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Asthma
(2003)
Die Adipositas und ihre mitunter schwerwiegenden Auswirkungen nimmt in öffentlichen Diskussionen einen immer größeren Stellenwert ein. In Deutschland leiden neben 37 Millionen Erwachsenen derzeit rund 2 Millionen Kinder an Übergewicht oder Adipositas. Das Arbeitsbuch wendet sich an die Eltern betroffener Kinder. Erklärt wird die Entstehung der Adipositas, zudem sind Informationen zu gesunder Ernährung und deren Umsetzung im Alltag enthalten. Zusätzlich wird auf den wichtigen Faktor der Bewegung sowie eine mögliche erneute Gewichtszunahme eingegangen. Entwickelt wurde das Arbeitsbuch im Rahmen einer Studie und spricht die teilnehmenden Eltern an, deren Kinder sich aufgrund von Adipositas in einer Reha-Klinik befinden. Die enthaltenen Informationen und Alltagshilfen sind jedoch auch für alle anderen betroffenen Eltern relevant.
Background: Research concerning child's food intake have considered various influencing factors, for example parental feeding strategies, demographic and weight factors. At this time, however, there are few findings that explore these factors simultaneously. Accordingly, the aim of this study was to test a structural equation model regarding the associations between maternal feeding strategies and child's food intake. Methods: 556 mothers and their children between 1 and 10 years of age participated in this crosssectional study. Besides socio-demographic and weight data, the mothers were asked about their feeding strategies as well as their child's food intake. Results: The well-fitting model explained 73% of the variance in the child's consumption of healthy and 34% of unhealthy food. In addition to the effect of the mother's social status and the child's age, a rewarding and modeling feeding behavior significantly influenced the child's food intake. Conclusion: The results highlight the relevance of maternal feeding behavior on the child's food intake. In terms of preventing eating- or weight-related problems, the findings indicate the usefulness of training parents in explicit modeling behavior and avoiding food as a reward.
Japanese parents and educators teach children to refrain from leaving food in their plates. Their teachings have direct (advising children to refrain from leaving food uneaten) and indirect (meal-related rituals before and after mealtimes) influence in enhancing gratitude for food in daily life.This cross-sectional study aimed to examine 1) the interaction of direct and indirect approaches to avoiding food waste behaviors and 2) the mediation of gratitude for food by preventing such behaviors. Overall, 400 Japanese adults (female: n = 200) responded to a self-administrated anonymous questionnaire survey measuring: the present food waste avoiding behaviors; current gratitude for food; direct and indirect childhood approaches for avoiding food waste behaviors. Participants' mean (standard deviation) age and body mass index were 40.0 (11.6) and 21.9 (3.9), respectively. A significant main effect of the indirect approach and the interaction of direct and indirect approaches were obtained by adjusting the participants' background. Moreover, through mediation analyses with percentile-corrected bootstrap confidence intervals, it was observed that gratitude for food mediated the association between direct and indirect childhood approaches and avoiding food waste behaviors. Despite no information on the current meal-related rituals of the respondents, this study suggests the potential of these approaches in enhancing gratitude for food as a new approach to reduce food waste worldwide.
Objective:
The purpose of this study was to examine the impact of age and weight status on adolescents' body dissatisfaction and its change over 20 months in a gender-comparing design. The influence of body image concern on eating concern was also investigated.
Method:
In a prospective study, 675 male and female adolescents aged 12–16 were assessed using self-report questionnaires on weight, shape, muscularity, and eating concerns. Height and weight measurements were taken by trained personnel. Data were analyzed using structural equation modeling.
Results:
Analyses of latent means revealed more pronounced weight/shape concern in females than males and more pronounced muscularity concern in males than females. Weight/shape concern increased in females over time, whereas muscularity concern remained stable in both genders. Baseline levels of weight/shape concern could be predicted by age and weight status in females and by weight status in males. The only predictor of change in weight/shape concern was weight status in males. Baseline levels of muscularity concern could be predicted by age in females and by weight status in males. Similar effects were found for changes in muscularity concern in both genders. Increases in weight/shape and muscularity concern were associated with more pronounced eating concern.
Discussion:
The results confirm gender differences in distinctive facets of body image concern and its prediction. The relevance of increase in body image concern in adolescents is underlined by its association with eating concern in both genders. Further explanatory variables for change in body dissatisfaction should be examined in future studies.
Anti-fat bias is widespread and is linked to the internalization of weight bias and psychosocial problems. The purpose of this study was to examine the internalization of weight bias among children across weight categories and to evaluate the psychometric properties of the Weight Bias Internalization Scale for Children (WBIS-C). Data were collected from 1484 primary school children and their parents. WBIS-C demonstrated good internal consistency (alpha = .86) after exclusion of Item 1. The unitary factor structure was supported using exploratory and confirmatory factor analyses (factorial validity). Girls and overweight children reported higher WBIS-C scores in comparison to boys and non-overweight peers (known-groups validity). Convergent validity was shown by significant correlations with psychosocial problems. Internalization of weight bias explained additional variance in different indicators of psychosocial well-being. The results suggest that the WBIS-C is a psychometrically sound and informative tool to assess weight bias internalization among children.
Disordered eating is highly prevalent during adolescence and has a detrimental effect on further development. Effective prevention programs are needed to prevent unhealthy developmental trajectories. This study evaluated the efficacy of the POPS-program (POtsdam Prevention at Schools), a universal school-based eating disorder prevention program for adolescents. In a cluster-randomized design, we compared the intervention group receiving the prevention program to a waiting control group. Outcomes included indicators of disordered eating and relevant risk factors for eating disorders (body dissatisfaction, internalization of the thin ideal, perceived media pressure, perfectionism, emotional element of exercise, social comparison, and perceived teasing). Questionnaires were administered at the start of the intervention, 3 and 12 months post intervention. At baseline, 1112 adolescents aged 10 to 16 years participated (49% girls; 51% intervention group). Intention-to-treat analyses with the complete data set and per-protocol analyses as a completer analysis were performed. The intervention group showed a more favorable course compared to the control group regarding all observed risk factors for eating disorders except for perceived teasing. Effect sizes were small but comparable to other primary prevention programs. At 1-year follow-up, a small but significant effect on disordered eating was observed. Results of the per-protocol analyses were mostly confirmed by the intention-to-treat analyses. Results were promising for both genders although girls benefited more regarding disordered eating and internalization of the thin ideal. Further studies are warranted examining successful program elements and whether gender-specific programs are needed.
Self-regulation is a dispositional skill of regulating attention and emotion to attain a certain goal. Poor self-regulation is associated with a higher body mass index (BMI) and is a risk factor for the development of obesity. Intuitive eating, an adaptive eating style characterized by eating in response to internal cues of hunger and satiety, is associated with a lower BMI. Using cross-sectional data, this study examined whether intuitive eating mediates the relationship between self-regulation and BMI in a community sample of adults. Participants (N = 530) completed the Self-Regulation Scale, the Intuitive Eating Scale-2 with its facets Unconditional Permission to Eat (UPE), Eating for Physical Rather Than Emotional Reasons (EPR), Reliance on Hunger and Satiety Cues (RHSC) and Body-Food Choice Congruence (B-FCC). They also self-reported their height and weight. Using percentile bootstrap resampling procedures, the simple mediation analysis showed an indirect relationship between self-regulation and BMI through intuitive eating. The multiple mediation analysis revealed that EPR and B-FCC, but not UPE and RHSC, mediated the relationship between self-regulation and BMI. Intuitive eating seems to play an important intermediating role in the relationship between self-regulation and BMI. Regarding weight management interventions, it could be useful to promote intuitive eating, especially for individuals with low self-regulation. Prospective studies are needed to explore the causal and temporal relationships among self-regulation, intuitive eating and BMI.
There is evidence that intrapersonal psychological factors might contribute to the development of binge eating. However, studies considering reciprocal effects between risk factors and disordered eating are rare. The present article investigates the nature of the temporal relationships between binge eating and low self-esteem, depressive symptoms, interoceptive deficits, perfectionism, weight/shape concerns, dietary restraint, and the internalization of the societal body ideal in adolescence while taking into account the moderating effects of age and gender. A German population-based sample of 1039 boys and girls from 12 to 19 years of age answered self-report questionnaires on risk factors and eating pathology on 2 measurement points separated by 20months. Data were analyzed using a cross-lagged panel design. Low self-esteem, interoceptive deficits, weight/shape concerns, and the internalization of the societal body ideal predicted binge eating longitudinally in bivariate analyses. Binge eating predicted later depressive symptoms, whereas perfectionism and dietary restraint were not longitudinally linked to binge eating in either direction. Low self-esteem and weight/shape concerns emerged as multivariate predictors of binge eating in girls and boys, respectively. No moderating effects of age were observed. The results suggest that depressive symptoms might rather be a consequence of binge eating than a risk factor, and this underscores that even subclinical eating pathology might be associated with negative psychological outcomes. Central risk factors that should be targeted in prevention programs might be low self-esteem for girls and weight/shape concerns for boys.
Common models propose that the internalization of societal beauty ideals influences disordered eating behaviors and muscularity-oriented behaviors via body image concerns. However, previous studies addressing these pathways have been mainly cross-sectional and primarily included female samples. We investigated these pathways prospectively in male and female adolescents and young adults, examining two pathways: a ‘weight/shape pathway,’ linking thin-ideal internalization, weight/shape concern, and restrained eating, and a ‘muscularity pathway,’ linking athletic-ideal internalization, muscularity concern, and muscularity-oriented behavior. Across three time points, 973 participants from the German general population were assessed. Although the hypothesized pathways could not be supported in their complete temporal sequence, several hypothesized pathways occurred across two time points. Among others, weight/shape concern predicted restrained eating and the athletic ideal played a prominent role in the prediction of muscularity-oriented behavior in both genders.
Hintergrund
Adipositas ist im Kindes- und Jugendalter stark verbreitet. Medizinische Rehabilitationsmaßnahmen mit ihrem umfassenden Behandlungsangebot stellen eine wesentliche Säule der Versorgung dar. Da Adipositas mit vielfältigen psychosozialen Belastungen verbunden ist, stellt sich die Frage, ob psychotherapeutische Angebote noch stärker berücksichtigt werden sollten.
Fragestellung
Untersucht wurde, wie verbreitet psychische Auffälligkeiten bei Kindern und Jugendlichen mit Adipositas sind und in welchem Zusammenhang sie zum Gewichtsverlauf stehen.
Material und Methoden
Die Stichprobe bestand aus 220 Kindern und Jugendlichen mit Adipositas (8 bis 16 Jahre, M = 13,11 Jahre; SD ± 1,88 Jahre; 54,5 % weiblich), die an einer stationären Rehabilitationsmaßnahme teilnahmen. Emotionale- und Verhaltensauffälligkeiten (Strengths and Difficulties Questionnaire, SDQ) wurden zu Rehabilitationsbeginn sowie 6 und 12 Monate nach Rehabilitationsende im Elternbericht erfasst. Zudem wurden Daten zur Bestimmung des Gewichtstatus durch das medizinische Personal der Kliniken bzw. in der Katamnese von Hausärzten erhoben.
Ergebnisse
Fast die Hälfte der Kinder und Jugendlichen (48,6 %) wies auffällige Werte auf; v. a. Mädchen waren signifikant häufiger betroffen. Die deskriptive Betrachtung nach Rehabilitationsende zeigte einen vergleichbar hohen Anteil. Zudem wirkte sich das Vorliegen psychosozialer Auffälligkeiten signifikant negativ auf den Gewichtsverlauf aus.
Schlussfolgerung
Psychische Probleme sollten im Rahmen der Adipositastherapie stärker berücksichtigt werden. Zum einen sollten evtl. belastete Kinder durch Screenings identifiziert werden, zum anderen psychotherapeutische Maßnahmen zur Reduktion psychosozialer Belastungen integraler Bestandteil der Behandlung sein.
The Body Appreciation Scale-2 (BAS-2) is the most current measure of body appreciation, a central facet of positive body image. This work aimed to examine the factor structure and psychometric properties of a German version. In Study 1 (N = 659; M-age = 27.19, SD = 8.57), exploratory factor analyses (EFA) revealed that the German BAS-2 has a one-dimensional factor structure in women and men, showing cross-gender factor similarity. In Study 2 (N = 472; M-age = 30.08, SD = 12.35), confirmatory factor analysis (CFA) further supported the original scale's one-dimensional factor structure after freeing correlated errors. The German BAS-2 also showed partial scalar invariance across gender, with women and men not differing significantly in latent mean scores. As predicted, we found convergent relationships with measures of self-esteem, intuitive eating, and variables associated with negative body image (i.e., weight-and shape concerns, drive for thinness). Correlations with BMI were small and in an inverse direction. Incremental validity was demonstrated by predicting self-esteem and intuitive eating over and above measures of negative body image. Additionally, the German BAS-2 showed internal consistency and 2-week test-retest reliability. Overall, our results suggest that the German BAS-2 is a psychometrically sound instrument.
How is intuitive eating related to self-reported and laboratory food intake in middle-aged adults?
(2020)
As intuitive eating (IE) is characterized by eating in response to internal cues of hunger and satiety and by monitoring the effect of food on the body, it has been hypothesized to lead to healthy food intake. Evidence concerning its link to food intake is scarce. This experimental study investigated the relationship between IE and food intake in middle-aged adults. Fifty-five participants aged 50-70 years completed the Intuitive Eating Scale 2 to measure IE. Usual consumption frequency of fruits, vegetables, snacks and sweets was assessed as a measure of healthy self-reported food intake. A taste test of apples, carrots, coated peanuts and chocolate was conducted as a measure of healthy and total laboratory food intake. Regression analyses were performed using Frequentist and Bayesian methods of inference. In line with our hypothesis, IE was associated with healthier self-reported food intake (medium effect size: f(2) = 0.24). The data were 49.80 times more likely under H-1 than under H-0. Contrary to our hypotheses, IE was neither associated with healthy nor total laboratory food intake in classical regression analyses. The accompanying Bayes factors revealed inconclusive evidence. Data only allow drawing cautious conclusions about the different relationship between IE and the self-reported consumption frequency of the foods vs. the amount of these foods consumed in a single test situation. Future studies combining different measures of IE (e.g., behavioral paradigms) and self-reported (e.g., diet quality, portion sizes) and laboratory (e.g., repeated taste tests with pre-selected foods) food intake are warranted to further explore their relationship.
Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to an age-unspecific CBT group delivered across ages in an inpatient setting. The primary outcome was body mass index standard deviation score (BMI-SDS) over the course of one year; secondary outcomes were health-related and disease-specific quality of life (QoL). 266 participants aged 16 to 21 years (65% females) were randomized. Intention-to-treat (ITT) and per-protocol analyses (PPA) were performed. For both group interventions, we observed significant and clinically relevant improvements in BMI-SDS and QoL over the course of time with small to large effect sizes. Contrary to our hypothesis, the age-specific intervention was not superior to the age-unspecific CBT-approach.
Die Lifespan-Forschung untersucht die Entwicklung von Individuen über den gesamten Lebenslauf. Die medizinische Rehabilitation hat nach geltendem Sozialrecht die Aufgabe, chronische Krankheiten abzuwenden, zu beseitigen, zu mindern, auszugleichen, eine Verschlimmerung zu verhüten und Negativfolgen für die Lebensführung zu reduzieren. Dies erfordert in wissenschaftlicher wie in praxisbezogener Hinsicht die Entwicklung einer Lebensspannenperspektive als Voraussetzung für die Klassifikation und Diagnostik chronischer Erkrankungen, die Beschreibung von verlaufsbeeinflussenden Faktoren, kritischen Lebensphasen und Critical Incidents (kritische Verlaufszeitpunkte), die Durchführung von prophylaktischen Maßnahmen, die Entwicklung von Assessmentverfahren zur Erfassung und Bewertung von Verläufen oder Vorbehandlungen, die Auswahl und Priorisierung von Interventionen, eine Behandlungs- und Behandlerkoordination auf der Zeitachse, die Präzisierung der Aufgabenstellung für spezialisierte Rehabilitationsmaßnahmen, wie beispielsweise Rehabilitationskliniken, und als Grundlage für die Sozialmedizin. Aufgrund der Vielfalt der individuellen Risikokonstellationen, Krankheitsverläufe und Behandlungssituationen über die Lebensspanne hinweg, bedarf es in der medizinischen Rehabilitation in besonderer Weise einer personalisierten Medizin, die zugleich rehabilitationsförderliche und -behindernde Umweltfaktoren im Rehabilitationsverlauf berücksichtigt.
Die Adipositas und ihre mitunter schwerwiegenden Auswirkungen nimmt in öffentlichen Diskussionen einen immer größeren Stellenwert ein. In Deutschland leiden neben 37 Millionen Erwachsenen derzeit rund 2 Millionen Kinder an Übergewicht oder Adipositas. Das Arbeitsbuch wendet sich an die Eltern betroffener Kinder. Erklärt wird die Entstehung der Adipositas, zudem sind Informationen zu gesunder Ernährung und deren Umsetzung im Alltag enthalten. Zusätzlich wird auf den wichtigen Faktor der Bewegung sowie eine mögliche erneute Gewichtszunahme eingegangen. Entwickelt wurde das Arbeitsbuch im Rahmen einer Studie und spricht die teilnehmenden Eltern an, deren Kinder sich aufgrund von Adipositas in einer Reha-Klinik befinden. Die enthaltenen Informationen und Alltagshilfen sind jedoch auch für alle anderen betroffenen Eltern relevant.