Evaluation of Dietary Quality Based on Intelligent Ordering System and Chinese Healthy Eating Index in College Students from a Medical School in Shanghai, China

Abstract

We intended to precisely evaluate the dietary quality of male and female medical college students using canteen data from the “Intelligent Ordering System” (IOS), combined with the supplemental food frequency questionnaire (SFFQ) and the Chinese Healthy Eating Index (CHEI) in Shanghai, China, to explore the potential factors influencing dietary quality. A total of 283 college students with the average age of 24.67 ± 3.21 years and Body Mass Index of 21.46 ± 3.49 kg/m2 in the medical school were enrolled in this study, and an online questionnaire investigation was conducted to collect the general information, lifestyle behavior, and SFFQ. The dietary data of the study participants from the school canteen were exported from the IOS of the Information Office of Fudan University. The CHEI consists of 17 components and the total score is 100, with a maximum score of each component of 5 or 10. We calculated each component score of the CHEI and aggregated the total score for male and female study participants. The Chi-square test and Wilcoxon rank sum test were employed in comparing the differences between the demographic characteristics and CHEI component scores of males and females. Univariate and multiple linear regression models were employed to examine the potential influencing factors of the total CHEI score. The CHEI median score was 66.65, and the component score for total grains was relatively low. Added sugars was the most overconsumed CHEI component. There were relatively serious deficiencies, based on the CHEI component scores, in fruits, soybeans, fish and seafood, and seeds and nuts in both sexes. Females had significantly higher CHEI scores than males (68.38 versus 64.31). The scores for tubers, total vegetables, dark vegetables, fruits, fish and seafood, dairy, and red meats were significantly higher in females than in males. Influencing factors including sex, education, dietary health literacy, and amount of time spent sedentarily were significantly associated with CHEI score. Our research revealed that the overall dietary quality needs to be further improved for college students at the medical school in Shanghai, China, with low intakes of total grains, fruits, soybeans, fish and seafood, and seeds and nuts, and high intakes of added sugars. Compared with males, females showed higher diet quality and conformed more strongly with the recommended Dietary Guideline for Chinese. Education, dietary health literacy, and amount of time spent sedentarily should be noted for improving the dietary quality of college students.

Health-Promoting Behavior and Lifestyle Characteristics of Students as a Function of Sex and Academic Level

“…Despite attaching high importance to healthy eating, <10% of the current students met the recommendations of ≥5 servings/day, slightly lower than among young adults in the general German population [ 61 ]. We also observed sex differences in healthy nutrition (52% female vs. 32% male consumed ≥ 3 servings of vegetables/fruits per day), concurring with Finland, Nigeria, and China [ 17 , 19 , 20 ].…”

“…Likewise, our MSc and PhD students differed significantly in meeting the SB recommendations, supporting that SB significantly increased from freshmen to senior students [ 16 ]. As for nutritional habits, we found only that significantly more MSc than BSc students considered healthy eating important, and more PhDs met both the FVC and water intake recommendations, concurring with the USA and China, where graduate students rated healthy eating significantly higher, and more frequently achieved the FVC recommendations than undergraduates [ 19 , 120 ]. Academic level was also associated with sleep quality, where more of our BSc than MSc/PhD students had impaired sleep, congruent with Ethiopia [ 32 ], and partially supporting Taiwan, where freshmen had shorter sleep duration than seniors, but seniors had higher sleep latencies [ 36 ].…”

“…Of note, sex differences have been reported in terms of PA and SB [ 12 ], as well as significantly increased sitting time from freshmen to senior years [ 16 ]. Sex differences have also been observed among university students regarding their achievement of dietary recommendations, e.g., in the UK, Nigeria, Greece, China and Finland [ 9 , 17 , 18 , 19 , 20 ], or their food choices during stressful periods [ 21 , 22 ], yet no firm conclusions could be drawn whether females or males consume healthier diets. Nevertheless, fruit and vegetable consumption (FVC) appear to be significantly associated with cardiovascular and mental health in otherwise healthy populations [ 23 , 24 ].…”

Food Literacy Scale: Validation through Exploratory and Confirmatory Factor Analysis in a Sample of Portuguese University Students

“…For example, it can be extended to participants in other countries, as long as they are also higher education students, given they particularities differentiating from other target groups, like general young adults. Many studies confirmed the singularities of the higher education students in what concerns food literacy and eating behaviors in different countries: Bangladesh [ 67 ], Belgium [ 68 ], China [ 69 ], Croatia [ 70 ], Egypt [ 70 ], Greece [ 70 ], Hungary [ 71 ], Italy [ 70 ], Jordan [ 72 ], Korea [ 73 ], Poland [ 74 ], Portugal [ 70 , 75 ], Serbia, [ 76 ], Slovenia [ 70 ], Spain [ 56 , 77 ], Syria [ 78 ], and the United States [ 79 ].…”