Research ArticlesPhysical activity, food choice, and weight management goals and practices among U.S. college students
Introduction
Overweight and obese adults are at increased risk for mortality and morbidity related to a wide range of chronic diseases, including coronary heart disease, hypertension, dyslipidemia, diabetes mellitus, gallbladder disease, and some types of cancer.1, 2 Recent estimates of body mass index (BMI) indicate that more than half (54%) of adults, 12% of adolescents, and 14% of children in the United States are overweight.3, 4 Further, the prevalence of overweight in each of these age groups has increased significantly over the past 15 years.3, 4, 5, 6
Recommendations for the long-term treatment and prevention of obesity in adults include multicomponent interventions that combine a healthy diet and exercise with behavior modifications designed to facilitate maintenance of these lifestyle changes throughout the life span.3, 7 National objectives for healthy dietary behaviors and physical activity include increased consumption of fruits and vegetables, reduced consumption of dietary fat, accumulation of at least 30 minutes of moderate physical activity most days of the week, participation in vigorous physical activity that promotes the development of cardiorespiratory fitness for 20 or more minutes at least 3 days per week, and regular performance of physical activities that enhance and maintain muscular strength, muscular endurance, and flexibility.2, 8, 9, 10
A national telephone survey of adults who were trying to lose weight found that 71% of women and 62% of men reported both changing their diets and exercising more.11 Use of low-fat and low-calorie foods was widespread among both women and men. The types of exercise most commonly employed included walking and aerobics classes among women, and walking and weight training among men. Women were more likely than men to engage in potentially harmful and unhealthy (e.g., diet pills, vomiting, and laxatives) weight control practices. A study of high school students participating in the Youth Risk Behavior Survey found that females who were trying to lose weight limited their intake of high-fat meats, fried foods, and dessert foods; males limited their intake of high-fat dessert foods.12 Consumption of fruits and vegetables was not associated with trying to lose weight among female or male students. Vigorous physical activity and muscle strengthening exercise were associated with trying to lose weight among female students, and trying to gain weight among male students.
Colleges and universities are potentially important settings for reducing the prevalence of overweight in the adult population through the promotion of healthy weight management practices. More than 12 million students currently are enrolled in the nation’s 3600 colleges and universities.13 One in 4 persons aged 18 to 24 years in the United States currently is either a full- or part-time college student,13, 14 and half of all persons aged 20 to 24 years have attended college.15 While overweight and obesity appear to track from childhood into adulthood, overweight during late adolescence is most strongly associated with increased risk of overweight in adulthood.16 Colleges and universities provide numerous opportunities to positively influence physical activity, nutrition, and weight management behaviors of large numbers of older adolescents and young adults in an educational setting.
Although numerous intervention studies have documented the extent to which subjects adhere to prescribed dietary and physical activity regimens during weight loss programs, few population-based observational studies have examined the extent to which persons who are trying to control their weight include fruits and vegetables and limit high-fat foods in their diets, and the extent to which they engage in specific types of physical activity. The 1995 National College Health Risk Behavior Survey (NCHRBS), part of the Youth Risk Behavior Surveillance System (YRBSS) implemented by the Centers for Disease Control and Prevention (CDC), assessed a broad range of priority health risk behaviors among a nationally representative sample of undergraduate college students attending 2- and 4-year institutions.17 We analyzed data from the 1995 NCHRBS to examine associations of physical activity and food choice with weight management goals and practices. Our study extends the current literature by describing the demographic distribution of overweight and selected weight management goals and practices among US college students, and the types of physical activity and food choices associated with these weight management goals and practices.
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Study design
The 1995 NCHRBS, a national mail survey of college students, used a 2-stage cluster sample design to produce a representative sample of undergraduate college students aged ≥ 18 years in the United States. The first-stage sampling frame contained 2919 primary sampling units, consisting of 2- and 4-year colleges and universities. Technical and trade schools or noncollegiate training programs (e.g., truck driving schools, security guard training, and beautician schools) were excluded from the
Results
The school-level response rate was 92% and the student-level response rate was 65%, representing an overall response rate of 60%. Based on weighted prevalence estimates, nearly half (45.6%; 95% CI, ± 3.9%) of all undergraduate students attended 2-year colleges. Compared to students attending 4-year colleges, students attending 2-year colleges were more often aged 25 years or older (51.3% vs 24.1%), of Hispanic ethnicity (9.5% vs 5.1%), employed full time (34.9% vs 13.4%), attending college part
Discussion
Based on self-reported height and weight, 35% of undergraduate college students in the United States were overweight or obese (BMI ≥ 25.0), and nearly half (46%) of all students were trying to lose weight. Female students were less likely than male students to be overweight, but more likely to be trying to lose weight. Among female and male students, trying to lose weight was associated with participation in vigorous physical activity and strengthening exercises, and consumption of fewer
Conclusion
College campuses provide an ideal forum for reaching large numbers of young adults with education and prevention programs that promote healthy weight management. In addition to vigorous physical activity, strengthening exercises, and limited consumption of high-fat foods, students should be encouraged to incorporate moderate physical activity and sufficient consumption of fruits and vegetables into their weight management strategy. Additional efforts to discourage potentially dangerous and
Acknowledgements
Presented in part at the 126th Annual Meeting of the American Public Health Association, Washington, DC, November, 17, 1998.
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