Association of Dietary Skipping and Screen Time with Academic Stress among College-Going Girls: A Cross-Sectional Study at MGM University, Chhatrapati Sambhajinagar

Introduction

Nutrition is a key component of health and well-being, and is essential for growth, development, disease prevention and quality of life. Adequate nutrition in adolescence and early adulthood is particularly important, as this stage is marked by rapid physical, psychological, and social changes that influence health behaviors for the rest of life (World Health Organization (WHO), 2023). College going girls are a vulnerable population group as they experience increased independence in food choices, academic responsibilities and lifestyle modifications. Nutritional knowledge is an individual's knowledge about the relationship between food, nutrients and health. It influences food choices and promotes the development of healthy eating habits. Studies have shown that people with higher nutrition knowledge are more likely to make healthier food choices and maintain better dietary practices (Spronk et al., 2014) [10] . However, knowledge alone does not always lead to healthy behavior, as food choices are also influenced by personal preferences, convenience, cost, peer influence, and environmental factors (Contento, 2008) [2] . In recent years, due to rapid urbanization, globalization and changing life styles, the dietary patterns of young adults have undergone significant changes.

The traditional diet, which is rich in fruits, vegetables, whole grains, and home-cooked foods, is being swapped for processed foods, fast foods, and sugar sweetened drinks. Such changes in diet have led to increasing cases of obesity, nutritional deficiencies and lifestyle diseases in younger age groups. Meal skipping, erratic eating patterns, low intake of fruits and vegetables, and regular consumption of junk foods are commonly observed in the dietary habits of college students (Nelson et al., 2008) [6] . Breakfast skipping is especially common among students, and has been linked to decreased concentration, lower academic achievement and poor nutritional status. Many students have basic nutrition awareness but don't follow healthy eating habits consistently. Things like physical activity, sleep patterns, screen time, stress these lifestyle factors play a big role in health outcomes as well. With the increased use of smartphones, computers, and social media, college students have become more sedentary and less physically active (Pearson & Biddle, 2011) [7] . Moreover, academic pressure, examinations, and personal challenges create stress, which can negatively influence dietary habits and health (Deb et al., 2015) [3] . Anthropometric measurements (height, weight, Body Mass Index (BMI)) are widely used to evaluate the nutritional status. Recent evidence points to adolescents and young adults suffering from undernutrition and overnutrition concurrently, leading to a dual burden of malnutrition (Black et al., 2013) [1] . Nutritional problems like anaemia, poor dietary intake, overweight and obesity are still prevalent among young women in India and are a significant public health problem (Ministry of Health and Family Welfare, 2021) [5] . Therefore, assessment of nutrition knowledge, dietary practices, lifestyle patterns and nutritional status among college going girls is imperative to identify the existing gaps and to devise effective interventions. Awareness of nutrition and its actual practices can help educational institutions and health professionals develop targeted programs that promote healthier lifestyles and improve the general well-being of young women.

Materials and Methods

The study was a descriptive cross-sectional research design to assess the existing dietary habits, screen time behavior and academic stress among college-going girls at a particular point of time. This design enabled the exploration of relations between these variables without intervention or manipulation. The study was conducted at MGM University, Chhatrapati Sambhajinagar, Maharashtra and the target population was college going female students of different undergraduate and post graduate courses. There were 153 participants in all in the study. Participants were selected by using convenience sampling technique as it was practical and appropriate in university setting. This approach allowed for efficient data collection from readily available respondents and provided valuable insight into the nutritional and lifestyle patterns of the study population.

Data Collection Tool: Data was collected using a structured self-administered questionnaire which was specially adapted to the objectives of the study. The tool was pre-tested in a pilot study to validate clarity, reliability and content validity. The questionnaire consisted of the following core sections:

Anthropometric Measurements (Nutritional Status)

Physical indicators were measured directly to calculate the Body Mass Index (BMI) of each participant to objectively evaluate their nutritional status:

• Height: Measured in centimetres (cm) using a standard measuring tape with the participants standing fully upright, barefoot, against a flat vertical surface. • Weight: Measured in kilograms (kg) using a calibrated weighing scale with participants wearing light clothing and no footwear. • Body Mass Index (BMI): BMI was calculated using the internationally accepted formula:

Participants were categorized according to the World Health Organization (WHO) BMI Classification standards:

• Normal Range: 18.5 -24.9

Data Collection Procedure

Before the study, Formal permission taken by University authorities and guide for data collection. Participants were informed about the study's objectives and academic purpose. All respondents gave informed consent, in the sense that participation was voluntary. The structured questionnaires were completed individually by the students and their physical weight and height were immediately measured and recorded. Responses were anonymous and confidential.

Data Analysis

The collected raw data were systematically organized, coded, and analyzed using basic statistical methods.

Frequency distributions and percentage analyses were implemented to evaluate the prevalence rates of dietary skipping, screen dependency levels, and academic stress patterns. The finalized metrics were tabulated and graphically illustrated using charts to visually establish clear associations between the target variables.

Results

Distribution of Demographic Variables

The baseline characteristics of the study population (N = 153) provide contextual insight into the socio-economic and environmental background of the students. Table 1 presents the demographic characteristics of the 153 participants in the study. The age distribution shows that the age group with the highest number of respondents was 19-20 years, with 50 (32.5%) participants. This was followed by the participants aged 23 years and above 37 respondents (24.5%). The age group of 21-22 years contained 36 participants (23.2%) and the least age group was 17-18 years with 30 participants (19.9%). These findings suggest that the study sample was predominantly young adults of 19 and 20 years of age. Regarding family structure, most of the respondents belonged to nuclear families. Out of the total participants, 97 (63.4%) were from nuclear families, whereas 56 (36.6%) were from joint families. This implies that nuclear family arrangements were more common within the study population. Geographically, the majority of the respondents were residents of urban areas. 98 participants (64.1%) were reported to live in urban areas and 55 participants (35.9%) were from rural areas. This is due to the higher proportion of urban dwellers in the study sample.

The analysis of monthly family income revealed that the highest proportion of participants belonged to families earning between ₹20,000 and ₹50,000 per month, accounting for 48 respondents (31.8%). This was followed by families with an income range of ₹50,000-₹1,00,000, represented by 43 participants (28.5%). Participants from families earning above ₹1,00,000 per month constituted 35 respondents (23.2%), while those with a monthly family income below ₹20,000 accounted for 25 participants (16.6%). These findings indicate that a considerable proportion of the study population belonged to middleincome households. Overall, the study participants were young adults aged 19-20 years, belonging to urban areas, from nuclear families and mostly from middle-income households.

Nutrition Knowledge Assessment: This section measures the theoretical awareness and conceptual understanding of nutrition principles among the participants (N = 153). Table 2 shows participants' responses to the nutrition knowledge questionnaire. The results showed that the majority of respondents had a good understanding of basic nutrition concepts. For the idea of balanced diet, 116 participants (75.8%) correctly identified balanced diet as having all nutrients in the right amounts while smaller proportions chose only carbohydrates (13.7%), only protein foods (9.2%) or only fruits and vegetables (11.1%). that a balanced diet contains all nutrients in proper amounts, while smaller proportions selected only carbohydrates (13.7%), only protein foods (9.2%), or only fruits and vegetables (11.1%). 79 participants (51.6%) correctly identified carbohydrates as the main energy giving nutrient when asked what the main source of energy was. However a significant percentage of respondents (50.3%) incorrectly selected protein, indicating some confusion as to the role of macronutrients. Knowledge of protein rich foods was relatively good with 111 (73.0%) correctly identifying pulses as a rich source of protein. Conversely, rice (19.7%), sugar (6.6%) and butter (7.2%) were selected by fewer respondents. With regard to micronutrient deficiencies, 99 (65.6%) participants correctly indicated that iron deficiency can cause anemia, although fewer people indicated that it can be caused by hypertension (20.5%), diabetes (13.2%), or obesity (6.0%). High awareness was noticed about the nutrients that are important for the bone health. Most participants (82.4%) correctly identified calcium as important for strong bones, whereas a minority chose iron (11.8%), sodium (8.5%) or potassium (3.9%). Likewise, 124 respondents (81.0%) correctly identified green leafy vegetables as a good source of iron, showing good awareness of dietary sources of this important mineral. Regarding meal patterns, 96 (62.7%) participants viewed breakfast as the most important meal of the day. However, 22.2 % considered it the least important meal. This highlights the need for improved nutrition education in relation to healthy eating. Knowledge of hydration was moderate and 96 participants (62.7%) correctly identified that adequate water intake helps digestion, hydration and removal of toxins. The other respondents chose only one of these benefits. The awareness level about the health consequences of junk food consumption was relatively high, with 113 participants (73.9%) correctly identifying that excessive junk food consumption may cause obesity, poor nutrition, and other health problems. Finally, 123 participants (80.4%) correctly stated fruits and vegetables should be consumed daily, indicating good knowledge of the recommended dietary practices. The results in general indicate that the majority of the participants had good nutrition knowledge, especially in the domains of balanced diet, protein sources, bone health, iron-rich foods, healthy eating habits, and importance of fruits and vegetables. However, some misconceptions persisted, particularly regarding the primary source of dietary energy and the significance of breakfast, suggesting that more nutrition education may be beneficial.

Dietary Habits and Skipping Practices

This section highlights the daily behavioral eating habits, dietary choices, and skipping patterns reported by the students.

Screen Time and Lifestyle Factors

This section documents sleep schedules, physical fitness behavior, screen use habits, and distracted eating trends. More than half (55.6%) of the participants reported eating food while watching television or using mobile devices, compared to only 25.2% who did not engage in this behavior. Overall the results show moderate sleep duration, irregular physical activity, high screen time, frequent stress and high prevalence of distracted eating among the participants.

Objective Nutritional Status (Anthropometric Data)

This section details the objective physical health profiles derived directly from physical height and weight measurements. The anthropometric distribution reveals a distinct dual burden of malnutrition inside the university. While 54.9% register a healthy normal BMI, nearly a quarter of the young women (24.2%) are clinically underweight often exacerbated by routine meal skipping while 20.9% are concurrently overweight or obese, driven by sedentary screen hours and highly accessible convenience foods.

The Knowledge Practice Gap: This section highlights the statistical conflict where academic nutrition literacy completely fails to convert into safe behavioral practices. A profound behavioral gap is evident: 85.6% of students state that they understand nutrition knowledge is supposed to guide healthy food choices. However, 57.9% explicitly admit to regularly consuming junk foods anyway. This demonstrates that theoretical awareness is frequently overridden by factors like academic workloads, time constraints, high screen time distraction, and structural university stress.

Discussion

The findings of the present study revealed that although a majority of participants possessed adequate nutrition knowledge (85.6%), unhealthy dietary practices remained prevalent. This observation supports the findings of Spronk, Kullen, Burdon, and O'Connor (2014) [10] , who reported that nutrition knowledge does not always translate into healthy dietary behavior. Similarly, Contento (2008) [2] emphasized that food choices are influenced by multiple factors beyond knowledge, including convenience, social influences, and environmental conditions. The substantial proportion of participants (57.9%) who consumed junk food despite being aware of its harmful effects highlights this knowledgepractice gap. Meal skipping was highly prevalent among the participants, with 59.2% reporting regular meal omission and breakfast being the most frequently skipped meal (74.0%). These findings are consistent with studies by Nelson, Story, Larson, Neumark-Sztainer, and Lytle (2008) and Pengpid and Peltzer (2021) [6,8] , who reported breakfast skipping as a common behavior among university students. Furthermore, Deshmukh-Taskar, Nicklas, O'Neil, Keast, Radcliffe, and Cho (2010) found that breakfast skipping is associated with poor nutrient intake and adverse health outcomes.

A large proportion of students (81.7%) reported experiencing academic or personal stress. Similar findings were reported by Deb, Strodl, and Sun (2015) [3] , who identified academic stress as a significant concern among Indian students. Yau and Potenza (2013) [12] further explained that stress can negatively influence eating behaviors, leading to irregular meal patterns and unhealthy food choices. The coexistence of high stress levels and meal skipping in the present study supports these observations. The study also demonstrated substantial screen exposure, with over one-third of participants spending more than four hours daily on screens and 55.6% engaging in distracted eating while using digital devices. These findings are in agreement with Pearson and Biddle (2011) [7] , who reported that prolonged sedentary behavior and screen time are associated with poorer dietary quality and unhealthy eating habits. Rosen, Carrier, and Cheever (2013) [9] similarly noted that excessive digital media use may adversely affect behavioral regulation and daily lifestyle practices. Anthropometric assessment revealed a dual burden of malnutrition, with 24.2% of participants being underweight and 20.9% classified as overweight or obese. These findings support the observations of Black et al. (2013) [1] , who highlighted the coexistence of undernutrition and overnutrition among adolescents and young adults in developing countries. Similar concerns have been reported in the National Family Health Survey (Ministry of Health and Family Welfare, 2021) [5] , which documented persistent nutritional challenges among young Indian women. Overall, the present findings indicate that nutrition knowledge alone is insufficient to ensure healthy dietary behavior. Consistent with the observations of Story, Neumark-Sztainer, and French (2002) [11] , dietary practices are shaped by a complex interaction of individual, social, environmental, and lifestyle factors.

Therefore, comprehensive interventions focusing on nutrition education, stress management, physical activity promotion, and digital wellness are necessary to improve the health and well-being of college-going girls.

Conclusion

The present study showed a significant association between dietary habits, screen exposure and academic stress among college going girls at MGM University. Although most of the participants had adequate nutrition knowledge, a substantial knowledge-practice gap was observed. Although they knew the negative health effects, many students still consumed junk foods and unhealthy eating behaviors. Skipping meals was a prominent concern, with over 50% of participants regularly skipping meals, particularly breakfast. High levels of academic and personal stress were also common and seemed to be related to irregular eating patterns. Additionally, the respondents reported a lot of prolonged screen exposure and distracted eating while using mobile devices or watching television, indicating the increasing influence of digital lifestyles on health behaviors. Anthropometric assessment revealed evidence of a double burden of malnutrition with large proportions of the participants being underweight as well as overweight or obese. These findings show that both undernutrition and overnutrition are important nutritional problems among the college-going girls. Overall, the study highlights that nutrition knowledge alone is insufficient to ensure healthy lifestyle practices. Effective interventions should focus on translating knowledge into behavior through practical nutrition education, stress management programs, promotion of regular physical activity, reduction of excessive screen time, and the creation of supportive campus environments that encourage healthy food choices. Such measures are essential for improving the nutritional status, physical health, and psychological wellbeing of college-going girls.

Acknowledgement

AcknowledgmentsThe authors express their sincere gratitude to the Department of Community Science, School of Basic and Applied Sciences, MGM University, Chhatrapati Sambhajinagar, for providing the necessary academic support and facilities to conduct this study. The authors are thankful to all study participants for their valuable cooperation and willingness to participate in the research. Appreciation is also extended to colleagues and field assistants who provided assistance during data collection and compilation of the study data.

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