AWARENESS, UNDERSTANDING, AND USAGE OF MYPYRAMID IN COLLEGE
STUDENTS
Mara Lee Beebe
A Thesis
Submitted to the Graduate College of Bowling Green
State University in partial fulfillment of
the requirements for the degree of
MASTER OF FAMILY AND CONSUMER SCIENCES
May 2010
Committee:
Younghee Kim, Advisor
Pricilla Coleman
Jie Wu
ABSTRACT
Younghee Kim, Advisor
Background. Since the release of the MyPyramid food guidance system in 2005, there
has not been any research conducted to assess the knowledge and usage of this important
educational tool among college students. The objectives of this study were to assess (1) college
students‟ awareness of the MyPyramid, (2) college students‟ perceived understanding of the new
components of the MyPyramid and new method of measuring serving sizes, (3) college students‟
usage of the MyPyramid.gov website, (4) college students‟ usage of MyPyramid as a dietary
guide, and (5) the relationship of demographic factors with awareness, understanding, usage, and
practice of MyPyramid.
Methods. A self-reported quantitative and qualitative online questionnaire was used to collect the
data from college students. A recruitment email was used to invite students to participate in the
study. Students accessed the questionnaire through a website.
Results. A total of 2,687 students participated in the study. Fifty-six percent of students surveyed,
and only 29% of students who were aware of MyPyramid had visited the website. Students
reported high levels of perceived understanding for both the MyPyramid messages and the
changes in serving size measurement. Students reported low levels of utilization of the
MyPyramid; only 21% used the MyPyramid as a guide and only 39% tried to reflect MyPyramid
in their food choices frequently or almost always. Forty-five percent reported making some or
substantial change in their diet after learning of MyPyramid. Females were found to be more
likely to be aware of MyPyramid (p <.05), use the MyPyramid website (p <.01), made changes
in their diet (p <.05), and use MyPyramid as a nutrition plan (p <.05). Furthermore, completion
ii
of a nutrition class in college resulted in similar positive impacts on awareness (p <.01), usage (p
<.01), and application of MyPyramid (p <.01) regardless of gender.
Conclusion. Students reported moderate levels of awareness for MyPyramid and high levels of
perceived understanding of MyPyramid. However, awareness did not translate to usage or
practice of MyPyramid, as 21% of the students stated to use MyPyramid as a guide for dietary
intake and 45% of the students stated to have made changes in their diets after learning about
MyPyramid. Students who had taken an introductory nutrition class in college had higher levels
of awareness, understanding, usage of the website, and reflection of MyPyramid in dietary
choices. These findings support the idea that efforts should be made to promote MyPyramid in
all facets of the education system. Continued research is needed to find ways to increase student
awareness of MyPyramid and to use it to make better food choices.
iii
ACKNOWLEDGMENTS
First, I would like to thank Dr. Kim for all of her hard work and dedication to the
research process. I would also like to thank Jie Wu and Dr. Coleman for agreeing to be on my
committee and helping me with the research process. Additionally, I would like to thank the
Family and Consumer Sciences Department for providing funding for the project. Lastly, I
would like to thank my husband and my family for being understanding, patient, and supportive
while working on my thesis and my graduate degree.
iv
TABLE OF CONTENTS
Page
CHAPTER I. INTRODUCTION ..........................................................................................
1
Statement of Problem .................................................................................................
2
Significance of Problem .............................................................................................
2
Objectives ..................................................................................................................
3
Definition of Terms....................................................................................................
4
CHAPTER II. REVIEW OF LITERATURE .......................................................................
6
History of the Food Guide Pyramid ...........................................................................
6
Utilization of the Food Guide Pyramid ......................................................................
7
Criticism of the Food Guide Pyramid ........................................................................
7
Development of MyPyramid......................................................................................
10
Technical Research ........................................................................................
11
Consumer Research .......................................................................................
11
Website Usability Testing ..............................................................................
17
Release of MyPyramid ...............................................................................................
17
Consumer Response to MyPyramid...............................................................
18
CHAPTER III. METHODS ..................................................................................................
20
Design ........................................................................................................................
20
Participants ................................................................................................................
20
Questionnaire Design .................................................................................................
20
Demographics ................................................................................................
21
Awareness ......................................................................................................
21
v
Understanding ................................................................................................
21
Usage ............................................................................................................
22
Data Analysis ............................................................................................................
22
CHAPTER IV. RESULTS ....................................................................................................
23
Response Rate ............................................................................................................
23
Demographics ............................................................................................................
23
Awareness ..................................................................................................................
23
Understanding ............................................................................................................
27
Usage ........................................................................................................................
28
Practice of MyPyramid ..............................................................................................
28
CHAPTER V. DISCUSSION ...............................................................................................
31
Limitations .....................................................................................................
38
Conclusions ....................................................................................................
38
REFERENCES ......................................................................................................................
40
APPENDIX A. RECRUITMENT EMAIL ...........................................................................
44
APPENDIX B. INFORMED CONSENT .............................................................................
46
APPENDIX C. ONLINE QUESTIONAIRE .........................................................................
48
vi
LIST OF FIGURES
Figure
Page
1
Final MyPyramid Graphic and Slogan ......................................................................
1
2
Food Guide Pyramid Designed by Willet and Associates .........................................
9
3
Phase I Graphic Concepts ..........................................................................................
14
4
Graphic Concepts for Phase II ...................................................................................
15
5
Final Graphic Variations of Concept J.......................................................................
16
vii
LIST OF TABLES
Table
Page
1
Phase I Slogans ..........................................................................................................
13
2
Phase II Slogans .........................................................................................................
16
3
Gender, Class Rank, Field of Study, Meal Behavior, Introductory Nutrition Class, and
Class Covering MyPyramid Frequencies............................................................................
4
24
Gender Differences in the Awareness of MyPyramid, Website Usage, and Application of
Knowledge ........................................................................................................................
25
5
Awareness of MyPyramid Variables .........................................................................
26
6
Impact of Completion of Nutrition Class on Awareness, Usage of Website, and
Application of Knowledge ..................................................................................................
26
7
Perceived Understanding of MyPyramid Messages ..................................................
27
8
Perceived Understanding of Portion Size Measurement in MyPyramid Better than
Previous Measurement Method ..........................................................................................
28
9
Usage of MyPyramid.gov Website ............................................................................
29
10
Practice of MyPyramid Variables ..............................................................................
30
1
CHAPTER I
INTRODUCTION
The MyPyramid Food Guidance System was released in April of 2005. The new three
dimensional pyramid graphic includes vertical columns representing the food groups, and
includes a figure walking up the pyramid steps to illustrate the new emphasis on physical activity
(1). Also new to the pyramid is the message “Steps to a Healthier You” to promote the notion
that changes in diet can occur one step at a time. The graphical MyPyramid, as shown below, is
intentionally simple, emphasizing individualization and encouraging consumers to look for more
information (1). Additional information for specific nutrition information has been made
available on the MyPyramid.gov website, in print form, and on CD-rom (1).
Figure 1. Final MyPyramid Graphic and Slogan
MyPyramid replaced the United States Department of Agriculture (USDA) Food Guide
Pyramid (FGP), which was released in 1992 as an educational tool to help consumers choose
foods as part of healthy diet and meet nutritional standards. The 1992 pyramid followed the
recommendations of the 1990 Dietary Guidelines for Americans (2). The Food Guide Pyramid
was widely distributed and had high levels of awareness by consumers (67%) (3). However, it
2
was found that many Americans were not following the guidelines (3). In addition, the FGP was
becoming outdated, as evidenced by the release of the revised Dietary Guidelines for Americans
and the establishment of new Dietary References Intakes for vitamins, minerals, and
macronutrients by the National Academy of Sciences‟ Institute of Medicine (IOM) (3).
To address these issues, the USDA‟s Center for Nutrition Policy and Promotion initiated
a review and revision of the Food Guide Pyramid in 2001 (1). The revision process included
technical research of the current food consumption patterns, energy requirements, and intakes
patterns in addition to consumer research of graphical representations and consumer messages.
Professional input was also sought from dietitians, nutritionists, educators, and other
professionals who could provide expertise (4).
Statement of Problem
After nearly three years since the release of the MyPyramid, there is no currently published
research on consumer awareness, understanding, or usage of MyPyramid. Public information on
usage is limited to a response statement released by the USDA in August of 2005, only four
months after the release of MyPyramid. Information on the number of website users since 2005
is limited to antidotal information provided in USDA press correspondence and data provided in
Federal Registar submissions.
Significance of Problem
Research into awareness, understanding, and usage of MyPyramid is needed to evaluate
MyPyramid as a nutrition education tool. Many changes were made to MyPyramid by adding
several new components were in order to improve MyPyramid as a dietary guidance. Research
on awareness will show if more efforts need to be made to publicize the new guidance system.
Data collection on the understanding of MyPyramid will show whether the changes made are
3
understood by consumers. Determining usage is also important to assess whether the consumers
are using MyPyramid as a guide and assess their response to the available online tools.
The evaluation of college student dietary behavior is also important. Research shows that
college students are not meeting the recommendations set by the 2005 Dietary Guidelines for
Americans (5). To determine ways to improve dietary habits of college students, it is important
to explore in this study student response regarding MyPyramid. Additionally, it is important to
explore the reasons why students choose not to follow MyPyramid guidelines. This research
could be used to improve nutrition education programs with college students and improve dietary
intake of students.
Objectives
The purpose of this study was to assess college student awareness of MyPyramid and the website
at MyPyramid.gov, measure students‟ perceived understanding of the new components of
MyPyramid, and analyze student usage of MyPyramid.gov and MyPyramid as a dietary guide.
The objectives of the study were:
1. To assess student awareness of MyPyramid, awareness of the former FGP, and awareness
of MyPyramid.gov.
2. To assess student‟s perceived understanding of the new components of MyPyramid
including the incorporation of physical activity, the vertical food group stripes, and the
new recommendations for oil and fat consumption, as well the new method of measuring
serving sizes for several food groups.
3. To assess student usage of the MyPyramid.gov website, the available tools, the number of
visits to the website, the purpose of the visits, and the easiness of using the website.
4
4. To assess student usage of MyPyramid as a dietary guide and the impact of learning
about MyPyramid on student diets.
5. To determine if there is a relationship between demographics and student awareness,
understanding, usage, or practice of MyPyramid.
Definition of Terms
Added Sugars: Sugars and syrups that are added to foods during processing or
preparation. Added sugars do not include naturally occurring sugars such as those that
occur in milk and fruit.
Dietary Reference Intake: A set of nutrient based reference values that expand upon and
replace the former Recommended Dietary Allowances (RDAs). They are a set of four
reference values: Estimated Average Requirements (EARs), RDAs, Adequate Intake
Levels (AIs), and Tolerable Upper Intake Levels (ULs).
Food Group: A set of food items that have been identified based on similarities in
nutrient content and/or use by consumers and grouped together for purposes of dietary
guidance. In MyPyramid, the basic food groups are bread, cereal, rice, and pasta; fruits;
vegetables; milk, yogurt, and cheese; and meat, poultry, fish, dry beans and peas, eggs,
and nuts. The short-hand name for the bread, cereal, rice, and pasta group is the “grain
group,” for the milk, yogurt, and cheese group is the “milk group,” and for the meat,
poultry, fish, dry beans and peas, eggs, and nuts group is the “meat and beans group.”
Food Subgroup: A distinct subset of foods within a food group with specified similarities,
for which there is a quantity recommendation for consumption. In MyPyramid, the
vegetable group is composed of the following subgroups: dark-green vegetables, orange
5
vegetables, dry beans and peas, starchy vegetables, and other vegetables. The grain group
is composed of the whole grains and refined grains subgroups.
MyPyramid Food Guidance System: A set of information and tools to help translate the
2005 Dietary Guidelines for Americans and help consumers follow its recommendations.
The Food Guidance System includes food intake patterns, print and Web-based consumer
materials, interactive tools, and information for professionals.
Oils: Fats that are liquid at room temperature, such as the vegetable oils used in cooking.
Oils come from many different plants and from fish. Some common oils are corn oil,
soybean oil, canola oil, cottonseed oil, olive oil, safflower oil, sunflower oil, walnut oil,
and sesame oil. Some foods are naturally high in oils, like nuts, olives, some fish, and
avocados. Most oils are high in monounsaturated or polyunsaturated fats and low in
saturated fats. A few plant oils, including coconut oil and palm kernel oil, are high in
saturated fats and for nutritional purposes should be considered to be solid fats. Oils that
have been partially hydrogenated contain trans fatty acids and for nutritional purposes
should also be considered to be solid fats. While oils are not considered a food group,
recommended amounts of oils are included in the MyPyramid food intake patterns
because oils are a major source of essential fatty acids and vitamin E.
Perceived Understanding: Measurement of how well a person feels he/she understands a
particular topic or statement.
6
CHAPTER II
LITERATURE REVIEW
History of Food Guide Pyramid
The USDA has been providing nutrition recommendations to consumers for more than 100
years. The first formal dietary standards were published in 1894 by W.O Atwater (2). These
standards included protein and calorie requirements for the average man. Atwater goal was to
create a balanced diet in order to avoid excess weight and diet related disease. The first food
guide was published in 1916 providing guidelines for five groups: milk and meat, cereals,
vegetables and fruits, fats and fat foods, and sugars and sugary foods (2). The food guide has
been updated throughout the years to reflect the situation during that time, such as the depression
(2). World War II yielded The National Wartime Nutrition Guide soon after the first
Recommended Dietary Allowances were established in 1941 (2).
Over time, this wartime guide became known as the Basic Seven, transitioned to the
National Food Guide and eventually became the Basic Four (3). The Basic Four originated in
1956 as part of the Essentials of an Adequate Diet. It was updated in 1979 with the creation of
the Hassle-Free Guide, which emphasized the restricted use of fat, sugar, and alcohol and
promoted adherence to calorie levels and increased fiber intake (3).
To address new research on the relationships between diet and disease, the first edition of
the Nutrition and Your Health: Dietary Guidelines for Americans was published in 1980.
Revisions were made in 1985 and 1990 (2). The original Food Guide Pyramid (FGP) was created
from these guidelines over a period of 10 years. Eight goals were established to guide the
development of the food guide. The main goals were to promote overall-health, to be based on a
7
foundation of up-to-date scientific nutrition research, to focus on the total diet, and to be useful,
realistic, flexible, practical, and evolutionary (2).
Utilization of the Food Guide Pyramid
The FGP became widely distributed during the later 1990s as an educational tool. The graphic
version of the pyramid was intended to be a supplement to the 32-page brochure explaining how
to use the pyramid. Later, a condensed version entitled “The Food Guide Pyramid…Beyond the
Basic 4,” was released. The effort to promote using the FGP was forceful, and the FGP could be
found on posters, in classrooms, on food packaging, and in health clinics (3). The Food Guide
Pyramid replaced the Four Food Groups in textbooks. In addition, the FGP was used in the
assessment of dietary intake. For example, the Healthy Eating Index (HEI) incorporates the
pyramid in five of its 10 subscales (3). Tailoring the FGP to specific ages and populations
became popular, as well as the use of the pyramid shape by other countries and cultures in the
development of their own food guides (3).
Criticism of the Food Guide Pyramid
While a 1997 American Dietetic Association survey found that 67% of Americans were aware of
the Pyramid, and another study reported that 43% of adults failed to meet fruit recommendations,
and 73% failed to meet dairy recommendations (3). In later research, Foote found that over 90%
of adults did not meet the recommendations for dairy and grains (6). Furthermore, less than 10%
of children met the recommendations for fruit and dairy (7). Additionally, the 1999-2000 HEI
showed that 74% of the population‟s diet “needs improvement” (8). Awareness was not
translating into practice.
Additionally, the FGP became a source of blame for the rising rates of obesity, especially
after the announcement that the FGP was going to be redeveloped. Some researchers argued that
8
the recommendations for a low fat diet to reduce the risk of heart disease were flawed, and the
resulting diet high in carbohydrates was a mediating factor for the increased incidence of
cardiovascular disease, type II diabetes, and obesity (9). Willet and Stampfer argued that limiting
total fat reduced monounsaturated and polyunsaturated fatty acids known to both lower LDL
cholesterol and raise HDL cholesterol, which in turn reduces risk for heart disease (10).
Reduction of total fat intake also reduces the intake of essential fatty acids and omega 3 and 6
fatty acids, which limit their health benefits. Willet also argued that consuming the
recommended amounts of refined carbohydrates, such as white bread, raises blood glucose to
unhealthy levels and can raise blood triglycerides and lower HDL cholesterol levels (11).
Furthermore, the rapid decline in blood glucose caused by the surge of insulin in response to
refined carbohydrate can cause hunger and overeating leading to increased weight gain and
obesity (11).
Many researchers at Harvard University came up with a modified version of the FGP in
2001 to reflect corrections to the areas of criticized in the FGP (12). The modified pyramid
includes weight control and exercise at the base. To be included next were whole grains and
plant oils at all meals. Vegetables were to eaten in abundance and fruits 2-3 times a day. Nuts
and legumes were recommended to be eaten 1-3 times a day, and Fish, poultry and eggs eaten 02 times a day. Dairy or calcium supplements were recommended1-2 times a day. Lastly, it
advises to limits the intake of red meat, butter, white rice, white bread, white pasta, potatoes,
soda, and sweets. Daily vitamins and alcohol in moderation is included on the side of the
pyramid.
9
Figure 2. Food Guide Pyramid Designed by Willet and Associates (12).
Some researchers suggested that the consumption of larger than recommended servings
of foods is responsible for the obesity epidemic, not the FGP‟s messages. The consumer
perception of one serving is often much different from what the FGP recommends as a serving
size. For example, ½ cup of cooked pasta or 1 ounce uncooked pasta is considered one serving.
However, many people consume two or more cups of spaghetti at a meal and equate that pasta to
one serving instead of the actual four servings (13). Consumer studies in 1999 showed that the
commonly perceived portion of grains was 1 ½ to 2 times greater than actual serving sizes (13).
For consumers with this misperception, 6 to 11 servings of grains may seem like a very large
amount of grains. Additionally, many consumers felt that 6 to 11 servings represented a
suggested range, where 6 was the minimum for consumption and 11 was the maximum (13).
10
Both consumer misunderstanding of servings sizes and number of servings needed have led
Americans to increase their intake of grains by an average of 300 calories per day (14).
However, Goldberg, et al. argued that the pyramid was not to be blamed for the obesity
epidemic (14). The authors pointed out that although Americans were not meeting
recommendations, they were gaining weight from other reasons, such as increasingly large
portion sizes and the large amounts of added fat (comprising 56% of total dietary fat intake) and
added sugar (three times the recommended amount) consumed daily (14). Goldberg et al, cited
the” multifaceted” nature of obesity and stated that one educational tool cannot be pinpointed as
the cause of obesity, when so many factors including decreased physical activity, genetics, the
current environment, and economics all played a part in society‟s failure to maintain healthy
weight (14).
Development of MyPyramid
In 2001, the USDA‟s Center for Nutrition Policy and Promotion initiated the process for the
review and revision of the FGP, which was almost 10 years old (1). Since the creation of the
pyramid in 1992, Dietary Reference Intakes (DRI) for 28 vitamins and minerals were issued, and
DRIs for macronutrients, including energy, carbohydrates, fiber, fat, specific fatty acids, and
proteins, were established. The DRIs have since been replaced with Recommended Dietary
Allowances (RDA) (1). These changes and the 2005 Dietary Guidelines for Americans were
integrated into the new food guidance system. Additionally, the new food guide would adapt to
the current consumption patterns of Americans. The food guide graphic would also be changed
and a slogan chosen. The revision of the pyramid took place in three phases. The timeline of the
development of the food guide is shown below (15):
Winter-Spring 2003: Technical research to develop proposed revisions to Pyramid food pattern.
11
Fall 2003…………...Proposed revisions to Pyramid food patterns published in Federal Registar
for peer review and public comment.
Fall-Winter 2003….. Analysis of FR comments and further revision of Pyramid food patterns.
Conceptualization and preliminary design of new graphic and consumer
materials. The process for updating the Pyramid will be coordinated with
the activities of the DGAC.
Spring 2004……….. Consumer testing of proposed new graphic and consumer messages.
Summer 2004………Proposed new Pyramid graphic and consumer messages published in
Federal Register for public comment.
Winter 2005……….. Finalization and clearance of revised Pyramid graphic and consumer
materials.
Technical Research
The technical research phase addressed the food intakes patterns and updated them based on the
new DRIs, 2005 Dietary Guidelines for Americans, and current research. Five steps were
completed to develop the food intake patterns (16)
1.
2.
3.
4.
Set energy levels based on Estimated Energy Requirements (EER) formulas.
Set nutrient goals based on Dietary References Intake (DRI) standards.
Establish food groupings based on nutrient content, use in meals, and familiarity.
Calculate nutrient profiles based on consumption-weighted average nutrient content
for foods in each group.
5. Determine food intake patterns. Iterative process to identify food group amounts that
meet nutrient goals within energy level.
Consumer Research
Between 2002 and 2005, six consumer studies were completed by the USDA and the CNPP to
obtain consumer feedback on the development of MyPyramid (17). The first round of research
addressed consumer understanding of the FGP‟s concepts and messages. Additionally it assessed
how consumers use the FGP to guide their food choices and considered barriers keeping
consumers from using the FGP (18). The major findings of the study include the following (17):
12




Consumers were aware of the FGP and could name key messages, but fewer than
20% could places all food groups in correct level on a blank FGP.
Most consumers could not differentiate between a “portion” and “serving” and felt
that common household measurements of cups and ounces instead of “servings”
would be easier to understand.
Most of the consumers stated that they did not use the FGP, and the recommended
number of servings was the most frequently reported barrier, followed by difficulty to
count servings and too much work, time, and/or self-discipline needed.
Consumers recommended using household measurements, providing more detailed
information about serving sizes, and providing a more individualized pyramid.
The objective of the next round of research was to assess how consumers understood
potential nutrition messages for MyPyramid. Key findings and comments included the following
(17):



Consumers found recommended amounts of food were easier to understand using
household measures instead of number of servings and were interested in more
information about how to choose amounts of foods for their gender, age, weight, and
activity level.
Practical information and example were need for consumer to understand food group
information about whole grains, vegetable subgroups, legumes, fats, and added
sugars.
Consumers commonly interpreted their level of physical activity incorrectly and were
especially hesitant to label themselves sedentary.
The third round of research investigated consumer response to potential graphics,
slogans, and messages for MyPyramid. The research was conducted in two phases. In phase one
consumers were asked to rate the graphics shown in Figure 3 in terms of overall appeal and
effectiveness in motivating consumers to eat healthier and encouraging consumers to look for
additional information (18).
13
Overall, three main themes emerged from the research discussion. First, consumers
gravitated toward graphics that communicated success and achievement. The positive
reinforcement and depiction of a human figure at the top or moving toward the top made
consumer feel they could reach their goals. Next, consumers liked the personal appeal of the
graphics with a human figure. Lastly, graphics containing concepts portraying movement were
well liked and thought to generate enthusiasm for physical activity (18). Of the graphics, J, N, U,
W, and Y were the highest ranking graphics (18) Recommendations for change in some of the
graphics included using solid colors instead of fading colors for graphic N and J and including a
human figure at the top of graphic J (18) The staircase in graphic J was also altered to be more
detailed.
Ten slogans were tested on the consumers. These slogans are shown below in Table 3.
Consumers preferred slogans that expressed positive messages and were inspiring. The top rated
slogans were K, X, and P.
Table 1. Phase I Slogans 17
Reference
code letter
C
E
G
K
M
P
R
S
T
Slogan
One pyramid. Many sides.
Your foods. Your moves. Your pyramid.
Your foods. Your moves. Your way.
Eat healthier. Move more. Feel better.
Help yourself to healthier.
Find your balance.
Balance is beautiful.
Shape your day.
Food & You. What to do.
V
Teach me to eat.
X
Eat Smart. Play Hard.
14
Figure 3. Phase I Graphic Concepts 17
In the second phase, graphics that were not eliminated were revised based on the
consumer comments and presented to a new group of consumers. The revised graphic concepts
are shown in Figure 4. Phase II took place in two segments. During the first research period of
phase II, the participants were asked to identify which concept would best represent health eating
and physical activity as a national symbol. Concept J was preferred over the other concepts by
41% of the participants (W 23%, N 21%, and B 12%) (18). Open-ended comments from
participants who chose concept J frequently identified the staircase was able to illustrate the
15
message of physical activity better than the other concepts (18). Concept J was selected for
further research.
For the second half of phase II, concept J was modified to create two similar concepts, C
and J. Concept D included different variations of the figure and staircase. The original concept J
was modified only slightly to improve artistic appeal. Sixty-one percent of consumer preferred
concept J over concept D (39% preferred concept D) (18).
Figure 4. Graphic Concepts for Phase II.
16
Figure 5. Final Graphic Variations of Concept J
Slogans were modified from phase I and 7 slogans were presented to participants in the
first portion of phase II. These slogans are shown in Table 2. The slogan “steps to a healthier you
most often given a high appeal ranking by participants (60%) and was chosen by more
participants as the best reminder to eat healthy and be physically active (27%) (18).
Table 2. Phase II Slogans
Slogan
Steps to a healthier you
Eat smart. Move more. Feel great
Eat smart, be active, America
Find your balance
Be your healthy best
Your foods. Your moves. Your pyramid
Your foods. Your moves. Your way
Best Reminder to Eat Healthy and
Be Physically Active (%)
27
21
17
10
11
8
6
Nutrition messages for each of the food groups were also evaluated during phase II for
ability ease of understanding and ability to help them make better food choices. All of the
messages were rated to be easy to understand by more than 80% of the participants and the
message “focus on fruits” had the highest rating of 98% (18). These messages included the
following:

Focus on Fruit
17






Go Lean on Protein
Make Half Your
Grains Whole
Vary Your Veggies
Get Your CalciumRich Foods
From the consumer interface research, graphic concept J and the slogan “steps to a healthier you”
were chosen to become the national symbol. All seven food group messages were approved for
usage in the final guidance system.
Website Usability Testing
The final component of the consumer research was the testing of a prototype of MyPyramid.gov.
The research was completed using one-on-one interviews with participants as they navigated
through the website. Most of the feedback was positive and the participants had little difficulty
navigating the website or creating a personalized plan (1). There was some confusion in defining
physical activity levels and some individuals wanted more personalization such as modifiers for
weight, health, pregnancy, or lactation (1). Other complaints included difficulty finding for
information on certain topics. These included vegetable subgroups and substituting beans and
nuts for meat. The information was available on the website, but several users were unable to
locate the information (1). The recommendations made by the users were addressed before the
web site was opened.
Release of MyPyramid
After the final consumer testing of MyPyramid, MyPyramid and the MyPyramid.gov website
were launched two months later in April of 2005. The final graphic version of MyPyramid
included many changes from the FGP. Though MyPyramid kept the iconic pyramid shape, the
food groups became vertical stripes, larger at the base and smaller at the apex (19). Additionally,
18
oils were given a recommended intake, separate from added fats and sugars. New to the pyramid
was the addition of figure walking stairs on the side of the pyramid, as well as a slogan “Steps to
a healthier you” (19).
The new graphic was designed to convey the new messages of MyPyramid. Vertical
stripes represented moderation. Foods lower in added fats and sugars placed at the wider base
indicating to choose these foods more often and choose foods with more fats and sugars, placed
at the top, less frequently (19). The vertical stripes also conveyed proportionality and variety.
The differing widths of the food group bands indicated that different food groups were to be
eaten in the correct proportion and would provide a variety of foods necessary for good health
(19). The exact proportions needed for each individual varies, and these proportions and amounts
are found at the MyPyramid.gov website. The web site, slogan, and person on the steps
symbolize the personalization of MyPyramid (19). Lastly, the slogan “steps to a healthier you,”
conveyed the message that positive change and benefits can be achieved by taking small steps in
improving diet and lifestyle (19).
Consumer materials for the website were available at the MyPyramid.gov website and in
print. However, the website provided the most detailed and personalized information. The
website was designed to personalize a food plan for each individual. After creating a plan,
visitors could learn more about each of the food groups and subgroups or use one of the many
tools to assess their diet or physical activity. Special sections have been developed for pregnant
and breast-feeding mothers, children, youth, and the elderly.
Consumer Response to MyPyramid
Over 45 million people visited the website on the day of release (20). At post five months of
release, the website had over 650 million hits. Most users of the site were from the general public
19
(97.5%) (20). Educators, organizations, and federal employees made up the other 2.5% of users.
The average length of time a visitor stayed on the website was over 10 minutes. After visiting the
website, over 61% of viewers stated they were likely to make changes to their diet, with 26%
expressing they were very likely to make changes (20). In October of 2008, it was reported that
MyPyramid.gov had over 5.7 billion hits, and the MyPyramid tools were receiving over 750,000
page views each day (21).
20
CHAPTER III
METHODS
Design
This study included both quantitative and qualitative analysis. A questionnaire was used to
collect the data from students. The data were collected during April of 2008. Recruitment emails
were sent to students inviting them to participate in the study (Appendix A). Reminder emails
were sent out after one week and again after two weeks. To improve the student response rate,
those students who completed the survey were entered into a drawing for two $75 certificates to
the campus bookstore.
Approval for this study was granted by the Human Subjects Review Board at Bowling
Green State University. Informed consent was obtained at the beginning of the questionnaire.
Consent was given by students choosing to continue on to the study questions. (Appendix B).
Participants
Bowling Green State University students were chosen as the target population for the study as a
convenience sample. Using a student database of emails, 19,203 students were recruited for
participation in the study. The student database included undergraduate, graduate, guest, and all
other groups of students. Only students 18 years or older were allowed to participate in the study.
Questionnaire Design
Using SNAP survey software, a program designed to create and publish online questionnaires, a
questionnaire was designed to collect data online (Appendix C). A questionnaire format was
chosen to collect data from a large sample and to measure multiple areas of interest. The
questionnaire consisted of 26 questions, of which 20 were closed-ended and 6 were open-ended.
Several types of closed ended questions were used, including multiple-choice questions allowing
21
only one selection, multiple-choice questions allowing more than one selection, likert-scale
questions, and yes or no questions. Open-ended questions were used to allow students to expand
on their selection of “other” for a multiple-choice question. The questionnaire was reviewed by a
panel of college professors and tested on college age individuals not attending the target sample
university. The questions were designed to address student demographics, awareness,
understanding, and usage.
Demographics
Six questions were used to measure student demographics. These questions asked about gender,
class rank, and primary field of study. Two questions were used to determine if students had
taken an introductory nutrition class and if that class covered MyPyramid. One question was
used to address student dietary habits in regards to usual place of dining.
Awareness
Awareness of MyPyramid and MyPyramid.gov was addressed using five questions. Students
were asked if they were aware of the existence of MyPyramid and MyPyramid.gov. Questions
were also used to determine where students have learned about MyPyramid, and if students
learned about MyPyramid in a school setting.
Understanding
Six questions were used to assess students‟ perceived understanding of some of the new
components of MyPyramid and changes from the previous FGP. Students were asked to rate
their understanding of the incorporation of exercise and the companion message, the meaning of
the pyramids vertical stripes, MyPyramid‟s overall nutrition message, and the new
recommendation for oil and fat consumption. Two other questions were used to determine if
22
students understood the new method for measuring serving size better than the method used in
the FGP for four food groups.
Usage
Nine questions addressed usage. Questions asked if students had visited MyPyramid.gov, the
number of times the site was visited, the purpose of the visit, the site tools used during visits, and
how students would rate the sites ease of use. Two questions addressed student usage of
MyPyramid as a dietary guide. These questions asked students to rate the impact of learning
about MyPyramid on their diet and if they tried to reflect what they learned about MyPyramid in
their dietary selections. Two more questions addressed the reasons why students do not use.
Data Analysis
Student questionnaire responses were electronically sent to Bowling Green State University‟s
SNAP server. The data were transferred into the analysis program Statistical Package for Social
Sciences (SPSS), version 14. Double submissions were removed from the data file before
analysis. Responses to open-ended questions were compiled and grouped according to similarity.
Grouped responses were then coded for qualitative analysis. Due to the large number of different
fields of studies, the majors were grouped into broader categories to improve analysis.
Frequencies for gender, college major, and year in school were determined to gauge the
demographics of the sample. Frequencies for the awareness, usage, and understanding questions
were calculated. To determine if demographic variables were related to awareness, usage, or
understanding outcomes, the Chi-Square test of significance was completed, with significance
being defined as p ≤ .05.
23
CHAPTER IV
RESULTS
Response Rate
Of the 19,203 students invited to participate in the study, 2,687(14%) students participated. The
response rate was lower than expected. Seventeen students were excluded from the study
because they were under the age of 18. Duplicate submissions from the same invitation email
address were excluded from the final sample of 2670 completed questionnaires.
Demographics
Frequencies for all categorical variables for the sample are shown in Table 3. Of the total
2760 respondents, 72% were female and 28% were male. The samples were near evenly
distributed across the class ranks, with only a small percentage of guest and other students. The
respondents were from a broad spectrum of major fields. Only 13% of the sample had completed
an introductory nutrition class and 70% of the student indicated that class covered MyPyramid.
Awareness
More students were aware (56%) of the existence of MyPyramid than unaware (44%).
Females were more likely to be aware of MyPyramid than males (p=.000). The association was
still significant when excluding students who completed an introductory nutrition class (p=.022).
Females were also more likely to be aware of the former FGP (p=.000). Gender differences are
summarized in Table 4. When asked about the MyPyramid.gov website, only 41% reported
being aware of website. Schools were the most often identified location of seeing or hearing
about MyPyramid. Almost 50% of students reported seeing MyPyramid at doctors‟ offices or
other health service provider locations and on food products. Of those students who selected
school, 83% reported learning about MyPyramid in high school compared to 48% in college.
24
Additionally, students who had completed a college nutrition class were more aware (p=.000) of
MyPyramid than those who had not taken a class. A summary of the impact of taking a nutrition
class on awareness, usage of MyPyramid.gov, and application of MyPyramid is shown in Table
6.
Table 3. Gender, Class Rank, Field of Study, Meal Behavior, Introductory Nutrition Class, and
Class Covering MyPyramid Frequencies (total N = 2670)
Characteristic
Gender
Female
Male
Class Rank
Freshman
Sophomore
Junior
Senior
Graduate Student
Field of Study
Education
Social Sciences
Business
Health and Nutrition
Science/Mathematics
Communication
Other
Meal Behavior
I eat at campus dining facilities or I eat out
I shop for and cook my own meals
I sometimes eat at campus dining/eat out
and sometimes I cook
I eat at home, at my sorority, or at my
fraternity
Other
College Nutrition Class Completed
Yes
No
If Yes, Covered MyPyramid (n= 355)
Yes
No
N
(%)
1931
739
(72.3)
(27.7)
536
546
513
621
421
(20.1)
(20.4)
(19.2)
(23.3)
(15.8)
632
384
353
342
263
239
446
(23.7)
(14.3)
(13.2)
(12.8)
(9.9)
(9.0)
(16.7)
812
769
(30.4)
(28.8)
994
(37.2)
81
(3.0)
13
(0.5)
355
2315
(13.3)
(86.7)
249
106
(70.1)
(29.9)
25
Table 4. Gender Differences in the Awareness of MyPyramid, Website Usage, and Application
of Knowledge.
Female
N
1931
Participants
Awareness
Aware of MyPyramid
1174*
How Learned about MyPyramid
(check all that apply)
School
936
Food Products/Grocery Store
920
Health Facilities
581
Media
48
Family and Friends
294
School MyPyramid Learned From
High School Only
487
College Only
179
High School and College
301
I did not learn about in school
207
Website Usage
Aware of Website
493
Visited Website
355**
Purpose of Visit (check all that apply)
School assignment
174
Learn About the New Pyramid
171
Increase Nutrition Knowledge
155
Gain Information for Weight Loss
98
Application
Change Since Learning of
MyPyramid
Substantial to Some Change
546*
Very Little to No Change
628
Reflection of MyPyramid in Food
Choices
Almost Always to Frequently
482**
Seldom to never
692
Nutrition Plan
Use MyPyramid
271*
Do Not Use MyPyramid
903
* significantly more than expected at p<.05
** significantly more than expected at p<.01
Male
Total
(%)
N
(%)
N
(%)
(72.3)
739
(27.7)
2670
(100.0)
(78.5)
321
(21.5)
1495
(100.0)
(62.6)
(61.5)
(38.9)
(3.2)
(19.7)
242
227
111**
117
75
(16.2)
(15.2)
(7.4)
(7.8)
(5.0)
1186
1147
700
596
369
(79.3)
(76.7)
(46.8)
(39.9)
(24.7)
(32.6)
(12.0)
(20.1)
(13.8)
197
39
57
58
(13.2)
(2.6)
(3.8)
(3.9)
654
218
358
265
(43.7)
(14.6)
(23.9)
(17.7)
(33.0)
(23.7)
33
23.7
(2.2)
(1.6)
526
426
(35.2)
(28.5)
(11.6)
(11.4)
(10.4)
(6.6)
35
35
23
14
(2.3)
(2.3)
(1.5)
(0.9)
210
206
184
112
(14.0)
(13.8)
(12.3)
(7.5)
(36.5)
(42.0)
129
192
(8.6)
(12.8)
675
820
(45.2)
(54.8)
(32.2)
(46.3)
102
219
(6.8)
(14.6)
584
911
(39.1)
(60.9)
(18.1)
(60.4)
50
271
(3.3)
(18.1)
321
1174
(21.5)
(78.5)
26
Table 5. Awareness of MyPyramid Variables
Awareness Variables
Aware of MyPyramid (n=2670)
Yes
Medium of Awareness
(check all that apply)
School
Food products/grocery stores
Health Facilities
Media
Family and Friends
School Location of Learning
High School Only
College Only
High School and College
I did not learn about in school
No
N
(%)
1495
(56.0)
1186
1147
700
596
369
(79.3)
(76.7)
(46.8)
(39.9)
(24.7)
654
218
358
265
1175
(43.7)
(14.6)
(23.9)
(17.7)
(44.0)
Table 6. Impact of Completion of Nutrition Class on Awareness, Usage of Website, and
Application of Knowledge
All
Awareness
Aware of MyPyramid
Website Usage
Aware of Website
Visited Website
Application
Change Since Learning of
MyPyramid
Substantial to Some Change
Very Little to No Change
Reflection of MyPyramid in Food
Choices
Almost Always to Frequently
Seldom to never
Nutrition Plan
Use MyPyramid
Do Not Use MyPyramid
* significantly more than expected at p<.01
Completed Nutrition Class
Yes
No
N
%
N
(%)
355
(13.3) 2315
(86.7)
Total
N
2670
(100.0)
284*
(19.0)
1211
(81.0)
1495
(100.0)
167*
143*
(11.2)
(9.6)
451
283
(30.2)
(18.9)
618
426
(41.3)
(28.5)
158*
126
(10.6)
(8.4)
517
694
(34.6)
(46.4)
675
820
(45.2)
(54.8)
153*
131
(10.2)
(8.8)
431
780
(28.8)
(52.2)
584
911
(39.1)
(60.9)
102*
182
(6.8)
(12.2)
219
992
(14.6)
(66.4)
321
1174
(21.5)
(78.5)
(%)
27
Understanding
When asked about their perceived understanding of several MyPyramid characteristics,
the majority of students indicated a “very good” or “good” level of understanding.
Understanding of the different widths and sizes of the pyramid‟s vertical stripes elicited the
highest proportion of students reporting a poor or very poor understanding (31%). Results for
message understanding are summarized in Table 7. For the fruits, vegetables, grains, and meats
food groups, most students indicated they understood the new measurement system for portion
size in MyPyramid better compared to the former FGP. Frequencies for perceived understanding
are shown below in Table 8. Over 80% of students also indicated they understood the daily
allowance of oil and the recommendation to limit “bad” oils and fats. When excluding students
who have completed the introductory nutrition class, females were associated with higher ratings
of understanding for the MyPyramid slogan (p=.045) and fruit (p=.000) and vegetable (p=.000)
portion sizes.
Table 7. Perceived Understanding of MyPyramid Messages
MyPyramid Messages
MyPyramid and its nutritional
messages
Different widths and sizes of the
vertical stripes
Slogan “Steps to a Healthier
You” and Illustration
Average Score
Very Good
N (%)
Good
N (%)
Poor
N (%)
Very Poor
N (%)
232 (15.5)
974 (65.2)
260 (17.4)
29 (1.9)
214 (14.3)
825 (55.2)
390 (26.1)
66 (4.4)
458 (30.6)
861 (57.6)
150 (10.0)
26 (1.7)
301 (20.2)
887 (59.3)
267 (17.8)
40 (2.7)
28
Table 8. Perceived Understanding of Portion Size Measurement in MyPyramid Better than
Previous Measurement Method
Food Group
Fruit
Vegetables
Grains
Meats
Average Score
Yes
N (%)
1154 (77.2)
1169 (78.2)
805 (53.8)
926 (61.9)
1013 (67.8)
No
N (%)
341 (22.8)
326 (21.8)
690 (46.2)
569 (38.1)
482 (32.2)
Usage
Frequencies for usage of MyPyramid are shown in Table 9. Of those students who
indicated they were aware of the website, only 29% had visited the website. Most students (66%)
indicated visiting the website two or more times. The most frequently cited purposes for visiting
the site were school assignment (49%), learning about the new pyramid (48%), and increasing
nutrition knowledge (43%). When asked about utilizing the MyPyramid tools, students reported
creating a personalized plan (53%) and learning about food groups and portion sizes (52%) most
often. Eighty-two percent of students who visited the website indicated that MyPyramid was
“very easy” or “somewhat easy” to navigate and use.
Practice of MyPyramid
Very few students reported making substantial changes in their diet after learning about
MyPyramid (2.9%), but 42% reported making some changes. Less than 20% indicated “no
change” in diet. Similarly, only 6% of students reported “almost always” trying to reflect
MyPyramid in their diet, but 33% indicated “frequently”. Females were more likely to try to use
MyPyramid as a guide compared to males (p=.035).
29
Table 9. Usage of MyPyramid.gov Website
Usage Variables
Visited MyPyramid.gov website
Yes
Purpose of Visit
School assignment
Learn about the new pyramid
Increase nutrition knowledge
Gain information for weight loss
Work or Teaching
Number of Visits
1
2-3 times
4 or more times
If yes, Use of MyPyramid Tools
To create a personalized plan
To learn about individual food groups and portion sizes
To enter my daily food intake and exercise
To learn about a weight loss plan
None
Website Ease of Use
Very easy
Somewhat easy
Neither easy nor difficult
Somewhat difficult
No
N
%
426
(28.5)
210
206
184
112
20
(49.3)
(48.4)
(43.2)
(26.3)
(4.7)
143
188
95
(33.6)
(44.1)
(22.3)
226
220
151
104
73
(53.1)
(51.6)
(35.4)
(24.4)
(17.1)
159
192
65
10
1069
(37.3)
(45.1)
(15.3)
(2.3)
(71.5)
The most cited reasons for not using MyPyramid as a guide were using a different nutrition plan
(28%), being uninterested (25%), and not desiring guidance (22%). Of note, lack of time and
money, as well as not thinking about food was frequent “other” responses. Friends and family
was the most selected source of nutrition information apart from MyPyramid (61%), followed
closely by internet websites (53%), and magazines (43%). Food labels were the most often
reported source of information from respondents that choose “other”. Frequencies for all
practices variables are shown in Table 10.
30
Table 10. Practice of MyPyramid Variables
Practice Variables
Diet Change Since Learning of MyPyramid (n=1495)
Substantial change
Some change
Very little change
No change
Reflection of MyPyramid in Diet (n=1495)
Almost always
Frequently
Seldom
Never
Reasons for Not Using MyPyramid (n=1495)
(check all that apply)
I use a different nutrition plan
I am not interested in MyPyramid
I do use MyPyramid
I do not need guidance
Other
I do not understand MyPyramid
Other Sources of Nutrition Information (n=2760)
(check all that apply)
Family or Friends
Internet websites
Nutrition or fitness magazines
Popular diet and nutrition books
School nutrition classes
Other
N
%
43
632
542
278
(2.9)
(42.3)
(36.3)
(18.6)
96
488
665
246
(6.4)
(32.6)
(44.5)
(16.5)
422
369
321
321
156
117
(28.2)
(24.7)
(21.5)
(21.5)
(10.3)
(7.8)
1633
1409
1154
448
328
321
(61.2)
(52.8)
(43.2)
(16.8)
(12.3)
(12.0)
31
CHAPTER V
DISCUSSION
The aim of this research was to evaluate college student awareness, perceived understanding, and
usage of the recently established MyPyramid, the most recent nutrition guidance system. This
research found that 56% of the students stated they were aware of MyPyramid and 79% of those
students who were aware felt they understood MyPyramid‟s messages and 68% felt they
understood the changes in measuring serving sizes. However, students were not frequently using
MyPyramid to guide meal choices (22%), and few (29%) students had utilized the
MyPyramid.gov website. Also of significance, females were found to be more likely to be aware
of MyPyramid, use the MyPyramid website, make changes in their diet, and use MyPyramid as a
nutrition plan. Furthermore, completion of an introductory college nutrition class resulted in
similar impacts on awareness, usage, and practice of MyPyramid regardless of gender.
The significant differences in gender found in this study are not surprising, as it is has
been well documented from previous research that females more closely adhere to nutrition
recommendations, have higher levels of nutrition knowledge, and are more concerned about
physical appearance and body image (22-24). These findings continue to support that gender
differences are seen in college students as well as the adult population. In contrast, what is
remarkable is the finding that taking an introductory nutrition class in college had a similar
influence on results. Students who had taken an introductory nutrition class had higher
percentages for awareness of MyPyramid. These students also reported higher levels of
understanding of the MyPyramid messages and new method of measurement for all food groups.
Furthermore, these students also reported using MyPyramid as a guide and reflecting
MyPyramid in their food choices more often than the rest of the population. This result also may
32
not be considered “surprising,” but the data may provide a foundation for research and
development of strategies to promote increased MyPyramid awareness and nutrition education in
college students.
Efforts should be made to increase awareness of MyPyramid in college students.
Although 56% of the college students surveyed were aware of the existence of MyPyramid, there
remains significant room for improvement. This is evidenced by the finding that of those
students not aware of MyPyramid, almost 80% were aware of the FGP. To date, no other studies
have measured student awareness.
School systems are an excellent place to promote awareness of MyPyramid, since schools
can reach nearly 100% of young adults. In a 2003 position statement on School Nutrition
Services, the American Dietetic Association, the Society for Nutrition Education, and the
American School Food Service Association recommended providing a sequential and
comprehensive nutrition education program in the schools systems beginning in pre-school and
continuing through the 12th grade (25). A recent study evaluating the progress of school nutrition
services published in 2009 found that only 61% of schools sampled were offering nutrition
education for each grade level (26). However, nearly 90% were meeting state standards for
nutrition education (26). Efforts should be made to encourage state legislature to increase the
nutrition education requirements for schools.
At the college level, MyPyramid should also be promoted since it is a time when students
are beginning to make their own meal choices, prepare meals, and shop for groceries. Not only
should dietary information based on MyPyramid be provided to students through classroom
courses, but also MyPyramid should be taught at the dining locations through handouts, posters,
33
table tents, displays, and point of purchase signs to encourage students to learn about MyPyramid
and make better food choices.
Additionally, students frequently mentioned hearing about MyPyramid through doctors‟
offices, hospitals, or health clinics. These venues should be utilized to increase awareness of
MyPyramid. Students do not come in contact with dietitians or other nutrition professionals
frequently. However, students do make routine visits to see physicians and nursing. These health
professionals could promote the use of MyPyramid through discussions of healthy eating and
maintaining a healthy weight, as well as providing nutrition related materials in the waiting
rooms.
Moderate levels of awareness (56%) did not translate into the same levels of usage of the
website (30%) or MyPyramid as a nutrition guide (21.5%) in the college student population. The
percentage visiting the website fell to less than 24% when students who took introductory
nutrition classes were removed. However, almost all students reported the website being easy or
very easy to use. This supports the results of a study completed with all female college students
who had never previously used my MyPyramid. Seventy-seven percent of the students in the
study reported the website to be easily navigated (27). The usability of the website was not as
highly scored in a 2007 study of literacy, linguistic, and cultural factors (28). The results showed
the website failed to meet 10 of the 20 usability criteria. Positive outcomes in the two studies
using college students may be due to college students having high levels of computer skills.
Usage of the websites tools was also favorable. Over half of the students had created
personalized plans and explored the website to learn about individual food groups and portion
sizes. Only 17% of students reported visiting the site but not using any of the available tools. The
website tools are also popular with American consumers as the Federal Register reported in
34
January of 2009 that 3.3 million people used the MyPyramid Tracker tool to create personalized
plans and 2.6 million of those people registered to save the information (29). However, only 10%
of those individuals use the tool to track their intake and exercise daily. It also reported that
logging daily meals and exercise takes individuals about 30 minutes for each day entered.
Though not assessed, students may be less likely to use the tracking tool consistently due to the
required time. A lack of time was a frequently cited reason for not using MyPyramid as a diet
guide.
These results and previous research on use of the internet as a source of health
information shows that the website could be a good tool to educate students about MyPyramid.
Research completed by the Pew Internet and American Life Project reported that in 2007, 74%
of Americans were online and 61% were using the internet to find health information (30). The
research showed that 68% of adults 18-32 were searching for health information and 63% of
adolescents have looked for information on body image and nutrition (30, 31). A 2006 Canadian
study found that 40% of respondents reported using the internet “frequently” to find nutrition
information and another 47% reported using the internet from “time to time” (32). Only books
and magazines were reportedly used more often when searching for nutrition information.
The popularity of the internet and the increasing utilization of the internet to find health
and nutrition information should be exploited to reach individuals with accurate, reliable, and
scientific based nutrition information. An effort to take advantage of this fact was made when the
MyPyramid.gov website was created during the revision of the FGP. However, even though
college students and young adults spend large amounts of time on the internet and look for health
and nutrition information on the internet, few students visited the MyPyramid website.
35
One possible strategy to increase the usage of the MyPyramid.gov website would be the
use of social media to promote MyPyramid in the cyber places young adults “hangout”. Social
media uses strategies to market information online using social networking sites. The Center for
Disease Control (CDC) website is an example of how social media can be used to promote a
health campaign (33). The CDC can be found on Twitter, Facebook, YouTube, iTunes, Second
Life Island, DailyStrength, and Flickr. CDC also is using blogs, podcasts, RSS Feeds, Widgets,
eCards, eGames, email updates, mobile updates, and other media tools to communicate with the
public and keep them updated. The use of these social networking sites and online-based tools,
which are popular with college age students, are helping the CDC reach more people about key
health issues. The same strategies could be used to promote MyPyramid to college students.
MyPyramid is currently only utilizing Twitter and podcasts. Expanding on the current social
media being used by the MyPyramid.gov website would increase the number of places where
college students become exposed to MyPyramid and increase opportunities to visit MyPyramid.
When asked why they were not using MyPyramid, many students reported not being
interested, not having time, or not thinking about nutrition. The website should include specific
information relevant to busy college students and young adults. Currently, the website provides
tailored information for kids (age 2-11) and pregnant or breastfeeding mothers. The college
population currently falls into information for the general population. Information on how to eat
right on campus or how to shop on a student budget might keep students at the website longer
instead of just displaying general information.
Currently, only 21.5% of students reported using MyPyramid as a guide for their diet.
Similarly only 39% of students aware of MyPyramid reported reflecting MyPyramid in their
food choices “frequently” or “almost always.” However, when students had visited the website,
36
nearly half of the students reported making “some change” or “significant change” in their diet.
These results could be interpreted to indicate that usage of the website may help increase the
utilization of MyPyramid in dietary choices. Of interest, the percent of students likely to make
changes in their diet after visiting the website (45%) was lower than the 61% of respondents
found in a USDA poll (20).
It is unclear why college students are less likely to make diet changes than the adults
surveyed in the USDA poll. However, this survey did reveal common themes on why students
are not using MyPyramid as a nutrition plan (80%). Many students indicated they used some
other nutrition plan or were not interested or did not need guidance. In the open-ended responses,
a common theme of indifference toward nutrition either through a lack of interest, time, or
motivation was seen in many responses. A few students indicated that MyPyramid was too hard
to follow or understand and others thought it was too expensive to follow. Efforts should be
made to increase interest in nutrition during college and subsequent young adult periods. This
could be accomplished by the methods discussed above to promote awareness of MyPyramid
and to include nutrition information during orientation and basic college courses.
Many colleges provide an introductory class, which currently includes topics on how to
use campus resources, how to properly study and prepare for class, what campus organizations,
and events are available, etc. This class provides an excellent opportunity to include information
on how to stay healthy at school by eating right and exercising. Materials on MyPyramid could
be provided during the class as resource information. Furthermore, students should be
encouraged to take an introductory nutrition class. As discussed earlier, students who took an
introductory nutrition class reported high levels of awareness, usage, and practice of MyPyramid.
37
This data supports the proposed strategy discussed above to implement more comprehensive
nutrition education in schools.
Providing more aggressive nutrition education in schools would help provide accurate
and scientific based nutrition information to students. This survey showed students are currently
getting information from unreliable sources. Students reported friends and family as the most
used source of nutrition information at 61%. This result is not favorable since most consumers do
not have a significant knowledge of nutrition or find nutrition information from reputable
sources. Internet websites were the second most popular response. A large portion of the students
also used nutrition and fitness magazines. The results of this research complement the findings
by Marquis & Dubeau that found adults reported using, in descending order, magazines, books,
internet, food labels, brochures, family/friends, television, newspapers, dietitians, physicians, and
grocery stores to find nutrition information (32). The student responses raise the question as to if
students are finding valid and scientific based nutrition information. This stresses the importance
of promoting MyPyramid to students beginning in elementary school and continuing into college
so students know where to find reliable sources of information.
In contrast to the low reported usage of MyPyramid by those students aware of
MyPyramid, students reported a high level of perceived understanding of MyPyramid
characteristics and messages. These characteristics and messages assessed reflect some of the
changes made from the original FGP. Students expressed an understanding of the incorporation
of physical activity and the meaning of the vertical stripes. Students also reported a greater
understanding of the new methods of measurements for serving sizes for several food groups
compared to the previous methods. Of interest, the fruit and vegetable food groups received a
higher percentage of students‟ understanding the new measurement better (77% and 78%,
38
respectively) compared to the grains (54%) and meats (62%) groups. The fruit and vegetable
groups were measured in cups, where as the meat and grains groups were measured in ounces.
These results support the consumer research completed during the development period of
MyPyramid, which found consumers preferred using common household measurements such as
cups and teaspoons (16). The research also supports that the changes and additions made to the
FGP were appropriate and effective for the fruit and vegetable groups, but the serving sizes for
the grains and meats groups may still not be clear to consumers.
Overall, this research showed that MyPyramid has the potential to be an effective tool for
teaching nutrition education to college students. This could be accomplished by including
comprehensive nutrition education in all grade levels, marketing MyPyramid to college students,
and tailoring the information to be most appropriate for college students or young adults. Also,
highlighted in the research is that awareness does not necessarily produce usage or practice in
everyday life. The ADA, SNE, and ASFSA stated in their position paper that 50 hours of
instruction and exposure are needed to impact behavior (25). Students currently only receive 13
hours of instruction (25). Implementing and requiring nutrition education at all levels of
education may be the only way to provide the necessary hours to translate awareness of
MyPyramid into practice.
Limitations
The study is limited by the use of a convenience sample of college students from only one midwest university. The results of the study may not be applicable to college students from large
universities in other regions of the United States. The study‟s response rate was lower than
average and data on non-responders was not available. The sample also had a high percentage of
female responders, which may have influenced the results.
39
Conclusion
This exploratory study of student awareness, usage, and understanding of MyPyramid showed
more than half of students are aware of the existence of MyPyramid. However, awareness did
not translate into usage of MyPyramid, as less than a quarter of the students stated to use
MyPyramid as a guide for dietary intake and less than half of the students stated to have made
changes in their diets after learning about MyPyramid. Students did report a good understanding
of MyPyramid, its new messages, and the changes in the measurement of serving sizes. The
findings showed students who had taken an introductory nutrition class had higher levels of
awareness, understanding, usage of the website, and reflection of MyPyramid in dietary choices.
These findings support the idea that efforts should be made to promote MyPyramid in all facets
of the education system and to encourage students to take nutrition courses in college in order to
facilitate the movement from only awareness to utilization and practice. Continued research is
needed to find ways to increase student awareness and increase the number of students using
MyPyramid to make better food choices.
40
REFERENCES
1. U.S. Department of Agriculture. Research summary report for MyPyramid Food Guidance
System development. Washington, DC: U.S. Department of Agriculture and Center for
Nutrition Policy and Promotion; August 2005.
2. Welsh S, Davis C, Shaw A. USDA‟s food guide: background and development. Washington
DC: U.S. Department of Agriculture; September 1993
3. Davis C, Britten P, Myers E. Past, present, and future of the Food Guide Pyramid. J Am Diet
Assoc. 2001;101:881-885.
4. Notice of availability of proposed Food Guide Pyramid daily food intake patterns and
technical support data and announcement of public comment period. Fed Regist. September
11, 2003;68:53536-53539.
5. Kolodinsky J, Harvey-Berino J, Berlin L, Johnson R, Reynolds T. Knowledge of current
dietary guidelines and food choices by college students: Better eaters have higher knowledge
of dietary guidance. J Am Diet Assoc. 2007;107:1409-1413.
6. Foot J, Giuliano A, Harris R. Older adults need guidance to meet nutritional
recommendations. J Am Coll Nutr. 2000; 19:628-240.
7. Brady L, Lindquist C, Herd S, Goran M. Comparison of children‟s dietary intake patters with
US dietary guidelines. Br J Nutr. 2000;84:361-367.
8. Britten P, Maroce K, Yamini S, Davis C. Consumer research for development of educational
messages for the MyPyramid Food Guidance System. J Nutr Educ Behav. 2006;38:S108S123.
9. Ottoboni A, Ottoboni F. The Food Guide Pyramid: Will the defects be corrected? J Am Phys
Surg. 2004;9:109-113.
41
10. Willet W. The dietary pyramid: does the foundation need repair. J Clin Nutr. 1998;68;218219.
11. Willet W, Stampfer M. Rebuilding the Food Pyramid. Sci Am. 2003;288:64-72.
12. Harvard School of Public Health. 2007. Food pyramids: what should you really eat.
Available at: http://www.hsph.harvard.edu/nutritionsource/pyramids.html. Accessed January
12, 2008.
13. Hogbin MB, Hess MA. Public confusion over food portions and servings. J Am Diet Assoc.
1999;99:1209-1211
14. Goldberg J, Belury M, Elam P, Finn S, Hayes D, Lyle R, et al. The obesity crisis: don‟t
blame it on the pyramid. J Am Diet Assoc. 2004;104:1141-1147.
15. United States Department of Agriculture. Backgrounder for revision of Food Guide Pyramid.
Washington DC: U.S. Department of Agriculture; September 2003.
16. Britten P, Maroce K, Yamini S, Davis C. Development of Food Intake Patterns for the
MyPyramid Food Guidance System. J Nutr Educ Behav. 2006;38:S78-S92.
17. United States Department of Agriculture and Center for Nutrition Policy and Promotion.
Research Summary Report for MyPyramid Food Guidance System Development. Washington
DC: U.S. Department of Agriculture and Center for Nutrition Policy and Promotion; August
2005.
18. Haven J, Burns A, Britten P, Davis C. Developing the consumer interface for the MyPyramid
Food Guidance System. J Nutr Educ Behav. 2006;38:S124-S135.
19. US Department of Agriculture and Center for Nutrition Policy and Promotion. MyPyramidgetting started. 2006. http://www.mypyramid.gov/downloads/MyPyramid_ Getting_
Started.pdf. Accessed May 15, 2009.
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20. US Department of Agriculture and Center for Nutrition Policy and Promotion. Public
Response to MyPyramid. August 2005. http://www.cnpp.usda.gov/Publications/
MyPyramid/DevelopmentMaterials/ConsumerResearch/PublicResponse.pdf. Accessed
January 11, 2008.
21. US Department of Agriculture and US Department of Health and Human Services. Dietary
Guidelines Advisory Meeting Minutes. October 2008. http://www.cnpp.usda.gov/
Publications/DietaryGuidelines/2010/Meeting1/DGACMtg1-MeetingMinutes.pdf. Accessed
August 15, 2009.
22. Liebman M, Propst K, Moore S, Pelican S, Holmes B, Wardlaw M, Melcher L, Harker J,
Dennee P, Dunnagan T. Gender differences in selected dietary intakes and eating behaviors
in rural communities in Wyoming, Montana, and Idaho. Nutr Research. 2003;23:991-1002
23. Gavin T. Determinants of gender differences in dietary behavior. Nutr Research.
1997;17:1105-1120.
24. Kiefer I, Rathmanner T, Kunze M. Eating and dieting differences in men and women. J Mens
Health Gender. 2005;2:194-201.
25. Position of the American Dietetic Association, Society for Nutrition Education, and
American School Food Service Association: Nutrition services: An essential component of
comprehensive school health programs. J Nutr Educ Behav. 2003;35:57-67.
26. Longley C, Sneed J. Effects of federal legislation on wellness policy formation in school
districts in the United States. J Am Diet Assoc. 2009;109:95-101.
27. Samuels E, Martinex-Pederson S, Pan J, Foord-May L, Metallino-Katsaras E. Is there room
for improvement for MyPyramid.gov as nutrition education tool? Top Clin Nutr.
2007;22:286-298.
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28. Neuhauser L, Rothschild R, Rodrigues F. MyPyramid.gov: Assessment of literacy, cultural
and linguistic factors in the USDA food pyramid web site. J Nutr Educ Behav. 2007;39:219225.
29. Notice of proposal for food guide graphic presentation and consumer materials; opportunity
for public comment. Fed Regist. January 22, 2009;74:3981-3983.
30. Jones S, Fox S. Generations online in 2009. Pew Internet & American Life Project, January
28, 2009. Available at http://www.pewinternet.org/ Reports/2009/Generations-Online-in2009.aspx, accessed August 15, 2009.
31. Skinner H, Biscope S, Poland B, Goldberg E. How adolescents use technology for health
information: Implications for health professionals from focus group studies. J Med Internet
Res. 2003;5:e32.
32. Marquis M, Dubeau C. Potential of the internet to address topics of interest in nutrition. Nutr
& Food Sci. 2006;36:218-224
33. Social Media at CDC. Centers for Disease Control and Prevention Web site.
http://www.cdc.gov/socialmedia/. Accessed August 16, 2009.
44
APPENDIX A: RECRUITMENT EMAIL
45
Hello Students,
I am a Master's degree student in the Family and Consumer Sciences Department. I would like to
invite you to participate in my thesis research project. The purpose of the study is to assess
university student awareness, understanding, and usage of MyPyramid.
You will be asked to complete a short online questionnaire that takes less then five minutes. If
you complete the survey, you will be entered into a drawing to WIN ONE OF TWO $75.00
BGSU BOOKSTORE GIFT CERTIFICATES!
To participate in the study please follow the link
http://survey.bgsu.edu/surveys/ir/mypyramid/mypyramid.htm?id=q82 0
to complete the survey. By completing the survey you are indicating consent to participate in the
study. Please complete by May 1,2008. Although your responses will remain confidential, in
order to contact you if you win one of the prizes, you will be asked to provide an email address.
To further protect your confidentiality, you may wish to use an email address that does not in any
way identify you (e.g., "[email protected]") rather than using your BGNET account. The
email address you provide will be used ONLY for contacting you if you win a prize. This email
address will not be shared with anyone at any point.
If you have any questions about the survey, please contact me at my
email address: [email protected].
Thank You for Your Participation! !!
Mara Lee Beebe
Graduate Student
School of Family and Consumer Sciences
Bowling Green State University
46
APPENDIX B: INFORMED CONSENT
47
Informed Consent to Participate in a Research Study
You are being asked to volunteer for a research study. Please read the information below and email or
call about any questions you may have about the study before agreeing to participate.
Project Title: “University Students‟ Awareness, Understanding, and Usage of MyPyramid”
Principal Investigators: Mara Lee Beebe
Advisor: Dr. Younghee Kim Ph. D.
Purpose of the Research Study: The purpose of the study is to assess university students‟ awareness,
understanding, and usage of MyPyramid Food Guide System.
Procedures: If you are 18 years of age or older and consent to participate in the research study, you will
be asked to complete an online questionnaire. Completion of the questionnaire will take approximately 5
minutes. By completing this questionnaire and clicking the “submit” button you are indicating your
consent to participate in the study. Please remember to clear your browser‟s cache and page history after
you submit the questionnaire in order to protect your privacy.
Risks and Benefits of Being in the Study: There are no foreseeable risks associated with participation in
the study. Students who complete the questionnaire will be entered into a drawing for two $100 bookstore
gift certificates. Additionally, by participating in the research, your information will contribute to the
body of knowledge on college students‟ and MyPyramid.
Anonymity: The study is completely anonymous. Your name in no way will be linked to your answers,
and your questionnaire will be added to other student questionnaires. However, e-mail is not 100%
secure, so it is possible that someone intercepting your e-mail will gain knowledge of your interest in the
study. Although your responses will remain anonymous, in order to contact you if you win one of
the prizes, you will be asked to provide an email address. The email address you provide will be
used ONLY contacting you if you win a prize. This email address will not be shared with anyone
at any point.
Voluntary Nature of the Study: Participation in this research study is completely voluntary. If at any
time you do not want to continue, you may choose to withdrawal from the study. Your decision to
participate or not participate will have no impact on your grade, class standing or relationship to BGSU
Contacts and Questions: The researchers conducting this research study can be contacted by email at
[email protected] if you have any questions or concerns about the study. You may also contact my
advisor at [email protected]. The chair of Human Subjects Review Board, Bowling Green University may
be contacted at (419) 372-7716 or [email protected] if you have any problems or concerns regarding your
rights as a research participant.
Please keep this copy of information for you own records.
Mara Lee Beebe
Graduate Student
School of Family and Consumer Sciences
Bowling Green State University
48
APPENDIX C: ONLINE QUESTIONAIRE
49
University Student Questionnaire
Please read and follow directions carefully and answer all questions as truthfully as possible.
Please enter or select the most appropriate answer.
1. What is your gender?
a. male
b. female
2. What is your current class level/rank at the university?
a. freshman
b. sophomore
c. junior
d. senior
e. graduate student
f. guest student
g. other
3. What is your major? Drop down box to select major from will be here.
4. Where do you eat your meals most of the times?
a. I eat at campus dining facilities or I eat out.
b. I shop for and cook my own meals
c. I sometimes eat at campus dining/eat out and sometimes I cook my own meals.
d. Other
Please specify
5. Have you taken an “Introductory Nutrition” class in college?
a. Yes
b. No (skip to #6)
6. If „yes‟ to question #4, did the class cover MyPyramid?
a. Yes
b. No
7. Are you aware or familiar with the existence of the MyPyramid Food Guide?
a. Yes
b. No
8. If no, were you aware of the existence of the previous version, which is the Food Guide
Pyramid?
a. yes
b. no
(Skip to #26)
50
9. Where have you seen or heard of MyPyramid? Check all that apply.
a. school
b. home
c. food products
d. grocery stores
e. Doctors offices/hospitals/health clinics
f. media
g. Other ____________________
10. If you learned about MyPyramid in school, where did you learn about it?
a. High school
b. College
c. Both
11. Are you aware of the existence of the MyPyramid.gov website?
a. yes
b. no
12. Have you ever visited MyPyramid.gov website?
a. Yes
b. No (skip down few questions)
13. What was the purpose or occasion for your visit? Check all that apply.
a. School assignment
b. Increase nutrition knowledge
c. Learn about the new pyramid
d. Gain information for weight loss
e. Other ______________
14. How often have you visited the site?
a. once
b. 2-3 times
c. 4 or more times
15. Have you used any of the following MyPyramid tools? Check all that apply.
a. To enter your own information and create a personalized plan for calorie intake
and food group amounts.
b. To learn about individual food groups and portion sizes.
c. To enter your daily food intake and exercise and receive information about intake
and expenditure.
d. To learn about using MyPyramid as a weight loss plan.
e. None
51
16. How easy was Mypyramid.gov to use?
a. very easy
b. somewhat easy
c. neither easy nor difficult
d. somewhat difficult
e. very difficult
17. How would you describe your understanding of MyPyramid and its nutritional
messages?
a. excellent understanding
b. good understanding
c. some understanding
d. somewhat poor understanding
e. very poor understanding
18. How would you describe your understanding different widths and sizes of the
vertical stripes representing each of the food groups?
a. excellent understanding
b. good understanding
c. some understanding
d. somewhat poor understanding
e. very poor understanding
19. MyPyramid uses cups to calculate your daily allowance of fruits and vegetables.
Do you find this easier to understand than using servings as used in the previous
Food Guide Pyramid?
Fruits
a. yes
b. no
Vegetables
a. yes
b. no
20. In MyPyramid, the recommended amount of grains and meats is measured in
ounces. Do you find this easier to understand than using servings as used in the
previous Food Guide Pyramid?
Grains
a. yes
b. no
Meat
a. yes
b. no
21. MyPyramid recommends your daily allowance of oil and recommends limiting
“bad” oils and fats. Do you feel you understand this message?
a. yes
b. no
52
22. How would you describe your understanding of the slogan “Steps to a Healthier
You” and the illustration of steps on the side of the pyramid to represent the
importance of exercise and changing your diet one step at a time?
a. Very Good
b. Good
c. Poor
d. Very Poor
23. How would you describe the change in your diet after learning about MyPyramid?
a. Substantial change
b. Some change
c. Very little change
d. No change
24. Do you try to reflect MyPyramid when making choices about your food intake?
a. Always
b. Frequently
c. Seldom
d. Never
25. If you do not use MyPyramid, what are your reasons for not using MyPyramid?
Check all that apply.
a. I DO use MyPyramid
b. I do not understand MyPyramid
c. I use a different nutrition plan
d. I am not interested in MyPyramid
e. I do not need guidance
f. Other __________________
26. Where else do you look for nutritional information? Check all that apply.
a. Internet websites
b. Nutrition or fitness magazines
c. Popular nutrition books
d. School nutrition classes
e. Family or Friends
f. Other _______________