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Humphreys L, Morley B, Nuss T, Dixon H, Ambrosini GL, O'Flaherty C, Ledger M, Sartori A, Wakefield M. Evaluation of the population-level impacts of the LiveLighter® obesity prevention campaign from 2012 to 2019 based on serial cross-sectional surveys. BMC Public Health 2024; 24:1016. [PMID: 38609966 PMCID: PMC11010377 DOI: 10.1186/s12889-024-18462-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Halting and reversing the upward trend in obesity requires sustained implementation of comprehensive, evidence-based strategies at the population-level. The LiveLighter® program targets adults using a range of public education strategies, including mass media campaigns, to support healthy lifestyle changes to attain or maintain a healthy weight and reduce the risk of chronic disease. LiveLighter® has been implemented in Western Australia (WA) since 2012 and, to our knowledge, includes the longest running adult-targeted mass media campaign for healthy weight and lifestyle promotion and education globally. This evaluation assessed the impact of LiveLighter® on WA adults' knowledge, intentions and behaviours as they relate to healthy eating and body weight from 2012 to 2019. METHODS LiveLighter® mass media campaigns, which are TV-led and aired statewide, depict genuine, graphic imagery of visceral fat around internal organs to raise awareness about the link between excess body weight and chronic diseases; demonstrate how unhealthy food and drink consumption can contribute to unhealthy weight gain; and recommend healthy alternatives. Cross-sectional telephone surveys were conducted at baseline and following each campaign phase with an independent, randomly selected sample of WA adults aged 25 to 49 years (n = 501 to n = 1504 per survey) to assess their knowledge of the link between excess body weight and chronic diseases, and their intentions and behaviours related to healthy eating and weight. Multivariable logistic regression models were undertaken to assess differences in responses between baseline and each post-campaign survey. RESULTS Compared to baseline, there were significant increases in the proportion of respondents reporting knowledge of excess body weight as a risk factor for certain cancers and type 2 diabetes, intentions to eat more fruit and vegetables and drink less sugar sweetened beverages (SSBs) in the next seven days, and the proportion of respondents who reported meeting guidelines for daily vegetable intake. Reported consumption of SSBs significantly decreased. CONCLUSIONS LiveLighter® is associated with improvements in knowledge of the health risks associated with excess body mass, increased vegetable intake and reduced SSB consumption in WA adults. These findings support the use of sustained, well-designed healthy lifestyle promotion and education programs as part of a comprehensive obesity prevention strategy.
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Affiliation(s)
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Tegan Nuss
- Centre for Behavioural Research in Cancer, Melbourne, VIC, Australia
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Gina L Ambrosini
- WA Department of Health, Perth, WA, Australia
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | | | - Melissa Ledger
- Cancer Council Western Australia, Subiaco, WA, Australia
| | | | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
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Ackermans M, Jonker N, de Jong P. Adaptive and maladaptive emotion regulation skills are associated with food intake following a hunger-induced increase in negative emotions. Appetite 2024; 193:107148. [PMID: 38042372 DOI: 10.1016/j.appet.2023.107148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 10/30/2023] [Accepted: 11/27/2023] [Indexed: 12/04/2023]
Abstract
Many individuals would like to lose weight and often attempt to do so by dieting. However, dieting attempts often backfire and contribute to the risk of weight gain and obesity. Food restriction inevitably leads to hunger and hunger, in turn, induces negative emotions. The inability to regulate such a hunger-induced increase in negative emotions in an adaptive way may be responsible for overeating. The current study aimed to gain a better understanding of this potential psychological mechanism underlying failed dieting attempts. Adaptive and maladaptive emotion regulation (ER) were assessed with an online questionnaire in women with a healthy weight. Subsequently, participants were assigned to the fasted condition (fasting for 14h, n = 49) or the satiated condition (eating between 2 h and 30 min before the lab session, n = 59) and attended a lab session in which they completed tasks while given the opportunity to eat chips and M&M's. We did not find an association between any ER variable and the likelihood to begin eating. Among those who began eating, higher scores on adaptive cognitive ER and on maladaptive behavioral ER were associated with lower caloric intake in fasted individuals. Higher scores on adaptive behavioral ER were associated with higher caloric intake in fasted individuals. Utilizing adaptive cognitive ER when experiencing a hunger-induced increase in negative emotions may help individuals manage their food intake and maintain a healthy weight.
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Affiliation(s)
- Mégane Ackermans
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands.
| | - Nienke Jonker
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands.
| | - Peter de Jong
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands.
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Andreu A, Casals G, Vinagre I, Flores L. Obesity management in women of reproductive age. ENDOCRINOL DIAB NUTR 2023; 70 Suppl 1:85-94. [PMID: 36424339 DOI: 10.1016/j.endien.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/27/2022] [Indexed: 11/23/2022]
Abstract
With the increasing prevalence of obesity among women of reproductive age, the detrimental effects on maternal and neonatal health are increasing. The objective of this review is to summarise the evidence that comprehensive management of weight control in women of reproductive age has on maternal-fetal outcomes. First, the impact that obesity has on fertility and pregnancy is described and then the specific aspects of continued weight management in each of the stages (preconception, pregnancy and postpartum) during these years are outlined, not only to benefit women affected by obesity before pregnancy, but also to avoid and reverse weight gain during pregnancy that complicates future pregnancies. Finally, the special planning and follow-up needs of women with a history of bariatric surgery are discussed in order to avoid nutritional deficiencies and/or surgical complications that endanger the mother or affect fetal development.
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Affiliation(s)
- Alba Andreu
- Unidad de Obesidad, Servicio de Endocrinología y Nutrición, Hospital Clínic de Barcelona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Barcelona, Spain
| | - Gemma Casals
- Sección de Reproducción Humana Asistida, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Irene Vinagre
- Unidad de Diabetes, Servicio de Endocrinología y Nutrición, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Lilliam Flores
- Unidad de Obesidad, Servicio de Endocrinología y Nutrición, Hospital Clínic de Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.
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Gago CM, Jurkowski J, Beckerman-Hsu JP, Aftosmes-Tobio A, Figueroa R, Oddleifson C, Mattei J, Kenney EL, Haneuse S, Davison KK. Exploring a theory of change: Are increases in parental empowerment associated with healthier weight-related parenting practices? Soc Sci Med 2022; 296:114761. [PMID: 35123371 PMCID: PMC8894077 DOI: 10.1016/j.socscimed.2022.114761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Parent health-related empowerment is defined as the process by which parents realize control over their life situation and take action to promote a healthier lifestyle. For decades, researchers have described the theoretical potential of empowerment in health promotion efforts, though few have empirically examined this hypothesized relationship. This study is one of the first to examine the relationship between parental empowerment and healthy weight parenting practices (i.e., food, physical activity, sleep, and media parenting), as a mechanism for early childhood health promotion in community settings. METHODS Low-income parents of preschool-aged children attending Head Start in Greater Boston between fall 2017 and spring 2019 were invited to complete a survey in the fall and spring of each academic school year (n = 578 with two surveys and n = 45 with four). Parental empowerment and healthy weight parenting practices were assessed using validated surveys. We used a multilevel difference-in-difference approach to estimate changes in healthy weight parenting practices score by changes in parental empowerment score. RESULTS Out of a possible score of four, the unadjusted mean (SD) score in fall was 3.20 (0.40) for empowerment and 3.01 (0.40) for parenting. An increase in parental empowerment was associated with an increase in healthier parenting practices (b = 0.14; 95% CI = 0.08, 0.20; p < 0.0001). CONCLUSIONS Parent empowerment may be an important target in interventions to prevent obesity in low-income children.
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Affiliation(s)
- Cristina M. Gago
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Janine Jurkowski
- Department of Health Policy, Management, and Behavior, State University of New York, Albany, NY, 12222, USA
| | | | | | - Roger Figueroa
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, 14853, USA
| | - Carly Oddleifson
- School of Social Work, Boston College, Chestnut Hill, MA, 02467, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Erica L. Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
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Kris-Etherton PM, Sapp PA, Riley TM, Davis KM, Hart T, Lawler O. The Dynamic Interplay of Healthy Lifestyle Behaviors for Cardiovascular Health. Curr Atheroscler Rep 2022; 24:969-80. [PMID: 36422788 DOI: 10.1007/s11883-022-01068-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The recent rise in cardiovascular disease (CVD) deaths in the USA has sparked interest in identifying and implementing effective strategies to reverse this trend. Healthy lifestyle behaviors (i.e., healthy diet, regular physical activity, achieve and maintain a healthy weight, avoid tobacco exposure, good quality sleep, avoiding and managing stress) are the cornerstone for CVD prevention. RECENT FINDINGS Achieving all of these behaviors significantly benefits heart health; however, even small changes lower CVD risk. Moreover, there is interplay among healthy lifestyle behaviors where changing one may result in concomitant changes in another behavior. In contrast, the presence of one or more unhealthy lifestyle behaviors may attenuate changing another lifestyle behavior(s) (poor diet, inadequate physical activity, overweight/obesity, poor sleep quality, tobacco exposure, and poor stress management). It is important to assess all of these lifestyle behaviors with patients to plan an intervention program that is best positioned for adherence.
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Ackermans MA, Jonker NC, Bennik EC, de Jong PJ. Hunger increases negative and decreases positive emotions in women with a healthy weight. Appetite 2021; 168:105746. [PMID: 34637770 DOI: 10.1016/j.appet.2021.105746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 01/06/2023]
Abstract
The term 'hangry' is colloquially used to describe being "bad tempered or irritable as a result of hunger," but remarkably few studies have examined the effect of hunger on emotions. Yet, women attempting to restrict their food intake may be at risk of becoming entangled in a vicious cycle of hunger and negative emotions. That is, hunger may lead to negative emotions, which can lead to overeating and overeating can, in turn, provoke subsequent restriction leading to more hunger. Therefore the aim of this study was to examine the effect of hunger on positive and negative emotions in women with a healthy BMI, and the role of subclinical eating disorder symptoms in this effect. We randomly assigned women to a hunger condition (fasting for 14 h, n = 53) or satiated condition (eat breakfast before the study, n = 55), and they completed the Eating Disorder Examination Questionnaire and the Profile of Mood States in the lab. Hungry women reported overall higher negative emotions (higher tension, anger, fatigue, and confusion) and lower positive emotions (lower vigour and marginally lower esteem-related affect) than satiated women. Moreover, for satiated but not for hungry women, higher eating disorder symptoms were associated with lower esteem-related affect. These findings show that food restriction leads to negative emotions, and practitioners and individuals should be aware of these implications of food restriction on mental health. Second, clinicians and individuals should be wary of relatively low esteem-related affect when satiated in individuals with eating disorder symptoms, as it could serve as a maintaining factor in eating pathology.
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Affiliation(s)
- M A Ackermans
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands
| | - N C Jonker
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands.
| | - E C Bennik
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands
| | - P J de Jong
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands
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Clarke F, Archibald D, MacDonald V, Huc S, Ellwood C. The well now course: a service evaluation of a health gain approach to weight management. BMC Health Serv Res 2021; 21:892. [PMID: 34461890 PMCID: PMC8404319 DOI: 10.1186/s12913-021-06836-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 07/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background The Well Now health and weight course teaches body respect and health gain for all. The course validates peoples’ lived experiences and knowledge through group activities and discussion with the aim of helping people to better understand their food and body stories. Well Now explores different ways of knowing, including the use and limits of body signals, like energy levels, hunger, taste and emotions and helps people keep food and behaviours in perspective by drawing attention to other factors that impact on health and wellbeing. This study undertook a service evaluation of the Well Now course to understand its acceptability for participants and its impact on diet quality, food preoccupation, physical activity and mental wellbeing. Methods This service evaluation combined quantitative pre- and post-course measures with telephone interviews with previous attendees. Paired t-tests were used to determine if there were statistically significant differences in the intended outcomes. Semi-structured qualitative telephone interviews were undertaken with previous attendees 6–12 months after attendance to understand how participants experienced the Well Now course. Results Significant improvements were demonstrated in diet quality, food preoccupation, physical activity and mental wellbeing outcomes. Medium effect sizes are demonstrated for mental wellbeing and diet quality, with smaller effect sizes shown for physical activity and food preoccupation. The weight and Body Mass Index (BMI) of attendees remained stable in this timeframe. The qualitative data corroborates and extends elements of the quantitative outcomes and highlights areas of the course that may benefit from further development and improvement. The findings further indicate that the Well Now approach is largely acceptable for attendees. Conclusions Well Now’s non-judgemental holistic approach facilitates change for those who complete the course, and for those who do not. This health gain approach upholds non-maleficence and beneficence, and this is demonstrated with this service evaluation for both completers and partial completers. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06836-z.
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Affiliation(s)
- Fiona Clarke
- Community Dietetics, RNI, Ness Walk, Inverness, IV3 5SF, UK
| | - Daryll Archibald
- School of Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD14HJ, UK.
| | - Valerie MacDonald
- Health Improvement Team, Public Health, NHS Highland, Larch House Stoneyfield Business Park, Inverness, IV2 7PA, UK
| | - Sara Huc
- Health Improvement Team, Public Health, NHS Highland, Larch House Stoneyfield Business Park, Inverness, IV2 7PA, UK
| | - Christina Ellwood
- David Anderson Building, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZP, UK
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Eakin EG, Reeves MM, Goode AD, Winkler EAH, Vardy JL, Boyle F, Haas MR, Hiller JE, Mishra GD, Jefford M, Koczwara B, Saunders CM, Chapman K, Hing L, Boltong AG, Lane K, Baldwin P, Millar L, McKiernan S, Demark-Wahnefried W, Courneya KS, Job J, Reid N, Robson E, Moretto N, Gordon L, Hayes SC. Translating research into practice: outcomes from the Healthy Living after Cancer partnership project. BMC Cancer 2020; 20:963. [PMID: 33023538 PMCID: PMC7539431 DOI: 10.1186/s12885-020-07454-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/23/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Healthy Living after Cancer (HLaC) was a national dissemination and implementation study of an evidence-based lifestyle intervention for cancer survivors. The program was imbedded into existing telephone cancer information and support services delivered by Australian state-based Cancer Councils (CC). We report here the reach, effectiveness, adoption, implementation, and maintenance of the program. METHODS In this phase IV study (single-group, pre-post design) participants - survivors of any type of cancer, following treatment with curative intent - received up to 12 nurse/allied health professional-led telephone health coaching calls over 6 months. Intervention delivery was grounded in motivational interviewing, with emphasis on evidence-based behaviour change strategies. Using the RE-AIM evaluation framework, primary outcomes were reach, indicators of program adoption, implementation, costs and maintenance. Secondary (effectiveness) outcomes were participant-reported anthropometric, behavioural and psychosocial variables including: weight; physical activity; dietary intake; quality-of-life; treatment side-effects; distress; and fear of cancer recurrence and participant satisfaction. Changes were evaluated using linear mixed models, including terms for timepoint (0/6 months), strata (Cancer Council), and timepoint x strata. RESULTS Four of 5 CCs approached participated in the study. In total, 1183 cancer survivors were referred (mostly via calls to the Cancer Council telephone information service). Of these, 90.4% were eligible and 88.7% (n = 791) of those eligible consented to participate. Retention rate was 63.4%. Participants were mostly female (88%), aged 57 years and were overweight (BMI = 28.8 ± 6.5 kg/m2). Improvements in all participant-reported outcomes (standardised effect sizes of 0.1 to 0.6) were observed (p < 0.001). The program delivery costs were on average AU$427 (US$296) per referred cancer survivor. CONCLUSIONS This telephone-delivered lifestyle intervention, which was feasibly implemented by Cancer Councils, led to meaningful and statistically significant improvements in cancer survivors' health and quality-of-life at a relatively low cost. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12615000882527 (registered on 24/08/2015).
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Affiliation(s)
- Elizabeth G Eakin
- The University of Queensland, Brisbane, QLD, Australia.
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston Road, Herston, QLD, 4006, Australia.
| | | | - Ana D Goode
- The University of Queensland, Brisbane, QLD, Australia
| | | | | | - Frances Boyle
- University of Sydney, Sydney, NSW, Australia
- Mater Hospital, Sydney, NSW, Australia
| | - Marion R Haas
- University of Technology Sydney, Sydney, NSW, Australia
| | - Janet E Hiller
- Swinburne University of Technology, Melbourne, VIC, Australia
| | - Gita D Mishra
- The University of Queensland, Brisbane, QLD, Australia
| | - Michael Jefford
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- University of Melbourne, Carlton, VIC, Australia
| | | | | | - Kathy Chapman
- University of Sydney, Sydney, NSW, Australia
- University of Newcastle, Newcastle, NSW, Australia
| | - Liz Hing
- Cancer Council New South Wales, Woolloomooloo, Australia
| | - Anna G Boltong
- University of Melbourne, Carlton, VIC, Australia
- Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
| | | | - Polly Baldwin
- Cancer Council South Australia, Adelaide, SA, Australia
| | - Lesley Millar
- University of Western Australia, Perth, WA, Australia
| | | | | | | | - Jennifer Job
- The University of Queensland, Brisbane, QLD, Australia
| | - Natasha Reid
- The University of Queensland, Brisbane, QLD, Australia
| | - Erin Robson
- The University of Queensland, Brisbane, QLD, Australia
| | - Nicole Moretto
- The University of Queensland, Brisbane, QLD, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Louisa Gordon
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Sandra C Hayes
- Griffith University, Menzies Health Institute Queensland, Brisbane, QLD, Australia
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Jonker NC, Bennik EC, de Lang TA, de Jong PJ. Influence of hunger on attentional engagement with and disengagement from pictorial food cues in women with a healthy weight. Appetite 2020; 151:104686. [PMID: 32234530 DOI: 10.1016/j.appet.2020.104686] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 01/12/2023]
Abstract
Because of inconsistencies in the field of attentional bias to food cues in eating behavior, this study aimed to re-examine the assumption that hungry healthy weight individuals have an attentional bias to food cues, but satiated healthy weight individuals do not. Since attentional engagement and attentional disengagement have been proposed to play a distinct role in behavior, we used a performance measure that is specifically designed to differentiate between these two attentional processes. Participants were healthy weight women who normally eat breakfast. In the satiated condition (n = 54), participants were instructed to have breakfast just before coming to the lab. In the fasted condition (n = 50), participants fasted on average 14 h before coming into the lab. Satiated women showed no stronger attentional engagement or attentional disengagement bias to food cues than to neutral cues. Fasted women did show stronger attentional engagement to food cues than to neutral cues that were shown briefly (100 ms). They showed no bias in attentional engagement to food cues that were shown longer (500 ms) or in attentional disengagement from food cues. These findings are in line with the assumption that healthy weight individuals show an attentional bias to food cues when food stimuli are motivationally salient. Furthermore, the findings point to the importance of differentiating between attentional engagement and attentional disengagement.
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Affiliation(s)
- Nienke C Jonker
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands.
| | - Elise C Bennik
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands
| | - Thomas A de Lang
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands
| | - Peter J de Jong
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands
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Fair F, Marvin-Dowle K, Arden M, Soltani H. Healthy weight services in England before, during and after pregnancy: a mixed methods approach. BMC Health Serv Res 2020; 20:572. [PMID: 32571321 PMCID: PMC7310438 DOI: 10.1186/s12913-020-05440-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 06/18/2020] [Indexed: 11/25/2022] Open
Abstract
Background Maternal overweight and obesity are associated with numerous adverse outcomes including higher rates of maternal and infant mortality and morbidity. Overweight and obesity before, during and after pregnancy are therefore a significant public health priority in England. This project explored and mapped healthy weight service availability at different stages of the childbearing cycle. Methods A mixed methods approach included a questionnaire-based survey disseminated through Local Maternity Systems and semi-structured interviews or focus groups with providers and commissioners. Current maternal weight service provision was explored along with some of the barriers and facilitators for providing, delivering and accessing healthy weight services. Descriptive statistics were reported for quantitative data and content analysis was used for thematic reporting of qualitative data. Results A total of 88 participants responded to the survey. All services were offered most frequently during pregnancy; with healthy eating and/or weight management services offered more often than physical activity services. Few services were targeted specifically at women with a raised body mass index. There was a high degree of inconsistency of service provision in different geographical areas. Several themes were identified from qualitative data including “equity and variation in service provision”, “need for rigorous evaluation”, “facilitators” to encourage better access or more effective service provision, including prioritisation, a change in focus and co-design of services, “barriers” encountered including financial and time obstacles, poor communication and insufficiently clear strategic national guidance and “the need for additional support”. Conclusions There is a need to reduce geographical variation in services and the potential health inequalities that this may cause. Improving services for women with a raised body mass index as well as services which encourage physical activity require additional emphasis. There is a need for more robust evaluation of services to ensure they are fit for purpose. An urgent need for clear national guidance so that healthcare providers can more effectively assist mothers achieve a healthy weight gain was identified. Commissioners should consider implementing strategies to reduce the barriers of access identified such as childcare, transport, location and making services free at the point of use.
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Affiliation(s)
- Frankie Fair
- College of Health, Wellbeing and Life Sciences, Collegiate Campus - Sheffield Hallam University, 34 Collegiate Crescent, Sheffield, S10 2BP, UK
| | - Katie Marvin-Dowle
- College of Health, Wellbeing and Life Sciences, Collegiate Campus - Sheffield Hallam University, 34 Collegiate Crescent, Sheffield, S10 2BP, UK
| | - Madelynne Arden
- Departmental Research & Scholarship Lead, Department of Psychology, Sociology & Politics, Collegiate Campus - Sheffield Hallam University, Sheffield, S10 2BQ, UK
| | - Hora Soltani
- College of Health, Wellbeing and Life Sciences, Collegiate Campus - Sheffield Hallam University, 34 Collegiate Crescent, Sheffield, S10 2BP, UK.
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van Eyk H, Baum F, Delany-Crowe T. Creating a whole-of-government approach to promoting healthy weight: What can Health in All Policies contribute? Int J Public Health 2019; 64:1159-72. [PMID: 31606749 DOI: 10.1007/s00038-019-01302-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES This paper examines the opportunities and barriers that the South Australian Health in all Policies (SA HiAP) approach encountered when seeking to establish a whole-of-government response to promoting healthy weight. METHODS The paper draws on data collected during 31 semi-structured interviews, analysis of 113 documents, and a program logic model developed via workshops to show the causal links between strategies and anticipated outcomes. RESULTS A South Australian Government target to increase healthy weight was supported by SA HiAP to develop a cross-government response. Our analysis shows what supported and hindered implementation. A combination of economic and systemic framing, in conjunction with a co-benefits approach, facilitated intersectoral engagement. The program logic shows how implementation can be expected to contribute to a population with healthy weight. CONCLUSIONS The HiAP approach achieved some success in encouraging a range of government departments to contribute to a healthy weight target. However, a comprehensive approach requires national regulation to address the commercial determinants of health and underlying causes of population obesity in addition to cross-government action to promote population healthy weight through regional government action.
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Jung ME, Bourne JE, Gainforth HL. Evaluation of a community-based, family focused healthy weights initiative using the RE-AIM framework. Int J Behav Nutr Phys Act 2018; 15:13. [PMID: 29373975 PMCID: PMC5787319 DOI: 10.1186/s12966-017-0638-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 12/18/2017] [Indexed: 12/12/2022] Open
Abstract
Background Childhood overweight and obesity is a major public health concern. Community-based interventions have the potential to reach caregivers and children. However, the overall health impact of these programs is rarely comprehensively assessed. This study evaluated a physical activity and healthy eating family program (Healthy Together; HT) using the RE-AIM framework. Methods Ten sites implemented the 5-week program. Thirty-nine staff members and 277 program participants (126 caregivers [Mage = 35.6] and 151 children [Mage = 13]) participated in the evaluation. Each RE-AIM dimension was assessed independently using a mixed-methods approach. Sources of data included archival records, interviews and surveys. Effectiveness outcome variables were assessed at pre- and post-intervention and 6-month follow-up. Results Reach: HT participants were almost entirely recruited from existing programs within sites. Effectiveness: Caregivers’ nutrition related efficacy beliefs increased following HT (ps < .03). Participation in HT was not associated with significant changes in physical activity or nutrition behaviour or perceived social support (ps > .05). Knowledge surrounding healthy diets and physical activity increased in children and caregivers (ps < .05). Adoption: Thirty-five percent of sites approached to implement HT expressed interest. The 10 sites selected recruited existing staff members to implement HT. Implementation: Program objectives were met 72.8% of the time and 71 adaptations were made. HT was finance- and time-dependent. Maintenance: Two sites fully implemented HT in the follow-up year and 5 sites incorporated aspects of HT into other programs. Conclusions Working alongside organizations that develop community programs to conduct comprehensive, arms-length evaluations can systematically highlight areas of success and challenges. Overall HT represents a feasible community-based intervention; however further support is required in order to ensure the program is effective at positively targeting the desired outcomes. As a result of this evaluation, modifications are currently being implemented to HT. Electronic supplementary material The online version of this article (10.1186/s12966-017-0638-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mary E Jung
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada.
| | - Jessica E Bourne
- Centre for Exercise, Nutrition and health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Heather L Gainforth
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada
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Moss JL, Liu B, Zhu L. Comparing percentages and ranks of adolescent weight-related outcomes among U.S. states: Implications for intervention development. Prev Med 2017; 105:109-115. [PMID: 28888823 PMCID: PMC5653428 DOI: 10.1016/j.ypmed.2017.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/20/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022]
Abstract
Understanding statistical differences in states' percentages and ranks of adolescents meeting health behavior guidelines can guide policymaking. Data came from 531,777 adolescents (grades 9-12) who completed the Youth Risk Behavior Surveillance System survey in 2011, 2013, or 2015. We measured the percentage of adolescents in each state that met guidelines for physical activity, fruit and vegetable (F&V) consumption, and healthy weight status. Then we ranked states and calculated the ranks' 95% CI's using a Monte Carlo method with 100,000 simulations. We repeated these analyses stratified by sex (female or male) or race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic/Latino, or other). Pearson's and Spearman's correlation coefficients examined consistency in the percentages and ranks (respectively) across behaviors and subgroups. Meeting the physical activity and F&V consumption guidelines was relatively rare among adolescents (25.8% [95% CI=25.2%-26.4%] and 8.0% [95% CI=7.6%-8.3%], respectively), while meeting the healthy weight guideline was common (71.5% [95% CI=70.7%-72.3%]). At the state level, percentages of adolescents meeting these guidelines were statistically similar; states' ranks had wide CI's, resulting in considerable overlap (i.e., statistical equivalence). For each behavior, states' percentages and ranks were moderately to highly correlated across adolescent subgroups (Pearson's r=0.33-0.96; Spearman's r=0.42-0.96), but across behaviors, only F&V consumption and healthy weight were correlated (Pearson's r=0.34; Spearman's r=0.37). Adolescents in all states could benefit from initiatives to support cancer prevention behaviors, especially physical activity and F&V consumption. Programs in states that ranked highly on all assessed health behaviors could be adapted for dissemination in lower-performing states.
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Affiliation(s)
- Jennifer L Moss
- Cancer Prevention Fellowship Program, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Room 4E514, MSC 9765, Bethesda, MD 20892-9765, USA.
| | - Benmei Liu
- Statistical Research and Applications Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Room 4E540, MSC 9765, Bethesda, MD 20892-9765, USA.
| | - Li Zhu
- Statistical Research and Applications Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Room 4E346, MSC 9765, Bethesda, MD 20892-9765, USA.
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Scheepers C, Wendel-Vos G, van Wesemael P, den Hertog F, Stipdonk H, Int Panis L, van Kempen E, Schuit A. Perceived health status associated with transport choice for short distance trips. Prev Med Rep 2016; 2:839-44. [PMID: 26844158 PMCID: PMC4721281 DOI: 10.1016/j.pmedr.2015.09.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background This study examines the association between active transport and perceived general health, perceived psychological wellbeing and a healthy body weight in the Netherlands. Methods Data were collected by an online questionnaire (N = 3663) in the Netherlands. Data collection was conducted over a period of one calendar year starting July 2012. Logistic regression analyses were used to investigate the association between choice of transport mode (bicycling vs car use and walking vs car use) and perceived general health, perceived psychological wellbeing and having a healthy weight respectively. The presented OR's may be interpreted as the likelihood of an average person in our dataset to have a better perceived health or body weight when choosing active transport (either bicycling or walking) over using the car for trips up to 7.5 km. Results Cycling was found to be significantly associated with a better perceived general health (OR = 1.35, 95%CI:1.07–1.70) and having a healthy body weight (OR = 1.52, 95%CI:1.28–1.79), but not with a better perceived psychological wellbeing (OR = 1.12, 95%CI:0.93–1.34). Walking was found to be significantly associated with having a healthy body weight (OR = 1.35, 95%CI:1.09–1.69), but not with a better perceived general (OR = 1.12, 95%CI:0.84–1.51) or psychological wellbeing (OR = 0.85, 95%CI:0.67–1.08). Conclusion Our results suggest that active transport use has been associated with a better perceived general health and a healthy body weight. However, more research is needed to be able to elucidate which factors cause this better health. No associations were observed between transport choice and perceived psychological wellbeing. Active transport users experience a better perceived general health. Active transport users are more likely to have a healthy body weight. No association between transport choice and perceived psychological wellbeing in The Netherlands
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Affiliation(s)
- C.E. Scheepers
- VU University Amsterdam, Department of Health Sciences and EMGO institute for Health and Care Research, De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands
- National Institute for Public Health and the Environment, Centre for Nutrition, Prevention and Health Services, PO Box 1, 3720 BA Bilthoven, the Netherlands
- Corresponding author at: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, the Netherlands. Fax: + 31 30 274 4407.Centre for Nutrition, Prevention and Health ServicesNational Institute for Public Health and the EnvironmentPO Box 1Bilthoven3720 BAthe Netherlands
| | - G.C.W. Wendel-Vos
- National Institute for Public Health and the Environment, Centre for Nutrition, Prevention and Health Services, PO Box 1, 3720 BA Bilthoven, the Netherlands
| | - P.J.V. van Wesemael
- Technical University Eindhoven, Department of the Built Environment, 5600 MB Eindhoven, the Netherlands
| | - F.R.J. den Hertog
- National Institute for Public Health and the Environment, Centre of Health and Society, 3720 BA Bilthoven, the Netherlands
| | - H.L. Stipdonk
- SWOV Institute for Road Safety Research, PO box 93113, 2509 AC Den Haag, the Netherlands
| | - L.L.R. Int Panis
- Flemish Institute for Technological Research (VITO), PHaRE, Mobile Health Unit, 2400 Mol, Belgium
- School for Mobility, Hasselt University, 3590 Diepenbeek, Belgium
| | - E.E.M.M. van Kempen
- National Institute for Public Health and the Environment, Centre for Sustainability, Environment and Health, PO Box 1, 3720 BA Bilthoven, the Netherlands
| | - A.J. Schuit
- VU University Amsterdam, Department of Health Sciences and EMGO institute for Health and Care Research, De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands
- National Institute for Public Health and the Environment, Centre for Nutrition, Prevention and Health Services, PO Box 1, 3720 BA Bilthoven, the Netherlands
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Owen R, Spencer RMC. Body ideals in women after viewing images of typical and healthy weight models. Body Image 2013; 10:489-94. [PMID: 23722050 DOI: 10.1016/j.bodyim.2013.04.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 04/16/2013] [Accepted: 04/16/2013] [Indexed: 10/26/2022]
Abstract
Viewing thin models, pervasive in popular culture, is correlated with body dissatisfaction and anxiety in women. Whether or not the same is true when viewing healthy weight models is unknown. In this study we tested whether viewing healthy weight models increases the ideal female body size. Body image, anxiety, happiness and depression were measured in 44 female participants following viewing of images of thin or healthy weight models (within-subject separated by two weeks). We found that after viewing images of healthy weight models, women's body ideals (as measured by a participant-adjusted virtual model) were significantly larger than when the same women viewed images of very thin models. This effect was greatest in those women with the highest levels of baseline anxiety (as measured by the Hospital Anxiety and Depression Scale). These results suggest that viewing healthy weight models results in more healthy body ideals than those typically promoted through media.
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Affiliation(s)
- Rebecca Owen
- Department of Psychology, University of Massachusetts Amherst, Amherst, MA 01003, USA
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