# Changes in Dietary Patterns and Environmental Footprints Among University Students: A Retrospective Study

## TL;DR

University students are increasingly adopting unhealthy and unsustainable diets, which raises risks of obesity and environmental harm, highlighting the need for institutional changes.

## Contribution

This study provides longitudinal evidence of declining adherence to sustainable dietary patterns and their environmental and health impacts among university students.

## Key findings

- Over 16 years, students shifted toward less sustainable diets with increased animal-based food consumption and proinflammatory eating habits.
- Adherence to Mediterranean and Planetary Health Diets declined, correlating with rising overweight and obesity rates.
- Dietary changes led to higher water and ecological footprints, with only fruits, vegetables, whole grains, and fish showing reduced carbon footprints.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Students’ shared environments, limited options, and lifestyle constraints lead to unhealthy, unsustainable diets that raise obesity and chronic disease risks.Rising dietary environmental footprints contribute to climate-related public health challenges.

Students’ shared environments, limited options, and lifestyle constraints lead to unhealthy, unsustainable diets that raise obesity and chronic disease risks.

Rising dietary environmental footprints contribute to climate-related public health challenges.

Public health significance—Why is this work of significance to public health?
Long-term data show a nutrition transition of declining adherence to health-promoting, sustainable dietary patterns among university students.A syndemic relationship between unhealthy diets and environmental decline underscores urgent integrated public health and sustainability approaches.

Long-term data show a nutrition transition of declining adherence to health-promoting, sustainable dietary patterns among university students.

A syndemic relationship between unhealthy diets and environmental decline underscores urgent integrated public health and sustainability approaches.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Universities should improve food environments, affordability, and accessibility to support healthy, sustainable choices of students.Aligning nutrition and sustainability goals and promoting nutrition literacy to make effective behavioral change, guiding future research and institutional planning are needed.

Universities should improve food environments, affordability, and accessibility to support healthy, sustainable choices of students.

Aligning nutrition and sustainability goals and promoting nutrition literacy to make effective behavioral change, guiding future research and institutional planning are needed.

Background: University students are often exposed to environments that encourage unhealthy eating, but universities can promote better health and sustainability by making sustainable food options more accessible. Methods: Temporal changes in dietary patterns and environmental footprints of 1684 students at the University of Rijeka, Croatia, over a 16-year period (2009–2025) were retrospectively analyzed using data from 3 cross-sectional studies. Results: A significant transition toward less sustainable diets, increased consumption of animal-based foods, and proinflammatory eating habits was observed (both p < 0.001). Adherence to the Mediterranean and Planetary Health Diet declined over time (p < 0.001), followed by increased prevalence of overweight and obesity. Three dietary patterns were identified: high fruit and vegetable intake, consistently high milk and dairy consumption, and lower-to-moderate intake of all other food groups with temporal variation. Consumption of most food groups increased, leading to higher water and ecological footprints. Only the intake of fruits, vegetables, whole grains, and fish declined, which corresponded with reduced carbon footprints for these and a few other food groups, while the environmental impact of other foods significantly increased (all p < 0.001). Gender, diet quality, and a proinflammatory diet were significant predictors of dietary environmental footprints. Conclusions: The findings underscore the need for systemic changes and addressing barriers at the university level to support sustainable eating behaviors. This study offers valuable insights for policymakers, educators, and researchers, which aim to help students become health-conscious and environmentally responsible consumers. Further research is needed to explore the broader factors influencing dietary choices and the long-term impact of future institutional interventions.