Food Security, Academic Performance and Physical Well‑Being of Rural University Students in Limpopo Province, South Africa

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Methods: A cross-sectional study was conducted among 319 students aged 18–25 years residing in both on-campus and accredited off-campus residences. Stratified random sampling was used to select participants. Data were collected using a researcher-administered questionnaire comprising sections on socio-demographics, food security, academic performance, and physical well-being. Food security was assessed using the Household Food Insecurity Access Scale (HFIAS). Descriptive statistics summarised the data, and Spearman’s rank correlation was used to examine associations between variables. Results: The Household Food Insecurity Access Scale classified 59.6% of students as food secure, 33.2% as mildly food insecure, 6.3% as moderately food insecure, and 0.9% as severely food insecure. Although 72.7% of students reported being physically healthy, only 31.2% felt energetic throughout the day, and 33.2% reported obtaining sufficient sleep. Academic motivation was high (84.3%), though 49.1% reported feeling overwhelmed by their workload. Food security demonstrated weak positive correlations with self-reported academic performance (ρ = 0.180, p 0.05). Physical well-being showed moderate positive correlations with self-reported academic performance (ρ = 0.429, p < 0.01) and module grades (ρ = 0.338, p < 0.05). Conclusions: Mild and moderate food insecurity were prevalent among students, while severe hunger was uncommon. Physical well-being demonstrated stronger associations with academic outcomes than food security alone. Interventions that address nutritional adequacy, sleep quality, and student health services may enhance academic success in rural university settings. These findings suggest that universities should consider combining food support with health and wellness programmes to better support students, especially in settings with limited resources. Food security Academic performance Physical well-being University students South Africa Figures Figure 1 1. Introduction Food insecurity is by far the most significant public health concern, which affects an increasing number of people globally. As a result, it leads to poor nutritional status and nutrition-related diseases, such as obesity and hypertension, which consequently limit students’ ability to progress academically and physically (Willis et al. 2020 ; Loofbourrow & Scherr 2023 ). Academically, the consequences are detrimental, with evidence of delayed graduation, higher dropout rates, and increased stress levels amongst students in institutions of higher learning (Freudenberger et al. 2019). Food insecurity remains prevalent among university students globally and in South Africa. Recent studies report prevalence rates ranging between 30% and 60% in higher education institutions across sub-Saharan Africa (Wagner et al. 2024 ; Urmi et al. 2024 ; Mashabela 2023 ). In South Africa, evidence from rural and historically disadvantaged institutions indicates persistent moderate-to-severe food insecurity among students, particularly those dependent on financial aid (Mushaphi et al. 2021 ; Mtshweni 2022 ). Although national graduation and retention rates have improved over time, socio-economic disparities continue to undermine academic success, particularly in rural institutions (DHET 2023). These findings underscore the continued relevance of food insecurity as a structural barrier to educational attainment Food insecurity affects a notable proportion of students: 28.68% in Bangladesh and 35.7%-45% in Nigeria. (Urmi et al. 2024 ; Ukegbu et al. 2019 ). Nationally, evidence indicates a high prevalence of food insecurity among university students. A study conducted at the University of the Free State found that 65% of students were food-insecure (Van den Berg & Raubenheimer 2015 ). Similarly, research at the University of Limpopo found that 24% of students experienced moderate food insecurity, while 16% experienced severe food insecurity (Mashabela 2023 ). Food insecurity has been associated not only with academic challenges but also with compromised physical well-being, including reduced energy levels, sleep disturbances, and decreased participation in physical activity (Lemp et al. 2023 ; Loofbourrow & Scherr 2023 ). Nutritional inadequacy may impair immune function and cognitive performance, thereby influencing both health and academic engagement (Willis et al. 2020 ; Isoard et al. 2023 ). Students who face food insecurity often report lower levels of physical well-being, including decreased energy, restricted participation in physical activities, and disturbed sleep patterns (Lemp et al. 2023 ). In contrast, having consistent access to sufficient and nutritious food can enhance physical health by supporting optimal bodily functioning (Isoard et al. 2023 ). This study seeks to investigate food security, academic performance, and physical well-being among students at the rural-based University of Venda. Despite growing international evidence linking food insecurity to academic and health outcomes, limited research in South Africa has simultaneously examined food security, physical well-being, and academic performance within rural universities. Most local studies focus primarily on prevalence without investigating the integrated relationships between nutritional access, perceived health, and academic functioning. Rural institutions such as the University of Venda predominantly serve students from low-income and first-generation backgrounds, making contextualised evidence essential. This study, therefore, addresses a critical gap by examining the interrelationships among food security, physical well-being, and academic performance in a rural higher education setting. This study aligns directly with Sustainable Development Goal (SDG) 2: Zero Hunger, which aims to end hunger, achieve food security, improve nutrition, and promote sustainable well-being (United Nations 2023). While SDG 2 is often framed at national and agricultural levels, its relevance within higher education institutions is increasingly recognised. University students represent a vulnerable population whose nutritional insecurity can undermine academic achievement and long-term human capital development. By examining food security within a rural university context, this study contributes to SDG 2 by generating context-specific evidence that may inform institutional food support programmes and targeted policy interventions in South African higher education. Although this study was conducted in a rural South African university, the challenges of student food insecurity, financial strain, and health vulnerabilities are shared across many low- and middle-income countries. Understanding how food access and physical well-being relate to academic outcomes can therefore provide insights that inform student support policies in similar higher education settings globally. 2. Methods and Materials 2.1 Study Design and Setting. A cross-sectional study design was used to investigate the food security, academic performance, and physical well-being of students at a rural-based university. The University of Venda has both on-campus and off-campus accredited residences. The university has 12 on-campus residences accommodating 3,000–4,000 students, as well as 84 accredited off-campus residences that house approximately 6,450 students (University of Venda 2025 ). On campus, food outlets included tuck shops, small convenience stores, and a limited number of dining facilities that offered affordable meals. Off campus, students had access to street vendors, local spaza shops, supermarkets, and fast-food restaurants. Students aged 18–24 years who consented and were present on the day of data collection were included in the study. Data were collected by the researcher and field workers using a questionnaire from July to October 2025. The researcher and supervisor trained the research assistants in data collection procedures and methods 2 weeks before data collection. The appointment of the fieldworkers was based on their qualifications, which were needed for both the study and competent general practice. This study is reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. 2.2. Sample Size and Sample Technique, procedure A stratified random sampling design was used to select 319 students, and a simple random sampling was used to select eleven from eighty-four residents. The students were divided into three strata based on residence type: male on-campus residences, female on-campus residences, and mixed off-campus residences. Each stratum had a certain number of residences. The male on-campus stratum had four residences, the female on-campus stratum had six, and the mixed-residence strata also had their own defined numbers of residences. To select students within each stratum, the researcher obtained an official list of all rooms from the University of Venda Housing Department. Each room was assigned a random number to ensure impartiality in the selection process. The random selection was conducted using small pieces of paper bearing the room numbers, which were placed in separate containers for each stratum. A neutral individual, independent of the study, was asked to draw the papers randomly to identify the rooms and students to be included. The sample size was calculated using Slovin’s formula (n = N / (1 + Ne²)), based on a residence population of 10,215 students. Using a 5% margin of error, a minimum sample of 385 students was required. To account for potential non-response, an additional 10% was added, resulting in a target sample of 423 students. Of the 423 students approached, 319 completed the questionnaire in full, yielding a response rate of 75.4%. Only fully completed questionnaires were included in the final analysis. 2.3. Variables Measured Data were collected using a structured, researcher-administered questionnaire comprising four sections: socio-demographic characteristics, food security, academic performance, and physical well-being. Food security was assessed using the Household Food Insecurity Access Scale (HFIAS) developed by the Food and Nutrition Technical Assistance (FANTA) project (Coates et al. 2007 ; Ballard et al. 2011 ). The HFIAS consists of 9 occurrence questions, yielding a total score ranging from 0 to 27; higher scores indicate greater food insecurity. Respondents were categorised as food-secure, mildly food-insecure, moderately food-insecure, or severely food-insecure. For analysis, HFIAS total scores (0–27) were grouped into four categories (0–6, 7–13, 14–20, and 21–27). The HFIAS has been widely validated and used in diverse low- and middle-income settings to assess household food insecurity Academic performance was assessed using a structured self-report instrument developed based on previously validated academic engagement measures (Credé & Kuncel 2008 ; York et al. 2015 ). The tool included items assessing academic motivation, understanding of coursework, class participation, workload perception, and module grades. Items were measured using dichotomous (yes/no) and categorical response options. Physical well-being was measured using an adapted version of the Well-Being Scale (WeBS) developed by Lui and Fernando (2018). The scale included Likert-type items assessing perceived physical health, energy levels, sleep adequacy, physical activity, and physical functioning. Responses ranged from “strongly agree” to “strongly disagree.” Minor wording adaptations were made to ensure contextual relevance to University of Venda students. The full questionnaire was piloted among a small group of students (10% of the calculated sample size) to assess clarity and comprehensibility before the main data collection. 2.4 Ethical Considerations Ethical clearance for this study was obtained from the University of Venda Research Ethics Committee (REC) (PROJECT NO: FHS/24/NUT/18/610). Before data collection, all participating students were provided with a detailed consent form, which they read and signed voluntarily. They were informed of their rights, including the right to withdraw from the study at any time without consequences, as well as the study's objectives and the researchers involved. The housing committee was informed and granted permission to provide information regarding student accommodation. To ensure confidentiality, numerical codes were assigned for statistical analysis, and all student identities were anonymised. Students did not have access to their own or others’ results. These procedures were implemented to ensure compliance with ethical standards. All procedures were conducted in accordance with relevant ethical guidelines and regulations. Consent to participate Written informed consent was obtained from all participants prior to participation in the study. Clinical Trial Number Clinical trial number: Not applicable. 2.5. Statistical Analysis Data were coded, cleaned, and analysed using IBM SPSS Statistics version 29.0 (IBM corp., Armonk, NY, USA). Descriptive statistics (frequencies and percentages) were used to summarise demographic characteristics, food security status, academic performance, and physical well-being. Spearman’s rank correlation coefficient (ρ) was used to assess associations between food security, academic performance, and physical well-being, as variables were not normally distributed. Statistical significance was set at p < 0.05. 3. Results 3.1 Socio-demographic characteristics A total of 319 students were included in the analysis, of whom 59.3% were female (Table 1). The majority were first-year students (35.1%) and bursary-funded (93.4%). Approximately 55.8% resided off-campus. 3.2. Food security status and hunger experiences Based on HFIAS scores, 59.6% of students were classified as food-secure, 33.2% as mildly food-insecure, 6.3% as moderately food-insecure, and 0.9% as severely food-insecure. Table 2. Food insecurity access scale score Score - range Food security status N % 0-6 Food secure 190 59.6 7-13 Mildly food-insecure 106 33.2 14-20 Moderately food-insecure 20 6.3 21-27 Severely food insecure 3 0.9 Total 319 100 3.3. Academic performance Most (84.3%) of the students felt motivated, 90% understood their coursework, and 79.3% were comfortable collaborating with their peers. Nevertheless, 49.1% felt their workload was heavy, and 52.4% said their physical well-being affected their ability to study effectively. Most (64%) students reported module grades of 60% or higher, with only 12% reporting grades below 50%. There were no significant differences in grades across food security categories (Figure 1). The figure shows students’ responses related to motivation, workload perception, collaboration, and self-reported academic performance. 3.4 Physical well-being The majority (72.7%) of students strongly agreed that they were physically healthy, while 64.9% felt physically fit. Only 31.2% of students reported feeling energetic throughout the day, and 33.2% reported getting enough sleep. Less than half (48.6%) of students believed their diet was balanced, while 30.8% exercised regularly. Nearly one‑third (31.1 %) reported missing lectures due to illness, and 33.9 % experienced frequent headaches (Table 3). Table 3 . Physical Well-Being of Students (n = 319) Statement Strongly Agree n % Agree n % Neutral n % Disagree n % Strongly Disagree n % Am physically healthy. 97 30.4 135 42.3 64 20.1 16 5.0 7 2.2 I am satisfied with my weight. 87 27.3 116 36.4 54 16.9 47 14.7 15 4.7 I have enough energy to do the things I need to do, 103 32.3 116 36.4 72 22.6 20 6.3 8 2.5 I take good care of my physical health. 96 30.1 120 37.6 77 24.1 22 6.9 4 1.3 I am satisfied with my physical appearance. 107 33.5 129 40.4 49 15.4 29 9.1 5 1.6 I feel energetic throughout most of the tuition day. 60 18.8 91 28.5 94 29.5 59 18.5 15 4.7 I get enough sleep to feel rested each morning. 65 20.4 84 26.3 80 25.1 70 21.9 20 6.3 I eat a balanced and healthy diet most of the time. 45 14.1 66 20.7 115 36.1 78 24.5 15 4.7 I feel physically strong and capable of daily tasks. 67 21.0 111 34.8 90 28.2 40 12.5 11 3.4 I rarely feel tired or fatigued during class. 41 12.9 82 25.7 96 30.1 78 24.5 22 6.9 I engage in physical activity or exercise regularly. 52 16.3 66 20.7 77 24.1 93 29.2 31 9.7 I rarely experience headaches or physical discomfort during the day. 57 17.9 79 24.8 78 24.5 79 24.8 26 8.2 I feel physically capable of walking or moving around campus easily. 96 30.1 122 38.2 53 16.6 33 10.3 15 4.7 I rarely miss lectures due to physical illness. 81 25.4 86 27.0 53 16.6 72 22.6 27 8.5 I enjoy participating in physical education or sports .activities 59 18.5 86 27.0 95 29.8 56 17.6 22 6.9 I feel my body is strong enough to handle stress. 91 28.5 103 32.3 71 22.3 40 12.5 14 4.4 I feel my physical health supports my ability to focus on my studies. 83 26.0 125 39.2 83 26.0 21 6.6 7 2.2 Table 4. Participants' correlations and p-value table Variable 1 2 3 4 5 6 Age (years) — Food expenditure 0.121* — Food security -0.143* 0.004 — Academic performance (Yes/No) -0.209*** 0.000 0.180** — Academic performance (Module grade) -0.102 -0.041 0.076 0.024 — Physical well-being -0.167** -0.047 0.043 0.429*** -0.008 — Food security demonstrated weak positive correlations with self-reported academic performance (ρ = 0.18) and module grades (ρ = 0.076). Physical well-being showed moderate positive correlations with self-reported academic performance (ρ = 0.429, p < 0.01) and module grades (ρ = 0.338, p < 0.05). Age was negatively associated with academic performance (ρ = −0.174, p < 0.05). 4. Discussion This study explored the relationships between food insecurity, academic performance, and physical well-being among students at a rural university in Limpopo Province. While severe hunger was uncommon, a considerable proportion of students experienced mild to moderate food insecurity, highlighting ongoing vulnerability within this population. These findings reinforce concerns that food insecurity remains a persistent challenge in higher education, particularly in resource-constrained rural contexts. The pattern observed in this study suggests that food insecurity among university students often manifests not as extreme deprivation, but as uncertainty, compromised dietary quality, and inconsistent access to meals. Even when severe hunger is rare, mild and moderate food insecurity may still affect daily functioning, energy levels, and overall health. This aligns with research indicating that students frequently cope with financial strain by skipping meals, reducing portion sizes, or relying on inexpensive, low-nutrient foods. Interestingly, food insecurity showed only weak associations with academic performance. The correlation with objective module grades was negligible, and the relationship with self-reported academic performance was modest. These findings suggest that the impact of food insecurity on academic outcomes may not be straightforward or immediately observable in cross-sectional analyses. Academic performance is shaped by multiple influences, including prior academic preparation, motivation, institutional support, and personal resilience. Some students may prioritise academic tasks despite experiencing food-related hardship, thereby buffering short-term academic decline. In contrast, physical well-being demonstrated stronger and more consistent associations with academic performance. Students who reported feeling healthy, energetic, and well-rested were more likely to report better academic engagement and performance. This finding underscores the critical role of health-related factors in supporting learning. Energy levels, sleep quality, and overall physical functioning directly influence concentration, cognitive processing, and sustained academic effort. It is therefore possible that the effects of food insecurity on academic performance operate indirectly, mediated through physical and psychological well-being rather than through direct academic decline. These findings highlight the need to view student success through a broader lens. Food insecurity does not occur in isolation; it often coexists with financial stress, housing instability, and other structural challenges. In rural university settings, limited employment opportunities and constrained institutional resources may intensify these pressures. Addressing food insecurity alone, without simultaneously supporting student health and well-being, may therefore yield limited academic gains. From a practical perspective, universities should consider integrated support strategies. Food assistance programmes remain essential, but they should be complemented by initiatives that promote sleep hygiene, mental health support, stress management, and accessible health services. Strengthening student well-being may provide a more direct pathway to improving academic outcomes. Importantly, the absence of strong statistical associations between food insecurity and academic performance in this study does not diminish the seriousness of food insecurity as a public health concern. Rather, it highlights the complexity of its influence. Cross-sectional data capture a snapshot in time and may not reflect cumulative or long-term academic consequences. Longitudinal research is needed to explore whether sustained exposure to food insecurity affects academic progression, retention, or completion rates. Spearman’s correlation analysis revealed that food security was weakly but significantly associated with academic performance (ρ = 0.180, p < 0.01), suggesting that improved food access is linked to slightly better academic outcomes. Age demonstrated weak negative associations with academic performance (ρ = -0.209, p < 0.001) and physical well-being (ρ = -0.167, p < 0.01). The strongest relationship observed was a moderate positive correlation between academic performance and physical well-being (ρ = 0.429, p < 0.001), indicating that students who reported better academic functioning also reported better overall physical well-being This study contributes to the growing literature on student food insecurity by focusing specifically on a rural South African university, a context that remains underrepresented in research. Examining food security, academic performance, and physical well-being together provides a more nuanced understanding of how these factors interact in shaping student experiences. 4.1. Strengths and limitations A key strength of this study is the use of a relatively large and heterogeneous sample, which enhances the generalisability of the findings. The study utilised a validated measure of food insecurity (HFIAS) and a validated physical well-being scale, alongside structured instruments informed by established academic engagement literature. Furthermore, the study offers an integrated analysis of the associations between household hunger, academic outcomes, and physical well-being, providing substantial evidence on the multidimensional effects of food insecurity among students. The use of Stratified sampling across faculties improves representativeness. However, the cross-sectional design precludes causal inference; longitudinal studies are needed to assess whether changes in food security or health behaviours lead to improved academic outcomes. Self-reported measures of educational performance and physical well-being may be subject to recall or social desirability bias. Additionally, combining different protein sources and food groups in the questionnaire may have limited dietary assessment precision, mirroring limitations noted in previous research. The internal consistency of the academic performance and physical well-being scales was not reassessed in the present sample, which may limit the interpretation of measurement reliability. Finally, our findings pertain to one rural university and may not generalise to urban institutions. These findings have implications for higher education policy, highlighting the importance of strengthening student support systems that address both food access and health needs. However, the socio-economic conditions of students in this setting are comparable to those in many rural universities in similar contexts, suggesting that the findings may be relevant beyond the study site. 5. Conclusions This study demonstrates that although severe food insecurity was relatively uncommon among students at this rural university, mild and moderate food insecurity remain meaningful concerns. While food insecurity showed only weak direct associations with academic performance, students’ physical well-being demonstrated stronger and more consistent relationships with academic engagement and module grades. These findings suggest that academic success in rural higher education settings is shaped not only by access to food, but also by broader health and well-being factors. Improving student outcomes therefore requires more than food provision alone. Universities should consider integrated approaches that combine food support programmes with initiatives that strengthen physical health, sleep quality, and overall student wellness. Addressing these interconnected factors may create a more supportive environment for academic achievement. Given the cross-sectional nature of this study, causal relationships cannot be established. Future longitudinal research is needed to better understand how sustained exposure to food insecurity and compromised well-being influence academic progression over time. Nonetheless, the findings highlight the importance of recognising food insecurity and student health as critical components of academic success within rural university contexts. Declarations Authors’ Contributions Mathole Mashaola First: Conceptualization, Methodology, Data collection, Formal analysis, Writing – original draft. Motadi Selekane Ananias: Writing – review and editing. Mugware Anzani: Writing – review and editing. Mushaphi Lindelani Fhumudzani: Writing – review and editing. Chauke Rhulani Caswell: Methodology, Supervision, Writing – review and editing Mandiwana Tshifhiwa Cynthia: Conceptualization, Methodology, Supervision, Writing – review and editing. Availability of data and materials The datasets supporting the conclusions of this study are available from the corresponding author on reasonable request. Consent for publication Not applicable. Acknowledgements The authors would like to thank the students who participated in this study and the research assistants who supported data collection. Funding This research received University of Venda research publication and incentives Conflict of Interest The author declares no conflict of interest References Ballard TJ, Coates J, Swindale A, Deitchler M. Household hunger scale: indicator definition and measurement guide. Washington (DC): Food and Nutrition Technical Assistance II Project (FANTA); 2011. Bonacchi A, Miccinesi G, Galli S, Primi C. 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Supplementary Files Table1.docx Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 11 May, 2026 Reviews received at journal 07 May, 2026 Reviewers agreed at journal 29 Apr, 2026 Reviewers agreed at journal 27 Apr, 2026 Reviewers agreed at journal 27 Apr, 2026 Reviews received at journal 26 Apr, 2026 Reviewers agreed at journal 13 Apr, 2026 Reviewers invited by journal 29 Mar, 2026 Editor invited by journal 13 Mar, 2026 Editor assigned by journal 10 Mar, 2026 Submission checks completed at journal 10 Mar, 2026 First submitted to journal 06 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9050886","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":614471862,"identity":"2a3b4c73-35a1-41e7-9932-d68d21778197","order_by":0,"name":"Mathole First","email":"data:image/png;base64,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","orcid":"","institution":"University of Venda","correspondingAuthor":true,"prefix":"","firstName":"Mathole","middleName":"","lastName":"First","suffix":""},{"id":614471864,"identity":"94af803a-c6ce-4448-bff7-7b3464694e8a","order_by":1,"name":"Motadi Selekane Ananias","email":"","orcid":"","institution":"University of Venda","correspondingAuthor":false,"prefix":"","firstName":"Motadi","middleName":"Selekane","lastName":"Ananias","suffix":""},{"id":614471865,"identity":"0ce1eaa9-e693-4eed-8825-54bc8e59090b","order_by":2,"name":"Mugware Anzani","email":"","orcid":"","institution":"University of Venda","correspondingAuthor":false,"prefix":"","firstName":"Mugware","middleName":"","lastName":"Anzani","suffix":""},{"id":614471866,"identity":"57932ea3-94ea-47a0-80e5-093894afd6dc","order_by":3,"name":"Mushaphi Lindelani","email":"","orcid":"","institution":"University of Venda","correspondingAuthor":false,"prefix":"","firstName":"Mushaphi","middleName":"","lastName":"Lindelani","suffix":""},{"id":614471867,"identity":"f4ef05de-3eaf-4730-a40f-bb047467c9b4","order_by":4,"name":"Chauke Rhulani Caswell","email":"","orcid":"","institution":"University of Venda","correspondingAuthor":false,"prefix":"","firstName":"Chauke","middleName":"Rhulani","lastName":"Caswell","suffix":""},{"id":614471868,"identity":"cfc7a62e-28c2-4fd7-a2dd-d9cc64ca4bf4","order_by":5,"name":"Mandiwana Tshifhiwa Cynthia","email":"","orcid":"","institution":"University of Venda","correspondingAuthor":false,"prefix":"","firstName":"Mandiwana","middleName":"Tshifhiwa","lastName":"Cynthia","suffix":""}],"badges":[],"createdAt":"2026-03-06 13:08:50","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9050886/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9050886/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106094737,"identity":"24d28749-e936-46a8-a818-6daa222d811b","added_by":"auto","created_at":"2026-04-03 11:43:10","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":58601,"visible":true,"origin":"","legend":"\u003cp\u003eParticipants' Academic performance and experiences\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9050886/v1/04970edb88ee992429f08255.png"},{"id":106402054,"identity":"9cd4c947-6454-4604-adcb-1faa824dc1ad","added_by":"auto","created_at":"2026-04-08 09:10:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":831384,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9050886/v1/9c2939e8-5b97-4bc7-8e3e-1931fc3d5755.pdf"},{"id":106068897,"identity":"67895778-1693-4eba-aab8-cd42c5b70d00","added_by":"auto","created_at":"2026-04-03 06:21:22","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":23348,"visible":true,"origin":"","legend":"","description":"","filename":"Table1.docx","url":"https://assets-eu.researchsquare.com/files/rs-9050886/v1/91cfbece38f4852245ea84f6.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Food Security, Academic Performance and Physical Well‑Being of Rural University Students in Limpopo Province, South Africa","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eFood insecurity is by far the most significant public health concern, which affects an increasing number of people globally. As a result, it leads to poor nutritional status and nutrition-related diseases, such as obesity and hypertension, which consequently limit students\u0026rsquo; ability to progress academically and physically (Willis et al. \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Loofbourrow \u0026amp; Scherr \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Academically, the consequences are detrimental, with evidence of delayed graduation, higher dropout rates, and increased stress levels amongst students in institutions of higher learning (Freudenberger et al. 2019).\u003c/p\u003e \u003cp\u003eFood insecurity remains prevalent among university students globally and in South Africa. Recent studies report prevalence rates ranging between 30% and 60% in higher education institutions across sub-Saharan Africa (Wagner et al. \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Urmi et al. \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Mashabela \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In South Africa, evidence from rural and historically disadvantaged institutions indicates persistent moderate-to-severe food insecurity among students, particularly those dependent on financial aid (Mushaphi et al. \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Mtshweni \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Although national graduation and retention rates have improved over time, socio-economic disparities continue to undermine academic success, particularly in rural institutions (DHET 2023). These findings underscore the continued relevance of food insecurity as a structural barrier to educational attainment\u003c/p\u003e \u003cp\u003eFood insecurity affects a notable proportion of students: 28.68% in Bangladesh and 35.7%-45% in Nigeria. (Urmi et al. \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Ukegbu et al. \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Nationally, evidence indicates a high prevalence of food insecurity among university students. A study conducted at the University of the Free State found that 65% of students were food-insecure (Van den Berg \u0026amp; Raubenheimer \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Similarly, research at the University of Limpopo found that 24% of students experienced moderate food insecurity, while 16% experienced severe food insecurity (Mashabela \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFood insecurity has been associated not only with academic challenges but also with compromised physical well-being, including reduced energy levels, sleep disturbances, and decreased participation in physical activity (Lemp et al. \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Loofbourrow \u0026amp; Scherr \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Nutritional inadequacy may impair immune function and cognitive performance, thereby influencing both health and academic engagement (Willis et al. \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Isoard et al. \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Students who face food insecurity often report lower levels of physical well-being, including decreased energy, restricted participation in physical activities, and disturbed sleep patterns (Lemp et al. \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In contrast, having consistent access to sufficient and nutritious food can enhance physical health by supporting optimal bodily functioning (Isoard et al. \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). This study seeks to investigate food security, academic performance, and physical well-being among students at the rural-based University of Venda.\u003c/p\u003e \u003cp\u003eDespite growing international evidence linking food insecurity to academic and health outcomes, limited research in South Africa has simultaneously examined food security, physical well-being, and academic performance within rural universities. Most local studies focus primarily on prevalence without investigating the integrated relationships between nutritional access, perceived health, and academic functioning. Rural institutions such as the University of Venda predominantly serve students from low-income and first-generation backgrounds, making contextualised evidence essential. This study, therefore, addresses a critical gap by examining the interrelationships among food security, physical well-being, and academic performance in a rural higher education setting.\u003c/p\u003e \u003cp\u003eThis study aligns directly with Sustainable Development Goal (SDG) 2: Zero Hunger, which aims to end hunger, achieve food security, improve nutrition, and promote sustainable well-being (United Nations 2023). While SDG 2 is often framed at national and agricultural levels, its relevance within higher education institutions is increasingly recognised. University students represent a vulnerable population whose nutritional insecurity can undermine academic achievement and long-term human capital development. By examining food security within a rural university context, this study contributes to SDG 2 by generating context-specific evidence that may inform institutional food support programmes and targeted policy interventions in South African higher education. Although this study was conducted in a rural South African university, the challenges of student food insecurity, financial strain, and health vulnerabilities are shared across many low- and middle-income countries. Understanding how food access and physical well-being relate to academic outcomes can therefore provide insights that inform student support policies in similar higher education settings globally.\u003c/p\u003e"},{"header":"2. Methods and Materials","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study Design and Setting.\u003c/h2\u003e \u003cp\u003eA cross-sectional study design was used to investigate the food security, academic performance, and physical well-being of students at a rural-based university. The University of Venda has both on-campus and off-campus accredited residences. The university has 12 on-campus residences accommodating 3,000\u0026ndash;4,000 students, as well as 84 accredited off-campus residences that house approximately 6,450 students (University of Venda \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). On campus, food outlets included tuck shops, small convenience stores, and a limited number of dining facilities that offered affordable meals. Off campus, students had access to street vendors, local spaza shops, supermarkets, and fast-food restaurants. Students aged 18\u0026ndash;24 years who consented and were present on the day of data collection were included in the study. Data were collected by the researcher and field workers using a questionnaire from July to October 2025. The researcher and supervisor trained the research assistants in data collection procedures and methods 2 weeks before data collection. The appointment of the fieldworkers was based on their qualifications, which were needed for both the study and competent general practice. This study is reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Sample Size and Sample Technique, procedure\u003c/h2\u003e \u003cp\u003eA stratified random sampling design was used to select 319 students, and a simple random sampling was used to select eleven from eighty-four residents. The students were divided into three strata based on residence type: male on-campus residences, female on-campus residences, and mixed off-campus residences. Each stratum had a certain number of residences. The male on-campus stratum had four residences, the female on-campus stratum had six, and the mixed-residence strata also had their own defined numbers of residences. To select students within each stratum, the researcher obtained an official list of all rooms from the University of Venda Housing Department. Each room was assigned a random number to ensure impartiality in the selection process. The random selection was conducted using small pieces of paper bearing the room numbers, which were placed in separate containers for each stratum. A neutral individual, independent of the study, was asked to draw the papers randomly to identify the rooms and students to be included.\u003c/p\u003e \u003cp\u003eThe sample size was calculated using Slovin\u0026rsquo;s formula (n\u0026thinsp;=\u0026thinsp;N / (1\u0026thinsp;+\u0026thinsp;Ne\u0026sup2;)), based on a residence population of 10,215 students. Using a 5% margin of error, a minimum sample of 385 students was required. To account for potential non-response, an additional 10% was added, resulting in a target sample of 423 students. Of the 423 students approached, 319 completed the questionnaire in full, yielding a response rate of 75.4%. Only fully completed questionnaires were included in the final analysis.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3. Variables Measured\u003c/h2\u003e \u003cp\u003eData were collected using a structured, researcher-administered questionnaire comprising four sections: socio-demographic characteristics, food security, academic performance, and physical well-being.\u003c/p\u003e \u003cp\u003eFood security was assessed using the Household Food Insecurity Access Scale (HFIAS) developed by the Food and Nutrition Technical Assistance (FANTA) project (Coates et al. \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Ballard et al. \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). The HFIAS consists of 9 occurrence questions, yielding a total score ranging from 0 to 27; higher scores indicate greater food insecurity. Respondents were categorised as food-secure, mildly food-insecure, moderately food-insecure, or severely food-insecure. For analysis, HFIAS total scores (0\u0026ndash;27) were grouped into four categories (0\u0026ndash;6, 7\u0026ndash;13, 14\u0026ndash;20, and 21\u0026ndash;27). The HFIAS has been widely validated and used in diverse low- and middle-income settings to assess household food insecurity\u003c/p\u003e \u003cp\u003eAcademic performance was assessed using a structured self-report instrument developed based on previously validated academic engagement measures (Cred\u0026eacute; \u0026amp; Kuncel \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2008\u003c/span\u003e; York et al. \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). The tool included items assessing academic motivation, understanding of coursework, class participation, workload perception, and module grades. Items were measured using dichotomous (yes/no) and categorical response options.\u003c/p\u003e \u003cp\u003ePhysical well-being was measured using an adapted version of the Well-Being Scale (WeBS) developed by Lui and Fernando (2018). The scale included Likert-type items assessing perceived physical health, energy levels, sleep adequacy, physical activity, and physical functioning. Responses ranged from \u0026ldquo;strongly agree\u0026rdquo; to \u0026ldquo;strongly disagree.\u0026rdquo; Minor wording adaptations were made to ensure contextual relevance to University of Venda students. The full questionnaire was piloted among a small group of students (10% of the calculated sample size) to assess clarity and comprehensibility before the main data collection.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Ethical Considerations\u003c/h2\u003e \u003cp\u003e Ethical clearance for this study was obtained from the University of Venda Research Ethics Committee (REC) (PROJECT NO: FHS/24/NUT/18/610). Before data collection, all participating students were provided with a detailed consent form, which they read and signed voluntarily. They were informed of their rights, including the right to withdraw from the study at any time without consequences, as well as the study's objectives and the researchers involved. The housing committee was informed and granted permission to provide information regarding student accommodation. To ensure confidentiality, numerical codes were assigned for statistical analysis, and all student identities were anonymised. Students did not have access to their own or others\u0026rsquo; results. These procedures were implemented to ensure compliance with ethical standards. All procedures were conducted in accordance with relevant ethical guidelines and regulations.\u003c/p\u003e \u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from all participants prior to participation in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eClinical Trial Number\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClinical trial number: Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e2.5. Statistical Analysis\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were coded, cleaned, and analysed using IBM SPSS Statistics version 29.0 (IBM corp., Armonk, NY, USA). Descriptive statistics (frequencies and percentages) were used to summarise demographic characteristics, food security status, academic performance, and physical well-being. Spearman\u0026rsquo;s rank correlation coefficient (\u0026rho;) was used to assess associations between food security, academic performance, and physical well-being, as variables were not normally distributed. Statistical significance was set at p \u0026lt; 0.05.\u0026nbsp;\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.1 Socio-demographic characteristics\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 319 students were included in the analysis, of whom 59.3% were female (Table 1). The majority were first-year students (35.1%) and bursary-funded (93.4%). Approximately 55.8% resided off-campus.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.2. Food security status and hunger experiences\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBased on HFIAS scores, 59.6% of students were classified as food-secure, 33.2% as mildly food-insecure, 6.3% as moderately food-insecure, and 0.9% as severely food-insecure.\u003c/p\u003e\n\u003cp id=\"_Toc217400644\"\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003eFood insecurity access scale score\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eScore - range \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 183px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFood security status \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 183px;\"\u003e\n \u003cp\u003eFood secure \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e59.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e7-13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 183px;\"\u003e\n \u003cp\u003eMildly food-insecure\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e33.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e14-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 183px;\"\u003e\n \u003cp\u003eModerately food-insecure\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e21-27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 183px;\"\u003e\n \u003cp\u003eSeverely food insecure \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 315px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e319\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.3. Academic performance\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Most (84.3%) of the students felt motivated, 90% understood their coursework, and 79.3% were comfortable collaborating with their peers. Nevertheless, 49.1% felt their workload was heavy, and 52.4% said their physical well-being affected their ability to study effectively. Most (64%) students reported module grades of 60% or higher, with only 12% reporting grades below 50%. There were no significant differences in grades across food security categories (Figure 1). The figure shows students\u0026rsquo; responses related to motivation, workload perception, collaboration, and self-reported academic performance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.4 Physical well-being\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe majority (72.7%) of students strongly agreed that they were physically healthy, while 64.9% felt physically fit. Only 31.2% of students reported feeling energetic throughout the day, and 33.2% reported getting enough sleep. Less than half (48.6%) of students believed their diet was balanced, while 30.8% exercised regularly. Nearly one‑third (31.1 %) reported missing lectures due to illness, and 33.9 % experienced frequent headaches (Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp id=\"_Toc217400646\"\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e. Physical Well-Being of Students (n = 319)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"633\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly Agree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;n \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;%\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeutral\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;% \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly Disagree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;n \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eAm physically healthy.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e97 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;30.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e135 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;42.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e64 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;20.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e16 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e7 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI am satisfied with my weight.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e87 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;27.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e116 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;36.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e54 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e47 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 14.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e15 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI have enough energy to do the things I need to do,\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e103 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;32.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e116 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;36.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e72 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;22.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e20 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e8 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI take good care of my physical health.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e96 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;30.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e120 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;37.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e77 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;24.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e22 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e4 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI am satisfied with my physical appearance.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e107 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;33.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e129 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;40.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e49 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;15.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e29 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e5 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI feel energetic throughout most of the tuition day.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e60 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;18.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e91 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;28.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e94 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;29.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e59 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e15 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI get enough sleep to feel rested each morning.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e65 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 20.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e84 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;26.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e80 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;25.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e70 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 21.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e20 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI eat a balanced and healthy diet most of the time.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e45 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;14.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e66 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;20.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e115 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;36.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e78 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 24.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e15 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI feel physically strong and capable of daily tasks.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e67 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 21.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e111 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;34.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e90 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;28.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e40 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e11 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI rarely feel tired or fatigued during class.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e41 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e82 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;25.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e96 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;30.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e78 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 24.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e22 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI engage in physical activity or exercise regularly.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e52 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;16.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e66 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;20.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e77 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;24.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e93 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 29.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e31 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI rarely experience headaches or physical discomfort during the day.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e57 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;17.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e79 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;24.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e78 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;24.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e79 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 24.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e26 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 8.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI feel physically capable of walking or moving around campus easily.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e96 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;30.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e122 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;38.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e53 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;16.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e33 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e15 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI rarely miss lectures due to physical illness.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e81 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;25.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e86 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;27.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e53 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;16.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e72 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 22.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e27 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI enjoy participating in physical education or sports .activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e59 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e86 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;27.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e95 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;29.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e56 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 17.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e22 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI feel my body is strong enough to handle stress.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e91 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 28.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e103 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;32.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e71 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;22.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e40 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e14 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eI feel my physical health supports my ability to focus on my studies.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e83 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;26.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e125 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;39.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e83 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 26.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e21 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e7 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp id=\"_Toc217400647\"\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u003c/strong\u003e Participants\u0026apos; correlations and p-value table\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eFood expenditure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e0.121*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eFood security\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e-0.143*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAcademic performance (Yes/No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e-0.209***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.180**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAcademic performance (Module grade)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e-0.102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePhysical well-being\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e-0.167**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e-0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.429***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e-0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eFood security demonstrated weak positive correlations with self-reported academic performance (\u0026rho; = 0.18) and module grades (\u0026rho; = 0.076). Physical well-being showed moderate positive correlations with self-reported academic performance (\u0026rho; = 0.429, p \u0026lt; 0.01) and module grades (\u0026rho; = 0.338, p \u0026lt; 0.05). Age was negatively associated with academic performance (\u0026rho; = \u0026minus;0.174, p \u0026lt; 0.05).\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study explored the relationships between food insecurity, academic performance, and physical well-being among students at a rural university in Limpopo Province. While severe hunger was uncommon, a considerable proportion of students experienced mild to moderate food insecurity, highlighting ongoing vulnerability within this population. These findings reinforce concerns that food insecurity remains a persistent challenge in higher education, particularly in resource-constrained rural contexts.\u003c/p\u003e\n\u003cp\u003eThe pattern observed in this study suggests that food insecurity among university students often manifests not as extreme deprivation, but as uncertainty, compromised dietary quality, and inconsistent access to meals. Even when severe hunger is rare, mild and moderate food insecurity may still affect daily functioning, energy levels, and overall health. This aligns with research indicating that students frequently cope with financial strain by skipping meals, reducing portion sizes, or relying on inexpensive, low-nutrient foods.\u003c/p\u003e\n\u003cp\u003eInterestingly, food insecurity showed only weak associations with academic performance. The correlation with objective module grades was negligible, and the relationship with self-reported academic performance was modest. These findings suggest that the impact of food insecurity on academic outcomes may not be straightforward or immediately observable in cross-sectional analyses. Academic performance is shaped by multiple influences, including prior academic preparation, motivation, institutional support, and personal resilience. Some students may prioritise academic tasks despite experiencing food-related hardship, thereby buffering short-term academic decline.\u003c/p\u003e\n\u003cp\u003eIn contrast, physical well-being demonstrated stronger and more consistent associations with academic performance. Students who reported feeling healthy, energetic, and well-rested were more likely to report better academic engagement and performance. This finding underscores the critical role of health-related factors in supporting learning. Energy levels, sleep quality, and overall physical functioning directly influence concentration, cognitive processing, and sustained academic effort. It is therefore possible that the effects of food insecurity on academic performance operate indirectly, mediated through physical and psychological well-being rather than through direct academic decline.\u003c/p\u003e\n\u003cp\u003eThese findings highlight the need to view student success through a broader lens. Food insecurity does not occur in isolation; it often coexists with financial stress, housing instability, and other structural challenges. In rural university settings, limited employment opportunities and constrained institutional resources may intensify these pressures. Addressing food insecurity alone, without simultaneously supporting student health and well-being, may therefore yield limited academic gains.\u003c/p\u003e\n\u003cp\u003eFrom a practical perspective, universities should consider integrated support strategies. Food assistance programmes remain essential, but they should be complemented by initiatives that promote sleep hygiene, mental health support, stress management, and accessible health services. Strengthening student well-being may provide a more direct pathway to improving academic outcomes.\u003c/p\u003e\n\u003cp\u003eImportantly, the absence of strong statistical associations between food insecurity and academic performance in this study does not diminish the seriousness of food insecurity as a public health concern. Rather, it highlights the complexity of its influence. Cross-sectional data capture a snapshot in time and may not reflect cumulative or long-term academic consequences. Longitudinal research is needed to explore whether sustained exposure to food insecurity affects academic progression, retention, or completion rates.\u003c/p\u003e\n\u003cp\u003eSpearman’s correlation analysis revealed that food security was weakly but significantly associated with academic performance (ρ = 0.180, p \u0026lt; 0.01), suggesting that improved food access is linked to slightly better academic outcomes. Age demonstrated weak negative associations with academic performance (ρ = -0.209, p \u0026lt; 0.001) and physical well-being (ρ = -0.167, p \u0026lt; 0.01). The strongest relationship observed was a moderate positive correlation between academic performance and physical well-being (ρ = 0.429, p \u0026lt; 0.001), indicating that students who reported better academic functioning also reported better overall physical well-being\u003c/p\u003e\n\u003cp\u003eThis study contributes to the growing literature on student food insecurity by focusing specifically on a rural South African university, a context that remains underrepresented in research. Examining food security, academic performance, and physical well-being together provides a more nuanced understanding of how these factors interact in shaping student experiences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.1. Strengths and limitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA key strength of this study is the use of a relatively large and heterogeneous sample, which enhances the generalisability of the findings. The study utilised a validated measure of food insecurity (HFIAS) and a validated physical well-being scale, alongside structured instruments informed by established academic engagement literature. Furthermore, the study offers an integrated analysis of the associations between household hunger, academic outcomes, and physical well-being, providing substantial evidence on the multidimensional effects of food insecurity among students. The use of Stratified sampling across faculties improves representativeness. However, the cross-sectional design precludes causal inference; longitudinal studies are needed to assess whether changes in food security or health behaviours lead to improved academic outcomes. Self-reported measures of educational performance and physical well-being may be subject to recall or social desirability bias. Additionally, combining different protein sources and food groups in the questionnaire may have limited dietary assessment precision, mirroring limitations noted in previous research. The internal consistency of the academic performance and physical well-being scales was not reassessed in the present sample, which may limit the interpretation of measurement reliability. Finally, our findings pertain to one rural university and may not generalise to urban institutions. These findings have implications for higher education policy, highlighting the importance of strengthening student support systems that address both food access and health needs. However, the socio-economic conditions of students in this setting are comparable to those in many rural universities in similar contexts, suggesting that the findings may be relevant beyond the study site.\u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eThis study demonstrates that although severe food insecurity was relatively uncommon among students at this rural university, mild and moderate food insecurity remain meaningful concerns. While food insecurity showed only weak direct associations with academic performance, students\u0026rsquo; physical well-being demonstrated stronger and more consistent relationships with academic engagement and module grades. These findings suggest that academic success in rural higher education settings is shaped not only by access to food, but also by broader health and well-being factors. Improving student outcomes therefore requires more than food provision alone. Universities should consider integrated approaches that combine food support programmes with initiatives that strengthen physical health, sleep quality, and overall student wellness. Addressing these interconnected factors may create a more supportive environment for academic achievement. Given the cross-sectional nature of this study, causal relationships cannot be established. Future longitudinal research is needed to better understand how sustained exposure to food insecurity and compromised well-being influence academic progression over time. Nonetheless, the findings highlight the importance of recognising food insecurity and student health as critical components of academic success within rural university contexts.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMathole Mashaola First: Conceptualization, Methodology, Data collection, Formal analysis, Writing \u0026ndash; original draft.\u003c/p\u003e\n\u003cp\u003eMotadi Selekane Ananias: Writing \u0026ndash; review and editing.\u003c/p\u003e\n\u003cp\u003eMugware Anzani: Writing \u0026ndash; review and editing.\u003c/p\u003e\n\u003cp\u003eMushaphi Lindelani Fhumudzani: Writing \u0026ndash; review and editing.\u003c/p\u003e\n\u003cp\u003eChauke Rhulani Caswell: Methodology, Supervision, Writing \u0026ndash; review and editing\u003c/p\u003e\n\u003cp\u003eMandiwana Tshifhiwa Cynthia: Conceptualization, Methodology, Supervision, Writing \u0026ndash; review and editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets supporting the conclusions of this study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the students who participated in this study and the research assistants who supported data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received University of Venda research publication and incentives \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author declares no conflict of interest\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBallard TJ, Coates J, Swindale A, Deitchler M. 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Thohoyandou (South Africa): University of Venda; 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUrmi TA, Ahmed S, Hossain M, Islam M. Food insecurity and academic performance among Bangladeshi university students. BMC Public Health. 2024;24:412.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVan den Berg L, Raubenheimer J. Food insecurity among students at the University of the Free State. S Afr J Clin Nutr. 2015;28(4):160\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWagner J, Peltzer K, Pengpid S. Food insecurity and mental health among university students in sub-Saharan Africa. Int J Environ Res Public Health. 2024;21(3):1457.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWillis DE, Wilson A, Stephens J, Jenkins R. Food insecurity and chronic disease risk. Prev Med. 2020;135:106062.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization (WHO). Constitution of the World Health Organization. Geneva (Switzerland): WHO; 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYork TT, Gibson C, Rankin S. Defining and measuring academic success. Pract Assess Res Eval. 2015;20(5):1\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZerbian J, De Luis Romero R. Food security as a multidimensional development challenge. World Dev. 2023;165:106183.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Table 1","content":"\u003cp\u003eTable 1 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-social-science-and-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"diss","sideBox":"Learn more about [Discover Social Science and Health](https://www.springer.com/journal/44155)","snPcode":"","submissionUrl":"","title":"Discover Social Science and Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Food security, Academic performance, Physical well-being, University students, South Africa","lastPublishedDoi":"10.21203/rs.3.rs-9050886/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9050886/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eThis study investigated the relationships among food security, academic performance, and physical well-being among students at a rural university in Limpopo Province, South Africa.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A cross-sectional study was conducted among 319 students aged 18–25 years residing in both on-campus and accredited off-campus residences. Stratified random sampling was used to select participants. Data were collected using a researcher-administered questionnaire comprising sections on socio-demographics, food security, academic performance, and physical well-being. Food security was assessed using the Household Food Insecurity Access Scale (HFIAS). Descriptive statistics summarised the data, and Spearman’s rank correlation was used to examine associations between variables.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe Household Food Insecurity Access Scale classified 59.6% of students as food secure, 33.2% as mildly food insecure, 6.3% as moderately food insecure, and 0.9% as severely food insecure. Although 72.7% of students reported being physically healthy, only 31.2% felt energetic throughout the day, and 33.2% reported obtaining sufficient sleep. Academic motivation was high (84.3%), though 49.1% reported feeling overwhelmed by their workload. Food security demonstrated weak positive correlations with self-reported academic performance (ρ = 0.180, p \u0026lt; 0.05) and module grades (ρ = 0.076, p \u0026gt; 0.05). Physical well-being showed moderate positive correlations with self-reported academic performance (ρ = 0.429, p \u0026lt; 0.01) and module grades (ρ = 0.338, p \u0026lt; 0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e Mild and moderate food insecurity were prevalent among students, while severe hunger was uncommon. Physical well-being demonstrated stronger associations with academic outcomes than food security alone. Interventions that address nutritional adequacy, sleep quality, and student health services may enhance academic success in rural university settings. These findings suggest that universities should consider combining food support with health and wellness programmes to better support students, especially in settings with limited resources.\u003c/p\u003e","manuscriptTitle":"Food Security, Academic Performance and Physical Well‑Being of Rural University Students in Limpopo Province, South Africa","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-03 06:21:18","doi":"10.21203/rs.3.rs-9050886/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-11T06:19:51+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-07T19:01:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"236518143599139359896558051421847569497","date":"2026-04-29T08:05:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"108700460016048821916967345806374691297","date":"2026-04-27T16:48:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"5492958128534264780403523805557606991","date":"2026-04-27T07:36:08+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-26T19:06:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"129826557048732681209162549456801744298","date":"2026-04-13T10:40:17+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-29T11:49:11+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-13T05:42:24+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-10T12:09:31+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-10T12:08:54+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Social Science and Health","date":"2026-03-06T13:04:55+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-social-science-and-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"diss","sideBox":"Learn more about [Discover Social Science and Health](https://www.springer.com/journal/44155)","snPcode":"","submissionUrl":"","title":"Discover Social Science and Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8db66879-fb40-4cc4-b205-9ad1d7e42f16","owner":[],"postedDate":"April 3rd, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-11T06:19:51+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-07T19:01:23+00:00","index":87,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-11T06:27:55+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-03 06:21:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9050886","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9050886","identity":"rs-9050886","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}