1. Andrew Pescovitz, Kent Ford
Christine Delong, Cameron Potter, Gabby Bertone
KNH 213
Dr. Miller
29 September 2015
Literature Review

2. ABSTRACT
As we move furtherintothe 21st century,thiscountryfacesa new epidemicinwhichwe need toact
uponimmediatelyinordertobetterthe healthof ourselves,ourchildren,andournationas a whole.
Obesityhasnowbecome one of the majorcontributorsto chronicdiseasessuchasheartdisease,type 2
diabetes,asthma,osteoarthritis,andevencertaincancers(The OhioObesityPreventionPlan,
2009).ObesityisdefinedasanindividualhavingaBMI or bodymass index of 30 or higher.InAmericaas
a whole,overone thirdof the adultpopulationisobese whichamountstoclose to78.6 million
Americanswhoare classifiedasobese (Ogdenetal.,2014). These currentstatisticsare alarmingand
seemtobe ona steadyrise ratherthanthe desireddecline.InOhioalone,over65% of adultsare now
classifiedasoverweightwhichisaBMI of 25 or greater andover29% are classifiedasobese (Scottetal.,
2010). As we narrowdownour demographicevenfurthertoencompassthe ButlerCountyareaof Ohio,
the statisticsare justas alarming.InonlyButlerCounty,over25% of all adultsare now classifiedas
obese andclose to 34% are classifiedasoverweight(HealthyOhioCommunityProfiles,2008).Thisnew
epidemicisbecomingmore concerningeverydayasthe cost of healthcare risesandthe healthof our
nationand ourstatessuffer.The estimatedannual medical costsforobesityforthe U.S.wasalmost
147$ Billiondollarsasof 2008 and an individualwhowasobese canexpecttopayclose to 2,000$ more
annuallythanan average person(Ogdenetal.,2014). These coststo our walletsaswell asourhealth
are alarmingandwill onlygetlargerif we donot act uponthisissue asquicklyaspossible.Withthe cost
of treatmentof obesitysohighforan individual,preventionisthe onlyoptiontocombatthe rise of this
newepidemicandturnthe healthof our county,state,and nationas a whole around.One areaof focus
interms of preventionthatisusuallyoverlookedisstudentsincollege.Theseyoungadultsare ata
critical time intheirliveswhere theyare learningtolive ontheirownanddeveloptheirownlifestylesso
a preventionprogramthatcentersoncollege studentshasthe possibilitytohave faroutreachingeffects
on the obesityratesof adultsas a whole.Recentresearchsuggeststhatbetweenafourthanda thirdof
all college studentsare obese (Furiaetal.,2009). Thisis a populationthathassignificantimportancein
termsof contributiontowardsthe obesityepidemicof adultsinthiscountrywhichiswhywe feel that
our program focusoncollege studentswill be animportantaspectof our effortsasa nationto battle the
rise inobesity.
FACTORSCONTRIBUTINGTO OBESITY IN BUTLER COUNTY
It isbecomingevenmore prevalentrecentlythatdietarybehaviorsandalack of physical activityare
leadingcontributorstothe obesityproblemthe state isfacing.In2010, only29% of adultsreported
consumingthe recommendedamountof servingsof fruitperdayandonly24% of adultsreported
consumingvegetablesatthe recommendedlevelof 3 or more timesperday(Scott etal.,2010). Physical
activityisalsobecominganissue foradultsto meetthe recommendedamountof time perweekof
moderate andvigorousphysical activity.Asof 2010, only43% of adultsinOhioreportedhaving
achievedthe recommendedamountof either300 minutesof moderate physical activityor150 minutes
of vigorousactivityora combinationof both(Scottetal.,2010). With the prevalence of fastfoodsand
quick,cheapprocessedfoodsinoursocietytoday,aswell asthe growinguse of cars, elevators,and

3. sedentaryjobs continue tomake itdifficultforadultstoleada healthyandactive lifestyle,awell
thoughtout andstructuredpreventionplanisnecessarytocounteractthese barriersthatwe face.This
program mustnot onlyaddressthe sedentarynature of ourdaily lifestylesinthesetimes,butalso
addressthe variousdietarybehaviorsthatmanyAmericanshave adopteddue tothe nature of our
lifestyles.Eatingahealthydietandhavinganactive lifestyle canbe difficultformanyadultsandeven
more so withcollege students.The demandforacademicperformance,pressuresfromfriendsto
participate inunhealthybehaviorsandthe costof foodcan be major barriersto mostcollege students
attemptingtoadopthealthybehaviorsthatwill stickwiththemforthe rest of theirlives.
OBESITY CENTERED INTERVENTION PROGRAMS
Many differentprogramshave beenusedtotryand measure the effectsof anobesityinterventionon
the population.Some of these programshave hadsuccessandsome of themhave not.Howeverin
orderto come upwitha frameworkfora superiorprogramthat can be successful,we mustreviewthese
past programsand pull outuseful informationtoproperlystructure ourprogram.There are a few key
aspectsto pointoutthat a handful of particularstudies didtoincorporate dietaryandphysical activity
programsfor college students.Some of the programsdiscusswaystocounteractthe “Freshman15” and
specificallydiscussalcohol consumptioninundergraduate students.Othersfocusonspecificdietary
habitsof college studentssuchassnacking,fasting,andgrazing.Recentresearchsuggeststhat“formost
people wantingtopreventprogressive weightgain,certaindietarybehaviorsneedtobe addressedfirst”
(Avery,2012). Othersuccessful aspectsof recentstudiesuse physical activityrequirementstointroduce
behaviorchange incollege students.A studywasperformedtoevaluatethe efficacyof assigningaPAP
or physical activitypassporttostudentstosee if thismotivatedthemtoexercise outside of class.The
PAPwas alsoincorporatedintothe curriculumof the studentsandwasevaluatedatthe endof the
semesterandaffectedthe student’sfinal grades.The studyfoundthatthose whoparticipatedinthe
PAPattendedfourtimesasmanyfitnessclassesthanthose whodidnot(McDaniel etal.,2014).
Anotherimportantstudyattemptedtoutilize onlinecoursesforstudentstoeducate themondietary
and physical activitybehaviors.The college made the classmandatoryforeverymajoratthe college and
the class mettwice a weekfor8 weeks.The goal wasto educate as manystudentsastheycouldby
implementingthe mandatoryonline course andthe classdesignersfeltthat“itisgenerallyaccepted
that the besttime to interveneinone’slife isduringchildhoodorearlyadulthood”(McFarlen,Jackson,
2008.) Anotherstudythatusedinternetbasedcourseshadgoodsuccesswithstudentsintermsof
dietarybehaviors.Eachstudentwhowasenrolledinthe course wasrequiredtoparticipate inthe study
for 12 weeksandthe studywascomparedto an on campuscourse that was offeredtostudentsatthe
same time.The resultsof the studyshowedthatthe online course wasmore effective thanthe on
campuscourse indietarybehaviorchange (LaChausse,2012.) The online course costsverylittle andwith
the prevalence of onlineactivityforstudentsatthistime,the online course provedtobe more effective
at behaviorchange andcost effectiveness.Howeverthe studydidfindthatthe course made little tono
change in physical activityinthe students.Anotherinterestingstudydone wasfocusedonmobile
approachesto weightlossinstudents.The researchersdevelopedaSMART programwhichstandsfor
Social Mobile ApproachestoReduce Weight.Thisprogramwasdesignedtotargetspecificbehaviors
that may increase the likelihoodof weightlossincollege students.The studywasdone over2years with

4. studentsparticipating5timesperweek.The resultsshowedthatthe variable thatthe researcherswere
able to improve uponthe mostwasself- monitoringof weightthroughthe mobile program
(Kolodziejczyketal.,2014). Anotherimportantpartof college life isthe dininghall.One particularstudy
attemptedtoaddressthe issue of portionsizesinthe dininghall ata college.The article analyzes
studentschosenportionsizesfordifferentfoodgroupsversustheirrecommendedportionsizes
accordingto theirBMI. Some interestingfindingof the studyshowedthatstudentschose significantly
largerportionsof highcarbohydrate foodsthanthat of higherfat foodsandthat the selectedportion
sizescouldbe predictedbasedonthe individualscurrentBMI(Burgeretal., 2007). Thisisimportant
because whenstudentsgotothe dininghall theyare givenfree reinonhow muchfoodtheywouldlike
to eat as opposedtoorderingspecificportionsatarestaurantor evencookingfoodforthemselves.
Anotherimportantstudyinvolvingcollege studentswasdone inaHispaniccollege sample.The study
was designedtoevaluatethe effectof educationandphysical activitycourse focusedoncollege
studentsof a Hispanicbackground.The studyfoundthatthe studentsdietarybehaviorspriortotaking
the courseswere quite poorcomparedtonational recommendationsbutthe coursesdidhave an
impacton the studentswhichdidreportpositive weightlossinthe students(D,2011). Another
interestingstudythatwasdone recentlywasone thatfocusedonincorporatinga wellnessandwalking
program instudents,faculty,andstaff of a college campus.The studydevelopedwellnesscoursesfor
the students,faculty,andstaff toattendas well asvariouswaysto incorporate more walkingintothe
participantslives.The studyhadgoodsuccesswithitsprogramwithalmosteveryparticipanthaving
measurable weightlossaswell asanincreasedknowledge of healthydietarybehaviorsfollowingthe
study(Haines,2010). The importance of group activityandteachingisclearas a keyto successin most
of these studies.People tendtohave more success inweightlossprogramsthatinvolveotherpeople or
are performedonacommunitylevel.One studythatwasnot focusesoncollege studentsbutuseda
communitybasedapproachtowardsyoungadultsof an AfricanAmericancommunityshowedgreat
promise.The studywasdone overa 12 weekperiodwithvariousclassesandphysical activityeventsfor
the adultsto participate in.The participant’sweightwasmonitoredthroughoutthe studyandatthe end
of the twelve weekprogram,the participantswereweighedone final time,andgivenasurveyof
questionstodetermine whethertheyhadtrulylearnedanythingfromthe program.90% of the
participantswere reportedtohave lostsignificantweightandthe surveysgivenatthe endof the
program showedthatthe individualshadinfactretainedthe knowledgetheywere taughtinregardsto
a healthylifestyleforthe future (Treadwell,2010).Finally,in2014, a groupof researchersattemptedto
compile datafromnumerousdifferentweightlossstudiestodeterminewhich of the aspectsof the
programswere mosteffective atproducingmeasurable weightlossresultsinparticipants.The review
foundthat the programsthat not onlyincorporatedmandatoryeducationclassesaswell asoffered
incentive forparticipationinphysicalactivityhadthe mostprofoundeffectonthe participant'sweight
lossresults(Peirson,2014).
CONCLUSION
Afterreviewingthe literature,itbecomesmore andmore apparentthatdesigningan
interventionprogramthathasa multifacetedapproachencompassingdietarybehavioreducation,as
well asphysical activityeducationproduceseffectiveresultsinreducingweightinindividualswhoare

5. overweightorobese.Aswe move furtherintothe future asa nationthe epidemicof obesitywillnotjust
go awaywithtime.Thisisa serioushealthissuethatisplaguingournationthatneedstobe addressed
as soonas possible forusto have a chance to defeatitonce andfor all.Earlyadulthoodisan extremely
challengingtime formostpeople introducingvariousnew life challengestoyoungadultsthatalready
have enoughontheirplate.Itis time thatwe make the challenge of creatinghealthybehaviorsthatlast
a lifetimejustasimportantasgettingyourdegree,orgettingthatdreamjob. Obesityisa serious
probleminthiscountryand teachingyoungcollege studentsthe necessaryknowledgetopreventthis
epidemicwill be keyinourfightasa nationtoendobesity.We feel thataprogram designedaround
interactive dietaryeducationcoursesandgroupphysical activityclasseswill have aprofoundeffecton
ButlerCountycollege studentsthatcannot onlylasta lifetime forthem, butforthe future studentsof
our nationas well.

6. REFERENCES
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