+Dario DiazMaxwell / Jakubowski9/15/2015Research Paper Source Citation

Individual Resource Paper

Nutrition intervention can be done a variety of ways ranging from the cognitive

perspective which focusses on the thought processes behind actions to the behavioral perspective

which instead fixates on the rewards or consequences of following or disregarding goals for

these intended actions; while models for intervention can vary, most experiments tend more

towards a specific behavioral model. Through the analysis of a scientific study conducted by Yi

Ning et al. of the effects of a behavioral learning model used to teach and promote healthy

eating, exercise, and other behavioral habits amongst obese adolescents, one may better assess

just how effective such a model can be as well as which changes, if any, should be made.

Ning’s study consisted of a multifaceted approach which would teach the adolescents

observed through nutrition education seminars, monitored exercise regiments, and behavioral

training sessions.1 Observing adolescents aged 11 to 18 all at or above the 95th percentile for their

age in terms of BMI according to the 2000 CDC growth charts, the adolescents observed were

initially analyzed for their nutritional intake in the form of 48 hour recalls used to calculate

caloric intake, activity through activity recall logs calculated in MET hours per week, as well as

for anthropomorphic data including weight, BMI, fat mass, fat free mass, and waist measurement

and repeated these same measurements when the six month duration of the experiment came to a

close observing any differences.1 Behavioral counseling was done in the same form as the

nutrition education presentations in 30 minute sessions which would alternate between behavior

and nutrition centered lessons and were held every two weeks.1 By contrast, the exercise portion

consisted of 60 minute session three times a week for the initial 12 weeks and then continued in

Dario DiazIndividual Research Paper

the form of biweekly classes thereafter; all exercise routines were supervised.1 While

descriptions about the behavioral learning method employed were brief, Ning et al.’s work

claimed to place less emphasis on setting milestones as to caloric restriction, but rather stressed

the importance of avoiding problematic behaviors such as grazing or eating hurriedly.1 Being a

behavioral model, this counseling may have included some form of reward or consequence

depending on the subject’s compliance to certain standards. The initial averages of the group

observed amounted to 240 MET hours per week and 2020 consumed calories per day;

conversely, the measurements at the end of the experiment showed a n average of 262 MET

groups per week and 1595 calories consumed per day.1 Moreover, the adolescents showed an

average decrease in weight of 3.6 kg and BMI of 1.5 for boys and a decrease of 5.6 kg and BMI

of 1.9 for girls as well as decreases in fat mass and waist measurements along with an increase in

fat free mass for both groups.1

While the experiment performed was successful, a closer analysis of the psychology

behind the behavioral learning theory can better elaborate upon the defining characteristics,

advantages, and potential flaws of this model. Walter Burnait et al.’s book on the concerns ad

possible initiatives to prevent adolescent obesity focuses in part on the various learning models

employed to counteract this issue; one of which includes the behavioral model.2 The book

describes the behavioral model as the oldest known, albeit least effective, intervention method

used to combat obesity and claims that the best way to make up for the method’s inherent

disadvantage is by focusing on the eating environment and how this contributes to a lack of

control.2 He continues to explain how the family of the child or adolescent may unconsciously be

being rewarded for certain harmful eating behaviors while the parents may be unaware that they

are bestowing such rewards.2 As a cited 1983 study by Brownell et al. demonstrated, a child

Dario DiazIndividual Research Paper

taught to avoid problematic eating behaviors by behavioral methods when his mother was

educated separately exhibited a more substantial change in behavior than when the child was the

only one being taught or when the mother and child were taught together.2 A similar 1990 study

conducted by Epstein et al. also showed a greater degree of behavioral change in avoiding these

behaviors when both the parent and child were taught through reinforcement separately.2 Perhaps

the most interesting suggestion lies in the use of methods combining the use of cognitive theories

in the forms of self-direction, self-awareness, and self-examination with behavioral

reinforcement for rewarding the desired behaviors.2 Epstein et al.’s aforementioned study used

such a combination of learning models; furthermore, it further involved the family’s influence by

both facilitating schedules family discussions and having therapists consult the parents directly.2

Through the examination of the success recorded in Ning et al.’s study as well as Burnait

et al.’s analysis of effective means by which to better the behavioral method, one may better

understand how to make nutrition education and intervention as effective as possible. Ning et

al.’s study was effective by focusing on the avoidance of problem behaviors; however, the results

did mention the lack of significant change in exercise habits.1 The integration of a family

counseling aspect to the experiment would better address changing the environment at home: one

of the largest contributors to problematic behaviors. Additionally, the addition of aspects to the

cognitive processes behind the problematic behaviors in contrast to focusing on simply avoiding

the behaviors themselves could integrate the cognitive and behavioral aspects to the experiments’

benefit. As with all experiments, the use of a learning model needn’t restrict the parameters of

how an experiment is done as the integration of aspects of various models may lead to a

collective benefit.

Dario DiazIndividual Research Paper

References

1. Ning Y, Yang S, Evans R, Stern M, Sun S, Francis G, Wickham E, Changes in body anthropometrics and composition in obese adolescents in a lifestyle intervention program. Eur J Nutr. 2014; 54(4):1093-102.

2. Burniat W, Lissau I, Cole, TJ. Child and Adolescent Obesity: Causes and Consequences, Prevention and Management. New York, NY: Cambridge University Press; 2002.

Dario DiazIndividual Research Paper