THE MEDITERRANEAN DIET, FOOD SECURITY, BEHAVIORAL AND PSYCHOSOCIAL FACTORS, AND MENTAL HEALTH SYMPTOMS AMONG COLLEGE STUDENTS

Abstract

College students are particularly vulnerable to mental health issues due to various biological and psychosocial factors, with a high prevalence of food insecurity (FI) being a significant concern. Previous research suggests that adhering to a Mediterranean diet (MedDiet) pattern may positively impact college students' health and mental well-being. This comprehensive research, encompassing cross-sectional, interventional, and longitudinal approaches, aims to investigate the effects of MedDiet adherence and FI on mental health symptoms (MHS) among college students. A cross-sectional study of first-year students (N=1,101) found low adherence to a MedDiet in 60.6%, and 25% experienced food insecurity. Approximately one-third reported moderate to severe depression and anxiety, with a moderate mean stress score of 25.8±9.3. There was an inverse association between MedDiet adherence and MHS (depression, anxiety, and stress) (beta = -0.08, p = 0.0007). FI was positively associated with MHS (beta = 0.12, p <.0001). No significant interaction was found between MedDiet adherence and FI on MHS. The intervention study was an 8-week Mediterranean-style diet educational intervention. Participants were randomly assigned to an intervention and education group (I & E; N=107) or an education-only group (E; N=110). At baseline, 43% had low MedDiet adherence, with mean Healthy Eating Index (HEI) and skin carotenoid status (SCS) scores of 61.9±11.6 and 345±107.8, respectively, with no significant differences between the groups. Post-intervention, the I & E group significantly improved MedDiet adherence, HEI, and SCS scores. Both groups experienced decreased depression and anxiety symptoms, with stress improving only in the I & E group. FI did not moderate the MedDiet-MHS relationship. Lastly, the longitudinal study covers four time points (2021-2024), (T1; N = 1,101), (T2; N = 493), (T3; N = 164), and (T4; N = 101). We found a cumulative high MedDiet adherence inversely correlated with MHS, while FI positively correlated with MHS over the years. The protective effects of MedDiet adherence on MHS were consistent across all food security levels. These findings highlight the critical need for early screening of MHS and FI among college students and may prompt university administrators to consider nutritional and food security interventions to promote student mental health and well-being.