The effect of goal setting on fruit and vegetable consumption and physical activity level in a Web-based intervention.

OBJECTIVE
To explore the relationship between goal setting and fruit and vegetable (FV) consumption and physical activity (PA) in an intervention for college students.


METHODS
Secondary data analysis of intervention group participants from a 10-week online intervention with complete weekly data (n = 724). Outcomes (cups of FV per day and minutes of PA per week) and goals for both behaviors were reported online each week. Weekly differences between goals and behaviors were calculated, as well as the proportion meeting individual goals and meeting recommendations for behaviors.


RESULTS
There were significant (P < .05) effects of goal setting on both behaviors and of goal group (tertile of meeting weekly goals) on behavior, as well as meeting recommendations for both behaviors. There was an increase in FV consumption (P < .001) but no change in PA over time.


CONCLUSIONS AND IMPLICATIONS
Goal setting as part of a Web-based intervention for college students was effective, but results differed for FV and PA. Goal setting for maintaining behavior may need to differ from goal setting for changing behavior.

. Effect of goal group on fruit and vegetable intake and physical activity and whether or not participants met recommendations for each behavior at the end of the intervention.
Results: There was a significant effect of goal setting on both fruit and vegetable consumption and physical activity. The effect was seen more clearly with fruit and vegetable consumption; the difference between goal and intake decreased over time, the correlation grew stronger, and the percent of subjects meeting or exceeding goals and percent of subjects meeting recommendations increased over time. For physical activity, the difference and correlation between goal and activity remained consistent throughout, the percent of subjects meeting or exceeding goals decreased over time with no significant change in percent of subjects meeting recommendations. There was a significant effect of goal group on meeting recommendations for both behaviors, which was stronger for fruit and vegetable consumption.
Conclusions: Goal setting as part of a web-based intervention was associated with an increase in fruit and vegetable consumption among young adults. While this study showed a significant effect of goal setting on physical activity, there were no increases in physical activity. Perhaps goal setting needs to be presented differently when trying to maintain versus change a behavior. There is a need for further research in this area, particularly with more reliable measures of intake and activity.

INTRODUCTION
According to the Centers for Disease Control and Prevention (CDC), chronic diseases are the leading cause of death and disability in the United States, accounting for 7 out of 10 deaths each year and being among the most costly and preventable health problems (1). Americans have not been meeting recommendations for fruit and vegetable consumption and physical activity for years; inadequate performance of these health related behaviors are major contributors to chronic disease prevalence (2-6). Recent data show that the typical American diet meets less than half of the recommendations for fruit and vegetable consumption and less than half of adults meet the recommendations for physical activity (2,5). Among college students, data show that 5.8 percent consume 5 or more servings of fruits and vegetables daily and 21.5 percent do moderate-intensity physical activity on 5 or more days per week (7).
The low intake of fruits and vegetables and suboptimal physical activity levels of these young adults are alarming. Young adults are transitioning from parental control to becoming responsible for their selves and making independent decisions and establishing life structure (8). They are in the process of forming adult habits and thus effective interventions improving these behaviors in young adults may reduce the development of chronic disease in the future.
Interventions that include goal setting have been shown to have a positive effect on fruit and vegetable consumption and physical activity. Goal setting has been studied in relation to task performance and has been found to be effective in increasing performance (9-11). According to Locke and Latham, there are three mechanisms through which goals directly affect performance. These mechanisms are: (1) a directive function (direct attention and effort toward goal-relevant activities and away from goal-irrelevant activities), (2) an energizing function (high goals lead to greater effort than low goals), (3) persistence (goals can prolong effort depending on difficulty level) (9,12). Goals also indirectly affect performance by leading to arousal, discovery, and/or use of task-relevant information (13).
There are goal setting guidelines through which the chances of attaining a goal can be increased. For example, it has been consistently shown that setting a specific, difficult goal leads to higher performance than an ambiguous "do your best" goal (9).
Falling under this umbrella would be S.M.A.R.T. goals, which this study used.
S.M.A.R.T. goals are specific to a behavior, measurable, attainable, realistic, and time bound (14). Another way to increase the chances of goal attainment would be to use implementation intentions. Implementation intentions specify the when, where, and how so that when a situation arises, a person will know how to respond so that they can achieve goals (15).
A goal is the object or aim of an action, or a level of performance proficiency that we wish to attain, usually within a specified time frame (9,10). While there is a clear definition of what a goal is, there is variability as to how goals are set. They can be self-set, assigned, set participatively, or even guided (9,16). Due to this variability in guidelines for goal setting procedure, studies define goal setting in different ways.
This could be one reason that some studies find goal setting to be an effective intervention while others do not (17)(18)(19)(20)(21).
Despite increasing evidence that goal setting has a positive effect on health related behaviors, there has been limited research on the effect of goal setting on fruit and vegetable consumption and physical activity specifically and the research that has been done shows differing results. Studies by Sternfeld et al., Dishman et al., and Heneman et al. used goal setting as one component of an intervention and found significant increases in fruit and vegetable consumption and/or physical activity level (17)(18)(19). On the other hand, studies by Thorndike et al. and Latif et al. did not find goal setting to be an effective intervention (20)(21). The research in these areas is even more limited for the young adult population. Due to this lack of extensive research, there is a need for studies that take a more in-depth look at the effects of goal setting in the areas of fruit and vegetable consumption and physical activity and among young adults.
The intervention for a study done by Greene et al. (Project WebHealth) was effective in increasing fruit and vegetable consumption and reducing decline in physical activity in college students (22) but the effect of goal setting was not assessed. The purpose of this study was to explore the relationship between goal setting and fruit and vegetable consumption as well as physical activity to see if there was a positive association between goal setting and behavior as part of a web-based intervention for young adults. The hypotheses for this study were as follows: cups of fruit ands vegetables consumed and minutes of physical activity completed will increase over time with the use of weekly goal setting and by the end of the intervention subjects that are more effective goal achievers (meeting or exceeding the majority of the goals) will consume more fruits and vegetables and complete more physical activity than those that are not as effective goal achievers.

DESIGN AND PARTICIPANTS
This study has a prospective, descriptive design. It is a secondary analysis of data from a previous research study (Project WebHealth), which used an experimental design with random assignment to groups (22). While the analysis of the data for this study took place at the University of Rhode Island, the data was collected from eight participating institutions around the country. subjects were asked to report their intake of fruits and vegetables in cups for the past week and set a goal for fruit and vegetable consumption in cups for the following week. In addition they were asked to report their performance of physical activity as number of days and minutes per day for the past week and set a goal for their physical activity in number of days and minutes per day for the following week. The exception to this goal setting was the final lesson, where the goal was for the next semester rather than the next week. These data are not reported in this study. The self-report and goal setting screens included a drop down menu with the following choices: less than ½ cup, ½ cup, 1 cup, 1 ½ cups, 2 cups, 2 ½ cups, 3 cups, 3 ½ cups, 4 cups, 4 ½ cups, or 5 cups or more of fruits and vegetables and 0, 1, 2, 3, 4, 5, 6, or 7 days of exercise with 10, 20,30,45,60,75,90,105,120,135,150,165, or 180+ minutes (on average) per day. In addition there was an option for don't know/not sure minutes of exercise (subjects choosing this option were excluded from exercise analyses). This weekly self-report and goal setting screen can be seen in Appendix B.
There were 4 lessons that included information about eating healthfully and 2 lessons including information about physical activity. In addition the first and last lessons included both behaviors. Only the relevant lessons will be described below.
Lesson 1 included an overview of the lessons, provided information on how to set a S.M.A.R.T. goal, assessed current fruit and vegetable consumption, physical activity level, and allowed subjects to set goals for the following week. Although lessons 3, 7, and 9 were about eating, they did not include information that was specific to fruit and

ANALYSES
All analyses were performed using SPSS (Version 20.0.0, SPSS, Inc.). Distributions of baseline characteristics were described using frequencies or means  SD. Weekly reported fruit and vegetable intake and goals were examined separately using repeated measures ANOVA with time as the within-subjects factor. Weekly reported fruit and vegetable intake was used to determine the percentage of subjects that were meeting recommendations for 5 or more cups of fruits and vegetables per day. A repeated measures ANOVA was then used to determine the effect of time on this proportion. A paired t-test was performed to determine the relationship between the goal that was set for fruit and vegetable consumption one week and the reported intake for that week, which was reported the following week. This was repeated for all weeks containing both a goal and a reported intake. Goal attainment is defined as meeting or exceeding the goal that was set by the participant each week. This was determined for fruit and vegetable intake and frequency was used to obtain a percentage of subjects that achieved goal attainment, which was called personal goal attainment. These analyses were then repeated separately for reported physical activity completed and goal for physical activity with recommendations for 150 minutes of physical activity or more per week.
Following this, subjects were grouped by how many goals they met or exceeded. Each week, a goal attainment score was determined for both fruit and vegetable consumption and physical activity by whether or not the subject met or exceeded the goal that they set for that week. A total goal attainment score was then calculated by summation of the weekly goal attainment score in each area and subjects were divided into tertiles by this total score. There were a total of 9 goals set during the intervention. For fruit and vegetable consumption, goal group 1 met or exceeded 0 to 3 goals, goal group 2 met or exceeded 4 to 5 goals, and goal group 3 met or exceeded 6 or more goals. For physical activity, goal group 1 met 0 to 2 goals, goal group 2 met 3 to 4 goals, and goal group 3 met 5 or more goals. ANCOVAs were run separately for fruit and vegetable consumption and physical activity at week 10 looking at the effect of goal group with initial value as a co-variate. Chi square analyses were used to look at the association between goal group and whether or not subjects were meeting recommendations at week 10 separately for both fruit and vegetable consumption and physical activity. Finally, a chi square analysis was done to determine if there was an association between those meeting recommendations at week 10 for fruit and vegetable consumption and those meeting recommendations at week 10 for physical activity.

RESULTS
A total of 830 subjects were assigned to the experimental group of the Project WebHealth study. Table 1 shows baseline characteristics. Of these subjects, 724 completed the ten online lessons, including weekly goal setting and self-reporting of cups of fruits and vegetables consumed. For physical activity, 665 subjects completed the ten online lessons, including weekly goal setting and self-reporting of minutes of physical activity completed (subjects choosing "don't know/not sure" for minutes of exercise were considered non-completers for physical activity analyses). Table 2 shows the relationship between the goal set for one week and the cups of fruits and vegetables that subjects reported that they consumed during that week. A significant effect was found (p<.001). The difference between the goal that was set and the reported cups of fruits and vegetables consumed appeared to decrease over time, going from -1.01  1.19 to -0.25  0.77, and the correlation between the two appeared to grow stronger, going from .559 to .831. The percentage of subjects who met or exceeded the goal that they set for fruit and vegetable consumption trended upward over time. Although a drop was seen from week 1 to week 2, goal for fruit and vegetable consumption increased consistently over time from weeks 3-9 (p<.001).
Reported fruit and vegetable intake and percentage of subjects meeting recommendations for fruit and vegetable consumption also increased over time (p<.001). Table 3 shows the relationship between the goal set for one week and the minutes of physical activity that subjects reported during that week. A significant effect was found (p<.001). The difference between the goal that was set and the reported minutes of physical activity completed appeared to increase overall throughout the intervention, going from -29.99  104.93 to -38.48  93.61. The correlation between the goal that was set and the reported minutes of physical activity completed remained relatively consistent throughout the intervention, ranging from .842 to .875. The percentage of subjects who met or exceeded the goal that they set for physical activity had an overall trend downward over time. There was no increase seen in goal for physical activity, however there was a significant effect for time (p<.001). There was a slight decrease seen in reported physical activity completed and percentage of subjects meeting recommendations for physical activity but no significant effects were seen. Table 4 shows the relationship between goal group and fruit and vegetable intake and physical activity completed at week 10 adjusted for initial value using ANCOVA. Goal group 3 (more effective goal achievers) consumed significantly more fruits and vegetables at week 10 than goal groups 1 and 2 (F=65, p<.001). Initial value had a significant effect on fruit and vegetable consumption at week 10 (F=215, p<.001). There was a significant difference for physical activity completed at week 10 between goal group 1 and goal group 3 (F=7, p=.001). Initial value had a significant effect on physical activity completed at week 10 (F=450, p<.001). Table 5 shows the association between goal group and whether or not subjects were meeting recommendations for fruit and vegetable consumption and physical activity at week 10. This association was significant for fruit and vegetable consumption (2=63.15, p<.001) and for physical activity (2=33.05, p<.001). For fruit and vegetable consumption, only 1.9% of subjects in goal group 1 met recommendations at week 10 while 3.9% of subjects in goal group 2 and 20.4% of subjects in goal group 3 did the same. For physical activity, only 28.1% of subjects in goal group 1 met recommendations at week 10 while 40.9% of subjects in goal group 2 and 57.3% of subjects in goal group 3 did the same.
The relationship between subjects that met recommendations at week 10 for both fruit and vegetable consumption and physical activity was examined but not included in the tables. There was no association found between meeting recommendations for both areas.

DISCUSSION
This study supports the hypothesis that fruit and vegetable consumption will increase over time with the use of weekly goal setting. It also supports the hypothesis that subjects that are more effective goal achievers will consume more fruits and vegetables than those that are not as effective goal achievers. Findings were not the same for physical activity. It is interesting that at the start of the intervention almost half of subjects were meeting recommendations for physical activity and only 3.1 percent were meeting recommendations for fruit and vegetable consumption. While this is consistent with the general population (3,6,7) it also suggests that goal setting may need to be framed differently for behaviors that are being maintained versus changed. This is supported by Thorndike et al. (20) who found no further increase in fruit and vegetable consumption or physical activity when goal setting was used as part of a maintenance intervention.
A similar study with a web-based intervention showed significant increases in both fruit and vegetable consumption and physical activity (17). The study, conducted by Sternfeld et al., used pre-set goals, which participants chose 1 to 2 of to work on per week. The assessments included both self-report of behaviors and a physical activity and diet questionnaire. Dishman et al. also found a significant increase in physical activity using both personal and team goal setting (18). The assessments done in this study included self-report, a physical activity questionnaire, and measured pedometer readings. It could be that a valid and reliable physical activity questionnaire or objective measures are able to more accurately capture the physical activity behavior as opposed to relying on self-report (23).
This study allowed subjects to choose their own goal from a drop down menu.
This format does not allow for ensuring that participants were selecting a difficult goal and therefore goal setting is most likely having an effect via directive function. This is similar to other studies (17)(18)(19)(20)(21). The drop down menu is a limitation in this study because the goal options for physical activity far exceeded the recommendations whereas goal options for fruit and vegetable intake provided a maximum that was equal to recommendations. There was essentially one choice that met the goal for fruit and vegetable consumption (5 or more cups of fruits and vegetables per day). There were numerous combinations of number of days and minutes per day that met the recommendations for physical activity (150 minutes or more per week). The goal options for fruit and vegetable intake was based on prior research with this population (24)(25) and only 3.1 percent of this sample reported an intake of 5 or more cups.
Nevertheless, a different goal option format might have produced different results.
Subjects were divided into 3 goal groups in this study. These groups were based on whether or not subjects achieved the goals that they set. There was no information available as to how subjects chose a goal and whether or not they followed the S.M.A.R.T goal setting guidelines that were outlined for them (22).
Presumably their goal setting reflected implementation intentions. Future studies should take a more in-depth look at the goal setting process, including how goals are set and what the mechanisms are being used.
Additional limitations besides the self-report and goal setting format described previously primarily reflect the sample. The sample was predominantly white college students enrolled in a health promotion study. Previous reports (22) found minimal differences between experimental and control and the sample was reflective of the four-year college population (25). However, additional research is needed to generalize beyond this sample. Strengths of the study included the geographic diversity, large sample size and consistent data collection over a nine week period.
This study paves the way for future research. It is difficult to compare the results to other studies because there is limited research focused on the relationship between goal setting and fruit and vegetable consumption and physical activity among young adults, and because goal setting procedures are so variable. This study not only takes a more in-depth look at the relationship between goal setting and two very important health related behaviors, it shows success in increasing fruit and vegetable consumption and provides guidance for future studies to increase physical activity. It suggests that goal setting may be a cost-effective way to help prevent chronic diseases.

CONCLUSIONS
Goal setting as part of a web-based intervention can be effective in increasing fruit and vegetable consumption among young adults but results were less clear for physical activity. There is a need for further research in this area, particularly with more reliable measures of intake and activity. Goal setting may need to look different when exploring its relationship to maintain versus change a behavior.    For fruit and vegetable intake: goal group 1 met 0-3 goals, goal group 2 met 4-5 goals, goal group 3 met 6 or more goals g For physical activity: goal group 1 met 0-2 goals, goal group 2 met 3-4 goals, goal group 3 met 5 or more goals    (Arnett, 2000). Effective interventions improving these behaviors in young adults may reduce the development of chronic disease in the future.
One technique that has been shown to increase health related behaviors is goal setting. Goal setting has shown promise as a useful, cost-effective, and empowering tool in previous studies and can easily be incorporated by a number of professionals (Pearson, 2012). Research shows that goal setting can increase performance on over 100 tasks in a variety of settings (Locke & Latham, 2002). Interestingly, the effectiveness of goal setting for dietary and physical activity behavior change has been shown more for adults and less for adolescents ).
There has also not been extensive research on goal setting during the transition period from adolescence to adulthood.
Research on goal setting has been going on for years, but increased in both quality and quantity during the latter half of the 20 th century. Locke and Latham developed a goal-setting theory, which states that there is a positive linear relationship between a specific high goal and task performance (Latham & Locke, 2007). A goal is defined as the object or aim of an action or a level of performance proficiency that we wish to attain, usually within a specified time frame (Latham & Locke, 2006;Locke & Latham, 2002). The research initially done on this topic focused on organizational or work-related tasks (Locke & Latham, 2002) but later expanded into health related behavior change.
Goal setting falls under several theories of behavior change, including the Cognitive Behavioral Theory (CBT) and the Social Cognitive Theory (SCT). The CBT induces change by utilizing a directive, action-oriented approach that teaches a person to explore, identify, and analyze dysfunctional patterns of thinking (Saphn et al., 2010). The SCT induces change by using four conditions (attention, retention, motor reproduction, and motivation) to help people learn from others (Saphn et al., 2010). The separation of goal-setting theory from the theories of behavior change that it falls under is rooted in its focus on the core properties of an effective goal. This includes specificity and difficulty level and moderators of goal effects (goal commitment, goal importance, self-efficacy, feedback, and task complexity), among others (Locke & Latham, 2002).
According to Locke and Latham, there are three mechanisms through which goals directly affect performance. These mechanisms are: (1) a directive function (direct attention and effort toward goal-relevant activities and away from goalirrelevant activities), (2) an energizing function (high goals lead to greater effort than low goals), (3) persistence (goals can prolong effort depending on difficulty level) (Locke & Latham, 2002;LaPorte & Nath, 1976). Goals also indirectly affect performance by leading to arousal, discovery, and/or use of task-relevant information (Wood & Locke, 1990).
There are goal setting guidelines through which the chances of attaining a goal can be increased. For example, it has been consistently shown that setting a specific, difficult goal leads to higher performance than an ambiguous "do your best" goal (Locke & Latham, 2002). Falling under this umbrella would be S.M.A.R.T. goals.
S.M.A.R.T. goals are specific to a behavior, measurable, attainable, realistic, and time bound. Another way to increase the chances of goal attainment would be to use implementation intentions. Implementation intentions specify the when, where, and how so that when a situation arises, a person will know how to respond so that they can reach goal attainment (Gollwitzer, 1999).
There has also been some research on guided goal setting where someone chooses a goal from a variety of goals that were already created by someone else . Regardless of how goals are set, there have been thousands of studies conducted all over the world that show their effectiveness in increasing a person's performance (Latham & Locke, 2006;Locke & Latham, 2002). Although the reasons for the effectiveness of goal setting are not one hundred percent clear, there are several things that might contribute. Some of these contributors could be: discovery of subpar performance, focused attention on goal-related behaviors, and an objective, unambiguous way to judge effectiveness (Latham & Locke, 2006).
Some studies have looked at goal setting as part of a web-based intervention.
Web-based interventions can be tailored to individuals and offered at a relatively low cost, along with the option of wide distribution (Broekhuizen, Kroeze, van Poppel, Oenema & Brug, 2012). With the ever-growing use of computers and the Internet, web-based interventions coincide with advances in technology and today's society.
Studies have shown this method of delivery to be effective with both dietary and physical activity interventions (Broekhuizen et al., 2012).
Goal setting has been shown to be effective in both web-based and other types of interventions. In a previous review (Cullen, Baranowski, & Smith, 2001), it was noted that there is a great amount of variability across studies related to what and how goal setting procedures were used. Table 1 shows selected studies that look at the effect of goal setting on fruit and vegetable consumption and/or physical activity.
Most of these studies provide little detail on goal setting procedures used. One of the studies shown is focused on an internet-based, worksite intervention to prevent weight gain which used goal setting as part of the chosen intervention . Another study is focused on finding an intervention that can reach large segments of the population to improve diet and physical activity and again used goal setting as part of the chose intervention . Other studies focus on goal setting, but look at it in relation to different populations, such as male children , adults (Dishman, DeJoy, Wilson & Vanderberg, 2009), or women (Heneman et al., 2005. Results from the studies shown in Table 1 vary. While some show significant increases in physical activity and fruit and vegetable consumption Dishman et al., 2009;Heneman et al., 2005) and one suggests a positive relationship between goal setting and healthy eating and physical activity (Kelley & Abraham, 2004), others show no effect of goal setting . None of these studies focus on the important population of young adults.
Despite increasing evidence that goal setting has a positive effect on health related behaviors, there is limited research on the effect of goal setting on fruits and vegetables and physical activity specifically. Due to this lack of extensive research, there is a great need for studies that take a more in-depth look at the effects of goal setting in the area of fruit and vegetable consumption and physical activity and among young adults.
To test the efficacy of a 9-month Internet-based intervention to prevent weight gain immediately following the 10-week nutrition and exercise program To evaluate the relationship between goal setting and diet and physical activity behavior and to examine whether home availability or preferences moderated the effects of goal setting To determine whether ALIVE achieved increases in the consumption of fruits and vegetables and physical activity and decreases the consumption of saturated fats, trans fats, and added sugars To increase physical activity using individual goal setting with a socialecologic model including management endorsement, employee-management steering committees, group and organizational goal setting, and environmental prompts To determine the effectiveness of pairing personalized goal-setting exercises within community-based nutrition education programs to promote behavior change in a lowincome population The 2005 US Dietary Guidelines define a cup of fruit or vegetables as 1 cup of cooked or raw vegetables, 2 cups of lettuce, 1 cup cooked or raw fruit, a piece of fruit, 1/2 cup of dried fruit like raisins, or 1 cup (8 ounces) of 100% fruit juice. Remember that combination foods such as pizza, spaghetti, and soup usually contain fruits and/or vegetables so don't forget to count them! Now, to the best of your ability, answer the questions below.

1) how many cups of fruits and vegetables a day did you usually eat?
2) how many days did you exercise?
3) How many minutes (on average) did you exercise on those days? This Week...

1) how many cups of fruits and vegetables a day do you intend to eat?
2) how many days do you plan to exercise?
3) How many minutes (on average) will you spend exercising on those days?

United States
The United States dietary guidelines suggests that nutrient needs should be met primarily through the consumption of foods. The recommendations are meant for Americans over 2 years of age. Key recommendations include consuming a variety of nutrient-dense foods and beverages within the basic food groups while choosing foods that limit the intake of saturated fat and trans fat, cholesterol, added sugars, salt, and alcohol. A sufficient amount of fruits and vegetables should be consumed daily with an emphasis on variety. Grain products should be whole or enriched and milk products should be fat-free or low-fat. When selecting and preparing meat, make choices that are lean, low-fat, or fat-free. Intake of fats and oils high in saturated and/or trans fatty acids should be limited, while choosing products low in fats and oils. Body weight should be maintained in a healthy range by balancing caloric intake with energy expenditure. Regular physical activity is encouraged. If alcohol is consumed, it should be done sensibly and in moderation.

Australia
The Australian guide to healthy eating recommends that Australians enjoy a wide variety of nutritious foods. Plenty of whole-grain breads and cereals, vegetables including legumes, and fruits should be consumed as well as a diet low in fat, particularly saturated fat. A healthy body weight should be maintained by balancing physical activity with food intake. Alcohol intake, sugars and foods containing added sugars, and salty foods should be limited. Breastfeeding is supported and encouraged.

Canada
Canada's food guide to healthy eating suggests that people four years and over enjoy a variety of foods from each food group every day. The four food groups recognized include grain products, vegetables and fruit, milk products, and meat and alternatives. Lower-fat foods and leaner meats such as poultry and fish should be consumed most often. Taste and enjoyment can also come from other foods and beverages that are not part of the four food groups. Some of these foods are higher in fat or Calories, so these foods should be consumed in moderation.

China
Food based dietary guidelines in China recommend eating a variety of foods. Nutrient dense foods such as vegetables, and fruits and tubers should be consumed more often with grains being the staple food. Milk products and legumes should be consumed daily while lean meats like fish, poultry, and eggs should be increased in the diet appropriately. A balance between the amount of food consumed and physical activity should be maintained for a healthy body weight. The consumption of fat meat/animal fat and fat/oil should be decreased and if alcohol is consumed, it should be in moderation.

Finland
The goal of the Food Based Dietary Guidelines is to improve the diet of the Finnish people. Dietary recommendations aim at increasing consumption of vegetables, fruit, berries, potatoes, whole-grain products with high fiber content, low-fat milk products, fish, and lean meat. They also aim at limiting the consumption of salt and salty foods as well as sugar and sugar-rich foods. Intake of hard fat should be decreased while the proportion of soft fat should be increased. Energy intake and energy expenditure should be in balance to maintain a healthy body weight. A moderate alcohol consumption and a minimum of 30 minutes of daily physical activity are also included in the recommendations.
Source: www.ktl.fi/nutrition/finnutrec98.pdf Japan Japanese dietary guidelines suggest enjoying delicious and healthy meals that are good for your mind and body. Aim to achieve a longer healthy life through your daily food choices. Other recommendations include establishing a healthy rhythm by keeping regular hours for meals and eating well-balanced meals with staple foods and a combination of various foods. Grains should be eaten at every meal to maintain sufficient intake of energy from carbohydrate while combining vegetables, fruits, milk products, beans and fish in your diet. Too much salt and fat should be avoided and when fatty foods are consumed, make a balanced choice of fat from animal, plant and fish sources. A healthy body weight should be maintained by balancing caloric intake with energy expenditure.

Nigeria
The general recommendations of the food based dietary guidelines aim at ensuring that the different age groups in all segments of the Nigerian population consume adequate amounts of food that contain the nutrients needed to attain and maintain good health. Good nutrition is emphasized by the consumption of as wide a variety of foods as possible from the age of 6 months. Fat intake from animal foods, salt and sugar should all be limited. A liberal consumption of fresh fruits in season is encouraged. A healthy lifestyle with plenty of exercise should be followed. Tobacco use in any form should be avoided and alcohol use should be moderated.

South Africa
South African food based dietary guidelines for adults and children over the age of seven years recommends enjoying a variety of foods while maintaining physical activity. Starchy foods should be the basis of most meals. Dry beans, split peas, lentils, and soy should be consumed on a regular basis and chicken, fish, milk, meat or eggs can be eaten daily. Lots of clean, safe water and plenty of fruits and vegetables daily are important parts of a healthy diet. Fats, salts, and food and drinks containing sugar should be used sparingly. Alcohol should be drunk sensibly if drunken at all. There are 2 lessons in Project WebHealth about ways to add more physical activity to your day.
Physical activity is any bodily movement that expends energy and incorporates "everyday" activities as well as things like exercise.
Exercise is planned, structured, purposeful physical activity done to improve or maintain fitness.

Physical Activity Goal Setting
It is recommended that everyone is at least moderately active most days of the week. Examples of moderate physical activities include, walking briskly or hiking, dancing, aerobics, or bicycling for more than 10 minutes at a time.
Currently, how many days a week are you at least moderately active?

Page 23 of 32
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How many days per week do you get at least 30 minutes of exercise?
Are you exercising at least 5 days per week for 30 minutes?
No, and I do NOT intend to in the next 6 months No, but I intend to in the next 6 months No, but I intend to in the next 30 days Yes, and I have been, but for LESS than 6 months Yes, and I have been for MORE than 6 months Page 24 of 32 << Previous Page Next Page >>

Fruit and Vegetable Goal Setting
The 2005 US Dietary Guidelines define a cup of fruit or vegetables as 1 cup of cooked or raw vegetables, 2 cups of lettuce, 1 cup cooked or raw fruit, a piece of fruit, 1/2 cup of dried fruit like raisins, or 1 cup (8 ounces) of 100% fruit juice.
Here are other foods equal to 1 cup of a fruit or vegetable.

Healthful Hint
One cup of tomato sauce is equal to 1/2 cup of vegetables.
Including snacks, how many cups of fruits and vegetables do you usually eat each day?
Page 27 of 32  Eat a piece of fruit for dessert instead of a sweet 2 nights this week  Eat 2 cups of salad for lunch 3 days this week  Attend a fitness class (aerobics, martial arts, pilates) once this week  Do jumping jacks for at least 10 minutes while watching TV 3 nights this week Throughout Project WebHealth you will explore the many ways to achieve your goals!

Couch Potato
That's OK. You are in charge in Project WebHealth.
Although you may not be ready to change, later on, you may decide you want to start eating more healthful foods or getting more exercise. Use the resources available at your university and think about setting goals. How easy or hard is this goal for you?
How important is meeting this goal to you?
You are more likely to achieve a goal that is a challenge and important to you. If a goal is too easy, you don't accomplish anything and will get bored with it. If a goal is too hard, you are likely to fail and get discouraged. The more important it is for you to achieve a goal, the more likely you are to reach that goal. Goals that are rated between 5 and 8 for their level of challenge and 7 or above for importance are more likely to be achieved.
Please print this page if you would like to refer to it in the future.

Maintaining a Healthy Body Weight: Lesson 10
Examine and Set Your Fruit and Vegetable and Physical Activity Goals for the Week Your profile page will keep track of your goal setting. YOUR GRAPHS ARE NOT AVAILABLE TO THE GENERAL PUBLIC. Your tracking graphs are for your own use only.
The 2005 US Dietary Guidelines define a cup of fruit or vegetables as 1 cup of cooked or raw vegetables, 2 cups of lettuce, 1 cup cooked or raw fruit, a piece of fruit, 1/2 cup of dried fruit like raisins, or 1 cup (8 ounces) of 100% fruit juice. Remember that combination foods such as pizza, spaghetti, and soup usually contain fruits and/or vegetables so don't forget to count them! To the best of your ability, answer the questions below.

1) how many cups of fruits and vegetables a day did you usually eat?
2) how many days did you exercise?
3) how many minutes (on average) did you exercise on those days? Next Semester... 1) how many cups of fruits and vegetables a day do you intend to eat this spring semester?
2) how many days do you plan to exercise this spring semester?
3) how many minutes (on average) will you spend exercising on those days?