Healthy Diet on Early Adulthood Women

Rena Latifa

, Dick Hurry Maulana

, Desi Nahartini

, Imam Subchi

and Dede Rosyada

Syarif Hidayatullah State Islamic University Jakarta

Keywords: healthy diet behavior, social support, health belief model

Abstract: A healthy diet is eating healthy or nutritious food, and doing physical activity that will improve stamina and

maintain health. The purpose of this study was to determine whether social support (emotional support or

appreciation, real support and instruments, informational support, and friendship support) and health belief

model (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to Action,

and self-efficacy) can predict healthy diet behavior. Respondent are 314 early adulthood women who go on

a diet (reducing the consumption of food, beverages that contain high calorie, high fat diet, and doing

physical activity) at least for one month. Hypothesis test show the value Rsquare = 0.682, meaning that is

the proportion of variance of healthy diet behavior described by all the independent variables by 68.2%.

There are five variables that had a significant influence on healthy diet behavior that is emotional support or

appreciation, support information, perceived severity, cues to action, and self-efficacy.

1 INTRODUCTION

Health is a fundamental aspect of human life.

Health, according to WHO, can be interpreted as a

healthy state of complete physical, mental, and

social, and not merely a condition that is free from

disease, disability and weaknesses (Smet, 1994).

Health is a basic and important thing for everyone,

and unfortunately most people often forget about it.

Usually when people fall ill, it is soon realized by

the patient. Therefore, health care needs, will be a

mandatory and required by the body. In everyday

life, the actual intake of food, beverage, and

nutrition absorbed by the body and physical activity

such as exercise should be a major concern.

Consuming good food, nutritious, and halal, will

improve the stamina, so that the health could always

be maintained.

Everyone wants to be healthy and want to have a

fit body, as well as having an ideal body’s shape and

weight. This is motivated by health reasons, as the

person weight could affect a person's appearance.

Appearance and Health is something that is often

arouse special attention, and every individual trying

to make its appearance looks healthy and perfect in

their social environment. It is very reasonable,

considering one of the five basic human needs

according to Maslow is the need for self-esteem/

self-respect. If the needs for self-respect and the

respect of others is not met, the individual will feel

helpless and feel inferior or insecure (Alwisol,

2009).

Young women are more likely to adopt the

values were based on outward appearance (Harper,

2009). This is because at this age, a woman wants to

always look attractive, and healthy in front of a

friend, spouse or coworkers. In addition, people who

are in their early adult phase would like to achieve

closeness with others and trying to escape from

aloofness (Papalia, 2009). Research conducted on

803 people in the United States, showed that,

compared to men, women give more attention to

health and their bodies (Wood, 2006).

Based on that idea, diet is one way that is

effective and efficient to have or achieve a normal

weight. Individuals are able to set the pattern of

healthy eating habits (diet), will be able to maintain

the stability of their weight properly so that they can

be protected from obesity or overweight (Dariyo,

2004).

Diet is something that is very appealing on

today. With an unlimited eating habit, plenty choices

of delicious food, sometimes lead to obesity and

make the body become less healthy. Many people

trying to make their body slim and appear to be

healthier. So far, women prefer a diet to lose weight

and gain healthy. Kim and Lennon (2006) explains

that the diet includes behavioral patterns vary from

Latifa, R., Maulana, D., Nahartini, D., Subchi, I. and Rosyada, D.

Healthy Diet on Early Adulthood Women.

DOI: 10.5220/0009941222372244

In Proceedings of the 1st International Conference on Recent Innovations (ICRI 2018), pages 2237-2244

ISBN: 978-989-758-458-9

2237

the selection of food for good health until a very

tight restrictions on the consumption of calories.

According to Calhoun (1995) in 1984, a market

research company reported that 30% of American

women and 16% of men go on a diet. National data

in the US also stated that, approximately 44% of

women trying to lose weight and the remaining

approximately 26% of women trying to maintain

their weight. Based on these data more than two-

thirds of women, whose have a majority of normal

body weight, they are all still actively control their

weight (French, Perry, Leon, & Fulkerson, 1995).

One's consciousness to maintain health are also

characterized by self-limiting in food consumption.

Researchers found that women who had a healthy

diet and feel the benefits of a healthy diet will help

her friends to have a healthy diet. So does with the

young women who go on a diet. Women in the age

of 20-30 years old is dieting not only to beautify

themselves but also to maintain the health (Papalia,

2009).

Most women in their 30’s or older, have a diet to

get back their shape. It is because at that age, usually

women experience changes in their body shape.

Centers for Disease Control and Prevention (CDC),

revealed that heart disease and stroke found among

adolescents and early adulthood, because their habit

of eating fast food. Not a few people with diseases

such as heart disease and stroke is in their early

adulthood, causing most women in early adulthood

or in their 20’s-30’s begins to realize the levels of

cholesterol or fat content in the food they consume.

In a report by the Weight Loss Plan (2012), a

few years ago, the adults may not have been all too

aware of the existing cholesterol in their bodies, but

now the adults began to realize how cholesterol

affects their lives. Controlling cholesterol through

diet and, if needed with drugs, can significantly

reduce the risk of coronary heart disease (Papalia,

2009).

Dietary adjustments in accordance with the rules

and aiming to maintain health and achieve ideal

body weight is called a healthy diet. A healthy diet

can make a person have the ideal body, without

incurring side effects that are harmful to the body.

Researchers revealed the successful and the

effective strategies for losing weight is to eat less fat

and doing more exercise. Participants from the

National Health and Nutritional Examination Survey

reported a weight loss of at least 5 percent of its

original weight if they do a little fat diet and plenty

of exercise and it will make a decrease of at least 10

percent of body weight when it is combined with a

weight loss program (Ashton, 2010). In an

experiment from 201 students who underwent

weight control program, a combination of diet and

exercise for 12 months, resulted in significant

weight loss and improve the functions of breathing

and the heart (Papalia, 2007).

Women who have been successful on a diet

usually continue to maintain their eating habit, even

though their weight is already normal. They go on a

diet in an effort to maintain a healthy body and

protect them from diseases caused by unhealthy

eating patterns. They go on a diet by adjusting the

eating habit into a healthy diet and do more exercise.

The problems that will arise later is the form of

dietary behaviors chosen by women. The must to get

the ideal body weight with a quick and easy process,

will make women perform unhealthy diet, such as

doing an unhealthy eating patterns, fasting

excessively, exercising excessively, and et cetera.

As research conducted by Erdianto (2009) on the

deviation tendency of eating behavior in women at

their early adulthood in the Social and Political

Sciences Faculty of University of Indonesia said

that, although the respondents have normal BMI,

they still find themselves obese (38.8%). The feeling

of having excessive fat perceived by the student as

their body looks big (81.5%) and it does not look

attractive. In addition, respondents also fear that

their weight may up and become obese (28.7%). A

total of 40.3% of respondents had a diet within the

past one year. The reason is, most of the women

doing dieting to prevent weight gain (85.2%) and

their desire to have an attractive body shape

(81.5%).

Dietary behavior committed by those who have a

normal BMI and weight or even less, is feared will

lead to insufficient nutritional intake that can affect

their daily activities. The negative perception had by

female students about the ideal body resulting in

their obsessive efforts to control weight. Erdianto

study (2009) reported some ways to control body

weight undertaken by the respondent is to reduce the

frequency of meals (63%), reducing fat intake

(59.3%), reducing the consumption of carbohydrates

(55.6%), and exercising excessively (40.7%).

Research conducted by Hendrayati (2007)

revealed that 95.56% of respondents have an

unhealthy diet with the category of unbalanced

nutrition. The comparison between their BMI and

nutrition showed that, 71.1% of respondents have a

normal BMI but their intake is insufficient. While

the results were alarming, that 17.78% of

respondents fit into the category of thin body and

they also have less intake.

ICRI 2018 - International Conference Recent Innovation

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Another study conducted by Ginting (2002) in

Noble (2010) showed that non medical students is

still lacking in choosing their food menu, and failed

to specify the time for a good meal, this statement is

evident from the results of studies showing that only

12.9% choose the menu of good food category and

14.3% of non-medical students who choose a proper

mealtimes in both category.

It is not easy for someone to decide having a

proper diet, especially a healthy diet. Support such

as the provision of information about a healthy diet,

the provision of a healthy eating patterns as well as

the appreciation for the selection of a healthy diet is

necessary for someone who wants to run a healthy

diet program. For that, they need social support from

their environment. The survey from the International

Food Information Council Foundation in 2011 stated

that significantly, amounting to 36% of support from

family and friends is a source of influence on

improving healthy diet. Dieting means limiting

carefully calorie consumption or certain foods, as

long as it is done in proportion to the needs of the

body, the diet can make the body lose weight and

stay healthy. However, if it is done carelessly, it can

be fatal. According to the survey from Horm and

Anderson (2008) showed that 40% of women doing

their weight reduction with unhealthy way. Many

health experts blame the diet program that recently

resulted in an increased incidence of anorexia or

eating chronic failure, which resulted in half starved,

and the occurrence of bulimia, trying to keep

vomitting, fasting, or excessive abuse of laxatives

(Calhoun, 1995).

A person with an unhealthy, or unbalanced

eating patterns may not be on a diet. This is because

the person does not receive social support in the

form of information support of the consequences of

the unhealthy diet. Social support can have

beneficial effects on food choices and healthy diet

changes (Devine, 2005).

People who are in overweight state but have no

awareness of their condition is very likely to not go

on a diet. If it happens to a child, the social support

as an instrumental support of the mother is very

influential on changing their eating patterns behavior

(Ireland, 2010). The instrumental support may

include the provision of a healthy eating pattern to

be consumed each day so that they can perform a

healthy diet.

Other forms of social support are in the form of

emotional support and giving special care or

attention. Many people may go on a diet, but not

many people are doing a healthy diet. Diet can be

done by taking weight-loss drugs, but of course it is

not a healthy one. Therefore it needs a special

attention and concern from the closest person to the

people who decide to go on a diet. Attention and

cares from people nearby can predispose a person to

a healthy diet. Someone will have a healthy diet

when people around them give a sense of care to

their behavior, the food they consume and the way

they go on a diet. Social support from home and

from fellow workers is positively associated with the

improved fruit and vegetable consumption and the

repair phase of eating habits consecutively

(Sorensen, 2005).

Moreover, basically dieters need much supports,

such as an appreciation when they go on a diet

especially the healthy one. With the appreciation

they got, it will affect the person to choose healthy

diet than to buy drugs to get instant results.

In relation to health behaviors, Rosenstock

(1966) developed a model of how an individual's

belief predisposes a person to choose healthier

behaviors. His theory is known as the health belief

model or abbreviated as HBM. Health belief model

of psychosocial approach is one of the most widely

used to describe the behavior related to health. The

main factor of this theory is the kinds of beliefs that

is owned by an individual to influence their healthy

behavior. By focusing on the belief or the individual

assessment of his health, this theory organizes

information about health and the factors that affect

individuals in changing unhealthy behavior (Taylor,

2006).

Health belief model (HBM) has long known as

one of the most influential and the most popular

model in the attempt to explain the behavior of

health, both in preventing the onset of disease and in

preventing the increase of the developed disease.

This theory emphasizes the aspects of cognition that

is often forgotten in studying the behavior of health

(Sarafino, 2008).

This theory assumes that if a person is motivated

to take healthy steps, the individuals need to be

convinced personally that their health is susceptible

to the disease (perceived susceptibility), and the

disease is classified as serious (perceived severity).

In addition, the perceived benefit is greater than the

negative aspects (perceived barriers) obtained, when

they put through healthy behaviors. Therefore, the

assessment of who and what it makes itself moved

(cues to action) to make healthy behavior, and the

belief that they will succeed (self-efficacy) to

perform the behavior is important. These four types

of beliefs, cues to action, self-efficacy of HBM give

more influence to an individual's decision whether

Healthy Diet on Early Adulthood Women

2239

they would take steps to healthy behavior or not

(Taylor, 2006).

Research by Abood, Black and Feral (2003) on

"Nutrition Education Intervention for University

Staff- Worksite Application of the benefits of health

belief model", reported that HBM especially,

perceived, successfully used in the practice of

healthy nutrition and nutritional knowledge

associated with heart disease and cancer.

Yunansih’s study (2002) on the observance of

type II diabetes mellitus patients, identified that high

confidence in the perceived severity (level of

perceived seriousness of the disease) give a strong

impetus to act on a patient-abiding and purposeful

suggestions by the doctor. Thus the health beliefs

helped identify the factors that influence health

behavior, where one of the healthy behaviors is the

behavior of the diet.

Based on the phenomenon and some research

above, the researchers are interested in doing a study

to find out whether social support (which consists of

the dimensions of emotional support or appreciation,

real support and instruments, support of information,

and support of friendship) and the health belief

model (perceived susceptibility, perceived severity,

perceived benefits, perceived barriers, cues to

action, and self-efficacy) can be a predictor of the

healthy diet behavior of early adulthood women.

Major Hypothesis:

There is a significant influence of social support,

health belief model to the healthy diet behavior of

early adulthood women.

Minor Hypothesis:

H1: There is a significant influence of emotional

support or appreciation, as a dimension of

social support, to the healthy diet behavior of

early adulthood women.

H2: There is a significant influence of real support

and instruments, as a dimension of social

support, to the healthy diet behavior of early

adulthood women.

H3: There is a significant influence of support of

information, as a dimension of social support,

to the healthy diet behavior of early adulthood

women.

H4: There is a significant influence of support of

friendship, as a dimension of social support, to

the healthy diet behavior of early adulthood

women.

H5: There is a significant influence of perceived

susceptibility, as a dimension of health belief

model, to the healthy diet behavior of early

adulthood women.

H6: There is a significant influence of perceived

severity, as a dimension of health belief model,

to the healthy diet behavior of early adulthood

women.

H7: There is a significant influence of perceived

benefits, as a dimension of health belief model,

to the healthy diet behavior of early adulthood

women.

H8: There is a significant influence of perceived

barriers, as a dimension of health belief model,

to the healthy diet behavior of early adulthood

women.

H9: There is a significant influence of cues to

action, as a dimension of health belief model,

to the healthy diet behavior of early adulthood

women.

H10: There is a significant influence of self-efficacy,

as a dimension of health belief model, to the

healthy diet behavior of early adulthood

women.

2 RESEARCH METHODS

In this study, a number of 314 female

respondents in their 20’s to 30’s (early adulthood

category; have a healthy diet for at least one month;

where their activities of diets can be in the limitation

of the consumption of foods and beverages that

contain calories, high fat diet, and physical activity)

selected as the research sample. Non-probability

sampling techniques employed with the type of

snowball sampling. Snowball sampling can identify

the characteristics required by members of the same

characteristics group (Henry, 1990).

Questionnaires used as the data collection.

Researchers use three scales shaped models; Likert

scale, health belief model, the social support scale,

and the scale of dietary behaviors were prepared

using four answer options, namely, strongly agree

(SA), agree (A), disagree (D), and very disagree

(VD).

The scale used is the scale of health belief model

(Glanz, 2008) consisting of dimensions of perceived

susceptibility, perceived severity, perceived benefits,

perceived barriers, cues to action andself-efficacy.

Social support scale (Sarafino, 2011) consisting of

dimensions: emotional support or appreciation, the

real support or support of instrument, support of

information, and support of friendship. Dietary

behavior scale used in this study are based on weight

loss behavior scale (WLBS) drawn up by the French,

Perry, Leon and Fulkerson to then used as an

indicator. Researchers only took 11 of the 23 weight

ICRI 2018 - International Conference Recent Innovation

2240

loss strategy that existed at that scale, because it is

already represented all the things that want to

measure. The methods of weight loss or a healthy

diet scale have reflects a healthy diet and exercise.

This method consists of: a reduction in calories,

exercising more, emphasis on eating fruits and

vegetables, reduce cravings, reduce fat intake,

reduce sweets or sugary foods, reduce food portions

consumed, changes the type of food, reduce meat

consumption, reduce carbohydrate foods, and

consume foods in low calories.

The analysis technique used is multiple

regression analysis where the calculations are

performed using SPSS 17.0 software.

3 FINDINGS

Based on the results of R

, it is 0.682, meaning

the proportion of the variance of the behavior of a

healthy diet, explained by emotional support or

appreciation, real support or instrument, with the

information and support of friendship, perceived

susceptibility, perceived severity, perceived benefits,

perceived barriers, cues to action,and self-

efficacyamounted to 68.2%, while 31.8% is

influenced by other variables outside of this study.

Table 1: Summary of regression test independent variable

to the dependent variable

The popularity test F on R2, obtained

significantly for 0000 (sig <0.005), meaning that

there was a significant effect of perceived

susceptibility, perceived severity, perceived benefits,

perceived barriers, cues to action, self-efficacy,

emotional support or appreciation, real support or

instruments, information support and friendship

support to the dietary behavior. The F test results

can be seen in table 2 below:

Table 2: The significance of the regression test of

independent variable (IV) to the dependent variable (DV).

Based on the regression coefficients in Table 3,

there are five variables that significantly contribute

to the behavior of a healthy diet that is emotional

support or appreciation (β = 0118), support

information (β =0.333), perceived severity (β

=0.255), cues to action (β =-0.142), self-efficacy (β

=0.333).

Table3: The regression coefficient predictor of the

behavior of a healthy diet

4 CONCLUSIONS

This study found a significant relationship

between social support and healthy dietary behavior.

This is according to research conducted by Wei

Chang, et al (2008) indicated that social support is

one of the factors that influence dietary behavior, but

the study only examined the overall social support

so it has not reveal where the most significant

dimensions is. In this research reported that

emotional support or appreciation have an influence

on the behavior of a healthy diet. This is in line with

Vicki (1996) where his research on cancer patients,

said that the role of social support for cancer patients

has an effect with their psychological adjustment.

His research suggests that emotional support is the

most desired by the patient. The results show that

emotional support has a strong association with

better adjustment in patients.

Support of information is also positively

influence the behavior of a healthy diet, meaning

that the higher the support information is, the higher

the behavior of a healthy diet will be. This is

consistent with research suggested by Thornton

(2006) in which the information support from

husband is the most influential, important, and

consistent support to the dietary behavior of a wife.

Other studies (Cullen, 2000) mention that the

information media such as television becomes a role

as a source of reference information in the search of

healthy foods. From this study it is also found that a

person who is undergoing a diet program, especially

a healthy diet will be easier to run their diet when

they are getting enough information support.

Furthermore, there is a significant influence

between the health belief model of diet on behavior.

Model R

R Square Adjusted R Square Std. Error of the Estimate

1 .826

.682 .671 544.834

Sum of Squares

Mean Square

F Sig.

Regression

19.253.077 10 1.925.308

64.859 .000

Residual

8.994.383 303 29.684

Total

28.247.460 313

Model

Healthy Diet on Early Adulthood Women

2241

This is according to research conducted by Robert

(1997) which states that the health belief model is

significantly influential in the reduction of stress in

women before the wedding, and those who are doing

dietary behavior. In another study by Abood, Black

& Ferai (2003) revealed that the health belief model

significantly succeed used in the practice of nutrition

and nutritional knowledge associated with heart

disease and cancer. Other researchers (Taylor, 2006)

reported that with one focuses on the belief or

judgment about health, it will affect them in

changing behaviors related to one’s health.

The Dimension of health belief model that gives

the most significant influence to predict the behavior

of a healthy diet is the dimension of perceived

severity. The higher the perceived severity owned by

the people, the higher their healthy dietary behavior

will be. The results of this study are supported by

Sarafino (2008) which states that individuals who

believe the consequences of their health problems as

a result of illness (perceived severity), such as the

medical consequences (death, disability, and pain),

psychological consequences (depression, anxiety

and fear), as well as social consequences (impact on

employment, family life and social relationships),

the greater the confidence that the threat will be up

to them. Confidence will be affected by the disease

(perceived severity) and make the people motivated

to make healthy diet behaviors due to its many

benefits and, it's also a lifestyle that become a trend

today.

Another Dimension of health belief model that

may influence significantly to predict the behavior

of a healthy diet is the dimension of cues to action,

where this dimension has a negative effect on the

behavior of a healthy diet. This means that the

higher the cues to action owned by a person, the

lower their dietary behavior is. With more powerful

cue or cues accumulation, a person is stimulated to

take action. The more people feel the importance of

assessing, or having bad omen for them, the lower

the effort to do a healthy diet will be. This alert did

not make a sign for people to change health

behavior. Baranowski (2003) ever found the results

of research that prove most of the people do not feel

the importance of assessing or getting bad sign for

them to change their behavior. For example, their

closest relatives died due to disease of obesity, but

this case did not make them aware to change their

health behavior.

The other dimension that significantly

determines the behavior of a healthy diet is the

dimension of self-efficacy. Self-efficacy describes

an individual's belief in their ability to make healthy

dietary behavior. The higher self-efficacy on the

individual the higher a person's healthy diet behavior

will be. Self-efficacy has a strong relationship and

significant impact on an individual's effectiveness in

performing a health program (Rita, 2012). A person

is more likely to perform the behavior when they

believe that they are able to do so. Self-efficacy is

not only increasing the likelihood of individuals to

adopt healthy behaviors but also reduces the

inhibitory effect on the running behavior. Improving

self-efficacy is the most effective way to reduce the

perceived difficulties in the behavior of certain

individuals.

The conclusion of this findings are: the behavior

of a healthy diet in early adulthood women can be

achieved in the presence of emotional support,

information support, perceived severity, and self

efficacy. Through emotional support, women feel

being more welcomed and can make adjustments to

choose a healthy diet. While going through the

support of information she can find references for a

healthy diet and positive effects of a healthy diet that

has ever been experienced by others. A healthy diet

will be easier to bear when people get enough

information. The higher the perceived severity in a

person the higher a person's healthy dietary behavior

will be. Confidence will be affected by the disease

(perceived severity) and make people motivated to

undergo healthy dietary behaviors due to its benefits

and also it's a lifestyle that is a trend today. The

higher self-efficacy owned by a person the higher

their healthy dietary behavior exists. Women are

more likely to make healthy dietary behaviors if they

believe that they are able to do so.

For further research, it can be examined the other

types of healthy eating patterns such as mayo diet,

water diet, and others diet in order to provide a

comparison between each type of diet. Other

researches also could study the behavior of a healthy

diet in men, children, and adolescents. Regarding to

the perceived severity, it may be advisable to early

adulthood women who are doing the diet in order to

increase their confidence to their healthy lifestyle

and a belief that the disease could come over

anytime. The seriousness of the danger of a medical

illness that actually can be resolved as quickly as

possible with early adjustment of diet, regular

exercise, avoiding stress derived from work, family

conflicts, and other social issues should be taken

seriously.

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