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PubMed2004

Special Supplemental Nutrition Program for Women, Infants, and Children participation and infants' growth and health: a multisite surveillance study.

CONTEXT: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is the largest food supplement program in the United States, serving almost 7 500 000 participants in 2002. Because the program is a grant program, rather than an entitlement program, Congress is not mandated to allocate funds to serve all eligible participants. Little is known about the effects of WIC on infant growth, health, and food security. OBJECTIVE: To examine associations between WIC participation and indicators of underweight, overweight, length, caregiver-perceived health, and household food security among infants < or =12 months of age, at 6 urban hospitals and clinics. DESIGN AND SETTING: A multisite study with cross-sectional surveys administered at urban medical centers in 5 states and Washington, DC, from August 1998 though December 2001. PARTICIPANTS: A total of 5923 WIC-eligible caregivers of infants < or =12 months of age were interviewed at hospital clinics and emergency departments. MAIN OUTCOME MEASURES: Weight-for-age, length-for-age, weight-for-length, caregiver's perception of infant's health, and household food security. RESULTS: Ninety-one percent of WIC-eligible families were receiving WIC assistance. Of the eligible families not receiving WIC assistance, 64% reported access problems and 36% denied a need for WIC. The weight and length of WIC assistance recipients, adjusted for age and gender, were consistent with national normative values. With control for potential confounding family variables (site, housing subsidy, employment status, education, and receipt of food stamps or Temporary Assistance for Needy Families) and infant variables (race/ethnicity, birth weight, months breastfed, and age), infants who did not receive WIC assistance because of access problems were more likely to be underweight (weight-for-age z score = -0.23 vs 0.009), short (length-for-age z score = -0.23 vs -0.02), and perceived as having fair or poor health (adjusted odds ratio: 1.92; 95% confidence interval: 1.29-2.87), compared with WIC assistance recipients. Rates of overweight, based on weight-for-length of >95th percentile, varied from 7% to 9% and did not differ among the 3 groups but were higher than the 5% expected from national growth charts. Rates of food insecurity were consistent with national data for minority households with children. Families that did not receive WIC assistance because of access problems had higher rates of food insecurity (28%) than did WIC participants (23%), although differences were not significant after covariate control. Caregivers who did not perceive a need for WIC services had more economic and personal resources than did WIC participants and were less likely to be food-insecure, but there were no differences in infants' weight-for-age, perceived health, or overweight between families that did not perceive a need for WIC services and those that received WIC assistance. CONCLUSIONS: Infants < or =12 months of age benefit from WIC participation. Health care providers should promote WIC utilization for eligible families and advocate that WIC receive support to reduce waiting lists and eliminate barriers that interfere with access.

Body Height↗
PubMed2003

Heaviness perception. III. Weight/aperture in the discernment of heaviness in cubes haptically perceived by thumb-index finger grasp.

Weight/aperture (W/A) and weight/square aperture (W/A2) rather than weight (W) previously emerged as possible heaviness models for when a cube is haptically held by thumb-index finger grasp. This is based on the convincing evidence that discernment of a cube's heaviness depends on the integration of sensory information about W and size of finger aperture (A). The present study, therefore, determined which model would be the best predictor for subject-perceived heaviness. Fifteen subjects were asked to judge whether the second of a pair of cubes was heavier, lighter, or identical to the first in 3 x 3 (density x weight) conditions. The subject responses were compared with the expected responses for each of the possible heaviness models as well as W. The percentage of consistent trials, i.e., subject response matched the expected response, was then compared among the three models and conditions within each model. The results indicated that subject responses were significantly more consistent with the expected responses determined from W/A compared with those determined from W or W/A2, suggesting W/A as a best predictor of perceived heaviness by finger-grasp perception. W/A2, however, reflected subject responses almost as accurately as W/A could and was, therefore, discussed as one of possible heaviness models when subjects perceive heaviness with different sensory modality.

Adolescent↗
PubMed2003

Differences in body shape representations among young adults from a biracial (Black-White), semirural community: the Bogalusa Heart Study.

In this study, the authors examined body image perception and body mass index (weight (kg)/height (m)(2)) among race-gender groups in a biracial (Black-White) population of young adults in Bogalusa, Louisiana. A mail-out survey was completed in 1994 by 3,698 (65%) participants aged 18.5-35 years in the Bogalusa Heart Study (mean age = 27.6 years). As part of the survey, body image perception was determined in terms of body shape representations from a figure rating scale. A body image discrepancy score was calculated from the difference between z-standardized values of body image perception and body mass index. A stepwise proportional odds model including the covariates income, employment, education, and physical activity was used to identify factors influencing lower perception of body shape. Mean body mass index was highest among Black females (p < 0.001). The odds of having a lower perception of body shape (vs. body mass index) were 1.72 times higher in Blacks (p < 0.001), 0.80 times lower in persons who were currently employed (p < 0.001), and 0.86 times lower in persons with a higher education (p = 0.032). Gender, income, and physical activity were not found to be significant predictors of body image perception (p > 0.05). The authors conclude that significant differences exist within racial groups concerning body image perception in relation to overweight status among young adults. This has implications for prevention and education programs.

Adult↗
PubMed2000

Does weight loss maintenance become easier over time?

OBJECTIVE: Studies of health-related behaviors, including weight loss, have shown that risk of relapse decreases over time, although reasons for this relationship are unclear. The purpose of this cross-sectional study was to determine if subjects who have maintained weight losses for varying periods of time report different strategies for weight loss maintenance or differences in the effort and pleasure associated with weight maintenance behaviors. RESEARCH METHODS AND PROCEDURES: Subjects were 758 women and 173 men who had maintained losses of at least 30 lb (mean = 60 lb) for 2 years or longer (mean = 6.8 +/- 7.0 years). Self-administered questionnaires assessed subjects' use of weight maintenance strategies in the past year and their perceptions of the effort, attention, and pleasure associated with weight maintenance. RESULTS: Subjects who had maintained weight losses longer used fewer weight maintenance strategies and reported that less effort was required to diet and maintain weight and that less attention was required to maintain weight. The pleasure derived from exercise, low-fat eating, and maintaining weight was unrelated to duration of weight loss maintenance. DISCUSSION: As duration increases, a shift in the balance between the effort and pleasure of weight maintenance may occur. This shift may increase the likelihood of continued maintenance.

Adult↗
PubMed2003

Xerostomia: 12-month changes in saliva production and its relationship to perception and performance of swallow function, oral intake, and diet after chemoradiation.

BACKGROUND: Previous investigators have found permanent changes in saliva production after chemoradiation but have not examined these in relation to swallowing measures, diet changes, and patient comfort over time. METHODS: Thirty patients with advanced stage cancer of the oropharynx treated with chemoradiation were followed with videofluoroscopic swallow studies, a measure of stimulated total saliva production, a questionnaire of their perception of dry mouth, and a questionnaire on the nature of their oral intake at pretreatment until 12 months after treatment. RESULTS: Saliva declined significantly from pretreatment to 12 months. Swallowing-related complaints increased significantly over the 12 months, especially in patients with lower saliva weights. Diet choices increased over time after treatment, except crunchy foods. Swallow measures did not relate to saliva weight. CONCLUSIONS: Reduced saliva weight does not correlate with slowed or inefficient swallow. Instead, reduced saliva weight seems to change patients' perceptions of their swallowing ability and, on that basis, their diet choices.

Adult↗
PubMed2006

Action understanding requires the left inferior frontal cortex.

Numerous studies have established that inferior frontal cortex is active when hand actions are planned, imagined, remembered, imitated, and even observed. Furthermore, it has been proposed that these activations reflect a process of simulating the observed action to allow it to be understood and thus fully perceived. However, direct evidence for a perceptual role for left inferior frontal cortex is rare, and linguistic or motor contributions to the reported activations have not been ruled out. We used repetitive transcranial magnetic stimulation (rTMS) over inferior frontal gyrus during a perceptual weight-judgement task to test the hypothesis that this region contributes to action understanding. rTMS at this site impaired judgments of the weight of a box lifted by a person, but not judgements of the weight of a bouncing ball or of stimulus duration, and rTMS at control sites had no impact. This demonstrates that the integrity of left inferior frontal gyrus is necessary to make accurate perceptual judgments about other people's actions.

Brain Mapping↗
PubMed1998

Mothers, daughters and dieting: investigating the transmission of weight control.

OBJECTIVES: Research by Pike & Rodin (1991) found higher levels of weight concern and dissatisfaction with family functioning in mothers of eating disordered adolescent girls. The present study sought to extend this research by examining the maternal influences on weight and dieting concerns at a younger age. DESIGN: A cross-sectional comparison of high and low dietary restraint girls and their mothers was used. METHODS: Two groups of 20 11-year-old girls and their mothers completed assessments of dietary restraint, body shape preference, self-perception, family functioning and body weight and height. RESULTS: Mothers of high restraint girls did not differ from comparison mothers in their current level of dieting, but did report more between-meal snacking and fasting. In addition, they rated their daughters' attractiveness significantly lower than the other mothers. Furthermore, families with a highly restrained daughter scored significantly lower on perceived family cohesion, organization and moral-religious emphasis. CONCLUSIONS: The parallel with the findings of Pike & Rodin supports the role that mothers may play in the transmission of cultural values regarding weight, shape and appearance. Importantly, it also places early dieting within a wider context of dissatisfaction with family functioning.

Adult↗
PubMed2006

What women want: understanding obesity and preferences for primary care weight reduction interventions among African-American and Caucasian women.

PURPOSE: To explore attitudes and perceptions of obesity, and identify preferences for weight-management interventions by African-American and Caucasian women who were followed in general internal medicine clinics. PROCEDURE: Surveys exploring these issues were mailed to African-American (n=240) and Caucasian (n=240) women with a BMI of > or =30. MAIN FINDINGS: Caucasian women felt past weight-loss efforts were helped by weight-loss programs significantly more than African-American women (P<0.001); African-American women were more likely to feel that their cultural background contributed to their weight gain than did Caucasian women (P=0.001). African-American women expressed a higher need for one-on-one counseling with their physician (P<0.001) as well as group meetings with the dietician, physician and other women (P=0.004) than did Caucasian women. African-American women also felt it was more important for weight-loss programs to have information on food common to their culture than did Caucasian women (P<0.001). CONCLUSIONS: Differences in cultural background and preferences about weight loss interventions have important policy implications for how the U.S. healthcare system provides care to an ever-increasing multicultural population with a national epidemic such as obesity.

Black or African American↗
PubMedDate not supplied

Altered perceptions after upper and lower extremity blocks: an initial investigation.

BACKGROUND AND OBJECTIVES: Nerve blocks frequently produce unusual altered perceptions in the extremities. We examined perceptual changes experienced after peripheral blocks. METHODS: Fifty consecutive patients having an upper or lower extremity block for surgery participated in this prospective study. Patients were divided into 2 groups: upper extremity (n = 20) and lower extremity (n = 30). Each group was asked a list of questions about perceptions of limb sensation, length, weight, and location and given a detailed 2-point discrimination test over the V(1)-V(3) divisions of the trigeminal nerve prior to block and sedation. While the extremity was still blocked, the exam was repeated before postanesthesia care unit discharge. RESULTS: In both groups, 98% of patients described altered limb perception. The perceptions in the upper extremity were: heaviness, 60%; numbness, 50%; warmth, 40%; pain, 30%; full or fat, 20%; floating, 5%; shorter, 0%; or thinner, 10%. The perceptions in the lower extremity were: numbness, 75%; heaviness, 46%; warmth, 33%; pain, 32%; full or fat, 36%; floating, 25%; shorter, 18%, or thinner, 7%. Upper extremity block patients were more likely to describe the limb as lighter (P <.0001); the lower extremity group was more likely to describe the limb as numb (P =.01) or floating (P =.0002). There was no difference in the ability to correctly identify the location of the limb between the groups. There was no difference in 2-point discrimination between each assessment for either group. CONCLUSION: The results of this study confirm and quantify the perceptions experienced by patients undergoing upper and lower extremity blocks. These perceptions are prevalent. This knowledge is helpful in providing patients with accurate preoperative preparation. Further investigation is warranted to determine the neurologic etiology of these observations.

Adult↗
PubMed1998

Serotonin neuronal function and selective serotonin reuptake inhibitor treatment in anorexia and bulimia nervosa.

Anorexia nervosa (AN) and bulimia nervosa (BN) are disorders characterized by aberrant patterns of feeding behavior and weight regulation, and disturbances in attitudes toward weight and shape and the perception of body shape. Emerging data support the possibility that substantial biologic and genetic vulnerabilities contribute to the pathogenesis of AN and BN. Multiple neuroendocrine and neurotransmitter abnormalities have been documented in AN and BN, but for the most part, these disturbances are state-related and tend to normalize after symptom remission and weight restoration; however, elevated concentrations of 5-hydroxyindoleacetic acid in the cerebrospinal fluid after recovery suggest that altered serotonin activity in AN and BN is a trait-related characteristic. Elevated serotonin activity is consistent with behaviors found after recovery from AN and BN, such as obsessionality with symmetry and exactness, harm avoidance, perfectionism, and behavioral over control. In BN, serotonergic modulating antidepressant medications suppress symptoms independently of their antidepressant effects. Selective serotonin reuptake inhibitors (SSRIs) are not useful when AN subjects are malnourished and under-weight; however, when given after weight restoration, fluoxetine may significantly reduce the extremely high rate of relapse normally seen in AN. Nonresponse to SSRI medication in ill AN subjects could be a consequence of an inadequate supply of nutrients, which are essential to normal serotonin synthesis and function. These data raise the possibility that a disturbance of serotonin activity may create a vulnerability for the expression of a cluster of symptoms that are common to both AN and BN and that nutritional factors may affect SSRI response in depression, obsessive-compulsive disorder, or other conditions characterized by disturbances in serotonergic pathways.

Anorexia Nervosa↗
PubMed1999

Predicting longitudinal growth curves of height and weight using ecological factors for children with and without early growth deficiency.

Growth curve models were used to examine the effect of genetic and ecological factors on changes in height and weight of 225 children from low income, urban families who were assessed up to eight times in the first 6 y of life. Children with early growth deficiency [failure to thrive (FTT)] (n = 127) and a community sample of children without growth deficiency (n = 98) were examined to evaluate how genetic, child and family characteristics influenced growth. Children of taller and heavier parents, who were recruited at younger ages and did not have a history of growth deficiency, had accelerated growth from recruitment through age 6 y. In addition, increases in height were associated with better health, less difficult temperament, nurturant mothers and female gender; increases in weight were associated with better health. Children with a history of growth deficiency demonstrated slower rates of growth than children in the community group without a history of growth deficiency. In the community group, changes in children's height and weight were related to maternal perceptions of health and temperament and maternal nurturance during feeding, whereas in the FTT group, maternal perceptions and behavior were not in synchrony with children's growth. These findings suggest that, in addition to genetic factors, growth is dependent on a nurturant and sensitive caregiving system. Interventions to promote growth should consider child and family characteristics, including maternal perceptions of children's health and temperament and maternal mealtime behavior.

Body Height↗
PubMed2002

Chronic placental insufficiency has long-term effects on auditory function in the guinea pig.

Very low birth weight and growth-restricted infants have an increased risk of auditory impairments. It is uncertain whether these impairments are related to adverse pre-, peri- or postnatal events. We aimed to determine whether a period of chronic placental insufficiency (CPI) in the guinea pig results in long-term alterations to auditory function. Near mid-gestation, CPI was induced via unilateral ligation of the uterine artery. At 8 weeks of age, auditory brainstem responses (ABRs) were recorded in response to unilateral acoustic stimulation in prenatally-compromised (PC, n=8) and control animals (n=8). Stimuli consisted of 100 micros clicks, presented at 33 pulses per second (pps) and tone pip stimuli at frequencies of 2, 4, 8, 16 and 32 kHz. To examine temporal response properties, click stimuli were also presented at rates of 66, 132 and 200 pps. Normal ABR waveforms were elicited by both click and tone pip stimuli in all animals. Moreover, there was no difference between control and PC animals in stimulus detection thresholds across the frequencies examined. Using high rate click stimuli, PC animals demonstrated a significant increase in both the latency of wave III (normalised to 33 pps) and the wave I-III inter-peak interval compared to the controls. We hypothesise that these functional changes reflect alterations in myelination of the auditory brainstem and/or changes in synaptic efficacy. The results suggest subtle deficits in neural conduction in the PC guinea pig at maturity, and may have implications for speech perception abilities of low birth weight or prenatally affected infants.

Acoustic Stimulation↗
PubMed1999

Dieting and the family context of eating in young adolescent children.

OBJECTIVES: The potential for undernutrition and links with eating disorders make early dieting an issue of concern. The aim of this research was to examine the eating patterns, social circumstances of eating, and parental use of food in young adolescent dieters. METHODS: Four hundred and two 12-year-old children (200 girls, 202 boys) completed assessments of dieting, eating patterns, food-related nurturance, and parental control of eating, together with body weight, height, and self-perception. RESULTS: Current dieting (20% girls, 8% boys) was strongly associated with fasting and dietary restraint. Highly restrained children ate fewer meals and snacks and reported significantly greater parental control of their eating. However, they did not differ in the social context of eating or in food-related nurturance. Dieting status was a stronger determinant than body weight of all these differences. CONCLUSIONS: These findings suggest that 12-year-old dieters are quite serious in their nutritional intentions. They also confirm an active role for parents in their children's dieting. Both children and their parents are in need of age and gender-specific advice concerning eating and weight.

Child↗
PubMed2006

Ethnic and sex variations in overweight self-perception: relationship to sedentariness.

OBJECTIVE: With increasing frequency, health promotion messages advocating physical activity are claiming weight loss as a benefit. However, messages promoting physical activity as a weight loss strategy may have limited effectiveness and cross-cultural relevance. We recently found self-perceived overweight to be a more robust correlate of sedentary behavior than BMI in Los Angeles County adults. In this study, we examined ethnic and sex differences in overweight self-perception and their association with sedentariness in this sample. RESEARCH METHODS AND PROCEDURES: We conducted bivariate and multivariate analyses of cross-sectional survey data from a representative sample of Los Angeles County adults. RESULTS: Women were more likely to perceive themselves to be overweight than men overall (73.2% of overweight/non-obese and 24.1% of average weight women vs. 44.5% of overweight/non-obese and 5.6% of average weight men) and within each ethnic group. African-Americans were least likely (41.3% of overweight/non-obese African-Americans self-identified as overweight) and whites were most likely to consider themselves overweight (60.6% of overweight/non-obese whites self-identified as overweight). Overweight (vs. average weight) self-perception was correlated with sedentariness among average weight adults (45.3% vs. 33.0%, p < 0.001), overweight adults (43.4% vs. 33.6%, p < 0.001), men (average and overweight: 38.4% vs. 27.8%, p < 0.001), overweight whites (41.9% vs. 29.7%, p = 0.0012), and African-Americans and Latinos (41.6% vs. 33.9%, p = 0.005). DISCUSSION: These data suggest that our society's emphasis on weight loss rather than lifestyle change may inadvertently discourage physical activity adoption/maintenance among non-obese individuals. However, further research is needed, particularly from prospective cohort and intervention studies, to elucidate the relationship between overweight self-perception and healthy lifestyle change.

Adult↗
PubMed2006

Obesity and risk of low self-esteem: a statewide survey of Australian children.

OBJECTIVE: There is variation in the psychological distress associated with child obesity. Low self-esteem, when observed, provides very little information about the nature of the distress and no indication of the proportion of obese children affected. This study used a domain approach to self-competence to evaluate self-esteem in a representative sample of Australian children. PARTICIPANTS AND METHODS: A total of 2813 children (mean age: 11.3 years) took part in the study. They were recruited from 55 schools and were all in the last 2 years of primary school. Participants completed the Self-perception Profile for Children, a measure of body shape perception, and their height and weight were measured. RESULTS: Obese children had significantly lower perceived athletic competence, physical appearance, and global self-worth than their normal weight peers. Obese girls scored lower in these domains than obese boys and also had reduced perceived social acceptance. Obese children were 2-4 times more likely than their normal weight peers to have low domain competence. In terms of prevalence, 1 of 3 obese boys and 2 of 3 obese girls had low appearance competence, and 10% and 20%, respectively, had low global self-worth. Body dissatisfaction mediated most of the association between BMI and low competence in boys but not in girls. CONCLUSIONS: Obesity impacts the self-perception of children entering adolescence, especially in girls, but in selected areas of competence. Obese children are at particular risk of low perceived competence in sports, physical appearance, and peer engagement. Not all obese children are affected, although the reasons for their resilience are unclear. Quantifying risk of psychological distress alongside biomedical risk should help in arguing for more resources in child obesity treatment.

Adolescent↗
PubMedDate not supplied

Emic perspectives of body weight in overweight and obese white women with limited income.

OBJECTIVE: The purpose of this study was to develop an understanding of body weight from emic perspectives of limited-income overweight and obese white women. DESIGN: In-depth individual interviews, including the use of contour drawings and body dissatisfaction parameters. SETTING: All methods were conducted in the homes of the research participants. PARTICIPANTS: A purposeful sample of limited-income white women (N=25), ages 19 to 44 years. PHENOMENA OF INTEREST: Personal perceptions of attractiveness, health, body weight, and body dissatisfaction. ANALYSIS: Transcripts were analyzed using content analysis. Triangulation of data was achieved by comparing data elicited by different methods in different sections of the interview. RESULTS: Disordered eating habits were common and considered consequences of social, economic, and familial pressures. Food was often used as a means of coping with life pressures. Social and economic barriers were identified as impeding the adoption of more healthful lifestyles. Weight loss was a low priority owing to financial, emotional, familial, and health care constraints. CONCLUSIONS AND IMPLICATIONS: Multidisciplinary programs addressing financial, emotional, and nutritional concerns may be the most effective for weight management among white limited-income women. Additional research is necessary to verify the results of this study with larger samples.

Adult↗
PubMed1997

Effects of surface texture and grip force on the discrimination of hand-held loads.

In this paper, we report the results from two experiments in which subjects were required to discriminate horizontal load forces applied to a manipulandum held with a precision grip. The roughness (and hence friction) of the grip surfaces and required grip force were manipulated. In the first experiment, subjects were instructed to judge the load while maintaining hand position and not letting the manipulandum slip. It was found that performance was influenced by surface texture; a given load was judged to be greater when the surface texture was smooth than when it was rough. This result is consistent with a previous study based on lifting objects and indicates that the effect of surface texture applies to loads in general and not just to gravitational loads (i.e., weight). To test whether the load acting on a smooth object is judged to be greater because the grip force required to prevent it from slipping is larger, a second experiment was carried out. Subjects used a visual feedback display to maintain the same grip force for smooth and rough manipulandum surfaces. In this case, there was no effect of surface texture on load perception. These results provide evidence that perceived load depends on the grip force used to resist the load. The implications of these results in terms of central and peripheral factors underlying load discrimination are considered.

Adolescent↗