Feature
Health
Good Habits as a Matter of Course
What College Students Think about Food and Fitness Leaves Researchers
Looking for Ways to Create a Healthier Campus
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Christina Economos, N96, and Annie Gazdag, research fellow
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Turn a conversation to the topic of one's college years and it
will invariably bring up fond memories--and sometimes regrets. Graduates
might remember those extra pounds known as the "Freshman Fifteen,"
a steady diet of pizza, or struggling with the stress of exams and
finding little time for even a brisk walk around the track.
More important, however, they might also realize that behaviors
they considered a temporary part of college life have actually become
a way of life. And over time, such habits take their toll. Poor
nutrition and inactivity, for instance, are responsible for as many
preventable deaths as smoking. These two lifestyle patterns alone
increase the risk for developing many serious illnesses such as
diabetes, osteoporosis, obesity and cardiovascular disease.
How do young adults develop these habits? Dr. Christina Economos,
N96, assistant professor at the School of Nutrition Science and
Policy, surveyed several hundred Tufts undergraduates in the spring
of 1998 to find out. The results of her study were revealing. Students
displayed major gaps in health knowledge and confusion about how
to achieve a healthy lifestyle. They yearned for stress management
and relaxation skills. One in five was overweight. And while they
were overwhelmingly concerned about dietary fat, their daily diets
left considerable room for improvement. Among women, negative body
image was rampant: most normal weight and some underweight women
said they were trying to lose weight.
"These findings really hit home," says Economos. "It
was obvious something needed to be done to help students make healthier
lifestyle choices. The problem is that we don't have a solid understanding
of why young adults make the choices they do. We can't effectively
motivate young adults to adopt preventive health behaviors until
we have that understanding." Toward that end, Economos designed
a groundbreaking study that she envisions will become a national
model. In the fall of 1998, together with Professor Jeanne Goldberg,
MEd 59, N86, J92P, she launched the Tufts Longitudinal Health Study
(TLHS).
Put simply, TLHS aims to instill healthful behaviors by creating
a campus environment where healthful lifestyles are the norm rather
than the exception. To accomplish this, the TLHS is first gaining
an understanding of studentsÕ needs, preferences and habits to then
build the programs that they want.
In the first phase, incoming freshmen receive a survey in the mail,
which they complete in August before they arrive on campus. Each
April thereafter, those who responded fill out more detailed surveys
that assess exercise habits, tendency toward depression and eating
patterns, for example, and they perform tests that measure indices
of health such as body composition, bone quality, aerobic fitness
and muscular strength. They can also opt to have their blood cholesterol
levels measured. The Class of 2004 is the third to be recruited
and two more are slated to join.
The study now has data on more than 1,500 incoming freshmen, and
more than 220 students have been part of the TLHS for one or more
years. "Although we have a fantastic response rate to the August
mailing--50 percent is very high--we're trying to improve our recruitment
strategies to get even more students as involved, interested and
as excited about the TLHS as we are," says Economos.
To the task of analyzing and interpreting the expansive TLHS database,
the senior investigators bring a range of experience. Economos,
an expert on the effect of diet and exercise on aging muscle and
bone, is dedicated to developing communication strategies, programs
and public policies that promote health through diet and exercise.
Goldberg, director of the Center on Nutrition Communication, collaborated
with Dr. Stephen Bailey of the Sociology/Anthropology department
on a series of studies of body image and health behaviors among
Tufts women undergraduates in the late 198os and early 1990s and
is an expert in health communications and behavioral interventions.
Annie Gazdag, a postdoctoral research fellow who joined the TLHS
team last year, brings a long-standing interest in college health.
She was a peer counselor in health and wellness as an undergraduate
at UC Davis, and is well versed on the effects of diet and exercise
on body weight and the processes that lead to diabetes.
What the team concludes from the observational phase of TLHS will
guide the second phase: the development and implementation of a
comprehensive set of health initiatives on the Tufts campus.
According to Goldberg, this phase reflects the philosophy of Tufts'
former president, Dr. Jean Mayer, who founded the School of Nutrition
Science and Policy at Tufts. She worked with Dr. Mayer for nearly
20 years, including assisting with his nationally syndicated column.
"Dr. Mayer believed that the college environment could play
a major role in helping students develop healthy lifestyles,"
she says. "He believed that while competitive athletics is
an integral component of undergraduate life, only a small percentage
of students participate and usually only through their college years.
He thought that the university should provide its students with
ample opportunities for leisure time activities that would promote
healthy lifestyles to last throughout their lives."
Although only in its third year, the TLHS has already gained national
and international attention. Economos and Gazdag presented the results
from the first two years of the study at international nutrition
and exercise science meetings in April and May 2000.
Initial findings suggest that current resources on campus do not
effectively promote healthy lifestyles in students. "The diets
of many of our incoming students leave room for improvement, and
unfortunately, when they come to Tufts, the diets they choose often
get worse," Economos says.
The data also suggest that college life leads to decreased physical
activity. The implications of this trend for personal well-being
are clear: students who exercise regularly report using their time
more productively, have greater confidence in their intellectual
competence, and feel more positively about themselves than students
who do not.
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Jeanne Goldberg, MEd 59, N86, J92P
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"Students often feel like they donÕt have time to exercise,
that it takes away from their studying and therefore their success
as a student," explains Gazdag. "But our data reveal the
opposite. The more accurate way of looking at exercise is that instead
of taking away from studentsÕ potential for success, regular physical
activity enhances it."
Not only do active students feel better about themselves, but
they also reap the benefits of exercise. Students who were physically
fit had healthier blood cholesterol profiles and lower body fat,
important risk factors for cardiovascular disease. Students with
greater muscular strength also had higher measures of bone quality.
"Given that the level of bone quality achieved in early adulthood
predicts risk for osteoporosis, making time for exercise is critically
important," says Gazdag.
Regarding emotional health, the TLHS researchers found that at
the end of freshmen year, men report greater use of alcohol to deal
with stress. Women develop a more negative body image and become
more preoccupied with food, two risk factors for developing disordered
eating behavior.
"The college student's transition into adult life can be emotionally
trying and stressful, and we're finding that at Tufts, coping with
this experience is associated with unhealthy changes in lifestyle,"
says Goldberg.
TLHS researchers believe comprehensive health promotion efforts
have the potential to improve studentsÕ health and well being on
campus and long after graduation. But these efforts--innovative
programming formats that will attract young people--are a tall order.
On the one hand, college is an opportune time for influencing
habits. The campus environment provides a convenient setting for
promoting healthy behaviors. It's where students spend most of their
time, even if they live off campus. The college years have been
singled out as one of the most "teachable" periods in
a person's life. Because young adults are still developing their
self-identity and asserting their independence, they are especially
open to new ideas. On the other hand, personal health often gets
short shrift.
"College is a crazy time," says Sandra Klemmer, a junior
majoring in biology and environmental studies. "There are so
many things to be involved in, and students face a lot of pressure
to overload their schedules with activities on top of all their
coursework. You see others with internships, jobs, volunteer work
and leadership positions. You feel like you have to do it all because
youÕll be competing with them for jobs and graduate schools. Balancing
everything can be overwhelmingÐexcelling academically, having fun,
eating and sleeping well, staying fit and in control."
The TLHS has the potential to make a difference in students' lives
while they are in college and as they age. And as the premier institute
for studying the way diet and exercise affect how well we age, the
School of Nutrition Science and Policy is ideally suited to take
the lead in this field of research, notes Economos.
"We want to create a campus that offers students sound information,
guidance, skill building programs and opportunities to find the
right set of healthy habits that fit their style," says Economos.
"TLHS programs at Tufts will establish a precedent by helping
students set the stage for a lifetime of health and wellbeing."
For more information about THLS, contact: Christina Economos, ceconomos@hnrc.tufts.edu,
617-556-3142 or visit the website at tlhs.tufts.edu.
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