"Stop eating lollies and do lots of sports": a prospective qualitative study of the development of children's awareness of dietary restraint and exercise to lose weight

"He's a little skinny and he's a little wide.": a mixed design investigation of American Indian student perceptions of healthy bodies

BACKGROUND

Childhood is a critical developmental time of wellness patterns, yet little is known about what children know and believe. Even less is known about non-majority cultures like American Indian youth. The purpose of this study was to explore American Indian students' understandings of nutrition and physical activity.

METHODS

This mixed methods study took place in 10 schools in an American Indian community in the Southwestern U.S. Ninety American Indian students in grades 3-12 (8-19 years old) were interviewed. The interview included an 8-point body size chart. Numerical data were analyzed via t-test statistics while a constant comparison process and analysis was used for the interview data.

RESULTS

Students rated approximately 85% of students in Category 5 or smaller on the scale while placing 60% of adults at or above that size. There was a general trend of a larger body type for boys seen as healthy compared to that for girls. Students generally believed that their classmates were larger than the healthy body size. For students, a healthy body was the result of compliance with "eat right and exercise" rules. They exhibited little understanding of nutrition or physical activity and there were few developmental differences in understanding. Health was a corporeal concept and violators of the eat right and exercise rules were seen as lazy.

CONCLUSIONS

Students held narrow and corporeal focused notions of health focused on simple rules. People who violated the rules were "lazy", a concept that seemed to underlie multiple constructs and a finding that holds true in other investigations. Students also reported few adult role models, a topic that should be explored with expanded family groups to better represent the multi-generational (e.g. grandparents, uncles, aunts) family housing common in the community. The findings are limited to a single American Indian community and a mixed design of relatively small numbers. This addition to the literature from a non-majority cultural group expands our knowledge of student perspectives on health. These findings can be used to create more effective curricula and interventions. Schools need more effective, but also alternately framed approaches that promote broader views of health.

Diet Quality and Changes in Food Intake during the University Studies in Polish Female Young Adults: Linkages with Food Experiences from Childhood and Perceived Nutrition Concerns

The transition from adolescence to young adulthood may be associated with unfavorable changes in food intake due to some substantial transformations in social life and environment. Factors that affect food choices and diet quality during early adulthood are still not well-recognized. This paper aims to explore the relationship between females’ childhood food experiences related to parents’ monitoring practices and healthy eating guidance, perceived nutrition concerns, changes in food intake during university studies, and diet quality. A cross-sectional study with the use of CAWI (Computer-Assisted Web Interview) was carried out on 657 female students aged 19–30 years. Beliefs and Eating Habits Questionnaire (KomPAN) was used to assess the frequency of eating various kinds of food and then to calculate the diet-quality index (DQI). Adults’ Memories of Feeding in Childhood (AMoFiC) questionnaire was used to assess food experiences from childhood, and Health Concern Scale (HCS) was used to assess nutrition concerns. Associations between changes in food intake, diet quality, and selected factors describing the study sample were verified using logistic regression analysis. The DQI of the majority of students indicated a low intensity of nonhealthy and pro-healthy dietary characteristics. The intensity was higher among nutrition and health students, those with low nutrition concerns, and those with childhood experiences of monitoring. The chances of a negative change in food intake were increased by a higher score for childhood food experiences associated with parents’ monitoring practices. The chances of a negative DQI were increased by bigger concerns about nutrition and by technical and agricultural majors; however, they were reduced by positive changes in food intake. Both childhood food experiences and perceived nutrition concerns should be factored into strategies aimed at improving youth diet and educating parents about effective parental feeding practices.

Gender Typicality, Pressure to Conform to Gender Norms, and Anti-Fat and Appearance Stereotypes in Girls

This mixed-methods study investigated the relation among gender identity (i.e., self-perceived gender similarity to girls and boys; self-perceived parental and peer pressure to conform to gender norms) and stereotyping about weight (i.e., anti-fat stereotypes), weight change, and appearance in 83 girls ages 6-9 (M_age = 7.60 years, SD = .85; 65% White, 16% Mixed/Other, 11% Black, 8% Latina) in the U.S. Stereotypes about weight change were assessed with open-ended responses (i.e., qualitatively), and the rest of the constructs were assessed with closed-ended responses (i.e., quantitatively). There was a positive association between pressure from parents to conform to gender norms and appearance stereotypes, and between pressure from peers and negative stereotypes about the fat and thin figures. Girls who were more gender typical, or more similar to girls, were more likely to endorse appearance stereotypes. There was no significant relation among stereotypes about weight change and gender identity. Many girls deemed the fat figure as unattractive, physically restrained, unhealthy, and likely to be bullied and believed that the fat figure should change back to look like a thinner figure. Most girls were aware that exercising, eating healthy, and dietary restriction can lead to weight loss and that food consumption and lack of exercise can lead to weight gain. Findings suggest that certain aspects of weight (anti-fat) and appearance stereotypes are closely linked to gender identity in girls, whereas other aspects of weight stereotypes (e.g., stereotypes about weight change) are so pervasive that they are common in most girls, regardless of their gender identity.

Do we cause harm? Understanding the impact of research with young children about their body image

Although research into the early development of body image and eating behaviors is essential, concerns have been raised about whether their assessment might precipitate body or eating concerns in children. We aimed to identify how parents perceived their young children (under 9 years) had been impacted from involvement in the longitudinal Children's Body Image Development Study (CBIDS) that assessed body image and eating behaviors. Participants were 218 parents (99 % mothers) who completed an online questionnaire assessing whether and why their child discontinued participation in CBIDS, and the perceived impact of participation on children's body image, weight attitudes, language about bodies, internalisation of appearance ideals, peer appearance conversations, dietary restraint, muscle building activities, and physical activity. Impact and reasons for cessation of participation were assessed retrospectively. Almost all parents were positive or neutral about their child's involvement, 0.5%-3.2% of parents perceived a negative impact in an area, and 0.9 % of parents moderately agreed that they regretted participating in CBIDS. Themes for positive and negative aspects of CBIDS involvement were explored using thematic analysis. Although research is essential to guide development of prevention strategies, this study highlights the need to implement safeguards to ensure a positive experience for all children.

The paths to children’s disordered eating: The implications of BMI, weight-related victimization, body dissatisfaction and parents’ disordered eating

Background

Being the target of peer victimization is frequent among children categorized as overweight and obese and is thought to play a central role in disordered eating behavior development. In accordance with a previous theoretical model, this cross-sectional study aimed to replicate among children the mediating role of weight-related victimization from peers and body dissatisfaction in the association between body mass index (BMI) and children’s disordered eating attitudes and behaviors (CDEAB), while also taking into account the contribution of parents’ disordered eating attitudes and behaviors (PDEAB).

Methods

Participants were 874 children aged between 8 and 12 years old who were recruited in elementary schools. Height and weight were measured and used to calculate BMI. Self-reported questionnaires were used to measure weight-related victimization, body dissatisfaction, CDEAB and PDEAB.

Results

For both girls and boys, a path analysis showed no direct effect of BMI on CDEAB, but a significant indirect effect was found, indicating that weight-related victimization and body dissatisfaction mediated this relationship. In addition, the indirect effect of weight-related victimization and body dissatisfaction remained significant even when controlling for PDEAB.

Conclusion

While weight itself appears to be insufficient to explain CDEAB, weight-related victimization may lead children to see their weight as problematic and develop disordered attitudes and behaviors toward eating. This suggests that weight-related victimization from peers and body dissatisfaction must be taken seriously and that preventive and intervention efforts must be pursued.

Body weight per se seems insufficient to explain children’s disordered eating attitudes and behaviors (CDEAB).

Weight-related victimization and body dissatisfaction mediate the association between BMI and CDEAB.

Parents‘ DEAB is associated with CDEAB.

The tested paths from BMI to CDEAB appear to be globally the same for boys and girls.

A qualitative, prospective study of children's understanding of weight gain

This study examined 3- to 5-year-old children's understandings of increases in body size via a qualitative prospective approach. A sample of 259 children (55.2% girls) was interviewed at 3, 4, and 5 years old. Participants were shown an average and a larger size figure of a child of their gender and age. Responses to 'Why do you think the boy/girl got bigger here?' were coded using thematic analysis. Diet was cited as a mechanism for increased body size by almost 50% of children referring to this by age 5. Few children mentioned physical activity. Responses suggesting that increases in body size had negative implications increased between ages 3 and 5. Awareness of associations between diet and weight gain emerges as young as 3 years old and increases over time, as do negative attitudes about weight gain. This age may be opportune for interventions targeting sustainable healthy behaviours. Statement of contribution What is already known on this subject? Even very young children present weight bias. Their understanding of the social messages regarding weight and shape increases with age. Older children present a partial understanding of how diet and physical activity are related to body size. What does this study add? Very young children's understandings of increases in body size were investigated. Eating and food-related mechanisms, as well as ageing, were salient. By age 5, over a third of children associated increases in body size with negative implications.

Adolescents With Overweight or Obesity: A Qualitative Study of Participation in an Internet-Based Program to Increase Physical Activity

Adolescents who are overweight or obese are reported to be less active than their peers. Motivation is a critical factor in sustaining physical activity and thereby positive health outcomes. This qualitative study explores how participation in a 12-week Internet-based intervention study, Young & Active, influenced the participants' short-term and long-term motivation to increase and sustain physical activity. The overall purpose of Young & Active was to design, test, and evaluate a health-promoting Internet-based program for use in the school health services in Norway. The program was informed by self-determination theory and motivational interviewing. Two postintervention qualitative research interviews were conducted with 21 adolescents, aged 13 to 14 years, with a 9- to 12-month interval. The adolescents were recruited from a total of 84 participants from the Young & Active study intervention group. Data were analyzed using qualitative content analysis. Self-determination theory was used as a theoretical and explanatory framework. Following the motivational continuum from self-determination theory, all adolescents showed changes in motivation, from extrinsic toward more intrinsic motivation, and for some, a reversal after completing the program. Analysis of the adolescents' utterances formed patterns that could be divided into four main categories: (a) reinforcement of a habit, (b) promotion of competence and enjoyment, (c) boost of temporary change, and (d) reinforcement of adverse habits. An Internet-based intervention may help adolescents increase and sustain physical activity if participation is based on self-choice and if they have sufficient support in their social environments. The intervention alone is not enough to support adolescents who are less motivated or have other challenges in life and may even provoke resistance and reinforce negative health behavior. Such a program may be used together with face-to-face counseling in school health services, provided that it is further refined on a larger scale and that the counseling is performed by qualified health service professionals.

Eating disorder symptomatology and body mass index are associated with readers' expectations about character behavior: Evidence from eye-tracking during reading

OBJECTIVE

Many theories have been put forward suggesting key factors underlying the development and maintenance of eating disorders, such as: unhealthy food-related cognitive biases, negative body attitude, and perfectionism; however, underlying cognitive processes associated with eating disorder symptomatology remain unclear. We used eye-tracking during reading as a novel implicit measure of how these factors may relate to eating disorder symptomatology.

METHOD

In two experiments, we monitored women's eye movements while they read texts in which the characters' emotional responses to food-, body image-, and perfectionism-related scenarios were described. Participants' eating disorder symptomatology was then assessed.

RESULTS

Both studies suggest that moment-to-moment processing of characters' emotional responses to perfectionism-, and to a lesser extent, body image-related information was associated with participants' eating disorder symptomatology, thus supporting theories in which these factors are key to developing and maintaining eating disorders. Interestingly, the moment-to-moment processing of characters' emotional responses to food-related scenarios was not related to eating disorder symptomatology.

DISCUSSION

These findings provide novel insights into cognitive processes underlying eating disorder symptomatology, as well as demonstrating the utility of more natural implicit measures.

The Development of Body Image and Weight Bias in Childhood

Negative body image attitudes are related to the onset of disordered eating, poor self-esteem, general mental health problems, and obesity. In this chapter, we will review the nature of body image attitudes in girls and boys in early (approximately 3-7 years old) and later childhood (approximately 8-11 years old). The body image attitudes explored in this chapter include body image attitudes related to the self, with a focus on body dissatisfaction, and body image attitudes related to others, with a focus on weight bias. Issues of measurement of body image and weight bias will first be explored. In light of measurement considerations, the prevalence and predictors of body dissatisfaction and related concerns, and weight bias will be examined. The chapter will conclude with a review of promising directions in the prevention of body dissatisfaction and weight bias in children.