Good Habits as a Matter of Course

What College Students Think about Food and Fitness Leaves Researchers Looking for Ways to Create a Healthier Campus

Christina Economos, N96, and Annie Gazdag, research fellow

Turn a conversation to the topic of one's college years and it will invariably bring up fond memories--and sometimes regrets. Graduates might remember those extra pounds known as the "Freshman Fifteen," a steady diet of pizza, or struggling with the stress of exams and finding little time for even a brisk walk around the track.

More important, however, they might also realize that behaviors they considered a temporary part of college life have actually become a way of life. And over time, such habits take their toll. Poor nutrition and inactivity, for instance, are responsible for as many preventable deaths as smoking. These two lifestyle patterns alone increase the risk for developing many serious illnesses such as diabetes, osteoporosis, obesity and cardiovascular disease.

How do young adults develop these habits? Dr. Christina Economos, N96, assistant professor at the School of Nutrition Science and Policy, surveyed several hundred Tufts undergraduates in the spring of 1998 to find out. The results of her study were revealing. Students displayed major gaps in health knowledge and confusion about how to achieve a healthy lifestyle. They yearned for stress management and relaxation skills. One in five was overweight. And while they were overwhelmingly concerned about dietary fat, their daily diets left considerable room for improvement. Among women, negative body image was rampant: most normal weight and some underweight women said they were trying to lose weight.

"These findings really hit home," says Economos. "It was obvious something needed to be done to help students make healthier lifestyle choices. The problem is that we don't have a solid understanding of why young adults make the choices they do. We can't effectively motivate young adults to adopt preventive health behaviors until we have that understanding." Toward that end, Economos designed a groundbreaking study that she envisions will become a national model. In the fall of 1998, together with Professor Jeanne Goldberg, MEd 59, N86, J92P, she launched the Tufts Longitudinal Health Study (TLHS).

Put simply, TLHS aims to instill healthful behaviors by creating a campus environment where healthful lifestyles are the norm rather than the exception. To accomplish this, the TLHS is first gaining an understanding of students’ needs, preferences and habits to then build the programs that they want.

In the first phase, incoming freshmen receive a survey in the mail, which they complete in August before they arrive on campus. Each April thereafter, those who responded fill out more detailed surveys that assess exercise habits, tendency toward depression and eating patterns, for example, and they perform tests that measure indices of health such as body composition, bone quality, aerobic fitness and muscular strength. They can also opt to have their blood cholesterol levels measured. The Class of 2004 is the third to be recruited and two more are slated to join.

The study now has data on more than 1,500 incoming freshmen, and more than 220 students have been part of the TLHS for one or more years. "Although we have a fantastic response rate to the August mailing--50 percent is very high--we're trying to improve our recruitment strategies to get even more students as involved, interested and as excited about the TLHS as we are," says Economos.

To the task of analyzing and interpreting the expansive TLHS database, the senior investigators bring a range of experience. Economos, an expert on the effect of diet and exercise on aging muscle and bone, is dedicated to developing communication strategies, programs and public policies that promote health through diet and exercise. Goldberg, director of the Center on Nutrition Communication, collaborated with Dr. Stephen Bailey of the Sociology/Anthropology department on a series of studies of body image and health behaviors among Tufts women undergraduates in the late 198os and early 1990s and is an expert in health communications and behavioral interventions.

Annie Gazdag, a postdoctoral research fellow who joined the TLHS team last year, brings a long-standing interest in college health. She was a peer counselor in health and wellness as an undergraduate at UC Davis, and is well versed on the effects of diet and exercise on body weight and the processes that lead to diabetes.

What the team concludes from the observational phase of TLHS will guide the second phase: the development and implementation of a comprehensive set of health initiatives on the Tufts campus.

According to Goldberg, this phase reflects the philosophy of Tufts' former president, Dr. Jean Mayer, who founded the School of Nutrition Science and Policy at Tufts. She worked with Dr. Mayer for nearly 20 years, including assisting with his nationally syndicated column.

"Dr. Mayer believed that the college environment could play a major role in helping students develop healthy lifestyles," she says. "He believed that while competitive athletics is an integral component of undergraduate life, only a small percentage of students participate and usually only through their college years. He thought that the university should provide its students with ample opportunities for leisure time activities that would promote healthy lifestyles to last throughout their lives."

Although only in its third year, the TLHS has already gained national and international attention. Economos and Gazdag presented the results from the first two years of the study at international nutrition and exercise science meetings in April and May 2000.

Initial findings suggest that current resources on campus do not effectively promote healthy lifestyles in students. "The diets of many of our incoming students leave room for improvement, and unfortunately, when they come to Tufts, the diets they choose often get worse," Economos says.

The data also suggest that college life leads to decreased physical activity. The implications of this trend for personal well-being are clear: students who exercise regularly report using their time more productively, have greater confidence in their intellectual competence, and feel more positively about themselves than students who do not.


Jeanne Goldberg, MEd 59, N86, J92P

"Students often feel like they don’t have time to exercise, that it takes away from their studying and therefore their success as a student," explains Gazdag. "But our data reveal the opposite. The more accurate way of looking at exercise is that instead of taking away from students’ potential for success, regular physical activity enhances it."

Not only do active students feel better about themselves, but they also reap the benefits of exercise. Students who were physically fit had healthier blood cholesterol profiles and lower body fat, important risk factors for cardiovascular disease. Students with greater muscular strength also had higher measures of bone quality.

"Given that the level of bone quality achieved in early adulthood predicts risk for osteoporosis, making time for exercise is critically important," says Gazdag.

Regarding emotional health, the TLHS researchers found that at the end of freshmen year, men report greater use of alcohol to deal with stress. Women develop a more negative body image and become more preoccupied with food, two risk factors for developing disordered eating behavior.

"The college student's transition into adult life can be emotionally trying and stressful, and we're finding that at Tufts, coping with this experience is associated with unhealthy changes in lifestyle," says Goldberg.

TLHS researchers believe comprehensive health promotion efforts have the potential to improve students’ health and well being on campus and long after graduation. But these efforts--innovative programming formats that will attract young people--are a tall order.

On the one hand, college is an opportune time for influencing habits. The campus environment provides a convenient setting for promoting healthy behaviors. It's where students spend most of their time, even if they live off campus. The college years have been singled out as one of the most "teachable" periods in a person's life. Because young adults are still developing their self-identity and asserting their independence, they are especially open to new ideas. On the other hand, personal health often gets short shrift.

"College is a crazy time," says Sandra Klemmer, a junior majoring in biology and environmental studies. "There are so many things to be involved in, and students face a lot of pressure to overload their schedules with activities on top of all their coursework. You see others with internships, jobs, volunteer work and leadership positions. You feel like you have to do it all because you’ll be competing with them for jobs and graduate schools. Balancing everything can be overwhelming–excelling academically, having fun, eating and sleeping well, staying fit and in control."

The TLHS has the potential to make a difference in students' lives while they are in college and as they age. And as the premier institute for studying the way diet and exercise affect how well we age, the School of Nutrition Science and Policy is ideally suited to take the lead in this field of research, notes Economos.

"We want to create a campus that offers students sound information, guidance, skill building programs and opportunities to find the right set of healthy habits that fit their style," says Economos. "TLHS programs at Tufts will establish a precedent by helping students set the stage for a lifetime of health and wellbeing." For more information about THLS, contact: Christina Economos, ceconomos@hnrc.tufts.edu, 617-556-3142 or visit the website at tlhs.tufts.edu.







© 2001 Trustees of Tufts University, all rights reserved.