American Heart Association Report: Unique Educational Course Helps College Students Improve Diet

SAN FRANCISCO, March 2, 2010 — Teaching college students — an understudied population for preventing weight gain — about societal issues related to food and agriculture may help them choose healthier diets, according to research presented at the American Heart Association’s 2010 Conference on Nutrition, Physical Activity and Metabolism.In a pilot study, researchers from Stanford University in California found that a college course focused on social issues related to food resulted in healthier diets than three classes focused on health related issues such as obesity. “We believe that this approach may produce larger and more sustained changes in eating behaviors than traditional educational approaches focusing on health as a motivator,” said Eric B. Hekler, Ph.D., lead study author and a post-doctoral research fellow at the Stanford Prevention Research Center at Stanford University. “The study suggests that interventions may promote greater behavior change when focusing on processes that motivate the behavior rather than on outcomes.”

The researchers compared two groups of students: 28 college undergraduates who participated in a course that addressed cultural, environmental, political and agricultural issues related to food; and 72 undergraduates who participated in one of three courses about health. All students were surveyed before the classes began (January 2009) and then again three months later at the completion of the class using a food frequency questionnaire.

Among the 100 students surveyed, those who took the “Food and Society” course reported:

• An overall improvement in their healthful eating diet score, while the general health students reported no significant changes in eating habits.

• An increase in vegetable consumption, from an average of 27.9 servings per week to 32.1.

• A decrease in high-fat dairy consumption, from an average of 8.5 servings per week to 6.3.

Historically, educational strategies for improving dietary habits have had limited success. In particular, maintaining healthful eating over the long-term is difficult. As such, the researchers sought to pilot test an innovative approach that may address these concerns.

The “Food and Society” course included reading selected portions of popular books and essays, such as Michael Pollan’s, “The Omnivore’s Dilemma: A Natural History of Four Meals,” a nonfiction book that analyzes food chains by tracing the origins of everything the author consumes. Students also watched a documentary film, “King Corn,” released in October 2007 that followed two college friends as they moved to Greene, Iowa, to grow and farm an acre of corn and examined the role that the increasing production of corn has for American society.

The general health courses were a seminar about obesity, a class addressing community assessment and health and a healthy psychology course.

At the beginning and end of the study, both groups of students were asked in questionnaires about their consumption of foods in six food groups: vegetables, fruits, high-fat meat, high-fat dairy, processed foods and sweets.

Students were also asked to rate the personal importance they placed on eating a healthful diet, staying physically fit, environmental sustainability, animals rights, social justice and ethics and mortality, compared to other things in their lives. After the course, “Food and Society” students reported an increased importance of eating healthy foods, the environment and animal rights in their lives.

“We believe that this approach has great potential to produce larger and more sustained changes,” Hekler said, “but it’s unclear whether books and films can inspire other populations to adopt a healthier lifestyle. Interventions that focus on processes more than outcomes may need to be tailored to different populations and cultures.”

Hekler and his co-authors, Thomas N. Robinson, M.D., M.P.H. and Christopher D. Gardner, Ph.D., plan to investigate how to take this program model and apply it to other groups of people at high risk for weight gain and obesity, including community college students, low-income communities, children, teens and parents.

Hekler was funded by the Public Health Service Training Grant from the National Heart, Lung, and Blood Institute. Author disclosures are on the abstract.

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