PATTERNS AND COMPOSITION OF WEIGHT CHANGE IN COLLEGE FRESHMEN Ryan J. Leone A Thesis Submitted to the Graduate College of Bowling Green State University in partial fulfillment of the requirements for the degree of MASTER OF EDUCATION & MASTER OF FOOD & NUTRITION May 2015 Committee: Mary-Jon Ludy, Advisor Carrie M. Hamady C. Matt Laurent Amy L. Morgan ii ABSTRACT Mary-Jon Ludy, Advisor Background: The transition to the university is a vulnerable time period for weight gain. The media refers to this phenomenon as the “freshman 15,” although actual gain is much more modest (~ 3.5 lb). Regardless, weight gain during the freshman year may lead to an increased risk of cardiometabolic diseases. Little research has examined potential patterns or composition of weight change in freshmen, nor is there extensive data regarding predictors/moderators of this trend. Objective: The primary aims of this study were to identify critical time periods for weight change in university freshmen and to quantify change as lean versus fat mass. Secondary aims were: to investigate the accuracy of self-reported weight and height; to explore taste sensitivity as a potential predictor/moderator of this trend; and to determine the utility of using simple anthropometric indices (e.g., body mass index (BMI), waist circumference (WC)) in lieu of body composition assessment. Methods: Freshmen (n=236) underwent measurements for weight, height, WC, and body composition (% fat) five times during the year (arrival to campus; pre- holiday; post-holiday; pre-spring break; pre-finals). A subset of participants (n=30) rated the intensity of salty and sweet solutions. Results: Freshmen (n=103) gained 2.6±3.1 kg with a concomitant increase in fat (1.7±3.3%; p<0.05 for both). Weight gain (1.4±2.1 kg) was most marked during the first 10-12 weeks on campus while most fat mass was gained during the spring (1.1±2.5%; p<0.05 for both). Overall, freshmen (n=128 F) reported their weight accurately, however those who underreported weighed more (+10.2 kg) and had higher waist circumference (+8.1 cm) and % fat (+4.0%; p<0.05 for all). Taste sensitivity was not associated with weight, adiposity, or weight change. BMI and WC performed poorly in identifying truly overweight/obese individuals (67% and 50%, respectively). Conclusions: Early weight gain iii occurred, but was not paralleled by fat gain. Thus, the final weeks on campus may be ideal for intervention and education. Practitioners relying on self-reported weight and height should be aware than individuals most at risk may be misrepresenting their true weight and reliance anthropometric indices—whether self-reported or directly-assessed—may lead to missed opportunities for intervention and prevention efforts. iv “We were together. I forget the rest.” -W.W. Dedicated to my wife Mia: my strength, my love, my best friend, my world. Thank you for your unconditional love and support. v ACKNOWLEDGMENTS I would first like to express my deepest gratitude to my advisor, Dr. Mary-Jon Ludy. You have served as a great inspiration and have shown me what a motivated researcher can accomplish. I thank you for your guidance in all aspects of this journey, your patience with countless early morning emails, and the vast opportunities you have provided for me. You are and incredible role model and are likely not aware of the degree of influence you have had on me over the last several years. Moreover, throughout this process, you have become a true friend and mentor. I would also like to sincerely thank Carrie Hamady, Dr. Matt Laurent, and Dr. Amy Morgan. You have all contributed more than you know and have had a profound impact on my professional development. In particular, I would like to thank Dr. Amy Morgan for your role in expanding my knowledge and skillset in the exercise science field. Your guidance and leadership has influenced me to continue my education in this field. I would also like to thank Dr. Jim Albert for his assistance and statistical expertise with our meta-analysis as well as all of the students who assisted me with data collection. I also thank my office mates for their assistance and friendship along the way; most importantly for having coffee ready when I got in for the day. Finally, the most eloquent words cannot express the love and appreciation I have for my wife Mia. You continually made abundant sacrifices and displayed extreme patience with long days of writing, listening to my rants (or at least acting as if you were), and my taking over your desk. I assure you, this has not gone unnoticed. Lacking your unshakable support, I’d be standing at mile 22 ready to give up. You’ve kept me out of the SAG Wagon and encouraged me the entire way to the finish line, as always. You’ve certainly earned a metaphorical ‘finisher’s medal.’ Mia Leone: you are an Ironman! vi TABLE OF CONTENTS Page INTRODUCTION ................................................................................................................. 1 CHAPTER I SEX & GEOGRAPHIC CHARACTERISTICS OF WEIGHT & ADIPOSITY CHANGE IN UNIVERSITY FRESHMEN: A META-ANALYSIS .................................... 5 Abstract ...................................................................................................................... 6 Context ....................................................................................................................... 7 Methods...................................................................................................................... 9 Evidence Acquisition ..................................................................................... 9 Study Selection .............................................................................................. 10 Statistical Analysis ......................................................................................... 10 Evidence Synthesis ........................................................................................ 11 Regional Analysis ...................................................................................................... 11 Sex Analysis............................................................................................................... 11 Weight ............................................................................................................ 11 % Fat .............................................................................................................. 12 Discussion .................................................................................................................. 12 Limitations and Future Research ................................................................... 16 Conclusions ............................................................................................................ 17 References .................................................................................................................. 18 CHAPTER II PATTERNS & COMPOSITION OF WEIGHT CHANGE IN COLLEGE FRESHMEN .......................................................................................................................... 32 Abstract ...................................................................................................................... 33 vii Introduction ................................................................................................................ 34 Methods...................................................................................................................... 37 Participants and Testing Schedule ................................................................. 37 Procedure ....................................................................................................... 38 Statistical Analysis ......................................................................................... 39 Results ........................................................................................................................ 40 Attrition .......................................................................................................... 40 Weight and Height ......................................................................................... 40 Body Mass Index ........................................................................................... 41 Waist Circumference ..................................................................................... 41 Body Composition ......................................................................................... 42 Correlations .................................................................................................... 42 Discussion .................................................................................................................. 42 Limitations ..................................................................................................... 47 Conclusions .................................................................................................... 47 Acknowledgments...................................................................................................... 47 References .................................................................................................................. 48 CHAPTER III VALIDATION OF SELF-REPORTED ANTHROPOMETRICS IN FEMALE COLLEGE FRESHMEN ....................................................................................................... 57 Abstract .....................................................................................................................