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Exploring the Experience of Academic Stress, Eating Behavior, and

Food Choice among Black University Students

Priscilla Oludara Jekayinfa & Elisha Oluwatobi Olabisi

Ladoke Akintola University of Technology

DOI: https://doi.org/10.51244/IJRSI.2024.1104048

Received: 30 March 2024; Accepted: 12 April 2024; Published: 16 May 2024

ABSTRACT

Introduction: Academic stress is a common problem faced by university students in the UK, and it tends to

affect dietary practices. The study explored the experience of academic stress, eating behaviour and food

choice among black university students.

Methods: Descriptive cross-sectional design was adopted. A convenience sampling technique was utilised.

Validated outcome measures were used for data collection. Data were analysed using descriptive statistics,

Spearman correlation, and Wilcoxon signed rank test. Association between variables were considered

significant at p< 0.050. IBM SPSS version 25 was used for data analysis.

Result: The response rate was meagre (n=42). The mean perceived stress scale score was 20.49±6.71,

depicting moderate academic stress. The mean food group diversity score (FGDS) was 9.32±1.16 in Nigeria

and lesser (6.38±2.090) in the UK. Rate of Food group adequacy (FGA) was 36(97.3%) in Nigeria as

compared to the UK 19(51.4%). Consumption of non-communicable diseases (NCDs) – protective food

groups (NCD protective) was higher (7.78±1.65) in Nigeria compared to the UK (4.35±2.41). However,

consumption of food that predisposes to NCDs (NCD risk) was higher (7.73±1.84) in Nigeria, compared to

the UK (5.16±3.59). Participants’ compliance with global dietary recommendations (GDR) was higher

(9.054±2.449) in Nigeria compared to the UK (8.189±3.487). The differences between dietary indicators

(FGDS, FGA, GDR, and NCD protective, NCD risk) scores in Nigeria and the UK were statistically

significant as (p<0.01) in each case. Lastly, the academic stress level had a moderate negative significant

correlation with their eating behaviour and food choices as measured by their GDR score (r=-.371, p=0.024).

Conclusion: Stress level was moderate, which negatively affected their dietary quality suggesting the need

to implement supportive measures and educational programmes that can contribute to better stress

management and improved nutritional practices. Further studies should ensure usage of a large and more

diverse sample to aid usability and generalizability of findings.

Keywords: Academic stress, Black, Eating behavior, Experience, Food choice

INTRODUCTION

Background

Stress encompasses the demands put on a person’s physical and mental well-being by the environment,

either physically or psychologically (Lin et al., 2020). Stress is a universal bodily reaction and capacity to

maintain homeostasis. Due to its detrimental effects on human health, it is a worldwide issue (Soe et al.,

2018). Stress is often unavoidable. When expectations are unreasonable or difficult to meet, a person may

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feel under pressure. A certain amount of stress might be energising and advantageous for leading a fruitful

existence. On the other hand, persistently high amounts of stress can result in severe physical issues

(Alsulami et al., 2018). College students experience academic and non-academic related stress, which can

take many forms and be influenced by social, environmental, and psychological factors (Bedewy & Gabriel,

2015). An individual’s reaction to academic obligations is known as academic-related stress. It entails

emotional anguish caused by the expected fear of scholastic failure. This can show up in several ways, such

as overwhelming sentiments while adjusting to college life, academic obligations or commitments and an

apparent barrier to reaching a goal (Anaman-Torgbor et al., 2021). Additionally, university undergraduate

and graduate students must deal with additional school-related pressures such as a highly demanding course,

extensive studying time, effective time optimisation, competition among fellow course mates in the

classroom, financial obligations, domestic duties, and acclimating to a new lifestyle (Barbayannis et al.,

2022).

The current cohort of students is significantly more worried and apprehensive than earlier generations since

society has a general opinion that these students are more capable, particularly in terms of technological

competency; yet, being esteemed to be more enlightened has placed huge expectations on their outcomes,

and they are being pushed to meet ridiculous standards (Ramli et al., 2018). University life necessitates

much individual effort, devotion, and commitment. It may also include living away from family, which

causes social isolation and increases personal vulnerability. Students may be unprepared for this adjustment

and feel academic stress (Rasheed et al., 2017). Most college students deal with academic stress, as revealed

by Caso et al. (2020). Three out of every four undergraduate or graduate students in the United States of

America reported feeling stressed, according to Barbayannis et al. (2022). A survey of university students in

Australia found that 53% of them suffered from psychological distress (Asif et al., 2020). Academic

accomplishment boosts students’ chances of getting a job in the labour market, consequently predicting their

social and professional exploits (Santana et al., 2017). Furthermore, academic success is significant because

of the family’s expectations and the desire to exceed one’s classmates. While stress generates excitement

that might be called an academic incentive to a point, chronic stress may result in poor performance and

cause health complications (Lin et al., 2020). Stress can result in the onset of psychological conditions, drug

misuse, tension, sadness, low learner’s self-esteem, and suicidal ideation (Atta & Almilaibary, 2022).

Experience of stress in its severe form can be detrimental to a student’s ability to concentrate and even

function mentally. (Awadalla et al., 2022). Academic stress may lower enthusiasm, impair educational

attainment, and raise university exit rates (Pascoe et al., 2020).

Furthermore, evidence suggests that stress alters food consumption, preference, and motivation (appetite and

urge to eat) by activating affective brain connections and increasing glucocorticoid and insulin release.

Affective cerebral connections and hormones impact several dietary behaviour elements (Debeuf et al.,

2018). Accordingly, based on the root cause of the stress as well as its degree, stress may lead to inadequate

or overeating (Debeuf et al., 2018). Individual variances exist as regards food intake; around 40% raise and

reduce their calorie consumption when stressed, respectively, whereas nearly 20% do not modify feeding

behaviour in stressful situations (Yau & Potenza, 2013). Hill et al. (2018) systematically reviewed primary

literature on stress-related concepts. They found that stress was associated with eating less nutritious foods

and detrimental consequences among persons aged 8 to 18. Furthermore, evidence suggests that college

students are more likely to eat unhealthy foods and develop negative healthy behaviours throughout their

time in school owing to academic stress, such as snacking and sweet foods consumption, junk food

consumption, fast food consumption, and reduced vegetable and fruit intake (Almogbel et al., 2019; Caso et

al., 2020). Failing to acclimate to an unfamiliar setting might also lead to unfavourable eating patterns, such

as heavy alcohol usage (Choi, 2020).

Moreover, the majority of the developing world or low- and middle-income countries dominated by blacks

are experiencing accelerated emigration due to several reasons, which include economic growth and

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efficiency of various sectors in the Countries, such as the health sector and educational sectors, among

others (International Organization for Migration, 2023). Keeping the emigration factors in view alongside

academic stress might make adjusting to a new dietary pattern regarding quality and diversity difficult,

consequently impairing food choice and behaviour (Lee et al., 2022). Food adjustment in occidental

countries may involve greater consumption of highly processed food items rich in saturated fats, sugars, and

salt (Lee et al., 2022). Furthermore, evidence suggests that the rapid transition from conventional food

regions to contemporary and industrialised diets that occurs as a result of migration to high-income

countries predisposes one to experience adverse risks such as obesity, diabetes and cardiovascular diseases,

among others (Berggreen-Clausen et al., 2022). According to research conducted in the USA, Blacks living

in America have been reported to be eating poorly and not adhering to nutritional guidelines frequently

(Brown et al., 2019).

However, eating behaviour is an essential component of daily life since it may impact long-term clinical

outcomes as destructive dietary patterns like eating nutritionally deficient food, fasting, and not having to

eat when necessary are known to result in a variety of medical conditions and dietary deficiencies (Kabir et

al., 2018). Moreover, dietary practices in a population may be a predictor of overall health as well as the

extent of their chances of developing lifestyle pathologies such as obesity, overweight, diabetes mellitus,

hyperlipidaemia, substance abuse, lung diseases, high blood pressure, and cardiovascular disease, which are

the leading causes of mortality across all nations (Al-Qahtani, 2016). Additionally, college is a crucial

moment for increased weight since high school students who gain admission into college need to adjust to a

new environment, making the prevention of overweight and obesity and its connected disorders a global

concern (Deliens et al., 2014). Despite the available evidence on stress, eating habits and food choices

among undergraduates, there is a dearth of research evidence in this resource setting. Moreover, there is a

dearth of recent evidence as regards academic stress prevalence, eating habits and food choices among

undergraduates generally and among a sample of the black population.

Findings of this study are of great benefit as they will influence policies and measures towards reducing

academic stress and poor dietary habits and food choices. Hence, the need for conceptualising this study to

explore the experience of academic stress, eating behaviour, and food choice among a sample of black

university students in UK.

Thus, the research addressed the following research questions;

1. What is the degree of academic stress among black university students?

2. What are black university students’ eating habits and dietary preferences?

3. Is there a significant difference between eating behaviour and food choice among black university

students in Nigeria and the UK?

4. Is there a significant relationship between the experience of academic stress and eating behaviour and

food choice among black university students?

Operational Definition of Terms

Academic Stress refers to the demands that are put on black university students of South-Western Dosset,

UK’s physical and mental well-being fromacademics, either physically or psychologically. The perceived

stress scale measures it.

Black University Students: These are Nigerians who migrated to the United Kingdom and are presently

undergoing formal educational training in tertiary institutions in South-Western Dosset, UK.

Eating Behaviour and Food Choice: These words are used jointly, and both depict the dietary habits and

quality of black university students, respectively; it is measured by the Diet Quality Questionnaire

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developed by the Global Diet Quality Project

METHODS

Research Design

A quantitative cross-sectional study design was adopted to investigate the experience of academic stress,

eating behaviour, and food choice among black university students in South-Western Dorset from April to

June 2023.

Quantitative approaches generate numerical data from large, randomly selected populations, ensuring the

generalizability of the study findings (Wright et al., 2016). Furthermore, the quantitative approach allowed

mathematical examination of the relationship between academic-related stress and eating habits (Setia,

2016; Kosche et al., 2021). The cross-sectional design has the advantage of carrying out research over a

short period as opposed to longitudinal studies (Kosche et al., 2021). Typically, they are affordable and

straightforward to carry out. They prove valuable in establishing initial indications when preparing for a

forthcoming, more robust investigation (Wang & Cheng, 2020).

Research Setting

The research was conducted at four universities and colleges in the United Kingdom’s southwestern region.

These universities are Bournemouth University, Bournemouth and Poole College, Weymouth College, Arts

University Bournemouth, and AECC University College (Complete University Guide, 2023). The United

Kingdom is positioned off the northwestern coast of mainland Europe and consists of various regions,

including England, Wales, Scotland, and the northern part of Ireland. As of 2023, the estimated population

is 67,879,000 (Gilbert et al., 2023).

Target Population

The study population are Black university students in South-western Dorset, UK. The blacks originate in an

African region with entirely different cultures and food choices. Hence, they are at risk of poor dietary

habits because they have to adjust to a new feeding pattern and choices now that they have become part of

the African diaspora. Moreover, it has been hypothesised that stress can alter their nutritional habits and

quality, which have been established among studies in other populations, although not among blacks.

Therefore, there is a need for such evidence among the Black population, who have now become a minority

ethnic group in the UK. The Nigerian population was selected as a sample of the black population. This is

because they are more easily accessible.

Inclusion and Exclusion Criteria

Defining criteria for including and excluding survey respondents is necessary for conducting high-quality

scientific studies (Patino & Ferreira, 2018). The inclusion criteria establish the characteristics that qualify a

person to participate in the research by reliably, consistently, and unbiasedly selecting the research

population. The exclusion criteria specify the characteristics that exclude the selected group from

participating in the research (Garg, 2016).

Inclusion Criteria: All blacks by race, age 19-64 years, who migrated into the United Kingdom from

Nigeria who are attending Bournemouth University, Bournemouth and Poole College, Weymouth College,

Arts University Bournemouth and AECC University College were included in the study. The age range was

chosen as defined by Erik Erikson as being the young and middle-aged adulthood period (Mcleod, 2023).

This ensures similarities among the study population to eliminate possible confounders from vast

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demographic differences. Furthermore, the younger age groups were excluded, considering the difficulties

of gaining informed consent from their parents to participate in the study.

Exclusion Criteria: All who were ill, unavailable throughout the data collection period, and unwilling to

participate in the study.

Instruments for Data Collection

A validated open- and closed-ended structured questionnaire was used, which is divided into three parts for

adequate analysis. The first part focused on the sociodemographic characteristics.

The second and third parts focus on eating behaviour and food choice. This was measured by the Diet

Quality Questionnaire (DQQ) developed by the Global Diet Quality Project (2021). The DQQ stands as a

widely recognised tool for assessing dietary patterns on a societal scale. Its primary purpose is to collect

data regarding the consumption of various food groups, which is crucial for calculating measures of

nutritional quality across worldwide communities (Uyar et al., 2023).The questionnaire typically includes 29

questions about food groups and adherence to specific dietary guidelines or recommendations. It covered

areas such as consuming fruits and vegetables, whole grains, lean proteins, unhealthy fats, sugary beverages,

and processed foods.

The fourth part is the perceived stress scale (PSS), which has been used in other studies and focused on the

experience of academic stress (Lin et al., 2020; Choi, 2020). The 10 question items are on Likert scales,

which graduated from 0-4 for positive statements and reversed and coded for negative statements.

Scoring: PSS scores were obtained by reversing responses (e.g., 0 = 4, 1 = 3, 2 = 2, 3 = 1 & 4 = 0) to the

four positively stated items (items 4, 5, 7, & 8) and then summing across all scale items. A short 4-item

scale could be made from questions 2, 4, 5 and 10 of the PSS 10-item scale (Cohen et al., 1983).

Diet quality indicators used in this study are the Food Group Diversity Score (FGDS) and the Global

Dietary Recommendation (GDR) score, which were obtained from the DQQ. These scores measure

alignment with WHO global recommendations for healthy diets (WHO, 2020).

The Minimum Dietary Diversity for Women (MDD-W) consists of ten categories of food: 1) grains, white

roots and tubers, and plantains; 2) pulses (beans, peas, and lentils); 3) nuts and seeds; 4) milk and milk

products; 5) meat, poultry, and fish; 6) eggs; 7) dark green leafy vegetables; 8) other fruits and vegetables

that are rich in vitamin A; 9) other vegetables; and 10) other fruits (Uyar et al., 2023). The Food Group

Diversity Score (FGDS) is a continuous score ranging from 0 to 10, representing the ten food groups in the

MDD-W, and applies to the entire population. A higher score indicates a greater probability of meeting

nutritional adequacy (Uyar et al., 2023).

The non-communicable diseases (NCDs) – protective food groups (NCD protective), NCD risk food groups,

and the overall GDR score were derived from the data on dietary consumption: (1) NCD protective score,

which represents five global suggestions for health-promoting foods in a balanced diet (such as fruits and

vegetables, legumes, nuts and seeds, whole grains, and dietary fibre); (2) NCD risk score, which reflects six

global recommendations concerning dietary components that should be restricted (including total fat,

saturated fat, dietary sodium, free sugars, processed meat, and unprocessed red meat); (3) overall GDR

score, obtained by subtracting the NCD risk score from the NCD protective score encompassed all eleven

recommendations in total (Wang et al., 2022).

Specifically, the overall GDR score is determined by subtracting the NCD risk score from the NCD

protective score and then adding 9 to adjust the range of scores from 0 to 18. A higher score indicates a

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greater likelihood of meeting more recommendations, reflecting a more health-protective dietary pattern

(i.e., higher scores correspond to increased adherence to health-promoting dietary guidelines).

The GDR score is presented as an average score within the population. Increased scores indicate diets of

higher quality. Similarly, the GDR sub-metrics (GDR-Healthy and GDR-Limit) are average scores. The

GDR score can also be represented as a binary indicator, indicating the percentage of the population that

meets at least half of the global dietary guidelines. On the other hand, the FGDS is expressed as an average

score within the population, where higher scores indicate better dietary quality. The FGDS can be presented

as the percentage of the population that consumes a minimum of five out of the ten specified food groups.

It is important to note that no established threshold exists to define an absolute interpretation of “good” or

“poor” diets about the GDR score, its subcomponents, or the overall DQ-Q score. There can be relative

classifications into high, medium, and low scores depending on the tertile (Agriculture, Nutrition & Health

Academy 2021).

Table 1: FGDS

(source: Agriculture, Nutrition & Health Academy 2021)

Table 2: Food Group Adequacy

(source: Global Diet Quality Project, 2021).

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Table 3: GDR Healthy Component

(source: Agriculture, Nutrition & Health Academy 2021).

Table 4: GDR Limit Component

(source: Agriculture, Nutrition & Health Academy 2021).

Validity and Reliability

Validity describes how well an instrument assesses what it is intended to assess as required by the research

questions and objectives (Ahmed & Ishtiaq, 2021). Although, there are “face”, “content”, “construct”, and

“criterion” validity. However, face and content validity were ascertained as a matter of necessity. Face and

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content validity was done by the study supervisor and other experts in nutrition studies to ensure the

instrument comprehensively measures the experience of academic stress, eating behaviour, and food choice

in black university students. The capacity of a study tool to produce consistent findings across repeated

assessments is implied by reliability, which is the measure of the tool’s internal consistency (Ahmed &

Ishtiaq, 2021).

The instruments used are validated and standardised tools. The PSS-10 exhibited satisfactory internal

coherence and reliability across multiple studies (Mozumder, 2022). The documented internal coherence of

the questionnaire, as measured by Cronbach’s alpha, ranged from .71 to .91, while the test-retest reliability

coefficient has consistently shown values above .70 in diverse populations (Mitchell et al., 2008; Chaaya et

al., 2010; Lee, 2012). The dietary diversity measurement subscale reliability coefficient was 0.76 (Hussien

et al., 2021). DQQ have used and validated several credible studies (WHO, 2021; Miller et al., 2022; Uyar

et al., 2023). Reliability coefficients yielding a score above 0.75 depict high reliability and internal

consistency (Koo & Li, 2016).

Sampling Technique

The study settings comprised five tertiary institutions. However, estimating the total black population

considering the study time frame is not feasible, preventing the use of stratified or multistage random

sampling techniques due to the accessibility of the students and the method of data collection. A

convenience sampling method was utilised for the study. The convenience sampling technique is a non-

probabilistic sampling approach based on the principle of accessibility and convenience. However, the

drawback to this is the risk of bias because all the students do not have equal chances of being selected to

participate in the study (Elfil & Negida, 2017). Thus, the instrument was administered to accessible students

based on the inclusion and exclusion criteria.

Sample Size Determination

Calculating the sample size involves making a statistical estimate of all the people who should take part in

the study. A sample size that is too large or too small is associated with inaccuracy in study findings (Kaur,

2017). Leslie Kish’s formula was utilised by Fishers (Kish, 1995).

n=z

pq÷d

Where;

n- desired sample size

q- The percentage not involved in the study

p- Percentage of the target population thought to possess a certain trait (prevalence of academic-related

stress =46.4%) (Chukwuocha et al., 2021)

z- The critical value for a two-tail test at a 95% confidence level.

d- The absolute precision required on either side of a normal distribution curve at a confidence level of 95%;

the degree of precision desired is usually set at 5%.

n= (1.96)

x 0.464x (1-0.464)

(0.05)

n=382

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Considering a 10% attrition rate for the sake of non-response or poorly filled questionnaires

n= 420 participants

Method of Data Collection

Validated instruments structured in English into an online form using the Bournemouth University Online

Survey Development Package were administered to the study participants. The questionnaire interface

became accessible after indicating their consent to participate in the study. Additionally, three research

assistants were recruited and underwent a three-day training program, lasting one hour per session, which

covered research ethics and the data collection process. The participants were accessed through their social

media platforms; thus, they received the survey link through their media platforms. Completing the study

instrument took approximately 20 minutes. The entire data collection process spanned over one month.

Statistical Analysis

The quantitative data was assessed for completeness and underwent a cleaning process. The collected data

was exported to IBM SPSS, version 25. Descriptive and inferential statistical methods were employed for

analysis. Categorical variables were analysed using frequencies and percentages, while continuous data was

described using mean and standard deviation (Guetterman, 2019).

To assess differences in diet quality between the retrospective data from Nigeria and the present diet quality,

the Wilcoxon signed-rank test was used, and the Spearman rank correlation was used to assess relationship

between academic-related stress and dietary habits due to non-normalcy of data determined after conducting

the Kolmogorov Smirnov test and Shapiro Wilk test (Sundjaja et al., 2022). Statistical significance between

variables was established at P<.050 (Tenny & Abdelgawad, 2022). The analysis results were presented in

tables and charts to provide an overview of the findings.

Ethical Consideration

A letter of introduction addressed to the Ethical Review Committee” of Bournemouth University was

obtained from the Faculty of Health and Social Sciences and submitted alongside the research proposal to

the committee. The ethical approval was given on 7th April 2023 with Ref.no: 47961.

The study was conducted in accordance with the “Declaration of Helsinki” (World Medical Association,

2018). The study participants were required to provide written informed consent, including a clear

explanation of the study objectives, benefits, absence of harm, the right to decide whether to participate

(autonomy) and the right to anonymity and confidentiality of the information provided. The file was

encrypted and stored in an SPSS format to prevent unauthorised access.

RESULTS

A total of 42 responses were retrieved, out of which 37 completed the study instrument and had adequate

data for analysis. This translates to a response rate of 88.1%.

Table 5: Sociodemographic Characteristics

Variables

Categories

n (%)

Gender

Female

23(62.2)

Male

14(37.8)

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Academic level

Postgraduate

35(94.6)

Undergraduate

2(5.4)

Having undertaken a nutrition-related course

Yes

9(24.3)

28(75.7)

Table 6: Degree of Academic Stress among Black University Students

Variables

Responses (n=37)

Mean±SD

Never

f(%)

Almost

never f(%)

Sometimes

f(%)

Fairly

often f(%)

Very often

f(%)

Being upset because of

something that happened

unexpectedly

2(5.4)

3(8.1)

19(51.4)

7(18.9)

6(16.2)

2.32±1.03

Feeling of nervousness and

stress

1(2.7)

4(10.8)

10(27)

9(24.3)

13(35.1)

2.78±1.13

Feeling of confidence about

one’s ability to handle

personal problems

0(0)

5(13.5)

16(43.2)

6(16.2)

10(27)

1.43±1.04

Feeling of things going their

way

0(0)

7(18.9)

14(37.8)

8(21.6)

1.54±1.04

Inability to control the

important things in their lives

2(5.4)

6(16.2)

13(35.1)

7(18.9)

9(24.3)

2.41±1.19

Not being able to cope with

all the things that they had to

2(5.4)

9(24.3)

17(45.9)

6(16.2)

3(8.1)

1.97±0.99

Ability to control irritations

in their life

1(2.7)

3(8.1)

18(48.6)

4(10.8)

11(29.7)

1.43±1.09

Feeling of being on top of

things

1(2.7)

6(16.2)

19(51.4)

6(16.2)

5(13.5)

1.78±0.98

Being angered because of

things that were outside of

control

2(5.4)

14(37.8)

10(27)

9(24.3)

2.59±1.09

Difficulties were piling up

so high that they could not

overcome them

3(8.1)

6(16.2)

14(37.8)

8(21.6)

6(16.2)

2.22±1.16

Overall Mean PSS score

20.49±6.71

Table 7: Food Group Diversity Score (FGDS) in Nigeria vs UK

Food groups consumed

Responses (n=37)

Nigeria f(%)

United Kingdom f(%)

Grains, white roots and tubers, and plantains

37(100)

Pulses (beans, peas and lentils)

34(91.9)

15(40.5)

Nuts and seeds

32(86.5)

17(45.9)

Diary

35(94.6)

27(73)

Meat, poultry and fish

36(97.3)

34(91.9)

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Eggs

30(81.1)

11(29.7)

Dark green leafy vegetables

33(89.2)

14(37.8)

Other vitamin A-rich fruits and vegetables

37(100)

23(62.2)

Other vegetables

34(91.9)

29(78.4)

Other fruits

37(100)

29(78.4)

Overall mean food group diversity score

9.32±1.16

6.38±2.09

Table 8: Food group adequacy in Nigeria vs UK

Food groups

Responses (n=37)

Nigeria f(%)

United Kingdom f(%)

Starchy staples

37(100)

Vegetables

37(100)

34(91.9)

Fruits

37(100)

30(81.1)

Pulses, nuts and seeds

36(97.3)

21(56.8)

Animal-source foods

37(100)

Mean FGA score

4.97±0.16

4.30±0.85

Table 9: NCD-Protect score

NCD Protect Food Groups

Responses (n=37)

Nigeria f(%)

United Kingdom f(%)

Whole grain

25(67.6)

7(18.9)

Pulses

34(91.9)

15(40.5)

Vitamin A-rich orange vegetables

27(73)

23(62.2)

Other vegetables

34(91.9)

29(78.4)

Vitamin A-rich fruits

36(97.3)

7(18.9)

Citrus

34(91.9)

24(64.9)

Nuts and Seeds

32(86.5)

17(45.9)

Dark green leafy vegetables

33(89.2)

14(37.8)

Other fruits

33(89.2)

25(67.6)

NCD Protect overall mean score

7.78±1.65

4.35±2.41

Table 10: NCD-Risk score

NCD Risk Food Groups

Responses (n=37)

Nigeria f(%)

United Kingdom f(%)

Soft drinks

33(89.2)

20(54.1)

Baked / grain-based sweets

35(94.6)

26(70.3)

Other sweets

30(81.1)

24(64.9)

Processed meat

25(67.6)

17(45.9)

Packaged ultra-processed salty snacks

31(83.8)

22(59.5)

Deep fried food

35(94.6)

22(59.5)

Unprocessed red meat

36(97.3)

20(54.1)

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Fast food and instant noodles

36(97.3)

23(62.2)

NCD Risk overall mean score

7.73±1.84

5.16±3.59

GDR Score Nigeria GDR Score in UK

Fig 1: Global Dietary Recommendations (GDR) score

Table 11: Differences between eating behaviour and food choice among black university students in Nigeria

and in the UK

Dietary quality parameters

Wilcoxon Signed Ranks Test statistic (Z)

FGDS (UK) – FGDS (Nigeria)

-4.878

0.000*

FGA (UK) – FGA (Nigeria)

-3.866

0.000*

GDR (UK) – GDR (Nigeria)

-1.530

0.126

NCD Protect (UK) – NCD Protect (Nigeria)

-4.810

0.000*

NCD Risk (UK) – NCD Risk (Nigeria)

-3.832

0.000*

*- significant at p<.050, p-Probability value

Table 12: Relationship between the experience of academic stress, eating behaviour, and food choice in

black university students

Variables

FGDS

FGA

NCD Protect

NCD Risk

GDR

Academic stress (PSS)

-0.278

-0.290

-0.292

0.151

-.371

0.095

0.082

0.080

0.373

0.024*

ρ - spearman correlation coefficient,*- significant at p<.050, p-Probability value

Table 5 revealed about two-third 23(62.2%) were females, majority 28(75.7%) have undertaken nutrition

related course while overwhelming majority 35(94.6%) were post-graduate students.

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Table 6 showed that, out of 40, the average academic stress score was 20.49±6.71, depicting an overall

moderate stress level. Feeling nervous and being angered because of things outside of control were fairly

often experienced. The feeling of things not going their way, being upset because of something that

happened unexpectedly, unable to control the essential things in their lives, not being able to cope with all

the things that they have to do, not feeling of being on top of things and difficulties piling up were

sometimes experienced.

Table 7 showed that, out of a total score of 10, the mean food group diversity score was 9.32±1.16 in

Nigeria, while it was 6.38±2.09 in the UK. Most prevalent individual food groups consumed both in Nigeria

and UK includes grains, white roots and tubers, and plantains, meat, poultry and fish, diary, fruits and

vegetables.

Table 8 showed overall FGA score of 4.97±0.16 in Nigeria and 4.30±0.85 in UK out of a total score of 5.

Food groups commonly eaten includes starchy staples, vegetables, fruits, pulses, nuts and seeds, and animal-

source foods.

Table 9 showed NCD- protect overall mean score was 7.78±1.65 in Nigeria and 4.35±2.41 in UK out of a

score of 9. The NCD-protective food groups include whole grain, pulses, vitamin A-rich orange vegetables,

vegetables, vitamin A-rich fruits, citrus, nuts and seeds and dark green leafy vegetables.

Table 10 showed NCD-risk overall mean score was 7.73±1.84 in Nigeria and 5.16±3.59 in UK out of a

score of 9. The NCD-risk food groups include soft drinks, sweets, processed meat, packaged ultra-processed

salty snacks, deep fried food, unprocessed red meat and fast food & instant noodles.

Fig 1 showed the GDR score to be 9.054±2.449 in Nigeria and 8.189±3.487 in UK out of a score of 18.

Table 11 showed a significant increase in the quality of eating behaviour and food choices in Nigeria

compared to the UK, thereby rejecting the null hypothesis. FGDS, FGA, and NCD protective and NCD-risk

dietary scores were significantly higher in Nigeria as compared to the UK with (Z=-4.878, p=0.01), (Z=-

3.866, p<0.01) and (Z=-4.810, p=0.01) respectively at p< .050. However, the NCD-risk dietary score was

significantly higher in Nigeria compared to the UK with (Z=-3.832, p<0.01) at p< .050.

Table 12 showed a moderate negative significant correlation between academic stress and GDR score with

(r=-.371, p=0.024) at p< .050. However, a negative correlation was found between the overall academic

stress level and the FGDS, FGA, and NCD Protect, while a positive correlation exists between the stress

level and the NCD risk score. However, the correlations were not statistically significant, as p> .050 in each

case.

DISCUSSION OF FINDINGS, CONCLUSION, RECOMMENDATIONS

Discussion of Findings

Stress can affect dietary practices in a population, which can predict overall health and the extent of their

chances of developing lifestyle pathologies (Debeuf et al., 2018; Hill et al., 2018). This study explored the

experience of academic stress, eating behaviour, and food choice in black university students, a larger

proportion of whom were females, postgraduate students, and those who had undertaken nutrition-related

courses.

Regarding the students’ eating behaviour and food choices, findings revealed that the majority had better

dietary practices in Nigeria than in the UK. This was evident by various dietary quality-based indicators

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such as the food group diversity scores, food group adequacy, NCD-protective dietary score, NCD risk

dietary score and global dietary recommendation score (Uyar et al., 2023; Global Diet Quality Project,

2023). Dietary Diversity refers to the number of food groups or foods consumed in a given period. They are

a good source of macro and micronutrients and best ensure nutrient adequacy necessary to promote a

healthy weight and reduce the risk for nutritional deficiencies and chronic diseases (Xu et al., 2022;

Weerasekara et al., 2020). While the Black students were in Nigeria, the average food group diversity score

was approximately 9 out of a score of 10 compared to the UK with 6 out of 10. The difference in the FGD in

Nigeria and the UK was statistically significantly different. However, the recommended food diversity score

is a minimum of five food groups, which the students in both countries met. Food groups still commonly

consumed in both regions include grains, white roots and tubers, plantains, meat, poultry and fish, dairy,

fruits and vegetables. However, it is arguable that diversities do not necessarily translate to healthy diets all

the time. This is why the association between food diversities and NCDs is not constant; it is also affected

by the type of food groups that are being consumed (Dolui et al., 2023). However, an ample body of

evidence supports the fact that continuous consumption of a singular food group causes deficiency in crucial

micronutrients and adds to the prevalence of micronutrient deficiencies (Abebe et al., 2023; Zeinalabedini et

al., 2023).

This finding is inconsistent with a study by Omage and Omuemu (2018) among undergraduates in Southern

Nigeria, who found that approximately half of the respondents had a high dietary diversity. However, the

finding is somewhat close to the present-day reality in the UK, with the mean food group diversity score

slightly above average. In contrast, a study among university students in South-western Nigeria by Sedodo

et al. (2014) revealed the students had low dietary diversity scores. This difference might be because

approximately all the participants in this present study are postgraduate students who, as in their last days in

Nigeria, had completed their undergraduate studies and probably would have secured a job and earned a

better living. To corroborate this opinion, Nzeagwu and Akagu (2011) revealed that economic factors have

been the most significant determinant of food habits among a sample of Nigerian undergraduates. However,

there is dearth of studies with focus only on postgraduate students or a mixture of undergraduates and

postgraduates. Moreover, the studies were conducted in just a region of Nigeria, which is not representative

of the whole nation.

Furthermore, this study showed that the overwhelming majority consumed all the five minimum food group

requirements in Nigeria within the framework of food group adequacy; this is not consistent with what is

observable in the UK, with approximately half meeting this requirement. The foods include starchy staples,

vegetables, fruits, pulses, nuts and seeds and animal-source foods. This may be due to several factors, such

as socioeconomic status. The broader body of evidence consistently indicates a favourable correlation

between the socioeconomic profile and food quality within various demographic segments of the UK

population (Northstone et al., 2014; Maguire & Monsivais, 2015). Although the economic state of the UK is

better than that of Nigeria, the standard of living is higher (World Bank 2022). Furthermore, Black African

students encounter substantial financial stress and challenges in comprehending and assimilating into the

culture of universities in the United Kingdom (Hyams-Ssekasi et al., 2014). Moreover, it was revealed that

in Nigeria, the students had good habits regarding food that protects against NCDs, such as whole grain,

pulses, vitamin A-rich orange vegetables, vegetables, vitamin A-rich fruits, citrus, nuts and seeds and dark

green leafy vegetables. The consumption of these foods has been reduced by half in the UK.However, the

food consumption rate that predisposes to NCDs was significantly higher in Nigeria compared to the UK.

These foods include soft drinks, sweets, processed meat, packaged ultra-processed salty snacks, deep-fried

food, unprocessed red meat fast food and instant noodles.

Furthermore, the findings of this study revealed that consumption of NCD-risk and NCD-protective food

was in similar proportions simultaneously in Nigeria and the UK. This is not a good practice as standard

dietary guidelines recommend higher consumption of NCD-protective foods and decreased consumption of

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NCD-protective food (Afshin et al., 2017). These findings support Sprake et al. (2018), who found out a

sample of university students in the UK adhered to four primary eating patterns: vegetarian, snacking, health-

conscious, and convenience-oriented, involving red meat and alcohol. This reveals the need to discourage

NCD-risk diets and encourage more of NCD protective diets.

Overall, the students’ GDR, which is a measure of the level of consumption of NCD-protective foods and

NCD-risk diets, was higher in Nigeria compared to the UK. However, this difference was not statistically

significant and the GDR was poorly met in both categories. Keeping in view this finding, a study revealed

that individuals of Black ethnicity exhibited significantly lower scores on the healthy eating rating and

reduced consumption of micronutrients (Li et al., 2017). This finding is somewhat close to Bennett et al.

(2022), who found out that Black/African American communities were identified as having lower fruit and

vegetable consumption rates. In contrast, Asian groups attained elevated diet quality ratings owing to

increased fish consumption and reduced fat intake. The limitation of these studies is that they were not

conducted strictly among university students.

However, in this present study, correlation analysis showed a moderate negative significant correlation

between academic stress experienced and adherence to the GDR. Thus, as the stress level increased, there

was a significant decrease in their dietary quality, evidenced by their eating behaviour and food choices.

Furthermore, negative correlations exist between the stress level and other healthy dietary indicators.

However, the correlations were not statistically significant. The level of stress among the population was

moderate. Specifically, nervousness, anger, upset, and inability to control things and situations were fairly

often experienced. This finding somewhat contrasts a multiracial study that reported high-stress levels in

general. However, they found that Blacks had non-statistically significantly lower levels than Whites

(Turner & Smith, 2015). The differences might be due to other factors associated with stress, as revealed in

a previous UK systematic review, such as childhood trauma, parental factors and other changes that come

with moving into higher education (Campbell et al., 2022). However, the lower level might be due to coping

and adaptive skills built by the Blacks who have had a history of discrimination and stigma. However, the

association between academic stress and eating behaviour is keeping in view with the findings of a study

among Black, Asian and Minority Ethnic groups, which revealed a significant association between stress in

university life and eating behaviour (Mensah et al., 2022). The consistency of these findings mandates

collaborative interventions from nutritionists, policy makers and mental health experts.

Conclusion

Conclusively, the study revealed that Black University Students in the UK experienced an overall moderate

level of academic stress, which negatively impacted their eating behaviour and food choices. The findings

underscore the significance of recognising and addressing the relationship between academic stress and

dietary practices among this group of university students.

Strengths and Limitations

A significant strength of this study is that major subjects, including stress and eating behaviour, were

explored. Eating behaviour and stress have an impact on conditions such as cancers and CVDs, which are

referred to as the leading causes of death. Another strength of the study is that validated tools were used in

the assessment, and appropriate statistical measures were employed. The study used a non-parametric test

for the inferential analysis, having observed the distribution’s non-normalcy and small sample size (Mishra

et al., 2019). Another uniqueness is that the study is the first of its kind among Black people residing in the

UK. Hence, the study serves as empirical support for further studies and can also contribute to the body of

evidence for qualitative or quantitative synthesis in systematic reviews.

Furthermore, the study provided room for further research to explore the impact of the environment on

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dietary behaviours. However, this study was limited by its response rate, as many people were non-

responsive to the research despite being assured that their responses would be confidential and that they had

the right to withdraw at any time as they deemed fit. This might be because no financial gifts were attached

to participation in the study. Therefore, we can say the study was limited by insufficient funding to cover a

broader geographical scope and give participants a token. Furthermore, the study’s small sample size may

affect the statistical power and increase the likelihood of type 2 errors (Shreffler & Huecker, 2023). Also,

the study’s generalizability was limited on account of the small sample size (Faber and Fonseca 2014).

The convenience sampling method predisposes to a high risk of bias (Jager et al., 2017), and cross-sectional

design is less effective in investigating causal relationships compared to longitudinal design (Savitz &

Wellenius, 2023). Moreover, confounding variables were not controlled, as the analysis was done via

correlation and Wilcoxon signed rank test (Pourhoseingholi et al., 2012). Recall bias has been established to

influence the self-reporting method of collecting data (Althubaiti, 2016).

Recommendations for Practice

Dietary Approach to Relieve Stress- This study revealed that the academic stress level had a moderate

negative significant correlation with their eating behaviour and food choices as measured by their GDR

score. One of the implications of this is to provide an evidenced-based nutritional approach to managing

stress as there are some dietary interventions to improve mood, such as the Mediterranean diet (Parletta et

al., 2019), a 50:50 ratio of corn and soybean oils (Gabbay et al., 2018).

Collaboration and Support: Collaborative approaches and supports are essential to addressing food

behaviours and academic stress among university students. This might require the universities to create and

implement programs tailored to their student’s particular requirements by consulting a diversified team of

health specialists, dietitians, nutritionists and mental health specialists. Psychologists and counsellors can

offer counselling sessions, workshops, and resources focusing on stress management techniques, coping

strategies, and resilience-building skills to Black university students. By doing this, the effect of stress on

their dietary habit will be reduced significantly. Furthermore, nutritionists, on the other hand, have a crucial

role here as they can provide valuable expertise in drawing evidence-based dietary educational programs.

Nutritionists can emphasise the importance of a balanced diet and help students plan realistic meals that suit

the cultural and environmental factors influencing food choices. They will help the students identify

possible food alternatives to what they usually consume while in their country of origin.

Stress Management Interventions: This study revealed a moderate level of academic stress among

university students. Therefore, it is crucial for educational institutions to implement stress management

interventions. Counseling services, workshops, and support groups tailored to address students’ specific

needs can be effective in helping them cope with academic stress.

Promotion of Healthy Eating Habits: This present study has identified significant differences in food

group diversity and consumption patterns when they were in Nigeria and the UK. Educational programs are,

therefore, recommended to focus on the importance of a balanced diet and NCD-protective diets rich in

fruits, vegetables, whole grains, and lean proteins. Furthermore, targeted nutrition education is necessary,

and the students should be educated about the health importance of the consumption of NCD-protective

food groups and the potential risks associated with NCD-risk diets.

Funding: This study was limited by insufficient funds; further studies would require grant application and

fundings. Woosong University Academic Research funded a similar study by Choi (2020).

Recommendations for Research

Further studies should be conducted using a larger sample size of the Black population in the UK via a

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mixed-method approach to promote generalizability and reduce underrepresentation. Also, studies should

adopt a probabilistic approach to sample selection to reduce the chances of sampling bias.

However, the sampled Blacks in the UK had better dietary habits in Nigeria, evidenced by higher

compliance with global dietary recommendations. Qualitative studies should be conducted to explore

cultural determinants of dietary behaviour and food choices in depth. Studies should also use qualitative

methods to explore the impact of relocation on dietary patterns. Furthermore, other determinants of stress

should be investigated, and confounding variables should be adjusted for in the analysis.

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255–267.

APPENDIX

APPENDIX 1: INFORMED CONSENT FORM

Participant Information Sheet

You are being invited to take part in a research project. Before you decide, it is important for you to

understand why the research is being done and what it will involve. Please take time to read the following

information carefully and discuss it with others if you wish. Ask us if there is anything that is not clear or if

you would like more information. Take time to decide whether or not you wish to take part.

The title of the research project:

Exploring the experience of academic stress, eating behavior, and food choice in black university students.

What is the purpose of the research/questionnaire?

The aim of this project is to explore the experience of academic stress, eating behavior, and food choices in

Nigerian postgraduate students studying in the United Kingdom. This simply means the project’s main

objective is to discover the significant relationship between stress, eating behavior, food choices, and

relocation.

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Why have I been chosen?

The project is looking to have Nigerian participants who lived in Nigeria prior to their studies in the United

Kingdom and are postgraduate students in the United Kingdom.

Do I have to take part?

It is up to you to decide whether or not to take part. If you do decide to take part, you will be given this

information sheet to keep and be asked to sign a participant agreement form. We want you to understand

what participation involves before you make a decision on whether to participate. If you or any family

member have an ongoing relationship with BU or the research team, e.g., as a member of staff, as a student,

or other service user, your decision on whether to take part (or continue to take part) will not affect this

relationship in any way.

Can I change my mind about taking part?

Yes, you can stop participating in study activities at any time and without giving a reason. After you decide

to withdraw from the study, we will not collect any further information from or about you. As regards to the

information we have already collected before this point, your rights to access, change or move that

information are limited. This is because we need to manage your information in specific ways in order for

the research to be reliable and accurate.

What would taking part involve?

Taking part in this project requires you to fill a 4-sectioned close-ended survey with questions pertaining to

the project title.

What are the advantages and possible disadvantages or risks of taking part?

Whilst there are no immediate benefits for those people participating in the project, it is hoped that this work

will vastly contribute to the study gap this project is aimed at filling, indirectly adding to the bulk of

knowledge required in Nutrition at large. Whilst we do not anticipate any risks to you in taking part in this

study, you may be required to process some questions which might have an emotional impact on you.

What type of information will be sought from me and why is the collection of this information

relevant for achieving the research project’s objectives?

Information concerning diet, stress, eating behavior, and food choices would be required. The responses to

the survey are the information intended to be used to answer research questions which would bring a

conclusion to this project.

How will my information be managed?

Bournemouth University (BU) is the organization with overall responsibility for this study and the Data

Controller of your personal information, which means that we are responsible for looking after your

information and using it appropriately. Research is a task that we perform in the public interest, as part of

our core function as a university. Undertaking this research study involves collecting and/or generating

information about you. We manage research data strictly in accordance with ethical requirements and

current data protection laws. These control the use of information about identifiable individuals but do not

apply to anonymous research data: “anonymous” means that we have either removed or not collected any

pieces of data or links to other data which identify a specific person as the subject or source of a research

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result.

BU’s Research Participant Privacy Notice sets out more information about how we fulfill our

responsibilities as a data controller and about your rights as an individual under the data protection

legislation. We ask you to read this Notice so that you can fully understand the basis on which we will

process your personal information. Research data will be used only for the purposes of the study or related

uses identified in the Privacy Notice or this Information Sheet. To safeguard your rights in relation to your

personal information, we will use the minimum personally-identifiable information possible and control

access to that data as described below.

Publication:

You will not be able to be identified in any external reports or publications about the research without your

specific consent. Otherwise, your information will only be included in these materials in an anonymous

form, i.e., you will not be identifiable.

Security and access controls:

BU will hold the information we collect about you in hardcopy in a secure location and on a BU password-

protected secure network where held electronically. Personal information which has not been anonymized

will be accessed and used only by appropriate, authorized individuals and when this is necessary for the

purposes of the research or another purpose identified in the Privacy Notice. This may include giving access

to BU staff or others responsible for monitoring and/or audit of the study, who need to ensure that the

research is complying with applicable regulations.

Further use of your information:

The information collected about you may be used in an anonymous form to support other research projects

in the future, and access to it in this form will not be restricted. It will not be possible for you to be

identified from this data.

Keeping your information if you withdraw from the study:

If you withdraw from active participation in the study, we will keep information which we have already

collected from or about you if this has ongoing relevance or value to the study. This may include your

personally identifiable information. As explained above, your legal rights to access, change, delete, or move

this information are limited as we need to manage your information in specific ways in order for the

research to be reliable and accurate. However, if you have concerns about how this will affect you

personally, you can raise these with the research team when you withdraw from the study. You can find out

more about your rights in relation to your data and how to raise queries or complaints in our Privacy Notice.

Retention of research data:

Project governance documentation, including copies of signed participant agreements: we keep this

documentation for a long period after completion of the research so that we have records of how we

conducted the research and who took part. The only personal information in this documentation will be your

name and signature, and we will not be able to link this to any anonymized research results.

Research results:

This research is being carried out as part of the coursework for a degree awarded by BU. We will keep your

personal information in identifiable form until after the assessment and award of the degree. You can find

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more specific information about retention periods for personal information in our Privacy Notice. We keep

anonymized research data indefinitely so that it can be used for other research as described.

Contact for further information:

If you have any questions or would like Further Information, please contact; Supervisor: Chloe Casey

[ccasey@bournemouth.ac.uk]

Research Team:

Priscilla Jekayinfa [S5515203@BOURNEMOUTH.AC.UK]

In case of complaints:

Any concerns about the study should be directed to s5515203@bournemouth.ac.uk.

If your concerns have not been answered by s5515203@bournemouth.ac.uk, you should contact

Bournemouth University by email to researchgovernance@bournemouth.ac.uk. Thank you for considering

taking part in this research project. Kindly respond if you have read the participant information sheet.

Please indicate that you have read and understood the participant information sheet for this research project

and you consent to take part in the questionnaire before continuing.

I have read and understood the participant information sheet and I consent to take part in this questionnaire [

]

I Do Not Consent To Take Part In This Questionnaire [ ]

I am a black university student currently studying the United Kingdom (a) Yes [ ] (b) No [ ]

APPENDIX II: QUESTIONNAIRE ON EXPLORING THE EXPERIENCE OF ACADEMIC

STRESS, EATING BEHAVIOR, AND FOOD CHOICE IN BLACK UNIVERSITY STUDENTS

Part 1: SOCIODEMOGRAPHIC PROFILE

Age as at last birthday years

Gender (a) male (b) female (c) prefer not to say

Average Monthly Income/allowance (in pounds)

Academic Level (a) undergraduate (b) postgraduate

Have you ever received nutrition-related education in any of your courses (a) Yes (b) No

SECTION 2: Dietary Quality while in NIGERIA. Now I’d like to ask you some yes-or-no questions about

foods and drinks that you consumed the day before the last day in Nigeria during the day or night, whether

you had it at home or somewhere else. Indicate yes or no as appropriate.

Food items

(circle answer)

Rice, semo, couscous, bread, spaghetti, masa, pap, or tuwo/nri-eserese?

YES or NO

Porridge, egbo/ dambu, corn, or Ofada rice?

YES or NO

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Sweet potato, fufu, gari, abacha, yam, lafun, blackamala, or plantain?

YES or NO

Beans, awara from soy, moinmoin, Bambara groundnuts, pigeonpeas, African

yambeans, or other local beans?

YES or NO

Vegetables:

Carrots, pumpkin, squash that is orange inside, or sweet potatoes that are orange

inside?

YES or NO

6.1

Ewedu/ayoyo, pumpkin leaves, water leaves, bitter leaves, green, soko leaves, or

baobab leaves?

YES or NO

6.2

Zobo leaves, afang/okazi, karkashi, garden egg leaves, sweet potato leaves, or

cowpea leaves?

YES or NO

7.1

Tomatoes, garden eggs, okro, cucumber, green pepper, cabbage, or green beans?

YES or NO

Fruits:

Mango, pawpaw, golden melon, locust bean fruit, or African cherry?

YES or NO

Orange, tangerine, or grape fruit?

YES or NO

10.1

Banana, guava, soursop, watermelon, cashewfruit, orapple?

YES or NO

10.2

Pineapple, avocado pear, coconut flesh, dates, African bush pear,or African elemi?

YES or NO

Sweets:

Cakes, cookies, sweet biscuits, wafers, chinchin, or puff puff?

YES or NO

Sweets, chocolates, ice cream, or sesame brittle?

YES or NO

Foods of animal origin:

Eggs or eggrolls?

YES or NO

Wara from milk, or dairy cheese?

YES or NO

Yogurt, nono, or furadenono?

YES or NO

Sausages, hotdogs, corned beef, or kilishi?

YES or NO

Cowmeat, rammeat, goatmeat, or any organs from these animals?

YES or NO

Pigmeat, rabbit, dogmeat, or bushmeat?

YES or NO

Chicken, turkey, guineafowl, quail, duck, or pigeon?

YES or NO

Fish, canned fish, crab, prawn, or shrimp?

YES or NO

Other foods:

Groundnuts, melonseeds, ogbono, bread fruit seeds, walnuts, or cashews?

YES or NO

Packaged potato chips such as Pringles, or packaged plantain chips?

YES or NO

Instant noodles such as Indomie or Chikki?

YES or NO

Fried plantain, fried sweet potato, fried yam, akara, eggroll, samosa or springrolls,

fried fish, or fried meat?

YES or NO

Beverages:

Milk including powdered milk?

YES or NO

Tea with sugar, coffee with sugar, 3-in-1, choco drink, Milo or Bournvita?

YES or NO

Fruit juice, fruit flavoured drinks, zobo, or kunu?

YES or NO

Soft drinks such as Coca-Cola, Fanta, Sprite, or chapman, malt drinks, or energy

drinks such as Red Bull?

YES or NO

Yesterday, did you get food from any place like…

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Mr. Biggs, Big Treat, Domino’s, KFC, Tantalizer, or other places that serve meat

pie, chicken pie, pizza or burgers?

YES or NO

SECTION 3: Dietary Quality now in UK. Now I’d like to ask you some yes-or-no questions about foods

and drinks that you consumed YESTERDAY during the day or night, whether you had it at home or

somewhere else.

Please read the list of foods and drinks, and if you ate or drank ANY ONE OF THEM YESTERDAY,

indicate yes.

Food items

(circle answer)

Rice, semo, couscous, bread, spaghetti, masa, pap, or tuwo / nri-eserese, pasta,

tortilla?

YES or NO

Porridge, egbo / dambu, corn, Ofada rice, Fresh corn, popcorn, oats, granola, brown

rice, or quinoa?

YESorNO

Sweet potato, fufu, gari, abacha, yam, lafun, black amala, or plantain?

YES or NO

Beans, refried beans, peas, lentils, hummus, chickpeas, tofu, lima beans, awara from

soy, moin moin, bambara groundnuts, pigeon peas, African yam beans, or other

local beans?

YES or NO

Vegetables:

Carrots, red tatase(red bell pepper), pumpkin, squash that is orange inside, or sweet

potatoes that are orange inside?

YES or NO

6.1

Ewedu / ayoyo, pumpkin leaves, water leaves, bitter leaves, green, soko leaves,

baobab leaves, broccoli, spinach, arugula, kale, collards, turnip greens, or mustard

greens?

YES or NO

7.1

Zobo leaves, afang / okazi, karkashi, garden egg leaves, sweet potato leaves, cowpea

leaves, Lettuce, tomatoes, green beans, celery, green peppers, cabbage, or cucumber?

YES or NO

7.2

Tomatoes, garden eggs, okro, cucumber, green pepper, cabbage, green beans,

zucchini, mushrooms, eggplant, cauliflower, okra, asparagus, or radish?

YES or NO

Fruits:

Mango, ogbono fruit, pawpaw, golden melon, locust bean fruit, African cherry,

canteloupe, mango, papaya, apricots, or dried apricots?

YES or NO

Orange, clementine, mandarin, tangerine, or grapefruit?

YES or NO

10.1

Banana, guava, soursop, watermelon, grapes, avocado, berries, cherries, cashew

fruit, or apple?

YES or NO

10.2

Pineapple, avocado pear, kiwi, plums, prunes, peaches, nectarines, coconut flesh,

dates, African bush pear, or African elemi?

YES or NO

Sweets:

Cakes, cookies, sweet biscuits, wafers, brownies, donuts, pastries, pie, chin chin, or

puff puff?

YES or NO

Sweets, candy, candy bars, chocolates, ice cream, popsicles, milkshakes, pudding,

ice cream, or sesame brittle?

YES or NO

Yesterday, did you eat any of the following foods of animal origin:

Eggs or egg rolls?

YES or NO

Wara from milk, or dairy cheese?

YES or NO

Yogurt, nono, or fura de nono?

YES or NO

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Sausages, hot dogs, corned beef, kilishi, pepperoni, luncheon meat, ham, or bacon?

YES or NO

Hamburger, lamb, venison, cow meat, ram meat, goat meat, or any organs from

these animals?

YES or NO

Pig meat, rabbit, dog meat, or bush meat?

YES or NO

Chicken, turkey, guinea fowl, quail, duck, or pigeon?

YES or NO

Fish, canned fish, crab, prawn, shrimp, tunafish, or seafood?

YES or NO

Other foods:

Groundnuts, melon seeds, ogbono, breadfruit seeds, walnuts, cashews, peanut

butter, almond butter, peanuts, almonds, pecans, or pistachios?

YES or NO

Packaged potato chips such as Pringles, packaged plantain chips, cheetos, Doritos,

Fritos, or Pringles?

YES or NO

Instant noodles such as Indomie or Chikki, ramen noodle soup or other instant

soups?

YES or NO

Fried plantain, fried sweet potato, fried yam, akara, egg roll, samosa or spring rolls,

fried fish, fried meat, french fries, onion rings, fried chicken, chicken nuggets, fish

sticks, fish fry, or fried shrimp?

YES or NO

beverages:

Milk, including dairy milk on cereal or in lattes?

YES or NO

Fruit juice, fruit-flavored drinks, lemonade, sweet tea, tea with sugar, coffee with

sugar, 3- in-1, choco drink, Milo or Bournvita?

YES or NO

Fruit juice, fruit flavoured drinks, zobo, or kunu?

YES or NO

Soft drinks such as Coca-Cola, Fanta, Sprite, or chapman, malt drinks, or energy

drinks such as Red Bull, Pepsi, or Dr Pepper, sports drinks?

YES or NO

Yesterday, did you get food from any place like…

Yesterday, did you get food from places that serve meat pie, chicken pie, pizza or

burgers, McDonald’s, Burger King, Subway or equivalents?

YES or NO

SECTION 4: PERCEIVED STRESS SCALE

INSTRUCTIONS: The questions in this scale ask you about your feelings and thoughts during the last

month. In each case, please indicate your response by placing an “X” over the circle representing HOW

OFTEN you felt or thought a certain way.

Items

Never Almost Never Sometimes Fairly Often Very

Often

1. In the last month, how often have you been

upset because of something that happened

unexpectedly?

2. In the last month, how often have you felt

that you were unable to control the important

things in your life?

3. In the last month, how often have you

felt nervous and “stressed”?

4. In the last month, how often have you felt

confident about your ability to handle your

personal problems?

5. In the last month, how often have you felt

that things were going your way?

INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)

ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XI Issue IV April 2024

Page 678

www.rsisinternational.org

6. In the last month, how often have you found

that you could not cope with all the things that you

had to do?

7. In the last month, how often have you been

able to control irritations in your life?

8. In the last month, how often have you felt

that you were on top of things?

9. In the last month, how often have you

been angered because of things that were

outside your control?

10. In the last month, how often have you felt

difficulties were piling up so high that you could

not overcome them?

Thank you so much for participating. Your responses to this survey are invaluable and they would definitely

contribute to the information gap in nutrition and behaviour at large.

APPENDIX III: ANALYSIS

Tests of Normality

Kolmogorov-Smirnov

Shapiro-Wilk

Statistic

Sig.

Statistic

Sig.

FGDS total

.315

.000

.624

.000

Food adequacy total score

.538

.000

.155

.000

GDR

.194

.001

.886

.001

FGDS2

.143

.054

.928

.020

Food Group Adequacy

.311

.000

.775

.000

Global Dietary Recommendations (GDR) score

.113

.200

.974

.520

NCD Protect

.256

.000

.756

.000

NCD Risk

.269

.000

.728

.000

NCD Protect

.159

.019

.950

.099

NCDRISK2

.218

.000

.815

.000

Sum PSS

.093

.200

.972

.454

*. This is a lower bound of the true significance.

a. Lilliefors Significance Correction

Ranks

Mean Rank

Sum of Ranks

FGDS2 – FGDS total

Negative Ranks

16.90

524.00

Positive Ranks

4.00

Ties

Total

Food Group Adequacy – Food adequacy total score

Negative Ranks

9.50

171.00

Positive Ranks

.00

Ties

Total

INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)

ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XI Issue IV April 2024

Page 679

www.rsisinternational.org

Global Dietary Recommendations (GDR) score – GDR

Negative Ranks

18.27

365.50

Positive Ranks

15.04

195.50

Ties

Total

NCD Protect – NCD Protect

Negative Ranks

17.71

549.00

Positive Ranks

6.00

12.00

Ties

Total

NCDRISK2 – NCD Risk

Negative Ranks

15.52

326.00

Positive Ranks

5.00

25.00

Ties

Total

a. FGDS2 < FGDS total

b. FGDS2 > FGDS total

c. FGDS2 = FGDS total

d. Food Group Adequacy < Food adequacy total score

e. Food Group Adequacy > Food adequacy total score

f. Food Group Adequacy = Food adequacy total score

g. Global Dietary Recommendations (GDR) score < GDR

h. Global Dietary Recommendations (GDR) score > GDR

i. Global Dietary Recommendations (GDR) score = GDR

j. NCD Protect < NCD Protect

k. NCD Protect > NCD Protect

l. NCD Protect = NCD Protect

m. NCDRISK2 < NCD Risk

n. NCDRISK2 > NCD Risk

o. NCDRISK2 = NCD Risk