nutrition and occupational therapy

What does nutrition have to do with school?

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Nutrition in university students

The American College Health Association reports that only 9% of US college students are eating the recommended 5-7 servings of fruits and veggies per day.1 College student nutrition can influence energy levels and may ultimately impact academic performance.2,3  In addition, body image related to weight in college students may influence the development of a student’s identity.4

Occupational therapy and nutrition

Health management and maintenance occupations are identified in the Occupational Therapy Practice Framework (3rd Ed.). Nutrition is important for health management and maintenance, so addressing nutrition with our clients is within the occupational therapy scope of practice.

Occupational therapists need to understand why students might not be eating healthy. Interestingly, students who have high expectations to complete university, have a future orientation, and positive attachment to school are most likely to eat well and exercise.5,6 

For those who are not eating well, it may be that they lack skills for healthy eating, such as knowledge of good food choices or knowing how to cook simple meals.  The college environment may also influence eating habits:  who the student eats with and where the student eats. 

Assessment

In order to address eating habits, it would be important to understand:

  • if the student wants to change their eating habits (motivational interviewing can help with this). It is important to understand a student’s motivation to eat healthy or not since even students with strong intentions to eat well do not always eat well.8
  • why the students might want to change their eating habits,
  • and what obstacles prevent students from eating well. Daily food logs can track food intake that can be used to look at nutritional balance and patterns.  It can also help students become more intentional in their food choices.

Intervention

  • Educate students on healthy eating and how to make healthy food choices. The CDC has great resources to help with this!
  • The best way to encourage habit change is through “implementation intention” and “environmental modifications” (check out this blog on habit change for a refresher!)
  • Since self-efficacy towards fruit and veggie consumption will impact eating behaviors, it would be important to:
    • Use goal setting, self-monitoring, and regular reflection on progress to increase self-efficacy.
    • Help a student learn about healthy eating and help them understand how to make healthy choices when faced with less than ideal circumstances.7,8
    • Problem-solve barriers to healthy eating.  For example, help the student learn how to find fruits and veggies in the local environment and where to find lower cost food.
  • Create individualized plans to improve eating behaviors with strategies to increase success (ie choosing a friend to help).9
  • Groups can be helpful.  Group cohesion has been shown to improve eating behaviors – where positive behavioral norms established in a group can encourage further healthy behavior.9
  • Education7,9
    • Education should not always be focused around health, but should revolve around student issues that are a concern for healthy eating (ie energy, body image/body esteem).9
    • You can discuss long term consequence of poor eating habits with students, but it is less effective.
  • Advocacy7
    • OTs who work on college campuses can advocate to administrators and food service providers to be more mindful of healthy food placement to encourage fruit and veggie consumption
    • OTs can work in dorm halls to encourage healthy eating – a shared community of healthy eating and physical activity behaviors can help with success.  Seminars, informational sessions and flyers on healthy lifestyle behaviors and rewards for participation can be effective strategies for healthy eating. 

REFERENCES

  1. American College Health Association (2009). American College Health Association: National College Health Assessment Spring 2008 Reference Group Data Report (abridged). J Am Coll Health, 57, 477–488.
  2. Bellisle, F. (2004). Effects of diet on behaviour and cognition in children. British Journal of Nutrition, 92(2), S227–S232. Retrieved from http://hundsundskolerestaurant.no/wordpress/wpcontent/uploads/2010/11/Bellisle-sugar-and-cognition-in-children-2004.pdf
  3. Brown, J. L., Beardslee, W. H., & Prothrow-Stith, D. (2008). Impact of school breakfast on children’s health and learning: An analysis of the scientific research. Retrieved from the Sodexo Foundation website: http://www.sodexofoundation.org/hunger_us/Images/Impact%20of%20School%20Breakfast%20Study_tcm 150-212606.pdf
  4. Nelson, S.C., Kling, J., Wängqvist, M., Frisén, A., & Syed, M. (2018).  Identity and the body:  Trajectories of body esteem from adolescence to emerging adulthood.  Developmental Psychology, 54(6), 1159-1171.  doi: 10..1037/dev0000435.supp
  5. Clarke, P.J., O’Malley, P.M., Schulenberg, J.E., Lee, H., Colabianchi, N. and Johnston, L.D. (2013). College expectations in high school mitigate weight gain over early adulthood: Findings from a national study of American youth.  Obesity, 21, 1321-1327. doi:10.1002/oby.2017
  6. McDade TW, Chyu L, Duncan GJ, et a (2011)l. Adolescents’ expectations for the future predict health behaviors in early adulthood. Social Sci Med,73, 391-398
  7. DESHPANDE, S., BASIL, M.D., & BASI, D.Z. (2009). . Factors influencing healthy eating habits among college students: An application of the Health Belief Model. Health Marketing Quarterly, 26,145–164. doi:10.1080/07359680802619834
  8. Jennifer R. Tomasone PhD, Natasha Meikle BAHon & Steven R. Bray PhD (2015) Intentions and trait self-control predict fruit and vegetable consumption during the transition to first-year university, Journal of American College Health, 63(3), 172-179. doi: 10.1080/07448481.2014.1003375
  9. Brown, D.M.Y., Bray, S.R., Beatty, K.R., & Kwan, Y.W. ( 2014).  Healthy active living:  A residence community-based intervention to increase physical activity and healthy eating during the transition to first-year university.  Journal of American College Health, 62(4), 234-242.   

Cover photo courtesy of pexels.com (https://www.pexels.com/photo/food-salad-restaurant-person-5317/)

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