1. Saturday, May 23 rd, 2009 CSSE Ottawa, Ontario Sarah Gray Saturday, May 23 rd, 2009 CSSE Ottawa, Ontario Sarah Gray The Nutritional Knowledge, Eating Habits, and Body Image of Adolescent Females

2. Introduction  Current state of adolescent females’ nutrition knowledge, eating habits, and body image  Context of Ontario high schools and curriculum  Current state of adolescent females’ nutrition knowledge, eating habits, and body image  Context of Ontario high schools and curriculum

3. Purpose  Does the current curriculum and high school programs facilitate an increase in nutritional knowledge, eating habits, or body image?  Are the nutritional knowledge, eating habits, or body image of adolescent females related to each other?

4. Adolescent Growth and Development  During adolescence, a person is undergoing a tremendous amount of physical as well as psychological and emotional change and development. (Larson et al., 2002; Spear, 2002)  Some females may experience body image dissatisfaction which can affect their food choices (Middleman & Durant, 1998).  Food habits from an early age are difficult to influence or change later in life (Brown, McIlveen, & Strugnell, 2000)  During adolescence, a person is undergoing a tremendous amount of physical as well as psychological and emotional change and development. (Larson et al., 2002; Spear, 2002)  Some females may experience body image dissatisfaction which can affect their food choices (Middleman & Durant, 1998).  Food habits from an early age are difficult to influence or change later in life (Brown, McIlveen, & Strugnell, 2000)

5. External Influences On Adolescent Nutrition and Development  Media  Food advertisers spend more than $2.5 billion per year to promote their food or restaurants and an additional $2 billion to promote food products (Goodman, 1999).  In 2006, Canadian adolescents 12 to 17 years of age watched 12.9 hours of television per week (Statistics Canada, 2006).  Peers  A relationship has been between the girls’ weight control practices and their peers (Troiano & Flegal, 1995).  Family  Young females often model the weight control behaviours of their mothers (Levine, Smolak, Moodey, & Hessen, 1994)  Females whose mothers are concerned about their body weight and shape are more likely to develop unhealthy eating habits (Hill & Franklin, 1998; Pike & Rodin, 1991).  Media  Food advertisers spend more than $2.5 billion per year to promote their food or restaurants and an additional $2 billion to promote food products (Goodman, 1999).  In 2006, Canadian adolescents 12 to 17 years of age watched 12.9 hours of television per week (Statistics Canada, 2006).  Peers  A relationship has been between the girls’ weight control practices and their peers (Troiano & Flegal, 1995).  Family  Young females often model the weight control behaviours of their mothers (Levine, Smolak, Moodey, & Hessen, 1994)  Females whose mothers are concerned about their body weight and shape are more likely to develop unhealthy eating habits (Hill & Franklin, 1998; Pike & Rodin, 1991).

6. Nutrition and Body Image  Body dissatisfaction was found to be highly correlated with eating disturbances among adolescent females (Fabian & Thompson, 1989).  Females are more likely to use food as a method to manipulate their weight compared to their male counterparts (Nowak, 1998).  Females have a higher tendency to skip meals and continue these behaviours well beyond the commencement of a diet (Nowak, 1998).  Body dissatisfaction was found to be highly correlated with eating disturbances among adolescent females (Fabian & Thompson, 1989).  Females are more likely to use food as a method to manipulate their weight compared to their male counterparts (Nowak, 1998).  Females have a higher tendency to skip meals and continue these behaviours well beyond the commencement of a diet (Nowak, 1998).

7. School Environment  Students consume one third of their calories at school (Finkelstein, 2009).  When given the opportunity of choice, student selections are high in fat, which can result in a poor balanced diet (Eves, Corney, Kipps, Nobel, & Lumbers 1997).  Most popular foods purchased at schools are chips, French fries, hamburgers, hotdogs, candy, and carbonated drinks (Warwick, McIlveen, & Strugnell 1999)  Decreases in the price of healthy food selections are met with an increase in the amount that is purchased by students (French et al., 2001)  Mandatory national nutrition education policy  Students consume one third of their calories at school (Finkelstein, 2009).  When given the opportunity of choice, student selections are high in fat, which can result in a poor balanced diet (Eves, Corney, Kipps, Nobel, & Lumbers 1997).  Most popular foods purchased at schools are chips, French fries, hamburgers, hotdogs, candy, and carbonated drinks (Warwick, McIlveen, & Strugnell 1999)  Decreases in the price of healthy food selections are met with an increase in the amount that is purchased by students (French et al., 2001)  Mandatory national nutrition education policy

8. School Based Nutrition Programs  Hidden curriculum is a school’s philosophy, nutrition policies, role modelling by staff, and the consistency of messages conveyed by the school (Dixey et al., 1999).  Teacher training in the field of nutrition not only increases the teachers’ knowledge of nutrition but also increases the amount of instructional time spent on nutrition (Weis & Klein, 1987)  Teachers may portray messages of weight prejudice, body image stereotypes, and fear of food. These messages may be perceived by the students as frightening and negative, which may in turn influence their body image and nutrition habits (O’Dea & Abraham, 2001; Piran, 1999; Ransley, 1999)  Hidden curriculum is a school’s philosophy, nutrition policies, role modelling by staff, and the consistency of messages conveyed by the school (Dixey et al., 1999).  Teacher training in the field of nutrition not only increases the teachers’ knowledge of nutrition but also increases the amount of instructional time spent on nutrition (Weis & Klein, 1987)  Teachers may portray messages of weight prejudice, body image stereotypes, and fear of food. These messages may be perceived by the students as frightening and negative, which may in turn influence their body image and nutrition habits (O’Dea & Abraham, 2001; Piran, 1999; Ransley, 1999)

9. Research Methodology Mixed Methods Research  Quantitative Data  Nutritional Knowledge Questionnaire  Eating Habits Questionnaire  Body Image Questionnaire  Qualitative Data  Participant Interviews  Ontario Curriculum Documents  Teaching Documents Mixed Methods Research  Quantitative Data  Nutritional Knowledge Questionnaire  Eating Habits Questionnaire  Body Image Questionnaire  Qualitative Data  Participant Interviews  Ontario Curriculum Documents  Teaching Documents

10. Participants and Site  High School In Southern Ontario  Convenience and Nonrandom Sampling  All female students within the school were invited to participate (approximately 400)  90 Grade 9-12 female students  Data collection occurred over 2 months  High School In Southern Ontario  Convenience and Nonrandom Sampling  All female students within the school were invited to participate (approximately 400)  90 Grade 9-12 female students  Data collection occurred over 2 months

11. Instrumentation and Analysis  All participants completed:  Nutritional knowledge questionnaire  Eating Habits questionnaire  Body Image questionnaire  Questionnaire data were analyzed with SPSS  20 participants completed interviews  Curriculum and teaching documents were also analyzed  All participants completed:  Nutritional knowledge questionnaire  Eating Habits questionnaire  Body Image questionnaire  Questionnaire data were analyzed with SPSS  20 participants completed interviews  Curriculum and teaching documents were also analyzed

12. Findings-Nutritional Knowledge Students who took nutrition curriculum  Significant differences found when compared to students who had no exposure to nutrition curriculum. Physical Education Students  No significant difference when compared to all other students. Grade Level  Significant differences found between grade 9 students and grade 11 and grade 12 students. Students who took nutrition curriculum  Significant differences found when compared to students who had no exposure to nutrition curriculum. Physical Education Students  No significant difference when compared to all other students. Grade Level  Significant differences found between grade 9 students and grade 11 and grade 12 students.

13. Findings-Eating Habits Students who took nutrition curriculum  No significant differences found. Physical Education Students  Significant difference when compared to all other students. Grade Level  Significant differences found between grade 9 students and all other grade levels. Students who took nutrition curriculum  No significant differences found. Physical Education Students  Significant difference when compared to all other students. Grade Level  Significant differences found between grade 9 students and all other grade levels.

14. Findings-Body Image Students who took nutrition curriculum  No significant differences found. Physical Education Students  Significant difference when compared to all other students. Grade Level  No significant differences were found between grades. Students who took nutrition curriculum  No significant differences found. Physical Education Students  Significant difference when compared to all other students. Grade Level  No significant differences were found between grades.

15. 5 Major Themes Developed:  School programs  Family  Friends  School cafeteria  Extracurricular activities and competitive sports 5 Major Themes Developed:  School programs  Family  Friends  School cafeteria  Extracurricular activities and competitive sports Findings- Interviews

16.  Exposure to nutrition knowledge should cause an increase in nutrition knowledge.  Differences between grades can be accounted by increase in exposure.  Some students may have forgotten some of the nutrition knowledge they learned because it may have been months or years since exposure.  Students may find nutrition curriculum boring, not useful and repetitive, therefore do not put forth effort into learning it.  Many external influences on nutrition knowledge.  Exposure to nutrition knowledge should cause an increase in nutrition knowledge.  Differences between grades can be accounted by increase in exposure.  Some students may have forgotten some of the nutrition knowledge they learned because it may have been months or years since exposure.  Students may find nutrition curriculum boring, not useful and repetitive, therefore do not put forth effort into learning it.  Many external influences on nutrition knowledge. Discussion- Nutrition Knowledge

17.  Limited application of the knowledge is taught in schools.  Significant difference between physical education students and other participants not surprising.  Studies have found correlations between unhealthy eating and the lack of physical activity (Lytle, Kelder, Perry & Klepp, 1995; Neumark-Sztainer, Story, Toporoff, et al., 1997).  Students have more choice and control over eating habits with age.  Time constraints, peer and family influence impacted food choices.  Limited application of the knowledge is taught in schools.  Significant difference between physical education students and other participants not surprising.  Studies have found correlations between unhealthy eating and the lack of physical activity (Lytle, Kelder, Perry & Klepp, 1995; Neumark-Sztainer, Story, Toporoff, et al., 1997).  Students have more choice and control over eating habits with age.  Time constraints, peer and family influence impacted food choices. Discussion- Eating Habits

18.  Significant difference between physical education students and other participants not surprising.  Studies have found correlations between physical activity and female body image (Marsh, 1994; Richman & Shaffer, 2000).  Single sex health and physical education classes versus other subjects’ mixed classes may have impact on teaching and learning.  No participants had unfavourable body images- many were neutral in their feelings.  Significant difference between physical education students and other participants not surprising.  Studies have found correlations between physical activity and female body image (Marsh, 1994; Richman & Shaffer, 2000).  Single sex health and physical education classes versus other subjects’ mixed classes may have impact on teaching and learning.  No participants had unfavourable body images- many were neutral in their feelings. Discussion- Body Image

19. Implications for Practice  Creativity and flexibility are essential to ensure that the curricular expectations are covered appropriately while making nutrition fun and meaningful  Small segments of information or activities about applying the nutrition information into everyday life should be incorporated into classes.  Healthy food choices should be available at all times  Nutrition information for food available for purchase should be available  Provide healthier food choices at a lower cost  Collaboration between teachers and departments  Creativity and flexibility are essential to ensure that the curricular expectations are covered appropriately while making nutrition fun and meaningful  Small segments of information or activities about applying the nutrition information into everyday life should be incorporated into classes.  Healthy food choices should be available at all times  Nutrition information for food available for purchase should be available  Provide healthier food choices at a lower cost  Collaboration between teachers and departments

20. Implications for Further Research  Long-term retention of the information  Impact of parental attitudes, opinions, and support  Knowledge, background, and interests of the classroom teacher  Self-efficacy  Role modelling of teachers  Long-term retention of the information  Impact of parental attitudes, opinions, and support  Knowledge, background, and interests of the classroom teacher  Self-efficacy  Role modelling of teachers

21. Conclusions Changes should be implemented  Are we providing enough nutrition education?  Should students receive mandatory nutrition education in high school?  Are we giving contradictory messages?  How can we expect students to make good food choices when we do not provide the opportunities?  Are there changes that should be implemented into the curriculum  Should we have more application of the knowledge? Students are open and want change Changes should be implemented  Are we providing enough nutrition education?  Should students receive mandatory nutrition education in high school?  Are we giving contradictory messages?  How can we expect students to make good food choices when we do not provide the opportunities?  Are there changes that should be implemented into the curriculum  Should we have more application of the knowledge? Students are open and want change