Influence of body dissatisfaction on 1-year change in nutrient intake of overweight and obese inner-city African American children.

This analysis aimed to examine the relationship of baseline body dissatisfaction with 1-year change in nutrient intake of inner-city, overweight and obese, African American children. This is a secondary analysis of 1-year pre-post data available for a convenience sample of 88 children. After adjusting for baseline intake of dietary variables and intervention group status, baseline body dissatisfaction was associated with 1-year increases in intake of energy, and all macronutrients in girls, but not in boys. These relationships were not substantially altered after adjusting for baseline BMIz and global self-worth. After including all adjustment factors, increasing baseline body dissatisfaction in girls was associated with 1-year increased intake of total energy, total sugars, total fat, discretionary fat, and total carbohydrates. This analysis suggests that, in girls but not necessarily in boys, body dissatisfaction might need to be targeted during interventions that aim to improve nutrient intake.

Taking Action Together: a YMCA-based protocol to prevent type-2 diabetes in high-BMI inner-city African American children.

BACKGROUND: Associated with a tripling in obesity since 1970, type 2 diabetes mellitus (T2DM) in children has risen 9-10 fold. There is a critical need of protocols for trials to prevent T2DM in children. METHODS/DESIGN: This protocol includes the theory, development, evaluation components and lessons learned from a novel YMCA-based T2DM prevention intervention designed specifically for high-BMI African American children from disadvantaged, inner-city neighborhoods of Oakland, California. The intervention was developed on the basis of: review of epidemiological and intervention studies of pediatric T2DM; a conceptual theory (social cognitive); a comprehensive examination of health promotion curricula designed for children; consultation with research, clinical experts and practitioners and; input from community partners. The intervention, Taking Action Together, included culturally sensitive and age-appropriate programming on: healthy eating; increasing physical activity and, improving self esteem. DISCUSSION: Evaluations completed to date suggest that Taking Action Together may be an effective intervention, and results warrant an expanded evaluation effort. This protocol could be used in other community settings to reduce the risk of children developing T2DM and related health consequences. TRIAL REGISTRATION: ClinicalTrials.gov NCT01039116.

Baseline correlates of insulin resistance in inner city high-BMI African-American children.

To characterize the influence of diet-, physical activity-, and self-esteem-related factors on insulin resistance in 8- 10-year-old African-American (AA) children with BMI greater than the 85th percentile who were screened to participate in a community-based type 2 diabetes mellitus (T2DM) prevention trial. In 165 subjects, fasting glucose- and insulin-derived values for homeostasis model assessment of insulin resistance (HOMA-IR) assessed insulin resistance. Body fatness was calculated following bioelectrical impedance analysis, and fitness was measured using laps from a 20-m shuttle run. Child questionnaires assessed physical activity, dietary habits, and self-esteem. Pubertal staging was assessed using serum levels of sex hormones. Parent questionnaires assessed family demographics, family health, and family food and physical activity habits. Girls had significantly higher percent body fat but similar anthropometric measures compared with boys, whereas boys spent more time in high-intensity activities than girls. Scores for self-perceived behavior were higher for girls than for boys; and girls desired a more slender body. Girls had significantly higher insulin resistance (HOMA-IR), compared with boys (P < 0.01). Adjusting for age, sex, pubertal stage, socioeconomic index (SE index), and family history of diabetes, multivariate regression analysis showed that children with higher waist circumference (WC) (P < 0.001) and lower Harter's scholastic competence (SC) scale (P = 0.044) had higher insulin resistance. WC and selected self-esteem parameters predicted insulin resistance in high-BMI AA children. The risk of T2DM may be reduced in these children by targeting these factors.

BMI screening in schools: helpful or harmful.

This is a comprehensive review of policies and research regarding body mass index (BMI) screening in schools in the United Kingdom and the United States. Although there are potential benefits to conducting screenings in schools, there is also the potential to do harm to the children who are identified as overweight. School administrators need to consider a number of factors discussed in this article before making a decision about committing resources to BMI screening.

The National Weight Control Registry: a critique.

This article is a critique of the claim that the National Weight Control Registry provides data showing that a significant number of adults in the United States have achieved permanent weight loss. We believe that promoting calorie-restricted dieting for the purpose of weight loss is misleading and futile. We advocate the adoption of a health-at-every-size (HAES) approach to weight management, focusing on the achievement and maintenance of lifestyle changes that improve metabolic indicators of health.

Self-reported dieting experiences of women with body mass indexes of 30 or more.

Self-reported information on dieting experiences of 149 women with a body mass index (BMI) of 30 to 70 was gathered to refute the notion that obese women have made few serious attempts to lose weight and to see whether women with higher BMIs report more frequent dieting than women with lower BMIs. Participants completed questionnaires about lifetime dieting experiences and provided demographic information, including heights and weights. Statistical comparisons among categorical variables were made using chi(2) tests. Women with higher BMIs tended to start dieting before age 14 (P<.001) and had dieted more frequently (P<.01) than women with lower BMIs. Negative memories of dieting far outnumbered positive or neutral ones. When a patient has a history of dieting failure, dietetics professionals should consider focusing on improvements in metabolic fitness through lifestyle changes for chronic disease risk reduction rather than encouraging continued attempts to lose weight.

Culturally relevant nutrition education improves dietary quality among WIC-eligible Vietnamese immigrants.

OBJECTIVE: To provide culturally appropriate nutrition education to improve the diets of Vietnamese women. DESIGN: A total of 152 homemakers were recruited to participate in a nutrition education project, with 76 receiving the intervention and 76 serving as the control group. SUBJECTS/SETTING: Non-English-speaking women eligible for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) with incomes below 185% of the poverty level living in 5 California counties. INTERVENTION: Bicultural, bilingual Vietnamese-American nutrition education assistants taught 5 to 7 lessons in the Vietnamese language using nutrition education materials written in the Vietnamese language by 2 bilingual, bicultural nutritionists. MAIN OUTCOME MEASURES: Twenty-four-hour food recalls were obtained before and after the 8-week interval on the treatment and control groups. STATISTICAL ANALYSIS: To examine if there were changes over time in nutrient intake and nutrient density within groups, matched pair t tests were done. Analysis of covariance techniques determined differences between groups. McNemar tests determined if, within groups, there were changes over time in food groups consumed. Chi-square techniques determined changes between groups. RESULTS: Over time, the number of treatment group participants who had at least one serving from each food group (P <.01), and who had the recommended number of servings from each food group (P <.05), significantly increased in comparison to the control group. Over time, the dietary nutrient density of calcium, riboflavin, and vitamin B6 (P <.05), as well as potassium (P <.01), of treatment group participants significantly improved in comparison to the control group. IMPLICATIONS: With training, bilingual, bicultural women can effectively deliver culturally relevant nutrition education to their peers.