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A Health Probe in College Students Living in Los Angeles and in Taiwan: Dietary Pattern, Physical Activity and Energy Balance

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Title: A Health Probe in College Students Living in Los Angeles and in Taiwan: Dietary Pattern, Physical Activity and Energy Balance
Language: English
Authors: Wang, Li Hui, Yang, Hsin Ling, Chen, Yin Chang, Davis, Rebecca, Schwartz, Miriam E., Tam, Chick F.
Source: College Student Journal. Sep 2008 42(3):756-770.
Availability: Project Innovation, Inc. P.O. Box 8508 Spring Hill Station, Mobile, AL 36689-0508. Tel: 251-343-1878; Fax: 251-343-1878; Web site: http://www.projectinnovation.biz/csj.html
Peer Reviewed: Y
Page Count: 15
Publication Date: 2008
Intended Audience: Students
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Descriptors: College Students, Physical Activities, Health Behavior, Life Style, Foreign Countries, Cultural Differences, Cross Cultural Studies, Eating Habits, Dietetics, Physical Activity Level, Nutrition
Geographic Terms: California, Taiwan
ISSN: 0146-3934
Abstract: The objective was to examine differences of dietary pattern, physical activity and energy balance in 240 college students with 137 of them enrolled in California State University, Los Angeles (LA) and the other 93 enrolled in China Medical University in Taichung, Taiwan (TW). A three-day dietary record and a 24-hour physical activity journal were designed to obtain data. LA was found to consume 1, 1.5, 0.8 more servings on fruits and vegetables, milk, citrus group, respectively and 1.2, 4.3 less servings on meats and beans, and grains, respectively, than those of TW with significant differences between student groups. Each group consumed 0.7 serving dark greens per day. Both groups did not obtain the recommended "5 A Day" servings of fruits and vegetables. For physical activity, although LA spent 1033.4 plus or minus 734.0 kcal/day on physical activity, 400 kcal more than TW (607.6 plus or minus 507.3 kcal/day) but LA had 400 more kcal total energy intake (1720.9 [plus or minus 624.8 kcal/day) than those of TW (1306.9 plus or minus 429.3 kcal/day). As a result, LA's energy balance (-995.5 plus or minus 1023.8 kcal/day) was not significantly different from TW (-894.4 plus or minus 696.6 kcal/day). The TW group seemed to have a more sedentary life style than the LA group. Multiple lifestyle modification, including dietary pattern, physical activity and energy balance, should be taken into consideration altogether by college students to promote their health. (Contains 3 tables.)
Abstractor: As Provided
Number of References: 53
Entry Date: 2008
Access URL: https://www.projectinnovation.biz/csj_2006.html
Accession Number: EJ816989
Database: ERIC
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  Value: <anid>AN0034262664;cgl01sep.08;2008Sep13.14:02;v2.2.460</anid> <title id="AN0034262664-1">A HEALTH PROBE IN COLLEGE STUDENTS LIVING IN LOS ANGELES AND IN TAIWAN: DIETARY PATTERN, PHYSICAL ACTIVITY AND ENERGY BALANCE </title> <p>The objective was to examine differences of dietary pattern, physical activity and energy balance in 240 college students with 137 of them enrolled in California State University, Los Angeles (LA) and the other 93 enrolled in China Medical University in Taichung, Taiwan (TW). A three-day dietary record and a 24-hour physical activity journal were designed to obtain data. LA was found to consume 1, 1.5, 0.8 more servings on fruits and vegetables, milk, citrus group, respectively and 1.2,4.3 less servings on meats and beans, and grains, respectively, than those of TW with significant differences between student groups. Each group consumed 0.7 serving dark greens per day. Both groups did not obtain the recommended "5 A Day" servings of fruits and vegetables. For physical activity, although LA spent 1033.4±734.0 kcal/day on physical activity, 400 kcal more than TW (607.6±507.3 kcal/day) but LA had 400 more kcal total energy intake (1720.9±624.8 kcal/day) than those of TW (1306.9±429.3 kcal/day). As a result, LA's energy balance (995.5±1023.8 kcal/day) was not significantly different from TW (-894.4±696.6 kcal/day). The TW group seemed to have a more sedentary life style than the LA group. Multiple lifestyle modification, including dietary pattern, physical activity and energy balance, should be taken into consideration altogether by college students to promote their health.</p> <p>Dietary pattern has long been proved to be strongly associated with health status. Some types of diets, such as the Mediterranean diet, the DASH diet and the Ornish diet, have been shown to possess benefits for the improvement of lipid profiles and the reduction of cardiovascular risks in humans (Panagiotakos et al, 2004; Dallongeville et al., 2003; Trichopoulou, Costacou, Barnia, Trichopoulos, 2003; PREMIER Collaborative Research Group, 2003; Aldana et al., 2003; Schroder, Schmelz, Marrugat, 2002; De Longeril et al., 1999). Eating more servings of fruits and vegetables is well-acknowledged to acquire health benefit. The "5 A Day for Better Health Program" encourages the public to eat 5 or more servings of vegetables and fruits each day and based on cohort studies that have proved its effect on prevention of stroke, many chronic diseases and certain common cancers in humans (He, Nowson, MacGregor, 2006; Heber, 2004).</p> <p>The United States Department of Agriculture (USDA) updated its Food Guide Pyramid and replaced with a new MyPyramid, "Steps to a Healthier You" in year 2005 (MyPyramid, 2005a). Physical activity level was added in the new MyPyramid to underscore the importance of physical activity with respect to health. In the press release of "MyPyramid", the following description was made: "Many Americans can dramatically improve their overall health by making modest improvements to their diets and by incorporating regular physical activity into their daily lives." The 2005 Dietary Guideline for Americans proposed at least 30 minutes moderate intensity activity most days or preferably every day (USDA & USDHHS, 2005) to foster a longer, healthier, happier and productive life.</p> <p>Physical activity is regarded as an independent factor for health promotion. It has shown that physical activity can have the protective effect on renal diseases (Finkelstein, Joshi, Hise, 2006), metabolic diseases (Li, Liu, Lin, 2006), cardiovascular diseases (Ignarro, Balestrieri, Napoli, 2006), breast cancer (Yang, Bernstein, Wu, 2003; Patel, Press, Meeske, Calle, Bernstein, 2003; Carpenter, Ross, PaganiniHill, Bernstein, 2003; Friedenreich, Courneya, Bryant, 2001), and osteoporosis (Borer K.T., 2005). Physical activity also discloses inverse association with triglycerides and fasting plasma glucose, and a positive association with high density lipoprotein cholesterol (HDL-C) (Li et al, 2006). The plausible mechanisms for physical activity to protect and promote cardiovascular functions include increased high density lipoprotein (HDL), lowered low density lipoprotein (LDL), increased myocardial oxygen supply, lowered myocardial oxygen demands, and decreased platelet aggregation, (Leeuwenburgh & Heinecke, 2001 ; Leaf, Kleinman, Hamilton, Deitrick, 1999).</p> <p>Whereas dietary pattern and health habit may vary with age, race, geophysical location, food security and accessibility, cultural and socioeconomic values of foods, there could be a link connecting dietary pattern and health habit such as physical activity. With respect to the idea to explore the relationship between dietary pattern and health habit, it is of interest to study people living in different areas of the world. The objective of this study is therefore to examine the differences of dietary pattern, physical activity, total energy intake (TEI) and energy balance (EB) between college students living in Los Angeles and in Taiwan.</p> <hd id="AN0034262664-2">Methods</hd> <hd1 id="AN0034262664-3"> Human Subjects </hd1> <p>The population study employed a convenient, nonrandomized, biased sampling method due to the location, majors, educational levels and ethnicity of the surveyed participants. A total of 240 college students were recruited in this study, 137 of them enrolled in California State University, Los Angeles (CSULA) and the other 93 were students studying in China Medical University (CMU) in Taichung, Taiwan. The CSULA subjects (LA) consisted of 101 females and 36 males and the CMU students (TW) consisted of 71 females and 22 males.</p> <hd1 id="AN0034262664-4"> Experimental Design </hd1> <p>Each student was assigned to complete a 3-day dietary record and a 24-hour physical activity journal. The 3-day dietary record was designed to record daily dietary intake on two consecutive weekdays and one weekend day to retrieve more accurate dietary data because the dietary habit could fluctuate between weekdays and weekend. A 24-hour physical activity journal was conducted in another week's day other than those obtaining for dietary records. A total of 137 LA (most of them were either Nutrition or Nursing majors) had been trained by the same nutritional professor on how to accurately estimate the serving size of their daily dietary intake and record their physical activity including activity of types, intensity and hours spent. A total of 93 TW had all been trained in previous nutrition classes to eyeball serving sizes of foods and note down on their dietary records. A study design and a detailed explanation for the method of this study were translated into Chinese for TW. They were also given Chinese written reference about Metabolic Equivalents (METs) (Stare & McWilliams, 1984) for physical activity journal. The calculation of total energy expenditure (TEE) including the basal metabolic rate (BMR), the specific dynamic action of food (S.D.A. of food) and the energy expenditure on all physical activity, total energy intake (TEI) from foods were instructed on both groups as well.</p> <hd1 id="AN0034262664-5"> Data Calculation </hd1> <p>Basic Four Food Groups: All food items shown in 3-day dietary record were further categorized into basic four food groups: fruits and vegetables (F/V), milk, grains, meats and beans (M/B). Meanwhile, the data of dark greens and citrus fruits consumption were additionally computed to support the study on college students' dietary patterns. Average serving sizes for basic four food groups, dark greens and citrus from 3-day dietary records were calculated manually</p> <p> <bold> BMR, S.D. A of food, All Physical Activity, TEE, TEI, EB and BMI: </bold> The calculations of TEE including energy expenditures for BMR, S.D.A. of food, total energy spent on physical activity were based on the formulas from Stare and McWilliams (Stare & McWilliams, 1984). EB = TEI — TEE. (TEE = BMR + S.D.A of food + physical activity). % RDA of Kcal intake was calculated as TEI divided by 1989 Recommended Dietary Allowances (RDA); for Kcal recommendation based on age group. The calculations of TEE including kcal expenditures for BMR, S.D.A. of food, physical activity, TEI from food, energy balance (EB) and Body Mass Index (BMI) were all doublechecked with Microsoft Excel 2003.</p> <hd1 id="AN0034262664-6"> Statistical Analysis </hd1> <p>All statistical analysis was performed by Statistical Package for Social Science (SPSS) 12.0 for Windows. Statistical tests set at p value <0.05 were deemed to be "significantly different".</p> <p> <bold> Basic Four Food Groups: </bold> The consumption of four basic groups, dark greens and citrus in daily dietary intake were compared between LA and TW using Independent-t-test. Milk, M/B, grains and citrus were corrected by Mann-Whitney test. The results were also adjusted for gender to compare between groups and within groups. When adjusted for gender between groups (LA females vs TW females, LA males vs TW males), Independent-t-test was used and then Mann-Whitney test was run for females' intake of M/B, grains and citrus groups as well as for males' intake of milk, M/B and citrus groups. When adjusted for gender within groups (LA females vs LA males, TW females vs TW males), Independent-t-test was used and then Mann-Whitney test was run for LA's citrus intake as well as TW's M/B intake. All data in table 2 were expressed as mean ± standard error of the mean (SEM) by groups.</p> <p> <bold> BMR, All Physical Activity, S.D.A. of food, TEE, TEI, EB and BMI: </bold> Independent-t-test was used to compare the differences of age, gender, weight, height, BMI, body surface area, BMR, physical activity, SDA of food, TEE, TEI, %RDA and EB. Mann-Whitney test was run for age, weight, BMI, physical activity, SDA, TEE, TEI and EB to correct the statistic outcome of Independent-t-test. All data in Table 1 and Table 3 were expressed as mean ± standard deviation of mean (SD) by groups.</p> <hd id="AN0034262664-7">Results</hd> <hd1 id="AN0034262664-8"> Subject Characteristics </hd1> <p>LA's average age was of 24.5±5.6 years (ranging from 18.9 to 30.1 years). The mean weight was 61.4±15.8 kg (ranging from 45.6 to 77.2 kg) and the mean height was 1.64±0.09 m (ranging from 1.55 to 1.73 m). Their average body surface area was 1.7±0.2 m<sups>2</sups> (ranging from 1.5 to 1.9 m<sups>2</sups>) and the mean BMI was 22.7±4.8 kg/m<sups>2</sups> (ranging from 17.9 to 27.5 kg/m<sups>2</sups>).</p> <p>TW's average age was of 22.1± 1.3 years (ranging from 20.8 to 23.4 years) and the mean weight was 56.2±10.0 kg (ranging from 46.2 to 66.2 kg). The mean height was 1.64+0.08 m (ranging from 1.56 to 1.72 m), the mean body surface area was 1.6±0.2 (ranging from 1.4 to 1.8 m<sups>2</sups>) and the mean BMI was 20.7±2.5 kg/m<sups>2</sups> (ranging from 18.2 to 23.2 kg/m<sups>2</sups>).</p> <p>There were no significant differences shown in gender, age and height but significant differences were found in weight, body surface area and BMI between LA and TW. The results revealed that in the average the weight of LA was approximately 5 kg heavier than those of TW and the averaged BMI of LA was 2 kg/m<sups>2</sups> more than those of TW. (Table 1)</p> <hd1 id="AN0034262664-9"> The Consumption of Basic Four Food Groups, Dark Greens, Citrus </hd1> <p> <bold> Comparisons within LA: </bold> LA's mean consumption of F/V, milk, M/B and grains were 3.8±0.2,2.0±0.3,2.8±0.1 and4.0±0.1 servings/day, respectively. The mean dark greens and citrus intake were 0.7±0.1 and 1.0±0.1 servings/day, respectively.</p> <p>After adjusted for gender, the mean intake of F/V, milk, M/B and grains of 101 LA females were 3.7±0.2,2.0±0.4,2.5±0.1 and 3.8±0.2 servings/day, respectively. The mean dark greens and citrus intake were 0.7±0.1 and 0.8±0.1 servings/day, respectively. The average intake of F/V, milk, M/B and grains of 36 LA males were 4.3±0.4,2.0±0.2,3.6±0.2 and 4.8±0.3 servings/day, respectively. The mean dark greens and citrus intake were 0.7±0.1 and 1.4±0.3 servings/day, respectively. LA males took in more F/V, M/B, grains and citrus than their female counterparts but only M/B and grains were significantly different between genders. (Table 2)</p> <p> <bold> Comparisons within TW: </bold> TW's mean consumption of F/V, milk, M/B and grains intake were 2.6+0.2,05.±0.1,4.0±0.2 and 8.3±0.3 servings/day, respectively. The mean dark greens and citrus intake were 0.7±0.1 and 0.2+0.0 servings/day, respectively.</p> <p>After adjusted for gender, the mean intake of F/V, milk, M/B and grains of 71 TW females were 2.6±0.2, 0.5+0.1, 3.6+0.2 and 7.8±0.3 servings/day, respectively. The mean dark greens and citrus intake were 0.7+0.1 and 0.2±0.1 servings/day, respectively. The mean intake of F/V, milk, M/B and grains of 22 TW males were 2.9±0.2,0.6±0.1,5.4±0.6 and 9.8±0.4 servings/day, respectively. The mean dark greens and citrus intake were 0.8±0.2 and 0.3+0.1 servings/day, respectively. TW males consumed more F/V, milk, M/B, grains, dark greens and citrus than their female counterparts but only the intakes of M/B and grains were significantly different between genders. (Table 2)</p> <p> <bold> Comparisons between LA and TW: </bold> Statistically significant difference was obtained in the consumption of F/V between LA (3.8 servings/day) and TW (2.6 servings/day); however, the consumption of F/V of both groups did not reach the recommended "5 A Day" serving of F/V. Moreover, LA consumed significantly more milk (2.0 servings/day) and citrus ( 1.0 serving/day) than TW (milk: 0.5; citrus: 0.2 servings/day) but TW consumed more M/B (4.0 serving/day) and grains (8.3 servings/day) than LA (M/B: 2.8; grains: 4.0 servings/day). With respect to their intake of dark greens, there was no significant difference between LA and TW. (Table 2)</p> <p>When compared by gender between different groups, the consumption of F/V, milk, and citrus by LA females was also significantly more than those of TW females. The same results were also found in the comparisons between LA males and TW males. There were no significant differences found on the consumption of dark greens between groups. (Table 2)</p> <hd1 id="AN0034262664-10"> BMR, All Physical Activity, S.D.A. of food, TEE, TEI and EB </hd1> <p> <bold> Comparisons within LA: </bold> The mean BMR of LA (N=137) was 1439.6±232.4 kcal/day. The average energy spent for all physical activity was 1033.4±734.0 kcal/day. The average energy intake from food (TEI) was 1720.9±624.8 kcal/day. The mean % RDA for kcal for 137 LA was 76.9±53.9%. After adjusted for gender, LA males (N=36) had significantly higher BMR, all kcal for physical activity, S.D.A of food, TEE, TEI than those of their female counterparts (N=101). % RDA for kcal for LA females was higher than those of LA males but had no significant difference. The energy imbalance was more observed for LA males (-1490.4±1408.3 kcal/day) than those of LA females (-819.0±782.2 kcayday). (Table 3)</p> <p> <bold> Comparisons within TW: </bold> The mean BMR of TW (N=93) was 1398.8±197.4 kcal/day. The average energy spent for all physical activity was 607.6+507.3 kcal/day. The average energy intake from food (TEI) was 1306.9±429.3 kcal/day. The mean %RDA for kcal for 93 TW was 55.3±16.1%. After adjusted for gender, TW males (N=22) had significantly higher BMR, all kcal for physical activity, S.D.A. of food, TEE, TEI than those of their female counterparts (N=71). % RDA for kcal for TW males was also higher than those of TW females but had no significant difference. The energy imbalance was more observed for TW males (1319.1±1142.2 kcal/day) than those of TW females (-782.0±473.1 kcal/day). (Table 3)</p> <p> <bold> Comparisons between LA and TW: </bold> Although the BMIs were significantly different between two groups (Table 1), their BMR had no significant difference (Table 3). LA spent more calories for physical activity; as a result, LA had higher S.D.A. of food and TEE (246.9±87.5 kcal/day; 2716.3±962.7 kcal/day, respectively) than those of TW (200.2±61.2 kcal/day; 2202.2±673.3 kcal/day, respectively). However, LA also took in more calories than those of TW during a day and evidently the EB was not statistically significant different between these two groups and both of them got negative EB (LA: -995.5±1023.8; TW: -894.4±696.6). (Table 3)</p> <p>LA females had higher BMR, kcal for physical activity, S.D.A. of food, TEE, TEI and %RDA of kcal intake than those of TW females and significant differences were found on kcal for physical activity, S.D.A. of food, TEE, TEI and % RDA of kcal intake but not on BMR. The comparison of EB between LA females and TW females was not significantly different. LA males had higher BMR, kcal for physical activity, S.D.A. of food, TEE, TEI and %RDA for kcal than those of TW males but with no significant difference. The comparison of EB between LA males and TW males was also not found to be significantly different. (Table 3)</p> <hd id="AN0034262664-11">Discussion</hd> <p>Whereas the etiologies of chronic diseases are usually considered as multifactorial, daily diet is one of these influential factors. However, regarding long-term dietary intake as a factor is notoriously difficult to qualify and quantify and the observation of the health influence of a particular nutrient could even take a long period of time to determine its confounding role. Notwithstanding the long-term variations of serving sizes of foods and dietary intakes could be difficult to measure in human populations, the results could be very meaningful in the determination of health outcome.</p> <hd1 id="AN0034262664-12"> Fruits and Vegetables </hd1> <p>In the present study, LA was found to consume one more serving F/V than those of TW (Table 2). The Nurses' Health Study and the Health Professionals' Follow-up Study reveals that each 1-serving increase in intake in fruit and vegetable per day could reduce the relatively risk of coronary heart disease by 4% among men and 3% among women (after the adjustment for variable risk factors) (Joshipura et al., 2001). The reduction is even observed among diabetic subjects. For diabetic men, each 1-serving increase of intake of fruit and vegetable lowers the risk of coronary heart disease by 10% and for diabetic women by 7%. In addition, nutrients, vitamins, minerals, phytochemicals, and antioxidants in vegetables and fruits altogether play protective role for risk reduction of cardiovascular disease (as cited in Ignarro et al., 2006). Moreover, higher fruit and vegetable intake is found to have lower risk for ischemic stroke. Each 1-serving increase in fruit or vegetable intake may lower the risk of ischemic stroke by 6% (Joshipura et al., 1999).</p> <p>Because of the combined calculations of fruit and vegetables in the current study, we could not show the difference based on either fruits or vegetables (Table 2). We observed the food preferences that LA ate more fruits and vegetables than those of TW based on their dietary records. We recommended that the Basic Four Food Group Plan should be disaggregated to Basic Five Food Group Plan according to the MyPyraimid: Grains, Vegetables, Fruits, Milk, Meats and Beans.</p> <hd1 id="AN0034262664-13"> Grains </hd1> <p>In the present study, grains consumption greatly reflected cultural food preference. TW ate 4 more servings/day grains than LA. TW males even consumed 5 more servings/day grains than LA males (Table 2). Although westernized dietary habit has been believed to overwhelm the whole world, the findings found in the current study still confirmed cultural factors strongly influence TW's food choices of more grains. College students are found to dine out more often than their parents (Wu-Tso, Yeh, Tarn, 1995). In terms of food items based on their dietary records, LA chose more fast foods than TW in this present study. For TW, they tended to eat special Taiwanese snacks more than typically western fast foods.</p> <p>Whole grains but not refined grains are indicated to have an inverse relationship with ischemic stroke in the Nurses' Health Study (as cited in Albert, 2005). Whole Grains include dark bread, whole grain breakfast cereal, popcorn, cooked oatmeal, wheat germ, brown rice, bran and other grains. Nevertheless, in the current study, we are short of detailed information to classify grains because most students did not specify what types of grains in their 3-day dietary records.</p> <hd1 id="AN0034262664-14"> Meats and Beans </hd1> <p>In the present study, TW consumed 1.2 more servings/day meats and beans than LA (Table 2). Based on TW's dietary records, the higher intake in this aspect in TW's diet can be attributed to versatile traditional soy products, such as tofu, soy bean curds, natto, miso and soy sauce. Asians are estimated to consume an average of 20 to 80 g of traditional soy foods daily and in contrast, Americans consume only about 1 to 3 g daily, such as soy drinks, breakfast cereals, energy bars, and soy "burgers" (Adetayo, Omoni, Aluko, 2005). The US Food and Drug Administration (FDA) allowed health claims on food labels of soy protein (US FDA, 1999) and the American Heart Association (AHA) also proposed the better use of soy protein (Krauss, Eckel, Howard, 2000). Besides soy intake, fish consumption is also inversely associated with the risk of coronary heart disease and the reduction is up to 20% to 36% (He et al., 2002). In this present report, we did not provide further categorization of food itmes with respect to protein sources and it should be done in our future report.</p> <p>Furthermore, foods could have different effects on different gender (Joshipura et al., 2001). In the current study, in both LA and TW, males' intake in grains, meats and beans significantly differed from their female counterparts. LA males had one more serving grains, and meats and beans than LA females. TW males had two more serving grains, meats and beans than TW females (Table 2). These findings on food choices by genders should be evaluated in future follow-up studies.</p> <hd1 id="AN0034262664-15"> Milk </hd1> <p>In this current study, TW consumed 1.5 less serving milk and dairy products per day than LA (Table 2). This is consistent with Wu-Tso et al finding in Asian American college students (Wu-Tso et al, 1995) that Asians consumed much less milk and dairy products than Caucasians. Gender comparisons did not reveal statistical difference on milk or dairy consumption in the current study (Table 2). For Asians, calcium is considered more likely to be obtained from small fish, soy products, vegetables and fruits rather than dairy products (as cited in Wu-Tso et al., 1995) because of several reasons: cultural food preferences, dietary practices learned in early life, and lactose maldigestion (lactose intolerance). However, the low intake of calcium-rich diet could result in calcium deficiency and its related diseases in TW. A couple of researches has displayed that lactose intolerance could be improved using a few simple dietary strategies (Jarvis & Miller, 2002). Health practitioners and dietitians in Taiwan need to educate the Taiwanese population to learn how to eliminate the problems of lactose intolerance and to take in a dairy-rich diet for calcium intake thus overcome the barrier of milk and dairy consumption to promote health for people living in Taiwan.</p> <hd1 id="AN0034262664-16"> Dark greens and Citrus </hd1> <p>For dark greens consumption, it was the same (0.7 serving per day) in both LA and TW; however, for citrus intake, LA consumed statistically significant 0.8 servings higher than TW in this current study. Genders did not reveal any preference on dark greens or citrus intake within groups but between groups, LA females had 0.6 more serving/day citrus intake than TW females; LA males also had 1.1 more serving/day citrus intake than TW males with significant differences of the means. (Table 2). Although the discrepancies here seemed insignificant, yet an earlier research revealed that for each 1-serving increase in intake of green leafy vegetables decreases risk for coronary heart disease by 16% among men and 30% among women. In addition, for each 1-serving increase in intake in total citrus fruit decreases risk for coronary heart disease by 5% among men and 7% among women (Joshipura et al., 2001).</p> <p>The lifestyles and socioeconomic structures have also been enormously changing in Taiwan and heart disease has become one of the leading causes of death (Taiwan Department of Health, 2004). The prevention of coronary heart disease with an increase of dark greens and citrus intakes for people living in Taiwan is essential.</p> <hd1 id="AN0034262664-17"> Physical Activity and Energy Balance </hd1> <p>The benefits of physical activity listed on the MyPyramid include: "improving self-esteem and feelings of well-being, increasing fitness level, helping build and maintain bones, muscles, and joints, preventing weight gain, building endurance and muscle strength, enhancing flexibility and posture, helping manage weight, lowering risk of heart disease, colon cancer, and type 2 diabetes, helping control blood pressure, and reducing feelings of depression and anxiety" (MyPyramid, 2005b). In the present study, LA was found to spend significantly 400 more calories on physical activity than TW and their TEEs were also significantly higher than TW (Table 3).</p> <p>Physical activity has been known to be associated with cultural value, economic level and social trend (Kriska, 2000). In 2004, National Surveys conducted in Taiwan revealed that merely 14% of Taiwanese adults have leisure-time physical activities which are three or more three times per week for at least 30 minutes of moderate intensity per session (Ku, Fox, McKenna, Peng, 2006). The age group between 20 to 44 years old is the one whose exercises decline most significantly from year 2001 to 2004 (from 33.4% to 15.9%). In the current study, TW aged from 20.823.4 years (Table 1) is right in this range of age subgroup.</p> <p>Meanwhile, we would like to point out that although strenuous exercises could produce too much free radicals overwhelmed the inner scavenging systems but moderate intensity aerobic activity is believed to be able to benefit endothelial function and also lower cardiovascular risk (Leeuwenburgh & Heinecke, 2001 ; Leaf et al., 1999). In this current report, we did not specify and classify physical activity level (mild, moderate, severe) as described in study of Liang et al (2007) and more details should be given in our future report.</p> <p>Physical Inactivity could predispose overweight and obesity of the general public. Besides overweight and obesity, early onset of breast cancer (younger or equal to 40 years old) has been observed in Asian countries (Suzuki et al., 2006; Yoo et al., 2002) and is a unique feature in Taiwan (Cheng et al., 2000). Not only do dietary factors play a critical role but physical inactivity also correlates with breast cancer (Lee et al., 2005; Yang et al., 2003; Patel et al, 2003; Carpenter et al., 2003; Friedenreich et al., 2001). Inactivity found in college students could be a public health concern for people living in Taiwan.</p> <p>In the present study, LA had higher TEI and as a result, EB was not significant different from TW (Table 3). Both of LA and TW had negative EB, this could be associated with the underestimation of serving sizes of their intakes of foods. Bountiful researches have been conducted to check out the ability of general people to appropriately estimate portion sizes and serving sizes. The disability to recognize appropriate portion sizes disclosed in studies in relation to overweight and obesity might attribute to the following reasons: 1) Food industry has been bulking portion sizes during the past two decades. Current sizes could be 2-5 times than the original sizes. 2) The sizes of marketplace portions are indeed greater than federal standard sizes by 2-8 folds. 3) Discrepancy exists between the USDA and the FDA standards for serving sizes. Dietary guidance follows the USDA criteria but food labeling is ruled by the FDA. A cup of cooked rice is one serving by the FDA standard but two servings by the USDA criteria. Although college students were well-instructed in class, they may still be confused and distorted by these two systems, food labels, and "super" portion sizes (Schwartz & Byrd-Bredbenner, 2006; Volker, Leary, Gill, 2003; Young & Nestle, 2003). Bulky meals provide excessive energy and may also contribute to the increases of prevalence of overweight and obesity.</p> <p>Studies conducted in Taiwan reveal that Taiwan is insidiously beginning an epidemic of overweight or obesity (Chu, 2005; Chu, 2001; Kou, 1998). The Department of Health in Taiwan applies BMI > 24 kg/m² and BMI ≤ 27 kg/m² to define overweight and obesity for the Taiwanese. Based on Taiwanese definition, in this present study, prevalence of overweight and obesity were 6.7% and 2.2% in TW, respectively. Prevalence of overweight and obesity during 2000-2001 for subgroups aged 20-44 years are 25.5% and 16.3% for males, 12.9% and 7.4% for females, respectively (Chu, 2005). Data from a nationwide cross-sectional population-based survey in Taiwan in 2002, prevalence of obesity is 19.2 % for males and 13.4% for females among all adult populations (Hwang, Bai, Chen, 2006). Compared with this current study, prevalence of overweight and obesity in TW using Taiwanese definition was much lower in % of overweight and obesity than the age-adjusted prevalence found in Chu's study and overall prevalence found in Hwang's report (Hwang, Bai, Chen, 2006).</p> <p>Based on WHO BMI cutoffs for global use (normal: <25, overweight: 25-29.9, obese: >30 kg/m2), prevalence of overweight and obesity were 21.2% and 5.8% in LA, respectively. The latest published prevalence of overweight and obesity in the U.S. during 2003 to 2004, after the adjustment for age, is 28.6% and 28.5% for obesity for subgroup aged 20 to 39 years, respectively (Ogden et al., 2006). Compared with this present study, prevalence of overweight (22.6%) and obesity (5.8%) in LA (aged from 19 to 30 years) were much lower than the corresponding young American adults. Our findings in the present study may not be generalized to all populations in Los Angeles or in Taiwan because our subjects were limited to the selection of nursing science and nutritional students. Nutritional and nursing students probably have better understanding and awareness on body weight maintenance.</p> <p>The United Nation predicts that life expectancy of 100 years could be arrived by the year 2300 (Department of Economic and Social Affairs, 2004) but obesity might have a strong inverse impact on this trend of longevity. For the severely obese case, obesity could shorten the length of their life by 5 to 20 years (Fontaine, Redden, Wang, Westfall, Allison, 2003). According to CDC Morbidity and Mortality Weekly Report (CDC, 2000), approximately more than 60% of overweight or obese adults have ever tried to lose weight by physical activity; nevertheless, only one-fifth of them met the physical activity guidelines. As a matter of fact, multiple lifestyle modifications including healthy dietary pattern (such as the DASH diet), moderate intensity activity (at least 30 minutes in most days or preferably every day), and weight loss might work more effective than merely engaging physical activity to reduce risk for chronic disease (The newest report of the PREMIER Collaborative Research Group, 2006; USDA & USDHHS, 2005). Dietary pattern, physical activity, energy balance and BMI should be taken into consideration at the same time by college students for the sake of their health.</p> <hd id="AN0034262664-18">Table 1. Subject Characteristics: Gender, Age, Weight, Height, and BMI</hd> <ct id="AN0034262664-19"> LA[§] TW[‡] Sample Size 137 93 Gender[a] Female 101 71 Male 36 22 Age(y)[*,b] 24.515.6 22.111.3 Height(cm)[*,c] 1.64±0.09 1.64±0.08 Weight(kg)[',d] 61.4115.8 56.2110.0 Body Surface Area (m<sups>2</sups>)[*'e] 1.710.2 1.6±0.2 BMI[*,±,f] 22.7±4.8 20.7±2.5 § LA referred to college students at California State University, Los Angeles $ TW referred to college students at China Medical University, Taichung, Taiwan * Age, height, weight and BMI were described as mean ± SD. 1 Body mass index was calculated as weight in kilograms divided by the square of height in meters. a,b,c LA vs TW, p>0.05; d,e,f LA vs TW, p<0.05</ct> <hd id="AN0034262664-20">Table 2. Comparisons of Basic Four Food Groups, Dark Greens and Citrus between LA§ andTW[‡]</hd> <ct id="AN0034262664-21"> Legend for Chart: A - LA(N-137)[§]: Total (N=137) B - LA(N-137)[§] Female (N=101) C - LA(N-137)[§] Male (N=36) Mean Serving Size[*] (serving/day) D - TW (N=93)[‡]: Total(N-93) E - TW (N=93)[‡] Femak(N=71) F - TW (N=93)[‡] Male(N=22) Mean Serving Size[*] (serving/day) A B C D E F Fruits and Vegetables 3.8±l.2a 3.7±0.2j 4.3±0.40 2.6±0.2a 2.6±0.2j 2.9±0.2o Milk 2.0±0.3b 2.0±0.4k 2.0±0.2p 0.5±0.lb 0.5±0.1k 0.6±0.lp Meats and Beans 2.8±0.1c 2.5±0.1W 3.6±0.2f,q 4.010.2c 3.6±0.2h,/ 5.4±0.6h,q Grains 4.0±0.1d 3.8±0.2g,m 4.810.3g,r 8.3±0.3d 7.8±0.3i,m 9.8±0.4i,r Dark Greens 0.710.1 0.710.1 0.7±0.1 0.710.1 0.710.1 0.810.2 Citrus 1.010.1c 0.810.1n 1.4±0.3s 0.2±0.0e 0.210.1n 0.310.1s § Referred to college students enrolled at California State University, Los Angeles ‡ Referred to college students enrolled at China Medical University, Taichung, Taiwan *Data were expressed as Mean±SEM a,b,c,d,e LA total vs TW total, p<0.05; f,g LA females vs LA males, p<0.05; h,i TW females vs TW males, p<0.05; j,k,l,m,n LA females vs TW females, p<0.05; o,p,q,r,s LA males vs TW males, p<0.05. Unless specified, there is no significant difference.</ct> <hd id="AN0034262664-22">Table 3. Comparisons of Basal Metabolic Rate, Physical Activity, Specific Dynamic Action of Food, Total Energy Expenditure, Total Energy Intake, % RDA of Kcal Intake and Energy Balance between LA§ and TW[‡]</hd> <ct id="AN0034262664-23"> Legend for Chart: A - LA(N=137)§: Total (N-137) B - LA(N=137)§: Female (N-101) C - LA(N=137)§: Male (N-36) D - TW (N=93)[‡]: Total (N-93) E - TW (N=93)[‡]: Female (N=71) F - TW (N=93)[‡]: Male(N=22) A B C D E F Basal Metabolic Rate (BMR) (kcal/day)[*] 1439.6±232.4 1343.1±150.3[f] 1708.0±211.3[f] 1398.8±197.4 1308.6±104.1/ 1695.2+127.1/ Kcal for AU Physical Activity (kcal/day)[*] 1033.4±734.0[a] 883.9±513.8[g,r] 1441.4±1050.6[g] 607.6±507.3[a] 512.1±332.7[m,r] 959.31817.3[m] Specific Dynamic Action (SDA) of Food (kcal/day)[*] 246.9±87.5[b] 222.7±60.9[h,s] 314.9±112.8[h] 200.2±61.2[b] 181.9±37.5[n,s] 269.2±82.5[n] Total Energy Expenditure (TEE) (kcal/day)[*] 2716.3±962.7[c] 2449.7±669.6[i,t] 3464.3±l240.7[i] 2202.2±673.3[c] 2001.2±412.7[o.t] 1637.9±528.0[o] Total Energy Intake (TEI) (kcal/day)[*] 1720.9±624.8[d] 1630.7±482.6[j,u] 1973.9±873.1[j] 1306.9±429.3[d] 1209.0±342.5[p.u] 1637.9±528.0[p] % RDA of Kcal Intake[*] 76.9+53.9[e] 79.8+60.0[v] 68.2+30.2 55.3+16.1[e] 55.0±15.6[v] 56.5+18.2 Energy Balance (EB) (kcal/day)[*] -995.5±1023.8 -819.0±782.2k -1490.4±1408.3k -894.4±696.6 -782.0±473.l[q] -1319.111142.2[q] §Referred to college students enrolled at California State University, Los Angeles $ Referred to college students enrolled at China Medical University, Taichung, Taiwan *Data were expressed as Mean±SD a,b,c,d,e LA total vs TW total, p<0.05; f,g,h,i,j,k LA females vs LA males, p<0.05; 1, m, n, o, p, q TW females vs TW males, p<0.05; r, s, t, u, v LA females vs TW females, p<0.05 Unless specified, there is no significant difference.</ct> <ref id="AN0034262664-24"> <title> Reference </title> <blist> <bibl id="bib1" type="bt"></bibl> <bibtext>Adetayo, O., Omoni, A.O., Aluko, R.E. 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Tam, School of Kinesiology and Nutritional Science, California State University at Los Angeles, 5151 State University Drive, Los Angeles, CA 90032, U.S.A.</p> </aug>
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  Data: A Health Probe in College Students Living in Los Angeles and in Taiwan: Dietary Pattern, Physical Activity and Energy Balance
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  Data: <searchLink fieldCode="SO" term="%22College+Student+Journal%22"><i>College Student Journal</i></searchLink>. Sep 2008 42(3):756-770.
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  Label: Page Count
  Group: Src
  Data: 15
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2008
– Name: Audience
  Label: Intended Audience
  Group: Audnce
  Data: Students
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Activities%22">Physical Activities</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Behavior%22">Health Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Life+Style%22">Life Style</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Cultural+Differences%22">Cultural Differences</searchLink><br /><searchLink fieldCode="DE" term="%22Cross+Cultural+Studies%22">Cross Cultural Studies</searchLink><br /><searchLink fieldCode="DE" term="%22Eating+Habits%22">Eating Habits</searchLink><br /><searchLink fieldCode="DE" term="%22Dietetics%22">Dietetics</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Activity+Level%22">Physical Activity Level</searchLink><br /><searchLink fieldCode="DE" term="%22Nutrition%22">Nutrition</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22California%22">California</searchLink><br /><searchLink fieldCode="DE" term="%22Taiwan%22">Taiwan</searchLink>
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0146-3934
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: The objective was to examine differences of dietary pattern, physical activity and energy balance in 240 college students with 137 of them enrolled in California State University, Los Angeles (LA) and the other 93 enrolled in China Medical University in Taichung, Taiwan (TW). A three-day dietary record and a 24-hour physical activity journal were designed to obtain data. LA was found to consume 1, 1.5, 0.8 more servings on fruits and vegetables, milk, citrus group, respectively and 1.2, 4.3 less servings on meats and beans, and grains, respectively, than those of TW with significant differences between student groups. Each group consumed 0.7 serving dark greens per day. Both groups did not obtain the recommended "5 A Day" servings of fruits and vegetables. For physical activity, although LA spent 1033.4 plus or minus 734.0 kcal/day on physical activity, 400 kcal more than TW (607.6 plus or minus 507.3 kcal/day) but LA had 400 more kcal total energy intake (1720.9 [plus or minus 624.8 kcal/day) than those of TW (1306.9 plus or minus 429.3 kcal/day). As a result, LA's energy balance (-995.5 plus or minus 1023.8 kcal/day) was not significantly different from TW (-894.4 plus or minus 696.6 kcal/day). The TW group seemed to have a more sedentary life style than the LA group. Multiple lifestyle modification, including dietary pattern, physical activity and energy balance, should be taken into consideration altogether by college students to promote their health. (Contains 3 tables.)
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: Ref
  Label: Number of References
  Group: RefInfo
  Data: 53
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2008
– Name: URL
  Label: Access URL
  Group: URL
  Data: <link linkTarget="URL" linkTerm="https://www.projectinnovation.biz/csj_2006.html" linkWindow="_blank">http://www.projectinnovation.biz/csj_2006.html</link>
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ816989
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ816989
RecordInfo BibRecord:
  BibEntity:
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 15
        StartPage: 756
    Subjects:
      – SubjectFull: College Students
        Type: general
      – SubjectFull: Physical Activities
        Type: general
      – SubjectFull: Health Behavior
        Type: general
      – SubjectFull: Life Style
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Cultural Differences
        Type: general
      – SubjectFull: Cross Cultural Studies
        Type: general
      – SubjectFull: Eating Habits
        Type: general
      – SubjectFull: Dietetics
        Type: general
      – SubjectFull: Physical Activity Level
        Type: general
      – SubjectFull: Nutrition
        Type: general
      – SubjectFull: California
        Type: general
      – SubjectFull: Taiwan
        Type: general
    Titles:
      – TitleFull: A Health Probe in College Students Living in Los Angeles and in Taiwan: Dietary Pattern, Physical Activity and Energy Balance
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Wang, Li Hui
      – PersonEntity:
          Name:
            NameFull: Yang, Hsin Ling
      – PersonEntity:
          Name:
            NameFull: Chen, Yin Chang
      – PersonEntity:
          Name:
            NameFull: Davis, Rebecca
      – PersonEntity:
          Name:
            NameFull: Schwartz, Miriam E.
      – PersonEntity:
          Name:
            NameFull: Tam, Chick F.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 09
              Type: published
              Y: 2008
          Identifiers:
            – Type: issn-print
              Value: 0146-3934
          Numbering:
            – Type: volume
              Value: 42
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: College Student Journal
              Type: main
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