Motivation and perceived competence for healthy eating and exercise among overweight/obese adolescents in comparison to normal weight adolescents

Children's Motivation Profiles in Sports and Physical Activities: A Latent Profile Analysis and Self-Determination Theory Approach

Using latent profile analysis and self-determination theory, the present study aimed to examine younger children's motivation profiles in sports and physical activities and the relations of those profiles to various predictors and achievement outcomes. A total of 1,116 German children from Grade 2 participated in this study. Latent-profile-analysis solutions based on five behavioral-regulation types covered in self-determination theory (i.e., intrinsic, identified, introjected, external, amotivation) were tested. Results favored a three-profile solution, showing three theoretically meaningful and distinct motivation profiles labeled "amotivated," "non-self-determined," and "self-determined." Older children and children with a lower physical self-concept were more likely to be members of the amotivated profile relative to the other profiles than younger children and children with a higher physical self-concept. Furthermore, children of the self-determined profile demonstrated the best physical performance in various motor-skills tests.

Understanding the antecedents of healthy and unhealthy weight control behaviours: Grit, motivation and self-control

OBJECTIVE

To understand the psychological antecedents or personal factors that lead to weight control behaviours that can help to develop more effective prevention strategies.

DESIGN

The present correlational study has a non-experimental, quantitative, cross-sectional design. A model was tested considering types of motivation (autonomous motivation, controlled motivation and amotivation) as mediators in the relationship between the Grit personality and healthy and unhealthy weight control behaviours, with self-control as a moderator in the aforementioned indirect effects.

SETTING

Monterrey (Nuevo León, México).

PARTICIPANTS

A representative sample of 1219 adults (men = 599; women = 620) aged 18-65 years (M = 29·37, sd = 11·83).

RESULTS

Findings supported the mediator role of the types of motivation. Specifically, Grit showed a positive indirect effect on healthy weight control behaviours through autonomous motivation. Conversely, Grit showed a negative indirect effect on unhealthy weight control behaviours through autonomous motivation. Furthermore, findings supported the moderator role of self-control in the relationship between amotivation and healthy and unhealthy weight control behaviours.

CONCLUSIONS

This study provides evidence for the key role of Grit in the adoption of healthy or unhealthy control behaviours, as well as the role of autonomous motivation in the development of healthy behaviours.

Prevalence and Predictors of Overweight and Obesity Among Adolescents in Seremban, Negeri Sembilan, Malaysia

Introduction: Obesity is recognized as a serious public health threat. Recent evidence has warned of the alarming rise in the prevalence of childhood overweight and obesity throughout the world. This study aimed to determine the prevalence of overweight and obesity, and its associations with socio-demographic, behavioral, and psychosocial factors among school-going adolescents in Seremban, Negeri Sembilan.

Methods: Cross-sectional study was conducted. A total of 2,221 adolescents were randomly selected from eight secondary schools. A questionnaire was administered to assess socio-demographic profiles, meal patterns, physical activity level, self-efficacy, self-esteem, body size satisfaction, perception of body weight status, depression, anxiety, stress, and nutrition knowledge. Bodyweight and height were measured and BMI-for-age z scores were computed to determine the body weight status. Bivariate analysis and multivariate logistic regression were used for the data analysis.

Results: The prevalence of overweight among the participants in this study was 17.0%, while the prevalence of obesity was 14.9%. The significant predictors of overweight and obesity in this study were breakfast skipping, low physical activity level, low self-efficacy scores in terms of healthy eating, weight and physical activity, body dissatisfaction, and perception of large body size.

Conclusion: The results emphasize the need to broaden the scope of nutrition guidelines, public health policies, and programs to address overweight and obesity among adolescents in Malaysia. The findings also suggest that health education programs should cover practical advice for modifying healthy eating behaviors, increasing physical activity, as well as matters on body image and body satisfaction.

Dietary Patterns among Adolescents Are Associated with Growth, Socioeconomic Features, and Health-Related Behaviors

Dietary patterns (DPs), usually established in adolescents, are important modifiable risk factors in the etiology of malnutrition and chronic diseases. This study aimed to identify DPs of adolescents and examine their associations with growth, sociodemographic, and lifestyle characteristics. A nationally representative, school-based, cross-sectional study was conducted in Israeli adolescents aged 11-18 years during 2015-2016. A self-administered survey queried sociodemographics, health behaviors, and diet. Weight and height were measured, and WHO height z-scores and BMI cutoffs were calculated. Food frequency questionnaire data were analyzed using principal components analysis (PCA) to identify DPs. Associations between growth, lifestyle, and sociodemographic characteristics and DPs were modeled using multivariable logistic regressions. A total of 3902 adolescents (46% males, mean age 15.2 ± 1.6 years) completed the survey. PCA identified five DPs, accounting for 38.3% of the total variance. The first two prominent DPs were the 'plant-based food' DP, which was associated with the female sex, higher socioeconomic status, overweight/obesity, and healthy lifestyle and the 'junk food' DP, which was associated with lower SES, unhealthy lifestyle, and lower height z-scores. Our results elucidate major DPs that strongly correlate with lifestyle risk behaviors and suboptimal growth among adolescents. Implementing screening for DPs should be further examined to identify higher risk health factors among youth.

Healthiness matters: Approach motivation for healthy food in overweight and obese individuals

It is well documented that approach tendencies for appetitive substances play a role in certain unhealthy patterns of consumption. However, it remains uncertain whether overweight individuals differ from healthy-weight individuals in terms of their tendency to approach unhealthy foods. Thus, the present study aimed to empirically test the hypothesis that overweight individuals are characterised by an elevated behavioural tendency to approach unhealthy food, rather than healthy food, as compared to healthy-weight individuals. Participants were forty-one overweight individuals (Mean BMI = 30.40 kg/m²) and forty-five healthy-weight individuals (Mean BMI = 22.17 kg/m²) aged between 17 and 47. They completed an Approach-Avoidance Task to assess behavioural approach-avoidance tendencies towards healthy and unhealthy food. Contrary to the hypothesis under test, results revealed a greater approach tendency towards healthy food in overweight individuals, as compared to healthy-weight individuals, whereas there were no group differences in behavioural approach-avoidance tendencies towards unhealthy food. These novel findings suggest that overweight individuals are characterised by an approach motivation for healthy food. We provide suggestions concerning how future researchers can build on these findings to test whether this approach tendency contributes to consumption behaviour in overweight individuals.

The Utility of Self-Determination Theory in Predicting Transition Readiness in Adolescents With Special Healthcare Needs

PURPOSE

Adolescents and young adults with chronic health conditions must learn skills to successfully manage their health as they prepare to transition into adult-based care. Self-determination theory (SDT), an empirically based theory of human motivation, posits that competence (feeling effective), autonomy (volition to perform behaviors), and relatedness (support for autonomy from others) influence behavioral change. This study evaluates the utility of SDT constructs in predicting transition readiness among adolescents and young adults recruited into an intervention to promote successful healthcare transition.

METHODS

Baseline assessments were completed by 137 patients aged 17-23 years recruited from pediatric renal, gastroenterology, or rheumatology clinical services. Surveys measured transition readiness (Transition Readiness Assessment Questionnaire) as well as SDT constructs, including competence (Patient Activation Measure); provider relatedness and parent autonomy support (Health Care Climate Questionnaire); and health care-related autonomy (Treatment Self-Regulation Questionnaire). Relationships between SDT constructs and transition readiness were evaluated using linear regression.

RESULTS

Between 44 and 48 participants were recruited from each service. Bivariate correlation coefficients between transition readiness and SDT constructs were competence (r = .44), autonomous autonomy (r = .34), controlled autonomy (r = .27), provider relatedness (r = .46), and parental autonomy support (r = .35) (p < .01). Age positively correlated with transition readiness (r = .47, p < .001). After controlling for age, gender, and clinical service, competence (p < .001) and provider relatedness (p = .008) successfully predicted transition readiness (R² = .423; F change; p < .001).

CONCLUSIONS

Findings from this cross-sectional study support the utility of SDT constructs in promoting transition readiness among adolescents and young adults with chronic conditions, underscoring the importance of building competence and provider support for autonomy during this critical period.

Dutch Preadolescents' Food Consumption at School: Influence of Autonomy, Competence and Parenting Practices

Eating habits appear to become less healthy once children move into adolescence. Adolescence is characterized by increasing independence and autonomy. Still, parents continue influencing adolescents' eating habits. This cross-sectional study used a Self-Determination Theory perspective to examine how parents can support preadolescents' food-related autonomy and competence and how these factors are associated with healthy eating motivation and food consumption at school. In addition, the effect of relative healthy food availability at home on preadolescents' food consumption at school was explored. In total, 142 Dutch preadolescents (mean age 12.18) and 81 parents completed questionnaires. The results showed that preadolescents perceived themselves as having higher food-related autonomy and lower competence to eat healthily as compared to their parents' perceptions. A path analysis was conducted to test the hypothesized model. Although parental support was positively associated with food-related autonomy, higher food-related autonomy was related to less healthy food intake at school. On the other hand, competence to eat healthily indirectly affected preadolescents' healthy intake ratio through their healthy eating motivation. Finally, the relative availability of healthy options at home was positively associated with preadolescents' healthy intake ratio outside the home. Findings from the study advance the understanding of individual and environmental factors that influence eating habits during the key life period of early adolescence. The results may inform interventions aiming to guide preadolescents to make healthy food choices on their own.

The Impact of Social Isolation during the COVID-19 Pandemic on Physical and Mental Health: The Lived Experience of Adolescents with Obesity and Their Caregivers

Adolescence is a complex developmental phase, made more complex by obesity and the social isolation imposed by the COVID-19 pandemic. The literature related to the impact of social isolation on obesity self-management in adolescents is scant and inconsistent. This paper describes the phenomenon from the perspectives of a sample of adolescents with obesity enrolled in an inpatients' multidisciplinary rehabilitation program for weight-loss and their caregivers, and its impact on different life domains. Individual semi-structured ad hoc interviews were conducted with 10 adolescent-caregiver dyads, and narratives were qualitatively investigated using an interpretative phenomenology approach to data. Twenty participants took part in the study. The major themes that emerged from this study fall into five basic categories: (1) COVID-19 as an opportunity to reconsider what makes a good life; (2) Persistence in life; (3) Empowering relationship; (4) Daily routine in quarantine; (5) Lives on hold. Understandings drawn from this study may assist health care professionals in providing holistic support, and guidance to adolescents with weight-related issues and their caregivers who experience social isolation during the COVID-19 pandemic.

Social Ecological Barriers for Healthy Eating of Obese Children and Their Caregivers in Low-income Families in South Korea

In this qualitative study, the focus is on healthy eating in children from low-income families who visit a Community Child Care center (CCC) in South Korea. Barriers for healthy eating were identified using focus group interviews with low-income overweight and obese children and their caregivers and applying a social ecological model as well as the framework analysis for qualitative data. The need for theory- and evidence-based health promotion interventions is indicated, at the level of the family, but also at the level of collaboration among all stakeholders, as well as multi-level policy changes.

Importance of Self-Efficacy in Eating Behavior and Physical Activity Change of Overweight and Non-Overweight Adolescent Girls Participating in Healthy Me: A Lifestyle Intervention with Mobile Technology

Very little is known about how multicomponent interventions directed to entire populations work in selected groups of adolescents. The aim was to evaluate the effectiveness of the Healthy Me one-year program on changes in healthy eating and physical activity among overweight and non-overweight female students. Randomization involved the allocation of full, partial or null intervention. The randomized field trial was implemented in 48 secondary schools (clusters) all over Poland among 1198 15-year-old girls. In this study, a sample of N = 1111 girls who participated in each evaluation study was analyzed. Using multimedia technologies, efforts were made to improve health behaviors and increase self-efficacy. The main outcome was a health behavior index (HBI), built on the basis of six nutritional indicators and one related to physical activity. HBI was analyzed before and immediately after intervention and at three months' follow-up, and the HBI change was modeled. Statistical analysis included nonparametric tests and generalized linear models with two-way interactions. Comparing the first and third surveys, in the overweight girls, the HBI index improved by 0.348 (SD = 3.17), while in the non-overweight girls it had worsened. After adjusting for other factors, a significant interaction between body weight status and level of self-efficacy as predictors of HBI changes was confirmed. The program turned out to be more beneficial for overweight girls.

Development and Validation of a Self-Determination Theory-Based Measure of Motivation to Exercise and Diet in Children

Objective: To develop and test the factorial structure of a new self-determination theory–based measure of behavioral regulation in children.

Methods: Five hundred ninety 590 (F = 51.7%) children aged 7 to 11 years completed the Motivation to Exercise and Diet (MED-C) questionnaire, which comprises 16 items (eight for exercise and eight for diet) grouped into eight factors (five motivations and three needs). Psychometric testing included confirmatory factor analysis and internal consistency. Measurement invariance analyses were also performed to evaluate whether the factorial structure of the MED-C was equivalent for gender (male vs. female), age (≤9 vs. ≥10 years), and the perception of having at least one parent with overweight or obesity (yes vs. no).

Results: Factorial analysis confirmed an acceptable factors solution for the MED-C and a good fit to the data for both the exercise and the diet subscales assessed independently. The maximal reliability coefficient revealed good reliability for the exercise and the diet subscales. Moreover, the MED-C factor structure was invariant across group comparisons.

Discussion: Findings support the construct validity and reliability of the MED-C. Therefore, it represents the first validated instrument simultaneously measuring motivational regulation and psychological need satisfaction in the context of children’s exercise and diet. Considering the goodness of these results, scale percentile ranks of the total score distribution as well as the z score and the T score were provided for clinical and research purposes.

Conclusion: The MED-C might support the understanding of motivations and needs of children with weight problems and assist their process of behavioral change in primary and secondary prevention programs. Psychological factors represent, in fact, potential targets for interventions to increase children’s motivation to exercise and diet.

Multidimensional motivation for exercise: A latent profile and transition analysis

OBJECTIVES

To: a) identify motivational profiles for exercise, using Self-Determination Theory as a theoretical framework, among a sample of parents of UK primary school children; b) explore the movement between motivational profiles over a five year period; and c) examine differences across these profiles in terms of gender, physical activity and BMI.

DESIGN

Data were from the B-Proact1v cohort.

METHODS

2555 parents of British primary school children participated across three phases when the child was aged 5-6, 8-9, and 10-11. Parents completed a multidimensional measure of motivation for exercise and wore an ActiGraph GT3X + accelerometer for five days in each phase. Latent profile and transition analyses were conducted using a three-step approach in MPlus.

RESULTS

Six profiles were identified, comprising different combinations of motivation types. Between each timepoint, moving between profiles was more likely than remaining in the same one. People with a more autonomous profile at a previous timepoint were unlikely to move to more controlled or amotivated profiles. At all three timepoints, more autonomous profiles were associated with higher levels of MVPA and lower BMI.

CONCLUSIONS

The results show that people's motivation for exercise can be described in coherent and consistent profiles which are made up of multiple and simultaneous types of motivation. More autonomous motivation profiles were more enduring over time, indicating that promoting more autonomous motivational profiles may be central to facilitating longer-term physical activity engagement.

Can Self-Determination Explain Dietary Patterns Among Adults at Risk of or with Type 2 Diabetes? A Cross-Sectional Study in Socio-Economically Disadvantaged Areas in Stockholm

Type 2 Diabetes (T2D) is a major health concern in Sweden, where prevalence rates have been increasing in socioeconomically disadvantaged areas. Self-Determination Theory (SDT) is posited as an optimal framework to build interventions targeted to improve and maintain long-term healthy habits preventing and delaying the onset of T2D. However, research on SDT, T2D and diet has been widely overlooked in socio-economically disadvantaged populations. This study aims to identify the main dietary patterns of adults at risk of and with T2D from two socio-economically disadvantaged Stockholm areas and to determine the association between those patterns and selected SDT constructs (relatedness, autonomy motivation and competence). Cross-sectional data of 147 participants was collected via questionnaires. Exploratory Factor Analysis was used to identify participants’ main dietary patterns. Multiple linear regressions were conducted to assess associations between the SDT and diet behaviours, and path analysis was used to explore mediations. Two dietary patterns (healthy and unhealthy) were identified. Competence construct was most strongly associated with healthy diet. Autonomous motivation and competence mediated the effect of relatedness on diet behaviour. In conclusion, social surroundings can promote adults at high risk of or with T2D to sustain healthy diets by supporting their autonomous motivation and competence.

Non-Hispanic Black Adolescents' Self-Reported Health Behaviors Associated With Childhood Obesity in an Urban Clinic

Background: The prevalence of children with overweight or obese weight status in the United States is ~30%. Limited data exist on urban adolescents’ self-reported health behaviors and their perceptions to healthy living. Objectives: To examine adolescents’ self-reported health behaviors and perceived barriers and their associations with weight status. Methods: In 2014, patients (ages 9+ years) were enrolled and completed health behavior surveys. Measurements were categorized into body mass index (BMI)-for-age percentiles. Adolescents without obesity (including underweight, healthy weight, and overweight) were compared against adolescents with obesity. Results: A total of 132 adolescents were enrolled. The only factor that was statistically significant between the 2 weight groups was frequent exercise, which decreased odds of obesity by 0.34 (95% CI 0.13-0.93). Surprisingly, the odds of being obese increased significantly by 11.1 (95% CI 4.2-33.3) in those reporting trying to lose weight. Conclusions: To combat obesity, we reiterate the need for frequent exercise. Health care professionals should consider highlighting increased frequency of exercise and explore why adolescents with obesity were more inclined to report weight loss methods.