Adherence to Recommended Food Group Intake and Associated Sociodemographic and Lifestyle Factors Among Undergraduate Students in Birgunj Nepal

The food we eat is more than just fuel; it is a daily conversation between our bodies and the world around us. For decades, scientists have known that the quality of this conversation matters deeply for our long-term health. When people consistently skip entire categories of food—like fruits, vegetables, or nuts—they increase their risk for serious conditions such as heart disease and diabetes later in life. This is not just about eating too much or too little, but about missing out on specific groups of foods that provide essential nutrients. In many parts of the world, especially where life is changing rapidly, young adults face a unique challenge. As they leave home for university, they gain independence but often lose the structure of family meals, finding themselves navigating a food environment filled with cheap, convenient options that may lack nutritional value. Understanding how these young people actually eat, and what helps or hinders them from eating a balanced diet, is crucial for building healthier communities.

In the bustling commercial city of Birgunj, Nepal, a team of researchers set out to listen to this conversation among undergraduate students. They were interested in a specific question: are these young adults eating from all five major food groups that experts recommend for a healthy diet? These groups include starchy staples like rice and bread, vegetables, fruits, pulses or nuts, and animal-source foods like meat or eggs. The researchers wanted to know not just what students ate, but who was managing to eat from every single group and who was missing out. They also looked at the lives of these students to see if factors like how much money their families had, whether they lived with their parents, or their habits like smoking and exercise played a role in their food choices.

To find the answers, the team visited three colleges in Birgunj between January and May 2025. They invited 380 undergraduate students to fill out a questionnaire about their lives and what they had eaten the day before. The students were between 18 and older, and the researchers made sure to exclude anyone who had a chronic illness that required a special diet, so the results would reflect the habits of typical young adults. The survey asked simple, direct questions: Did you eat a fruit yesterday? Did you have some beans or nuts? Did you eat meat or eggs? By counting how many of the five food groups each student touched, the researchers could determine if they were following the recommended pattern.

The results revealed a story of both consistency and gaps. Every single student reported eating starchy staples, which makes sense given that rice and bread are the foundation of meals in the region. Most also ate vegetables and foods from animals, with over 90 percent of students consuming animal-source foods and more than 86 percent eating vegetables. However, the picture changed when looking at fruits and pulses, nuts, or seeds. Only about two-thirds of the students ate fruit, and roughly three-quarters ate pulses or nuts. When the researchers added it all up, they found that fewer than half of the students—specifically 44.2 percent—had eaten from all five food groups in a single day. This means that for the majority of these young adults, their diet was missing at least one key piece of the nutritional puzzle.

The study then looked closely at the lives of the students to see what made the difference between those who ate a complete diet and those who did not. The findings pointed to three main factors that stood out. First, money mattered. Students whose families had higher monthly incomes were significantly more likely to eat from all five food groups compared to those from lower-income families. Second, where a student lived played a major role. Those who were living with their families were more than twice as likely to have a complete diet compared to those living on their own or with friends. This suggests that the shared resources and regular meal routines of a family home provide a safety net for better eating. Third, lifestyle habits were linked to food choices. Students who smoked or used tobacco were less likely to eat a complete diet, while those who engaged in moderate physical activity were much more likely to do so. Interestingly, the researchers found that gender, religion, the specific major a student was studying, or how much they slept did not significantly change the likelihood of eating a balanced diet.

These findings paint a clear picture of the challenges facing young adults in this part of Nepal. While the basic staples of their diet are secure, the more nutrient-dense foods like fresh fruit and nuts are often missing. The data suggests that this is not just a matter of personal willpower, but is deeply tied to economic resources and living situations. When students move away from home, they lose the structure that helps them eat well, and without extra money to buy a variety of foods, they may fall back on what is cheapest and most convenient. The link between smoking and poor diet, as well as the connection between exercise and good eating, hints that healthy habits often travel together; when one slips, the others may follow.

The researchers noted that their study had limits. Because they asked students to remember what they ate the day before, the answers might not be perfect, and the study design means they cannot prove that one thing causes another. They also focused on students in one city, so the results might look different in other parts of Nepal. However, the patterns they found are strong enough to suggest that helping young adults eat better requires more than just telling them what to eat. It may require making healthy foods more affordable, supporting students who live away from home, and creating programs that encourage healthy habits as a whole package. For the students in Birgunj, and perhaps for many others in similar situations, the path to a healthier diet seems to be paved with family support, financial stability, and a lifestyle that values movement and avoids tobacco.