An Exploration of University Students' Perspectives and Food Environments to Support Sustainable Dietary Patterns for Personal and Planetary Health

Abstract

Most United States (US) consumers follow a Western dietary pattern that is linked to detrimental health and environmental outcomes. Population shifts to dietary patterns that support personal and planetary health are needed. There are over 6,000 US universities and colleges that could apply institutional policy, systems, and environmental (PSE) change strategies to encourage young adults to adopt sustainable dietary patterns during a transitional period of their life. This PhD dissertation consists of four studies that explored how PSE change strategies could support US university students' adoption of sustainable dietary patterns. Study one was conducted using two-part focus groups with university students in 2024. Evidence was analyzed using inductive thematic analysis. The focus groups explored 1) university students' adoption of sustainable dietary patterns (n=24) and 2) plate models that communicate sustainable dietary patterns (n=19). Phase one described five themes summarizing students' food literacy competencies to support sustainable dietary patterns. Phase two described three themes summarizing graphic plate models' characteristics to support sustainable dietary patterns. This study may inform PSE change strategies to improve university food environments, marketing communications, and educational programs to strengthen US students' food literacy competencies to adopt sustainable dietary patterns. Study two explored how US higher education institutions use marketing-mix choice architecture strategies (MMCA) within the institutional food environment to encourage customers to select sustainable plant-rich menu options. A systematic scoping review identified 166 US higher education institutions across 36 states and the District of Columbia that applied MMCA strategies between 2010-2024. Institutions often adapted profile strategies (96.99%). These findings suggest there is some progress among higher education institutions to apply behavior change theory to practice and encourage sustainable dietary patterns. Study three explored Virginia Tech's (VT) Special Collections and University Archives to outline VT Dining Services efforts to encourage sustainable dietary patterns within the campus food environment. Findings highlight VT's practices from 1986-2010 to foster sustainable food environments on campus through promotional efforts but described gaps in the current knowledge of VT's present food environment to promote sustainable dietary patterns. Study four piloted the University Food Environment Assessment (Uni-food) tool to benchmark VT's food environment to support sustainable dietary patterns for students across three components, 16 domains, and 68 indicators. We collected and assessed evidence from online sources, nine food retail outlets, and 15 vending machines across VT's campus in 2025-2026. VT scored a 51%, suggesting an overall medium implementation of best practices for nutrition, sustainability, and equity across the campus food environment. Participatory efforts with undergraduate co-researchers and VT Dining Services leadership determined the results for the university systems and governance (49%), campus facilities (55%), food retail environment (48%), and corresponding sub-domains. These findings informed recommendations for VT leadership to implement comprehensive PSE change strategies to increase the accessibility and availability of sustainable and equitably priced foods for students. Collectively, the four studies described in this dissertation applied several theoretically grounded conceptual frameworks, addressed knowledge gaps, and may inform actions for higher education institutions to improve students' food environments for personal and planetary health.