Overweight Perception: Associations with Weight Control Goals, Attempts, and Practices among Chinese Female College Students.

BACKGROUND: Concurrent with the dramatic cultural and economic shifts occurring as mainland China becomes increasingly "Westernized," the weight perceptions, ideal body weight, and weight management goals and practices of Chinese females have also undergone significant changes. OBJECTIVE: To investigate relationships between overweight status, weight perception patterns, and weight management goals and practices in Chinese female college students. DESIGN/PARTICIPANTS/SETTING: A cross-sectional analysis was conducted with data from 902 female subjects aged 18 to 25 years participating in the China Seven Cities Study, a health promotion and smoking prevention study conducted in mainland China in 2003. MAIN OUTCOME MEASURES/STATISTICAL ANALYSES: Logistic regression models were used to explore associations between overweight status, weight perception, specific weight management goals and practices, and current levels of vigorous-intensity physical activity and food consumption. RESULTS: Based on World Health Organization standards for Asian adults, 16.7% of college females were overweight or obese, although 50.8% considered themselves to be "too heavy." Among participants perceiving themselves as overweight (n=458), 69.2% (n=371) were inaccurate and did not meet criteria for overweight or obese. The percentage of participants attempting weight loss was 48.2%, and 33.1% wanted to maintain their current weight. Attempts to lose or maintain weight were related to actual and perceived weight status, but not to increased vigorous-intensity physical activity or fruit and vegetable intake, nor to decreased consumption of sweets, soda, Western fast foods, and fried foods. Only 21.5% of participants desiring weight loss or maintenance reported using a combination of vigorous-intensity physical activity and a reduced-fat and -calorie diet, whereas 20.2% tried extreme methods such as fasting, using diet pills, vomiting, or smoking. CONCLUSIONS: Our findings underscore the need to promote healthy weight management practices among Chinese female college students, with an emphasis on diet and physical activity strategies that encourage balance rather than extremes.

Affective decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in 10th-grade Chinese adolescent smokers.

This study addressed the question of whether poor decision making would be associated with adolescent past 7-day smoking. We conducted a cross-sectional study of 208 10th-grade adolescents in Chengdu City, China. We used the Iowa Gambling Task (IGT) to assess decision-making, and the Self-ordered Pointing Task (SOPT) to assess working memory capacity. Paper and pencil questionnaires assessed the school academic performance (SAP) and smoking variables. The results showed that a significantly higher proportion of past 7-day smokers (91.7%) were susceptible to future smoking and cigarette offers from best friends compared to other levels of smokers (never, ever and past 30-day smokers). Consistent with these behavioral data, the neuropsychological assessments revealed that relative to never smokers, past 7-day adolescent smokers (but not ever smokers or past 30-day smokers) demonstrated significantly lower scores on the IGT. Moreover, a higher proportion of past 7-day smokers (91.7%) performed poorly (no more than an overall net score of 10) on the IGT than nonsmokers and irregular (ever or past 30-day) smokers (about 65.3%). There were no differences on working memory performance for smokers (at any level) compared to never smokers after adjusting for school-type. In addition, logistic regression showed that the IGT significantly predicted past 7-day smoking after controlling for the working memory, school academic performance and demographic variables. These results suggest that poor affective decision making might predispose some adolescents to smoking in the future or in the social situations where their peers are smoking. Intervention targeting affective decision making might hold promise for reducing adolescents' risks for substance use.

Perceived stress, depression and food consumption frequency in the college students of China Seven Cities.

The aim of the study was to explore the association between perceived stress, depression and food consumption frequency. A self-administered questionnaire that included the perceived stress scale, the depression scale and dietary intake was used in the baseline survey of a cohort study of 2579 local college students over 7 cities in China. Gender and city differences were found in perceived stress scores and depression scores. There were also significant differences among diverse smoking levels and among perceived weight categories in perceived stress and depression scores. Stepwise logistic regression models found that frequency of consumption of fresh fruit, ready-to-eat food and snack food had apparently independent effects on perceived stress, whereas the intake level of fresh fruit, ready-to-eat food and fast food was significantly associated with depression. The link between food consumption frequency, perceived stress and depression suggests that diet intervention may be considered a mediate strategy integrated in psychology prevention program among normal population of the college.

Tobacco use among youth and adults in Mainland China: the China Seven Cities Study.

OBJECTIVE: The China Seven Cities Study (CSCS) monitors geographic and temporal trends in tobacco use among adolescents and adults in seven cities throughout Mainland China: Harbin, Shenyang, Wuhan, Chengdu, Kunming, Hangzhou, and Qingdao. This article presents the methodology and prevalence data from the baseline survey of the CSCS, conducted in 2002. METHODS: Stratified random samples of middle schools, high schools, and colleges were selected within each city. Students and their parents completed self-report surveys of their tobacco use. Data were obtained from 6138 middle school students, 5848 academic high school students, 2448 vocational high school students, 2556 college students, and 25 697 parents. RESULTS: Smoking prevalence varied across age groups, school types, genders, and cities. Past-month smoking prevalence was 9% among middle school students, 8% among academic high school students, 26% among vocational high school students, 21% among college students, and 40% among parents. Smoking prevalence was higher among males than among females, with larger gender disparities among adults than among youth. Smoking also varied across cities, with higher smoking prevalence in southwestern cities and lower prevalence in coastal cities. Intraclass correlations of students within schools are presented to inform statistical power estimates for further research in China. CONCLUSIONS: These results provide a baseline for future longitudinal studies of smoking in these cities and identify demographic groups at risk for tobacco-related disease. Effective smoking prevention programmes for youth and smoking cessation programmes for adults are needed in China, especially in the lower-income southwestern cities and in vocational high schools throughout the country.

Influences affecting adolescent smoking behavior in China.

This study examined multiple influences on the use of tobacco by adolescents in China. Using the theory of triadic influences as a guide, we selected interpersonal, attitudinal/cultural, and intrapersonal constructs from baseline data to predict adolescent smoking 1 year later. We used prospective data from middle and high school students (N = 11,583) and their parents from the China Seven Cities Study, a longitudinal study that is evaluating the effects of changing economic and social factors on health behaviors including tobacco use. A multilevel regression analysis provided some support that each of the influences in the theory of triadic influences affects adolescent smoking in China. After adjusting for important confounders including age, gender, socioeconomic status, and smoking behaviors (lifetime and past 30-day) at baseline, we found significant risk factors within each of the three categories, including interpersonal influences (parental monitoring, good friend smoking, and peer smoking), attitudinal/cultural influences (school academic ranking, initial liking of smoking, and the meaning of smoking), and intrapersonal influences (susceptibility to smoking, and low self-confidence to quit smoking). Results suggest that the etiology of smoking among adolescents in China might be similar to that observed in western countries and that some of the techniques used successfully in prevention programs in those countries might be useful guides when developing prevention programs in China.

The interaction of curriculum type and implementation method on 1-year smoking outcomes in a school-based prevention program.

Studies have shown that the effectiveness of programs or curricula may depend in part on who delivers the material. In adolescent health education programs, peer leaders are often recruited to implement programs because they are more persuasive to other adolescents than adults. Teachers also systematically vary how groups are constructed in school-based health education programs. This study compared the effects of three leader and group selection methods within the context of two tobacco prevention programs. Eight schools received a social influences program (Chips) and eight received a program with a multicultural emphasis (Flavor). Within these 16 schools 84 classrooms consisting of 1486 students were randomly assigned to one of three leader and group creation conditions: (i) leaders defined as those who received the most nominations by students and groups created randomly (random group), (ii) same as (i) but groups created by assigning students to the leaders they nominated (network), and (iii) leaders and groups created by teachers (teacher). One year follow-up data showed that main effects of the curriculum and network assignments were non-significant on smoking initiation when entered alone. Interaction terms of curriculum and assignment methods, however, were significant such that the network and teacher conditions were less effective than the random group condition with Chips, and more effective than random group condition with Flavor. These data show that school-based prevention programs should be evaluated in light of who implements the program. Even a peer-led program will be differentially effective based on how leaders are selected and how groups are formed, and this effect may be curriculum dependent.

Hostility, depressive symptoms, and smoking in early adolescence.

Using logistic and multiple regression, we examined the association between hostility, level of depressive symptoms, and smoking in a sample of 1699 ethnically diverse students in California. Self-reports were collected twice from each student, at the beginning of the 6th and 7th grade years. Among 6th graders who had not smoked, depressive symptoms and hostility were associated with smoking initiation by the 7th grade. Among those students who had already tried smoking, increases in depressive symptoms and hostility were associated with more frequent smoking. The association between hostility and smoking was stronger for students reporting higher levels of depressive symptoms.

Sensations from initial exposure to nicotine predicting adolescent smoking in China: a potential measure of vulnerability to nicotine.

Sensations derived from initial exposure to nicotine are a potential indicator of an individual's vulnerability to nicotine. This study assessed whether sensations experienced during the first lifetime exposure to nicotine could predict current and established cigarette smoking. Data from 210 respondents who reported having ever tried cigarette smoking in Wuhan, China, were obtained for this study from 610 students in 10th grade at two schools. Subjects were participants in a multipurpose pilot survey for an adolescent smoking prevention trial. The survey was administered in a classroom setting using a paper-and-pencil questionnaire. Sensations reported were cigarette smell (59.2%), coughing (54.1%), dizziness (52.1%), nausea (42.5%), relaxation (19.1%), and pleasurable buzz/rush (9.0%). After controlling for confounders, multiple logistic regression analyses identified three sensations significantly associated with smoking: (a) Cigarette smell (OR for days smoked in the past 30 days=2.93, p<.05, OR for number of cigarettes smoked per day=2.69, p<.05, and OR for 100-cigarette smoking=5.40, p<.01), (b) pleasurable buzz/rush (OR for 100-cigarette smoking=11.09, p<.05), and (c) relaxation (OR for past 30-day smoking measures ranged from 3.69 to 4.48, p<.01, and OR for 100-cigarette smoking=4.12, p<.05). A dose-response relationship was observed between the sensations and cigarette smoking. Self-reported sensations from initial exposure to nicotine may be a useful indicator of an individual's vulnerability to nicotine. This information can be used for adolescent smoking prevention and cessation interventions.

Bone mass of asian adolescents in China: influence of physical activity and smoking.

INTRODUCTION/PURPOSE: Research addressing the role of biology and behavior on bone development during times of peak bone acquisition in adolescence is limited. The present investigation was conducted to address the influence of body composition (lean body mass, fat mass), menarche, leisure physical activity, sports team participation, smoking, and second-hand smoke on skeletal mass of a unique sample of Asian adolescents in China. METHODS: A total of 166 girls and 300 boys (ages 12-16 yr) participated in this study. Bone mineral density (BMD) and content (bone mineral content (BMC)) of the forearm and the os calcis were measured using dual energy x-ray absorptiometry (DXA); lean body mass (LBM) and fat mass were estimated by bioelectrical impedance analysis (BIA); grip strength was measured by isometric dynamometry. Menarche, leisure physical activity, sports team participation, and active and passive smoking were determined using questionnaire. RESULTS: In girls, a total of 44% of the variance in forearm BMC was attributed to a model which included LBM (32%), time since menarche (10%), and age (2%); heel BMC was best predicted by LBM alone (42%), with no significant contribution by other variables. In boys, a total of 39% of the variance in forearm BMC was attributed to a model which included LBM (28%), age (5%), sports team participation (4%), height (1%), and fat mass (1%); heel BMC was best predicted by LBM (50%) and height (3%), accounting for 53% of the variance. CONCLUSION: The findings of this study suggest that lean body mass is the primary determinant of bone mass in Chinese adolescents. Menarche is also an important contributor in girls, whereas age and sports team participation are secondary predictors of bone mass in boys.

Adolescent smoking in Wuhan, China: baseline data from the Wuhan Smoking Prevention Trial.

BACKGROUND: This study reports the prevalence of adolescent smoking in the urban and rural areas of Wuhan, China, the capital of Hubei Province, on the Yangtze River in central China. METHODS: Smoking behavior was examined by age, gender, and urbanicity as part of the Wuhan Smoking Prevention Trial. Subjects included 6994 seventh- to ninth-grade students attending 22 randomly selected schools in urban and rural districts. Outcome measures included lifetime smoking, past-30-day smoking, established smoking (>100 cigarettes in lifetime), and susceptibility to smoking (absence of a firm commitment not to smoke). RESULTS: Lifetime smoking prevalence was 47% among boys and 18% among girls. Past-30-day smoking prevalence was 16% among boys and 4% among girls. Established smoking prevalence was 2% among boys and 0% among girls. The prevalence of susceptibility to smoking was 31% among boys and 10% among girls. Smoking increased significantly with age (p<.0005). Susceptibility was more prevalent in rural areas than in urban areas (p<.05), but there were no urban-rural differences in lifetime, past 30-day smoking, or established smoking. Trend analyses revealed that smoking increased with age more rapidly among boys than among girls (p<.05). Smoking was more prevalent among rural boys than among urban boys, but it was more prevalent among urban girls than among rural girls (p<.05). CONCLUSIONS: Adolescent smoking is a significant public health problem in China. Boys are at particularly high risk, as are girls living in urban areas. Effective smoking prevention programs for adolescents, as well as restrictions on tobacco industry marketing and youth access to tobacco, are needed to prevent tobacco-related morbidity and mortality in China.