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Hahn SL, Burnette CB, Hooper L, Wall M, Loth KA, Neumark-Sztainer D. Do Weight Perception Transitions in Adolescence Predict Concurrent and Long-Term Disordered Eating Behaviors? J Adolesc Health 2023; 72:803-810. [PMID: 36739202 PMCID: PMC10121741 DOI: 10.1016/j.jadohealth.2022.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE Perceiving one's weight as "overweight" is associated with disordered eating in adolescence. Yet, it is unknown whether weight perceptions change during adolescence, or whether these weight perception transitions predict disordered eating. This study aims to: (1) characterize weight perception transitions from early to late adolescence among a population-based sample and (2) examine whether weight perception transitions in adolescence predict concurrent and future disordered eating into young adulthood. METHODS Eating and Activity in Teens and Young Adults (N = 1,414) survey data were used to examine correlates of weight perception transitions from early (Mage = 14.9 ± 1.6 years) to late adolescence (Mage = 19.4 ± 1.6 years). Adjusted generalized estimating equations were used to determine whether weight perception transitions in adolescence predicted concurrent and future disordered eating in emerging adulthood (Mage = 25.2 ± 1.6 years) and young adulthood (Mage = 31.0 ± 1.6 years). RESULTS Weight perceptions were stable from early to late adolescence for 77.2% of adolescents, whereas 15.5% transitioned to perceiving their weight as "overweight" and 7.3% stopped perceiving "overweight" in late adolescence. Perceived "overweight", especially in late adolescence, was associated with higher concurrent and long-term disordered eating up to 10 years later. For example, the predicted prevalence of binge eating in young adulthood among individuals who perceived their weight as "overweight" throughout adolescence was 20.1% compared to 6.6% for those who never perceived their weight as "overweight" in adolescence. DISCUSSION Adolescent weight perception was relatively stable in this population-based sample. However, weight perception transitions that involved perceiving "overweight", particularly in late adolescence, were associated with long-term higher risk of disordered eating.
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Affiliation(s)
- Samantha L Hahn
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota; Department of Psychiatry & Behavioral Health, University of Minnesota Medical School, Minneapolis, Minnesota; Central Michigan University College of Medicine, Mount Pleasant, Michigan.
| | - C Blair Burnette
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Laura Hooper
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Melanie Wall
- Department of Psychiatry, Columbia University, New York, New York
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
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Mori S, Asakura K, Sasaki S, Nishiwaki Y. Misreporting of height and weight by primary school children in Japan: a cross-sectional study on individual and environmental determinants. BMC Public Health 2023; 23:775. [PMID: 37106327 PMCID: PMC10134671 DOI: 10.1186/s12889-023-15682-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Appropriate body constitution during childhood is important for future health. However, it has been suggested that thinness is increasing among adolescent girls and boys in Japan. Since misreporting of height/weight may be a possible reflection of the child's ideal body image, we investigated the magnitude and direction of height/weight misreporting and its determinants among Japanese young adolescents. METHODS A total of 1019 children in public primary schools were included in the analysis. Both measured and self-reported values of height/weight were obtained. Misreporting of height/weight was calculated by subtracting the measured value from the self-reported value. The association between misreporting and several variables such as the BMI z-score of individuals and body constitution of surrounding children was explored by multivariate linear mixed models. RESULTS As BMI z-score increased, 'overreporting' of height by boys and 'underreporting' of height by girls became larger (p = 0.06 in boys, p = 0.02 in girls). Both boys and girls with a larger body size tended to underreport their weight (p < 0.01 in boys, p < 0.01 in girls). Boys who belonged to a school with a larger average BMI z-score were more likely to overreport their weight. This tendency was not observed for girls. CONCLUSIONS Self-reported height/weight was generally accurate in Japanese primary school children. However, even primary school children misreported their height/weight intentionally like adults, possibly due to social pressure to lose weight or that not to stand out. Thus, health education about appropriate body constitution should be provided from the beginning of adolescence, particularly for girls.
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Affiliation(s)
- Sachie Mori
- Department of Environmental and Occupational Health, Toho University Graduate School of Medicine, Omori-Nishi 5-21-16, Ota-Ku, Tokyo, #143-8540, Japan
| | - Keiko Asakura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Omori-Nishi 5-21-16, Ota-Ku, Tokyo, #143-8540, Japan.
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, #113-0033, Japan
| | - Yuji Nishiwaki
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Omori-Nishi 5-21-16, Ota-Ku, Tokyo, #143-8540, Japan
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Association between lifestyle-related, psychosocial factors and obesity among female adolescents in Taiwan. J Pediatr Nurs 2023; 68:e58-e68. [PMID: 36428129 DOI: 10.1016/j.pedn.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To examine a wide range of potential contributors to the risk of obesity in female adolescents. DESIGN AND METHODS Data for this study were collected using a cross-sectional design. A group of 175 female adolescents were recruited, and information on their demographic characteristics, lifestyle-related behaviors, and psychosocial factors was collected using a self-administered questionnaire during September 2018 to January 2019. Data were analyzed using SPSS 24.0. RESULTS An overestimation of body weight was negatively correlated with overweight in the female adolescents. Age at menarche was negatively correlated with the arisk of overweight. Adolescents who slept for >7 h on weekend nights were less likely to be overweight. Eating more cheese, fish, seafood, and organ meats was negatively correlated with obesity risk. The female adolescents were more likely to become overweight if they ate dinners prepared by family and experienced more disturbances from parents and other family members. CONCLUSIONS Female adolescents are a unique population affected by obesity. Although incorporating both lifestyle-related behavioral and psychosocial factors in future investigations and developing multicomponent interventions for obesity prevention are crucial, female adolescents should receive the utmost attention from researchers to alleviate the health burden of obesity. PRACTICE IMPLICATIONS The intertwined nature of obesity-related factors warrants future investigations to elaborate their roles interplaying with the risk of obesity. Multicomponent interventions should be developed, and nurses and health-care providers should target their efforts on obesity prevention for this specific population.
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Rogers NT, Cummins S, Forde H, Jones CP, Mytton O, Rutter H, Sharp SJ, Theis D, White M, Adams J. Associations between trajectories of obesity prevalence in English primary school children and the UK soft drinks industry levy: An interrupted time series analysis of surveillance data. PLoS Med 2023; 20:e1004160. [PMID: 36701272 PMCID: PMC9879401 DOI: 10.1371/journal.pmed.1004160] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/21/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Sugar-sweetened beverages (SSBs) are the primary source of dietary added sugars in children, with high consumption commonly observed in more deprived areas where obesity prevalence is also highest. Associations between SSB consumption and obesity in children have been widely reported. In March 2016, a two-tier soft drinks industry levy (SDIL) on drinks manufacturers to encourage reformulation of SSBs in the United Kingdom was announced and then implemented in April 2018. We examined trajectories in the prevalence of obesity at ages 4 to 5 years and 10 to 11 years, 19 months after the implementation of SDIL, overall and by sex and deprivation. METHODS AND FINDINGS Data were from the National Child Measurement Programme and included annual repeat cross-sectional measurement of over 1 million children in reception (4 to 5 years old) and year 6 (10 to 11 years old) in state-maintained English primary schools. Interrupted time series (ITS) analysis of monthly obesity prevalence data from September 2013 to November 2019 was used to estimate absolute and relative changes in obesity prevalence compared to a counterfactual (adjusted for temporal variations in obesity prevalence) estimated from the trend prior to SDIL announcement. Differences between observed and counterfactual estimates were examined in November 2019 by age (reception or year 6) and additionally by sex and deprivation quintile. In year 6 girls, there was an overall absolute reduction in obesity prevalence (defined as >95th centile on the UK90 growth charts) of 1.6 percentage points (PPs) (95% confidence interval (CI): 1.1, 2.1), with greatest reductions in the two most deprived quintiles (e.g., there was an absolute reduction of 2.4 PP (95% CI: 1.6, 3.2) in prevalence of obesity in the most deprived quintile). In year 6 boys, there was no change in obesity prevalence, except in the least deprived quintile where there was a 1.6-PP (95% CI: 0.7, 2.5) absolute increase. In reception children, relative to the counterfactual, there were no overall changes in obesity prevalence in boys (0.5 PP (95% CI: 1.0, -0.1)) or girls (0.2 PP (95% CI: 0.8, -0.3)). This study is limited by use of index of multiple deprivation of the school attended to assess individual socioeconomic disadvantage. ITS analyses are vulnerable to unidentified cointerventions and time-varying confounding, neither of which we can rule out. CONCLUSIONS Our results suggest that the SDIL was associated with decreased prevalence of obesity in year 6 girls, with the greatest differences in those living in the most deprived areas. Additional strategies beyond SSB taxation will be needed to reduce obesity prevalence overall, and particularly in older boys and younger children. TRIAL REGISTRATION ISRCTN18042742.
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Affiliation(s)
- Nina T. Rogers
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
- * E-mail:
| | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Hannah Forde
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Catrin P. Jones
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Oliver Mytton
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
- Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
| | - Stephen J. Sharp
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Dolly Theis
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
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Rios-Leyvraz M, Ortega N, Chiolero A. Reliability of Self-Reported Height and Weight in Children: A School-Based Cross-Sectional Study and a Review. Nutrients 2022; 15:nu15010075. [PMID: 36615731 PMCID: PMC9824624 DOI: 10.3390/nu15010075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Since anthropometric measurements are not always feasible in large surveys, self-reported values are an alternative. Our objective was to assess the reliability of self-reported weight and height values compared to measured values in children with (1) a cross-sectional study in Switzerland and (2) a comprehensive review with a meta-analysis. We conducted a secondary analysis of data from a school-based study in Switzerland of 2616 children and a review of 63 published studies including 122,629 children. In the cross-sectional study, self-reported and measured values were highly correlated (weight: r = 0.96; height: r = 0.92; body mass index (BMI) r = 0.88), although self-reported values tended to underestimate measured values (weight: -1.4 kg; height: -0.9 cm; BMI: -0.4 kg/m2). Prevalence of underweight was overestimated and prevalence of overweight was underestimated using self-reported values. In the meta-analysis, high correlations were found between self-reported and measured values (weight: r = 0.94; height: r = 0.87; BMI: r = 0.88). Weight (-1.4 kg) and BMI (-0.7 kg/m2) were underestimated, and height was slightly overestimated (+0.1 cm) with self-reported values. Self-reported values tended to be more reliable in children above 11 years old. Self-reported weight and height in children can be a reliable alternative to measurements, but should be used with caution to estimate over- or underweight prevalence.
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Affiliation(s)
- Magali Rios-Leyvraz
- Population Health Laboratory (#PopHealthLab), University of Fribourg, 1700 Fribourg, Switzerland
- Correspondence:
| | - Natalia Ortega
- Population Health Laboratory (#PopHealthLab), University of Fribourg, 1700 Fribourg, Switzerland
- Bern Institute of Primary Health Care (BIHAM), Faculty of Medicine, University of Bern, 3012 Bern, Switzerland
| | - Arnaud Chiolero
- Population Health Laboratory (#PopHealthLab), University of Fribourg, 1700 Fribourg, Switzerland
- Bern Institute of Primary Health Care (BIHAM), Faculty of Medicine, University of Bern, 3012 Bern, Switzerland
- Department of Epidemiology, School of Population and Global Health, McGill University, Montréal, QC H3A 1G1, Canada
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Hooper L, Puhl R, Eisenberg ME, Reicks M, Neumark-Sztainer D. How is weight teasing cross-sectionally and longitudinally associated with health behaviors and weight status among ethnically/racially and socioeconomically diverse young people? Int J Behav Nutr Phys Act 2022; 19:71. [PMID: 35739552 PMCID: PMC9219184 DOI: 10.1186/s12966-022-01307-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background Weight stigma is prevalent among young people and harmful to health. The current study used a health equity lens to examine cross-sectional and longitudinal associations between experiencing weight teasing (a form of weight stigma) with a range of weight-related health behaviors and weight status in an ethnically/racially and socioeconomically diverse sample of young people. We also assessed whether ethnicity/race and adolescent socioeconomic status (SES) operated as effect modifiers in these relationships. Methods Adolescents (n = 1568) were enrolled in EAT 2010–2018 (Eating and Activity over Time) and followed into young adulthood. Weight teasing; screen time; moderate-to-vigorous physical activity (MVPA); sleep duration; breakfast frequency; fruit, vegetable, sugar-sweetened beverage (SSB), and fast-food intake; and body mass index (BMI) were assessed at baseline (mean age = 14.4 years) and eight-year follow-up (mean age = 22.2 years). Multivariate linear regression estimated marginal means and 95% confidence intervals. All analyses adjusted for BMI and sociodemographic characteristics. Results Weight teasing was cross-sectionally associated with longer screen time, shorter sleep duration, and higher BMI during adolescence; and cross-sectionally associated with shorter sleep duration, lower breakfast frequency, higher fast-food intake, higher SSB intake, and higher BMI during young adulthood. In the longitudinal analyses, weight teasing was not associated with health behaviors but did predict higher BMI (teased: 28.2 kg/m2, not teased: 26.4 kg/m2, p < 0.001). White and higher adolescent SES subgroups had higher MVPA, more frequent breakfast intake, lower fast-food intake, and lower BMI than their respective counterparts. The relationships between weight teasing and health behaviors and weight status were largely consistent across ethnic/racial and adolescent SES subgroups. Conclusions Findings add to growing evidence that weight-based mistreatment poses a threat to weight-related health and that young people across ethnic/racial and SES subgroups are vulnerable to the negative effects of weight teasing. Limitations include attrition at follow-up and the self-reported nature of many measures. Results suggest a need for increased attention to existing recommendations to reduce weight stigma in young people from diverse ethnic/racial and socioeconomic backgrounds including training for healthcare providers to better equip them to address the harms of weight teasing and foster more compassionate care to promote health-supporting behaviors in young people. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01307-y.
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Affiliation(s)
- Laura Hooper
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S, 2nd St., Minneapolis, MN, 55454-1015, USA. .,Department of Food Science and Nutrition, University of Minnesota, 225 Food Science and Nutrition, 1334 Eckles Ave, St. Paul, MN, 55108, USA.
| | - Rebecca Puhl
- Department of Human Development & Family Sciences, College of Liberal Arts and Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269-1058, USA
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware Street SE, 3rd Floor, Minneapolis, MN, 55414, USA
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, 225 Food Science and Nutrition, 1334 Eckles Ave, St. Paul, MN, 55108, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S, 2nd St., Minneapolis, MN, 55454-1015, USA
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Hooper L, Mason SM, Telke S, Larson N, Neumark-Sztainer D. Experiencing Household Food Insecurity During Adolescence Predicts Disordered Eating and Elevated Body Mass Index 8 Years Later. J Adolesc Health 2022; 70:788-795. [PMID: 35078732 PMCID: PMC9038678 DOI: 10.1016/j.jadohealth.2021.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 10/24/2021] [Accepted: 11/23/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE Growing evidence indicates that experiencing household food insecurity during adolescence is associated with disordered eating and elevated body mass index (BMI). However, little is known about the temporal nature of these relationships. The current longitudinal study examined how adolescent experiences of household food insecurity are related to disordered eating and weight status 8 years later. METHODS A population-based sample of ethnically/racially and socioeconomically diverse participants (n = 1,340) were surveyed as adolescents (mean age = 14.5 years) and as young adults (mean age = 22.0 years). Parents/caregivers completed the six-item U.S. Household Food Security Survey Module at baseline. RESULTS Household food insecurity was common at baseline (37.8% of sample). In analyses adjusted for ethnicity/race and parental education, adolescent food insecurity longitudinally predicted a higher new onset of binge eating (food insecure: 21.3% vs. food secure: 16.2%, p = .038) and BMI ≥30 kg/m2 (food insecure: 15.9% vs. food secure: 11.0%, p = .024), but not unhealthy weight control behaviors in young adulthood. The majority of adolescents with unhealthy weight control behaviors and elevated BMI still had these problems in young adulthood, but persistence was not associated with adolescent household food insecurity for any outcome. DISCUSSION Results of this longitudinal study suggest that household food insecurity during adolescence is a risk factor for disordered eating and elevated BMI in young adulthood, highlighting a need to comprehensively address these intersecting problems.
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Affiliation(s)
- Laura Hooper
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
| | - Susan M Mason
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Susan Telke
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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Nagata JM, Hazzard VM, Ganson KT, Hahn SL, Neumark-Sztainer D, Eisenberg ME. Digital technology use and muscle-building behaviors in young adults. Int J Eat Disord 2022; 55:207-214. [PMID: 34904744 PMCID: PMC9023317 DOI: 10.1002/eat.23656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/01/2021] [Accepted: 12/04/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Digital technology use and muscle-building behaviors reflect a wide range of behaviors with associated health risks. However, links between digital technology use and muscle-building behaviors remain unknown and this study aimed to address this gap. METHOD Data were collected from a diverse sample of 1,483 young adults (mean age 22.2 ± 2.0 years) participating in the population-based Eating and Activity over Time 2018 study. Gender-stratified-modified Poisson regression models were used to determine cross-sectional associations between three types of digital technology use (screen time, social media, weight-related self-monitoring apps) and five types of muscle-building behaviors (changing eating, exercise, protein powders/shakes, pre-workout drinks, steroids/growth hormone/creatine/amino acids) in young adulthood, adjusted for sociodemographic characteristics and body mass index. RESULTS Screen time and social media were either not found to be associated with muscle-building behaviors or in a few instances, associated with less use of these behaviors (e.g., screen time and pre-workout drinks in men). In contrast, the use of weight-related self-monitoring apps was positively associated with all muscle-building behaviors, including steroids/growth hormone/creatine/amino acids in men (prevalence ratio [PR] = 1.83; 95% confidence interval [CI]: 1.13-2.97) and women (PR = 4.43; 95% CI: 1.68-11.68). DISCUSSION While most recreational screen time may represent sedentary behaviors not related to muscle-building behaviors, weight-related self-monitoring apps are highly associated with more muscle-building behaviors and could be a future target for interventions to discourage the use of steroids and other harmful muscle-building substances.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Vivienne M. Hazzard
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA,Department of Psychiatry & Behavioral Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Samantha L. Hahn
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA,Department of Psychiatry & Behavioral Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marla E. Eisenberg
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA,Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
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Patterns of restrained eating in Chinese adolescents' interpersonal contexts: A latent profile analysis. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02748-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Makri R, Katsoulis M, Fotiou A, Kanavou E, Stavrou M, Richardson C, Kanellopoulou A, Orfanos P, Benetou V, Kokkevi A. Prevalence of Overweight and Obesity and Associated Diet-Related Behaviours and Habits in a Representative Sample of Adolescents in Greece. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9010119. [PMID: 35053743 PMCID: PMC8774704 DOI: 10.3390/children9010119] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 01/22/2023]
Abstract
Excessive body weight during adolescence represents a significant public health problem worldwide. Identifying factors associated with its development is crucial. We estimated the prevalence of overweight and obesity in a representative sample of 11, 13 and, 15-year-olds living in Greece and explored the association with diet-related behaviours and habits. Self-reported data on weight, height, diet-related behaviours and habits were used from 3816 students (1898 boys, 1918 girls) participants in the Greek arm of the international Health Behaviour in School-Aged Children (HBSC) study during 2018. Overweight and obesity were defined using the 2007 WHO growth charts classification. Prevalence of overweight was 19.4% in the total sample, 24.1% for boys and 14.7% for girls, and prevalence of obesity was 5.3% in the total sample, 7.3% for boys and 3.4% for girls, respectively. In the total sample, overweight (including obesity) was positively associated with male gender, low family affluence, skipping breakfast, and being on a diet, and inversely associated with age and being physically active. Eating rarely with the family was positively associated with overweight only among boys and eating snacks/meals in front of screens only among girls. No association was noted for eating in fast-food restaurants, consuming vegetables, fruits, sweets, and sugar-sweetened beverages.
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Affiliation(s)
- Rafaela Makri
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 115-27 Athens, Greece; (R.M.); (P.O.)
| | - Michail Katsoulis
- Institute of Health Informatics, Faculty of Population Health Sciences, University College London, London ΝW1 2DA, UK;
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, Faculty of Population Health Sciences, London WC1E 7HB, UK
| | - Anastasios Fotiou
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
| | - Eleftheria Kanavou
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
| | - Myrto Stavrou
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
| | - Clive Richardson
- Department of Economic and Regional Development, Panteion University of Social and Political Sciences, 176-71 Athens, Greece;
| | - Afroditi Kanellopoulou
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 451-10 Ioannina, Greece;
| | - Philippos Orfanos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 115-27 Athens, Greece; (R.M.); (P.O.)
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 115-27 Athens, Greece; (R.M.); (P.O.)
- Correspondence: ; Tel.: +30-210-7462074
| | - Anna Kokkevi
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
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Lamb M, Buchholz A, Gunnell KE, Valois DD, Obeid N, Henderson K, Flament M, Goldfield GS. Examining the Bidirectional Association Between Body Esteem and Body Mass Index During Adolescence. J Dev Behav Pediatr 2021; 42:631-636. [PMID: 33908378 DOI: 10.1097/dbp.0000000000000945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 12/17/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Research on body esteem (weight and appearance esteem) and weight suggests that having a positive body esteem may be associated with more stable weight trajectories during adolescence, and adolescents with higher weight report lower levels of body esteem. However, bidirectional relationships between body esteem and weight have not yet been examined. This 3-year longitudinal study examined (1) bidirectional relationships between body esteem and body mass index (BMI) and (2) how BMI and body esteem changed together throughout adolescence. METHODS Participants (N = 1163 adolescents, at time 1 [T1] baseline; 60.3% female) from a school-based community sample completed surveys approximately annually for 3 years. RESULTS Latent growth modeling revealed that (a) among boys and girls, appearance and weight esteem scores decreased over time, (b) higher initial BMI scores were associated with slower decreases in appearance esteem over time. However, evidence for bidirectionality was not found, in which baseline appearance and weight esteem did not predict changes in BMI over time and vice versa. CONCLUSION Results suggest that changes in BMI and body esteem are co-occurring (rather than predictive) throughout adolescence. The decreasing trajectory of body esteem over time suggests the need for prevention efforts to improve body esteem throughout adolescence.
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Affiliation(s)
- Megan Lamb
- Carleton University Department of Psychology, Ottawa, ON, Canada
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Annick Buchholz
- Carleton University Department of Psychology, Ottawa, ON, Canada
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Katie E Gunnell
- Carleton University Department of Psychology, Ottawa, ON, Canada
| | - Darcie D Valois
- Carleton University Department of Psychology, Ottawa, ON, Canada
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Nicole Obeid
- Eating Disorders Program, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | | | | | - Gary S Goldfield
- Carleton University Department of Psychology, Ottawa, ON, Canada
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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12
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Hooper L, Puhl R, Eisenberg ME, Crow S, Neumark-Sztainer D. Weight teasing experienced during adolescence and young adulthood: Cross-sectional and longitudinal associations with disordered eating behaviors in an ethnically/racially and socioeconomically diverse sample. Int J Eat Disord 2021; 54:1449-1462. [PMID: 33969902 PMCID: PMC8355094 DOI: 10.1002/eat.23534] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE This study assessed cross-sectional and longitudinal relationships between weight teasing and disordered eating in an ethnically/racially and socioeconomically diverse sample of young people and examined these relationships across sociodemographic characteristics. METHOD The EAT 2010-2018 study surveyed adolescents (n = 1,534) in the Minneapolis/St. Paul public schools (mean age = 14.4 years) and 8 years later (mean age = 22.2 years). RESULTS Weight teasing was prevalent in adolescence (34.1%) and young adulthood (41.5%). In analyses adjusted for sociodemographic characteristics and body mass index, weight teasing was cross-sectionally associated with a higher prevalence of all disordered eating behaviors during both adolescence and young adulthood. For example, 64.5% of young adults who reported being teased about their weight engaged in unhealthy weight control behaviors, compared with 47.9% among those not teased (p < .001). There were fewer observed associations in longitudinal analyses, although weight teasing still predicted prevalent overeating and both prevalent and incident dieting (incident dieting-teased: 48.4% vs. not teased: 38.0%, p = .016). Weight teasing and disordered eating were more prevalent among Black, Indigenous, and People of Color (BIPOC) young people and those from low socioeconomic backgrounds, and the relationship between weight teasing and disordered eating was similar across ethnic/racial, socioeconomic, and gender demographic groups. DISCUSSION Results indicate that weight teasing is strongly correlated with disordered eating in both adolescence and young adulthood regardless of ethnicity/race, socioeconomic status, or gender. Finding suggest that future research and policy interventions should address weight stigma and prioritize the needs of BIPOC young people and young people from low socioeconomic backgrounds.
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Affiliation(s)
- Laura Hooper
- Division of Epidemiology and Community Health, University of Minnesota,Department of Food Science and Nutrition, University of Minnesota
| | - Rebecca Puhl
- Department of Human Development and Family Sciences, University of Connecticut
| | | | - Scott Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota,The Emily Program
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13
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Hazzard VM, Simone M, Austin SB, Larson N, Neumark-Sztainer D. Diet pill and laxative use for weight control predicts first-time receipt of an eating disorder diagnosis within the next 5 years among female adolescents and young adults. Int J Eat Disord 2021; 54:1289-1294. [PMID: 33949709 PMCID: PMC8273146 DOI: 10.1002/eat.23531] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To replicate findings from a prior study which identified prospective associations between use of products for weight control and subsequent receipt of a first-time eating disorder (ED) diagnosis among female adolescents and young adults. METHOD Data from a prospective cohort study, Project EAT (Eating and Activity in Teens and Young Adults), were used to examine prospective associations between self-reported past-year diet pill and laxative use for weight control and self-reported receipt of an ED diagnosis among females without prior receipt of an ED diagnosis (N = 1,015). Participants were followed from early/middle adolescence (EAT-I; Mage = 14.9 years) into late adolescence/emerging adulthood (EAT-II; Mage = 19.5 years) and young adulthood (EAT-III; Mage = 24.8 years). RESULTS First-time receipt of an ED diagnosis was reported by 2.4% of participants at EAT-II and 4.0% at EAT-III. After adjusting for demographics and weight status, participants using diet pills (risk ratio [RR] = 3.58, 95% confidence interval [CI]: 1.96-6.54) and laxatives (RR = 2.77, 95% CI: 1.01-7.64) had greater risk of receiving a first-time ED diagnosis within 5 years than those not using these products. DISCUSSION The present study replicated prior findings, providing further evidence for a prospective link between use of products for weight control and subsequent receipt of an ED diagnosis.
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Affiliation(s)
| | - Melissa Simone
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN
| | - S. Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA,Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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14
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Rodgers RF, Simone M, Franko DL, Eisenberg ME, Loth K, Neumark-Sztainer D. The longitudinal relationship between family and peer teasing in young adulthood and later unhealthy weight control behaviors: The mediating role of body image. Int J Eat Disord 2021; 54:831-840. [PMID: 33644886 PMCID: PMC8119351 DOI: 10.1002/eat.23492] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 01/29/2021] [Accepted: 01/29/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Sociocultural theories hold that family and peer weight-related teasing increases the risk for unhealthy weight control behaviors (UWCBs) by negatively impacting body image. Although much cross-sectional support exists for these pathways, longitudinal data are lacking. This study tested the longitudinal relationships among peer and family teasing (occurrence and perceived impact) in early adolescence, body satisfaction in late adolescence, and UWCBs in young adulthood among a racially/ethnically and socioeconomically diverse population. METHOD Data were drawn from three waves of Project EAT over a 15-year period (Eating and Activity in Teens and Young Adults), and included responses from 1,902 young adults (57% female). RESULTS Among female participants, a mediated indirect pathway emerged with family weight-related teasing predicting increased engagement in UWCBs in early adulthood via poorer body image in late adolescence. In contrast, peer teasing did not predict body image or UWCBs. Among boys, the mediated indirect pathways were not significant. However, poor body image in late adolescent males predicted higher likelihood of engaging in UCWBs in early adulthood. DISCUSSION These findings support the long-term impact of family weight-related teasing on greater risk for UWCBs among girls and young women, and poor body image as a mechanism accounting for this relationship. Moreover, the results highlight the poor body image among adolescent boys as a factor for increased risk of engaging in UWCBs in early adulthood. Pending replication in current cohorts, health promotion and prevention involving family members of early adolescents that address family weight teasing and body image are needed.
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Affiliation(s)
- Rachel F. Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts,Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France
| | - Melissa Simone
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Debra L. Franko
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts
| | - Marla E. Eisenberg
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Katie Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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15
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Yoon C, Simone M, Mason SM, Neumark-Sztainer D. A single summative global scale of disordered eating attitudes and behaviors: Findings from Project EAT, a 15-year longitudinal population-based study. Eat Behav 2020; 39:101418. [PMID: 32866851 PMCID: PMC7704841 DOI: 10.1016/j.eatbeh.2020.101418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The Project EAT Disordered Eating Attitudes and Behaviors (DEAB) scale was created from disordered eating attitudes and behaviors that tend to interrelate. To examine the appropriateness of the scale, we assessed the fit (i.e., how well a single latent factor fits a set of interrelated disordered eating attitudes and behaviors) and the convergent validity over time. METHOD Five interrelated disordered eating attitudes and behaviors were assessed in a longitudinal cohort (Project EAT, age 11 to 18 in 1998-1999, N = 1492). Confirmatory factor analysis examined the appropriateness of the DEAB scale. To examine whether individual variables function differently in relation to the latent construct across time, two models were compared: one requiring indicator-level factor loadings to remain equivalent across three time points (baseline [EAT-I], five-year follow-up [EAT-II], and 15-year follow-up [EAT-IV]), and the second allowing the factor loadings to vary over time. To examine the convergent validity, Pearson correlation with body satisfaction, self-esteem, depressive symptoms, and BMI was compared across time. RESULTS The fit indices for a single factor structure supported the use of the DEAB scale over time (standardized loadings: 0.60-0.87, 0.67-0.89, 0.59-0.77 at EAT-I, II, and IV respectively). As hypothesized, compared to fewer number of disordered eating attitudes and behaviors, greater number of attitudes and behaviors was associated with lower body satisfaction and self-esteem, and greater depressive symptoms and BMI (p < .01). DISCUSSION The Project EAT DEAB scale can be used as a proxy to measure the severity of disordered eating attitudes and behaviors over time in population-based studies.
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Affiliation(s)
- Cynthia Yoon
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
| | - Melissa Simone
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota 55454, USA
| | - Susan M. Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454, USA
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16
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Lang B, Rancourt D. Drive for leanness: potentially less maladaptive compared to drives for thinness and muscularity. Eat Weight Disord 2020; 25:1213-1223. [PMID: 31342456 DOI: 10.1007/s40519-019-00753-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 07/11/2019] [Indexed: 01/23/2023] Open
Abstract
PURPOSE Drive for leanness (DL), a motivating interest in having low body fat and toned muscles, is hypothesized to be less maladaptive than drives for thinness (DT) and muscularity (DM), which has implications for its inclusion in eating- and health-related prevention and treatment programs; however, little research has explored this hypothesis. The current study investigated DL's uniqueness from these other drives, as well as simultaneously explored if associations of DL and a range of health-related outcomes supported that it may be less maladaptive than DT and DM. METHODS A sample of 589 undergraduate participants completed an online battery of drive (DL, DT, DM) and health-related measures (disordered eating, aerobic and weight training frequency, exercise motivation, dieting, appearance enhancing supplement use, anxiety, and depression). Exploratory factor analysis and semi-partial correlations evaluated DL's uniqueness. Hierarchical regressions and generalized linear models evaluated comparative associations of drives with health-related outcomes. Analysis of covariance investigated comparative perceived drive healthiness. RESULTS DL was supported as unique from DT and DM. DL was less strongly associated with maladaptive outcomes (e.g., disordered eating, ExpB = .99, p = .86) and more strongly predictive of adaptive outcomes (e.g., healthy exercise motivation, β = .30, p < .001) than DT or DM. DL was perceived as healthier than either other drive. CONCLUSIONS DL was supported as a unique and less maladaptive motivation than DT or DM, suggesting the emergence of a lean ideal may be less problematic than body ideals focused on either thinness or muscularity alone. LEVEL OF EVIDENCE V, cross-sectional descriptive study.
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Affiliation(s)
- Brittany Lang
- Department of Psychology, University of South Florida, 4202 East Fowler Avenue, Tampa, FL, 33620, USA.
| | - Diana Rancourt
- Department of Psychology, University of South Florida, 4202 East Fowler Avenue, Tampa, FL, 33620, USA
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17
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Leung CW, Wolfson JA, Lahne J, Barry MR, Kasper N, Cohen AJ. Associations between Food Security Status and Diet-Related Outcomes among Students at a Large, Public Midwestern University. J Acad Nutr Diet 2020; 119:1623-1631. [PMID: 31561811 DOI: 10.1016/j.jand.2019.06.251] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 06/25/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Food insecurity is a growing issue of concern on college campuses. While many studies have focused on predictors of food insecurity, fewer studies have examined how food insecurity affects diet and diet-related outcomes among college students. OBJECTIVE The objective of this study was to examine differences in dietary intake, food and cooking agency, and body mass index (calculated as kg/m2) by food security status in a sample of college students at a large, public midwestern university. DESIGN We conducted a cross-sectional online survey administered from March to June 2018. PARTICIPANTS Students were recruited from a random sample (n=2,000) provided by the university, which included an oversample of minority racial/ethnic students from lower-income households and first-generation students. The response rate was 43% (n=851). After excluding students with missing data, the final sample was 754 enrolled students. MAIN OUTCOME MEASURES Food security status was measured using the US Adult Food Security Survey Module. Dietary intake was assessed using the National Cancer Institute dietary screener questionnaire. Cooking and food agency was measured using the Cooking and Food Provisioning Action Scale, a new validated questionnaire. Body mass index was calculated from self-reported height and weight. STATISTICAL ANALYSIS PERFORMED Differences between food security categories and diet-related outcomes were examined using generalized linear models. Models adjusted for sociodemographic covariates, such as student's age, sex, race/ethnicity, and receipt of financial aid. RESULTS Compared to students with high food security, low food security was associated with lower intake of fruits, and very low food security was associated with higher intakes of total added sugar and added sugar from sugar-sweetened beverages. Marginal and very low food security were positively associated with body mass index. Marginal, low, and very low food security were inversely associated with cooking and food agency. CONCLUSIONS Students with food insecurity experience diet-related challenges that could translate into health disparities over time. More research is needed to understand the longitudinal effects of food insecurity on student health and well being.
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18
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Yoon C, Mason SM, Hooper L, Eisenberg ME, Neumark-Sztainer D. Disordered Eating Behaviors and 15-year Trajectories in Body Mass Index: Findings From Project Eating and Activity in Teens and Young Adults (EAT). J Adolesc Health 2020; 66:181-188. [PMID: 31630924 PMCID: PMC6980455 DOI: 10.1016/j.jadohealth.2019.08.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/09/2019] [Accepted: 08/09/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Disordered eating behaviors are prevalent among adolescents. Understanding how these behaviors link to body mass index (BMI) across different stages of development and over an extended period may provide insight for designing interventions around eating and weight. This study had two objectives: (1) to assess the distribution of disordered eating behaviors and develop a global score of disordered eating behaviors among adolescents and (2) to examine the association between the number of disordered eating behaviors in adolescence and BMI trajectory over 15 years. METHODS Project Eating and Activity in Teens and Young Adults (EAT), a longitudinal study of weight-related health and behavior comprising four waves (EAT-I to EAT-IV), measured seven disordered eating behaviors (importance of weight and shape, frequent dieting, extreme unhealthy weight control behaviors, overeating, distress about overeating, loss of control while overeating, and frequency of overeating and loss of control) at baseline (N = 1,230, ages 11 to 18 years, 1998-1999). These behaviors were summed to create a disordered eating behavior score. BMI was self-reported at all four waves (up to age 27-33 years at EAT-IV). Repeated measures with random slope and intercept examined the association between disordered eating behaviors and BMI trajectories over 15 years. RESULTS At baseline, 50.7% and 33.7% of females and males endorsed disordered eating behaviors. Throughout 15 years of follow-up, sociodemographic-adjusted BMI was higher among adolescents who engaged in disordered eating behaviors. The association remained significant after further adjustment for baseline BMI (p < .05). CONCLUSIONS Among adolescents, regardless of the type of disordered eating behaviors, engagement in disordered eating behavior predicted higher BMI in a dose-response fashion.
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Affiliation(s)
- Cynthia Yoon
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
| | - Susan M. Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Laura Hooper
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Marla E. Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55454, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
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19
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Lang B, Ahlich E, Verzijl CL, Thompson JK, Rancourt D. The role of drive for thinness in the association between weight status misperception and disordered eating. Eat Behav 2019; 35:101319. [PMID: 31446165 DOI: 10.1016/j.eatbeh.2019.101319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 10/26/2022]
Abstract
UNLABELLED Weight status misperception is related to disordered eating outcomes, but little research has explored the differential impacts of misperception directionality, nor factors that explain these relationships. Self-Discrepancy Theory applied to body image gives a framework to how weight status over-perception may prompt a drive for thinness, which in turn may be important in the development of disordered eating cognitions and behaviors. AIMS To that end, the current study tested whether drive for thinness may account for the association between direction of weight status misperception and disordered eating behaviors. METHODS Young adults (N = 522) completed measures identifying weight status perception (accurate, under-, and over-perception), drive for thinness, and disordered eating attitudes and behaviors (appearance satisfaction, restrained, uncontrolled, and emotional eating). Indirect effect models with drive for thinness entered as the intervening variable were estimated for each outcome. RESULTS Drive for thinness accounted for the associations between weight status misperception and all outcomes. In general, compared to either accurate or under-perception, over-perception of weight status was associated with more disordered eating attitudes and behaviors via higher drive for thinness. CONCLUSIONS Consistent with Self-Discrepancy Theory, drive for thinness emerged as a possible mechanism of the association between weight status misperception and disordered eating outcomes. Findings suggest potential utility in targeting drive for thinness, as opposed to accuracy of weight status perception, for prevention of disordered eating attitudes and behaviors, including those that may contribute to weight gain.
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Affiliation(s)
- Brittany Lang
- University of South Florida, United States of America.
| | - Erica Ahlich
- University of South Florida, United States of America
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20
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Kilpela LS, Verzijl CL, Becker CB. Body image in older women: a mediator of BMI and wellness behaviors. J Women Aging 2019; 33:298-311. [PMID: 31751189 DOI: 10.1080/08952841.2019.1692629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Negative body image is prevalent among mid- and late-life women. In younger women, negative body image is associated with reduced quality of life (QOL) when controlling for body mass index (BMI), and mediates the relationship between obesity and emotional wellbeing. Yet, much remains unknown about body image in older populations. In our sample of women aged 50-86 (N = 181), negative body image mediated the relationship between BMI and sleep, all four domains of QOL, negative affect, nutritious food consumption, and psychosocial impairment, but not enjoyment of physical activity. Findings suggest negative body image impacts the wellbeing of older women.
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Affiliation(s)
- Lisa Smith Kilpela
- Department of Psychiatry, Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
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21
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Berge JM, Christoph MJ, Winkler MR, Miller L, Eisenberg ME, Neumark-Sztainer D. Cumulative Encouragement to Diet From Adolescence to Adulthood: Longitudinal Associations With Health, Psychosocial Well-Being, and Romantic Relationships. J Adolesc Health 2019; 65:690-697. [PMID: 31500945 PMCID: PMC7178792 DOI: 10.1016/j.jadohealth.2019.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/03/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of the study was to identify whether parent encouragement to diet as an adolescent predicts subsequent encouragement to diet from significant others/romantic partners as an adult and examine longitudinal associations between cumulative encouragement to diet from close relationships (i.e., parent and significant other) and later weight, weight-related, and psychosocial well-being outcomes in adulthood. METHODS Data from Project EAT I-IV, a 15-year longitudinal population-based study of socioeconomically and racially/ethnically diverse adolescents followed into adulthood (n = 1,116; mean age = 31.1 years; 61% female), were used for this study. Surveys and anthropometric measures were completed at school by adolescents in 1998-1999, and follow-up mailed and online surveys were completed at approximately 5-year intervals between 2003 and 2016. RESULTS Adolescents who experienced encouragement to diet from their parents were more likely to have a significant other as an adult who also encouraged them to diet. In addition, there was a significant (p < .05) cumulative effect of encouragement to diet, such that experiencing more encouragement to diet from both a parent(s) and significant other was associated with higher weight status, more unhealthy weight-control behaviors (e.g., dieting, binge eating, and unhealthy weight control behaviors), and lower psychosocial well-being (e.g., lower body satisfaction and self-esteem and higher depressive symptoms) as a young adult. CONCLUSIONS Encouragement to diet tracked from one close relationship to another and had a cumulative effect on adult weight, weight-related, and psychosocial well-being outcomes. Future interventions, clinical work, and research should be aware of these patterns and cumulative effects of encouragement to diet to target key relationships to reduce these harmful interpersonal patterns.
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Affiliation(s)
- Jerica M. Berge
- University of Minnesota Medical School, Department of Family Medicine and Community Health, Minneapolis, MN
| | - Mary J. Christoph
- Gilead Sciences, Health Economics and Outcomes Research Division, Foster City, CA
| | - Megan R. Winkler
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN
| | - Liza Miller
- Connecticut College, Department of Psychology, New London, CT
| | - Marla E. Eisenberg
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN;,University of Minnesota Medical School, Department of Pediatrics, Division of General Pediatrics and Adolescent Health, Minneapolis, MN
| | - Dianne Neumark-Sztainer
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN
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22
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Christoph MJ, Larson N, Laska MN, Neumark-Sztainer D. Nutrition Facts Panels: Who Uses Them, What Do They Use, and How Does Use Relate to Dietary Intake? J Acad Nutr Diet 2019; 118:217-228. [PMID: 29389508 DOI: 10.1016/j.jand.2017.10.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 10/16/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Nutrition labels are a low-cost tool with the potential to encourage healthy eating habits. OBJECTIVE To investigate correlates of frequent Nutrition Facts label use, describe the types of label information most often used, and measure how label use relates to dietary intake in young adults. DESIGN Cross-sectional population-based study of young adults participating in Project Eating and Activity in Teens and Young Adults-IV. PARTICIPANTS/SETTING Surveys and food frequency questionnaires were completed during 2015-2016 by young adults (N=1,817; weighted sample=49% women) aged 25 to 36 years. MAIN OUTCOME MEASURES Nutrition Facts label use, frequency of using specific information on labels, and dietary intake. STATISTICAL ANALYSES PERFORMED Relative risks and adjusted means were used to examine how demographic, behavior, and weight-related factors were associated with Nutrition Facts panel use, and how label use related to dietary outcomes. Associations with P values <0.05 were considered statistically significant. RESULTS Approximately one-third (31.4%) of participants used Nutrition Facts labels "frequently." Use was significantly higher for women; for participants with high education and income; among those who prepared food regularly; among those who were physically active; among those with a weight status classified as overweight; and among those who were trying to lose, gain, or maintain weight. Label components used most often included sugars (74.1%), total calories (72.9%), serving size (67.9%), and the ingredient list (65.8%). Nutrition Facts label users consumed significantly more fruits, vegetables, and whole grains and fewer sugar-sweetened beverages, compared with nonusers. Nutrition Facts label users ate significantly more frequently at sit-down restaurants but less frequently at fast-food restaurants compared with nonusers. CONCLUSIONS Although Nutrition Facts label use was associated with markers of better dietary quality in a population-based sample of young adults, only one-third of participants used labels frequently. Methods to improve label use should be studied, particularly through leveraging weight- or health-related goals (eg, interest in making healthier food choices), and meeting consumer preferences concerning label content.
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Wang SB, Haynos AF, Wall MM, Chen C, Eisenberg ME, Neumark-Sztainer D. Fifteen-Year Prevalence, Trajectories, and Predictors of Body Dissatisfaction From Adolescence to Middle Adulthood. Clin Psychol Sci 2019; 7:1403-1415. [PMID: 32864198 PMCID: PMC7451946 DOI: 10.1177/2167702619859331] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Body dissatisfaction is common in adolescence and associated with negative outcomes (e.g., eating disorders). We identified common individual trajectories of body dissatisfaction from mid-adolescence to adulthood, and predictors of divergent patterns. Participants were 1,455 individuals from four waves of Project EAT (Eating and Activity in Teens and Young Adults), a population-based, 15-year longitudinal study. Aggregate body dissatisfaction increased over 15 years, which was largely attributable to increases in weight. Growth mixture modeling identified four common patterns of body dissatisfaction, revealing nearly 95% of individuals experienced relatively stable body dissatisfaction from adolescence through adulthood. Baseline depression, self-esteem, parent communication/caring, peer dieting, and weight-based teasing predicted differing trajectories. Body dissatisfaction appears largely stable from mid-adolescence onward. There may be a critical period for body image development during childhood/early adolescence. Clinicians should intervene upon body dissatisfaction before it becomes chronic, and target depression, self-esteem, parent/child connectedness, and responses to teasing and peer dieting.
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Affiliation(s)
| | - Ann F. Haynos
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Melanie M. Wall
- Department of Biostatistics, Columbia University, New York, NY
| | - Chen Chen
- Department of Biostatistics, Columbia University, New York, NY
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Schnettler B, Rojas J, Grunert KG, Lobos G, Miranda-Zapata E, Lapo M, Hueche C. Family and food variables that influence life satisfaction of mother-father-adolescent triads in a South American country. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00328-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Lipsky LM, Haynie DL, Hill C, Nansel TR, Li K, Liu D, Iannotti RJ, Simons-Morton B. Accuracy of Self-Reported Height, Weight, and BMI Over Time in Emerging Adults. Am J Prev Med 2019; 56:860-868. [PMID: 31003807 PMCID: PMC6661894 DOI: 10.1016/j.amepre.2019.01.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Self-reported height and weight may lead to inaccurate estimates of associations between BMI and health indicators. The purpose of this study is to assess anthropometric misreporting in emerging adults, compare weight classification by self-reported and direct measures, and examine associations of self-reported and direct measures with cardiometabolic biomarkers. METHODS Self-reported and directly measured height and weight were obtained in five waves of a nationally representative cohort study of U.S. tenth graders (n=2,785) conducted in 2010-2016; data were analyzed in 2018. Cardiometabolic biomarkers were assessed in three waves in a systematically recruited subsample (n=567). Pearson correlations (r) and Lin's concordance correlations (ρc) evaluated misreporting. Gwet agreement coefficient-1 evaluated weight classification agreement by self-reported and direct measures. Generalized estimating equations examined associations of cardiometabolic biomarkers with self-reported and direct measures. RESULTS Participants overreported height by 1.0-1.7 cm and underestimated weight by 0.6-1.7 kg. Self-reported BMI was 0.6-1.0 lower than measured. Self-reported and measured height, weight, and BMI were strongly correlated (r=0.88-0.97, 0.86-0.98, and 0.65-0.96, respectively) and concordant (ρc=0.82-0.96, 0.94-0.97, and 0.65-0.95, respectively). Agreement of weight classification by self-reported and direct measures ranged from Gwet agreement coefficient-1=0.79-0.94. Associations of ten cardiometabolic biomarkers with self-reported BMI, measured BMI, and waist circumference were similar in magnitude, direction, and precision. CONCLUSIONS Self-reported and measured BMI were strongly correlated and concordant, providing substantial to near-perfect agreement in weight classification. Findings suggest self-reported BMI in U.S. emerging adults provides nearly identical estimates of associations with cardiometabolic biomarkers.
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Affiliation(s)
- Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
| | - Denise L Haynie
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Christine Hill
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Tonja R Nansel
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Kaigang Li
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado
| | - Danping Liu
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | | | - Bruce Simons-Morton
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
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Simone M, Hooper L, Eisenberg ME, Neumark-Sztainer D. Unhealthy weight control behaviors and substance use among adolescent girls: The harms of weight stigma. Soc Sci Med 2019; 233:64-70. [PMID: 31181470 DOI: 10.1016/j.socscimed.2019.05.047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/14/2019] [Accepted: 05/27/2019] [Indexed: 01/09/2023]
Abstract
RATIONALE Unhealthy weight control behaviors (UWCBs) often predict future substance use, resulting in a comorbidity that predicts later health consequences. OBJECTIVE The current study aimed to examine whether weight stigma and its associated harms magnify or attenuate the effect of UWCBs at baseline on substance use at 10-year follow-up among girls and to elucidate factors related to the perceived harms of weight stigma. METHODS Data from 1147 adolescent girls from Project EAT (Eating and Activity in Teens and Young Adults) were analyzed at baseline and 10-year follow-up. Participants were split into three groups at baseline: no weight stigma; weight stigma only (being teased by peers or parents); and weight stigma with perceived harms (e.g., being bothered by teasing). Moderation and stratified regression analyses examined the role of weight stigma and its perceived harms on the relationship between UWCBs and substance use. ANOVA models aimed to elucidate factors related to the perceived harms of weight stigma. RESULTS Moderation analyses revealed marginally significant effects of group membership on the effect of UWCB on substance use (p = .08). Stratified regression results indicated that UWCBs at baseline predicted substance use at 10-year follow-up among girls in the weight stigma with perceived harms group (p = .005), but not in the no weight stigma or weight stigma only groups. Girls in the weight stigma with perceived harms group reported higher weight concern, depressive symptoms and BMIs than girls who report no weight stigma or weight stigma only. CONCLUSIONS Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution. CONCLUSIONS Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution.
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Affiliation(s)
- Melissa Simone
- University of Minnesota, Minneapolis, MN, USA; Department of Psychiatry, 2450 Riverside Avenue, F227, Minneapolis, MN, 55454, USA.
| | - Laura Hooper
- University of Minnesota, Minneapolis, MN, USA; Division of Epidemiology and Community Health, School of Public Health, 1300 South 2nd Street, Minneapolis, MN, 55454, USA
| | - Marla E Eisenberg
- University of Minnesota, Minneapolis, MN, USA; Department of Pediatrics, 717 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Dianne Neumark-Sztainer
- University of Minnesota, Minneapolis, MN, USA; Division of Epidemiology and Community Health, School of Public Health, 1300 South 2nd Street, Minneapolis, MN, 55454, USA
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Nour M, Lutze SA, Grech A, Allman-Farinelli M. The Relationship between Vegetable Intake and Weight Outcomes: A Systematic Review of Cohort Studies. Nutrients 2018; 10:E1626. [PMID: 30400139 PMCID: PMC6266069 DOI: 10.3390/nu10111626] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 10/19/2018] [Accepted: 10/24/2018] [Indexed: 12/17/2022] Open
Abstract
The relationship between vegetable consumption and measures of adiposity was assessed in cohort studies. Seven databases were searched from inception until February 2018. The quality of individual studies was assessed using the Joanna Briggs Institute Critical Appraisal of Cohort Studies tool. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was applied to determine the quality of the body of evidence. Ten studies were included. Six measured change in vegetable intake over time. Two showed that increasing vegetable consumption resulted in weight loss of 0.09⁻0.1 kg over four years (p < 0.001). Increased vegetable intake was also associated with a reduced risk of weight gain and overweight or obesity (Odds ratios (ORs) ranged from 0.18 to 0.88) in other studies. Four studies measured vegetable intake at the baseline only. One showed that intakes >4 servings/day reduced the risk of weight gain (OR 0.27 (95% confidence interval (CI) 0.08⁻0.99) and another found an inverse association with waist circumference in women (-0.36 cm per vegetable serving/day). This review provides moderate quality evidence for an inverse association between vegetable intake and weight-related outcomes in adults. When these findings are coupled with no apparent harm from vegetable consumption, the evidence-base can be used with acceptable confidence to guide practice and policy.
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Affiliation(s)
- Monica Nour
- Charles Perkins Centre, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Sarah Alice Lutze
- Charles Perkins Centre, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Amanda Grech
- Charles Perkins Centre, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia.
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Sharpe H, Griffiths S, Choo TH, Eisenberg ME, Mitchison D, Wall M, Neumark-Sztainer D. The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 years. Int J Eat Disord 2018; 51:1168-1175. [PMID: 30194690 PMCID: PMC6289784 DOI: 10.1002/eat.22936] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of this study was to examine the relative importance of dissatisfaction, overvaluation, and preoccupation with body weight and shape in predicting increases in disordered eating behaviors and depressive symptoms from adolescence through to early adulthood. METHOD The study involved 1,830 participants (60% female) who completed the Project EAT survey during adolescence (mean age = 14.90 years, SD = 1.65 years) and again, 15 years later, in early adulthood. Participants provided assessments of dissatisfaction, overvaluation and preoccupation with weight and shape, as well as disordered eating and depressive symptoms at both time points. RESULTS The three aspects of body image had distinct patterns of association with the outcomes both concurrently and longitudinally. Dissatisfaction predicted depressive symptoms as well as a wide range of disordered eating outcomes, including dieting, unhealthy weight control behaviors (UWCBs), and binge eating, particularly in female participants. Preoccupation was associated with all of these disordered eating behaviors (but not with depressive symptoms) and was notably the strongest predictor of dieting and UWCBs in female participants. Overvaluation was associated with both disordered eating and depressive symptoms, although typically was a less potent predictor of difficulties than the other aspects of body image. DISCUSSION Dissatisfaction, overvaluation, and preoccupation are related but make distinct contributions to clinically significant outcomes. Models of eating disorders should move beyond focusing exclusively on dissatisfaction or overvaluation toward a broader conceptualisation of body image. Findings from this study particularly suggest the importance of considering preoccupation with weight and shape.
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Affiliation(s)
- Helen Sharpe
- Corresponding author: Helen Sharpe, Department of Clinical Psychology, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, +44 (0)131 6513 949,
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Tse-Hwei Choo
- Division of Biostatistics, Department of Psychiatry, Columbia University, USA
| | - Marla E. Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, USA
| | - Deborah Mitchison
- Centre for Emotional Health, Department of Psychology, Macquarie University, Australia; School of Medicine, Western Sydney University, Australia
| | - Melanie Wall
- Division of Biostatistics, Department of Psychiatry, Columbia University, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, USA
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Haynos AF, Wall MM, Chen C, Wang SB, Loth K, Neumark-Sztainer D. Patterns of weight control behavior persisting beyond young adulthood: Results from a 15-year longitudinal study. Int J Eat Disord 2018; 51:1090-1097. [PMID: 30353938 PMCID: PMC6391054 DOI: 10.1002/eat.22963] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 09/07/2018] [Accepted: 09/07/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Dieting and unhealthy weight control behaviors have been associated with negative outcomes. Most research has examined the prevalence of these behaviors in adolescence and young adulthood. Less is known about whether they persist further into adulthood. We examined patterns of weight control behaviors beyond young adulthood using data from 1,455 males and females participating in Project EAT (Eating and Activity in Teens and Young Adults), a 15-year population-based, longitudinal study. METHOD Participants completed surveys assessing dieting, high-frequency dieting (i.e., 5+ times/year), unhealthy weight control (e.g., fasting), and extreme weight control (e.g., vomiting) at each 5-year assessment (Waves 1-4). Longitudinal logistic regression models tested trends in weight control behaviors across the waves. Likelihood of persisting or discontinuing each behavior from Wave 3 to Wave 4 was examined through cross tabulations. RESULTS Between Waves 3 and 4 in adulthood, dieting increased for both genders (Women: p < .001; Men: p = .004) and high-frequency dieting (p < .001) and unhealthy weight control behaviors (p = .011) increased for men. For both genders, dieting and unhealthy weight control patterns initiated in prior to young adulthood were more likely to persist than cease in adulthood (ps < .001). DISCUSSION Weight control behaviors continue to be prevalent in adulthood, and to especially increase among men. Research is needed to understand the consequences of weight control behaviors in different life stages; however, the results suggest that interventions to decrease unhealthy weight management practices may be needed well into adulthood.
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Affiliation(s)
- Ann F. Haynos
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Melanie M. Wall
- Department of Biostatistics, Columbia University, New York, New York
| | - Chen Chen
- Department of Biostatistics, Columbia University, New York, New York
| | - Shirley B. Wang
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Katie Loth
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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French SA, Wall M, Corbeil T, Sherwood NE, Berge JM, Neumark-Sztainer D. Obesity in Adolescence Predicts Lower Educational Attainment and Income in Adulthood: The Project EAT Longitudinal Study. Obesity (Silver Spring) 2018; 26:1467-1473. [PMID: 30226010 PMCID: PMC6146410 DOI: 10.1002/oby.22273] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/21/2018] [Accepted: 07/07/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Prospective associations between obesity in adolescence and adult socioeconomic outcomes, and potential mediators, were examined in a contemporary cohort. METHODS Longitudinal data collected in 1998 to 1999 (Project EAT-I) and 2015 to 2016 (EAT-IV) were analyzed for 1,796 participants who provided data at both time points. Adolescents (mean age = 14.8 years) self-reported demographic and psychosocial variables (EAT-I) and follow-up outcomes (EAT-IV). Body weight and height were directly measured. Bachelor's degree or more education, income ≥ US $50,000, and partnered status at follow-up were examined by baseline obesity (>95th BMI percentile) using logistic regression. Self-esteem, depression, and weight-related teasing were examined as mediators using multivariate probit regressions. All analyses were adjusted for race, baseline age, and parent socioeconomic status. RESULTS Girls with obesity were significantly less likely to have achieved a bachelor's degree (OR 0.32, 95% CI [0.18, 0.58]; P < 0.001), earn ≥ $50,000 annually (OR 0.57, 95% CI [0.33, 0.99]; P < 0.04), or be partnered (OR 0.45, 95% CI [0.27, 0.75]; P < 0.002) in adulthood. No associations were observed among boys. Among girls, depression mediated 8.5% and 23.6% of the association between adolescent obesity and adult education and income, respectively. CONCLUSIONS Adolescent girls with obesity have lower educational attainment and income and are less likely to be partnered in later adulthood. Depression may partly mediate the associations.
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Affiliation(s)
- Simone A French
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Melanie Wall
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Thomas Corbeil
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Nancy E Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Larson N, Chen Y, Wall M, Winkler MR, Goldschmidt AB, Neumark-Sztainer D. Personal, behavioral, and environmental predictors of healthy weight maintenance during the transition to adulthood. Prev Med 2018; 113:80-90. [PMID: 29727637 PMCID: PMC6319368 DOI: 10.1016/j.ypmed.2018.04.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 04/19/2018] [Accepted: 04/28/2018] [Indexed: 11/19/2022]
Abstract
There is a high prevalence of overweight among U.S. young adults and the intergenerational implications of excess weight gain at this life stage are great. We used Project EAT (Eating and Activity in Teens and Young Adults) study data to identify personal, behavioral, and environmental factors that predicted healthy weight maintenance during the transition from adolescence to adulthood and as individuals progressed from the third to fourth decade of life. The sample included 1120 young adults who were secondary school students in Minneapolis-St. Paul at Time 1 (1998-1999) and responded at follow-ups in 2008-2009 and 2015-2016. Results showed individual factors and multiple environmental factors contribute to maintenance. The most consistent findings suggest that having higher body satisfaction and avoiding unhealthy weight control behaviors (e.g., skipping meals) and dieting are protective against excess weight gain for women and men. For example, the odds ratio associated with a one standard deviation increase in the probability of using an extreme weight control behavior from adolescence and adulthood was 0.67 (CI: 0.54, 0.84) among women and 0.34 (CI: 0.12, 0.96) among men indicating decreased odds of maintaining a healthy weight. Social support for healthy eating and physical activity were protective whereas close relationships with individuals who were dieting (e.g., parents, significant others) reduced the likelihood of maintaining a healthy weight. Primary prevention strategies should continue beyond adolescence and involve peer social support to encourage young people at a healthy weight to be satisfied with their shape/size and avoid restrictive weight control behaviors.
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Affiliation(s)
- Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
| | - Ying Chen
- Division of Biostatistics in the Department of Psychiatry, Department of Biostatistics in the Mailman School of Public Health, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States.
| | - Melanie Wall
- Division of Biostatistics in the Department of Psychiatry, Department of Biostatistics in the Mailman School of Public Health, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States.
| | - Megan R Winkler
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
| | - Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, 196 Richmond Street, Providence, RI 02903, United States.
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
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Verzijl CL, Ahlich E, Lang B, Rancourt D. Body mass index as a moderator of the association between weight status misperception and disordered eating behaviors. Eat Behav 2018; 30:98-103. [PMID: 29990654 DOI: 10.1016/j.eatbeh.2018.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 11/27/2022]
Abstract
Weight status under-perception is protective against disordered eating behaviors and weight gain; however, it is unclear whether under-perception may confer protection across all weight classes. This work explored body mass index as a moderator of the association between weight status perception accuracy and disordered eating behaviors among adults with overweight or obesity. A total of 572 adults (58.7% female; age M = 39.50, SD = 11.57) with overweight or obesity (body mass index M = 31.50, SD = 6.24) completed a series of online questionnaires assessing uncontrolled, emotional, and restrained eating, eating disorder symptoms, weight status perception, and demographics. Controlling for race/ethnicity, age, and sex, linear and negative binomial regressions were used to test hypotheses. Compared to accurate weight status perception, under-perception was associated with less uncontrolled (p = .003) and restrained eating (p = .002). Under-perception was particularly protective against emotional eating (p = .022) and eating disorder symptoms (p = .017) for individuals of overweight or Class I obesity. In general, weight status under-perception was associated with fewer disordered eating behaviors. The protective effects of under-perception of weight status may be maximized for individuals of overweight or Class I obesity statuses.
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Affiliation(s)
| | - Erica Ahlich
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Brittany Lang
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, FL, USA.
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Neumark-Sztainer D, Wall MM, Chen C, Larson NI, Christoph MJ, Sherwood NE. Eating, Activity, and Weight-related Problems From Adolescence to Adulthood. Am J Prev Med 2018; 55:133-141. [PMID: 29937114 PMCID: PMC6072273 DOI: 10.1016/j.amepre.2018.04.032] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 04/04/2018] [Accepted: 04/25/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Determining the population-based scope and stability of eating, activity, and weight-related problems is critical to inform interventions. This study examines: (1) the prevalence of eating, activity, and weight-related problems likely to influence health; and (2) the trajectories for having at least one of these problems during the transition from adolescence to adulthood. METHODS Project EAT I-IV (Eating and Activity in Teens and Young Adults) collected longitudinal survey data from 858 females and 597 males at four waves, approximately every 5 years, from 1998 to 2016, during the transition from adolescence to adulthood. Analyses were conducted in 2017-2018. Measures included high fast-food intake (≥3 times/week), low physical activity (<150 minutes/week), unhealthy weight control, body dissatisfaction, and obesity status. RESULTS Among females, the prevalence of having at least one eating, activity, or weight-related problems was 78.1% at Wave 1 (adolescence) and 82.3% at Wave 4 (adulthood); in males, the prevalence was 60.1% at Wave 1 and 69.2% at Wave 4. Of all outcomes assessed, unhealthy weight control behaviors had the highest prevalence in both genders. The stability of having at least one problem was high; 60.2% of females and 34.1% of males had at least one problematic outcome at all four waves. CONCLUSIONS The majority of young people have some type of eating, activity, or weight-related problem at all stages from adolescence to adulthood. Findings indicate a need for wide-reaching interventions that address a broad spectrum of eating, activity, and weight-related problems prior to and throughout this developmental period.
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Affiliation(s)
- Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
| | - Melanie M Wall
- Department of Biostatistics, Columbia University, New York, New York
| | - Chen Chen
- Department of Biostatistics, Columbia University, New York, New York
| | - Nicole I Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Mary J Christoph
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Nancy E Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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Hoffmann S, Cortés-García L, Warschburger P. Weight/shape and muscularity concerns and emotional problems in adolescent boys and girls: A cross-lagged panel analysis. J Adolesc 2018; 68:70-77. [PMID: 30041056 DOI: 10.1016/j.adolescence.2018.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 07/05/2018] [Accepted: 07/08/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The goal of the present study was to identify the prospective relations between weight/shape and muscularity concerns and emotional problems in adolescents. METHODS Self-report data of 966 German male and female adolescents were analyzed in a cross-lagged panel design. RESULTS Analyses of latent means revealed significant correlations between weight/shape concern and emotional problems as well as between muscularity concern and emotional problems in both genders. Moreover, weight/shape concern predicted emotional problems prospectively, but only in girls. Regarding muscularity concern, we could not find any prospective relation with emotional problems in boys or girls from the general population. CONCLUSIONS It is assumed that as appearance is highly relevant for the self-concept in girls, concerns about the look might promote emotional problems. Thus, weight/shape concern should be addressed in the prevention of emotional problems in adolescent girls, whereas further research is necessary investigating the contribution of muscularity concern in this context.
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Affiliation(s)
| | - Laura Cortés-García
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain.
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Wang H, Hu R, Du H, Fiona B, Zhong J, Yu M. The relationship between sleep duration and obesity risk among school students: a cross-sectional study in Zhejiang, China. Nutr Metab (Lond) 2018; 15:48. [PMID: 30002720 PMCID: PMC6038205 DOI: 10.1186/s12986-018-0285-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/26/2018] [Indexed: 12/14/2022] Open
Abstract
Background Obesity has been identified as a major risk factor for a large number of chronic diseases. Understanding factors related to adolescent obesity is critical for prevention of chronic diseases. The associations between sleep duration and obesity among adolescents in the existing literature are controversial. Our study was designed to determine the prevalence of short sleep duration, and assess the association of sleep duration and obesity, among middle and high school students in Zhejiang, China. Methods 18,403 Students in 442 schools were recruited and surveyed using an anonymous, self-administered questionnaires. Weighted multivariable logistic regression models were used for data analyses. Results The mean (SD) age of the students was 15.9 (1.8) years. 49.7% of students were girls. The mean (SD) height and weight were 166.2 (8.5) cm and 54.6 (11.1) kg, respectively. The overall prevalence of obesity and overweight were 3.4% (95% CI: 3.0–3.8) and 7.8% (95% CI: 7.4–8.3), respectively. The overall prevalence of short sleep duration among students was 66.0% (95% CI: 63.8–68.1), higher among girls than boys (69.8% vs. 62.1%) (P < 0.0001). The figures for middle school, academic high school, and vocational high school were 59.0, 82.4 and 59.7%, respectively (P < 0.0001). As compared with girls who sleep 8 h per day (reference), the odds ratios (95% CI) of obesity for girls who sleep < 7 h, 7 h, 9 h and ≥ 10 h were 1.97 (1.15–3.38), 1.90 (1.18–3.04), 1.38 (0.86–2.20) and 2.12 (1.22–3.67) respectively, after adjustment for socio-demographic status, lifestyle factors, and mental health. The corresponding figures among boys were 1.45 (0.97–2.16), 1.13 (0.81–1.57), 1.25 (0.89–1.74), and 1.12 (0.81–1.54), respectively. Conclusions Insufficient sleep is prevalent among students in Zhejiang China. A U-shaped relationship was found between sleep duration and obesity risk among girls, with the lowest risk among those who slept for 8 h, but not among boys. Adequate sleep duration may be an important component of obesity prevention initiatives among adolescents. Electronic supplementary material The online version of this article (10.1186/s12986-018-0285-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hao Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, #3399 Binsheng road, Binjiang District, Hangzhou, Zhejiang Province China
| | - Ruying Hu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, #3399 Binsheng road, Binjiang District, Hangzhou, Zhejiang Province China
| | - Huaidong Du
- 2Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.,3Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Bragg Fiona
- 2Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jieming Zhong
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, #3399 Binsheng road, Binjiang District, Hangzhou, Zhejiang Province China
| | - Min Yu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, #3399 Binsheng road, Binjiang District, Hangzhou, Zhejiang Province China
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Sánchez-Miguel PA, González JJP, Sánchez-Oliva D, Alonso DA, Leo FM. The importance of body satisfaction to physical self-concept and body mass index in Spanish adolescents. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2018; 54:521-529. [PMID: 29633263 DOI: 10.1002/ijop.12488] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 02/02/2018] [Indexed: 11/09/2022]
Abstract
This research examines the association between measured body mass index (BMI) and the perception of BMI by young students. Moreover, this research tests the importance of BMI and self-concept, in order to predict body dissatisfaction in high school students. The sample consisted of 2087 individuals from different high schools in Extremadura, Spain, both males (n = 1046) and females (n = 1041), ranging in age from 15 to 17 years old (M = 15.42; SD = 0.86). Initially, participants' BMIs were assessed through anthropometry. Later, all individuals were asked about their weight and height, and their self-reported BMI was calculated. Participants also answered a questionnaire about their perception of self-concept, as well as completed a test about body image perception using Stunkard images. Outcomes revealed that factors concerning self-concept and perceived BMI explained body dissatisfaction. Finally, results are discussed with the aim of improving knowledge in body dissatisfaction context.
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Affiliation(s)
| | | | - David Sánchez-Oliva
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain.,Faculty of Education, University of Cadiz, Cádiz, Spain
| | - Diana Amado Alonso
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain.,Centre for Sport Studies, Physical Education Area, Faculty of Juridical and Social Sciences, King Juan Carlos University, Alcorcón, Madrid, Spain
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Abstract
OBJECTIVE This study examined the mediating role of body dissatisfaction between Body Mass Index (BMI) and subsequent disordered eating (e.g. dieting and restricting/purging) among early adolescent African American girls. STUDY DESIGN Participants included 701 African American girls in 6th and 7th grades in urban schools serving low-income communities, mean age 12.15 (SD = 0.72) years. Participants were assessed at baseline and approximately 6 months later. Objectively measured height and weight were used to calculate BMI z-score. Participants completed questionnaires on body size dissatisfaction and recent dieting and restricting/purging behaviors. RESULTS At baseline, 51.5% of participants were overweight/obese, and 60.4% expressed body dissatisfaction and a desire to be smaller. Path analytic analyses revealed change in body dissatisfaction significantly mediates the relation between initial BMI z-score and increases in dieting behaviors (B = 0.924, SE = 0.280, p = 0.001) but not restricting/purging behaviors (p = 0.05). CONCLUSIONS Body dissatisfaction explains some associations between excess body weight and subsequent disordered eating symptoms among early adolescent, African American girls. Body dissatisfaction, identified by screening, may be an indicator of further negative consequences, including disordered eating behaviors.
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Berge JM, Winkler MR, Larson N, Miller J, Haynos AF, Neumark-Sztainer D. Intergenerational Transmission of Parent Encouragement to Diet From Adolescence Into Adulthood. Pediatrics 2018; 141:e20172955. [PMID: 29511051 PMCID: PMC5869334 DOI: 10.1542/peds.2017-2955] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/08/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Although previous cross-sectional research has revealed potential harmful outcomes associated with parent encouragement to diet, it is unclear whether these effects are long lasting and whether they are transmitted to the next generation. The main aim of the current study was to examine longitudinal associations between exposure to parent encouragement to diet in adolescence and weight-related and emotional health outcomes in adulthood and to examine whether intergenerational transmission of encouragement to diet occurs. METHODS This is a longitudinal, population-based study (ie, Project Eating and Activity in Teens and Young Adults) of socioeconomically and racially and/or ethnically diverse adolescents managed into adulthood and/or parenthood (n = 556; mean age = 31.4; 64.6% female). Surveys and anthropometrics were completed at school by adolescents in 1998-1999 and surveys were completed online in 2015-2016 by young adults. RESULTS Experiencing parent encouragement to diet as an adolescent was significantly associated with a higher risk of overweight or obesity, dieting, binge eating, engaging in unhealthy weight control behaviors, and lower body satisfaction 15 years later as a parent, after adjusting for sociodemographics and baseline measures of the outcomes (P < .05). Additionally, intergenerational transmission of encouragement to diet occurred and resulted in parents being more likely to report other weight-focused communication in the home environment. CONCLUSIONS Exposure to parent encouragement to diet as an adolescent had long-term harmful associations with weight-related and emotional health outcomes in parenthood and was transmitted to the next generation. It may be important for health care providers to educate parents about the potential harmful and long-lasting consequences of engaging in encouragement to diet with their children.
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Affiliation(s)
- Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School,
| | - Megan R Winkler
- Division of Epidemiology and Community Health, School of Public Health, and
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, and
| | - Jonathan Miller
- Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Ann F Haynos
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
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How accurate is the prevalence of overweight and obesity in children and adolescents derived from self-reported data? A meta-analysis. Public Health Nutr 2018. [PMID: 29516851 DOI: 10.1017/s1368980018000368] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The aim of the current meta-analysis was to evaluate the accuracy of using BMI based on self-reported height and weight (BMIsr) to estimate the prevalence of overweight and obesity among children and adolescents. DESIGN A systematic literature search was conducted to select studies that compared the prevalence rates of overweight and obesity based on BMIsr and BMIm (BMI based on measured height and weight). A random-effect model was assumed to estimate summary prevalence rates and prevalence ratio (PR). RESULTS Thirty-seven studies were included. The aggregated prevalence of overweight and obesity based on BMIsr (0·190, 95 % CI 0·163, 0·221) was significantly lower than that based on BMIm (0·233, 95 % CI 0·203, 0·265). The pooled mean PR was 0·823 (95 % CI 0·775, 0·875). Moderator analyses showed that the underestimation was related to gender, age, weight status screened (overweight v. obesity) and weight status screening tool. CONCLUSIONS BMIsr may produce less biased results under some conditions than others. Future researchers using BMIsr may consider these findings and avoid the conditions that could lead to more severe underestimation of the prevalence of overweight and obesity among children and adolescents.
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Christoph MJ, Loth KA, Eisenberg ME, Haynos AF, Larson N, Neumark-Sztainer D. Nutrition Facts Use in Relation to Eating Behaviors and Healthy and Unhealthy Weight Control Behaviors. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:267-274.e1. [PMID: 29276019 PMCID: PMC5845784 DOI: 10.1016/j.jneb.2017.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 11/06/2017] [Accepted: 11/09/2017] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Investigate the relationship between use of Nutrition Facts labels on packaged foods and weight-related behaviors. DESIGN Cross-sectional survey in 2015-2016. PARTICIPANTS Young adult respondents (n = 1,817; 57% women; average age 31.0 ± 1.6 years) to the Project Eating and Activity in Teens and Young Adults-IV survey, the fourth wave of a longitudinal cohort study. VARIABLES MEASURED Use of Nutrition Facts labels on packaged foods; healthy, unhealthy, and extreme weight control behaviors; intuitive eating; binge eating. ANALYSIS Linear and logistic regression models were adjusted for age, ethnicity/race, education, income, and weight status. RESULTS In women, greater Nutrition Facts use was associated with a 23% and 10% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a 17% greater chance of engaging in binge eating. In men, greater label use was associated with a 27% and 17% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a lower level of intuitive eating. CONCLUSIONS AND IMPLICATIONS Professionals advising patients and clients on weight management may consider possible gender differences in response to weight loss and management guidance. Since label use was related to engagement in some unhealthy behaviors in addition to healthy behaviors, it is important to consider how individuals may use labels, particularly those at risk for, or engaging in, disordered eating behaviors. Future research investigating potential relationships between Nutrition Facts use, intuitive eating, and binge eating is needed.
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Affiliation(s)
- Mary J Christoph
- Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, MN.
| | - Katie A Loth
- Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Marla E Eisenberg
- Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Ann F Haynos
- Department of Psychiatry, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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Lian Q, Su Q, Li R, Elgar FJ, Liu Z, Zheng D. The association between chronic bullying victimization with weight status and body self-image: a cross-national study in 39 countries. PeerJ 2018; 6:e4330. [PMID: 29404221 PMCID: PMC5794335 DOI: 10.7717/peerj.4330] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/16/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Childhood obesity and school bullying are pervasive public health issues and known to co-occur in adolescents. However, the association between underweight or thinness and chronic bullying victimization is unclear. The current study examined whether chronic bullying victimization is associated with weight status and body self-image. METHODS A school-based, cross-sectional study in 39 North American and European countries and regions was conducted. A total of 213,595 adolescents aged 11, 13, and 15 years were surveyed in 2009/10. Chronic bullying victimization was identified using the Revised Olweus Bully/Victim Questionnaire. Weight status was determined using self-reported height and weight and the body mass index (BMI), and body self-image was based on perceived weight. We tested associations between underweight and bullying victimization using three-level logistic regression models. RESULTS Of the 213,595 adolescents investigated, 11.28% adolescents reported chronic bullying victimization, 14.80% were classified as overweight/obese according to age- and sex-specific BMI criteria, 12.97% were underweight, and 28.36% considered themselves a little bit fat or too fat, 14.57% were too thin. Bullying victimization was less common in older adolescent boys and girls. Weight status was associated with chronic bullying victimization (adjusted ORunderweight = 1.10, 95% CI = 1.05-1.16, p = 0.002; adjusted ORoverweight = 1.40, 95% CI = 1.32-1.49, p < 0.0001; adjusted ORobese = 1.91, 95% CI = 1.71-2.14, p < 0.0001). Body self-image also related to chronic bullying victimization (adjusted ORtoo thin = 1.42, 95% CI = 1.36-1.49, p < 0.0001; adjusted ORa little bit fat = 1.54, 95% CI = 1.48-1.61, p < 0.0001; adjusted ORtoo fat = 3.30, 95% CI = 2.96-3.68, p < 0.0001). CONCLUSION Both perceived weight and self-rated overweight are associated with chronic bullying victimization. Both overweight and underweight children are at risk of being chronically bullied.
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Affiliation(s)
- Qiguo Lian
- Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China
- School of Public Health, Fudan University, Shanghai, China
| | - Qiru Su
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ruili Li
- Children Health and Development Department, Capital Institute of Pediatrics, Beijing, China
| | - Frank J. Elgar
- Institute for Health and Social Policy, McGill University, Montreal, QC, Canada
| | - Zhihao Liu
- Institute for Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, China
| | - Dongpeng Zheng
- Huajing Community Health Service Center, Shanghai, China
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Christoph MJ, Jarrett ES, Gower AL, Borowsky IW. Weight Status and Weight Perception in Relation to Mental Distress and Psychosocial Protective Factors Among Adolescents. Acad Pediatr 2018; 18:51-58. [PMID: 28838795 PMCID: PMC5756678 DOI: 10.1016/j.acap.2017.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 08/03/2017] [Accepted: 08/12/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To measure how weight status and weight perception relate to mental distress and psychosocial protective factors in adolescents. METHODS Adolescents in 8th, 9th, and 11th grade participating in the 2013 Minnesota Student Survey (N = 122,180) were classified on the basis of weight perception (overweight or not overweight) and weight status (not overweight, overweight, obese). Bivariate tests were used to assess the relationship of weight status and weight perception with internal mental distress, and generalized linear models were used to measure the association between weight status and weight perception with psychosocial protective factors including parent, school, and friend connectedness, social competency, and positive identity. Logistic regressions measured the relationship between psychosocial protective factors and internal mental distress. RESULTS Prevalence of internal mental distress ranged from 14.5% for overweight boys who perceived themselves as not overweight to 55.0% for girls who were not overweight but self-perceived as overweight. Across all weight-status categories, adolescents who perceived themselves as overweight, compared to those who did not, had higher internal mental distress and lower mean levels of psychosocial protective factors. All psychosocial protective factors were related to lower odds of internal mental distress, with significant small differences by weight status and weight perception. CONCLUSIONS Weight status and weight perception affected both mental distress and psychosocial protective factors. Those who perceived themselves as overweight, regardless of weight status, had the highest prevalence of mental distress and the lowest levels of psychosocial protective factors. Health care providers should consider screening for weight perception to provide a tailored approach to adolescent care.
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Affiliation(s)
- Mary J. Christoph
- Department of Pediatrics, University of Minnesota, Minneapolis,
Minnesota
| | | | - Amy L. Gower
- Department of Pediatrics, University of Minnesota, Minneapolis,
Minnesota
| | - Iris W. Borowsky
- Department of Pediatrics, University of Minnesota, Minneapolis,
Minnesota
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Goldschmidt AB, Wall MM, Choo THJ, Evans EW, Jelalian E, Larson N, Neumark-Sztainer D. Fifteen-year Weight and Disordered Eating Patterns Among Community-based Adolescents. Am J Prev Med 2018; 54:e21-e29. [PMID: 29132950 PMCID: PMC5736404 DOI: 10.1016/j.amepre.2017.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 08/24/2017] [Accepted: 09/07/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The current study aims to characterize weight-change trajectories and their concomitant associations with prospectively measured dieting and other disordered eating behaviors among initially nonoverweight adolescents during the transition to adulthood. METHODS A population-based sample (n=1,091) self-reported their height/weight, dieting, unhealthy weight-control behaviors, and binge eating at 5-year intervals between 1998/1999 and 2013/2014, spanning early/middle adolescence through middle/late young adulthood. Data were analyzed in 2016/2017. RESULTS Groups were categorized as those who were never overweight (n=562), were overweight during at least one measurement point and gained weight more rapidly (n=246) or gradually (n=238) than their peers, or were overweight during at least one measurement point but returned to nonoverweight status by middle/late young adulthood (n=45). Thus, nearly half of adolescents became overweight during the transition to adulthood. Those who were never overweight had the lowest rates of dieting (males: F[9, 1,314]=2.54, p=0.0069, females: F[9, 1,927]=3.02, p=0.0014) and unhealthy weight-control behaviors (males: F[9, 1,313]=3.30, p=0.0005, females: F[9, 1,927]=3.02, p=0.0014), whereas some of these behaviors tended to track with weight gain in rapid and gradual weight gainers. CONCLUSIONS Although adolescents who are already overweight are most frequently targeted for weight-gain prevention and early intervention programs, results suggest that healthy lifestyle interventions could also benefit individuals who may be perceived as low risk for overweight in adulthood by nature of being nonoverweight in adolescence. Dieting and unhealthy weight-control behaviors tended to be associated with weight gain, suggesting that they are ineffective in addition to being potentially harmful.
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Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island.
| | - Melanie M Wall
- Department of Biostatistics, Columbia University, New York, New York
| | - Tse-Hwei J Choo
- Department of Biostatistics, Columbia University, New York, New York
| | - E Whitney Evans
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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Accuracy of Self-Reported Weight Among Adolescent and Young Adults Following Bariatric Surgery. Obes Surg 2017; 27:1529-1532. [PMID: 28012151 DOI: 10.1007/s11695-016-2514-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This study evaluates accuracy of self-reported weight in adolescent bariatric surgery patients. MATERIALS AND METHODS During follow-up visits, participants self-reported weight and had weight measured. The differences between self-reported and measured weights were analyzed from 60 participants. RESULTS Participants were 70% (n = 42) female, 72% (n = 43) white, mean age of 20.8 years and a median body mass index of 36.6 kg/m2. At an average of 3.5 years following surgery, females underestimated weight (0.5 kg, range: -18.7 to 5.6 kg), while males overestimated (1.1 kg, range: -7.8 to 15.2 kg). Most (80%, n = 48) reported within 5 kg of measured weight. The majority of adolescents who previously underwent bariatric surgery reported reasonably accurate weights, but direction of misreporting varied by gender. CONCLUSION Self-reported weights could be utilized when measured values are unavailable without markedly biasing the interpretation of outcomes.
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Bidirectional associations between body dissatisfaction and depressive symptoms from adolescence through early adulthood. Dev Psychopathol 2017; 30:1447-1458. [PMID: 29144209 DOI: 10.1017/s0954579417001663] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Body dissatisfaction and depressive symptoms are commonly experienced during adolescence and increase the risk of adverse health outcomes, especially eating disorders. However, the dominant temporal associations between these two experiences (i.e., whether one is a risk factor for the other or the two are mutually reinforcing) has yet to be fully explored. We examined the associations between body dissatisfaction and depressive symptoms assessed at baseline and 5- and 10-year follow-up in younger (M age = 12.9 years at baseline, 56% female, n = 577) and older (M age = 15.9 years at baseline, 57% female, n = 1,325) adolescent cohorts assessed as part of Project Eating Among Teens and Young Adults. Associations between body dissatisfaction and depressive symptoms were examined using cross-lagged models. For females, the dominant directionality was for body dissatisfaction predicting later depressive symptoms. For males, the picture was more complex, with developmentally sensitive associations in which depressive symptoms predicted later body dissatisfaction in early adolescence and early adulthood, but the reverse association was dominant during middle adolescence. These findings suggest that interventions should be tailored to dynamic risk profiles that shift over adolescence and early adulthood, and that targeting body dissatisfaction at key periods during development may have downstream impacts on depressive symptoms.
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Craig BA, Morton DP, Kent LM, Butler TL, Rankin PM, Price KR. The Body Mass Index of Adolescents Attending Seventh-Day Adventist Schools in Australia: 2001-2012. THE JOURNAL OF SCHOOL HEALTH 2017; 87:630-637. [PMID: 28691170 DOI: 10.1111/josh.12535] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 12/15/2016] [Accepted: 01/25/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND We examined the body mass index (BMI) of students attending Seventh-day Adventist (Adventist) schools in Australia in 2001 and 2012. METHODS A total of 3069 students attending Adventist schools in Australia responded to a health and lifestyle survey in 2001 (N = 1335) and 2012 (N = 1734). The survey captured self-reported height and weight, demographics (age, sex, year level, religion), and select health behaviors. RESULTS Compared with national norms, lower rates of overweight and obesity were observed in the study cohort, but higher rates of underweight. There was no change in the mean BMI of the students attending Adventist schools in Australia from 2001 to 2012. Regression analyses indicated that a lower BMI was associated with age, sex, more regularly eating breakfast, consuming less soft drink, and having a regular exercise program. The students reported a high consumption of fruits, vegetables, and whole grains compared with Australian national norms, and 29% claimed to be vegetarian. CONCLUSIONS Students attending Adventist schools appear to have a lower prevalence of overweight and obesity than the secular population, but a higher prevalence of underweight. The mechanisms through which Adventist schools may influence student's BMI warrants further investigation.
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Affiliation(s)
- Bevan A Craig
- Lifestyle Research Centre, Avondale College of Higher Education, PO Box 19, Cooranbong, NSW 2265, Australia
| | - Darren P Morton
- Lifestyle Research Centre, Avondale College of Higher Education, PO Box 19, Cooranbong, NSW 2265, Australia
| | - Lillian M Kent
- Lifestyle Research Centre, Avondale College of Higher Education, PO Box 19, Cooranbong, NSW 2265, Australia
| | - Terry L Butler
- Lifestyle Research Centre, Avondale College of Higher Education, PO Box 19, Cooranbong, NSW 2265, Australia
| | - Paul M Rankin
- Lifestyle Research Centre, Avondale College of Higher Education, PO Box 19, Cooranbong, NSW 2265, Australia
| | - Kevin R Price
- Adventist Health Seventh-Day Adventist Church, Australia, 148 Fox Valley Road, Wahroonga, NSW 2076, Australia
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Puhl RM, Wall MM, Chen C, Bryn Austin S, Eisenberg ME, Neumark-Sztainer D. Experiences of weight teasing in adolescence and weight-related outcomes in adulthood: A 15-year longitudinal study. Prev Med 2017; 100:173-179. [PMID: 28450124 PMCID: PMC5852667 DOI: 10.1016/j.ypmed.2017.04.023] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 04/11/2017] [Accepted: 04/22/2017] [Indexed: 11/19/2022]
Abstract
Weight-based teasing is common among youth, but little is known about its long-term impact on health outcomes. We aimed to 1) identify whether weight-based teasing in adolescence predicts adverse eating and weight-related outcomes 15years later; and 2) determine whether teasing source (peers or family) affects these outcomes. Data were collected from Project EAT-IV (Eating and Activity in Teens and Young Adults) (N=1830), a longitudinal cohort study that followed a diverse sample of adolescents from 1999 (baseline) to 2015 (follow-up). Weight-based teasing at baseline was examined as a predictor of weight status, binge eating, dieting, eating as a coping strategy, unhealthy weight control, and body image at 15-year follow-up. After adjusting for demographic covariates and baseline body mass index (BMI), weight-based teasing in adolescence predicted higher BMI and obesity 15years later. For women, these longitudinal associations occurred across peer and family-based teasing sources, but for men, only peer-based teasing predicted higher BMI. The same pattern emerged for adverse eating outcomes; weight-based teasing from peers and family during adolescence predicted binge eating, unhealthy weight control, eating to cope, poor body image, and recent dieting in women 15years later. For men, teasing had fewer longitudinal associations. Taken together, this study shows that weight-based teasing in adolescence predicts obesity and adverse eating behaviors well into adulthood, with differences across gender and teasing source. Findings underscore the importance of addressing weight-based teasing in educational and health initiatives, and including the family environment as a target of anti-bullying intervention, especially for girls.
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Affiliation(s)
- Rebecca M Puhl
- Rudd Center for Food Policy & Obesity, Department of Human Development and Family Studies, University of Connecticut, Hartford, CT, United States.
| | - Melanie M Wall
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, NY, United States
| | - Chen Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, NY, United States
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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Accuracy of using self-reported data to screen children and adolescents for overweight and obesity status: A diagnostic meta-analysis. Obes Res Clin Pract 2017; 11:257-267. [PMID: 28389205 DOI: 10.1016/j.orcp.2017.03.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/11/2017] [Accepted: 03/14/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To estimate the accuracy of using the self-reported body mass index (BMIsr) for screening children and adolescents for overweight and obesity status by quantitatively synthesizing individual studies in the research literature. METHOD Three databases, namely PubMed, Web of Science, and EBSCOhost were searched up to September 2016. Studies were included that collected both the self-reported data (BMIsr) and direct measurement data (i.e., BMI based on measured height and weight, BMIm) to screen children and adolescents for overweight and obesity status, and provided sufficient data on sensitivity and specificity. Sensitivity, specificity, likelihood ratios, and diagnostic odds ratios from each of the included studies were pooled by using a random-effects meta-analytic model, and summary receiver operating characteristic curve (ROC) was also constructed. RESULTS Twenty-three studies were identified. For screening children and adolescents with overweight and obesity, the use of BMIsr presented a pooled sensitivity of 0.76 (95% CI, 0.76-0.77), a pooled specificity of 0.96 (95% CI, 0.96-0.97) and a pooled DOR of 92.4 (95% CI: 74.3-114.8). Moderator analyses showed that the sample regions (America vs. Europe vs. Asia), weight status screening references (IOTF vs. CDC vs. Nation-specific standard) and weight status screened (overweight vs. obesity) had contributed to the inconsistent findings concerning the screening accuracy across the studies. CONCLUSIONS Based on the results of current meta-analysis, the use of BMIsr has good overall performance with moderate sensitivity and high specificity, and it is a viable alternative when direct measurement of BMI is not available.
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Hoffmann S, Warschburger P. Weight, shape, and muscularity concerns in male and female adolescents: Predictors of change and influences on eating concern. Int J Eat Disord 2017; 50:139-147. [PMID: 27739586 DOI: 10.1002/eat.22635] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 09/15/2016] [Accepted: 09/15/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the impact of age and weight status on adolescents' body dissatisfaction and its change over 20 months in a gender-comparing design. The influence of body image concern on eating concern was also investigated. METHOD In a prospective study, 675 male and female adolescents aged 12-16 were assessed using self-report questionnaires on weight, shape, muscularity, and eating concerns. Height and weight measurements were taken by trained personnel. Data were analyzed using structural equation modeling. RESULTS Analyses of latent means revealed more pronounced weight/shape concern in females than males and more pronounced muscularity concern in males than females. Weight/shape concern increased in females over time, whereas muscularity concern remained stable in both genders. Baseline levels of weight/shape concern could be predicted by age and weight status in females and by weight status in males. The only predictor of change in weight/shape concern was weight status in males. Baseline levels of muscularity concern could be predicted by age in females and by weight status in males. Similar effects were found for changes in muscularity concern in both genders. Increases in weight/shape and muscularity concern were associated with more pronounced eating concern. DISCUSSION The results confirm gender differences in distinctive facets of body image concern and its prediction. The relevance of increase in body image concern in adolescents is underlined by its association with eating concern in both genders. Further explanatory variables for change in body dissatisfaction should be examined in future studies. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:139-147).
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Affiliation(s)
- Svenja Hoffmann
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Straße 24/25, Potsdam, 14476, Germany
| | - Petra Warschburger
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Straße 24/25, Potsdam, 14476, Germany
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50
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Morgen CS, Andersen PK, Mortensen LH, Howe LD, Rasmussen M, Due P, Sørensen TIA, Andersen AMN. Socioeconomic disparities in birth weight and body mass index during infancy through age 7 years: a study within the Danish National Birth Cohort. BMJ Open 2017; 7:e011781. [PMID: 28110282 PMCID: PMC5253532 DOI: 10.1136/bmjopen-2016-011781] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 11/07/2016] [Accepted: 12/15/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities in birth weight and in body mass index (BMI) later in childhood are in opposite directions, which raises questions about when during childhood the change in direction happens. We examined how maternal and paternal education and household income were associated with birthweight z-scores and with BMI z-scores at age 5 and 12 months and 7 years, and we examined the socioeconomic differences in the tracking of these z-scores across infancy and childhood. METHODS The associations were studied in a cohort of children in the Danish National Birth Cohort, single born between 1997 and 2003, for whom information on body size from at least 1 of 4 time points (n=85 062) was recorded. We examined the associations using linear mixed-effects modelling. RESULTS Children from families with a low maternal and paternal educational level changed their body size z-scores upwards between birth and age 7 years. At age 5 and 12 months, there were no educational gradient. A low maternal educational level was associated with lower birth weight for gestational age z-scores at birth for boys (-0.199; 95% CI -0.230 to -0.169) and girls (-0.198; 95% CI -0.229 to -0.167) and higher BMI z-scores at age 7 for boys (0.198; 95% CI 0.154 to 0.242) and girls (0.218; 95% CI 0.173 to 0.264). There was not a similarly clear pattern in the tracking between different household income groups. However, a low household income level was associated with higher z-scores of both birth weight and BMI at age 7 years, but with a much weaker gradient at 5 and 12 months. CONCLUSIONS The educational gradient shifts from positive with birth weight, to none during infancy to inverse with BMI at age 7 years. In contrast, the income gradient was positive at birth and at 7 years and much weaker during infancy.
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Affiliation(s)
- Camilla Schmidt Morgen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Per Kragh Andersen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laust Hvas Mortensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laura D Howe
- MRC Integrative Epidemiology Unit, The University of Bristol, and School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Copenhagen, Denmark
- MRC Integrative Epidemiology Unit, The University of Bristol, and School of Social and Community Medicine, University of Bristol, Bristol, UK
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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