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

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          Abstract

          Background

          College students may be vulnerable to food insecurity due to limited financial resources, decreased buying power of federal aid, and rising costs of tuition, housing, and food. This study assessed the prevalence of food insecurity and its sociodemographic, health, academic, and food pantry correlates among first-year college students in the United States.

          Methods

          A cross-sectional study was conducted among first-year students ( n = 855) across eight U.S. universities. Food security status was assessed using the U.S. Department of Agriculture Adult Food Security Survey Module. Cohen’s Perceived Stress Scale, Pittsburgh Sleep Quality Index, and Eating Attitudes Test-26 were used to assess perceived stress, sleep quality, and disordered eating behaviors, respectively. Participants self-reported their grade point average (GPA) and completed questions related to meal plan enrollment and utilization of on-campus food pantries.

          Results

          Of participating students, 19% were food-insecure, and an additional 25.3% were at risk of food insecurity. Students who identified as a racial minority, lived off-campus, received a Pell grant, reported a parental education of high school or less, and did not participate in a meal plan were more likely to be food-insecure. Multivariate logistic regression models adjusted for sociodemographic characteristics and meal plan enrollment indicated that food-insecure students had significantly higher odds of poor sleep quality (OR = 2.32, 95% CI: 1.43–3.76), high stress (OR = 4.65, 95% CI: 2.66–8.11), disordered eating behaviors (OR = 2.49, 95% CI: 1.20–4.90), and a GPA < 3.0 (OR = 1.91, 95% CI: 1.19–3.07) compared to food-secure students. Finally, while half of the students (56.4%) with an on-campus pantry were aware of its existence, only 22.2% of food-insecure students endorsed utilizing the pantry for food acquisition.

          Conclusions

          Food insecurity among first-year college students is highly prevalent and has implications for academic performance and health outcomes. Higher education institutions should screen for food insecurity and implement policy and programmatic initiatives to promote a healthier college experience. Campus food pantries may be useful as short-term relief; however, its limited use by students suggest the need for additional solutions with a rights-based approach to food insecurity.

          Trial Registration

          Retrospectively registered on ClinicalTrials.gov, NCT02941497.

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          Most cited references27

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          Sleep and obesity.

          This review summarizes the most recent evidence linking decreased sleep duration and poor sleep quality to obesity, focusing upon studies in adults. Published and unpublished health examination surveys and epidemiological studies suggest that the worldwide prevalence of obesity has doubled since 1980. In 2008, 1 in 10 adults was obese, with women more likely to be obese than men. This obesity epidemic has been paralleled by a trend of reduced sleep duration. Poor sleep quality, which leads to overall sleep loss has also become a frequent complaint. Growing evidence from both laboratory and epidemiological studies points to short sleep duration and poor sleep quality as new risk factors for the development of obesity. Sleep is an important modulator of neuroendocrine function and glucose metabolism and sleep loss has been shown to result in metabolic and endocrine alterations, including decreased glucose tolerance, decreased insulin sensitivity, increased evening concentrations of cortisol, increased levels of ghrelin, decreased levels of leptin, and increased hunger and appetite. Recent epidemiological and laboratory evidence confirm previous findings of an association between sleep loss and increased risk of obesity.
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            The food insecurity-obesity paradox: a review of the literature and the role food stamps may play.

            During the past decade, rates of food insecurity and obesity have risen, and an association has been made between these two seemingly paradoxical states. Although this relationship has not been repeatedly seen in men, research suggests a correlation in women. Studies have not been able to consistently show a relationship in children, because findings differ based on age, race/ethnicity, household income, and sex. Several proposed hypotheses explain why a correlation between food insecurity and obesity exists in adults - especially women - but not in children. This review proposes a conceptual framework linking the Food Stamp Program and other coping strategies to the food insecurity-obesity relationship. This link has implications for Food Stamp Program policy changes, welfare reform, and poverty prevention.
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              Perceived Stress, Sources and Severity of Stress among medical undergraduates in a Pakistani Medical School

              Background Recently there is a growing concern about stress during undergraduate medical training. However, studies about the same are lacking from Pakistani medical schools. The objectives of our study were to assess perceived stress, sources of stress and their severity and to assess the determinants of stressed cases. Methods A cross-sectional, questionnaire-based survey was carried out among undergraduate medical students of CMH Lahore Medical College, Pakistan during January to March 2009. Perceived stress was assessed using the perceived stress scale. A 33-item questionnaire was used to assess sources of stress and their severity. Results The overall response rate was 80.5% (161 out of 200 students). The overall mean perceived stress was 30.84 (SD = 7.01) and was significantly higher among female students. By logistic regression analysis, stressed cases were associated with occurrence of psychosocial (OR 5.01, 95% CI 2.44-10.29) and academic related stressors (OR 3.17 95% CI 1.52-6.68). The most common sources of stress were related to academic and psychosocial concerns. 'High parental expectations', 'frequency of examinations', 'vastness of academic curriculum', 'sleeping difficulties', 'worrying about the future', 'loneliness', 'becoming a doctor', 'performance in periodic examinations' were the most frequently and severely occurring sources of stress. There was a negative but insignificant correlation between perceived stress and academic performance (r = -0.099, p > 0.05). Conclusion A higher level of perceived stress was reported by the students. The main stressors were related to academic and psychosocial domains. Further studies are required to test the association between stressed cases and gender, academic stressors and psychosocial stressors.
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                Author and article information

                Contributors
                352-665-1001 , aseel.elzein@ufl.edu
                352-273-3535 , kpagan@ufl.edu
                865-974-6248 , scolby1@utk.edu
                352-294-3720 , mgraveley@ufl.edu
                865-974-9198 , wzhou4@utk.edu
                402-874-4028 , ggreene@uri.edu
                304-293-1918 , melissa.olfert@mail.wvu.edu
                865-974-6248 , kristin.riggsbee@gmail.com
                603-862-2547 , jesse.morrell@unh.edu
                352-294-3719 , anne.mathews@ufl.edu
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                29 May 2019
                29 May 2019
                2019
                : 19
                : 660
                Affiliations
                [1 ]ISNI 0000 0004 1936 8091, GRID grid.15276.37, Food Science and Human Nutrition Department, , University of Florida, ; PO Box 110370, Gainesville, FL 32611-0370 USA
                [2 ]ISNI 0000 0004 1936 8091, GRID grid.15276.37, Department of Family, Youth & Community Sciences, , University of Florida, ; PO Box 110310, Gainesville, FL 32611-0370 USA
                [3 ]ISNI 0000 0001 2315 1184, GRID grid.411461.7, Department of Nutrition, , University of Tennessee, ; 229 Jessie Harris Bldg., Knoxville, RN 37996 USA
                [4 ]ISNI 0000 0001 2315 1184, GRID grid.411461.7, Department of Business Analytics and Statistics, , University of Tennessee, ; 916 Volunteer Blvd, UT SMC 247, Knoxville, TN 37996 USA
                [5 ]ISNI 0000 0004 0416 2242, GRID grid.20431.34, Nutrition and Food Sciences, , University of Rhode Island, ; 125 Fogarty Hall, Kingston, RI 02881 USA
                [6 ]ISNI 0000 0001 2156 6140, GRID grid.268154.c, Animal and Nutritional Sciences, , West Virginia University, ; 1194 Evansdale Drive, G28 Ag. Sc. Bldg., Morgantown, WV 26506 USA
                [7 ]ISNI 0000 0001 2192 7145, GRID grid.167436.1, Agriculture, Nutrition, and Food Systems, , University of New Hampshire, ; 115 Kendall Hall, 129 Main Street, Durham, NH 03814 USA
                Author information
                http://orcid.org/0000-0003-3504-5826
                Article
                6943
                10.1186/s12889-019-6943-6
                6542079
                31142305
                50c55c50-2c4c-4f63-8b7a-fd808561816b
                © The Author(s). 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 13 April 2018
                : 7 May 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100005825, National Institute of Food and Agriculture;
                Award ID: 2014-67001-21851
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Public health
                food insecurity,food pantry,college students,bmi,stress,sleep,disordered eating,gpa
                Public health
                food insecurity, food pantry, college students, bmi, stress, sleep, disordered eating, gpa

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