A longitudinal study to explain strategies to change weight and muscles among normal weight and overweight children

Previous research has indicated that both boys and girls strive for a slim body, with boys having an additional focus on a muscular body build. The current study was designed to evaluate the utility of a biopsychosocial model to explain body image and body change strategies among children. The study evaluated changes over time in body image and strategies to lose weight and increase muscles among 132 normal weight and 67 overweight boys (mean age = 9.23 years) and 158 normal weight and 55 overweight girls (mean age = 9.33 years). The predictive role of BMI, positive and negative affect, self-esteem and perceived sociocultural pressures to lose weight or increase muscle on body image and body change strategies over a 16 month period was evaluated. All participants completed the questionnaire on both occasions. The results demonstrated that both overweight boys and girls were more likely to be dissatisfied with their weight, place more importance on their weight, engage in more strategies to lose weight as well as perceive more pressure to lose weight. Overweight boys and girls were also more likely to report lower levels of self-esteem and positive affect, and higher levels of negative affect, and reported a reduction in their self-esteem over time. Regression analyses demonstrated that among overweight boys, low self-esteem and high levels of perceived pressure to lose weight predicted weight dissatisfaction; for overweight girls, weight dissatisfaction was also predicted by low levels of self-esteem. The implication of these findings in terms of factors contributing to the adoption of health risk behaviors among children is discussed.     

Measurement properties of instruments that assess inclusive access to fitness and recreational sports centers: A systematic review

BackgroundExercise is necessary for overall health and well-being for all individuals. For people with disabilities, fitness and recreational sports centers are reported to be generally inaccessible and not user friendly.ObjectiveThis review study aimed to identify instruments that assess access to fitness and recreational sports centers and to appraise the identified instruments' qualitative and quantitative attributes.MethodsWe systematically searched databases (AMED, CINAHL, EMBASE, MEDLINE, SCOPUS, SPORTDiscus and Web of Science for the years spanning 1950 to April 2012) and web-based search engines (Google and Google Scholar) to identify instruments, published in English that objectively assess the accessibility of fitness and recreational sports centers. Identified instruments were critically appraised using the qualitative attributes QAPAQ Checklist Part I and the COSMIN checklist for measurement properties.ResultsSeven instruments were included in this review: ADA Accessibility Guidelines Checklist for Buildings and Facilities (ADAAG); ADA Checklist for Readily Achievable Barrier Removal; Accessibility Instruments Measuring Fitness and Recreation Environments (AIMFREE); Community Health Environment Checklist – Mobility (CHEC-M); Removing Barriers to Health Clubs and Fitness Facilities (RBHCFF); Health Empowerment Zone Environmental Tool Shortened Environmental Checklist: Fitness Centre Survey (HEZEAT-FCS); Community Health Environment Checklist – Exercise Facilities (CHEC-Fit). Only the AIMFREE and CHEC-M have aspects of measurement properties evaluated.ConclusionWe recommend that instrument developers consider conducting full psychometric assessment of their instruments using adequate sample sizes. We also recommend they consider scoring methods and respondent burden to provide scientifically robust instruments that are easy to administer.     

Effects of a circuit weight training program on the body images of college students.

OBJECTIVE: The present investigation examined the extent to which participation in a 6-week circuit-weight training program produced changes in participants' body images relative to a matched control group. METHOD: The weight trainers consisted of 39 college students (27 women and 12 men). The control group of 39 individuals did not weight-train currently or within the past year. All participants were pre- and posttested on the Multidimensional Body Self-Relations Questionnaire, the Social Physique Anxiety Scale, and the Physical Self-Efficacy Scale. Weight trainers were also pre- and posttested on muscular strength and assessed on their motives for exercise. RESULTS: The program successfully increased upper- and lower-body strength. In contrast to the comparison group, weight trainers had a significantly improved evaluation of their appearance, greater body satisfaction, reduced social physique anxiety, and enhanced physical self-efficacy. Outcomes were unrelated to the extent of concurrent aerobic exercise and largely unrelated to exercise motives. DISCUSSION: Even a relatively brief weight training program can produce improvements in multiple aspects of body image. Further research should investigate weight training as an adjunct to psychosocial treatments of body dissatisfaction.     

孕前体重指数、孕期增重对泌乳时间影响的纵向研究

目的 探讨孕前BMI和孕期增重对泌乳时间的影响。方法 采用纵向研究方法, 于2013年3-9月选取成都市妇幼医疗机构产前门诊751名单胎健康孕妇作为基线调查对象, 在其分娩前后各随访一次, 最终以473名孕妇作为研究对象, 通过问卷调查和病历记录获得其孕前体重、分娩方式、新生儿出生体重、泌乳时间及基本信息, 测量身高和分娩前体重, 计算孕期增重;控制分娩方式、母亲年龄等混杂因素后, 采用多因素有序logistic回归模型分析孕前BMI和孕期增重与泌乳时间的关系。 结果 调查对象泌乳时间<1、1~、24~、48~和≥72 h的构成比分别占16.3%、37.0%、17.5%、18.6%和10.6%。与孕前体重正常组相比, 孕前消瘦和孕前超重或肥胖均是泌乳时间延长的危险因素, OR值(95%CI)分别为2.85(1.91~4.27)和 3.42(1.69~6.90)。与孕前体重正常且孕期增重适宜组相比, 孕前消瘦且孕期增重适宜和过多均是泌乳时间延长的危险因素, OR值(95%CI)分别为2.34(1.31~4.18)和3.42(1.67~7.00);孕前超重或肥胖且孕期增重过多是泌乳时间延长的危险因素, OR值(95%CI)为3.10(1.15~8.37)。结论 孕前BMI是泌乳时间的独立影响因素, 孕期增重需联合孕前BMI对泌乳时间产生影响。     

Comparative study on body shape satisfaction and body weight control between Korean and Chinese female high school students

This study was conducted to compare body shape satisfaction, body image perception, weight control status, and dietary habits of Korean and Chinese female high school students in order to provide information for proper body image perception of adolescents. 221 students in Yongin, a city in Korea, and 227 students in Weihai, a city in China, were surveyed using questionnaires. Body shape satisfaction was significantly higher in Chinese students (P < 0.001) compared to Korean students. 76.2% of Korean students and 72.7% of Chinese students wanted a thinner body shape than their present body shapes. Experiences of weight control, laxative or diuretics uses, eating during weight control, and vomiting after eating were significantly higher in Korean students (P < 0.05-P < 0.001) compared to Chinese students. The score for dietary habits was significantly higher in Chinese students (P < 0.001) compared to Korean students, suggesting a more desirable dietary habit among Chinese students. Students of both countries showed a significantly positive correlation between body shape satisfaction and dietary habits, suggesting that as body shape satisfaction increases, dietary habits become more desirable. In conclusion, Korean female students showed a more distorted body image perception and had more poor dietary habits than Chinese students. Nutritional education for the establishment of normal body weight, proper body image perception, and healthy dietary habits are needed.     

胎儿形体发育变化趋势的初步分析

目的:研究胎儿发育不同孕期的形体特征的变化规律,为临床评估胎儿发育状况和指导孕妇科学膳食提供理论依据。方法:对147例孕12～36周胎儿的体长、坐高、肢体长度、头颅径线和体重进行了测量和统计。结果:胎儿的体长和坐高在3个月胎龄时分别为10.5 cm和7.7 cm;到7月胎龄时身长达36.3 cm,坐高达26.1 cm,为一生中生长最快的时期。从8月胎龄开始,胎儿的身长和坐高增幅下降。孕期全程,胎儿身长对胎龄的直线回归方程式为Y=-2.75+5.31χ,R值为0.82,P0.01;坐高的直线回归方程式为Y=-1.39+3.50χ,R值为0.77,P0.01。上、下肢长度在3月胎龄时分别为3.1 cm,3.2cm。从4月胎龄始,下肢和足的生长速度加快,到9月胎龄时下肢长于上肢3.3 cm、足长于手1.4 cm;胎儿的上肢、下肢、手和足的发育随胎龄呈直线型增长。3月胎龄胎儿的BPD和枕额径分别为19.6 mm和26 mm;以后胎儿BPD和枕额径增长迅速,孕6月时达到57.9 mm和72.3 mm。BPD增加了38.3 mm,枕额径增加了46.3 mm。6月胎龄后,BPD和枕额径增速放缓,9月胎龄时,BPD和枕额径分别仅增加了21.5 mm和25.1 mm。胎儿的BPD也与胎龄呈正相关关系。体重增加的快速期始于胎龄6个月,在3个孕月的时间内,胎儿体重增加了2倍,增长值达1 400 g之多。除3个月胎龄外,各月份的胎儿体重均高于15年前的胎儿。结论:目前胎儿形体生长发育长度指标与15年前没有明显差别。胎儿体重在妊娠6个月后生长明显加快;并高于15年前的胎儿,提示现今孕妇营养状况优于15年前。     

A longitudinal study of pediatric body mass index values predicted health in middle age

BACKGROUND AND OBJECTIVE: To characterize the use of pediatric body mass index (BMI) to predict obesity, overweight, and diseases in middle age. METHODS: A longitudinal study of people born in a week in 1958 (n=12,327). The main outcome measures are obesity (BMI > or = 30) and overweight (BMI > or = 25) at age 33 and disease history self-reported at age 42. Receiver operating characteristic (ROC) analysis was performed using BMI measured at ages 7, 11, and 16 years as predictors. RESULTS: BMI values measured at age 11 could predict obesity at age 33 with areas under ROC curve (AUC) of 0.78 for males and 0.80 for females (each P < .001). BMI values at age 11 predicted overweight with slightly smaller AUC (each P < .001). They could also predict history of diabetes and hypertension (AUC=0.60 and 0.56, respectively, each P < .01), both sexes pooled. Prediction based on BMI at age 7 was less satisfactory; that at 16 gave limited improvement. Cutoff points based on ROC curves, the international reference, and the 85th and 95th percentiles gave very different profiles of diagnostic features. CONCLUSION: Pediatric BMI may predict adult obesity and overweight with a reasonable profile of sensitivity and specificity.     

维吾尔族妇女孕期体重变化与妊娠结局的关系

目的:通过对500例单胎足月维吾尔族产妇病历进行回顾性分析,探讨孕期体重增长与妊娠结局的关系。方法:采用回顾性研究方法,选取乌鲁木齐市妇幼保健院的500例维吾尔族住院分娩初产妇的病历资料,按孕期BMI增幅分组,分别比较分娩方式、新生儿体重、妊娠合并症及并发症情况,分析维吾尔族妇女孕期体重变化对妊娠结局的影响。结果:不同BMI体重增长分组间妊娠期高血压疾病(χ2=8.371,P=0.015)、妊娠期糖尿病(χ2=6.308,P=0.043)、巨大儿发生率(χ2=6.422,P=0.040)的差别均有统计学意义。结论:孕期体重超增长对妊娠结局会产生不利影响。通过孕前适当控制体重,根据孕前体重指数指导孕妇合理营养并适当增加体重,以期获得最好的妊娠结局。     

Effects of spouses' socioeconomic characteristics on mortality among men and women in a Norwegian longitudinal study

A partner's socioeconomic characteristics can influence one's own health. Nevertheless, little is known about the relative importance of a partner's education, occupation and income in relation to inequalities in mortality. In this study, we consider the relative contribution of these three spouse characteristics to predicting general and cause-specific mortality in men and women. Data on married persons and their spouses were taken from a Norwegian cross-sectional survey of a total county population (the Nord-Trøndelag Health Study, HUNT 1, 1984–1986). A mortality follow-up was maintained until 2003. Associations of mortality with socioeconomic indicators were assessed computing hazard ratios and Relative Index of Inequality in Cox regression. In women, a clear gradient in age-adjusted mortality rates was observed according to all husband's characteristics. In men, wife's education was most consistently associated with their mortality. After mutual adjustment for all own and spouse's socioeconomic characteristics, the effect of husband's education on women's overall mortality diminished (HR 1.07), whereas the effects of husband's occupation and income remained of similarly moderate size (HR 1.12). Wife's education persisted after adjustment as a significant and strong predictor of men's all-cause mortality (HR 1.35). Effects of partner's characteristics were mostly pronounced in cardiovascular mortality and far less in cancer mortality. In men, wife's education was the strongest and only predictor of mortality across all causes of death examined, except stroke. In women, husband's occupation was mainly related to ischemic heart disease and lung cancer mortality, while husband's income influenced mainly stroke mortality. Wife's education and husband's occupation and income were the most important predictors of mortality across partner relationships. It is suggested that men contribute to their wives' health not only by means of financial security, but also through occupational class. Further research should test our hypothesis that the effect of husband's occupation on their spouses works through occupation-related lifestyle and social prestige.     

Parenthood and trajectories of change in body weight over the life course

Scholars call for greater attention to social contexts that promote and deter risk factors for health. Parenthood transforms social contexts in a myriad of ways that may influence long-term patterns of weight gain. Life course features of parenthood such as age at first birth, parity, and living with a minor child may further influence weight gain. Moreover, the social and biological features of parenthood vary in systematic ways for women and men, raising questions about how social contexts might differentially affect weight patterns by gender. We consider how parenthood influences trajectories of change in body weight over a fifteen year period (from 1986 to 2001) with growth curve analysis of data from the Americans' Changing Lives Survey, conducted with adults aged 24 and older in the contiguous United States (N = 3617). Findings suggest that parents gain weight more rapidly than the childless throughout the study period and that this weight gain occurs for both men and women. Men and women who have their first child earlier or later than about age 27 have accelerated weight gain, living with a minor child is associated with heavier weight for men than women, and parity is associated with greater weight gain for women than men. We conclude that parenthood contributes to a long term, cumulative process of weight gain for American women and men but life course factors that accelerate this process may differ by gender.     

2013年中国18岁及以上超重肥胖患者采取体重控制措施情况及影响因素分析

目的 了解2013年我国≥18岁超重肥胖患者采取体重控制措施情况,分析其影响因素。方法 2013年在中国慢性病及其危险因素监测的302个监测点,采用多阶段分层整群随机抽样方法调查≥18岁成年人179 570人。问卷调查获取人口学特征、采取体重控制措施情况等信息;通过体格检查获取个体的BMI、腰围和血压;采集调查对象静脉血,检测FPG、餐后2 h血糖、TC、TG、LDL-C和HDL-C。剔除关键信息缺失者152人,最终对87 545名调查对象资料进行分析。经复杂加权后分析不同特征超重肥胖患者采取体重控制措施情况及其影响因素。结果 我国≥18岁超重肥胖患者采取体重控制措施率为16.3%（95% CI：14.9%～17.7%）。在所有采取体重控制措施的12 133名患者中,采取体重控制措施的构成比例由高到低依次为：饮食（40.9%,95% CI：38.4%～43.3%）、饮食运动组合（31.5%,95% CI：28.9%～34.0%）、运动（22.8%,95% CI：21.0%～24.6%）和药物（1.3%,95% CI：1.0%～1.7%）。有利于采取体重控制措施的因素有女性（OR=1.26,95% CI：1.15～1.38）、低年龄（18～44岁,OR=1.51,95% CI：1.31～1.74）、高文化程度（大专及以上,OR=4.52,95% CI：3.76～5.43）、高年收入（2.4～万元,OR=1.94,95% CI：1.63～2.30）等;不利因素有农村（OR=0.63,95% CI：0.55～0.72）等。结论 我国超重肥胖患者采取体重控制措施率较低,且受性别、年龄、文化程度、收入水平等因素影响,应针对不同特征群体,开展针对性干预措施。     

西南3省妇女孕前体质指数和孕期增重对新生儿出生体重影响的前瞻性队列研究

目的 探讨孕妇孕前BMI、孕期增重对新生儿出生体重的影响。方法 以来自西南3省的5 395名孕妇为研究对象,根据WHO推荐的BMI分类标准将孕妇分为孕前低体重组、正常体重组、超重组以及肥胖组。按照美国医学研究院推荐的孕期增重标准定义各组孕妇孕期增重是否适宜。采用无序多分类logistic回归模型分析孕前BMI和孕期增重与新生儿出生体重的关系。结果 调整相关混杂因素后,孕前BMI较低（OR=1.91,95% CI：1.47~2.50）是分娩小于胎龄儿（SGA）的危险因素,但可降低分娩大于胎龄儿（LGA）的风险（OR=0.55,95% CI：0.47~0.66）。孕期增重不足会使SGA的发生风险增加（OR=1.57,95% CI：1.21~2.03）,分娩LGA的风险降低（OR=0.48,95% CI：0.41~0.57）。孕前超重肥胖（OR=1.85,95% CI：1.58~2.17）以及孕期增重过多（OR=1.87,95% CI：1.67~2.11）与LGA的发生风险呈正相关。分层分析显示孕期增重不足仅会使孕前BMI较低和正常的孕妇分娩SGA的风险升高,对孕前超重肥胖的孕妇分娩SGA的风险没有影响。结论 孕前BMI和孕期增重是新生儿出生体重的重要影响因素,应加强孕妇健康教育、合理控制孕期增重。     

孕前体质指数及孕期增重对新生儿出生体重影响的前瞻性队列研究

目的  分析孕妇孕前体质指数(body mass index, BMI)及孕期增重(gestational weight gain, GWG)与新生儿出生体重的关联性, 并探究孕妇孕前及孕中体重动态变化对新生儿低出生体重(low birth weight, LBW)及巨大儿的影响。 方法  收集中国孕产妇队列·协和纳入的孕早期孕妇孕前体重, 并随访至分娩后, 收集分娩前体重及新生儿出生结局。将孕妇孕前BMI分为低体重组、正常体重组及超重/肥胖组, 将GWG分为适宜、不足及过多组。采用多因素多分类(多项)Logistic回归分析模型探讨孕前BMI及GWG与新生儿出生体重的关系。 结果  孕前BMI及GWG与子代出生体重相关(均有P < 0.05)。孕前超重/肥胖(OR=2.339, 95%CI:1.674~2.282, P < 0.001)、GWG过多(OR=1.398, 95%CI:1.188~1.978, P=0.048)显示为巨大儿的危险因素, GWG不足(OR=1.479, 95%CI:1.461~1.679, P=0.035)显示为LBW的危险因素, GWG过多会降低LBW的发生风险(OR=0.428, 95%CI:0.225~0.817, P=0.010)。低BMI-GWG不足(OR=1.335, 95%CI:1.048~2.319, P=0.048)是LBW的危险因素; 正常BMI-GWG过多(OR=1.088, 95%CI:1.016~1.675, P=0.038)和超重/肥胖-GWG过多(OR=1.498, 95%CI:1.244~2.017, P=0.046)是巨大儿的危险因素。 结论  孕前BMI及GWG是影响新生儿出生体重的重要因素, 提示女性应合理控制孕前及孕中体重变化。     

绿茶提取物降低中年人血脂和体重指数的临床实验研究

目的探讨绿茶提取物对中年人血脂和体重指数的降低作用。方法248名轻度高脂血症患者随机分两组,分别口服含绿茶提取物的茶叶片和安慰剂20周,比较分析绿茶提取物对血脂和体重指数的影响。结果绿茶提取物降低了中年人血清总胆固醇(P<0.01)和低密度脂蛋白胆固醇(P<0.01);而且,饮绿茶降低了中年人体重指数(P<0.01)。结论绿茶提取物可降低中年高脂血症者的血脂和体重指数。