Television food advertisement exposure and FTO rs9939609 genotype in relation to excess consumption in children.

BACKGROUND/OBJECTIVE: Exposure to food advertisements may cue overeating among children, especially among those genetically predisposed to respond to food cues. We aimed to assess how television food advertisements affect eating in the absence of hunger among children in a randomized trial. We hypothesized that the fat mass and obesity-associated gene (FTO) rs9939609 single-nucleotide polymorphism would modify the effect of food advertisements. SUBJECTS/METHODS: In this randomized experiment, 200 children aged 9-10 years were served a standardized lunch and then shown a 34-min television show embedded with either food or toy advertisements. Children were provided with snack food to consume ad libitum while watching the show and we measured caloric intake. Children were genotyped for rs9939609 and analyses were conducted in the overall sample and stratified by genotype. A formal test for interaction of the food advertisement effect on consumption by rs9939609 was conducted. RESULTS: About 172 unrelated participants were included in this analysis. Children consumed on average 453 (s.d.=185) kcals during lunch and 482 (s.d.=274) kcals during the experimental exposure. Children who viewed food advertisements consumed an average of 48 kcals (95% confidence interval: 10, 85; P=0.01) more of a recently advertised food than those who viewed toy advertisements. There was a statistically significant interaction between genotype and food advertisement condition (P for interaction=0.02), where the difference in consumption of a recently advertised food related to food advertisement exposure increased linearly with each additional FTO risk allele, even after controlling for body mass index percentile. CONCLUSIONS: Food advertisement exposure was associated with greater caloric consumption of a recently advertised food, and this effect was modified by an FTO genotype. Future research is needed to understand the neurological mechanism underlying these associations.

Disordered eating and injuries among adolescent ballet dancers.

BACKGROUND: Ballet dancers are at elevated risk for eating disorders, but the extent to which disordered eating attitudes and behaviors represent a relatively benign adaptation to an environment that values extreme thinness, or a functionally impairing form of psychopathology, has sparked considerable debate. METHOD: To determine whether disordered eating is associated with role impairment in dancers, we evaluated its association with musculoskeletal injuries among 239 adolescent female ballet students. RESULTS: Dance students reported a variety of lifetime disordered eating behaviors to control weight including fasting (29.3%), vomiting (9.6%), and laxative use (4.2%). More than half (52.3%) reported a lifetime history of injury (stress fracture, broken bone, and/or medically treated tendonitis). A greater number of lifetime disordered eating behaviors was associated with a greater number of lifetime injuries (p=0.01). Moreover, vomiting history was associated with greater likelihood of injury (p=0.004) and increased time to recover from injury (median difference=22.8 days, p=0.006). CONCLUSION: Although the direction of causality cannot be determined from this retrospective design, these results suggest that disordered eating is associated with role-relevant functional impairment, even among members of a subculture that values extreme thinness.

Comparing the effects of entertainment media and tobacco marketing on youth smoking.

OBJECTIVES: To examine the concurrent effects of exposure to movie smoking and tobacco marketing receptivity on adolescent smoking onset and progression. METHODS: Cross-sectional study of 4524 northern New England adolescents aged 10-14 in 1999 with longitudinal follow-up of 2603 baseline never-smokers. Cross-sectional outcomes included ever tried smoking and higher level of lifetime smoking among 784 experimenters. The longitudinal outcome was onset of smoking among baseline never-smokers two years later. Movie smoking exposure was modelled as four population quartiles, tobacco marketing receptivity included two levels-having a favourite tobacco advert and wanting/owning tobacco promotional items. All analyses controlled for sociodemographics, other social influences, personality characteristics of the adolescent and parenting style. RESULTS: In the full cross-sectional sample, 17.5% had tried smoking; both exposure to movie smoking and receptivity to tobacco marketing were associated with having tried smoking. Among experimental smokers, the majority (64%) were receptive to tobacco marketing, which had a multivariate association with higher level of lifetime smoking (movie smoking did not). In the longitudinal study 9.5% of baseline never-smokers tried smoking at follow-up. Fewer never-smokers (18.5%) were receptive to tobacco marketing. Movie smoking had a multivariate association with trying smoking (receptivity to tobacco marketing did not). CONCLUSIONS: The results suggest separate roles for entertainment media and tobacco marketing on adolescent smoking. Both exposures deserve equal emphasis from a policy standpoint.

Neuroanatomical evidence for distinct cognitive and affective components of self.

This study examines whether the cognitive and affective components of self-reflection can be dissociated using functional magnetic resonance imaging. Using a simple paradigm in which subjects judged the personal relevance of personality characteristics that were either favorable (e.g., "honest") or unfavorable (e.g., "lazy", we found that distinct neural circuits in adjacent regions of the prefrontal cortex subserve cognitive and emotional aspects of self-reflection. The medial prefrontal cortex responded only to material that was self-descriptive, and this did not differ as a function of the valence of the trait. When material was judged to be self-relevant, the valence of the material was resolved in an adjacent region of ventral anterior cingulate. The nature of self is one of the most enduring questions in science, and researchers are now beginning to be able to decompose the neural operations that give rise to a unitary sense of self.

Predicting bulimic symptoms: an interactive model of self-efficacy, perfectionism, and perceived weight status.

An interactive model of perfectionism, perceived weight status, and self-efficacy was tested on 406 women to predict the bulimic symptoms of binge eating and inappropriate compensatory behaviors separately. This longitudinal study assessed hypothesized vulnerabilities of high perfectionism and low self-efficacy and the stressor of feeling overweight at Time 1 and then gathered weekly assessments of binge eating, vomiting, laxative use, fasting, and diet pill use for 11 weeks. As predicted, results showed that perfectionism, weight perception, and self-efficacy interacted to prospectively predict binge eating. In particular, women high in perfectionism who felt they were overweight and who had low self-efficacy reported the most number of weeks of binge eating. This interactive model did not predict inappropriate compensatory behaviors. Future directions and clinical implications are discussed.

Finding the self? An event-related fMRI study.

Researchers have long debated whether knowledge about the self is unique in terms of its functional anatomic representation within the human brain. In the context of memory function, knowledge about the self is typically remembered better than other types of semantic information. But why does this memorial effect emerge? Extending previous research on this topic (see Craik et al., 1999), the present study used event-related functional magnetic resonance imaging to investigate potential neural substrates of self-referential processing. Participants were imaged while making judgments about trait adjectives under three experimental conditions (self-relevance, other-relevance, or case judgment). Relevance judgments, when compared to case judgments, were accompanied by activation of the left inferior frontal cortex and the anterior cingulate. A separate region of the medial prefrontal cortex was selectively engaged during self-referential processing. Collectively, these findings suggest that self-referential processing is functionally dissociable from other forms of semantic processing within the human brain.

Effect of seeing tobacco use in films on trying smoking among adolescents: cross sectional study.

OBJECTIVE: To test the hypothesis that greater exposure to smoking in films is associated with trying smoking among adolescents. DESIGN: Cross sectional survey of 4919 schoolchildren aged 9-15 years, and assessment of occurrence of smoking in 601 films. SETTING: Randomly selected middle schools in Vermont and New Hampshire, USA. MAIN OUTCOME MEASURE: Number of schoolchildren who had ever tried smoking a cigarette. RESULTS: The films contained a median of 5 (interquartile range 1-12) occurrences of smoking. The typical adolescent had seen 17 of 50 films listed. Exposure to smoking in films varied widely: median 91 (49-152) occurrences. The prevalence of ever trying smoking increased with higher categories of exposure: 4.9% among students who saw 0-50 occurrences of smoking, 13.7% for 51-100 occurrences, 22.1% for 101-150, and 31.3% for >150. The association remained significant after adjustment for age; sex; school performance; school; parents' education; smoking by friend, sibling, or parent; and receptivity to tobacco promotions. The adjusted odds ratios of ever trying smoking for students in the higher categories of exposure, compared with students exposed to 0-50 occurrences of smoking in films, were 1.7 (95% confidence interval 1.2 to 2.4), 2.4 (1.7 to 3.4), and 2.7 (2.0 to 3.8). These odds ratios were not substantially affected by adjustment for parenting style or for personality traits of the adolescent. CONCLUSION: In this sample of adolescents there was a strong, direct, and independent association between seeing tobacco use in films and trying cigarettes, a finding that supports the hypothesis that smoking in films has a role in the initiation of smoking in adolescents.

Disordered eating and the transition to college: a prospective study.

OBJECTIVE: A longitudinal study was conducted to examine whether the transition to college changed eating disorder symptoms and related attitudes. METHOD: Participants were 342 women who completed an in-depth survey in the spring of their senior year of high school and again during their first year of college. We assessed changes in body self-perception, eating-related attitudes, and disordered eating classification (nondieter, dieter, problem dieter, subclinical eating disordered, or eating disordered on the basis of criteria for bulimia nervosa in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders). RESULTS: Although participants viewed themselves as significantly heavier in their first year of college, dieting frequency and disordered eating classification in college did not differ from high school assessment. DISCUSSION: Evidence from this study indicates that disordered eating symptoms and attitudes are established before college. However, our findings also reveal that poor self-image, dieting behaviors, and eating disorder symptoms are common among many young women, both before and during college.

Brand appearances in contemporary cinema films and contribution to global marketing of cigarettes.

BACKGROUND: The appearance of a cigarette brand in a cinema film gives the brand a certain distinction through its association with the characters and general tone of the film. Through the worldwide distribution of films, brands are promoted globally. We assessed the tobacco-brand appearances in a 10-year sample of contemporary films. METHODS: We viewed the contents of the top 25 US box-office films for each year of release, from 1988 to 1997 (250 films in total). We compared the prevalence of brand appearances for films produced before a voluntary ban on paid product placement by the tobacco industry (1988-90) with films produced after the ban (1991-97). Tobacco-brand appearance was defined as the screen appearance of a brand name, logo, or identifiable trademark on products or product packaging, billboards, store-front advertising, or tobacco promotional items. We defined actor endorsement of a brand as the display of a brand while being handled or used by an actor. FINDINGS: More than 85% of the films contained tobacco use. Tobacco brands appeared in 70 (28%) films. Brand appearances were as common in films suitable for adolescent audiences as they were in films for adult audiences (32 vs 35%), and were also present in 20% of those rated for children. Prevalence of brand appearance did not change overall in relation to the ban. However, there was a striking increase in the type of brand appearance depicted, with actor endorsement increasing from 1% of films before the ban to 11% after. Four US cigarette brands accounted for 80% of brand appearances. Revenues outside the USA accounted for 49% of total revenues for these films, indicating a large international audience. INTERPRETATION: Tobacco-brand appearances are common in films and are becoming increasingly endorsed by actors. The most highly advertised US cigarette brands account for most brand appearances, which suggests an advertising motive to this practice.

Favourite movie stars, their tobacco use in contemporary movies, and its association with adolescent smoking.

OBJECTIVE: To assess the relation between adolescents' favourite movie stars, the portrayal of tobacco use by those stars in contemporary motion pictures, and adolescent smoking. DESIGN AND SETTING: 632 students (sixth to 12th grade, ages 10-19 years) from five rural New England public schools completed a voluntary, self administered survey in October 1996. The survey assessed tobacco use, other variables associated with adolescent smoking, and favourite movie star. In addition, tobacco use by 43 selected movie stars was measured in films between 1994 and 1996. OUTCOME MEASURES: Students were categorised into an ordinal five point index (tobacco status) based on their smoking behaviour and their smoking susceptibility: non-susceptible never smokers, susceptible never smokers, non-current experimenters, current experimenters, and smokers. We determined the adjusted cumulative odds of having advanced smoking status based on the amount of on-screen tobacco use by their favourite film star. RESULTS: Of the 43 stars, 65% used tobacco at least once, and 42% portrayed smoking as an essential character trait in one or more films. Stars who smoked more than twice in a film were considered smokers. For adolescents whose favourite stars smoked in only one film, the odds of being higher on the smoking index was 0.78 (95% confidence interval (CI) 0.53 to 1.15). For adolescents whose favourite stars smoked in two films, the odds of being higher on the smoking index was 1.5 (95% CI 1.01 to 2.32). For adolescents whose favourite stars smoked in three or more films (Leonardo DiCaprio, Sharon Stone, John Travolta), the odds of being higher on the smoking index was 3.1 (95% CI 1.34 to 7.12). Among never smokers (n = 281), those who chose stars who were smokers in three or more films were much more likely to have favourable attitudes toward smoking (adjusted odds ratio 16.2, 95% CI 2.3 to 112). CONCLUSIONS: Adolescents who choose movie stars who use tobacco on-screen are significantly more likely to have an advanced smoking status and more favourable attitudes toward smoking than adolescents who choose non-smoking stars. This finding supports the proposition that the portrayal of tobacco use in contemporary motion pictures, particularly by stars who are admired by adolescents, contributes to adolescent smoking.

Self-Esteem and threats to self: implications for self-construals and interpersonal perceptions.

In 4 studies, the authors examined interpersonal perceptions as a function of self-construals and ego threats for those with high and low self-esteem. Previous research (T. F. Heatherton & K. D. Vohs, 2000a) found that after threat, high self-esteem people were rated as less likable by an unacquainted dyad partner, whereas low self-esteem people were rated as more likable. Study I showed that after threat, high self-esteem people seek competency feedback, whereas low self-esteem people seek interpersonal feedback. Study 2 showed that high self-esteem people become more independent after threat, whereas low self-esteem people become more interdependent. Study 3 linked differences in independence versus interdependence to interpersonal evaluations. Study 4 found that differences in independent and interdependent self-construals statistically accounted for differences in likability and personality perceptions of high and low self-esteem people after threat. Thus, the combination of threat and self-esteem alters people's focus on different self-aspects, which consequently leads to different interpersonal appraisals.

Interpersonal evaluations following threats to self: role of self-esteem.

In 2 studies, the authors used dyadic interactions to assess the influence of ego threat on likability as a function of self-esteem. In both studies, 2 naive participants engaged in a structured conversation; in half of the dyads, 1 participant received an ego threat prior to the interaction. In the 1st study, threatened high self-esteem participants were rated as less likable than were threatened low self-esteem participants. The 2nd study confirmed that ego threats are associated with decreased liking for those with high self-esteem and with increased liking for those with low self-esteem. A mediational analysis demonstrated that decreased liking among high self-esteem participants was due to being perceived as antagonistic. Study 2 also indicated that the findings could not be explained by trait levels of narcissism. These patterns are interpreted in terms of differential sensitivity to potential interpersonal rejection.

Personality features differentiate late adolescent females and males with chronic bulimic symptoms.

OBJECTIVE: The authors examined gender differences in bulimia-related personality variables among late adolescents with chronic bulimic symptoms. METHOD: Ninety-seven females and 14 males were included in the study. They participated in surveys in 1982, and again in 1992, and at each session reported elevated bulimic symptoms. Each respondent completed subscales of the Eating Disorders Inventory (Bulimia, Drive for Thinness, Perfectionism, and Interpersonal Distrust). RESULTS: Even compared to males with similar levels of chronic bulimic symptoms, females with chronic bulimic symptoms reported more drive for thinness; compared to females with chronic bulimic symptoms, males with chronic bulimic symptoms reported more perfectionism and interpersonal distrust. DISCUSSION: Late adolescent males and females with chronic bulimic symptoms can be distinguished on the basis of personality features. These findings have implications for theory, as well as for clinical assessment and therapeutics.

Three studies on the factorial distinctiveness of binge eating and bulimic symptoms among nonclinical men and women.

OBJECTIVE: According to DSM-IV's proposed nosology, binge eating disorder is separable from bulimia nervosa. The basis for separation rests with compensatory behaviors (e.g., induced vomiting)-people with bulimia nervosa engage in compensatory behaviors, whereas those with binge eating disorder do not. We addressed the validity of this nosology. METHODS: In three studies on 2,015 young men and women, we used factor-analytic techniques to assess whether bulimic and binge eating symptoms are separable in men and women. Results and Discussion Results of the three studies converged: Although binge eating symptoms may be distinct from bulimic symptoms among young men, the two syndromes are factorially inseparable among young women. Nosologic and sociocultural implications are noted.

Self-regulatory failure: a resource-depletion approach.

Three studies were conducted to test the behavioral consequences of effortful self-regulation. Individuals with chronic inhibitions about eating were exposed to situations varying in level of self-regulatory demand. Subsequently, participants' ability to self-regulate was measured. Two studies manipulated self-regulatory demand by exposing participants to good-tasting snack foods, whereas a third study required participants to control their emotional expressions. As hypothesized, exerting self-control during the first task led to decrements in self-control on a subsequent task. Moreover, these effects were not due to changes in affective state and occurred only when self-control was required in the first task. These findings are explained in terms of depletion of self-regulatory resources, which impairs successful volitional control.

Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: a model of bulimic symptom development.

An interactive model of perfectionism, perceived weight status, and self-esteem was tested on 342 female undergraduates to predict bulimic symptoms. Using a longitudinal design, the authors tested the model on data collected at 2 points: the spring of participants' senior year of high school and during participants' first year of college. The authors hypothesized and found that self-esteem moderates the interaction between perfectionism and perceived weight status in predicting bulimic symptoms. Women who are high in perfectionism and who consider themselves overweight exhibit bulimic symptoms only if they have low self-esteem (i.e., if they doubt they can attain their high body standards). High self-esteem women with the same diathesis-stress conditions are less likely to exhibit bulimic symptoms. These findings clarify the role of perfectionism in bulimic symptomatology.

First- and second-order factor structure of five subscales of the Eating Disorders Inventory.

OBJECTIVE: Insofar as the factor structure of the Eating Disorders Inventory (EDI) among nonclinical participants is unclear (despite very wide use), the present study addressed the factor structure of five EDI subscales (Drive for Thinness, Bulimia, Perfectionism, Interpersonal Distrust, and Maturity Fears). METHOD: Relatively large samples of non-patient women who participated in a cohort study of behavior and diet in 1982 (N = 617) and 1992 (N = 545) completed the five EDI subscales. RESULTS AND DISCUSSION: Results are the first to clearly support the intended factor structure of the EDI among nonclinical participants.

Ten-year stability and predictive validity of five bulimia-related indicators.

OBJECTIVE: The authors examined the temporal stability and predictive utility of bulimic symptoms and related variables over the course of 10 years, from 1982 to 1992. METHOD: The subjects were 459 women who were aged 18-22 years in 1982 and were surveyed in both 1982 and 1992. Each respondent completed five subscales of the Eating Disorders Inventory (bulimia, drive for thinness, maturity fears, perfectionism, and interpersonal distrust) and answered questions based on the DSM-III criteria for bulimia nervosa. RESULTS: The temporal stability of bulimic symptoms and related variables was relatively high. Bulimic status in 1982 conferred an approximately 15-fold increase in risk 10 years later. Drive for thinness and, to lesser degrees, maturity fears and perfectionism received support as long-term predictors of bulimic symptoms. CONCLUSIONS: Bulimic symptoms display high temporal stability and thus may affect long-term functioning and well-being. Later symptoms are related to scores on specific subscales of the Eating Disorders Inventory administered 10 years earlier. Assessment and therapy should be conducted accordingly.

Individual differences in the subjective effects of the first cigarette of the day: a self-report method for studying tolerance.

Some smokers are more sensitive than others to the subjective effects of cigarettes, especially the first cigarette of the day. This report explored self-reported subjective effects to the first cigarette of the day and examined the extent to which heaviness of smoking and years smoking are associated with subjective effects. In 3 independent samples (ns = 254, 116, 86). self-reports of light-headedness from the first cigarette of the day decreased with increasing heaviness of smoking and increasing the number of years smoking, suggesting that differences in responses were due to differences in chronic tolerance. Because measures of the subjective effects of drugs are useful in the study of drug response variability, this self-report item on light-headedness should be included in further research on individual differences in the subjective effects of cigarette smoking.

A 10-year longitudinal study of body weight, dieting, and eating disorder symptoms.

This article describes a 10-year longitudinal study of eating attitudes and behaviors. A sample of 509 women and 206 men completed a detailed survey in 1982 while they were in college. The authors contacted participants 10 years later and administered a 2nd questionnaire to assess stability and change in eating behaviors that occurred during the transition to early adulthood. Women in the study had substantial declines in disordered eating behavior as well as increased body satisfaction. However, body dissatisfaction and desires to lose weight remained at relatively high levels. Men, who rarely dieted or had eating problems in college, were prone to weight gain following college, and many of them reported increased dieting or disordered eating. The authors conclude that disordered eating generally tends to decline during the transition to early adulthood. However, body dissatisfaction remains a problem for a substantial segment of the adult population.