Friday Night Is Pizza Night: A Comparison of Children's Dietary Intake and Maternal Perceptions and Feeding Goals on Weekdays and Weekends.

Childhood obesity is a serious issue in the U.S. While obesity is the result of a multitude of factors, a great deal of research has focused on children's dietary intake. While children's eating patterns vary throughout the week, not much else is known about weekday-weekend differences. Therefore, the current study examined differences in the frequency and portion size of school-age children's consumption of common foods and beverages, as well as mothers' perceptions of those items and their child feeding goals, on weekdays and weekends. A total of 192 mothers of children aged 7 to 11 were recruited through Amazon's Mechanical Turk. Results showed a consistent pattern of more frequent consumption and larger portions of unhealthy foods and beverages on weekends. This aligned with mothers' perceptions of those foods and beverages as weekend items, as well as their feeding goals of health and price being less important on weekends. It is quite possible that weekends are viewed as having less structure and facilitate schedules that allow children to consume more meals away from home. These findings shed light on additional risk factors in children's eating patterns and highlight the serious implications that day of the week can have on childhood obesity.

Influence of maternal feeding goals and practices on children's eating behaviors.

Parents are highly influential in shaping their children's dietary habits. This study examined whether negative feeding practices mediated the relationship between feeding goals (health and convenience) and children's eating behaviors. One hundred ninety-two mothers (mean age = 34.2; mean BMI = 27.0) of 7-11 year old children participated via Amazon's Mechanical Turk. Results showed that negative feeding practices fully mediated the relationship between convenience feeding goals and children's eating behaviors (goals to healthy/unhealthy eating behaviors: ß = -0.08/.09, n.s.; goals to feeding practices: ß = 0.27, p < 0.01; feeding practices to healthy/unhealthy eating behaviors: ß = -0.57/.48, p < 0.05). On the other hand, negative feeding practices did not fully mediate the relationship between health feeding goals and children's eating behaviors (goals to healthy/unhealthy eating behaviors: ß = 0.66/-0.29, p < 0.01; goals to feeding practices: ß = -0.28, p < 0.001; feeding practices to healthy/unhealthy eating behaviors: ß = -0.26/.44, p < 0.05). In other words, children whose mothers emphasized health goals consumed more healthy food and less unhealthy food, above and beyond the use of negative feeding practices. Because parents are on the front lines of shaping children's eating habits, understanding the best point of intervention for parents (e.g., shaping parents' goals, changing parents' feeding practices) might be especially fruitful, considering that childhood obesity has become a global public health crisis and energy intake is one of the key factors contributing to this problem.

Does when you eat and exercise matter? Differences in eating and physical activity patterns in overweight and obese adults.

PURPOSE: Despite current recommendations and guidelines on the treatment of overweight and obesity, little is known about what patterns of energy intake or expenditure are ideal for weight loss. The present study examined patterns in energy intake and expenditure and explored whether those differences were associated with weight loss. METHODS: Self-monitoring data on energy intake and expenditure, along with minutes spent in exercise, were obtained from 90 overweight or obese adults (mean BMI = 38.0) enrolled in two behavioral weight loss programs. Energy intake and minutes of daily exercise were self-reported and energy expenditure was obtained from the Caltrac accelerometers that were provided to participants. RESULTS: On weekends (Friday through Sunday), participants consumed more calories from breakfast (271 vs. 241 kcals/day; p < .01), dinner (605 vs. 547 kcals/day; p < .001), and alcohol (59 vs. 27 kcals/day; p < .01), as well as total daily calories (1669 vs. 1520 kcals/day; p < .001) and expended fewer total calories (2515 vs. 2614 kcals/day; p < .01) than on weekdays. Higher caloric intake on weekdays was associated with less overall weight loss (r = -.29, p < .01) and was marginally associated on weekends (r = -.19, p = .051). CONCLUSION: This investigation found evidence that while eating patterns clearly contribute to daily energy intake on weekdays and weekends, they may not necessarily contribute to weight change. At the end of the day, what may be most important is regular self-monitoring and total caloric intake on both the weekdays and weekends.

Meals and snacks: Children's characterizations of food and eating cues.

This study examined preschoolers' and their parents' categorizations of eating episodes based on cues used for defining these occasions (i.e., time, portion size, preparation, content, and emotion) as a meal or snack. Thirty-four children aged 4 to 6 saw pictorial representations of each cue, along with a short verbal description, and were asked to place the picture in one of three boxes: "meal", "snack", or "either meal or snack". One parent per child (85% mothers, Mean age = 35.1 years) separately categorized the same items in an online survey. Results illustrated which cues play a role in how parents and children categorize eating occasions as meals or snacks. Parents used 24 of the 32 cue-related items to distinguish between eating occasions as a meal or a snack, while children used only four. Parents and preschoolers were consistent in using cartoon character packaging to indicate a snack, and also used several of the same content cues. The current study highlights the various cues used to categorize an eating occasion, and the unhealthy character of snacks, as participants associated some unhealthy foods and very few healthy foods with snacks. Future research should focus on the role of parents, the home environment, and advertising media in shaping children's characterizations of eating occasions towards development of healthy eating habits and away from problematic eating behaviors that may persist later in life.

Maternal Feeding Goals and Restaurant Menu Choices for Young Children.

BACKGROUND: Childhood obesity remains a major public health issue. One recent effort to improve the obesogenic environment is mandating that restaurants provide calorie and other nutritional content on menus. Little is known about whether maternal feeding for young children is influenced by calorie disclosure on menus. This study examined (1) whether maternal feeding goals associate with mothers' food selections for their young children and (2) whether mothers change entrée and side selections for their children when calories/fat grams are listed on menus. METHODS: One-hundred seventy mothers of children ages of 3-6 years participated in an online survey. Most participants identified as white (76.5%), with a mean BMI of 25.68 (standard deviation=5.94). Mothers were presented two menus (one with and one without calorie/fat information). RESULTS: The goal of feeding for the child's familiarity with the food was significantly associated with mothers' selection of original side dish and entrées, with greater endorsement of this goal associated with choosing high-calorie/-fat sides and entrées. Feeding for natural content was associated with mothers' selection of original entrée, with greater endorsement of this goal associated with choosing low-calorie/-fat entrées. Significantly fewer mothers chose a higher-calorie entrée when there was menu labeling. CONCLUSIONS: Maternal feeding goals are associated with mothers' selection of entrée and side dishes on restaurant menus. Results from this study suggest that menu labeling of calories and fat grams may influence entrée choices by mothers. Targeting mothers' feeding goals and labeling restaurant menus may improve the diets of young children.

Implicit bias about weight and weight loss treatment outcomes.

OBJECTIVES: The goal of the current study was to examine the impact of a weight loss intervention on implicit bias toward weight, as well as the relationship among implicit bias, weight loss behaviors, and weight loss outcomes. Additionally, of interest was the relationship among these variables when implicit weight bias was measured with a novel assessment that portrays individuals who are thin and obese engaged in both stereotypical and nonstereotypical health-related behaviors. METHODS: Implicit weight bias (stereotype consistent and stereotype inconsistent), binge eating, self-monitoring, and body weight were assessed among weight loss participants at baseline and post-treatment (N=44) participating in two weight loss programs. RESULTS: Stereotype consistent bias significantly decreased from baseline to post-treatment. Greater baseline stereotype consistent bias was associated with lower binge eating and greater self-monitoring. Greater post-treatment stereotype consistent bias was associated with greater percent weight loss. Stereotype inconsistent bias did not change from baseline to post-treatment and was generally unrelated to outcomes. CONCLUSION: Weight loss treatment may reduce implicit bias toward overweight individuals among weight loss participants. Higher post-treatment stereotype consistent bias was associated with a higher percent weight loss, possibly suggesting that losing weight may serve to maintain implicit weight bias. Alternatively, great implicit weight bias may identify individuals motivated to make changes necessary for weight loss.

Food consumption by young children: a function of parental feeding goals and practices.

Staggering health implications are associated with poor child diet. Given the importance of parents in impacting children's eating outcomes, the current study examined a theoretical framework in which both parental feeding goals and practices impact specific healthy and unhealthy child eating behaviors. Participants were 171 mothers of 3-6year old children who were diverse both socioeconomically and with regard to BMI. Mothers completed questionnaires via Mechanical Turk, an online workforce through Amazon.com. Structural Equation Modeling showed an adequate model fit in which Negative Feeding Practices (e.g., using food as a reward) mediated the relationship between Health-Related Feeding Goals (i.e., feeding children with health-oriented goals in mind) and Negative Eating Behaviors (e.g., consumption of candy and snacks). However, Negative Feeding Practices did not mediate the relationship between Health-Related Feeding Goals and Positive Eating Behaviors (i.e., fruits and vegetables). These findings suggest the important role of habitual food parenting practices in children's eating and have implications for parental health education programs.

Stereotypical images and implicit weight bias in overweight/obese people.

PURPOSE: In this brief report, an unanswered question in implicit weight bias research is addressed: Is weight bias stronger when obese and thin people are pictured engaging in stereotype consistent behaviors (e.g., obese-watching TV/eating junk food; thin-exercising/eating healthy) as opposed to the converse? METHODS: Implicit Associations Test (IAT) data were collected from two samples of overweight/obese adults participating in weight loss treatment. Both samples completed two IATs. In one IAT, obese and thin people were pictured engaging in stereotype consistent behaviors (e.g., obese-watching TV/eating junk food; thin-exercising/eating healthy). In the second IAT, obese and thin people were pictured engaging in stereotype inconsistent behaviors (e.g., obese-exercising/eating healthy; thin-watching TV/eating junk food). RESULTS: Implicit weight bias was evident regardless of whether participants viewed stereotype consistent or inconsistent pictures. However, implicit bias was significantly stronger for stereotype consistent compared to stereotype inconsistent images. CONCLUSION: Implicit anti-fat attitudes may be connected to the way in which people with obesity are portrayed.

Examining perceived stereotype threat among overweight/obese adults using a multi-threat framework.

OBJECTIVE: The Multi-Threat Framework accounts for potentially different forms of stereotype threat that differ in target (i.e., the individual or the group) and source (i.e., the self or others). This investigation examined how these different forms of perceived stereotype threat were related to concepts, such as group identity, stereotype endorsement, stigma consciousness, etc., among overweight and obese individuals. METHOD: 216 adults completed an online survey. Participants' mean age was 23.6 (SD 10.1; range 18-64) years and mean BMI was 31.6 (SD 7.5) kg/m². RESULTS: Participants reported a history of feeling threatened by stereotypes related to weight. When reflecting on past experiences of perceived stereotype threat, participants reported greater levels of self/own stereotype threat compared to group stereotype threat. Level of stereotype threat was related to a number of personal characteristics (i.e., sex, BMI) and individual factors (i.e., group identity, stigma consciousness, fear of fat). CONCLUSION: Individuals who are overweight report a history of being threatened by negative stereotypes. The findings support the Multi-Threat Framework for stereotype threat based on body weight. Overweight individuals' susceptibility to stereotype threat may vary systematically depending on several factors. Future research should examine weight-related stereotypes' impact on cognitive and behavioral outcomes.

Step-down approach to behavioural weight loss treatment: a pilot of a randomised clinical trial.

BACKGROUND: In a stepped-down approach, patients begin with a more intensive treatment and are stepped down to a less intensive treatment based on achieving treatment goals. This study compared a standard behavioural weight loss programme (BWLP) to a stepped-down approach to treatment. METHODS: Fifty-two overweight/obese adults (Age: M = 47 years, SD = 13.5; female = 67%) participated in an 18-week BWLP. Half of them were randomly assigned to be stepped down from weekly group meetings based on completion of weight loss goals (3%) every 6 weeks, while the other half remained in their groups regardless of weight loss. RESULTS: There was a significant difference favouring the BWLP in the proportion of participants who met or exceeded their 3% weight loss goal during the first six weeks. While not statistically significant by the end of treatment, the BWLP participants lost nearly 3% more body weight than stepped-down participants (SC = 4.9% vs. BWLP = 7.8%; p = .10). Greater self-monitoring was associated with increased likelihood of stepped-care eligibility and higher percent weight loss at the end of treatment (p < .01). CONCLUSION: There was little evidence to support the efficacy of the stepped-down approach for behavioural weight loss treatment employed in this investigation.

Combining behavioral weight loss treatment and a commercial program: a randomized clinical trial.

OBJECTIVE: To test the hypothesis that a novel weight loss approach that combined the fundamental components of professionally delivered behavioral weight loss (BWL) treatment with the existing Weight Watchers (WW) program would produce better weight losses than WW alone no differences were expected between the novel treatment and BWL alone. DESIGN AND METHODS: Participants were 141 overweight and obese adults (90% women, 67% non-White, mean age = 49.7 ± 9.2 years, mean body mass index = 36.2 ± 5.5 kg/m(2) ) randomly assigned to 48 weeks of BWL, 48 weeks of WW, or 12 weeks of BWL followed by 36 weeks of WW [combined treatment (CT)]. Assessments were conducted at baseline and weeks 12, 24, and 48, with weight change as the primary outcome. RESULTS: Linear mixed model analysis showed that 24-week weight losses did not differ significantly between treatment groups; however, weight losses at 48 weeks were greater in the WW group (M = -6.0 kg, standard error (SE) = 0.8) compared with the CT group (M = -3.6 kg, SE = 0.8; P = 0.032), with BWL not significantly different from either (M = -5.4 kg, SE = 0.8). Further, a greater proportion of WW participants lost 10% of baseline weight by 48 weeks compared with BWL or CT (36.7%, 13.0%, and 15.2%, respectively, P < 0.05). CONCLUSION: This study shows that the WW program can produce clinically meaningful weight losses and provides no evidence that adding brief BWL to the WW program improves outcome.

Food addiction in adults seeking weight loss treatment. Implications for psychosocial health and weight loss.

The present study examined food addiction symptomology and its relationship to eating pathology and psychological distress among adults seeking weight loss treatment. A primary interest was an examination of the relationship between food addiction symptoms and short-term weight loss. Adults beginning a behavioral weight loss program (N=57) were given the Yale Food Addiction Scale (YFAS) as well as measures of psychological distress, disordered eating, weight bias, and weight-focused attitudes. Weight loss was measured after 7 weeks. Severity of food addiction was related to increased depression, emotional eating, binge eating, anti-fat attitudes, internalized weight bias, body shame, and low eating self-efficacy, but not body satisfaction. Increased food addiction symptomology was also related to less weight lost at 7 weeks. Findings suggest that individuals attempting to lose weight while combating symptoms of food addiction may be especially prone to eating-related pathologies, internalized weight bias, and body shame. Importantly, findings provide evidence that food addiction may undermine efforts to lose weight. The pathology associated with addiction (e.g., tolerance, withdrawal) could make the adoption of more healthful eating habits especially difficult.