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Fortes Cavalcanti de Macêdo P, Brito E, de Magalhães Cunha C, Ribas de Farias Costa P, da Purificação Nazaré Araújo M, Cardoso Martins P, Leila Portela de Santana M. Weight stigma is a predictor of disordered eating in Brazilian college students during the COVID-19 pandemic: A 16-month cohort follow-up. Appetite 2024; 192:107084. [PMID: 37875240 DOI: 10.1016/j.appet.2023.107084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023]
Abstract
This study examined the relationship between weight stigma and disordered eating behaviors in university students during the COVID-19 pandemic, considering individuals with and without overweight. A national sample of 738 college students completed an online questionnaire at three time points between July 2020 and December 2021, reporting their experiences of weight stigma, perceived increase in weight stigma during the pandemic, internalized weight stigma, and disordered eating behaviors. The findings showed that the trajectories of disordered eating behaviors varied depending on participants' anthropometric status. Among those with overweight, there was a decrease over time in binge eating, food restriction, and purging. Conversely, the non-overweight group experienced a slight increase in binge eating from T2 to T3. Using the Generalized Estimating Equations model, the study revealed that weight stigma predicted disordered eating behaviors in both weight spectrums during the pandemic. Experiences of weight stigma and the perceived increase in weight stigma significantly increased the likelihood of engaging in binge eating, food restriction, and purging among individuals with overweight. Furthermore, the internalization of weight stigma was longitudinally associated with all examined eating behaviors, regardless of anthropometric status. These findings highlight the importance of addressing weight stigma to prevent disordered eating in college students.
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Affiliation(s)
| | - Edleide Brito
- Statistics Department, Federal University of Bahia, Salvador, Brazil.
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de Macêdo PFC, Brito E, de Magalhães Cunha C, da Purificação Nazaré Araújo M, Martins PC, de Santana MLP. Weight stigma and disordered eating behaviors during the COVID-19 pandemic: the mediating role of weight gain concern and psychological distress. Eat Weight Disord 2023; 28:78. [PMID: 37759035 PMCID: PMC10533574 DOI: 10.1007/s40519-023-01608-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVES The purpose of this study is to investigate whether the relationship between weight stigma experiences and disordered eating behaviors during the COVID-19 pandemic is mediated by weight gain concern and psychological distress among university students with and without overweight. METHODS A cross-sectional study was conducted with university students from five regions of Brazil who participated in the baseline assessment of the Online Cohort on Eating Behavior and Health (July/August 2020). Information on the frequency of binge eating episodes, food restriction, and purging, as well as experienced weight stigma, weight gain concern, and psychological distress, were recorded in an online questionnaire. Stratified structural equation modeling (SEM) analyses were performed to address the research questions of interest. RESULTS Out of the total sample (n = 2511), 33.5% of participants reported experiencing weight stigma. The prevalence of binge eating episodes, food restriction, and purging was 43.7%, 24.1%, and 5.4%, respectively. These behaviors were more prevalent in individuals with overweight than in those without this condition. Furthermore, it was observed that weight gain concern and psychological distress mediated the relationship between weight stigma and disordered eating behaviors regardless of body weight status. CONCLUSIONS Experiences of weight stigma and disordered eating behaviors were prevalent among Brazilian university students, especially among those with overweight. Weight gain concern and psychological distress appear to be important factors underlying the relationship between these constructs during the pandemic, and they can contribute to the development of targeted strategies for the prevention and management of disordered eating. LEVEL OF EVIDENCE Level V, cross-sectional study.
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Affiliation(s)
| | - Edleide Brito
- Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | - Carla de Magalhães Cunha
- School of Nutrition, Federal University of Bahia, Campus Canela, Rua Basílio da Gama, Salvador, BA, 40110-907, Brazil
| | | | - Poliana Cardoso Martins
- School of Nutrition, Federal University of Bahia, Campus Canela, Rua Basílio da Gama, Salvador, BA, 40110-907, Brazil
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Gottardi NRDM, Pereira ACDF, Cattafesta M, Salaroli LB, Soares FLP. Disordered eating during COVID-19 pandemic is associated with nutritional status, negative mood changes, and body image in university students. J Health Psychol 2023:13591053231151483. [PMID: 36721948 PMCID: PMC9895294 DOI: 10.1177/13591053231151483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Our objective was to evaluate disordered eating and associated factors in university students in the early period of the COVID-19 pandemic in Brazil. This is an analytical cross-sectional observational study, and data collection took place between May and June 2020, using an online semi-structured questionnaire. In total, 936 students were evaluated. Present signs/symptoms of the flu syndrome (OR = 1.605), negative mood changes (OR = 1.628), weight gain (OR = 1.739), obesity (OR = 3.089), follow fitness/health profile on social media (OR = 2.050), having inadequate body perception (OR = 2.416), and body dissatisfaction (OR = 2.612) increased the chances of presenting a higher score on the disordered eating scale.
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Affiliation(s)
| | | | | | | | - Fabíola Lacerda Pires Soares
- Federal University of Espírito Santo,
Brazil,Fabíola Lacerda Pires Soares, Graduate
Program in Nutrition and Health, Federal University of Espírito Santo, Marechal
Campos Avenue, 1468—Maruípe, Vitória, Espírito Santo 29043, Brazil.
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Raval CM, Bhatt RB, Tiwari DS, Panchal BN. Prevalence and characteristics of eating disorders among college students of a nonmetro city of Gujarat. Ind Psychiatry J 2022; 31:74-80. [PMID: 35800878 PMCID: PMC9255602 DOI: 10.4103/ipj.ipj_28_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/13/2021] [Accepted: 10/11/2021] [Indexed: 11/06/2022] Open
Abstract
CONTEXT There is a relative paucity of prevalence data about eating disorders (EDs) in India among young population. AIMS We aimed to estimate the prevalence and characteristics of EDs and abnormal eating behaviors among college students of a nonmetro city of Gujarat. SETTING AND DESIGN A cross-sectional survey was done among five colleges of a nonmetro city in Gujarat from February to September 2019. SUBJECTS AND METHODS Total 790 college students were assessed using a semi-structured format, Eating Attitudes Test-26, and Bulimic Investigatory Test Edinburgh followed by structured clinical interview as per DSM-5 criteria for EDs. STATISTICAL ANALYSIS Outcomes were expressed in frequency, proportion, mean, and standard deviation. P values were calculated by Pearson Chi-square test or Fisher's exact test to determine the significance of the result. RESULTS The prevalence of abnormal eating behaviors was 25.2% (n = 199). Anorexia nervosa (AN) was not detected. The prevalence of bulimia nervosa (BN) was 0.2% and other specified feeding or eating disorder (OSFED) was 0.6%. "Being aware of calorie content" (53.7%) and "preoccupation with desire of thinness" (46.3%) were commonly found. "Impulse to vomit after meals" (2.5%) was least common. Lower body mass index was found among subjects with abnormal eating behavior. None of the subjects had amenorrhea. CONCLUSIONS The prevalence of disordered eating behaviors, BN, and OSFED was 25.2%, 0.2%, and 0.6%, respectively. AN was not detected. OSFED was the most common ED and the characteristic "body image disturbance" was the most common symptom.
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Affiliation(s)
| | | | - Deepak S Tiwari
- Department of Psychiatry, M P Shah Medical College, Jamnagar, Gujarat, India
| | - Bharat N Panchal
- Department of Psychiatry, Government Medical College, Bhavnagar, Gujarat, India
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Hudson TA, Amaral ACS, Stice E, Gau J, Ferreira MEC. Dissonance-based eating disorder prevention among Brazilian young women: A randomized efficacy trial of the Body Project. Body Image 2021; 38:1-9. [PMID: 33780888 DOI: 10.1016/j.bodyim.2021.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 03/10/2021] [Accepted: 03/13/2021] [Indexed: 11/25/2022]
Abstract
A randomized controlled trial was conducted to assess the efficacy of the Body Project eating disorder prevention program in reducing eating disorder risk factors and symptoms in young Brazilian women. A total of 141 female university students aged 18-30 years old were randomly assigned to one of two conditions: assessment-only condition (n = 78) and Body Project condition (n = 63). Participants completed scales assessing body dissatisfaction, sociocultural influence, disordered eating attitudes and behaviors, eating disorders symptoms, body appreciation, depressive mood and negative affect at baseline, posttest, and at 1- and 6-month follow-ups. Body Project participants showed significantly greater reductions in body dissatisfaction, sociocultural influence, disordered eating, eating disorder symptoms, depressive symptoms, and negative affect, and greater increases in body appreciation (d = .35-.48) compared to assessment-only participants. Most of the effects persisted through 6-month follow-up (d = .35-.74). Results provide evidence that the Body Project is an effective intervention to reduce eating disorder risk factors and eating disorder symptoms among Brazilian young women, and that this intervention is naturally culturally adaptive.
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Affiliation(s)
- Tassiana Aparecida Hudson
- Department of Physical Education, Federal University of Juiz de Fora, s/n José Lourenço Kelmer Street, University Campus, Juiz de Fora, 36036-900, Brazil.
| | - Ana Carolina Soares Amaral
- Federal Institute of Education, Science and Technology of Southeast of Minas Gerais, 204 Monsenhor José Augusto Street, Barbacena, Minas Gerais, 36205-018, Brazil.
| | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305, United States.
| | - Jeff Gau
- Oregon Research Institute, 1776 Millrace Dr, Eugene, OR 97403, United States.
| | - Maria Elisa Caputo Ferreira
- Department of Physical Education, Federal University of Juiz de Fora, s/n José Lourenço Kelmer Street, University Campus, Juiz de Fora, 36036-900, Brazil.
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Campos PF, Almeida M, Neves CM, Rodgers RF, Ferreira MEC, de Carvalho PHB. Assessing the Rising Emphasis on Muscularity for Women: Psychometric Properties of the Brazilian Version of the Female Muscularity Scale. SEX ROLES 2021. [DOI: 10.1007/s11199-020-01222-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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de Matos AP, Rodrigues PRM, Fonseca LB, Ferreira MG, Muraro AP. Prevalence of disordered eating behaviors and associated factors in Brazilian university students. Nutr Health 2020; 27:231-241. [PMID: 33161871 DOI: 10.1177/0260106020971136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND University students may be a vulnerable group to adopt unhealthy behaviors, including changes in eating behavior. Assessment of factors associated with the prevalence of disordered eating behaviors in this population may facilitate the early identification of their predictors, thus allowing fast interventions. AIM To analyze the prevalence of disordered eating behaviors (DEB) and associated factors in Brazilian university students. METHODS Cross-sectional study of male and female students aged 16-25 years, enrolled in full-time degree program at a public university in the mid-west of Brazil. Disordered eating behaviors in the last three months (binge eating, purging, and food restriction), through an adapted version of the instrument developed by Hay, was evaluated and the association with demographic and socioeconomic characteristics, including lifestyle, body image, perceived stress, depressive symptoms, and excess weight, was analyzed. A hierarchical analysis model was performed to determine the relative importance of factors on the prevalence of DEB. RESULTS A total of 1608 university students were evaluated (50.7% male). Prevalence of DEB was 4.4% for binge eating, 2.5% for purging and 9.1% for food restriction, all of which were higher among women (7.0%, 4.4%, and 13.5%) compared with men (1.8%, 0,6%, and 4.9%, respectively). The factors that remained significantly associated with these behaviors were female sex, smoking, consumption of alcoholic beverages, dissatisfaction with body image, excess weight, high perceived stress, and presence of self-reported depressive symptoms. CONCLUSION Factors associated with DEB signal that intervention is required to create synergy between individual and population-level interventions in lifestyle behaviors.
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Affiliation(s)
| | | | - Lorena Barbosa Fonseca
- Faculdade de Nutrição, 67826Universidade Federal de Mato Grosso, Brazil.,Instituto de Saúde Coletiva, 67826Universidade Federal de Mato Grosso, Brazil
| | - Márcia Gonçalves Ferreira
- Faculdade de Nutrição, 67826Universidade Federal de Mato Grosso, Brazil.,Instituto de Saúde Coletiva, 67826Universidade Federal de Mato Grosso, Brazil
| | - Ana Paula Muraro
- Faculdade de Nutrição, 67826Universidade Federal de Mato Grosso, Brazil.,Instituto de Saúde Coletiva, 67826Universidade Federal de Mato Grosso, Brazil
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Moser CM, Terra L, Behenck ADS, Brunstein MG, Hauck S. Cross-cultural adaptation and translation into Brazilian Portuguese of the instruments Sick Control One Stone Fat Food Questionnaire (SCOFF), Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment Questionnaire (CIA). TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 42:267-271. [PMID: 32997042 PMCID: PMC7879072 DOI: 10.1590/2237-6089-2019-0083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/11/2019] [Indexed: 11/22/2022]
Abstract
Introduction Eating disorders (EDs) affect up to 13% of young people and are associated with significant morbidity and mortality. Nevertheless, important, internationally recognized instruments for brief ED screening (Sick Control One Stone Fat Food Questionnaire [SCOFF]), symptom severity assessment and diagnosis (Eating Disorder Examination Questionnaire [EDE-Q]) and assessment of ED-associated psychosocial impairment (Clinical Impairment Assessment Questionnaire [CIA]) were not yet available in Brazilian Portuguese. Our objective was to perform the cross-cultural adaptation and translation into Brazilian Portuguese of the instruments SCOFF, EDE-Q and CIA. Method The process involved a series of standardized steps, as well as discussions with experts. First, the relevance and adequacy of the scales’ items to our culture and population were extensively discussed. Then, two independent groups translated the original documents, creating versions that were compared. With the participation of external ED experts (i.e., who did not take part in the translation process), synthesized versions were produced. The syntheses were then applied to a focal group of patients with ED (n = 8). After that step, a preliminary version of the three scales in Brazilian Portuguese was produced and sent for back-translation by two English native speakers, who worked independently. A synthesis of the back-translations, along with the preliminary versions in Brazilian Portuguese, were sent to the original authors. Results The Brazilian Portuguese versions of SCOFF, EDE-Q and CIA were approved by the original authors and are now available for use. Conclusion This study provides important tools for the ED research field in Brazil.
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Affiliation(s)
- Carolina Meira Moser
- Programa de Transtornos Alimentares em Adultos, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Laboratório de Pesquisa em Psiquiatria Psicodinâmica, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Luciana Terra
- Laboratório de Pesquisa em Psiquiatria Psicodinâmica, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Andressa da Silva Behenck
- Programa de Transtornos Alimentares em Adultos, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Miriam Garcia Brunstein
- Programa de Transtornos Alimentares em Adultos, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Laboratório de Pesquisa em Psiquiatria Psicodinâmica, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Simone Hauck
- Programa de Transtornos Alimentares em Adultos, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Laboratório de Pesquisa em Psiquiatria Psicodinâmica, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
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Alvarenga MDS, Santos TSS, Andrade D. Item Response Theory-based validation of a short form of the Disordered Eating Attitude Scale (DEAS-s) to a Brazilian sample. CAD SAUDE PUBLICA 2020; 36:e00169919. [PMID: 32130318 DOI: 10.1590/0102-311x00169919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/19/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to validate a short version of the Disordered Eating Attitude Scale (DEAS-s). To this end, 2,902 adult individuals answered the original DEAS and informed age, weight, and height. Data were analyzed using the full-information factor analysis and Item Response Theory (IRT) analysis. Exclusion criteria retained items with adequate values of commonality and factor loadings. Estimation of IRT parameters, the Item Characteristic Curve (ICC), and test information guided the selection of the best quality items. The final model adjustment was evaluated using Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMSR), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI). The eating attitudes on each level of DEAS-s were described. The analyses were performed on R software and Microsoft Excel version 2013. As results, six items were excluded because of the low communalities and factor loadings, and one more was excluded because of an overlapping on the ICC. The remaining 17 items explained 0.53 of the total variance and had an adequate goodness-of-fit (RMSEA = 0.05; SRMSR = 0.05; CFI = 0.98; TLI = 0.98). The information test is more accurate between the scores 0 and +3. Scores higher or equal to 1.5 identified individuals with disordered eating attitudes. Women, older individuals, and those with a higher body mass index presented more disordered eating; thus, the one-dimensional and short version of DEAS showed a suitable adjustment and may contribute to properly evaluate disordered eating in diverse populations.
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Oliveira JD, Figueredo L, Cordás TA. Prevalência de comportamentos de risco para transtornos alimentares e uso de dieta “low-carb” em estudantes universitários. JORNAL BRASILEIRO DE PSIQUIATRIA 2019. [DOI: 10.1590/0047-2085000000245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivos Identificar a presença de compulsão alimentar associada ou não a práticas compensatórias em praticantes de dieta low-carb. Métodos Foram utilizadas a Escala de Compulsão Alimentar Periódica (ECAP) e o Questionário de Hay para avaliar a frequência de compulsão alimentar e práticas compensatórias, além de um questionário de frequência do consumo de chocolate, pão e arroz. A intensidade de restrição de carboidratos foi avaliada com escala de 1 a 8 pontos. Os participantes foram divididos nos grupos (i) dieta low-carb e (ii) controle. Foram realizadas comparações entre grupos, além de correlações entre variáveis de interesse no grupo dieta (p < 0,05). Resultados Participaram 853 universitários, sendo 75,97% mulheres com média de 22,04 anos (DP = 3,33) e índice de massa corporal (IMC) com média de 23,56 kg/m2 (DP = 4,38). Do total, 214 fizeram dieta low-carb e 639 não. A prevalência de um alto escore sugestivo de compulsão alimentar sem práticas compensatórias foi de 17,94% (n = 153) e a presença de compulsão alimentar associada com compensação foi de 2,23% (n = 19). No grupo dieta, 35,05% (n = 75) também realizaram jejum intermitente. O grupo dieta atingiu maiores valores para ECAP e IMC e menores para frequência de consumo de arroz e pão francês. Ainda, os escores da ECAP se correlacionaram positivamente com o consumo de chocolate (r = + 0,14 ; p = 0,0377) e valores de IMC (r = + 0,19; p = 0,0042), enquanto a restrição de carboidratos apresentou correlação negativa com o consumo de chocolate (r = - 0,13; p = 0,041), pão francês (r = - 0,20; p = 0,0024) e arroz (r = - 0,36; p = <0,0001). Conclusões Destacam-se a alta prevalência da prática de dieta (25,09%) e os maiores níveis de compulsão alimentar neste grupo, além de menor consumo de arroz e pão francês em relação aos que não fizeram dieta.
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Ronca DB, Blume CA, Cureau FV, Camey SA, Leotti VB, Drehmer M, Schaan BD, de Carvalho KMB. Diet quality index for Brazilian adolescents: the ERICA study. Eur J Nutr 2019; 59:539-556. [PMID: 30963230 DOI: 10.1007/s00394-019-01923-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 02/03/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to assess the dietary patterns of adolescents using a food-based diet quality index and their compliance with a healthy dietary guideline METHODS: Participants included 71,553 Brazilian adolescents (12-17 years old) from the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional school-based multicenter study.. Dietary intake was measured by one 24-h recall. A second recall was collected in a random subsample (~ 10%) to correct within-person variability. The Diet Quality Index for Adolescents adapted for Brazilians (DQIA-BR) was used to measure the overall quality of the dietary intake. The National Cancer Institute method was applied to estimate usual dietary intake. The DQIA-BR and the distribution of its components (quality, diversity, and equilibrium) were analyzed according to sex, geographical area, and type of school RESULTS: The mean (SD) DQIA-BR scores were 14.8% (6.1%) for females and 19.0% (6.3%) for males. All analyzed strata revealed low scores of DQIA-BR and its components. The median usual intake was five to sevenfold below the recommendations for vegetables and fruits and approximately twofold below the recommendations for dairy. The highest DQIA-BR mean scores were found in the northern region [17.0% (6.4%), females; 20.7% (6.3%), males]. Adolescents in both types of schools had relatively similar median intakes of snacks (~ 85 g) and sugared drinks (~ 600 ml) CONCLUSIONS: The overall diet quality of Brazilian adolescents is inadequate based on evaluated parameters in all regions and socioeconomic backgrounds.
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Affiliation(s)
- Débora Barbosa Ronca
- Graduate Program in Human Nutrition, Universidade de Brasília, Brasília, Brazil.
| | - Carina Andriatta Blume
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Vogt Cureau
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Suzi Alves Camey
- Postgraduate Program in Epidemiology, Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vanessa Bielefeldt Leotti
- Postgraduate Program in Epidemiology, Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Michele Drehmer
- Postgraduate Program in Epidemiology, Department of Nutrition and Food and Nutrition Research Center, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beatriz D Schaan
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Brandt LMT, Fernandes LHF, Aragão AS, Luna TPDC, Feliciano RM, Auad SM, Cavalcanti AL. RISK BEHAVIOR FOR BULIMIA AMONG ADOLESCENTS. REVISTA PAULISTA DE PEDIATRIA 2019; 37:217-224. [PMID: 30810694 PMCID: PMC6651302 DOI: 10.1590/1984-0462/;2019;37;2;00008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/28/2018] [Indexed: 11/22/2022]
Abstract
Objective: To analyze the risk behavior for bulimia among female adolescents from public and private high schools. Methods: A cross-sectional study with a random sample of 850 female students aged 15-18 years was carried out in a city in northeastern Brazil, using the Bulimic Investigatory Test of Edinburgh (BITE) to assess the risk behavior for bulimia. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software and the Pearson’s chi-square , Fisher’s exact and robust Poisson regression tests, adopting the significance level of 5%. Results: Less than half of the sample (42.0%) showed standards of dietary risk and weight control practices; in 1.4% of the sample, bulimia signs were already installed. Fear of gaining weight was reported by 62.8% of the subjects. Risk practices were lower among students from public schools; (Odds Ratio - OR - 0.82; confidence interval of 95% - 95%CI - 0.69-0.97). Among restrictive practices, fasting for a whole day was the most applied (29.9% of the students). Among individuals who were at risk situation, almost half believed to have normal eating habits (prevalence ratio - PR - 0.42; 95%CI 0.36-0.49). Individuals who consider their eating habits normal, who are afraid of gaining weight, those who seek emotional comfort in food and follow strict diets had higher risk for bulimia (p<0.05). Conclusions: The number of female adolescent students with risk behavior practices for bulimia is high, and the frequency of those unaware of this situation is also very high. Risk situations emerge as a collective health problem, and individuals from private schools were more likely to be in this situation.
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Leme ACB, Philippi ST, Thompson D, Nicklas T, Baranowski T. "Healthy Habits, Healthy Girls-Brazil": an obesity prevention program with added focus on eating disorders. Eat Weight Disord 2019; 24:107-119. [PMID: 29730727 DOI: 10.1007/s40519-018-0510-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 04/24/2018] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To evaluate the immediate post-intervention and 6-month post-intervention effects of a Brazilian school-based randomized controlled trial for girls targeting shared risk factors for obesity and disordered eating. METHODS Total of 253 girls, mean of 15.6 (0.05) years from 1st to 3rd grades of high school participated in this 6-month school-based cluster randomized controlled trial. "Healthy Habits, Healthy Girls-Brazil (H3G-Brazil)", originally developed in Australia, emphasized 10 key nutrition and physical activity (PA) messages delivered over 6 months. Disordered eating prevention procedures, i.e., prevention of weight-teasing, body satisfaction, and unhealthy weight control behavior, were added to the intervention. Body dissatisfaction, unhealthy weight control behaviors and social cognitive-related diet, and physical activity variables were assessed at baseline, immediate post-intervention, and 6-month post-intervention. Intervention effects were determined by one-way analysis of covariance or logistic regression, after checking for the clustering effects of school. The control group did not receive intervention prior to follow-up assessment. A conservative significance level was set at p < 0.01. RESULTS Beneficial effects were detected for PA social support (F = 6.005, p = 0.01), and healthy eating strategies (F = 6.08, p = 0.01) immediate post-intervention; and healthy eating social support (F = 14.731, p = 0.00) and healthy eating strategies (F = 5.812, p = 0.01) at 6-month post-intervention. Intervention group was more likely to report unhealthy weight control behaviors (OR = 1.92, 95% CI 1.15-3.21, p = 0.01) at 6-month post-intervention. No other significant immediate or 6-month post effects were detected. CONCLUSION H3G-Brazil demonstrated positive 6-month effects on some social cognitive variables but an adverse effect on unhealthy weight control behaviors. Thus, this study was not able to achieve synergy by combining obesity and disordered eating prevention procedures in an intervention among low-income girls in Brazil. TRIAL REGISTRATION Level I: cluster randomized controlled trial.
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Affiliation(s)
- Ana Carolina Barco Leme
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, USA. .,Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
| | | | - Debbe Thompson
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, USA
| | - Theresa Nicklas
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Tom Baranowski
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Trindade AP, Appolinario JC, Mattos P, Treasure J, Nazar BP. Eating disorder symptoms in Brazilian university students: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2018; 41:179-187. [PMID: 30328965 PMCID: PMC6781688 DOI: 10.1590/1516-4446-2018-0014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/19/2018] [Indexed: 12/14/2022]
Abstract
Objective: To synthesize the risk of eating disorder (ED) symptoms in Brazilian university students through a systematic review and meta-analysis. Secondary goals were to analyze whether any specific majors were related to higher ED risk and whether any regions of Brazil had higher proportions of college students at risk of ED. Methods: The procedures followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, and a search was conducted in three electronic databases (MEDLINE, LILACS, and SciELO). Results: Thirty-three studies were included in the analysis, of which 14 were included in the meta-analysis. All included studies used self-report questionnaires, the most frequent of which was the Eating Attitudes Test (EAT-26). None of the studies used a structured interview to diagnose ED. A meta-analysis of studies with a cutoff ≥ 20 for the EAT-26 (n=5) found 14.9% (95%CI 12.8-17.2%) positive screenings, while those with a cutoff of t ≥ 21 (n=9) found 13.3% (95%CI 11.3-15.6%) positive screenings. There was a significantly higher proportion of positive screenings among nutrition majors than all other majors combined (26.5 and 20.5%, respectively). Conclusion: Nutrition students seem to be at higher risk of ED. Further research should investigate whether positive screenings translate to actual ED diagnoses.
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Affiliation(s)
- Amanda P Trindade
- Grupo de Obesidade e Transtornos Alimentares, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, RJ, Brazil
| | - Jose C Appolinario
- Grupo de Obesidade e Transtornos Alimentares, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, RJ, Brazil
| | - Paulo Mattos
- Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Bruno P Nazar
- Grupo de Obesidade e Transtornos Alimentares, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, RJ, Brazil.,Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil
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15
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An etiological model of disordered eating behaviors among Brazilian women. Appetite 2017; 116:164-172. [PMID: 28478061 DOI: 10.1016/j.appet.2017.04.037] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/25/2017] [Accepted: 04/30/2017] [Indexed: 11/24/2022]
Abstract
The Tripartite Influence Model posits that parents, peers and media influences mediated by internalization and appearance social comparison are predictors of body dissatisfaction, a key risk factor for eating disorders. However, the Tripartite Influence Model has not been tested in Brazil where the people are known to have high levels of body image and appearance concerns. This study aimed to test an adapted Tripartite Influence Model of body dissatisfaction and disordered eating behaviors among Brazilian women. A sample of 741 undergraduate students (Mage = 23.55 years, SD = 4.09) completed measures of sociocultural influences, internalization of body ideal, social appearance comparison, body dissatisfaction, muscularity dissatisfaction, disordered eating and body change behaviors. Structural equation modeling analyses indicated that the proposed etiological model for Brazilian women has good fit indexes (χ2(2064) = 6793.232; p = 0.0001; χ2/gl = 3.29; CFI = 0.82; PCFI = 0.79; RMSEA = 0.056 [IC90% = 0.053-0.057]). Parent and media influences were related with both internalization and social comparison, while peer influence with social comparison. A full mediation model was found, with both internalization and social comparison contributing to body dissatisfaction. Finally, body dissatisfaction was associated with disordered eating behaviors. The findings inform the importance of considering cultural aspects that influence body image and eating behaviors, and highlight the validity of the proposed etiological model for Brazilian women, that can be used for research and clinical purposes.
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Ferreira DQC, Castro FN, Lopes FDA. Influência da formação acadêmica em Nutrição na expressão da neofobia alimentar. CIENCIA & SAUDE COLETIVA 2017. [DOI: 10.1590/1413-81232017222.13922015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O estudo objetivou avaliar a influência da formação acadêmica em Nutrição na expressão do comportamento alimentar neofóbico. Trata-se de um estudo transversal realizado com 247 universitários de ambos os sexos, com idade média de 24,6 ± 6,8 anos, matriculados no primeiro e no último ano de graduação em Nutrição e em outros cursos superiores da área de ciência da saúde. Foi avaliado o grau de neofobia alimentar através da Escala de Neofobia Alimentar associada a uma medida comportamental, obtida a partir da escolha entre alimentos conhecidos ou desconhecidos. De acordo com os resultados, os estudantes que estavam o início do curso de Nutrição apresentaram maiores escores de neofobia alimentar do que os do final do curso. No entanto, essa diferença não foi observada quando se comparou com os estudantes ingressantes e concluintes de outros cursos de graduação. Já na avaliação comportamental, foi visto que a maior parte dos estudantes concluintes do curso de Nutrição escolheu a preparação desconhecida, enquanto que nos demais grupos a maioria optou pela conhecida. Os resultados sugerem que a formação acadêmica em Nutrição pode ter influência sobre a expressão da neofobia alimentar.
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Litmanen J, Fröjd S, Marttunen M, Isomaa R, Kaltiala-Heino R. Are eating disorders and their symptoms increasing in prevalence among adolescent population? Nord J Psychiatry 2017; 71:61-66. [PMID: 27626363 DOI: 10.1080/08039488.2016.1224272] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND A debate concerns whether eating disorders are increasing in prevalence. The role of socio-economic status (SES) for adolescent eating disorders (ED) is another matter of debate. AIMS To ascertain whether self-reported eating disorders or their symptoms have increased in prevalence in adolescent population from the early 2000s to early 2010s. METHODS A person-identifiable classroom survey, Adolescent Mental Health Cohort study, was carried out among the 9th graders in comprehensive schools in Tampere, Finland, during academic year 2002-2003, and replicated among then 9th graders during academic years 2012-2013. Eating disorders were elicited with questionnaires tailored according to DSM-IV criteria for anorexia nervosa and bulimia nervosa. RESULTS No changes were observed between 2002-2003 and 2012-2013 in the prevalence of anorexia and bulimia, most of the symptoms of anorexia and bulimia, or the proportion of adolescents having received treatment due to eating disorders among the girls or the boys. Eating disorders, treatment contacts due to eating disorders, and eating disorder symptoms were not systematically associated with either low or high parental socio-economic status. CONCLUSION Based on this dataset, eating disorders are not increasing in the adolescent population. Adolescent eating disorders are not associated with socio-economic status of their family.
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Affiliation(s)
- Jessi Litmanen
- a School of Medicine , University of Tampere , Tampere , Finland
| | - Sari Fröjd
- b School of Public Health , University of Tampere , Tampere , Finland
| | - Mauri Marttunen
- c Department of Adolescent Psychiatry , National Institute for Health and Welfare , Helsinki , Finland.,d Department of Adolescent Psychiatry , Helsinki University Hospital , Helsinki , Finland.,e Department of Adolescent Psychiatry , University of Helsinki , Helsinki , Finland
| | - Rasmus Isomaa
- f The Department of Social Services and Health Care , Fredrikakliniken , Jakobstad , Finland
| | - Riittakerttu Kaltiala-Heino
- g Department of Adolescent Psychiatry, School of Medicine , Tampere University Hospital , Tampere , Finland.,h Department of Adolescent Psychiatry , University of Tampere , Tampere , Finland
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Senekal M, Lasker GL, van Velden L, Laubscher R, Temple NJ. Weight-loss strategies of South African female university students and comparison of weight management-related characteristics between dieters and non-dieters. BMC Public Health 2016; 16:918. [PMID: 27586376 PMCID: PMC5009639 DOI: 10.1186/s12889-016-3576-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 08/23/2016] [Indexed: 11/26/2022] Open
Abstract
Background Female university students are at risk for weight gain and use of inappropriate weight-loss strategies. By gaining a greater understanding of the weight-loss strategies used by and weight management related characteristics of these students, effective weight management interventions for this vulnerable group can be developed. Methods Two hundred and fifty female students from South Africa universities, aged 18–25 years, participated in this cross-sectional study; 162 attempted weight loss during the year preceding the study (dieters) and 88 were non-dieters. Weight and height were measured and BMI (kg/m2) computed. A self-administered questionnaire was used to record all other variables. Weight loss strategies were described for dieters and compared between BMI groups within the dieters group. Weight management related characteristics were compared between dieters and non-dieters. Statistical tests included Pearson Chi-square test, independent samples t-test or Mann-Whitney U test (depending on distribution of the data). Predictors for a higher BMI and being overweight/obese (BMI ≥25 kg/m2) were identified using regression models. Results Healthy weight-loss strategies included increased exercise and fruit/vegetable intake and decreased intake of sugar and fat containing items; unhealthy methods included eating little food and skipping meals; and extreme weight loss strategies included laxatives and vomiting. The most commonly used weight-loss product was Herbex. Dieters were characterized by a higher BMI, overestimation of their weight (especially normal weight students), dissatisfaction with weight and select body parts, higher intake of breakfast and healthy foods, lower intake of unhealthy foods, higher levels of vigorous physical activity, higher use of select informal weight-loss information sources and experiencing more pressure to lose weight from mothers, siblings and friends. Predictors of higher BMI and/or increased risk for BMI ≥25 included weight-loss attempt during the past year, race, dissatisfaction with waist, perception of currently being “chubby,” and higher frequencies of intake of a snack and fatty foods. Conclusion Attempting weight-loss is common among female students and predicts BMI. Healthy (mainly), unhealthy and extreme weight loss methods are used. Dieters are characterized by a less realistic body image, lower body satisfaction, higher pressure to lose weight, use of informal weight-management information and a healthier life-style.
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Affiliation(s)
- Marjanne Senekal
- Division of Human Nutrition, University of Cape Town, Anzio Rd, Anatomy Building Room 2.01.5, Observatory 7925, Cape Town, South Africa.
| | - Gabrielle L Lasker
- Division of Human Nutrition, University of Cape Town, Anzio Rd, Anatomy Building Room 2.01.5, Observatory 7925, Cape Town, South Africa
| | - Lindsay van Velden
- Division of Human Nutrition, University of Cape Town, Anzio Rd, Anatomy Building Room 2.01.5, Observatory 7925, Cape Town, South Africa
| | - Ria Laubscher
- Biostatistics Unit, Medical Research Council, Tygerberg, South Africa
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Alvarenga MDS, Carvalho PHB, Philippi ST, Scagliusi FB. Propriedades psicométricas da Escala de Atitudes Alimentares Transtornadas para adultos do sexo masculino. JORNAL BRASILEIRO DE PSIQUIATRIA 2013. [DOI: 10.1590/s0047-20852013000400002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Avaliar as propriedades psicométricas da Escala de Atitudes Alimentares Transtornadas (EAAT) para o sexo masculino. MÉTODOS: Duzentos e vinte e oito universitários (18-39 anos) responderam à EAAT, originalmente desenvolvida e validada para o sexo feminino. A consistência interna foi avaliada pelo Alpha de Cronbach e a validade convergente, por meio do coeficiente de correlação de Pearson comparando os escores da EAAT, do Teste de Atitudes Alimentares (EAT) e da Escala de Restrição (RS). A reprodutibilidade foi avaliada aplicando a escala numa subamostra (n = 38) com um mês de intervalo utilizando o coeficiente de correlação intraclasse (CCI). A validade known-groups foi obtida comparando o escore dos universitários na EAAT com o escore de homens com diagnóstico de transtornos alimentares (TA) (n = 28). RESULTADOS: A consistência interna da escala foi de 0,63. O escore da EAAT foi correlacionado com a EAT (r = 0,65) e RS (r = 0,51), e o CCI entre o teste e o reteste foi de 0,948. A análise known-groups diferenciou pacientes com TA de estudantes universitários (p < 0,001). CONCLUSÕES: A escala apresentou propriedades psicométricas adequadas e pode ser utilizada em estudos com homens adultos - uma vez que o constructo é pouco explorado em homens. Recomenda-se, de qualquer forma, uma revisão da escala e desenvolvimento de instrumentos específicos para o público masculino.
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