What Adolescents Think They Know About Nutrition Affects What They Feel About Nutrition and What They Eat

WHAT ADOLESCENTS THINK THEY KNOW ABOUT NUTRITION AFFECTS WHAT THEY FEEL ABOUT

NUTRITION AND WHAT THEY EAT

PETER L. BORDI’.’, DAVID A. CRANAGE’, MARIANNE BORJA’ and CONSTANCE COLE’

‘School of Hotel, Restaurant and Recreation Management The Pennsylvania State Universiry

201 Mateer Building Universiry Park, PA 16802

2Professor, Nutrition and Dietetics Marywood University

Accepted for Publication April 21, 2003

ABSTRACT

The purpose of this study was to determine if a child s nutritional beliefs influence their attitudes about certain foods, if these attitudes affect their intention to eat those foods, and if those intentions actually affect the child s eating patterns. The nutritional values of schoolchildren were investigated by conducting a survey of volunteers from grades 7 through 12. The survey offered a list of several foods and a list of adjectives from which students were to choose the one that best represented their attitudes towards a food or food group. The survey also posed questions regarding several other matters related to nutrition further allowing measurement of the student s knowledge of nutrition. Results were based on a survey from an audience that was 65 % female and 35 % male, with a majority of the feedback from grades 10 through 12. The responses were analyzed using simple regression and analysis of variance. The findings showed no significant difference by grade for nutritional beliefs, attitudes, intentions, or behaviors, nor was a distinction found among beliefs, attitudes, or intentions for gender. A considerable difference in eating behavior based on gender was noted. The female participants missed meals more ofen. Further results revealed that 60% of the students received information regarding nutrition from school, 62 % feel that they know “some ’’ about nutrition, and 61 ‘7% would like to increase their knowledge of nutrition. The study shows that children’s beliefs about nutrition are positively related to their attitudes about certain foods and these attitudes

’ Peter Bordi is an Assistant Professor of Hospitality Management; David Cranage is an Assistant Professor of Hospitality Marketing and Constance Cole is a Graduate Research Assistant. Corresponding author. EMAIL: [email protected]

Foodservice Research International 14 (2003) 65-75. All Rights Reserved. Vopyright 2003 by Food & Nutrition Press, Inc.. Trumbull, Connecricut. 65

66 P.L. BORDI, D.A. CRANAGE, M. BORJA and C. COLE

are positively correlated to their intention to consume those foods. Furthennore, their intentions are positively associated with their eating behaviors at meals that ofer these foods.

INTRODUCTION

Health professionals are growing more concerned that the eating patterns of young people may be potential risk factors in the development of many adult- onset diseases (Lytle et al. 2000). Patterns of eating developed early in life have been shown to influence eating patterns of adults (Dwyer et al. 2001). Food preferences are a predictor of eating behavior in populations at risk for disease (Harvey-Berino et al. 1997). The Centers for Disease Control state that school- based programs can play an important role in promoting lifelong healthy eating (CDC 1996).

In today’s society, health professionals are trained to view food as a source of nutrients that provide energy, regulate body processes, and furnish essential compounds needed for growth and maintenance of the human body. Munoz et al. (1997) and Kennedy and Powell (1997) have shown through surveillance data that children and adolescents consume less than the recommended amounts of fruits, vegetables, and milk, and more than the recommended amounts of fat, saturated fat, and sodium. Altering the intake of nutrients is a means to decrease risk of some disease (Weisburger 2000). The assumption is that people will purposely choose foods that contribute to their long-term physical well being by reducing the risk of chronic disease. However, many scientific researchers have identified nonbiological influences on food choices and food behavior (Germov and Williams 1999).

If one applies Maslow’s hierarchy of needs to food habits, eating for survival evolves into eating to satisfy needs for security, followed by belonging- ness, self-esteem, and self-actualization (Lowenberg 1974). However, what factors really motivate people to choose and eat the foods that they do? Research on food preferences and choices has been carried out from many different perspectives. Scientists have examined how physiological mechanisms might be influencing preferences for specific macronutrients and how mood may be affected by macronutrient consumption (Wurtman and Wurtman 1995). Research is currently being performed on emotional influences (e.g., stress, boredom, and fatigue) and food choices. Do people prefer to eat certain foods because these foods make them feel good? Do they eat foods because of pleasant or unpleasant associations with foods? Do life experiences have an influence on food choices?

What factors really motivate people to choose and eat the foods that they do? Research on food preference and choice has been carried out from many different perspectives. Surveyed teenagers selected time and availability as the

WHAT ADOLESCENTS THINK THEY KNOW ABOUT NUTRITION 61

Beliefs Attitudes

biggest influence on their food choice and selection (Story and Resnick 1986). In a study, performed on adults in both Europe and in the United States, it was noted that all U.S. respondents agreed that eating the right kinds of food could reduce the chances of developing major diseases, and that American women were more aware than men of the correlation between diet and disease. The study also concluded that being more educated was associated with greater awareness of diet and disease implications (Girois ef al. 2001).

In order to achieve a better understanding of the influence of individual nutritional beliefs and food attitudes on dietary behaviors, a closer look at the relationship between these factors is necessary. One relevant model for understanding the causal role of attitudes and beliefs on behavior (as it relates to food choice) is the theory of reasoned action (Shepherd ef al. 1995). In this theory, beliefs are linked to attitudes, which are in turn linked to intentions. Intentions are then linked to behaviors (Fishbein and Manfred0 1992). The theory of reasoned action is illustrated in Fig. 1. This model is a simplified version of the model for the theory of reasoned action illustrated in Shepherd ef al. (1995).

Intentions Behavior

FIG. 1 . MODEL OF THE THEORY OF REASONED ACTION

In the case of children’s behaviors relating to diet, attitudes can be defined as to whether the child views dietary behaviors as “good, beneficial, pleasant, etc.” (Shepherd ez al. 1995). Beliefs can be defined as attitudes about outcomes of dietary behaviors and nutrition, and “the person’s evaluations of these outcomes as good or bad” (Shepherd ef al. 1995). Such beliefs may be termed “nutritional knowledge. ”

Studies of food choice have effectively applied the theory of reasoned action, demonstrating its potential as a model for understanding the role of beliefs and attitudes in food choice and consumption (Shepherd 1989; Shepherd and Stockly 1987). In applying the theory of reasoned action to influences on children’s food choice and consumption, the basic components that mediate their dietary behaviors must be ascertained. These basic components include attitudes and beliefs. Important information about these components is contained in


children’s perceptions of what foods are “good for you. This perception then influences their eating habits, the extent of their nutrition knowledge, and where they learn about nutrition.

The current study was designed to obtain this information. The survey responses will show nutritional educators how to target the development of children’s dietary behaviors so that they result in good eating habits, and ultimately in better overall health.

Purpose of the Study

The survey was conducted in spring 2001, throughout schools in the state of Pennsylvania. The objectives of the study were to: (1) identify what children know about the nutritional value of several food categories, as well as where they obtained information that led to this knowledge, (2) describe their attitudes toward nutrition and the effect of nutritional knowledge on attitudes, and (3) investigate the effects of nutritional beliefs and attitudes on dietary behaviors.

The following three hypotheses were used: H,: Nutritional beliefs of children about foods are positively related to children’s attitudes about liking those foods. H,: Children’s attitudes about liking foods are positively related to children’s intentions of eating those foods. H,: Children’s intentions of eating foods are positively related to children’s actual eating behaviors of eating those foods.

Methodology

In 1994, the European Food Information Council (EUFIC) examined children’s views on nutrition and health by looking at where children learn about food and nutrition and how they view food safety. The questionnaire was shown to be effective in measuring attitudes, norms, and beliefs about food and nutrition (Proponnet 1997). This investigation used a similar format and questionnaire. The scales used to obtain information about beliefs, attitudes, intentions, and eating behaviors affecting food and meal choice were adapted from a study by Bordi ef al. (2003).

Procedure

The survey was conducted with students in grades 7 through 12, in family and consumer science courses. An explanation of the study was given and each student received an informed consent form to take home for his or her parents to sign and return. Teachers in each grade passed out the survey in class and monitored the survey. Participation in the survey was voluntary and the students were told that information provided would be kept confidential. Students also were told that truthful information was needed for a successful study, and


therefore were encouraged to answer honestly. Those students who decided not to participate were allowed to work on other assignments. Teachers reported that almost 100% of the students participated and 82% of the questionnaires were returned completed and were usable.

To measure nutritional beliefs, the survey presented the participants with a list of foods known by most children. They were then instructed to indicate, “How good the food items listed are for you” by circling either very good, good, okay, bad, or very bad. To measure attitudes, participants were asked, for the same list of foods, “to tell me which ones you like or don’t like”, and “whether you would or would not eat them” to measure intentions. Finally, regarding the same list of foods, the participants were asked, “in the past when these foods were offered at a meal, did you eat the meal or skip the meal?” Several other questions were asked to gain insight into the nutritional knowledge of the sample, as well as to separate the food lists to reduce carryover effects.

Analysis of Data

A Confirmatory Factor Analysis was run on the variables to show discrimination. Nutritional beliefs, attitudes, intentions and eating behaviors loaded separately on four factors as 0.84,0.77,0.75, and 0.86, respectively. In addition, the four factors were run in LISREL for a discriminate analysis. The four-factor model had a better fit (RMSEA = 0.041 and GFI = 0.96) than the one factor model (RMSEA = 0.326 and GFI = 0.69) showing the four variables as distinctly different measures. Relationships between variables were tested using simple regression. Significant differences between or among means were determined by a t-test and P-value, with the positive or negative value of the t-statistic showing the positive or negative direction of the relationship.

Results

The children in the study were in grades 7 through 12, with the majority in grades 10 (25%), 11 (22%), and 12 (29%). The gender of the children was 65% female and 35% male (Table 1). Analysis of Variance was run on grade and gender with the following variables: nutritional beliefs, attitudes, intentions, and behaviors. Results showed no significant difference by grade on nutritional beliefs, attitudes, intentions, or behaviors (F(l, 4m c 2.68, n.s.). For gender, there was no significant difference on beliefs, attitudes, or intentions (F(l, 4,,, c 3.29, n.s.). However, there was a significant difference in eating behavior based on gender (F(l, 4m = 26.16, P < 0.01). A more revealing two-sample t-test for eating behavior based on gender showed that girls skip meals more often (mean = 3.67) than do boys (mean = 1.45, t(481) = 5.11, P < 0.01).


In testing HI, “Nutritional beliefs of children about foods are positively related to children’s attitudes about liking those foods”, simple regression analysis indicated that nutritional beliefs were found to be significant and positive with attitudes = 4.8, P < 0.01). When children believed that a food or food group was good for them, their attitude about the food was that they liked it. The results support H,.

There was also a significant and positive relationship between attitudes and intentions (t(48,) = 5.1, P < 0.01). H2, “Children’s attitudes about liking foods are positively related to children’s intentions of eating those foods”, was supported. If children had a positive attitude toward the food (they liked it), their intentions were to eat that food or food group.

H3. “Children’s intentions of eating foods are positively related to children’s actual eating behaviors of those foods,” was also supported by the results. The regression equation and the analysis of variance showed intentions were significantly and positively related with eating behaviors (t(481) = 6.9, P < 0.01). Results imply that intentions to eat a food item or food group resulted in meals that include those foods.


School

290

60%

In addition to attitudes, beliefs, intentions, and behaviors, data were collected on several other factors for a more comprehensive look at the sample. When asked, "where have you learned the most about nutrition", 60% answered at school, only 22% said at home, and less than 4% said friends, television, magazines, commercials, or other. Their responses showed that 62% thought that they knew "some" about nutrition, 20% not very much and 4% almost nothing, while 12% said they knew quite a lot and 2% said they knew most everything. When asked, "Would you like to learn more about nutrition," 61 % responded yes. Lastly, the children were asked where the best place to learn more about nutrition is. Their responses were as follows: 60% at school, 16% at home, 8% from magazines, 5 % from television, 2% from commercials, and less than 1 % from friends. Results are shown in Tables 2 and 3.

Home Friends Television Magazines Commercials Other

107 15 16 19 15 21

22% 3% 3% 4% 3% 4%

Number

Percent

M O W ABOUT NUTRITION

72 P.L. BORDI, D.A. CRANAGE, M. BORTA and C. COLE

TABLE 3. LEARN MORE ABOUT NUTRITION

Percent 61 % 39 %

BEST PLACE TO LEARN MORE NUTRITION

The data show that the children in this sample generally believe they possess some nutritional information, they have learned nutrition primarily in school, they would like to learn more about nutrition, and they look to the schools to teach it to them.

DISCUSSION AND IMPLICATIONS

Study results suggest that, as according to the theory of reasoned action for behavior (Shepherd et al. 1995), children’s nutritional beliefs about foods are positively related to their attitudes about those foods. In addition, their attitudes about those foods are positively related to their intentions to eat them. Their intentions, in turn, are positively related to their eating behaviors at meals that offer those foods. This implies that children rely to some extent on their knowledge of nutritional information about foods when deciding what, and if, to eat. Since children believe they only possess “some” nutritional information, they want to learn more, and they look to the schools to supply that information. Thus, there is a tremendous opportunity for educators to change and improve children’s eating behaviors through classroom instruction on this subject. With trends in children’s eating tending toward junk food, fast food, anorexia, and bulimia, there is a significant need for change and improvement.


Limitations of the Study

The main limitations to the study were in the make-up of the samples, which did not include all school-age children, and was largely made up of grades 10 through 12. This did not allow for complete generalizability to all school-aged children, but results may be generalized to high school children. The sample was also slightly influenced by a higher percentage of female participants in relation to male participants. A review of the survey and procedures revealed that a higher percentage of boys either declined to take or did not complete the survey. This could influence the results; therefore, some caution should be taken in interpreting them, especially concerning the significant difference in gender for eating behaviors. However, the 169 male participants represented close to 65% of the male students in the classes.

Future Research

This study's primary objective was to look at high school children's beliefs, attitudes, intentions, and eating behaviors concerning many common foods. A future study should look at all age groups and compare them to see if these beliefs, attitudes, intentions, and behaviors change as the child grows and learns. Along those lines, an investigation should look at the effects of introducing additional, factual nutritional information on these variables. Could the child's family, educators, or school lunch program, by supplying factual nutrition information, changehmprove the child's eating behaviors? Researchers also could look at the effects of false or misleading information. Children often obtain information from unreliable sources, hear "old wives" tales, or hear conflicting reports on the nutrition of certain foods. Does this partial, false, or misleading information adversely affect children's eating behaviors? Lastly, the participants in this study indicated that they look to the schools to supply them with their nutritional information. A study could compare educators' nutritional beliefs, attitudes, intentions, and behaviors with those of students. Do these educators actually practice what they teach, and do the eating behaviors of these role models affect students eating behaviors?

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What Adolescents Think They Know About Nutrition Affects What They Feel About Nutrition and What They Eat