Young adults in Appalachia may face poor nutritional status due to low access to healthy food and high mental health symptoms attributed to high stress and the college environment. A cross-sectional design was used to investigate the relationship between diet intake and mental health status of this population via surveys. Participant responses (n = 1956) showed students’ mean number of depressed days over the past 30 days was 9.67 ± 8.80, and of anxious days, 14.1 ± 10.03. The mean fruit and vegetable intake was 1.80 ± 1.27 times per day and the mean added sugars intake was 1.79 ± 1.26 times per day. 36.7% of students were found to be food insecure. One-way ANOVA and Chi-Squared analyses were used to determine relationship between variables. Significant variables were placed into a full logistic regression model. Food insecurity and fruit and vegetable intake remained significant predictors of depression in males (odds ratio (OR) = 2.33 95% CI 1.47–3.71 and OR = 68 95% CI 50–89, respectively) and in females food insecurity remained a significant predictor of depression (OR = 2.26 95% CI 1.67–3.07). Food insecurity and added sugars intake were significant predictor of anxiety in males (OR = 2.33 95% CI 1.47–3.71 and OR = 1.09 95% CI 0.91–1.3, respectively) and for anxiety in females, added sugars intake and food insecurity were significant predictors (OR = 1.18 95% CI 1.05–1.32 and OR = 1.65 95% CI 1.27–2.16, respectively). Improving college student’s diet intake through increased access to healthy foods could improve the mental health and well-being of students
