Eating habits reported by secondary school students in a city of west Turkey

OBJECTIVE: The prevalence of obesity and underweight has increased in recent years due to the fact that eating and drinking habits have changed all over the world. This survey was conducted to estimate the prevalence of both obesity and underweight, as well as to understand the eating and drinking habits of a group of Turkish students. METHODS: 1044 students completed the survey. Responses were analyzed, using Chi-square (chi2) test and percent (%) ratios, according to gender. Differences were considered significant for p<0.05. RESULTS: About 10% of the students (123/1044, 11.8%) were underweight, most of them were male. Most students (868/1044, 83.1%) were of the correct weight. A small percentage of the students (52/1044, 4.9%) were overweight, with just one obese student, boy. Compared to boys, girls significantly obtained higher scores when questioned on preference of bran bread (62.0% vs. 38.0%, respectively), taking pains to not gain excess weight in order not to get fat (55.6% vs. 44.4%, respectively), doing physical exercise if they felt they were gaining too much weight (54.85% vs. 45.2%, respectively), and reducing food consumption when they felt that they were gaining weight (55.0% vs. 45.0%, respectively). CONCLUSION: For most people the importance of diet was obvious. This was especially reflected in the females' reports, since they reported a continual increase in their dieting and exercise behavior in an attempt to attain the contemporary ideal of being thin and physically fit.     

Body Weight and Body Image

HEALTH ISSUE: Body weight is of physical and psychological importance to Canadian women; it is associated with health status, physical activity, body image, and self-esteem. Although the problems associated with overweight and obesity are indeed serious, there are also problems connected to being underweight. Weight prejudice and the dieting industry intensify body image concerns for Canadian women and can have a major negative impact on self-esteem. KEY FINDINGS: Women have lower BMIs than men, a lower incidence of being overweight and a higher incidence of being underweight. However, women across all weight categories are more dissatisfied with their bodies. Sixty percent of women are inactive, and women with a BMI of 27 or higher are more likely to be inactive than women with lower BMIs. The data show that women are aware of the health benefits of exercise, but there is a gap between knowledge and practice. When asked about barriers to health improvement, 39.7% of women cited lack of time and 39.2% lack of willpower. DATA GAPS AND RECOMMENDATIONS: Weight prejudice must be made unacceptable and positive body image should be encouraged and diversity valued. Health policies should encourage healthy eating and healthy activity. Health curricula for young students should include information about healthy eating, active lifestyle, and self-esteem. Physical activities that mothers can participate in with their families should be encouraged. Research should be funded to elucidate the most effective methods of getting women to become and remain physically active without focusing on appearance.     

Very low calorie ketogenic diets in overweight and obesity treatment: Effects on anthropometric parameters,body composition,satiety, lipid profile and microbiota

According to the World Health Organization (WHO) the prevalence of obesity tripled worldwide since 1975. Obesity prevention and treatment is based upon lifestyle changes involving eating habits, physical activity and behaviour therapy. Various dietary patterns have been used as nutritional strategies and, in recent years, interest has been shown in very low calorie ketogenic diets (VLCKD) that provide less than 800 calories (kcal), no more than 20–50 g/day of carbohydrates and 0.8–1.5 g/kg ideal body weight of protein. We conducted a literature review of all clinical trials published between January 2014–November 2019 on people with obesity (PWO) that evaluated VLCKD effects on anthropometric parameters, body composition, satiety, lipid profile and microbiota. Findings from literature showed that VLCKD could be useful to ameliorate the quality of life and sleep of PWO. It leads to a rapid weight loss and results in improvements in body mass index (BMI = kg/m²), waist circumference and fat mass reduction preserving lean body mass and resting metabolic rate. This eating pattern reduced the desire to eat and increased satiety. Little is known regarding the effects of VLCKD on the microbiota of PWO for which it is important to conduct further studies.     

Predictors of fat stereotypes among 9-year-old girls and their parents

OBJECTIVE: To assess familial links in fat stereotypes and predictors of stereotypes among girls and their parents. RESEARCH METHODS AND PROCEDURES: Fat stereotypes were assessed using a questionnaire developed for this study. Participants indicated the extent to which they agreed with nine statements about thin people (e.g., thin people are smart) and the same statements about fat people (e.g., fat people are smart). Predictors of fat stereotypes that were examined include weight status (BMI; girls and parents), education (parents), income (parents), self-investment in physical appearance (parents), maladaptive eating attitudes (girls), and parenting practices and peer interactions focused on body shape and weight loss (girls). RESULTS: Girls and parents exhibited fat stereotypes. Fathers who were more educated and had a higher family income were more likely to endorse fat stereotypes, as were mothers and fathers with a high investment in their physical appearance. Although no associations were found between girls' and parents' fat stereotypes, girls were more likely to endorse fat stereotypes when interactions with parents and peers focused on body shape and weight loss. Girls were also more likely to endorse fat stereotypes when they reported higher levels of maladaptive eating attitudes. No associations were found between weight status and fat stereotypes. DISCUSSION: Although there was no association between girls' and parents' fat stereotypes, girls were more likely to express negative attitudes about obesity and obese persons when parenting practices and interactions with peers promoted a lean body type, suggesting that there may be an implicit link between the lean ideal and fat stereotypes.     

Sedentary behaviour, physical activity and weight problems in adolescents in Wales

OBJECTIVE: We studied the prevalence and stability of overweight and obesity in a cohort of adolescents, and the effects of sedentary behaviour and physical activity on changes in body mass. The study also examined the extent to which physical activity mediated the relationship between sedentary behaviour and body mass. DESIGN: Four-year cohort study. METHODS: The study was part of the Health Behaviour of School-aged Children Study that took place in Wales between 1994 and 1998. Body height and weight measurements and self-report data on sedentary behaviour, physical activity and psychosocial adjustment were collected from 355 adolescents on two occasions 4 years apart. The mean age of the sample at baseline was 12.30 (SD=6.30) years. RESULTS: Weight conditions (underweight, overweight and obesity) and body mass were moderately stable over the interval. Regression analyses showed that sedentary behaviour at Time 1 predicted body mass at Time 2, while physical activity predicted a change in body mass over time. The influence of sedentary behaviour on body mass was not found to be mediated by physical activity. However, weight problems in Year 7 coincided with getting bullied, bullying others, and feeling left out of things. Obesity was also related to snacking and skipping breakfast. CONCLUSIONS: Sedentary behaviour and physical activity in early adolescence both influenced body mass in late adolescence. Results indicated that promoting healthy diets and physical activities may have long-term health benefits for young people.     

Implicit internalization of the thin ideal as a predictor of increases in weight, body dissatisfaction, and disordered eating

The freshman year of college has been identified as a time when some students experience large changes in their eating behaviors, body image, and weight. One factor that is predictive of changes in these variables is internalization of the thin ideal (i.e., the degree to which an individual has accepted societal values of thinness and applies these values to herself). However, given the limitation of self-report and previous research demonstrating the additional predictive validity implicit measurement provides, it may be important to develop an implicit paradigm for assessing internalization of the thin ideal. The Implicit Association Test is the most common implicit measurement technique. However this test is associational in nature, which reflects only one aspect of human cognition. The current study evaluates a newly-created implicit measure of internalization of the thin ideal that utilizes the Implicit Relational Assessment Procedure (IRAP). In particular, the study investigates concurrent and prospective associations between internalization of the thin ideal and disordered eating, body image dissatisfaction, and weight in a group of women at the beginning and end of their freshman year in college. Results of the study indicate that weight, disordered eating and body image dissatisfaction increased during the freshman year, and that these were predicted by implicit internalization of the thin ideal at the beginning of the year. Moreover, the new implicit measure was predictive above and beyond any predictive ability of the explicit measure. Results indicate that the thin ideal IRAP can successfully predict changes in many variables of interest at the freshman year of college, and suggest it may be a beneficial screening tool to assess at-risk freshman. This study also highlights the need for additional implicit measures in the realm of body image and disordered eating.     

Perception of body weight and self-reported eating and exercise behaviour among obese and non-obese women in Saudi Arabia

A case control study was conducted to examine the theorized differences for eating and exercise behaviour among the obese and non-obese women from an urban health center in Saudi Arabia. Perceptions regarding actual and ideal body size were also determined. The obese were significantly more likely to eat under emotional conditions of stress and anger, in secrecy, and indulge in binge eating (P < 0.05). Frequent snacking and drinking of regular soda drinks was also more common in this group compared to the controls (P < 0.05). A weak association was observed for nibbling at food without being aware and preference of sweet foods compared to savoury ones by the obese (P < 0.1). A large group of the study population (75%) were either not exercising at all or doing so infrequently—a feature expected in the middle and lower social class group of women in this region. A sizable proportion of women either overestimated (28.6%) or underestimated (28.9%) their actual body weight with increasing education significantly related to overestimation of weight and vice versa (P < 0.05). A change in the concept of an ideal body image from the overweight female to that of the slim figure was also observed with advancing education. To control and prevent obesity in this region, it is suggested that health education related to an awareness of a healthy body size and appropriate eating and exercise behaviour should be given through primary health centers, other health facilities and schools.     

Affluent adolescent girls of Delhi: eating and weight concerns

Despite a dramatic increase in research on eating-related pathologies, gaps remain in our understanding of the factors responsible for the development and maintenance of dysfunctional attitudes and behaviour related to weight and eating among adolescents. A study was therefore conducted to compare eating and weight concerns among underweight, normal-weight and obese affluent adolescent girls in New Delhi. The sample comprised fifty underweight, fifty normal-weight and thirty obese girls, 16-18 years of age. Information was collected about their body image perception, weight concerns and eating attitudes by a well-structured questionnaire. Dietary intake was determined by 24 h recall and a food-frequency questionnaire. Body size was adjudged by measurements of weight, height, waist, hip and mid upper arm circumferences, and the BMI and waist : hip ratio were determined. Of the subjects, 99.2 % had a gynoid pattern of fat distribution. Concerns about excess weight were prevalent among the adolescent girls, even among those who were normal-weight and underweight. The level of satisfaction with body size decreased with increase in weight. Dieting behaviour was reported in a higher number of obese (76.6 %) compared with normal-weight (38 %) and underweight (14 %) girls. Of the obese girls, 43.3 % were found to be at a significantly (P=0.00109) greater risk of developing anorexia in the future. Characteristic dietary features of adolescence, such as missing meals, snacking and eating out, were observed. While the diets of most of the subjects were adequate in Ca, thiamin, riboflavin and vitamin C, they were found to be deficient in energy, protein, Fe, niacin, vitamin A and fibre. Thus, it is important to recognize that weight concerns and dissatisfaction with body size may pose a threat to a healthy nutritional state, and may develop into precursors of a later eating disturbance.     

An evaluation of eating disorders among a group of Turkish university students

The prevalence of eating disorders has been increasing in the last 20 years, not only in developed countries, but also in less developed countries such as Turkey. This study was conducted among 610 university students, 338 males and 272 females who are between 17 and 23 years old, in Ankara, the capital of Turkey, to determine eating disorders among the young. The data regarding the eating disorders and self-evaluation were assessed according to the EAT-40 test and the Body Cathexis Scale. The scores received from the eating attitudes test were low among the underweight (18.9+/-9.7) and higher among the overweight (21.6+/-15.9). Eating disorders risks are more prevalent among females compared to males (P<0.001). 17.2% of the underweight and 21.2% of the overweight are at higher risk of eating disorders. There was a positive correlation between the eating attitudes test scores and young people's body weight, BMI, mid-upper arm and waist circumferences, while a negative correlation was determined between the body cathexis scores and these variables. The authors believe that educating young people about healthy nutrition and monitoring them through longitudinal research studies will be helpful to prevent eating disorders, which are significant in terms of public health.     

Underweight, overweight and obesity as risk factors for mortality and hospitalization

AIMS: The prevalence of overweight and obesity is increasing in many countries. We aimed to investigate differences in mortality and severe morbidity between underweight people (body mass index (BMI)<18.5), overweight people (BMI 25 to <30), obese people (BMI> or =30), and those with normal weights (BMI 18.5 to <25). METHODS: Random samples of the Swedish population aged 16-74 years in 1980-81 and 1988-89 were followed for 12 years with regard to all-cause mortality and mortality from circulatory diseases, all inpatient care, and inpatient care for circulatory and musculoskeletal diseases. Relative risks (RRs) for different levels of BMI were adjusted for age, longstanding illness, smoking, and educational level at baseline. In addition, analyses were made with delayed entry until the fourth-year after interview. RESULTS: Obesity and underweight, but not overweight, was associated with higher all-cause mortality. Among underweight men, the adjusted RR for all-cause mortality was 2.4 (95% confidence interval 1.6-3.6), and among underweight women it was 2.0 (1.5-2.7), but population attributable risks (PARs) were small, at 1.2% and 2.7%, respectively. Overweight was associated with increased risks for inpatient care for circulatory diseases, with PARs being 13.4% among men and 8.1% among women, and musculoskeletal diseases (PARs were 12.7% and 12.9%, respectively). Obese men and women had about 50% higher risks of all-cause mortality than normal-weight people, PARs being 3.2% and 3.8% respectively. CONCLUSIONS: This study supports the findings of other studies, in that overweight seems to be an exaggerated risk factor for all-cause mortality, but is related to other chronic disease. Underweight and obesity generally implies greater increases of RRs, but avoidance of overweight may have greater effect on the population level with regard to reduced cardiovascular and locomotor disease.     

Prevalence and factors affecting underweight,overweight and obesity using Asian and World Health Organization cutoffs among adults in Nepal: Analysis of the Demographic and Health Survey 2016

ObjectiveThere is a little published data on prevalence and determinants of underweight, overweight and obesity among adults in Nepal. This study analysed the cross-sectional Nepal Demographic and Health Survey (NDHS) 2016 to obtain these using the World Health Organization (WHO) and Asian-specific cutoffs of body mass index (BMI).MethodsThe 2016 NDHS used a multistage cluster-sampling design to obtain data on major health indicators in Nepal. The BMI cutoffs for underweight was <18.5 kg/m². The BMI cutoffs for overweight/obesity as per the Asian and WHO classifications were ≥23, and ≥25 kg/m², respectively. After reporting the prevalence according to sex and background characteristics, multilevel logistic regression was conducted to estimate odds ratios.SubjectsThis analysis included 12,652 adults (5283 males and 7369 females) with a median age of 40 years (interquartile range [IQR]: 28–54).ResultsThe overall median BMI was 21.5 kg/m² (IQR:19.3–24.3). The overall prevalence of underweight was 16.7% (15.1% among males and 17.1% among females). The Asian-specific BMI cutoffs found the prevalence of overweight and obesity as 26.4% (27.4% among males and 25.6% among females) and 11.0% (7.7% among males and 13.3% among females), respectively. The WHO-recommended BMI cutoffs found 18.2% people overweight (16.7% among males and 19.3% among females) and 4.3% (2.5% among males and 5.6% among females) people obese. The prevalence and odds of extreme body weight categories (i.e., underweight, overweight and obesity) varied according to age, sex, education level, household wealth status, place, ecological zone and provinces of residence as per both recommended cutoffs. Overall, higher education level and wealth status were positively associated with overweight/obesity and inversely associated with underweight as per both cutoffs.ConclusionA large proportion Nepalese adults have either underweight, overweight or obesity, and could be at a greater risk of mortality and morbidity due to these extreme body weight categories. It is essential to address the factors or characteristics that are associated with the higher prevalence and likelihood of these extreme body weight categories to reduce the overall burden of underweight and overweight/obesity in Nepal.     

The relationship between fat mass, eating behaviour and obesity-related psychological traits in overweight and obese individuals

Behavioural and psychological factors related to eating have been associated with obesity, although their relationship to anthropometric measures, more specifically fat mass, has not been fully examined. This study examined the relationship between fat mass (n=98; 75M, 23 F) and behavioural measures of eating and obesity related psychological traits (n=337; 226M, 111 F) in overweight and obese individuals (Mean BMI 30.5±4.0; BMI range 25-46kg/m(2)). Two sets of principal component analyses (PCA) were performed: one on validated questionnaires of eating behaviour and psychological traits and a second on fat mass and body weight related anthropometric measures (BMI, weight) and the aforementioned questionnaire measures. From the initial PCA (n=337), the primary principal component, P1 (R(2) value of 0.33), represented a latent variable associated with overeating or binge eating behaviour. In a second PCA (questionnaire measures augmented by anthropometric variables, n=98), a single component was identified, P1(+) (R(2) of 0.28), similar to that identified as P1 in the previous analysis and this component was highly correlated with fat mass (ρ=0.68). These findings suggest that levels of body fat and eating behaviour (namely, binging or overeating) are strongly related and, at least in a subgroup of individuals, obesity may be driven by behavioural factors associated with eating in combination with pre-existing environmental and genetic factors.     

Weight concern, body image, and abnormal eating in college women tennis players and their coaches

In order to study weight concerns and eating disorders in women tennis players, 107 women tennis players and 26 women's tennis coaches from colleges across the U.S. responded to questionnaires relating to weight concern, body image, and abnormal eating. When evaluating drawings of female figures, players and coaches both considered the ideal body shape to be smaller than the healthiest one. Most players had normal weight, eating habits, and self-esteem; however, they also exhibited noticeable concern about their weight and appearance. Coaches revealed only moderate knowledge of weight related issues, believed such knowledge to be important, recognized that most of their players were of normal weight, and revealed somewhat negative feelings about overweight people. Players and coaches shared a healthy attitude toward tennis. The results of this study do not imply that college women tennis players are at greater risk of eating disorders than other young women, nor that college coaches are encouraging abnormal eating behaviors     

Association between puberty and disordered eating, body image, and other psychological variables.

OBJECTIVE: To examine associations between puberty and disordered eating, body image, and other psychological variables. METHOD: Females were grouped into three categories of age at puberty onset (Study 1; N = 267) as well as three categories of self-perception of prepubertal weight (Study 2; N = 222). Participants in both studies were matched on current body mass index (BMI) across categories. RESULTS: Females who perceived themselves to be overweight prior to puberty scored significantly higher on measures of disordered eating, body dissatisfaction, asceticism, drive for thinness, impulse regulation, interoceptive awareness, and perfectionism. They also perceived their current body figure to be larger when compared with those who believed they were average or underweight prior to puberty. Age at puberty onset was not significantly associated with disordered eating, body dissatisfaction, depression, or self-esteem. However, females who entered puberty at an earlier age scored higher on measures of asceticism, drive for thinness, impulse regulation, and social insecurity. They also chose a more slender ideal body figure than those who entered at an older age. DISCUSSION: Females who believe they are overweight prior to puberty may be at risk for the development of disordered eating, body image dissatisfaction, and related problems. Age at puberty onset is not a consistent risk factor of pathological eating.     

Improving psychological treatment for obesity. Which eating behaviours should we target?

People who are obese and want to lose weight without surgery deserve the best treatment that we can offer. In the absence of robust and enduring treatment effects for psychological interventions for obesity, it is useful to return to first principles. From a behavioural perspective, the first task is to identify the full range of target eating behaviours involved in obesity. Surprisingly, a consensus on the key target eating behaviours typically involved in obesity does not seem to currently exist. In this opinion piece, we discuss which eating behaviours might be important to consider when treating obesity, and provide a self-report questionnaire that aims to identify these behaviours (see Supplementary material). We believe that it is important to be aware of the full range of eating behaviours that are potentially relevant to obesity, as different eating behaviours may be problematic for different people. Target eating behaviours associated with obesity may also be different from those of key relevance to eating disorders. Factors that should be taken into account when assessing target eating behaviours and developing effective treatments for obesity are also discussed. Particular attention is paid to 'grazing,' a relatively neglected high risk eating behaviour for weight gain.     

A Systematic Review of Diet Quality Index and Obesity among Chinese Adults

Diet quality scores are designed mainly based on Western-style dietary patterns. They were demonstrated to be good indicators of obesity in developed but not developing countries. Several diet quality scores were developed based on the Chinese dietary guidelines, yet no systematic review exists regarding how they were related to obesity. We searched research articles published between 2000 and 2021 in PubMed, CINAHL, and Scopus databases. Both cross-sectional and prospective studies that examined the relationship between a diet quality score and weight, body mass index, obesity, or waist circumference conducted in a Chinese population were selected. From the 602 articles searched, 20 articles were selected (12 are cross-sectional studies and 8 are prospective cohort studies). The relationship between internationally used scores and obesity was inconsistent among studies. Scores tailored to the Chinese diet demonstrated a strong relationship with both being underweight and obesity. The heterogeneity of the populations and the major nutrition transition in China may partially explain the discrepancies among studies. In conclusion, diet quality scores tailored to the Chinese diet may be associated with both undernutrition and overnutrition, as well as being underweight and obesity outcomes.     

Body image dissatisfaction and disordered eating in black and white women

OBJECTIVE: This study predicted and found that body image dissatisfaction and bulimic symptoms have a curvilinear relationship among undergraduate women. RESULTS: For the women in this sample, regardless of race, body image dissatisfaction correlated with bulimic symptoms, such that women who perceived themselves as bigger or smaller than the ideal body size for their ethnic group endorsed bulimic symptoms. Black and white women differed regarding their ethnic group's ideal body image and their self-perceptions of how they compared with the ideal image. Black women tended to report being underweight, whereas white women tended to report being overweight. DISCUSSION: The findings in this study suggest that some black women are not buffered against eating disorders as suggested in previous research.     

Impulsivity and inhibitory control deficits are associated with unhealthy eating in young adults

Heightened impulsivity and inefficient inhibitory control are increasingly recognized as risk factors for unhealthy eating and obesity but the underlying processes are not fully understood. We used structural equation modeling to investigate the relationships between impulsivity, inhibitory control, eating behavior, and body mass index (BMI) in 210 undergraduates who ranged from underweight to obese. We demonstrate that impulsivity and inhibitory control deficits are positively associated with several facets of unhealthy eating, including overeating in response to external food cues and in response to negative emotional states, and making food choices based on taste preferences without consideration of health value. We further show that such unhealthy eating is, for the most part, associated with increased BMI, with the exception of Restraint Eating, which is negatively associated with BMI. These results add to our understanding of the impact of individual differences in impulsivity and inhibitory control on key aspects of unhealthy eating and may have implications for the treatment and prevention of obesity.     

Development of body image,eating disturbance,and general psychological functioning in female adolescents: Covariance structure modeling and longitudinal investigations

Objective: Covariance structure modeling (CSM) and longitudinal analyses were used to identify a possible causal sequence for factors that might lead to the development of body image and eating disturbance in adolescent females. Method: In Study 1, subjects were measured for level of obesity, perceived weight status, maturational timing, history of being teased about weight/size, body image, eating disturbance, and global psychological functioning. Study 2 was a systematic replication of Study 1 using different indices of body image and a more comprehensive assessment of eating disturbance. In Study 3, subjects from Study 1 were reassessed at a 3-year follow-up. Results: The findings from Study 1 indicated that level of obesity and perceived weight, but not maturational timing, had a directional influence on the other variables. In addition, teasing history was significantly related to the development of body image and eating disturbance. CSM and path analyses with Studies 2 and 3 data generally replicated and extended the results from Study 1. Discussion: These findings offer important insights into possible causal sequences for the development of body image and eating disturbance. © 1995 by John Wiley & Sons, Inc.     

The sociocultural model of eating disorder development: application to a Guatemalan sample

Exposure to Western ideals of appearance along with rapid societal change appears to be salient risk factors for eating disorder development. According to the sociocultural model, internalization of the thin ideal leads to body dissatisfaction and subsequent negative affect and dieting behaviors which increase the risk for eating disorder development. An expanded version of the sociocultural model was examined among an economically stratified sample of 347 girls in grades 5 and 6 from Guatemala City. Questionnaires used to measure disturbed eating attitudes and behaviors, body dissatisfaction, social sensitivity, and internalization of the thin ideal were administered and BMI was calculated following measurement of height and weight. Path analyses showed that the expanded sociocultural model was an excellent fit to the data. Both elevated adiposity and social sensitivity led to increased body dissatisfaction and thin ideal internalization. Thin ideal internalization led to body dissatisfaction and to disturbed eating attitudes and behaviors. Results suggest that developing countries are not immune to the influence of sociocultural risk factors for eating disorders.