Association between Academic Stress and Eating Patterns among University Students

The enhanced prevalence of symptoms of anxiety, stress and depression among university students is of great concern. Stress and lack of time due to studies puts students' health and wellbeing at risk and the most concerning factor is how their eating patterns are being affected. Objective: To assess eating patterns and compare its association with stress among university students. Methods: A cross-sectional study was conducted in different universities of Lahore from September 2022 to December 2022. Data had been collected from 100 students by using non-probability convenient sampling, with the help of a self-constructed questionnaire. Results: Almost 70% students reported that they have one meal a day while most 2% students had 2 meals a day and 28% students had 3 meals a day under academic stress (p-value = 0.031). Approximately 61% students were having late night meals more than 2 times a week under educational pressure (p-value = 0.028). Around 68% students were missing their breakfast more than 2 times a week while worrying about the examinations (p-value = 0.03). Nearly 59% students were forgetting to take proper meals due to stress of exams preparation (p-value = 0.037). Almost 43% students were caffeine dependent due to academic stress. Conclusions: There is a signi�cant link found between change in eating patterns due to the academic stress and pressure among university students.

Stress is de ned as any sort of physical, emotional or psychological strain.Our general well-being is greatly in uenced by how one can handle stress.Every student has low points; it's a normal aspect of development, especially for university students.Though it is alarming when these feelings persist for a longer period of time [1].However, academic stress is the type of stress that is induced by the continuous pressure about studies or anything related to academics that is either socially imposed or self-imposed, which can deplete the psychological reserves of a student [2].The enhanced chances of symptoms of anxiety, stress and depression among university students are of great concern [3].Although every country spends a considerable amount of money on education, it is noted that students face some serious challenges which include; work pressure, the demand for academic brilliance, di cult competence and the struggle to de ne one's personality [4].There has been no notable difference found between eating behavior and stress based on ethnicity or gender [5].However, university students under stress conditions have altered eating habits like either they eat too quickly or they leave food in their plates, they eat food even if they are not  analyzed what effect the academic stressors had on eating habits of the students of medical department in Riyadh, Saudi Arabia.This study was designed to assess the eating habits patterns and its relationship with stress faced by medical students.The sample included 105 male students.Data collection was done in the form of questionnaires.The results of the questionnaires concluded that freshmen had greater levels of stress than others, the abundance of fastfood restaurants results in a greater chance of students making unhealthy food choices and that students with higher levels of stress were more probably the ones to consume unhealthy foods than the ones with lower levels of stress [14].Another study done by Caso et al., in the year 2020 in Italy aimed to nd a signi cant association between unhealthy eating patterns and stress.The subjects of this study were 574 Italian undergraduate students.Different scales were used to assess the stress levels and the eating patterns.The results of this study concluded that the consumption of unhealthy foods increased among the students with increased academic stress [15].The purpose of conducting this research was to nd out how stress affects university students, in what grade of stress condition they fall into and to know the association between being stressed and their eating patterns.time period of 4 months from September 2022 to December 2022.Data were collected from 100 students by using non-probability convenient sampling technique.Data were taken with the help of self-formulated questionnaire approved by professionals.Data were analyzed and tabulated by using SPSS.Quantitative variables were analyzed by using standard deviation and mean values while qualitative variables were analyzed using frequencies and percentages.Out of 100 participants, 27 moderately stressed participants took one meal a day, 2 high stressed participants took two meals a day, 9 moderately stressed took three meals a day under academic stress.There is a signi cant association between number of meals a person has in a day under academic stress while worrying about examinations as the signi cance value was p-value < 0.05 (0.03) as shown in Table 2. Out of 100 participants, 18 moderately stressed participants forgot to have meals while studying, 15 slightly stressed participants did not forget to have meals while studying or working on an assignment while worrying about examinations.There is a signi cant association between people forgetting their meals under academic stress while worrying about the examination as the signi cance value was p-value < 0.05 (0.03) as shown in Table 3.

D I S C U S S I O N
Out of 100 participants, 43 depended on caffeine while studying for extra hours while 57 are not dependent as shown in Figure 2.
Figure 1 shows that out of 100 participants, 37 moderately stressed participants never ate late at night, 56 slightly stressed participants ate more than two times a week late at night during 11th hour preparations while worrying about examinations.There is a signi cant association between people eating late at night (in 11th hour preparations) under academic stress (exams, assignments) while worrying about the examination as the signi cance value was pvalue < 0.05 (0.028).Out of 100 participants, 26 high stressed participants skipped breakfast two times a week, while 60 high stressed participants skipped breakfast more than two times a week under academic stress.There is a signi cant association between breakfasts being skipped in a week under academic stress (exams, assignments, projects etc.) while worrying about examinations as the signi cance value was p-value < 0.05 (0.03) as shown in Table 4.The purpose of this study was to investigate the association between university student's eating habits and t h e i r a c a d e m i c s t re ss .T h e re s u l t s h owe d t h at examinations were the main source of stress.This was relatable to other earlier studies or researches that found students were under stress due to their inability to perform e ciently and effectively in exams.As results of this study stated 32% students had their breakfast less than or 2 times a week while 68% students had breakfast more than 2 times a week out of which 86% students were have high levels of stress due to examinations.However, one of the literature studies conducted on the medical students of Ghana has reported that 71.92% of the students' skip breakfast due to their academic routine [16].Another study conducted in Indonesia to determine the association between academic stress and eating habits in uenced by emotions in adolescents.A cross-sectional approach was used in this work.The data analysis showed that 47.4% of participants reported academic stress of moderate level, whilst 51.1% of participants suffered from emotional eating [17].In this study, it is found that under academic stress 51% students forget to have meals during studying or preparing for exams.Whereas, a study conducted in Korea showed that 53% of students tend to forget having meals and they were low on dietary intake due to academic strain [18].The results of current study concluded that 93% students were moderately stressed due to examinations out of which 61% students were taking late night meals more than 2 times a week.A study conducted online by Cornell University stated that almost 53% of the students had snacks late at night and they ate mostly junk food while the others didn't snack late at night at all [19].The results of this study have shown that almost 43% students were dependent on caffeine under academic pressure while the other 57 were not.On the other hand, according to a crosssectional study conducted by Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia to check the prevalence of caffeine intake among undergraduates, they concluded that about 63.8% students were addicted to caffeine due to Stress and Eating Patterns among University Students I N T R O D U C T I O N Association between Academic Stress and Eating Patterns ¹University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore, Pakistan

Table 2 :
Association between the numbers of meals taken in a day by students while worrying about the

Table 3 :
Association between students forgetting their meals under academic stress while worrying about the

Figure 1 :Figure 2 :
Figure 1: Association between students eating late at night under academic stress while preparation for examinations

Table 1 :
Demographical distributionA cross sectional study was conducted in University of Lahore, Lahore School of Economics, University of Management and Technology and Punjab University for a Table1indicates that out of 100 participants, 26% were male and 74% were females.Majority of participants were females.Approximately 78% participants were belonging from urban areas while 22% were from rural areas.Almost 7% participants belong from low, 69% from middle and 24% from high socio-economic status.