intervention studies to allow the effects of one treatment to clear before another is introduced. Since this was not an intervention study, washout periods were not relevant.

**Duration:** The study was conducted at a single point in time. While some questionnaires (like the USDA Food Security Survey Module and PSQI) ask about experiences over a preceding period (e.g., 12 months or 1 month), the data collection itself was not longitudinal.

**What this design can and cannot prove:**

**What it CAN prove:** A cross-sectional observational study can identify **associations** or **correlations** between variables. For example, it can show that students who are food-insecure are *more likely* to report poor sleep quality. It can also establish the **prevalence** of a condition (like food insecurity) within a specific population at a given time. The multivariate logistic regression models used in this study helped to quantify the strength of these associations (odds ratios) while statistically controlling for other factors (like sociodemographic characteristics and meal plan enrollment), making the identified relationships more robust.

**What it CANNOT prove:** Crucially, this design **cannot prove cause-and-effect relationships**. For instance, while the study found that food-insecure students had higher odds of poor sleep quality, it cannot definitively say that food insecurity *causes* poor sleep, or vice-versa, or if a third, unmeasured factor is influencing both. It's possible that financial stress contributes to both food insecurity and poor sleep, or that students with existing health issues leading to poor sleep might struggle more with managing finances and food. To establish causation, a longitudinal study (following individuals over time) or an experimental study (where an intervention is applied) would be necessary.

**Major methodological weaknesses:**

**Cross-sectional nature:** As explained, this is the primary limitation for inferring causality. We see correlations, but the direction of influence is unclear.

**Reliance on self-report:** All measures, including food security, stress, sleep, eating behaviors, and GPA, were self-reported by students. Self-report can be subject to recall bias (inaccurate memory), social desirability bias (reporting what is perceived as acceptable), or misunderstanding of questions. For example, a student might overestimate their GPA or underreport disordered eating behaviors.

**Specific population:** The study focused exclusively on first-year college students in the U.S. The findings may not be generalizable to students in other years of college, graduate students, students in other countries, or the general adult population.

**No objective measures:** The absence of objective measures (e.g., actigraphy for sleep, clinical assessments for eating disorders, official university records for GPA) means the findings are based solely on subjective experiences.

**Potential for unmeasured confounders:** While the study adjusted for some sociodemographic characteristics, there could be other factors not measured (e.g., mental health status, family support, academic major, part-time work hours) that influence both food security and the outcomes, thus affecting the observed associations.

Despite these limitations, the study provides valuable insights into the scope of food insecurity among first-year college students and highlights areas for further investigation and potential support.

The study revealed significant prevalence of food insecurity among first-year U.S. college students and identified several strong correlates.

**Prevalence of Food Insecurity:**

* **19%** of participating students were classified as food-insecure.

* An additional **25.3%** were at risk of food insecurity.

* Combined, this means **44.3%** of first-year students were either food-insecure or at risk.

**Sociodemographic Correlates of Food Insecurity:**

Students were more likely to be food-insecure if they:

* Identified as a **racial minority**.

* Lived **off-campus**.

* Received a **Pell grant** (indicating lower income).

* Reported a **parental education of high school or less**.

* Did **not participate in a meal plan**.

**Health and Academic Correlates of Food Insecurity (after adjusting for sociodemographic characteristics and meal plan enrollment):**

Food-insecure students had significantly higher odds of experiencing negative health and academic outcomes compared to food-secure students:

* **Poor Sleep Quality:** Food-insecure students had **2.32 times higher odds** (Odds Ratio [OR] = 2.32, 95% Confidence Interval [CI]: 1.43-3.76) of reporting poor sleep quality.

* **High Stress:** Food-insecure students had **4.65 times higher odds** (OR = 4.65, 95% CI: 2.66-8.11) of reporting high stress.

* **Disordered Eating Behaviors:** Food-insecure students had **2.49 times higher odds** (OR = 2.49, 95% CI: 1.20-