Determinants of fruit & vegetable and fat intake in university students: a cross-sectional explanatory study

Hannah

Verhoeven

De nefaste invloed van het studentenleven op de voedingsgewoonten

Overgewicht en obesitas treffen in de hedendaagse samenleving wereldwijd meer dan 1,4 miljard volwassenen. Deze aandoening kan leiden tot verscheidene gezondheidsproblemen zoals diabetes type 2, hoge bloeddruk, beroertes en zelfs bepaalde kankers. Meer nog, obesitas is één van de belangrijkste oorzaken van vroegtijdig overlijden. De 2,8 miljoen doden per jaar tonen aan hoe ernstig deze hedendaagse aandoening is.

De overgang van het secundair onderwijs naar het hoger onderwijs is een kritieke periode voor gewichtstoename. Deze gewichtstoename is deels te wijten aan de ongezonde voedingsgewoonten die gepaard gaan met het studentenleven. De meeste studenten overschrijden in deze periode de aanbevolen hoeveelheid vet in de vorm van hamburgers, pizza’s, frieten, chips, koeken,... Daarnaast nuttigen ze onvoldoende groenten en fruit.

Tijdens hun, meer zelfstandige, jaren aan een hogeschool of universiteit worden de voedingsgewoonten van studenten beïnvloed door verschillende factoren. Slechts enkele voorgaande studies onderzochten reeds de factoren die de voedingsgewoonten bij deze doelgroep beïnvloeden. Bovendien waren dit Amerikaanse studies. Aangezien er grote socio-culturele verschillen bestaan tussen het leven op en naast de campus van Amerikaanse en Europese universiteiten kunnen deze resultaten niet geëxtrapoleerd worden naar onze studenten. Het doel van deze studie was dan ook de factoren die de fruit- & groentenconsumptie en vetinname van Europese (Vlaamse) universiteitsstudenten beïnvloeden, te onderzoeken.

Uit de studie blijkt dat vrouwelijke studenten beduidend gezondere voedingsgewoonten vertonen. Ook studenten die op het moment van de ondervraging een dieet volgden, gaven aan meer fruit & groenten en minder vet te consumeren. Daarnaast blijken vegetarische eetgewoonten een zeer positieve invloed te hebben op de fruit- & groentenconsumptie van onze studenten.

Verscheidene onderzochte factoren beïnvloeden het voedingsgedrag van deze studenten zowel positief als negatief. De subjectieve norm, ook gekend als de persoonlijke motivatie van een student, is een factor met een zeer grote invloed op het voedingsgedrag. Studenten met een hoge subjectieve norm vertonen een beduidend hogere fruit- & groentenconsumptie en een lagere vetinname. Het kunnen weerstaan aan andere, ongezondere voedingswaren blijkt ook een zeer positieve invloed te hebben op fruit- & groentenconsumptie. Dit laatste wordt ook bepaald door de eigen-effectiviteit. Wanneer een student van zichzelf denkt dat hij in staat is voldoende fruit & groenten te eten, zal dit ook effectief resulteren in een hogere inname. Daarnaast blijken studenten die aangeven zich schuldig te voelen na het eten van vetrijke producten een lagere dagelijkse vetinname te vertonen. Dit schuldgevoel heeft eveneens een positieve invloed op de fruit & groentenconsumptie. De sociale omgeving, meer bepaald sociale normen, sociale steun en rolmodellen, heeft een positieve invloed op het voedingsgedrag van onze studenten. Bij studenten die gewichtsverlies, een verbeterde gezondheid en toegenomen tevredenheid over hun lichaam als voordelen van een gezond eetpatroon zien, resulteert dit ook in een hogere fruit- & groentenconsumptie en een lagere vetinname. Daarnaast zijn er ook verscheidene barrières die de fruit- & groentenconsumptie negatief beïnvloeden. Enkele daarvan zijn tijdsgebrek, gebrek aan discipline, verleiding van andere voedingsproducten en gebrek aan kennis en vaardigheden.

Goed doordachte interventies kunnen de, soms problematische, voedingsgewoonten van onze studenten verbeteren. Daarom is het belangrijk dat deze interventies inspelen op voorgaande factoren en op maat van de student ontwikkeld worden. Alleen zo kan de broodnodige gedragsverandering bij onze toekomstige wereldleiders tot stand komen!

Bibliografie

Bibliografie literatuurstudie

- Al-Rethaiaa, A. S., Fahmy, A. E. A., & Al-Shwaiyat, N. M. (2010). Obesity and eating habits among college students in Saudi Arabia: a cross-sectional study. Nutrition Journal, 9(39).

- Anding, J. D., Suminski, R. R., & Boss, L. (2001). Dietary intake, body mass index, exercise and alcohol: are college women following the dietary guidelines for Americans? Journal of American College Health, 49(4).

- Berghöfer, A., Pischon, T., Reinhold, T., Apovian, C. M., Sharma, A. M., & Willich, S. N. (2008). Obesity prevalence from a European perspective: a systematic review. BMC public health, 8(200).

- Bowman, S. A., & Vinyard, B. T. (2004). Fast food consumption of US adults: impact on energy and nutrient intakes and overweight status. Journal of the American College of Nutrition, 23(2), 163-168.

- Brevard, P. B., & Ricketts, C. D. (1996). Residence of college students affects dietary intake, physical activity, and serum lipid levels. Journal of the American Dietetic Association, 96, 35-38.

- Burke, G. L., Bild, D. E., Hilner, J. E., Folsom, A. R., Wagenknecht, L. E., & Sidney S. (1996). Differences in weight gain in relation to race, gender, age and education in young adults: the CARDIA study. Ethnicity & Health, 1(4), 327-335.

- Caballero, B. (2007). The global epidemic of obesity: an overview. Epidemiologic reviews, 29, 1-5.

- Chapelot, D. (2011). The role of snacking in energy balance: a biobehavioral approach. The Journal of Nutrition, 141, 158S-162S.

- Cluskey, M., & Grobe, D. (2009). College weight gain and behavior transitions: male and female differences. Journal of the American Dietetic Association, 109, 325-329.

- Crombie, A. P., Ilich, J. Z., Dutton, G. R., Panton, L. B., & Abood, D. A. (2009). The freshman weight gain phenomenon revisited. Nutrition Reviews, 67(2), 83-94.

- Delva, J., Johnston, L. D., & O’Malley, P. M. (2007). The epidemiology of overweight and related lifestyle behaviors – Racial/ethnic and socioeconomic status differences among american youth. American Journal of Preventive Medicine, 33(4S), S178-S186.

- Driskell, J. A., Meckna, B. R., & Scales N.E. (2006). Differences exist in the eating habits of university men and women at fast-food restaurants. Nutrition Research, 26, 524-530.

- Drummond, S., Crombie, N., & Kirk, T. (1996). A critique of the effects of snacking on body weight status. European Journal of Clinical Nutrition, 50(12), 779-783.

- Duvigneaud, N., Wijndaele, K., Matton, L., Deriemaeker, P., Philippaerts, R., Lefevre, J., Thomis, M., & Duquet, W. (2006). Prevalence of overweight, obesity and abdominal obesity in Flemish adults. Archives of public health, 64, 123-142.

- Economos, C. D., Hildebrandt, M. L., & Hyatt, R. R. (2008). College freshman stress and weight change: differences by gender. American Journal of Health Behavior, 32(1), 16-25.

- El Ansari, W., Stock, C., & Mikolajczyk, R. T. (2012). Relationships between food consumption and living arrangements among university students in four European countries – A cross-sectional study. Nutrition Journal, 11(28).

- Flegal, K. M., Carroll, M. D., Kit, B. K., & Ogden, C. L. (2012). Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA, 307(5), 491-497.

- Ford, E. S., & Mokdad, A. H. (2008). Epidemiology of obesity in the western hemisphere. Journal of Clinical Endocrinology & Metabolism, 93(11), S1-S8.

- Ganasegeran, K., Al-Dubai, S. A., Qureshi, A. M., Al-abed, A. A., Rizal, A. M., & Aljunid, S. M. (2012). Social and psychological factors affecting eating habits among university students in a Malaysian medical school: a cross-sectional study. Nutrition Journal, 11(48).

- Gatenby, S. J. (1997). Eating frequency: methodological and dietary aspects. British Journal of Nutrition, 77(1), S7-S20.

- Greaney, M. L., Less, F. D., White, A. A., Dayton, S. F., Riebe, D., Blissmer, B., Shoff, S., Walsh, J. R., & Greene, G. W. (2009). College students’ barriers and enablers for healthful weight management: A qualitative study. Journal of Nutrition Education and Behavior, 41, 281-286.

- Gropper, S. S., Simmons, K. P., Connell, L.J., & Ulrich, P. V. (2012). Changes in body weight, composition and shape: a 4-year study of college students. Applied Physiology, Nutrition, and Metabolism, 37, 1118-1123.

- Gropper, S. S., Simmons, K. P., Connell, L. J., & Ulrich, P. V. (2012). Weight and body composition changes during the first three years of college. Journal of obesity, 634-648.

- Guo, S. S., Wu, W., Chumlea, W. C., & Roche, A. F. (2002). Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. American Journal of Clinical Nutrition, 76, 653-658.

- Hingson, R. W., Zha, W., & Weitzman, E. R. (2009). Magnitude of and trends in alcohol-related mortality and morbidity among US college students ages 18-24, 1998-2005. Journal of Studies on Alcohol and Drugs, 16, 12-20.

- Hoefkens, C., Pieniak, Z., Van Camp, J., & Verbeke, W. (2012). Explaining the effects of a point-of-purchase nutrition-information intervention in university canteens: a structural equation modelling analysis. International Journal of Behavioral Nutrition and Physical Activity, 9(111).

- Howarth, N. C., Saltzman, E., & Roberts, S. B. (2001). Dietary fiber and weight regulation. Nutrition Reviews, 59, 129-139.

- Huang, T. T. K., Harris, K. J., Lee, R. E., Nazir, N., Born, W., & Kaur, H. (2003). Assessing overweight, obesity, diet and physical activity in college students. Journal of American College Health, 52(2).

- Irazusta, A., Hoyos, I., Irazusta, J., Ruiz, F., Diaz, E., & Gil, J. (2007). Increased cardiovascular risk associated with poor nutritional habits in first-year university students. Nutrition Research, 27, 387-394.

- Isganaitis, E., & Lustig, R. H. (2005). Fast food, central nervous system insulin resistance, and obesity. Arteriosclerosis, Thrombosis and Vascular Biology, 25, 2451-2462.

- Kilinc, F. N., & Cagdas, D. (2012). Evaluation of body compositions, dietary habits and nutritional knowledge of health college students. Turk Arch Ped, 47, 179-186.

- Kleinman, R. E., Hall, S., Green, H., Korzec-Ramirez, D., Patton, K., Pagano, M. E., & Murphy, L. M. (2002). Diet, breakfast, and academic performance in children. Annals of Nutrition and Metabolism, 46, 24-30.

- LaCaille, L. J., Dauner, K. N., Krambeer, R. J., & Pedersen, J. (2011). Psychosocial and environmental determinants of eating behaviors, physical activity and weight change among college students: a qualitative analysis. Journal of American College Health, 59(6), 531-538.

- Levitsky, D. A., Halbmaier, C. A., & Mrdjenovic, G. (2004). The freshman weight gain: a model for the study of the epidemic of obesity. International Journal of Obesity, 28, 1435-1442.

- Malik, V. S., Schulze, M. B., & Hu, F. B. (2006). Intake of sugar-sweetened beverages and weight gain: a systematic review. American Journal of Clinical Nutrition, 84, 274-288.

- Malinauskas, B. M., Raedeke, T. D., Aeby, V. G., Smith, J. L., & Dallas, M. B. (2006). Dieting practices, weight perceptions, and body composition: a comparison of normal weight, overweight, and obese college females. Nutrition Journal, 5(11).

- Mokdad, A. H., Serdula, M. K., Dietz, W. H., Bowman, B. A., Marks, J. S., & Koplan, J. P. (1999). The spread of the obesity epidemic in the United States, 1991-1998. JAMA, 282(16), 1519-1522.

- Morrow, M. L., Heesch, K. C., Dinger, M. K., Hull, H. R., Kneehans, A. W., & Fields, D. A. (2006). Freshman 15: fact or fiction? Obesity, 14(8), 1438-1443.

- Nelson, M. C., Kocos, R., Lytle, L. A., & Perry, C. L. (2009). Understanding the perceived determinants of weight-related behaviors in late adolescence: a qualitative analysis among college youth. Journal of Nutrition Education and Behavior, 41, 287-292.

- Nelson, M. C., Larson, N. I., Barr-Anderson, D., Neumark-Sztainer, D., & Story, M. (2009). Disparities in dietary intake, meal patterning and home food environments among young adult nonstudents and 2- and 4-year college students. American Journal of Public Health, 99(7), 1216-1219.

- Nelson, M. C., Story, M., Larson, N. I., Neumark-Sztainer, D., & Lytle, L. A. (2008). Emerging adulthood and college-aged youth: an overlooked age for weight-related behavior change. Obesity, 16, 2205-2211.

- Neslisah, R., & Emine, A. Y. (2011). Energy and nutrient intake and food patterns among Turkish university students. Nutrition Research and Practice, 5(2), 117-123.

- Neumark-Sztainer, D., Story, M., Perry, C., Casey, M. A. (1999). Factors influencing food choices of adolescents: findings from focus-group discussions with adolescents. Journal of the American Dietetic Association, 99, 929-934,937.

- Nielsen, S. J., & Popkin, B. M. (2004). Changes in beverage intake between 1977 and 2001. American Journal of Preventive Medicine, 27(3), 205-210.

- Papadaki, A., Hondros, G., Scott, J. A., & Kapsokefalou, M. (2007). Eating habits of university students living at, or away from home in Greece. Appetite, 49, 169-176.

- Pearson, N., Atkin, A. J., Biddle, S. J. H., Gorely, T., & Edwardson, C. (2009). Patterns of adolescent physical activity and dietary behaviours. International Journal of Behavioral Nutrition and Physical Activity, 6(45).

- Pliner, P., & Saunders, T. (2008). Vulnerability to freshman weight gain as a function of dietary restraint and residence. Physiology & Behavior, 93, 76-82.

- Racette, S. B., Deusinger, S. S., Strube, M. J., Highstein, G. R., & Deusinger, R. H. (2008). Changes in weight and health behaviors from freshman through senior year of college. Journal of Nutrition Education and Behavior, 40, 39-42.

- Rolls, B. J., Ello-Martin, J. A., & Tohill, B. C. (2004). What can intervention studies tell us about the relationship between fruit and vegetable consumption and weight management? Nutrition Reviews, 62(1), 1-17.

- Rosenheck, R. (2008). Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk. Obesity Reviews.

- Sakamaki, R., Amamoto, R., Mochida, Y., Shinfuku, N., & Toyama, K. (2005). A comparative study of food habits and body shape perceptions of university students in Japan and Korea. Nutrition Journal, 4(31).

- Sakamaki, R., Toyama, K., Amamoto, R., Liu, C. J., & Shinfuku, N. (2005). Nutritional knowledge, food habits and health attitude of Chinese university students – a cross sectional study. Nutrition Journal, 4(4).

- Sallis, J. F., & Owen, N. (2002). Ecological models of health behavior. In K. Glanz, B. K. Rimer, & F. M. Lenis (Eds.), In health behavior and health education: theory, research and practice (pp. 462-484). San Francisco: Jossey-Bass, 3rd ed.

- Savige, G., MacFarlane, A., Ball, K., Worsley, A., & Crawford, D. (2007). Snacking behaviours of adolescents and their association with skipping meals. International Journal of Behavioral Nutrition and Physical Activity, 4(36).

- Serlachius, A., Hamer, M., & Wardle, J. (2007). Stress and weight change in university students in the United Kingdom. Physiology & Behavior, 92, 548-553.

- Shuger, S. L., Barry, V. W., Sui, X., McClain, A., Hand, G. A., Wilcox, S., Meriwether, R. A., Hardin, J. W., & Blair, S. N. (2011). Electronic feedback in a diet- and physical activity-based lifestyle intervention for weight loss: a randomized controlled trial. International journal of behavioral nutrition and physical activity, 8(41).

- Silliman, K., Rodas-Fortier, K., & Neyman, M. (2004). A survey of dietary and exercise habits and perceived barriers to following a healthy lifestyle in a college population. Californian Journal of Health Promotion, 2(2), 10-19.

- Story, M., Neumark-Sztainer, D., & French, S. (2002). Individual and environmental influences on adolescent eating behaviors. Journal of the American Dietetic Association, 102(3), S40-S51.

- Swinburn, B. A., Caterson, I., Seidell, J. C., & James, W. P. T. (2004). Diet, nutrition and the prevention of excess weight gain and obesity. Public Health Nutrition, 7(1A), 123-146.

- Tanaka, M., Mizuno, K., Fukuda, S., Shigihara, Y., & Watanabe, Y. (2008). Relationships between dietary habits and the prevalence of fatigue in medical students. Nutrition, 24(10), 985-989.

- Vella-Zarb, R. A., & Elgar, F. J. (2009). The ‘Freshman 5’: A meta-analysis of weight gain in the Freshman year of college. Journal of American College Health, 58(2), 161-166.

- Wengreen, H. J., & Moncur, C. (2009). Change in diet, physical activity and body weight among young-adults during the transition from high school to college. Nutrition Journal, 8(32).

- West, D. S, Bursac, Z., Quimby, D., Prewitt, T. E., Spatz, T., Nash, C., Mays, G., & Eddings, K. (2006). Self-reported sugar-sweetened beverage intake among college students. Obesity, 14(10),1825-1831.

- Yang, C. C., & Chiou, W. B. (2010). Substitution of healthy for unhealthy beverages among college students. A health-concerns and behavioral-economics perspective. Appetite, 54, 512-516.

Web references

- World Health Organization (2009). Global health risks: Mortality and burden of disease attributable to selected major risks. Retrieved December 2, 2012, from http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_r…

- World Health Organization (2012). Global strategy on diet, physical activity and health: Promoting fruit and vegetable consumption around the world. Retrieved November 25, 2012, from http://www.who.int/dietphysicalactivity/fruit/en/index2.html

- World Health Organization (2012). Obesity and overweight: Fact sheet N°311, May 2012. Retrieved October 25, 2012, from http://www.who.int/mediacentre/factsheets/fs311/en

Bibliografie wetenschappelijk artikel

- Ackard, D. M., Croll, J. K., & Kearney-Cooke, A. (2002). Dieting frequency among college females: association with disordered eating, body image, and related psychological problems. Journals of Psychosomatic Research, 52, 129-136.

- Bolca, S., Huybrechts, I., Verschraegen, M., De Henauw, S., & Van de Wiele, T. (2009). Validity and reproducibility of a self-administered semi-quantitative food-frequency questionnaire for estimating usual daily fat, fibre, alcohol, caffeine and theobromine intakes among belgian post-menopausal women. International Journal of Environmental Research and Public Health, 6, 121-150.

- Bray, G. A., & Popkin, B. M. (1998). Dietary fat intake does affect obesity. The American Journal of Clinical Nutrition, 68, 1157-1173.

- Brownell, K. D., & Roden, J. (1994). The dieting maelstrom. Is it possible and advisable to lose weight? American Psychologist, 49(9), 781-791.

- Crombie, A. P., Ilich, J. Z., Dutton, G. R., Panton, L. B., & Abood, D. A. (2009). The freshman weight gain phenomenon revisited. Nutrition Reviews, 67(2), 83-94.

- de Bruijn, G.-J. (2010). Understanding college students’ fruit consumption. Integrating habit strength in the theory of planned behavior. Appetite, 54, 16-22.

- Driskell, J. A., Meckna, B. R., & Scales N.E. (2006). Differences exist in the eating habits of university men and women at fast-food restaurants. Nutrition Research, 26, 524-530.

- House, J., Su, J., & Levy-Milne, R. (2006). Definitions of healthy eating among university students. Canadian Journal of Dietetic Practice and Research, 67, 14-18.

- Isganaitis, E., & Lustig, R. H. (2005). Fast food, central nervous system insulin resistance, and obesity. Arteriosclerosis, Thrombosis and Vascular Biology, 25, 2451-2462.

- Louis, W., Davies, S., Smith, J., Terry, D. (2007). Pizza and pop and the student identity: the role of referent group norms in healthy and unhealthy eating. The journal of social psychology, 147(1), 57-74.

- Mokdad, A. H., Serdula, M. K., Dietz, W. H., Bowman, B. A., Marks, J. S., & Koplan, J. P. (1999). The spread of the obesity epidemic in the United States, 1991-1998. JAMA, 282(16), 1519-1522.

- Morrow, M. L., Heesch, K. C., Dinger, M. K., Hull, H. R., Kneehans, A. W., & Fields, D. A. (2006). Freshman 15: fact or fiction? Obesity, 14(8), 1438-1443.

- Papadaki, A., Hondros, G., Scott, J. A., & Kapsokefalou, M. (2007). Eating habits of university students living at, or away from home in Greece. Appetite, 49, 169-176.

- Schuette, L. K., Song, W. O., & Hoerr, S. L. (1996). Quantitative use of the food guide pyramid to evaluate dietary intake of college students. Journal of the American Dietetic Association, 96, 453-457.

- Shaikh, A. R., Yaroch, A. M., Nebeling, L., Yeh, M.-C., & Resnicow, K. (2008). Psychosocial predictors of fruit and vegetable consumption in adults: a review of the literature. American Journal of Preventive Medicine, 34(6), 535-543.

- Story, M., Neumark-Sztainer, D., & French, S. (2002). Individual and environmental influences on adolescent eating behaviors. Journal of the American Dietetic Association, 102(3), S40-S51.

- Vella-Zarb, R. A., & Elgar, F. J. (2009). The ‘Freshman 5’: A meta-analysis of weight gain in the Freshman year of college. Journal of American College Health, 58(2), 161-166.

- Wengreen, H. J., & Moncur, C. (2009). Change in diet, physical activity and body weight among young-adults during the transition from high school to college. Nutrition Journal, 8(32).

- Yahia, N., Achkar, A., Abdallah, A., & Rizk, S. (2008). Eating habits and obesity among Libanese university students, Nutrition Journal, 7(32).

- Yang, C. C., & Chiou, W. B. (2010). Substitution of healthy for unhealthy beverages among college students. A health-concerns and behavioral-economics perspective. Appetite, 54, 512-516.

Web references

- FAO (2010). Fats and fatty acids in human nutrition: Report of an expert consultation. Retrieved May 2, 2013, from http://www.who.int/nutrition/publications/nutrientrequirements/fatsandf…

- Nubel Voedingsplanner (2013). Retrieved April 29, 2013, from http://www.nubel.be/ned/default.aspx

- World Health Organization (2012a). Global strategy on diet, physical activity and health: Promoting fruit and vegetable consumption around the world. Retrieved November 25, 2012, from http://www.who.int/dietphysicalactivity/fruit/en/index2.html

- World Health Organization (2012b). Obesity and overweight: Fact sheet N°311, May 2012. Retrieved October 25, 2012, from http://www.who.int/mediacentre/factsheets/fs311/en

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Universiteit of Hogeschool

Vrije Universiteit Brussel

Thesis jaar

2013

Thema('s)

Geneeskunde

Kernwoorden

Voeding,

kanker,