Food insecurity and mental health of college students in Lebanon: a cross-sectional study

Abstract

The present study aimed to assess the prevalence of food insecurity (FI) among college students and explore its association with indicators of mental and psychosocial health. Data were collected using a cross-sectional online survey from college students in different universities in Lebanon during the Spring 2021 semester. FI was assessed using the validated eight-item food insecurity experience scale. The mental health of college students was assessed using validated screening tools for depression, anxiety and well-being, namely the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder-7 (GAD-7) and the World Health Organization (WHO-5) index, respectively. Multiple linear regression models were conducted to assess the relationship of FI with PHQ-9, GAD-7 and WHO-5 scores. A total of 745 students completed the online survey. Approximately 39 % of students in the sample were experiencing FI of which 27·4, 8·1, and 3·5 % were experiencing mild, moderate and severe FI , respectively. Low maternal education, low household monthly income and high levels of stress were significant correlates of FI among college students (P-trend < 0·001). In addition, 22·6 and 34·4 % of students showed severe symptoms of depression and anxiety, respectively. Regression models showed that FI was associated with higher scores on PHQ-9 and GAD-7 (β = 2·45; 95 % CI [1·41, 3·49]) and (β = 1·4; 95 % CI [1·1, 2·2], respectively) and lower scores on WHO-5 (β = −4·84; 95 % CI [−8·2, −1·5]). In conclusion, a remarkable proportion of college students reported experiencing different forms of FI, which was associated with poorer mental health and well-being outcomes. Public health programmes and interventions are needed to mitigate FI and improve student health-related outcomes.

Social determinants of student mental health before and after the Beirut port explosion: Two cross-sectional studies

“…For the rst time in the country's history, Lebanon has been agged for food insecurity risk by the United Nations (40), with 2.26 million people at risk. Food insecurity has also been found to be linked to poor mental health in students in Lebanon (15). Without economic and political reform in the country that can reduce nancial and food insecurity, we are unlikely to see major improvements in the population's mental health.…”

“…In these studies, more than half of the population were suffering from anxiety and traumatic stress. Amongst college students, over a third of students at the American University of Beirut reported severe symptoms of depression and anxiety, and this was strongly associated with food insecurity (15).…”

Exploring the perspective of young adults about anaemia prevention; the contributions of knowledge about at-risk groups and consequences of anaemia

“…In agreement with previous reports, food insecurity precipitated by weak finances, and the financial constraint inherent in higher education make these students prone to unhealthy lifestyle choices. Previous studies have found prevalence of food insecurity to be as high as 44% [ 21 ], 39% [ 22 ], 38 – 48% [ 23 , 24 ], respectively among students from University of California, Lebanon, and Australian universities, and therefore suggest a more global problem in the tertiary setting. Furthermore, although our cohort unanimously agreed that regular intake of balanced meals was an important preventive strategy to deal with anaemia, over two-thirds (73.5%) indicated skipping meals while on campus.…”

Food Insecurity in Higher Education: A Contemporary Review of Impacts and Explorations of Solutions

“…Both food insecurity and low fruit and vegetable intake were associated with depressive symptoms in a study by Wattick et al [96]. In a study of Lebanese college students, accounting for demographic and socioeconomic factors, food insecurity was linked with higher depression and anxiety scores compared with food secure peers [57]. In a recent study, Oh et al found links between food insecurity and substance use, including higher odds of binge drinking, cigarette smoking, and other illicit or prescription drug use after adjusting for demographic and employment factors [97].…”

“…Food insecurity in college remains high, with research from Australian universities indicating a food insecurity prevalence of 38-48% among students [55,56]. Similarly, a study of public and private college students in Lebanon indicated that food insecurity affected 39% of surveyed students [57]. As has been observed in US university students, food insecurity has been associated with poorer academic outcomes, with Malaysian students experiencing food insecurity having a lower GPA than food secure colleagues [58].…”