Cognitive determinants of weight control by dietary patterns among postmenopausal women with osteoporosis: An application of theory of planned behavior

Background: In this study, we aimed to assess the cognitive determinants of weight control behaviors by dietary patterns among postmenopausal women with osteoporosis. Methods: This cross-sectional study, based on the theory of planned behavior (TPB) was conducted from July to December 2017 among 240 postmenopausal women with osteoporosis in Tabriz, Iran. A validated and reliable TPB-based instrument, namely Weight-CuRB, and the food frequency questionnaire (FFQ) were used. Results: The results of exploratory factor analysis (EFA) indicated three dietary patterns (total variance explained=24.44%); healthy (n=71), mixed (n=78), and western (n=91). In addition, food items consumed by participants were classified into twenty-two food groups for dietary pattern analysis. In the healthy and western dietary patterns, attitude (β: 0.140, P<0.001) and subjective norms (SNs) (β: 0.498, P<0.01) were the only predictors of weight control behavior, respectively. In the women with healthy and western patterns, the TPB-based variables altogether explained 11% and 16% of variations in the behavior, respectively. Among all patients, the TPB-based variables explained 12.2% of variations in weight control behavior, within which SNs were the only significant predictor of the behavior (β=-0.199, P<0.01). Conclusion: Our findings highlighted the remarkable role of dietary patterns in the associations between weight control and its cognitive determinants. Dietary patterns should be considered while designing weight control educational interventions among women with osteoporosis. In such interventions, promoting SNs and perceived behavioral control (PBC) should be considered as the core strategies to promote the behaviors among the patients who follow an unhealthy diet.

Obesity and Eating Disorders in Children and Adolescents: The Bidirectional Link

Obesity, eating disorders and unhealthy dieting practices among children and adolescents are alarming health concerns due to their high prevalence and adverse effects on physical and psychosocial health. We present the evidence that eating disorders and obesity can be managed or prevented using the same interventions in the pediatric age. In the presence of obesity in the pediatric age, disordered eating behaviors are highly prevalent, increasing the risk of developing eating disorders. The most frequently observed in subjects with obesity are bulimia nervosa and binge-eating disorders, both of which are characterized by abnormal eating or weight-control behaviors. Various are the mechanisms overlying the interaction including environmental and individual ones, and different are the approaches to reduce the consequences. Evidence-based treatments for obesity and eating disorders in childhood include as first line approaches weight loss with nutritional management and lifestyle modification via behavioral psychotherapy, as well as treatment of psychiatric comorbidities if those are not a consequence of the eating disorder. Drugs and bariatric surgery need to be used in extreme cases. Future research is necessary for early detection of risk factors for prevention, more precise elucidation of the mechanisms that underpin these problems and, finally, in the cases requiring therapeutic intervention, to provide tailored and timely treatment. Collective efforts between the fields are crucial for reducing the factors of health disparity and improving public health.

Latent Class Analysis of Obesogenic Behaviors among Korean Adolescents: Associations with Weight-Related Outcomes

This study aimed to explore sex-specific latent class models of adolescent obesogenic behaviors (OBs), predictors of latent class membership (LCM), and associations between LCM and weight-related outcomes (i.e., weight status and unhealthy weight control behaviors). We analyzed nationally representative data from the 2019 Korea Youth Risk Behavior Survey. To identify latent classes for boys (n = 29,841) and girls (n = 27,462), we conducted a multiple-group latent class analysis using eight OBs (e.g., breakfast skipping, physical activity, and tobacco product use). Moreover, we performed a multinomial logistic regression analysis and a three-step method to examine associations of LCM with predictors and weight-related outcomes. Among both sexes, the 3-class models best fit the data: (a) mostly healthy behavior class, (b) poor dietary habits and high Internet use class, and (c) poor dietary habits and substance use class. School year, residential area, academic performance, and psychological status predicted the LCM for both sexes. In addition, perceived economic status predicted the LCM for girls. The distribution of weight-related outcomes differed across sex-specific classes. Our findings highlight the importance of developing obesity prevention and treatment interventions tailored to each homogeneous pattern of adolescent OBs, considering differences in their associations with predictors and weight-related outcomes.

Intrasexual Competition and Unhealthy Weight Control Behaviors among Late Adolescent Females

The purpose of this study was to test a mediating model whereby competitiveness among females for mates affects body dissatisfaction and dysfunctional diet and exercise through its influence on social comparison and fear of being negatively evaluated by others. The hypothesized model draws from several empirical models, including the sexual competition hypothesis and the tripartite influence model. Approximately 218 female college students completed an online survey. Most participants were heterosexual, White, and between the ages of 19 and 20. The proposed model was tested with MPlus 8.0 using maximum likelihood estimation (MLE). The hypothesized model was a good fit to the data, revealing both direct and indirect paths that were positive and statistically significant. The results suggest that body dissatisfaction may be intensified in environments such as schools wherein peer competition for mates is high and where adolescent females may feel that they cannot successfully compete. They may experience feelings of inadequacy about their bodies, which may result in the adoption of dysfunctional diets, exercise, or other practices that may be unhealthy and potentially life threatening in an effort to change their physical appearance.

Is Calorie Labeling on Menus Related to Weight Disturbances among Females in Saudi Arabia?

Calorie labeling is a recent initiative from the Saudi Food and Drug Authority (SFDA) aimed to reduce the prevalence of noncommunicable diseases (NCDs) by influencing people to make healthier food choices when they eat out and can also help people with weight disturbances to be more aware of their calorie intake. The present study aimed to investigate the association between the use of calorie labeling on restaurant menus, calorie intake, weight concern, body weight perception, and weight-control behaviors among young women. A quasi-experimental study was conducted among female students at a university restaurant. Participants were assigned to two groups: food menus with (experimental group) and without (control group) calorie labeling. The logistic regression model assessed the predictors of using calorie information separately for the experimental and control groups. Calorie labeling had a significant effect on reducing calorie consumption in the experimental group by 59 calories compared to the control group. The higher weight concern in the control group (OR = 0.410; 95% CI 0.230–0.730; P ≤ 0.002 ) was a predictor for using calorie information. The experimental group had higher weight concern (OR = 1.530; 95% CI 1.107–2.115; P ≤ 0.01 ) and body weight perception (OR = 4.230; 95% CI 1.084–6.517; P ≤ 0.038 ) and lower calorie intake (OR = 1.005; 95% CI 1.001–6.517; P ≤ 0.008 ) predictors for using calorie information. Weight-control behaviors did not significantly predict the use of calorie information in the groups. Calorie labeling might increase the weight disturbances among young females. More investigation is needed across various populations to gain a better understanding of calorie labeling as an effective food choice among people who are vulnerable to weight disturbances or already have weight disorders.

Weight Misperception among African American Adolescents: The Jackson Heart KIDS Pilot Study

Background: Weight misperception is a common problem among adolescents; how­ever, few studies have examined contribut­ing factors among an exclusively African American population. The purpose of this study was to examine factors associated with weight misperception among 12- to 19-year-old participants in the Jackson Heart KIDS Pilot Study (JHS-KIDS).Methods: Data were drawn from JHS-KIDS, a prospective, observational examination of cardiovascular-related risk factors among African American adolescents who were children or grandchildren of participants in the Jackson Heart Study. Adolescent weight misperception – discordance between mea­sured weight status and perceived weight status – was the primary outcome of inter­est. Self-reported weight control behaviors, parent concerns about adolescents’ weight, parent-perceived responsibility for adoles­cent’s weight and daily hassles were the primary independent variables of interest.Results: The analytic sample was equally divided by females (n=107) and males (n=105) and one third of study partici­pants (33.5%) had discordance between their actual and perceived weight. Results from fully adjusted sex-stratified modified Poisson regression models indicated that weight behavior control was significant among females (PR = .66, 95%CI:1.20- 2.30). Parental concerns about child weight were significant for males. Each additional point increase in the parent’s concern about their weight score was associated with a 9% increase in the adjusted prevalence of weight misperception among males (95%CI: 1.03-1.16).Conclusions: The sex-specific patterns in this study highlight heterogeneity among African American adolescents and an urgent need to consider sex and gender when developing targeted interventions for youth who are at high risk for weight misper­ceptions and unhealthy weight control practices. Ethn Dis. 2021;31(3):461-468; doi:10.18865/ed.31.3.461

LGB prevalence in schools is associated with unhealthy weight-control behaviors in lesbian, gay, and bisexual youth: a multilevel analysis

Background Previous studies have found that a school climate of more heteronormativity is associated with adverse effects on the mental health of LGB students. Accordingly, our aim was to assess the association between lower LGB prevalence in schools and unhealthy weight-control behaviors among LGB youth. Methods A cross-sectional, multilevel study based in public high schools in the city of Olinda, Northeast Brazil. A multilevel logistic regression was performed, including 2500 adolescents enrolled in 27 schools. The contextual variable was the prevalence of LGB youth in each school (as a proxy for heteronormativity in schools), while the outcome was unhealthy weight-control behaviors (fasting, purging, and taking diet pills). We controlled for socioeconomic characteristics (age, sex, receiving a family allowance), obesity, and self-reported happiness. Results Lower LGB prevalence in schools was associated with higher odds of engaging in unhealthy weight-control behaviors (OR: 1.5, 95%CI: 1.0, 2.2) among all youth, regardless of sexual orientation. No cross-level interactions between school context and individual characteristics were statistically significant. Conclusion Lower LGB prevalence in schools was associated with a higher risk of unhealthy weight-control behaviors in youth regardless of sexual orientation, which may reflect either the contextual influence of school climate, or may be due to residual confounding.