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Iversen KD, Pedersen TP, Rasmussen M, Hansen MBL, Roikjer BH, Teilmann G. Mental health and BMI in children and adolescents during one year in obesity treatment. BMC Pediatr 2024; 24:406. [PMID: 38918794 PMCID: PMC11201871 DOI: 10.1186/s12887-024-04835-7] [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: 06/22/2023] [Accepted: 05/16/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Mental health plays a major role in children and adolescents with obesity. The aim of this study was (1) to compare mental health in children with obesity with the background population and (2) to investigate if mental health changed during one year in an obesity treatment program. METHODS Data on self-reported mental health was collected in 107 children and adolescents (mean age 13.2 years) with obesity at first visit in an obesity treatment program and at one year follow-up (n = 47). Mental health was assessed by eight questions from the Danish Health Behaviour in School-aged Children (HBSC) questionnaire: (1) self-rated health (2) life satisfaction (3) feeling low (4) body-image (5) loneliness (6) self-esteem (7) self-efficacy and (8) social competence. Data was compared to a reference population based on HBSC data. BMI-SDS was based on Danish reference values. RESULTS Children and adolescents with obesity had significantly higher odds of reporting negative body image and feeling low and lower odds of reporting high self-rated health and high self-esteem compared to a reference population. There was no difference between the groups regarding life-satisfaction, social competence, self-efficacy or feeling lonely. There were no significant changes in mental health from first visit to one-year follow-up. CONCLUSION Our findings highlight the mental health difficulties in children and adolescents with obesity, and the importance of addressing these issues in obesity treatment. The results also indicate that children with obesity have psychosocial resources that should be exploited in treatment protocols.
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Affiliation(s)
- Katrine Decker Iversen
- Department of Pediatrics, The Children's Obesity Clinic, Copenhagen University Hospital - North Zealand, Hillerød, Denmark.
| | - Trine Pagh Pedersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Maj-Britt Lundsgaard Hansen
- Department of Pediatrics, The Children's Obesity Clinic, Copenhagen University Hospital - North Zealand, Hillerød, Denmark
| | - Birgitte Højgaard Roikjer
- Department of Pediatrics, The Children's Obesity Clinic, Copenhagen University Hospital - North Zealand, Hillerød, Denmark
| | - Grete Teilmann
- Department of Pediatrics, The Children's Obesity Clinic, Copenhagen University Hospital - North Zealand, Hillerød, Denmark
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Lister NB, Baur LA, Paxton SJ, Garnett SP, Ahern AL, Wilfley DE, Maguire S, Sainsbury A, Steinbeck K, Braet C, Hill AJ, Nicholls D, Jones RA, Dammery G, Grunseit A, Cooper K, Kyle TK, Heeren FA, Hunter KE, McMaster CM, Johnson BJ, Seidler AL, Jebeile H. Eating Disorders In weight-related Therapy (EDIT) Collaboration: rationale and study design. Nutr Res Rev 2024; 37:32-42. [PMID: 36788665 PMCID: PMC7615933 DOI: 10.1017/s0954422423000045] [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] [Indexed: 02/16/2023]
Abstract
The cornerstone of obesity treatment is behavioural weight management, resulting in significant improvements in cardio-metabolic and psychosocial health. However, there is ongoing concern that dietary interventions used for weight management may precipitate the development of eating disorders. Systematic reviews demonstrate that, while for most participants medically supervised obesity treatment improves risk scores related to eating disorders, a subset of people who undergo obesity treatment may have poor outcomes for eating disorders. This review summarises the background and rationale for the formation of the Eating Disorders In weight-related Therapy (EDIT) Collaboration. The EDIT Collaboration will explore the complex risk factor interactions that precede changes to eating disorder risk following weight management. In this review, we also outline the programme of work and design of studies for the EDIT Collaboration, including expected knowledge gains. The EDIT studies explore risk factors and the interactions between them using individual-level data from international weight management trials. Combining all available data on eating disorder risk from weight management trials will allow sufficient sample size to interrogate our hypothesis: that individuals undertaking weight management interventions will vary in their eating disorder risk profile, on the basis of personal characteristics and intervention strategies available to them. The collaboration includes the integration of health consumers in project development and translation. An important knowledge gain from this project is a comprehensive understanding of the impact of weight management interventions on eating disorder risk.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Sarah P Garnett
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Kids Research, Sydney Children's Hospital Network, Westmead, New South Wales2145, Australia
| | - Amy L Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Denise E Wilfley
- School of Medicine, Washington University in St. Louis, St. Louis, USA
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Katharine Steinbeck
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales2145, Australia
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Andrew J Hill
- Leeds Institute of Health Sciences, University of Leeds, UK
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, 2nd Floor, Commonwealth Building, Du Cane Road, London, W12 0NN, UK
| | - Rebecca A Jones
- MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Genevieve Dammery
- InsideOut Institute for Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Alicia Grunseit
- The Children's Hospital at Westmead, Nutrition and Dietetics, Weight Management Services, Westmead, New South Wales, NSW 2145, Australia
| | | | | | - Faith A Heeren
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Kylie E Hunter
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Caitlin M McMaster
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
| | - Brittany J Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia5042, Australia
| | - Anna Lene Seidler
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Hiba Jebeile
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
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Jiménez Boraita R, Gargallo Ibort E, Dalmau Torres JM, Arriscado Alsina D. Lifestyle habits, health indicators and sociodemographic factors associated with health-related quality of life and self-esteem in adolescents. Clin Child Psychol Psychiatry 2024; 29:493-512. [PMID: 37658652 DOI: 10.1177/13591045231200661] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
BACKGROUND Mental health is defined as a state of emotional, psychological, and social well-being, and has been shown to be positively associated with self-esteem and quality of life. It is important to note that mental health is dynamic and influenced by a wide range of social, biological, and behavioral factors. Therefore, the aim this study was to describe the health-related quality of life and self-esteem in adolescents, examining their relationship with various health indicators, lifestyle habits, and sociodemographic variables. METHOD A cross-sectional study was conducted with a representative sample of 761 students (14.51 ± 1.63 years). Health-related quality of life, self-esteem, satisfaction with body image, adherence to the Mediterranean diet, physical activity practice, hours of nightly sleep, maximum oxygen consumption, body mass index, academic performance, and various sociodemographic factors of all participants were analyzed. RESULTS Regression analysis showed that body satisfaction and academic performance were associated of both health-related quality of life and self-esteem. Additionally, physical activity, age, and favourable settings for physical activity engagement were also found to be related to health-related quality of life, whilst adherence to the Mediterranean diet, hours of nightly sleep, maximum oxygen consumption and socioeconomic status were associated with self-esteem. CONCLUSIONS Given the associations found between health-related quality of life and self-esteem with lifestyle habits and sociodemographic indicators, there is an urgent need to develop interdisciplinary and cross-cutting promotion strategies to improve the mental health of adolescents.
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Affiliation(s)
- Raúl Jiménez Boraita
- Department of Didactics of Physical Education and Health, Universidad Internacional de La Rioja, Spain
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Shouli MM, Shouli KM, Aqtam I, Ayed A. Effect of Nitro Counseling on Lifestyle of Obese Adolescence. SAGE Open Nurs 2024; 10:23779608241228637. [PMID: 38322623 PMCID: PMC10846033 DOI: 10.1177/23779608241228637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 11/30/2023] [Accepted: 12/22/2023] [Indexed: 02/08/2024] Open
Abstract
Introduction Obesity during adolescence represents a strong predictor of higher mortality in adulthood; thus, lifestyle interventions represent the recommended therapy. Objective To evaluate the effect of nitro counseling on lifestyle of obese adolescence, and develop life changing program. Method Quasi-experimental design was conducted between October 2021 and January 2022. A total of 117 university nursing students participated from two universities in Palestine. A self-reported questionnaire was used for data collection and included the following: socio-demographic characteristics, university students' knowledge, practices adolescent lifestyle, and anthropometric measurement to detect body mass index. The nitro counseling program was performed over three and half months. Percentage, mean value, standard deviation, Chi-square (X2), T paired test, and proportion probability (p-value), when p < 0.05 or < 0.02 it is statistically significant difference. Results The results revealed that 34.1% of students weren't aware of obesity pre-counseling, while it was improved to 93.1% post-nitro counseling implementation with highly statistical significance (p < 0.001). Less than half of adolescence were obesity class1, and more than one-third were obesity class II. There was a highly significant difference between students' knowledge and their practices pre- and post-nitro counseling program implementation. Conclusion This study confirmed that the total effect of obesity on adolescence self-esteem, social distress, and physical health demonstrated a highly significant difference between pre- and post-implementation of nitro counseling program. In addition to, improved adolescence knowledge and practices pre- and post-counseling implementation.
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Affiliation(s)
- Mustafa Mohammad Shouli
- Community Health Nursing Department, Nablus University for Vocational & Technical Education, Nablus, Palestine
| | - Khaila Mohammad Shouli
- Community Health Nursing Department, Nablus University for Vocational & Technical Education, Nablus, Palestine
| | - Ibrahim Aqtam
- Menatl Health Nursing Department, Nablus University for Vocational & Technical Education, Nablus, Palestine
| | - Ahmad Ayed
- Faculty of Nursing, Arab American University, Jenin, Palestine
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Jebeile H, Lister NB, Libesman S, Hunter KE, McMaster CM, Johnson BJ, Baur LA, Paxton SJ, Garnett SP, Ahern AL, Wilfley DE, Maguire S, Sainsbury A, Steinbeck K, Askie L, Braet C, Hill AJ, Nicholls D, Jones RA, Dammery G, Grunseit AM, Cooper K, Kyle TK, Heeren FA, Quigley F, Barnes RD, Bean MK, Beaulieu K, Bonham M, Boutelle KN, Branco BHM, Calugi S, Cardel MI, Carpenter K, Cheng HL, Dalle Grave R, Danielsen YS, Demarzo M, Dordevic A, Eichen DM, Goldschmidt AB, Hilbert A, Houben K, Lofrano do Prado M, Martin CK, McTiernan A, Mensinger JL, Pacanowski C, do Prado WL, Ramalho SM, Raynor HA, Rieger E, Robinson E, Salvo V, Sherwood NE, Simpson SA, Skjakodegard HF, Smith E, Partridge S, Tanofsky-Kraff M, Taylor RW, Van Eyck A, Varady KA, Vidmar AP, Whitelock V, Yanovski J, Seidler AL. Eating disorders in weight-related therapy (EDIT): Protocol for a systematic review with individual participant data meta-analysis of eating disorder risk in behavioural weight management. PLoS One 2023; 18:e0282401. [PMID: 37428754 PMCID: PMC10332604 DOI: 10.1371/journal.pone.0282401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/07/2023] [Indexed: 07/12/2023] Open
Abstract
The Eating Disorders In weight-related Therapy (EDIT) Collaboration brings together data from randomised controlled trials of behavioural weight management interventions to identify individual participant risk factors and intervention strategies that contribute to eating disorder risk. We present a protocol for a systematic review and individual participant data (IPD) meta-analysis which aims to identify participants at risk of developing eating disorders, or related symptoms, during or after weight management interventions conducted in adolescents or adults with overweight or obesity. We systematically searched four databases up to March 2022 and clinical trials registries to May 2022 to identify randomised controlled trials of weight management interventions conducted in adolescents or adults with overweight or obesity that measured eating disorder risk at pre- and post-intervention or follow-up. Authors from eligible trials have been invited to share their deidentified IPD. Two IPD meta-analyses will be conducted. The first IPD meta-analysis aims to examine participant level factors associated with a change in eating disorder scores during and following a weight management intervention. To do this we will examine baseline variables that predict change in eating disorder risk within intervention arms. The second IPD meta-analysis aims to assess whether there are participant level factors that predict whether participation in an intervention is more or less likely than no intervention to lead to a change in eating disorder risk. To do this, we will examine if there are differences in predictors of eating disorder risk between intervention and no-treatment control arms. The primary outcome will be a standardised mean difference in global eating disorder score from baseline to immediately post-intervention and at 6- and 12- months follow-up. Identifying participant level risk factors predicting eating disorder risk will inform screening and monitoring protocols to allow early identification and intervention for those at risk.
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Affiliation(s)
- Hiba Jebeile
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Natalie B. Lister
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Sol Libesman
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Kylie E. Hunter
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Caitlin M. McMaster
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
| | - Brittany J. Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Louise A. Baur
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Susan J. Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Sarah P. Garnett
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Amy L. Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Denise E. Wilfley
- Washington University in St. Louis, St Louis, Missouri, United States of America
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Sainsbury
- The University of Western Australia, School of Human Sciences, Crawley, Western Australia, Australia
| | - Katharine Steinbeck
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- The Academic Department of Adolescent Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Lisa Askie
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan, Ghent, Belgium
| | - Andrew J. Hill
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, London, United Kingdom
- NIHR ACR Northwest London, London, United Kingdom
| | - Rebecca A. Jones
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Genevieve Dammery
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Alicia M. Grunseit
- Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Kelly Cooper
- Weight Issues Network, New South Wales, Australia
| | - Theodore K. Kyle
- ConscienHealth, Pittsburgh, Pennsylvania, United States of America
| | - Faith A. Heeren
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, United States of America
| | - Fiona Quigley
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Co. Antrim, Northern Ireland
| | - Rachel D. Barnes
- University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - Melanie K. Bean
- Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Kristine Beaulieu
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | | | - Kerri N. Boutelle
- Department of Pediatrics, University of California, San Diego, San Diego, California, United States of America
| | | | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda (VR), Italy
| | - Michelle I. Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, United States of America
- WW International, Inc., New York, NY, United States of America
| | - Kelly Carpenter
- Optum Center for Wellbeing Research, Seattle, Washington, United States of America
| | - Hoi Lun Cheng
- The Academic Department of Adolescent Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda (VR), Italy
| | | | - Marcelo Demarzo
- Mente Aberta, The Brazilian Center for Mindfulness and Health Promotion, Univesidade Federal de São Paulo, UNIFESP, Brazil
| | | | - Dawn M. Eichen
- Department of Pediatrics, University of California, San Diego, San Diego, California, United States of America
| | - Andrea B. Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Philadelphia, United States of America
| | - Anja Hilbert
- Research Unit Behavioral Medicine, Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Katrijn Houben
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Mara Lofrano do Prado
- Department of Psychology, California State University, San Bernardino, California, United States of America
- Department of Kinesiology, California State University, San Bernardino, California, United States of America
| | - Corby K. Martin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Anne McTiernan
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
| | - Janell L. Mensinger
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, Florida, United States of America
| | - Carly Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, United States of America
| | - Wagner Luiz do Prado
- Department of Kinesiology, California State University, San Bernardino, California, United States of America
| | - Sofia M. Ramalho
- Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, Braga, Portugal
| | - Hollie A. Raynor
- Department of Nutrition, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Elizabeth Rieger
- Research School of Psychology, Australian National University, Canberra, Australia
| | - Eric Robinson
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Vera Salvo
- Mente Aberta, The Brazilian Center for Mindfulness and Health Promotion, Univesidade Federal de São Paulo, UNIFESP, Brazil
| | - Nancy E. Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Sharon A. Simpson
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Evelyn Smith
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Stephanie Partridge
- Engagement and Co-design Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Marian Tanofsky-Kraff
- Departments of Medical and Clinical Psychology and Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | | | - Annelies Van Eyck
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
- Member of the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Krista A. Varady
- University of Illinois Chicago, Department of Kinesiology and Nutrition, Chicago, Illinois, United States of America
| | - Alaina P. Vidmar
- Children’s Hospital Los Angeles and Keck School of Medicine of University of Southern California, Los Angeles, CA, United States of America
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Los Angeles, California, United States of America
| | | | - Jack Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, Maryland, United States of America
| | - Anna L. Seidler
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
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Cardiovascular endurance and psychosocial health predict short- and long-term BMI-SDS reduction: results from the CHILT III program. Eur J Pediatr 2023; 182:2225-2234. [PMID: 36867234 PMCID: PMC9982786 DOI: 10.1007/s00431-023-04876-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/09/2023] [Accepted: 02/11/2023] [Indexed: 03/04/2023]
Abstract
This longitudinal study analyzes data from the Children's Health Interventional Trial (CHILT) III, an 11-month juvenile multicomponent weight management program. The objective is to identify predictors of changes in body mass index standard deviation scores (BMI-SDS), so as to further enable the advancement of existing interventions with sustained impact. This study's sample consists of 237 children and adolescents with obesity (8-17 years, 54% girls) participating in the CHILT III program between 2003 and 2021. Anthropometrics, demographics, relative cardiovascular endurance (W/kg), and psychosocial health (i.e., physical self-concept and self-worth) were assessed at program entry ([Formula: see text]), end ([Formula: see text]), and one-year follow-up ([Formula: see text]; n = 83). From [Formula: see text] to [Formula: see text], the mean BMI-SDS was reduced by -0.16 ± 0.26 units (p < 0.001). Media use and cardiovascular endurance at baseline and improvements in endurance and self-worth over the course of the program predicted changes in BMI-SDS (adj. R2 = 0.22, p < 0.001). From [Formula: see text] to [Formula: see text], mean BMI-SDS increased ([Formula: see text], p = 0.005). Changes in BMI-SDS from [Formula: see text] to [Formula: see text] were associated with parental education, improvements in cardiovascular endurance and physical self-concept, and BMI-SDS, media use, physical self-concept, and endurance level at program end (adj. R2 = 0.39, p < 0.001). Conclusions: This study highlights the need for comprehensive, sustainable weight management approaches, in order to sustain the initial treatment benefits. In this context, improvements in cardiovascular endurance and psychosocial health could be essential strategies to pursue in practice, as they significantly predicted reductions in BMI-SDS - both pre- to post-intervention and at follow-up. TRIAL REGISTRATION DRKS00026785; date of registration: 13.10.202, retrospectively registered. WHAT IS KNOWN • Childhood obesity is associated with the onset of noncommunicable diseases, many of which are likely to carry into adulthood. Thus, effective weight management strategies for affected children and their families are vital. However, achieving lasting positive health outcomes with multidisciplinary weight management programs remains challenging. WHAT IS NEW • According to this study, short- and longer-term BMI-SDS reductions are associated to cardiovascular endurance and psychosocial health. These factors should therefore be given even greater consideration in weight management strategies, as they may be important not only in themselves but also for long-term weight loss (maintenance).
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Zamorano-García D, Infantes-Paniagua Á, Cuevas-Campos R, Fernández-Bustos JG. Impact of Physical Activity-Based Interventions on Children and Adolescents' Physical Self-Concept: A Meta-Analysis. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:1-14. [PMID: 34860643 DOI: 10.1080/02701367.2021.1927945] [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: 07/21/2020] [Accepted: 05/05/2021] [Indexed: 06/13/2023]
Abstract
Background: Observational studies associate physical activity (PA) with improved perceptions of children and adolescents' physical self-concept (PSC) and global self-concept (GSC). However, only a few PA-based interventions exist for improving PSC and their results have been inconclusive. Objective: To determine the effect of specific PA-based programmes on the PSC (including its sub-dimensions) and GSC of children and adolescents, and to assess possible moderators. Methods: The databases Web of Science, Scopus, SportDiscus, PubMed, CINAHL, and Cochrane Library were reviewed in February 2020. Only studies with pre-post measurements and control groups were included. The impact of PA-based interventions was explored through different meta-analyses and moderator analyses. Results: Altogether, 20 studies were included in the meta-analysis. Positive and significant effects of PA were determined on self-perceived physical appearance (g = 0.13; 95% CI = 0.03, 0.23), self-perceived sport competence (g = 0.30; 95% CI = 0.09, 0.51), self-perceived physical fitness (g = 0.19; 95% CI = 0.05, 0.32), PSC (g = 0.31; 95% CI = 0.10, 0.52), and GSC (g = 0.17; 95% CI = 0.01, 0.33). The existence of additional interventions in PA-based programmes (e.g., interventions focused on psychological factors or healthy habits) moderated the influence of PA on self-perceived sport competence and physical fitness. Moreover, environment and time were distinguished as moderators for self-perceived physical appearance and sport competence. Further, intervention type, gender, and frequency of intervention moderated the effects of PA on PSC. Conclusions: PA-based interventions, especially in school, seem to be beneficial for the development of positive physical self-perceptions.
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Grünberg L, Eisenburger N, Ferrari N, Friesen D, Haas F, Klaudius M, Schmidt L, Joisten C. Secular Trend of Self-Concept in the Context of Childhood Obesity-Data from the CHILT III Programme, Cologne. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010127. [PMID: 36670677 PMCID: PMC9856785 DOI: 10.3390/children10010127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
Juvenile obesity is associated with a lower self-concept. Given the continued prevalence of obesity, we examined the secular trend of body mass index standard deviation score (BMI-SDS) and self-concept in participants of a German weight management programme (n = 242, 53.3% female, mean age 12.5 ± 2.1 years, mean BMI-SDS 2.45 ± 0.46) over a period of 15 years. Anthropometric data, physical fitness (watt/kg), and demographic data were assessed. The years 2005 to 2020 were grouped into six sections containing a mean of n = 40 participants. The questionnaire for the assessment of self and competence in children (FSK-K) was used to assess the following domains: "scholastic competence", "social competence", "physical appearance", "global self-worth", and "behavioural conduct". No significant between-group differences in self-assessment across self-concept domains were found. In all time periods, heavier children assigned the lowest rating to physical appearance. Social competence increased with higher physical fitness. Even though no negative trend in the self-concept of children with obesity was found in this cohort, the findings confirmed an association between juvenile overweight/obesity and lower physical self-concept, and between a better social competence and increasing physical fitness. Accompanying psychosocial care, therefore, rightly remains an important pillar of obesity therapy.
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Affiliation(s)
- Lisa Grünberg
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
- Correspondence:
| | - Nina Eisenburger
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Nina Ferrari
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
- Cologne Center for Prevention in Childhood and Youth, Heart Center Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - David Friesen
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Fabiola Haas
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Marlen Klaudius
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Lisa Schmidt
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Christine Joisten
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
- Cologne Center for Prevention in Childhood and Youth, Heart Center Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
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9
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Yiyi O, Jie P, Jiong L, Jinsheng T, Kun W, Jing L. Effects of short-video use on undergraduates’ weight- loss intention: a regulatory mediation model. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03611-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractThis research intends to explore the effects of short video use on college students’ weight loss intentions, and its intrinsic mechanism of action, based on the responses of 1268 students from three universities in southwest China to questionnaires with the instruments of a sports participation scale, body image scale, self-esteem scale and weight loss intention scale. The findings are listed as follows: 1) Short video use can significantly and positively predict weight loss intention; 2) Body image mediates the relationship between short video usage and weight loss intentions; 3) Self-esteem plays a regulatory effect as the direct path between short video use and weight loss intention as well as partial mediation effect of body image. The direct effect of short video use on weight loss intentions and the mediating effect of body image gradually increased with the decrease of self-esteem. The results of the study suggest that short video use can affect the weight loss intentions of college students through either a direct or indirect path created by the mediating role of body image. Meanwhile, the influence of self-esteem on weight loss intention can’t be ignored, which is another key factor that affects college students’ weight loss intentions beyond short video use and body image.
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10
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Petrovics P, Nagy A, Sandor B, Palfi A, Szekeres Z, Toth K, Szabados E. Examination of Self-Esteem, Body Image, Eating Attitudes and Cardiorespiratory Performance in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413172. [PMID: 34948781 PMCID: PMC8701836 DOI: 10.3390/ijerph182413172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 11/24/2022]
Abstract
Self-esteem, body image and eating attitudes are important characteristics regarding adolescent mental health. In our present work, we aimed to investigate these psychological items in adolescent boys and girls examining gender differences and correlations with the BMI-for-age and cardiorespiratory performance. 374 students (209 girls with an average age of 16.4 ± 1.08 years, and 165 boys with an average age of 16.5 ± 1.03 years) underwent investigation using the Rosenberg self-esteem scale, EAT-26 and BAT questionnaires. The BMI-for-age was calculated with BMI growth charts and the cardiorespiratory performance was measured with the 20 m shuttle run test. Our results showed that adolescent girls scored lower self-esteem and higher values for BAT and each scale of eating behaviors, such as uncontrolled eating, cognitive restraints and emotional eating compared to boys despite the fact, that obesity and overweight were more common among boys. No significant correlation was found between BMI and psychological test results in either boys or girls, however, subjective body shape and gender predicted self-esteem and BAT scores and the cognitive restraints in the eating attitudes. Uncontrolled and emotional eating were primarily influenced by gender, in which BMI played only a weaker role. Cardiorespiratory performance was positively associated with self-esteem and body image among boys, and it had a negative correlation regarding BMI in both genders.
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Affiliation(s)
- Peter Petrovics
- Institute of Physical Education and Sport Sciences, Faculty of Sciences, University of Pecs, H-7624 Pecs, Hungary;
| | - Alexandra Nagy
- State Hospital for Cardiology, H-8230 Balatonfüred, Hungary;
| | - Barbara Sandor
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Anita Palfi
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Zsolt Szekeres
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Kalman Toth
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pecs, H-7624 Pecs, Hungary;
| | - Eszter Szabados
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
- Correspondence:
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11
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Jebeile H, Cardel MI, Kyle TK, Jastreboff AM. Addressing psychosocial health in the treatment and care of adolescents with obesity. Obesity (Silver Spring) 2021; 29:1413-1422. [PMID: 34431234 DOI: 10.1002/oby.23194] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 01/22/2023]
Abstract
Obesity affects 158 million youth worldwide and is associated with psychosocial comorbidity. This review describes weight management options utilized by adolescents, including both self-directed weight loss and medically supervised obesity treatment interventions, and associated psychosocial impacts. A majority of adolescents with obesity attempt to manage weight on their own, primarily through attempting weight loss, sometimes with supplement use. Approaches such as these are associated with a degree of risk, disordered eating behaviors, and further weight gain. In contrast, medically supervised multicomponent interventions are associated with improved psychosocial health, including quality of life, self-esteem, and body image, and reduced symptoms of depression, anxiety, and eating disorders. Few studies utilizing antiobesity pharmacotherapy have reported psychosocial outcomes, and trials of bariatric surgery show some early improvements with a need for sustained psychological support following surgery. Greater access to medically supervised treatment services is required to facilitate obesity care for adolescents. Early data on psychosocial health and obesity treatment offer promising outcomes; however, larger randomized controlled trials and longer-term data are needed. Future research should include both physiological and psychosocial outcomes to assess impact of interventions on the holistic health of adolescents with obesity.
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Affiliation(s)
- Hiba Jebeile
- Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, Florida, USA
| | | | - Ania M Jastreboff
- Department of Internal Medicine (Endocrinology & Metabolism), Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Pediatrics (Pediatric Endocrinology), Yale University School of Medicine, New Haven, Connecticut, USA
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12
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Mitrani R, Kohut T, Panganiban J, Carr RM. Transition of Care Model for Pediatric Patients With Nonalcoholic Fatty Liver Disease. Clin Liver Dis (Hoboken) 2021; 18:30-36. [PMID: 34484702 PMCID: PMC8405046 DOI: 10.1002/cld.1093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/18/2020] [Accepted: 01/03/2021] [Indexed: 02/06/2023] Open
Affiliation(s)
- Robert Mitrani
- Division of Gastroenterology and HepatologyUniversity of PennsylvaniaPhiladelphiaPA
| | - Taisa Kohut
- Division of Gastroenterology, Hepatology and NutritionChildren’s Hospital of PhiladelphiaPhiladelphiaPA
| | - Jennifer Panganiban
- Division of Gastroenterology, Hepatology and NutritionChildren’s Hospital of PhiladelphiaPhiladelphiaPA
| | - Rotonya M. Carr
- Division of Gastroenterology and HepatologyUniversity of PennsylvaniaPhiladelphiaPA
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13
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Watson PM, McKinnon A, Santino N, Bassett-Gunter RL, Calleja M, Josse AR. Integrating needs-supportive delivery into a laboratory-based randomised controlled trial for adolescent girls with overweight and obesity: Theoretical underpinning and 12-week psychological outcomes. J Sports Sci 2021; 39:2434-2443. [PMID: 34157957 DOI: 10.1080/02640414.2021.1939948] [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: 10/21/2022]
Abstract
When designing efficacy trials, researchers have a responsibility to "do no harm" and to "do good". Given the psychological vulnerability of adolescent girls with overweight and obesity, it is important to consider the implications of participating in weight-related research studies. We investigated psychological outcomes from a 12-week laboratory-based randomised controlled trial aimed at improving body composition and bone health in adolescent girls with overweight and obesity. Sixty-three participants were randomised to three groups (Recommended dairy diet plus exercise (RDa, n = 24); Low dairy diet plus exercise (LDa, n = 25); no-intervention control (n = 14)). Self-Determination Theory-informed strategies were applied in both intervention groups to foster motivation and enhance psychological wellbeing. Motivation, perceived competence and self-perceptions were measured at 0 and 12 weeks. Fifty-four participants (24 RDa, 23 LDa, 7 Control) provided complete psychological data. There were no between group differences in 0- to 12-week change in motivation, perceived competence or global self-worth. Both intervention groups showed significant improvements in physical self-worth (p = 0.001), body satisfaction (p = 0.002) and perceived physical conditioning (p = 0.002), compared with the control group. A theory-informed, laboratory-based diet and exercise intervention produced favourable psychological outcomes for adolescent girls with overweight and obesity.
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Affiliation(s)
- Paula M Watson
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Amanda McKinnon
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Canada
| | - Nicholas Santino
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Canada
| | | | - Melissa Calleja
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, Canada
| | - Andrea R Josse
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Canada.,Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, Canada
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14
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A new application of TMR: A study on implicit self-esteem. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01883-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Jebeile H, Lister NB, Baur LA, Garnett SP, Paxton SJ. Eating disorder risk in adolescents with obesity. Obes Rev 2021; 22:e13173. [PMID: 33410207 DOI: 10.1111/obr.13173] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/22/2020] [Accepted: 10/27/2020] [Indexed: 01/13/2023]
Abstract
The intersection between adolescent obesity and eating disorder risk is one that requires urgent attention. This review aimed to synthesize the literature on the risk of clinical eating disorders in adolescents with obesity, discuss challenges with assessing risk, and examine implications for clinical practice and future research. Obesity and eating disorders can coexist resulting in exacerbated physical and psychological health issues. Recognized eating disorder risk factors, including body dissatisfaction, poor self-esteem, depression, and engaging in dieting behaviors, are elevated and frequently reported in adolescents with obesity, highlighting a vulnerability to the development of eating disorders. Unsupervised dieting to manage weight may exacerbate eating disorder risk, while structured and supervised weight management is likely to reduce eating disorder risk for most adolescents. However, some adolescents may present to an obesity service with an undiagnosed eating disorder or may develop an eating disorder during or following treatment. We conclude that a risk management approach, with screening or monitoring for eating disorder-related risk factors and behaviors, should be utilized to identify those at risk. Future research to identify eating disorder risk factors specific to adolescents with obesity is required to inform screening and monitoring protocols, patient care, and address current knowledge gaps.
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Affiliation(s)
- Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia.,Kids Research, The Children's Hospital at Westmead, Westmead, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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16
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House ET, Gow ML, Lister NB, Baur LA, Garnett SP, Paxton SJ, Jebeile H. Pediatric weight management, dietary restraint, dieting, and eating disorder risk: a systematic review. Nutr Rev 2021; 79:1114-1133. [PMID: 33608718 DOI: 10.1093/nutrit/nuaa127] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
CONTEXT Whether dietary restraint and dieting are risk factors associated with eating disorders has not been explored in the context of pediatric weight management. OBJECTIVE To review associations between dietary pediatric weight management, dietary restraint, dieting, and eating disorder risk. DATA SOURCES, SELECTION, AND EXTRACTION Four databases - MEDLINE, EMBASE, Cochrane Library, and PsycINFO - were searched to May 2020 to identify pediatric weight management interventions with a dietary component for children and adolescents with overweight or obesity. The review was limited to studies reporting dietary restraint and/or dieting at preintervention, postintervention, and/or follow-up. Screening and quality assessment were conducted in duplicate, and data extraction was completed by 1 reviewer and cross-checked for accuracy. Data extracted included study characteristics, dietary restraint/dieting, and eating disorder-related outcomes (including disordered eating, body image, self-esteem, depression, and anxiety). RESULTS A total of 26 papers, representing 23 studies, were included. Of these, 20 studies reported on dietary restraint, which increased (10 postintervention, 6 follow-up) or remained unchanged (7 postintervention, 5 follow-up), and 5 studies reported on dieting, which increased (1 study), remained unchanged (2 studies) or decreased (2 studies) postintervention. All studies that reported on other eating disorder risk factors (eg, binge eating, body dissatisfaction, and depression) and weight-related outcomes found improvement or no change postintervention or at follow-up. CONCLUSION The results of this review suggest that current measures of dietary restraint and dieting are not associated with eating disorder risk within the context of pediatric weight management; however, long-term data is limited. In addition, those current measures may not be suitable risk markers. Concerns about dietary restraint and dieting leading to eating disorders should not prevent access to quality care for young people with obesity. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. 2017 CRD42017069488.
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Affiliation(s)
- Eve T House
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Megan L Gow
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
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17
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Rozga M, Handu D. Current Systems-Level Evidence on Nutrition Interventions to Prevent and Treat Cardiometabolic Risk in the Pediatric Population: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2021; 121:2501-2523. [PMID: 33495106 DOI: 10.1016/j.jand.2020.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/07/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
Improving and maintaining cardiometabolic health remains a major focus of health efforts for the pediatric population. Recent research contributes understanding of the systems-level nutrition factors influencing cardiometabolic health in pediatric individuals. This scoping review examines current evidence on interventions and exposures influencing pediatric cardiometabolic health to inform registered dietitian nutritionists working at each systems level, ranging from individual counseling to public policy. A literature search of MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, and other databases was conducted to identify evidence-based practice guidelines, systematic reviews, and position statements published in English from January 2017 until April 2020. Included studies addressed nutrition interventions or longitudinal exposures for participants 2 to 17 years of age who were healthy or had cardiometabolic risk factors. Studies were categorized according level of the social-ecological framework addressed. The databases and hand searches identified 2614 individual articles, and 169 articles were included in this scoping review, including 6 evidence-based practice guidelines, 141 systematic reviews, and 22 organization position statements. The highest density of systematic reviews focused on the effects of dietary intake (n = 58) and interventions with an individual child or family through counseling or education (n = 54). The least frequently examined levels of interventions or exposures were at the policy level (n = 12). Registered dietitian nutritionists can leverage this considerable body of recent systematic reviews to inform a systems-level, collaborative approach to prevention and treatment of pediatric cardiometabolic risk factors.
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18
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Grootens-Wiegers P, van den Eynde E, Halberstadt J, Seidell JC, Dedding C. The "Stages Towards Completion Model": what helps and hinders children with overweight or obesity and their parents to be guided towards, adhere to and complete a group lifestyle intervention. Int J Qual Stud Health Well-being 2020; 15:1735093. [PMID: 32148191 PMCID: PMC7144242 DOI: 10.1080/17482631.2020.1735093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose: Lifestyle interventions can be effective in the management of overweight and obesity in children. However, ineffective guidance towards interventions and high attrition rates affect health impacts and cost effectiveness. The aim of this study was to gain insight into the factors influencing participation, in particular guidance towards, adherence to and completion of an intervention. Methods: A narrative literature review was performed to identify factors related to participation, leading to the development of the “Stages towards Completion Model”. Semi-structured interviews (n = 33) and three focus group discussions (n = 25) were performed with children and parents who completed two different group lifestyle interventions, as well as with their coaches. Results: The main barrier to participating in a lifestyle intervention was the complex daily reality of the participants. The main facilitator to overcome these barriers was a personal approach by all professionals involved. Conclusions: Participation in a lifestyle intervention is not influenced by one specific factor, but by the interplay of facilitators and barriers. A promising way to stimulate participation and thereby increase the effectiveness of interventions would be an understanding of and respect for the complex circumstances of participants and to personalize guidance towards and execution of interventions.
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Affiliation(s)
- Petronella Grootens-Wiegers
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Medical Ethics and Health Law, Leiden University Medical Center, Leiden, The Netherlands
| | - Emma van den Eynde
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Amsterdam, The Netherlands.,Department of Pediatric Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jutka Halberstadt
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Amsterdam, The Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Amsterdam, The Netherlands
| | - Christine Dedding
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Medical Humanities, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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19
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Cardel MI, Szurek SM, Dillard JR, Dilip A, Miller DR, Theis R, Bernier A, Thompson LA, Dulin A, Janicke DM, Lee AM. Perceived barriers/facilitators to a healthy lifestyle among diverse adolescents with overweight/obesity: A qualitative study. Obes Sci Pract 2020; 6:638-648. [PMID: 33354342 PMCID: PMC7746964 DOI: 10.1002/osp4.448] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 11/24/2022] Open
Abstract
Objective Effectiveness of behavioural obesity treatments in adolescents is modest. Thus, incorporating participant feedback may lead to improvement of intervention acceptability. This qualitative study's objective was to assess perceived barriers/facilitators to weight loss and healthy lifestyles among diverse adolescents with overweight/obesity (OW/OB). Methods Adolescents ages 14-19 with BMI ≥ 85th percentile participated in focus groups and identified perceived barriers/facilitators to weight loss and healthy lifestyles. Results Ten sex-stratified focus groups (n = 41; n = 13 males, n = 28 females) were conducted in 2018 and 2019. Females reported experiencing weight struggles, whereas males often stated no struggles with weight, despite all participants meeting criterion for OW/OB. Barriers included eating behaviours, family members and internal motivation, with additional barriers of physical activity, friends, time and support cited in females. Facilitators included parental, familial and peer support of healthy eating and exercise, modelling behaviours, internal motivation and organized sports. Two additional findings regarding adolescents' perceived barriers/facilitators include substantial overlap and sex differences of perceived barriers/facilitators. Conclusions Adolescent males and females with OW/OB experience weight status differently, affecting their perceived barriers/facilitators to weight loss and healthy lifestyles. Tailoring weight management interventions to the unique needs of adolescent females versus adolescent males has the potential to improve intervention quality and effectiveness.
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Affiliation(s)
- Michelle I. Cardel
- Department of Health Outcomes and Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Sarah M. Szurek
- Department of Health Outcomes and Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Julia R. Dillard
- Department of Health Outcomes and Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Abhya Dilip
- Department of Health Outcomes and Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Darci R. Miller
- Department of Health Outcomes and Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Ryan Theis
- Department of Health Outcomes and Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Angelina Bernier
- Department of Pediatrics, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Lindsay A. Thompson
- Department of Pediatrics, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - A. Dulin
- Department of Behavioral and Social Sciences, Center for Health Equity ResearchBrown University School of Public HealthProvidenceRhode IslandUSA
| | - David M. Janicke
- Department of Clinical and Health Psychology, College of Public Health and Health ProfessionsUnivsersity of FloridaGainesvilleFloridaUSA
| | - Alex M. Lee
- Department of Health Outcomes and Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
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20
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Rêgo ALV, Pereira RA, Oliveira AJD, Lopes CS. INDICATORS OF ADIPOSITY ASSOCIATED WITH LOW BODY ESTEEM IN ADOLESCENTS. ACTA ACUST UNITED AC 2020; 38:e2018383. [PMID: 32187299 PMCID: PMC7077795 DOI: 10.1590/1984-0462/2020/38/2018383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/20/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the association between weight status and anthropometric indicators of adiposity with body esteem. METHODS Cross-sectional study including 305 adolescents from a public school in Rio de Janeiro, Brazil. Data were collected by a self-administered questionnaire and anthropometric measurements. The Body-Esteem Scale for Adolescents and Adults was used to evaluate total body esteem and the "appearance", "weight", and "attribution" domains. Body mass index (weight/stature2) was applied to assess weight status and waist circumference, the central body adiposity. The association between indicators of adiposity and body esteem was assessed using Student's t-test or Mann-Whitney's test and linear regression models, stratified by sex and age group. RESULTS Overweight/obesity was observed in 46% of younger adolescents (10 to 13 year-old girls, 10 to 14 year-old boys), 38% of older boys (15 to 18 year old), and 16% of older girls (14 to 18 year old). For both boys and girls in the younger age group, body mass index and waist circumference (as continuous variables) were inversely associated with total body esteem and weight domain. Overweight/obesity was associated with the appearance body esteem domain only among younger male adolescents; no association was found between either the body mass index or waist circumference and the attribution domain. CONCLUSIONS Indicators of adiposity were associated with low body esteem. These findings underscore the fact that considering adolescents' feelings concerning their body and appearance is important to promote a healthy control of weight.
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Affiliation(s)
- Ana Lúcia Viégas Rêgo
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Rosangela Alves Pereira
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Claudia Souza Lopes
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Gow ML, Tee MSY, Garnett SP, Baur LA, Aldwell K, Thomas S, Lister NB, Paxton SJ, Jebeile H. Pediatric obesity treatment, self-esteem, and body image: A systematic review with meta-analysis. Pediatr Obes 2020; 15:e12600. [PMID: 32020780 DOI: 10.1111/ijpo.12600] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pediatric obesity impacts on multiple domains of psychological health, including self-esteem and body image. OBJECTIVE To determine the effect of multicomponent pediatric obesity treatment interventions on self-esteem and body image. METHODS A systematic search of published literature up to June 2019 was undertaken using electronic databases MEDLINE, EMBASE, Cochrane Library, and PsychINFO. Eligible studies implemented an obesity treatment intervention, including a dietary and physical activity component with/without a behavioral component, in children and adolescents with overweight/obesity, and assessed self-esteem and/or body image. Data were extracted by one reviewer and cross-checked. Meta-analysis was used to combine outcome data and moderator analysis conducted to identify intervention characteristics influencing outcomes. RESULTS 64 studies were identified. Meta-analysis of 49 studies (n = 10471) indicated that pediatric obesity treatment results in increased self-esteem postintervention (standardized mean difference, [SE] 0.34 [0.03], P < .001, I2 87%), maintained at follow-up (0.35 [0.05] P < .001, I2 79%, 17 studies). Similarly, meta-analysis of 40 studies (n = 2729) indicated improvements in body image postintervention (0.40 [0.03], P < .001, I2 73%), maintained at follow-up (0.41 [0.08], P < .001, I2 89%, 16 studies). CONCLUSIONS Pediatric obesity treatment improves self-esteem and body image in the short and medium term. These findings may underpin improvements in other psychological outcomes.
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Affiliation(s)
- Megan L Gow
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Melissa S Y Tee
- The University of Sydney, Faculty of Medicine and Health, Sydney, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Weight Management Services, The Children's Hospital at Westmead, Sydney, Australia
| | - Katharine Aldwell
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Sarah Thomas
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
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22
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Andrade A, Correia CK, Coimbra DR. The Psychological Effects of Exergames for Children and Adolescents with Obesity: A Systematic Review and Meta-Analysis. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 22:724-735. [PMID: 31697604 DOI: 10.1089/cyber.2019.0341] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The systematic review and meta-analysis were conducted to analyze the psychological effects of exergames for children and adolescents with overweight or obesity. In August 2018, the electronic databases searched were PubMed, Scopus, Web of Science, SPORTDiscus, Science Direct, CINAHL, and PsycINFO. The eligibility criteria were defined according to the population, intervention, comparison, outcome, and study design. In relation to the population, only studies with children or adolescents with overweight or obesity and without any other comorbidities were analyzed. Only publications in English were considered. Nine studies were selected. The comparisons identified were in relation to weight, type of activity, and play style versus control and preintervention. The magnitude of effect size suggests that the practice of exergaming has a small effect on psychological outcomes. Furthermore, cooperative games produced greater attraction to the game (g = 4.71, 95% confidence interval [CI] = 3.23-6.19) and greater intrinsic motivation (g = 5.29; 95% CI = 3.68-6.90). It was verified that self-esteem (standard mean difference [SMD] = 0.37; 95% CI = 0.09-0.66), and self-efficacy (SMD = 0.42; 95% CI = 0.06-0.79) improved after playing an exergame. This systematic review and meta-analysis suggest that exergames may be effective in improving psychological aspects of children and adolescents with overweight or obesity. Given the limited number of studies, it is essential to increase scientific research in this area.
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Affiliation(s)
- Alexandro Andrade
- Laboratory of Psychology of Sport and Exercise, Department of Physical Education, Center of Health Sciences and Sports, Santa Catarina State University, Florianópolis, Brazil
| | - Clara Knierim Correia
- Laboratory of Psychology of Sport and Exercise, Department of Physical Education, Center of Health Sciences and Sports, Santa Catarina State University, Florianópolis, Brazil
| | - Danilo Reis Coimbra
- Laboratory of Psychology of Sport and Exercise, Department of Physical Education, Center of Health Sciences and Sports, Santa Catarina State University, Florianópolis, Brazil
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Lister NB, Jebeile H, Truby H, Garnett SP, Varady KA, Cowell CT, Collins CE, Paxton SJ, Gow ML, Brown J, Alexander S, Chisholm K, Grunseit AM, Aldwell K, Day K, Inkster MK, Lang S, Baur LA. Fast track to health - Intermittent energy restriction in adolescents with obesity. A randomised controlled trial study protocol. Obes Res Clin Pract 2020; 14:80-90. [PMID: 31818675 DOI: 10.1016/j.orcp.2019.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/20/2019] [Accepted: 11/20/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Intermittent energy restriction (IER) has shown early success in adolescents with obesity, however efficacy trials are needed. This study aims to determine if IER results in lower body mass index (BMI) z-score after 52 weeks in metabolically unhealthy adolescents with obesity compared with continuous energy restriction (CER). METHODS/DESIGN This is a prospective, randomised, multi-centre trial conducted in tertiary care settings, with three phases: jumpstart (weeks 0-4); intensive intervention (weeks 5-16); continued intervention and/or maintenance (weeks 17-52). During the jumpstart phase, all participants follow a very low energy diet (∼800kcal/3350kJ/day), then transition to their allocated intervention: IER or CER. IER involves three energy-restricted days/week, consuming one-third of daily energy requirements (∼600-700kcal/2500-2950kJ/day), and four days/week of a healthy meal plan. The CER, which is current standard care, has individually tailored energy prescription based on age and sex (13-14years, 1430-1670kcal/6000-7000kJ/day; 15-17years, 1670-1900kcal/7000-8000kJ/day). The study will recruit 186 (93 per arm) treatment-seeking adolescents aged 13-17years with obesity and at least one metabolic co-morbidity. The primary outcome is change in BMI z-score at 52 weeks. Secondary outcomes are changes at 4, 16 and 52 weeks in: body composition; diet quality, food choices and food patterns; cardio-metabolic risk factors; physical activity and sedentary behaviour; sleep and psycho-behavioural measures. DISCUSSION This study challenges existing clinical paradigms that CER is the only method for weight management in metabolically unhealthy adolescents. If successful, IER may offer an alternate medical nutrition therapy approach for those seeking treatment in tertiary settings. CLINICAL TRIAL REGISTRATION NUMBER ACTRN12617001630303.
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Affiliation(s)
- Natalie B Lister
- The University of Sydney, Sydney Medical School, Discipline of Child and Adolescent Health, Westmead, NSW 2145, Australia; The Children's Hospital at Westmead, Institute of Endocrinology and Diabetes, Westmead, NSW 2145, Australia.
| | - Hiba Jebeile
- The University of Sydney, Sydney Medical School, Discipline of Child and Adolescent Health, Westmead, NSW 2145, Australia; The Children's Hospital at Westmead, Institute of Endocrinology and Diabetes, Westmead, NSW 2145, Australia
| | - Helen Truby
- Monash University, Nutrition, Dietetics & Food, Melbourne, VIC, Australia
| | - Sarah P Garnett
- The University of Sydney, Sydney Medical School, Discipline of Child and Adolescent Health, Westmead, NSW 2145, Australia; The Children's Hospital at Westmead, Institute of Endocrinology and Diabetes, Westmead, NSW 2145, Australia; Kids Research, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Krista A Varady
- University of Illinois, Department of Kinesiology and Nutrition, Chicago, USA
| | - Christopher T Cowell
- The University of Sydney, Sydney Medical School, Discipline of Child and Adolescent Health, Westmead, NSW 2145, Australia; The Children's Hospital at Westmead, Institute of Endocrinology and Diabetes, Westmead, NSW 2145, Australia; Kids Research, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Clare E Collins
- University of Newcastle, Priority Research Centre in Physical Activity and Nutrition, School of Health Sciences, Faculty of Health and Medicine, Newcastle, NSW 2308, Australia
| | - Susan J Paxton
- La Trobe University, School of Psychology and Public Health, Melbourne, VIC, Australia
| | - Megan L Gow
- The University of Sydney, Sydney Medical School, Discipline of Child and Adolescent Health, Westmead, NSW 2145, Australia; The Children's Hospital at Westmead, Institute of Endocrinology and Diabetes, Westmead, NSW 2145, Australia
| | - Justin Brown
- Monash University, Department of Paediatrics, Clayton, VIC 3168, Australia; Monash Children's Hospital, Department of Paediatric Endocrinology and Diabetes, Clayton, VIC 3168, Australia
| | - Shirley Alexander
- The Children's Hospital at Westmead, Weight Management Services, Westmead, NSW 2145, Australia
| | - Kerryn Chisholm
- The Children's Hospital at Westmead, Weight Management Services, Westmead, NSW 2145, Australia; The Children's Hospital at Westmead, Nutrition and Dietetics, Westmead, NSW 2145, Australia
| | - Alicia M Grunseit
- The Children's Hospital at Westmead, Weight Management Services, Westmead, NSW 2145, Australia; The Children's Hospital at Westmead, Nutrition and Dietetics, Westmead, NSW 2145, Australia
| | - Katharine Aldwell
- The Children's Hospital at Westmead, Institute of Endocrinology and Diabetes, Westmead, NSW 2145, Australia
| | - Kaitlin Day
- Monash University, Nutrition, Dietetics & Food, Melbourne, VIC, Australia
| | - Mary-Kate Inkster
- Monash University, Nutrition, Dietetics & Food, Melbourne, VIC, Australia; Monash Children's Hospital, Department of Paediatric Endocrinology and Diabetes, Clayton, VIC 3168, Australia
| | - Sarah Lang
- Monash University, Nutrition, Dietetics & Food, Melbourne, VIC, Australia
| | - Louise A Baur
- The University of Sydney, Sydney Medical School, Discipline of Child and Adolescent Health, Westmead, NSW 2145, Australia; The Children's Hospital at Westmead, Weight Management Services, Westmead, NSW 2145, Australia
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ALAhmari T, Alomar AZ, ALBeeybe J, Asiri N, ALAjaji R, ALMasoud R, Al-Hazzaa HM. Associations of self-esteem with body mass index and body image among Saudi college-age females. Eat Weight Disord 2019; 24:1199-1207. [PMID: 29282654 DOI: 10.1007/s40519-017-0471-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 12/08/2017] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To examine the association of self-esteem with the body mass index (BMI), perceived body image (BI), and desired BI of college-age Saudi females. METHODS A cross-sectional study was conducted with 907 randomly selected females using a multistage stratified cluster sampling technique. Self-esteem and BI were assessed using the Rosenberg Self-Esteem Scale and Stunkard Figure Rating Scale, respectively. RESULTS The prevalence of low self-esteem was only 6.1% among college females; however, this percentage was higher (9.8%) among overweight or obese participants. The total self-esteem scores showed significant negative correlations with actual BMI and perceived BI, but not with desired BI. Meanwhile, multivariate analyses revealed significant differences in total self-esteem scores according to obesity/overweight status and perceived BI group, but not desired BI group. CONCLUSION Despite the high prevalence of overweight and obesity in Saudi Arabia, few Saudi college females have low self-esteem. In addition, body weight, BMI, perceived BI, and the BMI corresponding to the perceived BI all significantly differed between females with low self-esteem and those with normal self-esteem. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Tasneem ALAhmari
- College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi Arabia
| | - Abdulaziz Z Alomar
- College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi Arabia.
- Department of Orthopedics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
| | - Jumanah ALBeeybe
- College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi Arabia
| | - Nawal Asiri
- College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi Arabia
| | - Reema ALAjaji
- College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi Arabia
| | - Reem ALMasoud
- College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi Arabia
| | - Hazzaa M Al-Hazzaa
- Professor Emeritus, Pediatric Exercise Physiology Research Laboratory, King Saud University, Riyadh, Saudi Arabia
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Bonilla Ibañez CP, Díaz Heredia LP. Características de las intervenciones realizadas con adolescentes en condición de sobrepeso y obesidad: una revisión integrativa. REVISTA CUIDARTE 2019. [DOI: 10.15649/cuidarte.v10i3.681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: Dado que el sobrepeso y la obesidad en la población adolescente van en aumento, es necesario identificar las intervenciones para la prevención y manejo de estas condiciones en el grupo de jóvenes. Objetivo: Presentar la evidencia encontrada, en relación con las características de las intervenciones publicadas en revistas científicas indexadas, sobre la prevención y manejo del sobrepeso y de la obesidad, respecto de la nutrición y la actividad física, para ser utilizada en la toma de decisiones, en cuanto a políticas y programas de promoción y prevención de esta condición de salud. Materiales y Métodos: Se realizó la revisión sistemática de estudios cualitativos y cuantitativos (desde descriptivos hasta experimentales, que incluyeran tanto revisiones sistemáticas como meta-análisis), publicados en el período comprendido entre 2005 y 2017, a través de las bases de datos PubMed y ScienceDirect, las bibliotecas virtuales Ovid y SciELO, y el compendio de revisiones Cochrane. Resultados: Existe gran variedad en diseño e implementación de las intervenciones, en cuanto a componentes, teorías, escenarios, evaluación de los efectos, dosis, tiempo y seguimiento, que tienen efecto en los hábitos nutricionales, en la actividad física, en la autoeficacia y en el índice de masa corporal (IMC) de la población estudiada. Discusión: La efectividad de las intervenciones varía, dependiendo de los componentes y de la fidelidad en la aplicación de la misma, lo cual debe revisarse a la luz de los mejores efectos encontrados. Conclusiones: 47 estudios cumplieron los requisitos de inclusión. Las intervenciones se robustecen con el uso de una teoría que direccione y fundamente los hallazgos que permitan dar mayores y mejores resultados. Los componentes de las intervenciones incluyen: duración, dosis, intensidad de la intervención, respuesta y seguimiento. Los adolescentes prefieren metodologías participativas e interactivas; sin embargo, aún no existe una intervención concreta y claramente definida que pueda ser estandarizada para enfrentar este problema de salud.
Como citar este artículo: Bonilla CP, Díaz LP. Características de las intervenciones realizadas con adolescentes en condición de sobrepeso y obesidad: una revisión integrativa. Rev Cuid. 2019; 10(3): e681. http://dx.doi.org/10.15649/cuidarte.v10i3.681
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The Effectiveness of Physical Activity Interventions for Low-Income and Ethnic Minority Children and Youths: A Meta-Analysis. J Phys Act Health 2019; 16:799-808. [DOI: 10.1123/jpah.2018-0648] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/06/2019] [Accepted: 04/23/2019] [Indexed: 11/18/2022]
Abstract
Background: Children and youths from low-income families and certain ethnic minority groups show high levels of risk and vulnerability to physical inactivity. The aim of this review was to examine the effectiveness of interventions to increase physical activity (PA) in children and youths from low-income and ethnic minority (LIEM) families. Methods: Eight databases were systematically searched for PA interventions for LIEM children and youths. Twenty-six studies were included in the analyses. Effect sizes (ESs) were calculated using a random-effects model. The ESs were computed using Hedges g with 95% confidence interval. Results: There were small to medium effects of interventions on PA in LIEM children and youth (Q = 1499.193, df = 30, P < .05; I2 = 97.999). Analyses on the moderator variables showed that ES for participants aged 9–12 years (ES = 0.542, P = .01); intervention length less than 13 weeks (ES = 0.561, P = .01); specialists as the intervention agent (ES = 0.680, P < .05); interventions without technology (ES = 0.363, P = .02); and interventions with a behavioral modification component (ES = 0.336, P = .03) were significantly different from zero. Conclusion: PA intervention can be an effective strategy to increase PA for LIEM children and youths.
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Bahia L, Schaan CW, Sparrenberger K, Abreu GDA, Barufaldi LA, Coutinho W, Schaan BD. Overview of meta-analysis on prevention and treatment of childhood obesity. J Pediatr (Rio J) 2019; 95:385-400. [PMID: 30121174 DOI: 10.1016/j.jped.2018.07.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 06/25/2018] [Accepted: 07/03/2018] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES This study aimed to assess the quality of systematic reviews on prevention and non-pharmacological treatment of overweight and obesity in children and adolescents. DATA SOURCE A search was done in electronic databases (Medline via PubMed, Web of Science, Scopus, LILACS, the Cochrane Library, and Clinical Trials), including only systematic reviews with meta-analysis. Reviews were selected by two researchers, and a third one solved the divergences. PRISMA statement and checklist were followed. SUMMARY OF DATA A total of 4574 records were retrieved, including 24 after selection. Six reviews were on obesity prevention, 17 on obesity treatment, and one on mixed interventions for prevention and treatment of obesity. The interventions were very heterogeneous and showed little or no effects on weight or body mass index. Mixed interventions that included dieting, exercise, actions to reduce sedentary behavior, and programs involving the school or families showed some short-term positive effects. Reviews that analyzed cardiovascular risk factors demonstrated significant improvements in the short-term. CONCLUSION The systematic reviews of interventions to prevent or reduce obesity in children and adolescents generally showed little or no effects on weight or body mass index, although cardiovascular profile can be improved. Mixed interventions demonstrated better effects, but the long-term impact of obesity treatments of children and adolescents remains unclear.
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Affiliation(s)
- Luciana Bahia
- Universidade do Estado do Rio de Janeiro (UERJ), Departamento de Medicina Interna, Rio de Janeiro, RJ, Brazil; Instituto de Avaliação de Tecnologia em Saúde (IATS), Porto Alegre, RS, Brazil
| | - Camila Wohlgemuth Schaan
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
| | - Karen Sparrenberger
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil.
| | - Gabriela de Azevedo Abreu
- Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, RJ, Brazil
| | - Laura Augusta Barufaldi
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde, Brasília, DF, Brazil
| | - Walmir Coutinho
- Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Instituto Estadual de Diabetes e Endocrinologia (IEDE), Rio de Janeiro, RJ, Brazil
| | - Beatriz D Schaan
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Medicina Interna, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
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Bahia L, Schaan CW, Sparrenberger K, Abreu GDA, Barufaldi LA, Coutinho W, Schaan BD. Overview of meta‐analysis on prevention and treatment of childhood obesity. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Chen JL, Guedes CM, Lung AE. Smartphone-based Healthy Weight Management Intervention for Chinese American Adolescents: Short-term Efficacy and Factors Associated With Decreased Weight. J Adolesc Health 2019; 64:443-449. [PMID: 30409751 DOI: 10.1016/j.jadohealth.2018.08.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/02/2018] [Accepted: 08/22/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE This study aimed to examine the short-term efficacy of a smartphone-based intervention for Chinese American adolescents who are overweight or obese and to explore factors associated with decreased body mass index (BMI). METHODS A randomized controlled study design was used. Intervention group received culturally appropriate and tailored educational program for weight management while control group received general health information. Anthropometrics, blood pressure, levels of physical and sedentary activity, diet, self-efficacy, and quality of life were assessed at baseline, 3 months, and 6 months. Linear mixed-effects models and regression models were used to analyze outcomes. RESULTS The study included 40 adolescent participants. Adolescents in the intervention reduced their BMI (z = -4.89, p < .001), BMI z score (z = -4.72, p < .001), sugary beverage (z = -.44, P = .001), and TV and computer time (z = -.51, p < .001) and increasing in self-efficacy in nutrition and physical activity significantly more than those in the control group. BMI reduction was significantly correlated with decreased fast food consumption and increased physical activity (F = 6.99, p = .007, r2 = .40). Being female and decreased sugary beverage consumption were related to decreased BMI z score (F = 8.38, p = .003, r2 = .511). CONCLUSIONS A culturally appropriate smartphone-based intervention has great potential to reduce obesity and improve adherence to a healthy lifestyle. Reducing sugary beverages and fast food intake and decreasing sedentary time are associated with decreased BMI among adolescents who are overweight or obese.
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Affiliation(s)
- Jyu-Lin Chen
- University of California San Francisco, San Francisco, California.
| | - Claudia Maria Guedes
- Department of Kinesiology, San Francisco State University, San Francisco, California
| | - Audrey E Lung
- North East Medical Services, San Francisco, California
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