Effects of Behavioral, Clinical, and Policy Interventions in Reducing Human Exposure to Bisphenols and Phthalates: A Scoping Review.

BACKGROUND: There is growing interest in evidence-based interventions, programs, and policies to mitigate exposures to bisphenols and phthalates and in using implementation science frameworks to evaluate hypotheses regarding the importance of specific approaches to individual or household behavior change or institutions adopting interventions. OBJECTIVES: This scoping review aimed to identify, categorize, and summarize the effects of behavioral, clinical, and policy interventions focused on exposure to the most widely used and studied bisphenols [bisphenol A (BPA), bisphenol S (BPS), and bisphenol F (BPF)] and phthalates with an implementation science lens. METHODS: A comprehensive search of all individual behavior, clinical, and policy interventions to reduce exposure to bisphenols and phthalates was conducted using PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar. We included studies published between January 2000 and November 2022. Two reviewers screened references in CADIMA, then extracted data (population characteristics, intervention design, chemicals assessed, and outcomes) for studies meeting inclusion criteria for the present review. RESULTS: A total of 58 interventions met the inclusion criteria. We classified interventions as dietary (n=27), clinical (n=13), policy (n=14), and those falling outside of these three categories as "other" (n=4). Most interventions (81%, 47/58) demonstrated a decrease in exposure to bisphenols and/or phthalates, with policy level interventions having the largest magnitude of effect. DISCUSSION: Studies evaluating policy interventions that targeted the reduction of phthalates and BPA in goods and packaging showed widespread, long-term impact on decreasing exposure to bisphenols and phthalates. Clinical interventions removing bisphenol and phthalate materials from medical devices and equipment showed overall reductions in exposure biomarkers. Dietary interventions tended to lower exposure with the greatest magnitude of effect in trials where fresh foods were provided to participants. The lower exposure reductions observed in pragmatic nutrition education trials and the lack of diversity (sociodemographic backgrounds) present limitations for generalizability to all populations. https://doi.org/10.1289/EHP11760.

Weight gain in Namibians with HIV switching from efavirenz to dolutegravir.

BACKGROUND: Research suggests that integrase strand transferase inhibitor use can lead to weight gain, and data from sub-Saharan countries are limited. This study investigated changes in weight in Namibians switched from tenofovir DF/emtricitabine/efavirenz (TEE) to tenofovir DF/lamivudine/dolutegravir (TLD). METHODS: Longitudinal, retrospective, and quantitative study from outpatient records of Namibians living with HIV/AIDS switched from efavirenz-to dolutegravir-based regimen at four clinics. A linear mixed effects model predicting weight 6 months prior to the switch, time of the switch, and at 6, 12-, and 18-months post-switch was run. A second analysis comparing change in weights between males and females was also run. RESULTS: 242 patients switched from TEE to TLD. Compared to patient weight at the time of the switch, weights were significantly higher at 6 (+0.9 kg, p = 0.004), 12 (+1.7 kg, p < 0.001), and 18 months (+1.4 kg, p < 0.001) post-switch. There was no significant weight change for males, but females had a significant weight gain at 12 (+1.58 kg, p = 0.012) and 18 months (+1.49 kg, p = 0.024) post switch. CONCLUSIONS: Females living with HIV in Namibia gain weight when switched from TEE to TLD. Clinical implications on the development of cardiometabolic complications is unclear and mechanisms by which the weight gain occurs are unknown.

Individual and community preparedness to disasters and pandemics in Idaho Falls: A cross sectional analysis.

Communities form an integral component of disaster and pandemic preparedness. This study aimed to explore disaster/pandemic preparedness-with a special focus on coronavirus disease 2019 (COVID-19)-at the household and community level among residents within 50 miles of Idaho Falls. A structured online survey questionnaire was distributed, resulting in 924 responses from participants over 18 years of age. The results highlighted that 29 and 10 percent of participants were not prepared to deal with disasters and pandemics, respectively. Most participants trusted healthcare professionals (61 percent) for information about COVID-19, followed by scientists (46 percent) and local health departments (26 percent). The overall preparedness to disasters/pandemics at the community level was 50 percent. Males, participants older than 35 years, and participants with paid employment had higher odds of being prepared for disasters, whereas higher education was associated with higher preparedness for pandemics. This study highlights the need for better household and community disaster and pandemic preparedness.

Prevalence and Demographic Profiles of Food Insecure College Students at Main and Satellite Campuses in Northwestern USA.

Background: Recent studies demonstrated that food insecurity rates among college students surpass that of the general population. Both academic and health implications have been associated with food insecurity. Aim: This study compared the prevalence of food insecurity among students at three satellite campuses with those at the main campus of a 4-year, public university. Methods: In this cross-sectional design study, data were collected for four weeks using an anonymous, online questionnaire (10 demographic questions plus the USDA's Adult Food Security Survey 10-item module). A sample of 983 students was recruited from the 9064 undergraduate and graduate students attending a state university. Chi-square tests were used to assess demographic differences between food insecure students on the main and satellite campuses. Logistic regression was performed to evaluate the odds of food insecurity by campus (satellite vs. main), after controlling for demographics. Statistical significance was assessed at P < 0.05. Results: Bivariate results indicated the rate of food insecurity was significantly higher on the main campus (45%) than on the satellite campuses (34%, P = 0.007). However, after controlling for demographics there was no difference in the odds of food insecurity by campus (P = 0.239). Conclusion: The study findings are novel as no other studies compared the prevalence of food insecurity among students attending satellite campuses compared with those at the main campus. After controlling for demographics, type of campus (satellite vs. main) was not a significant factor in the odds of food insecurity.

Should we offer disaster preparedness and response training workshops across Idaho? A feasibility study.

INTRODUCTION: It is important for individuals and families to prepare for potential disasters to enable communities to generate a consolidated response. It is estimated that 30 percent of residents of the fourth largest city in Idaho, Idaho Falls, are not prepared to deal with disasters. A 1-day training workshop for healthcare professionals and students at Idaho State University in Pocatello was organized to build their capacity for acute disaster response and preparedness. This study assesses the impact of the workshop in improving knowledge and attitudes of the participants toward disaster management. METHODS: A mixed methods study design was employed. Pre- and post-tests were administered to the participants (n = 18) to examine change in self-perceived understanding of disasters, and disaster preparedness and management. Core competencies encompassing knowledge of disaster preparedness were assessed via 18 multiple-choice questions. Participant attitudes toward disaster training exercises in colleges, universities, and healthcare facilities were recorded, and written feedback regarding the workshop obtained. Chi-square and paired t-tests were used to examine changes in disaster preparedness and cumulative knowledge score. Quantitative variables and comments were analyzed using Stata.v.13 and Maxqda, respectively. RESULTS: Our assessment indicates an improvement in mean knowledge score [pretest: 10.7 (2.8), post-test: 12.5 (2.9); p = 0.007] and self-perceived disaster preparedness and management. The attitude of audience toward training workshops was wholly positive in both the pre- and post-tests. Participants commented that the workshop was "excellent," helped them polish their knowledge and skills, trained them to build emergency kits and communication plans, and perform triage amidst crises. CONCLUSION: Training workshops should be offered to communities to build their capacity to prepare for and respond to disasters.

Association of food insecurity on gut microbiome and metabolome profiles in a diverse college-based sample.

Voluntary caloric restriction (e.g., eating disorders) often results in alterations in the gut microbiota composition and function. However, these findings may not translate to food insecurity, where an individual experiences inconsistent access to healthy food options. In this study we compared the fecal microbiome and metabolome of racially and ethnically diverse first year college students (n = 60) experiencing different levels of food access. Students were dichotomized into food secure (FS) and food insecure (FI) groups using a validated, 2-question screener assessing food security status over the previous 30 days. Fecal samples were collected up to 5 days post survey-completion. Gut microbiome and metabolome were established using 16S rRNA amplicon sequencing, targeted liquid chromatography-tandem mass spectrometry, and gas chromatography-mass spectrometry. FI students experienced significantly greater microbial diversity with increased abundance of Enterobacteriaceae and Eisenbergiella, while FS students had greater abundance of Megasphaera and Holdemanella. Metabolites related to energy transfer and gut-brain-axis communication (picolinic acid, phosphocreatine, 2-pyrrolidinone) were elevated in FI students (q < 0.05). These findings suggest that food insecurity is associated with differential gut microbial and metabolite composition for which the future implications are unknown. Further work is needed to elucidate the longitudinal metabolic effects of food insecurity and how gut microbes influence metabolic outcomes.

Social contexts are related to health behaviors: mEMA findings from the SPARC study.

Understanding how social context is associated with behaviors can indicate circumstances when behaviors are more likely to occur. In this study 29,995 ecological momentary assessment (EMA) surveys from 805 participants were analyzed to determine the social context of when eating, drinking, physical activity behaviors, and none of those behaviors (not eating, drinking, or being physically active, "none") occurred. Within-person results indicated that participants had lower odds of reporting eating (OR = 0.81) and drinking (OR = 0.79), and higher odds of reporting physical activity behaviors (OR = 1.20) and "none" (OR = 1.11) when they were alone, compared to when they were with friends. Within-person results also indicated that when participants were off-campus they were more physically active (OR = 1.73) and had lower odds of being reported "none"(OR = 0.78) than when they were on campus. Surprisingly, within-person results also suggested participants reported less physical activity on the weekend (OR = 0.78) than during weekdays, and instead had higher odds of reporting "none" (OR = 1.11). Between-person results suggested participants who were alone had higher odds of reporting "none"(OR = 1.64). When stratified by demographics the findings were similar. These findings show that student behaviors are different when they are alone vs. not, and that social context matters when understanding student behaviors. Interventions aimed to improve dietary intake and promote physical activity may be more effective if a social context aspect is included in their design.

Triaxial Accelerometry-Based Moderate to Vigorous Physical Activity in Older Adults Using Four Different Methods.

The amount of physical activity reported using accelerometry can vary depending on the method used. This study examined variability in four different methods of calculating moderate to vigorous physical activity (MVPA) among older adults, as well as lifestyle correlates of physical activity. The MVPA data were captured (n = 111; Mage = 70.3 years, SDage = 6.3) using waist-worn ActiGraph wGT3X-BT monitors and examined using 10-min bouted versus sporadic methods, and with cut points calibrated to older and younger adults. The sample, on average, did not meet national guidelines of 150 min/week of MVPA when using bouted methods, irrespective of cut point used. This was not the case for sporadic MVPA. More physical activity was reported for participants with two or more physical hobbies, but no association with social behavior was found. These results demonstrate the wide variability possible in reporting methods for accelerometry data and their relation to adherence rates for national health recommendations.

Diet Quality and Mental Health Status among Division 1 Female Collegiate Athletes during the COVID-19 Pandemic.

The International Olympic Committee has identified mental health as a priority that significantly affects the physical health and safety of collegiate athletes. Interventions that improve diet quality have been shown to improve mental health in several populations. However, studies are needed to examine this relationship in female collegiate athletes, who have elevated risk of experiencing anxiety and depression symptoms, as well as dietary insufficiencies. In a quantitative, cross-sectional study, female student athletes at a U.S. university completed three mental health questionnaires: Depression Anxiety and Stress Scale (DASS-21), Athlete Psychological Strain Questionnaire (APSQ), and COVID Stress Scales (CSS). Each female athlete also completed a validated, web-based Diet History Questionnaire (DHQ-III) resulting in a Healthy Eating Index (HEI). Seventy-seven participants completed all survey information. HEI scores were consistently higher for athletes with poorer mental health. HEI scores were significantly positively associated with stress (p = 0.015), performance concerns (p = 0.048), CSS components of danger (p = 0.007), contamination (p = 0.006), and traumatic stress (p = 0.003). Although findings support statistically significant associations among dietary quality and mental health indicators, including broad symptom severity or stressors specific to athletics or COVID-19, these associations were in the opposite direction hypothesized. Possible reasons for results and suggestions for future research are discussed.

Understanding COVID-19 Vaccine Hesitancy Among Students in Health Professions: A Cross-Sectional Analysis.

INTRODUCTION: Vaccine hesitancy (VH), delay in acceptance, and/or refusal to vaccinate is influenced by complacency, confidence, unmet safety, and efficacy concerns. A survey was conducted among U.S. healthcare students to identify factors contributing to COVID-19 vaccine hesitancy. METHODS: The World Health Organization 2014 vaccine hesitancy guidelines informed development of a 37-item survey. This cross-sectional survey was distributed to students in 10 randomly selected nursing, pharmacy, and medical programs. Descriptive statistics and logistic regression were used to identify factors contributing to COVID-19 vaccine hesitancy. RESULTS: Of the 902 participants who started the survey, 398 completed all COVID-19 questions. Survey respondents were primarily from private schools (84%) and consisted of medical students (49%), female (71%), and millennials (57%). Students believed COVID-19 vaccine was important and protection of vulnerable communities more important than individual protection. Students in general agreed getting the vaccine was necessary to protect others (school and healthcare facilities) (77.4%); only one-third (33.7%) disagreed that they planned to wait and want to see how vaccine affected others before receiving it. Logistic regression results suggest significant differences based on program and political affiliation. CONCLUSIONS: Engagement of healthcare students may help reach student peers who are vaccine hesitant and help reduce the spread of COVID-19.

Dietary quality and bisphenols: trends in bisphenol A, F, and S exposure in relation to the Healthy Eating Index using representative data from the NHANES 2007-2016.

BACKGROUND: Given policy regulations restricting bisphenol A (BPA) in food-related products, and consumer concerns about adverse health effects, newer bisphenols such as bisphenol F (BPF) and bisphenol S (BPS) have been developed. Exposure to BPA has been linked to dietary behaviors and poor health outcomes. OBJECTIVES: We sought to examine how the Healthy Eating Index (HEI) and its 13 subgroups, the healthy American diet, the Mediterranean diet, the vegetarian diet, and other dietary quality behaviors are related to BPA and the newer substitutes in a representative sample of US adults. METHODS: Dietary intakes from the NHANES were used to determine dietary scores. Osmolality-adjusted urinary BPA (n = 6418) and BPF and BPS (n = 2520) concentrations were tested for their association with dietary intake in models that adjusted for sociodemographics. RESULTS: Compared with low scores, high scores for total HEI and the American, Mediterranean, and vegetarian diets were associated with lower odds of high BPA concentration (OR: 0.65, 0.60, 0.59, and 0.60, respectively). Of the HEI subgroups, lower BPA concentration was associated with high total fruit (OR: 0.61; 99.95% CI: 0.42, 0.89), whole fruit (OR: 0.59; 99.95% CI: 0.41, 0.86), and whole grain (OR: 0.68; 99.95% CI: 0.40, 0.94) intake, when compared with low intakes. Compared with low intakes, high intakes of plain and tap water were associated with lower odds of high BPA concentration (OR: 0.65; 99.95% CI: 0.47, 0.91 and OR: 0.70; 99.95% CI: 0.50, 0.99, respectively). A perception of high, compared with low, dietary quality was also associated with lower odds of high BPA concentration (OR: 0.72; 99.95% CI: 0.53, 0.98). CONCLUSIONS: Healthier dietary quality and several HEI subgroups were related to lower urinary BPA concentrations; no significant (P ≤ 0.0005) findings were observed for BPF and BPS. The association between bisphenol substitutes and dietary quality should continue to be monitored as bisphenol substitutes continue to increase in the food system.

Finding and Keeping Friends in College and Their Influence on Alcohol Use: A Network Analysis.

OBJECTIVE: We investigate how alcohol use and friendship co-evolve during students' transition to university. We discern effects of peer influence from friend selection based on alcohol use, whether such effects vary in strength across the school year, and whether alcohol has different effects on friendship formation versus friendship maintenance. METHOD: We gathered data on friendships, alcohol use, and binge drinking from 300 residence hall students (71% female) at a large, public U.S. university. Surveys were conducted at four time points during the 2015-2016 academic year. We used a stochastic actor-oriented model to test whether alcohol use was influenced by one's friends, while simultaneously testing for friend selection based on alcohol use and related network processes. RESULTS: Students were 7.0 times more likely to drink alcohol weekly if all versus none of their friends drank weekly and 6.8 times more likely to binge drink when all versus none of their friends engaged in binge drinking, after we controlled for friend selection. Alcohol use differentially affected friendship creation and maintenance in a complex manner: (a) weekly drinkers were more likely to form new friendships and dissolve existing friendships than nondrinkers and (b) similarity on drinking fostered new friendships but had no effect on friendship persistence. CONCLUSIONS: Friends influence one another's weekly drinking and binge drinking, whereas conversely, alcohol use contributes to both friendship formation and friendship instability.

First-year college students' weight change is influenced by their randomly assigned roommates' BMI.

BACKGROUND: There is ongoing debate about whether friends' greater similarity in Body Mass Index (BMI) than non-friends is due to friend selection, shared environments, or peer influence. METHODS: First-year college students (n = 104) from a southwestern U.S. university were randomly assigned roommates during the university's housing process, effectively removing friend selection effects. Participant BMI was measured up to four times (T1-T4) across 2015-2016. The influence of roommate baseline BMI (T1) on change in participant BMI over time (T2-T4) was analyzed using a linear mixed effects model adjusted for individual socio-demographics, linear time trends, baseline BMI, and physical clustering of students. A sensitivity analysis examining floormates was also conducted. RESULTS: Consistent with roommate influence, participants randomized to roommates with a higher BMI gained more weight between times T2 and T4 (ß = 0.06; 95% CI = 0.02, 0.10). No shared environment effects (shared campus or floor) were found. CONCLUSIONS: Randomly assigned roommates influenced each other's weight trajectories. This clarifies that BMI convergence can occur outside of friend selection or shared environments mechanisms.

Young adults' BMI and changes in romantic relationship status during the first semester of college.

PURPOSE: Identify how higher Body Mass Index (BMI) and weight discrimination are associated with romantic relationship formation and termination in young adults, and if the association was consistent for males and females. METHODS: First-year students (N = 1096) at entry to university (Time 1) provided BMI and self-reports of weight discrimination and romantic relationship status (in a relationship vs single); 550 were successfully resampled four months later (Time 2). Logistic generalized estimating equations (GEEs) examined if Time 1 relationship status was predicted by BMI and weight discrimination. Logistic GEEs were used to determine if Time 1 BMI and weight discrimination predicted Time 2 relationship status for the strata of students in, and out, of a relationship at Time 1. RESULTS: At baseline, students were less likely to be in a relationship if they had a higher BMI (OR = 0.94, 95% CI = 0.92, 0.96) or reported weight discrimination (OR = 0.69, 95% CI = 0.53, 0.90). When stratified by gender, the association between higher BMI and weight discrimination with relationship status was only observed for females. Longitudinally, a BMI-based selection effect was observed for romantic relationship formation, but not termination. Of the students who were single at Time 1, each one unit higher baseline BMI decreased the odds of the student transitioning to a relationship by 9% at Time 2 (OR = 0.91, 95% CI = 0.85, 0.96). When stratified by gender the association of higher BMI decreased odds of relationship formation was only significant for females. No weight discrimination differences for selection in or out of a romantic relationship were observed. CONCLUSIONS: These findings suggest a weight-related selection effect for romantic relationship initiation, but not termination, in young female adults with lower BMIs. Weight discrimination was not associated with romantic relationship initiation or termination in this sample.

Similarity in meal plan use among first-year roommates.

OBJECTIVE: To examine if first-year roommates made similar meal plan decisions. METHODS: Residence information for 1186 first-year students (N = 593 roommate pairs) and 559 floormates was obtained for the 2015-2016 academic year. Linear generalized estimating equations (GEEs) were used to examine if the number of meals students used over the semester was higher if their roommate used their meal plan more frequently. A logistic GEE examined joint meal plan usage between students and roommates for each month of the semester. To determine if residence, rather than roommate, explained the results, a simulation was conducted by randomly assigning the floormates to a same-sex roommate. RESULTS: The number of meals students used in spring was higher if the students' roommate had used more meals in spring, even after controlling for the number of meals students used in fall (Female: ß = 0.07, 99% CI = 0.00, 0.13; Male: ß = 0.10, 99% CI = 0.02, 0.18). Students were more likely to use a meal with their roommate if they were on the same meal plan (Female: OR = 1.61, 99% CI = 1.27, 2.04; Male: OR = 1.57, 99% CI = 1.09, 2.25), and less likely after the first month of being roommates (Female: OR = 0.57-0.25; Male: OR = 0.50-0.22; p < 0.001). The simulation analysis indicated these findings were not due to shared residence. DISCUSSION: Students' meal plan choices were associated with their roommates' meal plan choices. Roommates' joint meal plan usage was highest at the start of the year. Strategic roommate pairings may result in students using their meal plan more. Further research should determine the extent of roommate influence on students' diet.

Evaluating Potential Behavioral Mediators for Increasing Similarity in Friends' Body Size among College Students.

College students and their friends become more similar in weight status over time. However, it is unclear which mediators explain this relationship. Using validated survey measures of diet, physical activity, alcohol intake, sleep behaviors, mental health, and food security status, we take a comprehensive look at possible factors associated with excess weight gain that may explain friends' convergence on body mass index (BMI), waist circumference, waist to hip ratio, and waist to height ratio over time. We use linear mixed models applied to a longitudinal dataset of first-year college students to examine whether these variables satisfy two criteria for potential candidate mediators of friends' influence on anthropometrics-cross-sectional similarity among friends (n = 509) and longitudinal associations with increasing anthropometrics (n = 428). While friends were similar on some survey measures (such as dining hall use, home cooked meal consumption, fruit intake, alcohol intake, hours of sleep, and stress). Only dining hall use and stress emerged as potential explanations for why friends' BMI and anthropometric change may be similar. Given that only a few variables satisfied the two criteria as potential mediators, future research may need to consider alternative measurement approaches, including real-time assessments, objective measurements, and alternative factors causing the convergence of friends' and college students' body size over time.

Trends and disparities in urinary BPA concentrations among U.S. emerging adults.

BACKGROUND: Emerging adulthood (ages 18-25 years) is a key turning point in the life course characterized by particularly poor eating behaviors (e.g., low in fruits and vegetables, and high in fast food) and weight gain. Emerging adults are also prime consumers of personal care and other consumer products that may result in differential exposures to environmental contaminants, such as Bisphenol A (BPA), compared to adults aged 26+ years. This is of concern given BPA has been associated with adverse health outcomes such as obesity, metabolic disorders, miscarriage, infertility and breast cancer. However, no research has examined exposure to BPA among emerging adults. OBJECTIVE: To assess trends of exposure to urinary BPA among a representative sample of emerging adults compared to adults aged 26+ years. Secondarily, we aimed to identify differential associations between BPA concentrations and sociodemographic characteristics and BMI by age group. METHODS: This study uses National Health and Examination Surveys (NHANES) over 2003-2014 to test differences in BPA concentrations comparing emerging adults to adults aged 26+ years. Generalized linear models predicting log BPA by age group and sex, race/ethnicity, education, income, and food security status, and generalized linear models predicting BMI by log BPA, both age group and age as a continuous variable, sex, race/ethnicity, education, income, and food security status were conducted. Interactions with age group (i.e., age group x sex) were examined for the mutually adjusted models. All models controlled for survey year, month, and time of day, and were run with, and without, an adjustment for urinary creatinine. RESULTS: In models adjusted, and not adjusted, for urinary creatinine, emerging adults had a higher log BPA concentration than adults aged 26+ years (ß=0.153, p=0.004; ß=0.544, p<0.001), and a significantly steeper decline in BPA concentration between 2003-2004 and 2013-2014 than adults aged 26+ years (ß=-0.051, p=0.002; ß=-0.071, p=0.001). Males' log BPA concentration were lower than that for females when urinary creatinine was included in the model, and higher when urinary creatinine was excluded from the model (ß=-0.188, p<0.001; ß=0.203, p<0.001). Higher income was significantly associated with lower log BPA concentration (ß=-0.220, p<0.001; ß=-0.166, p<0.001). A significant interaction between emerging adult age group and food security status was observed, which was associated with higher BPA exposures. Log BPA concentration was associated with BMI only when urinary creatinine was excluded from the models (urinary creatinine included: ß=0.031, p=0.747; ß=0.022, p=0.815, urinary creatinine excluded: ß=0.528, p<0.001; ß=0.552, p<0.001). CONCLUSION: Findings indicate that emerging adults had higher BPA exposures than adults aged 26+ years in 2003-2004, and that emerging adults' exposure level has decreased faster than that of adults aged 26+ years. There were suggestions that the BPA concentration of emerging adults in 2013-2014 was lower than that for adults aged 26+ years, and that BPA exposure is associated with higher BMI. Our results highlight the need for additional research to identify the sources and routes of exposure to BPA and BPA replacements among emerging adults and to better characterize the variability in exposure. Intervention studies are needed to assist emerging adults in limiting their exposure to BPA, and potentially also the BPA alternatives.

Food Insecure College Students and Objective Measurements of Their Unused Meal Plans.

Some researchers have proposed the prevalence of food insecurity among college students is high due to students' meal plans providing insufficient meals. The association between college students' food security status and their meal plans have not yet been examined. In this study, United States (US) first year college students (N = 534) self-reported their food security status in the Fall 2015 and/or Spring 2016 semester(s). Objective measures of students' meal plans were obtained from the university. Logistic generalized estimating equations (GEEs) were used to determine if students' meal plan, and meal plan use, predicted food insecurity. Linear GEEs were used to examine several potential reasons for lower meal plan use. We found that students did not use all of their available meals. Compared to students on the most expensive (unlimited) meal plan, students on the cheapest (8 meals/week) meal plan were the most likely to report food insecurity (OR = 2.2, 95% CI = 1.2, 4.1). However, in the Fall semester, 26% of students on unlimited meal plans also reported food insecurity. For students on the 180 meals/semester meal plan, food insecurity was associated with using fewer meals (OR = 0.9, 95% CI = 0.8, 1.0). Students who worked tended to use their meal plan less (ß = -1.3, 95% CI = -2.3, -0.3). Students are reporting food insecurity while having meals left in their meal plan.

Friendship as a social mechanism influencing body mass index (BMI) among emerging adults.

BACKGROUND: Social relationships have been proposed as a significant factor shaping obesity risk. The first year of college, a period of major social, behavioral, and weight changes, provides a context well-suited to tracking longitudinally the impact of shifting friendships on weight outcomes. This study sought to identify social mechanisms impacting BMI change among emerging adults. METHODS: An analytic sample of 276 college students (71.0% female, 52.2% non-White) provided repeated reports of relationships and BMI was measured up to four times during 2015-2016. Stochastic actor-oriented models were used to examine change in BMI through social influence and change in friendships over time, controlling for sex and race/ethnicity. RESULTS: At baseline, mean BMI was 24.2±4.5 kg/m2. Overall, mean BMI increased over time; individual decreases in BMI were uncommon. There was a selection effect of BMI: participants with BMIs between 22 and 26 kg/m2 were most likely to be nominated as a friend. While participants did not select friends based on BMI similarity, participants who were reported as friends were more likely to experience convergence in BMI over time relative to the BMIs of non-friends (p = 0.015). An increase in BMI (versus stability or a decrease) was more likely for those whose friends had a higher BMI on average compared to participants whose friends had the same or lower BMI (OR = 2.85, 95% CI = 1.22, 6.71). CONCLUSION: Analyses indicated BMI affected friend selection, not through students selecting friends with similar BMI, but rather, by students avoiding friends with more extreme BMI levels.