2. I seek to find the relationship between education and health within the social community
occurring in our nation. Specifically, how does nutritional knowledge and education affect
American obesity? This social phenomenon is rising among Americans with more than one-third
(34.9%) of U.S. adults and 17% of the youth currently considered obese.
(http://www.cdc.gov/obesity/data/facts.html) This is alarming because we now have confirmed
studies that indicate obesity can lead to a number of conditions and diseases that are leading
causes of preventable death, while obesity itself is shown to yield a shorter life expectancy.
There is little research displaying the precise reason for this epidemic and has many social
scientists quite puzzled. Many consider genetics, hormones, and other biological factors the main
cause, while some are interested in the learned factors such as taught behavior, knowledge, and
education. Personally I am curious how the onset of nutritional and dietetic knowledge/education
has influence on the phenomenon of American obesity. Furthermore I believe this research can
shed light to controllable and implementable factors that may potentially alleviate this growing
national dilemma.
With respect to my research question, I’ve collected and examined two scholarly and
peer-reviewed articles to further expand my knowledge and help guide my research question and
corresponding study. Specifically they are themed around my two main concepts, obesity and
nutritional education.
The first article by George A. Bray, MD and Jennifer F. Wilson, titled, “In the clinic
Obesity” from the American College of Physicians (ACP) discusses the health consequences,
screening and prevention, diagnosis, and treatment concerned with American obesity. It also
reveals details of some previous studies performed where they could draw information from
confidently. The article begins by looking at the possible health consequences associated with
3. obesity. In short, excess body fat, especially visceral fat, increases the risk for numerous
diseases. This risk is a direct cause that comes from either enlarged fat cells which cause diseases
like Type-2 diabetes and hypertension, or from the actual increase in body mass causing
bone/joint and pulmonary diseases. A cohort study of 80,000 men and women, monitored over
14.7 years and excluding deaths in the first five years, concluded that the risk for death in
patients under 55 years of age was directly related to BMI in both genders with BMI beginning
at 21kg/m2 for women and 23 kg/m2 for men. It has been seen in almost all studies that mortality
and BMI have a J-shaped relationship. The article stresses how even limited weight loss can
substantially decrease your risk for so many diseases. They exemplify this with details of a
clinical trial using lifestyle interventions to lower blood pressure. The results showed that the
risk for hypertension lowered by 65% in those who maintained their weight loss of 4.5 kg (about
10 lbs.) for 30 months.
Furthermore the article discusses the need for clinicians to screen more regularly for
obesity. More precise, the U.S. Preventative Services Task Force has recommended that
clinicians screen all adult patients for obesity and offer intensive counseling and behavioral
interventions to sustain weight loss. As far as prevention, included were some health behaviors
that can reduce risk for becoming overweight. Even in the earliest stages of a life, pregnant
women should maintain normal weight gain, not smoke, and extend the duration of their breast-
feeding to help reduce the risk for their child. Learning healthy behaviors, having self-control in
consuming decisions, and physical activity are also crucial parts to preventing obesity.
Lastly, the professional journal touches upon the diagnosis and treatment concerned with
obesity. As previously stated, BMI is the most widely used and easiest tool to define obesity, but
it is in fact not the best predictor of weight-related problems. Specifically, children, older people,
4. and athletes are misleading populations in respect to their BMI measurements because of
differences in height and proportions of their fat and fat-free masses. Other factors or conditions
to consider when evaluating obesity are discussed, such as a patient’s ethnicity, their use of
medications, their current social situation, and life events that may influence weight-gain
(pregnancy). Moreover, there are genetic syndromes that are associated with obesity all
triggered by recessive abnormalities.
As far as treatment, it is wisely stated that clinicians should encourage attainable weight-
loss goals while promoting behavior modifications, counseling, and diet discussions. As most
have seen, there are many natural and herbal products marketed for weight loss, however, most
have unknown effectiveness and safety. With this said, the article suggests that pharmacological
therapy be recommended only when patients fail to meet individualized goals with counseling on
lifestyle and behavioral modifications. Two drugs in particular have been approved for induction
and on-going maintenance of weight-loss, sibutramine, which increases satiety and energy
expenditure by increasing one’s metabolic rate, and orlistat, which inhibits the action of
pancreatic lipase decreasing fat absorption in the small intestine. To back this claim, a 3-year
study was performed on patients who initially lost 5% or more of body weight after 8 weeks on a
diet. From the cohort, participants were randomly assigned to either lifestyle advice, or lifestyle
advice AND taking orlistat. At the end of three years the orlistat group was, on average, about 5
lbs. lighter.
In conclusion of the journal, it is again stated how even minimal weight loss can make
you that much healthier and summarizes the articles basic ideas. Lastly it lists some websites
with good information on losing weight.
5. The second article I reviewed was from the International Journal of Information and
Communication Technology Education, titled, “Adolescents Seeking Nutrition Information:
Motivations, Sources, and the Role of the Internet”. (Larsen & Martey, 2011) This piece
discussed research involving the potential of the internet for providing effective nutritional
information to adolescents, and more specifically asked, “What motivates adolescents to select
the internet when learning about nutrition?” The study was concentrated around the first two
aspects of the basic information-seeking process, initiation and selection. To study these, both a
survey and in-depth interviews were performed in this research and the corresponding results
were given.
The introduction to the article recognizes the need for implementing skill-building for
healthy nutrition and weight-control amongst adolescent Americans. It also recognizes the
internet as a potential tool for wide-spread populations to receive nutrition information
effectively and efficiently, which is promising due to the considerable amount of time this
generation of youth spends on the internet. With that said, it then looks at the use of online
nutrition resources by adolescents and it seems that while they definitely spend good amounts of
time online, only a small portion of that is used to obtain health information. The methods this
study used to examine adolescents motivations and resources for seeking nutritional information,
with a focus on the role of internet in that process, were a questionnaire survey, and then a
follow-up interview.
The survey involved a population of adolescents ages 12 to 16 from two Junior High
Schools in Northern Colorado. [Note: this population age is assumed to have reached a cognitive
level for a few years making them sufficient to think critically about choices, specifically on
what they eat and drink] A random sample of 79 students from three classrooms containing
6. cohorts of those who recently participated in school-district mandated nutrition education
courses were selected. Specifically, the elements selected had an average age of 13.7, 37 were
male, 42 female, 81% were white, 13% Hispanic, 5% Native American, 4% African American,
4% Asian, and 5% chose other. The survey was a 15-minute, paper and pencil questionnaire that
began with demographic questions and transitioned to ones about food and beverage
information. For example, “How much do you think about what you eat and drink?” was asked.
Additionally, questions about the internet playing a role in the information seeking process
concerned with both initiation and selection were included. Examples of these are, “How often
do you look on the internet for information about your health?” and “How useful do you feel the
internet is in helping you make decisions about what you eat or drink?” Lastly, questions about
the student’s comfort, knowledge, and skills of online nutrition information were asked, like “I
can tell which websites have nutrition information I can believe and trust?” All of the survey
questions were based on a 5-point Likert scale from either “Never” to “Always” or “Strongly
disagree” to “Strongly agree. This indicates the study used an ordinal level of measurement,
which is the least precise quantitative level of measuring.
In order to gain a deeper understanding of how and why these adolescents found and
made sense of nutrition information in different ways, they conducted a follow-up interview. Six
students who participated in the questionnaire and said they had used the internet to seek
nutrition information at least once were randomly selected. The elements were 3 males, 3
females, ages 13 to 15, with 5 being white and 1 considered both Hispanic and white. The 45-
minute interview used a semi-structured guide and asked things like, “Have you ever had
questions about what kinds of food or drink are healthy or unhealthy?” A constant comparative
technique was used to analyze the data.
7. The results of the two methods are given and suggest similar conclusions. The survey
results suggest that adolescents do in fact think about what they eat and drink, with 31% saying
they do so “very much” or “quite a bit”, and 32% “occasionally”. Furthermore, 52% said
knowing nutrition information was “very” or “extremely important”, and 11% claiming
“somewhat important” showing their acknowledgment of its significance.
Moving on to the interview process, the results show a recognition for the importance of
eating well, but it does not necessarily translate into searching for information about nutrition.
First it looks at adolescent motivation. Participants were most often motivated by other (mostly
teachers) to initiate a nutrition-information search with implementations of homework and
project assignments. Also, these information needs were almost always associated with an
assigned textbook as a source. Less frequently, nutrition information search was motivated by
conversations with friends. The initiation of nutrition information searches was usually prompted
by teachers and not self-initiated; therefore educational motivations have a significant influence
on how adolescents see nutrition information and their options for learning more about it.
So what sources are adolescents using for information-seeking? According to the survey,
82% of the participants “never” or “rarely” looked online for health information, and 75%
“never” or “rarely” did this for nutrition information. The interview shows that resources
selected were strongly guided by the wording and suggestions on the formal assignments from
teachers. Additionally, selecting sources for school related nutrition needs compared to personal
nutrition needs interestingly displayed similar results. For school-needs, adolescents most often
selected books because they were instructed by their teachers and for previous assignments all
the information that needed would be in them. When selecting a source for personal needs,
adolescents tended to still turn to parents, teachers, or books as opposed to the internet for
8. nutrition information. 53% of the participants said that the “internet was not useful in helping
them make decisions about what to eat or drink”. Some of the reasons given in the interview as
to why they used non-internet sources were lack of trust, conflicting information made gauging
validity difficult, and most importantly, the adolescents conceptualized the internet as a social
medium used for social-media sites, chats, and online games.
Lastly, in the article’s summation it explains how although adolescents are thinking about
nutrition, it is a topic they associate with their school setting. In contrast, the internet was a place
for “everyday life” things creating a serious lack of translation between nutrition information and
the internet. Furthermore, teachers rarely, if ever, asked students to use the internet in their
assignments resulting in a hesitation to use the internet to learn more about nutrition. In
conclusion, this article presses for integrating internet-based nutrition information into both
classroom and online social activities that adolescents enjoy to further enhance their comfort and
knowledge of online resources. While this article is very informative, I must note that only six
students were explored in-depth via interview and therefore its corresponding results cannot be
seen as highly representative of the larger adolescent population and making it difficult to draw
out patterns.
To enhance the study and potentially find further helpful results as pertaining to the social
science phenomena of drastically increasing American obesity, I would conduct my own
research study. With that said, I am more concerned with the learned causation of obesity as
opposed to genetic or uncontrollable factors. Let me first conceptualize my research to enhance
the understanding before operationalizing.
9. My research involves two fairly basic concepts, the first being nutritional
knowledge/education and then, American obesity. Nutritional education is something that
interests me as I wish to pursue a career in Nutrition in some form, but also because it is
something I’ve had to take upon myself to become knowledgeable in. Until my later years of
college (and on my own will), formal education on nutrition and proper diet were basically
nonexistent to me. We all remember once seeing a pyramid of food in grade school, which has
been drastically changed since by the way, but actual learning and informative methods of diet
and nutrition were really never presented to me, and I am confident this is a trend that occurs to
many Americans. The educational aspect of this concept includes classes nation-wide that
provide simple nutritional lessons and information to students starting in elementary schools.
The physical aspect of health is encouraged through physical education classes, while the actual
education part is often dimmed if touched on at all. Another part of this education could be seen
in cafeterias of the actual facilities. Presenting knowledge is important, but providing the
nutritionally appropriate food choices within the institutions is crucial. This allows students to
significantly put what they are learning and their actual daily behavior hand-in-hand. It is also
possible that some younger people may simply follow the dietary habits of their parents who
may be nutritionally uneducated. Formal education can prevent these habits and even help both
children and parents recognize unhealthy behavior in dietary patterns and change for the better.
The next concept I am concerned with is American obesity, a nationwide problem that is
drastically increasing among both adults and children. This is a multi-dimensional concept as it
consists of two subconcepts being obesity and the American trend aspect. First, obesity can be
simply defined as the condition of being excessively overweight. The most renowned
quantitative method of indicating obesity is measuring one’s Body Mass Index, or BMI. This
10. method is most often used because it correlates with the amount of one’s body fat by simply
using the height and weight of a person. Naturally the scale and corresponding indications vary
for men and women as biologically the average woman has a higher fat content than average
man. The BMI measurement is acquired through a fairly simple calculation which is: [Weight
(lbs.) / Height (in)2] X 703. Standardly, a BMI of less than 18.5 indicates underweight, 18.5-24.9
indicates normal weight, 25.0-29.9 indicates overweight, and 30.0 and above indicates obesity.
Now the BMI measurement definitely correlates to body fat and is both easy and inexpensive,
however, it is not the most precise way to measure obesity. Direct measures of body fat can be
done by underwater weighing which basically uses the difference in water displacement in
consideration of your fat and muscle densities to give you a precise body fat measurement. This
method is somewhat inaccessible and expensive to many Americans though. Subsequently, the
American aspect of this obesity epidemic ties with the incredible rate at which people are being
affected. From 1980 the obesity rate in adults has doubled, while in children it has more than
tripled! (http://healthyamericans.org/obesity/) The direct relation to higher risks for very deadly
diseases and other conditions from obesity is something that needs to be more thoroughly
addressed to the public, while the raw knowledge and easily informative education of nutrition
can be more available, if not mandated. I intend to present research that may influence this
position and help gear us to a healthier nation.
I wish to perform my research qualitatively with focus on idiographic explanations of
obesity, that being multiple events or reasons that may occur simultaneously with a similar
result. I confidently believe that the collaboration of both nutritional learning and available
nutritionally-appropriate foods are a huge factor for adolescents in battling obesity, and both of
which are controllable parts of basic education facilities. This lays the foundation for my
11. research question; how does nutritional knowledge and education affect American obesity? Also,
it guides the direction for my potential research study which I will conduct in the Western New
York area, specifically in Buffalo. I will choose my sample based on non-probability as I will use
an availability sample of various basic education facilities (elementary schools, high schools, &
adult education) within the Buffalo community for realistic research purposes. To gain access to
my sample, I will contact 3 of the 57 possible Buffalo Public School facilities, one of which an
elementary school, one a high school, and the last an adult education facility. After speaking with
the appropriate heads of each facility I will hopefully be granted access to conduct my research.
The method of my research will consist of simple observation and interviews with both
education students and staff members. I will be focused on both individual and group levels of
analysis as I am concerned with both how the facilities are promoting nutrition, and how
students, individually, are making their nutritional choices. My exploration of the two units will
help reduce risk of invalid causal conclusions from common generalizable fallacies (eg.
Ecological & Reductionist fallacy). My study will be cross-sectional where I will collect my data
at one point in time at each of the three facilities. I am concerned with the implementation, if
any, of nutritional education by educators as well as the food choices both available and selected
by students. Specifically to obtain this data, I will go to each facility and observe the day-to-day
activities the students’ experience. While observing, I will key in on the education or
acknowledgement of nutrition, if any, that is given by educators. I will note the technique in
which the information is given and how well/in-depth the information seems to be obtained by
students. Next, I will observe the cafeteria and its food possibilities and selections. While I am
curious as to what exactly are promoted or even available for meals, I am also concerned with
the general eating habits and choices of the students.
12. While observing these three facilities I will also conduct intensive interviews with
random students, but specific staff members responsible for the predominant health or physical
education of the facility. While interviewing I will ask a variety of open-ended questions as to
allow the participants to answer in their own words, which generally results in more reliable
data. With the students I will be focused on their perception and feelings toward nutrition and
diet, their current knowledge of nutrition, their daily eating choices and habits, and the reason for
those behaviors. Some questions I will ask are: How important, if at all, is nutrition and your diet
to you? What are some basic nutritional guidelines or helpful information about one’s diet you
could give? Where did you learn this information? What do you usually have for lunch? Why so?
The other portion of my interviews will be performed on the educational staff responsible
for health or physical education. With these participants, I will be concentrated on their strategies
and implementation of proper diet and nutrition education. Among some of the questions will be:
What is your primary job as an educator? In what ways, if any, do you promote a healthy
lifestyle to students? If so, how in depth is the learning of nutrition? How well do students seem
to absorb this information? How well do students seem to use this information to make better
food choices? Throughout the interviewing I will take note of how well the connection between
educators teaching and the student’s application of that information is displayed.
In the midst of my research, because I will be an overt observer, the use of jottings and
notes during observations are both appropriate and crucial. During the interview process I will
obtain my data collection by use of a recording device, whereas the participant will have full
knowledge of its use and therefore not deemed an unobtrusive operation.
13. To analyze the data I collect I will create a full embodiment of my observations, and sort
through to find the similarities or differences in educating techniques relating to nutrition. Also I
will look through my observations to find the comparisons of food choices within educational
cafeterias and the corresponding choices made by students. I will concentrate on finding
similarities within the different facilities which will help allow for a small sample-
generalizability of education and behavior research findings. For analyzing my interviews I will
create full transcripts of the audio recordings and examine the responses given by the
participants. Here I will look for connections between the implementation of nutritional
education and the way the corresponding students used this information in terms of their daily
dietary behaviors. This may potentially shed light on a correlation of lacking nutritional
education and poor health concerned with obesity.
The findings I expect to obtain from my research study support the correlation proposed
above, a positive relationship between the implementation of nutritional education and
nutritionally healthy behavior. This is important because the application of nutritionally healthy
behavior is proven to reduce the risk of obesity and the serious health issues it carries.
Specifically for my findings, I predict that the educational facilities I observe that revealed to
perform little or no nutritional education will include students who primarily make poorer dietary
choices. Furthermore, those facilities who do not promote the availability of healthier meal
options may result in more obese students.
I should note that because my research study will take place within an educational facility
filled with minors there are some ethical principles I must adhere by. While I must debrief the
subjects and disclose the details and reasons for my research to staff and even students, I must be
sure to not emotionally harm any participants by making them feel uncomfortable or
14. embarrassed. To make sure of this I may not single out those students I believe to be “obese” or
unhealthy nor ever make comment to that affect as the emotional state of youth is sensitive.
Furthermore, because the consenting age for research is 18 years, the schools may need to obtain
some consent by the student’s parents deeming myself permissible to study and perform research
on their children. Within these consent forms should include the standards to be taken to protect
the privacy of the data collected from the students, and my procedures to ensure the records
remain private, which would be a pad-locked drawer containing the physical notes and a
password-secured file of the electronic data.
At its most basic, my intentions for this research study are to draw attention toward the
education of proper diet/nutrition and the corresponding application of that which is taught.
Through my research investigation, I seek to open a window for further research pertaining to the
serious miscorrelation between American education and a healthy lifestyle, specifically relating
to the epidemic of obesity. Lastly, my research examines factors that, unlike genetics, are
completely controllable and therefore can potentially be improved and result in direct benefit of
health for the American people.
15. Bibliography
Literature Review:
Article 1-
Bray, George. "In the Clinic: Obesity." Annals of Internal Medicine. The American College of
Physicians. Web. <http://annals.org/article.aspx?articleid=743145&issueno=7>.
Article 2-
Jessica,Larsen. "Adolescents Seeking Nutrition Information: Motivations, Sources, and the Role
of the Internet" Academic One File. InternationalJournal of Information and Communication Technology
Education. Web.
<http://go.galegroup.com.gate.lib.buffalo.edu/ps/i.do?id=GALE|A273420620&v=2.1&u=sunybuff_main
&it=r&p=AONE&sw=w >.
Other References:
"Obesity." Trust for American's Health: Issues. Web. <http://healthyamericans.org/obesity/>.
"BMI Calculator - HowStuffWorks." HowStuffWorks. Web.
<http://health.howstuffworks.com/wellness/diet-fitness/weight-loss/bmi1.htm>.
"Facts." Centers for Disease Control and Prevention. Centers for Disease Controland
Prevention, 3 Sept. 2014. Web. <http://www.cdc.gov/obesity/data/facts.html>.
