Benchmarking the university campus food environment and exploring student perspectives about food insecurity and healthy eating: a case study from Australia

This component scored 4 out of 100 (4%), which was the lowest scoring component overall and held a weighting of 40%. The university has implemented sufficient sustainability frameworks however, these did not have a focus on food, this is highlighted within leadership and planning (25%). Additionally, there were no university-wide policies that aimed to govern the procurement of healthy foods and beverages on campus. Stakeholder engagement was absent and there were no strong partnerships relative to healthy eating on campus. These results are shown in Fig. 2.

This component scored 41 out of 100 (41%) and held a weighting of 40% as outlined in Fig. 3. The highest scoring domains was availability and accessibility (97%), whereas the lowest scoring domains was equity (18%). Whilst this score highlights the needs for improvements, some key strengths were identified in this component, such as the availability of culturally diverse food on campus, free drinking water widely available across campus, the availability of self-catering facilities at some dedicated location on campus. Moreover, the university also has strong waste management practices in place, including separated bins and sorting processes to ensure recycling occurs, as well as adequate personal and community development initiatives, including a community garden for students and the community. There were also evident educational initiatives regarding sustainability and healthy diets however, these were driven by student groups with limited involvement from the university.

This component was the strongest of all components within the audit and scored 45 out of 100 (45%), with a weighting of 20%, highlighted in Fig. 4. The highest scoring domains was promotions (79%), whereas the lowest scoring was information (14%). Promotions were a key strength as 15 out of the 24 food outlets (62.5%) were free from any promotions of unhealthy foods and beverages. In majority of the food outlets on campus, prices equally encourage the purchase of unhealthy and unhealthy foods as well as vegetarian and meat-containing options. Whilst there is no strong incentive to opt for the purchase of healthy and vegetarian foods, there is no significant encouragement to purchase unhealthy options which can be considered a strength.

Approximately 10 of the 24 food outlets sold predominantly unhealthy foods or beverages, with the remaining 14 offering either majority healthy options or a combination of both healthy and unhealthy food options. Most food outlets lacked sufficient nutritional information and only 14 of the 24 outlets provided very limited information on dietary requirements and common allergens. A significant gap was highlighted within the waste management domain as whilst many outlets utilised recyclable or reusable packaging, no food outlets had established waste monitoring and strong reduction systems.

A total of 48 participants completed the online screening survey and provided informed consent. After following up with the participants who had initially registered to participate, a total of 29 students were included in the analysis, with 17 (58.6%) were postgraduate students, and 12 (41.4%) were undergraduate. There were 13 (44.8%) domestic students and 16 (55.2%) international students with age range between 18 and 36. Participants’ ethnicities included Asian (34.5%), Australian (17.2%), Indian (10.3%), Indigenous (10.3%), and others including Arabic, British, Scandinavian and Sri Lankan (22.7%).

Results from the qualitative component of the study were grouped into themes (1) Healthy food options on campus (2), Influences of food choices on campus (3), Changes in eating habits since starting at university (4), Impacts of COVID-19 on eating habits (5), Health impacts of food insecurity (6), Barriers to accessing healthy food (7), Views on current university support, and (8) Future intervention ideas. Representative quotes for each theme and sub-theme are shown in Table 1.

Students mentioned that the most prominent opinions regarding healthy food on campus were those that contained either fruits or vegetables. Retailers predominately offering salads or sandwiches were perceived as an initial healthy option, as they contained vegetables and lower carbohydrate options. Food safety was also raised including unclean facilities, poor food preparation and presence of contaminants. When asked what they perceive to be healthy on campus (apart from mentioning food outlets), some students mentioned that nutritional composition and nutrient balances came to mind. Portion control and balanced composition of protein, carbohydrates and fibre were discussed. The consumption of unhealthy foods in moderation was raised as a concept of healthy eating at university in the absence of healthy food outlets.

Students were asked to discuss what may influence their choices when purchasing food on campus. Key barriers to purchasing and consuming healthy foods were highlighted throughout the discussions; these were predominantly focused on price and nutritional quality. Social factors such as peer influences and culture were raised by students as an impact on their eating habits as they may be more likely to consume what their peers are eating, or foods deemed culturally safe. Students also discussed foods with nutrients that supported them with energy to focus on their studies. They discussed time and location as large influences on their choice of food whilst on campus, which demonstrates that convenience has a major role in food consumption. The most prevalent influence on student food choices was pricing as many options were too expensive for students in general. Additionally, taste preferences were highly influential in food choices and consumption for students as they wanted to eat foods with appealing taste.

To further understand how eating habits may be altered as a university student, students were asked to discuss any changes that have occurred since starting their studies. Any factors that have influenced their eating habits since becoming a student were also mentioned including time constraints and the availability of foods around campus. Due to the time commitments and class schedules many students were not able to spend as much time as they wanted cooking and preparing healthy meals. As a result, students were now more likely to purchase convenient foods deemed unhealthy such as processed fast foods. Energy requirements needed to sustain their studies since being at university were raised.

To gain an understanding of the impact of the COVID-19 pandemic on student eating habits and experiences with food insecurity, students were asked to share any changes that may have occurred during this time. Students discussed difficulties with accessing grocery stores during the lockdown period due to store closures and travel restrictions. They also reported issues with finding stock of healthy foods during the pandemic, leaving students to rely on unhealthy options that were available. Furthermore, the frequency of meals throughout the day may have been altered to ensure food lasted for longer. Pricing of foods during the COVID-19 pandemic was discussed by students as a large issue. As a coping mechanism, students mentioned that they were living on cheaper foods which had less nutritional value. Some students reported being more health conscious during the COVID-19 pandemic. In contrast to negative impacts of the pandemic, having time during lockdown periods allowed students to develop their capacity and gain skills with cooking and food preparation.

Students discussed health impacts arising from their experiences with food insecurity which comprised of physiological and psychological changes. The physiological health impacts of food insecurity were raised during the focus group and interview sessions, including weight loss and gain, loss of energy, nutrient deficiencies, headaches, and gastrointestinal issues. Students also discussed the mental impacts of food insecurity, including feelings of shame, embarrassment, guilt, and stress. This was also due to the increased prices of some healthy foods, resulting in frustration.

As students were previously asked to share the influences on their eating habits during COVID-19, and since commencing at university, an overview of the generic barriers was captured to inform future initiatives. Students mentioned that healthy options are often more expensive than unhealthy options which prevented them from eating better. Particularly, fresh fruits and vegetables as these were expensive to purchase and alternatively, students chose frozen options as they were more affordable. International students were impacted by pricing as they also had lower incomes due to restricted employment as well as those needing to provide for their family. Location of supermarkets and food outlets was a significant barrier as students would be less likely to purchase healthy foods if they had to travel a longer distance to access them. Limited options of healthy foods were also reported to influence students’ dietary behaviours. In terms of food literacy, insufficient food, and nutrition knowledge made them more susceptible to nutrition misinformation. Additionally, lack of food preparation and cooking skills were raised as a concern.

Nutrition education within the university environment and curriculum was discussed by some students as they felt as though materials covered in tutorials or lectures provided knowledge and skills relative to healthy eating. Students discussed the food relief boxes that were available to students who were impacted by food insecurity. Although some students who experience food insecurity and accessed these boxes found them helpful, the contents were mostly canned and packaged goods which students perceived to be less healthy. Other students mentioned that they were not aware of the food relief boxes as they were not widely advertised, and the collection period was limited. Some students reported grocery vouchers provided by the university during the COVID-19 pandemic to help those who experienced food insecurity to purchase basic needs.

Nutrition education emerged as a prominent theme for future initiatives as some students expressed the need to gain knowledge and awareness of healthy foods. Students suggested that statistics and detailed information on the benefits of healthy should be available online on the university’s website to encourage healthier food consumption. Additionally, students expressed that if the food outlets on campus displayed nutrition information including energy and macronutrient contents, it would allow students to know what they are consuming. Students felt free fruits available all year on campus would be beneficial, rather than having these available for shorter periods.

Students mentioned that the healthy options on campus were quite expensive, however if discounts were offered by the university, this would make purchasing these options more affordable and appealing. Reward schemes and food vouchers were also discussed where students would get a discount after purchasing from an outlet. Self-catering facilities, including food preparation amenities such as toasters and microwaves across campus were mentioned. Students felt as though having a communal area and equipment to support students with food preparation, would encourage them to bring healthy food from home whilst also allowing them to build capacity and skills regarding food preparation. Having a canteen on campus that offered ready-made healthy meals would also improve healthy eating.

Students discussed the governance of food available at the university through policy implementation. A policy on healthy eating was raised as a beneficial initiative to improve the health of students, this could also be focused on sugar regulations. Policies and monitoring relative to food safety to ensure food is safe and adheres to high standards was also raised. In addition to other interventions suggested by students, increasing healthy food outlets on campus, including a small grocery store would be helpful to purchase healthy snacks and fresh produce. Farmer’s markets on campus were discussed by students as these would encourage students to purchase fresh produce and encourage sustainability.