Fat and fat-free mass measurement agreement by dual-energy X-ray absorptiometry versus bioelectrical impedance analysis: Effects of posture and waist circumference.

Background: Bioelectrical impedance analysis (BIA) operates under the assumption that the conductor has a uniform cylindrical shape. However, this assumption may be violated if measures are taken in the seated position, especially in people with a high waist circumference (WC). Aims: The aims of this research were to determine whether posture (supine, standing, and seated) and WC affect agreement between BIA and dual-energy X-ray absorptiometry (DXA) measures of fat mass (FM) and fat-free mass (FFM). Materials & Methods: Baseline data were collected from 28 adults (mean = 61.4 ± 6.9 years, 64.3% female) with obesity (BMI 38.6 ± 5.0 kg/m2). Body composition was measured using BIA in the supine, standing, and seated positions and by DXA while supine. Intraclass correlation coefficient (ICC) analyses with two-way mixed effects and absolute agreement were performed to determine agreement. Results: Point estimates were excellent for FM and FFM while supine, excellent for FM and good for FFM while standing, and moderate for FM and good for FFM while seated. BIA measures in the supine position resulted in the narrowest 95% confidence intervals compared with other positions. Better agreement was observed across all positions in participants with a WC below the median (118.3 cm). Discussion: Despite the potential pragmatic value of measuring with BIA in a seated position, the results of this analysis demonstrate the poorest agreement between DXA and BIA methods, especially in individuals with high WC. Conclusion: Findings from this study demonstrate that BIA, particularly when measured in a supine position, can serve as a viable alternative to DXA for measuring body composition in people with obesity.

Differences in Measured and Self-Categorized Food Security Status and Related Coping Strategies among College Students.

Qualitative studies suggest that college students with food insecurity (FI) experience stigma and misinterpret some of the USDA Adult Food Security Survey Module (AFSSM) questions, leading to misclassification of food security (FS) status. We aimed to evaluate differences in AFSSM-measured FS status and self-categorized FS status (based on USDA descriptions of the four FS levels) among college students, and to identify differences in the coping strategies and BMI of these students. Data were collected cross-sectionally from a convenience sample via web-based, self-reported surveys. Measured FS, self-categorized FS, coping strategies, and self-reported BMI were key variables of interest. Participants were 1003 undergraduate and graduate students (22.2 ± 4.6 years; 65.7% female). Of the participants measured as food insecure (40.0%), 57.8% self-categorized as food secure (MFI-SFS) and 42.2% self-categorized as food insecure (MFI-SFI). Significantly more MFI-SFI participants were AFSSM-categorized as having very low FS when compared to MFI-SFS participants (71.6% vs. 46.6%, p < 0.05). MFI-SFI participants reported significantly higher BMI (M = 24.7, SD ± 6.0 kg/m2) and coping strategies scores (M = 49.8, SD ± 7.5) when compared to MFI-SFS participants (M = 23.1, SD ± 3.6 kg/m2; M = 46.9, SD ± 7.5, respectively, p ≤ 0.01). Assessment of and interventions to address FI among college students should consider the potential influence of self-perception and students' interpretation of survey questions.

Obstacles to university food pantry use and student-suggested solutions: A qualitative study.

BACKGROUND: In the absence of federal programs and policies to alleviate college student food insecurity, the number of food pantries has grown rapidly in the United States. Yet, no studies, to date, have qualitatively examined students' experiences with this resource. OBJECTIVE: To explore college students' perspectives on barriers to using an on-campus food pantry and provide insights into student-suggested solutions. METHODS: In this qualitative study, 41 college students were recruited from a large public university in the southeastern US with a campus food pantry. Students participated in one-on-one, in-person, semi-structured interviews. All interviews were audio-recorded, transcribed verbatim, managed using NVivo 12, and analyzed using inductive, semantic thematic analysis. RESULTS: Most students were classified as food insecure (n = 33, 82.5%), and two-thirds identified as pantry users (at least once). The students' reasons for not using the food pantry indicated resistance and access barriers. Students either 'chose not to use' the campus food pantry due to (i) stigma and shame, (ii) perceived insufficient need, (iii) and unsuitable food or they experienced 'barriers' due to (i) lack of knowledge and (ii) limited food access. The main reason reported by food insecure non-pantry users was feelings of stigma and shame while that of food insecure pantry users was limited food access. Students suggested three solutions to minimize barriers experienced when utilizing the campus food pantry. These included (i) spreading awareness about the pantry through positive marketing messages that de-stigmatize use, (ii) improving accessibility of fresh produce and protein options, and (iii) improving access through satellite locations and online ordering systems. CONCLUSION: These barriers need to be systematically addressed to normalize food pantry use. Consideration of student recommendations by university program developers and policymakers may be of added value to expand access to food by college students with food insecurity.

Food Insecurity Is Associated with Increased Risk of Obesity in US College Students.

BACKGROUND: Food insecurity affects millions of Americans and college students are especially vulnerable. Little is known about the relation of food insecurity with weight status and dietary intake during this critical phase of emerging adulthood. OBJECTIVES: We aimed to examine the sex-specific associations of food insecurity with obesity and dietary intake among college students. The study also explored these associations by meal plan (MP) enrollment. METHODS: This cross-sectional study included 683 second-year students at 8 universities in the United States. Food security status and dietary intake were assessed using the USDA Adult Food Security Survey and the Dietary Screener Questionnaire, respectively. On-site anthropometrics were measured by researchers. RESULTS: The prevalence of food insecurity at the universities ranged from 19.0% to 34.1% with a mean of 25.4% for the entire sample. Compared with high food security, marginal food security and food insecurity were associated with 3.16 (95% CI: 1.55, 6.46) and 5.13 (95% CI: 2.63, 10.00) times increased odds of obesity, respectively, exhibiting a dose-response relation. Food insecurity remained a significant predictor of obesity among both sexes after adjusting for sociodemographic variables. Food-insecure (FI) students had a significantly lower intake of fruits and vegetables and higher intake of added sugars than food-secure (FS) students. Obesity rate and added sugars consumption were higher among FI students with MPs than among FI students lacking MPs and FS students regardless of MP status. Among students with MPs, FS students had a higher intake of fruits and vegetables than FI students. CONCLUSIONS: Food insecurity was associated with obesity and poor dietary intake among both sexes. Although MP subsidies may be a reasoned approach to combat food insecurity, it should be coupled with efforts to assist students in making healthy food choices.Registered at clinicaltrials.gov as NCT02941497.

Examining the effect of weight conscious drinking on binge drinking frequency among college freshmen.

OBJECTIVE: To examine the effect of weight-conscious drinking and compensatory behavior temporality on binge drinking frequency of college freshmen. Participants: Freshmen (n = 1149) from eight US universities, Fall 2015. Methods: Participants completed the Compensatory Eating Behaviors in Response to Alcohol Consumption Scale and Alcohol Use Disorders Identification Test-Consumption. Structural equation modeling was used to model the effect of weight-conscious drinking constructs on binge drinking frequency. Results: Bulimia, Dietary Restraint and Exercise, Restriction, proactive Alcohol Effects, during Alcohol Effects, and proactive Dietary Restraint and Exercise factors significantly predicted binge drinking frequency. Conclusion: Weight-conscious drinking among this cohort of college students comprises temporal factors significantly associated with binge drinking frequency. Relationships between Bulimia, Dietary Restraint and Exercise, and Restriction compensatory behaviors and binge drinking should be considered in interventions to address binge drinking among college students.

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

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.

Why Are Hungry College Students Not Seeking Help? Predictors of and Barriers to Using an On-Campus Food Pantry.

BACKGROUND: The number of food pantries on U.S. college campuses has increased in response to students' food insecurity, but limited information is available to describe the impact of this resource. The objective of this cross-sectional investigation was to examine the relationship between food insecurity and food pantry awareness, use, and perceived barriers to use. METHODS: Students attending the University of Florida in fall 2017 (n = 899) completed the United States Department of Agriculture (USDA) Adult Food Security Survey and responded to questions about food pantry awareness and use. Sociodemographic data were also collected and included in multivariate logistic regression models. RESULTS: While most students (70%) were aware of the existing food pantry, nearly a third of respondents were classified as being food insecure. After adjusting for sociodemographic correlates, factors such as identifying as being food insecure, international status, and receiving a student loan or a need-based federal financial aid (Pell grant) increased the likelihood of utilizing the campus food pantry. Despite these predictors, only 38% of food insecure students reported food pantry use. Among students who provided qualitative insights, four main barriers to using the on-campus food pantry were identified: social stigma, insufficient information on pantry use policies, self-identity, and inconvenient hours. CONCLUSIONS: Food security interventions and administrative policy should consider a new model of the traditional campus food pantry that reduces concerns of social stigma and is supported by clear and ongoing communications of operational procedures tailored for the college student population.