Associations Between Food Insecurity and Diet Quality Among Graduate Students and Postdoctoral Trainees in the Health Sciences at a Private University in Boston: A Cross-Sectional Study.

ABSTRACT

Background: Food insecurity is a pivotal determinant of health outcomes. Little evidence exists on the association between food insecurity and health behaviors and outcomes, including diet quality, among graduate students or postdoctoral trainees. Objectives: This study aimed to examine the association between food insecurity and diet quality among graduate students and postdoctoral trainees at 3 health-focused graduate schools (public health, medical, and dental medicine) within Harvard University. Methods: Between April and June 2023, 1287 graduate students and 458 postdoctoral trainees at the health-focused schools within Harvard University completed a web-based survey. The primary exposure was food security status, assessed using the United States Household Food Security Survey Module. The primary outcome was diet quality, measured using the 30-day Prime Diet Quality Score screener (ranges from 0 to 126, with higher scores indicating healthier diets). The associations between food insecurity and diet quality were examined using multivariable regression models, adjusting for sociodemographic covariates. Results: Among graduate students, compared with those with high food security, diet quality was significantly lower among those experiencing marginal food security [ß -4.7; 95% confidence interval (CI) -6.5, -2.9], low food security (ß -5.4; 95% CI -7.6, -3.3), and very low food security (ß -4.4; 95% CI -7.4, -1.4). Poor diet quality included lower intake frequencies of vegetables, fruits, beans/peas/soy products, nuts/seeds, poultry, fish, low-fat dairy, and liquid oils, and higher intake frequencies of refined grains/baked products, sugar-sweetened beverages, and fried foods. Among postdoctoral trainees, compared with those with high food security, diet quality was significantly lower among those experiencing low food security (ß -5.1; 95% CI -8.8, -1.4), and very low food security (ß -5.2; 95% CI -10.2, -0.2). Poor diet quality included lower intake frequencies of dark green leafy vegetables, other fruits, and whole grains. Conclusions: Graduate students and postdoctoral trainees who experienced degrees of food insecurity reported lower diet quality. These observations underscore the need for policies and interventions to simultaneously reduce food insecurity and improve diet quality.