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Ozbardakci EV, Lydecker JA. Reframing How Providers Advocate for Adolescent Well-Being in Body Image, Eating, and Weight. J Am Acad Child Adolesc Psychiatry 2023; 62:957-962. [PMID: 36948394 PMCID: PMC10728998 DOI: 10.1016/j.jaac.2023.03.008] [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: 09/07/2022] [Revised: 12/27/2022] [Accepted: 03/13/2023] [Indexed: 03/24/2023]
Abstract
Adolescence is a critical developmental period when youth are vulnerable to messages that promote unrealistic body shapes and a culture of weight-based stigma. Adolescents' vulnerability is reflected in high prevalence of body dissatisfaction among adolescents of all genders,1-3 which can lead to negative mental health consequences including disordered eating and depression.4,5 Importantly, body concerns are compounded among adolescents with higher weights who are more likely to experience weight-based victimization and internalize weight-based stigma compared with adolescents with lower weights.6,7 Health care providers have an opportunity to advocate for well-being of adolescent patients by providing nonstigmatizing messages regarding body image, eating, and weight. While body image prevention programs emphasize the need to promote positive body image and awareness of weight-based victimization, clinical guidelines instead focus on preventing or treating conditions (ie, obesity or eating disorders). Yet, adolescents' well-being would benefit from weight-inclusive, positive body image messages. Providers can model the importance of prioritizing positive body image messages by spending time discussing body image through a positive rather than problem-focused lens. We propose an advocacy framework for health care providers to support adolescents' body image and to reduce the impact of weight bias across 4 settings: the clinic, social media, adolescents' homes, and school.
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Xia W, Yang R, Zong Y, Yang Y, Xie Z, Chi T, Shi B, Gong C, Huang H. Depression in Chinese Patients with Cleft Lip and/or Palate: A Preliminary Study. J Clin Med 2023; 12:jcm12041366. [PMID: 36835901 PMCID: PMC9959099 DOI: 10.3390/jcm12041366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
(1) Objectives: To investigate the difference in prevalence of depression between patients with CL/P (cleft lip and/or palate) and analyze the possible demographic factors that affect the prevalence of depression in Chinese patients with CL/P. (2) Methods: Patients with CL (cleft lip only), CP (cleft palate), and CLP (cleft lip and palate) were included in the study group. Non-CL/P individuals were included in the control group. The Patient Health Questionnaire (PHQ-9) was used to screen the depression of Chinese patients with CL/P. The different proportions of different depression groups between the CL/P group and the control groups were tested by the Fisher-Freeman-Halton test and Bonferroni correction. The scores between the study groups and the control group were analyzed by one-way ANOVA. In the study groups, demographic and clinical data of the patients, including diagnosis (CL, CP, CLP), gender, age, the only child or not, and region were collected to analyze whether they were the possible factors affecting depression through one-way independent-samples t-test. Pearson correlation analysis was used to analyze the correlation between monthly family income and depression. (3) Results: 111 and 80 valid questionnaires were collected from the study and control groups, respectively. The mean PHQ-9 score of the study group (5.459 ± 6.082) was relatively higher than the control group (4.362 ± 3.384), and the difference in proportions of depression groups was statistically significant between the CL/P group and the control group (p = 0.01), especially in the mild depression (p < 0.05) and moderately severe depression groups (p < 0.05). Statistically significant differences in PHQ-9 scores were observed between the individuals of different genders (p = 0.036) and ages (p = 0.007) in patients with CL/P, the individuals who were the only child or not in patients with CL (p = 0.007), and the individuals of different ages in patients with CP (p = 0.016). (4) Conclusions: The prevalence of depression in Chinese patients with CL/P was different compared with those without CL/P, while gender, age, the only child or not, and region played significant roles in affecting depression psychology.
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Affiliation(s)
- Weiyao Xia
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Renjie Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Eastern Clinic, West China Hospital of Stomatology, Sichuan University, Chengdu 610051, China
| | - Yuan Zong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yichun Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zhuojun Xie
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ting Chi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bing Shi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Caixia Gong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (C.G.); (H.H.)
| | - Hanyao Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (C.G.); (H.H.)
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Lyu Z, Zheng P, Wang Z. Time Course of Attentional Biases Toward Body Shapes in Women Who Are Overweight or Obese. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9978-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Bowling AB, Tiemeier HW, Jaddoe VWV, Barker ED, Jansen PW. ADHD symptoms and body composition changes in childhood: a longitudinal study evaluating directionality of associations. Pediatr Obes 2018; 13:567-575. [PMID: 29869385 DOI: 10.1111/ijpo.12288] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/25/2018] [Accepted: 03/01/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is linked to increased risk of overweight/obesity among children and adults. Studies have also implicated obesity as a risk factor for ADHD. However, no studies have evaluated bidirectional, longitudinal associations between childhood fat mass and ADHD symptom severity. OBJECTIVES We investigate bidirectional associations between ADHD symptoms and measures of body composition between ages 1.5 and 9. We further examine effects of specific eating patterns linked to ADHD on associations between symptom severity and body composition. METHODS The study utilized data from children (N = 3903) participating in the Generation R cohort (Netherlands). Children were enrolled at birth and retained regardless of ADHD symptoms over time. Cross-lagged and change models examined bidirectional associations between body composition (body mass index/dual-energy X-ray absorptiometry) and ADHD symptoms at four time points in childhood. RESULTS A child with a clinically concerning ADHD symptom z-score two standard deviations above the mean at age 6 would be expected to experience about 0.22 kg greater fat mass gain measured via dual-energy x-ray absorptiometry between ages 6 and 9, even if they displayed healthy eating patterns (95% CI: 0.11 - 0.28, p < 0.001). Conversely, fat mass at any age did not predict worse ADHD symptoms later. CONCLUSIONS Beginning in early childhood, more ADHD symptoms predict higher fat mass at later ages. We did not find evidence of a reverse association. Based on these and prior findings, lifestyle counselling during treatment for children with a diagnosis of ADHD should be considered, even if they are diagnosed in early childhood and do not yet have a body mass index of clinical concern.
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Affiliation(s)
- A B Bowling
- Department of Health Sciences, Merrimack College, North Andover, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - H W Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Psychiatry, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - V W V Jaddoe
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - E D Barker
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - P W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, The Netherlands
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Zamora-Kapoor A, Omidpanah A, Nelson LA, Kuo AA, Harris R, Buchwald DS. Breastfeeding in Infancy Is Associated with Body Mass Index in Adolescence: A Retrospective Cohort Study Comparing American Indians/Alaska Natives and Non-Hispanic Whites. J Acad Nutr Diet 2017; 117:1049-1056. [PMID: 28082060 PMCID: PMC5586593 DOI: 10.1016/j.jand.2016.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 11/17/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND American Indians and Alaska Natives have the highest obesity prevalence in the United States, but the influence of early childhood variables on body mass index (BMI; calculated as kg/m2) is not well understood. Previous studies have investigated the association between breastfeeding in infancy and offspring BMI, but rarely included American Indians and Alaska Natives. OBJECTIVE This study investigated the association between breastfeeding in infancy and BMI in American Indians and Alaska Native and non-Hispanic white adolescents and young adults. DESIGN Longitudinal analysis based on data from the National Longitudinal Study of Adolescent to Adult Health (1994 to 2008). PARTICIPANTS Adolescent respondents who self-identified as American Indians and Alaska Native or non-Hispanic white, and whose parents completed the parental questionnaire, reported their height and weight. The final sample included 655 American Indians and Alaska Native and 10,305 non-Hispanic white respondents. STATISTICAL ANALYSES PERFORMED Generalized estimating equations were used to measure the mean differences, 95% CIs, and P values of the association between breastfeeding in infancy and offspring BMI in adolescence, stratifying by race, and adjusting for demographic and socioeconomic variables. RESULTS The length of breastfeeding was inversely associated with BMI in both populations. American Indians and Alaska Natives that were breastfed for 6 to 12 months or for more than 12 months had a mean BMI of 2.69 (95% CI -3.46 to -1.92; P<0.01) and 1.54 (95% CI -2.75 to -0.33; P<0.05) units lower than those that were never breastfed. Non-Hispanic whites that were breastfed for 3 to 6 months, 6 to 12 months, or more than 12 months had a mean BMI of 0.71 (95% CI -0.93 to -0.50; P<0.01), 0.68 (95% CI -0.87 to -0.50; P<0.01), and 0.85 (95% CI -1.09 to -0.62; P<0.01) units lower than those that were never breastfed. The association between the length of breastfeeding and offspring BMI varied by race (P<0.01). CONCLUSIONS Breastfeeding in infancy is associated with lower mean BMI. Future research should investigate causal pathways and whether interventions promoting breastfeeding in American Indians and Alaska Natives can prevent increasing BMI.
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Affiliation(s)
- Anna Zamora-Kapoor
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
- Department of Pediatrics, University of Washington, Seattle, WA
| | - Adam Omidpanah
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Lonnie A. Nelson
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Alice A. Kuo
- Department of Pediatrics, University of California-Los Angeles, Los Angeles, CA
| | - Raymond Harris
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Dedra S. Buchwald
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
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Goldzak-Kunik G, Leshem M. Body image drawings dissociate ethnic differences and anorexia in adolescent girls. Child Adolesc Psychiatry Ment Health 2017; 11:13. [PMID: 28293285 PMCID: PMC5348882 DOI: 10.1186/s13034-017-0150-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 02/21/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To distinguish between ethnic differences among segregated schoolgirls and restrictive anorexia nervosa using a simple culture-fair test of body image (BI) figure drawings. METHODS Several responses to BI figure drawings by 178 adolescent schoolgirls from three ethnically distinct and segregated schools and communities in Israel, Jewish secular (JS), Jewish Haredi (H), and Christian Arab (C), and a group of 14 severely restricting anorexic girls (AN). BI evaluations were analyzed by MANCOVA, followed by paired or Student-t tests for comparisons between responses and groups respectively. Pearson r served for correlations and the Fisher Z for differences between slopes. RESULTS Despite the total ethnic segregation among the schoolgirls, there are commonalities; all prefer a thinner ideal BI, and are similarly dissatisfied with their BI. However, ethnic differences also emerge: C underestimate their BI and how others view them, and H true and Ideal BI evaluations correlate, unlike the other groups. Despite this variability, and in stark contrast, the anorexic girls show a gross misperception of their BI, even in comparison to girls equated for BMI. DISCUSSION The findings show that figure drawings evaluation of BI is a simple and robust instrument dissociating clinical and ethnic responses. Clinicians may consider body figure drawings as a simple, supportive, diagnostic for first-line recognition for risk of AN in adolescent girls.
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Affiliation(s)
- Galit Goldzak-Kunik
- Nutrition Unit, Department of Diabetes, Haifa and Western Galilee, Clalit Health Services, Lin Medical Center, Rothschild Street 37, Haifa, Israel ,0000 0004 1937 0562grid.18098.38Department of Psychology, University of Haifa, 31905 Haifa, Israel
| | - Micah Leshem
- 0000 0004 1937 0562grid.18098.38Department of Psychology, University of Haifa, 31905 Haifa, Israel
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Chen T, Liu LL, Cui JF, Chen XJ, Wang Y. Developmental trajectory of time perspective: From children to older adults. Psych J 2016; 5:245-255. [PMID: 27718341 DOI: 10.1002/pchj.140] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/12/2016] [Accepted: 07/21/2016] [Indexed: 11/10/2022]
Abstract
Time perspective is a fundamental dimension of the psychological time construct, with a pervasive and powerful influence on human behavior. However, the developmental trajectory of time perspective across a human lifespan remains unclear. The current study aimed to portray the developmental trajectory of all dimensions of time perspectives from children to older adults in a large sample. A total of 1,901 individuals (aged 9-84 years) completed measures of time perspective. They were then divided into five age groups: children, teenagers, young adults, middle-aged adults, and older adults. Results suggested that each time perspective showed a unique developmental pattern across the lifespan. Moreover, perceived economic situation and education were related to some dimensions of time perspective.
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Affiliation(s)
- Tao Chen
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,School of Humanities, University of Chinese Academy of Sciences, Beijing, China
| | - Lu-Lu Liu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,School of Humanities, University of Chinese Academy of Sciences, Beijing, China
| | - Ji-Fang Cui
- Information Center, National Institute of Education Sciences, Beijing, China
| | - Xing-Jie Chen
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Ya Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Şanlier N, Türközü D, Toka O. Body Image, Food Addiction, Depression, and Body Mass Index in University Students. Ecol Food Nutr 2016; 55:491-507. [DOI: 10.1080/03670244.2016.1219951] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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9
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The relation between anxiety and BMI - is it all in our curves? Psychiatry Res 2016; 235:49-54. [PMID: 26708439 DOI: 10.1016/j.psychres.2015.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/21/2015] [Accepted: 12/03/2015] [Indexed: 11/24/2022]
Abstract
The relation between anxiety and excessive weight is unclear. The aims of the present study were three-fold: First, we examined the association between anxiety and Body Mass Index (BMI). Second, we examined this association separately for female and male participants. Next, we examined both linear and non-linear associations between anxiety and BMI. The BMI was assessed of 92 patients (mean age: M=27.52; 57% females) suffering from anxiety disorders. Patients completed the Beck Anxiety Inventory. Both linear and non-linear correlations were computed for the sample as a whole and separately by gender. No gender differences were observed in anxiety scores or BMI. No linear correlation between anxiety scores and BMI was observed. In contrast, a non-linear correlation showed an inverted U-shaped association, with lower anxiety scores both for lower and very high BMI indices, and higher anxiety scores for medium to high BMI indices. Separate computations revealed no differences between males and females. The pattern of results suggests that the association between BMI and anxiety is complex and more accurately captured with non-linear correlations.
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Abstract
OBJECTIVE To investigate weight concerns among adolescent boys and relationships with health indicators and family factors. DESIGN Analysis of the 2010 Health Behaviour in School-aged Children survey of 10-17-year-olds. SETTING Schools in the Republic of Ireland. RESULTS Among 6187 boys, 25.1% reported a desire to lose weight (weight 'loss' concern) and 7.7% reported a desire to gain weight (weight 'gain' concern). Both types of weight concerns were associated with poor self-rated health, life satisfaction and happiness, and with more frequent emotional and physical symptoms. Family factors were associated with boys' weight concerns. In adjusted analyses, the risk of weight 'loss' concerns decreased with daily family breakfasts (OR=0.80; 95% CI 0.66, 0.97). The risk of weight 'gain' concerns decreased with frequent family evening meals (OR=0.77; 95% CI 0.60, 0.99). Ease of communication with mother was associated with a decreased risk of weight 'loss' and weight 'gain' concerns among boys (OR=0.74; 95% CI 0.60, 0.90 and OR=0.61; 95% CI 0.44, 0.82, respectively). An open father-son relationship and having a father present in the home decreased the risk of weight 'loss' concerns (OR=0.69; 95% CI 0.57, 0.82 and OR=0.81; 95% CI 0.67, 0.98, respectively). CONCLUSIONS Body weight concerns were reported by a sizeable minority of boys and were associated with negative health outcomes. The findings support the need to promote frequent family meals and facilitate open communication in families.
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Dion J, Blackburn ME, Auclair J, Laberge L, Veillette S, Gaudreault M, Vachon P, Perron M, Touchette É. Development and aetiology of body dissatisfaction in adolescent boys and girls. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2015; 20:151-166. [PMID: 25931646 PMCID: PMC4391290 DOI: 10.1080/02673843.2014.985320] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 11/04/2014] [Indexed: 11/12/2022] Open
Abstract
This longitudinal study aims to describe the development of body dissatisfaction (BD), measured with the Contour Drawing Rating Scale, between the ages of 14 and 18, and to identify factors associated with BD at age 18, among 413 adolescents. Between the ages of 14 and 18, the proportion of girls wanting to be thinner increased, although it remained unchanged among boys. A ratio of 1:2 girls and 1:5 boys reported having seriously tried to lose weight. Factors associated with BD in girls at age 18 were (1) wanting to be thinner, (2) body mass index (BMI), (3) weight control behaviours and (4) negative comments about weight. Factors associated with BD in boys at age 18 were (1) wanting to be thinner or bigger, (2) BMI, (3) having experienced sexual intercourse and (4) negative comments about weight. The high prevalence of BD and weight-related concerns suggest a need for early interventions.
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Affiliation(s)
- Jacinthe Dion
- Département des Sciences de la Santé, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| | - Marie-Eve Blackburn
- Département des Sciences de la Santé, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
- ÉCOBES Recherche et Transfert, Cégep de Jonquière, Saguenay, Québec, Canada
| | - Julie Auclair
- ÉCOBES Recherche et Transfert, Cégep de Jonquière, Saguenay, Québec, Canada
| | - Luc Laberge
- Département des Sciences de la Santé, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
- ÉCOBES Recherche et Transfert, Cégep de Jonquière, Saguenay, Québec, Canada
| | - Suzanne Veillette
- ÉCOBES Recherche et Transfert, Cégep de Jonquière, Saguenay, Québec, Canada
| | - Marco Gaudreault
- ÉCOBES Recherche et Transfert, Cégep de Jonquière, Saguenay, Québec, Canada
| | - Patrick Vachon
- Département des Sciences de la Santé, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| | - Michel Perron
- ÉCOBES Recherche et Transfert, Cégep de Jonquière, Saguenay, Québec, Canada
- Département des Sciences Humaines, Université du Québec à Chicoutimi, Saguenay, Québec, Canada
| | - Évelyne Touchette
- Département de psychoéducation, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
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Kuzmar IE, Cortés-Castell E, Rizo M. Effectiveness of telenutrition in a women's weight loss program. PeerJ 2015; 3:e748. [PMID: 25674363 PMCID: PMC4319315 DOI: 10.7717/peerj.748] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 01/13/2015] [Indexed: 12/04/2022] Open
Abstract
Objective. The objective of this study is to evaluate the effectiveness of telenutrition versus traditional nutritional consultations for female obese patients in need of nutritional treatment. Methods. A comparative clinical study was conducted among 233 obese or overweight women (including 20 who dropped out and 60 who failed) who consulted a nutrition clinic in Barranquilla (Colombia) for nutritional assessment and chose either telenutrition or a traditional consultation that included a weekly follow-up consultation over 16 weeks, food consumption patterns, Body Mass Index (BMI, kg/m2) registeration and waist and hip circumference registeration. Treatment responses and differences between telenutrition and the traditional consultations were made according to BMI, waist, hip and initial-waist/height ratio (iWaist), calculating for the relative risk. Results. In 68 (29.2%) women who chose traditional attention, 9 (37.5%) dropped out, 24 (40%) failed and 35 (23.5%) were successful, showing 1.4% (1.0 SD) BMI loss, 5.8% (3.4 SD) in waist circumference, 4.5% (2.8 SD) in hip circumference and 0.04% (0.02 SD) in iWaist/height ratio. In 165 (70.8%) women who chose telenutrition, 15 (62.5%) dropped out, 36 (60%) failed and 114 (76.5%) were successful, showing 1.1% (1.0 SD) BMI loss, 5.0% (3.2 SD) in waist circumference, 3.5% (3.1 SD) in hip circumference and 0.03% (0.02 SD) in iWaist/height ratio. A significance level of p < 0.05 is considered. Conclusion. Telenutrition has a failure or dropout risk factor of about half of the value of traditional consultation, and showed slight, statistically significant differences. This study concludes that telenutrition can support or sometimes replace traditional consultations when developing weight loss programs for obese women.
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Affiliation(s)
- Isaac E Kuzmar
- Department of Nursing, Faculty of Health Sciences, University of Alicante , Alicante , Spain
| | - Ernesto Cortés-Castell
- Department of Pharmacology, Pediatrics and Organic Chemistry, School of Medicine, Miguel Hernández University , Alicante , Spain
| | - Mercedes Rizo
- Department of Nursing, Faculty of Health Sciences, University of Alicante , Alicante , Spain
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Zhang Z, Xu X, Ni H, Deng H. Predictive value of ionized calcium in critically ill patients: an analysis of a large clinical database MIMIC II. PLoS One 2014; 9:e95204. [PMID: 24736693 PMCID: PMC3988144 DOI: 10.1371/journal.pone.0095204] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 03/24/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Ionized calcium (iCa) has been investigated for its association with mortality in intensive care unit (ICU) patients in many studies. However, these studies are small in sample size and the results are conflicting. The present study aimed to establish the association of iCa with mortality by using a large clinical database. METHODS Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC II) database was used for analysis. Patients older than 15 years were eligible, and patients without iCa measured during their ICU stay were excluded. Demographic data and clinical characteristics were extracted and compared between survivors and non-survivors. iCa measure on ICU admission was defined as Ca0; Camax was the maximum iCa during ICU stay; Camin was the minimum value of iCa during the ICU stay; Camean was the arithmetic mean iCa during ICU stay. MAIN RESULTS A total of 15409 ICU admissions satisfied our inclusion criteria and were included in our analysis. The prevalence of hypocalcemia on ICU entry was 62.06%. Ca0 was significantly lower in non-survivors than in survivors (1.11 ± 0.14 vs 1.13 ± 0.10 mmol/l, p<0.001). In multivariate analysis, moderate hypocalcemia in Ca0 was significantly associated with increased risk of death (OR: 1.943; 95% CI: 1.340-2.817), and mild hypercalcemia was associated with lower mortality (OR: 0.553, 95% CI: 0.400-0.767). While moderate and mild hypocalcemia in Camean is associated with increased risk of death (OR: 1.153, 95% CI: 1.006-1.322 and OR: 2.520, 95% CI: 1.485-4.278), hypercalcemia in Camean is not significantly associated with ICU mortality. CONCLUSION The relationship between Ca0 and clinical outcome follows an "U" shaped curve with the nadir at the normal range, extending slightly to hypercalcemia. Mild hypercalcemia in Ca0 is protective, whereas moderate and mild hypocalcemia in Camean is associated with increased risk of death.
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Affiliation(s)
- Zhongheng Zhang
- Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Zhejiang, P.R. China
- * E-mail:
| | - Xiao Xu
- Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Zhejiang, P.R. China
| | - Hongying Ni
- Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Zhejiang, P.R. China
| | - Hongsheng Deng
- Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Zhejiang, P.R. China
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Rote AE, Swartz AM, Klos LA. Associations between lifestyle physical activity and body image attitudes among women. Women Health 2013; 53:282-97. [PMID: 23705759 DOI: 10.1080/03630242.2013.773956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Structured exercise can improve body image among women. Less is known if these associations extend to lifestyle physical activity-all activities of daily living with a full range of intensity. The purpose of this cross-sectional study was to examine the relationships between lifestyle physical activity and body image in undergraduate women (n = 120; 18-23 years) during the spring of 2010 and 2011. One week of lifestyle physical activity was measured objectively (accelerometer) and subjectively (7-Day Physical Activity Recall Questionnaire). Attitudinal dimensions of body image were assessed using the Multidimensional Body-Self Relations Questionnaire. Physical activity was unrelated to appearance-related dimensions of women's body image. Objectively-measured vigorous physical activity was positively related to investment in fitness and health (p < .005), while moderate physical activity was related to investment in fitness (p < .005). Light physical activity was unrelated to women's body image. A greater amount of self-reported vigorous physical activity was related to greater investment in fitness (p < .005). Results suggested that unlike structured exercise, lifestyle physical activity was generally unrelated to women's body image. The act of exercising may be more important than accumulation of lifestyle physical activity when considering women's body image.
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Affiliation(s)
- Aubrianne E Rote
- Department of Kinesiology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA.
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Swaminathan S, Selvam S, Pauline M, Vaz M. Associations between body weight perception and weight control behaviour in South Indian children: a cross-sectional study. BMJ Open 2013; 3:e002239. [PMID: 23474789 PMCID: PMC3612746 DOI: 10.1136/bmjopen-2012-002239] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 02/01/2013] [Accepted: 02/05/2013] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To examine the patterns of weight loss behaviour and the association between weight loss attempts with actual weight status and children's and parental perceptions of weight status. DESIGN A cross-sectional study. SETTING Karnataka, South India. PARTICIPANTS 1874 girls and boys aged 8-14 years from seven schools in Karnataka, South India. MAIN OUTCOME MEASURES The association between weight loss attempts and sociodemographic factors, weight status and the child's or the parent's perception of weight status. RESULTS Approximately 73% of overweight and obese, 35% of normal weight and 22% of underweight children attempted to lose weight. Children of lower socioeconomic groups studying in schools in the local vernacular and overweight/obese children were more likely to attempt to lose weight (adjusted OR ie, AOR=1.57, 95% CI 1.11 to 2.25; AOR=4.38, 95% CI 2.64 to 7.28, respectively). Perception of weight status was associated with weight loss attempts. Thus, children who were of normal weight but perceived themselves to be overweight/obese were three times more likely to attempt weight loss compared with those who accurately perceived themselves as being of normal weight, while the odds of attempting weight loss were the highest for those who were overweight and perceived themselves to be so (AOR∼18). CONCLUSIONS Children are likely to attempt weight loss in India irrespective of their weight status, age and gender. Children who were actually overweight as well as those who were perceived by themselves or by their parents to be overweight or obese were highly likely to try to lose weight. It is necessary to understand body weight perceptions in communities with a dual burden of being overweight and undernourished, if intervention programmes for either are to be successful.
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Affiliation(s)
- Sumathi Swaminathan
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, Karnataka, India
| | - Sumithra Selvam
- Division of Biostatistics and Epidemiology, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, Karnataka, India
| | - Maria Pauline
- Department of Physiology, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, Karnataka, India
| | - Mario Vaz
- Department of Physiology, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, Karnataka, India
- Division of Humanities and Health, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, Karnataka, India
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Aparicio E, Canals J, Voltas N, Hernández-Martínez C, Arija V. Emotional psychopathology and increased adiposity: follow-up study in adolescents. J Adolesc 2013; 36:319-30. [PMID: 23434271 DOI: 10.1016/j.adolescence.2012.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 11/06/2012] [Accepted: 12/14/2012] [Indexed: 10/27/2022]
Abstract
Based on data from a three-year longitudinal study, we assess the effect, according to gender, of emotional psychopathology in preadolescence on anthropometric and body composition parameters in adolescence (N = 229). Psychopathology was assessed using the Screen for Childhood Anxiety and Related Emotional Disorders, the Children's Depression Inventory and the MINI-International Neuropsychiatric Interview for Kids. Body fat percentage (%BF), waist circumference (WC) and body mass index (BMI) were also determined. Following analysis with adjusted multiple regression models, the results indicated that symptoms of depression and separation anxiety were significantly associated with increased WC and BMI in boys, and that somatic symptoms were associated with increased WC and %BF in girls. Diagnosis of social phobia, panic disorder or dysthymia led to significantly increased WC and/or BMI in boys and dysthymia increased WC in girls. These findings suggest that emotional psychopathology in preadolescence is associated with increased weight gain and abdominal fat in adolescence.
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Affiliation(s)
- Estefania Aparicio
- Faculty of Medicine and Health Sciences, Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), Reus, Spain
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Sharma S, Ikeda J, Fleming SE. Influence of body dissatisfaction on 1-year change in nutrient intake of overweight and obese inner-city African American children. Body Image 2013; 10:121-6. [PMID: 22921270 DOI: 10.1016/j.bodyim.2012.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 07/25/2012] [Accepted: 07/30/2012] [Indexed: 01/26/2023]
Abstract
This analysis aimed to examine the relationship of baseline body dissatisfaction with 1-year change in nutrient intake of inner-city, overweight and obese, African American children. This is a secondary analysis of 1-year pre-post data available for a convenience sample of 88 children. After adjusting for baseline intake of dietary variables and intervention group status, baseline body dissatisfaction was associated with 1-year increases in intake of energy, and all macronutrients in girls, but not in boys. These relationships were not substantially altered after adjusting for baseline BMIz and global self-worth. After including all adjustment factors, increasing baseline body dissatisfaction in girls was associated with 1-year increased intake of total energy, total sugars, total fat, discretionary fat, and total carbohydrates. This analysis suggests that, in girls but not necessarily in boys, body dissatisfaction might need to be targeted during interventions that aim to improve nutrient intake.
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Affiliation(s)
- Sushma Sharma
- Dr Robert C and Veronica Atkins Center for Weight and Health, University of California, Berkeley, CA 94720-3104, USA.
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Adami F, Schlickmann Frainer DE, de Souza Almeida F, de Abreu LC, Valenti VE, Piva Demarzo MM, Mello Monteiro CBD, de Oliveira FR. Construct validity of a figure rating scale for Brazilian adolescents. Nutr J 2012; 11:24. [PMID: 22500605 PMCID: PMC3349529 DOI: 10.1186/1475-2891-11-24] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 04/13/2012] [Indexed: 11/16/2022] Open
Abstract
Background Figure rating scales were developed as a tool to determine body dissatisfaction in women, men, and children. However, it lacks in the literature the validation of the scale for body silhouettes previously adapted. We aimed to obtain evidence for construct validity of a figure rating scale for Brazilian adolescents. Methods The study was carried out with adolescent students attending three public schools in an urban region of the municipality of Florianopolis in the State of Santa Catarina (SC). The sample comprised 232 10-19-year-old students, 106 of whom are boys and 126 girls, from the 5th "series" (i.e. year) of Primary School to the 3rd year of Secondary School. Data-gathering involved the application of an instrument containing 8 body figure drawings representing a range of children's and adolescents' body shapes, ranging from very slim (contour 1) to obese (contour 8). Weights and heights were also collected, and body mass index (BMI) was calculated later. BMI was analyzed as a continuous variable, using z-scores, and as a dichotomous categorical variable, representing a diagnosis of nutritional status (normal and overweight including obesity). Results Results showed that both males and females with larger BMI z-scores chose larger body contours. Girls with higher BMI z-scores also show higher values of body image dissatisfaction. Conclusion We provided the first evidence of validity for a figure rating scale for Brazilian adolescents.
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Affiliation(s)
- Fernando Adami
- Departamento de Saúde da Coletividade, Faculdade de Medicina do ABC, Av, Príncipe de Gales, 821, 09060650, Santo André, SP, Brazil.
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Goldzak-Kunik G, Friedman R, Spitz M, Sandler L, Leshem M. Intact sensory function in anorexia nervosa. Am J Clin Nutr 2012; 95:272-82. [PMID: 22205316 DOI: 10.3945/ajcn.111.020131] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In anorexia nervosa (AN), taste and smell are believed to be anhedonic, hunger and pain are muted, and body-image distortion obscures wasting, which together facilitate self-starvation. However, the emphasis on these deficits may be biased because other sensory systems have been sparsely investigated. OBJECTIVES Objectives of the study were to clarify whether these dysfunctions are specific or part of a pattern of sensory-perceptual deficits in AN patients and to test the gustatory senses dissociated from ingestion to clarify whether any deficit is sensory or affective. DESIGN In 15 adolescent, first-episode, hospitalized, restrictive AN patients and 15 matched healthy controls who responded to gustatory stimuli (intensity and hedonics of 5 basic tastes and tastes and odors of foods and nonfoods), size estimation (manual and oral judgment of size and shape, kinesthesia, and body size and esthetics), cold pain, and auditory and visual processing were compared. RESULTS AN patients did not differ on most tests, were better at odor recognition, were less successful in central auditory processing and oral assessment of size and shape, and may have been more sensitive to cold. Body-image dissatisfaction in AN patients was not related to dysfunctional size estimation. CONCLUSIONS There is no systematic sensory-perceptual deficit in AN patients, and specifically, not in gustatory function. The few differences shown might be due to fear of food-related stimuli or comorbidity.
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Ding H, Sun H, Chen A. Gender, BMI, values, and learning in physical education: A study on Chinese middle schoolers. LEARNING AND INDIVIDUAL DIFFERENCES 2011. [DOI: 10.1016/j.lindif.2011.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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