Research Brief
Eating Competence of College Students in an Introductory Nutrition Course

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Abstract

Objective

Describe eating competence, a positive and flexible way of conceptualizing eating attitudes and behaviors, in students enrolled in an introductory nutrition course.

Methods

Online completion of the Satter Eating Competence Inventory (ecSI) and self-assessment of eating disorder status by 557 students (343 ages 18-20 years and 180 ages 21-26 years; 377 females) at the beginning of 1 semester. Analysis of variance and post hoc Tukey adjusted tests were used.

Results

The mean ecSI score was 30.7 ± 0.29; 47.4% were classified as eating competent, or ecSI ≥ 32. Mean ecSI was higher for males than females (29.4 ± 0.95 vs 27.4 ± 0.77; P < .001). Mean ecSI was higher for students who never had an eating disorder, compared with those reporting current (32.0 ± 0.43 vs 22.9 ± 1.91; P < .001) or past (28.8 ± 0.93; P < .01) eating disorders.

Conclusions and Implications

Students had limited eating competence, but a majority of males were eating competent. Students who had never had an eating disorder had higher eating competence than students with current or past disorders. Examining nutrition courses as currently taught may reveal ways courses could contribute to eating competence.

Introduction

Nutrition education should promote the adoption of healthy eating behaviors,1 such as those reflected in the Satter Model of Eating Competence.2 The Satter Model of Eating Competence encourages eating based on the “body's natural processes: hunger and drive to survive, appetite and the need for pleasure, the social reward of sharing food and the tendency to maintain preferred and stable body weight.”3 In short, competent eaters have a flexible, positive approach to feeding themselves nutritious and enjoyable food. The Satter Model of Eating Competence does not address nutrient intake directly, but Satter Eating Competence Inventory (ecSI) scores have been shown to correlate with diet quality,4 serum lipid and other biomarkers of good health,5, 6 and self-reported physical activity.7, 8, 9, 10, 11 Thus, promoting eating competence (EC) seems to be worthwhile.

Students need better skills to pay attention to food and self while eating.

Studies have described EC in adults,8, 12 hypercholesterolemic ad-ults,5 elderly adults in Spain,6 and low-income women.4, 7, 13, 14 In all studies, fewer than half of subjects were eating competent (ECt), with EC ranging from 29.2% in low-income women7 to 46.2% in Spanish adults.6 Satter Eating Competence Inventory scores of ≥ 32 classify respondents as ECt, and higher mean ecSI scores were reported for females than males in 3 studies,6, 15, 16 but not in a fourth.5 Mean ecSI scores ranged from 26.3 ± 9.7 in low-income women7 to 31.9 ± 1.0 in hypercholesterolemic adults.5 Research on EC in college students is limited to 2 journal articles9, 15 and several published abstracts.10, 11, 16, 17 Reports describe the relationship between students' EC and weight-related attitudes and behaviors,9, 10, 15, 18 barriers to healthy eating,19 specific nutrition education curricula,16, 18 and sleep.11, 17 Infor-mation on EC in college students is important because early adulthood represents a time of transition for many young people,20 and habits established at this time can affect both their current health and their risk for developing chronic diseases in the future.21 Students enrolled in college nutrition courses may be easily targeted and uniquely receptive to positive influences on their dietary patterns. The purpose of this research was to describe the eating competence of college students at the beginning (week 2 of a 15-week semester) of an introductory nutrition course at Brigham Young University in Utah.

Section snippets

Methods

The authors asked all students enrolled in the 5 sections of the introductory nutrition course in 1 semester to complete the ecSI in an online format (Qualtrics Labs Inc, Provo, UT) as part of a research-participation assignment. The interactive nutrition course included small-group activities, online assessments, individual assignments, and lectures following the common textbook organization of macronutrient, micronutrient, and life cycle information. The survey did not collect data on

Results

Of the 569 enrolled students, 557 (97.9%) completed the survey. Table 1 reports the demographic details. Overall, the majority (52.6%) were NECt, but gender differences were significant. Males' mean ecSI score was significantly higher than that of females (P < .001), and 60% of males were ECt (Table 1). Mean eating attitude (P < .001), food acceptance (P < .01), and internal regulation (P < .01) subscale scores were significantly higher for males (Table 2).

Practical aspects of feeding oneself

Discussion

This study of 557 college students in an introductory nutrition course at the beginning of the semester revealed low levels of EC, especially for females and those who self-reported eating disorders. The mean ecSI score was < 32, which agrees with the finding that the majority (52.6%) were not ECt. These findings are similar to other studies of adults in the United States8, 12 and Spain,6 but are higher than the 41% reported in 2 studies of college students. One study included a convenience

Implications for Research and Practice

Overall, the majority of students were NECt, according to ecSI criteria. However, mean ecSI scores were higher for males and for never–eating-disordered students. Besides exploring further the relationship between EC and demographic characteristics, future research might explore these questions: Do students who enroll in nutrition courses have higher EC before enrolling, compared with students who do not enroll in nutrition courses? How do nutrition courses, as currently taught, affect EC?

Acknowledgments

The authors express appreciation to Dr. Rickelle Richards for insightful reviews of the manuscript.

References (25)

Cited by (27)

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    Covariates. Gender (with eight response options) was included since previous studies have demonstrated that males have higher ecSI 2.0™ scores than females (Brown et al., 2013; D. Clifford et al., 2010; V. Quick et al., 2015). Perceived stress management was measured with a single item and entered as a continuous variable: “On a scale from 0 (completely ineffective) to 10 (completely effective), how would you rate your ability to manage stress in the past 30 days?” (

  • Satter Eating Competence Inventory Subscale Restructure After Confirmatory Factor Analysis

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    Several studies demonstrated that EC, as measured by the Satter Eating Competence Inventory,2,3 is a proxy for a global approach to a healthful lifestyle. Competent eaters reported more physical activity,4 better sleep quality,5–7 greater parent modeling of healthful eating behaviors,8,9 higher dietary quality,10,11 less disordered eating,2,3,12 less emotional and uncontrolled eating,2,3 more positive affective behaviors toward food and eating,13 higher levels of social and emotional functioning,2 less stress14 as well as lower blood pressure,15 greater weight satisfaction,16 and less overweight/obesity.2,3 In addition to observations with adults, EC associations with health were shown in adolescents.17

  • Stress and psychological constructs related to eating behavior are associated with anthropometry and body composition in young adults

    2018, Appetite
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    Psychological constructs related to eating were also assessed by questionnaires within one month prior to arriving on campus and at end of the first semester including the Satter Eating Competence Inventory (ecSI) (Lohse et al., 2007), Perceived Stress Scale (PSS) (Cohen, Kamarck, & Mermelstein, 1983), and the Three Factor Eating Questionnaire (TFEQ) (Karlsson et al., 2000). The total score for the Satter Eating Competence Inventory, a 16-item validated questionnaire (Brown et al., 2013; Lohse et al., 2007) with excellent test-retest reliability (Stotts & Lohse, 2007), conveys the degree to which a respondent has a positive attitude and flexible approach toward feeding him- or herself healthfully. The ecSI score ranges from 0 to 48 with a score of ≥32 defined as ‘eating competence’ (Clifford et al., 2010; Lohse et al., 2007).

  • University Students Intend to Eat Better but Lack Coping Self-Efficacy and Knowledge of Dietary Recommendations

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    Alternatively, they may have positive attitudes, higher self-efficacy, and/or more cues to action toward healthier eating. The results are consistent with findings that college nutrition courses that focus on nutrition theories, rather than meal preparation skills, have not increased students’ eating competence scores.22 Teaching contextual skills (eg, how to plan and prepare nutritious meals within time and financial constraints) could address this intention-behavior gap.19

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