Are we taking enough care of the student body?

April 2, 2004

With the prevention of obesity high on the government's agenda, Matthew Baker and Luqman Hayes ask what campuses can do to turn students on to healthy eating and sport.

It can't be for nothing that the stereotype of student life is one where the Pot Noodle is king and lifting pint after pint in the student bar the nearest many get to exercise. But with obesity a hot issue in the media, should universities be taking a more active approach to encouraging students to make healthier choices in their diet and daily routine? After all, schools are at the forefront of the political battle on obesity, which steps up apace this month with the government's obesity summit. Should the health message be pushed just as strongly in higher education, or are students old enough to make up their own minds?

The health effects of obesity make grim reading. Storing Up Problems: The Medical Case for a Slimmer Nation - a report issued recently by the working party of the Royal College of Physicians, the Royal College of Paediatricians and Child Health and the Faculty of Public Health Medicine - notes the alarming rise in obesity in the UK and states that the problem causes some 30,000 deaths a year. It says that between 1990 and 2001, the percentage of 6 to 15-year-olds classed as obese trebled from 5 to 16 per cent. The percentage of obese adult men nearly quadrupled - from 6 to 22 per cent - between 1980 and 2002. Students sit in the middle of these two age groups. Many will have left home for the first time and may express their freedom by dining in a different fast-food outlet every night. They may have little knowledge about cooking or may be unable to distinguish between healthy or unhealthy foods and just rely on what's available on campus. Some may feel lonely and start "comfort eating", setting unhealthy patterns for later life.

Sharron Dalton, a US health academic and author of Our Overweight Children: What Parents, Schools, and Communities Can Do to Control the Fatness Epidemic , believes that higher education can encourage people with bad eating patterns into worse ones. "University students continue eating behaviours developed earlier," she says. "This means the majority eat high-calorie foods and drinks, many laden with added sugar and fat." She adds that as those who eat out regularly are more likely to eat unhealthily it is important for university caterers to provide alternatives to junk food.

Peter Kopelman, chair of the Storing Up Problems working party, says that although the report identifies children as being at greatest risk from the obesity "time bomb", students are also a huge concern. "We have a generation that is culinarily deficient, demanding that everything is fast and instant. Students are our leaders of the future. They are people who are privileged and should be better informed and better educated." That process must start at school, Kopelman says, but it should continue through universities. "We recommend that every public institution take this as a priority - they should look at their practice and see how they can improve and inform their students or employees."

The form education should take is unclear. Liam Donaldson, England's chief medical officer, recommends that the food industry be "strongly encouraged" to ensure that consumers can make informed choices about the sugar, fat and salt content of foods.

For Elizabeth Thomas, catering services manager at the London School of Economics and national chair and secretary to the University Catering Organisation, providing nutritional information for menus that change three times a day is a logistical nightmare. Besides, she argues, "over-regulation is not conducive to healthy eating".

Howard Shearer, catering manager at Brunel University, would welcome such initiatives, but remains realistic about their effect on what is a cash business. "You should educate generally but not be prescriptive," he says.

"I have to continue to provide a choice. To remove certain items because they are unhealthy would be commercial suicide." That choice, caterers all agree, is driven by demand. Shearer readily admits that his vending machines offer chocolate and cola, and his biggest sellers are pizza and chips. Likewise, Peter Taylor of Sodexho, a company that provides catering services to 20 UK universities, says the firm wouldn't countenance removing chips from the menu even if there is a healthier alternative. But Thomas says that things are changing and that the increasingly diverse student body means that caterers are more aware of health and dietary issues. But many people think universities can do only so much to encourage healthy eating. A spokeswoman for Universities UK says: "Let's not forget that students are adults ultimately responsible for their own choices and wellbeing."

Ken Fox, an expert in nutrition at Bristol University and an adviser to the health select committee on obesity, agrees: "Students are adults. They have their own budgets, they're old enough to make their own decisions and should be able to decide what's healthy." He believes, nonetheless, that a good diet gets neglected because of the growing economic burdens placed on students. "The financial pressure on them contributes to the consumption of high-calorie cheap fast food," he says. "When you're stretched to pay for your fees, your accommodation and the rest, food ends up low down on the list."

But Kopelman thinks universities have a responsibility to ensure that students are knowledgeable about nutrition. Some are taking steps to build that awareness. While most offer some form of "healthy option", Stirling University has created a slice of its catering operation dedicated to "Healthy Choices", with staff available for advice and tips on healthy eating. Portsmouth University's nutrition and food home page suggests healthy recipes for students to try, and Oxford Brookes University has created a Food for Thought website with help from community dietitians.

But obesity is not simply the consequence of a poor diet. Many of the problems of overweight are caused not by overconsumption but by lack of exercise. Here, universities are perhaps ahead of the rest of the UK. The recent Universities UK Sport in Higher Education report reveals that full-time students in Britain have the highest adult participation rate in sport - 76 per cent.

Furthermore, the report shows that 43 per cent of institutions have a strategy to drive up student participation in sport. Wolverhampton University is one such institution. Craig Mahoney, head of its School of Sport, Performing Arts and Leisure, explains: "When young undergraduates arrive here, they're at a crossroads," he explains. "It's a critical time for them. For many, if they don't develop any sporting interest, they'll probably get into the pattern of leading a sedentary lifestyle until they develop coronary heart disease or other sedentary lifestyle or obesity-related problems 40 years down the line. But by then it can be too late to start exercising."

Sport is promoted through the university's recreational and sports facilities, by a number of sports-related academic programmes and by events organised through the students' union. "It's a three-pronged attack," Mahoney says. "We have a duty of care to students, and because our sport and exercise science programmes are closely aligned to health we know we have to act.

"The mechanism is there in terms of the numerous sports opportunities we offer, from traditional sports such as football, athletics and rugby to dance, yoga and martial arts. We don't coerce students, but if we feel they could benefit from physical activity we talk to them."

The university is about to open a £7.2 million sports complex funded largely by the National Lottery, and it is offering bursaries worth Pounds 1,000 a year to talented sportsmen and women who compete at county level.

But the sporting carrot will not tempt everyone. Brunel University, one of the UK's leading sport science institutions, has recently invested in £14 million-worth of new sports facilities. Its pro vice-chancellor, Steve Hodgkinson, agrees that sports policies need to be creative and inclusive to attract those with little interest in sport.

"We pride ourselves on our diversity, and we're committed to allow everyone who wishes to participate in sport to do so on an equal basis," he stresses. "If people want to play in a single-sex environment, for example, we can accommodate this. The traditional sports are not for everyone, but I'm a firm believer that there's a sport for everyone. At the moment, the dance group is the biggest in the student union and it's a very active pursuit."

Of Brunel's 14,000 students, a third are signed up to university sports clubs and many more participate on an ad hoc basis. "We regularly turn out more than 50 teams on a Wednesday afternoon," Hodgkinson says.

The development of sport at the university is not just being achieved internally. Partnership working with external agencies is a key factor.

"We're forming partnerships at all levels from grassroots to elite," Hodgkinson explains. "We are forming partnerships with local education authorities and schools and local community groups to ensure that young people from primary school age onwards get access to our facilities."

But as universities assume more of a central role in community sports provision, will they threaten local authority leisure centres? "I don't think so," Hodgkinson says. "We're more specialist. Our aim is to supplement local authority sport and leisure provision, not compete with it."

To judge by the interest in Brunel's new facilities, which include outdoor and indoor athletic tracks and synthetic surface multi-sport pitches, the university won't have to compete. Six synthetic surface football pitches are already booked up for the year, Hodgkinson says.

Fostering a sporting culture that aims to encourage all students to realise their potential - be it competing at the Olympics, playing squash at a reasonable level or simply learning yoga - is something that Hodgkinson believes creates a unique higher education "finishing school" environment.

"In the past, we've focused on equipping students with the knowledge and skills to turn them out as professionals," he says. "Now we're able to do more than that by giving people the basics to take care of their health and live better-quality healthier lives.'

But some add a cautionary word to this exercise zeal. Diane Crone, a senior lecturer in exercise science at Gloucestershire University, says: "There's often a big drinking culture that goes with sports such as rugby and football, and with the government very concerned about binge drinking among young people, it's especially worrying to know that heavy drinking and sport go hand in glove at many universities.

"It's all very well if you play hard every week for your rugby team, but if you drink yourself stupid afterwards I'm not convinced you'll be reaping great health benefits."

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