Source: KENTUCKY STATE UNIVERSITY submitted to
ASSESSMENT OF EATING HABITS AND FOOD CHOICES OF ADOLESCENTS AND THE DEVELOPMENT OF A NUTRITION INTERVENTION PROGRAM
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
TERMINATED
Funding Source
Reporting Frequency
Annual
Accession No.
0186068
Grant No.
(N/A)
Project No.
KYX-50-00-15H
Proposal No.
(N/A)
Multistate No.
(N/A)
Program Code
(N/A)
Project Start Date
Oct 1, 2000
Project End Date
Sep 30, 2004
Grant Year
(N/A)
Project Director
Panemangalore, M.
Recipient Organization
KENTUCKY STATE UNIVERSITY
(N/A)
FRANKFORT,KY 40601
Performing Department
HUMAN NUTRITION & HOME ECON
Non Technical Summary
Adolescent diets are often high in fat, calories, and protein, but lacking in fiber, minerals, and vitamins. Adolescents are also prone to excessive dieting as well as overeating which increases the risk of chronic disease in later life. This project will increase knowledge of adolescent eating habits at home and in the School Lunch Program. The findings will be used to develop a computer based nutrition education program for adolescents and their parents.
Animal Health Component
100%
Research Effort Categories
Basic
(N/A)
Applied
100%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
7036010101030%
7036099302035%
7036010303035%
Goals / Objectives
1) Conduct focus group discussions to elicit information on food selection behavior, food choices and eating habits directly from adolescents and their parents. 2) Evaluate the School Lunch Program and recommend improvements to enhance nutritional content. Study food intake and choices of adolescents participating in the School Lunch Program and integrate this information with the data collected in Objective 1 from focus groups. 3) Develop an online nutrition education program based specifically on the information collected in Objectives 1 and 2 and test the program in adolescent and parent focus groups to evaluate the acceptance and effectiveness.
Project Methods
Focus group discussions provide qualitative data for new educational material. This method will be used to elicit information on adolescent food selection behaviors and attitudes toward improving their health, food choices, eating habits and meal patterns from adolescents and parents (32 adolescents and 32 parents; 8 per group) three times in a year. This information will be analyzed to identify specific patterns of food selection habits, eating and meal patterns. School Lunch Program (SLP) evaluation will be conducted in the school cafeteria: 1) weighed food intake to assess nutrient intake; 2) observe/record food choices and eating habits. We will gain knowledge of factors that influence eating habits and food choices of adolescents. Suggestions to improve the SLP will be made. The results will be used to compile a database of eating habits/choices of adolescents. The online nutrition intervention program will be modeled on the database. The interactive program will contain FAQs, graphics, puzzles and quizzes to deliver nutrition education to adolescents and their parents. The program will be tested in both the students and parents who participate in the focus group discussions. Copies of the program will be given to area schools to increase the exposure of students to essential principles of nutrition and health.

Progress 10/01/00 to 09/30/04

Outputs
We have determined the influence of competitive foods on plate waste and nutrient consumption of adolescents. The participants were 743 sixth-grade students purchasing lunch in three public middle school cafeterias in Frankfort, KY. Of them 493 purchased school lunch (SL) and 250 purchased school lunch + competitive foods (foods from vending machines; SL+CF) The data were collected over 24 days in three schools and replicated twice over two school years to affirm the data. Sample serving sizes and food left in plates were weighed to determine plate waste. A nutrient analysis database (Nutritionist 5) was used to calculate nutrient intake from the food consumption data, which were statistically analyzed for ANOVA and Chi square with SPSS 10 to determine significant differences between the SL and SL+CF groups. Food type influenced acceptance rates and waste. Whole apples had lower acceptance and greater waste (62%) compared with applesauce. The students who purchased SL + CF wasted more fruits (36% vs.52%), grain products (14% vs. 26%) and mixed dishes (18% vs.30%)as compared to the SL group. Energy intake was 25% of RDA, 33% of energy was from fat, and lunch provided less than 33% RDA of vitamins A, C, folate, thiamin, niacin and calcium; iron was adequate. The SL+CF group meal provided less energy and nutrients than the SL group, but CF purchases raised intakes of energy and a negative impact on nutrient intake. Lunchtime food intake in school cafeterias did not provide the 1/3rd of RDA of energy/nutrients mandated by the USDA. The plate waste of all chosen menu items was high. The fact that whole fruits were wasted more than any other food item suggests that offering fruits in an easy to eat form will increase consumption. The students found most vegetables unappealing and salad consumption was low. It is, thus, necessary to provide appealing and attractive school lunches to adolescent to increase acceptance and consumption. An HTML-based interactive nutrition education package was developed to enhance ability of students to make correct food choices. The package includes basic information on twenty-seven nutrients and allows students to choose from ten categories of food types. The students can assess their requirements, food choices and alternative choices within food types and their nutrient content. It also includes a food intake record form and a link to the USDA Interactive Healthy Eating Index Tool. The final component is a set of web links to sites where students, teachers, and parents can find educational games, curricular material, and general information on nutrition and health. After initial feedback, suggestions have been incorporated into the design and the whole program was positively accepted by the students and teachers. This program will be distributed to area schools through prinicpals and teachers.

Impacts
The data clearly show that school lunches do not provide enough calories and foods from vending machines reduced nutrient consumption of adolescents. School cafeteria managers and dieticians will find useful comparative data in this paper on school lunch waste by sixth grade adolescents and the influence of competitive foods increasing plate waste and reducing consumption. Our suggestions to reduce plate waste include the need to offer tasty and attractive meals, cut instead of whole fruit, and competitive foods with better more nutritious snacks and drinks instead of the currently available competitive foods

Publications

  • Templeton S, Marlette M and Panemangalore M (2005). Competitive foods increase the intake of energy and decrease the intake of certain nutrients by adolescents consuming school lunch. J. Am. Diet. Assoc. 105:215-220.


Progress 01/01/03 to 12/31/03

Outputs
We have determined the influence of competitive foods on plate waste and nutrient consumption of adolescents. The participants were 743 sixth-grade students purchasing lunch in three public middle school cafeterias in Frankfort, KY. Of them 493 purchased school lunch (SL) and 250 purchased school lunch + competitive foods (SL+CF) The data were collected over 24 days in three schools and replicated twice over two school years to affirm the data. Sample serving sizes and food left in plates were weighed to determine plate waste. A nutrient analysis database (Nutritionist 5) was used to calculate nutrient intake from the food consumption data. All replicate data were merged as there were no significant differences between the replicates; data were statistically analyzed for frequencies and ANOVA procedures of SPSS 10 to determine significant differences between the SL and SL+CF groups. Food type influenced acceptance rates and waste. Whole apples had lower acceptance (23%) and greater waste (62%) compared with applesauce (37% acceptance, 23% waste); mashed potatoes had similar acceptance to heated fries (70% vs. 68%), but much less was wasted (19% compared to33%). The students who purchased SL + CF had significantly greater waste of fruits ( 36% vs.52%), grain products ( 14% vs. 26%) and mixed dishes (18% vs.30% ), respectively, as compared to the SL group. The adolescents consumed meals that provided 25% of RDA for energy, higher than 33% RDA of protein and carbohydrates, 33% of energy from fat, less than 33% RDA of vitamins A, C, folate, thiamin, niacin and calcium, and adequate iron. The SL+CF group selected and consumed a SL meal that provided less energy and nutrients than the SL group. While their CF purchases increased their intakes of energy, carbohydrate, sugar and fat, their vitamin A, vitamin C, riboflavin, thiamin, folate and calcium intakes decreased, indicating that competitive foods had a negative impact on nutrient intake, but not on energy. The data also indicate that the lunches consumed in school cafeterias do not provide the USDA mandated intakes of 1/3rd RDA for all nutrients. This is probably because of high plate waste of all items on the menu chosen by the students. The fact that whole fruits are wasted more than any other food item suggests that offering fruits in an easy to eat form will increase consumption. The students find most vegetables unappealing and salad consumption is low. It is, thus, necessary to provide appealing and attractive school lunches to adolescent to increase acceptance and consumption. Based on the survey data we are developing computer based nutrition education program that would include quizzes, puzzles to improve the food choices and nutritional status of adolescents. This program will be tested on 6th graders.

Impacts
Our data clearly demonstrate the negative effects of competitive foods on nutrient consumption of adolescents. School cafeteria managers and dieticians will find useful comparative data in this paper on school lunch waste by sixth grade adolescents and the influence of competitive foods increasing plate waste and reducing consumption. Our suggestions to reduce plate waste include the need to offer tasty and attractive meals, cut instead of whole fruit, and competitive foods with better more nutritious snacks and drinks instead of the currently available competitive foods

Publications

  • Templeton S, Marlette M and Panemangalore M (2003). Competitive foods increase the intake of energy and decrease the intake of certain nutrients by adolescents consuming school lunch. Submitted J Am Dietet Assoc
  • Marlette M, Templeton S and Panemangalore M (2003). Competitive foods increase school lunch plate waste by adolescents. Submitted J Am Dietet Assoc


Progress 01/01/02 to 12/31/02

Outputs
Incorrect eating habits and food choices lead to consumption of high fat and high protein diets, which most often lead to the development of diet-related conditions such as diabetes, obesity and cardiovascular disorders. Federal standards require that school lunches provide one-third of RDA for six specified nutrients-energy, protein, vitamin A, vitamin C, calcium and iron. The objective of this study was to evaluate food and nutrient intakes of foods consumed at school lunches provided by the public schools. Sixth-graders (n=369; 51% female; 81% white) consuming school lunches at three area middle schools participated in this 12 day study. Five sample lunch trays representing the all menu items offered on each day were purchased to determine the average weight of portions. Student trays were tagged with ID numbers and photographed before and after the meal was eaten to identify food selections; leftovers on the trays (including the drinks) were collected individually in plastic bags. The leftovers were weighed and food intake was calculated from weight of each original portion of food item served to students. The following were computed:1) food item acceptability; 2) plate waste; 3) nutrient intake. Some menu items had greater acceptability than others: spaghetti was chosen by 80%; pizza/pasta by 92%, ham by 92, other meats by 60%, tacos by 63%, sandwiches by 27%, potatoes by 64%, corn by 45%; salad/green beans by 33% and chocolate milk by 80% of the students. The percentage of leftovers was highest for fruits and vegetables: 35% on average, with whole apple wastage at 73%; leftovers of meats of various types were about 19%, cereal products averaged 14% and 7% of cheese was left on the tray. Sixteen percent of milk was wasted, while the wastage of noncarbonated fruit drinks was 6%, that of chips was 3% and of cake/cookie items was 6% (mostly purchased by students). The intakes for protein and energy were 50% and 25% of RDA, respectively; fat provided 32% of total energy and sugar provided 15%. Among the vitamins, A, C, folate and riboflavin intakes were adequate at 135%, 42%, 28% and 28% of RDA; intakes of E, thiamin, niacin and were significantly lower than 1/3 RDA at 13%, 19%, 16%, respectively. Calcium and iron intakes were 30% and 26% of RDA, respectively. The fruit drinks, snack cakes and chips purchased by 31% of the students provided 39% of dietary energy intake, but few important nutrients. The data suggest the importance of eliminating "junk" food options and providing more nutritionally balanced, appealing and tasty menu items for school lunches, which would be completely consumed by the students.

Impacts
The data from the school survey suggest that the menu items and options offered did not adequately provide all nutrients because of low acceptability, high wastage of fruits and vegetables and access to "junk" foods that reduced the intake of fruits vegetables and entrees such as sandwiches and consequently the intake of important minerals, vitamins and dietary energy. These data should enable improved menu planning that enhances taste, appearance and also enhances food consumption, which in turn would increase micronutrient and energy intakes.

Publications

  • Hayes A, Templeton S, and Marlette M (2002). Effective Use of Web Forms for Health Survey Data Collection. J KY Acad Sci 63: 70. (Abstract)
  • Marlette M and Templeton S (2002). Food Choices of 6th Grade Students. J KY Acad Sci 63:70-71. (Abstract)


Progress 01/01/01 to 12/31/01

Outputs
National nutrition and health surveys indicate that intake of several nutrients, including energy, calcium and folate, begin to decline around age ten and remain inadequate throughout adolescence and often into adulthood. In addition, incorrect eating habits and food choices lead to consumption of high fat and protein diets that are a significant health risk, often resulting in conditions such as diabetes, obesity and cardiovascular disorders. The objective of this study was to assess how adolescents make food choices and what factors are responsible for such choices through focus group discussions with 6th graders attending local schools. Focus group discussions were conducted at three local middle schools. Groups of no more than 6 students were included in each discussion and 33 sixth graders participated. Foods consumed in the past 24 hours were categorized into four types: fresh/home-prepared foods, convenience foods (frozen/ready-to-eat), restaurant fast food, or sweet/salty snacks. At the end of the discussion, participants also completed a questionnaire about food choice factors and food-related behavior at home. Among 33 participants aged 11-13, 31% were males and 69% were females, 68% were Caucasian, 24% were African-American, and 8% were Asian. Factors that influenced food choices the most were 1) taste, 2) hunger or craving, 3) convenience and 4) health benefits; while incentives and cultural influences were of least importance. Factors that did not influence food choices much were food allergies, parents' or friends' recommendation, price, TV advertising and appearance. The survey results also show that 46% of the sixth graders took part in home menu planning, 46% in grocery shopping and 31% in meal preparation, while 54 % of the students mostly spent their own money for food, drinks or snacks. The food items that were consumed in the previous 24-hours by the included 8 home-prepared dishes, 2 fast-food items, 1 convenience food item and 5 snacks; 27% reported that their family evening meal was eaten-out or brought-in at least 3 days a week. This suggests that ready-to-eat foods constituted an equal or larger portion of the diet than home prepared meals. The high fat content of fast and convenient foods usually enhances taste and perhaps makes them more appealing to 6th graders, since taste is the most important criterion for selecting a food item as indicated by our focus groups. Similar focus group discussions with parents of middle school children are in progress and these discussions could either reinforce or modify our current findings. These preliminary results indicate a need for the improvement of food choices and eating habits of adolescents through targeted nutrition education using information obtained from focus group discussions.

Impacts
The data though not complete suggest the possibility that participation of 6th graders and their parents in focus group discussions could have heightened their awareness of the importance of their food choices. Once the data are complete the results will be used to develop targeted nutrition education programs for parents and middle school children to improve adolescent food choices and thereby their nutritional and health status.

Publications

  • Marlette M and Templeton S (2002). Food choices of sixth grade students. J KY Acad Sci In press. (Abstract)


Progress 10/01/00 to 12/31/00

Outputs
The realization that a multitude of health problems in later life are of nutritional origin is increasing the momentum to identify eating habits and behaviors of adolescents. Adolescence is not only a period of profound physiological and physical changes, but also of social and psychological development. Additionally, when nutritional needs are at its highest, adolescents are prone to dieting that leads to eating disorders, meal skipping, snacking and eating fast foods. Excess fat intake at this early age is related to the development heart disease, obesity, and cancer risk. Federal statistics suggest that in the general population, the consumption of fruits and vegetables has increased by 22%, while, fat and oil intake has also increased by a similar amount because of increased poultry and cheese consumption over the last 5-10 years. The target age group for research and intervention to modify eating behavior/food choices is adolescence. It is a period when additional macro - and micro - nutrients are essential for attaining peak and maximal growth associated with puberty, and when `at risk' eating habits/behaviors become entrenched and last a life time. Therefore, the initial objective of this project is to identify food choices and eating habits in adolescent 6th graders though separate focus groups of adolescents and their parents. Since this project was initiated about 3 months ago, we have made a small headway in getting approval of the Director of Education, and contacted local middle schools principals and teachers regarding participation in research project and received letters of cooperation from the Franklin County Board of Education and the Independent School System. We have obtained and assessed pertinent literature on focus group strategies and techniques as well as the diet habits and some factors that influence adolescents. Preliminary analysis of CSFII 1994-96 and the 1998 CSFII Supplemental Children' Survey has also been completed. We have prepared information sheets Participant's Bill of Rights and Consent Forms for focus group participants. Discussions with adolescent and parent groups will be conducted separately and we will compare contrast the two versions. New nutrition education strategies will be developed based on the findings, and will be used to design internet (web-based) nutrition education program/plan.

Impacts
New project

Publications

  • No publications reported this period