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Citation: Kelly EFA, Guney-Coskun M, Weech
M, Fallaize R, Hwang F, Lovegrove JA (2025)
Exploring the dietary changes and support
required for healthy eating with female students
at UK universities: Findings from focus group
discussions. PLoS ONE 20(4): e0319388.
https://doi.org/10.1371/journal.pone.0319388
Editor: Habiba I. Ali, United Arab Emirates
University, UNITED ARAB EMIRATES
Received: August 28, 2024
Accepted: February 2, 2025
Published: April 10, 2025
Copyright: © 2025 Kelly et al. This is an open
access article distributed under the terms of
the Creative Commons Attribution License,
which permits unrestricted use, distribution,
and reproduction in any medium, provided the
original author and source are credited.
Data availability statement: All relevant
data are within the paper and Supporting
Information files.
Funding: This study was supported with
funding from the University of Reading’s
Institute for Food, Nutrition and Health (IFNH)
IDRF grant, for participant reimbursement and
professional transcription of the focus groups
RESEARCH ARTICLE
Exploring the dietary changes and support
required for healthy eating with female
students at UK universities: Findings from
focus group discussions
Eve F. A. Kelly 1, Merve Guney-Coskun 1,2, Michelle Weech1, Rosalind Fallaize1,3,
Faustina Hwang 4, Julie A. Lovegrove 1*
1 Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading, United Kingdom, 2 Department
of Nutrition and Dietetics, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey,
3 School of Health, Medicine and Life Sciences, University of Hertfordshire, Hateld, United Kingdom,
4 Biomedical Engineering Section, School of Biological Sciences, University of Reading, Reading, United
Kingdom
* j.a.lovegrove@reading.ac.uk
Abstract
Students’ diets often change when leaving home and starting university due to increased
responsibility for their diet and nances. However, there is limited qualitative research
with students at UK universities about how their diets change during the transition to, and
whilst at university and the reasons for these changes. The aim of this study was to quali-
tatively explore three topics: 1) specic dietary changes reported by students at UK univer-
sities, 2) reasons for these dietary changes and 3) how students can be supported to eat
more healthily. Fifteen students (100% female, 54% white) across different academic years
(60% undergraduate and 40% postgraduate) from the Universities of Reading and Hert-
fordshire were recruited. Four online focus groups were conducted, ranging from groups
of 2 to 6 participants, using a semi-structured topic guide. Discussions were recorded and
professionally transcribed. Transcripts were coded and themes derived for each research
topic using qualitative analysis software. After joining university, dietary changes com-
monly reported by the students included either increased or decreased fruit and vegeta-
ble intake, increased snacking behaviour, and increased alcohol and convenience food
consumption. Common reasons for changes included limited budget, time management
struggles, a lack of cooking skills, and peer inuence. Students suggested that reduced
cost of healthy foods on campus and cooking classes to learn new skills could help them
to adopt a healthier diet. These suggestions could be used to guide future healthy eating
interventions for university students.
Introduction
Student numbers at UK universities have steadily increased since the 1990s, reaching 2.86
million students in the 2021-22 academic year [1]. Notably, the proportion of 18 year olds
remaining in higher education and going to university has risen from 25.0% to 35.8% in just
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
over a decade [1]. Starting university is a time of large adjustment for most students, many of
whom leave home for the first time. This period is associated with increased independence
and responsibility for their own health and wellbeing [2]. A key aspect of optimal health and
wellbeing is favourable dietary behaviour, which requires university students to effectively
manage their grocery budget and take responsibility for purchasing healthy food and drink
options [3]. However, research suggests that this population may have other priorities and
face barriers to healthy eating [3–5]. Whilst there have been studies conducted in university
populations worldwide, including the US and some European countries, there is a need for
further research in students at UK universities due to cultural differences and the recent UK
cost-of-living crisis.
Emerging evidence suggests a shift in dietary behaviours during the transition to univer-
sity. These changes are often maintained by students during their time at university and can
continue into later life [6]. Studies around the world report increased alcohol consumption
[7,8], reduced fruit and vegetable intake [9] and a higher consumption of fast and conve-
nience foods [10] in university students compared with their pre-university diet. Unfavour-
able dietary behaviours such as these whilst at university can lead to weight gain [7,11–14],
lower academic performance [15], poorer mental health [16], sustained unfavourable dietary
behaviours throughout life [6,17] and an increased longer-term risk of non-communicable
diseases (NCDs) [18].
Specifically, a systematic review of the association between diet quality and mental health of
university students demonstrated that unhealthy diets were associated with poorer mental health
including depression, anxiety, and stress [16]. Additionally, poor dietary behaviours whilst at
university are associated with lower academic performance in first year university students,
particularly in males [15]. On the other hand, favourable dietary behaviours (e.g., breakfast con-
sumption) and higher diet quality have been linked to improved academic performance [19,20].
A number of factors can influence students’ dietary choices including time constraints,
social influence, a lack of nutrition/cooking knowledge, and/or limited kitchen facilities
[3,4]. Limited budget also acts as a barrier to healthy eating, with around 1.5 million UK
university students relying on student loans [21]. The current cost-of-living crisis in the UK
(which started in 2021) is having an additional impact on many students’ dietary choices and
includes students missing meals to keep food costs down [22]. A recent analysis of UK food
prices reported that “less healthy” foods (classified using a nutrient profiling model) typi-
cally cost £0.33/100 kcal, whereas “more healthy” foods were almost 2.5 times more expen-
sive (£0.81/100 kcal) [23]. Likewise, a meta-analysis suggested the daily cost of consuming a
healthier dietary pattern was approximately US$1.50 (£1.17) more per 2000 kcal than a less
healthy dietary pattern [24]. As such, students may opt for less healthy foods (such as those
higher in salt, sugar and saturated fat) due to their lower cost compared with healthier food
and drink items (such as fruit and vegetables, fish and poultry) [25].
Therefore, the aim of this study was to better understand any dietary changes that students
experience when starting university in the UK, the reasons for these changes, and finally, how
students can be supported to eat more healthily. These were qualitatively explored via discus-
sions with students from UK universities to provide in-depth conversations and the sharing of
experiences and ideas.
Methods
Ethics and consent
Favourable ethical opinion for conduct was given by the University of Reading’s School of
Chemistry, Food and Pharmacy Research Ethics Committee (study number: 41/2022). After
[IFNH003 to MW]. EK’s PhD research was
funded by FNS-Cloud, which has received fund-
ing from the European Union’s Horizon 2020
Research and Innovation programme (H2020-
EU.3.2.2.3. – A sustainable and competitive
agri-food industry) under Grant Agreement No.
863059 – www.fns-cloud.eu. Neither funding
sources played a role in the study design,
collection, analysis, and interpretation of the
data, in writing of the report or in the decision
to submit the article for publication.
Competing interests: I have read the journal's
policy and the authors of this manuscript
have the following competing interests:
Julie A. Lovegrove is Deputy Chair of the UK
governments Scientific Advisory Committee
on Nutrition (SACN). The other authors have
declared that no competing interests exist. This
does not alter our adherence to PLOS ONE
policies on sharing data and materials.
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
reading the Participant Information Sheet outlining the purpose of the study, what would be
required of them if they took part, and any risks and benefits associated with the study, all
participants provided digital consent by ticking each consent statement when registering for
the study. At the start of each focus group, participants were reminded about the study pro-
cedure and given an opportunity to ask questions. They were then asked to re-confirm their
consent verbally, which was captured on the Microsoft Teams recording and witnessed by the
researchers.
Recruitment and eligibility
This study aimed to conduct three focus groups each consisting of between 6-8 partici-
pants, which was in line with recommended sample sizes for focus groups [26–28].
Participants were recruited between the 5th and 14th of June 2023 from two UK universi-
ties, University of Reading and University of Hertfordshire, both of which offer a range
of degree programmes to both undergraduate and postgraduate students. Students were
informed of the study via university student mailing lists and advertising distributed
around these campuses.
Eligibility criteria included being aged 18 years and over, studying full time in any aca-
demic year on a taught or research programme at the Universities of Reading or Hertford-
shire, solely responsible for their own meal preparation and/or food purchases (fully catered
students were also eligible on the basis they had freedom of choice in university canteens),
and willing to discuss the focus group topics in a group setting. Both males and females were
eligible to take part. Exclusion criteria included being pregnant, having a self-reported medical
condition which significantly affected food choices or a diagnosed eating disorder, following a
restrictive or weight loss diet, receiving dietary advice from a nutritionist or healthcare profes-
sional and/or being unable to contribute to a discussion spoken in English.
Study design
Students interested in taking part in the focus group were invited to complete an online
screening form (Online Surveys, Jisc, UK) to determine study eligibility. Participants were
also asked to provide their ethnicity, year of study, degree course, and to rate how important a
healthy diet was to them on a scale of 0 to 10 (with 0 being “not important” and 10 being “very
important”). Students were not asked whether they were a home or international student at
screening; however, some mentioned this during the discussions.
To encourage participants to share their opinions and perspectives with their group and
feel at ease, they were allocated to a focus group with participants in a similar year of study.
We used a qualitative exploratory approach [29] to gain further insight and understanding
into the dietary behaviours of students since starting at a UK university. The researchers
created a semi-structured topic guide for the focus groups (Table 1), with the topics, questions,
and structure of the focus groups guided by previous literature, [4,30,31] which was used as a
framework to develop the overarching research topics. Questions were designed to cover three
main research topics (RT): 1) changes to students’ diets since starting university in relation to
their pre-university diet (such as when living at home with their families), 2) reasons for these
dietary changes and 3) support that could encourage the students to eat healthier. The latter
included the type of support that the universities could provide, the optimal time to provide
support, and barriers that may prevent student engagement with any support offered. This
initial exploratory research aimed to develop ideas and find solutions to encourage healthier
eating in university students. These could be used to direct the design of quantitative dietary
studies and interventions.
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
The focus groups took place after the end of the summer term (late June 2023) and were
conducted online via Microsoft Teams. Discussions were led and moderated by one of two
female researchers (MG (PhD student) or MW who was experienced conducting online
discussions (Postdoctoral researcher)). The first author (EK), a female PhD student, acted as
an observer who took summary notes for each discussion point and benefitted from famil-
iarisation of the focus group discussions prior to data analysis. EK was muted during the
focus groups to avoid overwhelming the discussion with multiple researchers. This study is
part of her doctoral thesis. Video recording was used to facilitate conversation among the
groups, to show non-verbal cues from participants (e.g., nodding in agreement), and to aid
transcription (e.g., to identify which participant was speaking). The researchers did not know
the participants prior to the study and therefore introduced themselves to each group, which
included their role within the study and at the university. Participants were reminded that the
researchers were keen to hear their honest opinions and experiences, including both positive
and negative.
Furthermore, participants were asked to introduce themselves to the group (icebreaker),
after which the three main RT were asked in turn, with the moderator introducing each indi-
vidual question and asking the participants to share their thoughts (Table 1). Questions were
open-ended to prevent researchers from influencing the participants responses. Participants
who were not forthcoming with responses or who provided behavioural responses (such as
nodding their head in agreement with another participant’s comments) were prompted to
share their opinions. Occasionally, the moderator asked additional questions and/or provided
prompts to obtain further insight and detail about the topics covered. At the end of each focus
group, participants were asked whether there was any further information they would like to
provide or expand upon. No repeat interviews were conducted. After completion, participants
were given £10 for participating in the study.
The team of authors brings diversity of academic expertise, cultural and ethnic back-
grounds, and individual university experiences to the study. The team collaborated closely
throughout the study, so all stages of the research were shaped by these diverse perspectives.
Table 1. Focus group topic guide.
Topic goal Question
Icebreaker for participants 1. Please share your name, degree course, year of study
and one brief reason why you chose your degree course
Dietary changes since starting university 2. Thinking back to when you started university, can you
describe any significant changes you noticed to what
you had been eating and drinking prior to university?
3. What factors do you think influence(d) these
changes?
Role of the university in healthy eating 4. Do you think the university can support students to
eat healthily?
5. What could the university do to support students
like yourselves to eat better whilst at university?
Support required to eat healthier whilst at university 6. Thinking about your own experience, when do you
think university students have the biggest need for
support to make healthy eating choices and why do
you think this?
7. If the support that you have just discussed became
available, would you be interested in this?
8. Can you think of any barriers that might prevent
you from taking up any support offered?
Additional comments 9. Is there anything else you would like to say about your
experiences or healthy eating whilst at university?
https://doi.org/10.1371/journal.pone.0319388.t001
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
All authors had particular research interests in designing interventions to support individuals
to eat more healthily.
Data analysis
Microsoft Excel was used to calculate descriptive statistics from data collected at screening to
characterise the focus group samples. All focus group recordings were sent to an independent
professional company (Way With Words Limited, UK) for transcription. Transcripts were not
returned to participants for comment or correction. Each transcript was read in full to re-
familiarise the lead researcher (EK) with the content prior to analysis. The transcripts were then
uploaded to the qualitative software NVivo 12 Pro (QSR International, 2017). Inductive and
deductive thematic analyses were used to analyse the data by developing the themes based on the
three RTs from the discussions. Firstly, each RT within each focus group transcript was individ-
ually coded (by EK) with codes assigned to recurring instances of similar quotes. For each RT,
codes from all four focus group transcripts were combined into a single dataset. Codes with sim-
ilar meanings were grouped together to form sub-themes which were further grouped to form
overarching themes. As no new themes were derived by the end of the coding process, it was
determined that data saturation had been reached and additional focus groups would not draw
out new themes. Before being finalised, the proposed themes were discussed between all authors
who all feel comfortable sharing their ideas between the group and come from a range of cultural
backgrounds and prior university experiences. This brought diverse perspectives to the discus-
sion. Quotations from the transcripts are presented in the results illustrating the themes within
each RT. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist [32]
and a guide to reporting thematic analysis [33] directed the reporting of results.
Results
Sample characteristics
A total of 23 students registered their interest for the study; however, 8 participants failed to respond
after screening or were unable to commit to the study. Therefore, four semi-structured discussions
were conducted involving a total of 15 participants. The final size of the discussion groups ranged
from 2 to 6 participants. All participants were university students from the Universities of Reading
and Hertfordshire. Participant group characteristics are described in Table 2. Even though both males
and females were eligible to participate and registered for the study, all participants who took part
were female (n = 15). In line with the student body populations at the Universities of Reading and
Hertfordshire (63%/61% undergraduates, 37%/39% postgraduates, respectively [34,35], these focus
groups included a similar ratio of 1st year undergraduates (UG1, 33%), 3rd year undergraduates (UG3,
27%), and postgraduate students (40%). The majority of participants were studying a Psychology
(60%) or Nutrition/Food (27%) related course. The mean self-rated importance of a healthy diet was
7 out of 10 (SD ± 1, range: 5-10), with 10 being “very important”.
Qualitative results
The mean focus group length was 89 minutes (SD ± 11, range: 76–102). The themes that
emerged from each RT are summarised in Fig 1. Themes under RT2 were categorised by the
researcher, based on the findings, into individual, environmental and social factors. Partici-
pants were not asked to provide feedback on these findings.
RT1: Dietary changes since starting university.
The healthiness and variety of students’ whole diet changed: Compared with their
pre-university diets (e.g., when living at home), students considered their overall diets to
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
Table 2. Characteristics of focus group participants (n = 15).
Characteristic n (%) or mean (±SD)
Sex: female (%) 15 (100)
Student status (%)
Undergraduate 9 (60)
1st year undergraduate 5 (33)
2nd year undergraduate 0 (0)
3rd year undergraduate (or above) 4 (27)
Postgraduate 6 (40)
Study discipline (%)
Psychology 9 (60)
Nutrition/Food 4 (26)
Data Science 1 (7)
Languages 1 (7)
Ethnicity (%)
White 8 (54)
Asian 5 (33)
Black 2 (13)
Self-rated importance of a healthy diet (out of 10)a7 ( ± 1)
aImportance of a healthy diet was self-rated by the students on a scale of 0 to 10 with 0 being ‘not important’ and 10 being ‘very
important’.
https://doi.org/10.1371/journal.pone.0319388.t002
Fig 1. Summary of the themes that emerged from each of the three research topics (RT).
https://doi.org/10.1371/journal.pone.0319388.g001
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
be less healthy whilst at university: “I wouldn’t really eat as healthy as I would at home.” (P7,
UG1). They also reported eating less varied and simpler meals at university: “I’d have a lot
more variety of food at home, because we have a lot more ingredients and my parents are cook-
ing for four people” (P9, UG1).
Changes in fruit and vegetable intake differed amongst students: It was noted that fruit
and vegetable consumption decreased for some participants whilst at university: “So, I ate a lot
more healthier at home, and then when I was at uni, I found it harder to eat vegetables and stuff
because they go off so quick.” (P9, UG1). In contrast, others experienced increased consump-
tion: “I’d just buy vegetables and just fry them up. So, I eat more healthy when I was at univer-
sity than [when] I was at home.” (P6, UG1).
Students engaged in more snacking behaviour at university: Some students mentioned an
increase in snacking behaviour during their time at university: “I think a lot of snacky things
as well, because sometimes, at the end of the day, after university, you don’t want to come home
and cook for yourself.” (P6, UG1) and “I’d always just be snacking all the time.” (P7, UG1).
Consumption of convenience food varied amongst students: Some students discussed
consuming more convenience foods such as takeaways, fast food, and ready meals at univer-
sity: “When you go out clubbing, it’s a tradition to get a takeaway afterwards, so I think a lot of
people do that.” (P6, UG1). However, some students said they avoided such foods due to their
cost and portion size: “I mostly avoid takeaway food because it’s very expensive and the quan-
tity is less.” (P14, PG).
Students started drinking more alcohol at university: Increased alcohol consumption was
also experienced by some students whilst at university: “I didn’t really start drinking socially
until I came to university” (P3, UG3) and “At home I wouldn’t really drink…but with uni, espe-
cially in the UK, there’s a drinking culture. I definitely drank a lot more.” (P4, UG3).
RT2: Reasons for these dietary changes since starting university.
Individual factors:
Increased independence. The increased independence and freedom experienced by many
students at university was linked to changes in their dietary behaviour. Some students high-
lighted the positive effect of increased independence on their diet: “I think, at the beginning, at
university, I started eating healthier because at home I can’t really choose what to eat, and some-
times when I want something light I go for a salad.” (P4, UG3). However, other students reported
that increased independence negatively affected their diet: “Being at university it kind of meant
that I went a bit crazy with freedom and I’d order lots of takeout food a bit more often.” (P3, UG3).
Limited cooking skills. Some students acknowledged that they did not cook much before
starting university: “I was living with my family and I was not cooking much.” (P5, PG). Others
suggested that many students lack cooking knowledge and skills: “Most of my flatmates didn’t
know how to cook…If you’re in halls and they’re not catered, you’re going to be cooking frozen
pizzas because you don’t know how to cook.” (P1, PG).
Psychological wellbeing. Extra pressure and stress from university and exams also con-
tributed to changes in the students’ dietary behaviours. For some students, stress resulted in
decreased appetite: “I noticed that I lost a lot of weight since I came here because I tend to lose
a lot of weight when I get stressed, and I tend to lose my appetite as well.” (P12, PG). Others
described how they noticed their friend’s diets had changed during exam periods: “I know
some of my friends, they said that they started eating more because there were snacks during
revising and stuff like this, and that they gained weight, perhaps, or stuff during exam season,
and were stressed about that.” (P8, UG1).
Environmental factors:
Cultural change. Some participants mentioned they had moved to the UK for their studies
and spoke of dietary changes due to the lack of availability of foods that were familiar to
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
them: “I’m from a different country, so when I started, obviously, it was basically changing the
whole diet because what is readily available in my country is not what’s readily available in
the UK.” (P15, PG). Additionally, the change in culture enabled students to adapt their food
choices and preferences: “At home I would mainly have an East Asian diet. Meaning, rice as the
main source of carbs but I’m not actually a huge fan of rice, I like pasta more. So when I came
to uni, actually, my whole taste becomes a lot more European. And I think also the groceries
available here in this country is very different to things available at home.” (P4, UG3).
Time constraints. Students spoke about struggling to balance the time required to prepare
and eat regular meals alongside their university and employment commitments: “But now-
adays because the lecture times are at different times or I might have work at a certain time, I
find it a lot harder to regulate how to have three meals a day.” (P3, UG3) and “Before my PhD I
had more of a nine to five job, so it was easier to plan meals as well.” (P1, PG). Limited time to
prepare and eat meals became more of a problem when students were stressed or had exams:
“The time when there is a lot of exams and deadlines is the time where I give more importance to
that, so it’s not really my choice of what I want to eat.” (P12, PG) and “Especially during study-
ing for exams as well, I would say that I felt like I had less time to eat and was more focused on
my exams.” (P10, UG3).
Limited budget. Participants across the academic year groups spoke about the impact of a
limited budget in relation to buying healthier foods, eating three meals a day, and food choice.
P8 (UG1) stated that “Sometimes healthier foods are more expensive. Even fruits and vegeta-
bles can be more expensive than [instant noodle brand], which can be 40p, do you know what
I mean? So, I think some people would just prefer to eat something cheaper and eat something
than pay two, three times more to eat something healthier.” This was supported by others: “Also,
just affording three healthy meals a day is something that is quite expensive and can be consid-
ered a luxury, I think, to many students... The cost-of-living crisis is huge right now and a lot of
people are struggling to figure out how to eat healthily.” (P3, UG3), “I think there’s definitely a
drive that some students have to make an effort to have healthy meals and prepare those things,
but ultimately, you’re kind of bound by your student budget.” (P10, UG3) and “I tend to go for
the food that is most convenient as well as cheap” (P12, PG). One student also mentioned the
cost of foods they would typically have in their home country were less expensive than in the
UK and described the subsequent impact this had on their diet, “Here, the vegetables that are
from India are very expensive, so we started eating vegetables that are available here and the
variety of vegetables reduced.” (P14, PG).
Restricted storage space. Some students mentioned limited food storage space in their
shared accommodation influenced the quantity of food they bought. “Because we’d obviously
only have one fridge shelf. So, it was limited what you could get, because obviously otherwise
you couldn’t store it.” (P7, UG1). Limited storage space also influenced the type of food bought,
such as buying fresh vs frozen fruit and vegetables: “I might choose to buy a bag of frozen vege-
tables rather than having fresh vegetables in my fridge because I need space for butter and bread
and other things in my fridge.” (P3, UG3). In accommodation where there was more food
storage and cookware space enabled students to have more choice over what they cooked:
“I’ve actually been living with just one other person, and I’ve just really noticed that I have been
making better decisions. And I have been able to buy bulk and store it and make meals for the
week and take my time in the kitchen and have more than one saucepan.” (P10, UG3).
Social factors:
Cooking for one person. Many participants spoke about the challenges of cooking for
one person: “Cooking for one person can be really annoying and difficult because you can’t
really buy that amount of food.” (P11, UG3). This also had an impact on the variety of both
the undergraduate and postgraduate students’ diets: “I’d cook one meal, and then I’d have that
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
same meal every day for the whole week.” (P7, UG1) and “Whereas because now I live by myself,
I normally batch cook which means that I end up eating the same meal, for example, the same
lunch for a few days in a row.” (P1, PG). Food waste when buying food and cooking for one
person was also mentioned: “If I’m just buying for me, then I’m not going to buy as much veg
because it won’t get used and then it’s a waste of money.” (P9, UG1).
Social influence. Participants reflected on the impact of peer influence and university culture
on their increased alcohol intake and fast-food consumption: “I definitely drank a lot more…
and sometimes it just helps with the social situation.” (P4, UG3) and “Especially after the Stu-
dent Union Wednesday, you would literally leave, and they [popular takeaway pizza company]
would be right there with pizzas you could get. And obviously everyone’s leaving drunk so you’re
just going to it then without thinking.” (P8, UG1).
RT3: Support required to eat healthier whilst at university.
University students are in favour of support methods to encourage them to eat
healthier:Participants identified methods of promoting and engaging university students in
healthier eating. One method was increasing the amount of healthier food options on campus:
“Maybe, a store with ready-to-make healthy food, maybe like sandwiches that are healthier or stuff
like that.” (P15, PG) and “The food that they serve on campus, they could just incorporate more
healthy options.” (P13, PG). Other participants suggested lowering the cost of healthier food
options: “The healthier options are a bit more expensive for students. Maybe that could change,
if they have any power on it, they could make more healthier options available and cheaper.” (P5,
PG) and “Maybe, a grocery shop inside the uni, a cheap grocery shop. We do have one in the uni,
but when we compare it to [budget supermarket chain] it’s expensive.” (P14, PG). The idea of
group cooking classes for students to learn new skills was also viewed favourably by participants:
“I think that would be super helpful for so many people, because I think so many people go,
obviously, living at home for 18 years, having all their meals cooked for them, to then going to uni
where you have to make every food for yourself.” (P8, UG1). Providing students with recipes was
also supported by many students: “I think that is a very good idea, to have easier recipes with less
ingredients, but are still healthy and incorporating a good balanced diet into them.” (P9, UG1) and
“I think there’s a lot information around uni about alcohol consumption and being smart and safe
about that. So, I think the same could be used for food and definitely recipes for people who have
just started uni and maybe don’t know what’s cheaper and quick and easy to make.” (P11, UG3).
Students feel the timing of healthy eating support is important when supporting them to
eat healthier: The start of university was identified by many participants as a good time to
educate and support university students with healthy eating behaviours: “It’s probably good
to do it right at the beginning, because everyone’s a bit clueless.” (P6, UG1) and “The start of
uni because it can set a good foundation. So, I really made an effort to eat healthily when I first
started uni. And that helped me to build up from it for the rest of the uni years.” (P4, UG3).
In addition, students felt continued support throughout their time at university would be
beneficial as well as during more stressful periods such as exam season: “I just think it needs to
be a constant message and it applies to all years at all stages of your course.” (P10, UG3) and “In
exam season, it’s very easy to just get lost and forget what you’re doing.” (P7, UG1).
University students are concerned there are barriers which may prevent them from taking
up healthy eating support offered: Although students recognised the need for healthy eating
support whilst at university, some identified barriers which may prevent them from taking
up support offered, such as a lack of time and potential costs associated with the support
offered. “I feel like the classes are a great idea. But there’s a few things that the uni runs that are
good ideas but because there’s so much else going on, it’s hard to find the time to actually join
them and partake in them.” (P7, UG1) and “So, as students, the cost is another thing, so if we’re
having to pay an amount that’s quite expensive to learn to make one portion of meal I think that
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
might kind of take away the point of it.” (P4, UG3). One student mentioned that some students
may feel ashamed to attend cooking classes: “There could be people who might be a bit more
shy and don’t want to go these sessions or might feel a bit ashamed.” (P3, UG3). Another student
mentioned their individual food preferences would affect their engagement with cooking
classes: “If it’s going to be something that I’m not used to eating, then I think I would not really
participate.” (P13, PG).
Discussion
The focus group participants highlighted a variety of changes in their dietary behaviour since
starting university and offered several explanations for these changes. They also identified bar-
riers which prevented them from adopting healthier dietary behaviours; however, they were
open to receiving healthy eating support.
Students mentioned changes to their whole diet since starting university and, for some,
there was less variety in their diet. Reasons for these included difficulties in cooking for one
person because ingredients are usually enough for more than one portion. Therefore, some
students were eating the same meals multiple times a week to avoid food wastage although
this may lead to a lack of diversity in the diet. Since diverse diets are generally more expensive
[23–25], this may discourage students from increasing variety in their diets. For example,
consuming five food groups a day (dairy, fruit, vegetables, meat, and grains) is associated with
an 18% higher food cost than consuming three or less food groups a day [36]. A lack of diet
variety has been found in other student populations such as in Mexico and Brunei [9,37], and
particularly in those with specific dietary patterns such as snackers [38].
Some students reported eating fewer fruits and vegetables whilst at university. This is con-
sistent with a self-reported health behaviours study in UK university students that found 86%
of participants did not consume the UK’s recommended intake of 5 fruit/vegetable servings
a day [8]. Since fresh foods, such as fruit and vegetables, have short shelf-lives, participants
in the current study were cautious about how much food they were buying to avoid food
wastage. Additionally, limited storage space in communal kitchens (e.g., university halls of
accommodation) meant that students prioritised space for other fresh food products, with
some choosing to buy frozen varieties instead. A lack of facilities and limited storage space in
university accommodation has been well documented in other research looking at barriers to
healthy eating in university students in the United States and Spain [39,40].
Some participants also reported increased alcohol consumption at university. Whilst alco-
hol consumption was not quantified in this study, other studies have also reported high alcohol
intakes in university students, including UK students [41,42]. Although students’ alcohol con-
sumption can be high across all years of study, this tends to reduce as students progress through
university [43]. Students’ living environments, such as living on campus and having numerous
room-mates, are also linked to drinking more alcohol [44]. Frequently consuming alcohol has
been linked to lower academic performance in first year university students [15]. Concerningly,
a systematic review of cohort studies identified that elevated consumption of alcohol during ado-
lescence may continue into adulthood and lead to dependency [45], both of which increase the
risk of cancer, diabetes, cardiovascular, liver and pancreatic diseases [46]. University culture and
social influence were identified as contributors to increased alcohol consumption in this study,
which supports other studies reporting peer pressure, a desire to enjoy an evening and social
events centred around alcohol act as contributors to increased alcohol consumption in university
students [43,47].
Other dietary changes included increased snacking and increased consumption of conve-
nience foods, sometimes arising from limitations in cooking abilities. Sprake, et al. [48] found
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
that students with limited cooking ability were less likely to have a healthier diet (defined as
vegetarian or health-conscious dietary patterns) than students who could cook. Interventions
targeting cooking ability could be interesting and worthwhile because better cooking ability is
also associated with greater adherence to the Mediterranean diet [49], which is known for its
health-promoting effects [50–52]. Therefore, improving cooking skills could positively impact
dietary intake [53] and health outcomes in later life. Time constraints were also a barrier to
eating healthily, where students reported challenges with time management to prepare meals
alongside other pressures, such as socialising, coursework and exams. When these other factors
took priority over healthy eating and spending time preparing meals, this sometimes resulted
in students relying on foods that required little preparation. This supports previous research in
other European countries which has consistently found time pressures at university negatively
influence dietary choices, such as relying on fast and convenience foods [3,4,40].
The current cost-of-living crisis in the UK is considered “very concerning” for over 50% of
university students, with 32% being very concerned about paying for groceries and food costs
[54], and this was also a worry for our participants. Reports suggest that 1 in 4 UK students
cannot afford food and regularly go without [55], which is supported by a Times Higher
Education report that highlighted 63% of students spent less money on food, with 28% going
to extreme measures, such as skipping meals, to save money [22]. Therefore, it was unsurpris-
ing that students in this study discussed the considerable influence their budget has on their
dietary choices. They would also generally purchase cheaper less healthy options than more
expensive healthier alternatives, supporting previous research that reported students relied on
cheaper food with poorer nutrition [55].
Culture changes were also responsible for dietary changes in students who had relocated
to the UK to study. Foods that international students would typically consume in their home
country were either not available in UK food stores or more expensive, which meant that for
some students, their whole diets changed. This has been identified by other groups investigat-
ing the dietary experiences of international students in the UK and US [56,57] and can lead
to international students adopting the dietary practices of the host country (dietary accultura-
tion) [58].
Interestingly, some students mentioned that their psychological wellbeing (e.g., high stress)
negatively affected their dietary behaviour. However, poor diet quality has been shown to nega-
tively impact mental health, which may subsequently reinforce poor dietary choices and poorer
diet quality affecting their mental health even further [16]. For example, higher perceived stress in
students has been significantly associated with infrequent fruit and vegetable consumption; how-
ever, consumption of such foods may protect against stress and anxiety [59], leading to a cyclical
detrimental effect between mental health and dietary behaviour. Therefore, university students
who have poor dietary behaviours and low diet quality may be negatively impacting their mental
health, which is important given 57% of students in the UK reported having a mental health issue
and 30% said their mental health had worsened since starting university [54].
Whilst many dietary changes were not conducive to a healthy lifestyle some students
thought their diet was healthier after starting university because they were free to choose
which foods to eat and in what quantities, such as wanting to eat more fruits and vegetables
than what was available to them at home pre-university. This is consistent with previous
research which found that not all students at UK universities had unhealthy dietary patterns
and this was particularly likely in female students and those who had greater self-reported
cooking ability [48].
Overall, the dietary changes discussed by the students should be confirmed in studies
which accurately assess dietary intake to compare how university students’ diets have changed
since starting university.
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
The student feedback highlighted that there are several opportunities to provide healthy
eating support for university students. For example, a lack of cooking skills was identified
as a barrier to healthy eating and students were in favour of introducing cooking classes to
teach them new skills. The benefits of cooking skills were demonstrated in previous research
which found that although individuals may wish to cook healthy meals, a lack of cooking
skills can act as a key barrier to eating healthily [60]. Evidence also suggests that frequent
food preparation and cooking in young adults is associated with a higher likelihood of
meeting the dietary recommendations for fruit, vegetables and wholegrain intakes and
decreased consumption of fast-food [61] as well as greater adherence to a Mediterranean
diet [53]. Cooking skills interventions with various populations, including university stu-
dents, have successfully improved efficacy and confidence in cooking ability and influenced
positive dietary behaviours [62–64]. Therefore, motivating students to develop cooking
skills may improve their confidence following a recipe, encourage them to prepare their
own meals and improve diet quality [65].
Whilst introducing cooking classes may be beneficial, it is important to acknowledge that
there are other factors which may influence student engagement with the support. Students
mentioned that the cost and timing of support on offer may impact whether they are available
to make use of it, particularly if they have other priorities. Therefore, alternative interventions,
such as online courses, which are cheaper and allow students to engage with the material in
their own time may be beneficial. This could also ensure the interventions are accessible to
students who may feel ashamed about lacking cooking skills and would benefit from indirect
healthy eating support. Educational interventions could include providing budgeting tips and
recipe booklets to students to teach them how to eat well on a budget. Other suggestions from
the students include improving storage space and cooking facilities in student accommoda-
tion and for universities to lower the cost of healthy food items on campus, which was also
proposed by Sprake, et al. [48].
Students also considered the timing of support to be important as they have other
commitments which may take priority. Some students felt that healthy eating support
should be offered continuously throughout their time at university, whilst others felt it
was most important during exam seasons and other stressful times of the year with dead-
lines. In general, research suggests that implementing dietary interventions during the
transition of late adolescence to young adulthood could be beneficial to university stu-
dents as leaving home is associated with poorer diet quality [66]. For example, students
living away from home may be more likely to have unfavourable dietary behaviours (such
as lower fruit and vegetable consumption) compared with students still living at home
[67]. Therefore, supporting the transition of leaving home with healthy eating advice may
be beneficial.
However, it is important to note that postgraduate students have typically been responsi-
ble for their dietary intake for longer than other students, such as first year undergraduates.
Evidence suggests that older students may become more aware of the impact of their dietary
choices on their health and positively change their eating behaviours to reflect this [48,68].
Therefore, the type of healthy eating support required by postgraduate students may differ
from undergraduate students.
Overall, improving students’ dietary behaviour could have many potential benefits,
including improved academic performance [19,20], reduced risk of poor mental health linked
to dietary choices [16], and reducing the likelihood of sustained poor dietary behaviours
throughout life [6].Therefore, given the importance of eating healthily at university, studies
that evaluate student engagement with any form of dietary intervention and accurately assess
changes in diet quality in response to these interventions are warranted.
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
Strengths and limitations
This study is one of few to qualitatively explore the changes that students at UK universities
make to their diets and the reasons for these changes. The findings are valuable for identifying
opportunities for interventions that target these areas and are welcomed by the end-users. The
study recruited British as well as international students and students from a range of aca-
demic years (including undergraduate and postgraduate), which resulted in a rich discussion
amongst the participants. Additionally, the study was designed to group students in similar
academic years together which can help encourage participants to feel confident voicing their
opinions and experiences [69] and promote group interaction [70].
A limitation of this study is that, although both males and females were eligible to take
part, all participants were female, so the results may have differed if male university students
were included. For example, research suggests that women tend to be more concerned about
making healthy dietary choices than men [71–74], which could also explain why this study
received greater interest from women than men. Some of the discussions were small, consist-
ing of two participants due to restrictions with participant availability as the academic term
had finished for many students. However, there were beneficial insights from all discussions.
Additionally, participants were not asked about their understanding of the term ‘healthy
eating’ nor provided with a reliable definition during the discussions. Although most partici-
pants were enrolled on a health-related degree (psychology or a food/nutrition-based course),
it could be assumed that these students had a greater interest and/or knowledge about diet
and nutrition than the general student population; however, the focus groups showed these
students still faced barriers with eating healthily whilst at university and were also open to
receiving support. Assuming greater nutrition knowledge in this group, this may also explain
why nutrition knowledge deficit was not identified as a barrier to healthy eating, contrary to
other studies with university students [39,75].
Finally, the students were from one of two UK universities (Universities of Reading and
Hertfordshire) and from a limited range of degree programmes on offer at both universities
so the generalisability of this study’s findings to other UK student populations may be limited.
Nevertheless, the results from this study still identify potential opportunities for improving
dietary support for students at UK universities which could apply regardless of their sex,
degree course or university location.
Conclusions
In this study, the students reported a variety of dietary changes since starting university,
including increased alcohol and convenience food consumption, less variety in their diet and
a mixture of both increased and decreased fruit and vegetable intake. They identified that a
lack of time, limited budget, cultural changes, and/or psychological wellbeing are some of the
reasons responsible for these changes. The students were open to being offered support from
their university to encourage them to eat healthier suggesting cooking classes and reducing
the cost of healthy food options on campus. Future healthy eating interventions should target
the barriers students face in following a healthy diet whilst at university, such as limited
budget and time constraints. Finally, interventions should be optimally timed, such as when
starting university and/or during exam periods, to encourage student engagement and provide
support when it is most beneficial to them.
Acknowledgments
The authors would like to thank the students for their participation in the study.
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PLOS ONE Dietary changes and support required for healthy eating with female students at UK universities
Author contributions
Conceptualization: Eve F. A. Kelly, Merve Guney-Coskun, Michelle Weech, Faustina Hwang,
Julie A. Lovegrove.
Formal analysis: Eve F. A. Kelly.
Funding acquisition: Michelle Weech, Faustina Hwang, Julie A. Lovegrove.
Investigation: Eve F. A. Kelly, Merve Guney-Coskun, Michelle Weech.
Methodology: Eve F. A. Kelly, Merve Guney-Coskun, Michelle Weech, Rosalind Fallaize,
Faustina Hwang, Julie A. Lovegrove.
Supervision: Michelle Weech, Rosalind Fallaize, Faustina Hwang, Julie A. Lovegrove.
Writing – original draft: Eve F. A. Kelly.
Writing – review & editing: Eve F. A. Kelly, Merve Guney-Coskun, Michelle Weech, Rosalind
Fallaize, Faustina Hwang, Julie A. Lovegrove.
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