{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T05:47:40Z","timestamp":1767764860283,"version":"3.48.0"},"reference-count":44,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2025,9,24]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Lack of consistent access to sufficient, nutritious food is a pressing issue globally. Resilient food systems amalgamating multiple sectors like agriculture, animal husbandry, healthcare and education are essential to resolve food insecurity. College students, particularly in medical colleges, are vulnerable to food insecurity due to limited access to healthy food, lack of resources (time, money and knowledge), resulting in unhealthy eating habits. This study aims to investigate the presence of food deserts within medical colleges in Kerala, analyse factors influencing student food preferences and explore the consequences of food insecurity on their health and academic performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A cross-sectional study will be conducted at a private medical college in Central Kerala over 8 months. Data will be collected from medical students (medical, dental, nursing and laboratory) throughout all years using structured questionnaires, focus group discussions and interviews with food outlet operators. We plan to recruit 400 students for the quantitative survey and 1 focus group with 6\u20138 participants for the qualitative study. Stratified random sampling will ensure representation across different academic years and disciplines. Food outlets within a one-mile radius of the campus will be identified and assessed for affordability, variety and availability of healthy food options. Observations of food outlets will evaluate food variety, pricing and hygiene standards. Quantitative data will be analysed using descriptive and inferential statistics, while qualitative data will be thematically analysed to gain deeper insights.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval (PIMSRC\/E1\/388\/107\/2024) has been obtained from the Institutional Ethics Committee of the Pushpagiri Institute of Medical Sciences &amp; Research Center, and informed consent will be collected from participants. Data confidentiality will be strictly maintained. Findings will be disseminated through academic conferences, publications and policy briefs using deidentified data to advocate for healthier food environments on campuses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-002773","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T05:15:12Z","timestamp":1767762912000},"page":"e002773","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Food deserts and food insecurity in Indian medical colleges: a mixed-methods study protocol exploring myths and realities"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1002-7422","authenticated-orcid":false,"given":"Mekha","family":"Joykutty","sequence":"first","affiliation":[{"name":"Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0717-8288","authenticated-orcid":false,"given":"Reshma Vazhakalayil","family":"Ramachandran","sequence":"additional","affiliation":[{"name":"Pushpagiri Medical College Hospital, Thiruvalla, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9873-8550","authenticated-orcid":false,"given":"Anjum","family":"John","sequence":"additional","affiliation":[{"name":"Community Medicine, Pushpagiri Medical College Hospital, Thiruvalla, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"2026010621150756000_4.1.e002773.1","unstructured":"Organization WH . 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Planning for Sustainable Food Systems: Students and Food Swamps in Waterloo Region. Waterloo: Waterloo, 2016."},{"key":"2026010621150756000_4.1.e002773.10","unstructured":"Mowreader A . Five factors causing food inseurity among college students. Inside Higher Education; 2023. 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Food insecurity among students at the University of the Free State, South Africa. 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About Eat Right Campus, Available: https:\/\/eatrightindia.gov.in\/EatRightCampus\/home"},{"key":"2026010621150756000_4.1.e002773.39","unstructured":"Akhshayakalpa . How mess committees and on-campus nutritionists can make a palpable difference, 2025. Available: https:\/\/gfm.akshayakalpa.org\/read\/feature-article\/mess-on-my-plate-indias-students-are-fixing-their-college-diets?utm_source=chatgpt.com [Accessed 1 Sep 2025]."},{"key":"2026010621150756000_4.1.e002773.40","unstructured":"India Go . Minimum standard requirements for the medical college. Pocket; 14, Sector 8, Dwarka, NEW DELHI \u2013 110 077 MEDICAL COUNCIL OF INDIA, 2018.110."},{"key":"2026010621150756000_4.1.e002773.41","unstructured":"Perappadan BS . MBBS curriculum sees overhaul, time limit for completion of course. 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