A Cross-Sectional Study on Association between Dietary Habits and Mental Health Status among College Students in Field Practice Area of Osmania Medical College, Hyderabad, Telangana

Diet is an integral determinant of both physical and mental health. Irregular eating patterns, high consumption of fast food, economic constraints, psychological stress, and emotional eating can adversely affect the health status of individuals. Excessive intake of meat has also been associated with behavioural changes. The prevalence of mental health disorders in India has risen steadily in recent years, and these conditions now constitute a major public health burden.

Globally, the prevalence of depression stands at 48.9%, anxiety at 39.65%, and stress at 45%. In India, the prevalence of depression is reported to be 59.8%, anxiety 32%, and stress 83%. There is increasing mental distress and anxiety among students as they transition into college life, a period characterised by academic pressure, social adjustments, and changing dietary patterns. Despite this growing concern, limited data exist on the relationship between dietary habits and mental health in the Indian college-going population.

The present study was therefore undertaken to assess dietary habits and mental health status, and to determine the association between dietary intake and mental health outcomes, among degree college students in the urban field practice area of Osmania Medical College, Hyderabad.

Table 1: Sociodemographic Characteristics of Study Participants (n = 403)

3.1 Sociodemographic Profile

A total of 403 students participated in the study. The majority were male (70.0%). The largest age group was 20–22 years (49.1%), followed by 17–19 years (47.4%). Engineering students formed the largest stream (28.0%), followed by others (34.8%), medical (22.1%), and law (15.1%). The majority (46.2%) were in their 2nd year of study. Approximately 42.9% were hostel residents.

3.2 Dietary Habits and Lifestyle Characteristics

The majority of participants (72.7%) were non-vegetarians. Among non-vegetarians, chicken was the most commonly consumed meat (71.7%), followed by egg (65.0%), fish (47.4%), seafood (30.0%), and mutton (24.8%). With regard to BMI, 26.5% were underweight, 56.0% were in the normal range, 13.1% were overweight, and 4.7% were obese. Food cravings were reported by 59.1% of participants, and 50.3% reported frequent consumption of fast foods. Most participants (86.6%) used pocket money to purchase fast food; 13.4% concealed the expenditure from parents. Smoking and alcohol consumption were reported by 5.0% and 7.7% of participants, respectively.

Table 2: Dietary Habits, BMI, and Lifestyle Variables (n = 403)

3.3 Mental Health Status (DASS-21)

Mental health was assessed using the DASS-21 scale. Overall, 46.9% of participants had some degree of depression (above normal range), 47.1% had some degree of anxiety, and 45.9% had some degree of stress. In terms of severity, extremely severe depression was observed in 9.2%, extremely severe anxiety in 8.4%, and extremely severe stress in 4.7%. Moderate and severe levels of all three domains were also substantially prevalent. Prevalence of depression, anxiety, and stress was higher among females compared to males. A significant association was found between stress and gender (p <0.05) as well as between stress and food cravings (p <0.05).

Table 3: Mental Health Status Based on DASS-21 Severity Classification (n = 403)

The present study examined the association between dietary habits and mental health status among college students in Hyderabad, Telangana. A cross-sectional design with systematic random sampling and the validated DASS-21 instrument was employed to ensure reliable data. The predominance of non-vegetarian dietary patterns (72.7%) in our sample reflects the broader dietary culture of Telangana and is consistent with published data from similar urban south Indian populations. Chicken was the most commonly consumed meat, followed by eggs and fish. The high rate of food cravings (59.1%) in our study was markedly higher than the 36% reported by a comparable study from Tamil Nadu (2021), suggesting potentially higher dietary impulsivity or greater fast-food availability in the current study area. Approximately half of participants (50.3%) reported frequent consumption of fast food, which aligns with global trends of increasing reliance on processed and convenience foods among young adults.

The overall prevalence of any depression (46.9%), anxiety (47.1%), and stress (45.9%) found in our study is consistent with, though somewhat lower than, national estimates (depression 59.8%, stress 83%). These figures nonetheless indicate a substantial mental health burden among the college student population. The observation that females reported higher levels of depression, anxiety, and stress than males is consistent with a large body of literature, likely reflecting psychosocial vulnerabilities including societal expectations, academic pressure, and interpersonal stressors that disproportionately affect young women. A significant association between stress and food cravings is a notable finding. Food cravings, particularly for high-calorie and high-fat foods, are known to be exacerbated by stress through hypothalamic-pituitary-adrenal (HPA) axis activation and dopaminergic reward pathways. This creates a potential vicious cycle wherein stress drives unhealthy dietary choices, which in turn may worsen mental health outcomes. The significant association between stress and gender further corroborates the differential mental health burden observed across sexes in the college-going population. The high proportion of underweight students (26.5%) alongside prevalent food cravings and fast food consumption points to a paradoxical nutritional profile – one characterised by inadequate macro- and micronutrient intake co-existing with excessive consumption of energy-dense, nutrient-poor foods. This dual nutritional challenge is emerging as a critical concern in Indian urban youth populations.

Limitations of this study include its cross-sectional design, which precludes causal inference; reliance on self-reported data, which may be subject to recall bias; and the restriction to degree colleges in a single urban field practice area, which may limit generalisability. Future longitudinal studies in diverse populations, including rural settings and different educational levels, are warranted.

The majority of the study population followed a non-vegetarian diet, with chicken being the most commonly consumed meat. The prevalence of depression, anxiety, and stress, as assessed by the DASS-21, was approximately 47%, 47%, and 46% respectively, indicating a high mental health burden among college students. Females demonstrated a consistently higher prevalence across all three mental health domains. A statistically significant association was found between stress and both gender and food cravings, highlighting the interplay between dietary behaviour and psychological well-being.

1.       Jacka FN, Mykletun A, Berk M. Moving towards a population health approach to the primary prevention of common mental disorders. BMC Med. 2012;10:149.

2.       Rao TSS, Asha MR, Ramesh BN, Rao KSJ. Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008;50(2):77-82.

3.       Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of Depression in the Community from 30 Countries between 1994 and 2014. Sci Rep. 2018;8(1):2861.

4.       Poobalan AS, Aucott LS, Clarke A, Smith WCS. Diet behaviour among young people in transition to adulthood (18-25 year olds): a mixed method study. Health Psychol Behav Med. 2014;2(1):909-928.

5.       Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scales. 2nd ed. Sydney: Psychology Foundation; 1995.

6.       Negi P, Garg S, Bhatt R. Prevalence of Anxiety and Depression among Medical Students of a Private Medical College. J Med Sci Clin Res. 2019;7(2):346-350.

7.       Singh S, Misra N. Depression in women: An updated review. Indian J Psychiatry. 2023;65(2):140-147.

8.       Evers C, Stok FM, De Ridder DTD. Feeding your feelings: Emotion regulation strategies and emotional eating. Pers Soc Psychol Bull. 2010;36(6):792-804.