Food acculturation and nutrient intake among international students in India: an exploratory cross-cultural study

Food acculturation and dietary transitions among international students (IS) in Western countries have been reported to result in undesirable changes in eating behaviors and dietary patterns, which may negatively affect nutritional status and health after migration. These dietary changes may be influenced by various factors specific to the host country. Given the recent increase in IS enrollment in culturally diverse Asian countries such as India, there is a need to investigate food acculturation in the Indian context. Therefore, this study explored food acculturation, changes in eating behaviors, the factors influencing these changes, and pre- and post-migration differences in anthropometric measures and nutrient intakes.

In this exploratory study with a retrospective pre-post design, IS (n = 320) enrolled at several universities in Pune, India, an education hub, were recruited through purposive sampling. An 83-item structured questionnaire with five sections: (a) sociodemographic information, (b) anthropometric parameters, (c) perceived factors influencing food acculturation, (d) changes in eating behaviors, and (e) food frequency questionnaire (FFQ), was developed, validated, and administered to capture pre- and post-migration changes. Portion sizes and FFQ data were converted to daily intakes to calculate nutrient intake using DietCal version 15.1.3. Multinomial regression analysis and the Wilcoxon signed-rank test were performed using Statistical Package for the Social Sciences (SPSS) version 30.0. Statistical significance was set at p ≤ 0.05.

IS (n = 320) with a mean age of 22.5 ± 4.1 years, height of 169.7 ± 10.3 cm, weight (pre-migration = 65.2 ± 14.3 vs. post-migration = 67.0 ± 14.1 kg), and body mass index (BMI) (pre-migration = 22.58 ± 4.1 vs. post-migration = 23.18 ± 3.9 kg/m²) participated in this study. The study participants reported increased meal skipping (78.7%), consumption of convenience foods (50.3%), eating out (50%), appetite loss (47.5%), replacing meals with snacks (54%), decreased portion size (43%), and a drop in meal frequency to two meals per day (40%) post-migration. These eating behaviors were significantly associated with age, sex, marital status, standard of living, education, region of origin, and Hindi-speaking ability for food purchases (all p < 0.05). Among the perceived factors, the majority reported past acculturation, food availability, accessibility, environment, affordability, sociocultural factors, religious factors, and culinary factors. Regarding food consumption frequency, a statistically significant (all p < 0.005) decrease was noted for beef, mutton, fish, seafood, eggs and poultry, milk and milk products, pulses and legumes, nuts and oilseeds, green leafy vegetables, and fruits. This low food intake was also reflected in nutrient intake, with declines (all p < 0.05) in protein, iron, calcium, vitamin B12, and zinc, whereas high energy, carbohydrate, and fat intakes were evidenced by increased body weight across regions of origin.

Food acculturation patterns observed among IS led to undesirable changes in food and nutrient intake, which may have negative long-term health implications. Planning nutrition interventions that promote the adoption of local, nutritious food is of key importance, while conducting in-depth, qualitative, and longitudinal studies to achieve a better understanding of food acculturation in the Indian context is also needed.