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Epidemic
Rates of obesity and overweight status have reached epidemic proportions across all age
groups in the United States. One of the most understudied, yet significant, groups affected by the
issue of obesity are college campus students. Although everyone dreads the “Freshman 15,”
minimal research and interventions has been created to control and prevent obesity on college
campuses. As more than one third of college students are overweight or obese, college campuses
are an ideal environment for the implementation of fruits and vegetables education (FRUVED)
interventions. FRUVED is an USDA grant-funded research project that aims to help students live
healthy lives through educational nutrition interventions. Queens College, one of the
the impact of a nutritious cooking demonstration on the food choices of its students. A
pre-survey was administered to quantify students’ eating behaviors, nutrition knowledge and
readiness to make healthy lifestyle choices. Upon completion of the intervention, a post-survey
was conducted to evaluate changes and effects of the intervention. The results were analyzed
using Microsoft Excel. As a significant number of students are unfamiliar with preparing healthy
lunches, campus-wide interventions are crucial in motivating and educating students on the
importance of healthy lifestyles. The successes of the intervention can be used as a model for
The expression “Freshman 15” refers to the belief that college students commonly gain
15 pounds during their freshman year. The dreaded experience is a real issue college students
face today. According to the College Health Association, the percent of overweight (Body Mass
Index of 25-29.9) and obese (Body Mass Index of >30) college students in America has
increased from 27.4% in 2006 to 29.2% in 2011. At this rate, it has been predicted that by 2030,
the rates of obesity will rise to over 50% of the college population (1).
The number of overweight and obese people have reached epidemic proportions in all
age groups in the United States. According to the Centers for Disease Control and Prevention,
obesity affects one third of the adult population and an estimated 12.7 million children and
adolescents in the United States (2). Over the past 20 years, a significant increase in obesity and
obesity-related complications have been seen amongst people in their teens and twenties (3).
Weight gain has been found to be in greater incidences in college students due to lifestyle
changes and the transition from living at home to college. It has been suggested that the increase
in independence and the freedom has contributed to the poor eating behaviors and choices of
college students (4). Parents are no longer around to guide or limit choices, inclining busy
college students to choose foods that are quick to prepare, cheap and oftentimes unhealthy.
The College Weight Gain and Behavior Study found that 25% of both college male and
females gained more than 2.3 kg of body weight in an 8 month period (5). Minimizing weight
gain is critical because overweight college students are at a greater risk for becoming obese
adults. By preventing weight gain at an early stage, the rates of adult obesity can be reduced.
Adult obesity is dangerous as it can lead to the further development of complications such as
hypertension, type 2 diabetes, cancer and cardiovascular disease. With early intervention, the risk
As more than one third of college students are overweight or obese, the college campus
setting is an ideal place to implement programs that are tailored to their needs and lifestyles (6).
The establishment of campus-wide initiatives that promotes health and weight management are
needed to tackle the “Freshman 15” and improve the overall college experience.
harassment (3) the obesity epidemic on college campuses is a real issue that must be addressed; it
is a threat that compromises the health of students in the present and even more significantly in
the future. Besides addressing the serious public health issue, capitalizing on the lifestyle issues
and creating behavioral interventions benefits the college itself. The programs highlight the
college’s values of responsibility, ethics and health. Participation will help students develop into
One of the greatest challenges college students face is adapting a healthy lifestyle,
including incorporating good food choices, proper sleeping habits and physical activity into their
daily routines. The various lifestyle factors all contribute to weight gain and obesity. Research
has shown that obesity is an issue far greater than physical health itself; obesity also impacts the
emotional and social well-being of the person. The emotional effects of obesity include anxiety,
depression and lowering of the self-esteem. Students become more self-conscious of their weight
gain, taking away time and energy from their studies (7). Often, the psychological distress leads
to an uncontrolled cycle of overeating and weight gain to soothe and combat the feelings of
choices are the driving force behind the challenging epidemic. Research has shown that the most
important influencing factors that impact food selection on college campuses are taste, cost and
convenience (8). Little to no attention is focused on the nutrition and health consequences of the
foods. One study showed that a high percentage of surveyed college students who were
overweight engaged in unhealthy eating habits, such as a diet low fruit, vegetable and fiber
intake (9). Another study noted the excessive intake of fatty foods and alcohol amongst U.S
College students turn to fast foods and processed foods because of their convenience and
low cost. With busy schedules and little time to prepare food, on average, students consume fast
food 1-3 times a week (11). However, these food choices are oftentimes high in fat, salt and
energy. In addition, high consumption of fast foods and processed foods is associated with
decreased intake of fruits and vegetables. According to the American College Health Association
(11), only 7.3% of students ate five or more servings of fruits and vegetables a day.
Compared to the cheap fast food, the pricier cost of fresh and healthy food is another
determinant of poor eating behaviors of college students. One such study was performed to
understand the effects of price on the consumption of fruits and salads in a cafeteria setting. The
results showed that by reducing the prices in half, intake nearly nearly tripled and as soon as the
original price was returned, consumption went back to its original levels (12). These and other
research studies suggest the need for greater attention to diet and healthy eating interventions for
obesity nationwide, an important strategy in tackling the obesity epidemic would be to target this
population with lifestyle interventions that improve diet and overall health. College programs
have the unique opportunity to lay the foundation and create a supportive environment for
lifelong healthy habits and choices. Resources to help students can be provided in a
nonjudgmental, sensitive and helpful manner. To target the obesity epidemic on college
campuses, this study will aim to increase the intake of fruits of vegetables of Queens College
students. The FRUVED intervention will educate students about the physical and emotional
health benefits of making good food choices. The intervention will be a cooking demonstration
that teaches college students how to prepare meals and snacks that are tasty, quick and cheap.
College students should be encouraged to improve eating habits through interventions that teach
Methods
Research Design:
study collected data on the population subset at a single point in time (13). The study was used to
measure knowledge gained in a nutrition intervention through a pre and post survey. A pre
evaluate the participants’ nutrition-based knowledge. The pre survey was used to quantify their
eating behaviors, nutrition knowledge and preparedness to make healthy lifestyle choices. The
post survey assessment was conducted immediately after the intervention to evaluate changes in
nutrition knowledge, the level of confidence and readiness to change. The change in pre and
post survey reflected the effectiveness of the intervention in increasing nutrition knowledge and
willingness to change.
The data collection and intervention occurred at the Queens College cafeteria. The
intervention occurred during the Spring 2018 semester. Three researchers set up a table with
explain the purpose of the intervention. As students walked by, researchers offered a healthy
A pre and post survey was developed before the intervention. A pre-assessment survey
was designed to measure the students’ nutrition-related knowledge and self-efficacy before the
cooking demonstration. Students completed the survey prior to viewing the cooking
demonstration. After the pre-assessment survey was completed, the cooking demonstration was
conducted and the participants were educated on healthy food choices. The rainbow salad
(APPENDIX C) cooking demonstration taught students how to prepare a healthy, quick and
affordable lunch. Healthy portion sizes, recommendations for food groups and nutritional
benefits of fruits and vegetables were taught throughout the lesson (APPENDIX D). Upon
completion of the cooking demonstration, the post survey was conducted. Using the data,
(APPENDIX E) with additional healthy recipes and the MyPlate handout (APPENDIX F) were
A random sampling was used to gather students for the intervention. Participants were
recruited as they passed the intervention table and were invited to attend the cooking
students, enrolled in the Spring 2018 semester. Due to FRUVED’s mission to improve health of
college undergraduate students, staff members and graduate students were excluded from the
study. Informed consent was given by all participants of the study (APPENDIX G).
Ingredients for the rainbow salad (see Appendix C) were reimbursed by FRUVED. The
cooking equipment and the poster were provided by the researchers. A table and space were
Statistical Evaluation:
The raw data was collected from the participants and analyzed using Microsoft Excel.
Because the research design is a pre and post test, the mean differences between the pre and post
were compared. Averages of fruit and vegetable intake were analyzed using Excel to understand
Gantt Chart:
The Gantt Chart outlining the breakdown of activities can be found in APPENDIX H.
A total of fifty students participated in the FRUVED nutrition intervention. After initial
screening of the surveys, it became clear that majority of the participants were Queens College
undergraduate students; their responses were included in the final results. However, because the
intervention targeted the Queens College undergraduate population, the responses of the four
Queens College staff participants were removed from the final study.
Using Microsoft Excel, the results of the pre-survey were analyzed. A number of
questions were solely intended to become familiar with the participants of the study and to
understand their baseline level of nutritional knowledge. When asked the source of reliance for
nutrition information, a total of 50% of the participants reported that they rely on the internet as
their primary source of nutrition information, 18% rely on reading food labels and 18% do not
look for nutrition information. A mere two participants reported that they depend on their
Queens College professors of nutrition for diet and nutrition information. The data showed that
only 12% of the participants prepared lunch at home on a daily basis. As the students were
asked, “How often do you cook a meal for yourself,” a total of 22% reported that they actually
Four questions were used in the pre and post-survey to evaluate the effectiveness of the
nutrition intervention. The first question asked “What is the recommended servings of fruits per
day?” In the pre-survey, 54% answered 1-2 cups. In the post-survey, 78% answered 1-2 cups
(refer to Table 1). The second question asked “What is the recommended servings of vegetables
per day?” In the pre-survey, 62% answered 3-4 cups. In the post-survey, 72% answered 3-4 cups
of vegetables per day (refer to Table 2).The third question asked students to look at a specific
meal instead of a daily intake. Question 3 asks, “How much of your plate should be fruits and
vegetables?” In the pre-survey, 56% answered with the correct choice of half your plate and in
the post-survey, 94% answered half (refer to table 3). The final question, asking, “How confident
do you feel you can prepare a healthy lunch at least once this week,” 48% answered very
confident in the pre-survey and after the nutrition intervention 66% felt very confident (refer to
table 4).
Discussion
Upon comparison of the pre- and post-survey answers, the increased percentages of
confidence and correct answers, reflects the effectiveness of the FRUVED intervention. The
impact of the nutritional intervention on the Queens College undergraduate students was
significant. Various educational and counseling techniques were used to impact the students and
their effectiveness is reflected in the results. The rainbow salad demonstration was able to
increase nutritional knowledge and self-efficacy in the participating students. After the
demonstration, there was an 18% increase in self-efficacy of lunch preparation. Another method
of information dissemination was the use of educational handouts; every participant received a
MyPlate guide with appropriate serving sizes of each food group. The students were asked a
knowledge-based question (question 3) to evaluate the effectiveness of the handout. The 38%
increase of the correct answer in the post-survey, suggests that the participants understood and
retained the information from both, the handout and the presentation.
Based off questions 1 and 2, assessing recommended portion sizes of fruits and
vegetables, the 24% increase in correct answers for fruit servings, and the 10% increase in
recommendations demonstrates that the guidelines are realistic and achievable. Proven by the
results of the post-survey, the impact of the FRUVED intervention is one step in targeting the
Strengths of this intervention include the simplicity of the surveys and recipes, a
well-placed intervention site in a busy cafeteria and the use of a variety of teaching techniques.
Verbal, demonstrative, and printed methods were used to educate the participants. Weaknesses
of the intervention include the inability to track long-term change and effectiveness.
Conclusion
confidence of the Queens College undergraduate participants. Hopefully, the intervention will
encourage the students to improve eating habits and implement healthful changes. Choosing
fruits and vegetables is one small, individual step that can ultimately have a large impact on the
College. The more exposure to nutritional knowledge and skills, the more likely lasting changes
will result. Future interventions should monitor the long-term impact of the programs and eating
nutritional resource for students. The increase in nutrition interventions on college campuses will
serve as a more readily available and reliable source of nutritional information for students. The
implementation of this nutrition intervention across college campuses in America, and others
alike, can have a profound impact on the obesity epidemic, helping our people improve their
APPENDIX
1. What is the recommended number of servings of fruits you should consume in one day?
a) 0 cup
b) 1-2 cups
c) 3-4 cups
d) 4 -5 cups
2. What is the recommended number of servings of vegetables you should consume in one day?
a) 0 cup
b) 1-2 cups
c) 3-4 cups
d) 4 -5 cups
3. How much of your plate should be fruits and vegetables?
a) 25%
b) 50%
c) 75%
d) 100%
4. How confident do you feel you can prepare a healthy lunch at least once this week?
a) I am very confident
b) I am kind of confident
c) I am not very confident
d) I am not confident at all
7. What source do you rely on the most for information about food, diet, and nutrition?
a) Internet
b) Food/Nutrition Labels
c) Nutrition courses
d) Friends/peers
e) I don’t look
f) Other __________
8. How often do you buy food from the following places? (Circle one)
Dining hall: Always Most of the time About half the time Sometimes Never
Campus Cafe: Always Most of the time About half the time Sometimes Never
Restaurant: Always Most of the time About half the time Sometimes Never
Grocery Store: Always Most of the time About half the time Sometimes Never
Convenience : Always Most of the time About half the time Sometimes Never
APPENDIX B: Post-Survey Test ID #
1. What is the recommended number of servings of fruits you should consume in one day?
e) 0 cup
f) 1-2 cups
g) 3-4 cups
h) 4 -5 cups
2. What is the recommended number of servings of vegetables you should consume in one day?
e) 0 cup
f) 1-2 cups
g) 3-4 cups
h) 4 -5 cups
3. How much of your plate should be fruits and vegetables?
e) 25%
f) 50%
g) 75%
h) 100%
a)
4. How confident do you feel you can prepare a healthy lunch at least once this week?
e) I am very confident
f) I am kind of confident
g) I am not very confident
h) I am not confident at all
APPENDIX C: Cooking Demonstration Recipe
Ingredients:
● 1 cup spinach/kale
● 1/2 beet
● 1 carrot
● 1/2 cup farro
● Dressing:
● 1/4 cup lemon juice
● 1/2 cup olive oil
● 1 Tablespoon chives (chopped)
● salt and pepper
Directions:
1. Shred beet and carrots with a box grater.
2. Cook grains according to package instructions.
3. For dressing mix together lemons juice, zest, chives, and salt/pepper.
4. Mix together the salad ingredients and dressing.
5. Store overnight for improved flavor.
APPENDIX D: Lesson Plan
Introduction
Body of Lesson
Materials List (attached page): i.e.: audio-visual equipment, food models, video, flip chart,
specific foods for food demo, pencils, paper, attendance sheet, pre/post tests, handouts
(specified), other visuals, etc.
Buddha Bowls:
Ingredients:
Directions:
Ingredients:
● ⅛ teaspoon salt
● 1 medium tomato, chopped
● 1 avocado, chopped
● 3 strips cooked bacon,
crumbled
● 8 large leaves red- or
green-leaf lettuce
● 4 10-inch flour tortillas,
preferably whole-wheat
Directions:
Sponsor FRUVED
Research Statement The purpose of this study is to determine the effectiveness of a cooking
and nutrition education intervention in changing nutrition-related
knowledge and willingness to change lifestyle habits.
Confidentiality & Subject may withdraw from the study at any time of the study, including
Voluntary Refusal and at the time of the pre-test, intervention, and post-test.
Right to Withdraw
Find out
FRUVED
reimbursement
Have ingredients
and materials
Data analysis
Table 1: Comparison of Pre- and Post-Test Responses to Question #1
References
1. College R, College R. Don't Become a Statistic: Prevent Obesity Now. Rasmussenedu. 2017.
Available at:
http://www.rasmussen.edu/degrees/health-sciences/blog/dont-become-a-statistic-prevent-obesity-
2. Adult Obesity Facts | Overweight & Obesity | CDC. Cdcgov. 2017. Available at:
4. Barnes J. Perceived Parenting Style and the Eating Practices of College Freshmen. Ericedgov.
5. Cluskey M, Grobe D. College Weight Gain and Behavior Transitions: Male and Female
doi:10.1016/j.jada.2008.10.045.
Associations between Body Mass Index, Chronic Illness, and the Physical and Mental
doi:10.1038/oby.2000.17.
sedentary behaviour in university students: a qualitative study using focus group discussions.
2003;52(2):83-86. doi:10.1080/07448480309595728.
university students: a qualitative study using focus group discussions. BMC Public Health.
2014;14(1). doi:10.1186/1471-2458-14-53.
11. Deshpande S, Basil M, Basil D. Factors Influencing Healthy Eating Habits Among College
2009;26(2):145-164. doi:10.1080/07359680802619834.
doi:10.1006/pmed.1994.1135.
13. Selecting the Appropriate Study Design. Academy Research Toolkit 2011 (Academy of
14.Statistics: T-tests. Academy Research Toolkit 2011 (Academy of Nutrition and Dietetics).
2017; 15-17.
15. Bowl V, Bowl V, Casner C. Vegan Buddha Bowl Recipe. Eating Well. 2017.
http://www.eatingwell.com/recipe/258091/vegan-buddha-bowl/.
http://www.eatingwell.com/recipes/22371/mealtimes/lunch/budget/for-work/slideshow/cheap-he
althy-lunch-ideas-for-work/?recipeId=252626.
17. MyPlate | Food and Nutrition Service. Fnsusdagov. 2017.
https://www.fns.usda.gov/tn/myplate.
18. The Informed Consent Process. Steps to Developing a Research Project: Resources to Help