There is an increase in the interest in food consumption and, by extension; eating behaviors in the last few years, and in today’s modern environment, more people are aware of their eating behaviors [1]. This move to more healthy eating makes sense as it has been scientifically proven that many serious or even life-threatening disorders are related to unhealthy eating. Coronary heart disease, diabetes, and obesity are clearly related to the quality of eating behavior [2]. Yet, often, food choices are worsening as time passes. In many developed countries, there is a decrease in fruit and vegetable consumption [3]. Also, there is an increase in soft drink consumption [4]. As these harmful behaviors continue throughout the years, there is a paradox of contradictory actions in human behavior; nutritionists and health specialists warn and advise about the consequences of such behavior, whereas people do not seem to follow. Therefore, this is an important issue that needs to be thoroughly explored. Eating behavior is important as it determines health; for an individual to be healthy all it takes is to follow a healthy diet and lifestyle. However, as simple as it may sound, maintaining a healthy diet involves complex behaviour and is not only driven by personal dietary needs but also by several factors such as socio-economic, cultural and psychological ones [5]. Eating behaviour is developed throughout a person’s lifespan and it starts to form during childhood and usually becomes more stable during adulthood. Thus, acquired eating behaviour has a long-term effect upon the health of the individual [6]. Eating behaviors and food preferences are multi-determined. Food, as an essential prerequisite for life provides energy along with organic and inorganic substances to maintain body functions [7]. The normal regulation of food intake is primarily hunger and satiety which is regulated mainly by the hypothalamic centers. In addition, knowledge, deriving from education, has a significant impact on the food choices and health status of some people [8]. Furthermore, food choices are affected mainly by culture and religion and individual likes and dislikes. These apply to all groups and categories of people across the globe [9].

Aim

The aim of this discussion paper is to identify the main factors that influence food choices made by tertiary education students and critically elaborate on their circumstances in relation to food, health, and knowledge.

A systematic, critical appraisal of the literature was undertaken via: Medline, Scopus, Google scholar, Cochrane Library and Cinahl by use of combinations of the following key words: diet, eating habits, food choices and students, within the past two decades, i.e., 2000-2020.

The initial search revealed 365 studies which after abstract perusal were reduced to 63. These were then scrutinized for purpose, content, level of evidence and clinical significance. Hence, five key domains were identified as most relevant in both primary nursing importance and student food choices (Figure 1). Thus, primary nursing interventions focusing on different aspects of consulting young students regarding healthy eating are presented under five main categories covering both functional and behavioral states, i.e., Nutritional Knowledge, Eating Attitudes, Biological and genetic factors, social factors, Physical and personal factors. 

Figure 1: Flow chart of systematic search and resulting domains.

Nutritional Knowledge

Healthy eating behaviour is the key to leading a healthy life (National Obesity Observatory, 2011)[10]. For example, a longitudinal study of Laszlo et al. (2015) where school students were followed for two years revealed that students who engaged in healthy eating behaviours had better health-related quality of life [11]. Another study, investigating the association between healthy diet and health outcomes of Russian older adults, highlighted the fact that healthy eating behaviour in combination with exercise, are significant factors for improving health [12], [13]. The World Health Organisation (2015) points out that a healthy diet can prevent chronic diseases such as, diabetes, cancer, cardiovascular diseases, and obesity [14]. In addition, this was also reported that specific dietary changes could decrease the incidence of chronic disease. Even though it is widely known now that healthy eating could help prevent many diseases, international reports, show that the leading causes of death worldwide are related to both unhealthy behaviour and poor eating habits [15-17].

Eating Attitudes

Eating attitudes can affect personal food choices; therefore, they can influence the eating behaviour. Eating attitudes could be defined as the beliefs and the feelings about eating, whereas eating behaviour is a pattern of eating and the two terms should not be confused [18]. For students to adopt a healthy eating behaviour, providing information and knowledge is not enough as it is necessary to form positive eating attitudes towards healthy eating patterns) [19]. Therefore, students who have positive attitudes to healthy eating and foods that are healthy are more likely to adopt a healthy behaviour [20]. The study of Kontochristou et al. (2012), on university students, revealed that students were more likely to eat junk food as it is more appealing to them [21]. Another study on 1,800 university students, conducted by the Centre for Research, Technological Development, and Innovation (KETAK-2013), regarding their eating attitudes, showed that students preferred their food to be tasty (39%) and cheap (36%) rather than healthy and of good quality (7%) [22]. This eating attitude was reflected on eating behaviour, as 87% reported drinking soft drinks (containing artificial sweeteners) and 58% were eating junk food every day. Although eating attitudes and behaviour is an interesting topic, there are not many studies conducted specifically on student population. Most of the studies on university students and the association between eating attitudes and behaviours were focused on eating disorders (anorexia and bulimia).

Biological and Genetic Factors

Eating behaviour can be influenced by biological factors that cannot be controlled by the individual, such as gender, age, hunger, and satiety [23]. Biological and physiological needs of humans provide the essential determinants of food choice, as human body requires energy and nourishing substances to survive [24]. More specifically, age seems to influence eating behaviour. Thus, nutritional needs and therefore eating behaviours can change or increase as people get older and variant nutrients are important at different stages of life [25-26]. This is happening because of changes that occur in the body and because the process of aging affects the absorbance of nutrients. Therefore, infants need as many nutrients as possible, children’s nutrition should emphasize on whole foods, but calorie needs reduce once a child reaches the age of four until adulthood. A study conducted by Sepulveda et al. (2010) on university students, found that older students had more balanced diets and higher self-esteem than younger students [27]. Another study by Michaelsen et al., (2009) found that first year students consumed more junk food and high sugared desserts than senior students [28]. Furthermore, eating behaviour is different between genders as the study of Mead (2009) reveals; the study showed that male students ate more meals per day than female students [29]. In addition, female students were consuming less water than male students. Hunger and satiety are important factors that influence eating behaviour, as they are affected by the consistency of food that has been consumed, the metabolism of blood glucose and hormones such as insulin. Moreover, hunger and satiety are the outcome of a complicated physiological set of actions, where the sensation of hunger occurs and stimulates the need for food [30], [31]. The result of eating to quell hunger is satiation, that is, satisfaction of the appetite, and the whole process is controlled by the central nervous system. The amount of food consumed is an indication of satiety. However, it is a very common problem that many people are not aware what the right amount of food that should be consumed to satisfy their appetite or they do not control it; therefore overconsumption occurs [32-33]. This may result in many adverse health issues, like overweight and obesity that can lead to more serious health problems such as type-2 diabetes or heart disease.

Psychological Factors

A key factor which can greatly affect the eating habits is the psychological aspect. A relevant study revealed that when people feel stressed, they end up consuming larger quantities of food than what their body really needed [34-35]. Anxiety, for example, is characterized by the dominance of negative thoughts and fears about future events. Intense stressful situations, such as university exams, including the before mentioned psychological dimensions are likely to trigger changes in eating behaviour e.g., before an examination or before getting the results [36-37]. On the other hand, there is the idea that perfectionism may be accompanied by intense stress and the desire of having a certain body image, like being thin and in good shape which can also occur in neutral and non-stressful situations [38-39]. However, the same is not true when it comes to the role of parental expectations, where the desire of being liked and accepted is a prominent stressful situation that can lead to alteration of eating behaviour [40]. Moreover, questions arise about the role of emotions regarding personal eating attitudes and behaviours, as these may be greatly influenced by personal emotions. The choice of food, the quantity and frequency of meals may be related to the psychological state of individuals and how they feel about their daily food intake [41]. Emotions such as anxiety, anger, pleasure and depression can affect the behaviour people display towards food. Several surveys showed that higher consumption of food appeared with emotions such as boredom, depression, anger, and pleasure, whereas with feelings of fear and sadness food consumption was reduced. Regarding anger, researchers noticed that many people who are in a state of anger increase the speed they eat without paying attention to the quality of food they consume while people who felt pleasure and joy ate food because they liked the flavour or because it was part of a healthy diet [42].   Many nutritional problems are observed during student life, as this population group, with high nutrient needs due to increased intellectual challenges in combination with intense stress, tend not to eat properly. Many of these nutritional problems are the result of a transition from family life, and by extension from a familial meal preparation to a not well-organized student environment [43]. The lack of home-cooked meals and the hours that students spend studying, can create a fitful eating behaviour that consists of sporadic meals during the day, lack of fruit and vegetables and increased consumption of junk food. Research in the United States, has shown that 58% of female students felt pressure to be a certain weight, and 83% were on a diet to lose weight [44].  More studies investigating the eating behaviour of students indicate that students under stress are more prone to develop a nutrition problem [45-47]. However, many students think that eating behaviour during periods of stress could be affected in both ways, as some students have the inclination to eat more healthily and decide not to eat junk food, in contrast with students who tend to consume junk food in periods of high stress. On the other hand, it is known that food, nutrition and body experiences all have emotional implications. There are some foods that are believed to offer stress relief, therefore many students tend to eat foods that consist of high carbohydrates and fats when they undergo a lot of stress, in order to soothe themselves from sentiments of displeasure and achieve higher levels of exhilaration. Some aspects of university life may be experienced in an emotionally negative manner. Hence, students may attempt to manage negatively charged situations and relieve themselves from discomfort, such as a fear of failing, by following strategies which are harmful for their health, such as binge eating and drinking. Regarding eating behaviours in particular, students tend to consume more ‘comfort’ food, as it positively affects their mental and physical states. But poor eating behaviours can have a negative impact on their academic performance, as good quality food sustains optimum brain function [48].

Social Factors

Eating behaviour is affected, either positively or negatively, by the society in which a person lives. An individual may be influenced by members or groups of people within a society with regard to food choice and eating behaviour [49]. Social factors interact with cultural and economic factors, therefore, socio-cultural and socio-economic factors should be co-examined as they play a major part on eating behaviours. Eating attitudes and behaviours are also influenced by conscious and unconscious forces which originate from memories of early childhood or from interactions with others, but most cannot be recalled. Therefore, social factors of food choice and nutrition could be direct or indirect. A study conducted by Groth et al. (2001), showed that lower social class groups consumed more added fats than higher social class groups [50]. As mentioned above, the formation and determination of the eating behaviour of an individual, is strongly influenced by the interaction with other people within different groups that he is involved, such as family, school or university, work and friends. Based on a past longitudinal study of adults' social networks, it was indicated that eating behaviour and being overweight or underweight, derives from social interactions [51]. Nevertheless, concrete evidence is missing, concerning influences between social networks and eating behaviour, that could prove if there is an actual causation and not only an association, between these variables. In addition, food is a symbol of sociability and social acceptance and can be used by individuals to initiate and maintain social relationships and interactions. In this light, inviting friends and relatives for dinner, is a way of creating a closer relationship with them or sustaining an existing one.

Physical and Personal Factors

While some eating-related factors mentioned earlier are essential for people to survive and that eating behaviours derive from ‘social drives or psychological mood, food choices are also majorly influenced by personal factors that could be controlled by the individual [52]. These factors are time, accessibility, availability, and skills. Lack of time, is widely mentioned, mostly among young adults and well-educated adults, as a block to eating healthily. Restricted eating time is mostly because food preparation in relation to a busy schedule is characteristic of our modern times. A study by Ismawati et al., (2014) revealed that people with busy lifestyle reported that they did not have the time to prepare and eat healthy food and ended up making convenience and time saving choices such as eating out or eating junk, fast food and ready meals [53]. Although, buying take away food and ready meals is more expensive than cooking with basic ingredients, people are disposed to pay more as it is more convenient. On the other hand, some ready meals or fast foods can be nutritious and of good quality and their consumption can improve nutritional quality of a diet. In addition, food preparation is also translated as a stress factor because people every day are trying to balance between different aspects of their life and busy schedules which equal struggling with time, family, and work. However, a study by Pelletier and Laska (2012) showed that many professionals retain a balanced lifestyle and healthy eating behaviour whilst having a full-time working schedule [54]. In addition, accessibility and availability of healthy foods is essential for maintaining healthy eating behaviours. As it has been stated before, low-income individuals face the difficulty of accessing the necessary foods to maintain a healthy diet. But cost is not the only factor that makes products inaccessible to people [55]. Accessibility to stores selling food products, such as farmers markets or supermarkets, is a basic factor that influences eating behaviour and might depend on transport or the place of residence [56]. The study of Pan et al. (2000), found that Asian students studying in the United States used to import food from their countries, whenever they visited, or bought products from local Asian stores, if possible [57]. On the other hand, the possibility of a wide range of options might not improve fruit and vegetable consumption but might increase junk food consumption as they could be widely available. Moreover, food literacy is not useful without practical cooking skills and lack of cooking skills can affect food choices as people without food preparation skills tend to either choose foods that require a small amount of preparation or food already cooked, such as ready prepared food [58]. What is more, a study conducted by Chenhall (2010) revealed a link between cooking skills and health and suggested interventions aiming to instruct and develop cooking skills in order to promote healthy eating [59]. More than ever before, ready meals and junk food have infested societies but by knowing how to cook, the individual can become more independent concerning food choice. However, knowing how to cook does not mean that it is going to be put into practice, as other factors may play part in ultimately determining this, such as a lack of cooking facilities.

Nowadays, where many diseases are linked to imbalanced eating habits and even becoming epidemic, food labels could bring more power in the hands of the consumer. Food labels that include nutritional information, list of ingredients and additives of each product can make an important contribution to building healthier dietary behaviours towards disease prevention and over all lifestyle change. Furthermore, food labels, intend to guide the consumer carefully in order to consciously choose products based on nutritional value. This information is presented in a table on the packaging of a product which is legible and theoretically enables consumers to make an informed choice. A recent study by Cooke & Papadaki, (2014) indicated that nutrition related knowledge and attitudes were positively associated with those who used food labels but this showed found a weak association between knowledge and attitudes [60]. In the United States, currently facing high rates of obesity and type II diabetes, the Food and Drug Administration (FDA) has developed sophisticated food labelling systems. A review of European studies on food labels reported that although consumers understand the labels, they still think they need to be improved [61]. Given this information it can be concluded that there is a great need for development of nutritional food labelling systems based on the needs of the consumer. In particular, the Food Standards Agency (FSA) in England, introduced the 'Traffic Lights System' which is based on a standard classification of nutrients and uses red, amber and green to mark foods with respectively high or low levels of undesirable ingredients such as salt and saturated fat [62]. This system has proven to be effective for groups such as children, elderly and people with lower educational level and as study revealed, 61.6% of the sample, used this system while shopping [63]. However, another study reported that it took too much time to comprehend some labels. Nevertheless, there are several studies highlight that many products do not provide the enough information and deliberately omit specific details of concern to health. In this context, the FDA found many products that provided false nutritional values and reported misleading claims, such as falsely assuring that a product can fortify the immune system [64].

Eating behaviour is important as it determines health. However, as simple as it may sound, maintaining a healthy diet involves complex behaviour. This discussion paper clearly demonstrates that there are many factors which influence food attitudes and choices of students. Some of these include nutritional knowledge, eating attitudes, biological and genetic factors, psychological and social factors, plus physical and personal factors. Availability and price also are of importance, so too the understanding and use of food labels. It is suggested that students should have freshman classes in ways to maintain health through a conscious choice of or healthful foods and drinks.

1. Brindal E. Exploring Fast Food Consumption Behaviours and Social Influence:Adelaide: University of Adelaide. 2010.
2. World Health Organization (WHO). 2019; 301-311.
3. Boeing H, Bechthold A, Bub A, Ellinger S, Haller D, Kroke A. The Role of Fruit and Vegetable Consumption in Human Health and Disease Prevention. European Journal of Nutrition. 2013; 51:637-663.
4. Pantopoulos G. Findings of an eaitng habits study on students. 2019.
5. Bagordo F, Grassi T, Serio F, Idolo A, De Donno A. Dietary habits and health among university students living at or away from home in southern Italy. Journal of Food and Nutrition Research. 2013; 52:164-171.
6. Casey B, Getz S, Galvan A. The Adolescent Brain. Developmental Review. 2008; 28:62-77.
7. Swaminathan M, Bhavani R. Food production & availability--essential prerequisites for sustainable food security. The Indian Journal of Medical Research. 2013; l38: 383-391.
8. Devaux M, Sassi F, Church J, Cecchini M, Borgonovi F. Exploring the Relationship Between Education and Obesity. OECD Journal: Economic Studies. 2009;1:121-159.
9. Dindyal S, Dindyal S. How Personal Factors, Including Culture And Ethnicity, Affect The Choices And Selection Of Food We Make. The Internet Journal of Third World Medicine. 2003; 1: 43-52.
10. National Obesity Observatory. Public Health England.
11. Laszlo B, Piko B, Steger M. A reason to stay healthy: The role of meaning in life in relation to physical activity and healthy eating among adolescents. Journal of Health Psychology. 2015; 20: 473-482.
12. Ashton L, Hutchesson M, Rollo M, Morgan P, Collins C. Motivators and Barriers to Engaging in Healthy Eating and Physical Activity: A Cross-Sectional Survey in Young Adult Men. Am. J. Men’s Health. 2017;11:330-343.
13. Selivanova A. The relationship between healthy behaviors and health outcomes among older adults in Russia. BMC Public Health. 2014;14:1183.
14. World Health Organisation (WHO) WHO Preparing a health care workforce for the 21st century: the challenge of chronic conditions. Geneva: World Health Organization Publications.
15. Amore L, Buchthal  O, Banna J. Identifying Perceived Barriers and Enablers of Healthy Eating in College Students in Hawai'i: A Qualitative Study Using Focus Groups. BMC Nutr. 2019;2:16-21.
16. Sogari G, Velez-Argumedo C, Gómez M, Mora C. College Students and Eating Habits: A Study Using An Ecological Model for Healthy Behavior. Nutrients. 2018;10:1823-1829.
17. Hilger-Kolb J, Loerbroks A, Diehl K. Eating behaviour of university students in Germany: Dietary intake, barriers to healthy eating and changes in eating behaviour since the time of matriculation. Appetite. 2017;109:100-107.
18. Alvarenga M, Scagliusi F, Philippi S. Comparison of eating attitudes among university students from the five Brazilian regions. Ciência & Saúde Coletiva. 2012;17: 435-444.
19. Brug J. Determinants of healthy eating: motivation, abilities and environmental opportunities. Family Practice. 2008; 2:50-55.
20. Kalogiros S, Kolovelonis A. The effect of a health education program on eating attitudes and perceptions of primary school students. Epistimoniko Vima. 2007; 3:116-124.
21. Kontochristou A, Malasioti K, Papadopoulou K. The alimentary habits of students of department of nutrition and dietics in TEI of Crete (1st ed.). 2012.
22. Centre for Research, Technological Development and Innovation. 2019.
23. Gibson-Moore H. Satiation, satiety and their effects on eating behaviour. Nutrition Bulletin. 2009; 34:412-416.
24. Lewis M. Understanding Nutrition. Journal of Nutrition Education and Behavior. 2014; 46: 88-94.
25. Schultchen D, Reichenberger J, Mittl T. Bidirectional relationship of stress and affect with physical activity and healthy eating. Br J Health Psychol. 2019; 24: 315-333.
26. Dovey T. Eating behaviour (1st ed.). Maidenhead: McGraw-Hill/Open University Press. 2010.
27. Michaelsen K, Hoppe C, Roos N, Kaestel P, Stougaard M, Lauritzen L. Choice of foods and ingredients for moderately maln ourished children 6 months to 5 years of age. Food and Nutrition Bulletin. 2009; 30: S343-S404.
28. Sepulveda A, Carrobles J, Gandarillas A. Associated Factors of Unhealthy Eating Patterns among Spanish University Students by Gender. The Spanish Journal of Psychology. 2010; 13: 364-375.
29. Mead A. Gender Differences in Food Selections of Students at a Historically Black College and University (HBCU). College Student Journal. 2009; 43:800-806.
30. Anderson L, Reilly E, Schaumberg K, Dmochowski S, Anderson D. Contributions of mindful eating, intuitive eating, and restraint to BMI, disordered eating, and meal consumption in college students. Eat Weight Disord. 2016;21:83-90.
31. Pouliou E. Comparison of dietary habits between college students in first and seventh Semester at TEI in Sitia (1st ed.).:Sitia: TEI of Crete. 2012.
32. Lee C, Liao L, Lai I, Chang L. Effects of a healthy-eater self-schema and nutrition literacy on healthy-eating behaviors among Taiwanese college students. Health Promot Int. 2019;34:269-276.
33. Sørensen L, Møller P, Flint A, Martens M, Raben A. Effect of sensory perception of foods on appetite and food intake: a review of studies on humans. International Journal of Obesity. 2003;27:1152-1166.
34. Kabir A, Miah S, Islam A. Factors influencing eating behavior and dietary intake among resident students in a public university in Bangladesh: A qualitative study. PLoS One. 2018;18:e0198801.
35. Lattimore P,Casswell N. Differential effects of active and passive stress on food intake in restrained and unrestrained eaters. 2004;42:167-173.
36. Parra-Fernández M, Rodríguez-Cano T, Onieva-Zafra M. Prevalence of orthorexia nervosa in university students and its relationship with psychopathological aspects of eating behaviour disorders. BMC Psychiatry. 2018; 18:364-369.
37. Lyon B. Stress, Coping and Health: A conceptual overview. In V. H. Rice Ed, Handbook of Stress, Coping, and Health: Implications for Nursing Research, Theory, and Practice Portland: Ringgold Inc. 2012. 588.
38. Hilger-Kolb J, Diehl K. 'Oh God, I Have to Eat Something, But Where Can I Get Something Quickly?'-A Qualitative Interview Study on Barriers to Healthy Eating among University Students in Germany. Nutrients. 2019;11:2440
39. De Berardis D, Pizzorno A, Cotellessa C, Salerno R, Ferro F, Serroni N. Alexithymia and Its relationships with dissociative experiences, body dissatisfaction and eating disturbances in a non-clinical female sample. Cognitive Therapy and Research. 2009;33:471-479.
40. Leme A, Philippi S, Silva É. Association of Brazilian Adolescents with Healthy Eating: Knowledge, Perceptions and Food Choices. Food and Nutrition Sciences. 2011;2:1036-1042.
41. Canetti L, Bachar E, Berry E. Food and emotion. Behavioural Processes. 202;60:157-164.
42. Lang S. Mood-food connection: We eat more and less-healthy comfort foods when we feel down, study finds.:Cornell Chronicle. 2007.
43. Blichfeldt B, Gram M. Lost in Transition? Student food consumption. Higher Education. 2013; 65: 277-289.
44. Malinauskas B, Raedeke T, Aeby V, Smith J, Dallas M. Dieting practices, weight perceptions, and body composition: A comparison of normal weight, overweight, and obese college females. Nutrition Journal. 2006; 5: 55-62.
45. Dhillon J, Diaz Rios L, Aldaz K. We Don't Have a Lot of Healthy Options: Food Environment Perceptions of First-Year, Minority College Students Attending a Food Desert Campus. Nutrients. 2019;11:816-821.
46. Banna J, Gilliland B, Keefe M, Zheng D. Cross-cultural comparison of perspectives on healthy eating among Chinese and American undergraduate students. BMC Public Health. 2016;16:1015-1021.
47. Brown O, O’Connor L, Savaiano D. Mobile MyPlate: A pilot study using text messaging to provide nutrition education and promote better dietary choices in college students. J Am Coll Health. 2017;62:320-327.
48. Deliens T, Clarys P, De Bourdeaudhuij I, Deforche B. Determinants of eating behaviour in university students: a qualitative study using focus group discussions. BMC Public Health. 2014;14:53-59.
49. Contento I. Nutrition Education: Linking Research, Theory, and Practice (2nd ed.).:Sudbury: Jones & Bartlett. 2011.
50. Groth M, Fagt S, Brøndsted L. Social determinants of dietary habits in Denmark. European Journal of Clinical Nutrition. 2001;55:959-966.
51. Christakis N, Fowler J. The Spread of Obesity in a Large Social Network over 32 Years. The New England Journal of Medicine. 2007; 357:370-379.
52. Counihan C, Van Esterik P. Food and culture: a reader (2nd ed.).:Routledge. 2008.
53. Ismawati S, Zainalabidin M, Golnaz R. Healthy Eating: The Preventive Factors among Malaysians. Journal of Economics, Business and Management. 2014;2:257-261.
54. Pelletier J, Laska M. Balancing Healthy Meals and Busy Lives: Associations between Work, School, and Family Responsibilities and Perceived Time Constraints among Young Adults. Journal of Nutrition Education and Behavior. 2012;44:481-489.
55. Lunau T, Bambra C, Eikemo T, van der Wel K, Dragano N. A balancing act? Work–life balance, health and well-being in European welfare states. European Journal of Public Health. 2014;24:422-427.
56. Block D, Kouba J. A comparison of the availability and affordability of a market basket in two communities in the Chicago area. Public Health Nutrition. 2006; 9: 837-845.
57. Pan Y, Dixon Z, Himburg S, Huffman F. Changes in food neophobia and dietary habits of international students. Journal of the American Dietetic Association. 2000;2:301-311.
58. Ternier S. Understanding and measuring cooking skills and knowledge as factors influencing convenience food purchases and consumption. SURG: Studies by Undergraduate Researchers at Guelph. 2010;3:21-29.
59. Chenhall C. Improving Cooking and Food Preparation Skills: A Synthesis of the Evidence to Inform Program and Policy Development: Her Majesty the Queen in Right of Canada. 2010
60. Cooke R, Papadaki A. Nutrition label use mediates the positive relationship between nutrition knowledge and attitudes towards healthy eating with dietary quality among university students in the UK. 2014;83:297-303.
61. Grunert K, Wills, J. A review of European research on consumer response to nutrition information on food labels. Journal of Public Health. 2007; 15:385-399.
62. Méjean C, MacOuillard P, Péneau S, Hercberg S, Castetbon K. Perception of front-of-pack labels according to social characteristics, nutritional knowledge and food purchasing habits. Public Health Nutrition. 2013;16:392-402.
63. Ollberding N, Wolf R, Contento I. Food label use and its relation to dietary intake among US adults. Journal of the American Dietetic Association. 2020;111: S47-S51.
64. Silverglade B, Ringel Heller I. Food Labeling Chaos. The Case for Reform.;Washington, DC: Center for Science in the Public Interest. 2010.