Adequate Dietary Diversity Versus Suboptimal Diet Quality: The Paradox of Food Insecurity Among International Students in Hungary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Ethical Considerations
2.3. Instruments and Measures
2.3.1. Sociodemographic Questionnaire
2.3.2. Anthropometric Measurements
2.3.3. Food Frequency Questionnaire (FFQ)
- FGDS: Calculated by summing the number of food groups consumed over seven days across 12 groups (cereals and grains; roots and tubers; legumes; dairy products; meat and poultry; fish and seafood; eggs; fruits; vegetables; fats and oils; sweets and snacks; sugar-sweetened beverages) [29].
- FVS: Total number of individual food items consumed, reflecting diversity within and across food groups [30].
- Food group diversity categories: Classification of individuals based on the number of distinct food groups consumed over seven days.
- Low/Medium/High dietary diversity (LDD/MDD/HDD): Consumption of 0–3, 4–6, and ≥7 food groups, respectively, over seven days [31].
- Low/Medium/High food variety (LFV/MFV/HFV): Consumption of 0–33, 34–67, and 68–101 distinct food items, respectively, over seven days.
2.3.4. Food Insecurity Experience Scale (FIES)
- Never (1);
- Rarely (2);
- Sometimes (3);
- Often (4).
2.4. Data Analysis
3. Results
3.1. Participant Characteristics
3.2. Prevalence of Food Insecurity and Dietary Diversity Among Participants
3.3. Distribution of Dietary Diversity Scores Among Participants
| Variable | Median (IQR) | 25th Percentile (Q1) | 50th Percentile (Median) | 75th Percentile (Q3) | Min. | Max. |
|---|---|---|---|---|---|---|
| FGDS | 11.0 (10.0–12.0) | 10.0 | 11.0 | 12.0 | 9 | 12 |
| FVS | 53.0 (37.0–78.8) | 37.0 | 53.0 | 78.8 | 25 | 97 |
3.4. Food Access and Dietary Practices Among Participants
| Variable | Category | n | % |
|---|---|---|---|
| Monthly food expenditure (€) | €50–€105 | 193 | 51 |
| €130–€210 | 175 | 46 | |
| ≥€235 | 12 | 3 | |
| Primary food source | Discount supermarkets | 142 | 37 |
| Mainstream supermarkets | 208 | 55 | |
| Local/ethnic shops | 22 | 6 | |
| Online/other sources | 8 | 2 | |
| Shopping frequency (groceries/month) | 1 time | 25 | 7 |
| 2–3 times | 120 | 32 | |
| 4–5 times | 192 | 51 | |
| >5 times | 43 | 11 | |
| Eating out frequency (per month) | 0 | 8 | 2 |
| 1–2 | 123 | 32 | |
| 3–4 | 143 | 38 | |
| ≥5 | 103 | 27 | |
| Food preparation | Always prepare own food | 237 | 62 |
| Do not always prepare own food | 143 | 38 | |
| Skipping meals | Yes | 229 | 60 |
| No | 151 | 40 |
3.5. Association Between Food Security Status and Sociodemographic and Behavioural Characteristics
3.6. Differences in Dietary Diversity Scores Across Food Security Levels
3.7. Association Between Food Insecurity and Dietary Diversity After Adjusting for Confounders
4. Discussion
4.1. Food Insecurity and Its Determinants
4.2. Dietary Diversity and Variety Patterns
4.3. Socioeconomic and Behavioural Predictors of Dietary Diversity
5. Public Health and Policy Implications
6. Strengths and Limitations
7. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
| ANOVA | Analysis of Variance |
| DD | Dietary Diversity |
| DDS | Dietary Diversity Score |
| FAO | Food and Agriculture Organization |
| FFQ | Food Frequency Questionnaire |
| FGDS | Food Group Diversity Score |
| FIES | Food Insecurity Experience Scale |
| FSS | Food security status |
| FVS | Food Variety Score |
| IQR | Interquartile range |
| KMO | Kaiser–Meyer–Olkin |
| VIF | Variance Inflation Factor |
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| Variables | Category | n | % |
|---|---|---|---|
| Gender | Male | 193 | 51 |
| Female | 187 | 49 | |
| Age | 18–25 | 207 | 55 |
| 26–30 | 129 | 34 | |
| >30 | 44 | 12 | |
| Race | African/African American | 222 | 58 |
| Asian | 100 | 26 | |
| Spanish/Hispanic | 8 | 2 | |
| White/Caucasian | 50 | 13 | |
| Regional distribution in Hungary | Central Hungary | 137 | 36 |
| Northern Hungary | 39 | 10 | |
| Northern Great Plain | 145 | 38 | |
| Southern Transdanubia | 28 | 7 | |
| Southern Great Plain | 31 | 8 | |
| Accommodation | Renting alone | 100 | 26 |
| Shared housing (free) | 20 | 5 | |
| Shared housing (paid) | 169 | 45 | |
| University dormitory | 91 | 24 | |
| Scholarship status | Not on scholarship | 170 | 45 |
| Scholarship recipient | 210 | 55 | |
| Level of study | Postgraduate | 180 | 48 |
| Undergraduate | 200 | 53 | |
| Employment status | Employed, full-time | 17 | 5 |
| Self-employed | 8 | 2 | |
| Student, unemployed | 269 | 71 | |
| Working part-time | 86 | 23 | |
| Monthly income (€) | ≤€265 | 77 | 20 |
| €290–€400 | 92 | 24 | |
| €425–€530 | 114 | 30 | |
| €555–€795 | 72 | 19 | |
| >€795 | 25 | 7 |
| Variables | Category | n | % |
|---|---|---|---|
| Food security status | Food secure (FIES 0–3) | 144 | 38 |
| Moderately food insecure (FIES 4–6) | 117 | 31 | |
| Severely food insecure (FIES 7–8) | 119 | 31 | |
| Food group diversity | High Dietary Diversity (≥7 food groups) | 367 | 97 |
| Medium Dietary Diversity (4–6 food groups) | 13 | 3 | |
| Food variety categories | High Food Variety (68–101 items) | 117 | 31 |
| Medium Food Variety (34–67 items) | 190 | 50 | |
| Low Food Variety (0–33 items) | 73 | 19 |
| Variable | χ2 (df, n) | p-Value | Cramer’s V |
|---|---|---|---|
| Gender | χ2(2, 380) = 5.40 | 0.067 | 0.12 |
| Scholarship | χ2(2, 380) = 6.12 | 0.047 | 0.13 |
| Employment | χ2(8, 380) = 7.05 | 0.531 | 0.10 |
| Meal Skipping | χ2(2, 380) = 314.87 | <0.001 | 0.91 |
| Dependent Variable | Food Secure (n = 144) | Moderately Food Insecure (n = 117) | Severely Food Insecure (n = 119) | F(2,377) | p-Value |
|---|---|---|---|---|---|
| FGDS | 11.2 ± 1.1 | 10.7 ± 1.1 | 10.9 ± 1.2 | 5.18 | 0.006 |
| FVS | 58.7 ± 22.9 | 55.0 ± 23.4 | 56.3 ± 23.7 | 0.89 | 0.411 |
| Model 1: Adjusted for Sociodemographic, Behavioural and Economic Variables | ||||
|---|---|---|---|---|
| Predictor Variable | FGDS (β) | p-Value | FVS (β) | p-Value |
| Food security status | 0.01 | 0.267 | 0.08 | 0.361 |
| Monthly income | 0.17 | 0.001 | 0.06 | 0.280 |
| Monthly food expenditure | –0.05 | 0.342 | −0.02 | 0.671 |
| Age group | 0.09 | 0.098 | 0.05 | 0.297 |
| Gender | 0.01 | 0.914 | 0.00 | 0.952 |
| Scholarship status | 0.14 | 0.006 | 0.28 | <0.001 |
| Employment status | 0.10 | 0.063 | 0.20 | <0.001 |
| Meal-skipping | –0.26 | 0.004 | −0.19 | 0.033 |
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Mposula, Z.; Pacza, T.; Szepesi, J.; Wagaki, M.M.; Máthé, E. Adequate Dietary Diversity Versus Suboptimal Diet Quality: The Paradox of Food Insecurity Among International Students in Hungary. Nutrients 2026, 18, 946. https://doi.org/10.3390/nu18060946
Mposula Z, Pacza T, Szepesi J, Wagaki MM, Máthé E. Adequate Dietary Diversity Versus Suboptimal Diet Quality: The Paradox of Food Insecurity Among International Students in Hungary. Nutrients. 2026; 18(6):946. https://doi.org/10.3390/nu18060946
Chicago/Turabian StyleMposula, Zibuyile, Tünde Pacza, Judit Szepesi, Morris Mbuthia Wagaki, and Endre Máthé. 2026. "Adequate Dietary Diversity Versus Suboptimal Diet Quality: The Paradox of Food Insecurity Among International Students in Hungary" Nutrients 18, no. 6: 946. https://doi.org/10.3390/nu18060946
APA StyleMposula, Z., Pacza, T., Szepesi, J., Wagaki, M. M., & Máthé, E. (2026). Adequate Dietary Diversity Versus Suboptimal Diet Quality: The Paradox of Food Insecurity Among International Students in Hungary. Nutrients, 18(6), 946. https://doi.org/10.3390/nu18060946

