Influence of mental health on eating practices among university students during the COVID-19 pandemic: A systematic review

This systematic review examines how anxiety, depression, and stress influence university students' dietary behaviors during the COVID-19 pandemic. After registering the protocol at PROSPERO(CRD42025639716), we searched seven databases, gray literature and references list. Observational studies assessing mental health as exposure and dietary changes as outcomes were selected by two reviewers. The JBI tools assessed risk of bias. A qualitative synthesis of the findings was performed to integrate results narratively. Of 2,624 records, 22 studies (20 cross-sectional, 2 cohort) were included, 95.46% at low risk of bias but methodologically diverse. Heightened anxiety, depression, and stress were linked to emotional or uncontrolled eating and increased ultra-processed food intake. A small subset (13.64%) reported atypical patterns, such as reduced dessert consumption or increased consumption of fresh/minimally processed foods. Pandemic-related disruptions appeared to exacerbate psychological-disstress-induced dietary changes. Future longitudinal or intervention studies should clarify causal pathways and assess programs targeting mental health and nutrition.