Abstract:
Ethiopia is one of the developing countries hit by the double burden of
malnutrition.Inappropriate food choice decisions and unhealthy diet practicesare among the
reasons for the problem, which are poorly investigated in the country particularly inthe study
area.
Objective: To assess drivers of food choice, healthy diet practice, overweight/obesityand
associated factors among adult private college students in Bole Sub-City, Addis Ababa,
Ethiopia,
Methods and materials: Institution based cross-sectional study was conducted among 330
students who were selected using multistage sampling from 01-30 June, 2021. Data were
collected using self-administered questionnaire. Collected data were entered into Epi Info
version 7 and exported to STATA version 16.0 for analysis. Descriptive statistics,
confirmatory factor analysis, andlinear and logisticregression models were used to analyze the
data.Both bivariable and multivariable linear and logistic regression analyses were used to
assess the association between independent and dependent variables. Odds ratio and beta
coefficients along with 95% confidence intervals (CIs) were estimated to measure the
strengths of the association. Level of statistical significance was declared at p-value < 0.05.
Results:Mood, health concern, sensory appeal, price, convenience, natural content, familiarity
and weight benefitwere confirmed as drivers of food choice with significant factor loadings (p
< 0.001) and acceptable internal consistency of items (α=0.91). The mean(±SD)healthy dietary
index(HDI) score of participants was12.54 (±2.86), and 145(43.9%)95%CI (12.22, 12.85) had
HDI score below the mean.Being female [(β=1.20, 95% CI: (0.57, 1.82)], health
concern[(β=0.09, 95% CI: (0.01, 0.17)], and sensory appeal[(β=0.12, 95% CI: (0.01, 0.23)]
were positively associated with healthydiet index (HDI). Thirty-five (10.74%) 95%CI (7.69,
14.43)of the participants were overweight/obese. Age(AOR = 1.163, 95%CI: 1.087, 1.245)was
positively associated with overweight/obesity. Conclusion:The study identified various
biological, social and economic factors that drive food choice decisions, poor diet practices
and warning magnitude of overweight/obesity among college students. Effective nutrition
education and preventive interventions should be implemented to reduce over nutrition and
improve healthy diet practices among college students through promoting favorable food
choice decisions
