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Attitudes, practices, and concerns about child feeding and child weight status among socioeconomically diverse white, Hispanic, and African-American mothers.

Parents play an important role in the development of their children's eating behaviors. We conducted 12 focus groups (three white, three African-American, and three Hispanic-American low-income groups; three white middle-income groups) of mothers (N=101) of 2- to less than 5-year-old children to explore maternal attitudes, concerns, and practices related to child feeding and perceptions about child weight. We identified the following major themes from responses to our standardized focus group guide: 12 groups wanted to provide good nutrition, and most wanted children to avoid eating too many sweets and processed foods; 12 groups prepared foods their children liked, accommodated specific requests, and used bribes and rewards to accomplish their feeding goals (sweets were commonly used as bribes, rewards, or pacifiers); and 11 of 12 groups believed their children were prevaricating when they said they were full and mothers encouraged them to eat more. The common use of strategies that may not promote healthful weight suggests work is needed to develop culturally and socioeconomically effective overweight prevention programs. Further study is needed to verify racial/ethnic or income differences in attitudes, practices, and concerns about child feeding and perceptions of child weight.

Adult↗

The relationship between maternal child-feeding practices and overweight in Hmong preschool children.

OBJECTIVE: Maternal child-feeding practices have been linked to overweight in several studies. Overweight is a prevalent condition in Hmong preschool children in the United States, therefore, the purpose of this study was to determine whether maternal child-feeding attitudes and practices were associated with overweight in Hmong preschool children. DESIGN: The Child-Feeding Questionnaire (CFQ) was revised and administered to Hmong mothers with normal-weight and overweight children. SETTING: Women, Infant, and Children Supplemental Food Program (WIC) clinics and community centers in the Minneapolis-St. Paul metropolitan area. PARTICIPANTS: Hmong mothers of normal-weight (n=45) and overweight (n=35) children. MAIN OUTCOME MEASURES: Relationships between maternal perceptions of child's weight, practices in child feeding, including monitoring, restriction, and pressure to eat, and overweight status in children. RESULTS: No association was found between maternal attitudes and practices in child feeding and body mass index (BMI) of the child except for mother's perception of her child's weight. Mother's perception of her child's weight was also associated with maternal restriction of certain foods. Mother's education and children's weight status were weakly positively associated. Mothers with more education tended to be younger and to work outside the home. CONCLUSION: The lack of a relationship between maternal child-feeding practices and children's weight status may be due to factors such as mother's education, role of other caregivers, and cultural factors.

Adolescent↗

Self-perceptions of the stigma of overweight in relationship to weight-losing patterns.

Preliminary, exploratory studies examine self-perceptions of the stigma of overweight in relatiopship to weight-losing patterns of female and male children of different ages. It is suggested that the concept of stigma may be a viable analytical tool in studying overweight as: an exclusive focus in interaction, related to a negative body image, overwhelming others with mixed emotions, clashing with other attributes of the person, an equivocal predictor of activities, and related to one's sense of responsibility for one's overweight. Female adolescents in the Slimnastics class in a high school and children and adolescents in an obesity clinic in a hospital were studied. Male children and female adolescents had more trouble losing weight than did female children and male adolescents. Youth who viewed overweight as both one's responsibility and as an illness that required the joint efforts of oneself and others, especially professional experts, were more successful in losing weight than those youth who believed that overweight was solely their responsibility or not at all their responsibility. Intensive focusing on one's overweight and one one's negative body image seemed to inhibit or deter weight losing for some youth.

Adolescent↗

Physician weight counseling for adolescents.

Adolescent obesity prevalence is increasing, with minimal study of physician weight counseling with youth. This study examines adolescents' (n=110) perceptions of physicians' weight counseling. Overweight adolescents (> or =85th percentile for body mass index, BMI) report receiving counseling more than nonoverweight adolescents. Physicians more often have counseled obese (> or =95th BMI percentile) than overweight but not obese adolescents (85th-94th BMI percentile). Prior counseling and adolescents' ethnicity were related to greater perceived physician concern and adolescent receptivity to future counseling. Overweight adolescents report attempting weight loss strategies at rates similar to recommendations, but recommendations for specific weight control behaviors do not increase the likelihood of adolescent attempts. Clin Pediatr. 2002;41:575-585

Adolescent↗

A cross-cultural perspective on adolescent girls' body perception.

The purpose of the study was to examine the body perception of 122 Jamaican adolescent girls. The study is a part of a larger project investigating the psychosocial adjustment of these adolescents. Included in the survey were items asking for demographic information such as height, weight, and age. In addition, subjects were asked to indicate whether they were pregnant and whether they considered themselves under- or overweight. Using the standard system of desirable weight the subjects' perceptions of whether they were under- or overweight were compared with their actual weights. In general, Jamaican adolescent girls had accurate perceptions of their body size and weight.

Adolescent↗

Maternal concern and perceptions of overweight in Australian preschool-aged children.

OBJECTIVE: To assess maternal concern about overweight in Australian preschool-aged children and factors predicting maternal concern about children's current and future weight status. DESIGN: Cross-sectional survey of child's body mass index and parent questionnaire. SETTING: Metropolitan Melbourne, Victoria, 2002. PARTICIPANTS: A community-based cohort of 324 4-year-old children and their parents. MAIN OUTCOME MEASURES: Mothers' reports of concern about the child's current and future weight status, and perceptions of the child's weight, diet and activity relative to their peers were compared with the child's measured weight status, and parent and child characteristics. RESULTS: The prevalence of overweight or obesity was 19%, but only 5% of mothers indicated concern about their child being currently overweight, while 16% worried their child would become overweight. Over 70% of mothers of overweight children saw them as being of similar weight to their peers. Most mothers saw their children as being equally or more active than other children and having a diet at least as healthy as their peers. Overweight daughters were more likely to elicit maternal concern about current weight than overweight sons (relative risk, 4.6; 95% CI, 1.1-19.8). Mothers were more likely to worry about their child's potential for future overweight if they or the child's father were overweight. CONCLUSIONS: Despite mounting public concern about childhood obesity in Australia, most mothers surveyed were not concerned about their child's weight, and many mothers did not perceive their overweight children as different from their peers. This may have implications for interventions that rely on acknowledgement of child overweight as a first step to change.

Adult↗

Behavioral and cognitive effects of smoking: relationship to nicotine addiction.

Nicotine addiction is an extremely complex process that involves biological, psychological, behavioral, and cultural factors. Three factors that influence smoking and that are influenced by smoking are performance, stress, and body weight. We know that if nicotine-addicted smokers are deprived of nicotine, attentional and cognitive abilities can be impaired, and such deficits can be reversed if the person smokes or is given nicotine. In nonsmokers and nondeprived smokers, nicotine enhances finger tapping, focused and sustained attention, recognition memory, and reasoning. Stress results in increased smoking, but there is little empirical evidence that smoking reduces stress. Stress reduction from smoking is likely the relief of withdrawal-induced negative mood that is experienced between cigarettes. Smokers weigh on average 3-4 kg less than nonsmokers, and the weight-gain seen after quitting smoking also averages 3-4 kg. Changes in eating and energy expenditure are responsible for the body weight changes seen during smoking cessation and relapse. We need to know the full range of conditions under which nicotine affects behavior. The mechanisms by which stress functions to maintain nicotine addiction are not well understood. We do not know what interventions are effective in addressing the stress experienced during smoking cessation. Because no effective interventions have been developed to prevent weight-gain after quitting, research should focus on the concern or perception of weight-gain. We need to understand how and why body weight concerns vary across gender, age, and ethnicity because of the implications for designing effective smoking-cessation programs.

Attention↗

Predictors of four functional tasks in patients with osteoarthritis of the knee.

PURPOSE: The purpose of this study was to identify predictors of performance on four functional tasks in adults with osteoarthritis (OA) of the knee. DESIGN: Descriptive correlation. METHODS: A voluntary sample of 78 community dwelling adults who reported knee pain and were previously diagnosed with osteoarthritis of the knee were timed while they performed the functional tasks of going down and getting up off of the floor and ascending and descending a flight of stairs as quickly as possible. Subjects were also evaluated for their joint pain while performing these activities, their leg strength, perceptions of joint pain, stiffness, functional ability, and other health status information. FINDINGS: This study indicates that knee extension strength (quadriceps), joint pain during the activity, perceptions of functional ability and body weight combined can predict between 39% and 56% of the variance in the time to perform four functional tasks in adults with OA of the knee. CONCLUSION: Interventions that improve quadriceps strength and reduce joint pain and body weight along with facilitating perceptions of functional ability may have a positive impact upon the ability to get down to and rise up off of the floor and ascend/descend stairs in adults with OA of the knee.

Activities of Daily Living↗

The relationship between dieting and body image, body ideal, self-perception, and body mass index in Turkish adolescents.

OBJECTIVE: The current study examined the roles of body image, ideal body weight, self-perception, and body mass index (BMI) on the dieting behavior of Turkish adolescents. METHOD: The 531 subjects who participated in the study ranged from 15 to 17 years old and were recruited from five selected high schools in Ankara. They completed the Self-Perception Profile for Adolescents (SPPA), the Body Image Satisfaction Questionnaire (BISQ), and the Dieting Status Measure (DiSM). Height and weight were measured. RESULTS: Dieting adolescents received significantly lower scores than nondieters for most of the BISQ items and for the physical appearance and global self-worth subscales of the SPPA. A thinner body ideal, the physical appearance domain of self-concept, and low global self-worth were the predicting factors of frequent dieting. However, BMI and body image dissatisfaction were not predicting factors. DISCUSSION: The results indicate that a thinner body ideal, low self-worth, and low physical self-concept have more significant effects on body dissatisfaction and dieting than being actually overweight does. Furthermore, high physical self-concept scores and body satisfaction may not necessarily preclude having a thinner body ideal and, hence, dieting in girls.

Adolescent↗

Correlates of body mass index, weight goals, and weight-management practices among adolescents.

The study examined associations among physical activity, cigarette smoking, body mass index, perceptions of body weight, weight-management goals, and weight-management behaviors of public high school adolescents. The CDC Youth Risk Behavior Survey provided a cross-sectional sample (n = 3,089) of public high school students in South Carolina. Logistic regression models were constructed separately for four race-gender groups. Adjusted odds ratios and 95% confidence intervals were calculated to determine the magnitude of associations. Based on self-reported height and weight, 13% of students were overweight, while 15% were at risk for becoming overweight. However, 42% of students were trying to lose weight, and 22% were trying to maintain current weight. Female students were less likely than male students to be overweight, but more likely to be attempting to lose weight. Extreme weight control practices were reported by 27% of the sample. Among Black females trying to lose weight, positive associations were observed for strengthening exercises (OR = 1.55), but that relationship was associated inversely in Black males (OR = .600). Among White females, attempted weight loss was associated with strengthening exercises (OR = 1.72) and cigarette smoking (OR = 1.54). For White males, attempted weight loss was associated positively with vigorous exercise (OR = 1.41) and inversely related to moderate exercise (OR = .617). Effective weight-management practices for adolescents should focus on appropriate eating behaviors, physical activity, and low-fat/calorie diets. Multicomponent weight management interventions should be conducted within a coordinated school health framework.

Adolescent↗

Body percept change in obese females after weight reduction therapy.

Video-image representations of body size were measured on a television monitor that was modified to give a display continuum that ranged from 50% under- to 50% over-estimation of objective size. Sixty-eight females who were undergoing weight reduction counseling were measured before and after treatment. All Ss judged themselves to be significantly more obese than they actually were, with a tendency for errors to be greatest among the more obese Ss. After therapy, more realistic estimates of their physiques ensued. A drop-out rate of 23% was recorded; the drop-outs saw themselves as significantly more obese than those who graduated from the program.

Adolescent↗

Aspects of body image perception in obese and normal-weight youngsters.

Perceptual and projective aspects of body image in obese youngsters (not in psychological treatment) and normal-weight youngsters 8-9 years of age and 12-13 years of age were investigated. The results indicate that perceptual distortions in estimating various body dimensions of oneself are primarily a function of age rather than weight status. The accuracy of estimating the weight of peers and an adult showed an association with the sex of the subject. No group differences were found in terms of projective aspects of body image as measured by barrier and penetration responses. This study suggests that obese youngsters in the middle childhood and entering puberty periods in comparison to normal-weight youngsters of the same age do not manifest differences in perceptual factors of body image.

Adolescent↗

Hefting for a maximum distance throw: a smart perceptual mechanism.

Objects for throwing to a maximum distance were selected by hefting objects varying in size and weight. Preferred weights increased with size reproducing size-weight illusion scaling between weight and volume. In maximum distance throws, preferred objects were thrown the farthest. Throwing was related to hefting as a smart perceptual mechanism. Two strategies for conveying high kinetic energy to projectiles were investigated by studying the kinematics of hefting light, preferred, and heavy objects. Changes in tendon lengths occurring when objects of varying size were grasped corresponded to changes in stiffness at the wrist. Hefting with preferred objects produced an invariant phase between the wrist and elbow. This result corresponded to an optimal relation at peak kinetic energy for the hefting. A paradigm for the study of perceptual properties was compared to size-weight illusion methodology.

Adult↗

Mistakes were made: misperception as a barrier to reducing overweight.

OBJECTIVE: To examine the agreement between individuals' weight status as measured by their body mass index (BMI) and their perceptions of their weight status in the US population. DESIGN: Data from the third National Health and Nutrition Examination Survey, 1988-94 (NHANES III), were used to cross-tabulate actual weight status and self-assessed weight status, identifying population proportions that underassessed or overassessed weight status. The study accounts for gender and socioeconomic and demographic variables to identify subpopulations in which relatively large numbers of individuals misperceive their weight status. MEASUREMENTS: Survey data included clinically measured height and weight. BMI was categorized (overweight, healthy weight, or underweight) following conventional cutpoints. In addition, each surveyed individual was asked to assess their own (categorical) weight status. SUBJECTS: NHANES III is representative of the US population. The sample included 7758 males and 8451 females aged 20 y or above after excluding women who were pregnant or breastfeeding. RESULTS: We show that large segments of the US population misperceive their weight status. The mix of misperceptions differs by gender, with men who are obese or overweight more likely than obese or overweight women to underassess their weight status. Women who are healthy weight/underweight are more likely than men to believe they are overweight. In addition to the gender differences, underassessors are more frequently found among those aged 65 y and over, individuals with relatively low education levels, lower income levels, and among non-Hispanic black subjects. Overassessors are more frequently found among women less than 65 y old (between the ages of 35 and 64 y for men), individuals with higher education levels, higher income levels, and among non-Hispanic white subjects. CONCLUSIONS: Information programs linking overweight and obesity with health risks might fail to induce diet and lifestyle changes if individuals fail to recognize they are overweight or obese. While there are large number of individuals who fail to recognize their overweight or obese status, there are indicator variables that can help identify this subpopulation. Thus, it is possible to first target a message that would attempt to correct misperceptions. If successful, the size of the population susceptible to a weight-health risk information program could increase.

Adult↗

The impact of a national mass media campaign in The Netherlands on the prevention of weight gain.

OBJECTIVE: A 5-year nationwide mass media campaign aimed at prevention of overweight was organised from 2002 onwards. The present study evaluates the first campaign, which was aimed primarily at increasing awareness of weight gain. DESIGN AND SUBJECTS: Data were collected by telephone interview in four independent cross-sectional surveys among non-obese Dutch adults aged 25-35 years (total n = 1,949) for statistical analyses. Awareness of personal body-weight status, overweight-related risk perceptions, attitudes towards weight-gain prevention, motivation to prevent weight gain and self-reported body mass index (BMI) were measured in each survey. Campaign exposure was assessed in the post-intervention surveys. To identify intervention effects over time multiple linear and logistic regression analyses were used, adjusted for secular time effects and age. RESULTS: After the campaign about 65% of the respondents knew about the campaign. The campaign was associated with more positive attitudes towards the prevention of weight gain (beta = 0.16; P < 0.01) and higher self-reported BMI (beta = 0.14; P < 0.01). CONCLUSIONS: The results suggest that the first campaign reached a large proportion of the population and initiated some positive change in attitudes, but did not achieve significant improvements in other determinants of weight-gain prevention among non-obese young adults.

Adult↗

Length, weight, and width: covariation assessments based on haptic exploration.

Intuitive judgements about covariations of length, weight, and width were assessed in two experiments using a series of propositional statements. In Exp. 1, only a priori judgements were rendered, whereas in Exp. 2 blindfolded participants physically manipulated and described a series of objects varying on these dimensions before rendering their judgements. Analyses indicated participants judged weight and width as positively correlated, length and weight as uncorrelated and, to some extent, length and width as negatively correlated. If judgements are rendered after the haptic exploration phase, weight and width are (again) judged as positively correlated, and length and weight were still judged as uncorrelated. However, after the database intervention. length and width were judged as positively correlated. Results are discussed relative to research on reasoning about covariation and belief perseveration as well as perceived covariations between height, weight, and body fat.

Adipose Tissue↗

Heaviness perception. I. Constant involvement of haptically perceived size in weight discrimination.

With visual input blocked, subjects in this study utilized fingertips only to investigate the involvement of haptically perceived size in heaviness perception among humans. The objects used for testing consisted of three sets - copper (CP), aluminum (AL), and plastic (PL) - of ten cubes of various weights (0.05-0.98 N). All of the cubes were covered with a smooth vinyl material to eliminate any extraneous input concerning the actual composition. Screens enclosed the working space to eliminate any possible visual cues. Each comparison was between a pair of cubes of the same material to eliminate the effect of density. Fifteen subjects ( M=19.2, SD=0.68 years) attempted to judge differences in heaviness between the first and second cube in each trial that had been handed to them by the experimenter and were grasped between the thumb and the index finger. A total of 340 trials with 70 combinations of weight composed of 160 ascending trials (heavier), 160 descending trials (lighter), and 20 identical weight trials were pseudo-randomly presented to each subject for each material. Combinations of difference in weight and the number of trials were identical for all materials so that haptic size was regarded as the single independent factor. Accuracy of the subjects' responses for identical weight differences that resulted from placing a pair of cubes of the same combination was compared among the three materials. It was observed that a material like CP that had a lesser size effect facilitated significantly more accurate discrimination of the identical weight differences than PL with its greater size effect. This suggests that small changes in haptic size by the fingertips have a direct influence on heaviness perception when comparing objects of equal density. This finding, therefore, can be considered analogous to the size-weight illusion when comparing objects of unequal density. The findings of this study also suggest the constant involvement of haptic size in heaviness perception by humans along with the existence of a processing mechanism that integrates the factors of weight and haptic size in which heaviness increases either as weight increases or as size decreases, and vice versa.

Adolescent↗