Project Title: Young Consumers; the communication and utilisation of nutritional information.

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Abstract.

The incidence of nutrition related disease is becoming an increasing concern in the developed world. Childhood obesity is at record highs and dramatic changes are being made in UK education policy to restrain this development. The aim of this study was to determine how the sources of nutritional information available to young people (aged 18-25 years) influence their attitudes and beliefs and ultimately their nutritional choices.

Using a simple questionnaire, young peoples’ sources of information were identified and compared to the accuracy of their knowledge and their likelihood to put the information to use. Knowledge about recommended daily allowances of salt and the suggested five portions of fruit a day was high but utilisation of this knowledge was poor.

Conclusion: Young people are generally aware of what constitutes a healthy diet, however this knowledge does not always lead to healthy eating choices.

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Table of Contents.
Title Page……………………………………………………………………………..1 Abstract……………………………………………………………………………….2 Table of Contents……………………………………………………………………3 Figures and Tables………………………………………………………………….4 Introduction…………………………………………………………………………..5 Past Research……………………………………………………………………….7 Historic Media Interest in Young Consumers…………………………………….9 The ‘official’ views about the nutrition of young people and nutrition education……………………………11 Recent media interest in young consumers…………………………………..…14 Nutrition………………………………………………………………………….….16 Proteins……………………………………………………………………16 Fats………………………………………………………………………...17 Salt…………………………………………………………………………18 Sugars……………………………………………………………………..18 Fibre……………………………………………………………………….19 Body Mass Index (BMI)…………………………………………………19 What is a healthy diet?…..………………………………………………………..20 Sources of nutritional information………………………………………………...22 Materials and Methods……………………………………….……………………23 Interviews………………………………………………………………….24 Observations………………………………………………………………24 Diaries……………………………………………………………………...25 Questionnaires…………………………………………………………….26 Results…………………………………………………………………………………28 Discussion and Conclusions…………………………………………………………34 References………………………………………………….…………………………38 Appendices……………………………………………………………………………42 Appendix A – Information Sheet…………………..………………………..42 Appendix B – Copy of the Survey..…………………………………………43 Appendix C – Raw Data Results……………………………………………50

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Figures and Tables.

Title.

Page.

Figure 1: Frequency of different nutritional information sources……...….28 Table 1: Average BMI based on source of information………………...….30 Table 2: Percentage of correct identification between healthy and unhealthy fats………………32

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Introduction.

The health and consumption choices of young people have recently come under a popular media focus, whilst during the past two decades rates of childhood obesity have risen dramatically in developed nations. In the UK the focus has been placed particularly on ‘school meals’ and the environmental and social influences that may have an impact on the choices a young person makes, or is able to make, about their diet.

The aim of this project is to determine the level of interest that 18 to 25 year olds have toward nutritional information, where they obtain information and how this influences their food choices. Consideration of attitudes and beliefs towards nutrition will be incorporated. For example, do young people who have obtained all of their nutritional information from television programmes have poorer diets than those who have received formal training in nutrition?

This report will also assess the nutritional knowledge of the young people who complete the questionnaire; in order to discover if they are aware of recent and current health promotions such as salt reduction and increased fruit and vegetable consumption and to determine what influence these promotional schemes have had on their diet.

By comparing their nutritional awareness to their BMI, it will hopefully be possible to determine what part, if any, nutritional information plays in affecting obesity levels.

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Obesity levels are increasing worldwide. This can pose serious health concerns as overweight, and particularly obesity, have been linked with increased death rates and contributes to a wide range of conditions, including ischaemic heart disease, hypertension, stroke, diabetes, certain cancers, and diseases of the gall bladder. (Must et al, 1999)

As a result of the significant impact of such chronic conditions, the World Health Organisation (WHO) has designated obesity as one of the primary public health threats. (Lissau et al, 2004)

By the end of this report, it is hoped that an understanding of the current nutritional attitudes of young people aged 18 to 25 will have been established and some links between their attitudes and their nutritional choices highlighted. The aim is also to have an insight into the effectiveness of past health promotion schemes which could help determine which forms of health promotion will be most effective in the future.

In an ideal situation, the research would be carried out over a wide geographical area and include young people with varying levels of education. With such a wide scope it may be possible to obtain a better understanding of nutritional attitudes that could in turn improve health promotion toward young people and improve the health of young people in the UK.

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Past Research.

Previous research suggests that there is much confusion over certain nutritional concepts both amongst adults and children alike. For example the notion of a portion is not clearly understood, an example being when a participant in a study estimated that one serving of fruit salad contained five servings – presumably because it contained five different fruits. Also a primary school pupil reasoned that a banana eaten on its own amounted to a portion but, if eaten together with cereal and toast; it did not count. (Coulsen et al, 1998)

In 2003, Which? Magazine carried out a survey into school meals and what children were eating. They found that school caterers were complying with the new guidelines introduced in 2001 but still the most popular foods in schools were pizza, chicken nuggets, fishcakes, chips, ‘smiley faces’ and baked beans. They also found that the diet of the average secondary school pupil consisted of crisps, chips, chocolate and soft drinks. The report stated that those that kept food diaries in the survey understood the problems caused by a poor diet but still chose unhealthy options. (Gillard, 2003)

Past research (carried out on a much larger scale than this research) found that “approximately 11% of children and adolescents were overweight in 1988 to 1994, and an additional 14% had a BMI between the 85th and 95th percentiles”. (Troiano & Flegal, 1998) It will be useful to compare the BMI results of this research with that of previous studies.

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Reports indicate that the occurrence of obesity in the UK increased by nearly 10% between 1987 and 1997 (Seidell, 2001) and other Western countries such as the US have shown similar increases in the prevalence of overweight and obesity (Demerath et al, 2004). According to the World Health Organisation, in 2002, there were more than 1 billion overweight people worldwide and over 300 million of them were obese (WHO, 2003)

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Historic media interest in young consumers.

The topic of young consumers has been of interest to the media since the introduction of the Education (Milk) Act, 1971 when Margaret Thatcher withdrew free milk for school children aged over seven and later reduced the subsidy which was in place to ensure balanced school meals. The importance of providing free milk for school children or subsidised school meals was in question as there were many conflicting opinions on their value to the nutrition of the British population as a whole. The National Advisory Committee on Nutrition Education (NACNE) was formed in 1979 to supply “a point of reference that would provide simple and accurate information on nutrition.” (Walker and Cannon, 1985) In 1981, the committee set Dr Philip James the task of forming a working party to compile “an authoritative statement of the present consensus over the whole field”; the working party stated that the British diet was too high in sugars and salt and too low in fibre.

This statement proved to be highly controversial and many of the findings of the working party were dismissed as being over-zealous. It is interesting to note that many of the findings in the original NACNE Report are now the generally accepted views about the nutritional status of the UK. Recent research shows that the issues raised in the largely discredited NACNE Report have become the major issues of concern in this country. The National Food Survey, carried out by The Ministry of Agriculture, Farming and Fisheries (MAFF) and more recently the Department of the Environment, Farming and Rural Affairs (DEFRA) have shown that the consumption of fresh fruit and

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vegetables has gradually been decreasing in the UK whilst the total fat content of the food consumed in UK homes has steadily increased. (MAFF, 2001 & DEFRA, 2001)

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The ‘official’ views about the nutrition of young people and nutrition education.

The Government’s White Paper (Choosing health: making health choices easier), published on 16 November 2004, commits the Government to revising primary and secondary school meal standards; reducing the consumption of fat, salt and sugar; increasing the consumption of fruit and vegetables and other essential nutrients.

Raising the quality of school meals would be beneficial for public health, agriculture, the food industry, rural employment, food safety, education and culture and thus the Government needs to address this and take decisive action to upgrade school meal provision. (Vann, 2005)

The introduction of the National Curriculum in 1988 meant the change from domestic science and home economics to the introduction of food technology, however, this is not a compulsory subject to GSCE level. With an increase in the reliance on convenience foods and a measurable decline in the health of the population “nutrition and cooking skills, with an emphasis on providing healthy meals on a low income should be reintroduced into the curriculum.” (CPAG, 1999)

However, looking at the curriculum as a whole, it is possible to see examples of concepts related to food and nutrition covered in science, design and technology and health education at Key Stages 1 and 2, before children arrive at secondary school.

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The following details from the curriculum show what children should be taught in these subjects:

In Science: “Children should be introduced to major organ systems and should build on their understanding of health and the contribution made by diet, oral hygiene and exercise.” (DfES, 2004)

In Design and Technology: “Children would be required to work with a range of products which includes food… Examples of the use of food may be seen in activities such as finding out how the school cook chooses the menu for the school dinners.” (DfES, 2004)

In Health Education: “They should examine the role that food plays for bodily health and growth and learn that some foods are better than others… The importance of nutrients and their individual effects on the human body should be examined.” (DfES, 2004)

Most secondary schools offer food technology as a GCSE but it is not a statutory requirement, however, aspects of food can be covered through a range of subjects including Science and Personal, Social, Health Education (PSHE). At Key Stage 3, science pupils are expected to be taught about the need for a balanced diet containing carbohydrates, proteins, fats, minerals, vitamins, fibre and water and about foods that are sources of these. In PSHE Key Stage 4, pupils are expected to be taught about the link between eating

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patterns and self-image, including eating disorders, about the health risks of alcohol and about safer choices they can make. (DfES, 2004)

In the autumn term 2003 and the spring term 2004, childcare inspectors and Her Majesty’s Inspectors from Ofsted, accompanied by nutritionists

commissioned by the Food Standards Agency, visited 25 schools and nurseries. The inspection focused on evaluating the appropriateness and quality of the work with food that the children undertook; assessing the extent to which the environment in which the children work and eat is supportive of promoting good health and nutrition, and identifying the factors that support or impede food and nutrition education.

They found that there were a number of key factors that impeded effective food and nutrition education in a significant proportion of the settings visited. In particular; there was rarely a coherent programme of food and nutrition education that built on children’s knowledge and understanding of healthy eating in a planned and systematic way. As a result, children’s knowledge of food and nutrition was generally poor and what they learned had very little impact on what they chose to eat and drink, even when they had the opportunity to select from a range of options. (Ofsted, 2004)

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Recent media interest in young consumers.

Interestingly, some 25 years after Margaret Thatcher was an important media figure with regards food standards in schools; the media was once again referring to her as some of the changes brought in by her government were reverted and guidelines were reintroduced saying that schools must provide at least two items a week from four food groups - starchy foods; vegetables and fruit; milk and dairy foods; and meat, fish and alternative protein. (Lightfoot, 2005)

Many articles reflect the current opinions of official bodies whilst at the same time being critical of the “flawed nutritional standards” which allow schools to show compliance without providing food that is as nutritious as current research suggests is necessary. (Lightfoot, 2004)

There has been some coverage of the changes in curriculum discussed above as well as the Government’s plans to introduce rules, which will cut levels of sugar, fat and salt in school meals. (Daily Mail, 2005)

Many of the news articles, which discuss the nutrition of young people, were printed around the time Jamie Oliver was appearing on the Channel Four series Jamie’s School Dinners. At the same time, he launched the “Feed me Better” campaign to improve the standard of school meals, whilst Jamie Oliver still has some involvement with the issue; media interest in the subject has decreased noticeably.

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Media focus on nutrition issues has tended to focus on either the nutrition of young children or nutrition of the middle aged or older people; there has been little focus on adolescents and young adults. This lack of focus is a reflection of official research which tends to focus on the extremes of the age spectrum rather than those in between. This is a critical oversight of research into nutrition as the diet and health of 18 to 25 year olds can indicate what they have learnt as younger children, or how effectively they have been taught, and gives an insight into the future health of adults in our society.

Some research and media attention has focused on teenagers rather than their younger counterparts but this has mainly been focused on nutritional issues related to puberty and the growth ‘spurt’. (Daily Mail, 2000)

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Nutrition.

The science of nutrition is the study of all processes of growth, maintenance and repair of the living body, which depend upon the digestion of food; and the study of that food. Nutrition, by definition, is the way our bodies take in and use nutrients from food.

Food is any solid or liquid which, when swallowed, can supply any of the following: • material from which the body can produce movement, heat or other forms of energy • material for growth, repair or reproduction • substance necessary to regulate the production of energy or the processes of growth and repair.

The components of foods, which have these functions, are called nutrients. A good diet will provide adequate amounts of all the nutrients, without harmful excesses, from a wide range of foods. (FSA, 2001)

Proteins.

Dietary proteins fall into two groups. Complete proteins contain all eight essential amino acids. The proteins found in fish, meat, poultry, eggs, cheese, milk and yogurt are complete proteins. However, grains, legumes, seeds, nuts and a variety of other foods contain incomplete proteins which only provide

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some of the essential amino acids; however, it is possible to combine different incomplete proteins to obtain all necessary amino acids. (Jensen, 2000)

Fats.

Fat is a vital part of our diet; it regulates circulation, inflammation and surrounds each neuron of the brain. Whilst the intake of fats must be regulated to counter overweight and obesity, they must also be included in a healthy diet. A number of food including chips, margarine, crisps and biscuits contain trans fatty acids. Trans fatty acids are rarely found in nature and are mostly man made.

By modifying natural fats, we have altered the basic building blocks of the human body – in particular the brain. With the expanding practice of hydrogenation of oils to increase “shelf life”, the presence of good oils in the diet has decreased dramatically over the last two decades. What is worse, these hydrogenated oils actually block the body’s ability to use the essential fats that may still be present in some of the food we eat.

Omega 6 oils are fairly common to the foods we eat, such as salad dressing, mayonnaise and sunflower oil and we are unlikely to be deficient in them. However, most of us are deficient in Omega 3 oils because of the change to our diet in recent history. Omega 3 oils are found naturally in oily fish (i.e. mackerel, salmon, fresh tuna, sardines and herrings), flaxseed oil, wheat germ, nuts and seeds. (MacArthur, 2004)

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Salt.

The Committee on Medical Aspects of Food Policy (COMA) panel on Dietary Reference Values suggested that sodium intake should be kept below 3.2g per day (8.4g of salt) and set the Reference Nutrient Intake at 1.6g per day (4.2g of salt). COMA’s Cardiovascular Review Group went on to recommend that salt intake in the UK should gradually be reduced to a daily average of 6g. This figure has since been endorsed by the Chief Medical Officer of England. (Joint Health Surveys Unit, 2006)

Whilst a reduction in salt intake is advisable in order to reduce sodium intake; high levels of which increase blood pressure and the risk of stroke, it is essential that some salt is consumed as the remainder of it is potassium which has a beneficial effect on blood pressure. In a diet where salt intake needs to be restricted, potassium can be obtained from other sources such as bananas, tomatoes and avocados. (FSA, 2002)

Sugars.

Sugars are carbohydrates; the simplest carbohydrates are monosaccharides, disaccharides are made up of two monosaccharide units and longer chains are known as polysaccharides. The term sugars, refers to monosaccharides and disaccharides but not to polysaccharides. (COMA, 1991)

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Sugars are an essential part of the diet but it is generally agreed that the more complex and less processed they are, the better they are for nutrition.

Fibre.

Non-starch polysaccharides (commonly known as dietary fibre) are found in certain foods such as wholegrain cereals, pulses and some fruit and vegetables. Insoluble fibre adds bulk to the faeces, preventing constipation and reducing the likelihood of a variety of other health issues. Soluble fibre, which can be absorbed, helps reduce the quantity of cholesterol in the blood. Excessive intake of fibre can lead to a decrease in the absorption of some nutrients but it is more common for a diet to be lacking in fibre and it is generally advisable to try to increase the intake of fibre. (FSA, 1995)

More fibre can be introduced into the diet by consuming foods rich in complex carbohydrates (made up of starch and dietary fibre), which can be found in many foods of plant origin as the plant cell wall materials. (Southgate, 1992)

Body Mass Index (BMI).

BMI is calculated by dividing a subject’s weight by the square of their height (kg/m2). ‘Normal weight’ is classified as a BMI figure of between 18.5 and 25, ‘overweight’ is over 25 and obesity is when the BMI is 30 or above (Troiano & Flegel, 1998).

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BMI is useful as a screening tool to identify possible weight problems however; it is not a diagnostic tool. In order to determine if the excess weight a person is carrying poses a threat to their health, a healthcare provider would need to perform further assessments. Examples of the assessments they may carry out include skin-fold thickness measurements, evaluations of the individual’s diet, physical activity and family history.

What is a healthy diet?

Put simply, a healthy diet is a balanced diet, without excesses, which provides all the nutrients required for healthy functioning of the body, from a wide range of sources.

The FSA has produced a leaflet title The Balance of Good Health that aims to reduce confusion about the meaning of healthy eating. The Balance of Good Health follows the Government’s ‘Eight Guidelines for a Healthy Diet’. These guidelines are:

• “Enjoy your food. • Eat a variety of different foods. • Eat the right amount to be a healthy weight. • Eat plenty of foods rich in starch and fibre. • Eat plenty of fruit and vegetables. • Don’t eat too many foods that contain a lot of fat.

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• Don’t have sugary foods and drinks too often. • If you drink alcohol drink sensibly.” (FSA, 2001)

The Balance of Good Health is based on the following five food groups:

• “Bread, cereals and potatoes. • Fruit and vegetables. • Milk and dairy. • Meat, fish and alternatives. • Foods containing fat; foods and drinks containing sugar.” (FSA, 2001)

The Balance of Good Health goes on to list the type of foods that fit into each of the five groups and gives details of the main nutrients provided by each food group. Recommendations are then made regarding the quantities of the different food groups that should be eaten and additional information such as preparation and how to make healthier choices.

A guide to portion sizes is included in The Balance of Good Health (FSA, 2001), to clarify how much fruit and vegetables make up a portion (or serving). Some of examples of one portion of fruit or vegetables are: one apple; half an avocado pear; two plums; a handful of grapes and; one tablespoonful of raisins. They variety in what constitutes a serving of fruit and vegetables could

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cause confusion amongst members of the public and awareness needs to be raised to ensure people who are trying to eat a more healthy diet, are able to do so.

Sources of nutritional information.

There are a number of sources of nutritional information that people may use to guide them towards a healthy diet, a selection of them have been included in the survey to see what, if any, effect the source of such information has on an individual’s nutritional behaviour. This report will also identify other sources of nutritional information that could be included in future research.

The main hypothesis of this research could be stated as “There will be a significant link between the source of nutritional information and its utilisation” with additional points being covered, including whether people who are aware of recent nutritional recommendations are significantly more likely to have a healthy diet than those who are not aware of them.

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Materials and Methods.

The sample used for this research was only a small representative of the UWE student population and a very small sample of 18-25 year olds across the UK. With more time and resources, the sample could have been extended to include a wider range of subjects. There is some concern that by studying students, the results will not accurately reflect the UK population as a whole, however previous studies have found that “the prevalence of overweight did not vary systematically with race-ethnicity, income, or education” (Troiano & Flegal, 1998) so the results of this research may be more representative of 18-25 year olds in general than one may assume.

The main aim of this research was to find out where young people acquire their nutritional knowledge and whether or not the primary source of their nutritional knowledge influences their nutritional choices and eating behaviour. Options that could have been used for this research include:

• Interviews • Observations • Diaries • Questionnaires

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Interviews.

These are very time consuming and with the time available for a twenty credit module it would only be possible to interview a relatively small number of people (Bell, 2003) plus, it is not a simple task to transcribe and encode the vast quantity of information produced by such a method. Analysis can be difficult because interviews produce non-standard responses. Consistency and objectivity can be hard to achieve, which can raise questions with regard to reliability.

Responses cannot always be assumed to be truthful because the interviewee may desire to produce the “expected” response to please the interviewer. Interviewing requires careful preparation; a great deal of patience and considerable practice to achieve what is required. (Cohen et al, 2003)

Observations.

Using observations could have raised ethical issues, as it would not have been possible to disclose the true purpose of the research to all who were under observation, leading to the absence of informed consent in the participants and deception by the researcher. It could be argued that other ethical issues would be invasion and protection of privacy. It could also be argued that there would be little or no reliability in the data being obtained because observations may be collected on the basis of availability and convenience, which may have lead to generalising of data. For a twenty-credit

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module, a researcher would need to be experienced and familiar with the techniques involved to benefit from unstructured observation. (Bell, 2003)

Diaries.

For this research, diaries could have produced some very useful data. One example of how this approach could have been used is that the participants could have kept a diary of everything they ate and drank over the course of a week. The researcher has little influence over the responses of the participants, as it is completed away from the researcher.

The main disadvantage of this method is that completing the diary is timeconsuming and can be irritating for a busy person, who has to stop what they are doing to make an entry. (Bell, 2003) There are also issues with the participants completing the diaries completely and accurately and also a risk of them losing the diaries before the research is complete. The amount of data produced by this method could be very useful for analysis but the analysis of such a large amount of data would be very time consuming.

Oppenheim draws attention to a major problem with this research method:

“That the respondent’s interest in filling up the diary will cause him to modify the very behaviour we wish him to record. If, for instance, he is completing a week’s diary of his television-viewing behaviour, this may cause him to

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engage in ‘duty viewing’ in order to ‘have something to record’, or he may view ‘better’ types of programs in order to create a more favourable impression.” (Oppenheim, 1966 cited in Bell, 2003)

Questionnaires.

The advantages of this research method include: • It is economical in terms of time, materials and cost. • It is easy to arrange. • Supply standardised answers so that the data are unlikely to be contaminated through variations in wording of and asking questions such as in interviews. • Pre-coded answers allow for ease of collation and analysis, and respondents often have an easier task in simply selecting answers that are spelt out rather than having to generate ideas.

One disadvantage of questionnaires is that pre-coded questions can bias the findings towards the researcher rather than the respondent’s perspective.

This research method was chosen because it would provide standardised answers that would be easier to collate and therefore it would be a more straightforward task to analyse the results. It is an easy task for the respondents to simply select answers rather than having to generate their own ideas thus the validity of the responses should be increased. Some

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sections were included where the participants needed to generate their own ideas as a response but these are not to be analysed, they are there to give a wider view of the responses and provide an insight for potential further research.

A very brief questionnaire was devised to determine how young people acquire their knowledge, whether this knowledge is accurate and how this knowledge is put to use (i.e. do they eat five or more servings of fruit and vegetables a day, do they add salt to their food, what is their BMI?)

The height and weight of the subjects of this research were self-reported which could affect the reliability of the results as the obese tend to underreport their weight which would result in a lower prevalence of obesity than is actually the case (Lissau et al, 2004) but research has shown self-reported weight to be reliable, with BMIs from self-reports being similar to the actual BMIs measured as part of the research. (Mokdad et al, 2003, Himes, & Faricy, 2001, Rowland, 1990, Palta et al, 1982).

Gender has been specifically left out of this research for two reasons; one is that it would increase the amount of analysis of the results that would be required but the main reason is that there is evidence that there is no significant difference between the BMI of males and females in the age group being researched (Irazusta et al, 2007).

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Results.

Fig.1 – Frequency of different nutritional information sources.
Sources of Nutritional Information.
70 60 Percentage 50 40 30 20 10 0
Fa m ily Te le vi si on N ew sp ap er M ag az Fr ie nd s Sc ho ol O th er in es s

Source

A breakdown of the responses given to this survey gives the following basic information:

55% of respondents listed television as a source of nutritional information.

The television programmes that were most commonly given were: Adverts; Gillian McKeith’s ‘You Are What You Eat’; Cooking Programmes; GMTV; Diet Doctors; News; Cook Yourself Thin; Diet Doctor; F Word. ‘You Are What You Eat’ was the most common response with eleven people citing it as one of their sources of information.

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19% of respondents listed newspapers as a source of nutritional information.

The newspapers cited as sources of information were: Daily Mail; The Sun ‘Health Pages’; Daily Telegraph; The Guardian; Daily Express. The Daily Mail was the only newspaper to be listed by two respondents.

28% of respondents listed magazines as a source of nutritional information.

The magazines cited as sources of nutritional information were: Sainsbury’s Magazine; Men’s Health; Glamour Magazine; Tesco Magazine; Company Magazine; Closer; New; Newsweek; Time; Look; Weightwatchers Magazine; Cosmopolitan.

Glamour, Company and Cosmopolitan were all given by two respondents but the most common response was ‘supermarket magazines’ (this includes the answers Sainsbury magazine, Tesco magazine and supermarket magazine) which were listed by four respondents.

15% of respondents listed school as a source of nutritional information.

49% of respondents listed family as a source of nutritional information.

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60% of respondents listed friends as a source of nutritional information.

43% of respondents gave other sources of nutritional information.

A wide range of responses were given by people selecting ‘other’ sources of nutritional information; it would be interesting in future research to compare the BMI according to each alternative source of information to determine what (if any) effect their choice of nutritional information has on their nutritional choices. The sources of information given by respondents selecting other were: University; Work; Gym; Books; Food Packaging; Advertisements; Journals; Internet; Radio; Doctor.

The mean BMI of the group as a whole was 24.15 this is just below the threshold limit for overweight. In order to determine the possible influence of different sources of nutritional information the average BMI was calculated for each group:

Table 1: Average BMI based on source of information.
Source of information Television Newspapers Magazines School Family Friends Other Average BMI 23.79 24.72 23.55 24.48 23.32 23.7 25.28

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There is little variation between the average BMIs of the group based on their source of nutritional information, people who gave ‘Other’ as a response had a slightly higher average – going above a BMI of 25, which is overweight.

8% of respondents had a BMI below 18.5, 60% had a BMI of 18.5 to 25, 23% were overweight with a BMI between 25 and 30 and 9% had a BMI of 30+, making them obese. The lowest BMI was 16.1 and the highest was 41.4. A BMI of 40+ is referred to as morbid obesity as it is considered to be a level of overweight that is a threat to health.

The average daily allowance of salt given by the group was 5.72g – 60% of the group gave 4, 5 or 6g whilst the remainder of the group either gave the figure as 1-3g or (in three cases) 10 or 20g. It seems that the majority of people are aware of the recommended daily allowance for salt – it is of some concern that two people gave a figure of 10g and one gave a figure of 20g; it can only be hoped that they are not consuming this much salt each day. The feedback sheet that will be given to respondents will clearly state the recommended daily allowance of salt – hopefully this will ensure that none of the participants of this study are consuming excessive quantities of salt. Where people gave a response of 1 or 2g it is possible that they either underestimated the recommended daily allowance of salt or they may have been stating the recommended intake of sodium, which is around 2g.

45% of respondents add salt whilst cooking their food and 25% add salt to their food at the table.

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98% of respondents stated that the recommended minimum daily number of fruit and vegetable servings was five. It would appear that the five-a-day health promotions have been effective; this could partly be that many products now state that they serve as one portion of the recommended five-a-day on their packaging.

Considering the high proportion of respondents who were aware of how much fruit and vegetables they should consume each day, it is disappointing to see that only 30% of respondents stated that they ate five or more portions in the previous day.

98% of respondents correctly stated that recommendations are that people should try to include more fibre in their diet; the other 2% gave no response so it is not clear whether or not they knew the correct answer.

Table 2: Percentage of correct identification between healthy and unhealthy fats. Fat/oil %age of correct choices Polyunsaturates 77 Omega-3 100 Saturates 96 Omega-6 77

The results about fats that are healthy and unhealthy in the diet provided some interesting results which suggest there is some confusion about which fats should be included in the diet: 100% of respondents correctly stated that 32

Omega-3 oils are healthy whereas only 77% stated that Omega-6 oils are also healthy. This could be because the majority of health promotion is about Omega-3 oils which are generally lacking from the modern diet rather than Omega-6 which is more likely to be present in sufficient amounts in a reasonably well-balanced diet.

Again, only 77% of respondents correctly stated that polyunsaturates should be included in the diet. Fortunately 96% of respondents correctly stated that saturated fat should be limited in the diet for health reasons.

72% of respondents check the nutrition labels on food packaging but the majority of them simply check the kilocalories with few of them checking sodium, sugar, fat or fibre levels.

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Discussion and Conclusions.

The initial aim for this project was to survey a minimum of 100 people, unfortunately only 80 people were invited and of those, 53 completed the survey in time to be included in the analysis above. If this research were to be repeated it would be necessary to invite more people to participate and allow them more time to complete the survey. If the study were carried out during term-time (or wasn’t aimed at university students) it should be a relatively simple task to invite a larger number of participants.

Further research into how much fruit or vegetables people think make up one serving would be useful to help determine whether or not people are actually aware of the amount of fruit and vegetables they should be eating or if they are just aware of the general ‘five-a-day’ message.

It would be interesting to conduct this research again in ten years time to determine if the current changes in the National Curriculum will have produced young adults with an improved knowledge of nutrition and a healthier diet. As this research has shown; there is a need to improve nutritional awareness and the utilisation of such awareness to prevent a further decline in health in the UK.

Whilst this research hasn’t provided any conclusive evidence that the source of young peoples’ nutritional information has a significant effect on their

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nutritional attitudes and behaviour – it has identified a number of issues for further research, including:

• How well do people understand the concept of one portion of fruit or vegetables? • What nutritional information do people receive from the sources identified by the survey (i.e.: work; the gym; books (and which books?); the radio and; the internet (and which sites do they visit?))? • How much salt do people add when cooking and how much do they add at the table? 45% of respondents add salt during cooking but the amount they use could vary considerably. • Why did only 30% of respondents eat five or more servings of fruit and vegetables per day even though 98% of them were aware that they should? • Only 15% of respondents listed school as a source of nutritional information, will this have changed in the future due to the changes in the national curriculum, and will this have a significant impact on the health of the nation?

It is of some concern that the average BMI of the group as a whole was 24.15 – nearing overweight. Even though 60% of participants had a BMI in the desirable range of 18.5 to 25, a shocking 32% of the group were either overweight or obese, these figures reflect the global situation as discussed previously; but it is still unsettling to see confirmation arising from this research.

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49% of respondents listed family as a source of information, further study could discover more about the family of respondents to see what effects variables such as social class, household income and parental education level have on the nutritional information young people acquire from the home.

The survey would benefit from the addition of questions where participants are required to list the information sources in order of the priority they place on them, by giving different weightings to the sources listed first, second, third etc., some useful information about the popularity of different sources could be generated.

A number of statements about nutritional choices, for example “I think it is important to eat five or more portions of fruit and vegetables a day.”, could have been listed with a Likert scale (or similar) to determine more about the participants attitude towards nutritional advice and information.

A number of additional improvements could be made to the survey used for this project; if it were to be repeated by someone with previous experience of compiling questionnaires for research such as this, the results would likely have more validity in a national context. The depth of this research was restricted due to inexperience but has still raised a number of important issues which could be investigated further.

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If this project achieves anything in addition to generating questions, hopefully it will be in raising awareness of the issues noted during the research – the feedback that will be sent out to the participants will include details about the recommended daily allowance of salt, an explanation about which fats are healthy and which are not, and guidance as to what constitutes one portion of fruit or vegetables. Although it is only a small group of people, any improvement in their diet that results from this research would be a worthwhile achievement.

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References. Barasi, M. (1997) Human Nutrition: A Health Perspective. Hodder Headline, London. Bazzano, L. (2006) The High Cost of Not Consuming Fruits and Vegetables. Journal of the American Dietetic Association, 106, 1364-1368. Bell, J. (2003) Doing Your Research Project. Open University Press, Maidenhead. Bianchini, F., Kaaks, R. & Vainao, H. (2002) Overweight, Obesity and Cancer Risk. The Lancet Oncology, 3, 565-574. Bingham, S., Luben, R., Welch, A., Tasevska, N., Wareham, N. & Khaw, K. (2007) Epidemiological Assessment of Sugars Consumption using Biomarkers: Comparisons of Obese and Nonobese Individuals in the European Prospective Investigation of Cancer Norfolk. Cancer Epidemiology, Biomarkers and Prevention, 16, 8. British Nutrition Foundation (2003) Healthy Eating: A Whole Diet Approach. [online] Available from: http://www.nutrition.org.uk/healthyeating.htm Accessed: 10 August 2007. Child Poverty Action Group (CPAG) (1999) School Meals and Healthy Eating – CPAG Briefing. [online] Available from: http://www.cpag.org.uk Accessed: 10 August 2007. Committee on Medical Aspects of Food (COMA) (1991) Sugars in the Diet. Health Education Authority, London. Cohen, L., Manion, L. & Morrison, K. (2001) Research Methods in Education. (5th Edition) RoutledgeFalmer, London. Coulson, N.S., Eiser, C. & Eiser, J.R. (1998) Nutrition Education in the National Curriculum. Health Education Journal, 57, 81-88. Daily Mail (2000) Teenage Nutrition. Daily Mail, 5 December. Daily Mail (2005) Healthy cooking lessons for teens. Daily Mail, 3 October. DEFRA (2001) National Food Survey 2000. HMSO, London. Demerath, E., Li, J., Sun, S., Chumlea, W., Remsberg, K., Czerwinski, B. & Sievogel, M. (2004) Fifty-year Trends in Serial Body Mass Index During Adolescence in Girls: the Fels Longitudinal Study. The American Journal of Clinical Nutrition, 80, 441-446.

38

Department of Health (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. HMSO, London. Department for Education and Skills (DfES) (2004) National Curriculum. [online] Available from: http://www.curriculumonline.gov.uk Accessed 12 June 2007. Drewnowski, A. & Bellisle, F. (2007) Liquid Calories, Sugar, and Body Weight. The American Journal of Clinical Nutrition, 85, 651-661. Food Standards Agency (1995) Manual of Nutrition. HMSO, London. Food Standards Agency (2001) The Balance of Good Health. Food Standards Agency, Middlesex. Food Standards Agency (2002) Eating for Later Life. Food Standards Agency, Middlesex. Food Standards Agency (2002) Men and Food. Food Standards Agency, Middlesex. Gillard, D. (2003) Food for Thought: Child Nutrition, the School Dinner and the Food Industry. [online] Available from: http://www.dg.dial.pipex.com/educ25.shtml Accessed 10 August 2007. Garrow, J.S. (1991) Obesity and Overweight. Health Education Authority, London. Himes, J.H. & Faricy, A. (2001) Validity and reliability of self-reported stature and weight of US adolescents. American Journal of Human Biology, 13, 255260. Irazutsa, A., Hoyos, I., Irazusta, J., Ruiz, F., Diaz, E. & Gil, J. (2007) Increased Cardiovascular Risk Associated with Poor Nutritional Habits in First-year University Students. Nutrition Research, 27, 387-394. Jacoby, J., Chestnut, R. & Silberman, W. (1977) Consumer Use and Comprehension of Nutrition Information. Journal of Consumer Research, 4, 119-128. Jensen, E. (2000) Brain-based Learning. The Brain Store Publishing, San Diego. Joint Health Surveys Unit (2006) An Assessment of Dietary Sodium Levels among Adults (Aged 19-64) in the General Population, Based on Analysis of Dietary Sodium in 24 Hour Urine Samples. National Centre for Social Research, London.

39

Kenchaiah, S., Evans, J., Levy, D., Wilson, P., Benjamin, E., Larson, M., Kannel, W. & Vasan, R. (2002) Obesity and the Risk of Heart Failure. The New England Journal of Medicine, 347, 305-313. Lightfoot, E. (2004) Children shun healthy eating in schools for chips. Telegraph, 13 July. Lightfoot, E. (2005) Parents are asked to help make school meals healthy. Telegraph, 11 February. Lissau, I., Overpeck, M., Ruan, W.J., Due, P., Holstein, B.E. & Hediger, M.L. (2004) Body Mass Index and Overweight in Adolescents in 13 European Countries, Israel, and the United States. Arch Pediatric and Adolescent Medicine, 158, 27-33. MacArthur, J.D. (2004) The Human Brain. [online] Available from: http://www.fi.edu/brain/credits.htm Accessed: 12 June 2007. MAFF (2000) National Food Survey 1999. HMSO, London. Mokdad, A., Ford, E., Bownman, B., Dietz, W., Vinicor, F., Bales, V. & Marks, J. (2003) Prevalence of Obesity, Diabetes and Obesity-Related Health Risk Factors, 2001. Journal of the American Medical Association, 289, 76-79. Must, A., Spandano, J., Coakley, E.H., Field, A.E., Colditz, G. & Dietz, W.H. The Disease Burden Associated with Overweight and Obesity. Journal of American Medical Association, 282, 1523-1529. Nessa, N. & Gallagher, J. (2004) Diet, Nutrition, Dental Health and Exercise. Office for National Statistics, London. Office for National Statistics (2004) Social Trends 34. HMSO, London. Office for National Statistics (2005) Social Trends 35. HMSO, London. Office for National Statistics (2006) Social Trends 36. HMSO, London. Ofsted (2004) Starting Early: Food and Nutrition Education of Young Children. [online] Available from: http://www.ofsted.gov.uk/publications/index.cfm?fuseaction=pubs.displayfile&i d=3672&type=pdf Accessed 12 June 2007. Palta, M., Prinease, R., Berman, R. & Hannan, P. (1982) Comparison of selfreported and measured height and weight. American Journal of Epidemiology, 115, 223-230. Papas, M., Alberg, A., Ewing, R., Helzlsouer, K., Gary, T. & Klassen, A. (2007) The Built Environment and Obesity. Epedemiologic Reviews, 29, 129-143.

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Powell, L., Szczypka, G. & Chaloupka, F. (2007) Arch Pediatric and Adolescent Medicine, 161, 553-560. Resnick, H., Valsania, P., Halter, J. & Lin, X. (2000) Relation of Weight Gain and Weight Loss on Subsequent Diabetes Risk in Overweight Adults. Journal of Epedemiological Community Health, 54, 596-602. Rowland, M.L. (1990) Self-reported weight and height. American Journal of Clinical Nutrition, 52, 1125-1133. Russo, J., Staelin, R., Nolan, C., Russel, G. & Metcalf, B. (1986) Nutrition Information in the Supermarket. Journal of Consumer Research, 13, 48-70. Sanders, T. (1994) Dietary Fats. Health Education Authority, London. Seidell, J.C. (2001) The Epidemiology of Obesity. In Bjorntorp, P. (Ed) (2001) International Textbook of Obesity. John Wiley and Sons, Chichester, 23-29. Southgate, D.A.T. (1992) Starch and Dietary Fibre. Health Education Authority, London. Troiano, R. & Flegal, K. (1998) Overweight Children and Adolescents: Description, Epidemiology, and Demographics. Pediatrics, 101, 497-504. Vann, L. (2005) Food for Thought. Managing Schools Today, 25. 123-131. Walker, C. & Cannon, G. (1985) The Food Scandal. Century Hutchinson Ltd., London. West, D., Bursac, Z., Quimby, D., Prewitt, E., Spatz, T., Nash, C., Mays, G. & Eddings, K. (2006) Self-Reported Sugar-Sweetened Beverage Intake among College Students. Obesity, 14, 1825-1831. World Health Organization (2003) World Health Organization Global Noncommunicable Disease InfoBase Online. [online] Available from: http://www.who.int/ncd_surveillance/infobase/en/ Accessed 10 August 2007.

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