A Systematic Literature Review of Interventions Aimed to Improve Dietary Intake and/or Nutrition Knowledge in Higher Education Students

Background: The importance of a healthy balanced diet throughout life is well-established. The transition to higher education has been associated with poor dietary behaviors. This systematic review aimed to provide the most recent literature on nutrition interventions, focused on improving nutrition education and/or dietary intake in higher education students to help inform future implementation. Methods: A systematic search was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) guidelines. All studies included an outcome measuring dietary intake and/or nutrition knowledge, were in the English language and published from 2000-2022. Studies were excluded if only qualitative results were reported, weight was the only outcome, or the sample was not solely students. All studies were screened and rated for risk of bias independently by two authors following Cochrane guidelines on quality assessment. Any discrepancies were resolved through discussion with the third author. Results: Fifty-five studies from thirteen countries, with 14,979 participants met eligibility criteria. Many were of moderate (n=25, 45.5%) or strong quality (n=21, 38.2%). Most reported at least one significant improvement in nutrition knowledge or dietary intake with several studies (n=52, 85.2%) having multiple significant outcomes. Among single interventions, point-of-purchase nutrition information and color-coded indicators in canteens positively influenced dietary intake and awareness of eating a healthful diet. Most studies were educational interventions (n=42, 76.4%) and improved nutrition knowledge and/or dietary intake (n=39, 92.9%). Conclusion: Third level students are at risk of developing unhealthy dietary behaviours but respond positively to nutrition education and dietary interventions that (i) are underpinned by a theoretical foundation, (ii) are interactive and delivered online, (iii) provide information aimed at improving nutrition knowledge and dietary intake at point-of-purchase settings in higher education environments.