Weight gain prevention: identifying theory-based targets for health behavior change in young adults.

Young adults attending college are more vulnerable to weight gain than the general population. We sought to identify health behavior change targets related to weight management in college students. Based on the Social Cognitive Theory model for health behavior change, we investigated the health-related lifestyle behaviors and physiological characteristics of this population. Forty-three college students (18.3+/-0.1 years) completed a series of quantitative assessments (eg, body weight and composition, cardiorespiratory fitness, and diet and activity habits) and structured qualitative assessments (ie, structured interview or focus group). Participants were predominantly normal weight (mean body mass index 22.2+/-0.4) and fit (maximal oxygen consumption 50.5+/-1.5 mL/kg/minute). However, healthful eating and physical activity were not considered high priorities, despite having ample free time, high exercise self-efficacy, positive outcome expectations for exercise, and a desire to exercise more. Participants reported that regularly engaging in exercise was difficult. This may have been due to poor planning/time management, satisfaction with body image, lack of accountability, and feelings of laziness. Dietary patterns generally met recommendations but were low in fruits, vegetables, and whole grains. Social support for exercise and healthful dietary habits were important factors associated with health behaviors. Students reported a decline in exercise and dietary habits relative to high school, which may have contributed to college weight gain. Our results suggest that this population may not have adequate self-regulatory skills, such as planning and self-monitoring, to maintain healthful behaviors in the college environment. Food and nutrition professionals working with young adults attending college may use these findings to guide the behavioral therapy component of their weight management medical nutrition therapy goals and outcomes.

[1]  Laleh Hajhosseini,et al.  Changes in Body Weight, Body Composition and Resting Metabolic Rate (RMR) in First-Year University Freshmen Students , 2006, Journal of the American College of Nutrition.

[2]  E. Obarzanek,et al.  Pathways to obesity prevention: report of a National Institutes of Health workshop. , 2003, Obesity research.

[3]  D. Levitsky,et al.  The freshman weight gain: a model for the study of the epidemic of obesity , 2004, International Journal of Obesity.

[4]  Liviu Klein,et al.  Consistently Stable or Decreased Body Mass Index in Young Adulthood and Longitudinal Changes in Metabolic Syndrome Components: The Coronary Artery Risk Development in Young Adults Study , 2007, Circulation.

[5]  J. Sallis,et al.  Project GRAD: two-year outcomes of a randomized controlled physical activity intervention among young adults. Graduate Ready for Activity Daily. , 2000, American journal of preventive medicine.

[6]  Glen Mays,et al.  Self‐Reported Sugar‐Sweetened Beverage Intake among College Students , 2006, Obesity.

[7]  D. Black,et al.  Change in diet, physical activity, and body weight in female college freshman. , 2004, American journal of health behavior.

[8]  L. Weissfeld,et al.  Weight Gain Prevention among Women , 2007, Obesity.

[9]  Nutrition Board,et al.  Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids , 2005 .

[10]  Sheila G. Winett,et al.  Guide to health: Nutrition and physical activity outcomes of a group-randomized trial of an internet-based intervention in churches , 2007, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[11]  R. Bogdan.  Qualitative research for education : an introduction to theory and methods / by Robert C. Bogdan and Sari Knopp Biklen , 1997 .

[12]  James O. Hill,et al.  Obesity and the Environment: Where Do We Go from Here? , 2003, Science.

[13]  L. Atwood,et al.  Evaluating the Believability and Effectiveness of the Social Norms Message "Most Students Drink 0 to 4 Drinks When They Party" , 2006, Health communication.

[14]  A. Mokdad,et al.  The spread of the obesity epidemic in the United States, 1991-1998. , 1999, JAMA.

[15]  P. Karoly,et al.  Social support and social norms: do both contribute to predicting leisure-time exercise? , 2003, American journal of health behavior.

[16]  Richard A. Winett,et al.  Social cognitive determinants of physical activity in young adults: A prospective structural equation analysis , 2002, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[17]  Daniel W. Jones,et al.  Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. , 2003, Hypertension.

[18]  A. Stunkard,et al.  The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. , 1985, Journal of psychosomatic research.

[19]  Richard A. Krueger,et al.  Focus groups : a practical guide for applied research / by Richard A. Krueger , 1989 .

[20]  R. H. Deusinger,et al.  Weight Changes, Exercise, and Dietary Patterns During Freshman and Sophomore Years of College , 2005, Journal of American college health : J of ACH.

[21]  E. H. Heath.  Acsm’s Guidelines for Exercise Testing and Prescription, 7th Edition , 2005 .

[22]  C B Corbin,et al.  A 10,000-Step Count as a Physical Activity Target for Sedentary Women , 2001, Research quarterly for exercise and sport.

[23]  M. Hovell,et al.  Risk of excess weight gain in university women: a three-year community controlled analysis. , 1985, Addictive behaviors.

[24]  L. Horn.  Research: Successful Approaches , 2007 .

[25]  J. Shapiro,et al.  The freshman year of college as a critical period for weight gain: an initial evaluation. , 2003, Eating behaviors.

[26]  J. Garrett,et al.  The Natural History of the Development of Obesity in a Cohort of Young U.S. Adults between 1981 and 1998 , 2002, Annals of Internal Medicine.

[27]  L. Radloff.  The CES-D Scale , 1977 .

[28]  N. Rose,et al.  Whole-grain intake is associated with body mass index in college students. , 2007, Journal of nutrition education and behavior.

[29]  P. Thompson,et al.  ACSM's Guidelines for Exercise Testing and Prescription , 1995 .

[30]  N. Christakis,et al.  The Spread of Obesity in a Large Social Network Over 32 Years , 2007, The New England journal of medicine.

[31]  T. J. Sheehan,et al.  Rates of weight change for black and white Americans over a twenty year period , 2003, International Journal of Obesity.

[32]  D. Garner,et al.  The Eating Attitudes Test: psychometric features and clinical correlates , 1982, Psychological Medicine.

[33]  J L Collins,et al.  Youth risk behavior surveillance--United States, 1995. , 1996, The Journal of school health.

[34]  A. Bandura.  Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[35]  A. Bauman,et al.  Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. , 2007, Circulation.

[36]  R. Jeffery,et al.  Preventing weight gain in adults: the pound of prevention study. , 1999, American journal of public health.

[37]  D R Jacobs,et al.  Weight gain continues in the 1990s: 10-year trends in weight and overweight from the CARDIA study. Coronary Artery Risk Development in Young Adults. , 2000, American journal of epidemiology.

[38]  A. Bandura.  Self-Efficacy: The Exercise of Control , 1997, Journal of Cognitive Psychotherapy.

[39]  S. Blair,et al.  The utility of the Digi-walker step counter to assess daily physical activity patterns. , 2000, Medicine and science in sports and exercise.