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Paraskeva N, Pegram G, Goel R, Mandhaani M, Suneja V, White P, Diedrichs PC. A cognitive dissonance body image intervention 'Free Being Me' delivered by guide leaders to adolescent girl guides in India: A pilot and acceptability trial. Body Image 2024; 48:101658. [PMID: 38141491 DOI: 10.1016/j.bodyim.2023.101658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 11/08/2023] [Accepted: 11/25/2023] [Indexed: 12/25/2023]
Abstract
This pilot study assessed the acceptability and pre-post intervention effects of a cognitive dissonance-based body image intervention, Free Being Me, delivered by Guide leaders to adolescent girls in India. Girls aged 11-14 years (Mage = 12.6, N = 117), who were members of the national scouting and guiding association of India, received the intervention across five weekly 1-hour group sessions. The primary outcome (body esteem) and secondary outcomes (self-esteem, internalisation of appearance ideals, negative and positive affect, and life disengagement) were measured pre-intervention and immediately post-intervention. The intervention was acceptable. Adolescent girls reported high levels of comfort (89%), enjoyment (90%), and perceived importance (92%) with suggestions for improvement including more interactive activities. Facilitator adherence and competence delivering Free Being Me was rated good. Significant within-groups pre-post intervention improvements in body esteem (Cohen's d = 0.28) and reductions in internalisation of appearance ideals (Cohen's d = 0.49) were identified. No changes to self-esteem, negative or positive affect, or life disengagement were observed. This study suggests that Free Being Me is acceptable for community-based delivery and Guide leader format with promising pre-post intervention effects. Going forward, a randomised controlled trial is necessary to make confident interpretations on the effectiveness of Free Being Me.
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Affiliation(s)
- Nicole Paraskeva
- Centre for Appearance Research, University of the West of England, Bristol, UK.
| | - Georgina Pegram
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | | | | | - Vanya Suneja
- O.P Jindal Global University, Sonipat, Haryana, India
| | - Paul White
- Applied Statistics Group, University of the West of England, UK
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Awasthi S, Kumar D, Dixit S, Mahdi AA, Gupta B, Agarwal GG, Pandey AK, Awasthi A, A. R. S, Bhat MA, Kar S, Mahanta BN, Mathew JL, Nair S, Singh CM, Singh K, Thekkumkara Surendran A. Association of dietary intake with micronutrient deficiency in Indian school children: a cross-sectional study. J Nutr Sci 2023; 12:e104. [PMID: 37829085 PMCID: PMC10565204 DOI: 10.1017/jns.2023.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/05/2023] [Accepted: 08/30/2023] [Indexed: 10/14/2023] Open
Abstract
Adequate nutrition is necessary during childhood and early adolescence for adequate growth and development. Hence, the objective of the study was to assess the association between dietary intake and blood levels of minerals (calcium, iron, zinc, and selenium) and vitamins (folate, vitamin B12, vitamin A, and vitamin D) in urban school going children aged 6-16 years in India, in a multicentric cross-sectional study. Participants were enrolled from randomly selected schools in ten cities. Three-day food intake data was collected using a 24-h dietary recall method. The intake was dichotomised into adequate and inadequate. Blood samples were collected to assess levels of micronutrients. From April 2019 to February 2020, 2428 participants (50⋅2 % females) were recruited from 60 schools. Inadequate intake for calcium was in 93⋅4 % (246⋅5 ± 149⋅4 mg), iron 86⋅5 % (7⋅6 ± 3⋅0 mg), zinc 84⋅0 % (3⋅9 ± 2⋅4 mg), selenium 30⋅2 % (11⋅3 ± 9⋅7 mcg), folate 73⋅8 % (93⋅6 ± 55⋅4 mcg), vitamin B12 94⋅4 % (0⋅2 ± 0⋅4 mcg), vitamin A 96⋅0 % (101⋅7 ± 94⋅1 mcg), and vitamin D 100⋅0 % (0⋅4 ± 0⋅6 mcg). Controlling for sex and socioeconomic status, the odds of biochemical deficiency with inadequate intake for iron [AOR = 1⋅37 (95 % CI 1⋅07-1⋅76)], zinc [AOR = 5⋅14 (95 % CI 2⋅24-11⋅78)], selenium [AOR = 3⋅63 (95 % CI 2⋅70-4⋅89)], folate [AOR = 1⋅59 (95 % CI 1⋅25-2⋅03)], and vitamin B12 [AOR = 1⋅62 (95 %CI 1⋅07-2⋅45)]. Since there is a significant association between the inadequate intake and biochemical deficiencies of iron, zinc, selenium, folate, and vitamin B12, regular surveillance for adequacy of micronutrient intake must be undertaken to identify children at risk of deficiency, for timely intervention.
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Affiliation(s)
- Shally Awasthi
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Divas Kumar
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Swati Dixit
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Abbas Ali Mahdi
- Department of Biochemistry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Barkha Gupta
- Lead-Nutritional Claims & Medical Affairs (Global HFD), HUL R&D Centre, Gurgaon, India
| | - Girdhar G. Agarwal
- Department of Statistics, University of Lucknow, Lucknow, Uttar Pradesh, India
| | - Anuj Kumar Pandey
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Avivar Awasthi
- Department of Endocrinology, Kasturba Medical College, Manipal, Karnataka, India
| | - Somashekar A. R.
- Department of Pediatrics, M. S. Ramaiah Institute of Medical Sciences, Bangalore, Karnataka, India
| | - Mushtaq A. Bhat
- Department of Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Sonali Kar
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Orissa, India
| | - B. N. Mahanta
- Department of Medicine, Assam Medical College, Dibrugarh, Assam, India
| | - Joseph L. Mathew
- Department of Pediatric Medicine, Post Graduate Institute of Medical Sciences, Chandigarh, India
| | - Suma Nair
- Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka, India
| | - C. M. Singh
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Kuldeep Singh
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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The relationship between socio-demographic characteristics with genital self-image in the women, 2016. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2021. [DOI: 10.52547/jgbfnm.18.2.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
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Lewis-Smith H, Garbett KM, Chaudhry A, Uglik-Marucha N, Vitoratou S, Dhillon M, Shroff H, Diedrichs PC. Adaptation and validation of the Eating Disorder Examination-Questionnaire in English among urban Indian adolescents. Int J Eat Disord 2021; 54:187-202. [PMID: 33305881 DOI: 10.1002/eat.23431] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Eating pathology is a salient issue in India, with clinical features reported among adults and adolescents. However, there are currently no validated measures of disordered eating in the Indian context. The present study therefore aimed to validate a culturally appropriate English language version of the Eating Disorder Examination Questionnaire (EDE-Q), a widely used measure, among adolescents in India. METHOD We adapted and examined the factor structure, reliability, and construct validity of the EDE-Q among an urban sample of 1,413 Indian adolescents (mean age = 13 years; 45% girls). RESULTS In contrast to the original four-factor model, exploratory factor analysis identified a two-factor solution for girls and boys, which was verified by confirmatory factor analysis; a "Preoccupation and Control" subscale and a "Weight and Shape Concerns" subscale. The total scale comprised 15 items for girls and 18 items for boys. Test-retest reliability and internal consistency were satisfactory for the girls' and boys' scales (Cronbach's α = .91 for both) and their comprising subscales (αs ≥ .80). Concurrent validity was established through medium-high significant correlations with measures of body image and internalization of appearance ideals. Combining items common to both versions of the scale led to a psychometrically acceptable model which was largely invariant across both genders, thus facilitating gendered comparison. DISCUSSION Findings indicate the reliability and validity of the EDE-Q among English-speaking urban Indian adolescents. This will facilitate further research examining the prevalence and nature of eating pathology among adolescents in India.
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Affiliation(s)
- Helena Lewis-Smith
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Kirsty M Garbett
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | | | | | | | - Megha Dhillon
- Lady Shri Ram College, University of Delhi, New Delhi, India
| | - Hemal Shroff
- Tata Institute of Social Sciences, Mumbai, India
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Leandro CG, Fonseca EVDSD, de Lim CR, Tchamo ME, Ferreira-E-Silva WT. Barriers and Enablers That Influence Overweight/Obesity/Obesogenic Behavior in Adolescents From Lower-Middle Income Countries: A Systematic Review. Food Nutr Bull 2019; 40:562-571. [PMID: 31272220 DOI: 10.1177/0379572119853926] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Overweight/obesity during adolescence in lower-middle income countries has become a public health problem with consequences in adulthood. Inadequate dietary habits, poor diet quality, sedentary behavior, and parental obesity have been reported. OBJECTIVE To describe management of obesity-like food habits and behavior of adolescents from lower-middle income countries with respect to what keeps them using this diet (barriers) and what helps them avoid it (enablers). METHODS Systematic review of the literature related to obesity and food intake of adolescents conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). RESULTS We classified 11 eligible studies describing the barriers to and enablers of the management of obesity-like food intake and obesity lifestyle. The dual burdens of malnutrition and increased urbanization have been observed. There is preference for processed food, dietary habits, and obesity-like food intake and sedentary behavior. Barriers to managing body weight gain included mostly consumption of fast-food and snack food, less vegetable and fruit intake, skipping meals, and sedentary behavior. Enablers of managing body weight gain included changes in nutritional habits, perception of the consumption of healthy food, physical activity, and engagement in programs to change lifestyle. CONCLUSION The globalization of the fast food industry has provided an obesogenic environmental stimulus for adolescents in lower-middle income countries.
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Affiliation(s)
- Carol Góis Leandro
- Department of Nutrition, Federal University of Pernambuco, CAV-UFPE, Recife, Brazil.,Department of Physical Education and Sports Science, Federal University of Pernambuco, CAV-UFPE, Recife, Brazil
| | | | - Cybelle Rolim de Lim
- Department of Nutrition, Federal University of Pernambuco, CAV-UFPE, Recife, Brazil
| | - Mario Eugénio Tchamo
- Faculty of Physical Education and Sports, Pedagogic University, Maputo, Mozambique
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Abstract
There has been sporadic research on eating disorders in India, with no published attempt to collate and summarize the literature landscape. Hence, the present narrative review aims to summarize Indian work related to eating disorders, discern current trends, and highlight gaps in research that will provide directions for future work in the area. Electronic search using the MEDLINE, Google Scholar, and PsycINFO databases was done to identify relevant peer-reviewed English language articles, in October 2018, using combinations of the following medical subject headings or free text terms: "eating disorders," "anorexia nervosa," "bulimia," "treatment," "epidemiology," "co-morbidity," "management," "medications," "behavioral intervention," and "psychosocial intervention." The data extracted from studies included details such as author names, year, from which of the states in India the work originated, type of intervention (for interventional studies), comparator (if any), and major outcomes. There is increasing research focused on eating disorders from India over the last decade, but it continues to be an under-researched area as evidenced by the relative paucity of original research. The cultural differences between east and west have contributed to variations in the presentation as well as challenges in the diagnosis. Hence, there is a need for the development of culturally sensitive instruments for diagnosis, as well as generating locally relevant epidemiological data about eating disorders from community and hospital settings.
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Affiliation(s)
- Sivapriya Vaidyanathan
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Pooja Patnaik Kuppili
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Association of socio-culture factors with disordered eating behavior: An empirical study on urban young girls of West Bengal, India. ANTHROPOLOGICAL REVIEW 2018. [DOI: 10.2478/anre-2018-0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
A shift towards the concept of thin body image is occurring among the urban girls, as an outcome of mass media exposure. A large section of the girls are involved in attaining thin body image which at times develops dissatisfaction over body weight. Body weight dissatisfaction gives rise to the development of body weight concern and disordered eating behavior. The present research aimed to find out the association of socio-cultural factors with disordered eating behavior among a group of urban girls. The study group included 400 girls aged between 14 and 21 years, residing in the city of Howrah, West Bengal, eastern state of India. Information on socio-demographic characteristics, body weight concern, media habits, and family-peer environments was collected using standard pretested questionnaires. A cross-culturally tested questionnaire developed by Srinivasan and colleagues in 1998, was used to measure disordered eating behavior. Bivariate analyses found significant associations between eating behavior and several socio-cultural factors. Multivariate analysis revealed that education level of fathers and birth order of the participants, body weight concern and peers’ influence were the significant predictors of disordered eating behavior of the study participants. Socio-cultural factors have significant associations with the disordered eating behavior of the study participants.
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Ganesan S, Ravishankar SL, Ramalingam S. Are Body Image Issues Affecting Our Adolescents? A Cross-sectional Study among College Going Adolescent Girls. Indian J Community Med 2018; 43:S42-S46. [PMID: 30686874 PMCID: PMC6324036 DOI: 10.4103/ijcm.ijcm_62_18] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/13/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Body image relates to how people think and feel about their own body. In today's society, with the growing sense of ideal body image, adolescents try to lose or gain body weight to attain that perfect body. Body image perception is still naive, and this research will try to understand these unexplored areas, where there is paucity of body image-related studies. OBJECTIVES The objective of the study is to find out the proportion of girls dissatisfied about body image, and the association of various factors with body image dissatisfaction and to ascertain the weight control behaviors adopted by adolescent college girls. METHODOLOGY A cross-sectional study was done among 1200 college girls in Coimbatore. A semi-structured questionnaire was used to collect data on various factors associated with body image dissatisfaction. Body mass index (BMI) of the participants was calculated. RESULTS Body image dissatisfaction was there among 77.6% of the girls. It was found that factors such as higher BMI, sociocultural pressure to be thin and depression were all significantly associated with body image dissatisfaction. The most commonly followed weight control behaviors were eating small meals and skipping meals. Improving the appearance and body shape were the main reasons for weight control behaviors. CONCLUSION This study establishes the fact that body image dissatisfaction is no longer a western concept and affects Indian adolescent girls to a great extent. Hence, effective interventions have to be planned to increase awareness on ideal body weight and protect our young generation from pressures of negative body image.
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Affiliation(s)
- Subhashini Ganesan
- Department of Community Medicine, PSGIMSR, Coimbatore, Tamil Nadu, India
| | - S. L. Ravishankar
- Department of Community Medicine, PSGIMSR, Coimbatore, Tamil Nadu, India
| | - Sudha Ramalingam
- Department of Community Medicine, PSGIMSR, Coimbatore, Tamil Nadu, India
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Uddin MJ, Nag SK, Sil SK. Anthropometric Assessment of Nutritional Status of Adolescents in Rural School of Unokoti District of Tripura, North-East India. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/09720073.2015.11891661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Md. Jashim Uddin
- Department of Human Physiology, Tripura University (A Central University) , Suryamaninagar, West Tripura 799 022, Tripura, India
| | - Samir Kumar Nag
- Department of Human Physiology, M.B.B. College, Agartala , West Tripura 799 2004, Tripura, India
| | - Samir Kumar Sil
- Department of Human Physiology, Tripura University , Tripura, India
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Mallick N, Mukhopadhyay S, Ray S. Eating attitudes and its relationship with nutritional status: a micro level study on a group of adolescent girls in the city of Howrah, West Bengal. Int J Adolesc Med Health 2017; 30:/j/ijamh.ahead-of-print/ijamh-2016-0083/ijamh-2016-0083.xml. [PMID: 28063258 DOI: 10.1515/ijamh-2016-0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 10/25/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND To assess the relationship between eating attitudes and nutritional status. METHODS This cross-sectional study was conducted among 400 adolescent girls (258 aged 14-17 years and 142 aged 18-21 years) from the city of Howrah, West Bengal. Eating attitude was measured using eating distress syndrome (EDS) questionnaire. Nutritional status was assessed using body mass index, waist-hip ratio (WHR) and body fat percentage (BF%). RESULTS Participants with disordered eating attitudes revealed significantly higher values for body mass index (BMI), WHR and BF% than those with normal eating attitudes (p≤0.01). Hierarchical linear regression analyses show that eating attitudes and socio-demographic characteristics (like mothers' education and occupation, age and birth order of the participants) significantly predict nutritional status. CONCLUSION The nutritional status of adolescents depends on their eating attitudes and socio-demographic characteristics.
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Affiliation(s)
- Nadira Mallick
- Department of Anthropology, University of Calcutta, Kolkata, India
| | - Susmita Mukhopadhyay
- Biological Anthropology Unit, Indian Statistical Institute, 203 B.T. Road, Kolkata 700 108, India, Phone: 09051159413, E-mail:
| | - Subha Ray
- Department of Anthropology, University of Calcutta, Kolkata, India
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Weight concerns and food habits of adolescent girls in two contrasting ecological regions: A comparative study in India. Eat Behav 2016; 20:21-6. [PMID: 26599837 DOI: 10.1016/j.eatbeh.2015.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 10/12/2015] [Accepted: 11/11/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the incidence of weight concerns and food habits between two ethnically different groups of adolescent girls residing in two distinct ecological settings: the plains of Kolkata and the mountains of Sikkim. METHODS Two separate cross-sectional studies were conducted within a period of five years in urban hilly areas of Sikkim and the city of Kolkata, India. A total of 506 girls aged 14-19 years were selected from the study areas of Sikkim (n=224) and Kolkata (n=282). Girls were interviewed for weight concerns and food habits along with socio-demographic characteristics. Weight concerns were assessed with four variables such as, perceptions about own body weight, felt dissatisfied with own body weight, urge for dieting and use of weight reduction diet. Food habits included consumption of major foods during the past one week. RESULTS Bivariate analyses showed that Kolkata girls perceived themselves as overweight, remained dissatisfied with body weight, expressed perceived need for dieting and followed weight reduction diet more compared to the girls of Sikkim. Food habits indicated that all Sikkimese girls preferred to consume cereals regularly, while Kolkata girls consumed vegetables, pulses, fish, fruits, bread and butter and fried foods more than Sikkimese girls. Multivariate analyses showed that place of residence was significantly (p<0.05) associated with both weight concerns and food habits of girls. CONCLUSION Diversity in culture, ethnicity and socio-economic standard perhaps develop the disparity in food habits and weight concerns between girls of urban hilly areas of Sikkim and the city of Kolkata.
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A randomised cross-over pilot study investigating the use of acupuncture to promote weight loss and mental health in overweight and obese individuals participating in a weight loss program. Eat Weight Disord 2015; 20:379-87. [PMID: 25630840 DOI: 10.1007/s40519-014-0175-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 12/23/2014] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Acupuncture is widely used as an alternative modality for weight loss. Despite its increasing use, few acupuncture studies have evaluated the effect of a weight loss program on the mental health of obese/overweight participants and none have looked at the effect on those with eating, weight and shape concerns. OBJECTIVES To investigate the feasibility of conducting an acupuncture study involving overweight or obese individuals undertaking a weight loss program with particular reference to those with eating concerns. METHODS Thirty-five overweight/obese males and females participated in a single-blinded randomised cross-over study. The two intervention phases were: (1) nutritional counselling plus Traditional Chinese Medicine (TCM) acupuncture and (2) nutritional counselling plus sham acupuncture. OUTCOME MEASURES This study evaluates the feasibility and practicalities of the study including recruitment, retention, adverse events, effectiveness for defining eating and weight concerns, study design and statistics for power calculations. CONCLUSION The outcome measures, the recruitment of those with eating and weight concerns and the acceptability of the intervention demonstrate a larger trial investigating the use of acupuncture for weight loss in those who have elevated eating and weight concerns is feasible.
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Abstract
Eating disorders, especially anorexia nervosa and bulimia nervosa have been classically described in young females in Western population. Recent research shows that they are also seen in developing countries including India. The classification of eating disorders has been expanded to include recently described conditions like binge eating disorder. Eating disorders have a multifactorial etiology. Genetic factor appear to play a major role. Recent advances in neurobiology have improved our understanding of these conditions and may possibly help us develop more effective treatments in future. Premorbid personality appears to play an important role, with differential predisposition for individual disorders. The role of cultural factors in the etiology of these conditions is debated. Culture may have a pathoplastic effect leading to non-conforming presentations like the non fat-phobic form of anorexia nervosa, which are commonly reported in developing countries. With rapid cultural transformation, the classical forms of these conditions are being described throughout the world. Diagnostic criteria have been modified to accommodate for these myriad presentations. Treatment of eating disorders can be quite challenging, given the dearth of established treatments and poor motivation/insight in these conditions. Nutritional rehabilitation and psychotherapy remains the mainstay of treatment, while pharmacotherapy may be helpful in specific situations.
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Affiliation(s)
- Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - A Shyam Sundar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
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Deschamps V, Salanave B, Chan-Chee C, Vernay M, Castetbon K. Body-weight perception and related preoccupations in a large national sample of adolescents. Pediatr Obes 2015; 10:15-22. [PMID: 24453118 DOI: 10.1111/j.2047-6310.2013.00211.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 09/24/2013] [Accepted: 10/28/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to investigate the association between body-weight (BW) perception, weight preoccupation and behaviour, including weight control practices and compulsive over-eating episodes, across gender and actual BW classes. DESIGN This study used a cross-sectional observational study. PARTICIPANTS A large, nationally representative sample of 6404 ninth-grade French adolescents was randomly selected from schools throughout France. METHODS Weight and height were measured, and BW preoccupation, BW control practices and compulsive over-eating were self-reported using standardized questionnaires. RESULTS Nearly one-third of adolescents misperceived their BW. Misperception was more frequent among girls than boys (42.2% vs. 27.3%, P < 0.01). Underestimation of BW among overweight adolescents, like BW overestimation among underweight adolescents, was associated with less preoccupation with weight and fewer weight control practices than accurate perception of BW. Normal weight adolescents who overestimated their BW were more likely to declare weight preoccupations (ORa = 8.66 [6.67-11.25]), dieting (ORa = 4.81 [3.68-6.27]) and recurrent compulsive over-eating episodes (ORa = 2.36 [1.72-3.23]) compared with their counterparts who correctly estimated their BW. CONCLUSION Our study underlines the role of these associations in each category of actual BW (underweight, normal weight and overweight) in a large national sample.
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Affiliation(s)
- V Deschamps
- Unité de Surveillance et d'Epidémiologie nutritionnelle (Usen), Institut de Veille sanitaire (InVS), Saint-Maurice, France; Unité de Surveillance et d'Epidémiologie nutritionnelle (Usen), Université de Paris 13, Bobigny, France
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Body weight and body shape concerns and related behaviours among Indian urban adolescent girls. Public Health Nutr 2014; 18:1075-83. [DOI: 10.1017/s1368980014001451] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo assess the associations of body weight and body shape concerns and related behaviours with actual weight status among urban adolescent girls.DesignIn the present cross-sectional study, a self-administered questionnaire was used to collect data on body weight and body shape concerns and related behaviours. Sociodemographic information was collected using a pre-tested schedule. Weight and height of each girl were measured to assess actual weight status.SettingTwin cities of Kolkata and Howrah, West Bengal, India.SubjectsA total of 1223 adolescent girls aged 14–19 years were selected from nine schools in Kolkata and Howrah in West Bengal.ResultsMany overweight girls perceived themselves as overweight and engaged in weight-reducing activities. However, several normal-weight girls also perceived them as overweight and attempted to lose weight. Unhealthy eating practices to reduce weight were followed by both overweight and normal-weight girls and even by a few underweight girls. Multivariate binary logistic regression showed a significant association between actual weight status and use of unhealthy weight-loss measures. The likelihood of adopting unhealthy eating practices was significantly higher among overweight than normal-weight girls.ConclusionsHealth education programmes should be introduced at schools to promote effective weight-control practices that help dispel myths about weight loss.
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Talaie-Zanjani A, Faraji F, Rafie M, Mohammadbeigi A. A comparative study of nutritional status and foodstuffs in adolescent girls in iran. Ann Med Health Sci Res 2014; 4:38-43. [PMID: 24669328 PMCID: PMC3952294 DOI: 10.4103/2141-9248.126606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The prevalence of obesity and overweight in children and adolescents is increasing world-wide. Obesity in children and adolescents is a major risk factor for diabetes, heart diseases, hypertension, and cancer in adulthood. AIM The aim of the study was to compare the nutritional status and food-stuffs among high-school girls in Arak, Iran, in matter of body mass index (BMI) and associated factors. SUBJECTS AND METHODS A cross-sectional survey of a representative sample of 278 adolescents was conducted in six randomly chosen high-schools. Height and weight of students were collected using standard methods and the BMI calculated and BMI percentiles of these girls are compared with the Center of Disease Control and Prevention (CDC) reference data. The 5(th), 8(th), and 95(th) percentiles of the CDC were adopted as cut-off points for underweight, overweight and obese girls, respectively. Data were analyzed using SPSS by analysis of variance and Chi-square tests. RESULTS On the basis of CDC, the overall prevalence rates of underweight, overweight, and obesity were estimated 10.1% (28/278), 12.9% (36/278), and 1.4% (4/278), respectively. There was no significant difference between nutritional knowledge scores and the rate of physical activities in various groups. The mean age at menarche was significantly higher among the obese girls (P = 0.02). Consumption of ice-cream and chocolate was significantly higher in the obese girls group (P = 0.03). CONCLUSION According to the present study, the prevalence of overweight and obesity in high-school girls of Arak is lower than that of many other parts of Iran and some neighboring countries, which are at the high-risk of overweight and obesity. This study warrants the necessity of paying attention to promote healthy life-style and weight control. The earlier age of menarche is alarming.
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Affiliation(s)
- A Talaie-Zanjani
- Department of Health and Nutrition, Islamic Azad University of Arak, Arak, Iran
| | - F Faraji
- Department of Neurology, Arak University of Medical Sciences, Arak, Iran
| | - M Rafie
- Department of Epidemiology and Biostatistics, Arak University of Medical Sciences, Arak, Iran
| | - A Mohammadbeigi
- Health Policy and Promotion Research Center Department of Epidemiology, Qom University of Medical Sciences, Qom, Iran
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Abstract
This paper presents a global review of research done on adolescent eating behaviours and food choices and the probable factors underlying it. Worldwide adolescent girls tend to develop moderate to high level of disordered eating behaviour as a result of their excessive concern with body weight or obsession with thinness. The objective of the review is to understand the concerns over body weight and the current eating patterns of adolescent girls in the developed and developing countries.
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Lal M, Abraham S. Adolescent development and eating disorder related quality of life in Indian females. Eat Weight Disord 2011; 16:e56-60. [PMID: 21727783 DOI: 10.1007/bf03327522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To study the relationship of adolescent development and eating disorder related quality of life in Indian females. METHOD 461 female school students (aged 12-17 yrs) were recruited from middle to high socio-economic status (SES), English speaking schools in Delhi, India. Adolescent development was measured by Tanner stage and months since menarche. Subjects completed the Quality of Life for Eating Disorders questionnaire (QOL ED), which included six subscores. Correlation and partial correlation coefficient analysis to control for Body Mass Index (BMI) were performed. RESULTS After controlling for BMI, all adolescent development measures were correlated with the psychological feelings (PSY) subscore. This subscore contained items relating to confusion, social unease, sadness, difficulty coping, desiring perfection and loss of control. Tanner breast stage was correlated with the eating behaviour (EB) subscore. DISCUSSION During adolescent development, Indian girls became more aware of their psychological feelings and emotions. Only those reporting breast development were using behaviours to control their body, weight and shape. These behaviours are not associated with the presence of disordered eating thoughts, such as preoccupation with food, eating, body weight or shape.
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Affiliation(s)
- M Lal
- Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, NSW 2065, Australia.
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Stigler MH, Arora M, Dhavan P, Shrivastav R, Reddy KS, Perry CL. Weight-related concerns and weight-control behaviors among overweight adolescents in Delhi, India: a cross-sectional study. Int J Behav Nutr Phys Act 2011; 8:9. [PMID: 21299879 PMCID: PMC3045278 DOI: 10.1186/1479-5868-8-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Accepted: 02/07/2011] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Obesity is emerging as a public health problem among adolescents in India. The aim of this study was to describe specific weight-related concerns among school-going youth in Delhi, India and to assess the prevalence of weight control behaviors, including healthy and unhealthy ones. Differences by weight status, gender, grade level, and school-type (a proxy for SES in this setting) are considered. METHODS This study is cross-sectional by design. A sample of eighth and tenth graders (n=1818) enrolled in Private (middle-high SES) and Government (low SES) schools (n=8) in Delhi, India participated. All students' height and weight were measured. Students participated in a survey of weight-related concerns and weight-control behaviors, as well. Mixed-effects regression models were used to test for differences in weight-related concerns and weight-control behaviors across key factors of interest (i.e., weight status, gender, grade level, and SES). RESULTS The combined prevalence of obesity and overweight was 16.6%, overall. Controlling one's weight was important to overweight and non-overweight youth, alike (94.2% v. 84.8%, p<0.001). Significantly more overweight or obese youth reported trying to control their weight last year, compared to those who were not overweight (68.1% v. 18.0%, p<0.001). Healthy weight control behaviors were more common than unhealthy or extreme practices, although the latter were still prevalent. Half of the overweight or obese students misclassified their weight status, while about 1 in 10 non-overweight youth did the same. Body dissatisfaction was highest among overweight youth and girls. CONCLUSIONS Interventions to promote healthy weight control should be pertinent to and well-received by school-going youth in India. Healthy weight control practices need to be explicitly encouraged and unhealthy practices reduced. Future interventions should address issues specific to body image, too, as body dissatisfaction was not uncommon among youth.
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Affiliation(s)
- Melissa H Stigler
- Michael & Susan Dell Center for Healthy Living, School of Public Health, University of Texas; Austin and Houston, Texas, USA
| | - Monika Arora
- HRIDAY (Health-Related Information Dissemination Amongst Youth); Delhi, India
- Public Health Foundation of India (PHFI); Delhi, India
| | - Poonam Dhavan
- Michael & Susan Dell Center for Healthy Living, School of Public Health, University of Texas; Austin and Houston, Texas, USA
| | - Radhika Shrivastav
- HRIDAY (Health-Related Information Dissemination Amongst Youth); Delhi, India
| | | | - Cheryl L Perry
- Michael & Susan Dell Center for Healthy Living, School of Public Health, University of Texas; Austin and Houston, Texas, USA
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Recipe for diabetes disaster: a study of dietary behaviors among adolescent students in south Delhi, India. Int J Diabetes Dev Ctries 2011. [DOI: 10.1007/s13410-010-0009-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Eating and weight concerns among Sikkimese adolescent girls and their biocultural correlates: an exploratory study. Public Health Nutr 2010; 14:853-9. [DOI: 10.1017/s1368980010002478] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectivesGrowing concern about ideal body image among adolescent girls in developing countries has led them to follow dietary modifications. In general, the ideal body image is perceived as a ‘thin body’ and now tagged with the concept of being physically fit. The present study evaluates the prevalence of weight concerns, and subsequent eating behaviour modifications among a group of adolescent girls in Sikkim.DesignPre-tested FFQ and dietary behaviour questionnaire were canvassed through direct interviews. Anthropometric measurements were taken following standard techniques. In the present study, dieting stands for skipping meals or avoiding certain food items.SettingSikkim, India.SubjectsA total of 577 girls were selected from several blocks of all four districts of Sikkim.ResultsThe results of the study show that concern with weight reduction is growing among adolescent girls, particularly among urban girls of affluent families. Girls from families with a higher economic status are about two times more likely to report dissatisfaction with their body weight (OR = 1·96; P ≤ 0·05) and these girls are five times more likely to report the need for dieting.ConclusionsIt is evident that weight concern and dissatisfaction over body weight are growing among adolescents. It can be safely argued that eating disorder, once a problem of the Western world, is now slowly creeping in among adolescents of the developing world as a consequence of rapid lifestyle changes over the past few decades.
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Al Sabbah H, Vereecken C, Abdeen Z, Kelly C, Ojala K, Németh A, Ahluwalia N, Maes L. Weight control behaviors among overweight, normal weight and underweight adolescents in Palestine: findings from the national study of Palestinian schoolchildren (HBSC-WBG2004). Int J Eat Disord 2010; 43:326-36. [PMID: 19437462 DOI: 10.1002/eat.20698] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The objective of the study is to examine the relationship between weight-control behaviors and self-reported sociodemographic characteristics, weight status, and perception of body weight in a large, representative sample of adolescents in the West Bank and Gaza Strip territories of Palestine. METHOD Self-report measures of sociodemographic characteristics, body weight perception, height and weight, and weight-control behaviors were completed by 8,885 male and female students aged 12-18 years from 405 randomly selected schools as part of the 2003/2004 Palestinian Health Behavior in School-aged Children Study (HBSC). RESULTS In both genders, dieting to lose weight was common among adolescents and significantly higher among overweight than among underweight or normal weight adolescents. Extreme weight-control behaviors (vomiting, diet pills, or laxatives) and smoking were more common among boys than girls, and extreme weight-control behaviors were particularly common among underweight boys. Older adolescents were less likely than younger adolescents to engage in weight-control behaviors. Perception of body weight as too fat was an influential factor in following an unhealthy diet to lose weight. DISCUSSION Practices to control weight, particularly extreme and unhealthy weight-control behaviors, are common among adolescents in the Palestinian territories. These findings suggest the need to design appropriate prevention and early intervention programs for adolescents in Palestine.
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Affiliation(s)
- Haleama Al Sabbah
- Department of Public Health, Faculty of Medicine, Gent University, Belgium
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Abstract
AbstractObjectiveTo investigate the relationships between weight reduction behaviour among non-overweight schoolchildren and dietary habits, perception of health, well-being and health complaints.DesignAnalysis of the 2006 Health Behaviour in School-aged Children survey, a cross-sectional study involving schoolchildren aged 10–17 years.SettingSchools in the Republic of Ireland.ResultsThe proportion of children (n3599) engaged in weight reduction behaviour (‘dieting’ among non-overweight students) was 10·3 %. Older children, females and those from higher social classes (SC) were more likely to report such behaviour. Non-overweight schoolchildren who reported weight reduction behaviour were less likely than those not engaged in such behaviour to frequently consume sweets, soft drinks, crisps and chips/fried potatoes (OR from 0·39 (95 % CI 0·17, 0·89) to 0·72 (95 % CI 0·53, 0·99)); were more likely to consume diet soft drinks (OR 1·50 (95 % CI 1·03, 2·18); and were more likely to miss breakfast during the week (OR 0·62 (95 % CI 0·48, 0·80). The risk of subjective health complaints increased (OR from 1·47 (95 % CI 1·13, 1·91) to 1·92 (95 % CI 1·48, 2·49)); as did body dissatisfaction (OR 9·17 (95 % CI 6·99, 12·02)), while perception of health and well-being decreased (OR 0·47 (95 % CI 0·36, 0·61)) to 0·54 (95 % CI 0·41, 0·70)). All analyses were controlled for age, gender and SC.ConclusionsWeight reduction behaviour among non-overweight schoolchildren is associated with considerable risk to physical health and emotional well-being. Since the risks associated with such behaviour varies by weight status, health professionals and researchers need to consider these issues in parallel.
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Banerjee SR, Chakrabarty S, Vasulu TS, Bharati S, Sinha D, Banerjee P, Bharati P. Growth and nutritional status of Bengali adolescent girls. Indian J Pediatr 2009; 76:391-9. [PMID: 19205646 DOI: 10.1007/s12098-009-0015-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2007] [Accepted: 04/28/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Assessment of the growth and nutritional status among healthy Bengali adolescent schoolgirls at peri-urban area. METHODS In this cross sectional study, sample consists of 527 school going adolescent girls, aged 10 to 18 years. The sample of the present study was collected from a peri-urban area (Duttapukur) of north 24 parganas district of West Bengal, India. Standard anthropometric measurements including linear, curvilinear and skinfold thickness were collected from each subject. Percentile curves and nutritional indices were used to determine the growth and nutritional status respectively. RESULTS The nature of distance curves and percentile curves of the body measurements showed a high rate of increase in 10-11 years of age group corresponding to an earlier adolescent growth spurt than average Indian girls. The adolescent girls in the current study were found to be significantly (p<0.0001) taller than Indian girls and heavier than both Indian and urban Bengali girls but slightly shorter than urban Bengali girls. They are significantly (p<0.0001) shorter and lighter than American girls, which also corresponded to 50(th) percentile curves. Age specific nutritional assessment shows different grades of malnutrition among them. Gomez's classification indicates about 60 % to 70 % adolescent girls show either moderate to mild malnutrition during their growth period. Both the indices of Waterlow's classification show least percentage of least malnutrition among the girls. CONCLUSION The growth pattern and nutritional status observed among adolescent girls in peri-urban situation show heterogeneity with respect to some anthropometric traits and in conformity with the growth pattern and nutritional status of urban girls.
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Affiliation(s)
- S R Banerjee
- Islamia Hospital, 8 Jessore Road, Kolkata, India
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Al Sabbah H, Vereecken C, Abdeen Z, Coats E, Maes L. Associations of overweight and of weight dissatisfaction among Palestinian adolescents: findings from the national study of Palestinian schoolchildren (HBSC-WBG2004). J Hum Nutr Diet 2009; 22:40-9. [DOI: 10.1111/j.1365-277x.2008.00901.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Batnitzky A. Obesity and household roles: gender and social class in Morocco. SOCIOLOGY OF HEALTH & ILLNESS 2008; 30:445-462. [PMID: 18373507 DOI: 10.1111/j.1467-9566.2007.01067.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Often referred to as the developing world's new burden of disease, obesity constitutes a major and growing health epidemic in Morocco, in particular for women (22% of women versus 8% of men). Through an analysis of qualitative data, I demonstrate how gender roles influence obesity risk in the Moroccan context. Current social and economic theories, including the nutrition transition theory, are inadequate in explaining the persistent gender differentials in health status across time and place. I suggest that Moroccan women's higher prevalence of obesity is predominantly the outcome of different risks acquired from their distinct roles. In the Moroccan context, we can gain insight into how men and women divide household labour and how the overall non-egalitarian nature of social roles may deleteriously affect women's health. I hypothesise that marital status, age and socioeconomic status determine Moroccan women's household roles and help to explain why women are more likely to be obese than men. The main findings support this hypothesis and demonstrate the interactive relationship between culture and structure in influencing obesity risk.
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Tam CK, Ng CF, Yu CM, Young BW. Disordered eating attitudes and behaviours among adolescents in Hong Kong: prevalence and correlates. J Paediatr Child Health 2007; 43:811-7. [PMID: 17803673 DOI: 10.1111/j.1440-1754.2007.01195.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To study the prevalence of disordered eating attitudes and behaviours among adolescents in Hong Kong and to examine the socio-demographic and behavioural correlates. METHODS Three secondary schools with different academic performance were selected from the Eastern District of Hong Kong. A total of 2382 students enrolled in Forms 1-7 at the three schools completed a specially designed questionnaire. The questionnaire contained questions on socio-demographic information, body weight satisfaction, exposure to mass media, health behaviours as well as the Eating Attitudes Test - 26 (EAT-26). Data were analysed using Student's t-test, chi2 analysis and multivariate logistic regression models. RESULTS Disordered eating (EAT score > or =20) was present in 52 (3.9%) adolescent boys and 68 (6.5%) adolescent girls. The youngest case was only 11 years old. A high degree of body weight dissatisfaction was shared by our adolescents. Teenage girls, overweight youths and those with poor academic performance were at increased risk of having disordered eating. Strong associations were found between disordered eating and other health-compromising behaviours including smoking, alcohol and soft drug use, delinquent behaviours, suicidal ideation and self-harm behaviours. Exposure to entertainment, beauty and youth magazines was positively related to disordered eating. CONCLUSIONS Disordered eating is prevalent among adolescents in Hong Kong. It remains a significant public health challenge to our community. Prevention programmes targeting youths at the greatest risk should be considered.
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Affiliation(s)
- Carmen Km Tam
- Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
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Puri S, Marwaha RK, Agarwal N, Tandon N, Agarwal R, Grewal K, Reddy DHK, Singh S. Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: relation to nutrition and lifestyle. Br J Nutr 2007; 99:876-82. [PMID: 17903343 DOI: 10.1017/s0007114507831758] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Forty to fifty per cent of skeletal mass, accumulated during childhood and adolescence, is influenced by sunlight exposure, physical activity, lifestyle, endocrine status, nutrition and gender. In view of scarce data on association of nutrition and lifestyle with hypovitaminosis D in Indian children and adolescents, an in-depth study on 3,127 apparently healthy Delhi schoolgirls (6-18 years) from the lower (LSES, n 1,477) and upper socioeconomic strata (USES, n 1650) was carried out. These girls were subjected to anthropometry and clinical examination for hypovitaminosis D. Girls randomly selected from the two strata (LSES, n 193; USES, n 211) underwent detailed lifestyle, dietary, biochemical and hormonal assessment. Clinical vitamin D deficiency was noted in 11.5 % girls (12.4 % LSES, 10.7 % USES). USES girls had significantly higher BMI than LSES counterparts. Prevalence of biochemical hypovitaminosis D (serum 25-hydroxyvitamin D < 50 nmol/l) was seen in 90.8 % of girls (89.6 % LSES, 91.9 % USES, NS). Mean intake of energy, protein, fat, Ca, vitamin D and milk/milk products was significantly higher in USES than LSES girls. Conversely, carbohydrate, fibre, phytate and cereal intakes were higher in LSES than USES girls. Physical activity and time spent outdoors was significantly higher in LSES girls (92.8 v. 64 %, P = 0.000). Significant correlation between serum 25-hydroxyvitamin D and estimated sun exposure (r 0.185, P = 0.001) and percentage body surface area exposed (r 0.146, P = 0.004) suggests that these lifestyle-related factors may contribute significantly to the vitamin D status of the apparently healthy schoolgirls. Hence, in the absence of vitamin D fortification of foods, diet alone appears to have an insignificant role.
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Affiliation(s)
- Seema Puri
- Department of Foods and Nutrition, Institute of Home Economics, University of Delhi, New Delhi, India
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