Background A number of studies have measured college student food insecurity prevalence higher than the national average; however, no multicampus regional study among students at 4-y institutions has been undertaken in the Appalachian and Southeast regions of the United States. Objectives The aims of this study were to determine the prevalence of food insecurity among college students in the Appalachian and Southeastern regions of the United States, and to determine the association between food-insecurity status and money expenditures, coping strategies, and academic performance among a regional sample of college students. Methods This regional, cross-sectional, online survey study included 13,642 college students at 10 public universities. Food-insecurity status was measured through the use of the USDA Adult Food Security Survey. The outcomes were associations between food insecurity and behaviors determined with the use of the money expenditure scale (MES), the coping strategy scale (CSS), and the academic progress scale (APS). A forward-selection logistic regression model was used with all variables significant from individual Pearson chi-square and Wilcoxon analyses. The significance criterion α for all tests was 0.05. Results The prevalence of food insecurity at the universities ranged from 22.4% to 51.8% with an average prevalence of 30.5% for the full sample. From the forward-selection logistic regression model, MES (OR: 1.47; 95% CI: 1.40, 1.55), CSS (OR: 1.19; 95% CI: 1.18, 1.21), and APS (OR: 0.95; 95% CI: 0.91, 0.99) scores remained significant predictors of food insecurity. Grade point average, academic year, health, race/ethnicity, financial aid, cooking frequency, and health insurance also remained significant predictors of food security status. Conclusions Food insecurity prevalence was higher than the national average. Food-insecure college students were more likely to display high money expenditures and exhibit coping behaviors, and to have poor academic performance.

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Objective: To assess the relationship between food insecurity, sleep quality, and days with mental and physical health issues among college students. Design: An online survey was administered. Food insecurity was assessed using the 10-item Adult Food Security Survey Module. Sleep was measured using the 19-item Pittsburgh Sleep Quality Index (PSQI). Mental health and physical health were measured using three items from the Healthy Days Core Module. Multivariate logistic regression was conducted to assess the relationship between food insecurity, sleep quality, and days with poor mental and physical health. Setting: Twenty-two higher education institutions. Participants: College students (n=17,686) enrolled at one of 22 participating universities. Results: Compared to food secure students, those classified as food insecure (43.4%) had higher PSQI scores indicating poorer sleep quality (p<.0001) and reported more days with poor mental (p<.0001) and physical (p<.0001) health as well as days when mental and physical health prevented them from completing daily activities (p<.0001). Food insecure students had higher adjusted odds of having poor sleep quality (adjusted odds ratio [AOR]:1.13, 95% confidence interval [CI]: 1.12-1.14), days with poor physical health (AOR: 1.01, 95% CI: 1.01-1.02), days with poor mental health (AOR: 1.03, 95% CI: 1.02-1.03), and days when poor mental or physical health prevented them from completing daily activities (AOR: 1.03, 95% CI: 1.02-1.04). Conclusions: College students report high food insecurity which is associated with poor mental and physical health and sleep quality. Multi-level policy changes and campus wellness programs are needed to prevent food insecurity and improve student health-related outcomes.

Background: Intake of tree nuts and peanuts is associated with reduced risk of cardiovascular disease (CVD) and diabetes. However, no studies have been published on beliefs, attitude, perceived barriers and benefits, and knowledge regarding tree nuts and peanuts among individuals with or at risk for these conditions. Methods: The objective of this study was to assess the beliefs, attitude, perceived barriers and benefits, and knowledge regarding tree nuts and peanuts intake among 85 Caucasian and African Americans (mean age 63 years) individuals with or at risk for CVD and/or diabetes. A survey questionnaire was utilized to collect date from to healthcare facilities in a small town in southeastern United States. Results: About 32% were unaware of the hypocholesterolemic effects of nuts and an additional 21% disagreed that nuts exhibit such effects. Fifty-three percent agreed or strongly agreed that eating tree nuts and peanuts would help them to be healthier. Most participants (63%) strongly agreed or agreed with the statement, "I would eat nuts on most days of a week if my doctor recommended me to do so." About one-third of the participants strongly agreed, agreed, or neither agreed/disagreed with the statement, "I should not eat nuts on most days of the week because I would gain weight." The majority of participants answered all five knowledge questions concerning the nutrient content of tree nuts and peanuts incorrectly Conclusions: The results indicate that the beliefs and knowledge of individuals with or at risk for CVD and/or diabetes are largely inconsistent with the scientific findings. The results also indicate that the best way to change attitude, perceived barriers and benefits could be accomplished by physicians.

IntroductionObesity prevalence in the rural United States is higher than in urban or suburban areas, perhaps as a result of the food environment. Because rural residents live farther from supermarkets than their urban- and suburban-dwelling counterparts, they may be more reliant on smaller corner stores that offer fewer healthful food items.MethodsAs part of a Communities Putting Prevention to Work (CPPW) healthy corner store initiative, we reviewed audit tools in the fall of 2010 to measure the consumer food environment in eastern North Carolina and chose the NEMS-S-Rev (Nutrition Environment Measures Survey-Stores-Revised) to assess 42 food stores. During the spring and summer of 2011, 2 trained graduate assistants audited stores, achieving interrater reliability of at least 80%. NEMS-S-Rev scores of stores in rural versus urban areas were compared.ResultsOverall, healthful foods were less available and of lower quality in rural areas than in urban areas. NEMS-S-Rev scores indicated that healthful foods were more likely to be available and had similar pricing and quality in rural corner stores than in urban corner stores.ConclusionFood store audit data provided a baseline to implement and evaluate a CPPW healthy corner store initiative in Pitt County. This work serves as a case study, providing lessons learned for engaging community partners when conducting rural food store audits.

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