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Roth AM, Gruber JR, Reif A, Schultze M, Matura S. Exploring weight-related self-monitoring as a potential risk factor for eating disorder symptoms in adults - A systematic review and meta-analysis. Appetite 2024; 202:107610. [PMID: 39069082 DOI: 10.1016/j.appet.2024.107610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 07/17/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE Weight-related self-monitoring (WRSM), which involves the intentional tracking of body weight metrics, has been considered a potential risk factor for eating disorders. Therefore, the aim of this study was to systematically summarize the current state of the literature and to quantify the possible association between WRSM and eating disorder symptoms in adults. METHOD Preregistration was carried out using PROSPERO (ID CRD42022366133). The PubMed, PsycInfo, and Web of Science databases were searched until December 21, 2023. A study had to be 1) be available in English or German, 2) be peer-reviewed and quantitative, 3) include adult participants (age ≥18 years) from the general population, 4) assess eating disorder symptoms via at least one of the following questionnaires: EDI, EAT, FEV, TFEQ, DEBQ, EDE-Q, Munich ED-Quest or IEG, and 5) include WRSM. Data analyses included descriptive analyses and three-level meta-analysis, corrected for correlations, for the global score and the different subscales of the eating disorder questionnaires. RESULTS A total of 28 studies (n = 17,370 participants), with an overall fair methodological quality, were included in the systematic review. Out of these studies, nine studies with n = 13,507 participants were ultimately analyzed in the meta-analysis. The three-level meta-analysis did not reveal a significant association between WRSM and the eating disorder global score (r = 0.13, 95% CI [-0.02, 0.28]; p = 0.08), with this pattern also being evident in the subgroup analysis (diet monitoring). DISCUSSION WRSM alone does not generally translate into an increased risk of disordered eating symptoms in the general population. We assume that individual factors are likely to determine whether the use of WRSM could lead to eating disorder symptoms. These factors should be accounted for in future research.
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Affiliation(s)
- Annika M Roth
- Goethe-University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany; Department of Psychological Methods with Interdisciplinary Orientation, Goethe-University Frankfurt, Germany.
| | - Judith R Gruber
- Goethe-University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Andreas Reif
- Goethe-University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Martin Schultze
- Department of Psychological Methods with Interdisciplinary Orientation, Goethe-University Frankfurt, Germany
| | - Silke Matura
- Goethe-University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
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Hahn SL, Bornstein C, Burnette CB, Loth KA, Neumark-Sztainer D. A mixed-methods longitudinal examination of weight-related self-monitoring and disordered eating among a population-based sample of emerging adults. J Eat Disord 2024; 12:112. [PMID: 39113131 PMCID: PMC11304648 DOI: 10.1186/s40337-024-01069-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/24/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Weight-related self-monitoring (WRSM) apps are used by millions, but the effects of their use remain unclear. This study examined longitudinal relationships between WRSM and disordered eating among a population-based sample of emerging adults. METHODS Participants (n = 138) were recruited from EAT 2010-2018 (Eating and Activity over Time study) to participate in a mixed-methods (quantitative and qualitative) longitudinal study to understand the impacts of WRSM. In 2018, participants (Mage=21.7 ± 1.9 years) reported motivations for use and types of WRSM apps used. Dependent variables collected in 2022 (Mage=25.7 ± 1.9 years) included past year total number of disordered weight control behaviors, disordered muscle building behaviors, compulsive exercise, and binge eating. Linear and logistic regressions were used adjusting for sociodemographics, body mass index, and baseline disordered eating. Semi-structured interviews (n = 25) were analyzed using inductive thematic analysis. RESULTS Participants using WRSM apps for weight management demonstrated an increase in disordered weight control behaviors over time (β = 0.894, p = .012). Using WRSM apps for "healthy" eating was marginally associated with an increase in disordered weight control behaviors. (β = 0.673, p = .052). Qualitatively, participants reported varied temporality between WRSM and disordered eating, but believed that app use encouraged restriction/binge cycles and normalized disordered eating. CONCLUSIONS Findings suggest there may be individual variation in the relationships between WRSM and disordered eating, but that using WRSM apps with the motivation of managing eating or weight may increase disordered eating in some. Additionally, WRSM apps may normalize or encourage disordered eating. Therefore, safeguards, including screening and monitoring, are needed to ensure WRSM does not cause or escalate harm among WRSM users.
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Affiliation(s)
- Samantha L Hahn
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI, 48859, USA.
| | - Caroline Bornstein
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, Suite 300, West Bank Office Building, Minneapolis, MN, 55454, USA
| | - C Blair Burnette
- Department of Psychology, Michigan State University, 316 Physics Rd, East Lansing, MI, 48823, USA
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, Suite 300, West Bank Office Building, Minneapolis, MN, 55454, USA
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Berry RA, Driscoll G, Fuller-Tyszkiewicz M, Rodgers RF. Exploring longitudinal relationships between fitness tracking and disordered eating outcomes in college-aged women. Int J Eat Disord 2024; 57:1532-1541. [PMID: 38469879 DOI: 10.1002/eat.24192] [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: 11/14/2023] [Revised: 02/12/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVE A growing body of research, primarily cross-sectional, suggests a relationship between the practice of tracking one's food intake and exercise behaviors using fitness-tracking smartphone applications ("apps") or wearable devices ("wearables") and disordered eating symptomatology. The aim of the present study was to explore longitudinal relationships between fitness tracking and disordered eating outcomes among college-aged women, as well as to determine whether the individual-level risk factors of pre-existing eating concerns, perfectionism, and rumination about food moderated the relationship. METHOD N = 68 female undergraduates used the MyFitnessPal app for 8 weeks while completing a series of self-report measures. RESULTS At the trait level, fitness tracking frequency was positively associated with weight/shape concerns, but not with the other outcome measures. Daily levels of fitness tracking did not predict next-day levels for any of the outcome measures. Within-day fitness tracking at one timepoint was associated with lower reports of dietary restraint efforts at the next timepoint. None of the proposed moderators significantly interacted with the relationships over time. DISCUSSION These results suggest that while those who engage in fitness tracking may experience higher weight/shape concerns as a trait, over time fitness tracking was not associated with an increase in concerns. Further work exploring whether fitness tracking may affect particular subgroups in different ways is warranted.
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Affiliation(s)
- Rachel A Berry
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
- Student Health and Wellness Counseling and Psychological Services, University of Virginia, Charlottesville, Virginia, USA
| | - Geneva Driscoll
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | | | - Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France
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Eguren-García I, Sumalla-Cano S, Conde-González S, Vila-Martí A, Briones-Urbano M, Martínez-Díaz R, Elío I. Risk Factors for Eating Disorders in University Students: The RUNEAT Study. Healthcare (Basel) 2024; 12:942. [PMID: 38727499 PMCID: PMC11083517 DOI: 10.3390/healthcare12090942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024] Open
Abstract
The purpose of the study is to assess the risk of developing general eating disorders (ED), anorexia nervosa (AN), and bulimia nervosa (BN), as well as to examine the effects of gender, academic year, place of residence, faculty, and diet quality on that risk. Over two academic years, 129 first- and fourth-year Uneatlántico students were included in an observational descriptive study. The self-administered tests SCOFF, EAT-26, and BITE were used to determine the participants' risk of developing ED. The degree of adherence to the Mediterranean diet (MD) was used to evaluate the quality of the diet. Data were collected at the beginning (T1) and at the end (T2) of the academic year. The main results were that at T1, 34.9% of participants were at risk of developing general ED, AN 3.9%, and BN 16.3%. At T2, these percentages were 37.2%, 14.7%, and 8.5%, respectively. At T2, the frequency of general ED in the female group was 2.5 times higher (OR: 2.55, 95% CI: 1.22-5.32, p = 0.012). The low-moderate adherence to the MD students' group was 0.92 times less frequent than general ED at T2 (OR: 0.921, 95%CI: 0.385-2.20, p < 0.001). The most significant risk factor for developing ED is being a female in the first year of university. Moreover, it appears that the likelihood of developing ED generally increases during the academic year.
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Affiliation(s)
- Imanol Eguren-García
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
| | - Sandra Sumalla-Cano
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
- Department of Health, Nutrition and Sport, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
| | - Sandra Conde-González
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
| | - Anna Vila-Martí
- Research Group M3O, Methodology, Methods, Models and Outcomes of Health and Social Sciences, Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia, 08500 Vic, Spain;
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), 08500 Vic, Spain
| | - Mercedes Briones-Urbano
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
- Department of Health, Nutrition and Sport, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
- Department of Health, Universidad Internacional Iberoamericana, Arecibo, PR 00613, USA
| | - Raquel Martínez-Díaz
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
- Faculty of Health Sciences, Universidade do Cuanza, Cuito EN250, Bié, Angola
- Faculty of Health Sciences, Universidad de La Romana, La Romana 22000, Dominican Republic
| | - Iñaki Elío
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
- Department of Health, Nutrition and Sport, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
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Generoso RA, Bauer KW, Sonneville KR, Hahn SL. Identifying methods used to manage weight and shape by first year university students: A qualitative analysis. Eat Behav 2024; 53:101885. [PMID: 38772294 DOI: 10.1016/j.eatbeh.2024.101885] [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: 11/16/2023] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVE To identify current strategies used by first-year university students to lose weight, maintain weight, or change their body shape. METHODS First-year university students (n = 661) completed an open-ended, web-based survey. Cross-sectional data were analyzed qualitatively using a reflexive thematic approach to identify strategies used to lose weight, maintain weight, or alter body shape/composition. Thematic maps were constructed for each weight- and shape-related goal. RESULTS Four main types of strategies were used to achieve all three weight or shape-related goals among first-year college students: changes in diet, changes in exercise, self-monitoring, and disordered eating. One behavioral strategy observed across all weight-related goals was prioritizing protein consumption, including protein gained from supplementation. However, there were also differences in strategies by weight- or shape-related goal. For example, only participants aiming to lose or maintain weight reported mindful strategies for monitoring diet. Individuals aiming to alter body composition reported heterogeneity in goal-related intentions, targeting specific body parts through exercise, and extensive supplement use. CONCLUSIONS First-year college students use a variety of strategies to manage their weight and shape. Some strategies were observed across goals, whereas others are specific to the weight- or shape-related goal. More research is needed to understand the impacts, both positive and negative, of using the strategies identified in the present study.
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Affiliation(s)
- Rica A Generoso
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48858, USA.
| | - Katherine W Bauer
- University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
| | - Kendrin R Sonneville
- University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
| | - Samantha L Hahn
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48858, USA.
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O’Loughlin EK, Marashi M, Sabiston CM, Lucibello KM, Sylvestre MP, O’Loughlin JL. Predictors of Food and Physical Activity Tracking Among Young Adults. HEALTH EDUCATION & BEHAVIOR 2023; 50:647-657. [PMID: 36942324 PMCID: PMC10492434 DOI: 10.1177/10901981231159679] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Monitoring food intake and physical activity (PA) using tracking applications may support behavior change. However, few longitudinal studies identify the characteristics of young adults who track their behavior, findings that could be useful in designing tracking-related interventions. Our objective was to identify predictors of past-year food and PA tracking among young adults. METHODS Data were available for 676 young adults participating in the ongoing longitudinal Nicotine Dependence in Teens Study. Potential predictors were measured in 2017-2020 at age 31, and past-year food and PA tracking were measured in 2021-2022 at age 34. Each potential predictor was studied in a separate multivariable logistic regression model controlling for age, sex, and educational attainment. RESULTS One third (37%) of participants reported past-year PA tracking; 14% reported past-year food, and 10% reported both. Nine and 11 of 41 potential predictors were associated with food and PA tracking, respectively. Compensatory behaviors after overeating, trying to lose weight, self-report overweight, reporting a wide variety of exercise behaviors, and pressure to lose weight predicted both food and PA tracking. CONCLUSION Food and PA tracking are relatively common among young adults. If the associations observed herein between compensatory behavior after overeating and tracking (among other observed associations) are replicated and found to be causal, caution may need to be exercised in making "blanket" recommendations to track food intake and/or PA to all young adults seeking behavior change.
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Affiliation(s)
- Erin K. O’Loughlin
- Centre de recherche du centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada
- University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Marie-Pierre Sylvestre
- Centre de recherche du centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada
- Université de Montréal, Montreal, Quebec, Canada
| | - Jennifer L. O’Loughlin
- Centre de recherche du centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada
- Université de Montréal, Montreal, Quebec, Canada
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Hahn SL, Kramer-Kostecka EN, Hazzard VM, Barr-Anderson DJ, Larson N, Neumark-Sztainer D. Weight-related Self-monitoring App Use Among Emerging Adults is Cross-sectionally Associated With Amount and Type of Physical Activity and Screen Time. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231212086. [PMID: 37970791 PMCID: PMC10655642 DOI: 10.1177/00469580231212086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 11/19/2023]
Abstract
Weight-related self-monitoring (WRSM) apps are often used by emerging adults to assist in behavior change. However, little is known about the relationship between WRSM among the general population of emerging adults and various physical activity and screen time behaviors. This paper examines associations between WRSM app use and various forms of physical activity and screen time among a population-based sample of emerging adults. Data come from EAT 2018 (N = 1,568, mean age = 22.0 ± 2.0 years), a population-based sample of emerging adults from Minneapolis/St. Paul, Minnesota. Participants reported on the types of WRSM apps used (physical activity and/or dietary focused), in addition to how much time they spent doing physical activity, whether they practiced yoga, compulsive exercise, recreational screen time, social media use, and whether they viewed dieting/weight loss materials. Linear and logistic regressions were used to assess adjusted means and prevalences of outcomes. We found that physical activity-focused WRSM app users engaged in more hours of total (8.7 vs 7.2, P < .001), and moderate-to-vigorous (5.1 vs 4.3, P = .002) physical activity compared to non-users. Similar results were found for dietary WRSM app users compared to non-users. However, WRSM app users had higher levels of compulsive exercise and were more likely to view dieting/weight loss materials (Ps < .001). Findings suggest that although physical activity is higher among WRSM users, the types of physical activity and screen time behaviors WRSM users are engaging in may be harmful.
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Affiliation(s)
- Samantha L. Hahn
- Central Michigan University College of Medicine, Mount Pleasant, MI, USA
- University of Minnesota School of Public Health, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Vivienne M. Hazzard
- University of Minnesota School of Public Health, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Nicole Larson
- University of Minnesota School of Public Health, Minneapolis, MN, USA
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Rossmaier LWS. Commercial mHealth Apps and Unjust Value Trade-offs: A Public Health Perspective. Public Health Ethics 2022; 15:277-288. [PMID: 36727099 PMCID: PMC9883713 DOI: 10.1093/phe/phac016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Mobile health (mHealth) apps for self-monitoring increasingly gain relevance for public health. As a mobile technology, they promote individual participation in health monitoring with the aim of disease prevention and the mitigation of health risks. In this paper, I argue that users of mHealth apps must engage in value trade-offs concerning their fundamental dimensions of well-being when using mobile health apps for the self-monitoring of health parameters. I particularly focus on trade-offs regarding the user's self-determination as well as their capacity to form personal attachments. Depending on the user's level of advantage or disadvantage, value trade-offs can pose a threat to the users' sufficient fulfillment of the dimensions of well-being. As such, value trade-offs can entrench existing structural injustices and prevent disadvantaged users to benefit from this technology. I argue that value trade-offs are, to some, a type of injustice that can drive disadvantaged users away from a sufficiency threshold of well-being, risk users to fall below the threshold, or have an accumulative effect on different dimensions of the user's well-being.
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Hahn SL, Hazzard VM, Larson N, Klein L, Loth KA, Neumark-Sztainer D. Correlates of weight-related self-monitoring application use during emerging adulthood in a population-based sample. Eat Weight Disord 2022; 27:2107-2119. [PMID: 35040079 PMCID: PMC9288498 DOI: 10.1007/s40519-021-01349-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/17/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study was designed to examine (1) the types of technologies or other applications (apps) emerging adults use to track their eating, physical activity, or weight; (2) who uses these apps and (3) whether eating and weight-related concerns during adolescence predict app use in emerging adulthood. METHODS Longitudinal survey data were obtained from EAT 2010-2018 (Eating and Activity over Time study, N = 1428), a population-based sample of ethnically/racially and socioeconomically diverse adolescents (mean age: 14.5 ± 2.0 years), who were followed into emerging adulthood (mean age: 22.0 ± 2.0 years). Data were used to examine sociodemographic correlates of physical activity- and dietary-focused app use. Adjusted, gender-stratified logistic regressions were used to investigate longitudinal relationships between eating and weight-related concerns in adolescence and app use in emerging adulthood. RESULTS Compared to men, women were more likely to use physical activity- (23.2 versus 12.5%, p < 0.001) and dietary-focused apps (16.1 versus 5.5%, p < 0.001). Among women, eating and weight-related concerns in adolescence, particularly unhealthy muscle-building behaviors (OR = 1.73, 95% CI 1.03-2.92), were associated with later dietary-focused app use. Among men, use of other muscle-building behaviors and body dissatisfaction in adolescence predicted use of physical activity- (ORother muscle-building = 1.60, 95% CI 1.03-2.49 and ORbody dissatisfaction = 1.67, 95% CI 1.06-2.65) and dietary-focused (ORother muscle-building = 2.18, 95% CI 1.07-4.47 and ORbody dissatisfaction = 2.35, 95% CI 1.12-4.92) apps 8 years later. CONCLUSIONS Eating and weight-related concerns may predict later use of physical activity- and dietary-focused apps; future research is needed to understand whether use of such apps further increases eating and weight-related concerns. LEVEL OF EVIDENCE III, well-designed longitudinal cohort study.
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Affiliation(s)
- Samantha L Hahn
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, 300 Block West Bank Office Building, Minneapolis, MN, 55454, USA. .,Department of Psychiatry and Behavioral Health, University of Minnesota Medical School, 2450 Riverside Ave, Minneapolis, MN, 55454, USA.
| | - Vivienne M Hazzard
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, 300 Block West Bank Office Building, Minneapolis, MN, 55454, USA.,Department of Psychiatry and Behavioral Health, University of Minnesota Medical School, 2450 Riverside Ave, Minneapolis, MN, 55454, USA.,Sanford Center for Biobehavioral Research, 120 Eighth St S, Fargo, ND, 58103, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, 300 Block West Bank Office Building, Minneapolis, MN, 55454, USA
| | - Laura Klein
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, 300 Block West Bank Office Building, Minneapolis, MN, 55454, USA
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, 300 Block West Bank Office Building, Minneapolis, MN, 55454, USA
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Hahn SL, Hazzard VM, Loth KA, Larson N, Klein L, Neumark-Sztainer D. Using apps to self-monitor diet and physical activity is linked to greater use of disordered eating behaviors among emerging adults. Prev Med 2022; 155:106967. [PMID: 35065981 PMCID: PMC8832499 DOI: 10.1016/j.ypmed.2022.106967] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/23/2021] [Accepted: 01/15/2022] [Indexed: 02/03/2023]
Abstract
Use of weight-related self-monitoring (WRSM) apps is common among emerging adults, as are weight and shape concerns. The present study aimed to examine (1) whether emerging adult use of dietary-focused (e.g., MyFitnessPal) and physical activity-focused (e.g., Fitbit) WRSM apps was associated with weight-control and muscle-building behaviors, including commonly recommended/conventional behaviors and disordered behaviors and (2) whether prior use of weight-control and muscle-building behaviors in adolescence might explain such relationships. Data were collected as part of the EAT (Eating and Activity over Time) 2010-2018 study (n = 1446) and analyzed using gender-stratified logistic regression models adjusted for demographic characteristics and body mass index. Among women and men, physical activity- and dietary-focused app use were associated with greater adjusted prevalence of disordered weight-control behaviors (e.g., fasting, purging), and disordered muscle-building behaviors (e.g., using steroids). Physical activity- and dietary-focused app use were also associated with a higher adjusted prevalence of commonly recommended weight-control and conventional muscle-building behaviors (e.g., exercising, changing eating habits), but only among those who were also engaging in disordered behaviors. The observed associations remained statistically significant in models that further adjusted for adolescent use of the respective behaviors. Findings suggest that emerging adults who use physical activity- and dietary-focused WRSM apps are more likely to engage in disordered weight-control and muscle-building behaviors and that associations are not explained by engagement in these behaviors during adolescence. Future research is needed to examine if there are aspects of WRSM apps that could be modified to reduce potential harm.
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Affiliation(s)
- Samantha L Hahn
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, Suite 300, West Bank Office Building, Minneapolis, MN 55454, USA; Department of Psychiatry & Behavioral Health, University of Minnesota Medical School, 2450 Riverside Ave, Minneapolis, MN 55454, USA.
| | - Vivienne M Hazzard
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, Suite 300, West Bank Office Building, Minneapolis, MN 55454, USA; Department of Psychiatry & Behavioral Health, University of Minnesota Medical School, 2450 Riverside Ave, Minneapolis, MN 55454, USA; Sanford Center for Biobehavioral Research, 120 Eighth St S, Fargo, ND 58103, USA.
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Minneapolis, MN, USA.
| | - Nicole Larson
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, Suite 300, West Bank Office Building, Minneapolis, MN 55454, USA.
| | - Laura Klein
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, Suite 300, West Bank Office Building, Minneapolis, MN 55454, USA.
| | - Dianne Neumark-Sztainer
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, Suite 300, West Bank Office Building, Minneapolis, MN 55454, USA.
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Nagata JM, Hazzard VM, Ganson KT, Hahn SL, Neumark-Sztainer D, Eisenberg ME. Digital technology use and muscle-building behaviors in young adults. Int J Eat Disord 2022; 55:207-214. [PMID: 34904744 PMCID: PMC9023317 DOI: 10.1002/eat.23656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/01/2021] [Accepted: 12/04/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Digital technology use and muscle-building behaviors reflect a wide range of behaviors with associated health risks. However, links between digital technology use and muscle-building behaviors remain unknown and this study aimed to address this gap. METHOD Data were collected from a diverse sample of 1,483 young adults (mean age 22.2 ± 2.0 years) participating in the population-based Eating and Activity over Time 2018 study. Gender-stratified-modified Poisson regression models were used to determine cross-sectional associations between three types of digital technology use (screen time, social media, weight-related self-monitoring apps) and five types of muscle-building behaviors (changing eating, exercise, protein powders/shakes, pre-workout drinks, steroids/growth hormone/creatine/amino acids) in young adulthood, adjusted for sociodemographic characteristics and body mass index. RESULTS Screen time and social media were either not found to be associated with muscle-building behaviors or in a few instances, associated with less use of these behaviors (e.g., screen time and pre-workout drinks in men). In contrast, the use of weight-related self-monitoring apps was positively associated with all muscle-building behaviors, including steroids/growth hormone/creatine/amino acids in men (prevalence ratio [PR] = 1.83; 95% confidence interval [CI]: 1.13-2.97) and women (PR = 4.43; 95% CI: 1.68-11.68). DISCUSSION While most recreational screen time may represent sedentary behaviors not related to muscle-building behaviors, weight-related self-monitoring apps are highly associated with more muscle-building behaviors and could be a future target for interventions to discourage the use of steroids and other harmful muscle-building substances.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Vivienne M. Hazzard
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA,Department of Psychiatry & Behavioral Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Samantha L. Hahn
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA,Department of Psychiatry & Behavioral Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marla E. Eisenberg
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA,Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
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Hahn SL, Linxwiler AN, Huynh T, Rose KL, Bauer KW, Sonneville KR. Impacts of dietary self-monitoring via MyFitnessPal to undergraduate women: A qualitative study. Body Image 2021; 39:221-226. [PMID: 34534770 PMCID: PMC8643308 DOI: 10.1016/j.bodyim.2021.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/23/2021] [Accepted: 08/28/2021] [Indexed: 11/30/2022]
Abstract
The present study explored college women's perceptions of how dietary self-monitoring alters eating and body image-related cognitions and behaviors. The sample consisted of undergraduate women (N = 20), aged ≥ 18 (mean = 21.9 ± 6.6 years) from a cross-sectional qualitative study using semi-structured interviews conducted upon participants' completion of a randomized controlled trial testing the effects of dietary self-monitoring via the smartphone app, MyFitnessPal. Inductive content analysis was utilized to identify participants' perceptions of how engaging in dietary self-monitoring for one month impacted them. Participants' experiences dietary self-monitoring was highly variable, with some participants reporting increased negative feelings (n = 9), positive feelings (n = 7), or both (n = 2). Other notable findings included increases in weight and/or shape concerns (n = 10) and a number of changes in dietary intake and other behaviors. Participants indicated that dietary self-monitoring may be helpful when trying to lose weight but harmful if the behavior becomes obsessive or if the user has poor body image. Individual experiences with dietary self-monitoring varies widely, and while dietary self-monitoring may be a useful tool for some college women, use should be monitored to avoid possible harmful side effects.
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Affiliation(s)
- Samantha L. Hahn
- Department of Nutritional Sciences, University of Michigan School of Public Health,Division of Epidemiology & Community Health, University of Minnesota School of Public Health,Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School
| | - Ashley N. Linxwiler
- Department of Nutritional Sciences, University of Michigan School of Public Health
| | - Tran Huynh
- Department of Nutritional Sciences, University of Michigan School of Public Health
| | - Kelsey L. Rose
- Department of Nutritional Sciences, University of Michigan School of Public Health,Division of Adolescent Medicine, Boston Children’s Hospital
| | - Katherine W. Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health
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Introducing Dietary Self-Monitoring to Undergraduate Women via a Calorie Counting App Has No Effect on Mental Health or Health Behaviors: Results From a Randomized Controlled Trial. J Acad Nutr Diet 2021; 121:2377-2388. [PMID: 34427188 DOI: 10.1016/j.jand.2021.06.311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/17/2021] [Accepted: 06/30/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Strong positive relationships between dietary self-monitoring and eating disorder risk are seen in population-based, observational studies. However, current evidence cannot establish causality. Furthermore, little is known about other mental and behavioral health consequences of dietary self-monitoring among college women, a population vulnerable to eating disorders. OBJECTIVE To determine if introducing dietary self-monitoring via a popular smartphone app to undergraduate women impacts eating disorder risk, other aspects of mental health, or health behaviors including dietary intake and physical activity. DESIGN Randomized controlled trial. PARTICIPANTS/SETTING Undergraduate women who had not engaged in dietary self-monitoring in the past year and who were at low-risk for an eating disorder participated between May and October 2019 (n = 200). INTERVENTION Participants were randomly assigned to engage in dietary self-monitoring via MyFitnessPal for approximately 1 month or to receive no intervention. MAIN OUTCOME MEASURES Self-report data on eating disorder risk, other mental health outcomes, and health behaviors were collected at baseline and post-intervention. STATISTICAL ANALYSES PERFORMED Linear and logistic regressions were utilized to test hypotheses. RESULTS Adherence to the intervention was high, with participants recording their dietary intake via MyFitnessPal on average 89.1% of days between baseline and post-intervention. Assignment to the intervention was not associated with changes in eating disorder risk, anxiety, depressive symptoms, body satisfaction, quality of life, nutritional intake, physical activity, screen time, or other forms of weight-related self-monitoring (all P > .05). CONCLUSIONS Among dietary self-monitoring naive undergraduate women with low-risk of an eating disorder, dietary self-monitoring via MyFitnessPal for 1 month did not increase eating disorder risk, impact other aspects of mental health, or alter health behaviors including dietary intake. The null results in our study may be due to the selection of a low-risk sample; future research should explore whether there are populations for whom dietary self-monitoring is contraindicated.
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