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Biomedical subjects

M Story

Publications and source records attributed to M Story.

At least 73 records · Page 4Linked to original sources

Adolescent vegetarians. A behavioral profile of a school-based population in Minnesota.

OBJECTIVE: To compare a population-based sample of vegetarian and nonvegetarian adolescents regarding food intake patterns, disordered eating, and a range of other non-food-related health-compromising and health-promoting behaviors. DESIGN: A cross-sectional school-based survey. SETTING: Public schools within nonurban areas of Minnesota. PARTICIPANTS: Adolescents (n = 107) aged 12 to 20 years who reported on the Minnesota Adolescent Health Survey that they follow a vegetarian diet and a comparison group of nonvegetarian youth (n = 214) matched for sex, age, and ethnicity. The percentage of self-identified vegetarians in the study population was relatively low (0.6%); most of the vegetarians were female (81%). MAIN OUTCOME MEASURES: Food intake patterns, disordered eating (frequent dieting, binge eating, self-induced vomiting, and laxative use), health-compromising behaviors (tobacco, alcohol, and marijuana use and suicide attempts), and health-promoting behaviors (seat belt use, physical activity, and brushing teeth regularly). RESULTS: Vegetarian adolescents were twice as likely to consume fruits and vegetables (P < .001), one third as likely to consume sweets (P < .001), and one fourth as likely to eat salty snack foods (P < .001) more than once a day compared with nonvegetarians. Vegetarians were almost twice as likely to report frequent dieting (P < .001), 4 times as likely to report intentional vomiting (P < .001), and 8 times as likely to report laxative use (P < .001) than nonvegetarians. Overall, associations with other health-compromising and health-promoting behaviors were not apparent. CONCLUSIONS: A vegetarian diet may be beneficial because of increased fruit and vegetable consumption and decreased consumption of foods high in fat, salt, and sugar. However, adolescents following a vegetarian diet need to be screened for adequate food intake and potential disordered eating behaviors.

Adolescent↗

Ethnic differences in psychosocial and health behavior correlates of dieting, purging, and binge eating in a population-based sample of adolescent females.

OBJECTIVE: To examine ethnic differences in factors associated with disordered eating behaviors. METHOD: Data were collected from 17,159 adolescent females who completed a school-based health survey conducted in 1987. RESULTS: In all ethnic groups, dieting was associated in bivariate analyses with weight dissatisfaction, perceived overweight, and low body pride. Purging was associated with weight dissatisfaction, perceived overweight, low body pride, greater suicide risk, and greater alcohol use. Binge eating was associated with weight dissatisfaction, perceived overweight, low body pride, lower family connectedness, greater peer acceptance concerns, and emotional stress. DISCUSSION: Body dissatisfaction and perceived overweight are consistent correlates of dieting and binge eating in adolescent females of diverse ethnic groups. Ethnic subculture does not appear to protect against the broader sociocultural factors that foster body dissatisfaction among adolescent females. Implications for understanding sociocultural influences on dieting, obesity, and eating disorders are discussed.

Adaptation, Psychological↗

Psychosocial concerns and health-compromising behaviors among overweight and nonoverweight adolescents.

OBJECTIVE: To compare weight-specific and global psychosocial concerns and health-compromising behaviors among overweight and nonoverweight youth across gender and ethnicity. METHODS: A cross-sectional school-based survey of 31,122 adolescents in grades 7 to 12. Based on self-reported heights and weights, respondents were categorized as nonoverweight (body mass index (BMI) < 85th percentile), moderately overweight (85th percentile < BMI < 95th percentile), or severely overweight (BMI > 95th percentile). RESULTS: Global psychosocial concerns, such as emotional well-being, suicidal ideation, future job concerns, and peer concerns, did not differ greatly between nonoverweight, moderately overweight, and severely overweight adolescents. Substance abuse behaviors were equally or less prevalent among the overweight group. Overweight girls were significantly less likely to consume alcohol, whereas overweight boys were at lower risk for marijuana use. In contrast, overweight youth were more likely to perceive their health as only fair or poor and were more likely to express weight-specific concerns and engage in behaviors such as chronic dieting and binge eating than nonoverweight youth. Overweight American Indian girls perceived their physical health more positively than nonoverweight American Indian girls. Strong associations were found between overweight status and chronic dieting among African American boys and girls. CONCLUSIONS: Nutritional counseling and educational programs need to address the weight-specific concerns and behaviors of overweight adolescents. However, assumptions regarding global psychosocial concerns and health-compromising behaviors among overweight adolescents of different genders and ethnicities should be avoided. These broad issues need to be explored in more depth at both the research and intervention levels.

Adolescent↗

Do children eat what they say? Validity of intended food choices among Native American school children.

OBJECTIVE: To examine the agreement between school children's intended food choices and observed food choices. DESIGN: Native American students in the second through fifth grade completed a questionnaire that asked them to select from 10 paired food choices for a given meal or snack. Three weeks later students chose among foods identical to those on the questionnaire as part of their usual school lunch or breakfast over three consecutive days; afternoon snacks were also offered. RESULTS: Agreement between students' intended food choices and observed food choices was examined across 10 food pairs. The composite kappa coefficient between intended and observed food choices was 0.09 (95% confidence interval 0.06, 0.012), including virtually no agreement above that expected by chance. There were no differences in agreement by sex or grade. CONCLUSIONS: Intended food choices were not significantly associated with observed food choices. It is unclear whether intended food choices reflect nutrition knowledge, socially desirable responses, food preferences, or some other dimension of eating behavior. Although responsive to school-based nutrition interventions, the interpretation of changes in intended food choices must be clarified in future research.

Child↗

Psychosocial concerns and weight control behaviors among overweight and nonoverweight Native American adolescents.

OBJECTIVE: To compare the psychosocial and weight-related concerns and weight control, eating, and exercise behaviors of overweight and nonoverweight Native American adolescents living on or near reservations. STUDY DESIGN: A cross-sectional survey assessed psychosocial, health, and weight-specific concerns; disordered eating; and health-promoting behaviors. STUDY POPULATION: The study population included 11,868 Native American youth in grades 7 through 12. STATISTICAL ANALYSES PERFORMED: Analyses of variance and chi 2 tests were used to examine associations between weight status and psychosocial and weight-related concerns and behaviors. Stratified analyses were done by gender and by gender and age. RESULTS: Self-reported weights and heights indicated that 25% of the study population was overweight. Overweight youth were twice as likely to report health concerns as nonoverweight youth. Although a high percentage of nonoverweight youth expressed body- or weight-related concerns and reported engaging in disordered eating behaviors, prevalence rates for these concerns were significantly higher among overweight youth. Overweight youth were also somewhat less likely to engage in health-promoting behaviors. In contrast, differences in global psychosocial concerns were minimal. APPLICATIONS: Overweight Native American youth were concerned about their weight, but did not appear to have major psychosocial concerns associated with being overweight. Interventions aimed at obesity prevention and overall health promotion are essential, given the high prevalence of obesity and of psychosocial and weight-related concerns and behaviors among the study population as a whole. The challenge is to develop culturally appropriate interventions aimed at the promotion of healthful weight control behaviors that will not lead to negative psychosocial consequences.

Adolescent↗

Covariations of eating behaviors with other health-related behaviors among adolescents.

PURPOSE: The study objectives are: (1) to examine and compare patterns of covariation of a wide range of health behaviors among adolescent boys and girls; (2) to determine whether eating behaviors are part of a larger construct of health-related behaviors and to identify the behaviors with which they share underlying similarities; and (3) to determine whether youth engaging in other health-compromising behaviors are at risk for unhealthy eating. METHODS: Data were analyzed from the Minnesota Adolescent Health Survey, a classroom-administered questionnaire, completed by 36,284 adolescents, in grades 7-12 from 1986-87. RESULTS: Among boys, factor analysis revealed five factors: (1) risk-taking behaviors, (2) school-related behaviors, (3) "quietly" disturbed behaviors (e.g., frequent dieting, self-induced vomiting, suicide attempts), (4) health-promoting behaviors; and (5) exercise. Eating behaviors loaded on the construct of health-promoting behaviors with brushing teeth and seat belt use. Among girls, four similar factors emerged; however, exercise loaded on the construct of health-promoting behaviors. Therefore, eating behaviors loaded with brushing teeth, seat belt use, and exercise among girls. Logistic regression analyses, controlling for sociodemographic and personal variables, revealed that boys and girls engaging in health-promoting behaviors were less likely to have unhealthy eating behaviors, while those engaging in quietly disturbed behaviors, risk-taking behaviors, and problematic school behaviors were more likely to have unhealthy eating behaviors. CONCLUSIONS: Eating behaviors appear to be part of a health-promoting behavioral construct and should not be viewed in isolation from other behaviors. Although eating behaviors do not appear to be part of the "problem behavior syndrome," youth engaging in a wide range of health-compromising behaviors are at risk for unhealthy eating; emphasizing the need to target high-risk youth with health promotion programs.

Adolescent↗

Effect of parental mental health status on adolescents' dietary behaviors.

PURPOSE: The purpose of this study was to explore whether adolescents of substance-abusing and depressed parents were more likely to have poor dietary behaviors than those in the health comparison families. METHODS: The sample consisted of 841 adolescents in families of substance-abusing parents, depressed parents, and parents without a diagnosable psychiatric disorder. All adolescents were given a food frequency questionnaire. RESULTS: Adolescents whose parents had substance abuse disorder had lower intakes of fruits and higher intakes of high fat foods, and also ate more frequently at fast-food restaurants and purchased more snacks. Adolescents whose parents were depressed had lower intakes of all food groups. Mother's mental health status impacted more on adolescents' dietary behaviors than did the father's mental health status. CONCLUSION: This research suggests that at-risk behaviors among youth of psychiatrically impaired parents may extend to food behaviors.

Adolescent↗

Psychosocial correlates of health compromising behaviors among adolescents.

The objective of the present study was to examine psychosocial correlates of diverse health-compromising behaviors among adolescents of different ages. The study population included 123,132 adolescents in sixth, ninth and 12th grades. Psychosocial correlates of substance abuse, delinquency, suicide risk, sexual activity and unhealthy weight loss behaviors were examined. Risk-taking disposition was significantly associated with nearly every behavior across age and gender groups. Other consistent correlates included sexual abuse and family connectedness. Correlates of health-compromising behaviors tended to be consistent across age groups. However, stronger associations were noted between sexual abuse and substance use for younger adolescents, and risk-taking disposition and school achievement were stronger correlates for older youth. The results suggest the presence of both common and unique etiological factors for different health-compromising behaviors among youth. The results emphasize the importance of focusing on positive 'risk-taking' experiences for youth in prevention programs; being sensitive to possible sexual abuse experiences among both female and male adolescents in health-care consultations; integrating strategies for improved family connectedness into health promotion efforts; and making school relevant for all adolescents.

Adolescent↗

Recommendations from overweight youth regarding school-based weight control programs.

This study aimed to obtain recommendations from overweight youth on the development of school-based weight control programs; to determine their level of interest in participation; and to learn about the outcomes they desired from such a program. Because obesity is prevalent among youth of certain minority groups and low socioeconomic backgrounds, and since few programs address the needs of these youth, the study population was selected from inner city public schools with high percentages of youth from minority groups and low socioeconomic backgrounds. Sixty-one overweight adolescents participated in semi-structured, in-depth individual interviews, which were audiotaped, transcribed, coded, and analyzed. Findings indicated that many overweight adolescents were interested in participating in school-based weight control programs, provided they are conducted in a supportive manner; offer enjoyable activities; are informative; are sensitive to the needs of overweight youth; and do not conflict with other activities. Adolescents stressed the importance of a program leader who understands the difficulties that overweight youth face, and many expressed their preference for a leader who is currently overweight or had been overweight in the past.

Adolescent↗

Psychosocial and behavioral correlates of dieting and purging in Native American adolescents.

OBJECTIVE: This study examined the relationship of psychosocial factors and health behaviors to frequent dieting and purging behaviors in Native American adolescent boys and girls. DESIGN: School-based health survey. SETTING AND PARTICIPANTS: A total sample of 13 454 Native American youth in grades 7 through 12 living on or near reservations from eight Indian Health Service areas completed a self-report, school-based health questionnaire. RESULTS: Almost half (48.3%) of the girls and one third (30.5%) of the boys had dieted in the past year. More than one fourth (28%) of the girls and 21% of the boys reported purging behavior of some type. Dieting frequency and purging status were associated with negative psychosocial factors and health risk behaviors. Dieting frequency in girls was associated with weight dissatisfaction, concerns about being overweight, high emotional stress, binge eating, alcohol use, tobacco use, suicide ideation and attempts, delinquent behaviors, and physical and sexual abuse. Purging status was positively and independently associated with negative psychosocial and health behavior risk factors. There were fewer significant relationships in boys. CONCLUSIONS: Findings from this study suggest that dieting and purging are associated with similar psychosocial factors and health-compromising behaviors in Native American and white youth. Implications for future research and prevention programs are discussed.

Adolescent↗

The effects of cigarette smoking and gestational weight change on birth outcomes in obese and normal-weight women.

OBJECTIVES: The associations of infant birth outcomes with maternal pregravid obesity, gestational weight gain, and prenatal cigarette smoking were examined. METHODS: A retrospective analysis of 1343 obese and normal-weight gravidas evaluated the associations of cigarette smoking, gestational weight change, and pregravid body mass index with birthweight, low birthweight, and small- and large-for-gestational-age births. RESULTS: Smoking was associated with the delivery of lower-birthweight infants for both obese and normal-weight women, and gestational weight gain did not eliminate the birthweight-lowering effects of smoking. Women at highest risk of delivering lower-birthweight infants were obese smokers whose gestational gains were less than 7 kg and normal-weight smokers whose gestational gains were less than 11.5 kg. CONCLUSIONS: To balance the risks of small and large-size infants, gains of 7 to 11.5 kg for obese women and 11.5 to 16 kg for normal-weight women appear appropriate.

Birth Weight↗

A pricing strategy to promote low-fat snack choices through vending machines.

OBJECTIVES: This study examined the role of price on purchases of low-fat snacks from vending machines. METHODS: Sales of low-fat and regular snacks were monitored in nine vending machines during a 4-week baseline, a 3-week intervention in which prices of low-fat snacks were reduced 50%, and 3 weeks postintervention. RESULTS: The proportion of low-fat snacks purchased was 25.7%, 45.8%, and 22.8% in the three periods, respectively. Total snack purchases did not vary by period. CONCLUSIONS: Reducing relative prices may be effective in promoting lower-fat food choices in the population. Vending machines may be a feasible method for implementing such nutrition interventions.

Commerce↗

Covariations of unhealthy weight loss behaviors and other high-risk behaviors among adolescents.

OBJECTIVES: To determine if unhealthy weight loss methods are associated with other health-compromising behaviors among adolescents and to examine covariation patterns across gender and age groups. STUDY DESIGN AND PARTICIPANTS: The study sample was drawn from a larger population of 123 132 adolescents in the 6th, 9th, and 12th grades in Minnesota who completed a statewide school-based survey. The index group included all adolescents who used unhealthy weight loss methods (n=4514), and the comparison group comprised a random sample of 4514 adolescents who did not use these methods and who were matched for gender, ethnicity, and grade. MAIN OUTCOME MEASURES: Unhealthy weight loss methods included vomiting and use of laxatives, diuretics, and diet pills. Other health-compromising behaviors that were assessed included suicide attempts; delinquency; tobacco, alcohol, and marijuana use; unprotected sexual intercourse; and multiple sexual partners. RESULTS: Adolescents who used unhealthy weight loss methods were more likely to engage in other health-compromising behaviors. Odds ratios ranged from 1.9 to 14.8, and odds ratios were all highly significant among boys and girls in early, middle, and late adolescence. Among the girls, a monotonic decrease in the strength of all associations was found with increased age. CONCLUSIONS: Adolescents who engage in unhealthy weight loss methods are more likely to engage in a range of other health-compromising behaviors. Different perceptions of unhealthy weight loss behaviors (eg, normative vs problematic) may in part explain the differences in the strengths of associations between different grade and gender groups. Our results suggest that screening and counseling of adolescents who engage in unhealthy weight loss methods should be comprehensive and intervention programs aimed at the secondary prevention of disordered eating need to address other problematic behaviors.

Adolescent↗

Sexual orientation and prevalence of body dissatisfaction and eating disordered behaviors: a population-based study of adolescents.

OBJECTIVE: The hypothesis that homosexual orientation would be associated with higher rates of body dissatisfaction, dieting, and eating disordered behaviors in males, but lower rates in females, relative to those of heterosexual orientation, was examined. METHODS: A population-based sample of 36,320 students in Grades 7 through 12 completed a health behavior survey that included questions on sexual orientation, body satisfaction, and weight control behaviors. A subset of heterosexual males (N = 212) and females (N = 182) were selected for comparison with the adolescents who self-identified as homosexual (N = 81 males and N = 38 females) or bisexual (N = 131 males and N = 144 females). RESULTS: Homosexual males were more likely to report a poor body image (27.8% vs. 12.0%), frequent dieting (8.9% vs. 5.5%), binge eating (25.0% vs. 10.6%), or purging behaviors (e.g., vomiting: 11.7% vs. 4.4%) compared with heterosexual males. Homosexual females were more likely than heterosexual females to report a positive body image (42.1% vs. 20.5%). However, they were not less likely to report frequent dieting (20.8% vs. 23.7%), binge eating (25.0% vs. 31.8%), or purging behaviors (e.g. vomiting: 19.4% vs. 12.1%). DISCUSSION: These results support the hypothesis that homosexual orientation is associated with greater body dissatisfaction and problem eating behaviors in males, but less body dissatisfaction in females. The possible role of sociocultural influences or gender identification on these relationships is discussed.

Adolescent↗

Pregnancy complications and birth outcomes in obese and normal-weight women: effects of gestational weight change.

OBJECTIVE: To compare the pregnancy course and outcomes in obese and normal-weight women and their associations with gestational weight change. METHODS: Multivariate logistic regression described the relation of weight change to pregnancy course and outcomes in a retrospective study of 683 obese and 660 normal-weight women who delivered singleton living neonates. RESULTS: Compared with normal-weight women, obese women gained an average of 5 kg (11 lb) less during pregnancy and were more likely to lose or gain no weight (11% versus less than 1%). Obese women were significantly more likely to have pregnancy complications, but the incidence of complications was not associated with weight change. Compared with obese women who gained 7-11.5 kg (15-25 lb), obese women who lost or gained no weight were at higher risk for delivery of infants under 3000 g or small for gestational age infants, and those who gained more than 16 kg (35 lb) were at twice the risk for delivery of infants who were 4000 g or heavier. CONCLUSION: Gestational weight change was not associated with pregnancy complications in obese or normal-weight women. To optimize fetal growth, weight gains of 7-11.5 kg (15-25 lb) for obese women and 11.5-16 kg (25-35 lb) for normal-weight women appear to be appropriate.

Birth Weight↗