Personal Weight Status Classification and Health Literacy Among Supplemental Nutrition Assistance Program (SNAP) Participants

Association between bodyweight perception, nutritional status, and weight control practices: A cross-sectional analysis from the Chilean Health Survey 2016–2017

This research aimed (1) to examine the agreement between body mass index (BMI)-based nutritional status and perceived nutritional status overall and by socio-demographic factors and (2) to state the association between the accuracy of weight perception and weight control practices in the Chilean adult population. A population-based cross-sectional study was carried out with 5,192 Chilean adult participants from the Chilean National Health Survey 2016–2017. Agreement between BMI-based weight status and body weight perception for the total sample and across subgroups was determined using the weighted kappa coefficient. The agreement between BMI-based and perceived nutritional status of the total sample was fair (kappa = 0.38). A higher rate of weight perception accuracy was identified in women, younger respondents, and participants with higher education, a higher income, and from urban areas than their counterparts. Respondents with overweight or obesity tended to underestimate their nutritional status. Actions to lose weight were higher in those who had the right perception of their overweight/obesity condition and those who overestimated their body weight, regardless of their nutritional status. In all groups, weight loss behaviors were more related to the perceived than the BMI-based nutritional status. The consequences of accurate perception of the nutritional status are discussed including its effects on body weight and mental health.

Health literacy as a determinant of childhood and adult obesity: a systematic review

OBJECTIVES

To assess whether Health Literacy (HL) acts as a determinant of obesity in adults and children by synthesizing the results of recent scientific evidence.

CONTENT

This is a systematic qualitative review following the MOOSE guidelines. A systematic, computer-assisted literature search via PubMed scientific database, between January 1st, 2000, and September 30th 2020, was conducted. Only cross-sectional epidemiologic research studies that were published in the English language, investigating HL's possible role as a determinant of childhood and adult obesity, were included.

SUMMARY

After screening 725 citations from the PubMed database, 39 (n=39) studies in total were included in this literature review; Four (n=4) studies were conducted in the children population, seven (n=7) studies were performed in children-parent/caregiver dyads, and 28 studies (n=28) enrolled adults. There is significant evidence that HL knowledge and skills determine the consequent management of obesity and BMI rates in children and adult populations.

OUTLOOK

Despite policies and action plans put in place by countries globally, overweight and obesity continue to be a pressing public health issue and one of the critical drivers of non-communicable diseases, constituting a health, social and economic burden worldwide. Health Literacy as an essential health policy and promotion agenda item and a critical empowerment strategy could increase children's and adults' control over their overall health and awareness to overcome obesity issues. Initiatives to improve HL levels could be useful tools in managing the obesity epidemic, starting from integrating HL in the school curriculum and further in family and community action plans.

Health Literacy and Weight Loss After Bariatric Surgery

BACKGROUND

There are many factors that affect weight loss after bariatric surgery. The present study evaluated the impact of health literacy on weight loss after bariatric surgery in morbidly obese patients.

METHODS

The data of 118 patients who underwent laparoscopic sleeve gastrectomy for morbid obesity (body mass index-BMI ≥ 40 kg/m²) and completed a 1-year follow-up period were recorded and evaluated, prospectively. The Turkish version of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to evaluate the health literacy of these patients. Their demographic characteristics, preoperative and postoperative weight (at 6 and 12 months), BMI, the percentage of excess weight loss (% EWL), excess BMI loss (% EBL) and total weight loss (%TWL), comorbidities, socioeconomic characteristics (marital status, income level, educational status, and duration), and HLS-EU-Q47 results were recorded and compared.

RESULTS

A significant inverse relationship was identified between preoperative BMI and scores for health promotion health literacy and general health literacy indexes (p = 0.024 and p = 0.032, respectively). A significant positive relationship was noted between % EWL and % EBL at 6 and 12 months, and health promotion health literacy index scores (6 months: p = 0.004, p = 0.006; 12 months: p < 0.001 and p < 0.001, respectively). A similar significant positive relationship was recorded between the % EWL and % EBL at 12 months and the health care health literacy index scores (p = 0.042 and p = 0.036, respectively). There was also a significant positive relationship between general health literacy index scores and % EWL and % EBL at 12 months (p = 0.022 and p = 0.021, respectively). % EWL at 12 months increased by 0.39, with a 1-point increase in health promotion and health literacy index scores.

CONCLUSIONS

A high health literacy index score in morbidly obese patients is associated with successful weight loss after bariatric surgery.

Low health literacy and excess body weight: a systematic review

OBJECTIVE

There is recent evidence that poor health literacy (HL) could be implicated in the aetiology of obesity and could be an important reason behind obese people's inability to encounter difficulties in overcoming obesity issues. The current study reviews the recent scientific evidence investigating the possible link between poor HL levels and excess body weight in adults and children.

METHODS

The authors performed a thorough systematic computer-assisted literature search from 1 January 2005 up to 31 May 2017. Only English original studies in healthy people, investigating the relationship between HL and excess body weight, were included.

RESULTS

Twenty-two studies in total were included in this literature review, 17 studies were conducted in adults and 5 in children. In 17 out of 22 studies reviewed, low HL was significantly associated with increased body mass index, overweight and obesity. In case of children and adolescents, the above association seems to be more consistent compared to adults.

CONCLUSION

There is good evidence that low levels of HL are associated with excess body weight, particularly in children. Initiatives to improve health literacy levels could be a useful tool in the management of the obesity epidemic.

The demographic and morbidity characteristics of a population receiving food support in Israel

BACKGROUND

Food supply to poor populations is a big challenge, particularly in periods of economic stress and in an era of chronic diseases epidemics. In Israel more than 4000 poor families are currently receiving food support. Many of the food support products given to the family have low nutrient values, therefore not appropriately ensuring food security of the population. The aim of the current study was to examine for the first time the demographic, nutritional and chronic diseases profiles of food support beneficiaries, so as to aid in planning future food support components in Israel. In addition, the study examined associations between levels of food insecurity status and selected morbidities among food support recipients.

METHODS

In 2016, 3000 families (classified as very poor) in 24 municipalities received food support in Israel from the "National Food Security Project" (NFSP), under the guidance of the National Food Security Council. The 400 new families who joined the program in 2016 were requested to complete a questionnaire regarding the demographic and health characteristics of their families. Three hundred sixty-two of them completed the questionnaire for a response rate of 90%. The current study includes these families only.

RESULTS

The disposable income per capita of the surveyed families was very low - less than NIS 1100 a month ($280). About half the families were working families and 40% of them were in debt. Of the 362 responding families, about 82% of them were food insecure, with more than half severely food-insecure; this, despite receiving food support. About one-third of the families had at least one member with anemia, and a quarter of the families had a member with hyperlipidemia. Hypertension is present in about 22% of the families, diabetes in 17%, and there is a 12% incidence of at least one family member with heart disease. These rates are markedly higher than those in the general population. Higher levels of food insecurity were associated with higher levels of hyperlipidemia, heart disease and hypertension.

DISCUSSION AND CONCLUSIONS

The nutrition and medical status of the population receiving food support is much worse than in the general population. There is a need to improve the nutritional value of food support; this could include greater emphasis on whole grains, fruits and vegetables. There is also a need for a nationwide education program to focus on healthy nutrition and to subsidize healthy foods. Many health and nutrition promotion models show that in order to effect changes in dietary habits and behaviors related to improving nutrition, there is a need for nutrition education (Kamp et al., J Nutr Educ Behav 42:72-82, 2010).

Overweight and Obesity, Weight Perception, and Weight Management Practices Among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) Participants in Georgia: A Needs Assessment

OBJECTIVE

Examine associations among weight status, weight perception, and weight management practices of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) participants in Georgia.

METHODS

Self-reported weight, height, and weight-related practices were assessed and analyzed in 270 SNAP-Ed participants.

RESULTS

Almost three quarters of the sample self-reported overweight or obesity. Among overweight and obese subjects, 39% and 69%, respectively, accurately perceived themselves as overweight. More than half of the sample desired weight loss and 44% had attempted weight loss in the past year. Overweight/obese subjects who accurately perceived their weight were more likely to desire and to have attempted weight loss than those who under-perceived their weight. Approximately 58% of all subjects who had attempted to lose weight reported use of both methods suggested for weight loss: exercise and dietary changes.

CONCLUSIONS AND IMPLICATIONS

The high prevalence of self-reported overweight/obesity combined with a desire to lose weight among the study sample demonstrated the necessity to develop SNAP-Ed curricula emphasizing weight management.