Hungry to learn: The prevalence and effects of food insecurity on health behaviors and outcomes over time among a diverse sample of university freshmen

Background: To examine longitudinal associations between food insecurity (FI) and health behaviors/outcomes among a diverse sample of university freshmen. Methods: Freshman students (n = 1138; 65% female 49% non-white) participating in the Social impact of Physical Activity and nutRition in College study completed surveys on health behaviors and had height/weight measured up to 4 times (T1-T4) in Arizona during 2015-2016. Structural equation models were estimated to determine if, after adjusting for covariates, FI predicted concurrent behaviors/outcomes and subsequent behaviors/outcomes. Analyses reported here were conducted in 2017. Results: The prevalence of FI was significantly higher at the end of each semester (35% and 36%, respectively) than at the start of the year (28%). Longitudinally, FI was not related to any health behaviors/outcomes at future time points. However, FI was significantly and inversely associated with concurrent breakfast consumption on most days of the week (OR = 0.67, 99% CI = 0.46, 0.99), daily evening meal consumption (OR = 0.55, 99% CI = 0.36, 0.86) healthy eating habits on campus (OR = 0.68, 99% CI = 0.46, 1.00), healthy physical activity habits on campus (OR = 0.66, 99% CI = 0.44, 1.00), and positively related to the likelihood of experiencing stress (OR = 1.69, 99% CI = 1.16, 2.46) and depressed mood (OR = 1.98, 99% CI = 1.34, 2.91). Conclusions: Compared with US prevalence rates, the sample FI prevalence was high. FI was related to poorer eating patterns, physical activity behaviors, and mental health, even after adjusting for prior levels of behavior.