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Cervantes-Ortega M, Palma AM, Rook KS, Biegler KA, Davis KC, Janio EA, Kilgore DB, Dow E, Ngo-Metzger Q, Sorkin DH. Health-Related Social Control and Perceived Stress Among High-Risk Latina Mothers with Type 2 Diabetes and Their At-Risk Adult Daughters. Int J Behav Med 2023; 30:814-823. [PMID: 36650345 PMCID: PMC10350477 DOI: 10.1007/s12529-022-10145-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Diabetes-related multi-morbidity and cultural factors place Latinas with diabetes at increased risk for stress, which can threaten illness management. Families provide an ideal focus for interventions that seek to strengthen interpersonal resources for illness management and, in the process, to reduce stress. The current study sought to examine whether participating in a dyadic intervention was associated with reduced perceived stress and, furthermore, whether this association was mediated by persuasion and pressure, two forms of health-related social control. METHOD Latina mothers with diabetes and their at-risk adult daughters participated in either (1) a dyadic intervention that encouraged constructive collaboration to improve health behaviors and reduce stress, or (2) a usual-care minimal control condition. Actor-partner interdependence model analysis was used to estimate the effect of the intervention on dyads' perceived stress, and mother-daughter ratings of health-related social control as potential mediators. RESULTS Results revealed that participating in the intervention was associated with significantly reduced perceived stress for daughters, but not for mothers (β = - 3.00, p = 0.02; β = - 0.57, p = 0.67, respectively). Analyses also indicated that the association between the intervention and perceived stress was mediated by persuasion, such that mothers' who experienced more health-related persuasion exhibited significantly less post-intervention perceived stress (indirect effect = - 1.52, 95% CI = [- 3.12, - 0.39]). Pressure exerted by others, however, did not evidence a mediating mechanism for either mothers or daughters. CONCLUSION These findings buttress existing research suggesting that persuasion, or others' attempts to increase participants' healthy behaviors in an uncritical way, may be a driving force in reducing perceived stress levels.
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Affiliation(s)
| | - Anton M Palma
- Institute for Clinical and Translational Science, University of California, Irvine, Irvine, CA, 92697, USA
| | - Karen S Rook
- Department of Psychological Science, University of California, Irvine, Irvine, CA, 92697, USA
| | - Kelly A Biegler
- Department of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Katelyn C Davis
- Department of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Emily A Janio
- Department of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - David B Kilgore
- Department of Family Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Emily Dow
- Department of Family Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Quyen Ngo-Metzger
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, 91101, USA
| | - Dara H Sorkin
- Institute for Clinical and Translational Science, University of California, Irvine, Irvine, CA, 92697, USA.
- Department of Medicine, University of California, Irvine, Irvine, CA, 92697, USA.
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MOTA VECD, HAIKAL DS, MAGALHÃES TA, SILVA NSSE, SILVA RRV. Dissatisfaction with body image and associated factors in adult women. REV NUTR 2020. [DOI: 10.1590/1678-9865202033e190185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective To associate body image with sociodemographic profile, lifestyle, anthropometry and health conditions in adult women. Methods Prevalence study, conducted in a probabilistic cluster sample (n=35 Primary Education Schools) conducted in 2016 with 633 teachers. Sociodemographic characteristics were evaluated; morbidities, anthropometric variables; subjective health issues; lifestyle and self-reported morbidities. Results The prevalence of body image dissatisfaction was 48.7%. There was a greater chance of dissatisfaction among older women who have children, unsatisfactory lifestyle, are overweight, with poor health/poor self-perception of health, and the presence of depressive symptoms. Women who had a poor lifestyle had a four-fold greater chance of dissatisfaction with body appearance (Odds Ratio=4.193) than women who had a satisfactory lifestyle. Conclusion The results revealed that almost half of the adult women surveyed in this study reported dissatisfaction with their body image. This outcome indicates the need for interventions and program implementation related to body image dissatisfaction among women.
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Berger MB, Steinberg DM, Askew S, Gallis JA, Treadway CC, Egger JR, Kay MC, Batch BC, Finkelstein EA, DeVries A, Brewer A, Bennett GG. The Balance protocol: a pragmatic weight gain prevention randomized controlled trial for medically vulnerable patients within primary care. BMC Public Health 2019; 19:596. [PMID: 31101037 PMCID: PMC6525404 DOI: 10.1186/s12889-019-6926-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 04/30/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND For patients with obesity who are not ready for or experience barriers to weight loss, clinical practice guidelines recommend provider counseling on preventing further weight gain as a first-line treatment approach. Unfortunately, evidence-based weight gain prevention interventions are not routinely available within primary care. To address this gap, we will implement a pragmatic 12-month randomized controlled trial of a digital weight gain prevention intervention delivered to patients receiving primary care within a network of Federally Qualified Community Health Centers in central North Carolina. METHODS Balance (Equilibrio in Spanish) is a pragmatic effectiveness trial that will randomize adult patients who have overweight or obesity (BMI of 25-40 kg/m2) to either: 1) a weight gain prevention intervention with tailored behavior change goals and tracking, daily weighing on a network-connected electronic scale, and responsive weight and goal coaching delivered remotely by health center registered dietitians; or 2) a usual care program with automated healthy living text messages and print materials and routine primary care. The primary outcome will be weight gain prevention at 24-months, defined as ≤3% change in baseline weight. To align with its pragmatic design, trial outcome data will be pulled from the electronic health record of the community health center network. DISCUSSION For underserved, often rurally-located patients with obesity, digital approaches to promote a healthy lifestyle can curb further weight gain. Yet enrolling medically vulnerable patients into a weight gain prevention trial, many of whom are from racial/ethnic minorities, can be difficult. Despite these potential challenges, we plan to recruit a large, diverse sample from rural areas, and will implement a remotely-delivered weight gain prevention intervention to medically vulnerable patients. Upcoming trial results will demonstrate the effectiveness of this pragmatic approach to implement and evaluate a digital weight gain prevention intervention within primary care. TRIALS REGISTRATION NCT03003403 . Registered December 28, 2016.
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Affiliation(s)
- Miriam B Berger
- Duke Global Digital Health Science Center, Duke University, Campus Box 90086, Durham, NC, 27708-0086, USA.
| | - Dori M Steinberg
- Duke Global Digital Health Science Center, Duke University, Campus Box 90086, Durham, NC, 27708-0086, USA.,Duke University School of Nursing, 307 Trent Drive, Pearson Room 2055, DUMC 3322, Durham, NC, 27708, USA
| | - Sandy Askew
- Duke Global Digital Health Science Center, Duke University, Campus Box 90086, Durham, NC, 27708-0086, USA
| | - John A Gallis
- Duke Global Health Institute, Duke University, Trent Drive, Room 236, Durham, NC, 27708, USA
| | - Cayla C Treadway
- Duke Global Digital Health Science Center, Duke University, Campus Box 90086, Durham, NC, 27708-0086, USA
| | - Joseph R Egger
- Duke Global Health Institute, Duke University, Trent Drive, Room 236, Durham, NC, 27708, USA
| | - Melissa C Kay
- Duke Global Digital Health Science Center, Duke University, Campus Box 90086, Durham, NC, 27708-0086, USA
| | - Bryan C Batch
- Duke University Medical Center, DUMC 3031, Durham, NC, 27710, USA
| | - Eric A Finkelstein
- National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Abigail DeVries
- Piedmont Health Services, Inc., 127 Kingston Drive, Chapel Hill, NC, 27514, USA
| | - Ashley Brewer
- Piedmont Health Services, Inc., 127 Kingston Drive, Chapel Hill, NC, 27514, USA
| | - Gary G Bennett
- Duke Global Digital Health Science Center, Duke University, Campus Box 90086, Durham, NC, 27708-0086, USA.,Duke University, Department of Psychology and Neuroscience, Campus Box 90086, Durham, NC, 27708, USA
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Sorkin DH, Rook KS, Campos B, Marquez B, Solares J, Mukamel DB, Marcus B, Kilgore D, Dow E, Ngo-Metzger Q, Nguyen DV, Biegler K. Rationale and study protocol for Unidas por la Vida (United for Life): A dyadic weight-loss intervention for high-risk Latina mothers and their adult daughters. Contemp Clin Trials 2018; 69:10-20. [PMID: 29597006 PMCID: PMC5964027 DOI: 10.1016/j.cct.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/18/2018] [Accepted: 03/20/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Half of Mexican-American women are under-active and nearly 78% are overweight/obese. The high lifetime risk of developing type 2 diabetes necessitates a culturally appropriate lifestyle intervention. PURPOSE Unidas por la Vida is a novel dyadic intervention that capitalizes on the centrality of family in Latino culture to mobilize an existing family dyad as a resource for health behavior change. The intervention aims to improve health behaviors and promote weight loss in two at-risk members of the same family: mothers with type 2 diabetes and their overweight/obese adult daughters who are at risk for developing diabetes. METHODS Participants (N = 460 mother-adult daughter dyads) will be randomized into one of three conditions: 1) dyadic participation (mothers-daughters) in a lifestyle intervention; 2) individual participation (mothers alone; unrelated daughters alone) in a lifestyle intervention; and 3) mother-daughter dyads in a minimal intervention control group. RESULTS The primary outcome is weight loss. Secondary outcomes include physical activity, dietary intake, physiological measures (e.g. HbA1c), and body composition. Both the dyadic and individual interventions are expected to produce greater weight loss at 6, 12, and 18 months than those in minimal intervention control group, with women assigned to the dyadic intervention expected to lose more weight and to maintain the weight loss longer than women assigned to the individual intervention. CONCLUSION Because health risks are often shared by multiple members of at-risk families, culturally appropriate, dyadic interventions have the potential to increase the success of behavior change efforts and to extend their reach to multiple family members. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02741037.
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Affiliation(s)
- Dara H Sorkin
- Department of Medicine, University of California, Irvine, Irvine, CA, USA.
| | - Karen S Rook
- Department of Psychology and Social Behavior, University of California Irvine, Irvine, CA, USA
| | - Belinda Campos
- Department of Chicano/Latino Studies, University of California Irvine, Irvine, CA, USA
| | - Becky Marquez
- School of Public Health, Brown University, Providence, RI, USA
| | | | - Dana B Mukamel
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Bess Marcus
- School of Public Health, Brown University, Providence, RI, USA
| | - David Kilgore
- Department of Family Medicine, University of California Irvine, Irvine, CA, USA
| | - Emily Dow
- Department of Family Medicine, University of California Irvine, Irvine, CA, USA
| | - Quyen Ngo-Metzger
- Department of Medicine, University of California, Irvine, Irvine, CA, USA; US Preventive Services Task Force, Agency for Healthcare Research and Quality, Rockville, MD, USA
| | - Danh V Nguyen
- Department of Medicine, University of California, Irvine, Irvine, CA, USA; Biostatistics, Epidemiology and Research Design, University of California Irvine, Irvine, CA, USA
| | - Kelly Biegler
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
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Marquez B, Murillo R. Racial/Ethnic Differences in Weight-Loss Strategies among US Adults: National Health and Nutrition Examination Survey 2007-2012. J Acad Nutr Diet 2017; 117:923-928. [PMID: 28330732 DOI: 10.1016/j.jand.2017.01.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/24/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dieting, exercising, and seeking professional help have been associated with intentional weight loss among adults. OBJECTIVE This study examined the use of diet (eg, ate less, ate less fat, or switched to low-calorie foods), exercise, diet and exercise, and professional help (eg, weight-loss program or prescribed diet pills) for weight loss among non-Hispanic whites, Mexican Americans, and non-Hispanic blacks. DESIGN Cross-sectional data from the 2007-2012 National Health and Nutrition Examination Survey were used. PARTICIPANTS Males and females (n=9,046) aged 20 to 65 years were included. MAIN OUTCOME MEASURE The weight history questionnaire assessed weight-loss attempts and use of weight-loss strategies in the past year. STATISTICAL ANALYSES PERFORMED Multivariate logistic regression models were used to estimate associations of race/ethnicity with strategies to lose weight. Models controlled for age, sex, education, and body mass index. In fully adjusted models, interactions of race/ethnicity by sex were tested. RESULTS Lower proportions of Mexican Americans (35%) and non-Hispanic blacks (35%) than non-Hispanic whites (39%) reported trying to lose weight. Among those who tried to lose weight, non-Hispanic blacks were less likely than non-Hispanic whites to use diet (odds ratio [OR] 0.78, 95% CI 0.67 to 0.90) or exercise (OR 0.83, 95% CI 0.70 to 0.99) for weight loss. Mexican Americans (OR 0.71, 95% CI 0.53 to 0.95) and non-Hispanic blacks (OR 0.71, 95% CI 0.52 to 0.95) were also less likely than non-Hispanic whites to use professional help for weight loss. The relationships between race/ethnicity and weight-loss strategy were stronger for females than males. CONCLUSIONS Targeted efforts are needed to address racial/ethnic disparities in weight-loss attempts and use of recommended strategies especially among females.
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Ford ME, Magwood G, Brown ET, Cannady K, Gregoski M, Knight KD, Peterson LL, Kramer R, Evans-Knowell A, Turner DP. Disparities in Obesity, Physical Activity Rates, and Breast Cancer Survival. Adv Cancer Res 2016; 133:23-50. [PMID: 28052820 PMCID: PMC6598680 DOI: 10.1016/bs.acr.2016.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The significantly higher breast cancer (BCa) mortality rates of African-American (AA) women compared to non-Hispanic (NHW) white women constitute a major US health disparity. Investigations have primarily focused on biological differences in tumors to explain more aggressive forms of BCa in AA women. The biology of tumors cannot be modified, yet lifestyle changes can mitigate their progression and recurrence. AA communities have higher percentages of obesity than NHWs and exhibit inefficient access to care, low socioeconomic status, and reduced education levels. Such factors are associated with limited healthy food options and sedentary activity. AA women have the highest prevalence of obesity than any other racial/ethnic/gender group in the United States. The social ecological model (SEM) is a conceptual framework on which interventions could be developed to reduce obesity. The SEM includes intrapersonal factors, interpersonal factors, organizational relationships, and community/institutional policies that are more effective in behavior modification than isolation from the participants' environmental context. Implementation of SEM-based interventions in AA communities could positively modify lifestyle behaviors, which could also serve as a powerful tool in reducing risk of BCa, BCa progression, and BCa recurrence in populations of AA women.
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Affiliation(s)
- M E Ford
- Medical University of South Carolina, Charleston, SC, United States; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States.
| | - G Magwood
- Medical University of South Carolina, Charleston, SC, United States
| | - E T Brown
- Morehouse School of Medicine, Atlanta, GA, United States
| | - K Cannady
- Medical University of South Carolina, Charleston, SC, United States; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
| | - M Gregoski
- Campbell University, Buies Creek, NC, United States
| | - K D Knight
- Medical University of South Carolina, Charleston, SC, United States; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
| | - L L Peterson
- Washington University School of Medicine, St. Louis, MO, United States
| | - R Kramer
- Medical University of South Carolina, Charleston, SC, United States
| | - A Evans-Knowell
- South Carolina State University, Orangeburg, SC, United States
| | - D P Turner
- Medical University of South Carolina, Charleston, SC, United States; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
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Burkert NT, Rásky É, Großschädl F, Muckenhuber J, Freidl W. The relation of weight to women's health: a matched sample study from Austria. Women Health 2015; 55:134-51. [PMID: 25679266 DOI: 10.1080/03630242.2014.979967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
While being underweight, overweight, or obese has been associated with higher rates of morbidity and mortality, such relations have not been studied in Austrian women. Therefore, the aim of this study was to analyze differences in health, health behaviors, and quality of life among women of various weight status categories, using data from the Austrian Health Interview (AT-HIS) 2006/07. First, women between 20 and 60 years of age, from four different weight status groups (underweight, normal weight, overweight, and obese) were matched case to case on age and socioeconomic status. After matching, the total number of women included in the analyses was 516 (N = 129 per). Differences in health status among women in different weight status categories were calculated using multiple conditional logistic regression analyses. Compared to females in the other three groups, women with normal weight had the best state of health: they had better self-reported health, suffered from fewer chronic conditions (e.g., sacrospinal complaints or migraines), and needed medical treatment less often. Moreover, they had better self-reported quality of life. In contrast, women who were underweight or obese showed worse health than women of normal weight. Appropriate health programs for weight risk groups are needed.
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Affiliation(s)
- Nathalie T Burkert
- a Institute of Social Medicine and Epidemiology , Medical University Graz , Graz , Austria
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Feasibility of enlisting social network members to promote weight loss among Latinas. J Acad Nutr Diet 2013; 113:680-7. [PMID: 23498969 PMCID: PMC10005842 DOI: 10.1016/j.jand.2013.01.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 01/14/2013] [Indexed: 10/27/2022]
Abstract
Shaping network members into sources of support for healthy eating and exercise behaviors may be an effective strategy to enhance obesity treatment outcomes. This pilot study examined the feasibility and preliminary efficacy of a behavioral weight loss intervention adapted for Latinas with a social network component. Twenty-seven Latinas (43.0±10.2 years and body mass index 36.9±5.7) participated in a 24-week randomized controlled intervention study. Participants attended group-based treatment either individually (Individual Lifestyle Group [ILG]) or with a weight loss partner selected from their existing network (Partner Lifestyle Group [PLG]). Repeated measures analysis of variance was conducted to compare ILG and PLG participants on changes in weight or psychosocial variables. Participants in both intervention groups attended 70% of treatment sessions; 96% and 100% completed assessment at post-treatment (12 weeks) and follow-up (24 weeks), respectively. Significant weight loss (P<0.01) was achieved at post-treatment (ILG -4.7±4.2 kg and PLG -4.3±4.4 kg) and follow-up (ILG -5.0±6.4 kg and PLG -4.7±5.0 kg), with nearly 50% of participants losing at least 5% of initial body weight. Both groups also experienced increased self-efficacy for weight loss (P<0.01), self-efficacy for exercise (P=0.02), and family social support for exercise habits (P=0.01). There were no significant differences between groups. Results from this study suggest a behavioral weight loss intervention for Latinas is feasible, but there is less support for the efficacy of weight loss partners.
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Brooten D, Youngblut JM, Golembeski S, Magnus MH, Hannan J. Perceived weight gain, risk, and nutrition in pregnancy in five racial groups. ACTA ACUST UNITED AC 2012; 24:32-42. [PMID: 22243679 DOI: 10.1111/j.1745-7599.2011.00678.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Examine perceived pregnancy weight gain needed, perceived risks to mother, and infant of excessive weight and underweight, perceptions of actual, ideal, realistic body size, nutritional intake in five racial/ethnic groups. DESIGN Cross-sectional Setting: Physicians' offices Participants: A total of 54 women <20 weeks gestation. METHODS Questionnaires-perceived weight gain needed, risks of weight gain for mother, infant, perceptions of body size, food frequency. RESULTS A total of 39% of women are overweight or obese (57% Caribbean Black, 50% African American). Perceived pregnancy weight gain needed highest in Central American Hispanic women, lowest Caribbean Black women. African-American women had low perceived risk for mother and infant of gaining too much pregnancy weight, highest perceived risk for both of gaining too little. Caribbean Black women perceived highest risk to mother of gaining too much pregnancy weight, highest risk to infant of gaining too little. White Non-Hispanic women reported smaller prepregnant, ideal, realistic body sizes than other four groups. Daily caloric intake ranged from 599 to 5856 calories. African-American women had significantly more calories; protein, total fats, monounsaturated, polyunsaturated, and saturated fats; carbohydrates, sugar; and iron than White Non-Hispanic women. Women in each racial/ethnic group had less than recommended intake of protein, carbohydrates, calcium, iron, folate, and fiber. CONCLUSIONS Education is needed to raise awareness of risks of prepregnancy weight and excessive weight gain for mother and infant. The need for prenatal nutritional counseling to reduce the intake of calories, fats, sweets, and snacks; increase intake of vegetables, fruits, foods with iron, folate, and fiber.
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Affiliation(s)
- Dorothy Brooten
- Florida International University, Miami, Florida Center for Research & Grants, Baptist Health South Florida, Miami, Florida.
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Powell-Wiley TM, Ayers CR, Banks-Richard K, Berry JD, Khera A, Lakoski SG, McGuire DK, de Lemos JA, Das SR. Disparities in counseling for lifestyle modification among obese adults: insights from the Dallas Heart Study. Obesity (Silver Spring) 2012; 20:849-55. [PMID: 21818156 PMCID: PMC3514073 DOI: 10.1038/oby.2011.242] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Clinician counseling is a catalyst for lifestyle modification in obesity. Unfortunately, clinicians do not appropriately counsel all obese patients about lifestyle modification. The extent of disparities in clinician counseling is not well understood. Obese participants (BMI ≥30 kg/m(2), N = 2097) in the Dallas Heart Study (DHS), a probability-based sample of Dallas County residents ages 18-65, were surveyed regarding health-care utilization and lifestyle counseling over the year prior to DHS enrollment. Health-care utilization and counseling were compared between obese participants across three categories based on the presence of 0, 1, or 2+ of the following cardiovascular (CV) risk factors: hypertension, hypercholesterolemia, or diabetes. Logistic regression modeling was used to determine likelihood of counseling in those with 0 vs. 1+ CV risk factors, stratified by race, adjusting for age, sex, insurance status, and education. Among obese subjects who sought medical care, those with 0 CV risk factors, compared to those with 1 or 2+ CV risk factors, were less likely to report counseling about losing weight (41% vs. 67% vs. 87%, P trend <0.001), dietary changes (44% vs. 71% vs. 85%, P trend <0.001), and physical activity (46% vs. 71% vs. 86%, P trend <0.001). Blacks and Hispanics without CV risk factors had a lower odds of receiving counseling than whites without risk factors on weight loss (adjusted odds ratio (OR), 95% confidence interval (CI) for nonwhites 0.19, [0.13-0.28], whites 0.48, [0.26-0.87]); dietary changes (nonwhites 0.19, [0.13-0.27], whites 0.37, [0.21-0.64]); and physical activity (nonwhites 0.22, [0.16-0.32], whites 0.32, [0.18-0.57]). Lifestyle counseling rates by clinicians are suboptimal among obese patients without CV risk factors, especially blacks and Hispanics. Systematic education about and application of lifestyle interventions could capitalize on opportunities for primary CV risk prevention.
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Affiliation(s)
| | - Colby R. Ayers
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kamakki Banks-Richard
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jarett D. Berry
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Amit Khera
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Susan G. Lakoski
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Darren K. McGuire
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - James A. de Lemos
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sandeep R. Das
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Jang SY, Kim JH, Lim MK, Kim HJ, Jee SH, NamKoong K, Cho WH, Park EC, Lee SG. Relationship Between BMI, Body image, and Smoking in Korean Women as Determined by Urine Cotinine: Results of a Nationwide Survey. Asian Pac J Cancer Prev 2012; 13:1003-10. [DOI: 10.7314/apjcp.2012.13.3.1003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Shoneye C, Johnson F, Steptoe A, Wardle J. A qualitative analysis of black and white British women's attitudes to weight and weight control. J Hum Nutr Diet 2011; 24:536-42. [PMID: 21838745 DOI: 10.1111/j.1365-277x.2011.01198.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rates of obesity among black African and black Caribbean women in the UK are consistently higher than among white women. Cultural, attitudinal and behavioural differences may contribute to ethnic variation in weight, and the present study aimed to explore attitudes towards weight and weight control among black and white British women using a qualitative approach. METHODS Ethnically homogeneous focus groups were carried out with 25 white women [mean (SD) body mass index (BMI, kg m(-2)) = 26 (7.2) kg m(-2) ] and 24 black women [mean (SD) BMI = 29 (6.6) kg m(-2) ]. Women were recruited from London boroughs (Lambeth, Southwark and Croydon) and Guildford, Surrey, and focus groups were conducted in London. Focus groups were recorded and transcribed verbatim, and were analysed using thematic analysis. RESULTS All participants had fairly good knowledge of the causes, consequences and treatment of being overweight. However, black women primarily emphasised the health consequences of being overweight, whereas white women were more likely to focus on the perceived social and emotional consequences. White women associated being overweight with negative character traits, whereas black women had a broadly positive attitude towards larger body sizes. CONCLUSIONS Black women were as well-informed about the causes and health risks of obesity as white women in this sample of mainly educated, working women, although they were more accepting of larger body sizes and experienced less social pressure to be slim.
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Affiliation(s)
- C Shoneye
- Epidemiology and Public Health, University College, London, UK
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Cox TL, Ard JD, Beasley TM, Fernandez JR, Howard VJ, Affuso O. Body image as a mediator of the relationship between body mass index and weight-related quality of life in black women. J Womens Health (Larchmt) 2011; 20:1573-8. [PMID: 21815779 DOI: 10.1089/jwh.2010.2637] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Body image (BI) may be important in understanding weight-related attitudes and behaviors in black women. Specifically, body dissatisfaction may mediate the relationship between body mass index (BMI) and weight-related quality of life (QOL) in black women. We examined the relationship between BMI and weight-related QOL in black women and tested for mediation by body dissatisfaction. METHODS The sample included 149 black women recruited from Birmingham, Alabama, for a one-time clinic visit. BIs were self-reported using the Pulvers figure rating scale. Body discrepancy (BD), a surrogate measure of body dissatisfaction, was calculated as perceived current image minus ideal image. QOL was self-reported using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite). Baron and Kenny's test for mediation was conducted where BMI was the predictor, IWQOL-Lite score was the outcome, and BD was the mediator under investigation. RESULTS Mean age was 40.5 years, and mean BMI was 36.1 kg/m(2). The mean IWQOL-Lite score was 81.1±15.8 out of 100. Participants had a BD score of 2.3, indicating a desire to be two figure sizes smaller than their current perceived body size. Tests for mediation revealed that BD partially mediated the relationship between BMI and IWQOL-Lite scores in this sample. CONCLUSIONS BD was in the pathway of the association between BMI and IWQOL-Lite scores. BI dissatisfaction may contribute to explaining more about black women's weight-related QOL beyond actual BMI alone. Additional research is needed to better understand black women's perception of weight and subsequent weight-related behaviors.
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Affiliation(s)
- Tiffany L Cox
- Department of Health Education and Health Behavior, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
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Linder J, McLaren L, Siou GL, Csizmadi I, Robson PJ. The epidemiology of weight perception: perceived versus self-reported actual weight status among Albertan adults. Canadian Journal of Public Health 2011. [PMID: 20364540 DOI: 10.1007/bf03405563] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND To understand, prevent, and manage weight-related health issues, researchers and clinicians rely on the ability to identify those at risk. Prevention and management strategies may also rely on accurate self-perception of weight and body composition in the general population. METHODS We analyzed data from The Tomorrow Project (n = 7,436), a prospective cohort study enrolling adults aged 35-69 years, in Alberta, Canada. Weight perception accuracy was defined based on body mass index (BMI), waist circumference (WC), and a combined (BMI and WC) risk profile. RESULTS The majority of participants correctly perceived themselves as overweight. Women were more accurate than men in identifying themselves as overweight. In terms of inaccuracy, more normal-weight women than men perceived themselves to be overweight, while more overweight men than women perceived themselves as about the right weight. When using the combined risk profile, all men with normal weight (BMI) but higher risk WC perceived their weight as about right whereas just under half of men who were overweight (BMI) but lower risk WC perceived their weight as about right. For women, a much higher proportion recognized their weight status as overweight when only BMI was elevated compared to when only WC indicated higher risk. DISCUSSION Adults in our sample showed reasonable accuracy in weight perception. Gender differences reveal that women were more accurate than men in identifying themselves as overweight. Incongruence between weight status indicators was noted, indicating the importance of using both BMI and waist circumference as health status measures.
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Affiliation(s)
- Jordana Linder
- Department of Community Health Sciences, University of Calgary, Calgary, AB.
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Raynor KJ, Modeste N, Marshak HH, Santos HD. Gender Differences in Perceptions of Weight and Body Image and Comparison to Recommended Weight among Adult Bermudians. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2010; 30:153-69. [DOI: 10.2190/iq.30.2.e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of this study was to determine adult Bermudians' perceptions of ideal weight, overweight, and body image and to decide if a discrepancy exists between their perceptions and World Health Organization standards. A cross-sectional survey of body weight perceptions was administered to 462 men ( n = 207) and women ( n = 255), 18–65 years of age and various body weights, living on the Island of Bermuda. Additionally, measurement of height, and weight was collected. There was a significant difference in mean current body mass index (BMI) between men ( M = 28.6, SD = 5.82), and women ( M = 30.1, SD = 6.80) ( p < .05). Significant gender differences were evident in mean self-perceived BMI, ideal BMI, and perceived body image. The data presented have important implications for understanding perceptions, knowledge, and beliefs concerning body weight and body image. Public health programs must stress to adults the correct definition of overweight and obesity acceptable by medical standards.
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Abstract
SummaryThe objective of the present analysis was to study the associations between body weight psychosocial correlates and body mass index (BMI) among four groups of adults in the Quebec population. Data were taken from the Social Lifestyles and Health 1998 Survey performed by the Institut de la Statistique du Québec (ISQ). The suggested guidelines of the ISQ were used to estimate the population's proportions and for statistical analysis. The groups studied were 25- to 44- and the 45- to 64-year-old men and women. In all groups, currently trying to lose weight increased the odds of reporting an excess weight. Better perceived eating habits was associated with lower BMI in most groups except in the 25- to 44-year-old women, where the trend was not significant. Higher number of physical activities related to transport and cigarette smoking were associated with lower BMI in both men groups. In both women groups, more frequent consumption of alcoholic beverages decreased significantly the odds of reporting excess body weight. A university degree was associated with a lower BMI only in the 25- to 44-year-old men. Regular practise of leisure time physical activity was associated with a lower BMI only in 45- to 64-year-old women. Opposite associations were observed between perceived health and BMI. In the 45- to 64-year-old men, better perceived health increased the odds of reporting an excess weight. Conversely, the odds of reporting excess weight decreased with better health in 25- to 44-year-old women. Many correlates differ between age group and sex. The identification of these factors illustrates the need to adapt obesity-related programmes toward specific sub-groups within the general population.
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Tribess S, Virtuoso Junior JS, Petroski EL. [Nutritional status and perceived body image of elderly women in the Northeast of Brazil]. CIENCIA & SAUDE COLETIVA 2010; 15:31-8. [PMID: 20169229 DOI: 10.1590/s1413-81232010000100008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Accepted: 05/08/2008] [Indexed: 11/22/2022] Open
Abstract
This paper aims to investigate the association between perceived body image and nutritional status in elderly women. The methodology used was a cross-sectional cohort study of a sample of 265 elderly women aged 60 to 96 and selected by randomized proportional stratification by groups of convenience in the town of Jequié, Bahia, Brazil. Each subject was interviewed in order to obtain information on sociodemographic characteristics (age, marital status, educational level and economic class) and perceived body image (on a nine-silhouette scale) and their body mass and height were measured in order to calculate their Body Mass Index as a parameter of nutritional status. Data analysis employed descriptive statistics, measures of association and non-parametric analysis. A total of 43.8% of the elderly women interviewed were well-nourished, 3.4% were underweight and 52.8% were overweight. With reference to perceived body image, 54% of the women were unsatisfied, primarily due to excess body mass (35.1%), and this was associated with nutritional status, in that increases in BMI raised the percentage of unsatisfied women. The elderly from Bahia were unsatisfied with their body images, and this dissatisfaction was associated with the prevalence of obesity.
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Affiliation(s)
- Sheila Tribess
- Departamento de Educação Física, Universidade Federal do Triângulo Mineiro, Uberaba, MG.
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Carter-Edwards L, Bastian LA, Revels J, Durham H, Lokhnygina Y, Amamoo MA, Ostbye T. Body image and body satisfaction differ by race in overweight postpartum mothers. J Womens Health (Larchmt) 2010; 19:305-11. [PMID: 20113143 PMCID: PMC2834437 DOI: 10.1089/jwh.2008.1238] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Body image (BI) and body satisfaction may be important in understanding weight loss behaviors, particularly during the postpartum period. We assessed these constructs among African American and white overweight postpartum women. METHODS The sample included 162 women (73 African American and 89 white) in the intervention arm 6 months into the Active Mothers Postpartum (AMP) Study, a nutritional and physical activity weight loss intervention. BIs, self-reported using the Stunkard figure rating scale, were compared assessing mean values by race. Body satisfaction was measured using body discrepancy (BD), calculated as perceived current image minus ideal image (BD<0: desire to be heavier; BD>0: desire to be lighter). BD was assessed by race for: BD(Ideal) (current image minus the ideal image) and BD(Ideal Mother) (current image minus ideal mother image). RESULTS Compared with white women, African American women were younger and were less likely to report being married, having any college education, or residing in households with annual incomes >$30,000 (all p < 0.01). They also had a higher mean body mass index (BMI) (p = 0.04), although perceived current BI did not differ by race (p = 0.21). African Americans had higher mean ideal (p = 0.07) and ideal mother (p = 0.001) BIs compared with whites. African Americans' mean BDs (adjusting for age, BMI, education, income, marital status, and interaction terms) were significantly lower than those of whites, indicating greater body satisfaction among African Americans (BD(Ideal): 1.7 vs. 2.3, p = 0.005; BD(Ideal Mother): 1.1 vs. 1.8, p = 0.0002). CONCLUSIONS Racial differences exist in postpartum weight, ideal images, and body satisfaction. Healthcare providers should consider tailored messaging that accounts for these racially different perceptions and factors when designing weight loss programs for overweight mothers.
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Affiliation(s)
- Lori Carter-Edwards
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
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Cullen KW, Buzek BB. Knowledge about type 2 diabetes risk and prevention of African-American and Hispanic adults and adolescents with family history of type 2 diabetes. DIABETES EDUCATOR 2009; 35:836-42. [PMID: 19696204 DOI: 10.1177/0145721709341851] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to assess type 2 diabetes knowledge, perceptions, risk factor awareness, and prevention practices among African American and Hispanic families with a history of diabetes. METHODS Ninth and tenth grade Houston area students who had a parent who spoke English or Spanish and had a family history of type 2 diabetes were recruited. Student interviews took place during lunch. Parents were interviewed via telephone. Open-ended questions in the interview guide assessed knowledge of diabetes and risk factors, diabetes prevention practices, and perceived risk. Students reported dietary behaviors. Responses were recorded. RESULTS Interviews were conducted with 39 parents (95% female, 49% African-American, 51% Hispanic) and 21 ninth and tenth grade adolescents (71% female, 43% African-American, 57% Hispanic). The majority were overweight. Approximately one-half of both groups reported some knowledge of diabetes. The majority (74%) of parents correctly identified family history as a risk factor, but few adolescents responded correctly. Being overweight was identified as a risk factor by 26% of the parents and 10% of the adolescents. Losing weight was not acknowledged as a way to reduce diabetes risk. Sweetened beverage consumption consisted of 2 cans/day and 43% reported to have skipped breakfast. CONCLUSIONS Overall, there was a lack of knowledge about risk and prevention of type 2 diabetes among African American and Hispanic families at risk. From a public health perspective, there is a critical need for innovative prevention programs targeting families at risk for diabetes.
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Affiliation(s)
| | - Bonnie B Buzek
- Baylor College of Medicine, Department of Pediatrics, Houston, Texas
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Durant NH, Bartman B, Person SD, Collins F, Austin SB. Patient provider communication about the health effects of obesity. PATIENT EDUCATION AND COUNSELING 2009; 75:53-57. [PMID: 19038523 DOI: 10.1016/j.pec.2008.09.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Revised: 09/11/2008] [Accepted: 09/17/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVE We assessed the influence of race/ethnicity and provider communication on overweight and obese patients' perceptions of the damage weight causes to their health. METHODS The study included 1071 overweight and obese patients who completed the 2002 Community Health Center (CHC) User survey. We used logistic regression analyses to examine determinants of patients' perceptions of the impact of their weight on their health. Models were adjusted for covariates and weighting was used to account for the sampling design. RESULTS Forty-one percent of respondents were overweight and 59% were obese. Non-Hispanic Blacks and Hispanics were half as likely as non-Hispanic Whites to believe weight was damaging to their health while controlling for covariates. Overweight/obese CHC patients who were told they were overweight by healthcare providers were almost nine times more likely to perceive that weight was damaging to their health compared to those not told. CONCLUSIONS We observed large racial/ethnic disparities in the perception that overweight is unhealthy but provider communication may be a powerful tool for helping patients understand that overweight is damaging to health. PRACTICE IMPLICATIONS Given obesity is a national epidemic, further attention to the role of patient provider communication in illness is essential with important implications for both health professional training and health care provision.
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Affiliation(s)
- Nefertiti H Durant
- Division of General Pediatrics and Adolescent Medicine, Department of Medicine, MTC 201, 1600 7th Avenue South, Birmingham, AL 35233, United States.
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Records K, Keller C, Ainsworth B, Permana PA. Overweight and obesity in postpartum Hispanic women. Health Care Women Int 2008; 29:649-67. [PMID: 18569049 DOI: 10.1080/07399330802089214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Overweight and obesity vary in prevalence among particular groups, and are especially problematic for childbearing Hispanic women. The complex interaction between physical changes associated with pregnancy, role changes accompanying birth, and family and cultural values related to childbearing are superimposed upon the underlying mechanisms that create or perpetuate obesity. In this article we review biological and behavioral research on obesity in postpartum Hispanic women to identify critical components for intervention studies focused on weight management. Recommendations are offered for health care providers and researchers.
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Affiliation(s)
- Kathie Records
- Arizona State University College of Nursing and Healthcare Innovation, Phoenix, Arizona, USA.
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22
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Keller C, Records K, Ainsworth B, Permana P, Coonrod DV. Interventions for Weight Management in Postpartum Women. J Obstet Gynecol Neonatal Nurs 2008; 37:71-9. [DOI: 10.1111/j.1552-6909.2007.00202.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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23
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Hemingway A. Determinants of coronary heart disease risk for women on a low income: literature review. J Adv Nurs 2007; 60:359-67. [DOI: 10.1111/j.1365-2648.2007.04418.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Inoue M, Toyokawa S, Miyoshi Y, Miyano Y, Suzuki T, Suyama Y, Inoue K, Kobayashi Y. Degree of Agreement between Weight Perception and Body Mass Index of Japanese Workers: MY Health Up Study. J Occup Health 2007; 49:376-81. [DOI: 10.1539/joh.49.376] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Mariko Inoue
- Department of Public HealthGraduate School of Medicine, University of TokyoJapan
| | - Satoshi Toyokawa
- Department of Public HealthGraduate School of Medicine, University of TokyoJapan
| | - Yuji Miyoshi
- Division of Health PromotionMeiji Yasuda Life Insurance CompanyJapan
| | - Yukie Miyano
- Division of Health PromotionMeiji Yasuda Life Insurance CompanyJapan
| | - Toshiko Suzuki
- Division of Health PromotionMeiji Yasuda Life Insurance CompanyJapan
| | - Yasuo Suyama
- Meiji Yasuda Life Foundation of Health and WelfareJapan
| | - Kazuo Inoue
- Department of Public HealthGraduate School of Medicine, University of TokyoJapan
| | - Yasuki Kobayashi
- Department of Public HealthGraduate School of Medicine, University of TokyoJapan
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Madan AK, Whitfield JD, Fain JN, Beech BM, Ternovits CA, Menachery S, Tichansky DS. Are African-Americans as successful as Caucasians after laparoscopic gastric bypass? Obes Surg 2007; 17:460-4. [PMID: 17608257 DOI: 10.1007/s11695-007-9083-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been demonstrated to provide weight loss comparable to open gastric bypass. It has been suggested that African-Americans (AA) are not as successful as Caucasians (CA) after bariatric surgery. Our hypothesis was that AAs are just as successful as CA after LRYGBP in terms of weight loss and comorbidity improvement. METHODS A retrospective chart review was performed on all AA and CA patients who underwent LRYGBP for a 6-month period. Success after LRYGBP [defined as (1) 25% loss of preoperative weight, (2) 50% excess weight loss (EWL), or (3) weight loss to within 50% ideal weight] was compared by ethnicity. RESULTS 102 patients were included in this study. 97 patients (30 AA patients and 67 CA patients) had at least 1-year follow-up data available. Preoperative data did not differ between both groups. There was a statistically significant difference in %EWL between AA and CA (66% vs 74%; P<0.05). However, there was no ethnic difference in the percentage of patients with successful weight loss (as defined by any of the above 3 criteria). Furthermore, there was no statistical difference between the percentages of AA and CA patients who had improved or resolved diabetes and hypertension. CONCLUSIONS LRYGBP offers good weight loss in all patients. While there may be greater %EWL in CA patients, no ethnic difference in successful weight loss exists. More importantly, co-morbidities improve or resolve equally between AA and CA patients. LRYGBP should be considered successful in AA patients.
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Affiliation(s)
- Atul K Madan
- Section of Minimally Invasive Surgery, Department of Surgery, University of Tennessee Health Science Center, 956 Court Ave., Room G210, Memphis, TN 38163, USA.
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26
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Saarni SE, Silventoinen K, Rissanen A, Sarlio-Lähteenkorva S, Kaprio J. Recurrent dieting and smoking among Finnish men and women. Obesity (Silver Spring) 2007; 15:1851-9. [PMID: 17636104 DOI: 10.1038/oby.2007.219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To examine the association of smoking with recurrent dieting and BMI among Finnish adults. RESEARCH METHODS AND PROCEDURES We used questionnaire data from 1990 on 11,055 subjects from the Finnish Twin Cohort who were 33 to 61 years of age. Multinomial logistic regression analysis was carried out using lifetime dieting as the outcome variable and smoking as the main explanatory variable, adjusted for BMI and age. Twin pairs discordant for dieting and smoking were studied to examine the effect of environmental and genetic factors. RESULTS Among women, current smokers [odds ratio (OR), 1.09 to 1.41 at different ages] and former smokers (OR, 1.52 to 2.82) were more likely to have dieted recurrently than never smokers. Among men, current smokers were less likely (OR, 0.69; 95% confidence interval, 0.55, 0.87) and former smokers were more likely (OR, 1.30; 95% confidence interval, 1.05, 1.61) to have dieted recurrently at different ages. The differences between the discordant pairs were consistent with this, although not statistically significant. DISCUSSION Recurrent dieting was associated with former smoking in both sexes and with current smoking in women.
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Affiliation(s)
- Suoma E Saarni
- Department of Public Health, PO Box 41, University of Helsinki, and Department of Psychiatry, Helsinki University Hospital, Finland.
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Barnes AS, Goodrick GK, Pavlik V, Markesino J, Laws DY, Taylor WC. Weight loss maintenance in African-American women: focus group results and questionnaire development. J Gen Intern Med 2007; 22:915-22. [PMID: 17415617 PMCID: PMC2219715 DOI: 10.1007/s11606-007-0195-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Revised: 12/27/2006] [Accepted: 02/09/2007] [Indexed: 01/22/2023]
Abstract
BACKGROUND African-American women are disproportionately affected by obesity. Weight loss can occur, but maintenance is rare. Little is known about weight loss maintenance in African-American women. OBJECTIVES (1) To increase understanding of weight loss maintenance in African-American women; (2) to use the elicitation procedure from the theory of planned behavior (TPB) to define the constructs of attitude, subjective norms, and perceived behavioral control regarding weight loss and maintenance; and (3) to help develop a relevant questionnaire that can be used to explore weight loss and maintenance in a large sample of African Americans. DESIGN Seven focus groups were conducted with African-American women: four with women successful at weight loss maintenance, three with women who lost weight but regained it. Discussions centered on weight loss and maintenance experiences. PARTICIPANTS Thirty-seven African-American women. APPROACH Content analysis of focus group transcripts. RESULTS Weight loss maintainers lost 22% of body weight. They view positive support from others and active opposition to cultural norms as critical for maintenance. They struggle with weight regain, but have strategies in place to lose weight again. Some maintainers struggle with being perceived as sick or too thin at their new weight. Regainers and maintainers struggle with hairstyle management during exercise. The theoretical constructs from TPB were defined and supported by focus group content. CONCLUSIONS A weight loss questionnaire for African Americans should include questions regarding social support in weight maintenance, the importance of hair management during exercise, the influence of cultural norms on weight and food consumption, and concerns about being perceived as too thin or sick when weight is lost.
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Affiliation(s)
- Ann Smith Barnes
- Department of General Internal Medicine, Baylor College of Medicine, 1504 Taub Loop, Houston, TX 77030, USA.
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Pawlińska-Chmara R, Wronka I, Suliga E, Broczek K. Socio-economic factors and prevalence of underweight and overweight among female students in Poland. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2007; 58:309-18. [PMID: 17574555 DOI: 10.1016/j.jchb.2006.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2005] [Accepted: 10/21/2006] [Indexed: 01/20/2023]
Abstract
The aim of the work was to assess the prevalence of underweight among young women and to analyse factors contributing to this phenomenon. The study group consisted of 718 female students aged 18-24 years. Underweight, overweight and obesity was classified according to BMI and WHO criteria. To assess the socio-economic status (SES), place of residence before entering the university and education of parents were used. Variables characterising lifestyle such as sports activity, cigarette smoking and alcohol drinking were also taken into account. In the studied group, the prevalence of underweight was much higher than the prevalence of overweight and obesity (15.3% and 3.5%, respectively). Low BMI was more frequent among persons with higher SES. Moreover, it was noted that 70% of women having normal weight (BMI=18.50-24.99 kg/m2) wanted to have slimmer figure. No correlation was found between prevalence of very low body mass and lifestyle variables.
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Affiliation(s)
- R Pawlińska-Chmara
- Department of Biotechnology and Molecular Biology, Opole University, Kominka 4, 45-035 Opole, Poland.
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29
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Yancey AK, Simon PA, McCarthy WJ, Lightstone AS, Fielding JE. Ethnic and sex variations in overweight self-perception: relationship to sedentariness. Obesity (Silver Spring) 2006; 14:980-8. [PMID: 16861602 DOI: 10.1038/oby.2006.112] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE With increasing frequency, health promotion messages advocating physical activity are claiming weight loss as a benefit. However, messages promoting physical activity as a weight loss strategy may have limited effectiveness and cross-cultural relevance. We recently found self-perceived overweight to be a more robust correlate of sedentary behavior than BMI in Los Angeles County adults. In this study, we examined ethnic and sex differences in overweight self-perception and their association with sedentariness in this sample. RESEARCH METHODS AND PROCEDURES We conducted bivariate and multivariate analyses of cross-sectional survey data from a representative sample of Los Angeles County adults. RESULTS Women were more likely to perceive themselves to be overweight than men overall (73.2% of overweight/non-obese and 24.1% of average weight women vs. 44.5% of overweight/non-obese and 5.6% of average weight men) and within each ethnic group. African-Americans were least likely (41.3% of overweight/non-obese African-Americans self-identified as overweight) and whites were most likely to consider themselves overweight (60.6% of overweight/non-obese whites self-identified as overweight). Overweight (vs. average weight) self-perception was correlated with sedentariness among average weight adults (45.3% vs. 33.0%, p < 0.001), overweight adults (43.4% vs. 33.6%, p < 0.001), men (average and overweight: 38.4% vs. 27.8%, p < 0.001), overweight whites (41.9% vs. 29.7%, p = 0.0012), and African-Americans and Latinos (41.6% vs. 33.9%, p = 0.005). DISCUSSION These data suggest that our society's emphasis on weight loss rather than lifestyle change may inadvertently discourage physical activity adoption/maintenance among non-obese individuals. However, further research is needed, particularly from prospective cohort and intervention studies, to elucidate the relationship between overweight self-perception and healthy lifestyle change.
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Affiliation(s)
- Antronette K Yancey
- Department of Health Services, UCLA School of Public Health, Los Angeles, CA 90095-6900, USA.
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