Project EAT: Project Results

Project Results: Points of Interest

Findings from Project EAT have been disseminated in more than 150 publications and numerous presentations. For more information, please see our Publications page.

• Over the past decade (1999-2010) between Project EAT-I and EAT 2010, ethnic/racial disparities in the prevalence of obesity increased, pointing to a need for more effective interventions aimed at reaching diverse populations. More on Disparities and Trends in Weight Status
• A high number of adolescent boys (38%) and girls (50%) participating in EAT 2010 used unhealthy weight control behaviors such as skipping meals, taking diet pills, and smoking more cigarettes to lose or control their weight. More on Dieting and Weight Concerns
• Being teased about one’s weight in middle school or high school predicts poorer emotional well-being and use of unhealthy weight control behaviors in late adolescence and early young adulthood. More on Weight Teasing 
• Higher levels of body dissatisfaction during adolescence are related to greater use of unhealthy behaviors that may lead to weight gain. More on Body Image

• Only 30% of adolescent girls and 43% of adolescent boys were found to be getting enough calcium. More on Nutrition Intake

• Many adolescents skip breakfast and just 37% of participants in EAT 2010 reported eating breakfast daily. More on Breakfast
• Participation in family meals varies widely among youth and is related to a number of positive outcomes, including better dietary intake, fewer unhealthy weight control behaviors, and better psychosocial health. More on Family Meals
• A high number of parents/caregivers of adolescents (39%) experienced food insecurity in 2010 and were at increased risk for poor nutrition outcomes. More on Food Insecurity
• Vegetarianism was reported by 6% of adolescents. More on Vegetarianism
• Just over 50% of adolescent participants in EAT 2010 achieved current recommendations for physical activity by participating in at least seven hours per week. More on Activities and Sports

Disparities and Trends in Weight Status

The increasing prevalence of overweight and obesity among adolescents is a major public health problem. Over the past decade (1999-2010) between Project EAT-I and EAT 2012, the overall prevalence of obseity and ethnic/racial disparities increased, particularly among boys.

Results from the most recent EAT 2010 survey indicated that approximately 19% of girls and 26% of boys had body mass index values at or above the 95th percentile, which is the cut-off point used for defining obesity in youth. Another 20% of girls and 16% of boys were overweight (defined as at or above the 85th percentile but less than the 95th percentile).

Girls: For girls, obesity was most common among African American, Hispanic and Native American youth. The prevalence of obesity was considerably lower among Asian American and White girls, but there was evidence of an increase in the prevalence of obesity over the past decade among Asian youth from 7% to 13%.

Boys: Obesity was more common among Hispanic, Asian, and Native American boys than White and African American boys.  Evidence of increases in the prevalence of obesity over the past decade was observed for African American (from 14% to 21%) as well as Asian (from 21% to 33%) and Hispanic youth (from 20% to 34%). 

Longitudinal results from Projects EAT-I, II, and III have also shown overweight/obesity increases among young people during the transition from adolescence to young adulthood. Among youth who were not overweight in adolescence, 34% of females and 45% of males were found to have a body mass index in the range used to define overweight or obesity when they reached young adulthood.  

Please also see our publications on overweight and obesity among adolescents and young adults

Dieting and Weight Concerns

The use of dieting and unhealthy weight control behaviors is common among teenagers and may counterintuitively lead to weight gain through the long-term adoption of unhealthy behaviors such as binge eating, reduced breakfast consumption, and lower levels of physical activity. Over the past decade (1999-2010) between Project EAT-I and EAT 2010, there were decreases in the percent of young people using unhealthy weight control behaviors while healthy behaviors were found to increase.

  Results from the most recent EAT 2010 survey indicated…

•   Nearly one third of boys and 46% of girls went on a diet in the past year.

•  Fifty-four percent of boys and 58% of  girls regularly used healthy weight control behaviors such as eating less high-fat food, eating less sweets, and eating more fruits and vegetables over the past year.

• A concerning 38% of boys and 50% of the girls used unhealthy weight control behaviors such as skipping meals, taking diet pills, and smoking more cigarettes specifically to lose or control their weight.

• A smaller but quite worrisome percentage of students were the 4% of boys and 7% of girls who reported use of extreme weight control behaviors such as taking laxatives or diuretics, vomiting after meals, or fasting.

Results from Project EAT have also shown the prevalence of weight control behaviors remains high or increases among young people during the transition from adolescence to young adulthood and these behaviors tend to track within individuals over time. For example, findings from the 10-year follow-up survey of Project EAT-I participants showed…

• The prevalence of dieting increased from 22% to 28% among male participants who transitioned from middle adolescence (mean age = 16 years) to middle young adulthood (mean age = 26 years).

• The use of unhealthy weight control behaviors remained high but showed a small decrease in prevalence (from 61% to 54%) among female participants who transitioned from middle adolescence to middle young adulthood.

• Among female participants who transitioned from early adolescence (mean age = 13 years) to early young adulthood (mean age = 23 years), the prevalence of extreme weight control behaviors more than doubled from 8% to 20%.

Please also see our publications on unhealthy weight control behaviors

Weight Teasing

Approximately 22% of adolescent boys and 25% of adolescent girls who participated in Project EAT-I reported being teased about their weight at least a few times per year. These young people reported teasing by both peers and family members.

These findings are concerning as being teased about one’s weight in middle school or high school was found to predict poorer emotional well-being five years later in Project EAT-II. Adolescents who were ever teased about their weight reported lower levels of self-esteem and higher levels of body dissatisfaction. Among females and older males (in high school at EAT-I), ever being teased about one’s weight also predicted more depressive symptoms five years later.

Females who reported being teased about their weight at Project EAT-I were also more likely to report frequent dieting at five-year follow-up than their peers who were not teased.

Males who reported being teased about their weight at Project EAT-I were more likely than their peers to report binge eating and the use of unhealthy weight control behaviors five years later.

Findings from Project EAT-IIII further indicate that weight teasing remains a concern as young people transition from adolescence to young adulthood. The prevalence of weight teasing remained stable among most groups and, among males transitioning from early adolescence (mean age = 13 years) to early young adulthood (mean age = 23 years), reports of experiencing weight teasing at least a few times each year were found to increase from 18% to 27%.

Please also see our publications on teasing

Body Image

High prevalences of adolescents express body dissatisfaction, which was found to longitudinally predict both unhealthy behaviors and weight gain. Project EAT-I found that 46% of girls and 26% of boys had high levels of body dissatisfaction. Body dissatisfaction during the teen years is related to greater use of unhealthy behaviors that may lead to weight gain.

Findings from follow-up surveys of Project EAT-I participants at five and ten years have shown…

• Young people having higher levels of body dissatisfaction at Project EAT-I were more likely to report unhealthy weight control behaviors, binge eating, and lower levels of physical activity at five-year follow-up.

• Higher levels of body dissatisfaction at EAT-I predicted greater weight gains over time, even after taking starting body mass index into account.

• Higher levels of body dissatisfaction at Project EAT-I were further related to increased risk for depression and poor self-esteem over time.

Please also see our publications on body image and psychosocial health

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Nutrition Recommendations vs. Actual Intake

Project EAT-I found there are large gaps between nutrition recommendations and the actual dietary patterns of adolescents.

Among the students surveyed, only 30% of girls and 42% of boys consumed the recommended amount of calcium (1300 mg or more per day). Approximately 45% of both girls and boys ate more than two servings of fruit per day, while only about 16% ate more than three servings of vegetables per day. Middle school students had higher calcium, fruit, and vegetable intakes than older students in high school.

Across ethnicity, nutrient intakes varied considerably. Fewer Asian American and Hispanic youth met calcium intake recommendations compared to their peers. However, Asian American and Hispanic youth were most likely to report eating five or more fruits and vegetables daily.

Over the five years between Project EAT-I and Project EAT-II, young people decreased their intake of fruits and vegetables as they transitioned from middle school to high school and from high school to post-high school.

Please also see our publications on food choices

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Breakfast anyone?

Eating breakfast has been linked to better academic performance and overall dietary intake, and may also contribute to maintenance of a healthy weight.

Results from the most recent EAT 2010 survey indicated that just 37% of adolescent participants ate breakfast every day. Another 30% of adolescents ate breakfast 3-6 days a week. Of concern, 22% only ate breakfast 1-2 days a week and 11% of adolescents never ate breakfast.

 

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Family Meals:  

Family meals are a challenge given the busy schedules of adolescents and their parents, but eating together is beneficial when it does occur. Major reasons for not having family meals include parent and adolescent schedules, adolescents’ desire for autonomy, dissatisfaction with family relationships, and dislike of foods served at family meals.

Project EAT-I found that adolescents eating regular family meals had higher fruit, vegetable, and calcium intakes than their peers not reporting regular family meals, and they drank significantly fewer soft drinks. Results from Project EAT-II further showed that young people who were having more family meals during high school had higher daily intakes of fruit, vegetables, calcium, and other important nutrients in early young adulthood.

Project EAT-III survey results showed that having more frequent shared household meals in young adulthood was associated with some markers of better nutrition. A higher frequency of shared household meals in young adulthood was predicted by having more frequent family meals during adolescence.

In addition to the observed nutritional benefits, family meals have also been cross-sectionally and/or prospectively related to higher academic performance, greater psychosocial well-being and a reduced risk of using unhealthy weight control behaviors.

Over the past decade (1999-2010) between Project EAT-I and EAT 2010, increased attention has been given to family meals in the scientific literature and popular media. Despite this attention to the benefits of eating together, results from the recent EAT 2010 survey indicated the frequency of family meals either remained constant or decreased in the homes of adolescents across different segments of the population.

Please also see our publications on family meals

Food Insecurity

Household food insecurity was experienced by almost 39% of the parents and caregivers who participated in Project F-EAT, and 13% reported very low food security. Food-insecure parents of adolescents were more likely than food-secure parents to be overweight and reported poorer nutrition-related outcomes:

• Food-insecure parents ate breakfast less frequently, consumed more sugar-sweetened beverages, and were more likely to report binge eating compared to those who were food secure.

• Among parents who reported having family dinners, those who were food insecure reported more often serving sugar-sweetened beverages at dinner and less often serving healthy items such as green salad, vegetables, and fruit compared to those who were food secure.

• In comparison to food-secure parents, those who were food insecure reported greater barriers to purchasing fruits and vegetables in terms of neighborhood access to a variety of affordably-priced and high-quality produce.

Vegetarianism

Vegetarianism was reported by about 6% of adolescents who participated in Project EAT-I, nearly 75% were females, and 75% had been so for longer than 1 year.

When asked why they were vegetarian, students reported the following top five reasons:

1. To lose or not gain weight (35%)
2. Do not want to kill animals (28%)
3. Don’t like the taste of meat (27%)
4. To have a healthier diet (25%)
5. To help the environment (17%)

Vegetarians were more likely to use unhealthy weight control behaviors, particularly males. Since vegetarianism seems to have interest and appeal to adolescents, education regarding healthy vegetarianism is critical to help prevent unhealthy weight control behaviors among youth.

Please also see our publications on vegetarianism

Activities & Sports

Physical activity has numerous benefits, including better cardiovascular health, stronger bones, and improved mental health and mood. The Physical Activity Guidelines for Americans recommend that adolescents do 60 minutes or more of physical activities every day. It is also recommended that young people limit their time spent in more sedentary activities. Specifically, the American Academy of Pediatrics recommends that adolescents spend no more than two hours on an average day with screen media, including TV and video watching as well as time spent playing video games and using a computer for activities other than homework.

Results from the recent EAT 2010 survey indicated that just over 50% of adolescent participants met the current guidelines for physical activity by participating in at least seven hours of physical activity per week.

Approximately 85% of young people exceeded the American Academy of Pediatrics recommendation for screen time and reported more than 14 hours of screen time in a given week; 47% reported more than 35 hours of screen time.

Longitudinal results from Projects EAT-I, II, and III have also shown that moderate and vigorous physical activity tends to decrease and computer use (not for work or homework) tends to increase as young people transition from adolescence to young adulthood.

Please also see our publications on physical activity