Nutrition Education Program to Prevent Obesity Epidemic - Essay Example

? Nutrition Education Program to Prevent Obesity Epidemic Introduction According to the Centers for Disease Control and Prevention (CDC), the number of individuals diagnosed with obesity and other chronic diseases has steadily increased over the past decade (Centers for Disease Control and Prevention 1). Data from the Behavioral Risk Factor Surveillance System showed that young adults between the ages of 18-29 have shown a dramatic increase in the prevalence of overweight and obesity in recent years and presently estimate 20.3% of the U.S. population (Centers for Disease Control and Prevention 3). The issue of unhealthy dietary techniques and exercise regimes among young adults are not properly addressed in America. Tackling this problem can be a meaningful effort towards reducing the incidence of overweight and obesity in the United States. There is a need to develop a nutrition education program for young adults during their first year on campus. With obesity and other chronic diseases steadily increasing over time, this program can serve as an excellent solution. Nutrition, Physical Activity, and Health The association between nutrition, physical activity, and good health has now become an accepted fact. The literature on the topic is vast. Most renowned nutrition and wellness organizations in the United States have agreed on the critical role of nutrition and physical activity on the overall health of the nation. The Centers for Disease Control and Prevention (p. 1) indicated that the nation can no longer afford to be physically inactive and follow unhealthy eating patterns. The consequences of such a lifestyle increase the prevalence of chronic diseases, especially obesity (Victoria 1). Since 1985, the U.S. Department of Agriculture has published periodically reviewed versions of the Dietary Guidelines for Americans. One of the guidelines were published in 2005 under the expertise of public health and nutrition professionals in the field who systematically reviewed scientific research related to the effects of diet on chronic disease (U.S. Department of Health and Human Services and U.S. Department of Agriculture 1). Furthermore, the Center for Nutrition Policy and Promotion's "MyPyramid," the recently revised Food Guide Pyramid of 1992, is an interactive, personal teaching and assessment tool based on the Dietary Guidelines for Americans that encourages the promotion of healthier eating and physical activity patterns (Hentges 4). Regular physical activity has been shown to significantly reduce the risk of cardiovascular disease and improves overall quality of life. Kruger, Bowles, Jones, Ainsworth, and Kohl (321) examined the association between health-related quality of life and physical activity among 9,173 participants. Results showed that the prevalence of health-related quality of life was inversely related to physical activity participation. A similar epidemiological study to examine the association between physical activity and body mass index alone and in combination with cardiovascular disease biomarkers in a cohort of women in the Women's Health Study found that any increase in physical activity was generally associated with more favorable cardiovascular biomarkers (Mora, Lee, Buring, & Ridker, 1418). Wessel et al. (1185-1186) also found that higher physical fitness scores were independently associated with fewer incidences of coronary artery disease risk factors among Women. Research also supports the claim that physical activity increases longevity in both men and women (Franco et al., 2359-2360). A review of evidence-based research on the relationship between obesity related cardiovascular disease and nutrition indicated several key dietary modifications that could reduce the risk of such diseases related to obesity. These strategies included: reduction of saturated fat and substitution with unsaturated fats, adoption of the Mediterranean diet as proposed by the American Heart Association which includes high consumption of fruits and vegetables, beans, nuts, and seeds, use of olive oil as an important fat source, and increasing intake of omega-3 fats (Mead et al., 417-419). Willcox and colleagues' study of the lifestyle and its association with overall survival and exceptional survival in a cohort of men aged 45 to 68 years supported the claims that a balanced diet and exercise significantly reduces risk of chronic illness and increases longevity (Willcox et al., 2343). Similarly, among other findings of the Food Habits in Later Life (FHILL) cross-cultural study by the International Union of Nutritional Sciences in conjunction with the World Health Organization, individuals aged 70 years and older who adhered to a Mediterranean diet and were physically active showed the greatest effects in significantly reducing mortality (Wahlquist et al., 5-6). Even though nutrition and physical activity are independently associated with good health, the strength of association increases when they exist in combination. Wilding Study has shown that leading a physical active lifestyle along with a balanced diet significantly reduces the risk of chronic disease as well as maintains or reduces body mass index scores among men and women alike (Wilding, 142-143). Practical Reasoning Obesity and Overweight: Implications for Young Adults Obesity is 1 of the 10 leading indicators of health in the United States. As of 2012, more than half the population of the United States are overweight and more than 26.7 % of individuals are obese. These statistics are generally the same for both genders. Although these numbers escalate over time, young adults aged 18 to 29 years appeared to one of the major cohorts that report more incidence of overweight and obesity (Centers for Disease Control and Prevention ‘Morbidity and Mortality Weekly Report’ 3). Statistics also show that overweight adolescents have a 70% chance of becoming overweight adults. This number increases to 80% if one or both parents are overweight or obese (U.S. Department of Health and Human Services 10). Research has shown that obesity increases the risk for other chronic diseases such as hypertension, dyslipidemia, type 2 diabetes, cancer, and especially heart disease and stroke (Centers for Disease Control and Prevention, ‘Physical Activity and Good Nutrition’ 1-4). Health of the Nation Annual Report published in 2005 has also shown that cardiovascular disease (CVD), particularly heart disease and stroke, ranked first and third, respectively, as leading causes of death in the United States (National Center for Health Statistics 11). Even though the prevalence of CVD in America is less of a burden for young children, adolescents, and young adults (600 cases per year), 1 in 5 unexpected deaths among children ages 1 to 13 and 1 in 3 among 14- to 21-year-olds can be accounted for by a sudden cardiac episode (Thorn et al., e85-eI51). College Students: Eating Behavior and Physical Activity Trends The transition from high school to college is a challenging time for many Americans. It is a time characterized by change in every avenue of life and parallels the shift from adolescence to young adulthood. For most Americans, leaving home for college initiates independent decision making. Making choices about food, including the choice not to eat at all is a prime example. What is most important is that such choices are made several times a day and are influenced by various factors which further increase the barriers to developing and maintaining healthy nutrition and physical activity habits (Nathan 23-31). The life of a college student is usually characterized by limitations in critical factors such as time and finances. A study by Levi and colleagues on a sample of undergraduate students, of which over 50% were freshmen, showed that students were more prone to choose foods based on taste, cost, and convenience rather than nutritional benefit and tended to eat out at least three times a week (Levi, Chan, & Pence, 96-97). There is no surprise then that fast food chains tend to cluster within walking distances to elementary and high schools and secure a spot in college campus dining facilities (Austin et al., 15; Stanish 1). The literature on the eating and physical activity habits of college students present results that rouse the need for intervention strategies. While the theory of the "freshman 15" has been revoked in recent literature, weight gain is likely to occur during freshman year and the observed weight gain (6 pounds) is sufficient enough to place these individuals at risk for obesity and chronic diseases later in life (Hoffman, Policastro, Quick, & Lee, 41-45). To investigate changes in dietary and exercise habits arid weight gain among students post freshman year, Racette et al. (245­) assessed 290 college students during the first 2 years of college. The study revealed that weight gain increased from freshman to sophomore year. In addition to this, exercise activity was kept at a bare minimum over the 2 year period. Consumption of high fat fast foods remained high and fruits and vegetable intake averaged less than five portions per day. Alcohol consumption has been shown to start in high school and steadily increases throughout college. With a provision of 7 kilocalories per gram, it cannot be underemphasized how this significantly contributes to weight gain among this vulnerable group. According to the literature, use of alcohol is higher among college students than among non-college students of the same age cohort (O'Malley & Johnson, 37-38). Prevalence of drinking during college years also show to be highest during the early years of college (Caudill et al., 153-154). As a part of the National College Health Assessment (NCHA), assessment of a random sample of 297 college students at a midsized university in America indicated that students aged 21 or older were more likely to be overweight and obese than those under 21 (40%). More than 70% of obese and overweight students were attempting to lose weight. Among weight loss strategies, exercise, dieting, diet pills, and vomiting were most prevalent. Less than half of the students who were trying to lose weight reported using exercise and diet together (American College Health Association 3). In fact, use of dietary supplements to manage weight is becoming increasingly popular among this cohort regardless of knowledge of safety of the products and can potential hazardous to overall health if consumed without professional advice (Fogel & Kholodenko 2). Other studies on college students are in support of these findings and highlight inactivity and unhealthy dietary behaviors that characterize many students during the early years of college (Hajhosseini et al., 126- 127). Nutrition Education Programs It is the position of the American Dietetic Association (ADA) that, “Nutrition education is essential for the public to achieve and maintain optimal nutritional health.” (Shafer et al., 1996, p. 1183) Nutrition education may vary from providing knowledge, promoting skill development, or utilization of intervention techniques to foster behavioral change. Effective programs should feature information based on the needs and interests of the target population and should be made easily accessible. This section reviews current nutrition education programs in the community those specifically designed for college students and the effectiveness of such programs. Community Nutrition Programs Nutrition education in school systems has become popular in many states. Federal programs such as the School Breakfast and Lunch Programs have promoted and encouraged health and nutrition by providing nutritionally balanced, low-cost or free meals to thousands of school children daily (U.S. Department of Agriculture 1). Over the years the program has been partially successful in its efforts but continues to face challenges. Consumption of competitive foods, defined by the United States Department of Agriculture (USDA) as foods that are not served under the USDA's school meal program but are offered at school, have been shown to undermine the integrity of these programs and decreases trends in program participation (U.S. Department of Agriculture, 1). Nevertheless, these programs continue to promote health and wellness to most underprivileged children in America. The U.S. Department of Agriculture also guides the Expanded Food and Nutrition Education Program (EFNEP), a primary prevention program that targets low-income families and youths in 50 states and six U.S. territories. Assisting participants gain knowledge, skills, and behavior change necessary to maintain nutritionally balanced meals are main goals of this program. State EFNEP programs are evaluated annually using impact indicator methods designed by the USDA. Townsend, Johns, Shilts, and Farfan-Ramirez (30) evaluation of the EFNEP program in California for 9- to l1-year­olds using the USDA's federal impact indicator method showed favorable results. Children who participated in the study produced greater gains in knowledge, skills, and behavior with regards to nutrition compared to control participants on these three indicators. Other nutrition education programs have also shown to be effective in delivery of information and behavioral change of participants. Powers, Struempler, Guarino, and Parmer (129-133) determined the effects of a nutrition education program designed for elementary school children on dietary behavior and nutrition knowledge among second and third graders. This program incorporated age appropriate materials such as games and fun and creative questionnaires based on the theory of social cognition to assess students. Findings from this study revealed that the treatment group exhibited significantly greater improvement in dietary knowledge and behaviors than those in the control group. Kinedinst's evaluation of the effectiveness of a nutrition education program designed for urban, low-income older adults called, Eat and Learn Nutrition Program, resulted in increased knowledge of nutrition among most participants (Klinedinst, 102-103). Nutrition Education for College Students Nutrition education programs designed for college students have shown to be effective. Abood, Black, and Birnbaum (135) evaluated the efficacy of a nutrition education intervention designed for college female athletes in improving nutrition knowledge, promote self-efficacy, and improve dietary intake. A pre-test/post-test control group design was used. Dietary records, 24-hour recalls, lecture, and sessions on application of material learn through lecture were primary intervention tools. Treatment participants were found to significantly improve nutrition knowledge, self-efficacy, and dietary changes than control participants (Abood et al. 138-139). Sun, Sangweni, Chen, and Cheung (241) also investigated the efficacy of a community-based nutrition education program on the dietary behavior of Chinese-American college students using the PRECEDE model. The PRECEDE model, developed by Green and Kreuter, was used as an evaluation tool to assess knowledge, attitude, and behavior. Workshops, self­-monitoring, goal setting, and lectures were used by registered dietitians to deliver the program. Thirteen topics were addressed regarding nutrition and wellness incorporating major components of the PRECEDE model including: predisposing, enabling, and reinforcing factors of behavior. Individuals in the treatment group showed an increase in perceptions in nutrition and health and dietary behavior than the control group. Many wellness and health centers on campuses across America offer nutrition education opportunities to students to help increase progression toward objective of developing healthy campuses in America. Pennsylvania State University's Peer educators Health Works Peer Education Outreach Program offers workshops on major health topics including nutrition and physical activity to students on campus upon request from advisors, clubs, and staff. The program is conducted by the university's health service office of Health Promotion and Education, a fully accredited ambulatory health care center (Pennsylvania State University 1). Bethany College in Kansas also offers a course in the Physical Education Department called Concepts of Wellness and Leisure to introduce concepts of fitness and leisure to promote wellness in both lecture and laboratory settings (Bethany College, 1). Weight Loss 101: A Healthy Approach to Weight Loss is a program developed by nutrition professionals to provide basic nutrition information and weight control education at 50-minute sessions, once a week, for 4 weeks to college students at Mississippi State University. It is a university sponsored program offered through the university's student health center by graduate assistants trained in nutrition and dietetics under the supervision of a registered dietitian (Hunt, Bogle, Gillentine, & Daughtrey 26-27). The University of Georgia also provides individual nutrition counseling, workshops, seminars, or classes by the registered dietitian on campus at a fee to the students (University of Georgia, 1). No effectiveness studies on these programs have been conducted. Many programs also exist to encourage healthy eating and physical activity among college students. These programs are available at an extra cost. Effectiveness studies on achieving this goal have not been conducted. My Student Body Comprehensive College Health Suite is one such program which provides college health information on health-related issues on college campuses including: alcohol, stress, tobacco use, sexually transmitted diseases, and nutrition. Developed and tested by the National Institute of Diabetes and the National Institute of Digestive and Kidney Diseases, the nutrition component of this online resource that provides a basic background into the concepts of nutrition and physical activity including body image issues, fitness, weight control, and time constraints and food consumption (MyStudentBody.com, 1). Summary Nutrition education programs strive to correct the obesity epidemic facing our society today. Being one of the most influential factors in chronic disease development, obesity has been a major culprit in deaths by chronic disease in America. Fast food chains, restaurants, campus dining facilities, and the wake of convenience foods have exacerbated this problem. Tackling this issue then is a challenge for everyone especially poor college students who are pressed for time and prefer foods that are convenient and cheap enough to fit their tight budgets. Significant weight gain is a reality for many college students especially freshmen and is a direct result of poor eating habits, increased alcohol intake, and a reduction in physical activity. This transitional stage in life offers a window of opportunity to educate students on the importance of a healthy diet and exercise. Providing practical guidelines and tips that could forfeit the obstacles faced by college students will be essential in changing behavioral habits. Healthy eating habits and regular physical activity have both been implicated in promoting longevity and have been shown to reduce risks of obesity, cardiovascular disease and other chronic diseases. Individuals that combine both lifestyle habits, the benefits to health are strengthened. Nutrition education is an excellent approach to foster nutrition knowledge and to encourage changes in lifestyle habits to promote health and wellness. Motivation and self-efficacy are important components of any education program that seeks to foster change. At the hub of community nutrition efforts, nutrition education must rely on needs assessment data and should be driven by the participants in order to address the issues affecting the target population and to encourage any change in behavior. Coalitions and organizations have begun to incorporate educational techniques to encourage these lifestyle changes among all groups in the United States. This type of program can be beneficial to promote the underlying messages of the importance of nutrition and exercise while promoting self efficacy and motivation. Work Cited Abood, D. A., Black, D. R., & Birnbaum, R. D. “Nutrition education intervention for college female athletes.” Journal of Nutrition Education Behavior, 36, (2004): 135-139. American College Health Association. National College Health Assessment: Reference Group Executive Summary Spring 2001. Baltimore: American College Health Association, 2001. Austin, S. B., Melly, S. J., Sanchez, B. N., Patel, A., Buka, S., & Gortmaker, S. L. “Clustering of fast-food restaurants around schools: A novel application of spatial statistics to the study of food environments.” American Journal of Public Health, 95(9), (2005).1575-1581. Bethany College. “Physical education and health course descriptions.” (2012) Retrieved from http://www.bethanylb.edu/pdf/09-10-BethanyCollegeAcademicCatalog.pdf Caudill, B. D., Crosse, S. B., Campbell, B., Howard, J., Luckey, B., & Blane, H. T. “High-risk drinking among college fraternity members: A national perspective.” Journal of American College Health, 55(3), 141-155. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report. State-Specific Prevalance of Obesity Among Adults-United States, 2009, 59, (2010), 1-5. Centers for Disease Control and Prevention. Physical Activity and Good Nutrition: Essential Elements to Prevent Chronic Diseases and Obesity, 2004, 1-4. Feb. 2012. Fogel, J., & Kholodenko, N. (2006). “Consumers of dietary supplements: Gender and immigrant status differences among college students.” Internet Journal of Internal Medicine, 3(1),2. Food Manufacturers.” StudentPulse. Vol. 2. No. 11. 2010. Web. 3 Feb. 2012. Franco, O. H., de Laet, C., Peeters, A., Jonker, J., Mackenbach, J., & Nusselder, W. “Effects of physical activity on life expectancy with cardiovascular disease. Archives of Internal Medicine”, 165, (2005), 2355-2360. Green, L. W., & Kreuter, M. W. Health Promotion Planning and Educational and Environmental Approach. Mayfield, Toronto, 1991. Hajhosseini, L., Holmes, T., Mohamdi, P., Goudarzi, V., McProud, L., & Hollenbeck, C. B. “Changes in body weight, body composition and resting metabolic rate in first-year university freshmen students.” Journal of the American College of Nutrition, 25(2), (2006). 123-127. Hentges, Eric J. “Hearing before the Subcommittee on Agriculture, Rural Development, and Related Agencies.” 2006. Retrieved from https://www.hsdl.org/?view&did=466476 Hoffman, D. J., Policastro, P., Quick, V., & Lee, S. “Changes in body weight and fat mass of men and women in the first year of college: A study of the Freshman 15.” Journal of American College Health, 55(1),41-45. Hunt, B. P., Bogle, V., Gillentine, A., & Daughtrey, C. “Weight loss 101: A healthy. weight loss program for college students.” American Journal of Health Studies, 17(1), (2001). 26-30. Klinedinst, N. J. “Effects of a nutrition education program for urban, low-income, older adults: A collaborative program among nurses and nursing students.” Journal of Community Health Nursing, 22(2), (2005): 93-104. Kruger, J., Bowles, H. R., Jones, D. A., Ainsworth, B. E., & KoW, H. W. “Health­ related quality of life, BMI, and physical activity among US adults: National Physical Activity and Weight Loss Survey, 2002.” International Journal of Obesity,31 (2), (2002). 321-327. Levi, A., Chan, K. K., & Pence, D. “Real men do not read labels: The effects of masculinity and involvement on college students' food decisions.” Journal of American College Health, 55(2), (2006): 91-98. Mead, A., Atkinson, G., Albin, A., Alphey, D., Baic, S., et al. “Dietetic guidelines on food and nutrition in the secondary prevention of cardiovascular disease-evidence from systematic reviews of randomized controlled trials.” Journal of Human Nutrition and Dietetics, 19, (2006), 401-419. Mora, S., Lee, I., Buring, J. E., & Ridker, P. M. “Association of physical activity and body mass index with novel and traditional cardiovascular biomarkers in women.” Journal of the American Medical Association, 295, (2006): 1412-1419. MyStudentBody.com. MyStudentBody comprehensive college health suite. (2012). Retrieved from http://www.mystudentbody.com/classicsite/about/QuickTour/Nutrition/index.html Nathan, R. My freshman year: What a professor learned by becoming a student. New York: Cornell University Press, 2005. National Center for Health Statistics, & Center for Disease Control and Prevention. (2005). Health, United States. Health of the Nation Annual Report, 29, 292-295. O'Malley, P. M., & Johnson, L. D. “Epidemiology of alcohol and other drug use among american college students.” Journal of Studies on Alcohol, 14,23-39. Pennsylvania State University. Health Works peer education outreach program, (2012). Retrieved from http://studentaffairs.psu.edu/health/wellness/healthWorks.shtml Powers, A. R., Struempler, B. J., Guarino, A., & Parmer, S. M. “Effects ofa nutrition education program on the dietary behavior and nutrition knowledge of second-grade and third-grade students.” Journal of School Health, 75(4), (2005): 129-133. Racette, S. B., Deusinger, S. S., Strube, M. J., Highstein, G. R., & Deusinger, R. H. “Weight changes, exercise, and dietary patterns during freshman and sophomore years of college.” Journal of American College of Health, 53(6), (2005). 245­-251. Shafer, L., Gillespie, A., Lynn-Wilkins, J., & Borra, S. T. (1996). “Position of the american dietetic association: Nutrition education for the public.” Journal of the American Dietetic Association, 96(11), 1183-1187. Stanish, Janelle R. “The Obesity Epidemic in America and the Responsibility of Big Sun, W. Y., Sangweni, B., Chen, J., & Cheung, S. “Effects of a community-based nutrition education program on the dietary behavior of chinese-american college students.” Health Promotion International, 14(3), (1999). 241-249. Thorn, T., Haase, N., Rosamond, W., Howard, J., Rumsfeld, J., Manolio, T., et al. “Heart disease and stroke statistics-2006 update: A report from the american heart association statistics committee and stroke statistics subcommittee.” Circulation, 113(6), (2006).e85-eI51. Townsend, M. S., Johns, M., Shilts, M. K., & Farfan-Ramirez, L. (2006). “Evaluation of a USDA nutrition education program for low-income youth.” Journal of Nutrition Education and Behavior, 38,30-41. U.S. Department of Agriculture. Food sold in competition with USDA school meal programs: a report to congress. (2001) Retrieved, from http://www.cspinet.org/nutritionpolicy/Foods_Sold_in_Competition_with_USDA_School_Meal_Programs.pdf U.S. Department of Agriculture. The school breakfast program: Program factsheet. (2006) Retrieved from http://www.fns.usda.gov/cnd/breakfast/AboutBFast/SBPFactSheet.pdf U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines/or Americans 2005 (6th ed.). Washington, DC: U.8. Government Printing Office, 2005. U.S. Department of Health and Human Services. The Surgeon General's call to action to prevent and decrease overweight and obesity. Washington, DC: U.S. Government Printing Office, 2001. University of Georgia. University health center: Nutrition. (2012). Retrieved from www.uhs.uga.edu/nutrition Victoria. “The Real Causes of the Obesity Epidemic: The Largest of All.” n.d. Web. 5 Wahlquist, M. L., Darmadi-Blackberry, I., Kouris-Blazos, A., Jolley, D;, Steen, B., Lukito, W., et al. “Does diet matter for survival in long-lived cultures?” Asia Pacific Journal of Clinical Nutrition, 14(1), (2005): 2-6. Wessel, T. R., Arant, C. B., Olson, M. B. Johnson, B. D., Reis, S. E., Sopko, G., et al. “Relationship of physical fitness versus body mass index with coronary artery disease and cardiovascular events in women.” Journal of the American Medical Association, 292, (2004), 1179-1187. Wilding, J. P. H. “Treatment strategies for obesity”, Obesity Reviews, 8(1), (2007).137­144. Willcox, B. J.,He, Q., Chen, R., Yano, K., Masaki, K. H., Grove, J. S., et al. “Midlife risk factors and healthy survival in men. Journal of the American Medical Association”, 296, (2006): 2343-2350. Read More