RESUMEN
Las guías dietéticas oficiales para bajar peso incluyen la práctica de una alimentación saludable, sin embargo, tales recomendaciones no siempre comprenden el contexto cultural. El objetivo de este estudio fue medir el efecto de recomendar una dieta descrita como casera (ejemplificada por preparaciones de comidas típicas consumidas en México) vs. recomendar una dieta isocalórica descrita como saludable (representada por el plato del bien comer) en el peso de mujeres mexicanas con sobrepeso u obesidad. Inicialmente fueron asignadas al azar 159 mujeres a la dieta casera o la dieta saludable y 30 mujeres completaron la intervención. El efecto sobre el peso de la dieta recomendada a 4, 8 y 12 semanas se determinó por análisis de varianza unifactorial y por modelo de regresión aleatorio. Las participantes en promedio bajaron significativamente de peso durante la intervención sin diferencia estadística significativa entre la dieta casera y la dieta saludable. Este hallazgo apoya la estrategia contra la obesidad de recomendar dietas tradicionales en términos reconocidos culturalmente (AU)
The official dietetic guidelines for weight loss include the practice of healthy eating. However, such recommendations rarely take into account the cultural context. The aim of the present study was to measure the effect of recommending a traditional homemade diet (exemplified by typical meals consumed in Mexico) vs. recommending an iso-caloric healthy diet (represented by the eatwell plate) on the weight of Mexican women with overweight or obesity. Initially 159 women were randomly assigned to the homemade diet or the healthy diet and 30 women completed the intervention. The effect on weight of the recommended diet at 4, 8 and 12 weeks was determined by one-way analysis of variance and by random regression model. Participants on average reduced weight significantly throughout the intervention without statistical difference between the homemade diet and the healthy diet. This finding supports an anti-obesity strategy of recommending traditional diets in culturally recognised terms (AU)
Asunto(s)
Humanos , Femenino , Adulto , Dieta/etnología , Dieta/métodos , Dieta Reductora/etnología , Dieta Saludable/etnología , Dieta Saludable/métodos , Sobrepeso/terapia , Obesidad/terapia , Nutrición, Alimentación y Dieta , México/etnologíaRESUMEN
OBJECTIVE: To examine associations between psychological stress and dieting behavior along with the heterogeneity of this association by gender and race in a diverse sample of adolescents with overweight/obesity. METHODS: One hundred and sixty-one adolescents between the ages of 13-19 years of age with overweight/obesity (65% female; 53% non-Hispanic black/47% non-Hispanic white; age: 16.7 ± 1.7 years) were recruited from Southeast MI and included in this analysis. Psychological stress was measured using the Perceived Stress Scale, and dieting behavior was assessed using the dieting subscale from the Eating Attitudes Test (EAT-26) questionnaire. Multivariable linear regression models were conducted to examine the association between psychological stress and dieting behavior by gender and race. RESULTS: Psychological stress was significantly associated with dieting (ß = 0.18 ± 0.06; p < 0.01), with greater stress associated with greater frequency of dieting behavior. This relationship remained significant (ß = 0.15 ± 0.06; p = 0.016), even when controlling for covariates (age, body fat, gender, race, and pubertal development). There were no statistically significant differences in the association of psychological stress and disordered eating indices by gender or race/ethnicity (p's > 0.05). CONCLUSIONS: Increased psychological stress is associated with increased dieting behavior among adolescents with overweight/obesity. These findings suggest that psychological stress equally affects dieting behavior among adolescents with overweight/obesity, regardless of gender and race. Future studies should seek to identify the unique sources of psychological stress that contribute to increased dieting behavior among adolescents with overweight/obesity.
Asunto(s)
Conducta del Adolescente/psicología , Dieta Reductora/psicología , Conducta Alimentaria/psicología , Obesidad Infantil/psicología , Estrés Psicológico/psicología , Adolescente , Conducta del Adolescente/etnología , Población Negra/psicología , Dieta Reductora/etnología , Conducta Alimentaria/etnología , Femenino , Humanos , Modelos Lineales , Masculino , Michigan , Obesidad Infantil/etnología , Grupos Raciales/psicología , Factores Sexuales , Estrés Psicológico/etnología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: The increase in adiposity problems among United States adolescents has been accompanied by persistently high prevalence of unhealthy dieting behaviours (UDBs) such as fasting, taking diet pills/powders/liquids, and vomiting/taking laxatives. This study aimed to examine the associations of self-perceptions of weight status, weight change intentions (WCIs) and UDBs with sex, age and race, as well as trends of UDBs in American adolescents across the weight spectrum. METHODS: Data come from the biennial cross-sectional, school-based surveys, the Youth Risk Behaviour Surveillance System (1999-2013, n = 113,542). The outcome measures were the self-reported UDBs: fasting for 24 h or more; taking diet pills/powders/liquids; and vomiting/taking laxatives. Sex-stratified logistic regressions assessed relationships between weight status misperceptions across all weight statuses, race and WCIs with UDBs. Differential trends between races were assessed using race*year interaction terms. RESULTS: In males, all non-White races had higher odds of fasting and vomiting/taking laxatives than Whites (except fasting in Hispanic/Latinos), with Adjusted Odds Ratios (AORs) between 1.44 and 2.07. In females, Black/African Americans and Hispanic/Latinos had lower odds of taking diet pills/powders/liquids compared to Whites (AORs 0.50 and 0.78 respectively). Racial disparities persisted throughout the study period. Prevalence of fasting and vomiting/taking laxatives did not change between 1999 and 2013 for all races, while taking diet pills/powders/liquids decreased. Compared to individuals of normal weight who were accurate weight status perceivers, individuals of almost all other combinations of weight status and weight status perception had significantly higher odds of displaying any UDB outcome. Overestimation of weight status was found to be the strongest determinant of UDBs. Compared to individuals endorsing "not wanting to do anything" about their weight, individuals endorsing all other WCIs (including wanting to gain weight) also showed significantly higher odds for every UDB outcome, with wanting to lose weight having AORs of the greatest magnitudes. CONCLUSIONS: Prevalence of UDBs is persistently high, and highest among females across all racial groups. UDBs may elevate undesired weight gain and weight loss in individuals who are obese/overweight and underweight respectively. Further research into weight status perceptions among adolescents may inform efforts to reduce UDBs.
Asunto(s)
Conducta del Adolescente/psicología , Dieta Reductora/psicología , Conductas de Riesgo para la Salud , Adolescente , Conducta del Adolescente/etnología , Fármacos Antiobesidad/administración & dosificación , Peso Corporal , Estudios Transversales , Dieta Reductora/etnología , Ayuno/psicología , Femenino , Humanos , Laxativos/administración & dosificación , Masculino , Grupos Raciales/psicología , Grupos Raciales/estadística & datos numéricos , Factores de Riesgo , Autoimagen , Factores Sexuales , Estados Unidos , Vómitos/etnología , Vómitos/psicologíaRESUMEN
OBJECTIVE: This study examined the mediating role of body dissatisfaction between Body Mass Index (BMI) and subsequent disordered eating (e.g. dieting and restricting/purging) among early adolescent African American girls. STUDY DESIGN: Participants included 701 African American girls in 6th and 7th grades in urban schools serving low-income communities, mean age 12.15 (SDâ¯=â¯0.72) years. Participants were assessed at baseline and approximately 6â¯months later. Objectively measured height and weight were used to calculate BMI z-score. Participants completed questionnaires on body size dissatisfaction and recent dieting and restricting/purging behaviors. RESULTS: At baseline, 51.5% of participants were overweight/obese, and 60.4% expressed body dissatisfaction and a desire to be smaller. Path analytic analyses revealed change in body dissatisfaction significantly mediates the relation between initial BMI z-score and increases in dieting behaviors (Bâ¯=â¯0.924, SEâ¯=â¯0.280, pâ¯=â¯0.001) but not restricting/purging behaviors (pâ¯=â¯0.05). CONCLUSIONS: Body dissatisfaction explains some associations between excess body weight and subsequent disordered eating symptoms among early adolescent, African American girls. Body dissatisfaction, identified by screening, may be an indicator of further negative consequences, including disordered eating behaviors.
Asunto(s)
Negro o Afroamericano/psicología , Imagen Corporal/psicología , Índice de Masa Corporal , Trastornos de Alimentación y de la Ingestión de Alimentos/etnología , Sobrepeso/etnología , Población Urbana , Adolescente , Negro o Afroamericano/estadística & datos numéricos , Niño , Dieta Reductora/etnología , Femenino , Humanos , Obesidad/etnología , Satisfacción Personal , Factores de Riesgo , Población Urbana/estadística & datos numéricos , Vómitos/etnologíaRESUMEN
Obesity and increased arterial stiffness are risk factors for cardiovascular disease. A well-known characteristic of obesity is the chronic low-grade inflammatory state, and it causes elevation of arterial stiffness. Weight-loss reduces arterial stiffness and inflammatory level in obese individuals. However, it is unclear which inflammatory factor is most related to weight loss-induce decreases in arterial stiffness in overweight and obese men. Thus, the aim of this study was to determine which circulating cytokine level has the most effect on decreasing arterial stiffness after lifestyle modification. Twenty overweight and obese men completed a 12-week period of lifestyle modifications (combination of aerobic exercise training and dietary modification). We measured brachial-ankle pulse wave velocity (baPWV) as an index of arterial stiffness, and circulating cytokine levels using comprehensive analysis. After the 12-week lifestyle modifications, body mass was markedly decreased. Also, baPWV and the levels of several circulating cytokines significantly decreased after the lifestyle modifications. We observed a positive correlation between changes in baPWV and circulating interleukin-6 (IL-6) levels. Furthermore, multiple liner regression analysis revealed that change in baPWV was significantly associated with that in IL-6 levels after consideration of changes in systolic blood pressure and body mass index. These results suggest that for overweight and obese men, a 12-week period of lifestyle modifications-induced a decrease in circulating cytokine levels (especially IL-6 levels), leads to decreased baPWV.
Asunto(s)
Regulación hacia Abajo , Interleucina-6/sangre , Obesidad/terapia , Sobrepeso/terapia , Rigidez Vascular , Pérdida de Peso , Programas de Reducción de Peso , Adulto , Índice Tobillo Braquial , Biomarcadores/sangre , Índice de Masa Corporal , Terapia Combinada , Citocinas/sangre , Dieta Reductora/etnología , Ejercicio Físico , Estilo de Vida Saludable , Humanos , Japón , Masculino , Persona de Mediana Edad , Obesidad/sangre , Obesidad/etnología , Obesidad/inmunología , Sobrepeso/sangre , Sobrepeso/etnología , Sobrepeso/inmunología , Pacientes Desistentes del Tratamiento , Análisis de la Onda del Pulso , Pérdida de Peso/etnologíaRESUMEN
BACKGROUND: This study examined whether racial/ethnic minority early adolescents with overweight/obesity are at increased risk of disordered weight control behaviors, defined as unhealthy behaviors aiming to control or modify shape and weight, ranging from self-induced vomiting to the use of dietary supplements. METHODS: U.S. Middle school children (n=12.511) provided self-report of gender, race/ethnicity, height, and weight as well as dieting and disordered weight control behaviors. RESULTS: In the entire sample, 25.6% (n=1514) of girls and 16.6% (n=1098) of boys reported dieting within the last month, while 3.5% (n=200) of girls and 2.7% (n=176) of boys reported DWCB. Within all racial/ethnic groups, participants classified as being overweight/obese (34% to 50%) were more likely to report dieting compared to their counterparts without overweight/obesity (9.6% to 29.6%). Racial/ethnic minority children with overweight/obesity had an increased risk of dieting and disordered weight control behaviors compared to their counterparts without overweight/obesity, and, for some outcomes, compared to their White peers with overweight/obesity. CONCLUSIONS: Racial/ethnic minority early adolescents with overweight/obesity are a particularly vulnerable group for disordered eating.
Asunto(s)
Dieta Reductora/etnología , Etnicidad/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/etnología , Disparidades en el Estado de Salud , Grupos Minoritarios/psicología , Sobrepeso/etnología , Obesidad Infantil/etnología , Adolescente , Niño , Dieta Reductora/psicología , Etnicidad/estadística & datos numéricos , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Femenino , Humanos , Masculino , Grupos Minoritarios/estadística & datos numéricos , Sobrepeso/psicología , Obesidad Infantil/psicología , Medición de Riesgo , AutoinformeRESUMEN
BACKGROUND & AIMS: The usefulness of low-carbohydrate diet (LCD) for Japanese patients with type 2 diabetes mellitus (T2DM) has not been fully investigated. Therefore, we compared the effectiveness and safety of LCD with calorie restricted diet (CRD). METHODS: This prospective, randomized, open-label, comparative study included 66 T2DM patients with HbA1c >7.5% even after receiving repeated education programs on CRD. They were randomly allocated to either the 130g/day LCD group (n = 33) or CRD group (n = 33). Patients received personal nutrition education of CRD or LCD for 30 min at baseline, 1, 2, 4, and 6 months. Patients of the CRD group were advised to maintain the intake of calories and balance of macronutrients (28× ideal body weight calories per day). Patients of the LCD group were advised to maintain the intake of 130 g/day carbohydrate without other specific restrictions. Several parameters were assessed at baseline and 6 months after each intervention. The primary endpoint was a change in HbA1c level from baseline to the end of the study. RESULTS: At baseline, BMI and HbA1c were 26.5 (24.6-30.1) and 8.3 (8.0-9.3), and 26.7 (25.0-30.0) kg/m2 and 8.0 (7.6-8.9) %, in the CRD and LCD, respectively. At the end of the study, HbA1c decreased by -0.65 (-1.53 to -0.10) % in the LCD group, compared with 0.00 (-0.68 to 0.40) % in the CRD group (p < 0.01). Also, the decrease in BMI in the LCD group [-0.58 (-1.51 to -0.16) kg/m2] exceeded that observed in the CRD group (p = 0.03). CONCLUSIONS: Our study demonstrated that 6-month 130 g/day LCD reduced HbA1c and BMI in poorly controlled Japanese patients with T2DM. LCD is a potentially useful nutrition therapy for Japanese patients who cannot adhere to CRD. This trial was registered at http://www.umin.ac.jp/english/ (University Hospital Medical Information Network: study ID number 000010663).
Asunto(s)
Diabetes Mellitus Tipo 2/dietoterapia , Dieta Baja en Carbohidratos , Dieta para Diabéticos , Hiperglucemia/prevención & control , Hipoglucemia/prevención & control , Cooperación del Paciente , Medicina de Precisión , Anciano , Índice de Masa Corporal , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/etnología , Dieta Baja en Carbohidratos/etnología , Dieta para Diabéticos/etnología , Dieta Reductora/etnología , Ingestión de Energía/etnología , Femenino , Estudios de Seguimiento , Hemoglobina Glucada/análisis , Humanos , Japón , Masculino , Persona de Mediana Edad , Ciencias de la Nutrición/educación , Sobrepeso/sangre , Sobrepeso/complicaciones , Sobrepeso/dietoterapia , Sobrepeso/etnología , Cooperación del Paciente/etnología , Educación del Paciente como Asunto , Pérdida de Peso/etnologíaRESUMEN
OBJECTIVE: The aim of this study was to investigate the effects of two interventions in breakfast with different fatty acid content on metabolic and inflammatory biomarkers in individuals at different cardiovascular risk levels. METHODS: This crossover clinical trial included 80 overweight participants who were grouped according to the presence of metabolic syndrome (MetS). The participants received two isocaloric breakfast interventions for 4 wk, with a 2-wk washout. The "Brazilian" breakfast was enriched with saturated fat, whereas the "modified" meal was enriched with unsaturated fatty acids and fibers. Repeated-measures analysis of variance was used to compare dietary data, and Student's t or Wilcoxon tests were used to compare clinical and inflammatory variables. A χ2 test was employed to compare frequencies. RESULTS: Frequencies of MetS increased after the Brazilian breakfast and decreased after the modified meal. Significant reduction in mean values of WC and diastolic blood pressure (DBP) and elevation in high-density lipoprotein cholesterol were detected at the end of the modified intervention. Participants with or without the MetS exhibited contrasting responses to the modified breakfast: respectively, significant changes in DBP levels (-3.7 ± 6.9 versus -0.5 ± 6.9 mm Hg; P < 0.05), plasma glucose (-3 ± 7.3 versus 3 ± 7.4 mg/dL; P < 0.05), and apolipoprotein-B (-0.1 ± 0.6 versus 0.2 ± 0.3 mg/mL; P < 0.05), interferon-γ (-0.6 ± 1.2 versus 0.1 ± 1.3 pg/mL; P < 0.05), and tumor necrosis factor-α concentrations (0.4 ± 3.6 versus -0.8 ± 2.8 pg/mL; P < 0.05) were observed. CONCLUSIONS: Dietary intervention of small magnitude, for a short period, was able to improve traditional risk factors for cardiovascular disease and inflammatory markers, as well as the frequency of MetS. Responses to dietary interventions of individuals at different levels of cardiovascular risk should be examined through different biomarkers.
Asunto(s)
Desayuno , Enfermedades Cardiovasculares/prevención & control , Dieta Mediterránea , Dieta Reductora , Síndrome Metabólico/prevención & control , Obesidad/dietoterapia , Sobrepeso/dietoterapia , Adulto , Anciano , Biomarcadores/sangre , Índice de Masa Corporal , Brasil/epidemiología , Desayuno/etnología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Estudios Cruzados , Dieta Reductora/etnología , Femenino , Humanos , Mediadores de Inflamación/sangre , Masculino , Síndrome Metabólico/epidemiología , Síndrome Metabólico/etiología , Persona de Mediana Edad , Obesidad/etnología , Obesidad/inmunología , Obesidad/metabolismo , Sobrepeso/etnología , Sobrepeso/inmunología , Sobrepeso/metabolismo , Pacientes Desistentes del Tratamiento , Factores de Riesgo , Pérdida de PesoRESUMEN
The Food Cravings Questionnaires, State (FCQ-State) and Trait (FCQ-Trait), are commonly used to assess food-craving behavior. This study aimed to develop and validate the Brazilian version of these questionnaires, and to explore potential gender differences in the trait version scores. Data were collected from (n = 611) undergraduate students. Confirmatory factor analysis was conducted to examine the questionnaires structure, and construct validity was assessed. The FCQ-State-Br and FCQ-Trait-Br presented good psychometric properties, adequate model fit, and internal consistency, in general and by gender. A conservation of original structure of the Food Cravings Questionnaires was verified in the Brazilian versions. A good performance in the evaluations concerning the discriminant and convergent validity seem to corroborate these structures. Overweight individuals showed an increase in food-craving behavior. In females, this increase occurred in the guilt dimension, whereas in males, the increase was in the lack of control dimension. In addition, female dieters presented higher scores on the guilt dimension compared with female non-dieters. FCQ-State-Br and FCQ-Trait-Br constitute valid instruments for measuring food-craving behavior in the Brazilian population. Moreover, these findings suggest that food cravings may be an important aspect to be considered in clinical management of overweight individuals, and may require a sex-specific approach.
Asunto(s)
Ansia , Preferencias Alimentarias , Hiperfagia/fisiopatología , Sobrepeso/etiología , Adolescente , Adulto , Índice de Masa Corporal , Brasil , Encuestas sobre Dietas , Dieta Reductora/etnología , Dieta Reductora/psicología , Análisis Factorial , Femenino , Preferencias Alimentarias/etnología , Preferencias Alimentarias/psicología , Culpa , Humanos , Hiperfagia/etnología , Hiperfagia/psicología , Masculino , Sobrepeso/dietoterapia , Sobrepeso/etnología , Sobrepeso/psicología , Cooperación del Paciente/etnología , Cooperación del Paciente/psicología , Escalas de Valoración Psiquiátrica , Psicometría , Reproducibilidad de los Resultados , Autocontrol/psicología , Caracteres Sexuales , Adulto JovenRESUMEN
The efficacy and safety of liraglutide 3.0 mg versus placebo, as adjunct to diet and exercise, was evaluated in racial subgroups. This post hoc analysis of pooled data from five double-blind randomized, placebo-controlled trials was conducted in 5325 adults with either a body mass index (BMI) ≥27 kg/m(2) plus ≥1 comorbidity or a BMI ≥30 kg/m(2). Statistical interaction tests evaluated possible treatment effect differences between racial subgroups: white (4496, 84.4%), black/African-American (550, 10.3%), Asian (168, 3.2%) and other (111, 2.1%). Effects of liraglutide 3.0 mg on weight loss, associated metabolic effects and safety profile were generally consistent across racial subgroups. All achieved statistically significant mean weight loss at end-of-treatment with liraglutide 3.0 mg versus placebo: white 7.7% versus 2.3%, black/African-American 6.3% versus 1.4%, Asian 6.3% versus 2.5%, other 7.3% versus 0.49%. Treatment effects on weight and cardiovascular risk markers generally showed no dependence on race (interaction test p > 0.05). Adverse events were similar across racial subgroups.
Asunto(s)
Fármacos Antiobesidad/uso terapéutico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Liraglutida/uso terapéutico , Obesidad/tratamiento farmacológico , Sobrepeso/tratamiento farmacológico , Estado Prediabético/tratamiento farmacológico , Adulto , Fármacos Antiobesidad/administración & dosificación , Fármacos Antiobesidad/efectos adversos , Pueblo Asiatico , Población Negra , Índice de Masa Corporal , Terapia Combinada/efectos adversos , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/etnología , Dieta Reductora/etnología , Método Doble Ciego , Ejercicio Físico , Femenino , Hemoglobina Glucada/análisis , Humanos , Hiperglucemia/etnología , Hiperglucemia/prevención & control , Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/efectos adversos , Liraglutida/administración & dosificación , Liraglutida/efectos adversos , Masculino , Obesidad/complicaciones , Obesidad/etnología , Obesidad/terapia , Sobrepeso/complicaciones , Sobrepeso/etnología , Sobrepeso/terapia , Estado Prediabético/sangre , Estado Prediabético/complicaciones , Estado Prediabético/etnología , Calidad de Vida , Pérdida de Peso/efectos de los fármacos , Pérdida de Peso/etnología , Población BlancaRESUMEN
The nation's fight against fat has not reduced obesity, but it has had other worrying effects. Mental health researchers have raised the possibility that the intense pressures to lose weight have heightened the risks of developing eating disorders, especially among the young. Medical anthropology can help connect the dots between the war on fat and disordered eating, identifying specific mechanisms, pathways, and contextual forces that may lie beyond the scope of biomedical and psychiatric research. This article develops a biocitizenship approach that focuses on the pathologization of heaviness, the necessity of having a thin, fit body to belonging to the category of worthy citizen, and the work of pervasive fat-talk in defining who can belong. Ethnographic narratives from California illuminate the dynamics in individual lives, while lending powerful support to the idea that the battle against fat is worsening disordered eating and eating disorders among vulnerable young people.
Asunto(s)
Dieta Reductora , Conducta Alimentaria , Trastornos de Alimentación y de la Ingestión de Alimentos , Adulto , Antropología Médica , California/etnología , Dieta Reductora/etnología , Dieta Reductora/psicología , Conducta Alimentaria/etnología , Conducta Alimentaria/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/etnología , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Femenino , Humanos , Narración , Obesidad/etnología , Adulto JovenRESUMEN
OBJECTIVE: To examine the acceptability and feasibility of using smartphone technology to assess beverage intake and evaluate whether the feasibility of smartphone use is greater among key sub-populations. DESIGN: An acceptability and feasibility study of recording the video dietary record, the acceptability of the ecological momentary assessment (EMA), wearing smartphones and whether the videos helped participants recall intake after a cross-over validation study. SETTING: Rural and urban area in Shanghai, China. SUBJECTS: Healthy adults (n 110) aged 20-40 years old. RESULTS: Most participants reported that the phone was acceptable in most aspects, including that videos were easy to use (70%), helped with recalls (77%), EMA reminders helped them record intake (75%) and apps were easy to understand (85%). However, 49% of the participants reported that they had trouble remembering to take videos of the beverages before consumption or 46% felt embarrassed taking videos in front of others. Moreover, 72% reported that the EMA reminders affected their consumption. When assessing overall acceptability of using smartphones, 72% of the participants were favourable responders. There were no statistically significant differences in overall acceptability for overweight v. normal-weight participants or for rural v. urban residents. However, we did find that the overall acceptability was higher for males (81%) than females (61%, P=0·017). CONCLUSIONS: Our study did not find smartphone technology helped with dietary assessments in a Chinese population. However, simpler approaches, such as using photographs instead of videos, may be more feasible for enhancing 24 h dietary recalls.
Asunto(s)
Bebidas/efectos adversos , Dieta Reductora , Conocimientos, Actitudes y Práctica en Salud , Política Nutricional , Sobrepeso/dietoterapia , Cooperación del Paciente , Teléfono Inteligente , Adulto , Bebidas/análisis , Índice de Masa Corporal , China , Estudios Cruzados , Registros de Dieta , Dieta Reductora/etnología , Estudios de Factibilidad , Femenino , Conocimientos, Actitudes y Práctica en Salud/etnología , Humanos , Masculino , Recuerdo Mental , Sobrepeso/etnología , Cooperación del Paciente/etnología , Salud Rural , Caracteres Sexuales , Salud Urbana , Grabación en Video/instrumentación , Adulto JovenRESUMEN
BACKGROUND: Food insecurity is hypothesized to influence mothers' use of parenting strategies to regulate children's eating. Little is known about the parenting practices directed toward adolescents in food-insecure households. OBJECTIVE: Our aim was to examine the differences in use of eating- and weight-related parenting practices among mothers of adolescents by household food-security status. DESIGN: This was a cross-sectional study. PARTICIPANTS/SETTING: A sociodemographically diverse sample of mothers and adolescents from the Minneapolis/St Paul, MN, metropolitan area who participated in the Eating and Activity Among Teens 2010 and Project Families and Eating and Activity Among Teens studies in 2009 to 2010 (dyad n=2,087). Seventy percent of mothers identified as nonwhite. MAIN OUTCOME MEASURES: We examined mother-reported use of parenting practices, including pressuring children to eat, restricting high-calorie foods, and encouraging dieting. STATISTICAL ANALYSES PERFORMED: Logistic regression models were used to determine the predicted probabilities of parenting practices among food-secure, low food-secure, and very-low food-secure households. Sociodemographic characteristics, mothers' body mass index, and adolescents' body mass index-for-age percentile were examined as confounders. RESULTS: In unadjusted models, food-insecure mothers were more likely than food-secure mothers to frequently encourage their children to diet, comment on their child's weight, be concerned about their child's weight, use restrictive feeding practices, and use pressured feeding practices. After adjustment for sociodemographic characteristics and mothers' and children's body mass index, compared to food-secure mothers, mothers with low food security were more likely to frequently comment on their sons' weight (41.5% vs 32.9%, prevalence difference=8.6; 95% CI 0.9 to 16.3) and mothers with very low food security were more likely to be concerned about their sons' weight (48.8% vs 35.1%; prevalence difference=13.7; 95% CI 3.5 to 23.9). Mothers with very low food security were more likely to frequently use restrictive feeding practices with their daughters compared to food-secure mothers (33.0% vs 20.5%; prevalence difference=12.4; 95% CI 4.2 to 20.7). CONCLUSIONS: Interventions to improve food-insecure adolescents' eating behaviors may benefit from supporting mothers' use of health-promoting parenting practices.
Asunto(s)
Fenómenos Fisiológicos Nutricionales de los Adolescentes , Dieta/efectos adversos , Abastecimiento de Alimentos , Relaciones Madre-Hijo , Responsabilidad Parental , Obesidad Infantil/prevención & control , Salud Urbana , Adolescente , Fenómenos Fisiológicos Nutricionales de los Adolescentes/etnología , Índice de Masa Corporal , Estudios Transversales , Dieta/economía , Dieta/etnología , Dieta Reductora/economía , Dieta Reductora/etnología , Ingestión de Energía/etnología , Salud de la Familia/economía , Salud de la Familia/etnología , Femenino , Abastecimiento de Alimentos/economía , Conocimientos, Actitudes y Práctica en Salud/etnología , Humanos , Masculino , Minnesota , Relaciones Madre-Hijo/etnología , Responsabilidad Parental/etnología , Obesidad Infantil/dietoterapia , Obesidad Infantil/economía , Obesidad Infantil/etnología , Autoinforme , Factores Socioeconómicos , Salud Urbana/economía , Salud Urbana/etnologíaRESUMEN
OBJECTIVE: We investigated the association between adherence to the recommendations of the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and breast cancer (BC) risk in the Cancer de Màma (CAMA) study in a Mexican population. DESIGN: Population-based case-control study. SUBJECTS: Incident BC cases (n 1000) and controls (n 1074) matched on age, region and health-care system were recruited. SETTING: In-person interviews were conducted to assess BC risk factors and habitual diet was assessed with an FFQ. Conformity to the WCRF/AICR recommendations was evaluated through a score incorporating seven WCRF/AICR components (body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, alcoholic drinks and breast-feeding), with high scores indicating adherence to the WCRF/AICR recommendations. RESULTS: No statistically significant associations between WCRF/AICR score and risk of BC were observed. After excluding BMI from the WCRF/AICR score, the top quartile was associated with a decreased BC risk overall, with ORQ4-Q1=0.68 (95% CI 0.49, 0.92, P trend=0.03), and among postmenopausal women, with ORQ4-Q1=0.60 (95% CI 0.39, 0.94, P trend=0.03). Inverse associations were observed between BMI and risk of BC overall and among premenopausal women, with OR=0.57 (95% CI 0.42, 0.76, P trend <0.01) and 0.48 (95% CI 0.31, 0.73, P trend<0.01), respectively. Physical activity level was inversely associated with BC risk. CONCLUSIONS: The WCRF/AICR index was not related with BC risk in the CAMA study. A combination of six components excluding BMI showed strong protective associations, particularly in postmenopausal women. Further prospective studies are required to clarify the role of adherence to WCRF/AICR recommendations, particularly with respect to BMI, in the Mexican population.
Asunto(s)
Neoplasias de la Mama/prevención & control , Dieta , Conducta Alimentaria , Actividad Motora , Política Nutricional , Cooperación del Paciente , Adulto , Anciano , Índice de Masa Corporal , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/etnología , Neoplasias de la Mama/etiología , Estudios de Casos y Controles , Terapia Combinada , Dieta/efectos adversos , Dieta/etnología , Dieta Reductora/etnología , Conducta Alimentaria/etnología , Femenino , Humanos , Incidencia , México/epidemiología , Persona de Mediana Edad , Sobrepeso/etnología , Sobrepeso/fisiopatología , Sobrepeso/prevención & control , Sobrepeso/terapia , Cooperación del Paciente/etnología , Factores de Riesgo , Conducta Sedentaria/etnologíaRESUMEN
OBJECTIVE: To examine the feasibility, acceptability, and initial efficacy of a technology-based weight loss intervention for urban, low-income mothers. METHODS: Eighteen obese, ethnic minority, socioeconomically disadvantaged mothers in the first year after childbirth were randomly assigned to either: 1) technology-based intervention, which included empirically supported behavior-change strategies, daily skills, and self-monitoring text messages with personalized feedback, biweekly counseling calls from a health coach, and access to a Facebook support group, or 2) usual-care control. RESULTS: After 14 weeks of treatment, the technology-based intervention participants had significantly greater weight loss (-2.9 ± 3.6 kg) than usual care (0.5 ± 2.3 kg; adjusted mean difference: -3.2 kg, 95% confidence interval -6.2 to -0.1 kg, P = .04). One-third of intervention participants (3 of 9) and no control participants lost > 5% of their initial body weight at follow up. CONCLUSIONS AND IMPLICATIONS: Results suggest the potential for using technology to deliver a postpartum weight loss intervention among low-income racial/ethnic minorities.
Asunto(s)
Dieta Reductora , Salud de las Minorías , Actividad Motora , Obesidad/dietoterapia , Periodo Posparto , Medios de Comunicación Sociales , Salud Urbana , Adulto , Índice de Masa Corporal , Terapia Combinada/economía , Dieta Reductora/economía , Dieta Reductora/etnología , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Salud de las Minorías/economía , Salud de las Minorías/etnología , Motivación , Obesidad/economía , Obesidad/etnología , Obesidad/terapia , Aceptación de la Atención de Salud/etnología , Cooperación del Paciente/etnología , Philadelphia , Proyectos Piloto , Pobreza/etnología , Salud Urbana/economía , Salud Urbana/etnología , Pérdida de Peso/etnología , Adulto JovenRESUMEN
Intuitive eating programs that improve self-efficacy and dietary habits could enhance glycemic control in African-American women with type 2 diabetes. The goal of our study was to investigate how current eating practices and beliefs of African-American women living with diabetes aligned with intuitive eating concepts. African-American women with type 2 diabetes referred for diabetes education class during 2009-2012 were recruited for a qualitative study using focus groups for data collection. Verbatim group transcriptions were analyzed by two independent reviewers for themes using a combined inductive-deductive approach. Participants (n=35) had an average age 52±9 years, mean body mass index 39±7, and mean time with a type 2 diabetes diagnosis of 10±10 years. Participants' self-reported dietary practices were poorly aligned with intuitive eating concepts. The women reported a lack of self-control with food and regularly eating in the absence of hunger, yet stated that the determinant factor for when to stop eating was to recognize a feeling of fullness. Participants reported knowing they were full when they felt physically uncomfortable or actually became sick. Women frequently cited the belief that individuals with diabetes have to follow a different diet than that recommended for the general public. Many women also discussed diabetes-related stigma from family/friends, and often did not tell others about their diabetes diagnosis. These findings demonstrate that intuitive eating techniques are not currently applied by the women in this sample. Future studies should assess the influence of intuitive eating interventions on dietary habits among low-income African-American women with type 2 diabetes.
Asunto(s)
Diabetes Mellitus Tipo 2/dietoterapia , Dieta para Diabéticos , Conducta Alimentaria , Intuición , Cooperación del Paciente , Negro o Afroamericano , Alabama , Actitud Frente a la Salud , Índice de Masa Corporal , Estudios de Cohortes , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/etnología , Dieta para Diabéticos/etnología , Dieta Reductora/etnología , Conducta Alimentaria/etnología , Femenino , Grupos Focales , Estudios de Seguimiento , Humanos , Hiperfagia/fisiopatología , Hiperfagia/prevención & control , Comidas , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/dietoterapia , Obesidad/etnología , Obesidad/etiología , Cooperación del Paciente/etnología , Estigma SocialRESUMEN
There is evidence that Aboriginal children and youth in Canada and elsewhere are at higher risk of obesity and overweight than other children. However, there has been no review of healthy weights interventions specifically aimed at Aboriginal children. A structured search for peer-reviewed articles presenting and evaluating healthy weights interventions for Aboriginal children and youth was conducted. Seventeen articles, representing seven interventions, were reviewed to identify their main characteristics, evaluation design, and evaluation outcomes. Interventions included several large community-based programs as well as several more focused programs that all targeted First Nations or American Indians, rather than Métis or Inuit. Only 1 program served an urban Aboriginal population. None of the published evaluations reported significant reductions in obesity or overweight or sustained increases in physical activity, although some evaluations presented evidence of positive effects on children's diets or on nutrition knowledge or intentions. We conclude that broader structural factors affecting the health of Aboriginal children may limit the effectiveness of these interventions, and that more evidence is required regarding interventions for Aboriginal children in various geographic and cultural contexts in Canada including Inuit and Métis communities.
Asunto(s)
Fenómenos Fisiológicos Nutricionales de los Adolescentes , Fenómenos Fisiológicos Nutricionales Infantiles , Asistencia Sanitaria Culturalmente Competente , Dieta Reductora , Medicina Basada en la Evidencia , Obesidad/dietoterapia , Sobrepeso/dietoterapia , Adolescente , Fenómenos Fisiológicos Nutricionales de los Adolescentes/etnología , Canadá , Niño , Fenómenos Fisiológicos Nutricionales Infantiles/etnología , Terapia Combinada , Dieta/efectos adversos , Dieta/etnología , Dieta Reductora/etnología , Humanos , Indígenas Norteamericanos , Inuk , Actividad Motora , Obesidad/etnología , Obesidad/etiología , Obesidad/terapia , Sobrepeso/etnología , Sobrepeso/etiología , Sobrepeso/terapia , Salud Rural/etnologíaRESUMEN
This study examined the main and interaction effects of gender, traditional gender role orientation, and media-influenced sociocultural values and ideals about appearance in a sample of 96 Latino adolescents controlling for age, country of origin, and BMI. Girls and less traditionally oriented youth reported significantly more disordered eating and appearance concerns than did boys and more traditionally oriented youth. Gender moderated the relationship between traditional gender role orientation and disordered eating and appearance concerns. Contrary to our hypothesis, media-influenced sociocultural values and ideals about appearance did not significantly predict disordered eating and appearance concerns. However, the interaction between gender and sociocultural values and ideals about appearance was significant. Our findings highlight the importance of continued research on gender, media, and cultural influences as they relate to disordered eating and appearance concerns among Latino youth.
Asunto(s)
Trastorno Dismórfico Corporal/etnología , Trastorno Dismórfico Corporal/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/etnología , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Identidad de Género , Hispánicos o Latinos/etnología , Hispánicos o Latinos/psicología , Medios de Comunicación de Masas , Valores Sociales/etnología , Socialización , Adolescente , Trastorno Dismórfico Corporal/diagnóstico , Índice de Masa Corporal , Dieta Reductora/etnología , Dieta Reductora/psicología , Ejercicio Físico/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Factores de Riesgo , Conformidad Social , Somatotipos/psicología , Encuestas y CuestionariosRESUMEN
To assess weight loss attempt among a Latino immigrant population from the Dominican Republic we analyzed data on 585 overweight and obese Dominicans from a cross-sectional survey using Chi-square statistics, Student's t-tests, and logistic regression models. We found 58% of the overweight and obese tried to lose weight. Female gender (OR 2.28, CI 1.53-3.39), overweight perception (OR 2.37, CI 1.57-3.60) and weight loss advice from health professionals (OR 1.90, CI 1.24-2.91) were strongly associated with weight loss attempt. Individuals with diabetes were more likely to receive advice to lose weight (OR 2.58, CI 1.18-5.63; yet, they were more satisfied with their weight (40.5 vs. 27.8%, p < 0.021), and no difference in their weight loss attempt (p = 0.849) was detected compared to individuals without diabetes. We conclude a significant proportion of overweight and obese Dominican immigrants do not attempt to lose weight. Overweight perception and, except among individuals with diabetes, weight loss advice were strong inducements to weight loss attempt.
Asunto(s)
Dieta Reductora/etnología , Emigrantes e Inmigrantes , Hispánicos o Latinos , Motivación , Pérdida de Peso/etnología , Adulto , Estudios Transversales , República Dominicana/etnología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados UnidosRESUMEN
The aim of the current study was to examine and compare dieting and unhealthy weight-control behaviours (UWCB) in population-based samples in two large urban areas in Spain (Barcelona) and in the USA (Twin Cities of Minneapolis and St. Paul, Minnesota). Additionally, use of UWCB across weight categories was explored in both samples. Participants included 1501 adolescents from Barcelona (48% girls, 52% boys) and 2793 adolescents from the Twin Cities (53% girls, 47% boys). The main outcome measures were dieting, UWCB (less extreme and extreme) and weight status. Although dieting and UWCB were prevalent in both samples, particularly among girls, the prevalence was higher in the US sample. In both countries, the report of dieting and use of UWCB was highest among overweight and obese youth. Prevention interventions that address the broad spectrum of eating and weight-related problems should be warranted in light of the high prevalence and co-occurrence of overweight and unhealthy weight-related behaviours.