Dawn Clifford

Health at Every Size College Course Reduces Dieting Behaviors and Improves Intuitive Eating, Body Esteem, and Anti-Fat Attitudes

OBJECTIVE To investigate the effects of a Health at Every Size general education course on intuitive eating, body esteem (BES), cognitive behavioral dieting scores, and anti-fat attitudes of college students. METHODS Quasi-experimental design with 149 students in intervention (45), comparison (66), or control (46) groups. Analysis of variance and post hoc Tukey adjusted tests were used. RESULTS Mean scores for total general education course on intuitive eating (P < .001), unconditional permission to eat (P < .001), reliance on hunger (P < .001), cognitive behavioral dieting scores (P < .001), BES appearance (P = .006), BES weight (P < .001), and anti-fat attitudes (P < .001) significantly improved from pre to post in the intervention group compared with control and comparison groups. CONCLUSION AND IMPLICATIONS Students in the Health at Every Size class improved intuitive eating, body esteem, and anti-fat attitudes and reduced dieting behaviors compared with students in the control and comparison groups.

Impact of Non-Diet Approaches on Attitudes, Behaviors, and Health Outcomes: A Systematic Review

OBJECTIVE To determine the overall effect of non-diet, weight-neutral interventions on factors such as weight, biochemical measures, food and activity behavior, body image, and mental health. DESIGN Systematic review of intervention literature. SETTING Group classes in community and worksite settings (14 studies), and individual counseling (1) and online education (1) in college settings. PARTICIPANTS Eighteen research articles (representing 16 studies) evaluating non-diet interventions using quasi-experimental and randomized study designs with either a comparison or control group. MAIN OUTCOME MEASURES Anthropometric, physiological, psychological, and dietary intake. ANALYSIS Systematic search of 168 articles and review of 18 articles meeting inclusionary criteria. RESULTS Non-diet interventions resulted in statistically significant improvements in disordered eating patterns, self-esteem, and depression. None of the interventions resulted in significant weight gain or worsening of blood pressure, blood glucose, or cholesterol, and in 2 studies biochemical measures improved significantly compared with the control or diet group. Primary limitations were inconsistent definitions of non-diet approaches and the use of different assessment instruments for measuring outcomes. CONCLUSIONS AND IMPLICATIONS Because of the long-term ineffectiveness of weight-focused interventions, the psychological improvements seen in weight-neutral, non-diet interventions warrant further investigation.

Edutainment and teen modeling may spark interest in nutrition & physical activity in elementary school audiences.

Providing knowledge alone is simply not enough to motivate children to eat fruits and vegetables. Innovative nutrition education strategies are often needed to improve attitudes and behaviors about fruit and vegetable intake. Educational theater for nutrition education is one approach in particular that rarely gets attention from academia. The use of education entertainment, or ‘‘edutainment,’’ is the incorporation of education with entertainment and is known to enhance the overall learning experience for the audience. Although previous theaterbased nutrition education programs exist, the literature concerning the effect of teen-led interventions is limited. The main objective of this research was to guide high school students in developing and evaluating an entertaining and educational performance about nutrition and physical activity for kindergarten-6th grade (K-6) audiences. The main messages that were selected for the performance were to eat more fruits and vegetables and participate in regular physical activity.

Nutrition Students Gain Skills from Motivational Interviewing Curriculum

T O PROMOTE LASTING DIETARY behavior changes, many registered dietitian nutritionists (RDNs) are progressing from advice-giving roles to client-centered counseling methods. Motivational interviewing (MI) is one such counseling method used to increase intrinsic motivation and reduce ambivalence to change. MI is based on four key principles: 1) expressing empathy, 2) developing discrepancy, 3) rolling with resistance, and 4) supporting selfefficacy. The MI spirit encompasses collaborating with clients, using clients’ ideas to evoke change, and respecting clients’ autonomy. Open-ended questions, affirmations, reflections, and summaries (OARS) are used throughout MI sessions to build rapport, explore concerns, and convey empathy. The use of MI in nutrition counseling has facilitated successful improvements in fruit and vegetable consumption, increased physical activity, and shortterm weight loss with clients. MIbased nutrition counseling also resulted in positive dietary changes in patients with cancer, diabetes, and chronic heart failure. Although MI is gaining momentum among RDNs, many do not receive adequate training. Rapoport and Perry surveyed 394 dietitians registered in the British Dietetic Association Database and found 44% who felt inadequately trained in MI during their dietetics education. Most participants (77%) believed dietetic programs would benefit from teaching MI to students. Little is known about effective methods for training nutrition students in MI, but training programs for practicing dietitians were found to be effective. In a study of 37 practicing dietitians, those who received a 3-day MI training, displayed more empathy and change-focused statements than dietitians who did not receive training. MI curricula has been implemented in medical schools and with diabetes nurse educators, with positive results; however, the curricula developed were not grounded in learning theories. The Adult Learning Theory (ALT) is a primary theory used in higher education. According to ALT, adult learners are self-directed, autonomous, experienced, goaland relevance-oriented, and practical. The ALT is preferred by instructors vs traditional teachingmethods, and resulted in 82% more knowledge retention in a study of medical residents. The aim of this article is to demonstrate the implementation and evaluation of a theory-based MI curriculum in undergraduate nutrition courses.