Association between secondary school nutrition education and dietary behaviour in UK university students: a cross-sectional study

Abstract Background Dietary behaviours established during adolescence are known to track into adulthood and influence long-term health outcomes. In the United Kingdom, nutrition education is delivered through secondary school health and curriculum programmes; however, its longer-term relevance for dietary behaviour in early adulthood remains unclear. This study examined whether retrospective exposure to secondary school nutrition education is associated with dietary behaviour among university students and whether these associations vary according to parental education. Methods A cross-sectional online survey was conducted among 407 university students aged 18 years and older in the United Kingdom. Dietary behaviour was assessed using the Starting the Conversation (STC) questionnaire. Nutrition education exposure was measured using both a binary indicator (exposed vs. not exposed) and a continuous cumulative exposure score based on reported curriculum coverage. Hierarchical regression and correlation analyses examined associations between nutrition education and dietary behaviour, adjusting for covariates. Interaction terms assessed moderation by parental education. Results Participants had a mean STC score of 6.52 (SD = 3.47). Overall, 59.2% reported receiving nutrition education, and among exposed participants the mean cumulative exposure score was 2.67 (SD = 0.59). Participants reporting nutrition education demonstrated significantly healthier dietary behaviour than those reporting no exposure ( B = -2.60, β = − 0.38, p < .001). However, among exposed participants only, the cumulative exposure score was not significantly associated with dietary behaviour ( B = -1.19, β = − 0.23, p = .068), although sensitivity analyses including unexposed participants indicated a significant association. Within the exposed subsample, older age was associated with healthier dietary behaviour ( B = -0.19, β = − 0.19, p = .017). Parental education did not significantly moderate associations between nutrition education exposure and dietary behaviour. Conclusions Exposure to nutrition education during secondary schooling was associated with healthier dietary behaviour in early adulthood. However, evidence for a dose-response relationship was inconsistent, suggesting that exposure itself may be more important than the extent of exposure. Given the cross-sectional design, retrospective measurement, and potential confounding, causal conclusions cannot be drawn. Longitudinal research using objective measures is needed to clarify the long-term impact of school-based nutrition education.