Food insecurity and lifestyle behaviours in university students amidst the COVID-19 pandemic: a comparative survey across three countries

• Published in: BMC public health 2024-12, Vol.24 (1), p.3571-13, Article 3571
• Main Authors: Witkowiak, Maria M, Idris, Adama Nana, Sato, Alma, Sacre, Hala, Haddad, Chadia, Rizk, Rana, Malaeb, Diana, Strahler, Jana, Salameh, Pascale, Ierodiakonou, Despo
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; College students; Colleges & universities; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; Cross-Sectional Studies; Cyprus - epidemiology; Developing countries; Diet; Economic aspects; Education; Exercise; Female; Food; Food Insecurity; Food quality; Food security; Food supply; Germany - epidemiology; GNI; Gross National Income; Health aspects; Healthy eating; Humans; LDCs; Lebanon - epidemiology; Life Style; Lifestyle; Lifestyles; Male; Mediterranean diet; Nutrition research; Pandemics; Per capita; Physical activity; Psychological aspects; Questionnaires; Regression analysis; Regression models; Sleep; Social aspects; Social networks; Statistical analysis; Students; Students - psychology; Students - statistics & numerical data; Surveys and Questionnaires; Universities; University students; Young Adult
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-21033-3

University students, often unemployed and reliant on low-nutrition foods, are susceptible to food insecurity (FI) with potential physical and mental health challenges. This study explores FI and its impact on lifestyle behaviours among university students. A cross-sectional web-based study was performed by sending an online questionnaire to university students in Lebanon, Cyprus, and Germany during the COVID-19 pandemic. Using validated measures, i.e., the Household Food Insecurity Access Scale, International Physical Activity Questionnaire, Pittsburgh Sleep Quality Index, and Mediterranean Diet Adherence Screener, adjusted linear regression models were performed to assess the associations between country, FI and physical activity, sleep quality, and diet. In a convenience sample of 611 individuals (350 in Germany, 214 in Lebanon, and 47 in Cyprus) enrolled in the study, 547 provided complete response. 190 (34.7%) experienced FI, of whom 52 (9.5%) were severely food-insecure, with variation of FI prevalence between countries (18.9% in Germany, 14.9% in Cyprus, and 60.3% in Lebanon). Lifestyle behaviours also differed between participants from the three countries, with students in Germany exhibiting the highest physical activity level and the lowest adherence to the Mediterranean diet compared with Lebanon and Cyprus. On the other hand, participants from Lebanon and Cyprus had similar physical activity and diet behaviours. Concerning sleep, students in Cyprus showed the poorest quality. FI significantly correlated with reduced physical activity (beta - 0.171, 95% Confidence Interval (-0.313, -0.029)), but not with sleep or diet. The country of residence independently predicted lifestyle behaviours (p