The Problem

As of 2021, more than half of U.S. youngest adults, 56% of those ages 18 to 25, are considered overweight or obese (Ellison-Barnes et al., 2021). The obesity prevalence in 2017 was 39.8% among adults aged 20 to 39 years and currently one in three adults are obese (Centers for Disease Control and Prevention, 2022). Specifically, in Washington, D.C., more than half of all adults are overweight or obese, with rates continuing to climb over the last decades, becoming a major public health concern (Centers for Disease Control and Prevention, n.d.).

While the majority of research has focused on obesity during childhood and adolescence, a large increase in body mass index (BMI) occurs during the transition from adolescence to adulthood. During this transition to adulthood, many young adults become obese for the first time in their lives, yet little research has examined why people at this age become obese (Sogari et al., 2018). As stated by the World Health Organization (WHO), obesity is due to unhealthy eating practices that start during adolescence, which include a lack of fruit and vegetable consumption during college years that continue into adulthood (Sogari et al., 2018).

In 2018, the ACHA-National College Health Assessment II reported that more than 95% of college students surveyed ate less than five servings of fruits and vegetables per day and 8.4% of participants reported eating no servings of these foods on a daily basis (American College Health Association, 2018). Further research suggests that students’ weight gain is not reflective of normal growth and development, and that these large cumulative gains in weight may eventually lead to an increased risk of chronic disease and mortality (Monroe et al., 2017).

The Priority Population

Especially for undergraduate college women, weight gain in college can pose risks for poor body image and psychological well-being, with research documenting that weight concerns, body dissatisfaction, and eating problems are highly prevalent among college women (Sarigiani et al., 2020). Researchers have found that women gain roughly 5.5 pounds over their first year of college and continue to gain weight, even though they are more concerned with losing weight and are more likely than their male counterparts to be actively trying to lose weight (Wayment et al., 2020). Given the physical and psychological risks of obesity, intervening at this young adulthood window of opportunity has the potential to positively alter future developmental trajectories (Sarigiani et al., 2020). Therefore, implementing a program at American University, located in Washington, D.C., with an undergraduate population made up of 63% women, could provide valuable insight (University Stats, 2023).

The Opportunity

Researchers have found that enablers to healthy behavior are improved food knowledge and education, meal planning, involvement in food preparation, and being physically active (Sarigiani et al., 2020). Therefore, we propose to increase fruit and vegetable intake in young adult women, ages 18-22, in the Delta Gamma sorority at American University in Washington, D.C. by providing hands-on skill building and nutrition education. The improvement of diet quality and nutrition will promote positive health outcomes while preventing the risk of obesity and noncommunicable diseases.

Our pilot program, Nutrition for You, will test and gather information which can then be implemented at a larger scale among the seven sororities at American University. Since Nutrition for You will be conducted on a smaller scale, which is important for the improvement of the quality and efficiency of the full-scale program, the pilot program will take place for a total of 6 weeks, with the program designers and the participants meeting every Sunday for 20 minutes (In, 2017). Prior to the nutrition skills-based education component, a two-hour kitchen safety skills training taught by the program designers is mandatory for all participants. For the first 4 weeks, the program team will teach skills regarding preparation and cooking fruits and vegetables (e.g., chopping, heating basic ingredients, grilling, steaming, and stir-frying). For the last 2 weeks, the participants will be introduced to easy ways to implement more vegetables and fruits into their snacks and meals using MyPlate recipes (e.g., soups, chili, oatmeal, pizza, and salad).

The Potential

Through this pilot program, we will be able to assess the recruitment process, increase the researchers’ experience with the skills interventions, and the feasibility of this program. Additionally, this program will allow students to develop the knowledge, tools, and skills that are necessary for this transition from living with parents into building a life on their own. Previous research studies have found that increased skills related to preparing and cooking fruits and vegetables have been associated with healthier eating behaviors and greater vegetable and fruit consumption among adolescents (LeBlanc et al., 2022). Overall, this program will increase daily consumption of fruits and vegetables among the women of Delta Gamma at American University, increase their self-efficacy by improving basic knowledge of preparation and cooking skills, and prevent the development of obesity and noncommunicable diseases. In this way, a dietary life skills program may be viewed as a public health initiative with many findings demonstrating the need for nutrition interventions during this age and support the importance of teaching food literacy to young adults (Valand et al., 2022).

The Nutrition for You pilot program will show successful feasibility because it is based on the social-ecological model and considers the complex interplay between individual, relationship, community, and societal factors (Centers for Disease Control and Prevention, 2022). At the individual level, a large majority of students know that eating healthy is good for them, however many students are unable to create this change due to lack of skills. Therefore, the program will focus on the individual level by increasing their skills regarding preparing and cooking fruits and vegetables. Additionally, the interpersonal level will be targeted in this program since we will be targeting young women in the Delta Gamma sorority. Having a network of social support is particularly important for making healthy behavior change, and these young women will be able to rely on each other for support which can help facilitate and maintain these changes (McKenzie et al., 2017, p.168).

Research has shown that positive eating habits are established in young adulthood and involve adoption of healthy food practices, including adequate vegetable and fruit consumption (Mello Rodrigues et al., 2019). By increasing fruit and vegetable consumption, college students will experience positive health outcomes such as the reduction of obesity and noncommunicable diseases (Mello Rodrigues et al., 2019). Overall, Nutrition for You will be successful pilot program since participants will have the skill sets necessary to incorporate fruits and vegetables into their meals and snacks daily, which will help them make healthier food choices and allow them to create a positive impact on their current and future health. From this pilot program, we can then implement this program on larger scale among the seven sororities at American University.

References

American College Health Association-National College Health Assessment II: Reference Group Executive Summary Fall 2018. American College Health Association. (2018). Retrieved March 20, 2023, from https://www.acha.org/documents/ncha/NCHA-II_Fall_2018_Reference_Group_Executive_Summary.pdf

Bailey, C. P., Sharma, S., Economos, C. D., Hennessy, E., Simon, C., & Hatfield, D. P. (2020). College campuses’ influence on student weight and related behaviors: A review of observational and Intervention Research. Obesity Science & Practice, 6(6), 694–707. https://doi.org/10.1002/osp4.445

Centers for Disease Control and Prevention. (2022, January 18). The social-ecological model: A framework for prevention |violence prevention|injury Center|CDC. Centers for Disease Control and Prevention. Retrieved March 20, 2023, from https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html 

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Ellison-Barnes, A., Johnson, S., & Gudzune, K. (2021). Trends in obesity prevalence among adults aged 18 through 25 years, 1976-2018. JAMA, 326(20), 2073. https://doi.org/10.1001/jama.2021.16685

In, J. (2017). Introduction of a pilot study. Korean Journal of Anesthesiology, 70(6), 601. https://doi.org/10.4097/kjae.2017.70.6.601

LeBlanc, J., Ward, S., & LeBlanc, C. P. (2022). The association between adolescents’ food literacy, vegetable and fruit consumption, and other eating behaviors. Health Education & Behavior, 49(4), 603–612. https://doi.org/10.1177/10901981221086943

McKenzie, J. F., Neiger, B. L., & Thackeray, R. (2017). Planning, implementing, and Evaluating Health Promotion Programs: A Primer. Pearson.

Mello Rodrigues, V., Bray, J., Fernandes, A. C., Luci Bernardo, G., Hartwell, H., Secchi Martinelli, S., Lazzarin Uggioni, P., Barletto Cavalli, S., & Proença, R. P. (2019). Vegetable consumption and factors associated with increased intake among college students: A scoping review of the last 10 years. Nutrients, 11(7), 1634. https://doi.org/10.3390/nu11071634

Monroe, C. M., Turner-McGrievy, G., Larsen, C. A., Magradey, K., Brandt, H. M., Wilcox, S., Sundstrom, B., & West, D. S. (2017). College freshmen students’ perspectives on weight gain prevention in the digital age: Web-based survey. JMIR Public Health and Surveillance, 3(4). https://doi.org/10.2196/publichealth.7875

Sarigiani, P. A., Olsavsky, A. L., Camarena, P. M., & Sullivan, S. M. (2020). Obesity and depressive symptoms in college women: Analysis of body image experiences and comparison to non-obese women. International Journal of Adolescence and Youth, 25(1), 765–779. https://doi.org/10.1080/02673843.2020.1740751

Sogari, G., Velez-Argumedo, C., Gómez, M., & Mora, C. (2018). College students and eating habits: A study using an ecological model for healthy behavior. Nutrients, 10(12), 1823. https://doi.org/10.3390/nu10121823

University Stats. (2023). American University student population and Demographics. Univstats. Retrieved March 20, 2023, from https://www.univstats.com/colleges/american-university/student-population/

Valand, I. U., Øverby, N. C., Strömmer, S., Barker, M., Bjornes, C., Nordli, J., Pettersen, L., Bjørkkjær, T., Vik, F. N., Kiland, C., & Hillesund, E. R. (2022). “It is really just brilliant to get credits for something that is so important to you!” skills for life: University students’ perceptions of a planned dietary life skills course. PLOS ONE, 17(4). https://doi.org/10.1371/journal.pone.0260890

Wayment, H. A., Eiler, B. A., & Cavolo, K. (2020). Self-evaluation strategies in college women trying to lose weight: The relative use of objective and social comparison information. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.01254