ABSTRACT
EATING BEHAVIORS IN OVERWEIGHT/OBESE CALIFORNIA
STATE UNIVERSITY, FRESNO STUDENTS
More than 50% of adults are overweight or obese in the
United States. This study researched why college students,
in particular, are facing weight issues normally occurring
in people many years older.
At seemingly the healthiest and most active times in
their lives, college students are increasingly overweight
and obese. In order to gain an understanding of the
relationship between eating behaviors and weight gain,
specifically with those students who are overweight and
obese, this researcher developed a study to focus on
California State University, Fresno (Fresno State) students
and their particular eating behaviors.
Although this study was not exhaustive, this
researcher discovered important indicators for weight
status like weight gain/loss, skipping meals,
snack/beverage consumption, fruit/vegetable consumption,
and a variety of other behaviors.
Wan-Hsia Lee
May 2010
EATING BEHAVIORS IN OVERWEIGHT/OBESE CALIFORNIA
STATE UNIVERSITY, FRESNO STUDENTS
by
Wan-Hsia Lee
A thesis
submitted in partial
fulfillment of the requirements for the degree of
Master of Science in Food and Nutritional Sciences
in the Jordan College of Agricultural Sciences
and Technology
California State University, Fresno
May 2010
APPROVED
For the Department of Food Science and Nutrition:
We, the undersigned, certify that the thesis of
the following student meets the required
standards of scholarship, format, and style of
the university and the student's graduate degree
program for the awarding of the master's degree.
Wan-Hsia Lee
Thesis Author
Sandra Witte (Chair)
Food Science and Nutrition
Dennis Ferris
Food Science and Nutrition
Mollie Smith
Food Science and Nutrition
For the University Graduate Committee:
Dean, Division of Graduate Studies
AUTHORIZATION FOR REPRODUCTION
OF MASTER’S THESIS
I grant permission for the reproduction of this
thesis in part or in its entirety without
further authorization from me, on the condition
that the person or agency requesting
reproduction absorbs the cost and provides
proper acknowledgment of authorship.
X
Permission to reproduce this thesis in part or
in its entirety must be obtained from me.
Signature of thesis author:
ACKNOWLEDGMENTS
First, I offer thanks to my parents for supporting my
study. They shared their love and never put any pressure on
me; I can do whatever I want. They also provided me a lot
of psychological support. They always told me that I am the
best and to not give up. Without my loving parents, I could
never have finished this by myself.
Second, I thank Jen-Liang Liu, my husband, for pushing
me forward, listening to my complaints, reviewing early
versions of this study, and asking me to do a professional
job. Besides that, he also gave me unlimited hugs and
kisses when I lost my motivation. Without him, this could
never have happened.
Third, I would like to thank all my professors who
supported my study. Some professors provided me the freedom
to explore whatever I wanted. Some professors always stood
behind me and believed I could make it. Some professors
allowed me to come into class to do surveys without knowing
me from before. I am glad that I had them around me; they
helped me become who I am.
Last, but not least, I thank all my friends for always
being by my side. Their humor, their smiles, their hugs,
and so much more gave me power to overcome all my barriers.
TABLE OF CONTENTS
Page
LIST OF TABLES
. . . . . . . . . . . . . . . . .vii
LIST OF FIGURES . . . . . . . . . . . . . . . . viii
Chapter
1. INTRODUCTION
. . . . . . . . . . . . . . .
1
Purpose of Study . . . . . . . . . . . . .
3
Objectives
. . . . . . . . . . . . . . .
4
Hypotheses
. . . . . . . . . . . . . . .
4
Definition of Terms . . . . . . . . . . . .
4
Application of Results . . . . . . . . . . .
5
2. REVIEW OF LITERATURE
. . . . . . . . . . . .
6
. . . . . . . . . . . . .
6
Reasons for Overweight/Obesity. . . . . . . .
8
Recent Problems
Diet and Food Habits Among College Students
. . 13
3. METHODOLOGY . . . . . . . . . . . . . . . . 15
Subjects
. . . . . . . . . . . . . . . . 15
Instruments . . . . . . . . . . . . . . . 16
Data Collection
Analysis
. . . . . . . . . . . . . 17
. . . . . . . . . . . . . . . . 17
4. RESULTS AND DISCUSSION. . . . . . . . . . . . 18
Basic Information and Self-Reported Eating
Behaviors . . . . . . . . . . . . . . . 18
24-Hour Diet Recall . . . . . . . . . . . . 24
Taking Nutrition Classes . . . . . . . . . . 27
vi
Chapter
Page
Discussion
. . . . . . . . . . . . . . . 27
5. SUGGESTIONS AND SUMMARY . . . . . . . . . . . 33
Suggestions Before, During, and After the
Survey . . . . . . . . . . . . . . . . 33
Suggestions Before, During, and After Analysis . 34
Suggestions for Future Research . . . . . . . 35
Summary . . . . . . . . . . . . . . . . . 36
REFERENCES . . . . . . . . . . . . . . . . . . . 37
APPENDICES . . . . . . . . . . . . . . . . . . . 46
A. EMAIL REQUEST TO INSTRUCTORS FOR PERMISSION TO
SURVEY STUDENTS . . . . . . . . . . . . . 47
B. REQUEST FOR PARTICIPATION
C. SIGN-UP SHEET SAMPLE
. . . . . . . . . . 49
. . . . . . . . . . . . 51
D. SURVEY . . . . . . . . . . . . . . . . . . 53
LIST OF TABLES
Table
Page
1.
Self-reported heights of participants according
to gender . . . . . . . . . . . . . . . . 19
2.
Self-reported weights of participants according
to gender . . . . . . . . . . . . . . . . 20
3.
Weight categories based on self-reported heights
and weights . . . . . . . . . . . . . . . 20
4.
Participant weight gained or lost . . . . . . . 21
5.
Meals skipped per day by different weight
categories . . . . . . . . . . . . . . . 21
6.
Types of the most frequently consumed beverages
and daily amounts . . . . . . . . . . . . . 23
7.
The average grain group consumption for
participants according to weight category . . . 24
8.
The average meat and bean consumption for
participants according to weight category . . . 25
9.
The average dairy consumption for participants
according to weight category . . . . . . . . 25
10. The average vegetable consumption for
participants according to weight category . . . 26
11. The average fruit consumption for participants
according to weight category . . . . . . . . 27
LIST OF FIGURES
Figure
Page
1.
Gender of participants according to age
. . . . 19
2.
Number of times subjects consumed fast food in a
week
. . . . . . . . . . . . . . . . . 22
Chapter 1
INTRODUCTION
Currently, America is facing an epidemic of overweight
and obesity among its citizenry. The number of
overweight/obese Americans has increased significantly
within the past few decades (1-3) and this problem will
soon become a crisis if the underlying causes are not
addressed now (1-8).
In the United States (U.S.), more than half of adults
are either overweight or obese (1-7). About 127 million
adults are overweight, 60 million are obese, and 9 million
are severely obese (1). Furthermore, according to the 2001
and 2005 California Health Interview Surveys (CHIS), the
incidence of overweight/obesity was 54.4% in California in
2001 and 56.1% in 2005 (9). Fresno County has a higher
incidence of overweight/obesity than other counties: 63.6%
in 2001 and 57.8% in 2005 (10). On a per capita basis, 19%
of California adults were obese in 2001, but as a county,
Fresno has the fourth highest rate of obese adults: 26.6%
(11).
Research on overweight and obesity has produced a
variety of conflicting conclusions: (a) an imbalance of
energy intake and output contributes to the increased
prevalence of overweight and obesity, (b) childhood obesity
2
is linked to adult obesity, and (c) decreased physical
activity has caused the current overweight and obesity
trend (1,3,5-6,12-19).
The most commonly agreed upon source of weight gain is
the excessive consumption of calories. People learn to make
food choices during childhood and develop eating habits via
their parents’ influences (18,20-21). Parents and
caregivers necessarily introduce children to different
types of foods during their developing years and they
establish most of their food preferences from these
experiences (18,20). Peers also influence eating habits in
children. Children may or may not receive nutrition
education in school (20,22). Either way, during this period
of time parents provide the greatest influence in their
children’s eating choices (18,20-21).
In college, many students experience a major shift in
their eating behaviors. Those students who leave home for
college live more independently and commonly develop new
eating habits (4,23-28). Their parents no longer provide
their food and, for most of these students, it is the first
time they are free to make all their own food choices. They
may begin to think about how to have a healthy lifestyle by
improving eating habits (28-30). Other students and college
courses, particularly those related to nutrition, influence
their decisions as well (26,31). In the classroom, students
learn that a healthy lifestyle and family history influence
3
health status. This information may cause students to
change their eating habits for the better (26,28-29,31).
Though they may have taken nutrition courses, most
students do not grasp the overall subject of nutrition and
how the nutrients in foods influence their health. Many
students do not know whether their eating habits are
unhealthy or how to improve them (4,23,26,28-31). Improving
one’s eating habits begins with learning about nutrition.
Some students desire to make changes, but somehow they
still cannot develop better eating habits.
Additionally, they tend to be careless about the
nutrients they consume. Most students eat for convenience
and preference, not for nutritional balance. Common choices
are fast food, fried food, or empty-calorie foods
(1,13,16,23-24,27,30,32). It goes without saying that the
excessive consumption of the above-mentioned foods can lead
to unhealthy weight gain.
Purpose of Study
The purpose of this study was to determine if poor
eating habits influence the Body Mass Index (BMI) status of
students at Fresno State. This researcher explored the role
of energy intake and output by surveying the eating
behaviors of a sample of overweight and obese college
students.
4
Objectives
1. Calculate students’ BMIs.
2. Classify students as underweight, normal weight,
overweight, or obese according to BMIs (as defined below).
3. Compare eating behaviors among different weight
categories.
Hypotheses
Hypothesis #1: College students with higher BMIs (as
defined below) have different eating habits from those
college students with normal BMIs.
Hypothesis #2: College students with higher BMIs
consume more high-fat foods, more meat and beans, and fewer
dairy products, vegetables, and fruits.
Definition of Terms
For the purposes of this study, the following terms
will be defined:
Body Mass Index (BMI): A ratio of weight to height has
been shown to be a valid measure of weight and nutritional
status. The formula to calculate BMI: [Weight (kg) ÷ height
(m)2] (33).
Calories: Units by which energy is measured. The
amount of energy required to raise the temperature of 1 ml
of water at 15ºC by 1ºC (33). Food is measured in
kilocalories, abbreviated as kcalories or kcal (34). The
5
scientific use of the term kcalorie is the same as the
popular use of the term calorie (34).
Eating habits: Food consumption behavior acquired
through frequent repetition, quantities, and foods.
Healthy weight: A BMI ranging from 18.5 to 24.9 (33).
Morbidly obese: A BMI of 40 or higher (33).
Obese: A BMI of 30 or higher (33).
Overweight: A BMI ranging from 25 to 29.9 (33).
Underweight: A BMI of 18.4 or less (33).
Application of Results
First, knowing college students’ eating habits will
help nutrition professionals to identify where the eating
problems occur during this period of life and help the
overweight and obese students develop healthier eating
habits (1,13,26,28-29). Second, studying the eating
behaviors of Fresno State students may provide clues as to
why Fresno County has a high rate of obesity. Consequently,
nutritionists or dietitians may identify appropriate
methods to improve students’ eating behaviors and to lower
the overweight and obesity rates in Fresno County.
Chapter 2
REVIEW OF LITERATURE
This chapter will first address the current problem of
obesity and overweight in the U.S. and in other countries.
Second, this chapter will present the reasons for being
overweight or obese, as discovered in other studies.
Recent Problems
The overweight and obesity problem is spreading across
the globe. According to some surveys, overweight and
obesity problems are relatively uncommon in Africa and Asia
(35). However, in South-East Asia, shifts from a normal
diet to a Western diet and decreased physical activity have
rapidly increased the prevalence of overweight and obesity
(35). Additionally, over the past 10 years, the rate of
obesity has been growing by 10%–40% in most European
countries (35).
The overweight and obesity problem is especially
prevalent in the U.S. About 67% of adults are either
overweight or obese (1-7). About 127 million adults are
overweight, 60 million are obese, and 9 million are
morbidly obese (1). The rate of being overweight is higher
for men than for women; however, obesity is higher for
women than for men (36-37).
7
California’s rate of overweight and obesity is 37% in
the 18-24 age range, and for those over 25, the prevalence
of overweight and obesity is greater than 50% (9). With
increasing age, the percentages of those overweight also
rise (9). While 54.4% of California’s residents belong to
the overweight or obese groups, the proportion is as high
as 63.6% for residents older than 18 years in Fresno
County, California (9).
The overweight and obese population incurs higher
medical costs and endures a lower quality of life than does
the normal-weight population (3,38-41). Overweight/obesity
may increase the risk factors for morbidity and mortality
from many chronic diseases, including hypertension; type 2
diabetes; heart disease; stroke; osteoarthritis; and
cancers of the breast, prostate, and colon (3,5,18,22,3839,41-49). In the U.S., diseases related to overweight or
obesity cause an increased number of deaths annually, about
300,000 (3). Furthermore, overweight and obesity are
considered to be the second leading cause of unnecessary
death (39). Each year the healthcare costs of American
adults who are overweight and obese amount to approximately
$100 billion (3,50). In California, the cost of adult
medical expenses attributable to obesity is estimated to be
about $7.7 billion (40).
8
Reasons for Overweight/Obesity
Adult overweight or obesity is an ever-changing topic
that has been widely debated and researched. The problem is
partially due to childhood weight gain: it has been
discovered that about 16% of children between the ages of 6
and 11 are overweight, and 14.3% are at risk of being
overweight (18). For children under 18, weight status is
determined by a percentile of the CDC (Centers for Disease
Control) BMI-for-age chart. Also, 15.5% of adolescents
belong to the overweight or obese categories (3,42).
Overweight and obesity problems seem to occur in all age
groups (27,42); however, the greatest rate of weight gain
appears to occur in adults between the ages of 18-29 (1).
While the number of overweight and obese people is
increasing, the age at which people become overweight and
obese is decreasing (2,7). There are also many adults who
have been overweight or obese since they were very young
(18,51-54).
One study found that the heavier the mother, the
heavier the offspring from birth to 31 years old (53).
Among African Americans, children with rapid weight gain
during early infancy were more likely to become obese by
age 20 (55). Another study concluded that during a 5-year
transitional period, between adolescence and young
adulthood, the proportion of adolescents becoming and
remaining obese was very high. This trend is likely to
9
continue (51). One study concluded that a child with a high
BMI percentile based on the CDC BMI-for-age chart had a
higher risk of becoming overweight or obese at 35 years old,
and this risk would only increase with age (52).
Studies also show that insufficient physical activity
contributes to the overweight and obesity trend in the U.S.
(1,3,12,17,41). Despite the known benefits of exercise, a
substantial portion (25%) of U.S. adults are not physically
active on a regular basis (56-57). According to another
self-reported response, 58% of 21-year-old males and 70% of
21-year-old females do not engage in physical activities
(57). Additionally, only 46.7% of women and 49.7% of men
were engaged in moderate physical activities during the
month preceding another study (58).
As stated in the Healthy People 2010 report related to
physical activity and fitness, more Hispanics (54%) than
African Americans (52%) or American Indians (46%) reported
having no leisure time physical activity (59). Women in all
ethnic groups engaged in fewer leisure time physical
activities than men. Latinos, from among all ethnic groups,
report the highest level of leisure time inactivity (60).
Mexican American women had the highest rate of leisure time
physical inactivity when compared to Mexican American men
and non-Hispanic black women (60). Mexican American women
and other women of color, over the age of 40 and without a
college education, had the lowest levels of participation
10
in leisure time physical activity when compared to white
women (60).
Among both genders of different ethnic backgrounds in
California, rates of physical inactivity were the following:
1. Asian (29.9%),
2. African (28.3%),
3. Hispanic (25.8%), and
4. White (19.2%) (61).
For men, the rates of inactivity were:
1. Asian (28.6%),
2. Hispanic (23.5%),
3. African (21.9%), and
4. White (17.7%).
For women, the rates of inactivity were:
African (31.5%),
Asian (31.3%),
Hispanic (29%), and
White (20.9%) (61).
In the U.S., about one-third of students reported
rarely engaging in physical activity in a typical week (62).
Most reported that they engaged in physical activities
fewer than three times per week (63). Results from the 1995
National College Health Risk Behavior Survey indicate that
42.2% of undergraduates did not participate in moderate or
vigorous physical activity during the week before the
11
survey (63). The rates for female and minority college
students tended to be worse (63).
In California, 27% of adults engage in nonmoderate or
vigorous physical activities (61). Moderate physical
activity is defined as 10 minutes or more of exercise “that
caused light sweating or slight to moderate increase in
breathing or heart rate” (61). Vigorous exercise is defined
as 10 minutes or more of exercise “that caused heavy
sweating or large increases in breathing or heart rate”
(61). In Fresno County, 28.6% of adults reported taking
part in no moderate or vigorous physical activities (64).
Other studies concluded that the disproportionate
consumption of food causes overweight and obesity (5).
Studies have found that the total amount of food we consume
has steadily increased over the past decade (5). Croissants,
bagels, and quesadillas are bigger here than in other
countries (5,65). On average, the sizes of chain fast-food
portions in Europe are smaller than those in the U.S. (66).
For example, the largest order of French fries in the U.S.
contains 610 calories, whereas the largest size in the
United Kingdom contained 446 calories (66). Needless to say,
larger portion sizes lead to greater energy intake and
contribute to the overweight/obesity problem (6,14,65).
Some research has concluded that eating at Limited
Service Menu (LSM) restaurants or consuming ready-to-eat
meals is strongly associated with the prevalence of
12
overweight and obesity because these foods in the U.S.
provide larger portions and concurrent increases in
calories (6,14,65). While burgers were found to be
comparable among most burger chains in the U.S., French
fries and soft drink portions are getting larger (65-66).
French fries have increased in weight and, necessarily,
calories. For example, a regular order of French fries was
2.4 ounces in the 1950s and became a whopping 7.1 ounces in
2003 (67). Drinks have increased in both volume and calorie
content as well. For example, currently, McDonald’s “large”
drink weighs the same as the 1998 “Super size,” and the
2001 “Supersize” weighed nearly an ounce more (66). For
instance, the 7-Eleven Double Gulp, a 64-oz soda, contains
nearly 800 kcalories—an amount 10 times the size of a
serving of Coca-Cola when it was introduced in the 1950s
(66-67).
One study pointed out that the increased use of
high-fructose corn syrup (HFCS) corresponded with the rapid
increase in obesity in the U.S. (19).
Besides LSM restaurants, recipes in the U.S. have
larger portion sizes than do other countries’ recipes. For
example, when comparing a French cookbook with an American
one, comparable meat-based recipes are 53% larger in the
U.S., while vegetable-based recipes are actually 25%
smaller (68).
Some researchers believe that snack consumption is a
large part of the problem (18,69). One study stated that
13
30% of the calories students consumed in a day come from
sweets or desserts (4). According to another study, college
students who live in dormitories usually keep some snacks
in their rooms; these snacks can quickly satisfy eating
desires at any time (6,24). These factors contribute to the
increased energy intake among students, particularly
through frequent snacking (4,6,18,24,27,69).
Some studies concluded that many college students
misunderstand what is healthy food and healthy eating
habits, though many colleges offer several nutrition
classes (4,24,29-30). Consequently, people who choose
unhealthy foods may become overweight or obese. Most
receive inaccurate information about food from restaurants’
commercials, Web sites, or television commercials (4,70).
Health educators may be underestimating the severity of
college kids’ ignorance of nutrition, so determining the
eating behaviors of college students and providing a
social-ecological approach to the improvement of nutrition
status is vital (1,16,29).
Diet and Food Habits Among
College Students
One recent study found that more than 69% of students
consumed fewer than five servings of fruits and vegetables
per day (13). According to a 1995 National College Health
Risk Behavior Survey, 74% of college students consumed
fewer than 5 or more servings of fruits and vegetables per
14
day (16). This research reached the following conclusion:
Only a minuscule percentage of students (1.3%) consumed the
daily recommended servings of vegetables. Also, one study
revealed that more than 67% of students reported that they
consumed fewer than 20g of fiber per day, which implies
that most students consume too few fruits, vegetables, or
grain products, as recommended (13).
Chapter 3
METHODOLOGY
The purpose of this study was to determine the eating
behaviors of overweight and obese college students. This
section will provide a description of the subjects and
criteria for selection, the instrument, data collection,
and data analysis.
Subjects
In the fall of 2007, subjects were randomly selected
from general education (G.E.) courses at Fresno State.
According to Fresno State, the number of full-time
undergraduate students enrolled in fall 2006 was 18,951
(71). According to the Sample Size Calculator and using a
95% confidence level, a sample size of 377 was needed for
adequate representation of this group (72).
The fall class schedule published by Fresno State was
used in order to ensure an adequate number of participants
for the study. An updated online class schedule was used as
well. G.E. classes open in fall 2007 were numbered. A
random number table was used to select 15 G.E. classes from
which participants were gathered (73). After selecting the
classes, e-mail was the primary method used to contact
instructors to request permission to administer surveys to
16
their classes (see Appendix A). Students were given a
request to participate with a sign-up sheet attached. Those
interested in participating printed their names, e-mail
addresses, and telephone numbers on a sign-up sheet (see
Appendices B and C).
All college students enrolled at Fresno State who were
taking a G.E. course were eligible. Although gender was
denoted in this study, it was not a determining factor with
regard to eating habits. Students enrolled in more than one
of the participating courses completed only one survey.
Instruments
The survey was developed by this researcher using a
variety of surveys available from previous research
projects (26,69,74-75). A new 4-page survey was created.
The survey was divided into 4 parts: (a) basic information,
(b) eating behaviors, (c) 24-hour recall, and (d) questions
related to the 24-hour recall (see Appendix D).
The first section of the survey covered age, height,
and weight. The self-reported heights and weights were used
to calculate the BMIs. Using the calculated BMIs, subjects
were classified according to weight status. The second
section of the survey gathered information regarding
general eating behaviors. For example, “How many meals do
you usually consume per day?” The third part involved a
simple, 24-hour recall. Subjects recorded every food or
17
beverage consumed in the previous 24 hours. This included
types of food and quantities eaten. This part was used to
estimate the calories the subject consumed per day.
Finally, the last part included questions related to the
24-hour recall. This provided information regarding how the
subjects consumed certain foods. For example, “When I eat
meat, fish, or poultry, I fry, broil, bake, or stew it.”
Data Collection
Data were collected from subjects enrolled in G.E.
classes. Only surveys completed during class time were
included in the study. Only completed surveys were
analyzed.
Analysis
All the data were analyzed using a Statistical Package
for the Social Sciences (SPSS), Graduate Pack 14.0 for
Windows version (76). Frequencies, means, standard
deviation, and analysis of variance (ANOVA) were used for
data analysis. The information from the 24-hour recall was
analyzed by this researcher by ESHA Food Processor (77).
Chapter 4
RESULTS AND DISCUSSION
This two-part chapter will provide the results of the
study and discussion. The first part will include basic
information about participants and self-reported general
eating behaviors, the 24-hour recall, and taking nutrition
classes. The second part will include discussion.
Basic Information and Self-Reported
Eating Behaviors
This study was conducted in fall 2007. Participants
came from 11 courses. There were 448 survey subjects.
Ages and Gender
This study consisted of 282 females (62.95%) and 166
males (37.05%). Participants were mostly between the ages
of 18 and 20 years. According to self-reported data, the
gender distribution can be seen in Figure 1.
There were more female participants in this study. The
ratio of males and females (34.3%:65.7%) in this study was
not representative of the male/female ratio (41.2%:58.8%)
of Fresno State students.
19
56.74
53.61
60
50
40
% 30
25.89
22.29
22.29
20
11.7413.25
10
6.63
2.84 4.22
0
<18
18‐20
21‐23
24‐26
>27
Age (years)
Female
Male
Figure 1. Gender of participants according to age.
Heights and Weights
The self-reported heights of all the participants,
categorized according to gender, are found in Table 1. The
self-reported weights of all participants, categorized
according to gender, are found in Table 2.
Table 1. Self-reported heights of participants
according to gender
Female
Items
Average height
Range
Standard deviation
Male
inches
64.0
cm
162.50
inches
70.00
cm
177.10
53.0-73.0
134.60185.40
7.68
53.00-81.0
134.60205.70
9.58
3.0
3.77
20
Table 2. Self-reported weights of participants
according to gender
Female
Male
lbs
kg
lbs
kg
Average weight
133.00
60.69
174.00
79.16
Range
92.00300.00
29.56
41.77136.20
13.44
115.0305.00
36.08
52.21138.47
16.40
Items
Standard deviation
BMI Categories
Using the self-reported heights and weights, BMI was
calculated for each participant. For females, the range was
16.84-51.54 kg/m2. For males, the range was 17.51-45.09kg/m2.
Using the calculated BMI, subjects were classified as
underweight (BMI<18.5 kg/m2), healthy weight (BMI 18.5-24.9
kg/m2), overweight (BMI 25-29.9 kg/m2), and obese (BMI>30
kg/m2). Table 3 represents the distributions in each
category.
Table 3. Weight categories based on
self-reported heights and weights
Weight categories
N
%
14
3.15
299
66.74
Overweight
91
20.22
Obese
44
9.89
Underweight
Healthy weight
Weight Changing
Each of the participants was asked about weight
gained, lost, or maintained since entering Fresno State.
21
Among the 112 subjects who gained weight, only 108 reported
how many pounds were gained. Among the 86 subjects who lost
weight, only 60 reported how many pounds were lost. The
following data represent the amount of weight gained and
lost for those who reported their values.
Table 4. Participant weight gained or lost
Items
Average
Range
Weight gained
Weight lost
(n=108)
(n=86)
lbs
kg
lbs
kg
11.81
1.00-50.00
5.36
4.54-22.70
12.47
9.50-64.00
5.66
4.31-29.06
Skipping Meals
Participants responded to a question about meal
skipping. Table 5 presents the answers according to weight
category.
Table 5. Meals skipped per day by different weight
categories
Weight
categories
Underweight
Healthy weight
Overweight
Obesity
Meal skipped(%)
No meal skipped(%)
52.94
65.54
68.89
81.82
47.06
34.46
31.11
18.18
22
Eating Fast Food
When asked about fast food intake, only 81 subjects
(18.1%) reported eating no fast food. The remaining
subjects reported the number of times they ate fast food
per week. One subject did not answer this question. There
were no significant differences among different weight
categories as to the number of times they ate at fast food
restaurants.
5‐6 Times per week
0 Times per week
13%
19%
3‐4 Times per week
27%
1‐2 Times per week
41%
Figure 2. Number of times subjects consumed fast food in a
week.
Beverage Consumption
Behaviors
For subjects who reported drinking soda, 68.9% of the
participants reported drinking regular soda, compared with
only 31.1% who reported drinking diet soda. For subjects
23
who reported drinking fruit-type beverages, 37.88% of the
participants reported drinking fruit drinks—a sweetened
beverage of diluted fruit juice, compared to 62.12% of the
participants who reported drinking 100% fruit juice. For
subjects who reported drinking coffee, 42.02% of the
participants reported drinking plain coffee, compared to
57.98% of the participants who reported drinking gourmet
coffee, such as cappuccino, latte, or a Frappuccino.
On the question of the most frequently consumed
beverages, only one answer was allowed. Water was the most
popular drink for these participants, followed by soda,
juice, tea, diet soda, and milk. Less popular drinks, in
descending order, were energy or sport drinks, coffee,
punch, lemonade, beer, and pink lemonade.
Table 6. Types of the most frequently
consumed beverages and daily amounts
Beverage
Water
Regular soda
Fruit juice
Tea
Milk
Diet soda
Sport drinks
Coffee
Other drinks
%
Cups/Day
70.09
12.50
4.69
3.12
2.90
2.90
2.23
0.90
0.67
6.84
3.29
3.91
4.69
3.59
3.17
3.91
N/A
N/A
24
24-Hour Diet Recall
The 24-hour diet recall asked the participants to
write down the foods and quantities they consumed the day
prior to the survey. The researcher sorted and analyzed
this information according to different food categories.
Grain Group
Complex carbohydrates include bread, rice, tortillas,
other flour products, and cereals. The participants’ selfreported average complex carbohydrate consumption one day
prior to the survey was 4.75 ounces.
Table 7. The average grain group consumption for
participants according to weight category
Weight categories
oz/day
Underweight
Healthy weight
Overweight
Obesity
12.32
2.84
4.50
3.08
Meat and Beans Group
Meat and beans include pork, beef, fish, seafood,
eggs, lunch meat, and beans. Regarding meat and beans, 379
participants (84.6%) reported consuming meat and beans one
day before taking the survey; 15.4% consumed no meat or
beans the day before the survey. The participants selfreported consuming an average of 6.21 ounces of meat and
beans the day before the survey.
25
Table 8 displays the data regarding total meat and
bean consumption according to weight status.
Table 8. The average meat and bean
consumption for participants according
to weight category
Weight categories
Underweight
Healthy weight
Overweight
Obese
oz/day
2.97
5.76
7.24
8.32
Dairy
The dairy group includes whole milk, low-fat milk, 2%
milk, fat free milk, cheese, and yogurt. The average volume
of dairy products consumed the day before the survey was
2.11 cups. According to the survey, 346 participants
(77.23%) consumed dairy products one day before the survey
and 22.77% consumed no dairy products the day before the
survey.
Table 9 displays the participants’ dairy food
consumption according to weight status.
Table 9. The average dairy consumption for
participants according to weight category
Weight categories
Underweight
Healthy weight
Overweight
Obesity
Cups/day
2.56
2.15
2.11
1.71
26
Vegetables Group
The participants self-reported consuming an average of
1.08 cups of vegetables the day before the survey. Per
survey results, 255 participants (56.92%) consumed
vegetables the day before the survey and more than 43%
consumed no vegetables the day before the survey.
When comparing vegetable consumption according to
weight status, Table 10 reveals that overall vegetable
consumption was constant.
Table 10. The average vegetable consumption
for participants according to weight category
Weight categories
Cups/day
Underweight
Healthy weight
Overweight
Obesity
1.03
1.00
1.38
1.00
Fruit Group
The participants self-reported consuming an average of
1.44 cups of fruit the day before the survey. Per the
survey results, 286 participants (63.84%) consumed fruit
one day before the survey, and more than 36.16% consumed no
fruit the day before the survey.
When comparing fruit consumption according to weight
status, Table 11 reveals that overall fruit consumption
varied little.
27
Table 11. The average fruit consumption for
participants according to weight category
Weight categories
Cups/day
Underweight
Healthy weight
Overweight
Obesity
1.06
1.47
1.46
1.34
Taking Nutrition Classes
When asked about previous nutrition courses, 448
participants responded. There were 72.32% who reported
taking a nutrition course. There were 13.84% who reported
having taken a nutrition class within the past year. There
were 4.47% who reported having taken a nutrition class
within the last 2 years. There were 7.14% who reported
having taken a nutrition class more than 2 years ago. There
were 2.23% who reported having taken a nutrition class, but
did not remember when.
Discussion
According to the study, the amount of grains consumed
within the different weight categories differed from that
seen in previous studies. Underweight subjects consumed the
most grain products, followed by overweight subjects, obese
subjects, and healthy-weight subjects. Nevertheless, only
underweight subjects consumed more grain products than the
amount recommended. This could be due to a number of
factors, one of them being that perhaps underweight
28
subjects prefer to consume more grain products in order to
maintain their weight status since grain products provide
fewer calories than fat. However, other research did not
support this hypothesis. Based on other studies, a lowcarbohydrate diet may contribute to weight loss. One study
showed that a low-carbohydrate diet group lost a greater
percentage of body weight than the overweight/obese
population (78). Another study found that a lowcarbohydrate diet for the obese group helped with glycemic
control and promoted weight loss (79). The speculation
about this study versus other research may be that this
study intended to compare the eating behaviors of
overweight/obese college students to healthy weight college
students. Other research focused on the relationship
between low-carbohydrate diets and weight loss in the obese
group only. In conclusion, both this study and other
research discovered clues to weight loss and weight
maintenance.
According to this study, different weight categories
consumed different amounts of dairy products. The obese
group consumed the least amount of dairy products, followed
by the overweight, the healthy-weight, and the underweight
group. Like complex carbohydrate consumption, the
underweight group consumed more dairy than any other group.
As weight increased, fewer dairy products were consumed.
According to the findings, reduced dairy-product
29
consumption may influence weight status in college
students. Furthermore, increased dairy-product consumption
may lead to weight loss. Other studies have reached a
similar conclusion. Dairy products appear to play a pivotal
role in the regulation of energy metabolism and obesity
risk (80-82). This study drew a similar result.
For meat and bean consumption, obese subjects had the
highest intake, followed by the overweight, the healthyweight, and the underweight. In comparing the amounts
consumed within every group, the healthy-weight group
consumed almost twice the amount that the underweight group
consumed. Also, the obese group consumed almost three times
more than did the underweight group. The increased meat and
bean consumption may have resulted in the heavier weight.
Since meat generally contains more fat than other food
groups, it provides more calories and therefore a greater
risk for weight gain, especially when coupled with a
sedentary lifestyle. Other studies made similar
discoveries. One study showed that increased meat
consumption may contribute to obesity and diabetes (83).
Another study found that the lowest weight gain was
observed among those who had shifted to a diet containing
fewer meat products (84). Based on the results from this
study and literature, greater meat consumption may lead to
excessive weight gain.
30
For vegetable intake, only the overweight group had a
slightly higher intake. The underweight, the healthyweight, and the obese groups had similar intakes. However,
all the groups consumed less than the recommended amounts
of dairy. In general, most university students had
similarly low vegetable intakes during this study.
With regard to fruit intake, the healthy weight group
had the highest intake, followed by the overweight, the
obese, and then the underweight. However, none of them
reached the daily amount of fruit recommended.
The reasons why students did not consume enough
vegetables and fruits vary. Students may eat fewer
vegetables and fruits because of their higher prices per
calorie. Students may also eat fewer vegetables and fruits
because they rot in their refrigerators before they can eat
them. Basically, impediments to vegetable and fruit
consumption are their high cost and people’s low socioeconomic status (85). However, to know the actual reason
why college students do not consume enough vegetables and
fruits requires further study.
Additionally, this study revealed that lower vegetable
and fruit consumption was common among college students.
This result is similar with those of other studies.
According to one study, 18-24 year olds are not consuming
enough vegetables and fruits (86). Clearly, eating less
31
than the recommended amount of vegetables and fruits is a
common situation for college students.
For the participants in this survey, skipping meals
was common, based upon a three-meal/day regimen. In every
weight category, the percentage of skipped meals was higher
than the percentage of meals eaten. For example, with
regard to skipped meals, the obese group had the higher
incidence, followed by the overweight, the healthy-weight,
and then the underweight group. Due to a higher ratio of
skipped meals in the overweight and obese categories, these
results supported that frequently skipping meals may
increase the risk of being overweight and obese. These
findings are consistent with a study by Savige that showed
that overweight/obese subjects had a higher rate of
skipping meals than did other groups (87). The study also
indicated that these subjects may not understand that
skipping meals can increase the risk of being
overweight/obese (87). Subjects may also skip one meal and
then have a binge meal containing excessive amounts of
calories. Thusly, the more meal skipping, the higher the
chance of being overweight/obese. In this study, results
indicated that overweight/obese subjects had a higher rate
of skipping meals than did other groups.
Based on overall results of this study, college
students with higher BMIs have different eating habits from
those college students with normal BMIs. College students
32
with higher BMIs also consumed more meats and beans, and
fewer dairy products. They also had higher percentage of
meal skipping. It showed hypothesis #1 was accepted.
Hypothesis #2 could not be accepted. College students with
higher BMIs did not consume more high-fat foods, and fewer
vegetables and fruits.
Comparing college students’ eating styles helps to
identify the eating behaviors occurring in this period of
life, such as types of foods and beverages chosen within
different weight groups. When eating behaviors of college
students are well understood, establishing appropriate
interventions to assist overweight and obese college
students may improve their eating behaviors and help
control weight. Furthermore, knowing the eating behaviors
of Fresno State students may provide more information for
future challenges, such as obesity among college students
in Fresno County, as well as Fresno County overall.
Chapter 5
SUGGESTIONS AND SUMMARY
This chapter will discuss what happened before and
after the survey and analysis, summarize the findings of
this research, and recommend future improvements.
Suggestions Before, During,
and After the Survey
Thirty-six classes were pre-selected for the survey.
All instructors were asked permission and 11 allowed this
researcher to come into their classrooms. Therefore, only
one-third of the instructors granted me permission to
survey their students. This rate was lower than expected.
One year before this study, this researcher asked a similar
request of other G.E. instructors. More than half of the
instructors contacted indicated they would agree to this
study. This difference in response rates might be because
this survey was scheduled for early in the fall semester
and e-mail requests were sent during the summer vacation.
The previous request was scheduled for the middle of the
fall semester and e-mail requests were sent during the fall
semester. This researcher determined that in the future,
requests should be sent during the semester in order to
secure more participants.
34
Even though only one-third of the instructors
participated in this study, a sufficient number of
participants was obtained for the research. E-mails
requesting participation were transmitted during summer
vacation. Most instructors responded within 2 days. It
showed that e-mail was a reliable communication tool and
could be the primary method for this or other research.
In order to encourage and increase accuracy, this
researcher provided a 5-minute presentation by using
PowerPoint to educate participants on how to estimate their
diet by using cups, tablespoons, or teaspoons. This
researcher also brought measuring tools for participants to
use. Participants reported that the measuring tools were
useful for estimating their food intake.
Suggestions Before, During,
and After Analysis
This study was analyzed using SPSS. Collecting data
were recoded into an Excel file before transferring them to
SPSS software. All answers were translated into different
numbers. For example, a participant’s “Yes” answer was
coded as a “1.”
After recoding, Excel was used to achieve basic
calculations, like averages for cups, height, weight, and
BMIs. These simple calculations were accomplished in Excel
before using SPSS for the two-factor comparison. The
35
results from Excel and SPSS guarded against any mistakes
during the transferring process.
Suggestions for Future Research
Since weights and heights were not measured, BMIs
could have been inaccurate. In a follow-up study, more
precise weights and BMIs would be obtained if height and
weight were measured and BMIs were calculated by the
research.
Types and amounts of beverages consumed may be a
possible explanation for larger weight gains found in this
study. More data may be needed to determine if there is a
relationship between types and amounts of drinks and weight
gain in college students of this group.
This study found that fewer dairy products were
consumed as weight increased. More study is necessary to
discover the actual mechanism of how dairy product
consumption influences weight maintenance.
The participants in this study consumed less than the
recommended daily amounts of fruits and vegetables. The
nature of this study was not designed to discover the
reasons behind this situation. More study to uncover the
reasons behind this situation is needed.
For future studies, it is recommended that more
detailed information be gathered from the 24-hour recall.
It become apparent that the information received from this
36
survey was not sufficient to estimate the total energy
intake of the participants. A more detailed 24-hour recall
would make possible a better understanding of what college
students eat.
Summary
This study was conducted during the fall 2007 semester
and surveyed 448 subjects. All subjects answered several
general questions and reported their eating behaviors. In
this study, the ages of the majority of subjects were 18 to
20. This study consisted of about 60% females and 40%
males. All subjects self-reported their heights and
weights, and weight status. Their BMIs were determined by
their height and weight. Subjects also reported their
weight gain or loss data.
Most subjects reported skipping meals. Subjects also
reported their behaviors regarding eating out, eating fast
food, and drinking beverages. All participants were
required to do a 24-hour diet recall. This 24-hour diet
recall covered dairy products, grains, vegetables, fruits,
and proteins. Subjects answered questions regarding eating
behaviors for certain foods.
Lastly, subjects were asked to indicate whether they
were willing to learn about nutrition. About half of
participants were interested in taking nutrition classes
after they completed the survey.
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APPENDICES
APPENDIX A
EMAIL REQUEST TO INSTRUCTORS FOR
PERMISSION TO SURVEY STUDENTS
48
Date: Thursday, July 12, 2007 11:19 pm
Dear professor,
This is Ashley Lee. I am a postbachelor student from
Nutrition department. I am doing my thesis. Would you
please do me a favor? This study may help nutritionists to
understand more about students’ eating habits and help them
based on the information in the future.
My thesis is about Fresno State student’s eating behaviors.
Your class has been randomly selected. I would like to
collect information from your class. Would you please allow
me coming into your class and doing survey during class
time in fall? I probably will need up to 20 minutes to
complete this survey. Also, in order to file my thesis this
semester, may I request coming to your class before October
1st? If you may want to participant my study, please reply
this mail and let me know when and where will be best for
you. If you may not have extra time for me, that will be
fine. Your response is very important for me.
Thank you for your kindness. Have a great summer.
Sincerely,
Ashley Lee
APPENDIX B
REQUEST FOR PARTICIPATION
50
I am conducting research on college students’ eating behaviors. If you feel you
would like to participate in my study, please sign up.
APPENDIX C
SIGN-UP SHEET SAMPLE
52
Name
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
Email Address
Phone
APPENDIX D
SURVEY
54
College Student’s Eating Behaviors in California
State University, Fresno
This survey is going to investigate Fresno State
students’ eating habits. There is no “right” or “wrong”
answer. Please complete the information based on your
knowledge. The information you provide will not be used for
any commercial purposes.
 Use yesterday as your standard for how you eat
 Include snacks as well as meals and beverages
 Be sure to answer every item in this sheet. If you do
not eat a food that listed below, write a “0” in the
space provided. Please do NOT leave blanks.
Basic Information:
1.
Age (years): <18
18-20
21-23
24-26
27 and more
2.
Gender: female
3.
Height (in/ft): ________________ (without shoes)
4.
Weight (lb):_________________(when not pregnant)
5.
I believe that I am overweight. Yes
male
No
Maybe
Don’t
know
6.
I have one or more families who are
overweight/obese. Yes
7.
No
Maybe
Don’t know
Have you gained weight since entering Fresno
State? Yes,how many? ____
weight____
No, weight loss____; Same
Not sure
Eating behaviors information:
8.
How many meals do you usually have each day? ________
55
9. Do you usually have meals at regular time (morning, noon,
and evening)? Yes
No
10. Do you usually skip meals? Yes, which one? ______
No
11. Where do you get food when you are on campus? Residence
Restaurants on campus Bringing your
Dining Facility
own food
Don’t eat on campus
12. On average, how many times do you eat in any types of
restaurants per week? ______times (if needed, say “0”)
13. How many times do you eat fast food in a week? Include
fast food meals eaten at school, at home, or at fastfood restaurants, carryout or drive thru. ________times
(if needed, say “0”)
14. Do you usually have a snack? Yes
No, please go to
Question #10
15. Where do you get your snacks? Brought from
home
Vending machine
vending)
Bought on campus (not
Others____________
16. If you have a snack, what you will have (Check all
apply)? Candy Bars
chips
Popcorn
Cookies
Cake
Potato
Fruits/vegetables
Sandwich
Others
____________
17. What kind of beverages do you usually have (Check all
apply)? Regular soda
juices
Milk
coffee
Water
Diet soda
Plain Coffee
Fruit drink
Fruit
Gourmet
Alcoholic Drink
Others_______
18. What beverage do you have the most frequently (choose
one only) and how many cups do you have per day?
Beverage: _______
Cups: ________
56
19. How many cups of milk or yogurt do you have per day?
________cups (if needed, say “0”)
20. How many alcoholic drinks do you drink per week?
________servings (if needed, say “0”)

21. Did you have any classes which related to nutrition?
 No, go to question 24
Yes, go to question 22
22. When did you take these classes? Taking courses now
year
<2 years
>2 years
<1
Don’t remember
23. Do you think you practiced the nutrition information
after taking these classes? Yes
sure
Some
No
Not
Did not learn anything
24. Do you plan to take more nutrition classes to learn more
about nutrition? Yes
No
24 Hours Recall: What kind of food did you have in last 24
hours? 1 cup=8oz; TBS=Tablespoon
Food Items
25. Breakfast
cereals (cup)
27. Bread, tortilla
(slice)
29. Pasta (cup)
31. Chips/ French
fries (cup)
33. Vegetable (cup)
35. Mayonnaise (TBS)
37. Whole eggs
39. Red meat (oz)
41. Fish or
shellfish (oz)
43. Fruits, fresh/
dried (cup)
Amount
Food Items
26. Potato, or rice
(cup)
28. Biscuits (piece)
30. Beans (cup)
32. Lunch meats
(slice)
34. Salad dressing
(TBS)
36. Butter (TBS)
38. Bacon, sausage
(piece)
40. Poultry (oz)
42. Sugar (TBS)
44. Fruit juice (cup)
Amount
57
45. Cakes/ cookies
(piece)
47. Milk, or yogurt
(oz)
49. Nuts (TBS)
51. Beverages (not
diet) (cup)
53. Other: (Please write down
needed)
46. Candy bars
48. Cheese (oz/slice)
50. Ice cream (scoop)
52. Alcoholic
drinks(oz)
brands, names, size if
Water?
- PLEASE CONTINUE –

Use yesterday as your standard for how you eat

For each following items, check only ONE answer that
best describe you.
54. When I
ate
___ a. I had them with butter, margarine, sour
cream, gravy, or sauce; or fried
potatoes or ___ b. I had with No fat listed above
rice,
___ c. I did not eat potatoes or rice
55. When I
___ a. I had them with butter,
ate bread,
rolls, or
muffins
margarine, or mayonnaise
___ b. I had them with no butter,
margarine, or mayonnaise
___ c. I had them with reduced fat
butter, margarine, or mayonnaise
___ d. I did not eat bread, rolls, or muffins
56. When I
___ a. I ate the skin
ate turkey
___ b. I did not eat the skin
or chicken, ___ c. I didn’t eat chicken or
58
turkey
57. When I
ate meat,
fish, or
poultry
___ a. I had it fried, breaded, or cooked with
oil or fat or with gravy
___ b. I had it boiled, baked, or
stewed, and without any gravy
or fat
___ c. I did both a and b
___ d. I did not eat meat, fish or poultry
58. When I
___ a. I had them with or cooked with butter,
ate
margarine, oil, other
vegetables,
fat or sauce
___ b. I had them with NO fat
___ c. I had them with reduced
fat butter, margarine,
oil, other fat or sauce
___ d. I did not eat vegetable at all
59. When I
used salad
dressing,
___ a. I used a regular creamy or ranch
dressing
___ b. I had a regular oil-based dressing, like
vinaigrette
___ c. I had both
___ d. I used low-calorie or fat-free salad
dressing
___ e. I did not use salad dressing
60. When I
___ a. I drank whole milk
drank milk, ___ b. I drank low-fat (2%) milk
___ c. I drank non-fat milk
___ d. I did not drink milk
California State University, Fresno
Non-Exclusive Distribution License
(to make your thesis available electronically via the library’s eCollections database)
By submitting this license, you (the author or copyright holder) grant to CSU, Fresno
Digital Scholar the non-exclusive right to reproduce, translate (as defined in the next
paragraph), and/or distribute your submission (including the abstract) worldwide in print
and electronic format and in any medium, including but not limited to audio or video.
You agree that CSU, Fresno may, without changing the content, translate the submission
to any medium or format for the purpose of preservation.
You also agree that the submission is your original work, and that you have the right to
grant the rights contained in this license. You also represent that your submission does
not, to the best of your knowledge, infringe upon anyone’s copyright.
If the submission reproduces material for which you do not hold copyright and that would
not be considered fair use outside the copyright law, you represent that you have obtained
the unrestricted permission of the copyright owner to grant CSU, Fresno the rights
required by this license, and that such third-party material is clearly identified and
acknowledged within the text or content of the submission.
If the submission is based upon work that has been sponsored or supported by an agency
or organization other than California State University, Fresno, you represent that you
have fulfilled any right of review or other obligations required by such contract or
agreement.
California State University, Fresno will clearly identify your name as the author or owner
of the submission and will not make any alteration, other than as allowed by this license,
to your submission. By typing your name and date in the fields below, you indicate
your agreement to the terms of this distribution license.
Wan‐Hsia Lee Type full name as it appears on submission
May 17, 2010 Date