This study was conducted to determine the changes in the FI risk status and dietary habits of international students receiving education in Türkiye during the COVID-19 pandemic. It was found that, during the COVID-19 pandemic, the frequency of FI increased among the participants, and they rated their economic status, the share of their monthly income allocated for food, and their self-assessed FS status as worse.
University students are more prone to FI than is the general population [17], and it was stated that the COVID-19 pandemic worsened FI among university students even further [18]. The percentages of university students whose FS status worsened after the onset of the COVID-19 pandemic were 22.6% according to Mialki et al. [9], 20% according to Soldavini et al. [19], and 15.1% according to Hagedorn et al. [20]. In this study, it was found that the COVID-19 period resulted in newly developing FI among 6.5% of the participants. Although this rate in our study appeared to be lower than that reported in other studies conducted during the same period, it is believed that this result was associated with the already very low levels of FS among most participants before COVID-19.
The number of international students at higher education institutions continues to increase worldwide, and this population faces different challenges in terms of healthy eating in environments to which they are not used. It was reported that international students were two to three times more likely to experience FI than their peers were [8]. The significant impact of the COVID-19 pandemic on the accessibility of food worldwide [21] has made FI even worse for international students [22, 23]. This is because FI in high-risk groups may be affected disproportionately by crises such as COVID-19 [7]. Similarly, Mihrshahi et al. [22] showed that, as in the period before the COVID-19 pandemic, international students had a greater rate of experiencing FI than their domestic counterparts. Similarly, Shi et al. [23] reported that international students were two times more likely to experience FI during the COVID-19 pandemic. In this study, the FI rate among the participants increased significantly during the COVID-19 period from 74.7–81.2% (Table 1). Additionally, compared to those in the prepandemic period, the participants in the pandemic period reported that their economic status, share of their income allocated for food, and FS status worsened (p < 0.01) (Table 3). As mentioned above, one of the important issues here is that the rate of FI among international students was already high before the COVID-19 pandemic. Nevertheless, two different studies carried out in Türkiye revealed that domestic university students also had high rates of FI (35.5% [24] and 68.2% [25]). Türkiye is a developing country, and the high inflation in general and inflation in food prices in recent years may have led to problems in terms of access to food and, therefore, FI [25]. International students are more likely to experience FI because they pay more tuition than domestic students are; they have less access to student loans and other financial aid offered by states and universities; their employment opportunities are restricted; they have limited access to the foods they are used to in their culture; and they may have difficulties preparing food commonly consumed in their destination country [8, 26]. In addition to these problems, because dormitories on campuses were shut down due to COVID-19 and because eating and food shopping facilities on campuses were limited in the second half of the 2020 Spring semester, the pandemic had an unprecedented impact on university students. Many students returned to their families after campuses were shut down, but some international students were unable to return to their home countries due to travel restrictions [27]. It is thought that all these problems may have resulted in the worsening of FI among international students in Türkiye.
The prevalence of FI in university students may vary depending on various factors, such as demographic characteristics (e.g., gender, ethnic origin), class year, place of residence (e.g., apartment vs. dormitory), and economic factors (e.g., financial aid, employment opportunities, income) [28]. In this study, the prevalence of FI in participants from Africa (87.3%) was significantly greater than that in those from Asia (77.4%) and Europe (54.6%) (p < 0.05). The reason for this difference may be that the majority of the participants were international students from Asian (53.9%) or African (43.7%) countries, and the low socioeconomic status of African countries may have contributed to the high rate of FI among the African participants. Similarly, in a study conducted with university students in South Africa, 60% of students experienced FI “in addition to hunger”, whereas 26% experienced FI “but did not experience hunger” [29]. The results of our study showed that the prevalence of FS among participants whose fathers were university graduates (22.7%) was greater than that among participants whose fathers were primary school graduates (12.2%) (p < 0.05), suggesting that the socioeconomic status of the family may be an important indicator of the FI status of international students.
Students who do not have FS frequently have to purchase less expensive and less healthy foods [30]. Several studies have demonstrated that students without FS consume fruits, vegetables, and whole grains less, and they consume more sugar-added drinks, saturated fats, and salt [8, 24, 31]. In this study, it was also determined that the healthy dietary habits of the participants who experienced FI during the COVID-19 pandemic and their habits of consuming red meat, chicken, or fish; milk and dairy products; vegetables; fruits; legumes; cereals; and dried nuts decreased more than did their habits among those with FS (p < 0.01). This suggested that the quality of the diet of students experiencing FI also decreases. In a study in Australia, it was shown that students with FI had significantly lower Diet Quality Index scores than did those with FS (p = 0.027) [32].
Limitations
This study is the first study in Türkiye to investigate food insecurity among international students, and it has several limitations. First, as the decision to participate in the study may have reflected bias associated with the characteristics of the university students who agreed to participate in the study, there may have been self-selection bias to some extent. This was a cross-sectional study, and the results do not indicate a causal relationship where the prevalence of FI observed in the sample was explained solely as a consequence of the COVID-19 pandemic. The questionnaire included questions that required the participants to remember their FI status in the last 12 months and other pieces of information pertaining to the pre-COVID-19 period and the COVID-19 period. The participants may have experienced recall bias while answering these questions.