Knowledge, Perceived Barriers, and Whole-Grain Bread Consumption among University Students in Southwest Iran in the...

Whole-grain bread is rich in fiber and micronutrients, yet student consumption is low and linked to poor health outcomes. This study evaluates students' nutritional knowledge, perceived barriers to whole-grain bread consumption, and overall dietary habits at Ahvaz Jundishapur University of Medical Sciences.

A cross‑sectional study of 567 students (408 undergraduates, 159 postgraduates) assessed knowledge, barriers, and dietary habits using a validated questionnaire. Two trained nutritionists conducted face‑to‑face interviews. The questionnaire was pretested in 50 students; the barriers section showed high reliability (α = 0.88) and CVI/CVR = 1.

Of 567 students, 239 (42.15%) rarely consumed whole‑grain bread, 144 (25.4%) consumed it 1-2 times per month, and 184 (32.45%) consumed it ≥ 1-3 times per week. Mean knowledge and barrier scores were 13.88 and 18.53, respectively. Significant associations were found between whole‑grain consumption and education status (p = 0.04), knowledge (< 0.001), barriers (p < 0.001), sugar‑sweetened beverage (SSB) intake (p = 0.04), and the number of main meals per day (p = 0.006). Positive correlations with knowledge (r = 0.196) and negative correlations with barriers (r = -0.422) were observed (both p < 0.001). Higher knowledge was associated with greater dairy intake (OR = 1.194; 95% CI: 1.079-1.321), while barriers correlated negatively with vegetable (OR = 0.943; 95% CI: 0.907-0.980), fruit (OR = 0.941; 95% CI: 0.910-0.974), and dairy intake (OR = 0.938; 95% CI: 0.906-0.972), and positively with sweet/salty snacks (OR = 1.067; 95% CI: 1.029-1.105).

Students showed moderate to high awareness of whole-grain bread benefits; however, low consumption was associated with accessibility and price. Higher whole-grain bread intake was associated with better overall dietary quality.