Abstract
BACKGROUND: Food 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. OBJECTIVES: We 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. METHODS: This 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. RESULTS: The 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. CONCLUSIONS: Food 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.