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Allnutt AE, Smith DJ, Torrence WA, Alexander DS. Examining weight bias attitudes and obesity beliefs among undergraduate students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1814-1819. [PMID: 35834745 DOI: 10.1080/07448481.2022.2093114] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 05/23/2022] [Accepted: 06/19/2022] [Indexed: 06/15/2023]
Abstract
Objective: This cross-sectional study examined the weight bias attitudes and obesity beliefs of health science (HS), nursing, and pre-medicine undergraduate students. Methods: Using snowballing and convenience sampling strategies, students (N = 139) completed an online survey, including a 24-item Antifat Attitudes Scale (AFAS) and eight-item Belief About Obese Persons (BAOP) scale. Results: HS students have higher weight bias than nursing and pre-medicine students combined (M = 43.45, SD = 10.75), t(137) = -2.45, p = .016). A negative correlation exists between AFAS and BAOP suggesting high weight bias influences a belief that obesity is controllable. Gender positively predicted weight bias attitudes (ß = -11.43, t = -4.33, p < .001) and obesity beliefs (ß = 3.75, t = 3.01, p = . 003). Conclusions: Findings confirm that HS students have weight bias attitudes. This supports undergraduate curricular changes on obesity etiology that may improve treatment plans of individuals who are obese.
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Affiliation(s)
| | - Daniel J Smith
- Concordia University Chicago, River Forest, Illinois, USA
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Zadeh H, Curran M, Del Castillo N, Morales C, Dukes K, Martinez D, Salinas JL, Bryant R, Bojang M, Carvour ML. Epidemiological approaches to multivariable models of health inequity: A study of race, rurality, and occupation during the COVID-19 pandemic. Ann Epidemiol 2024; 94:42-48. [PMID: 38642626 PMCID: PMC11326713 DOI: 10.1016/j.annepidem.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE Methods for assessing the structural mechanisms of health inequity are not well established. This study applies a phased approach to modeling racial, occupational, and rural disparities on the county level. METHODS Rural counties with disparately high rates of COVID-19 incidence or mortality were randomly paired with in-state control counties with the same rural-urban continuum code. Analysis was restricted to the first six months of the pandemic to represent the baseline structural reserves for each county and reduce biases related to the disruption of these reserves over time. Conditional logistic regression was applied in two phases-first, to examine the demographic distribution of disparities and then, to examine the relationships between these disparities and county-level social and structural reserves. RESULTS In over 200 rural county pairs (205 for incidence, 209 for mortality), disparities were associated with structural variables representing economic factors, healthcare infrastructure, and local industry. Modeling results were sensitive to assumptions about the relationships between race and other social and structural variables measured at the county level, particularly in models intended to reflect effect modification or mediation. CONCLUSIONS Multivariable modeling of health disparities should reflect the social and structural mechanisms of inequity and anticipate interventions that can advance equity.
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Affiliation(s)
- Hannah Zadeh
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Department of Sociology and Criminology, College of Liberal Arts and Sciences, University of Iowa, 401 North Hall, Iowa City, IA 52242, United States
| | - Michaela Curran
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, United States
| | - Nicole Del Castillo
- Department of Psychiatry, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States
| | - Carol Morales
- Department of Internal Medicine, University of New Mexico School of Medicine, MSC10-5550, 1 University of New Mexico, Albuquerque, NM 87131, United States
| | - Kimberly Dukes
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States
| | - Denise Martinez
- Department of Family Medicine, Carver College of Medicine, 200 Hawkins Drive, University of Iowa, Iowa City, IA 52242, United States
| | - Jorge L Salinas
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Department of Medicine, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, United States
| | - Rachel Bryant
- Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, United States
| | - Matida Bojang
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States
| | - Martha L Carvour
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, United States.
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Taylor SF, Krobath DM, Cuevas AG, Hennessy E, Roberts SB. Breaking Academic Silos: Pedagogical Recommendations for Equitable Obesity Prevention Training and Research During an Age of Nutrition Polarization. AJPM FOCUS 2024; 3:100217. [PMID: 38638941 PMCID: PMC11024911 DOI: 10.1016/j.focus.2024.100217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Introduction Obesity is a preventable chronic condition and a risk factor for poor health and early mortality. Weight stigma and weight-neutral medicine are popular topics in social media that are often at odds with current medical guidelines on obesity treatment and prevention. This conflict may erode the public's trust in science, impede research progress on preventing obesity in marginalized groups, and uphold the ongoing and historical lack of diversity among nutrition trainees. Methods The authors conducted a series of student-led dialogue sessions with nutrition graduate students in Boston, Massachusetts, from March to May 2023 to understand perceptions of obesity research, health equity, and racism and discrimination. This article summarizes the lessons learned and provides pedagogical recommendations for jointly addressing obesity at the population level and the recruitment, training, and retention of diverse scholars, clinicians, and public health practitioners. Results Dialogue sessions revealed that students perceive a disproportionate focus on the harms of obesity as a chronic disease, highlighting that inadequate attention is given to weight stigma and discrimination. Some participants believed that weight-based discrimination is equally detrimental to individual health and wellbeing as having obesity. Discussions also emphasized the need to pinpoint the multidimensional and cultural manifestations of weight stigma, which necessitates collaboration across social sectors and academic disciplines. Students recognized the urgent need to apply an equity lens to obesity research and teaching but felt limited in their access to experts within nutrition science who specialize in racism, discrimination, eating disorders, and weight stigma. Conclusions This study identified concrete opportunities for urgently needed new training and research in population-level obesity prevention, emphasizing antiracism, harm reduction, and elimination of stigma and bias across multiple levels of science and society. Overall, the decision to use the BMI within pedagogy and training must be explicitly stated-research, population surveillance, decision-making, or treatment pedagogy and training-while acknowledging its strengths and limitations across diverse settings. Finally, the social determinants of obesity should incorporate not only weight stigma but also racism and multiple forms of discrimination.
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Affiliation(s)
- Salima F. Taylor
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Danielle M. Krobath
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Adolfo G. Cuevas
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, New York
- Center for Antiracism, Social Justice, and Public Health, New York University School of Global Public Health, New York, New York
| | - Erin Hennessy
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Susan B. Roberts
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
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Jiang S, Pan X, Li H, Su Y. Global trends and developments in mindfulness interventions for diabetes: a bibliometric study. Diabetol Metab Syndr 2024; 16:43. [PMID: 38360701 PMCID: PMC10870632 DOI: 10.1186/s13098-024-01288-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/08/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Diabetes is a metabolic disorder posing a global threat to health. Many scholars are dedicated to developing non-pharmacological therapies, and mindfulness intervention is among the potentially effective approaches. Due to the rapid increase in relevant research in recent years, along with the diverse focus and interventions used in studies, it has become challenging for practitioners to quickly comprehend the key features of this field and the directions worth paying attention to. Bibliometric analysis, in response, can help scholars understand this field and identify points of interest. METHODS Publications related to mindfulness intervention in diabetes from the establishment of the Web of Science Core Collection (WOSCC) to September 2023 were searched. We employed four bibliometric techniques: General Analysis of Publications, Collaborative Network Analysis, Co-citation Analysis, and Keyword Analysis. The CiteSpace 6.1.R was used to analyze the literature with the strongest citation bursts, while VOSviewer 1.6.13 was used to provide visualizations of publicly available data by analyzing co-citations or co-authorship affiliations. RESULTS We found a total of 387 articles. The results indicate that research on this topic has been steadily increasing over time. The United States is the top producer of relevant publications, with Tilburg University being the institution that publishes the most articles. The journal "Mindfulness" has the highest publication count. In the collaborative network analysis, the United States emerged as the main hub for global cooperation in this research field, contributing 182 articles with a total of 5872 citations. The journal "Diabetes Care" was frequently cited and played a central role. The keyword analysis revealed that researchers have shown a strong interest in how mindfulness interventions affect the mental health of diabetic individuals. Additionally, there is a focus on studying elderly diabetic groups and exploring how mindfulness interventions impact metabolic diseases. These areas are currently the main research priorities. CONCLUSION Our findings demonstrate the current trend and hotspots in mindfulness intervention and offer some directions for future research.
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Affiliation(s)
- Sijia Jiang
- College of Physical Education, Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Xiaoli Pan
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China
| | - Hansen Li
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China
| | - Yuqin Su
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China.
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Zhang Y, Guo Z, Liu Y, Zhou Y, Jing L. Is dancing an effective intervention for fat loss? A systematic review and meta-analysis of dance interventions on body composition. PLoS One 2024; 19:e0296089. [PMID: 38232096 DOI: 10.1371/journal.pone.0296089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE The systematic review aimed to review the research on the effects of dance interventions, relative to normal lifestyles, on body composition in people with overweight and obesity. METHODS 7 databases were searched from their inception to 3 July 2023 for studies with dance interventions and normal lifestyles groups. Only studies investigating dance interventions in people with overweight and obesity(body mass index (BMI)>24kg/m2 and percent fat mass (Fat(%)) abnormal(male>20%, female>25%)) were included in the meta-analysis. There were no restrictions on dance forms. RESULTS 654 studies were identified from the databases, and 10 studies were evaluated to be eligible. The meta-analysis revealed that compared to normal lifestyles dance had meaningful improvements in body mass(BM), BMI, waist circumference(WC), Fat(%), and fat mass(Fat(kg)). No significant differences were found in the waist-to-hip ratio(WHR). CONCLUSIONS Dance is effective on fat loss in people with overweight and obesity, and has a significant improvement on body composition and morphology. For its high efficiency and greater sense of enjoyment, dance can be a beneficial exercise intervention for fat loss.
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Affiliation(s)
- Yaya Zhang
- School of Physical Education, Hunan University of Science and Technology, Xiangtan, China
| | - Zhicheng Guo
- Clinical Research Innovation and transformation Center, Zhangjiagang First People's Hospital, Suzhou, China
| | - Yin Liu
- School of Physical Education, Hunan University of Science and Technology, Xiangtan, China
| | - Yongxu Zhou
- School of Physical Education, Hunan University of Science and Technology, Xiangtan, China
| | - Longjun Jing
- School of Physical Education, Hunan University of Science and Technology, Xiangtan, China
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Kendrick KN, Bode Padron KJ, Bomani NZ, German JC, Nyanyo DD, Varriano B, Tu L, Stanford FC. Equity in Obesity Review. Endocrinol Metab Clin North Am 2023; 52:617-627. [PMID: 37865477 DOI: 10.1016/j.ecl.2023.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Obesity disproportionately affects racial and ethnic minoritized populations and those of lower socioeconomic status. Similarly, disparities exist in the development of its downstream consequences, such as type 2 diabetes and hypertension. The causes of these disparities are multifactorial and are influenced by structural factors such as segregation and healthcare access, and individual-level factors such as weight stigma. Interventions to decrease disparities in obesity should consider macro-level, community, and individual-level factors that might reduce disparities and improve equity in obesity care. Clinicians must also recognize the chronic nature of obesity, and how bias and stigma may impact patient care.
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Affiliation(s)
- Karla N Kendrick
- Beth Israel Lahey Health, Winchester Hospital Weight Management Center.
| | - Kevin J Bode Padron
- Massachusetts General Hospital Neuroendocrine and Pituitary Tumor Clinical Center, 100 Blossom Street, Cox Building Suite 140, Boston, MA 02114, USA; Duke University School of Medicine, DUMC 2927, 40 Duke Medicine Circle, 124 Davison Building, Durham, NC 27710, USA
| | - Nichola Z Bomani
- Massachusetts General Hospital Neuroendocrine and Pituitary Tumor Clinical Center, 100 Blossom Street, Cox Building Suite 140, Boston, MA 02114, USA; Case Western Reserve University School of Medicine, 9501 Euclid Avenue, Cleveland, OH 44106, USA
| | - Jashalynn C German
- Duke Division of Endocrinology, Metabolism, and Nutrition, 200 Trent Drive, Baker House, DUMC Box 3021, Durham, NC 27710, USA
| | - Dennis D Nyanyo
- Beth Israel Lahey Health, Winchester Hospital Weight Management Center; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Harvard Kennedy School of Government, 79 John F. Kennedy Street, Cambridge, MA 02138, USA
| | - Brenda Varriano
- Mass-General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Lucy Tu
- Department of Sociology, Harvard University, 33 Kirkland Street, Cambridge, MA, USA; Department of History of Science, Harvard University, 1 Oxford St #371, Cambridge, MA, USA
| | - Fatima Cody Stanford
- Massachusetts General Hospital MGH Weight Center, 50 Staniford Street, Suite 430, Boston, MA 02114, USA
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Hayashi LC, Benasi G, St-Onge MP, Aggarwal B. Intuitive and mindful eating to improve physiological health parameters: a short narrative review of intervention studies. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:537-547. [PMID: 34913327 PMCID: PMC10098784 DOI: 10.1515/jcim-2021-0294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/29/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES This brief narrative review aims to give an up-to-date overview of intuitive and mindful eating (I/ME) interventions with specific focus on cardiometabolic risk factors, including glucose, lipid profile, blood pressure and inflammatory markers. CONTENT I/ME intervention studies in adults which measured at least one physiological parameter other than weight were identified from PubMed. The clinical trial/randomized controlled trial filters and publication dates 2001 through April 2021 with variations of the following keywords were applied: intuitive eating, mindful eating, weight neutral. Ten articles were identified. SUMMARY AND OUTLOOK Of the 10 studies, seven showed I/ME interventions were more effective than control in at least one cardiometabolic outcome, two showed significant I/ME within-group improvements but no between-group differences, and one showed neither within-group nor between-group differences. Specifically, I/ME improved glucose levels among pregnant women with or without gestational diabetes, lipid profile among adults with overweight or obesity, blood pressure among participants with overweight and inflammatory markers among post-menopausal women with obesity. However, the positive impact of I/ME on each of these cardiometabolic parameters was not consistent across studies: of the six studies that examined glucose regulation, two demonstrated positive outcomes for I/ME group, whereas four found no effect compared to control. Three out of five studies had positive lipid effects, one out of five demonstrated systolic blood pressure (SBP) improvements and one of two showed improvements in inflammatory markers. Given these mixed results, more research is needed to understand the possible effectiveness of I/ME to improve cardiometabolic health.
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Affiliation(s)
- Lauren C. Hayashi
- College of Medicine, University of Florida, Gainesville, FL, USA; Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Giada Benasi
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Marie-Pierre St-Onge
- Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY, USA; Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Brooke Aggarwal
- Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University Irving Medical Center. 51 Audubon Avenue, Suite 505, New York, NY 10032, USA; Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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Albajri E, Naseeb M. Sex differences in intuitive eating and its relationship with body mass index among adults aged 18-40 years in Saudi Arabia: a cross-sectional study. Front Nutr 2023; 10:1214480. [PMID: 37538925 PMCID: PMC10395086 DOI: 10.3389/fnut.2023.1214480] [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] [Received: 04/29/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction Intuitive eating (IE) is eating without judgment, relying only on physiological hunger and satiety. Sex differences in IE have been reported; however, none of the studies have explicitly examined IE and its relationship with body mass index (BMI) in the Saudi Arabian population. Thus, this study aimed to investigate sex differences in IE and its relationship with BMI in the Saudi population. Subjects/methods A cross-sectional online survey of 360 participants (18 years or older) with self-reported weight and height was conducted. IE was measured using the Intuitive Eating Scale-2 (IES-2). Separate multiple linear regression analyses were conducted to determine if total IE and its subscale scores differed across sexes. It was also conducted to assess the relationship between IE and BMI across sexes. Results Women had higher total IE score, eating for physical rather than emotional reasons (EPR), and body-food choice congruence (BFCC) scores compared to men (p = 0.013, p = 0.01, p <0.001, respectively). The analysis showed a significant negative association between total IE, BFCC, EPR scores, and BMI in women compared to men (p = 0.023, p = 0.01, p = 0.003, respectively). Conclusion The data on the sex differences in IE and its subscales and their different association with BMI encourage tailing nutrition-related recommendations in the context of intuitive eating based on sexes. Future studies are needed to explore how intuitive eating functions differently in women compared to men and explore the causal relationship between IE and BMI in this population.
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Loor JM, Mullins CR, Smith JE. Examination of ecological validity of intuitive eating. Appetite 2023; 188:106761. [PMID: 37421977 DOI: 10.1016/j.appet.2023.106761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/14/2023] [Accepted: 06/25/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Intuitive eating, which involves following internal cues of hunger and satiety to guide eating choices, would be better understood if studied at the individual momentary level instead of globally or cross-sectionally. The current study employed ecological momentary assessment (EMA) to examine the ecological validity of a popular intuitive eating measure, the Intuitive Eating Scale (IES-2). METHOD College males and females completed a baseline assessment of trait levels of intuitive eating as measured by the IES-2. Participants then followed a seven-day EMA protocol where they completed brief smart phone assessments about intuitive eating and related constructs while in their natural daily environments. Participants were asked to complete recordings before and after eating about their state level of intuitive eating at that moment. RESULTS Among 104 participants, 87.5% were female, mean age was 24.3, and mean BMI was 26.3. Baseline trait level intuitive eating was significantly correlated with state level intuitive eating reported across EMA recordings, with some evidence suggesting that correlations were stronger before eating compared to after eating. Intuitive eating generally was related to less negative affect, fewer eating restrictions, and more anticipated taste enjoyment before eating, as well as less guilt and regret after eating. DISCUSSION Individuals who reported high trait levels of intuitive eating also reported following their internal cues for hunger and satiety and had less guilt, regret, and negative affect surrounding eating in their naturalistic environments, thereby supporting the ecological validity of the IES-2.
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Affiliation(s)
- Jamie M Loor
- University of New Mexico Health Sciences Center, MSC08-4506, Albuquerque, NM 87131-0001, United States.
| | - Chloe R Mullins
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM 87131-0001, United States.
| | - Jane Ellen Smith
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM 87131-0001, United States.
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Loor JM, Mullins CR, Pacheco C, VanderJagt H, Smith JE. A qualitative exploration of perceived barriers and facilitators to following an intuitive eating style. Eat Behav 2023; 49:101744. [PMID: 37178460 DOI: 10.1016/j.eatbeh.2023.101744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Intuitive eating involves following internal cues of hunger and satiety to guide eating choices as opposed to responding to external signals, strong emotions, or dietary rules. This style of eating has consistently been shown to be related to better physical and psychological health indicators, and more interventions are being designed and studied to promote this eating style. The current study aimed to identify anticipated facilitators and barriers to following this style of eating among a group of college students enrolled in a larger study of intuitive eating. METHOD Following a week of tracking their current eating as part of a larger study, college students read a description of intuitive eating. They then answered three open-ended questions about following intuitive eating including facilitators, barriers, and perceived ability to follow long term. Responses were coded using thematic analysis to identify themes across responses. RESULTS Among 100 participants, 86 % were female, 46 % were Hispanic (41 % non-Hispanic White, 13 % other race/ethnicity), mean age was 24.3 years, and mean body mass index was 26.2. The most commonly anticipated participant-reported facilitators of intuitive eating were being in touch with the body's needs and hunger cues, positive perceptions of intuitive eating, and health considerations. The most commonly anticipated barriers were logistical constraints (e.g., busyness and mealtimes), difficulty with hunger cues and reactions to food, and negative perceptions of intuitive eating. The majority of participants (64 %) would consider following this style of eating long term. DISCUSSION This study provides information that can be used to improve efforts aimed at promoting intuitive eating to college students, including marketing intuitive eating interventions, and clarifying misunderstandings of its key tenets that might serve as barriers.
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Affiliation(s)
- Jamie M Loor
- University of New Mexico Health Science Center, Albuquerque, NM, United States.
| | - Chloe R Mullins
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Catalina Pacheco
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Hayley VanderJagt
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Jane Ellen Smith
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
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Donnachie C, Sweeting H, Hunt K. A Qualitative Study on Young Men's Experiences of Intentional Weight-Gain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3320. [PMID: 36834015 PMCID: PMC9964095 DOI: 10.3390/ijerph20043320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
This qualitative study investigated how young men perceive their body image and experiences of purposively gaining weight, and what these reveal about broader sociocultural meanings around food, consumption and male body image. The participants in this study were a subsample of men participating in the 'GlasVEGAS' study which examined the effect of weight-gain and weight loss on metabolism, fitness and disease risk in young adult men. Twenty-three qualitative, semi-structured interviews were conducted with thirteen men (mean age 23 years) at GlasVEGAS baseline (n = 10) and weight-gain (6-week) follow-up assessment (n = 13). Data were analysed using the principles of framework analysis. The majority of men viewed the foods provided as part of the GlasVEGAS study as 'luxury' items despite their being of low nutritional value. The weight-gain process prompted men to reflect on how cultural norms and social environments may amplify overeating. Several described being surprised at how quickly they assimilated unhealthy eating habits and/or gained weight. Some valued changes in their appearance associated with weight-gain, including appearing larger or having increased muscle size. These factors are vital to consider when developing weight management initiatives targeting young men, including the valorisation of unhealthy foods, wider social influences on diet and male body image ideals.
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Affiliation(s)
- Craig Donnachie
- School of Social and Political Sciences, University of Glasgow, Glasgow G12 8RS, UK
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow G1 1QE, UK
| | - Helen Sweeting
- Retired—Previously MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow G3 7HR, UK
| | - Kate Hunt
- Institute for Social Marketing and Health, University of Stirling, Stirling FK9 4LA, UK
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Cloutier-Bergeron A, Samson A, Provencher V, Mongeau L, Paquette MC, Turcotte M, Bégin C. Health At Every Size intervention® under real-world conditions: the rights and wrongs of program implementation. Health Psychol Behav Med 2022; 10:935-955. [PMID: 36210868 PMCID: PMC9543046 DOI: 10.1080/21642850.2022.2128357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Implementation integrity is known to be critical to the success of interventions. The Health At Every Size® (HAES®) approach is deemed to be a sustainable intervention on weight-related issues. However, no study in the field has yet investigated the effects of implementation on outcomes in a real-world setting.
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Affiliation(s)
| | - Amélie Samson
- Centre de recherche Nutrition, santé et société (NUTRISS), INAF, Université Laval, Québec, Canada
- Ministère de la santé et des services sociaux, Québec, Canada
| | - Véronique Provencher
- Centre de recherche Nutrition, santé et société (NUTRISS), INAF, Université Laval, Québec, Canada
- School of Nutrition, Université Laval, Québec, Canada
| | - Lyne Mongeau
- School of Public Health, Université de Montréal, Montréal, Canada
| | - Marie-Claude Paquette
- Institut national de santé publique du Québec, Québec, Canada
- Department of Nutrition, Université de Montréal, Montréal, Canada
| | - Mylène Turcotte
- Centre de recherche Nutrition, santé et société (NUTRISS), INAF, Université Laval, Québec, Canada
| | - Catherine Bégin
- School of Psychology, Université Laval, Québec, Canada
- Centre de recherche Nutrition, santé et société (NUTRISS), INAF, Université Laval, Québec, Canada
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Gough Courtney M, Carroll A. Sex differences in overweight and obesity among Mexican Americans in the National Health and Nutrition Examination Survey: A comparison of measures. SSM Popul Health 2022; 20:101297. [PMID: 36451850 PMCID: PMC9703813 DOI: 10.1016/j.ssmph.2022.101297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022] Open
Abstract
The increasing prevalence of overweight and obesity in the United States, and disparities by race, ethnicity, and gender, have caused concern among public health practitioners, health care providers, and others, in part because overweight and obesity may be linked to chronic health problems and weight stigma. Researchers have traditionally relied upon body mass index (BMI) as a measure of overweight and obesity, despite its limitations. In this study we apply an intersectional framework and use data from the 2011-2018 waves of the nationally representative National Health and Nutrition Examination Survey (NHANES) to study sex differences in the risk of overweight and obesity among Mexican Americans, triangulating three measures that proxy for overweight and obesity: BMI, high waist circumference, and high percent body fat. We assess heterogeneity across nativity, education, income by parenthood status, food security, time in the United States (for immigrants), and receipt of SNAP/WIC benefits (for the low-income sample). Results from logistic regression models indicate choice of cutoff values and measure are critical to determining whether sex disparities exist. We find no evidence of disparities in BMI but evidence of greater risk for females using traditional cutoff values for high waist circumference and high percent body fat. Adjusted cutoff values provide differing results. Minimal heterogeneity is seen. Results reinforce the importance of considering sex disparities and emphasize the importance of critically examining measures that proxy for overweight and obesity risk, given the high stakes surrounding weight stigma.
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14
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Wong K, Myre M, Moules NJ, Lefebvre D, Morhun JM, Saunders JF, Estefan A, Russell-Mayhew S. The enigma of weight: Figures, flux, and fitting in. Front Psychol 2022; 13:930360. [PMID: 36337472 PMCID: PMC9631431 DOI: 10.3389/fpsyg.2022.930360] [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: 04/28/2022] [Accepted: 09/14/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose In Western society, the measurement of weight is prioritized over a person’s bodily experience. Hermeneutic philosopher Gadamer warned against the emphasis on measurement, rather than experience, in the medical sciences. An examination of the complexity of the experience of weight provides the opportunity to shift focus from quantifying the connection between health and weight to the experience of the person being weighed. Methods This qualitative hermeneutic study aims to understand people’s experiences of weight from the interviews of professionals (n = 7) and lay experts (n = 10). Interviews were analyzed using an interpretive hermeneutic method. Results The interviews revealed that weight was experienced as a number imbued with meaning and bias, as a number that could be manipulated, and as a constant and anticipated bodily change. Weight change was expected and often unwelcomed, despite weight being a quality of the body that is always in flux. External measures of weight meant to monitor wellness and health inadvertently became an unhealthy fixation that prevented some participants from fully participating in life events and appreciating the stages their bodies were in. Conclusion Weight change is a necessary condition of being human, and bodies are and will be constantly changing. To achieve health and harmony, one must fit together the acceptance of change and their bodily experience of weight. It is often the preoccupation with weight, not weight itself, that gets in the way of living.
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Affiliation(s)
- Katherine Wong
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Maxine Myre
- Counselling Psychology, Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Nancy J. Moules
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Danielle Lefebvre
- Counselling Psychology, Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Janelle M. Morhun
- Counselling Psychology, Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Jessica F. Saunders
- Psychology Convening Group, Ramapo College of New Jersey, Mahwah, NJ, United States
| | - Andrew Estefan
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Shelly Russell-Mayhew
- Counselling Psychology, Werklund School of Education, University of Calgary, Calgary, AB, Canada
- *Correspondence: Shelly Russell-Mayhew,
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Factors Associated with White Fat Browning: New Regulators of Lipid Metabolism. Int J Mol Sci 2022; 23:ijms23147641. [PMID: 35886989 PMCID: PMC9325132 DOI: 10.3390/ijms23147641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/03/2022] [Accepted: 07/07/2022] [Indexed: 11/20/2022] Open
Abstract
Mammalian adipose tissue can be divided into white and brown adipose tissue based on its colour, location, and cellular structure. Certain conditions, such as sympathetic nerve excitement, can induce the white adipose adipocytes into a new type of adipocytes, known as beige adipocytes. The process, leading to the conversion of white adipocytes into beige adipocytes, is called white fat browning. The dynamic balance between white and beige adipocytes is closely related to the body’s metabolic homeostasis. Studying the signal transduction pathways of the white fat browning might provide novel ideas for the treatment of obesity and alleviation of obesity-related glucose and lipid metabolism disorders. This article aimed to provide an overview of recent advances in understanding white fat browning and the role of BAT in lipid metabolism.
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16
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Campos MB, Menezes IHCF, Peixoto MDRG, Schincaglia RM. Intuitive eating in general aspects of eating behaviors in individuals with obesity: Randomized clinical trial. Clin Nutr ESPEN 2022; 50:24-32. [DOI: 10.1016/j.clnesp.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 05/17/2022] [Accepted: 06/01/2022] [Indexed: 10/18/2022]
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17
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Hadwen BB, He JB, Funk C, McKinney K, Wilk P. Association between accuracy of weight perception and life satisfaction among adults with and without anxiety and mood disorders: a cross-sectional study of the 2015-2018 Canadian Community Health Survey. J Public Health (Oxf) 2022:6572299. [PMID: 35460257 DOI: 10.1093/pubmed/fdac047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Weight status and weight perception have a significant impact on life satisfaction. As overweight prevalence increases in Canada, it is important to understand how accuracy of weight perception (AWP) is associated with life satisfaction. This study explored the association between AWP and life satisfaction among Canadian adults with and without anxiety and/or mood disorders. METHODS Using data from the 2015-2018 cycles of the Canadian Community Health Survey, an indicator of AWP was created to capture concordance between perceived weight and actual weight status. Univariate and multivariate Gaussian generalized linear models were assessed while stratifying by sex and presence of anxiety and/or mood disorders. RESULTS Our sample included 88 814 males and 106 717 females. For both sexes, perceiving oneself as overweight or underweight, regardless of actual weight status, was associated with lower life satisfaction (β = -0.93 to -0.30), compared to those who accurately perceived their weight as 'just about right'. Perceiving oneself as overweight or underweight was associated with more pronounced differences in life satisfaction scores in those with anxiety and/or mood disorders (β = -1.49 to -0.26) than in those without these disorders (β = -0.76 to -0.25). CONCLUSION Weight perception is more indicative of life satisfaction than actual weight status, especially in those with anxiety and/or mood disorders.
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Affiliation(s)
- Brook B Hadwen
- Department of Epidemiology and Biostatistics, Western University, London N6G 2M1, Canada
| | - Jennifer B He
- Department of Epidemiology and Biostatistics, Western University, London N6G 2M1, Canada
| | - Celine Funk
- Department of Epidemiology and Biostatistics, Western University, London N6G 2M1, Canada
| | - Kelly McKinney
- Department of Epidemiology and Biostatistics, Western University, London N6G 2M1, Canada
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Western University, London N6G 2M1, Canada.,Department of Paediatrics, Western University, London N6A 5W9, Canada.,Child Health Research Institute, London N6C 2V5, Canada.,Lawson Health Research Institute, London N6C 2R5, Canada.,ICES, London N6A 5W9, Canada.,Institute of Social and Preventive Medicine, University of Bern, Bern 3012, Switzerland
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18
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Online Consumer Survey Comparing Different Front-of-Pack Labels in Greece. Nutrients 2021; 14:nu14010046. [PMID: 35010921 PMCID: PMC8746628 DOI: 10.3390/nu14010046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022] Open
Abstract
According to the WHO, front-of-pack nutrition labeling provides simplified nutrition information in the form of symbols, colors or words that can help consumers understand the nutritional quality of food, thus leading them to healthier food choices. It is considered of the utmost importance to explore the knowledge and understanding of consumers about this form of nutrition labeling. The aim of this study was to investigate the understanding and perceptions of Greek consumers in response to five different front-of-pack nutrition labels (FoPLs): the Multiple Traffic Lights, Health Star Rating System, Guideline Daily Amounts, Warning Symbols and Nutri-Score. From April 2021 to June 2021, 1278 participants from Greece took part in an online survey where they were asked to rank three products according to their nutritional quality. The classification process was performed first without FoPLs and then with FoPLs. The ability to classify products according to their nutritional quality was evaluated with multinomial logistic regression models, and the Nutri-Score label presented greater improvements when compared to the GDA label for Greek consumers. The Nutri-Score seemed to better help the Greek consumers rank foods according to their nutritional value.
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19
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Murray-Davis B, Darling EK, Berger H, Melamed N, Li J, Guarna G, Syed M, Barrett J, Geary M, Mawjee K, McDonald SD. Midwives perceptions of managing pregnancies complicated by obesity: A mixed methods study. Midwifery 2021; 105:103225. [PMID: 34915446 DOI: 10.1016/j.midw.2021.103225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 02/05/2021] [Accepted: 12/05/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The growing prevalence of obesity is a concern for midwives. In Canada, the absence of regulatory standards, varying protocols and consultant preferences shape clinical decision making for the midwife and may lead to inconsistent practice. Our aim was to understand the barriers, enablers, and knowledge gaps that influenced experiences of midwives in Ontario, Canada when providing care to clients impacted by obesity. METHODS Mixed methods design using a sequential, explanatory approach. Surveys conducted with midwives were administered using an online platform, followed by semi-structured interviews to understand the perspectives elicited in the survey in greater detail. Interviews were audio recorded and transcribed verbatim. Survey data were analyzed using descriptive statistics, and thematic analysis was used for generating codes, categories and themes from the interview data. RESULTS 144 midwives completed the survey and 20 participated in an interview. The participants described their clinical management when caring for those with obesity which included considerations regarding additional tests/investigations, consultation and transfer of care, and place of birth. Up to 93% of surveyed midwives believed that clients with obesity were appropriate for midwifery-led care however there was less certainty about suitability as BMI increased to higher ranges such as > 45). The care management was influenced by beliefs and attitudes, knowledge, and system-level factors. Midwives experienced barriers such as inconsistent practices and role confusion, and felt ill equipped to care for pregnancies affected by obesity due to unclear guidelines. CONCLUSIONS Overall, midwives believe clients with obesity are suitable for midwifery-led care due to its individualized, non-judgmental approach to care. Additional training for midwives and other obstetric care providers would be beneficial to help overcome barriers in providing effective care to pregnancies affected by obesity.
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Affiliation(s)
- Beth Murray-Davis
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada.
| | - Elizabeth K Darling
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada.
| | - Howard Berger
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Ontario, Canada.
| | - Nir Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
| | - Jenifer Li
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada.
| | - Giuliana Guarna
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada.
| | - Maisah Syed
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada.
| | - Jon Barrett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
| | - Michael Geary
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland.
| | - Karizma Mawjee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Ontario, Canada.
| | - Sarah D McDonald
- Division of Maternal-Fetal Medicine, Departments of Obstetrics & Gynecology, Radiology & Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.
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Kim B, Kim G, Kim E, Park J, Isobe T, Sakae T, Oh S. The A Body Shape Index Might Be a Stronger Predictor of Chronic Kidney Disease Than BMI in a Senior Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412874. [PMID: 34948483 PMCID: PMC8701813 DOI: 10.3390/ijerph182412874] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/23/2021] [Accepted: 12/05/2021] [Indexed: 12/20/2022]
Abstract
The A Body Shape Index (ABSI) was recently introduced to quantify abdominal adiposity relative to the body mass index (BMI) and height. This cross-sectional study was performed to explore whether the ABSI is linked to chronic kidney disease (CKD) in older adults and compare the predictive capacity of the ABSI versus BMI for CKD. In total, 7053 people aged ≥ 60 years were divided into normal, mild, and moderate-to-severe CKD groups based on their estimated glomerular filtration rate (eGFR). The correlation of the ABSI with the eGFR and the differences and trends in the ABSI and BMI among the groups were analyzed, and the cutoff points for moderate-to-severe CKD were calculated. The association between the ABSI and CKD was stronger than that between the BMI and CKD. The ABSI had a better capacity to discriminate the CKD stage than did the BMI. The capacity of the ABSI to predict moderate-to-severe CKD was higher than that of the BMI and was more substantial in women than men. The ABSI cutoff points for CKD were ≥0.0822 and 0.0795 in men and women, respectively. In conclusion, the ABSI serves as a better index than the BMI for screening and detecting high-risk individuals with CKD.
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Affiliation(s)
- Bokun Kim
- Department of Kinesiology, Silla University, Busan 46958, Korea;
| | - Gwonmin Kim
- Medical Research Institute, Pusan National University Hospital, Busan 49241, Korea; (G.K.); (J.P.)
| | - Eonho Kim
- Department of Physical Education, Dongguk University, Seoul 04620, Korea;
| | - Jonghwan Park
- Medical Research Institute, Pusan National University Hospital, Busan 49241, Korea; (G.K.); (J.P.)
| | - Tomonori Isobe
- Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan; (T.I.); (T.S.)
| | - Takeji Sakae
- Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan; (T.I.); (T.S.)
| | - Sechang Oh
- Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan; (T.I.); (T.S.)
- Correspondence: ; Tel.: +81-29-853-3291
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21
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Ambwani S, Elder S, Sniezek R, Goeltz MT, Beccia A. Do media portrayals and social consensus information impact anti-fat attitudes and support for anti-weight discrimination laws and policies? Body Image 2021; 39:248-258. [PMID: 34655859 DOI: 10.1016/j.bodyim.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 09/20/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
Although weight stigma and discrimination are associated with increased body dissatisfaction and eating disorder risk, reduced opportunities, and poorer well-being, there are few legal protections for such discrimination in the U.S. We addressed one barrier to enacting protective legislation - public attitudes toward anti-weight discrimination laws - by assessing the impact of media representations of fatness and information about peer attitudes. Using a 2 × 2 experimental design, participants (N = 525) completed baseline assessments of political conservatism and weight bias and were randomly assigned to view fat-negative or fat-positive media content that was ostensibly supported or not supported by their peers, followed by questionnaires assessing fat phobia and legislative attitudes. Two-way ANCOVAs controlling for baseline weight bias and political conservatism indicated a significant effect for media framing, with greater fat phobia and less support for anti-discrimination laws and policies among those who viewed the fat-negative frame; however, effects for ostensible peer support and interaction effects were not significant. These preliminary findings suggest that efforts to shift media rhetoric may enhance support for anti-weight discrimination laws. Future research should investigate other barriers to anti-discrimination legislation and estimate their impact on body dissatisfaction, eating disorder risk, and other indicators of population health.
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Affiliation(s)
- Suman Ambwani
- Department of Psychology, Dickinson College, United States.
| | - Scott Elder
- Department of Psychology, Dickinson College, United States
| | | | | | - Ariel Beccia
- Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, United States; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, United States
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22
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Care of Pregnant Women With a History of Bariatric Surgery. Nurs Womens Health 2021; 25:384-394. [PMID: 34534496 DOI: 10.1016/j.nwh.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/30/2021] [Accepted: 08/01/2021] [Indexed: 11/21/2022]
Abstract
In recent years, the incidence of bariatric surgery has increased among women of reproductive age. Health care providers should be knowledgeable about the impact bariatric surgery has on women and developing fetuses to effectively provide care from preconception through postpartum. Although pregnancy in women with normal weight or with excess weight after bariatric surgery has better outcomes when compared to pregnancy complicated by obesity, it is associated with complications such as nutritional deficiencies, low birth weight, and fetal growth restriction. Consequently, a multidisciplinary approach is recommended to ensure adequate nutrition, counseling, and screening before and during pregnancy. This article summarizes evidence regarding pregnancy complications that may occur in women with a history of bariatric surgery and presents a nursing, advanced practice nursing, and midwifery plan of care for these women before, during, and after pregnancy.
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23
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Mensinger JL, Cox SA, Henretty JR. Treatment Outcomes and Trajectories of Change in Patients Attributing Their Eating Disorder Onset to Anti-obesity Messaging. Psychosom Med 2021; 83:777-786. [PMID: 34267090 PMCID: PMC8428859 DOI: 10.1097/psy.0000000000000962] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 02/05/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Given the increased prevalence of eating disorders (EDs) among individuals higher on the weight spectrum, we aimed to 1) report the prevalence of ED patients in higher levels of care (residential, partial hospitalization, and intensive outpatient) attributing the onset of their ED to anti-obesity messaging, 2) report the most commonly recollected sources of those messages, and 3) determine if those attributing the onset of their ED to anti-obesity messaging a) enter, b) exit, and c) respond to treatment differently from peers who did not. METHODS This retrospective cohort study used data from 2901 patients receiving ED treatment in higher levels of care at a US-based center between 2015 and 2018. Multilevel models examined differences in ED symptoms and trajectories of change over time. NVivo was used to analyze the patients' comments about sources of messages. RESULTS Eighteen percent attributed their ED onset to anti-obesity messaging, 45% did not, and 37% were unsure. Of those providing comments, the most common sources included the following: educational curriculum/school context (45.9%), media/Internet (24.7%), health care (10.4%), family (9%), and peer bullying (3.7%). At admission, patients attributing their ED onset to anti-obesity messaging had more severe ED symptoms than those who did not (γ = 0.463, standard error [SE] = 0.086, p < .001) and those who were unsure (γ = 0.288, SE = 0.089, p < .001); no differences were evident at discharge (p > .483). During phase 2 of treatment, patients attributing their ED onset to anti-obesity messaging improved faster than those who did not (γ = 0.003, SE = 0.001, p = .008) and those who were unsure (γ = 0.003, SE = 0.001, p = .014). CONCLUSIONS Anti-obesity messaging may put vulnerable individuals at risk for EDs. We recommend increasing weight bias training for school personnel and health care professionals. To reduce health disparities, we also suggest the promotion of weight-neutral health-enhancing self-care practices in media and public health campaigns, legislative policies, and health care overall.
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24
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Wang J, You D, Wang H, Yang Y, Zhang D, Lv J, Luo S, Liao R, Ma L. Association between homocysteine and obesity: A meta-analysis. J Evid Based Med 2021; 14:208-217. [PMID: 33145936 DOI: 10.1111/jebm.12412] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/26/2020] [Accepted: 09/27/2020] [Indexed: 01/11/2023]
Abstract
According to previous studies of obesity, we found that the association between homocysteine concentrations and obesity was reported controversially. Thus, we carried out this meta-analysis to investigate this association. We searched PubMed, The Cochrane library, and EMBASE database for studies that evaluate the relationship between homocysteine concentrations and obesity from inception to March, 2019. The quality of all included studies was assessed by the Newcastle Ottawa Scale (NOS) and the Agency for Healthcare Research Quality (AHRQ). The RevMan5.3 software and Stata12.0 software were used for conducting all data analyses. Standardized mean differences (SMD) with the corresponding 95% confidence intervals (95% CIs) were used as a measure of effect size to assess the relationship between homocysteine concentrations and obesity through a meta-analysis. The level of significance was set at P < .05. A total of 14 studies were ultimately included in our meta-analysis. Meta-analysis of the 14 studies found remarkable lower homocysteine concentrations in controls than in obese patients (SMD = 0.76, 95% CI = 0.25-1.27, P < .01; I2 = 94% and P < .01 for heterogeneity), regardless of nutritional status, dietary habit, insulin resistance (IR) status, special disease history, history of medicine taken, genetic background, and so on. Homocysteine concentrations in nonobese patients with polycystic ovarian syndrome (PCOS) were lower than obese patients with PCOS (SMD = 0.48, 95% CI = 0.20-0.77, P < .01; I2 = 39% and P = .18 for heterogeneity). The result of our meta-analysis showed that homocysteine concentrations were significantly elevated among obese patients.
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Affiliation(s)
- Jinxiang Wang
- Department of Digestive Medicine, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Dingyun You
- Department of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Huaping Wang
- University Library, Kunming Medical University, Kunming, Yunnan, China
| | - Yanhong Yang
- Department of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Dan Zhang
- Department of Digestive Medicine, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Junyan Lv
- Department of Digestive Medicine, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Sufeng Luo
- Department of Digestive Medicine, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Rui Liao
- University Library, Kunming Medical University, Kunming, Yunnan, China
| | - Lanqing Ma
- Department of Digestive Medicine, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
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25
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Punna M, Lappalainen R, Kettunen T, Lappalainen P, Muotka J, Kaipainen K, Villberg J, Kasila K. Can peer-tutored psychological flexibility training facilitate physical activity among adults with overweight? JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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26
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Mond J, Gorrell S. "Excessive exercise" in eating disorders research: problems of definition and perspective. Eat Weight Disord 2021; 26:1017-1020. [PMID: 33389704 PMCID: PMC8068596 DOI: 10.1007/s40519-020-01075-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
- Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia.,School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.
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Rathbone JA, Cruwys T, Jetten J. Non-stigmatising alternatives to anti-obesity public health messages: Consequences for health behaviour and well-being. J Health Psychol 2021; 27:1601-1614. [PMID: 33719629 DOI: 10.1177/1359105321999705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This project investigated how alternative non-stigmatising public health messages influence people's health behaviours and well-being, relative to traditional stigmatising weight-loss messages. We conducted three experimental studies (total N = 1281) that compared traditional weight-loss messages to weight-neutral messages (Study 1), weight-inclusive messages (Study 2) and size acceptance messages (Study 3). Results revealed that public health messages have differential effects on health behaviours and well-being, depending on the audience's BMI or perceived weight. However, campaigns that challenge weight stigma and promote body positivity have positive effects on some psychological indicators of health and well-being for people of all body sizes.
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28
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Pausé C, Parker G, Gray L. Resisting the problematisation of fatness in COVID-19: In pursuit of health justice. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2021; 54:102021. [PMID: 34840940 PMCID: PMC8606246 DOI: 10.1016/j.ijdrr.2020.102021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/14/2020] [Accepted: 12/14/2020] [Indexed: 05/07/2023]
Abstract
The purpose of this paper is to explore the problematisation of fatness in contemporary responses to the COVID-19 pandemic. This paper draws from the catalogue of reports from journalists informed largely by an array of non-peer reviewed scientific literature documenting the relationship between fatness and COVID-19. Our method of enquiry is to examine fatness and COVID-19 through a problematisation lens that enables us to interrogate the scientific, political, and economic processes implicated in the production of fat bodies as problems. Fatness has been problematised in the COVID-19 pandemic. This has diverted responsibility for preparedness and well-being away from health systems and governments and onto the back of fat people and communities. This is unjust and unethical. In juxtaposition, fat activists around the world have challenged the problematisation of fatness and its effects, finding ways for fat people to subvert fat phobic institutions in the midst of the COVID-19 pandemic by collectively organising to support one another. The ways in which fatness is being taken up in current COVID-19 pandemic responses diverts responsibility for health system preparedness and community resiliency to fat individuals. This is both unjust and also obstructs meaningful action to address the health inequities laid bare by COVID-19. This paper is believed to be the first to analyse the problematisation of fatness in COVID-19, highlighting that lessons can be learned about health justice in disasters from the work of fat activists during this COVID-19 pandemic.
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Affiliation(s)
- Cat Pausé
- Massey University, PB 11 222, Palmerston North, 4442, New Zealand
| | | | - Lesley Gray
- University of Otago, Wellington, New Zealand
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Pearce C, Rychetnik L, Wilson A. The obesity paradigm and the role of health services in obesity prevention: a grounded theory approach. BMC Health Serv Res 2021; 21:111. [PMID: 33526017 PMCID: PMC7851945 DOI: 10.1186/s12913-021-06089-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 01/14/2021] [Indexed: 11/17/2022] Open
Abstract
Background Health services have a clear role in the treatment of obesity and diseases linked to obesity but a less well-established role in prevention, particularly in hospital and community-based health services. Methods The aim of this research was to examine whether and how hospital and community-based health services incorporate adult obesity prevention into policy and practice. The case study setting was an Australian based health service. Grounded theory informed all aspects of the research including participant recruitment, data collection and data analysis. A systems approach guided the analysis of diverse perspectives, relationships and interconnections within the study context. Results The prevailing paradigm within the health service is that obesity is a matter of choice. This dominant perspective combined with a disease focused medical model overly simplifies the complex issue of obesity and reinforces the paradigm which treats obesity as a matter of individual responsibility. A focus on individual change hinders health services from playing an effective role in obesity prevention and leads to unintended consequences, including increasing stigma. Conclusions Health service responses to obesity and its prevention compound the negative elements associated with obesity for individuals and are ineffective in creating positive change at individual or a societal level. An alternative systems-level approach is needed to align health service responses with contemporary approaches that address obesity prevention as a complex problem.
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Affiliation(s)
- Claire Pearce
- Canberra Health Services, Canberra, Australia. .,The Australian Prevention Partnership Centre, Sydney, Australia. .,Menzies Centre for Health Policy, University of Sydney, Sydney, Australia.
| | - Lucie Rychetnik
- The Australian Prevention Partnership Centre, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Andrew Wilson
- The Australian Prevention Partnership Centre, Sydney, Australia.,Menzies Centre for Health Policy, University of Sydney, Sydney, Australia
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Preventing Nutritional Disorders in Adolescents by Encouraging a Healthy Relationship With Food. J Adolesc Health 2020; 67:875-879. [PMID: 33220798 DOI: 10.1016/j.jadohealth.2020.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 11/28/2022]
Abstract
Nutritional disorders, including overweight, underweight, and/or nutrient deficiency, are a significant cause of morbidity and mortality. These disorders are frequently related to abnormal patterns of eating and/or physical activity, which commonly begin in adolescence and persist into adulthood. Abnormal eating and exercise behaviors may stem from an unhealthy relationship with food, which often takes root in preadolescence or early adolescence. To prevent eating disorders, overweight, underweight, and nutritional deficiencies in adolescence and beyond, health care providers need to proactively support early adolescents and their caregivers to develop a healthy relationship with food and their bodies. Anticipatory guidance, nutrition and exercise counseling, and encouragement of body positivity and healthy self-image during the vulnerable period of early adolescence can prevent maladaptive behaviors from emerging later on. Advocacy beyond the health care setting is also needed to ensure that adolescents are exposed to consistent and positive nutritional messaging. In this position article, authors from both the Nutrition/Obesity Committee and the Eating Disorder Committee of the Society of Adolescent Health and Medicine provide practical recommendations for health care professionals to guide their young patients and caregivers toward a flexible, balanced, and satisfying approach to nutrition that will lead to physical and emotional wellness throughout their lifetimes.
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Jessen-Winge C, Ilvig PM, Thilsing T, Lee K, Fritz H, Christensen JR. Health professionals' perceptions of weight loss programmes and recommendations for future implementation: a qualitative study. BMJ Open 2020; 10:e039667. [PMID: 33208329 PMCID: PMC7677371 DOI: 10.1136/bmjopen-2020-039667] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Obesity is an increasing public health challenge and most weight loss programmes are still inadequate to support sustainable weight loss. One reason for the continued lack of success might be the dominant biomedical, individualised approach to weight loss. Holistic approaches that focus on overall health and well-being in addition to weight loss are increasingly recommended. In Denmark, health professionals in the municipalities are responsible for developing and conducting weight loss programmes. The objective of this study was to explore what health professional's perceived as an ideal, holistic weight loss programme that could be feasibly implemented in the municipalities. DESIGN A phenomenological-hermeneutical qualitative study was performed using semistructured interviews. SETTING Thirty-two Danish municipalities were weight loss programmes are developed and conducted. PARTICIPANTS Thirty-five health professionals with experience conducting weight loss programmes. RESULTS Three themes emerged from the analysis: Support from the social network are important both during and after a weight loss, Changing the self-belief by positive discussions and doing activities, Maintaining changes through daily life. CONCLUSION Future municipal weight loss programmes should emphasise overall health and well-being instead of weight loss and adopt a holistic approach including a focus on social relationships, meaningful activities and successes as part of a balanced daily life.
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Affiliation(s)
- Christina Jessen-Winge
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
- Department of Health, University College Copenhagen, Kobenhavn, Denmark
| | - Pia Marie Ilvig
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Trine Thilsing
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Kim Lee
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Heather Fritz
- Department of occupational therapy, Wayne State University, Detroit, Michigan, USA
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Toft BS, Galvin K, Nielsen CV, Uhrenfeldt L. Being active when living within a large body: experiences during lifestyle intervention. Int J Qual Stud Health Well-being 2020; 15:1736769. [PMID: 32156205 PMCID: PMC7144297 DOI: 10.1080/17482631.2020.1736769] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Background: In-depth understanding of the experiences of both well-being and suffering in relation to being severely obese and becoming active through lifestyle intervention is lacking.Aim: to explore and describe adults' existential experiences of being active, when living within a large body-before and during a lifestyle intervention.Methods: A longitudinal design of repeated individual interviews with 16 adults with BMI ≥40, based on hermeneutic phenomenology, existential philosophy and a theory of well-being was performed. The study was approved by the Danish health authorities.Results: Two dimensions of experiences were found; "Living within a downward spiral" and "Striving for enjoyment and settlement". The themes describing suffering were: 'Sense of being thwarted and defeated ' and "Tackling energy depletion and impact of sense of self". The themes describing well-being were: "Hoping for renewal and energised resoluteness" and "Enduring discomfort and feeling safe".Conclusions: Interacting existential experiences can be facilitators or barriers for physical activity. It seems relevant for health care providers to address the individual's lifeworld experiences of well-being, lack of well-being and suffering. Well-being as a sense of feeling "at home" when physically active may break down an inactivity spiral. Promoting well-being is a legitimate aim of lifestyle intervention.
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Affiliation(s)
- Bente Skovsby Toft
- Department of Lifestyle Rehabilitation, Horsens Regional Hospital, Brædstrup, Denmark
| | - Kathleen Galvin
- School of Health Sciences, University of Brighton, Brighton, UK
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Frayn M, Khanyari S, Knäuper B. A 1-day acceptance and commitment therapy workshop leads to reductions in emotional eating in adults. Eat Weight Disord 2020; 25:1399-1411. [PMID: 31541426 DOI: 10.1007/s40519-019-00778-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 09/06/2019] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Emotional eating has been defined as the tendency to overeat in response to negative emotions and is a symptom of emotion dysregulation. Interventions for emotional eating have been developed based on acceptance and commitment therapy (ACT). However, these interventions only address emotional eating in the context of weight loss programs and are therefore not available in a weight neutral context. METHODS The present study aimed to test the feasibility and acceptability of a 1-day ACT workshop that taught skills to reduce emotional eating, without promoting weight loss. The workshop was delivered in a single day and aimed to reduce emotional eating by improving values clarification and commitment, acceptance, and mindfulness. Follow-ups were conducted at 2 weeks and 3 months post-intervention. RESULTS Results suggest feasibility and acceptability of the 1-day workshop; participants described appreciating the brevity of the program and its applicability to their everyday lives. Improvements in emotional eating were found at 2 weeks (t(31) = 5.80, p < 0.001) and 3 months (t(29) = 6.96, p < 0.001). A repeated measures MANOVA revealed a significant main effect of time (F(14, 96) = 4.98, p < 0.001, partial η2 = 0.421), with follow-up ANOVAs indicating that this effect held for all variables. CONCLUSION The results from this study can be used to inform a larger-scale randomized controlled trial to determine the efficacy of the program in a larger sample and eventually disseminate it in other real-world settings. TRIAL REGISTRATION ClinicalTrials.gov, NCT03744780. LEVEL OF EVIDENCE Level IV, evidence obtained from multiple time series with the intervention.
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Affiliation(s)
- Mallory Frayn
- Department of Psychology, McGill University, 2001 McGill College, Montreal, QC, H3A 1G1, Canada.
| | - Sabrah Khanyari
- Department of Psychology, McGill University, 2001 McGill College, Montreal, QC, H3A 1G1, Canada
| | - Bärbel Knäuper
- Department of Psychology, McGill University, 2001 McGill College, Montreal, QC, H3A 1G1, Canada
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Jain S, Rothenberger SD, Bennett WL, Clark JM, Conroy MB, Herring SJ, Kraschnewski JL, Lent MR, Bramante CT, Cappella N, McTigue KM. Provider Advice and Patient Perceptions on Weight Across Five Health Systems. Am J Prev Med 2020; 59:e105-e114. [PMID: 32446748 PMCID: PMC10803073 DOI: 10.1016/j.amepre.2020.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/15/2020] [Accepted: 03/17/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION To improve the management of overweight and obesity in the primary care setting, an analysis of patient perceptions of weight status and predictors of weight loss attempts for those with overweight and obesity is needed. METHODS Primary care patients (n=949) across 5 health systems in the Mid-Atlantic region of the U.S. were surveyed in 2015; data analysis was performed in 2018. Survey data was combined with data via the electronic health record to understand patients' perceptions of weight, factors associated with weight loss efforts, and provider counseling practices. RESULTS Most participants with overweight or obesity perceived themselves as weighing too much and reported trying to lose weight. Furthermore, most participants with obesity reported receiving advice to lose weight by a provider in the past 12 months. However, less than half of patients with overweight reported receiving advice to lose weight, maintain weight, or develop healthy eating and physical activity patterns from a health professional in the past 12 months. Among participants with overweight and obesity, multivariable logistic regression analysis demonstrated that the perception of being overweight and receiving healthcare advice to lose weight had the highest odds of reporting attempted weight loss (OR=5.5, 95% CI=2.7, 11.2 and OR=3.9, 95% CI=1.9, 7.9, respectively). CONCLUSIONS The findings emphasize the importance of provider attention to weight management counseling and identifies patients with overweight as needing increased attention by providers.
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Affiliation(s)
- Seema Jain
- Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Scott D Rothenberger
- Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Wendy L Bennett
- Department of Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Jeanne M Clark
- Department of Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Molly B Conroy
- Department of Internal Medicine, University of Utah, Salt Lake, Utah
| | - Sharon J Herring
- Department of Internal Medicine, Temple University, Philadelphia, Pennsylvania
| | | | - Michelle R Lent
- Department of Clinical Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Carolyn T Bramante
- Department of Internal Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Nickie Cappella
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kathleen M McTigue
- Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Physical Activity, Step Counts, and Grip Strength in the Chinese Children and Families Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176202. [PMID: 32859094 PMCID: PMC7504127 DOI: 10.3390/ijerph17176202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/16/2020] [Accepted: 08/19/2020] [Indexed: 11/30/2022]
Abstract
Objectives: This paper describes the development of a physical activity questionnaire (PAQ) designed for Chinese adolescents and their mothers in urban and rural settings, and reports on results of the PAQ, pedometry, and hand grip dynamometry from the Chinese Children and Families Cohort Study pilot investigation (CFCS). Methods: As part of a pilot investigation to evaluate the feasibility to follow-up and obtain detailed nutrition, dietary, physical activity, and ultraviolet radiation (UVR) data from CFCS participants, data were collected in 2013 for 93 adolescent/mother pairs from a rural (n = 41) and an urban site (n = 52) in two provinces. Respondents were asked to wear a pedometer for seven days (Omron HJ-151), use a Takei Digital Grip Strength Dynamometer on (each hand; three trials; two separate days), and complete a 39 item, eight domain PAQ covering the past year. Self-reported physical activity (PA) was linked to metabolic equivalent of task (MET) scores in kcal/kg/hr and used to calculate METs for different domains of PA and intensity categories. Results: Compliance was high (95%) in this measurement protocol administered by health staff during a series of data collection efforts at home and local clinics or health centers. Step counts were highly variable, averaging between 5000 and 10000 per day with somewhat higher step counts in rural adolescent boys. Maximum grip strength (Kgs) was greater in children (Mean = 36.5, SE = 0.8) than mothers (Mean = 28.8, SE = 0.8) and similar in the urban (Mean = 29.6, SE = 0.6) compared to the rural (Mean = 29.6, SE = 0.5) communities overall. Grip strength, step counts, and measures of time spent in different activities or activity intensities were uncorrelated. Conclusion: Device and question-based measurement of PA and strength were readily accepted in these Chinese urban and rural populations. The PAQ on physical activity in the past year produced some plausible population averages, but individual responses suggested recall challenges. If data about specific activities are required, future studies should explore use of standardized survey questions concerning such fewer specific activities or instruments examining shorter time periods such as one, three, or seven day recalls.
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Smith JM, Serier KN, Belon KE, Sebastian RM, Smith JE. Evaluation of the relationships between dietary restraint, emotional eating, and intuitive eating moderated by sex. Appetite 2020; 155:104817. [PMID: 32739329 DOI: 10.1016/j.appet.2020.104817] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022]
Abstract
Intuitive eating involves attention to feelings putatively related to hunger and satiety to guide eating choices. This adaptive eating style has been linked to a number of positive physical and psychological outcomes. Interestingly, women tend to report lower levels of intuitive eating compared to men. It has been hypothesized that sociocultural pressures or dieting could be contributing factors to this sex discrepancy. The current study aimed to explore whether sex moderates the relationship between either dietary restraint and intuitive eating, or between emotional eating and intuitive eating. Assessments were administered to a sample of college males and females (N = 478) as part of a larger study of eating behaviors. Moderation analyses indicated that higher dietary restraint was more strongly associated with lower levels of intuitive eating in women than in men. Emotional eating also had a stronger negative association with intuitive eating in women compared to men. Additionally, relationships between dietary restraint/emotional eating and a component of intuitive eating, "eating for physical rather than emotional reasons", was stronger for women compared to men. These findings suggest that dietary restraint and emotional eating may serve as barriers in the implementation of an intuitive eating style, especially for women. Prevention and intervention efforts should target those high in dietary restraint and emotional eating.
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Affiliation(s)
- Jamie M Smith
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM, 87131-0001, United States.
| | - Kelsey N Serier
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM, 87131-0001, United States.
| | - Katherine E Belon
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM, 87131-0001, United States; New Mexico Veterans Affairs Health Care System, 1501 San Pedro SE, Albuquerque, NM, 87108, United States.
| | - Riley M Sebastian
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM, 87131-0001, United States.
| | - Jane Ellen Smith
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM, 87131-0001, United States.
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Manchón J, Quiles M, León E, López-Roig S. Acceptance and Commitment Therapy on physical activity: A systematic review. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Nichols CE. The wazan janch: The body-mass index and the socio-spatial politics of health promotion in rural India. Soc Sci Med 2020; 258:113071. [PMID: 32485461 DOI: 10.1016/j.socscimed.2020.113071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/23/2020] [Accepted: 05/17/2020] [Indexed: 11/29/2022]
Abstract
The body mass index (BMI), which measures body mass divided by height squared (kg/m²), has become a popular technology for quickly measuring and assessing individuals' health and disease risk. However, the BMI has also been widely criticized by health professionals who argue that it's a poor measure of health. Feminist scholars are also critical, arguing BMI is a technology of neoliberal health promotion that pathologizes body size, and produces responsibilized subjects invested in maintaining "proper" weights, while often ignoring the social and environmental conditions that result in differently sized bodies. In this paper, I look at a series of BMI "camps" held across rural North India in 2017 and put forth two central arguments. First, BMI is not an a priori technology of neoliberal governmentality, but can be also be a means to highlight social marginalization and create relations of care. I find the spaces of BMI deployment are tightly linked to the types of responsibility and care it produces. Second, while the intended goal of these BMI camps is to propel people, mostly women, to change their behavior to be more healthful, this behavior change was often stymied by the everyday business of surviving in India's current political economic climate. Despite that women were unable to implement much of the nutrition advice (and sometimes reported additional stress due to attendance at such camps), women continued to attend health-related camps. This paper draws on the notion of cruel optimism, which argues that the objects of our attachments, such as ideas of "the good life" can be self-detrimental, as a way to unpack the paradox of women who continue to show up for health camps despite not taking anyway many useful skill and sometimes causing them anxiety.
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Affiliation(s)
- Carly E Nichols
- University of Iowa, Department of Geographical and Sustainability Sciences, 312 Jessup Hall, Iowa City, IA, 52245, USA.
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Barrada JR, Cativiela B, van Strien T, Cebolla A. Intuitive Eating. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2020. [DOI: 10.1027/1015-5759/a000482] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Abstract. Intuitive eating is defined as an adaptive way of eating that maintains a strong connection with the internal physiological signs of hunger and satiety. It has four elements: unconditional permission to eat whenever and whatever food is desired, eating for physical rather than for emotional reasons, reliance on hunger and satiety cues to determine when and how much to eat, and body-food choice congruence. In this study, we assessed the differences and similarities between intuitive eating, as measured with the Intuitive Eating Scale-2 (IES-2), and eating styles (restrained, emotional, and external eating), assessed with the Dutch Eating Behavior Questionnaire (DEBQ). Using a Spanish sample of mainly university students ( n = 1,095) we found that (a) unconditional permission to eat presented a large negative correlation with restrained eating, r = –.82; (b) eating for physical reasons had a large negative correlation with emotional eating, r = –.70; (c) the dimensions of intuitive eating only showed very small correlations with positive and negative affect, satisfaction with life, body dissatisfaction or weight control behavior after restrained, emotional, and external eating had been partialled out. Altogether, the present results suggest that two of the dimensions of intuitive eating as assessed with the IES-2 are not very new or innovative. The most promising new dimension of intuitive eating seems to be body-food choice congruence.
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Affiliation(s)
- Juan Ramón Barrada
- Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, Teruel, Spain
| | - Blanca Cativiela
- Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, Teruel, Spain
| | - Tatjana van Strien
- Institute for Gender Studies and Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands
- Faculty of Earth and Life Sciences, Institute of Health Sciences, VU University Amsterdam, The Netherlands
| | - Ausiàs Cebolla
- Facultad de Psicología, Universitat de València, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto Carlos III, Santiago de Compostela, Spain
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Nordmo M, Danielsen YS, Nordmo M. The challenge of keeping it off, a descriptive systematic review of high-quality, follow-up studies of obesity treatments. Obes Rev 2020; 21:e12949. [PMID: 31675146 DOI: 10.1111/obr.12949] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 01/10/2023]
Abstract
The aim of this systematic review is to answer the question: Is substantial, stable, and long-term weight loss a viable goal for adults with obesity? To answer this question, we conducted a broad systematic search of non-surgical and non-pharmacological obesity treatment studies with the following strict criteria: (a) minimum 3-year follow-up, (b) 5% body mass lost, (c) no continued interventions in the follow-up-period, (d) prospective design, and (e) less than 30% attrition from the start of the follow-up period. While the search revealed a very large number of published articles, only eight studies met the inclusion criteria. Several of the nonincluded studies report a majority of participants achieving satisfactory weight loss and little regain, especially among studies with continued interventions during the follow-up period. In contrast, the eight high-quality studies included in this study demonstrate a trend of weight regain towards pretreatment baseline. This review concludes that the majority of high-quality follow-up treatment studies of individuals with obesity are not successful in maintaining weight loss over time. The results suggest that excess weight can be lost but is likely regained over time, for the majority of participants.
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Affiliation(s)
- Morten Nordmo
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | | | - Magnus Nordmo
- Department of Psychology, University of Oslo, Oslo, Norway
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Rapata H, Cutfield WS, Milne BJ, Shackleton N, Waetford C, Richards R, Taylor RW, Raureti T, Derraik JGB, Camp J. Stable prevalence of obesity among Ngāti Whātua 4-year-old children in 2010–2016. J R Soc N Z 2019. [DOI: 10.1080/03036758.2019.1691613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hannah Rapata
- A Better Start – National Science Challenge, Auckland, New Zealand
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wayne S. Cutfield
- A Better Start – National Science Challenge, Auckland, New Zealand
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Barry J. Milne
- A Better Start – National Science Challenge, Auckland, New Zealand
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
| | - Nichola Shackleton
- A Better Start – National Science Challenge, Auckland, New Zealand
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
| | | | - Rosalina Richards
- A Better Start – National Science Challenge, Auckland, New Zealand
- Centre for Pacific Health, Va’a o Tautai, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Rachael W. Taylor
- A Better Start – National Science Challenge, Auckland, New Zealand
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Terina Raureti
- A Better Start – National Science Challenge, Auckland, New Zealand
- Te Koronga, School of Physical Education and Sports, University of Otago, Dunedin, New Zealand
| | - José G. B. Derraik
- A Better Start – National Science Challenge, Auckland, New Zealand
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Justine Camp
- A Better Start – National Science Challenge, Auckland, New Zealand
- Te Koronga, School of Physical Education and Sports, University of Otago, Dunedin, New Zealand
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Cloutier-Bergeron A, Provencher V, Mongeau L, Paquette MC, Carbonneau É, Turcotte M, Bégin C. Does Health At Every Size® fit all? A group-based trajectory modeling of a non-diet intervention. Appetite 2019; 143:104403. [DOI: 10.1016/j.appet.2019.104403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 11/26/2022]
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Keirns NG, Hawkins MAW. Intuitive eating, objective weight status and physical indicators of health. Obes Sci Pract 2019; 5:408-415. [PMID: 31687166 PMCID: PMC6819977 DOI: 10.1002/osp4.359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Intuitive eating (IE) has emerged as a weight-neutral approach to health promotion for those with overweight/obesity. This weight-neutral paradigm has some support, although research thus far has often neglected to control for potential confounds (i.e. objective weight status and demographics) and foundational studies are lacking. The objective of the current study was to observe the unique association of IE with physical health indicators in a sample of adults, independent of objective weight status. METHODS Participants were 248 adults (32 ± 14 years old, 73% female, 64% White) of all weight categories (18.2-55.3 kg m-2), with an average body mass index (BMI) of 30 ± 8 kg m-2. IE was measured with the Intuitive Eating Scale-2 (IES-2). BMI was objectively measured in-lab. Health indicators included blood pressure (BP) and fasting glucose. RESULTS A series of hierarchical linear regressions revealed no significant associations between IE and systolic BP (β = -0.076, P = 0.256), diastolic BP (DBP; β = -0.122, P = 0.073) or fasting glucose (β = 0.047, P = 0.500) after controlling for BMI. All effects sizes were small or below (f 2 = 0.00 to -0.04). Sensitivity analyses revealed significantly lower DBP in high intuitive eaters versus low when analysed with a t-test, t(111.651) = 3.602, P < 0.001, Levene corrected; however, after controlling for relevant covariates (i.e. BMI and demographics), analysis of covariance revealed no difference in DBP between groups, F(1, 116) = 0.330, P = 0.567. No significant differences in systolic BP or fasting glucose were observed between low and high intuitive eaters before or after considering covariates. CONCLUSIONS In sum, this study investigated associations between IE and common indicators of physical health after controlling for objective weight status. Findings revealed no unique relationship between IE and physical health, and any IE-physical health relationships that were observed were accounted for BMI and/or demographic factors.
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Affiliation(s)
- N. G. Keirns
- Department of PsychologyOklahoma State UniversityStillwaterOKUSA
| | - M. A. W. Hawkins
- Department of PsychologyOklahoma State UniversityStillwaterOKUSA
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Scribani M, Norberg M, Lindvall K, Weinehall L, Sorensen J, Jenkins P. Sex-specific associations between body mass index and death before life expectancy: a comparative study from the USA and Sweden. Glob Health Action 2019; 12:1580973. [PMID: 30947624 PMCID: PMC6461107 DOI: 10.1080/16549716.2019.1580973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Understanding the impact of obesity on premature mortality is critical, as obesity has become a global health issue. OBJECTIVE To contrast the relationship between body mass index (BMI) and premature death (all-cause; circulatory causes) in New York State (USA) and Northern Sweden. METHODS Baseline data were obtained between 1989 and 1999 via questionnaires (USA) and health exams (Sweden), with mortality data from health departments, public sources (USA) and the Swedish Death Register. Premature death was death before life expectancy based on sex and year of birth. Within country and sex, time to premature death was compared across BMI groups (18.5-24.9 kg/m2 (reference), 25-29.9 kg/m2, 30.0-34.9 kg/m2, ≥35.0 kg/m2) using Proportional Hazards regression. Absolute risk (deaths/100,000 person-years) was compared for the same stratifications among nonsmokers. RESULTS 60,600 Swedish (47.8% male) and 31,198 US subjects (47.7% male) were included. Swedish males with BMI≥30 had increased hazards (HR) of all-cause premature death relative to BMI 18.5-24.9 (BMI 30-34.9, HR = 1.71 (95% CI: 1.44, 2.02); BMI≥35, HR = 2.89 (2.16, 3.88)). BMI≥25 had increased hazards of premature circulatory death (BMI 25-29.9, HR = 1.66 (1.32, 2.08); BMI 30-34.9, HR = 3.02 (2.26, 4.03); BMI≥35, HR = 4.91 (3.05, 7.90)). Among US males, only BMI≥35 had increased hazards of all-cause death (HR = 1.63 (1.25, 2.14)), while BMI 30-34.9 (HR = 1.83 (1.20, 2.79)) and BMI≥35 (HR = 3.18 (1.96, 5.15)) had increased hazards for circulatory death. Swedish females showed elevated hazards with BMI≥30 for all-cause (BMI 30-34.9, HR = 1.42 (1.18, 1.71) and BMI≥35, HR = 1.61 (1.21, 2.15) and with BMI≥35 (HR = 3.11 (1.72, 5.63)) for circulatory death. For US women, increased hazards were observed among BMI≥35 (HR = 2.10 (1.60, 2.76) for all-cause and circulatory HR = 3.04 (1.75, 5.30)). Swedish males with BMI≥35 had the highest absolute risk of premature death (762/100,000 person-years). CONCLUSIONS This study demonstrates a markedly increased risk of premature death associated with increasing BMI among Swedish males, a pattern not duplicated among females.
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Affiliation(s)
- Melissa Scribani
- a Bassett Healthcare Network, Bassett Research Institute , Cooperstown , NY , USA.,b Epidemiology and Global Health, Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden
| | - Margareta Norberg
- b Epidemiology and Global Health, Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden
| | - Kristina Lindvall
- b Epidemiology and Global Health, Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden
| | - Lars Weinehall
- b Epidemiology and Global Health, Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden
| | - Julie Sorensen
- a Bassett Healthcare Network, Bassett Research Institute , Cooperstown , NY , USA
| | - Paul Jenkins
- a Bassett Healthcare Network, Bassett Research Institute , Cooperstown , NY , USA
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Dugmore JA, Winten CG, Niven HE, Bauer J. Effects of weight-neutral approaches compared with traditional weight-loss approaches on behavioral, physical, and psychological health outcomes: a systematic review and meta-analysis. Nutr Rev 2019; 78:39-55. [DOI: 10.1093/nutrit/nuz020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Abstract
Context
Weight-neutral approaches for health are emerging therapeutic alternatives to traditional weight-loss approaches. The existing literature base comparing these approaches has not yet been systematically evaluated by a meta-analysis.
Objective
This review aims to determine if weight-neutral approaches are valid alternatives to weight-loss approaches for improving physical, psychological, and behavioral health outcomes.
Data Sources
Embase, Scopus, PsycINFO, PubMed, CINAHL, and the University of Queensland Library databases were searched.
Study Selection
Peer-reviewed, experimental, or quasi-experimental studies that included weight-neutral and weight-loss arms and reported physical, psychological, or behavioral outcomes were eligible. A total of 525 studies were identified through initial database searches, with 10 included in the final analysis after exclusion criteria were applied.
Data Extraction
Screening and eligibility assessment of studies followed the PRISMA protocol. The following outcomes were extracted: weight, body mass index, lipid and glucose variables, blood pressure, eating behavior, self-esteem, depression, quality of life, physical activity, and diet quality.
Data Analysis
Studies were graded per the National Health and Medical Research Council (NHMRC) level-of-evidence tool and the Academy of Nutrition and Dietetics quality-evaluation tool. Effect sizes were examined as a meta-analysis of standardized and mean differences using a random-effects inverse-variance model with 95%CIs. Practice recommendations for each outcome were graded per NHMRC body-of-evidence guidelines.
Conclusions
Weight-neutral approaches resulted in greater improvement in bulimia (P = 0.02), but no significant differences were observed for any other outcome. Weight-neutral approaches may be as effective as weight-loss methods for improving physical, psychological, and behavioral outcomes. Limitations include inconsistent definitions of both approaches and variable time frames of follow-up.
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Affiliation(s)
- Jaslyn A Dugmore
- J.A. Dugmore, C.G. Winten, H.E. Niven, and J. Bauer are with the School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Australia
| | - Copeland G Winten
- J.A. Dugmore, C.G. Winten, H.E. Niven, and J. Bauer are with the School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Australia
| | - Hannah E Niven
- J.A. Dugmore, C.G. Winten, H.E. Niven, and J. Bauer are with the School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Australia
| | - Judy Bauer
- J.A. Dugmore, C.G. Winten, H.E. Niven, and J. Bauer are with the School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Australia
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Hwang J, Lee EY, Lee CG. Measuring Socioeconomic Inequalities in Obesity among Korean Adults, 1998⁻2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1617. [PMID: 31072072 PMCID: PMC6539011 DOI: 10.3390/ijerph16091617] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/05/2019] [Accepted: 05/05/2019] [Indexed: 02/08/2023]
Abstract
Obesity is a prominent global public health challenge as its prevalence has grown. Even though the increase in prevalence of obesity in Korea has been relatively low, it is expected to continually increase in the next several years, leading to social and economic burdens. This study aimed to assess socioeconomic inequalities in obesity among Korean adults. Using nationally representative survey datasets, the concentration index (CI) and decomposition of the CI were used to capture and quantify obesity-related inequalities from 1998 to 2015. The results suggested that pro-poor inequalities in obesity existed in Korea, indicating that obesity was more concentrated among individuals with lower income. In a gender-stratified model, obesity was more concentrated among women with lower income and men with higher income, showing that the trend and magnitude of inequalities in obesity each vary by gender. The decomposition approach revealed that, over the past 17 years, the main contributors to the existing inequalities were higher education and higher income levels. These findings suggest that comprehensive and multifaceted interventions at the local and national levels should be considered to address the identified income- and education-related barriers with respect to obesity among Korean adults.
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Affiliation(s)
- Jongnam Hwang
- Division of Social Welfare & Health Administration, Wonkwang University, Iksan 54538, Korea.
| | - Eun-Young Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada.
| | - Chung Gun Lee
- Institute of Sport Science, Department of Physical Education, Seoul National University, Seoul 08826, Korea.
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Leo CG, Mincarone P, Bodini A, Sedile R, Guarino R, Tumolo MR, Malorgio R, Quitadamo M, Sabato E, Viegi G, Insalaco G, Sabina S. Obstructive sleep apnoea: Improving healthcare services by combining process modelling and population analysis. Int J Med Inform 2019; 127:43-51. [PMID: 31128831 DOI: 10.1016/j.ijmedinf.2019.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/01/2019] [Accepted: 04/09/2019] [Indexed: 01/06/2023]
Abstract
CONTEXT Disease management broke through in the early 1990s to counterbalance hyper-specialization with a more comprehensive approach. Its role became immediately relevant in chronic conditions and, consequently, in Obstructive Sleep Apnoea (OSA). This is a common chronic condition for which is important to organise services at the local level, taking into account organisational factors and the characteristics of the assisted population. OBJECTIVES The aim of this work is to propose and apply, coherently with a disease management approach, a combination of healthcare process modelling and population analysis as a way to identify critical issues and explore shared solutions. METHODS A multidisciplinary working group was created with scholars who are skilled in process analysis, statistics and medicine. Through semi-structured interviews and on-site meetings, healthcare processes were represented with a standard graphical language: Unified Modeling Language™. Population analysis was based on statistical analysis performed on a 5-year retrospective cohort assisted by a Community Pulmonary Service. RESULTS A shared graphic presentation of the current healthcare process and the results of the statistical analyses constituted the knowledge base to identify critical issues and recommend corresponding solutions, which include: a) refine the local patient database with additional details on comorbidities and risk factors; b) support a greater involvement of "gate-keepers" in the screening phase; c) provide practical tools for the definition of strategies to increment the adherence to therapy; d) include recommendations for physical exercise and interdisciplinary cooperation; and e) define process indicators for measuring the quality of the screening and therapeutic phases. CONCLUSION The concomitant analyses of formalised processes and critical risk factors represent a useful approach for systematically identifying areas of improvement in healthcare processes and allow us to discuss solutions. Moreover, the specific adoption of UML® for graphical modelling and representation of patient care processes allows us to formalise them by adopting a standard language that can be taken as the basis for implementing web services to support the execution of the modelled processes.
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Affiliation(s)
- Carlo Giacomo Leo
- National Research Council, Institute of Clinical Physiology, Branch of Lecce, c/o Ecotekne via Monteroni, 73100 Lecce, Italy.
| | - Pierpaolo Mincarone
- National Research Council Institute, for Research on Population and Social Policies, Research Unit of Brindisi, c/o ex Osp. Di Summa, Piazza Di Summa, 72100 Brindisi, Italy.
| | - Antonella Bodini
- National Research Council, Institute for Applied Mathematics and Information Technologies "Enrico Magenes", Branch of Milan, Via Bassini 15, 20133 Milan, Italy.
| | - Raffaella Sedile
- National Research Council, Institute of Clinical Physiology, Branch of Lecce, c/o Ecotekne via Monteroni, 73100 Lecce, Italy.
| | - Roberto Guarino
- National Research Council, Institute of Clinical Physiology, Branch of Lecce, c/o Ecotekne via Monteroni, 73100 Lecce, Italy.
| | - Maria Rosaria Tumolo
- National Research Council Institute, for Research on Population and Social Policies, Research Unit of Brindisi, c/o ex Osp. Di Summa, Piazza Di Summa, 72100 Brindisi, Italy.
| | - Roberto Malorgio
- Local Health Unit of Brindisi, Community Pulmonary Service, Via Dalmazia 3, 72100, Italy.
| | - Matteo Quitadamo
- Local Health Unit of Brindisi, Community Pulmonary Service, Via Dalmazia 3, 72100, Italy.
| | - Eugenio Sabato
- National Research Council Institute, for Research on Population and Social Policies, Research Unit of Brindisi, c/o ex Osp. Di Summa, Piazza Di Summa, 72100 Brindisi, Italy; Local Health Unit of Brindisi, "Perrino" Hospital, Pulmonary Department, S.S. 7 per Mesagne Brindisi, Italy.
| | - Giovanni Viegi
- National Research Council, Institute of Biomedicine and Molecular Immunology "Alberto Monroy", via U. La Malfa, 153, 90146 Palermo, Italy.
| | - Giuseppe Insalaco
- National Research Council, Institute of Biomedicine and Molecular Immunology "Alberto Monroy", via U. La Malfa, 153, 90146 Palermo, Italy.
| | - Saverio Sabina
- National Research Council, Institute of Clinical Physiology, Branch of Lecce, c/o Ecotekne via Monteroni, 73100 Lecce, Italy.
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Meyer LB, Waaddegaard M, Lau ME, Tjørnhøj-Thomsen T. (Dis-)solving the Weight Problem in Binge-Eating Disorder: Systemic Insights From Three Treatment Contexts With Weight Stability, Weight Loss, and Weight Acceptance. QUALITATIVE HEALTH RESEARCH 2019; 29:597-608. [PMID: 29642775 DOI: 10.1177/1049732318764874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Binge-eating disorder (BED) is a severe eating disorder strongly associated with obesity. Treatments struggle to provide safe and effective ways of addressing weight in a BED context. This study explored a two-phased treatment for BED developed at a major out-patient eating disorder service in Denmark. The study used interviews and participant observations to gain insight into experiences and processes related to weight and body issues in three treatment contexts that addressed weight stability, weight acceptance, and weight loss. Using systems theory, the study proposed a relational weight problem that embeds feelings of non-acceptance due to weight, a merge of weight and identity, and an internalized body- and weight-critical gaze of others. Contrary to critical claims that weight acceptance discourages people with obesity from engaging in weight loss efforts, this study suggests that acceptance and a disentanglement of weight and identity are prerequisites for weight loss for this group.
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Affiliation(s)
- Lene Bomholt Meyer
- University of Southern Denmark, Odense, Denmark
- Capital Region of Denmark, Stolpegaard, Denmark
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Willer F, Hannan-Jones M, Strodl E. Australian dietitians' beliefs and attitudes towards weight loss counselling and health at every size counselling for larger-bodied clients. Nutr Diet 2019; 76:407-413. [PMID: 30811815 DOI: 10.1111/1747-0080.12519] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/13/2019] [Accepted: 01/28/2019] [Indexed: 01/17/2023]
Abstract
AIM Research suggests that dietitians now employ weight-neutral (WN) approaches (Health at Every Size (HAES), Intuitive Eating and non-diet) as well as more traditional weight-centric (WC) approaches (weight loss counselling) to address adult weight concerns. This study aimed to compare the knowledge of and attitudes towards WN practice compared with WC practice in Australian dietitians who work with larger-bodied clients as delineated by practice approach. METHODS A cross-sectional web-based knowledge, attitudes and practices survey was conducted with Australian dietitians who counsel adults with a body mass index >25 kg/m2 . Based on their responses, dietitians were categorised into WC (preferring weight loss counselling), WN (preferring HAES counselling) or mixed approach (MA). Between-group comparisons were conducted using Pearson's chi- squared tests for knowledge and practice and independent t-tests for attitudes. RESULTS Of the 317 respondents, 18.3% fulfilled the criteria for WN practitioners, 30.3% for WC practitioners and the remainder were classified as providing a MA. Weight-neutral approaches were more positively regarded generally than WC approaches (84.5% vs 53.9%) as well as considered professionally responsible (86% vs 58.7%) and perceived as more helpful for clients (61.2% vs 35%). Knowledge of WN practice goals was poor with only 36.9% (n = 117) of the participants indicating correctly that this mode of treatment is incompatible with a weight loss goal. CONCLUSIONS Weight-neutral practice was considered acceptable by Australian dietetics professionals who counsel larger-bodied people regardless of their personal practice preference although many displayed inaccurate knowledge of WN approaches.
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Affiliation(s)
- Fiona Willer
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Mary Hannan-Jones
- School of Exercise and Nutrition Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Bergen M, Mollen D. Teaching Sizeism: Integrating Size into Multicultural Education and Clinical Training. WOMEN & THERAPY 2019. [DOI: 10.1080/02703149.2018.1524065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Martha Bergen
- Counseling and Psychological Services, Texas Woman’s University, Denton, Texas
| | - Debra Mollen
- Department of Psychology and Philosophy, Texas Woman’s University, Denton, Texas
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