The Association of Nutrition Intake and Physical Activity to Weight in Female College-Aged Students

Transcription

1 Indiana University of Pennsylvania Knowledge IUP Theses and Dissertations (All) The Association of Nutrition Intake and Physical Activity to Weight in Female College-Aged Students Mandy N. Stinchcomb Indiana University of Pennsylvania Follow this and additional works at: Recommended Citation Stinchcomb, Mandy N., "The Association of Nutrition Intake and Physical Activity to Weight in Female College-Aged Students" (2013). Theses and Dissertations (All) This Thesis is brought to you for free and open access by Knowledge IUP. It has been accepted for inclusion in Theses and Dissertations (All) by an authorized administrator of Knowledge IUP. For more information, please contact cclouser@iup.edu, sara.parme@iup.edu.

2 THE ASSOCIATION OF NUTRITION INTAKE AND PHYSICAL ACTIVITY TO WEIGHT IN FEMALE COLLEGE-AGED STUDENTS A Thesis Submitted to the School of Graduate Studies and Research in Partial Fulfillment of the Requirements for the Degree Master of Science Mandy N. Stinchcomb Indiana University of Pennsylvania August 2013

3 Indiana University of Pennsylvania School of Graduate Studies and Research Department of Health and Physical Education We hereby approve the thesis of Mandy N. Stinchcomb Candidate for the degree of Master of Science Madeline Paternostro-Bayles, Ph.D. Advisor Professor of Health and Physical Education Elaine Blair, Ph.D. Professor of Health and Physical Education Kevin McKee, D.Ed. Associate Professor of Health and Physical Education ACCEPTED Timothy P. Mack, Ph.D. Dean School of Graduate Studies and Research ii

4 Title: The Association of Nutrition Intake and Physical Activity to Weight in Female College-Aged Students Author: Mandy N. Stinchcomb Thesis Chair: Dr. Madeline Paternostro-Bayles Thesis Committee Members: Dr. Elaine Blair Dr. Kevin McKee During the college years, individuals change their lifestyle habits which results in weight change, decrease in physical activity, and poorer eating habits. However, the association of physical activity and nutrition intake to weight has not been well established. This study is to determine the association between nutrition intake and physical activity to weight in female college-aged students. A total of 41 freshman or senior females ranging from 18 to 24 years of age within the business or nursing programs volunteered to participate. Subjects completed the Modifiable Activity Questionnaire and Food Frequency Questionnaire. Independent t-tests and chi squared and crosstabulation analyses were used to determine the association of physical activity and nutrition intake to weight between academic status and major. The results showed a significant increase in weight between senior year of high school and senior year of college as well as an increase in weight during freshman year of college. iii

5 ACKNOWLEDGEMENTS I would like to thank my parents, Dennis and Kathleen, who have supported me during these past five years and throughout my life. They have been my support base and I can t thank them enough for all the encouragement to reach for my goals, live up to my potential, and never give up on my dreams and aspirations. Thank you to my brother, Denny, for being a role model and giving me the strength to pursue my dreams. He is the strongest person I know and he makes me very proud to be his sister. I would like to thank my friends for the support and memories collected over the five years. I would like to thank Dr. Madeline Bayles for being my thesis chairperson as well as for encouraging me to partake in my master s program. She has devoted many hours in preparation of this manuscript. I am also grateful for her help and encouraging words during my undergraduate and graduate career. I would like to thank Ms. Leslie Stenger for her help and dedication to my education. She has provided me professional experience as well as developed my writing style. I would like to thank Dr. Elaine Blair and Dr. Kevin McKee for serving on my thesis committee. They provided feedback and encouragement throughout my thesis process. I would like to thank Indiana University of Pennsylvania s Exercise Science department for allowing me to have the opportunity to be a graduate assistant during the school year. The experience and knowledge I have gained will help develop me as a professional. Lastly, I would like to acknowledge my grandfather, Bud, who died March 14, He was a very strong man who fought illness for a number of years. He dedicated his whole self to his family. He was a wonderful man and I couldn t have asked for a better grandfather. Throughout this process, I could feel him with me, keeping me strong and relieving my stress. iv

6 TABLE OF CONTENTS Chapter Page I INTRODUCTION...1 Statement of the Problem...3 Research Question...3 Hypotheses...3 Definition of Terms...4 Assumptions...5 Limitations...5 Significance of Study...5 II REVIEW OF LITERATURE...7 Nutrition Status and Eating Habits...7 Physical Activity...8 Obesity and Weight Gain...9 Nutrition Status, Eating Habits, and Weight Gain in College Students...11 Physical Activity and Weight Gain in College Student...12 Measures of Dietary Intake...13 Measures of Physical Activity...14 III METHODOLOGY...16 Sample Population...16 Recruitment...16 Data Collection...17 Instruments...17 Data Analysis...18 IV RESULTS...20 Introduction...20 Subjects Characteristics...20 Statistical Analysis...30 Hypothesis I...30 Hypothesis II...38 Hypothesis III...39 Hypothesis IV...40 Hypothesis V...42 Hypothesis VI...44 V DISCUSSION, CONCLUSION, RECOMMENDATIONS...47 Summary...47 Limitations...51 Future Applications...53 ii

7 REFERENCES...55 APPENDICES... Appendix A Informed Consent...58 Appendix B Demographic Information...61 Appendix C Modifiable Activity Questionnaire...64 Appendix D Food Frequency Questionnaire...67 iii

8 LIST OF TABLES Table Page 1 ACSM Classification of Disease Risk Based on Body Mass Index (BMI) Demographic of Total Participants Demographic Statistics Between Freshman and Senior Students Freshman Students versus Race Crosstabulation Senior Students versus Race Crosstabulation Freshman Students versus How often do you drink? Crosstabulation Freshman Students versus How many drinks? Crosstabulation Seniors Students versus How often do you drink? Crosstabulation Seniors Students versus How many drink? Crosstabulation Freshmen x Do you smoke cigarettes? Crosstabulation Freshmen x How often do you smoke? Crosstabulation Seniors x Do you smoke cigarettes? Crosstabulation Seniors x How often do you smoke? Crosstabulation Classification of Total Weekly Amounts of Aerobic Physical Activity Categories Freshman Students Physical Activity Levels Senior Students Physical Activity Levels Recommended Macronutrient Proportions by Age Freshmen Nutrition Intake by Academic Major Seniors Nutrition Intake by Academic Major Meeting Dietary Guidelines x Meeting Physical Activity Guidelines High School Weight x Current Weight by Academic Status Nutrition Intake and Physical Activity by Academic Major Nursing Students Nutrition Intake and Physical Activity Statistics Business Students Nutrition Intake and Physical Activity Statistics...47 iv

9 LIST OF FIGURES Figure Page 1 Leisure physical activity of total group Carbohydrate percentage by academic status and academic major Protein percentage by academic status and academic major Fat percentage by academic status and academic major v

10 CHAPTER I INTRODUCTION Currently in the United States, the prevalence of obesity is at epidemic levels. According to the Centers for Disease Control and Prevention, obesity rates are greater than 20% in all states within the nation, with Mississippi s prevalence being the highest at 34.9% (CDC, 2011.) Obesity accounts for at least 300,000 deaths every year (Boyle, & LaRose, 2008). Approximately 65% of the American population is overweight and among the traditional college aged population, nearly 35% are recorded as being overweight (Monteiro et al., 2010). Many factors influence the obesity epidemic in this country, such as the types and amounts of food consumed and levels of physical activity. An increase in weight often reflects a change in lifestyle whether that is an increase in calories consumed or a decrease in physical activity level (Butler et al., 2004). To help curb weight gain, the U.S. Department of Health and Human Services (2008) recommends for adults to perform at least 150 minutes of moderate intensity physical activity a week or 75 minutes of vigorous intensity physical activity a week. A study conducted by Bray and Born (2004) stated that high school students are used to a routine providing them with a certain comfort level. This routine such as meal and physical activity times are usually organized by their parents, school administers, or coaches. Once a student graduates high school and transitions to college, those meal and physical activity times are no longer scheduled for that individual which may lead to poor eating habits and lack of physical activity. Past studies have shown that a decline in physical activity occurs in the early years of adulthood between 18 and 24 years of age (Boyle, & LaRose, 2008; Racette et al., 2005). One such period of potential change in physical activity is during 1

11 the college years. At that time, students change many habits due to a variety of factors including class schedule times, social situations, and increase in independence. Two studies by Jung and Butler reported uncharacteristic findings regarding calorie intake and weight gain in freshman university females. Their research suggested that a decrease in caloric intake occurred within those females studied, however, weight gain was reported in the majority of the participants. This may be due to lack of physical activity (Jung et al, 2008; Butler et al, 2004). Another study conducted by Racette and colleagues which examined weight change, exercise, and diet patterns found similar results as Jung and Butler. Out of 101 women in this study, 66% gained an average of 7.54 pounds over the course of the first 12 months of college. Therefore, those individuals who gained weight also increased their percentage body fat (Racette et al., 2008). In this same study, the caloric intake of all the subjects, whether they gained or lost weight, decreased over the 12 months of time. Those individuals, who lost weight did not change physical activity patterns but those who gained weight, decreased their physical activity level (Racette et al., 2008.) College students often decrease their physical activity and as a result, this decrease may persist into adulthood. The influence of physical activity and nutrition intake in college age females on weight gain has not been well established. Determining whether nutrition and physical activity habits change during college, this study has the potential to provide important information regarding these same lifestyle habits after college and beyond. Reducing physical activity levels to a more sedentary lifestyle during the college years can result in sedentary behavior, weight gain, or development of chronic disease later in life. (Woodruff, & Hanning, 2010). Therefore, this study will examine the association between nutrition intake and physical activity on weight change in freshman and senior female students. 2

12 Statement of the Problem The purpose of this study was to examine the association between nutrition intake and physical activity levels on weight change in freshman and senior female nursing and business students aged For comparison purposes, the business field was chosen to represent the general student population and the nursing field was chosen due to their health related backgrounds. This investigation examines if an association exists between the foods consumed and the physical activity levels and weight in traditional female college students via the Block FFQ (Block Food Frequency Questionnaire) and the MAQ (Modified Activity Questionnaire) (U.S Department of Health and Human Services, 2008; U.S. Department of Health and Human Services, 2010.) Another goal of this study was to determine whether the nutrition and physical activity habits of nursing students significantly differ from the nutrition and physical activity habits of business students. This determined if an association exists between college major and nutrition and physical activity habits to weight. Also, this study determined if academic status (freshman verses senior students) had an effect on those parameters evaluated. Comparisons were made within each group and between the two groups and results were compared. Research Question Is there an association between nutrition intake and physical activity levels to weight in freshman and senior college aged females? Hypotheses 1. The majority of college females will not meet the recommended guidelines for physical activity and nutrition intake. 3

13 2. Healthier eating habits will be associated with greater reported physical activity levels in all participants. 3. The majority of college females will gain weight from high school and that weight gain will persist from freshman through senior years. 4. Business students will report healthier eating habits and greater amounts of physical activity than nursing students. 5. Freshman nursing students will report healthier eating habits and higher physical activity levels than senior nursing students. 6. Senior business students will report healthier eating habits and higher levels of physical activity than freshman business students. Definition of Terms College-age individuals who are between the age of years of age Food Frequency Questionnaire- a questionnaire that assesses certain food groups, the frequency at which the foods are consumed, and the portion size over the past year Modifiable Activity Questionnaire a questionnaire used to determine physical activity level of individual over the past year Nutrition intake types of foods, frequency of foods, and quality of foods consumed by an Individual Nutrition status the foods consumed as well as the amount of food consumed during a given period of time 4

14 Obesity excess amount of body fat which results in a high body weight which exceeds a BMI of 30 kg/m 2 Objective measure Any measure that requires little or no judgment on the part of the person making the measurement. Objective measures are more resistant to experimenter biases than subjective measures. Physical activity any bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above a basal level and enhances health. Self-report a report about one's behavior provided especially by one who is a subject of research Social support group of individuals who are perceived as caring for an individual Subjective measure - A measure based primarily on participants' uncorroborated opinions, feelings, biases, or judgment Assumptions 1. All participants will answer questionnaires accurately and truthfully. 2. Participants will complete the questionnaire. 3. Senior students were not transfer students based on a review of credit status. Limitations 1. Surveys used are not objective measures of physical activity or nutrition intake. 5

15 2. Self-report may cause inaccuracy. 3. Length of survey may limit participation. Significance of Study Studies on physical activity compared to dietary habits in freshman college students have been conducted in the past by a number of researchers. These studies included comparisons between physical activity and nutrition intake to other factors such social support and obesity. A study conducted by Boyle and LaRose (2008) indicated that healthy weight females have healthier eating habits than healthy weight males but females participate in less physical activity and more sedentary behaviors than males. Based on this information, females of healthy weight need to be participating in a higher level of physical activity while consuming healthier foods. Due to limited research, the significance of this study is to determine if there is an association between nutrition intake and physical activity to weight in female college-aged students. Nursing students were chosen based on their health related background and business students were chosen as a general population. Findings from this study can assist health care providers and wellness professionals in promoting physical activity programs during the college years. This study will help students understand the importance of maintaining a healthy weight by consuming higher quality foods and participating in higher levels of physical activity in order to reduce the risk of disease. 6

16 CHAPTER II REVIEW OF LITERATURE A person s eating habits are derived from a combination of their socioeconomic status, geographical location, and habits of their parents and family members. These key factors also have an influence on a person s physical activity and sport participation habits. Whether those habits are healthy or unhealthy can eventually affect a person s weight. Weight gain is a major problem in the United States and has contributed to an epidemic of obesity. Among college students, gaining weight has become a part of college life, perhaps as a result of the transition from parental control to greater independence. The true reason for weight gain during those years, however, has yet to be determined. Nutrition Status and Eating Habits Nutrition intake is a major factor that contributes to overall health. Stress, availability, time, and socioeconomic status may be barriers to the consumption of healthy foods. Learning to balance the types of foods that a person consumes is a difficult task for many individuals. Having poor nutrition habits can be detrimental and can lead to the development of heart disease, stroke, cancer, diabetes, osteoporosis fractures, and birth defects (Lin et al., 1999). According to Lin and colleagues (1999), a large amount of money is spent each year on medical treatment as a result of chronic disease and disability resulting from poor dietary habits. By improving one s nutritional habit, the cost of medical treatment, the amount of missed work, and the number of premature deaths will decrease, saving potentially as much as $5.1 to $10.6 billion each year (Lin et al., 1999) The U.S. Department of Health and Human Services (2010) reported that American households with lower incomes are unable to provide adequate food supplies due to 7

17 insufficient money funds. Past studies have shown that low consumption of vegetables and fruits, as well as skipping breakfast, can lead to higher body mass index (Perusse-Lachance et al., 2010). Only about 3% of individuals currently meet the daily recommendations for vegetable intake and only 28% meet the daily recommendations for fruits (Boyle, & LaRose, 2008). It has been said that eating five fruits and vegetables a day can contribute to the reduction in the risk of cancer (Boyle, & LaRose, 2008). Also, higher body fat has been displayed in individuals that consume a low level of calcium (Perusse-Lachance et al., 2010). Low-fat milk product consumption has been associated with better weight control in the long term due to the lower amount of fat included in each product (Perusse-Lachance et al., 2010). Interestingly, past studies have concluded that individuals who consume a poor diet have significantly lower amounts of physical activity when compared to those with a quality diet (Woodruff, & Hanning, 2010). Physical Activity Physical activity accounts for about 20-30% of the body s total energy output, and during physical activity, the energy expended varies according to intensity and duration of the activity (Bascobert, 2005). It has been shown that physical activity-induced energy expenditure decreases by more than 50% between the ages of 20 and 30 years and over the age of 65 years (Westerterp, 2010). Past studies have suggested that weight gain may be associated with lower levels of physical activity or sedentary behaviors and that physical activity may help maintain weight after a person has lost weight, although exercise alone will not effectively facilitate weight loss (Perusse-Lachance et al., 2010; Butler et al., 2004; Racette et al., 2005; Westerterp, 2010). Many studies have suggested that adolescents in the United States are not achieving recommended levels of moderate intensity physical activity. That is, they are not 8

18 participating in at least 30 minutes of physical activity on five or more days per week (Bascobert, 2005). This may be in part to school districts decreasing physical education and recess from student s curriculum. Perhaps this has gotten worse over time. In 1991, 42% of high school students were participating in physical education courses daily but in 1995, only 25% of high school students were participating daily (Bascobert, 2005). By 2011, however, the Centers for Disease Control and Prevention reported that 31% of high school students were participating in daily physical education. According to the Centers for Disease Control and Prevention, only 25% of American adults engage in the recommended level of physical activity (Racette et al., 2005). In order to obtain substantial benefits from physical activity, according to the U.S. Department of Health and Human Services (2008), an individual should aerobically exercise for at least 150 minutes per week. Most United States adults do not achieve this standard. A study conducted by Racette and colleagues (2005) concluded that only half of the college students, both male and female, were participating in 3-5 days of aerobic exercise per week. This percentage was consistent from the beginning of freshman year until the end of sophomore year, therefore, no change in physical activity occurred. Although physical activity level did not change, weight gain occurred in approximately 70% of students causing researchers to assume that diet was the main cause. It is unclear, however, how much diet affects weight gain in college students (Racette et al. 2005). Obesity and Weight Gain When an individual s energy intake exceeds his or her energy expended, weight gain results (Woodruff, & Hanning, 2010). Once an individual exceeds a BMI of 30 kg//m 2, obesity results and the risk of developing a chronic disease increases greatly. Higher weight, higher rates of obesity, and greater risk of chronic disease have been seen in some racial and 9

19 ethnic groups when compared to Caucasian individuals (U.S. Department of Health and Human Services, 2010). Globally, obesity is the fifth leading cause of mortality as well as a risk factor for the development of diabetes mellitus, heart disease, stroke, high blood pressure, osteoporosis, and cancer (Perusse-Lachance et al., 2010; Bascobert, 2005; Al- Rethaiaa et al., 2010). Weight gain and obesity are caused by a number of factors, including genetics and environmental factors. Excessive caloric intake, family history, insufficient physical activity levels, genetic predisposition, and individual metabolism are some of the factors that could also affect obesity rates in individuals (Bascobert, 2005). In 2000, 30% of the population was reported obese, but according to the NHANES , 35.7% of the adult population was reported as obese (Bascobert, 2005). Availability of fast foods is another contributing factor for the increase in weight and obesity rates. In the last few years, the United States population has decreased the amount of meals that are cooked and eaten around the dinner table. It has been suggested that away from home foods have lower nutritional quality than home foods. Due to an increase in eating out, Americans have a poorer diet and an increase in adipose tissue (Lin et al., 1999). It has been stated that certain periods of time in an individual s life, such as the transition from high school to college, can be more influential on that person s behavior later in life. In one study by Butler and colleagues (2004), 20.5% of college age students were classified as overweight and obese nationwide. According to the World Health Organization, adult women are more often reported as being obese compared to their male counterparts, however, in the college population, it has been seen that male students have higher rates of obesity than female students (Al-Rethaiaa et al., 2010). In order to minimize the factors that 10

20 affect weight gain, individuals must find a balance between physical activity levels and eating habits (Woodruff, & Hanning, 2010). Nutrition Status, Eating Habits, and Weight Gain in College Students The first year of college has been seen as the transitional year where students are discovering who they are without their parents influence. The transition from minimal responsibilities and constant parental decisions to individual decision making can be hard on any new college student (Bray et al., 2004). During the first year of college, a student s diet changes due to campus cafeteria s buffet style serving or portion size increase. College students are more likely to choose foods that are convenient, cheap, and viewed as unhealthy over something more expensive and of higher quality or healthier (Monteiro et al., 2005). Breakfast has been noted as the most important meal of the day, and those that eat breakfast are less likely to be overweight (Monteiro et al., 2010). According to a study conducted by Kazi and Coopoo (2010), only 21% of college students eat breakfast regularly. This same study showed that the majority of students eat moderate size portions and 71% of the students eat while watching television (Kazi & Coopoo, 2010). A study by Racette and colleagues (2005) reported that approximately 31% of the 208 college males and females surveyed eat more than 5 fruits and vegetables per day but half of the population eats high-fat fast foods at least three times per week (Racette et al., 2005). Female college-aged students report having better dietary habits such as label reading than their male counterparts resulting in healthier choices and less weight gain (Monteiro et al., 2005). Finally, alcohol consumption and smoking may also negatively affect dietary habits of college aged students. It has been shown in a study by Kazi and Coopoo that 24% of college students currently smoke cigarettes. Also, according to this same study, it was noted that 17% of students participating in the sports science curriculum consumed alcohol beverages on 11

21 more than eleven occasions in the last month when compared to 9% of the general student group. Having a strong social group, such as family and friends, who consume healthier foods has been seen to influence first year students into developing their own healthy dietary habits. In regard to physical activity, having a strong social group has resulted in weight lose rather than weight gain (Gruber, 2008). Physical Activity and Weight Gain in College Students A couple of studies have noted a significant decline in physical activity levels among individuals in college (Jung et al., 2008;Racette et al., 2005). The term, Freshman 15, which refers to weight gain associated with the first year of college, has not been associated with dietary intake, but rather with a decrease in physical activity level and an increase in sedentary behavior (Jung et al., 2008). During one study performed on student and faculty members in Canada, two thirds of the respondents were considered to be sedentary individuals (Perusse-Lachance et al., 2010). College students require greater hours dedicated to attending classes, studying, and doing homework, therefore, resulting in an increase in sedentary time. It has been found that over fifty percent of individuals at the college level do not report participating in any form of vigorous or moderate activity on three or more days of the week (Boyle, & LaRose, 2008). In a recent study, it was shown that there is a decline in vigorous physical activity in college students compared to those in high school (Bray, & Born, 2004). For example, 54% of high school seniors participate in an adequate amount of vigorous physical activity according to the United States 1995 Youth Risk Behavior Survey. However, approximately 37% of college students participate in vigorous physical activity during their first year of college according to the U.S. National College Health Risk Behavior 12

22 Survey (Bray, & Born, 2004). In a comparison of college students who gained weight compared to those who lost weight in college, it was reported that physical activity patterns were substantially different with the weight loss group maintaining the same level of physical activity throughout their first year and the weight gain group decreasing in their physical activity level (Jung et al., 2008). Measures of Dietary Intake Dietary intake includes all foods and beverages that are consumed through the mouth with the exclusion of dietary supplements due to lack of information on their composition (Rutishauser, 2005). Measuring dietary intake is an indirect way of acquiring information on nutrients available and the amount of energy an individual has for metabolism (Rutishauser, 2005). Dietary intake can be measured through a number of different methods, however, there is always the potential for error with every method. More controlled, laboratory-based methods such as food monitoring could be used which requires participants to consume foods that are provided, measured, and recorded. The food remaining would also be measured and recorded after the meal (Rutishauer, 2005). A 24-hour dietary recall is the most commonly used dietary assessment tool that requires the individual to record all foods and beverages consumed during a given meal or snack within the last 24 hours (Baranowski, 2006; Rutishauer, 2005). During the interview, the researcher may ask who was present during the meal or snack, time of consumption, and duration of meal or snack (Baranowski, 2006). The 24 hour recall should be conducted over multiple days to account for variability. This method of assessment can be complicated for individuals other than registered dietitians. Other issues are portion size estimation inaccuracy, under reporting of participants, and lengthy administration. A food record involves the participant to record all food items consumed over a 3-day period of time. Each food item consumed should be broken down into different components and described specifically (Rutishauer, 2005). Other items to be recorded are the 13

23 amount of each food consumed either weighed or estimated, method of preparation, and the time each item was consumed. Some disadvantages to this method would be portion size estimation problems if meals are not weighed and recall problems occur if foods aren t recorded right after consumption (Baranowski, 2006). Another method of assessing dietary intake is the use of a food frequency questionnaire which was used during this study. This type of questionnaire lists selected foods from each food group and requires the participant to report how often each food is consumed over a given period of time, usually the past year (Rutishauer, 2005; Baranowski, 2006, Strong Heart Study Coordinating Center, 2006). The questionnaire used in the current study asked how much one ate each time and how often one ate certain foods (Strong Heart Study Coordinating Center, 2006). The Food Frequency Questionnaire is inexpensive and containing up to 200 items per questionnaire. Also, the Food Frequency Questionnaire can collect a large amount of data in a relatively short amount of time in order to assess an individual s entire diet (Baranowski, 2006). Measures of Physical Activity Researchers measure physical activity levels to help the professional field better understand energy expenditure, to determine whether physical activity helps with weight maintenance, or to investigate physical activity affects on individual s emotional state of mind. Physical activity can be assessed both objectively and subjectively. Objective physical activity assessments require the participants to partake in physical activity while being monitored by a pedometers or accelerometers (Foster et al., 2009). A pedometer is a measure of physical activity worn on the waist to count the number of steps an individual takes (MedicineNet, 2013; Ayabe et al., 2008). Although intensity of physical activity cannot be measured by a pedometer, inexpensive cost, ability to see direct results, and minimal difficulty to use are advantages of using a pedometer, however, they do tend to underestimate causing errors to occur (Ayabe et al., 2008). Pedometers are most accurate at a walking speed 14

24 greater than three miles per hour and cannot be worn during activities were the device may get wet (MedicineNet, 2013). Another type of physical activity assessment tool is subjective in nature which means the participant provides opinions, feelings, and biases (Janz et al., 2008). One form of subjective assessment is the physical activity diary. In the physical activity diary, each day is divided into 15 minute intervals in which the subject is asked to record the dominant activity performed within that given time (Pietilainen et al., 2010). Questionnaire assessment is another option for examining physical activity, however, there are many types of questionnaires. Cost, accessibility, and ability to survey a large number of subjects at a time make questionnaires convenient and easy to use. The Modifiable Activity Questionnaire (MAQ), used in this study, is one type of questionnaire that is used to assess occupational and leisure activity as well as levels of inactivity due to disability within the past year (Kriska et al., 1992; Bauer et al., 2010; Wright et al., 2010). This questionnaire can be modified to include any activity that has been performed at least ten times by the participant within the last year (Krista et al. 1992; Bauer et al., 2010). From that information, physical activity level can be estimated within the last week, year, or any specific time period during an individual s life (Bauer et al., 2010). The ability to modify the MAQ to satisfy special populations is a strength of this questionnaire (Krista et al. 1992; Bauer et al., 2010; Wright et al., 2010). Therefore, this study examined nutrition intake and physical activity level via the Food Frequency Questionnaire and the Modifiable Activity Questionnaire respectively in collegeaged females. 15

25 CHAPTER III METHODOLOGY Sample Population The subjects in this study were female college students enrolled in the nursing or business departments at Indiana University of Pennsylvania during the spring 2013 semester. Participants were either freshman or seniors within these departments between the ages of 18 and 24 years. Female students in the nursing and business departments were chosen based on the diversity of socioeconomic status, geographical location, and overall knowledge of wellness and disease. Business students were chosen to represent the general college population. Nursing students were also chosen based on their health related backgrounds. Key faculty members of the respective departments determined the specific classes from which the students were recruited. A total of 41 female students volunteered to participate in this study. Out of these 41 participants, 10 were senior nursing students, 13 were senior business students, 9were freshman nursing students, and the remaining 9 were freshman business students. Recruitment Nursing and business students were recruited during the month of March and identified by the key faculty members in the nursing and business departments. Permission to recruit subjects from these classes was obtained from these key faculty members at that time. During April and May, the principal investigator attended the last five minutes of the designated nursing or business classes. Once dates were set to attend specific classes, the principal investigator would use the last few minutes of the designated classes to describe the 16

26 goals and subject eligibility criteria. The principal investigator provided an explanation of the subject selection criteria and the purpose of the study after the professor had left the room. Confidentiality and the data collection process as well as the voluntary nature of the study were explained at this time. Data Collection During recruitment, the principal investigator explained all study requirements, as well as the process for returning completed questionnaires. The principal investigator provided consent forms to all individuals who were willing to participate. Each subject signed and dated the consent form, as well as provided contact information. After the consent form was signed by all participants, the principal investigator distributed the questionnaires. The subjects were told to take the questionnaire home with them and return the questionnaire back to the principal investigator during their next designated class period. The principal investigator ed the participants one day prior to the pick-up date in order to remind subjects to complete the surveys if they had forgotten. After the questionnaires were returned, the principal investigator logged the demographic information into SPSS 20 and calculated each participant s leisure physical activity level. The following is the equation used to calculate leisure physical activity: Hours per week averaged over the past year = (no. of mo.) x (times/mo.) x (min/time) 60 min/hr 52 wk/yr Instruments The principal investigator provided a basic survey to collect participant demographic information (Appendix B). The Modifiable Activity Questionnaire (MAQ) (Appendix C) was used to assess the physical activity habits of the participants within the past year and took 17

27 approximately 10 minutes to complete (Krista et al., 1992). This instrument has been used in numerous studies and has been noted as valid and reliable (Kriska et al., 1992; Bauer et al., 2010; Wright et al., 2010). The MAQ asked the participants about their leisure and occupational physical activity levels. The leisure portion of the questionnaire asked the participant to identify all leisure time activities performed on at least 10 different occasions over the past year. The monthly participation rate for each activity was marked on the form, along with number of times participated in one month and duration of each activity. Sedentary behavior was assessed by the average number of hours per day spent watching television or confined to a bed or chair for longer than a week. The occupational section of the MAQ assessed each job held for at least a month by the participant within the past year. Each job was noted along with the number of months the participant held this position. Means of transportation to work was also noted on the questionnaire, as well as number of hours per day sitting at work. To assess nutrition intake, the principal investigator used the Food Frequency Questionnaire (FFQ). This questionnaire (Appendix D) assessed the dietary habits of an individual by questioning the frequency that specific food groups were consumed in a certain time period. The length of this questionnaire was reduced to approximately 70 items and took approximately 30 minutes to complete. Within the questionnaire, the individual s typical portion size was evaluated. This questionnaire is a validated and reliable source that has been used in a number of different studies (NutritionQuest, 2009). The FFQ food list was derived from the NHANES III dietary recall data and the nutrient database came from the USDA Nutrient Database for Standard Reference (NutritionQuest, 2009.) Data Analysis The principal investigator used public domain instruments and SPSS software to analyze the data collected. Descriptive statistics were used to compare demographic 18

28 information among the group. Measures of central tendency were used to find the mean and standard deviation of the descriptive statistics. To analyze the Modifiable Activity Questionnaire, first the principal investigator calculated leisure physical activity hours per week. For the Food Frequency Questionnaire, data was entered into FoodWorks 2009 Professional Edition. With this program, the principal investigator was able to determine each participant s protein, fat, and carbohydrate values. After these values were determined by the FoodWorks program, the principal investigator analyzed the data with SPSS. Once all the data was inputted into SPSS 20 software, descriptive statistics and independent t-tests were conducted on all the demographic information provided to the principal investigator. Independent t-tests were run to compare leisure physical activity to the academic major, as well as academic status. Also, independent t-tests were conducted to analyze protein percentage, carbohydrate percentage, and fat percentage per day compared to academic status and academic major. Chi-squared and crosstabulation analyses were conducted to determine the amount of the participants who were meeting the recommendations for macronutrient intake and meeting the recommendations for physical activity prescribed by the federal government. Independent t-tests were conducted to determine if weight was gained from senior year of high school through college. 19

29 CHAPTER IV RESULTS Introduction Obesity rates have skyrocketed in the last two decades, placing more people at risk of developing chronic health conditions associated with obesity. In the United States, nearly 65% of adults are considered overweight or obese (Monteiro et al., 2010). Among collegeaged adults, it was reported that 35% of the men and women are considered overweight (Monteiro et al., 2010). The author suggests that the greatest increases in overweight and obesity occur within college-aged individuals, aged 18 to 24 years (Boyle, & LaRose, 2008). As weight increases, healthier eating habits appear to decrease. A study conducted by Boyles and LaRose (2008), suggests for all individuals over the age of two years, only 28% are currently meeting the daily recommendations for fruits and even fewer are meeting the daily recommendations for vegetables. Within college-aged students, consumption of high-fat fried foods and fast foods are reported at least three times per week (Racette et al., 2005). Those individuals who had poor dietary habits also reported having significantly lower levels of physical activity (Woodruff, & Hanning, 2010). A healthy balance between good dietary habits and physical activity will positively influence an individual s body weight. The following study examined the association between the foods consumed and the hours spent being physically active to weight in college-aged students. Subjects Characteristics The present study included 41 female subjects attending Indiana University of Pennsylvania. Out of 41 female participants, all of the participants were able to complete all questionnaires. It was determined that nine participants were freshman business students. 20

30 There were nine freshman nursing students, thirteen senior business students, and ten senior nursing students. All participants were between of the ages of 18 and 24 years. With the use of descriptive statistics, the principal investigator determined that of those 41 participants, the average age of the participants was 20.67±1.87 years. Analysis of the demographic information revealed that the majority (73.7%) of the participants (n=41) were Caucasian. African American females represented 17.1% of the total participant population. Table 1summarizes the demographic information regarding average height, weight, and BMI values for the total population (n=41). The average height was 1.64±.065 meters or 5 feet 4 inches. The average current weight of the participants was 63.75±12.45 kilograms or pounds. Therefore, the current body mass index (BMI) average was 23.66±4.32 kilograms per meter squared. According to ACSM classification of disease risk based on body mass index (2010) represented in Table 2, this value is within the normal category or between 18.5 and 24.9 kg/m 2, however, it is on the upper end of this category. The highest value for current BMI was kg/m 2 which identify this individual as obese. The lowest value for current BMI was kg/m 2 which identifies this person as underweight and in an unsafe body fat range because she fell below the normal range of 18.5 to 24.9 kg/m 2. For the high school weight, the average weight in kilograms was 60.09±9.43 or pounds. Therefore, the average high school body mass index was kg/m 2. This is a normal value for the year old age group. The highest high school BMI value was kg/m 2 which is a value in the overweight category. The lowest high school BMI value was kg/m 2 which is an unsafe value of body fat. Table 1 summarizes the information presented above. 21

31 Table 1 Demographic Statistics of Total Participants Minimum Maximum Mean Current Weight (kg) ±12.45 High School Weight (kg) ±9.43 Height (meters) ±.065 Current BMI (kg/m 2 ) ±4.32 High School BMI (kg/m 2 ) ±3.20 Table 2 ACSM Classification of Disease Risk Based on Body Mass Index (BMI) (ACSM s guidelines for exercise testing and prescription, 9 th Ed, 2014) Category BMI (kg/m 2 ) Underweight <18.5 Normal Overweight Obesity Class: I II III 40 The average age of the freshman nursing students (n=9) was 18.55±.53 years. When examining the freshman business (n=9) females, it was determined that the average age was 19.11±.60 years old. This means that the ages between the groups are relatively similar to each other. There was no significant difference between the ages of the freshman nursing and freshman business students (p=.505). Table 3 summarizes the above results about average age of the freshman students. The average height of the freshman nursing students (n=9) was 1.62±.08 meters with an average current weight of 59.43±7.32 kilograms. The average height of the freshman business participants (n=9) was 1.66±.04 meters. There was no significant difference between the average heights for the nursing versus business students (p=.256). The results for the freshman students height are displayed in Table 3. The average current weight of the freshman business population was 65.91±12.75 kilograms. There was, however, a statistically significant difference between current weights of the nursing and business 22

32 students (p=.033). Table 3 shows the above results for current weight. The average high school weight for the freshman nursing students (n=9) was 64.80±12.58 kilograms. The business females (n=9) high school weight was 58.84±8.03 kilograms. There was no significant difference between the high school weights for the nursing versus business students (p=.080). The results for high school weight is displayed in Table 3. The freshman nursing students average current basal metabolic index (BMI) was 22.62±2.94 kg/m 2 and the average high school BMI was 22.42±3.45 kg/m 2. The current BMI of the freshman business students was 23.98±4.13 kg/m 2 and the high school BMI was 23.60±4.20 kg/m 2. There was no significant difference in the current BMI values between the nursing and business students (p=.123). Table 3 summarizes the above information about current BMI and high school BMI. There was no significant difference between the high school BMI for the nursing versus business students (p=.144). The current BMI and high school BMI values are trending towards significance which means current BMI and high school BMI may not be similar. Table 3 Demographic Statistics Between Freshman and Senior Students Academic Academic N Mean Std. Sig. Status Major Deviation Age (yr) Freshman Nursing Freshman Business Senior Nursing Senior Business Height (m) Freshman Nursing Freshman Business Senior Nursing Senior Business Current Weight (kg) Freshman Nursing Freshman Business Senior Nursing Senior Business High School Weight (kg) Freshman Nursing Freshman Business Senior Nursing Senior Business Current BMI (kg/m 2 ) Freshman Nursing Freshman Business Senior Nursing

33 High School BMI (kg/m 2 ) Senior Business Freshman Nursing Freshman Business Senior Nursing Senior Business Table 3 displays the average demographic statistics for the senior students. When examining the senior students, it was found that the average age of the senior nursing students (n=10) was 22.00±1.05 years and the senior business students (n=13) averaged 22.15±1.14 years of age. There was no significant difference between the average age for the nursing students versus business students (p=.858). The average height of the senior nursing students was 1.65±.05 meters and the senior business students was 1.63±.08 meters. There was no significant difference between the average heights for the nursing students versus business students (p=.041). The results for average height for the senior students are displayed in Table 3.The average current weight of the senior nursing participants (n=10) was 64.91±10.56 kilograms. For the senior business students (n=13) current weight, it was 64.36±16.44 kilograms. There was no statistical significance between the current weights of the business and nursing students (p=.159) but it is trending on significance. Table 3 shows the information stated above regarding current weight of the senior students. When examining high school weights for the senior students, it was determined that the nursing students (n=10) weight was 59.39±4.77 kilograms and the business students (n=13) weight was 58.25±10.43 kilograms. There was no significant difference between the high school weights for the nursing students versus business students (p=.064), however, it is trending on significance. The results for high school weight are displayed in Table 3.The senior nursing students had an average current BMI of 23.82±4.33 kg/m 2. The average current BMI for the senior business students was 24.02±5.49 kg/m 2. There was no significant difference between the current BMI for the nursing students versus business students (p=.281). This results in the 24

34 senior group having similar BMI values. Lastly, the high school BMI of the senior nursing students (n=10) was 21.79±2.38 kg/m 2 and the senior business students high school BMI was 21.75±2.91 kg/m 2. There was no significant difference between the high school BMI for the nursing students versus business students (p=.499). Table 3 displays the demographic statistics for the total group divided into their appropriate disciplines. As part of the demographic information collected, participants (n=41) were asked questions pertaining to work or clinical involvement, cigarette smoking habits, and alcohol consumption. From the frequency analysis conducted, it was determined that 73.2% of the participants (n=41) participated in some type of work or clinical opportunity during their week. Of the 41 participants, 25 participants (61%) reported participating in drinking activities only on special occasions, 10 participants (24.4%) reported drinking only on the weekends, and 6 participants (14.6%) reported drinking 3-5 times per week. When examining the amount of drinks consumed during these occasions by the 41 subjects, it was determined that 16 participants (39%) only drink one or two drinks, 11 participants (26.8%) consumed three to four drinks, 7 participants (17.1%) did not consume any drinks, and 7 participants (15%) consumed five or more drinks during each drinking event. Only three participants (7%) reported smoking cigarettes and two participants (5%) reported smoking one to five cigarettes per day while the last individual recorded smoking eleven to twenty. Examining the students by academic major identified that eight of the nine freshman nursing students were Caucasian and one participant was Asian (Table 4). Out of the nine freshman business students, six participants (67%) were Caucasian; one participant (11%) was African American, and the last two participants (22%) reported being other. There was no significant difference in the ethnic background between the nursing and business major (p=.608). Table 4 summarizes the above information on race for the freshman participants. 25

35 Table 4 Freshman Students versus Race Crosstabulation African American Race Asian Cauc Other Sig. Academic Major Nursing Business Total For those participants who were senior students, nine of the ten nursing students (90%) were Caucasian and one participant (10%) was African American. When examining the senior business students, out of thirteen individuals, seven participants (54%) reported being Caucasian, five participants (38%) were African American, and one participant (8%) reported other. For this group of participants, there was a significant difference (.001) in the ethnic background between the groups. Table 5 summarizes the above information on the race of the senior students. Table 5 Senior Students versus Race Crosstabulation Race Sig. African American Cauc Other Academic Major Nursing Business Total Next, Table 6 depicts results from participants alcohol consumption. Of the nine freshman students, only six participants (67%) reported that they drank on occasion, two participants (22%) drink only on the weekends, and one participant (11%) reported drinking three to five times per week. Of the nine freshman business students, four participants (44%) 26

36 reported drinking only on occasions, four participants (44%) drank only on the weekends, and one participant (11%) drank three to five times per week. There was no significant different between freshman students (p=.872) in the reported drinking habits. Table 6 summarizes the above results on how often the freshman participants drink alcohol. Table 6 Freshmen Students versus How often do you drink? Crosstabulation How often do you drink? Sig. 3-5 Weekends Occasion Nursing Academic Major.872 Business Total Table 6 examines the results regarding how many drinks participants drink per occasion, it was reported that of the freshman nursing students (n=9), one individual (11%) drank nine or greater drinks per occasion, three individuals (33%) drank three to four drinks, three individuals (33%) drank one to two drinks, and two individuals (22%) reported not drinking at all. The freshman business participants (n=9) reported that two individuals (22%) consumed five to six drinks per drinking event, three individuals (33%) drink three to four drinks, two individuals (22%) consumed one to two drinks, and two (22%) reported not drinking at all. There was no significant difference in the reported number of drinks per occasion (p=.749) between the freshman nursing and freshman business groups. Table 7 displays the above results of the freshman students consumption of alcohol habits. Table 7 Freshmen Students versus How many drinks? Crosstabulation How many drinks? >9 Sig. Academic Major Nursing Business Total

37 In Table 8, the senior nursing students (n=10) indicated that seven participants (70%) drank only on occasion, one participant (10%) drank on the weekends, and two participants (20%) drank three to five times a week. When looking at the senior business (n=13) group, eight participants (62%) reported drinking only on occasion, three participants (23%) drank only on the weekends, and two individuals (15%) drank three to five times per week. There was no significant difference between the number of drinking occasions per week for the senior nursing students versus the senior business students (p=.661). Table 8 summarizes the above information on how often the senior students consume alcohol. Table 8 Senior Students versus How often do you drink? Crosstabulation How often do you drink? Sig. 3-5 Weekends Occasion Nursing Academic Major.661 Business Total Of the nursing students (n=10), one person (10%) reported consuming five to six drinks per occasion, three individuals (30%) had three to four drinks, five people (50%) only had one or two drinks, and one person (10%) reported not consuming any drinks. In the senior business group, three individuals (23%) of the thirteen participants indicated drinking five to six drinks per drinking occasion. Two of thirteen participants (15%) reported drinking three or four drinks, six participants (46%) consumed one or two drinks, and two people (15%) reported not drinking any drinks. There was no significant difference between the amount of drinks consumed per drinking occasion for the senior business versus senior nursing students (p=.353). Table 9 displays how many alcoholic drinks are consumed by the senior students on a given occasion. Table 9 Senior Students versus How many drinks? Crosstabulation 28

38 How many drinks? Sig. Academic Major Nursing Business Total When observing the cigarette smoking habits of the participants, it was concluded that of the nine freshmen nursing students, eight subjects (89%) do not smoke cigarettes and one individual (11%) smokes cigarettes. This same situation occurred with the freshman business students (n=9). Eight of the participants (89%) do not smoke and one participant (11%) smokes cigarettes. There was no significant difference between the smoking habits of the nursing and business students (p=1.00). Table 10 summarizes the freshman students smoking habits as discussed above. Of the individuals who reported smoking cigarettes (n=2), both participants reported smoking one to five cigarettes per day. There was no significant difference between the amount of cigarettes smoked per day (p=1.00). Table 11 displays the above results about how many cigarettes are smoked daily. Table 10 Freshmen x Do you smoke cigarettes? Crosstabulation Do you smoke cigarettes? Sig. Yes No Nursing 1 8 Academic Major 1.00 Business 1 8 Total Table 11 Freshmen x How often do you smoke? Crosstabulation How often do you smoke? Sig Nursing 8 1 Academic Major 1.00 Business 8 1 Total

39 When inspecting the senior participants, it was determined that none of the nursing individuals (n=10) reported smoking cigarettes. Out of the senior business participants (n=13), one participant (7%) reported being a smoker. This participant reported smoking eleven to twenty cigarettes per day. There was no significant difference between the smoking habits of nursing and business students (p=.071). Table 12 displays the above results on cigarette smoking habits. Also, there was no significant difference between the amount of cigarettes smoked per day for the nursing and business students (p=.071). Table 13 summarizes how often the senior students smoke cigarettes. Table 12 Seniors x Do you smoke cigarettes? Crosstabulation Do you smoke cigarettes? Sig. Yes No Nursing 0 10 Academic Major.071 Business 1 12 Total Table 13 Seniors x How often do you smoke? Crosstabulation How often do you Sig. smoke? Nursing 10 0 Academic Major.071 Business 12 1 Total Statistical Analysis Hypothesis I: The majority of college females will not meet the recommended guidelines for physical activity and nutrition intake. REJECTED According to the Federal Physical Activity Guidelines for Americans, adults should participate in at least 150 minutes a week of moderate-intensity or 75 minutes a week of 30

40 vigorous-intensity aerobic physical activity (U.S. Department of Health and Human Services, 2008). When the guidelines refer to physical activity, this is defined as any bodily movement that enhances health, therefore, physically active occupations can count for meeting the physical activity guidelines (U.S. Department of Health and Human Services, 2008). Based on these guidelines, which includes leisure physical activity and occupational physical activity, the average leisure, occupational, and total physical activity do meet these recommendations. According to ASCM guidelines, physical activity is defined as any bodily movement produced by the contraction of skeletal muscles that result in a substantial increase over resting energy expenditure (American College of Sports Medicine, 2010). To classify as meaningful activity according to ACSM, occupational activity would be excluded because these values are not high enough to classify them as working at moderate-intensity, therefore, leisure activity is analyzed (American College of Sports Medicine, 2010). Based on ACSM guidelines, moderate-intensity exercise should be performed for at least 30 minutes on most days of the week for a total of at least 150 minutes per week or 75 minutes of vigorous activity per week (American College of Sports Medicine, 2010). Table 14 displays the categories for classifying physical activity level. Therefore, this study only examines leisure physical activity from the Modifiable Activity Questionnaire. Table 14 Classification of Total Weekly Amounts of Aerobic Physical Activity Categories Levels of Physical Activity Range of Moderate-Intensity Minutes a Week Summary of Overall Health Benefits Inactive No activity beyond baseline None Low Activity beyond baseline but fewer than Some 150 minutes a week Medium 150 minutes to 300 minutes a week Substantial High More than 300 minutes a week Additional 31

41 Figure 1. Leisure physical activity of total group. For the entire population, the average amount of time spent per week in leisure activity was 4.75±2.92 hours or 285 minutes per week. Twelve out of the 41 participants (29%) did not meet the 150 minutes of leisure physical activity per week. This result is displayed in Figure 1. After the participants were divided according to academic status, it was observed that the freshman nursing students (n=9) participated in 3.73±1.95 hours of leisure physical activity per week and freshman business students (n=9) participated in 5.04±2.89 hours per week of leisure physical activity. There was no significant difference between the leisure physical activity per week for the freshman business versus freshman nursing students (p=.454). Table 15 summarizes the above information about leisure physical activity for the freshman students. Table 15 Freshman Students Physical Activity Levels 32

42 Leisure Physical Activity (hr) Occupational Physical Activity (hr) Total Physical Activity (hr) Academic Major N Mean Std. Deviation Nursing Business Nursing Business Nursing Business Sig The principal investigator then examined the senior students. The average leisure physical activity reported by the senior business students was 4.77±3.45 hours of physical activity per week and reported by nursing seniors was 5.39±3.11 hours per week of leisure physical activity. It was determined that there was no statistically significant difference between senior nursing and business students (p=.473). Table 16 summarizes the above information about leisure physical activity for the senior students. Table 16 Senior Students Physical Activity Levels Academic Major N Mean Std. Deviation Sig. Leisure Physical Activity Nursing (hr) Business Occupational Physical Nursing Activity (hr) Business Total Physical Activity (hr) Nursing Business When analyzing the Food Frequency Questionnaire, the principal investigator obtained the macronutrient intake percentages which include protein, carbohydrate, and fat values for the given year. According to the descriptive statistics, the group (n=41) averaged a daily intake of 15% proteins, 30.1% fats, and 45.4% carbohydrates. According to the Dietary Guidelines for Americans 2010 (Table 17), this population on average barely met the recommendations for carbohydrates which is 45-65% of their daily intake. Also, the group 33

43 was on the lower end of intake requirements for recommended protein intake which are 10-35% of their daily intake, but on the higher side of the fat recommendations which are 20-35% of their daily intake. When examined individually, the majority of the participants (n=41) met the recommendations for protein and fat, but 21 out of 41 participants (51%) did not meet the guidelines for carbohydrate intake. There are 17 participants (41%) out of 41 that did not meet the recommended macronutrient guidelines, which are listed below in Table 17. Table 17 Recommended Macronutrient Proportions by Age Carbohydrates Proteins Fats Young children (1-3 years) 45 65% 5 20% 30 40% Older children and 45 65% 10 30% 25 35% adolescents (4-18 years) Adults (19 years and older) 45-65% 10 35% 20 35% When analyzing by academic status, the freshmen nursing (n=9) students consumed on average 45.00±9.46% carbohydrates and the freshmen business (n=9) students consumed 42.33±9.51% carbohydrates per day. The guidelines for carbohydrates per day are between 45% and 65%, therefore, the business students did not consume the daily recommendation while the nursing freshmen students barely consumed the recommendations for the carbohydrate macronutrient. There was no significant difference in carbohydrate percentage for the freshman nursing and freshman business students (p=.959). Table 18 summarizes the macronutrient percentages consumed by the freshman nursing and business students. Table 18 Freshmen Macronutrient Percentages by Academic Major Academic Major N Mean Std. Deviation Sig. Protein % Nursing Business Fat % Nursing

44 Carbohydrate % Business Nursing Business For the senior group, the nursing students (n=10) consumed on average 49.30±7.07% carbohydrates and the business students consumed 44.77±8.54% carbohydrates. As a group, the business seniors did not consume the recommended 45-65% carbohydrates from their diet per day while the nursing students consumed the carbohydrate recommendations. There was no significant difference in carbohydrate percentage for the senior nursing versus senior business students (p=.504). Table 19 summarizes the macronutrient percentages consumed by the senior nursing and business students. Also, Figure 2 displays the percentage of carbohydrates consumed by the total group after being divided into academic status and academic major. Table 19 Seniors Macronutrient Percentages by Academic Major Academic Major N Mean Std. Deviation Sig. Protein % Nursing Business Fat % Nursing Business Carbohydrate % Nursing Business

45 Figure 2. Carbohydrate percentage by academic status and academic major. The freshmen nursing students (n=9) reported a protein intake value of 14.67±4.00% which is within the normal range of 10-35% for dietary intake for protein. The business freshman (n=9) reported an average of 15.56±4.10% of protein per day. There was no statistical significance in protein intake in the freshmen nursing and the freshman business students (p=.983). Table 18 displays the above information regarding the protein macronutrient consumed by the freshman subjects. For the senior group, the nursing students (n=10) consumed 15.60±2.76% protein per day, falling within the normal range of 10-35% intake of protein. The business students (n=13) consumed14.38±3.73% protein per day. There was no significant difference in protein intake in the senior nursing versus senior business students (p=.165), however, carbohydrate values are trending. Table 19 summarizes the above information about the consumption of protein by the senior participants. Figure 3 36

46 displays the percentage of protein consumed by the total group after being divided into academic status and academic major. Figure 3. Protein percentage by academic status and academic major. For the macronutrient, fat, intake of the freshman participants, the nursing students (n=9) consumed 32.33±7.25% fat per day while the business students (n=9) consumed 28.78±7.01% of fats. Both freshman groups consumed the daily recommended values of 20-35% fats per day, however, the nursing students consumed a higher level of fat which could not be good for their diets. There was no significant difference for fat intake between the freshman nursing versus freshman business students (p=.801). Table 18 displays the above results regarding the fat macronutrient percentage consumed by the freshman students. The senior nursing students (n=10) consumed 28.20±4.78% fats while the business seniors (n=13) consumed 31.00±4.78% fats. Both senior groups fell within normal limits of 20-35% of fat 37

47 from diet, but the business seniors consumed higher levels. Therefore, this might result in a poorer diet. There was no statistically significant difference in fat percentage for the senior nursing and senior business students (p=.989). Table 19 summarizes the above results regarding the fat macronutrient percentage consumed by the senior students. Figure 4 displays the percentage of fat consumed by the total group after being divided into academic status and academic major. Figure 4. Fat percentage by academic status and academic major. Hypothesis II: Healthier eating habits will be associated with greater reported physical activity levels in all participants. REJECTED Participants were divided into two groups: Meeting Dietary Guidelines and Not Meeting Dietary Guidelines. Also, the participants were divided into a Meeting Physical 38

48 Activity Recommendations group and a Not Meeting Physical Activity Recommendations group. In order to be in the Meeting Dietary Guidelines group, participant had to consume 45-65% of carbohydrates, 10-35% of protein, and 20-35% of fats. If a participant did not meet these guidelines, they were placed into the Not Meeting Dietary Guidelines group. The requirement for inclusion in the Meeting Physical Activity Recommendations group was selfreported participation in at least 150 minutes of leisure physical activity per week. If these guidelines were not met, the participant was placed into the Not Meeting Physical Activity Recommendations group. With the use of crosstabulation and a chi-square analysis, it was determined that of the entire group (n=41) only 38% met the physical activity guidelines and met the dietary guidelines. It was determined that 50% of the group (n=41) met the dietary guidelines, but did not meet the physical activity recommendations. Sixty- two percent of the participants (n=41) met the recommended guidelines for physical activity which is at least 150 minutes of moderate physical activity per week, but did not meet the dietary recommended of 45-65% carbohydrates, 20-35% proteins, and 10-35% fats consumed per day. Lastly, fifty percent of the population (n=41) did not meet either one of the recommendations. Therefore, it was concluded that meeting at least one of the recommendation guidelines was more common than meeting both the physical activity and dietary recommendations. There was no statistically significant difference between meeting dietary recommendations and meeting physical activity recommendations (p=.475). Table 20 displays the percentage of individuals who met the dietary and physical activity recommendations against the percentage that did not meet those recommendations. Table 20 Meeting Dietary Guidelines x Meeting Physical Activity Guidelines Meet Physical Activity Meet Total Yes No Yes Count % within Meet Physical Activity 37.9% % Sig. 39

49 Dietary Guidelines %.475 No Count % within Meet Physical Activity 62.1% 50.0 % 58.5% Hypothesis III: The majority of college females will gain weight and that weight gain will persist from freshman through senior years. ACCEPTED With the use of a paired t-test, the principal investigator compared current weight to high school weight of both academic status groups. This was conducted due to the subjects having a different number of years between their current academic status and their senior year of high school. For the freshman students (n=18), it was determined that the mean high school weight was 61.82±10.69 kilograms. The average current weight value was 62.67±10.62 kilograms. Therefore, it was found that from senior year of high school to the end of their first year of college, the students (n=18) gained an average of.85 kilogram. There was no statistical significance found within the freshman group (p=.450). Even though there was an increase in weight during this year of time, it was not statistically significant. Table 21 displays freshman students high school weight compared to the freshman students current weight. Table 21 High School Weight x Current Weight by Academic Status Academic Status N Mean Std. Sig. Deviation Freshman Students High School Weight Current Weight Senior Students High School Weight Current Weight When looking at the senior groups (n=23) weight gain from their senior year of high school to their senior year of college, it was concluded that there was statistically significant 40

50 increase in weight (p=.020). Table 21 summarizes the following information regarding the comparison of high school weight to current weight. The senior females had a mean of 58.74±8.31 kilogram as their weight for their senior year of high school. For their current weights, the mean value in kilograms was 64.60±13.89 which was now their senior year of college. On average, the senior subject s (n=23) gained 5.86±11.15 kilograms between the end of their high school careers and the end of their senior year of college. This demonstrated that the senior group (n=23) of females gained weight and that weight gain persisted from freshman through senior year of college. Hypothesis IV: Business students will report healthier eating habits and greater amounts of physical activity than nursing students. REJECTED Two-sample tests were used to compare carbohydrate percentage, fat percentage, protein percentage, and leisure hours of physical activity in nursing versus business students. It was determined that the mean carbohydrate percentage reported for nursing students (n=19) was 47.26±8.35% and the business students (n=22) averaged 43.77±8.82%. Nursing students consumed a higher percent of carbohydrates per day. Also, the nursing students (n=19) consumed the daily recommendation of 45-65% of carbohydrate and the business students (n=22) did not get the recommended values. There was no statistically significant difference in carbohydrate percentages between the nursing group and business group (p=.750). Therefore, the two groups had similar dietary carbohydrate intakes. Table 22 displays the above results regarding carbohydrate percentages for the business and nursing students. When examining the fat percentages for the two groups, the nursing students (n=19) consumed 30.16±6.27% of their total daily diets from fats and the business students (n=22) consumed an average of 30.09±5.75%. Both groups consumed between 20-35% of the daily 41

51 recommended value for fats. Although there was not a significant difference between the two groups for the fat macronutrient (p=.801), the nursing students still consumed a higher amount of fat. Table 22 displays the above results regarding the fat macronutrient percentages for the business and nursing students. The last macronutrient, protein, was analyzed, demonstrating the nursing students (n=19) consumed an average of 15.16±3.34% of their daily diet from proteins and the business students (n=22) consumed14.86±3.83% proteins. Both of these groups were on the lower end of the consumption percentage which is 10-35% protein per day, but nursing students (n=19) consumed more protein per day than reported by the business students (n=22). There was no significant difference in protein percentage for the nursing versus business students (p=.400). Table 22 displays the above results regarding protein percentages for the business and nursing students. Table 22 Nutrition Intake and Physical Activity by Academic Major Academic Major N Mean Std. Sig. Deviation Carbohydrate % Nursing Business Fat % Nursing Business Protein % Nursing Business Leisure Physical Activity (hr) Nursing Business The last section of the hypothesis discusses leisure physical activity hour values. The nursing students (n=19) participated in an average of 4.60±2.69 hours of physical activity a week while the business students (n=22) participated in 4.88±3.16 hours of physical activity a week. In relation to the ACSM guidelines, both groups on average met the weekly recommendations of 150 minutes of moderate to vigorous physical activity, however, the business students (n=22) participated in more hours per week than the nursing students 42

52 (n=19). There was no significant difference in the number of hours spent in leisure physical activity between the freshman nursing and the senior nursing groups (p=.517). Table 22 summarizes the above result about leisure physical activity participation of the nursing and business students. After examining the t-test results, it was also determined that there was no statistically significant difference between the nutrients consumed, the physical activity participated in, and the student s academic major during her college career. Hypothesis V: Freshman nursing students will report healthier eating habits and higher physical activity levels than senior nursing students. REJECTED The principal investigator conducted a two-sample t-test to compare freshman nursing students (n=9) to senior nursing students (n=10) on a number of different variables such as carbohydrate percentage, protein percentage, fat percentage, and leisure physical activity hours. According to the results, the freshman nursing students (n=9) consumed 45.00±9.46% of carbohydrates each day, but senior nursing students consumed 49.30±7.07% carbohydrates per day. The freshman group of nursing students (n=9) on average barely consumed the recommended values which are between 45-65% for carbohydrates. The senior nursing students (n=10) achieved the daily recommendations for carbohydrate and consumed on average more carbohydrates then the freshman students. There was no statistically significant difference in carbohydrate consumption for the freshman nursing versus senior nursing students (p=.485). Table 23 displays the above results regarding carbohydrate percentages for the freshman and senior nursing students. When examining the fat percentages for both the freshman and senior groups, it was determined that the freshman students (n=9) consumed an average of 32.33±7.25% fat and the senior students (n=10) consumed 28.20±4.78% fat. Both groups reported consuming the 43

53 daily recommended values for fat which is between 20-35% of fat per day. However, the freshman group (n=9) was in the higher end of the percentage range, therefore, this group was less healthy than the senior group (n=10). There was no statistically significant difference between the fat intake of the freshman nursing students and the senior nursing students (p=.442). Table 23 displays the above results regarding fat percentages for the freshman and senior nursing students. Protein percentages ranges are between 10-35% for healthy adults. After examining the given population, it was concluded that the freshman nursing students (n=9) consumed on average 14.67±4.00% protein per day while the senior students (n=10) consumed 15.60±2.76% proteins. Both groups met the daily recommendations for this macronutrient, but the senior students consumed a higher percentage making them the healthier of the two groups. There was no statistically significant difference in protein percentage for the freshman nursing versus senior nursing students (p=.365). Table 23 displays the above results regarding protein percentages for the freshman and senior nursing students. Table 23 Nursing Students Nutrition Intake and Physical Activity Statistics Academic N Mean Std. Deviation Sig. Status Carbohydrate % Freshman Senior Fat % Freshman Senior Protein % Freshman Senior Leisure Physical Activity (hr) Freshman Senior The last item analyzed was leisure physical activity hours. The freshman nursing students (n=9) participated in 3.73±1.95 hours of physical activity a week. Senior nursing students (n=10) participated in 5.39±3.11 hours of physical activity a week. The senior and 44

54 freshman groups met the recommendations of the ACSM consisting of 150 minutes of moderate-intensity physical activity per week. However, the senior students participated in a higher number of hours per week. There was no statistically significant difference (p=.177) between the two nursing groups, however, there were trends that show a possibility of different amounts of leisure physical activity participation. In conclusion, the t-test results showed that there is no significant difference between the nutrients consumed, the physical activity participated in, and the academic status of participants. Table 23 displays the above results regarding leisure physical activity levels for the freshman and senior nursing students. Hypothesis VI: Senior business students will report healthier eating habits and higher levels of physical activity than freshman business students. REJECTED When examining the eating and physical activity habits of the business students, it was determined that the freshman students (n=9) consumed 42.33±9.51% of carbohydrates per day and senior students (n=13) consumed 44.77±8.55% of their diet in carbohydrates. The daily recommendations for carbohydrates are between 45-65% per day. The freshman business students (n=9) did not consume values within this recommended range and the senior business students (n=13) were just slightly below the recommended guidelines. For the business students, there was no significant difference (p=.841) between the freshman business and senior business students which means that the senior students consumed similar amounts of carbohydrates compared to the freshman students. Table 24 displays the above results regarding carbohydrate percentages for the freshman and senior business students. The freshman business students (n=9) reported consuming 28.78±7.01% of their daily intake from fats. The senior business students (n=13) reported 31.00±4.78% fat per day. The Dietary Guidelines for Americans 2010 state that healthy adults should be consuming 45

55 between 20-35% of their daily intake from fats. Both business groups were within these guidelines, however, the freshmen consumed lower levels of fat which is healthier for their diet. There was no statistically significant difference between the fats consumed by the freshman business students and the senior business students (p=.170), but the result is trending on significance. This means that the fats consumed between the groups may be different. Table 24 summarizes the above results regarding fat percentages for the freshman and senior business students. For protein intake, the freshman business students (n=9) average consumption was 15.56±4.10% and the senior students (n=13) consumed 14.38±3.73% of protein per day. The consumption range for the daily recommendation for protein is 10-35% for healthy adults. The entire business group (n=22) met the daily recommendations, however, there was no significant difference between the groups for protein intake (p=.893). This means that the freshman students are consuming similar levels of protein compared to the senior business students. Table 24 displays the above results regarding protein percentages for the freshman and senior business students. Table 24 Business Students Nutrition Intake and Physical Activity Statistics Academic N Mean Std. Deviation Sig. Status Carbohydrate % Freshman Senior Fat % Freshman Senior Protein % Freshman Senior Leisure Physical Activity (hr) Freshman Senior When looking at the last part of the hypothesis, the average leisure physical activity participated in by the freshman business students (n=9) was 5.04±2.89 hours per week. The 46

56 senior business students (n=13) participated in 4.77±3.45 hours of leisure physical activity per week. Both of these groups met the daily recommendations for physical activity which is at least 150 minutes of moderate physical activity per week. There was no statistically significant difference for leisure physical activity time between the freshman business students and senior business students (p=.240) which means that the groups reported similar levels of leisure physical activity. Table 24 summarizes the above results about leisure physical activity hours for the freshman and senior business students. 47

57 CHAPTER V DISCUSSION, CONCLUSION, RECOMMENDATIONS Summary With the increase in technology and fast food services, there has been a large increase in the rates of overweight and obese individuals. As teenagers enter their college years, their physical activity and nutrition habits tend to change due to academic obligations, social events, and foods prepared by campus staff (Boyle, & LaRose, 2008). These changes in physical activity and nutrition intake usually have a negative impact on weight in the collegeaged population. Only a limited amount of research has been conducted in regard to this issue, therefore, this study was conducted to determine the association of physical activity and nutrition intake on weight in college-aged students. This study examined the following research hypotheses: H1) The majority of college females will not meet the recommended guidelines for physical activity and nutrition intake, H2) Healthier eating habits will be associated with greater reported physical activity levels in all participants, H3) The majority of college females will gain weight and that weight gain will persist from freshman through senior years, H4) Business students will report healthier eating habits and greater amounts of physical activity than nursing students, H5) Freshman nursing students will report healthier eating habits and higher physical activity levels than senior nursing students, H6) Senior business students will report healthier eating habits and higher levels of physical activity than freshman business students. A demographic survey containing questions about age, academic status, academic major, and lifestyle habits was completed. Also, the Modifiable Activity Questionnaire, which asks about leisure and occupational physical activity levels and a Food Frequency 48

58 Questionnaire which asks about food group consumption frequency were administered to 41 subjects. Independent t-tests, chi squared analysis, and crosstabulation were used to conduct the statistical analyses in SPSS version 20 to determine if there was an association between physical activity and nutrition intake on weight in college-aged females. H1: The data revealed that the majority of the females within the study met the recommendation for physical activity which involved 150 minutes of moderate to vigorous activity performed per week. However, there was no statistically significant difference between the nursing and business students. These findings may be due to the participant age group being more active due to social support and stress release (Gruber, 2008). It was found that the majority of the participants did not meet the recommendations for dietary intake which required the participant to intake 45-65% carbohydrates, 20-35% fats, and 10-35% protein per day, and there was no significant difference between the nursing and business students. The fact that the majority of the participants did not meet the dietary recommendations could be due to increased stress, fried food accessibility, and low income (Monteiro et al, 2010). H2: It was determined that the majority of participants did not meet the dietary intake and physical activity recommendations for healthy adults. Most participants met the physical activity recommendations of 150 minutes of moderate or vigorous activity per week but did not meet the dietary intake recommendations. There was no significant difference between the groups. Not meeting the dietary guidelines could be due to lack of time or consuming empty calories. College students have a tendency to consume larger portion sizes because of buffets provided by campus cafeterias. They may not realize they are not consuming adequate dietary recommendations because they are not required to prepare and cook their 49

59 known meals. There hasn t been a demonstrated causal relationship between increased portion size and obesity, however, controlling portion size can help limit calorie intake (Kazi, & Coopoo, 2010). Students may participate in adequate amounts of physical activity because of insecurity in current weight, a need to feel healthier, or peer pressure. H3: The data revealed that freshman students and senior students on average increased in weight from their senior year of high school to their current academic status. Weight gain was significantly related to academic status in college-aged senior students, but not in freshman students. A number of studies have also shown that calorie intake may decrease during the college years, but body weight increases (Butler et al., 2004; Jung et al., 2008; Racette et al., 2005). These opposite changes could be due to increased caffeine intake or a high level of empty calorie consumption, as well as a decrease in physical activity (Butler et al., 2004; Jung et al., 2008; Racette et al., 2005). H4: When examining eating habits and physical activity levels in business and nursing students, it was determined that nursing students consumed higher levels of carbohydrates, fats, and protein compared to the business students. There was no significant difference between the nursing and business students. The business students participated in higher levels of physical activity but there was no significant difference between the groups. To explain the business student s participation in higher levels of leisure physical activity, one would have to consider the difference in curriculum requirements. Nursing students are required to participate in clinical sections, especially during their senior year of college, therefore, instead of participating in leisure physical activity, they would be partaking in occupational physical activity hours. Due to the large number of hours spent in the occupational setting, nursing students may be eating in order to keep their energy level up, therefore, meeting the dietary intake guidelines. 50

60 H5: The data revealed that senior nursing students consumed higher levels of carbohydrates and proteins, but lower levels of fats compared to the freshman nursing students. There was no statistically significant difference in carbohydrate, protein, and fat consumption between the freshman and senior students. Again, this may be due to senior students subconsciously realizing that they are burning a large number of calories while participating in occupational physical activity, whereas most freshman nursing students have not been placed into the clinical positions yet. When analyzing leisure physical activity, the senior students participated in higher levels of physical activity compared to the freshman nursing students, however, there was no significant difference between the groups. Senior students may be participating in a higher level of leisure physical activity due to advanced development in organization skills compared to the freshman students. Compartmentalizing and prioritizing tasks comes with maturity, therefore, managing time to exercise may come easier to senior nursing students compared to freshman nursing students. When prioritizing, organizing when to study or when to eat becomes a larger task than anticipated for freshman students and usually when to exercise is considered less important and may be eliminated by this population. H6: It was determined that the senior students consumed higher levels of carbohydrate and fat, but the freshman consumed higher levels of protein and participated in higher levels of physical activity. There is no significant difference in macronutrient intake values between the two groups. Also, there was no significant difference in physical activity level between the freshman business and senior business students. As seniors, students are required to participate in an internship which is designed to resemble the job setting. A large number of the internships reported by these students were sedentary jobs. It has been reported that with sedentary behavior during work comes sedentary behavior at home (Owen et al., 2010). During most sedentary behaviors, people have a tendency to eat which may be the reason 51

61 senior students consumed higher levels of fat and carbohydrate. As a freshman, everything is new, such as living in a new place or not having classes every day, so freshman students may have different stressors compared to senior year of college and one way to eliminate stress is through exercise. To summarize, a trend in weight gain was shown from senior year of high school to freshman year of college as well as from senior year of high school to senior year of college. Therefore, weight gain may occur and persist throughout the college years. Limitations Lack of participation and recruitment issues were the major limitations with this study. Finding students who were willing to participate and who met the principal investigators parameters was difficult. Due to the population size (n=41) being limited, there were no significant differences in physical activity or nutrition intake between the entire population. Lack of variability may be due to the subjects all residing in the same geographical location and therefore, limiting locations for eating. As freshman, similar stressors may cause students to consume similar carbohydrate, protein, and fat percentage (Kazi, & Coopoo, 2010). Being younger in age may give individuals the idea that they can consume whatever foods they desire without realizing the effect it may have on them later in life (Kazi, & Coopoo, 2010; Monteiro et al., 2010). As seniors, both the nursing and business students have to participate in a form of off campus experiences, such as clinical or an internship and therefore, they do not have as much time for leisure physical activity (Jung et al., 2008). Limited participation in physical activity for the most part may be due to homework and studying. According to the U.S. Department of Health & Human Services (2008), lack of interest, lack of energy, and perceived lack of fitness are only a few of the 52

62 barriers that effect physical activity participation. Participants in this study were not asked about their barriers for physical activity participation which may have been a limitation. Multiple issues occurred during the recruitment process. In the future, the choice of questionnaire should be reevaluated. The length of the questionnaire potentially was a barrier to participation in the study and thus may have decreased the number of students willing to participate. Due to the length of the questionnaire, the participants were not as willing to fill out the survey in the classes the principal investigator was attending, therefore, the principal investigator allowed a number of students to take the questionnaire home with them to complete. This caused a number of participants to take the questionnaire, but not return it, decreasing participation rate. Once the participants took the questionnaire with them, the only source of communication the principal investigator had with the subjects was by . At least three s were sent to each participant over the course of a week s period of time, however, if participants did not respond to the s the principal investigator was not certain how many questionnaires would be returned at a given time. Another issue was the selection of the food frequency questionnaire. Because of cost, the principal investigator was not able to have the company process the food frequency questionnaires, but instead was required to input and analyze all 180 questions into the FoodWorks Professional Edition. This was not initially anticipated and significantly increased time for data collection and data analysis. Within the nursing departments, the majority of the faculty members allowed the principal investigator to attend classes to recruit, however, there were only about six classes where the senior and freshman students attended. Choosing the nursing population, the amount of classes that the senior students attended was limited as a result of off campus clinical practicum. In terms of recruiting business students at Indiana University of 53

63 Pennsylvania, the business department is not chaired by just one individual; rather there are a number of different departments under the business college. Unlike the nursing department, numerous s were sent between faculty members of multiple business departments and the principal investigator in order to determine which professors taught appropriate classes for the principal investigator to attend. Also, another problem with the chosen population is that freshman students are usually not taking courses within their major department until their sophomore year of college. With both the freshman nursing and business students, the principal investigator was required to attend liberal studies courses in order to recruit one or two students per class attended. One final issue was locating faculty members in the business and nursing departments that were willing to participate in the study s recruitment process. As a result of only communicating with faculty members through , the principal investigator was unaware what the faculty members looked like and vice versa when it came time to attend specific classes. Due to this lack of knowledge, professors would release students while the principal investigator was waiting for the professor to be acknowledged. Also, a number of faculty members forgot about appointments made with the principal investigator because the principal investigator was attending the last five minutes of class rather than the first five minutes. Future Applications Numerous of studies have been conducted on physical activity and dietary habits among freshman college students that also examined other factors such as obesity, weight gain, or social support. One study suggested that healthy weight females are reported to have better dietary habits than healthy weight males (Boyle, &LaRose, 2008). The same study also suggests that more males reported participating in at least 150 minutes of moderate intensity 54

64 activity per week, as well as having spent less time in sedentary behaviors when compared to females (Boyle, & LaRose, 2008). The significance of this study is that there is limited research on the association between nutrition intake and physical activity on weight change in female college-aged students. To the principal investigator s knowledge, there have been no studies to determine if there are differences in eating habits and physical activity levels in female business students and female nursing students, as well as differences between the freshman and senior age groups within each major. It may be recognized that these groups have contradicting background and knowledge. Business students were chosen as a representation of the general college population while nursing students were chosen based on their health related background. In the future, the principal investigator would modify the participants diet and objectively measure physical activity to determine if there is an association between academic major and weight. Findings from this study will help health and wellness professionals develop and promote physical activity programs. These programs will emphasize the importance for all students to participate in physical activity during college years in hopes that those habits will persist beyond their college years. 55

65 References Al-Rethaiaa, A. S., Fahmy, A. A., & Al-Shwaiyat, N. M. (2010). Obesity and eating habits among college students in Saudi Arabia: A cross-sectional study. Nutrition Journal, 9(39), American College of Sports Medicine. (2010). ACSM s guidelines for exercise testing and prescription. (8 th ed). Baltimore, MD: Lippincott Williams & Wilkins. Ayabe, M., Aoki, J., Ishii, K., Takayama, K., & Tanaka, H. (2008). Pedometer accuracy during stair climbing and bench stepping exercises. Journal of Sports Science and Medicine, 7, Baranowski, T. (2006, March). Selecting a measure of dietary intake for children. Behavioral Nutrition and Physical Activity at the meeting of Children s Nutrition Research Center, University of Washington. Bascobert, R. (Ed.). (2005). The science of energy balance: Calorie intake and physical activity. Colorado Springs, CO: Biological Sciences Curriculum Study. Bauer, P. W., Pivarnik, J. M., Feltz, D. L., Paneth, N., & Womack, C. J. (2010). Validation of an historical physical activity recall tool in postpartum women. Journal of Physical Activity and Health, 7, Blundell, J. E., & Neil, K. A. (1999). Physical activity and regulation of food intake: Current evidence. Medicine & Science in Sports & Exercise, 31(11), S573-S583. Boyle, J. R., & LaRose, N. R. (2008). Personal beliefs, the environment and college students exercise and eating behaviors. American Journal of Health Studies, 23(4), Bray, S. R., & Born, H. A. (2004). Transition to university and vigorous physical activity: Implications for health and psychological well-being. Journal of American College Health, 52(4), Butler, S. M., Black, D. R., Blue, C. L., & Gretebeck, R. J. (2004). Change in diet, physical 56

66 activity, and body weight in female college freshman. American Journal Health Behavior, 28(1), Foster, C., Hillsdon, M., Jones, A., Grundy, C., Wilkinson, P., White, M.,, & Thorogood, M. (2009). Objective measures of the environment and physical activity: Results of the environment and physical activity study in english adults. Journal of Physical Activity and Health, 6(Suppl 1), S70-S80. Gruber, K. J. (2008). Social support for exercise and dietary habits among college students. Adolescence, 43(171), Janz, K. F., Medema-Johnson, H. C., Letuchy, E. M., Burns, T. L., Eichenberger Gilmore, J. M., Torner, J. C.,, & Levy, S. M. (2008). Subjective and objective measures of physical activity in relationship to bone mineral content during late childhood: The Iowa bone development study. British Journal of Sports Medicine, 42, Doi: /bjsm Jung, M. E., Bray, S. R., & Martin Ginis, K. A. (2008). Behavior change and the freshman 15: Tracking physical activity and dietary patterns in 1 st -year university women. Journal of American College Health, 56(5), Kazi, H. A., & Coopoo, Y. (2010). Physical activity, alcohol use, smoking and dietary profiles of a cohort of university students [Supplemental material]. African Journal for Physical, Health Education, Recreation and Dance, 1, Kriska, A. M.. & Bennett, P. H. (1992). An epidemiological perspective of the relationship between physical activity and NIDDM: From activity assessment to intervention. Diabetes Metabolism Revolution, 8, Lin, B. H., Frazao, E., & Guthrie, J. (1999). Away-from-home foods increasingly important to quality of American diet. Economic Research Service/USDA, 1, MedicineNet. (2013). Pedometers. Retrieved from 57

67 Monteiro, A. C., Jeremic, M., & Budden, M. C. ( 2010). Can we have fries with that, please? Nutrition and physical activities among college students. Contemporary Issues In Education Research, 3(11), NutritionQuest. (2009). Block Brief 2000 FFQ. Retrieved from Ottevaere, C., Huybrechts, I., Beghin, L., Cuenca-Garcia, M., De Bourdeaudhuij, I., Gottrand,, & De Henauw, S. (2011). Relationship between self-reported dietary intake and physical activity levels among adolescents: The HELENA study. International Journal of Behavioral Nutrition and Physical Activity, 8(8), 1-9. Owen, N., Healy, G., Matthews, C., & Dunstan, D. (2010). Too much sitting: The populationhealth science of sedentary behavior. Exercise Sport Science Review, 38(3), doi: /JES.0b013e3181e373a2. Perusse-Lachance, E., Tremblay, A., & Drapeau, V. (2010). Lifestyle factors and other health measures in a canadian university community. Applied Physiology, Nutrition, and Metabolism, 35, doi: ?h Pietilainen, K. H., Korkeila, M., Bogi, L. H., Westerterp, K. R., Yki-Jarvinen, H., & Rissanen, A. (2010). Inaccuracies in food and physical activity diaries of obese subjects: Complementary evidence from doubly labeled water and co-twin assessments. International Journal of Obesity, 34, Prentice, A., & Jebb, S. (2004). Energy intake/physical activity interactions in the homeostasis of body weight regulation. Nutrition Reviews, 62(7), S98-S104. Racette, S. B., Deusinger, S. S., Strube, M. J., Highstein, G. R., & Deusinger, R. H. (2005). Weight changes, exercise, and dietary patterns during freshman and sophomore years of college. Journal of American College Health, 53(6),

68 Rutishauser, I. H. (2005). Dietary intake measurements. Public Health Nutrition, 8(7A), doi: /phn Sokolowski, M., Kaiser, A., & Cepulenas, A. (2010). Physical activity of female students of the university school of physical education in Poznan on the basis of IPAQ- Educational and social perspectives. Sportas Nutrition, 3(78), Strong Heart Study Coordinating Center. (2006). Strong heart study: Block food frequency questionnaire. The National Heart, Lung, and Blood Institute of the National Institute of Health, 9(1), U.S. Department of Health and Human Services. (2008). Physical activity guidelines for Americans. Retrieved from U.S. Department of Health and Human Services. (2010). Dietary guidelines for Americans. Retrieved from Westerterp, K.R. (2010). Physical activity, food intake, and body weight regulation: Insights from doubly labeled water studies. Nutrition Reviews, 63(3), doi: /j x. Woodruff, S. J., & Hanning, R. M. (2010). Associations between diet quality and physical activity measures among a southern Ontario regional sample of grade 6 students. Applied Physiology, Nutrition and Metabolism, 35, 82. Wright, N. D., Groisman-Perelstein, A. E., Wylie-Rosett, J., Vernon, N., Diamantis, P. M., & Isasi, C. R. (2010). A lifestyle assessment and intervention tool for pediatric weight management: The HABITS questionnaire. Journal of Human Nutrition and Dietetics,24, Doi: /j X x 59

69 APPENDIX A INFORMED CONSENT 60

70 Informed Consent Form This is an invitation to participate in a research study. You are invited to participate in this study because you are a freshman or senior female in the nursing or business program at Indiana University of Pennsylvania. Your participation is voluntary. This study is being conducted to examine the relationship between the foods that college students eat and their level of physical activity on weight gain or loss. Therefore, this study looks at both eating and physical activity levels. You will be asked to complete two questionnaires equaling approximately 40 minutes to complete. Your name will not be recorded on the questionnaire, therefore, your responses to the questions will be anonymous. There are no known risks associated with participating in this research study. Also, your professor will not be in the room designated by the principal investigator while the survey is being filled out. Your decision to participate or not to participate will not affect your grade in this course and will not affect any privileges or services you receive as an IUP student. Again your participation in this study is completely voluntary. By notifying the principal investigator, you are able to withdraw from this study only while the questionnaire is being filled out. Once the questionnaire is handed to the principal investigator, it becomes anonymous and withdrawing will no longer be possible. The information obtained in this study may be published in scientific journals or presented at scientific meetings but your identity will be kept confidential by all data being reported as group data. If you are willing to participate in this study, please sign the statement below and deposit in the designated box by the door. If you choose not to participate, deposit the unsigned copy in the designated box by the door. Principal Investigator: Miss Mandy Stinchcomb Indiana University of Pennsylvania 242 Zink Hall Indiana, PA Phone: This project has been approved by the Indiana University of Pennsylvania Institutional Review Board for the Protection of Human Subjects (Phone: 724/ ). 61

71 Informed Consent Form (continued) VOLUNTARY CONSENT FORM: I have read and understand the information on the form and I consent to volunteer to be a subject in this study. I understand that my responses are completely confidential and that I have the right to withdraw at any time. Thank you for your assistance. Participant Name (Please Print) Signature Date I certify that I have explained to the above individuals the nature and purpose, the potential benefits, and possible risks associated with participating in this research study, have answered any questions that have been raised, and have witness the above signature. Date Investigator s Signature 62

72 APPENDIX B DEMOGRAPHIC INFORMATION 63

73 Please circle answer that best applies. DEMOGRAPHIC INFORMATION: 1. How old are you? a. Less than 18 years old b. 18 years old c. 19 years old d. 20 years old e. 21 years old f. 22 years old g. 23 years old h. 24 years old i. Greater than 24 years old Background Information 2. Current Height: feet inches 3. Current Weight: lbs 4. Weight during senior year of High School: lbs 5. Are you a nursing student or a business student? a. Nursing b. Business 6. Academic Status: a. Freshman ( credits completed) b. Sophomore ( credits completed) c. Junior ( credits completed) d. Senior (90 + credits completed) 7. With which group do you most identify? a. African American b. Asian American or Pacific Islander c. Hispanic/Latino d. Native American e. Caucasian f. Other 8. Do you have a job/clinical outside of going to school? a. Yes b. No 64

74 LIFESTYLE QUESTIONS: 9. How often do you consume alcohol? a. Every day b. 3-5 times a week c. Once a week d. Only on weekends e. On special occasions 10. How many drinks on average do you usually consume in one sitting? a. 0 b. 1-2 c. 3-4 d. 5-6 e. 7-9 f. More than Do you smoke cigarettes? a. Yes b. No 12. How many cigarettes do you smoke a day? a. 0 b. 1-5 c d e. 21 or more 65

75 APPENDIX C MODIFIABLE ACTIVITY QUESTIONNAIRE 64

76 65

77 66

78 APPENDIX D FOOD FREQUENCY QUESTIONNAIRE 67

79 68

80 69

81 70

82 71

83 72

84 73

85 74

86 75