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Sifre N, Deringer R, Prapkree L, Palacios C. Disordered Eating Attitudes and Their Association with Age, BMI, Stress, and Diet in College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:766. [PMID: 38929012 PMCID: PMC11204199 DOI: 10.3390/ijerph21060766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/05/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE College students are at risk of disordered eating, particularly students with overweight/obesity and with higher stress, but little is known about how disordered eating may be related to diet. This study evaluated the associations between the Disordered Eating Attitudes Scale (DEAS) and age, BMI, stress, and diet. METHODS This is a secondary analysis of the baseline data in participants from the Snackability Trial. Participants completed a questionnaire on socio-demographics, DEAS, and snacking, self-reported their weight and height (to calculate BMI), and completed two 24 h non-consecutive dietary recalls (to calculate diet quality using HEI-2015 and snack quality score using an algorithm developed by our group). Associations between variables were assessed with Spearman correlations. RESULTS A total of 140 participants completed all assessments. The median age was 21.0 and the median BMI was 28.5 kg/m2 (43.7% had overweight and 41.5% had obesity). A total of 86.4% were females, 41.4% were white, 51.4% were low-income, and 30.7% were Hispanic/Latino. The total DEAS and the subscale 'Relationship with food' were positively correlated with stress and BMI (p < 0.05) but inversely correlated with HEI-2015 (p < 0.05). The subscales 'Restrictive and compensatory behaviors' and 'Concern about food and weight gain' were also positively correlated with stress (p < 0.001). CONCLUSION College students with higher disordered eating attitudes also had higher stress and BMI but poorer diet quality. Interventions may be needed for this group to manage stress and improve weight and diet quality, as well as promote awareness about disordered eating attitudes.
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Affiliation(s)
| | | | | | - Cristina Palacios
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33174, USA; (N.S.)
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2
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Ju S, Helton JJ, Iwinski S. Protective role of family mealtime frequency against disordered eating behaviors: Racial and ethnic differences. Appetite 2024; 197:107328. [PMID: 38556054 DOI: 10.1016/j.appet.2024.107328] [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: 02/05/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/02/2024]
Abstract
Family mealtimes have been recognized for their positive effect on child and adolescent health outcomes. Frequent family meals have been shown to have protective effects in reducing disordered eating behaviors, but the variability of these effects across different racial and ethnic backgrounds has been less explored. To address the gap, the current study utilizes a sample of 33,417 families with children (ages 6-17) in the United States who participated in the 2022 National Surveys of Children's Health (NSCH). Logistic regressions were conducted to examine the association between family mealtime frequency and the manifestation of disordered eating across youth from diverse racial/ethnic backgrounds. Our findings revealed that frequent family mealtimes are associated with a lower risk of engaging in disordered eating behaviors in youth. However, there were disparities in the associations between family mealtime frequency and the prevalence of disordered eating behaviors among children from different racial/ethnic backgrounds. Youth who never participated in family mealtimes were at a greater risk of engaging in disordered eating behaviors among those identifying as non-Hispanic Black or of 'other' racial groups. In youth identifying with multiple races, the frequency of family was not associated with the odds of disordered eating behaviors. The results provide insights into the nuanced influence of family mealtime frequency on disordered eating based on diverse racial/ethnic groups. This highlights the need for future studies to identify factors associated with racial/ethnic identities that may contribute to disordered eating behaviors in youth to identify the unique needs and challenges faced by families in leveraging the protective effect of family mealtimes.
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Affiliation(s)
- Sehyun Ju
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA.
| | - Jesse J Helton
- School of Social Work, St. Louis University, Saint Louis, MO, USA.
| | - Samantha Iwinski
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA.
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3
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Hochgraf AK, Fosco GM, Lanza ST. Comorbidity between body dissatisfaction and nicotine vaping among young adults in college: a daily diary study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-7. [PMID: 38713866 DOI: 10.1080/07448481.2024.2346354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 04/09/2024] [Indexed: 05/09/2024]
Abstract
Objective: The purpose of this study was to elucidate comorbidity between body dissatisfaction and nicotine vaping. Participants: Participants were 121 college students (M age = 20.51 years; 75.0% female; 75.2% White) who participated in a 14-day daily diary study. Methods: Logistic regression was used to test links between baseline trait body dissatisfaction and vaping frequency across 14 days. Multilevel logistic regression was used to test within-person, daily links between body dissatisfaction and nicotine vaping. Results: Each additional unit of trait body dissatisfaction increased the odds of frequent vaping by 33% (95% CI [1.00, 1.77]) and daily vaping by 54% (95% CI [1.10, 2.15]). Within-person, daily associations between body dissatisfaction and vaping were nonsignificant. Conclusions: Body dissatisfaction may increase college students' risk for engaging in frequent nicotine vaping. However, daily changes in body dissatisfaction may not predict same- or next-day vaping. College students with body dissatisfaction may benefit from nicotine interventions.
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Affiliation(s)
- Anna K Hochgraf
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
- Division of Epidemiology and Community Health, School of Public Health, The University of Minnesota, Minneapolis, Minnesota, USA
| | - Gregory M Fosco
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Stephanie T Lanza
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
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4
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Hochgraf AK, Berge JM, Lanza ST. Age-varying associations between attempts to change weight and suicidal ideation among adolescents in the United States. Prev Med 2024; 182:107946. [PMID: 38574970 PMCID: PMC11084873 DOI: 10.1016/j.ypmed.2024.107946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/20/2024] [Accepted: 04/01/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE The goal of this study was to inform theory and suicide prevention efforts by examining how the link between attempts to change weight and suicidal ideation varies across adolescence, when it is strongest, and whether there are sex differences. METHODS Data were from 13,518 youth ages 14-18 years who participated in the 2019 Youth Risk Behavior Survey, a nationally representative study of U.S. high school students. Time-varying effect modeling was used to estimate associations between attempts to change weight and suicidal ideation as continuous functions of age and to test sex differences in these links. RESULTS The link between attempts to lose weight and suicidal ideation was positive and significant between ages 14.0-17.3 years, with the strongest association at age 15.0 (OR = 2.07). There were no sex differences in this age-varying association. The association between attempts to gain weight and suicidal ideation was positive and age-varying for girls, with the strongest association at age 17.2 years (OR = 2.79). This association was not significant for boys at any age. CONCLUSIONS Girls and boys who are trying to lose weight and girls who are trying to gain weight may be at elevated risk for suicidal ideation between ages 14 and 18 years. Findings illuminate patterns of association during adolescence and have implications for suicide prevention.
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Affiliation(s)
- Anna K Hochgraf
- Division of Epidemiology and Community Health, School of Public Health, The University of Minnesota, Minneapolis, MN, USA.
| | - Jerica M Berge
- Department of Family Medicine and Community Health, Medical School, The University of Minnesota, Minneapolis, MN, USA
| | - Stephanie T Lanza
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
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5
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Miller KK, Hooper L, Kaja SM. Move and Thrive: Development of an Adolescent Friendly and Inclusive Online Fitness Resource. Health Promot Pract 2024:15248399241245055. [PMID: 38590221 DOI: 10.1177/15248399241245055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
While physical activity (PA) is a strong protective factor for adolescents, many youth experience discrimination and intimidation in traditional fitness spaces. This is especially true for youth of color, youth in larger bodies, and transgender youth. This manuscript describes the development of Move and Thrive, an online resource for PA promotion designed specifically for adolescents prioritizing inclusivity and diversity. Working with Community and Youth Advisory Boards, we developed guiding principles of Move and Thrive: to create resources that are 1) youth and community driven; 2) inclusive of diverse representation; 3) body and weight neutral; 4) trauma informed; and 5) accessible. We developed a guide for PA instructors to use trauma informed approaches; avoid mention of weight talk or physical appearance; use gender inclusive language; and offer multiple options to improve accessibility. Specific care was taken to hire instructors diverse in body size, race, ethnicity, and gender identity. The first iteration of Move and Thrive was launched in March 2021, and the current resource contains 72 PA videos. Over the course of 12 months, the site had more than the site had over 9,000 views in over 40 countries, including six continents. Users have reported high levels of satisfaction with Move and Thrive, and physicians have responded enthusiastically to sharing Move and Thrive as a free resource for adolescents. University of Minnesota Move and Thrive Project is currently available on an ad-free YouTube Channel. We believe that Move and Thrive has the potential to reach populations historically excluded from PA resources.
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Affiliation(s)
- Kathleen K Miller
- Children's Minnesota, Minneapolis, MN, USA
- University of Minnesota, Minneapolis, MN, USA
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6
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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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Harris CL, Benjamin K, Miao Z, Fantuzzi J, Averill M. Gender differences in factors related to eating competence in college students: Weight-and-body shame and guilt, weight satisfaction, weight loss effort, and eating disorder risk. Eat Behav 2023; 51:101797. [PMID: 37639735 DOI: 10.1016/j.eatbeh.2023.101797] [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: 05/13/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE This study aimed to determine which weight-and-body-related attitudes and behaviors were most predictive of Eating Competence (EC) in college students amidst COVID-19, according to gender. METHODS This cross-sectional study was part of a larger study in which an online survey was administered during autumn quarter 2020 to undergraduate students at a northwestern U.S. public university. Measures included EC (ecSI 2.0™), weight-and-body shame and/or guilt (WEBSG), weight satisfaction, current weight loss effort, and eating disorder risk. RESULTS Of the 1996 respondents included in the final analyses, 40.2 % were eating competent (ecSI 2.0™ ≥32). Gender distribution was 71.6 % women, 23.1 % men, and 4.6 % trans-and-gender non-conforming (TGNC). WEBSG and WEB-S were higher in women and TGNC than in men. Weight satisfaction was lower in women and TGNC students than men, and 47.3 % of the sample was trying to lose weight at the time of the study. Eating disorder (ED) risk was prevalent with nearly 34 % scoring ≥2 on SCOFF and 33 % reporting they saw themselves as having an ED now or in the past. Significant factors of EC varied for each gender, although WEB-S was a shared model factor for all genders. CONCLUSION EC may be protective, as this was related to less WEB-S in all genders; less WEB-G and greater weight satisfaction in men and women; and lower likelihood of ED risk and trying to lose weight among women. Further research is needed to elucidate whether these maladaptive weight-and-body attitudes and behaviors in college students can be improved to increase EC. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Affiliation(s)
- Cristen L Harris
- Department of Epidemiology, Nutritional Sciences Program, School of Public Health, University of Washington, 305 Raitt Hall, Box 353410, Seattle, WA 98195-3410, United States of America.
| | | | - Zhen Miao
- Microsoft, Redmond, WA, United States of America
| | - Jordyn Fantuzzi
- Nutritional Sciences Program, School of Public Health, University of Washington, 305 Raitt Hall, Box 353410, Seattle, WA 98195-3410, United States of America.
| | - Michelle Averill
- Department of Environmental and Occupational Health Sciences, Nutritional Sciences Program, School of Public Health, University of Washington, 305 Raitt Hall, Box 353410, Seattle, WA 98195-3410, United States of America.
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8
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Le TP, Jin L, Kang N. Sexual, gendered, and internalized racism's associations with disordered eating among sexual minority Asian American men: Emotional eating as mediator. Eat Disord 2023; 31:533-552. [PMID: 37032549 DOI: 10.1080/10640266.2023.2201024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Research related to disordered eating among sexual minority Asian American men is scarce. Thus, the present study utilized an intersectional framework to examine how three different forms of racism (i.e. sexual racism, gendered racism, and internalized racism) are associated with disordered eating among sexual minority Asian American men, as well as the mediating role of emotional eating. A cross-sectional survey containing the study's measures of interest were administered to participants. The final sample consisted of 180 sexual minority Asian American men. Both sexual racism and internalized racism were positively associated with disordered eating whereas gendered racism was not associated with disordered eating Emotional eating mediated the association between internalized racism and disordered eating, though it did not mediate the association between sexual racism and disordered eating. Researchers and practitioners are encouraged to utilize an intersectional framework that takes into account multiple forms of racism, especially sexual racism and internalized racism, when considering this underrepresented population's disordered eating. Results also demonstrate the importance of addressing racism in eating disorder prevention efforts among sexual minority Asian American men.
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Affiliation(s)
- Thomas P Le
- Department of Psychology, Bryn Mawr College, Philadelphia, Pennsylvania, USA
- University of Maryland
| | - Lily Jin
- Department of Psychology, Bryn Mawr College, Philadelphia, Pennsylvania, USA
- University of Maryland
| | - Naru Kang
- Department of Psychology, Bryn Mawr College, Philadelphia, Pennsylvania, USA
- University of Maryland
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9
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West CE, Hazzard VM, Loth KA, Larson N, Hooper L, Neumark-Sztainer D. The interplay between food insecurity and family factors in relation to disordered eating in adolescence. Appetite 2023; 189:106994. [PMID: 37544329 PMCID: PMC10617248 DOI: 10.1016/j.appet.2023.106994] [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] [Received: 02/28/2023] [Revised: 07/21/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023]
Abstract
This study examined the association between food insecurity and both binge eating and unhealthy weight-control behaviors (UWCBs) and assessed whether such associations differ by factors within the family environment. Data were collected from a diverse sample of adolescents (Mage = 14.5 years; 54.1% female) and their parents/guardians (N = 2137 dyads) participating in EAT 2010 (Eating and Activity over Time). Food-insecure adolescents were more likely to report binge eating (prevalence ratio [PR] = 1.94; 95% confidence interval [CI]: 1.41-2.69) and UWCBs (PR = 1.34; 95% CI: 1.21-1.49) than food-secure adolescents. Family meal importance (p = .03) and family communication (p < .001) significantly moderated the association between food insecurity and UWCBs, such that the association was weaker at lower levels of these factors. Significant interactions with parental weight talk/concern (p < .001) and weight teasing (p = .04) indicated a weaker association between food insecurity and UWCBs in the presence of these factors. Findings indicate that the association between food insecurity and UWCBs among youth is less salient in the absence of family protective factors and in the presence of family risk factors for UWCBs, indicating the importance of targeting food insecurity itself, regardless of the presence of family risk or protective factors for UWCBs.
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Affiliation(s)
- Caroline E West
- Department of Psychological Sciences, Kent State University, Kent, OH, USA.
| | - Vivienne M Hazzard
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Laura Hooper
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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10
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Rosenqvist E, Konttinen H, Berg N, Kiviruusu O. Development of Body Dissatisfaction in Women and Men at Different Educational Levels During the Life Course. Int J Behav Med 2023:10.1007/s12529-023-10213-x. [PMID: 37592079 DOI: 10.1007/s12529-023-10213-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Our study examines the rarely investigated associations between body dissatisfaction and educational level over the life course in women and men. METHODS A Finnish cohort (N = 1955) was followed by questionnaires at ages 22, 32, 42, and 52. Body dissatisfaction was measured by asking the respondents to evaluate their appearance using five response options. Analyses were done using logistic regression, while latent class analyses were used to identify classes of body dissatisfaction trajectories over the life course. RESULTS Body dissatisfaction increased with age in women and men. Among men, body dissatisfaction was related to lower education at the ages of 32 and 42. Also, men with lower education were more likely to maintain a less positive body image over the life course. In women, increasing body dissatisfaction during the life course was associated with lower education. CONCLUSIONS Differences in body dissatisfaction based on educational level are important to take into account in public health actions aiming to reduce socioeconomic inequalities in health and well-being.
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Affiliation(s)
- Elena Rosenqvist
- Faculty of Social Sciences, University of Helsinki, P.O. Box 42, 00014, Helsinki, Finland.
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - Hanna Konttinen
- Faculty of Social Sciences, University of Helsinki, P.O. Box 42, 00014, Helsinki, Finland
| | - Noora Berg
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Olli Kiviruusu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
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11
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Arlinghaus KR, Hahn SL, Larson N, Eisenberg ME, Berge JM, Neumark-Sztainer D. Helicopter Parenting Among Socio-Economically and Ethnically/Racially Diverse Emerging Adults: Associations with Weight-Related Behaviors. EMERGING ADULTHOOD (PRINT) 2023; 11:909-922. [PMID: 38617057 PMCID: PMC11013951 DOI: 10.1177/21676968231171317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Helicopter parenting, a parenting style defined by over-involvement, may lead to poor health outcomes. However, research has primarily focused on children and adolescents from White, high socio-economic families, with little research examining weight-related health or with emerging adult children. The current study examined associations with emerging adult diet, physical activity, and body mass index (BMI) among a diverse population-based sample of parent and emerging adult dyads (n = 919). Helicopter parenting was highest among lower socioeconomic households and those identifying as Black, Indigenous, or people of color. Helicopter parenting was associated with both healthy and less healthy dietary behaviors across ethnic/racial groups, but was not associated with physical activity or BMI. Greater consideration of the cultural context related to helicopter parenting is needed before making conclusions about its benefits or harms.
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Affiliation(s)
- Katherine R. Arlinghaus
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Samantha L. Hahn
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
- Department of Psychiatry & Behavioral Health, University of Minnesota Medical School, Minneapolis, MN, USA
- Central Michigan University College of Medicine, Mount Pleasant, MI, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Marla E. Eisenberg
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Jerica M. Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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12
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West CE, Sato AF. Weight and disordered eating among adolescents from low-income backgrounds. Eat Behav 2023; 50:101768. [PMID: 37390518 DOI: 10.1016/j.eatbeh.2023.101768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 07/02/2023]
Abstract
Disordered eating affects youth from varying socioeconomic backgrounds; however, representation of youth from low-income backgrounds within disordered eating research has been limited. The aim of the current study was to examine the association between adolescent weight and disordered eating among a sample of youth from a low-income background and to examine specific socioenvironmental factors that might moderate this association. Adolescents ages 12-17 (N = 73) from a low-income background and their parents/guardians completed self-report questionnaires. Adolescent height and weight were objectively measured to calculate BMI z-score. Adolescent weight was significantly positively associated with global disordered eating (95 % CI [0.26, 0.54]), after controlling for sex. Parental weight concern moderated the association between weight and global disordered eating, F(4, 68) = 18.44, p < .01, such that the relation between adolescent zBMI and disordered eating was no longer significant at low levels of parental weight concern. Structured family meals moderated the association between weight and global disordered eating, F(4, 68) = 11.99, p < .01, such that more frequent meals weakened the association between adolescent zBMI and disordered eating. Findings suggest that higher weight is associated with greater levels of disordered eating among adolescents from a low-income background. In addition, lower levels of parental weight concern and more frequent family meals significantly buffered the association between weight and disordered eating in this at-risk, yet understudied population. Both parental weight concern and family meals present as factors within the family environment that may serve as targets for intervention.
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Affiliation(s)
- Caroline E West
- Department of Psychological Sciences, Kent State University, Kent, OH, United States of America.
| | - Amy F Sato
- Department of Psychological Sciences, Kent State University, Kent, OH, United States of America; Brain Health Research Institute, Kent State University, Kent, OH, United States of America
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13
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Hooper L, Puhl RM, Eisenberg ME, Berge JM, Neumark-Sztainer D. Can Family and Parenting Factors Modify the Impact of Weight Stigma on Disordered Eating in Young People? A Population-Based Longitudinal Study. J Adolesc Health 2023; 73:44-52. [PMID: 36914449 PMCID: PMC10293098 DOI: 10.1016/j.jadohealth.2023.01.024] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/22/2022] [Accepted: 01/21/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE Weight stigma is a prevalent problem in adolescents and a risk factor for disordered eating behaviors (DEBs). This study examined whether positive family/parenting factors were protective for DEBs among an ethnically/racially and socioeconomically diverse sample of adolescents with and without weight stigmatizing experiences. METHODS In Project Eating and Activity over Time (EAT) 2010-2018, 1,568 adolescents (mean age = 14.4 ± 2.0 years) were surveyed and followed into young adulthood (mean age = 22.2 ± 2.0 years). Modified Poisson regression models examined the relationships between three weight-stigmatizing experiences and four DEBs (e.g., overeating and binge eating) in models adjusted for sociodemographic characteristics and weight status. Interaction terms and stratified models examined whether family/parenting factors were protective for DEBs based on weight stigma status. RESULTS Higher family functioning and support for psychological autonomy were cross sectionally protective for DEBs. However, this pattern was primarily observed in adolescents who did not experience weight stigma. For example, among adolescents who did not experience peer weight teasing, high support for psychological autonomy was associated with lower prevalence of overeating (high support: 7.0%, low support: 12.5%, p = .003). Whereas, in participants who experienced family weight teasing, the difference in prevalence of overeating based on support for psychological autonomy was not statistically significant (high support: 17.9%, low support: 22.4%, p = .260). DISCUSSION General positive family and parenting factors did not entirely offset the effects of weight-stigmatizing experiences on DEBs, which may reflect the strength of weight stigma as a risk factor for DEBs. Future research is needed to identify effective strategies family members can use to support youth who experience weight stigma.
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Affiliation(s)
- Laura Hooper
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota.
| | - Rebecca M Puhl
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut
| | - Marla E Eisenberg
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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Hochgraf AK, Fosco GM, Lanza ST. Age-Varying Associations Between Attempts to Lose Weight and Nicotine Vaping Across Adolescence: Results From a Nationally Representative Sample. J Adolesc Health 2023; 72:352-358. [PMID: 36424336 PMCID: PMC10062420 DOI: 10.1016/j.jadohealth.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/18/2022] [Accepted: 10/04/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE The prevalence of nicotine vaping is increasing among adolescents and emerging evidence suggests weight concerns may promote risk for vaping. The aims of this study were to investigate whether there is an association between attempting to lose weight and nicotine vaping during adolescence, when this association emerges and is strongest, and whether there are sex differences in this link. METHODS This study used time-varying effect modeling, an analytic method that estimates regression coefficients as a continuous function of age, to model dynamic associations between weight loss behavior and nicotine vaping across adolescence and sex differences in these links. Data were from 13,677 adolescents (aged 14-18 years, 49.4% female) who participated in the 2019 National Youth Risk Behavior Survey, a nationally representative U.S. SAMPLE RESULTS Results revealed an age-varying association that differed by sex. Girls who were trying to lose weight were at a higher risk for past 30-day vaping from ages 14.2-15.9 years, with the strongest association at 14.8 years (odds ratio [OR] = 1.92, 95% confidence interval [CI] [1.25, 2.95]). For boys, this association was nonsignificant across age (OR = 1.76, 95% CI [0.91, 3.41] at age 14.0 years). Girls who were trying to lose weight were at a higher risk for frequent vaping (vaping on 20-30 of the past 30 days) from ages 15.2-17.1 years, with the strongest association at 16.1 years (OR = 2.59, 95% CI [1.45, 4.62]). This link was not meaningfully significant at any age for boys (OR = 3.26, 95% CI [0.86, 12.33] at age 14.0 years). DISCUSSION Girls, but not boys, who are trying to lose weight appear vulnerable to nicotine vaping during adolescence.
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Affiliation(s)
- Anna K Hochgraf
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania; Division of Epidemiology and Community Health, The University of Minnesota, Minneapolis, Minnesota.
| | - Gregory M Fosco
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania; The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania
| | - Stephanie T Lanza
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania; Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania
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15
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Hahn SL, Burnette CB, Borton KA, Carpenter LM, Sonneville KR, Bailey B. Eating disorder risk in rural US adolescents: What do we know and where do we go? Int J Eat Disord 2023; 56:366-371. [PMID: 36305331 PMCID: PMC9951233 DOI: 10.1002/eat.23843] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/14/2022] [Accepted: 10/14/2022] [Indexed: 02/03/2023]
Abstract
Adolescence is a vulnerable period for the development of eating disorders, but there are disparities in eating disorder risk among adolescents. One population that may be at increased risk but is vastly understudied, is adolescents residing in rural regions within the United States. Rural communities face many mental and physical health disparities; however, the literature on rural adolescent eating disorder risk is nearly nonexistent. In this paper we summarize the scant literature on disordered eating and eating disorder risk and prevalence among rural US adolescents. We also detail eating disorder risk factors that may have unique influence in this population, including socioeconomic status, food insecurity, healthcare access, body image, and weight stigma. Given the presence of numerous eating disorder risk factors, we speculate that rural adolescents may be a particularly vulnerable population for eating disorders and we propose critical next steps in research for understanding eating disorder risk among the understudied population of rural adolescents. PUBLIC SIGNIFICANCE: Rural adolescents may be at increased risk for eating disorders due to disproportionate burden of known risk factors, though this relationship remains understudied. We present a summary of the literature on prevalence and unique risk factors, proposing that this may be a high-risk population. We detail next steps for research to understand eating disorder risk in this population to inform future prevention, identification, and treatment efforts needed in this community.
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Affiliation(s)
- Samantha L. Hahn
- Central Michigan University College of Medicine, Mount Pleasant, Michigan, USA
| | - C. Blair Burnette
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Kelley A. Borton
- Oakland University School of Health Sciences, Rochester, Michigan, USA
- Center of Hope Counseling, Mount Pleasant, Michigan, USA
| | | | | | - Beth Bailey
- Central Michigan University College of Medicine, Mount Pleasant, Michigan, USA
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McGowan A, Barry MR, Sonneville KR, Leung CW. Greater social adversity is associated with more disordered eating attitudes and behaviors among children from Southeast Michigan. Int J Eat Disord 2022; 55:1670-1677. [PMID: 35833678 PMCID: PMC10084038 DOI: 10.1002/eat.23775] [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: 01/23/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study is to examine the association between indicators of social adversity, including socioeconomic status and race/ethnicity, and children's disordered eating behaviors and attitudes. METHODS Children ages 8-10 years old (n = 183) were recruited from Michigan. Data were collected through in-home surveys. The Children's Eating Attitudes Test (ChEAT-24) measured disordered eating attitudes and behaviors in the sample. Cumulative social adversity was considered the sum of four binary variables: caregiver race/ethnicity, caregiver education, household income, and child-reported food security status. Linear mixed models examined the association between social adversity indicators and ChEAT-24 scores. RESULTS Children of primary caregivers of color had significantly higher ChEAT-24 scores than children of white caregivers (p = .03). Children who reported food insecurity had significantly higher ChEAT-24 scores compared to children who reported food security (p = .01). Compared to children with the lowest social adversity score, children with the highest score had a 4.8-unit higher ChEAT-24 score (95% CI .3-9.4), after adjusting for covariates. A significant trend was observed for greater social adversity and higher ChEAT-24 score (p-trend = .02). CONCLUSION A linear association was observed between greater social adversity and more disordered eating behaviors and attitudes among children in this sample. These findings emphasize the need for eating disorder research in children from racial/ethnic minorities and socioeconomically disadvantaged populations to support future prevention efforts. PUBLIC SIGNIFICANCE Greater exposure to social adversity was associated with more disordered eating behaviors among preadolescent children. Given that eating disorders are understudied in lower-income and minority racial/ethnic populations, this study highlights the need for additional research to better support prevention and treatment efforts among children from socioeconomically diverse backgrounds.
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Affiliation(s)
- Andrea McGowan
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Mikayla R Barry
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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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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Schaumberg KE, Robinson L, Hochman A, Micali N. Prospective Associations Between Driven Exercise and Other Eating Disorder Behaviors in Adolescence: A Longitudinal Cohort Study. J Adolesc Health 2022; 70:781-787. [PMID: 35086755 PMCID: PMC9038608 DOI: 10.1016/j.jadohealth.2021.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Dysfunctional exercise is a common, debilitating symptom across eating disorders (ED). We examined the cross-sectional and longitudinal associations between experiences of exercise and ED behaviors and cognitions in an adolescent, population-based sample. METHODS Adolescents (n = 4,054) self-reported whether they exercised to control shape and weight (exercise for weight loss [EWL]), and, if so, whether they exercised even when injured, and whether exercise interfered with life functioning (driven exercise) at age 14 years, allowing delineation of three exercise-based groups: no-EWL, EWL, and driven exercise. Participants also reported ED cognitions at age 14 years along with other ED behaviors (fasting, purging, binge eating) at ages 14 and 16 years. Sex-stratified regression approaches were employed to examine relationships between these exercise categories at age 14 and ED behaviors and cognitions at ages 14 and 16. RESULTS Cross-sectionally, those in the driven exercise group, compared to the no-EWL group, consistently reported higher levels of ED cognitions and behaviors, with those in the EWL group also reporting higher levels of some ED cognitions and behaviors relative to the no-EWL group. Those in the EWL and driven exercise groups at age 14 also demonstrated a higher prospective likelihood of fasting (boys and girls) and purging (girls only) at age 16, relative to those in the no-EWL group at age 14. DISCUSSION Results inform our understanding of EWL and driven exercise and the developmental timing of ED behaviors in adolescence and point toward the potential utility of targeted prevention for young people who report EWL.
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Affiliation(s)
| | - Lauren Robinson
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; GOSH Institute of Child Health, University College London, London, UK
| | - Ayelet Hochman
- Department of Psychology, St. John's University, Queens, New York
| | - Nadia Micali
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; GOSH Institute of Child Health, University College London, London, UK; Great Ormond Street Institute of Child Health, Child and Adolescent Mental Health Palliative care and Pediatrics Section, UCL, London, UK; Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Pediatrics, gynecology and obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Altman E, Linchey J, Santamaria G, Thompson HR, Madsen KA. Weight Measurements in School: Setting and Student Comfort. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:249-254. [PMID: 35277221 PMCID: PMC9135350 DOI: 10.1016/j.jneb.2021.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To examine how body mass index assessments are conducted in schools and whether student comfort with assessments varies by students' perceived weight status, weight satisfaction, or privacy during measurements. METHODS In-person cross-sectional surveys with diverse fourth- to eighth-grade students (n = 11,510) in 54 California schools in 2014-2015 about their experience being weighed in the prior school year. RESULTS Half of the students (49%) reported being weighed by a physical education teacher and 28% by a school nurse. Students were more comfortable being weighed by nurses than physical education teachers (P = 0.01). Only 30% of students reported privacy during measurements. Students who were unhappy with their weight (P <0.001) and those who perceived themselves as overweight (P <0.001) were less comfortable being weighed than their peers. CONCLUSIONS AND IMPLICATIONS Student weight dissatisfaction, higher perceived weight status, and being female were associated with discomfort with school-based weight measurements. Prioritizing school nurses to conduct weight measurements could mitigate student discomfort, and particular attention should be paid to students who are unhappy with their weight to avoid weight stigmatization.
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Affiliation(s)
- Emily Altman
- School of Public Health, University of California Berkeley, Berkeley, CA.
| | - Jennifer Linchey
- School of Public Health, University of California Berkeley, Berkeley, CA
| | - Gabriel Santamaria
- School of Public Health, University of California Berkeley, Berkeley, CA
| | - Hannah R Thompson
- School of Public Health, University of California Berkeley, Berkeley, CA
| | - Kristine A Madsen
- School of Public Health, University of California Berkeley, Berkeley, CA
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