Purpose. To identify impact of an online nutrition and physical activity program for college students. Design. Randomized, controlled trial using online questionnaires and on-site physical and fitness assessments with measurement intervals of 0 (baseline), 3 (postintervention), and 15 months (follow-up). Setting. Online intervention delivered to college students; a centralized Web site was used for recruitment, data collection, data management, and intervention delivery. Subjects. College students (18–24 years old, n = 1689), from eight universities (Michigan State University, South Dakota State University, Syracuse University, The Pennsylvania State University, Tuskegee University, University of Rhode Island, University of Maine, and University of Wisconsin). Intervention. A 10-lesson curriculum focusing on healthful eating and physical activity, stressing nondieting principles such as size acceptance and eating competence (software developer: Rainstorm, Inc, Orono, Maine). Measures. Measurements included anthropometrics, cardiorespiratory fitness, fruit/vegetable (FV) intake, eating competence, physical activity, and psychosocial stress. Analysis. Repeated measures analysis of variance for outcome variables. Results. Most subjects were white, undergraduate females (63%), with 25% either overweight or obese. Treatment group completion rate for the curriculum was 84%. Over 15 months, the treatment group had significantly higher FV intake (+.5 cups/d) and physical activity participation (+270 metabolic equivalent minutes per week) than controls. For both groups, anthropometric values and stress increased, and fitness levels decreased. Gender differences were present for most variables. First-year males and females gained more weight than participants in other school years. Conclusion. A 10-week online nutrition and physical activity intervention to encourage competence in making healthful food and eating decisions had a positive, lasting effect on FV intake and maintained baseline levels of physical activity in a population that otherwise experiences significant declines in these healthful behaviors.

About Eating is a 5‐lesson, web‐based program developed to enhance eating competence and related skills of low‐income adults; preview at http://web.survey.psu.edu/AboutEatingPreview. Program impact was assessed in Pennsylvania with 512 (224 control, 288 intervention) SNAP‐Ed eligible, healthy women age 18 to 45 y. Research protocol included: randomization to About Eating or USDA's Click ‘n Go website; online surveys at baseline, lesson completion, and program completion; frequent communications and incentives. Surveys included the USDA Food Security Screener and EFNEP questions. Of study completers (n=302) 60% were SNAP users, 42% had ≤ high school education, 39% were food insecure, and 60% were overweight/obese. Total access time for About Eating was 45 ± 27 min. Reviews were positive; > 99% agreed About Eating was interesting, easy to understand and read. About Eating, unlike Click ‘n Go, increased use of written budgets (P=. 008), “Nutrition Facts” labels (P=.013), meal planning (P=.002), and confidence to manage money for healthful foods (P=.001). Compared to changes in controls, the decrease in likelihood of running out of food at month's end was significantly greater for About Eating (P=.04) and increases in the practice of comparing prices to save money tended to be greater for About Eating (P=.06). About Eating effectively improved food resource management skills of low‐income women. Funded by USDA.

Weight gain and an increase in overweight and obesity in college students raise serious health concerns. Weight management interventions for college-age men and women might be more effective if they were tailored to subgroups of students with similar behavioral and psychosocial characteristics associated with body weight status. The purpose of this study was to use cluster analysis to identify homogenous subgroups of college-aged men and women enrolled in a weight gain prevention study (Project WebHealth) using baseline data collected in 2008. Project WebHealth was a 15-month nutrition and physical activity intervention designed to decrease the rate of unwanted weight gain in 1,689 college students at eight geographically diverse universities in the United States. Outcome measures included anthropometrics, fruit and vegetable intake, physical activity, cardiorespiratory fitness, and psychosocial variables associated with weight status in college students. Cluster analysis was performed separately by sex using a two-step clustering procedure using weight-related eating and exercise behaviors and psychosocial variables. Cluster groupings were validated against students' measured weight status and waist circumference as indicators of health risk. The study design was cross-sectional. Results showed that three similar clusters were identified for each sex. Validity of the cluster solution was supported by significant group differences in body mass index and waist circumference with the High Risk cluster at elevated health risk compared to the others. For men, variability in eating competence and cognitive restraint scores contributed most to the difference between clusters, whereas for women, emotional eating and uncontrolled eating scores did. These findings could be used to improve effectiveness of messages and interventions by tailoring them to subgroups of college students with similar behavioral and psychosocial characteristics associated with elevated health risk.

The Three Factor Eating Questionnaire (TFEQ) has demonstrated genetic variation and association with Satter Eating Competence Inventory (ecSI) scores. We studied college students (n=661, 36% male, 91.5% non-Hispanic white, 26% overwt/obese) to identify genotype and eating competence (EC) relationships. PPARα L162A, PPARγ 12A, PPARβ/δ rs226766, and PGC-1α G482S genotype distributions were compared with TFEQ-R18 and ecSI scores; responses were gender-specific and paralleled published values. Results confirmed less emotional eating (EE) (P<.001), cognitive restraint (CR) (P<.001) and uncontrolled eating (UE) (P=.1) with EC (ecSI score ≥ 32). Subjects in the lowest ecSI tertile had significantly more CR (P<.001), EE (P<.001), and UE (P=.007). The homozygous G/G PPARβ/δ genotype tended (P=.06) toward less UE; females with the homozygous G/G PPARβ/δ genotype tended (P=.1) toward less CR than males. Homozygous A/A PPARγ genotype tended (P=.08) toward less CR and significantly more UE (P=.04). Students of homozygous S/S PGC-1α genotype (n=35) tended not to be eating competent (P=.05) and to be in the lowest ecSI tertile (P=.14). The PPARβ/δ genotype and gender interaction was significant (P=.04) with higher ecSI scores for males (35.3 ± 5.8 vs. 30.8± 4.9) who were homozygous G/G. These data support the hypothesis of a link between EC and PPARβ/δ and PGC-1α genotypes. Funded by NRI, USDA #2005-35215-154121541.

Identify a possible confounder to evaluating eating competence change in a low-income group.

"About Eating" (AE) is a 4‐lesson web‐based module (adapted from Project WebHealth, a program for college students) addressing constructs of the Satter Eating Competence Model. Following cognitive interviews with 25 low‐income men and women for the 4 modules, revisions were made in wording, graphics, lesson length and layout. Finalized lessons were assessed online by 19 reviewers with links to evaluation tools (ie., food security screener, Satter Eating Competence Inventory for Low Income (ecSI/LI). Reviewers were mostly female, white, non‐college educated, overweight or obese, food stamp participants, with marginal to very low food security and not eating competent (mean ecSI/LI 26.2 ± 10.6; possible range 0 ‐ 48). Each lesson was assessed independently for usability, navigation, design, reading level, and interest. All 4 lessons were reviewed favorably. More than 75% of reviewers denoted lessons as useful; 84% or more identified lessons as interesting. Navigation issues were identified by 7% of the reviewers for 2 of the lessons and at least 6% felt the lessons were difficult to read. Length and design were reviewed positively for all 4 lessons. Findings informed additional revisions prior to use with a larger low‐income audience. Availability of tested web‐based lessons on eating competence facilitates education about eating competence and impact testing in low‐income audiences. Funded by USDA CSREES NRI, USDA FNS SNAP‐Ed and Penn State University.

This study characterized lunch packing needs and practices of parents of preschoolers plus evaluated a newsletter series for relevance, quality, usefulness, and perceived behavior change.

The ecSatter Inventory (ecSI), a validated survey with 4 subscales, assessed change in eating competence (EC) following university student (N=133, mean age 19.6 ± 1.2 y) participation in a 10‐lesson web‐based curriculum that utilized a non‐dieting approach to weight management. 4 of the 10 lessons focused on EC constructs related to eating enjoyment, food acceptance (FA), internal regulation (IR) and food contextual skills (CS). EC responses were gender‐specific. For males (N=45), a decrease in eating enjoyment was the only significant change (P=.04). Females (N=88) significantly increased total ecSI score (P=.04) and FA (P=.001); CS tended to increase (P=.07). At baseline, females scored significantly lower than males for total score (29.3 ± 7 vs 34.6 ± 7.1; P<.001), eating enjoyment (10.0±3.4 vs 12.5±2.5; P<.001), FA (4.9 ±2.5 vs 6.0 ±2.5; P=.025), and IR (6.3±1.8 vs 7.4±1.6; P=.001). Following intervention, only eating enjoyment remained significantly lower for females compared to males (10.1±3.6 vs 11.6±2.9; P=.018). EC changes following the intervention were compared between males and females; male EC deteriorated with trends toward or significant decreases in total ecSI score (−.95 vs +1.5; P=.058) and eating enjoyment (−.84 vs +.24; P=.049). Body mass index remained unchanged and unrelated to ecSI scores or gender. Further research is needed to ensure that gender is not masking impact as a result of intervention‐driven cogitation affecting perceived competence upon transitioning from a pre‐contemplative stage in EC. Supported by NRI, USDA CSREES, grant #2005‐ 35215‐15412, PSU Dept Nutritional Sciences

Developing eating competence (EC) is one approach to obesity prevention. EC was explored in college students to inform designers of an online nutrition curriculum about a non-dieting approach to weight management. Self-reported data from 164 students (mean age=20 y; males=70) attending 9 geo-dispersed colleges were obtained from web-based surveys completed by students participating in online focus groups. EC was measured with the ecSatter Inventory (EC ≥ 32); total, tertile, and subscale scores were compared to outcomes from the Three-Factor Eating Questionnaire-R18, International Physical Activity Questionnaire, body mass index (BMI), and fruit and vegetable intake. Students were physically active (87.8%) and mostly normal weight (72.4% had a BMI 18.5 to 24.9), but only 40.9% were EC. Compared to males not EC, EC males showed higher cognitive restraint (p=0.024) and were more likely to eat recommended fruit servings (66.7% vs. 24.3%; p=0.001) and to engage in regular vigorous physical activity (57.6% vs. 29.7%; p=0.059). EC females had lower cognitive restraint (p=0.002), uncontrolled eating (p=0.007), and emotional eating (p=0.005) than females not EC. Findings suggest a rationale to enhance EC in young adults and promote resource management favoring EC curricular development. Supported by the National Research Initiative of the USDA CSREES, grant #2005- 35215-15412, PSU Dept Nutritional Sciences.