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Biomedical subjects

M Story

Publications and source records attributed to M Story.

At least 91 records · Page 5Linked to original sources

Psychosocial predictors of binge eating and purging behaviors among adolescents with and without diabetes mellitus.

PURPOSE: This study aims to compare dieting, binge eating, and purging behaviors, and to examine predictors of binge eating and purging behaviors among adolescents with and without Diabetes Mellitus (DM). METHODS: The index group included 310 adolescents who reported that they had DM on a statewide population survey of 36,284 adolescents in grades 7-12 in Minnesota. The comparison group included a random sample matched for socioeconomic status (SES), of 850 adolescents without chronic illness. Disordered eating behaviors assessed in the present study included binge eating, vomiting, laxative use, and diuretic use. Potential predictor variables assessed included weight loss behaviors, body image, sexual abuse, sexual attractions, emotional well-being, family connectedness, poor school performance, age, race, Body Mass Index (BMI), and SES. RESULTS: Binge eating and purging were significantly more prevalent among adolescents with DM than among the comparison group. Different risk profiles were found for adolescents with and without DM and for males and females. Predictors of binge eating and purging among females with DM included weight dissatisfaction, bisexual/homosexual attractions, and younger age. Predictors among males with DM included bisexual/homosexual attractions, younger age, sexual abuse, and an interaction between sexual abuse and emotional well-being. CONCLUSIONS: Adolescents with DM should be screened for unhealthy weight control practices and eating disorders. If disordered eating is present, clinicians need to be sensitive to the variety of factors possibly associated with these behaviors among different individuals.

Adolescent↗

Patterns of health-compromising behaviors among Minnesota adolescents: sociodemographic variations.

OBJECTIVES: This study compared prevalence rates of health-compromising behaviors among boys and girls from different ethnic backgrounds in early, middle, and late adolescence and compared co-occurrences of such behaviors across gender and ethnic groups. METHODS: The study population included 123 132 adolescents in grades 6, 9, and 12. Adolescents completed a classroom-administered statewide survey focusing on high-risk behaviors, including unhealthy weight loss, substance abuse, suicide risk, delinquency, and sexual activity. RESULTS: Prevalence rates of most health-compromising behaviors differed by gender, increased with age, and tended to be highest among American Indian youth and lowest among Asian Americans. Strong associations were found between substance abuse and delinquency across all ethnic groups. Substance abuse and delinquency were associated with suicide risk across most ethnic groups. Covariations with sexual activity and unhealthy weight loss behaviors showed more ethnic variation. CONCLUSIONS: Prevention interventions should take into account the tendency for health-compromising behaviors to co-occur and should be sensitive to demographic and socioeconomic differences in behavior patterns.

Adolescent↗

School-Based Nutrition Education Programs and Services for Adolescents.

School-based nutrition education programs and services can offer a systematic and efficient venue for promoting health-enhancing eating behaviors among youth. This article reviews priority nutrition concerns of adolescents; guidelines for healthful eating; and plans of action schools can take to improve nutritional health of students, including an integrated model for comprehensive school-based nutrition education consisting of eight interrelated components.

Journal Article↗

Body dissatisfaction and unhealthy weight-control practices among adolescents with and without chronic illness: a population-based study.

OBJECTIVE: To compare body dissatisfaction and unhealthy weight-loss practices among adolescents with and without chronic illness. DESIGN: Survey. PARTICIPANTS: The sample consisted of 2149 adolescent boys and girls with diabetes, asthma, attention deficit disorder, physical disabilities, or seizure disorders; and a comparison group of 1381 adolescents without chronic illness. MAIN OUTCOME MEASURES: Body concerns, binge eating, frequent dieting, vomiting, and laxative or diuretic use among adolescents. RESULTS: Adolescents with chronic illness reported higher body dissatisfaction and engaged in more high-risk weight-loss practices than adolescents without chronic illness. This trend was consistent across the different conditions and was not limited to those with a nutrition-related condition such as diabetes. The trend remained after conducting logistic regression and controlling for age, race, socioeconomic status, and body mass index. CONCLUSIONS: Adolescents with chronic illness are at high risk for engaging in unhealthy weight-loss practices and should be screened and targeted for prevention and treatment.

Adolescent↗

Ethnic/racial and socioeconomic differences in dieting behaviors and body image perceptions in adolescents.

This study examined differences in perceptions of body weight, dieting, unhealthy eating behaviors, and weight control methods among adolescent males and females of various racial/ethnic and socioeconomic (SES) subgroups. Data were derived from a comprehensive health survey administered to 36,320 students in grades 7 through 12 in Minnesota. Differences among ethnic/racial and SES groups were assessed using multivariate logistic regression controlling for grade and body mass index (BMI). Results showed that unhealthy weight control behaviors are not confined to upper SES white females. Compared to white females, Hispanic females reported greater use of diuretics; Asians reported more binge eating; and blacks reported higher rates of vomiting. Black and American Indian females were more likely to be satisfied with their body. Among males and females, higher SES was associated with greater weight satisfaction and lower rates of pathological weight control behaviors. Findings from this study suggest that future research should focus on the validity of self-reports of dieting and weight control behaviors in different ethnic subgroups.

Body Image↗

Self-esteem and obesity in children and adolescents: a literature review.

The relationship between self-esteem and obesity has not received a great deal of empirical evaluation using strong research methodologies. Thus, it is not clear whether self-esteem is consistently related to obesity, whether the relationship is global or specific to physical appearance, whether the relationship differs by demographic variables such as age, gender or race/ethnicity, or whether self-esteem moderates weight changes during weight loss treatment programs. This review examines these questions using empirical evidence from 35 studies on the relationship between self-esteem and obesity in children and adolescents. Thirteen of 25 cross sectional studies clearly showed lower self-esteem in obese adolescents and children. Five of the six cross-sectional studies that included a measure of body esteem found lower body esteem in obese compared to normal weight children and adolescents. Results from two prospective studies examining initial self-esteem and later obesity were inconsistent. Results from six of eight treatment studies showed that weight loss treatment programs appear to improve self-esteem. However, it is unclear whether increases in self-esteem are related to enhanced weight loss. Many studies were methodologically weak primarily due to small and select samples and lack of appropriate comparison groups. Implications for prevention and treatment of childhood obesity are discussed.

Adolescent↗

Frequent dieting among adolescents: psychosocial and health behavior correlates.

OBJECTIVES: The present study examined correlates of frequent dieting in 33,393 adolescents. It was hypothesized that frequent dieting would be correlated with negative psychosocial and health behavior outcomes. METHODS: A comprehensive, school-based health behavior survey was administered in 1987 to public school students in grades 7 through 12 in Minnesota. Students self-reported dieting behavior; substance use; suicidal, sexual, and delinquent behavior; family and peer concerns; sick days; and abuse history. Differences on psychosocial and health behavior risk factors by dieting frequency and by purging status were assessed with multivariate logistic regression, with body mass index and demographic variables controlled. RESULTS: Dieting frequency was associated with history of binge eating (females: odds ratio [OR] = 1.46, males: OR = 1.53); poor body image (females: OR = 0.56, males: OR = 0.63); lower connectedness to others (females: OR = 0.79); greater alcohol use (females: OR = 1.17); and greater tobacco use (females: OR = 1.08). Purging status was independently associated with negative risk factors in both males and females. CONCLUSIONS: These findings suggest that frequent dieting efforts in adolescents should not be viewed in isolation, but rather in the broader context of health and risk-taking behaviors.

Adolescent↗

Weight perceptions and weight control practices in American Indian and Alaska Native adolescents. A national survey.

OBJECTIVE: To assess weight perceptions and weight control practices among American Indian-Alaska Native adolescents. DESIGN: Survey. SETTING: Nonurban schools from eight Indian Health Service areas. PARTICIPANTS: A total of 13,454 seventh- through 12th-grade American Indian-Alaska Native youths. MAIN OUTCOME MEASURES: A revised version of the Adolescent Health Survey, a comprehensive, anonymous self-report questionnaire with eating- and body image-related questions. RESULTS: Forty-one percent of the adolescent girls reported feeling overweight, 50% were dissatisfied with their weight, and 44% worried about being overweight. Almost half (48%) had been on a weight-loss diet in the past year, with 27% reporting that they had self-induced vomiting at some time to try to lose weight. Eleven percent reported using diet pills. Girls who reported feeling overweight were more likely to engage in unhealthy weight control practices than were those who felt they were of normal weight or underweight. A larger proportion of boys were satisfied with their weight (68%), with 22% worrying about being overweight. However, compared with rural Minnesota youth, both American Indian girls and boys had greater dissatisfaction with body weight. CONCLUSIONS: Our study shows that American Indian youth, particularly girls, are dissatisfied with their weight and are worried about being overweight, and that unhealthy weight control practices are common. More attention needs to be placed on developing culturally appropriate weight management programs for Indian youths.

Adolescent↗

Food advertisements during children's Saturday morning television programming: are they consistent with dietary recommendations?

Children in the United States spend more time watching television than they do in any other activity except sleep. Given the number of food commercials to which children are exposed, we thought it would be of interest to examine current food advertising during children's television programs and to assess whether the products advertised are consistent with dietary recommendations for good health. The 52.5 hours of children's Saturday morning television we viewed from five major networks contained 997 commercials selling a product and 68 public service announcements. Of the 564 food advertisements (56.5% of all advertisements), 43.6% advertised foods classified in the fats, oils, and sweet food group. The most frequently advertised product was high-sugar cereals. We found that commercials broadcast during children's Saturday morning programming promote foods predominantly high in fat and/or sugar, many of which have relatively low nutritional value. As such, the diet presented on Saturday morning television is the antithesis of what is recommended for healthful eating for children. We conclude that the issue of television food advertising to young children be revisited on a national level.

Adolescent↗

Induction of apoptotic cell death in chronic lymphocytic leukemia by 2-chloro-2'-deoxyadenosine and 9-beta-D-arabinosyl-2-fluoroadenine.

2-Chloro-2'-deoxyadenosine (CldAdo) and 9-beta-D-arabinosyl-2-fluoroadenine (F-ara-A) have shown marked activity in the treatment of indolent lymphoid malignancies. Based on the susceptibility of various lymphocyte populations to apoptosis, we investigated whether CldAdo or F-ara-A would induce this process in lymphocytes from patients with chronic lymphocytic leukemia (CLL). In vitro exposure of leukemic lymphocytes to CldAdo or F-ara-A for 24 to 72 hours elicited features of apoptosis visible by light and electron microscopy. Analysis of DNA integrity showed DNA cleavage into nucleosomal-sized multimers. Using a quantitative assay, drug-induced DNA fragmentation was both time and dose dependent. Inhibition of active macromolecular synthesis did not prevent drug-induced fragmentation; however, both drug-induced and spontaneous DNA fragmentation were prevented by intracellular calcium chelation. In vitro culture with phorbol ester generally decreased drug-induced DNA cleavage. After prolonged incubation, CLL cells exhibited spontaneous cleavage; albeit, at significantly lower rates than drug-treated cells. Heterogeneity was observed for spontaneous and drug-induced DNA fragmentation and was significantly lower in B-leukemic cells obtained from patients with high-risk and refractory disease. We conclude that CldAdo and F-ara-A are potent inducers of apoptotic death in CLL and that this feature correlates with the disease status.

Adenosine Triphosphate↗

Indications of early obesity in low-income Hmong children.

OBJECTIVE: To determine if there is evidence of obesity in low-income Hmong children. DESIGN: Cross-sectional survey. SETTING: Women, Infants, and Children clinics in Minneapolis, Minn. PARTICIPANTS: 271 US-born Hmong children, ages 1.00 through 4.99 years. SELECTION PROCEDURES: Consecutive sample of all Hmong children seen in two clinics between September and December 1989. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Heights and weights were measured and converted to National Center for Health Statistics z scores of weight for age, height for age, and weight for height. Relative to National Center for Health Statistics reference data, mean height-for-age z scores decline progressively after age 2 years to--1.2 z at age 4.5 years. Mean weight-for-height z scores exceeded the National Center for Health Statistics reference significantly at ages 3 and 4 years, and there was more than a fourfold excess of Hmong children beyond the 95th percentile in weight for height at these ages. CONCLUSIONS: There is evidence of early obesity in Hmong children, an ethnic group heretofore considered to be a low risk for obesity.

Asia, Southeastern↗

Validity of self-reported weight and stature of American Indian youth.

Stature, weight, and body mass index (BMI) were obtained by self-reports and by measurements for 69 American Indian youth, 12-19 years of age, to determine the validity of self-reported values for research and clinical use. Self-reported weight was significantly less than measured weight by 2.64 kg and 2.76 kg for boys and girls, respectively. There was no systematic bias in self-reported stature in either sex. BMI based on self-reported values was significantly less than measured BMI by about 1 kg/m2 in each sex. Reporting errors for weight and BMI were related to measured size, with the greatest underestimates at the highest values of measured weight and BMI. If the patterns observed in this sample exist more widely, self-reported measures may not be acceptable proxies for measured values.

Adolescent↗

Reducing fat and sodium in school lunch programs: the LUNCHPOWER! Intervention Study.

This study developed, implemented, and evaluated a healthful school lunch program that provided tasty food choices that were lower in fat and sodium. The LUNCHPOWER! Intervention Program was implemented in 34 elementary schools in four school districts that represented diverse geographic areas of Minnesota. A team of registered dietitians, foodservice directors, and cook managers reduced the fat and sodium content of school lunches by modifying recipes and food preparation methods and by identifying and selecting vendor products (prepared food products) that were lower in fat and sodium. Nutrition education messages for students and parents were developed for the 5-month intervention. Monthly menus were analyzed for fat, sodium, and energy content before and after the intervention. There was a significant decrease in both total grams of fat and percent of energy from fat between baseline and follow-up. At all 34 schools, mean daily amount of total fat in the lunch menu decreased 39% (from 32 g to 20 g) and percent of energy from fat decreased 29% (from 40% to 28%). We found that schools could serve lower-sodium and lower-fat meals and retain student participation in the school lunch program.

Child↗

Demographic and risk factors associated with chronic dieting in adolescents.

A comprehensive, school-based survey was administered to 36,320 Minnesota public school students in grades 7 through 12 during the 1987-1988 school year. Self-reported chronic dieting was much higher in girls than in boys (12.1% of all girls vs 2.1% of boys). For girls, the percentage of chronic dieters was significantly less in grades 7 and 8 (7.8%) than in grades 9 and 10 (13.5%) or grades 11 and 12 (14.3%). There were no differences among urban, suburban, or rural youth. Black girls were less likely to diet compared with white girls. Chronic dieters were more likely than other students to report maladaptive weight-loss techniques, such as self-induced vomiting (relative risk, 9.92 for girls and 9.40 for boys), laxative use (relative risk, 7.18 for girls and 11.00 for boys), ipecac use (relative risk, 8.33 for girls and 11.00 for boys), and diuretic use (relative risk, 7.30 for girls and 13.5 for boys). It is suggested that chronic dieting may serve as a screening marker for more severe eating and weight-loss behaviors.

Adolescent↗

Prevalence of obesity in American Indians and Alaska Natives.

Obesity is an important risk factor for cardiovascular diseases and non-insulin-dependent diabetes, which are chronic diseases that afflict American Indians and Alaska Natives today. Because American Indians are not represented in most national health and nutrition surveys, there is a paucity of data on actual prevalence of obesity in American Indians. We estimated prevalence of overweight and obesity for American Indian adults, school-age children, and preschool children from existing data. The prevalence of obesity in adults was estimated from self-reported weights and heights obtained from a special survey of American Indians performed as part of the 1987 National Medical Expenditure Survey. Prevalence of obesity in American Indians was 13.7% for men and 16.5% for women, which was higher than the US rates of 9.1% and 8.2%, respectively. Obesity rates in American Indian adolescents and preschool children were higher than the respective rates for US all-races combined.

Adolescent↗

The prime time diet: a content analysis of eating behavior and food messages in television program content and commercials.

The purpose of this study was to identify and analyze messages related to food and eating behavior as presented on prime time television (8:00-11:00 pm) both in programming and commercials. Food references occurred an average of 4.8 times per 30 minutes of programming time. Over half (60 percent) of all food references in programs were for low nutrient beverages and sweets. The prime time diet is inconsistent with dietary guidelines for healthy Americans.

Advertising↗