Running Head: EATING HABITS AMONG COLLEGE AGE STUDENTS

What are the Effects of Nutrition Among College Students?

Gina Antonucci, Polixeni Chirgott, Kaitlyn Viglio, and Brittaney Zupko
Professor Molly Roche MSN, RNC, CNS
NURS 3749 – Evidence Based Practice
22 June 2016
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Table of Contents

Abstract 3
I. Introduction 4
II. Review of Literature 4-23
A. Nutrition Among College Students 5-10
1. Changes in Eating and Physical Activity Behaviors 5-7
2. Young Adults’ Food Selection Patterns 7-8
3. Disturbed Eating Behaviors and Psychographic Characteristics 8-10
B. Long-Term Consequences 10-14
1. Obesity and Health Promotion Strategies 10-11
2. Coronary Artery Disease Related to Lifestyle Choices in College 11-13
3. Identifying Clusters of College Students at Elevated Health Risk 13-15
C. What has been done so far?
1. Text Messaging to Improve Dietary Patterns 15
2. E-mailing to Improve Dietary Patterns 16-17
3. Internet Based Nutrition Course to Improve Dietary Patterns 17-18
D. Future Recommendations
1. Dietary Interventions 18-20
2. Understanding Food Choices and Eating Habits 20-21
3. The Impact of Eating and Exercise Habits 21-23
III. Limitations 23-24
IV. Conclusion 24-25
References 26-27
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Abstract

The purpose of this paper is to provide a comprehensive overview of the role that eating

habits can play among college students. In order to achieve this goal, research has been gathered

from various scholarly resources including CINAHL, Ovid, and Google Scholar. As a result,

this paper will include a brief background of the current major nutrition problems and trends

among college age students, a few of the short-term and long-term consequences that can

manifest from poor eating habits, and a few of the strategies that have been implemented thus far

to combat these issues. Finally, based on this research, a recommended course of action that

college campuses can take will be addressed.

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Introduction

The purpose of this research related project is to describe what a literature review of

twelve research articles reviewed by BSN nursing students in an undergraduate nursing research

class revealed about the effects of nutrition on college students. This research group consisting of

four students critically read twelve articles on the relationship of problems associated with

nutrition, the consequences of negative eating habits, what has been done to correct this issue,

and recommendations to improve nutrition among college students. This class assignment is

being implemented to assist in learning the research process and its importance to nursing

practice. The concept of health promotion was chosen by the class to increase the understanding

of this topic with college students. Health promotion was chosen as an important concept in

Healthy People 2020. Through poster presentations students will share current knowledge about

their findings and implications for nursing practice.

II. Review of Literature

According to the World Health Organization, “obesity is one of the most neglected

diseases of significant public health importance” (Koukourikous & Avramika, 2013, p. 128).

Therefore, with a rise in the number of individuals having obesity as well as other chronic

illnesses today, it is important to examine the dietary and exercise patterns of Americans,

especially college students. Although young adults often do not experience the negative ill

effects of a poor diet right away, eating habits usually form during this stage and can eventually

lead to heart disease and diabetes among other chronic illnesses. As a result, the aim of this

literature review is to primarily examine the eating habits among college students and conclude

with what actions colleges, universities, and nurses can take in order to promote healthy eating.
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In order to better understand how to best implement these measures, a search of the

literature was conducted using the following databases: CINAHL, Ovid, and Google Scholar. A

combination of key words and phrases, such as nutrition among college students and eating

habits of college students, were inputted into the databases. Within the search databases, many

of the journals were over ten years old; however, for the purpose of this paper and for relevancy,

articles were only selected from the past five years. In total, 12 articles were retrieved and

included a mix of qualitative and quantitative studies. Three common themes, which emerged

from the review, included (1) how the transition to college can lead to poor dietary decisions due

to stress and more independence in decision-making, (2) how some college students do not meet

the recommended daily input of fruits and vegetables, and (3) how a number of barriers, such as

time constraints, cost, roommates, availability, and taste, can lead to unhealthy eating habits.

These themes along with others will be discussed as well as limitations and recommendations for

the future.

A. Nutrition Among College Students

1. Changes in Eating and Physical Activity Behaviors

College is an extremely important time in one’s life. This is when there is a transition

from adolescence to adulthood. During this period, a person is forced to become more

independent, making decisions that will have a long-term impact on his or her life. One aspect

that people really become responsible for is their health. For instance, college students do not

only begin to make choices regarding the types of foods they are going to eat, but also their level

of physical activity. The study conducted by Small, Bailey-Davis, Morgan, and Maggs (2012)

was designed to take a look at approximately 608 students and their eating behaviors and

physical activity levels over seven semesters. A random and diverse population of students was
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chosen during the fall of their freshman year to take part in this study. All of the participants

selected were first-year, first-time, and full-time students.

In general, from the fall semester of their freshman year to the fall semester of their

senior year, these students would take a survey each semester followed by 14 consecutive daily

surveys focusing on dietary behaviors and physical activity levels. This design almost

represented a journal and the students would record their actions from the day before. These

students were also asked to give their gender, height and weight (for BMI calculations), and

living situation (on campus or off campus). At the end of the seven semesters, the results

showed that college students do not necessarily engage in the healthiest behaviors. For instance,

according to Small et al. (2012), the amount of fruits and vegetables consumed declined

approximately 14% from beginning to end. In addition, the frequency of physical activity

declined by 6% each semester (Small et al., 2012).

Interestingly, the study also examined whether living on or off campus influenced dietary

behaviors and physical activity. In the end, the results revealed that living off campus negatively

impacted both fruit and vegetable consumption as well as moderate physical activity (Small et

al., 2012). One reason for this may be due to the fact that college students living off campus are

limited in many ways. For instance, eating fresh, nutrient rich foods can be difficult because

students may not have access to transportation to grocery stores or other places where these

foods are available. Furthermore, Small et al. (2012) argue that living off campus with

roommates often comes with negotiating not only how foods will be purchased, but also how

they will be cooked and shared. Therefore, in these situations, it is almost easier and more cost-

effective to purchase and prepare cheap, unhealthy foods.

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In conclusion, both fruit and vegetable consumption and physical activity are at an all

time low for college students. Furthermore, based on the research conducted, it is evident that

college students do not often meet the national recommendations for daily consumption (Small et

al., 2012). Moreover, it is also evident that whether or not students live on or off campus can

play a role. On top of these obstacles, the heavy workload and lack of time can make it hard to

find time to exercise and prepare healthy meals.

2. Young Adults’ Food Selection Patterns

The study conducted by Lydecker, Palmberg, Hill, and Mazzeo (2015) focused not only

on the eating patterns of college students, but also their food selection patterns. In order to better

understand the correlation between the two, a total of 783 diverse students participated in a two-

part study. From this number, 500 students participated in part one and 283 students participated

in part two.

In part one of the study, 500 students received class credit for taking an online survey that

used the Three-Factor Eating Questionnaire to measure disordered eating, focusing on

disinhibition, hunger, and restraint. For example, students were asked where they commonly ate

when they were feeling emotional including a list of any restaurant, convenience store, or other

place that accepted the university’s dining plan (Lydecker et al., 2015). Meanwhile, 283 students

in part two of the study voluntarily completed their survey in class answering where they would

eat when feeling emotional. Instead of including all locations that accepted the university’s

dining plan, the students chose categories of locations that accepted the dining plan (Lydecker et

al., 2015). Clickers were used to record the answers of the participants in the second part of the

study in order to provide anonymity. The results of this study showed that there is a relationship

between emotions and eating patterns of college students.

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According to Lydecker et al. (2015), the results suggested that disinhibition and hunger

were associated with buying food when feeling sad, stressed, frustrated, and bored, as opposed to

restraint. It was also determined that “when experiencing emotions, college students more often

selected dining venues they did not normally patronize” (p. 496). Some of these different venues

included convenience stores and off-campus restaurants.

In conclusion, the different emotions of college students certainly have an influence on

their eating patterns and where they choose to eat. In other words, as indicated by the study, not

only do college students purchase food when feeling sad, stressed, frustrated, and bored, but they

also tend to buy food at places that they typically would not eat, which can lead to poor food

choices. Moreover, as Lydecker et al. (2015) pointed out, the type of dining plans offered by

different universities can also make it extremely easy for students to binge eat. In other words,

the unlimited portions that come with certain dining plans can lead to overconsumption.

3. Disturbed Eating Behaviors and Psychographic Characteristics

With college being an extremely important and transitional period in one’s life, there are

many changes that occur, especially eating patterns. The purpose of the study conducted by

Quick and Bredbenner (2013) then, was to explore not only the disturbed eating behaviors of

college students, but also the associated psychographic characteristics of college students as well.

In order to achieve this, a diverse group of 2,604 students from three different U.S.

universities were chosen to participate and complete an online survey. This survey was

composed of three different parts looking at different information. In other words, part one was

used to collect demographic information from the participants including sex, age, race, and

ethnicity. Height and weight were also recorded in order to calculate BMI. Meanwhile, part two

of the study took a look at the disturbed eating behaviors of college students. This included
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restriction, binge eating, and inappropriate compensatory behaviors in order to control both

weight and shape (self-induced vomiting, excessive exercise, and medication misuse), emotional

eating, disinhibited eating, and night eating. Lastly, part three explored the psychographic

characteristics associated with eating behaviors. This included body image perception,

psychological characteristics, and sociocultural environment (Quick & Bredbenner, 2013).

According to Quick and Bredbenner (2013), “dichotomous thinking is another psychological

characteristic associated with disturbed eating behaviors” (p. 2). Basically, this means that

people see things in black and white, and in this case, food is looked at as either good or bad.

Once the surveys were complete, different scales were then used to score each individual

section in order to ensure that the information was accurately measured. Based on the results,

the data revealed that there were not many students that had eating concerns or engaged in

restraining themselves. On the other hand, the occurrence of binge eating was much higher with

approximately one in seven people reporting binge eating at least four times in a 28-day period

(Quick & Bredbenner, 2013).

Regarding part two of the study, 25% of the participants reported shape and weight

concerns, and physical appearance did play a decent part in the students’ perception of their self-

worth (Quick & Bredbenner, 2013). Furthermore, in regards to psychological characteristics, the

study showed that depression and anxiety were reported by approximately half of the study’s

participants, with many of them also reporting OCD-related symptoms (Quick & Bredbenner,

2013). Lastly, there were not a significant number of participants that reported problems with

the sociocultural environment; however, the students were aware of pressures from the media to

attain the “perfect body” and also indicated some type of pressure from family members (Quick

& Bredbenner, 2013). In conclusion, college students do show disturbed eating behaviors, with
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psychographic characteristics playing a significant role. In order to eliminate this problem, it is

believed that many students would benefit from nutrition education.

B. Long-Term Consequences

1. Obesity and Health Promotion Strategies

Obesity, defined as a body mass index greater than or equal to thirty, can negatively

affect a person’s health and lead to the development of numerous health problems. A study

conducted in 2007 analyzed the changes in body weight, composition, and shape in college

students over a period of four years. The researchers in this study reviewed various aspects of

students’ health such as height and weight, body composition, and body shape. Specifically, the

study was to be conducted on 248 college students, a combination of male and female, at the

beginning of their freshman year and the end of their senior year.

According to Gropper, Simmons, Connell, and Ulrich (2012), “college freshman were

randomly recruited from Auburn University’s incoming freshman class via email, flyers, and

class announcements in introductory courses typically taken by first year students at the

beginning of fall semester in 2007” (p. 1119). The people that were excluded from the study

included students under the age of seventeen or over the age of nineteen, pregnant women,

married students, parents of children, students diagnosed with an eating disorder, and those who

enrolled at the university prior to the fall semester of 2007. Assessment of the participants began

at the beginning of their freshman year in late August and early September of 2007, and ended in

late April and early May of their senior year in 2011.

Aside from the physical assessment conducted during the start of the study, participants

completed a demographic questionnaire to obtain personal information regarding gender, race,

date of birth, state of permanent residence, and their location of residence while attending
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college. The study initially began with two hundred and forty participants; however, only one

hundred and thirty-one students returned at the end of their senior year to be reassessed.

In conclusion, Gropper et al. (2012) discovered “significant increases in student’s weight

(3.0 kg), BMI (1.0 kg x m-2), body fat (3.6%), and absolute fat mass (3.2 kg)” (p. 1118). The

study also revealed that 70% of the participants gained weight throughout their four years of

college. In other words, at the beginning of their freshman year, 18% of the students were

classified as overweight-obese; however, the study found that the percentage of overweight-

obese students jumped to 31% at the end of their senior year (Gropper et al., 2012). As a result,

this study revealed a significant decline in students’ health caused by an unhealthy increase in

weight during their college years. According to Gropper et al. (2012) “the distribution of weight,

especially as fat, on the body has been shown to influence health. For example, increased waist

circumference has been associated with increased risk of type 2 diabetes and heart disease” (p.

1122). As a result, this study suggests that additional health promotion strategies be implemented

on college campuses due to the increase in obesity among college students.

2. Coronary Artery Disease Related to Lifestyle Choices in College

College students often experience much more freedom now compared to when they were

living at home. For example, during this transition, students have the ability to make their own

choices without needing to receive permission from their parents. Fernandes, Arts, Dimond,

Hirshberg, and Lofgren’s (2013) study examines this topic in-depth. Specifically, the risk

college students have in developing coronary heart disease caused by lifestyle choices such as

diet and level of physical activity. According to Fernandes et al., “risk factors for developing

scoronary heart disease include being overweight, low-density lipoprotein cholesterol,

hypertension, elevated triacylglycerol, and low high-density lipoprotein cholesterol” (p. 647).
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Unfortunately, a college student’s consumption of a lower quality diet and a decrease in physical

activity compared to their high school years increases the risk of developing coronary heart

disease.

Interestingly, previously conducted research has discovered that college students’ diets

exceed daily recommendations of total fat and saturated fat, and lack the recommended amount

of whole grains and fiber. According to Fernandes et al. (2013), “more than 60% of college

students do not engage in moderate or vigorous physical activity. Poor diet and inactivity in

college contribute to weight gain, which occurs six times faster for college students compared

with young adults not in college” (p. 648). Weight gain that occurs throughout student’s college

years can potentially lead to dyslipidemia and hypertension, which increases the risk of

developing coronary heart disease.

Overall, this study was conducted on first year college students at the University of

Rhode Island. The study initially consisted of 294, a combination of male and female, between

the ages of 18 and 24. Participants were randomly recruited through flyers, classroom

announcements, and advertisements in the school newspaper. The assessment of each participant

consisted of the measurement of their height and weight, blood pressure, blood draw, three

random twenty-four hour food recalls, and the completion of the International Physical Activity

Questionnaire Short Form to estimate physical activity level.

In conclusion, the study focused on 261 students due to the lack of participation from 33

students previously involved in the study. The results of the study revealed that students with

poor dietary patterns, such as insufficient fiber intake, high BMI, and an increase in the

consumption of sugar and alcohol, placed college students at an increased risk for developing

coronary heart disease. According to Fernandes et al. (2013), “body mass index was most
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strongly associated with coronary heart disease factors, and dietary components were better

predictors in this population than physical activity patterns” (p. 650). As a result, this study

encourages college campuses to make changes to improve the overall health of their students.

Small efforts made my college campuses can majorly impact the well being of college students

throughout the nation.

3. Identifying Clusters of College Students at Elevated Health Risk

According to Greene et al. (2011), “the aims of this study were to use cluster analysis to

identify sex-specific, homogenous subgroups of students on the basis of selected psychosocial

and behavioral characteristics, and to validate identified clusters against weight related indicators

of health-related risk in college students” (p. 395). The study was conducted in the fall of 2008

through a program called WebHealth. This program was designed to decrease the rate of

unwanted weight gain in college students by using nutrition and physical activity interventions

over a period of three months. Participants involved in the study were full-time freshmen,

sophomore, and junior students between the ages of 18 and 24. Overall, across eight different

college campuses, 1,689 students participated in the study. Students with a BMI greater than or

equal to 18.5, non-nutrition or exercise science majors, and those that were not pregnant or

lactating were eligible to participate in the study.

Throughout the course of the study, students completed online questionnaires assessing

several aspects of their health. The questionnaires examined students’ demographics, desired

weight, and cognitive and behavioral components of eating behaviors. Researchers assessed

students’ fruit and vegetable intake, level of eating competence, emotional and psychological

stress level, and frequency of physical activity. A physical assessment was also conducted, which
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included the measurement of students’ height and weight, waist circumference, BMI, and their

level of cardiorespiratory fitness.

In conclusion, researchers classified students into three clusters: psychosocially secure,

behaviorally competent, and high risk. The psychosocially secure cluster of students reported

low levels of weight-related concerns, and had high eating competence scores. Men and women

in this cluster expressed healthy behaviors, with the lowest BMI and waist circumference

measurements. Men and women placed in the behaviorally competent cluster had the highest

intake of fruit and vegetables, and the highest level of physical activity. However, researchers

discovered that the men and women in the behaviorally competent cluster were motivated to be

healthy for different reasons due to their gender. For example, the men appeared to be content

with their bodies and eating behaviors. On the other hand, women appeared to be motivated by

losing weight, possibly caused by societal standards of being thin. Lastly, men and women

classified in the high risk cluster desired to lose the greatest amount of weight, had the highest

emotional eating scores, and reported the greatest level of psychological and emotional distress.

The men in women in the high-risk cluster were found to have the highest BMI and waist

circumference measurements than other clusters.

Overall, these findings suggest that every person has unique nutritional habits. According

to Greene et al. (2011), “for men, variability in eating competence and cognitive restraint scores

contributed most to the difference between clusters, whereas for women, emotional eating and

uncontrolled eating scores did” (p. 394). Therefore, it is important to recognize that different

efforts must be made in an attempt to promote healthy lifestyles due to the fact that all people are

motivated for unique reasons.

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C. What has been done so far?

1. Text Messaging to Improve Dietary Patterns

MyPlate is a visual representation of the amount of each food group that should be

consumed during each of the three main meals in a day and it also emphasizes the importance of

physical activity being incorporated into daily routines. Brown, O’Connor, and Savaiano (2014)

conducted a study to evaluate how nutrition-based text messages being periodically sent to

college students effects their knowledge and fruit and vegetable consumption. During the study,

there were 150 undergraduate students between the ages of 18 and 24 that participated in the

study; more specifically, the participants were non-health major students who had text messaging

capabilities.

Brown et al. (2014) conducted this study by the intervention group receiving biweekly

text messages that contained the MyPlate icon along with a dietary guideline developed from the

Dietary Guidelines Alliance for seven consecutive weeks. The control group in this study only

received one brochure sent to their houses by mail that contained the information the text

messages contained. By exposing these students in the study to the MyPlate icon and website, it

allowed many of the students to do further investigation into the proper serving sizes of each

food group and to be able to recognize those food group distributions.

At the conclusion of the seven-week study, Brown et al. (2014) revealed that 98% of the

intervention group reported that text messaging is a viable and useful way to distribute health

information during their busy schedules. Along with text messaging being the best way to

communicate with college students in this study, it also showed a better knowledge of the

MyPlate food groups and a significant increase in fruit and vegetable consumption compared to

the control group who only received a single brochure sent by mail.
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2.E-mailing to Improve Dietary Patterns

As college students begin the transition from being dependent on their parents or

guardians to now being independent adults, eating and health behaviors often become molded

during this period of time. In addition, these behaviors, whether they are good or bad, can carry

on even after college. Unfortunately, Schweitzer, Ross, Klein, Lei, and Mackey (2016) explain

that if these habits involve poor eating habits and a sedentary lifestyle, it can lead to an increased

risk to diseases later in life such as obesity, cardiovascular disease, and some cancers. Therefore,

a study was conducted to “assess the feasibility and to determine preliminary efficacy of an

electronic wellness program in improving diet and physical activity in college students”

(Schweitzer, 2016, p. 1).

In short, there were 148 subjects, 99 for the intervention group and 49 in the control

group, selected to participate in this study between the ages of 18 and 20 years old on a diverse

college campus. At the end of this study, only 68 intervention group participants and 38 control

group participants made it to the conclusion of the study. In general, Schweitzer et al. (2016)

conducted their study by taking the students body measurements, weight, height, and blood

pressure along with food diaries and physical activity logs at the beginning of the, 12-week

mark, and at the end of the 24-week study. The intervention group received interactive diet and

physical activity goals sent by email through the eHealth intervention. This intervention was

referred to as A Lifestyle Intervention (ALIVE), or an evidence-based behavior change program

created and managed by NutritionQuest (Schweitzer et al., 2016). Furthermore, the control

group were e-mailed fact sheets that were non-diet and non-physical activity related.

At the halfway or 12-week mark, there was a slight increase in the consumption of fresh

fruits and vegetables; however, there was a significant increase in the consumption of fruits and
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vegetables in the intervention group compared to the control group at the 24-week mark

(Schweitzer et al., 2016). In addition, there was also a decrease in the amount of consumed

saturated fats at both the 12 and 24 week benchmarks. Therefore, in the study conducted by

Schweitzer (2016), the ALIVE program was a feasible way in improving the dietary changes in

the 106 college students who finished the study, but there was no benefit or change measured

with respects to body measurements and fitness.

3. Internet Based Nutrition Course to Improve Dietary Patterns

In the study conducted by LaChausse (2012), he states that compared to the 29% of

college students in 2000 that were considered overweight or obese, in 2009 that percentage

jumped to 32.5%; therefore, the purpose of his study was to “determine the impact of My

Student Body (MSB)-Nutrition, an Internet-based obesity prevention program for college

students” (p. 324). In total, 312 college students between the ages of 18 and 25 in undergraduate

studies on an ethnically diverse college campus participated in the study. From this amount, the

participants were further divided among three different interventions: the MSB, an on-campus

course, and a comparison group.

According to LaChausse (2012), the difference between these interventions was that the

“MSB participants logged onto the interactive, internet-based program designed to provide

nutrition and physical fitness education for an average of 29.84 times during the 42-week process

[whereas] the on-campus class met once a week for 2 hours a day for the 12 weeks” (p. 325). In

addition, the students who were in this study also took a survey at the beginning of the study and

the end, which included their nutrition and physical activity habits, self-efficacy, stress, attitudes,

and body weight. According to LaChausse (2012), among the 3 different groups in the study,
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there was no change in exercise habits or the students’ attitudes with regards to exercise; also,

there was no change in the participants BMI between the 3 groups.

Overall, with regards to the impact the MSB online program had on students, the study

indicated that there was an increase in fruit and vegetable consumption, but no improvement for

the on-campus students was evident from the pretest to post-test. Furthermore, the study also

indicated there was a significant decrease in stress among the MSB-Nutrition program students.

In all, LaChausse (2012) states there was “no incidence in the on-campus course students having

better outcomes than the students who are in the MSB-nutrition or comparison group” (p. 329).

D. Further Future Recommendations

1. Dietary Interventions

Kelly, Mazzeo, and Bean’s (2013) work is a systemic review of dietary interventions

among college students. Specifically, their work attempts to clarify potential directions for

future research and practice. In order to achieve this goal, they examine 14 research articles

evaluating interventions targeting dietary outcomes. In addition, they also assign several main

outcome measures including diet/nutrition intake, knowledge, and self-regulation to name a few.

In general, they argue how the transition to college can pose a number of challenges.

Such challenges that Kelly et al. (2013) list include the responsibility of now purchasing and

preparing healthy meals, concerns about the cost of healthy meals, and social factors.

Furthermore, they also point out that stress related to new academic challenges can also play a

role as well. As a result, they believe these factors are one of the main reasons for why the

typical college students’ diet is high in fat, sugar, and sodium. Overall, they argue this is

concerning because poor nutritional intake can lead to a number of negative health outcomes
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such as “the freshman 5” and chronic diseases. As a result, they examine in-person, online, and

environmental interventions to combat this issue.

First, the in-person intervention examined a couple of nutrition education classes. The

one class they examined focused on dietary intake. In general, this class involved meeting three

times per week for 50 minutes and included personalized and interactive activities based on

participants’ food logs. The three-day food logs revealed “positive dietary changes, including

increases in fruit, vegetable, whole grain, and skim milk consumption; decreases in soda

consumption; and increases in nutritional knowledge” (Kelly et al., 2013, p. 305). However,

because a control group was not used during this study, the researchers believed it was difficult

to determine whether these changes were due to social desirability bias or other cofounding

variables.

By contrast, the online intervention examined a few web-based courses that included

using educational e-mails and newsletters. Interestingly, the one course revealed that “although

changes were noted in the intervention group’s self-regulation and self-efficacy, there we no

between-group difference in dairy intake” (Kelly et al., 2013, p. 309). Lastly, the environmental

intervention examined the idea behind using point-of-purchase strategies. One primary reason for

this is that it is largely believed that by using visually stimulating materials on products, there is

an increased chance of capturing the consumers’ attention. As a result, a few studies were

conducted to see the impact of using such a strategy on buying healthy options over non-healthy

options. One study, for example, that placed vibrant cartoon characters at the entrance of a

dinning hall revealed that there was an increase in the number of healthier selections purchased

over the two-week intervention (Kelly et al., 2013). However, the researchers believe a number

of cofounding variables, such as changes in mood and priorities, could influence these outcomes.
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In conclusion, it is evident that colleges and universities are working towards promoting

healthier eating habits through several environmental and programmatic strategies. Although

one strategy did not fully solve the problem or come without its shortcomings, the systematic

review argue that “a number of approaches, particularly those in involving self-regulation

strategies have the potential to facilitate changes in students’ dietary intake” (Kelly et al., 2013,

p. 312). Therefore, more rigorous studies should be geared towards self-regulation in the future.

2.Understanding Food Choices and Eating Habits

Gustave Ado’s (2015) study is an attempt to better understand how certain barriers, such

as tight budgets and time constraints to prepare healthy meals, can cause some college students

to have poor dietary patterns, which can ultimately predispose these students to future health

problems. As a result, the aim of Ado’s study is to provide a current assessment of students’

eating behaviors at a community college located in New Jersey. Specifically, this assessment is

geared towards understanding the eating and exercising habits the students followed in their

daily lives as well as their perspectives on fast food, plant-based foods, and physical activity

using a mixed method. In other words, the study included using both a likert scale survey

ranging from 1-5 with 105 students as well as holding 30-60 minute individual interview

sessions with 100 students answering questions.

Overall, one of the main emergent themes from the surveys conducted was that only a

small percentage of participants reported consuming the recommended number of servings for

fruits and vegetables, which can result in significant health consequences (Ado, 2015).

Interestingly, based on the interview transcripts, a few of the main reasons for why there is a low

consumption of healthy meals included cost, taste, and inadequate nutritional knowledge.

Furthermore, interview data also revealed that a number of students ate unhealthy meals because
EATING HABITS AMONG COLLEGE AGE STUDENTS 21

of their lack of cooking skills. By contrast, in regards to physical activity habits, several students

indicated that they do not exercise regularly mostly due to time constraints. In addition, students

also blamed the absence of bike lanes on New Jersey’s public roads and felt the community

college itself encouraged sedentary lifestyles by not promoting students to actively move around

the classroom.

In conclusion, although it is evident that a number of colleges and universities have tried

to implement various strategies to promote healthy eating, Ado (2015) points out that “these

students need their community college-based nutrition education curricula to be programmed

more frequently for longer duration in order to have a real impact on their eating patterns” (p. 4).

Furthermore, there also needs to be more focus on training about eating patterns, modifications

to unhealthy food options on campus, and food price reductions on healthy meals.

3. The Impact of Eating and Exercise Habits

Ruggeri and Seguin’s (2016) study discusses the current eating and exercise habits

among traditional college students at a liberal arts college in Columbia, Missouri. They believe

both of these factors are important to examine since many life-long habits can form from them,

especially during this period of an individual’s life. For example, Ruggeri and Seguin (2016)

argue that the medical costs related to obesity, is expected to exceed the cost of smoking in the

United States in years to come.

Although a number of studies have been conducted thus far in regards to eating habits

among college students to combat obesity among other health issues, only a few have addressed

the role environmental factors play in affecting eating behaviors. As a result, Ruggeri and

Seguin (2016) attempt to fill this gap by exploring the impact of point-of-selection nutrition

information. In order to achieve this goal, an online survey was e-mailed during the Spring 2014
EATING HABITS AMONG COLLEGE AGE STUDENTS 22

semester to individuals enrolled as day students via their assigned e-mail address, or 884

students. During this study, evening, online, and students attending satellite campuses were

excluded from receiving the survey.

In general, the survey included 48 questions and could be completed in roughly 10

minutes. The main topics covered in the survey ranged from overall health to awareness of

nutritional information posted in the dinning hall. Furthermore, the survey also examined the

frequency of visits to 14 popular national fast food chain restaurants, with Taco Bell and

McDonald’s being the most frequented restaurants (Ruggeri & Seguin, 2016). Overall, 96

students of the 884 e-mailed participated in the survey.

From this percentage, the survey revealed that in regards to overall level of health “39%

of participants indicated they were somewhat healthy, 26% reported average health, 2% reported

very unhealthy, and 16% indicated they were very health” (Ruggeri & Seguin, 2016, p. 197). On

the other hand, in regards to exercise, the primary means of exercise were walking and

running/jogging. Next, in regards to consuming fast food “students visited fast food restaurants

an average of 3.79 times per week” (Ruggeri & Seguin, 2016, p. 197). Interestingly, the study

also revealed that students residing in a residence hall on campus ate at a fast food restaurant

more frequently than those who lived off campus (Ruggeri & Seguin, 2016). The primary reason

noted for consuming fast food included convenience, quality/taste, and price.

Finally, in regards to being aware of nutritional information for meals being posted in the

dining hall “27% of the students indicated they were aware, 23% indicated that no nutritional

information was in the dining hall, and 51% stated that they did not know whether or not

nutritional information was posted” (Ruggeri & Seguin, 2016, p. 197). This statistic further

indicates that “students who were aware of the posted nutritional information also ate at fast food
EATING HABITS AMONG COLLEGE AGE STUDENTS 23

restaurants less often (2.68 times per week) than those who stated no information was posted

(3.52 times per week) and those who did not know the information was posted (4.38 times per

week)” (Ruggeri & Seguin, 2016, p. 197).

In conclusion, Ruggeri and Seguin (2016) believe that posting nutritional information in

the dinning hall has little effect, since roughly more than 50% of students were unaware that

information was even posted. However, considering the study revealed that the students who

frequently read the nutrition labels consume fast food less frequently than those who do not read

them, posting information in a different location to attract students’ attention may lead to smarter

choices. In addition, they also recommend using alternative content of nutritional information to

encourage healthier eating choices such as indicating which food options are healthier

alternatives. Furthermore, they also suggest that considering students living on campus eat fast

food more frequently than those living off campus may indicate a need for extended hours of the

campus dinning hall or other on-campus food restaurants. Finally, since the survey was

conducted from one college in the Midwest, they argue it can raise external validity issues. As a

result, they believe future research should include more diverse educational settings.

III. Limitations

Similar to other research studies, a number of limitations were evident in each of the 12

articles examined. These methodological limitations ranged from the sample sizes used in the

studies to self-reported data. In other words, in regards to the sample sizes used, considering a

few of the studies were limited to either one or three colleges it is difficult to thus conclude that

the results can be generalized or transferred to other colleges. This is primarily due to the small

number of participants sampled as well as the location of each college among other external

variables. On the other hand, a number of studies also listed self-reported data as a limitation as
EATING HABITS AMONG COLLEGE AGE STUDENTS 24

well. One potential source of this bias can be exaggeration. For example, according to Lydecker

et al. (2015), “participants might have underestimated or overestimated their responses because

of social desirability influences” (p. 498).

In addition, to sample size and self-reported data, longitudinal effects also appear to be a

limitation of the articles. In other words, due to time constraints, the majority of researchers did

not measure the long-term effectiveness of their interventions. Furthermore, the reliability of

data gathered can also be considered a limitation. For instance, Brown et al. (2014) points out

that when analyzing the results of the MyPlate study, there was no tracker to guarantee that

students read the text messages sent. Therefore, this factor could have influenced the data.

Despite these limitations and shortcomings, all of the articles contained several strengths and

suggested useful hypotheses to consider in the future as far as how to improve dietary patterns

and promote physical activity among college students.

V. Conclusion and Implications

Overall, a number of interventions have been proposed and implemented at various

colleges and universities to promote health-eating strategies. As indicated above, some of these

interventions have proven to be successful within a small population, while others have not made

much of an influence. Based on this, it is evident that further integration needs to occur with

more diverse campuses to see the effectiveness of these strategies on a much larger scale, which

in turn, can eventually lead to dietary recommendations in the clinical setting.

In addition, it is also evident that a holistic approach needs to be used. In other words,

physiological, psychological, emotional, and social factors all need to be taken into account in

order to address the complexity of dietary patterns among college students. One primary reason

for this is because of the amount of stress that often occurs when transitioning into college as
EATING HABITS AMONG COLLEGE AGE STUDENTS 25

well as the number of new barriers that can accompany it such as time restraint. Therefore,

practitioners need to shift their way of thinking that eating less and exercising more is the only

way to combat poor dietary patterns.

Although these two components can greatly reduce weight and prevent further chronic

illnesses in the future, it is also important to examine the psychological reasons behind why an

individual is over indulging in food as well as take into account the genetic and environmental

factors of and surrounding an individual. Otherwise, failure to do so will result in non-effective

treatment plans, since they do not target the underlying cause. As a result, it would also be

beneficial to do more longitudinal studies on a larger scale to help clarify cause and effect

relationships and to gain further insight into more effective and efficient treatment options. For

instance, one research question in the future can be- does the stress of a college students’ major

cause the student to over indulge in food? By contrast, in terms of environment- does the setting

of a two-year or four-year college effect dietary patterns?

Finally, although the purpose of this paper primarily focused on college students, it is

also evident that further teaching needs to occur early on. In other words, statistically speaking

“in 2010, more than one third of children and adolescents were overweight or obese”

(“Childhood,” 2013, p. 1). Unfortunately, when developing in children, this condition can lead to

both immediate and long-term effects on overall health and wellbeing. Therefore, considering

children often learn by observation and thus try to copy their parents’ eating habits, it is essential

to promote and teach healthy eating habits to this population. Moreover, it is also essential that

resources, such as nurse educators, dietitians, 24-hour phone availability, and school support

programs, are made available to this population as well, especially for children who are

overweight or obese. By implementing this type of comprehensive care early on, revising
EATING HABITS AMONG COLLEGE AGE STUDENTS 26

nutrition courses to make them more applicable, promoting exercise inside and outside the

classroom, offering healthier food options and extending the hours of on-campus restaurants, it is

likely that the dietary patterns among college students can improve. Moreover, it is likely that

these strategies can decrease the number of chronic illnesses in the future.
EATING HABITS AMONG COLLEGE AGE STUDENTS

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