University students have suggested that healthier food should be made available in the canteen and from vending machines and there should be a health promotion office on campus and stress management programmes to help them make healthier choices.

A paper entitled The Dietary Habits of Maltese University students by Carmel Cefai and Liberato Camilleri, published in the Malta Medical Journal, shows that, on average, students had only one or two servings of fruit and vegetables a day, more than half chose the less healthy food option, fewer than half regularly had a healthy breakfast and a third consumed soft drinks. However, female students were more likely to be conscious of their diet.

The students made various recommendations as to how the university could help them make healthy choices, particularly by increasing the availability of healthy food on campus.

The authors concluded that, despite being a highly educated group, the majority of students did not reach the healthy diet benchmarks explored in the study. Further research is meanwhile suggested to explain the psychological correlates underlying the dietary habits of Maltese University students.

The objective of this study was to explore the students’ perceived diet and related health practices and whether these varied by gender, faculty and year of course.

A self-administered questionnaire was completed by a representative sample of 494 undergraduate students stratified by gender and faculty. This explored various features of the students’ perceived physical and mental health and lifestyle, including diet – the focus of this paper.

When asked how the university campus could help improve their health, the majority of students suggested healthier food in the canteen as their main recommendation. They also suggested alternative food outlets on campus, free drinking water and healthy food vending machines, amongst other things.

They also recommended regular campaigns to raise awareness about healthy eating and encourage students to adopt a healthier lifestyle.

The majority of students in the study did not reach the dietary benchmarks examined in the study, with less than half starting their day with a healthy breakfast, having about five daily servings of fruit and/or vegetables, or consuming nutritional food and drinks on a regular basis. These figures reflect the rather unhealthy dietary behaviour of young people in general, both locally and abroad.

Only one third of 15 to 24-year-olds in Malta have two or more portions of fruit per day, 14 per cent have two or more portions of vegetable and/or salad a day, and nine per cent had two or more fruit or vegetable juices a day, with a gender bias towards females.

Female university students are consistently more conscious of their diet, performing better than males on the three healthy diet indicators. This reflects other studies which suggest that Maltese women in general are more conscious of what constitutes a healthy diet and more likely to engage in it.

Female students may be more exposed to socio-cultural pressure related to weight and body image, while male students may have more positive views of weight and may be still subjected to gender eating stereotypes, such as avoiding ‘feminine’ salads or fruit.

Students are aware of the benefits of a healthy diet, with more than 60 per cent saying they need to consume healthier food, but they seem to suggest that they also need an environment that helps them make good choices, where the healthy choice becomes the easier one. Indeed, availability is one of the key factors in determining the kind of food one consumes, with people more likely to consume healthy food if it is available in stores and canteens nearby.

Healthy food is usually more expensive than fast food and unhealthy snacks, thus making the healthier choice the more difficult one for students on a tight budget.

Fast food may also be more attractive and convenient for busy students, who may find it more convenient to skip a healthy breakfast and instead have a less healthy snack later on.

The authors points out that, clearly, knowledge on its own is insufficient to bring about a change in dietary habits. The vast majority of Maltese, including young people, believe they have adequate information on what constitutes a healthy diet.

However, information needs to be accompanied and complemented by other factors such as self-efficacy, priority values, availability and affordability, positive peer pressure, emotional regulation and stress management and the removal of barriers, among other things.

Body weight is an issue of serious concern in Malta. One third of adults are overweight and one fifth are obese, Maltese 15-year-olds are the most overweight and obese out of 38 countries in Europe and North America, and 31.4 per cent of those aged 15 to 24 are overweight or obese.

These figures are somewhat reflected in the university students’ responses, with one third saying they do not feel they have the right weight, a quarter describing themselves as overweight, and more than half saying they are on a diet or intend to start one to achieve the correct weight. Usually, females express more concern about body image and weight than males, but female participants in this study appear to be more satisfied with their weight than males. On the other hand, however, they are more conscious of the need to keep to the right weight and are thus more likely to take action to lose weight.

While male students need be encouraged to take more care of their weight, particularly dieting, female students may be encouraged to use exercise more as a weight reduction strategy besides diet.

In view of the findings of the study, the authors described as “essential”, that the university seeks to actively promote a healthy diet on campus as part of a healthy lifestyle amongst the student population, making use of educational initiatives, nutrition counselling, and social engineering strategies amongst others.

One in five students said they used comfort eating as a way of coping with stress. Comfort foods that are usually high in fat and sugars provide relief from stress hormones such as cortisol. Consequently, stress management programmes, particularly close to the examination period, would thus help students to avoid comfort eating and fatty foods and to maintain their healthy habits.

Exercise is another way to deal effectively with stress and maintain control over weight and diet. As the students themselves suggested, more sports facilities and opportunity and incentives to practice sports on campus, particularly for females, would be also be helpful for students in this regard.

Finally, in view of the dietary patterns of the Maltese population in general and children and adolescents in particular, the article stresses the need for continued efforts on a national level to encourage healthy eating, making use of a multi-modal campaign combining education, social skills training, family and community empowerment and social engineering strategies.

Such efforts need to start as early as possible in families, schools and local communities.

Since this was a general descriptive study of Maltese University students’ health habits and lifestyle, it did not examine the diet of Maltese University students in depth, particularly the factors influencing food choices such as beliefs and attitudes towards food and dieting, self-efficacy, self-esteem and sense of control, peer pressure and social support, perceived barriers and other socio-cultural aspects of diet.

Further research taking such factors into consideration is suggested to help identify the processes that facilitate or inhibit the healthy diet of university students.