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What do college students eat? Food selection and meal pattern
Nutrition Research, Vol. 14, No. 8, pp. 1143-1153, 1994 Copyright 9 1994 Elsevier Science Ltd Printed in the USA. All fights reserved 0271-5317/94 $6.00 + .00
Pergamon
0271-5317(94)E00043-3
WHAT DO COLLEGE BTUDENT8 EAT ? FOOD B E L E C T I O N I ~ ' D MF~L PATTERN
Ya-Li Huang, MS., Won O. Song 1, Ph.D., R.D., Rachel A. Schemmel Ph.D., R.D., Sharon M. Hoerr Ph.D., R.D. Department of Food Science and Human Nutrition, Michigan State University East Lansing, MI 48824-1224, USA
ABSTRACT
Data are limited on food selections of young adults. This study was undertaken to examine the eating practices of college students relevant to improving nutrition and health education programs. Dietary records (n=1912) were used to determine the frequency of meals skipped and specific foods selected by male and female students in different seasons between Fall, 1990 and Summer, 1991. Twenty-two percent, 8%, and 5% of the students skipped breakfast, lunch, and dinner, respectively; 80% of the students snacked at least once a day. There were no significant differences in frequency of meals skipped and snacks consumed among seasons, or between men and women. Forty foods consumed most frequently for meals and snacks included various carbonated beverages but few vegetables and fruits. Skimmed milk, 2% milk and chicken or turkey w e r e a m o n g the top 40 foods selected by both genders whereas whole milk and higher-fat meats were not. Men consumed more high calorie and high fat foods, more fast foods but fewer vegetables than women. These findings suggest that health promotion for young adults in college should address importance of eating vegetables and fruits with less frequent consumption of carbonated beverages and high fat combination dishes. The message for men may need to differ for women. Key words:
College students, Dietary record, Food habits, Dietary pattern, Food consumption. INTRODUCTION
Large enrollments in nutrition and health courses support the fact that college students are interested in nutrition. Several investigators have reported, however, that nutrition lecture i Corresponding Author 1143
1144
Y.-L. HUANG et al.
courses improve students' nutritional knowledge but not their food intake (1-3). To improve food intake behavior as well as nutritional knowledge, nutrition education should focus on specific problematic areas of the target population's diet. Diet is one of the two dominant and preventable health problems of young adults according to the Healthy People 2000, the National Health Promotion and Disease Prevention objectives (4). Adoption by young adults of healthful food intake patterns in line with the U.S. Dietary Guidelines is an essential foundation for chronic disease prevention and maintenance of a healthy life style (4). A l t h o u g h more than 50% of high school graduate go onto college (5), studies are limited which identify problem areas in dietary practices of college population. A few authors have described nutrient intakes of this age group and reported low intakes for calcium and folate, and, iron among females (6-10). Low energy intakes with p r o p o r t i o n a l l y high fat intake by college age adults have been reported (8). This information on adequacy in nutrient intake is not, however, the same as data on food selections. Information on consumption of specific foods, meal patterns, seasonal and gender preferences is needed to help target specific problematic areas relevant to the U.S. Dietary Guideline. Therefore, the specific objectives of this study were to determine: i) the frequency of meals skipped; 2) foods consumed most frequently for meals and snacks; and 3) differences in food selections by season and gender.
METHODS Subiects Subjects in this study were the students enrolled in an introductory nutrition course at Michigan State University from September 1990 through August 1991. This study was approved by the university Committee on Research Involving Human Subjects at Michigan State University, as a part of a campus-wide health promotion program. The introductory nutrition course fulfills the Natural science requirement in general education, and about 10% of freshmen and sophomores at the university enroll in it. The average ages of the men and women were 20 and 19 years, respectively. No women included were pregnant or lactating. The body mass indexes (Kg/m 2) of the 607 men and 1305 women in the study were within normal range for their age with 23.8 • 3 for men, and 21.8 • 3 for women, respectively. Other characteristics such as the major of the students did not differ by term enrolled. Data collection For a class assignment, students were required to complete a food intake record for one typical weekday between the second and third week of each quarter. The purpose of the assignment was to get the students become aware of their own dietary intake. All students were given detailed instruction to complete the record including methods of food preparation, description of ingredients for mixed dishes, beverages and condiments consumed as well as how to estimate serving sizes. In addition, each student reported age, height, weight, hours spent for various levels of physical activity and use of vitamin and
FOOD SELECTION AND MEAL PATTERN
1145
mineral supplements. Students then used a nutrition software package, MSU NutriGuide (Song W.O., Nutritional Analysis Computer Program, Version 1.5, Michigan State University, 1988), to enter dietary information and evaluate their own intakes. Students were encouraged to use the software throughout the term for their own information. The dietary records were collected in the format of American standard code for information interchange (ASCII) by MSU NutriGuide. MSU NutriGuide analyzes diets for 27 nutrients in 953 different foods. Its nutrient composition data came from Michigan State University main-frame database and USDA Handbook-8 (ii). The nutrient database of NutriGuide includes foods frequently consumed by college students including fast food items and those foods served by the campus foodservice programs in residence halls. Incomplete and multiple dietary records were eliminated so that the final data set included complete data collected from 1912 out of 2054 individuals. Data Analysis Data analyses were conducted using programs available in the personal computer edition of the Statistical Package for the Social Sciences, Version 5.0 (SPSS Inc., Chicago, IL, 1990), at a significance level of p < 0.05. First, frequencies of skipped breakfast, lunch, and dinner were computed b y g e n d e r and by season (Fall, Winter Spring or Summer terms in the quarter system). Statistical differences in meal skipping practices by gender or by season were determined by Chisquare tests. Secondly, the frequency of consumption of each food was calculated by meal, season and gender using a program written by Turbo Pascal (Borland International Inc., Scotts Valley, CA, 1987). From this frequency list, the 40 foods consumed most frequently for each day, and each meal including snacks were identified by gender and season. Finally, in an attempt to indirectly evaluate "variety" of foods consumed by the subjects, the total number of different foods consumed in one day was tallied for both males and females for the different seasons. In the computation, a combination dish such as macaroni and cheese as well as one single food such as an apple were each considered as one food item. Consumption of the same food at multiple eating occasions in a day was also counted as one single food consumed for the day. RESULTS A p p r o x i m a t e l y one in four to five college students in this study skipped breakfast (Table i). There were no significant differences between genders in skipping meals, except for summer (n=264) when the frequency of skipping breakfast was greater for females (27%) than for males (ii%) (p<0.05). About 80% of students reported that they snacked at least once a day (Table i), with no significant differences related to season or gender. The young adults in this study consumed an average of thirteen different food items daily regardless of season or gender. There were no differences by seasons in the 40 most frequently consumed foods; therefore, the results for all seasons were combined for further statistical analysis and presentation. One exception observed was beer, one of the most often consumed foods only during the summer.
1146
Y.-L. HUANG et al. TABLE 1 Percentage of College Students Who Skipped Meals and Snacked (n=1912). % of Students Who Skipped
Gender
Male
Breakfast
Who Consumed
Lunch
Dinner
Snacks*
20.3
6.3
3.1
79.4
21.5
8.1
4.8
78.7
(n=607) Female (n=1305)
* snacks consumed at least once during the day. The forty foods most frequently consumed by the subjects are listed in Table 2. Skimmed milk (31.9%) and 2% milk (22.9%) were consumed more frequently than whole milk (4.8%) by both genders. Men consumed whole and 2% milk more frequently than women (p<0.05), whereas women consumed skim milk more often than men (p<0.05). Low fat meat selections, such as turkey (14.4%) and chicken (6.3%), were popular with college students for single meat dishes. Combination dishes such as pizza (8.5%), hamburgers (6.6%), and ham and cheese sandwiches (6.1%) were also frequent selections. Turkey was selected more often by women than by men (p<0.05), whereas fastfood-type combination dishes were consumed more often b y m e n (p<0.05). Of the most frequently consumed vegetables, tossed salad was the only non-starch item and eaten most (46.8%). Women consumed tossed salads more often than did men (p<0.05). Various forms of potato were also frequently consumed: French fried, mashed and baked. French fries were consumed twice as often by men as by women. Apples (17.5%), bananas (12.5%), and oranges (5.9%) were the most frequently consumed fruits throughout the four seasons. Selection of fruits and vegetables, particularly those rich in vitamin A was limited. The most popular bread items were bagels (20.7%) followed by white bread (19.7%), whole wheat bread (18.3%), and Italian bread (7.5%). Butter/margarine, peanut butter, chocolate chip cookies and potato chips also were consumed frequently by students. Surprisingly, butter/margarine was consumed more often by women than by men. six of the 40 most frequently consumed items were carbonated beverages with apparent differences in gender: diet carbonated beverages were consumed frequently by women, whereas regular carbonated drinks by men. Foods selected most frequently as snacks (Table 3) were regular and diet carbonated beverages, popcorn, potato/nacho chips, apples, regular and lite beer, candy bars, cookies and pizza. Although there were no significant differences in frequency of snacking between men and women, the snack items selected differed. Chips, candy bars, pizza, regular pop and beer were consumed more by males than females. Females often consumed crackers, popcorn, frozen yogurt and diet pop.
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1147
TABLE 2 Forty Foods Consumed Most Frequently by C o l l e g e S t u d e n t s for 4 Seasons. % of s t u d e n t s w h o c o n s u m e d Food
All n=1912
D a i r y Products skimmed milk 2% m i l k cream cheese c h e e s e , natural~processed
Male n=607
Intake
Female n=1305
31.9 22.9 7.8 3.9
24.2 33.6 5.9 19.3
35.5 17.9 8.7 25.5
* * * *
14.4 6.3
11.4 6.1
15.9 * 6.4
8.5 8.0 6.6 6.1
12.2 10.2 10.7 9.9
46.8 13.9 8.2 7.3 6.9
Average #
2.4 2.5 2.4 4.1
cup cup Tbsp oz
Meets turkey chicken
7.8 oz 1.3 e a c h
Combination Dishes pizza spaghetti with meat sauce hamburger ham and cheese sandwich
6.8 7.0 4.7 4.4
* * * *
2.8 2.1 1.2 I.i
slice cup each each
38.2 20.1 9.6 8.4 5.8
50.7 * ii.0 * 7.6 6.8 7.4
5.5 1.4 i.i 1.3 0.9
cup cup each cup cup
17.5 12.5 5.9 26.1 9.4 6.7 6.0
12.0 1.7 5.1 36.1 9.1 6.6 5.9
20.1 * 12.9 6.2 21.5 * 9.6 6.7 6.0
1.1 1.1 1.2 1.6 1.5 1.4 2.3
medium medium small cup cup cup cup
20.7 19.7 18.3 7.5
12.9 23.4 15.7 7.9
24.4 * 17.9 * 19.5 * 7.3
1.4 2.4 2.2 2.0
each slice slice slice
20.9 14.2 7.6 5.9 5.9 5.8 7.8 7.0
32.0 5.3 3.5 9.4 8.4 7.6 7.9 8.1
15.8 18.4 9.5 4.3 4.7 4.9 7.8 6.4
* * * * * *
1.6 1.7 1.6 2.1 1.3 1.3 2.8 2.1
can can can can can can cup cup
14.1 6.9 6.2 5.8 9.4 16.0
11.2 6.1 7.1 5.4 i0.0 21.3
15.5 * 7.2 5.7 6.0 9.1 13.6 *
1.9 2.1 2.5 1.4 2.5 1.4
tsp tsp Tbsp Tbsp each cup
Vegetables tossed salad French fries baked potatoes mashed potatoes sweet corn
Fruits & Fruit Juices apple banana orange f r o z e n o r a n g e juice, apple juice grape juice lemonade
diluted
Grains bagel white bread whole wheat bread Italian bread
Beverages: non-dairy, non-fruit juice Coca-cola diet Coke diet Pepsi cola Mountain Dew Pepsi cola Sprite fruit punch drinks coffee Other Foods butter/margarine peanut butter Italian dressing mayonnaise chocolate chip cookies potato chips
* p ~ 0 . 0 5 by g e n d e r # Average daily intake by those subjects who consumed the
food
item
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Y.-L. HUANG et al.
Foods Most
TABLE 3 C o n s u m e d as S n a c k s by C o l l e g e
Frequently
% of s t u d e n t s Food
All n=1912
Students.
who consumed
Male n=607
Female n=1305
Dairy 2% m i l k skimmed milk yogurt, f r o z e n ice c r e a m cheese, n a t u r a l / p r o c e s s e d
2.3 1.7 1.5 1.1 1.1
3.1 2.1 0.4 0.8 2.1
1.9 1.6 1.9 1.3 0.6
7.7 2.1 2.0 1.7 1.7 1.6
5.6 2.3 1.0 3.1 1.0 0.6
8.7 1.9 2.4 i.i 1.9 2.0
14.9 9.5 8.8 6.8 3.4 1.6
Ii. 1
16.9
*
4.7 13.5 ii.0 2.5 1.5
11.2 6.6 5.0 3.8 1.7
* * *
18.4 10.4 7.0 1.8 1.6 1.2
28.9 3.8 15.2 1.9 1.7 0.6
13.5 13.4 3.2 1.8 1.6 1.5
* * *
bars
4.7 6.1
6.6 5.8
3.8 6.4
pizza gum, s u g a r l e s s / r e g u l a r peanut butter
3.7 2.8 1.7
6.8 1.4 1.2
2.2 3.3 1.9
Fruits and Fruit Juices apple banana orange orange juice apple juice lemonade
Salted Snacks/Grain popcorn crackers potato chips nacho chips pretzels bagel
Beveragesz
non-dairy,
carbonated beverage, carbonated beverage, beer, r e g u l a r / l i t e Kool-aid coffee fruit punch
non-fruit Juice regular diet
Candy # a n d C o o k i e s Snickers cookies
Other Foods
* P
also
FOOD SELECTION AND MEAL PATTERN
1149
DISCUSSION It is often assumed that knowledge students gain in college will be applied to improve their food and health habits. Findings from this study, however, show that the gender differences in typical food selections of college students already parallel those of older adults. Similar to the findings of surveys conducted with college students i0 and 40 years ago (10,12), breakfast was frequently skipped by students in this study. According to national survey data (13), breakfast is the most frequently skipped meal by all age groups, and young adults skip this meal more often than other age groups. Several studies have indicated that omission of breakfast contributed to dietary inadequacy (14,15). As reported in 1986 (16), most all college students in this study snacked. The relationship between snacking patterns and skipping meals is unclear (6,9) and cannot be investigated in this study, because students did not report the time of day when they ate snacks. College students selected skimmed milk, 2% milk, and low fat meat dishes over whole milk and high fat meat items. High fat foods such as pizza, hamburger, French fries and potato chips were also frequently consumed, especially by men. These high fat foods were listed as among 50 major dietary sources of fat for U.S. adults (17) suggesting that college students have knowledge about low fat meat selections, but perhaps not about the high fat content of selected fast foods. Alternatively, college students' taste preferences and need for convenience may influence selection of fast-food-type combination dishes, especially for men. Regardless of causes, young adults exhibit food patterns similar to those of older adults, relative to high fat foods. The variety of fruits and vegetables selected was limited in this study. The most frequent selection of apples, bananas and oranges are consistent with those consumed by the US population (19). Inadequate consumption of fruits and vegetables is an area of nutritional concern for young adults in college as well as for the general adult population. Patterson et al.(20) reported that only 9% of the adult p o p u l a t i o n in NHANES II met the minimum Food Wheel intake standards (5-9 servings per day) for fruit and vegetable servings. Hernon et al. (21) reported that college men consumed more fruits than did college women. In our study, no significant differences were found between genders in fruit selection with the exception that apples were consumed more often by women than by men who consumed orange juice more often. Women consumed whole wheat bread more frequently than men, whereas men consumed white bread more frequently. It was of interest to find both bagels and cream cheese among the most frequently consumed foods. It is unclear whether this finding is a regional or secular trend. Our finding that men selected more high fat foods than women is suggested by another study with college-age and older adults (17). Lieux et al. examined evening meals selected by 214 college students and found, as we did, that fast-food items, including grilled cheese sandwiches, hamburgers, and steak sandwiches, were selected by more men than women (18). Considering the selection of higher fat foods by men, the finding that women consumed more butter/margarine is puzzling. Females might have been more precise in recording spreads
1150
Y.-L HUANG et al.
and condiments consumed than males, or females might have been compensating for consumption of skim milk and diet beverages with more generous use of butter and margarine. Season did not affect overall meal skipping and snacking or food selections, except for beer in the summer. In this study, alcohol consumption was based on a weekday's dietary record, whereas consumption of alcoholic beverages would be expected to be higher on weekends than weekdays through the school year. During summer, the frequency of skipping breakfast was greater for females (27%) than for males (11%) suggesting that the meal patterns of college students differ by gender most in the summer. Weight control concern of young women is one possible explanation for the difference. The young adults in this study consumed a daily average of 13 different foods which contrast with the average intake of 16.3 different food items consumed daily by the adult population in the Nationwide Food Consumption Survey, 1987-88 (23). Limited food variety in young adults might be a cause for concern, because eating a variety of foods reduces the chance of developing a deficiency or excess of any one nutrient and assures a balanced intake of m i c r o n u t r i e n t (24-25). When compared to the studies on snack consumption 30-40 years ago, the snack foods frequently consumed by young adults in this study differed slightly. Earlier studies reported carbonated beverages, salty snacks, candies, gums, and fruits as snacks (6,9,22). In this study, diet beverages, beer, and pizza were reported frequently as snacks. One-day food intake records were used in this study with a large sample size. One-day food intake records have shown to evaluate adequately the large group intake by Guthrie and Crocetti (26). Purpose of this study was to evaluate students' food selection crosssectionally, and the limitation of one-day food record is not expected to have affected the result. Although the large number of students included in this study was not randomly selected from the entire student body at M i c h i g a n State University (N=42,000), the demographics and food intakes of the subjects included in the present study did not differ from those in an introductory language and art class (data not shown). Similarly, findings on food intake and meal patterns of this study are similar to those of older adults (13,17,19), which are somewhat surprising, given the assumed uniqueness of a collegiate life style. Findings of this study obviously cannot be generalized for all college students' food selection practices throughout the country nor throughout the week. Data presented in the current study do not reflect the potentially different dietary habits between the weekend and weekdays. It was concluded from this study that the following recommendations for nutrition education of college age young adults are made in the context of the current diet and meal patterns: be specific by gender; increase awareness of the fat content of foods, especially fast foods; provide specific examples of convenient low fat foods; address the importance of eating breakfast for weight control and suggest fast nutritious food choices; suggest how to incorporate fruits and vegetables into the diet and; focus on selection of healthy snack foods. A future study may be suggested to examine the differences in
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1151
the dietary practices of college students between weekdays and weekend days, at multiple universities, to assess the needs to establish nutrition education messages specific for the weekend. ACKNOWLEDGEMENTS The development of MSU NutriGuide was supported by the W.K. Kellogg Foundation as a part of the Healthy U program, a campus-wide health promotion program at MSU. This particular project was funded by a Health U grant for dissemination of findings. Authors appreciate Jae Son and Eunmi Choi for their expertise in computer programming, and Margeret Krebs and Jo Barr for their contribution in the beginning of this project. REFERENCES
i.
skinner JD. Change in students' dietary behavior during a college nutrition course. J Nutr Educ 1991; 23:72-75.
2.
Amstutz MK, Dixon DL. Dietary change resulting from the Expanded Food and Nutrition Education Program. J Nutr Educ 1986; 18:55-69.
3.
Nied SA. Effect of an interactive computerized diet analysis program in nutrition education. Thesis for M.S. Michigan State University, 1991.
4.
Healthy People 2000, National Health Promotion and Disease Prevention Objectives. DHHS Publication No. (PHS)91-50212 1990. Digest of Education Statistics. Washington DC: US Department Education, National Center for Education Statistics, 1992:174
6.
Khan MA, Lipke LK. Snacking and its contribution to food and nutrient intake of college students. J Am Diet Assoc 1982; 81:583-586.
7.
Horwath CC. Dietary intake and nutritional status among university undergraduates. Nutr Res 1991; 11:395-404.
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Hoffman CJ. Dietary intake of calcium, iron, folacin, alcohol and fat for college students in central Michigan. J Am Diet Assoc 1989; 89:836-838.
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Jakobovits C, Halstead P, Kelly L, Roe DA, Young CM. Eating habits and nutrient intake of college women over a thirty year period. J Am Diet Assoc 1977; 71:405-411.
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Driskell JA, Keith RE, Tangney CC. Nutritional status of white college students in Virginia. J Am Diet Assoc 1979; 74:32-35.
ii.
U.S. Department of Agriculture. Composition of Food: Raw, Processed, Prepared Agric. Handbook No. 8. AH 8-1, Dairy and Egg Products, 1976; AH 8-2, Spices and Herbs, 1977; AH 8-3,
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Y.-L. HUANG et al. Baby Foods, 1978; AH 8-4, Fats and Oils, 1979; AH 8-5, Poultry, 1979; AH 8-6, Soup, Sauces and Gravies, 1980; AH 89, Fruits and Fruit Juices, 1982; AH 8-10, Breakfast Cereal, 1988; AH 8-11, Vegetables and Vegetable Products, 1984; AH 812, Nut and Seed Products, 1984; AH 8-13, Beef Products, 1986; AH 8-14, Beverages, 1986; AH 8-15, Fish and Shellfish Products, 1987; AH 8-16, Legumes and Legume Products, 1986; AH 8-17, Lamb, Veal and Game Products, 1989; AH 8-20, Cereal Grains and Pasta, 1989; AH 8-21, Fast foods, 1989; 1989 supplement, 1990. Washington, D.C.
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Stasch AR, Johnson MM, Spanglar GJ. Food Practices and preferences of some college students. J Am Diet Assoc 1970; 57:523-527.
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Pao EM, Sykes KE, Cypel YS. USDA Methodological Research for Large-Scale Dietary Intake Survey, 1975-1988. 1989:82-117.
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Skinner JD, Salvetti NN, Ezell JM, Penfield MP, Costello CA. A p p a l a c h i a n adolescents' eating patterns and nutrient intake. J Am Diet Assoc 1985; 85:1093-1099.
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Nutrient intakes: Individuals in 48 States, Year 1977-1978. Report no. I-2. U.S. Department of Agriculture, 1984.
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Marrale JC, Shipman HL, Rhodes ML. What some college students eat. Nutr Today 1986; 21:16-21.
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Block G, Dresser CM, Hartman AM, Carroll MD. Nutrient Sources in the American diet: quantitative data from the NHANES II survey. Am J Epide 1985; 122: 27-40.
18.
Lieux EM, Manning CK. Evening meals selected by college students: Impact of the food service system. J Am Diet Assoc 1992; 92:560-564.
19.
DHHS, FDA Food labeling: Nutrition Labeling of raw fruit, vegetables and fish; Guidelines for voluntary nutrition labeling of raw fruit, vegetables, and fish; Identification of the 20 most frequently consumed raw fruit, vegetables and fish; definition of substantial compliance; corrections. Federal Register. 1992; 57 8174- 8191.
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P a t t e r s o n BH, Block G, Rosenberger WF, Pee D, Kahle L. Fruit and vegetables in the American diet: Data from the NHANES II Survey. Am J Public Health 1990; 80:1443-1449.
21.
Hernon JF, skinner JD, Andrews FE, Penfield MP. Nutrient intakes and foods selected by college students: Comparisons among subgroups divided by energy intake. J Am Diet Assoc 1986; 86:217-221.
22.
Young CM, Fortune TD. Effect of food preferences on nutrient intake. J Am Diet Assoc 1957; 33:98-103.
23.
Pao EM, Sykes KE, Cypel YS. USDA Methodological Research for Large-Scale Dietary Intake Survey, 1975-1988. 1989,157-185.
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24.
Krebs-Smith SM, Smiciklas-Wright H, Guthrie HA, Krebs-Smith J. The effect of variety in food choices on dietary quality. J Am Diet Assoc 1987; 87:897-903.
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Recommended Dietary Allowances, National Academy Press; 1989.
26.
Guthrie HA, Crocetti AF. Variability of nutrient intake over 3-day period. J Am Diet Assoc 1985; 85:325-327.
Accepted f o r publication on March 23, 1994.
10th edition. Washington,
DC:
Pergamon
0271-5317(94)E00043-3
WHAT DO COLLEGE BTUDENT8 EAT ? FOOD B E L E C T I O N I ~ ' D MF~L PATTERN
Ya-Li Huang, MS., Won O. Song 1, Ph.D., R.D., Rachel A. Schemmel Ph.D., R.D., Sharon M. Hoerr Ph.D., R.D. Department of Food Science and Human Nutrition, Michigan State University East Lansing, MI 48824-1224, USA
ABSTRACT
Data are limited on food selections of young adults. This study was undertaken to examine the eating practices of college students relevant to improving nutrition and health education programs. Dietary records (n=1912) were used to determine the frequency of meals skipped and specific foods selected by male and female students in different seasons between Fall, 1990 and Summer, 1991. Twenty-two percent, 8%, and 5% of the students skipped breakfast, lunch, and dinner, respectively; 80% of the students snacked at least once a day. There were no significant differences in frequency of meals skipped and snacks consumed among seasons, or between men and women. Forty foods consumed most frequently for meals and snacks included various carbonated beverages but few vegetables and fruits. Skimmed milk, 2% milk and chicken or turkey w e r e a m o n g the top 40 foods selected by both genders whereas whole milk and higher-fat meats were not. Men consumed more high calorie and high fat foods, more fast foods but fewer vegetables than women. These findings suggest that health promotion for young adults in college should address importance of eating vegetables and fruits with less frequent consumption of carbonated beverages and high fat combination dishes. The message for men may need to differ for women. Key words:
College students, Dietary record, Food habits, Dietary pattern, Food consumption. INTRODUCTION
Large enrollments in nutrition and health courses support the fact that college students are interested in nutrition. Several investigators have reported, however, that nutrition lecture i Corresponding Author 1143
1144
Y.-L. HUANG et al.
courses improve students' nutritional knowledge but not their food intake (1-3). To improve food intake behavior as well as nutritional knowledge, nutrition education should focus on specific problematic areas of the target population's diet. Diet is one of the two dominant and preventable health problems of young adults according to the Healthy People 2000, the National Health Promotion and Disease Prevention objectives (4). Adoption by young adults of healthful food intake patterns in line with the U.S. Dietary Guidelines is an essential foundation for chronic disease prevention and maintenance of a healthy life style (4). A l t h o u g h more than 50% of high school graduate go onto college (5), studies are limited which identify problem areas in dietary practices of college population. A few authors have described nutrient intakes of this age group and reported low intakes for calcium and folate, and, iron among females (6-10). Low energy intakes with p r o p o r t i o n a l l y high fat intake by college age adults have been reported (8). This information on adequacy in nutrient intake is not, however, the same as data on food selections. Information on consumption of specific foods, meal patterns, seasonal and gender preferences is needed to help target specific problematic areas relevant to the U.S. Dietary Guideline. Therefore, the specific objectives of this study were to determine: i) the frequency of meals skipped; 2) foods consumed most frequently for meals and snacks; and 3) differences in food selections by season and gender.
METHODS Subiects Subjects in this study were the students enrolled in an introductory nutrition course at Michigan State University from September 1990 through August 1991. This study was approved by the university Committee on Research Involving Human Subjects at Michigan State University, as a part of a campus-wide health promotion program. The introductory nutrition course fulfills the Natural science requirement in general education, and about 10% of freshmen and sophomores at the university enroll in it. The average ages of the men and women were 20 and 19 years, respectively. No women included were pregnant or lactating. The body mass indexes (Kg/m 2) of the 607 men and 1305 women in the study were within normal range for their age with 23.8 • 3 for men, and 21.8 • 3 for women, respectively. Other characteristics such as the major of the students did not differ by term enrolled. Data collection For a class assignment, students were required to complete a food intake record for one typical weekday between the second and third week of each quarter. The purpose of the assignment was to get the students become aware of their own dietary intake. All students were given detailed instruction to complete the record including methods of food preparation, description of ingredients for mixed dishes, beverages and condiments consumed as well as how to estimate serving sizes. In addition, each student reported age, height, weight, hours spent for various levels of physical activity and use of vitamin and
FOOD SELECTION AND MEAL PATTERN
1145
mineral supplements. Students then used a nutrition software package, MSU NutriGuide (Song W.O., Nutritional Analysis Computer Program, Version 1.5, Michigan State University, 1988), to enter dietary information and evaluate their own intakes. Students were encouraged to use the software throughout the term for their own information. The dietary records were collected in the format of American standard code for information interchange (ASCII) by MSU NutriGuide. MSU NutriGuide analyzes diets for 27 nutrients in 953 different foods. Its nutrient composition data came from Michigan State University main-frame database and USDA Handbook-8 (ii). The nutrient database of NutriGuide includes foods frequently consumed by college students including fast food items and those foods served by the campus foodservice programs in residence halls. Incomplete and multiple dietary records were eliminated so that the final data set included complete data collected from 1912 out of 2054 individuals. Data Analysis Data analyses were conducted using programs available in the personal computer edition of the Statistical Package for the Social Sciences, Version 5.0 (SPSS Inc., Chicago, IL, 1990), at a significance level of p < 0.05. First, frequencies of skipped breakfast, lunch, and dinner were computed b y g e n d e r and by season (Fall, Winter Spring or Summer terms in the quarter system). Statistical differences in meal skipping practices by gender or by season were determined by Chisquare tests. Secondly, the frequency of consumption of each food was calculated by meal, season and gender using a program written by Turbo Pascal (Borland International Inc., Scotts Valley, CA, 1987). From this frequency list, the 40 foods consumed most frequently for each day, and each meal including snacks were identified by gender and season. Finally, in an attempt to indirectly evaluate "variety" of foods consumed by the subjects, the total number of different foods consumed in one day was tallied for both males and females for the different seasons. In the computation, a combination dish such as macaroni and cheese as well as one single food such as an apple were each considered as one food item. Consumption of the same food at multiple eating occasions in a day was also counted as one single food consumed for the day. RESULTS A p p r o x i m a t e l y one in four to five college students in this study skipped breakfast (Table i). There were no significant differences between genders in skipping meals, except for summer (n=264) when the frequency of skipping breakfast was greater for females (27%) than for males (ii%) (p<0.05). About 80% of students reported that they snacked at least once a day (Table i), with no significant differences related to season or gender. The young adults in this study consumed an average of thirteen different food items daily regardless of season or gender. There were no differences by seasons in the 40 most frequently consumed foods; therefore, the results for all seasons were combined for further statistical analysis and presentation. One exception observed was beer, one of the most often consumed foods only during the summer.
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Y.-L. HUANG et al. TABLE 1 Percentage of College Students Who Skipped Meals and Snacked (n=1912). % of Students Who Skipped
Gender
Male
Breakfast
Who Consumed
Lunch
Dinner
Snacks*
20.3
6.3
3.1
79.4
21.5
8.1
4.8
78.7
(n=607) Female (n=1305)
* snacks consumed at least once during the day. The forty foods most frequently consumed by the subjects are listed in Table 2. Skimmed milk (31.9%) and 2% milk (22.9%) were consumed more frequently than whole milk (4.8%) by both genders. Men consumed whole and 2% milk more frequently than women (p<0.05), whereas women consumed skim milk more often than men (p<0.05). Low fat meat selections, such as turkey (14.4%) and chicken (6.3%), were popular with college students for single meat dishes. Combination dishes such as pizza (8.5%), hamburgers (6.6%), and ham and cheese sandwiches (6.1%) were also frequent selections. Turkey was selected more often by women than by men (p<0.05), whereas fastfood-type combination dishes were consumed more often b y m e n (p<0.05). Of the most frequently consumed vegetables, tossed salad was the only non-starch item and eaten most (46.8%). Women consumed tossed salads more often than did men (p<0.05). Various forms of potato were also frequently consumed: French fried, mashed and baked. French fries were consumed twice as often by men as by women. Apples (17.5%), bananas (12.5%), and oranges (5.9%) were the most frequently consumed fruits throughout the four seasons. Selection of fruits and vegetables, particularly those rich in vitamin A was limited. The most popular bread items were bagels (20.7%) followed by white bread (19.7%), whole wheat bread (18.3%), and Italian bread (7.5%). Butter/margarine, peanut butter, chocolate chip cookies and potato chips also were consumed frequently by students. Surprisingly, butter/margarine was consumed more often by women than by men. six of the 40 most frequently consumed items were carbonated beverages with apparent differences in gender: diet carbonated beverages were consumed frequently by women, whereas regular carbonated drinks by men. Foods selected most frequently as snacks (Table 3) were regular and diet carbonated beverages, popcorn, potato/nacho chips, apples, regular and lite beer, candy bars, cookies and pizza. Although there were no significant differences in frequency of snacking between men and women, the snack items selected differed. Chips, candy bars, pizza, regular pop and beer were consumed more by males than females. Females often consumed crackers, popcorn, frozen yogurt and diet pop.
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TABLE 2 Forty Foods Consumed Most Frequently by C o l l e g e S t u d e n t s for 4 Seasons. % of s t u d e n t s w h o c o n s u m e d Food
All n=1912
D a i r y Products skimmed milk 2% m i l k cream cheese c h e e s e , natural~processed
Male n=607
Intake
Female n=1305
31.9 22.9 7.8 3.9
24.2 33.6 5.9 19.3
35.5 17.9 8.7 25.5
* * * *
14.4 6.3
11.4 6.1
15.9 * 6.4
8.5 8.0 6.6 6.1
12.2 10.2 10.7 9.9
46.8 13.9 8.2 7.3 6.9
Average #
2.4 2.5 2.4 4.1
cup cup Tbsp oz
Meets turkey chicken
7.8 oz 1.3 e a c h
Combination Dishes pizza spaghetti with meat sauce hamburger ham and cheese sandwich
6.8 7.0 4.7 4.4
* * * *
2.8 2.1 1.2 I.i
slice cup each each
38.2 20.1 9.6 8.4 5.8
50.7 * ii.0 * 7.6 6.8 7.4
5.5 1.4 i.i 1.3 0.9
cup cup each cup cup
17.5 12.5 5.9 26.1 9.4 6.7 6.0
12.0 1.7 5.1 36.1 9.1 6.6 5.9
20.1 * 12.9 6.2 21.5 * 9.6 6.7 6.0
1.1 1.1 1.2 1.6 1.5 1.4 2.3
medium medium small cup cup cup cup
20.7 19.7 18.3 7.5
12.9 23.4 15.7 7.9
24.4 * 17.9 * 19.5 * 7.3
1.4 2.4 2.2 2.0
each slice slice slice
20.9 14.2 7.6 5.9 5.9 5.8 7.8 7.0
32.0 5.3 3.5 9.4 8.4 7.6 7.9 8.1
15.8 18.4 9.5 4.3 4.7 4.9 7.8 6.4
* * * * * *
1.6 1.7 1.6 2.1 1.3 1.3 2.8 2.1
can can can can can can cup cup
14.1 6.9 6.2 5.8 9.4 16.0
11.2 6.1 7.1 5.4 i0.0 21.3
15.5 * 7.2 5.7 6.0 9.1 13.6 *
1.9 2.1 2.5 1.4 2.5 1.4
tsp tsp Tbsp Tbsp each cup
Vegetables tossed salad French fries baked potatoes mashed potatoes sweet corn
Fruits & Fruit Juices apple banana orange f r o z e n o r a n g e juice, apple juice grape juice lemonade
diluted
Grains bagel white bread whole wheat bread Italian bread
Beverages: non-dairy, non-fruit juice Coca-cola diet Coke diet Pepsi cola Mountain Dew Pepsi cola Sprite fruit punch drinks coffee Other Foods butter/margarine peanut butter Italian dressing mayonnaise chocolate chip cookies potato chips
* p ~ 0 . 0 5 by g e n d e r # Average daily intake by those subjects who consumed the
food
item
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Y.-L. HUANG et al.
Foods Most
TABLE 3 C o n s u m e d as S n a c k s by C o l l e g e
Frequently
% of s t u d e n t s Food
All n=1912
Students.
who consumed
Male n=607
Female n=1305
Dairy 2% m i l k skimmed milk yogurt, f r o z e n ice c r e a m cheese, n a t u r a l / p r o c e s s e d
2.3 1.7 1.5 1.1 1.1
3.1 2.1 0.4 0.8 2.1
1.9 1.6 1.9 1.3 0.6
7.7 2.1 2.0 1.7 1.7 1.6
5.6 2.3 1.0 3.1 1.0 0.6
8.7 1.9 2.4 i.i 1.9 2.0
14.9 9.5 8.8 6.8 3.4 1.6
Ii. 1
16.9
*
4.7 13.5 ii.0 2.5 1.5
11.2 6.6 5.0 3.8 1.7
* * *
18.4 10.4 7.0 1.8 1.6 1.2
28.9 3.8 15.2 1.9 1.7 0.6
13.5 13.4 3.2 1.8 1.6 1.5
* * *
bars
4.7 6.1
6.6 5.8
3.8 6.4
pizza gum, s u g a r l e s s / r e g u l a r peanut butter
3.7 2.8 1.7
6.8 1.4 1.2
2.2 3.3 1.9
Fruits and Fruit Juices apple banana orange orange juice apple juice lemonade
Salted Snacks/Grain popcorn crackers potato chips nacho chips pretzels bagel
Beveragesz
non-dairy,
carbonated beverage, carbonated beverage, beer, r e g u l a r / l i t e Kool-aid coffee fruit punch
non-fruit Juice regular diet
Candy # a n d C o o k i e s Snickers cookies
Other Foods
* P
also
FOOD SELECTION AND MEAL PATTERN
1149
DISCUSSION It is often assumed that knowledge students gain in college will be applied to improve their food and health habits. Findings from this study, however, show that the gender differences in typical food selections of college students already parallel those of older adults. Similar to the findings of surveys conducted with college students i0 and 40 years ago (10,12), breakfast was frequently skipped by students in this study. According to national survey data (13), breakfast is the most frequently skipped meal by all age groups, and young adults skip this meal more often than other age groups. Several studies have indicated that omission of breakfast contributed to dietary inadequacy (14,15). As reported in 1986 (16), most all college students in this study snacked. The relationship between snacking patterns and skipping meals is unclear (6,9) and cannot be investigated in this study, because students did not report the time of day when they ate snacks. College students selected skimmed milk, 2% milk, and low fat meat dishes over whole milk and high fat meat items. High fat foods such as pizza, hamburger, French fries and potato chips were also frequently consumed, especially by men. These high fat foods were listed as among 50 major dietary sources of fat for U.S. adults (17) suggesting that college students have knowledge about low fat meat selections, but perhaps not about the high fat content of selected fast foods. Alternatively, college students' taste preferences and need for convenience may influence selection of fast-food-type combination dishes, especially for men. Regardless of causes, young adults exhibit food patterns similar to those of older adults, relative to high fat foods. The variety of fruits and vegetables selected was limited in this study. The most frequent selection of apples, bananas and oranges are consistent with those consumed by the US population (19). Inadequate consumption of fruits and vegetables is an area of nutritional concern for young adults in college as well as for the general adult population. Patterson et al.(20) reported that only 9% of the adult p o p u l a t i o n in NHANES II met the minimum Food Wheel intake standards (5-9 servings per day) for fruit and vegetable servings. Hernon et al. (21) reported that college men consumed more fruits than did college women. In our study, no significant differences were found between genders in fruit selection with the exception that apples were consumed more often by women than by men who consumed orange juice more often. Women consumed whole wheat bread more frequently than men, whereas men consumed white bread more frequently. It was of interest to find both bagels and cream cheese among the most frequently consumed foods. It is unclear whether this finding is a regional or secular trend. Our finding that men selected more high fat foods than women is suggested by another study with college-age and older adults (17). Lieux et al. examined evening meals selected by 214 college students and found, as we did, that fast-food items, including grilled cheese sandwiches, hamburgers, and steak sandwiches, were selected by more men than women (18). Considering the selection of higher fat foods by men, the finding that women consumed more butter/margarine is puzzling. Females might have been more precise in recording spreads
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Y.-L HUANG et al.
and condiments consumed than males, or females might have been compensating for consumption of skim milk and diet beverages with more generous use of butter and margarine. Season did not affect overall meal skipping and snacking or food selections, except for beer in the summer. In this study, alcohol consumption was based on a weekday's dietary record, whereas consumption of alcoholic beverages would be expected to be higher on weekends than weekdays through the school year. During summer, the frequency of skipping breakfast was greater for females (27%) than for males (11%) suggesting that the meal patterns of college students differ by gender most in the summer. Weight control concern of young women is one possible explanation for the difference. The young adults in this study consumed a daily average of 13 different foods which contrast with the average intake of 16.3 different food items consumed daily by the adult population in the Nationwide Food Consumption Survey, 1987-88 (23). Limited food variety in young adults might be a cause for concern, because eating a variety of foods reduces the chance of developing a deficiency or excess of any one nutrient and assures a balanced intake of m i c r o n u t r i e n t (24-25). When compared to the studies on snack consumption 30-40 years ago, the snack foods frequently consumed by young adults in this study differed slightly. Earlier studies reported carbonated beverages, salty snacks, candies, gums, and fruits as snacks (6,9,22). In this study, diet beverages, beer, and pizza were reported frequently as snacks. One-day food intake records were used in this study with a large sample size. One-day food intake records have shown to evaluate adequately the large group intake by Guthrie and Crocetti (26). Purpose of this study was to evaluate students' food selection crosssectionally, and the limitation of one-day food record is not expected to have affected the result. Although the large number of students included in this study was not randomly selected from the entire student body at M i c h i g a n State University (N=42,000), the demographics and food intakes of the subjects included in the present study did not differ from those in an introductory language and art class (data not shown). Similarly, findings on food intake and meal patterns of this study are similar to those of older adults (13,17,19), which are somewhat surprising, given the assumed uniqueness of a collegiate life style. Findings of this study obviously cannot be generalized for all college students' food selection practices throughout the country nor throughout the week. Data presented in the current study do not reflect the potentially different dietary habits between the weekend and weekdays. It was concluded from this study that the following recommendations for nutrition education of college age young adults are made in the context of the current diet and meal patterns: be specific by gender; increase awareness of the fat content of foods, especially fast foods; provide specific examples of convenient low fat foods; address the importance of eating breakfast for weight control and suggest fast nutritious food choices; suggest how to incorporate fruits and vegetables into the diet and; focus on selection of healthy snack foods. A future study may be suggested to examine the differences in
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the dietary practices of college students between weekdays and weekend days, at multiple universities, to assess the needs to establish nutrition education messages specific for the weekend. ACKNOWLEDGEMENTS The development of MSU NutriGuide was supported by the W.K. Kellogg Foundation as a part of the Healthy U program, a campus-wide health promotion program at MSU. This particular project was funded by a Health U grant for dissemination of findings. Authors appreciate Jae Son and Eunmi Choi for their expertise in computer programming, and Margeret Krebs and Jo Barr for their contribution in the beginning of this project. REFERENCES
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Accepted f o r publication on March 23, 1994.
10th edition. Washington,
DC: