Violencia de pareja y depresión en mujeres que trabajan en una institución de salud de México

ObjectiveTo assess the effect of intimate partner violence on the risk of depression and depressive symptoms among adult women.MethodWe analyzed data from the Mexican Health Workers’ Cohort study (n = 470). Type and severity of intimate partner violence was ascertained between 2004 and 2011. Self-reported medical diagnosis of depression (2011) was the main outcome; depressive symptoms ascertained with the Centre for Epidemiologic Studies-Depression (CES-D) scale was the secondary outcome. Random-effects regressions were run to model the risk of depression (logistic) and depressive symptoms (linear) in relation to intimate partner violence.Results41.9% women experienced intimate partner violence at baseline. The incidence of depression was 7.2%. The risk of depression increased with any type of IPV (adjusted odds ratio [aOR] = 2.9; 95% confidence interval [95%CI]: 1.4–6.2) and with physical (aOR = 4.3; 95%CI: 1.8–10.1), psychological (aOR = 3.1; 95%CI: 1.4–6.6) and sexual (aOR = 3.1; 95%CI: 1.2–8.2) violence. Depressive symptoms (CES-D) increased slightly with physical and sexual intimate partner violence.ConclusionsIntimate partner violence was associated with a higher risk of depression in this sample of women working in a Mexican health facility. Our results indicate the need to develop infrastructure, to implement strategies of attention and counselling, and to provide a safe environment in the workplace for women who experience intimate partner violence.     

A pilot study to assess the feasibility and acceptability of a community based physical activity intervention (involving internet,telephone, and pedometer support), integrated with medication and mood management for depressed patients

ObjectiveTo assess the feasibility and acceptability of a multi-component intervention to treat depression in primary care.MethodsA single group prospective design was used to examine the feasibility and acceptability of a 12-week intervention combining antidepressant medication, brief behavioral counseling and physical activity (PA) promotion, and also associated changes in depression and various self-reported measures. A sample of adults with mild-to-moderate major depression and willingness to take antidepressant medication were recruited through local primary care clinics. A Research Nurse Practitioner (RNP) prescribed the selective serotonin reuptake inhibitor, escitalopram (10–20 mg), and provided brief weekly counseling. In addition participants received a pedometer, printed materials, and weekly emails addressing behavioral skills to increase their physical activity. Participants' depressive symptoms, quality of life and PA attitudes were surveyed at baseline, 6 and 12 weeks. At week 12 they also reported their satisfaction with the study components.ResultsOf the 36 participants recruited, 64% of participants completed measures at week 12, 30% completed all 12 counseling sessions and 60% responded to half the emails. By week 12, participants reduced their depressive symptom scores (by 4.7; p < .001), improved their quality of life scores (by 9.7; p < .001) and increased their daily step counts (by 2449.2; p < .03). Of the 23 who responded, over 70% thought the pedometer, calls and print materials helped improve their mood. Those who completed more counseling were more likely to reduce their depressive symptoms at week 12 (r = −.46; p < .05).ConclusionThis pilot study demonstrated the feasibility and acceptability of a multi-component intervention to reduce depressive symptoms in a sample of mild-to-moderately depressed adults.     

Effect of exercise intensity on depressive symptoms in women

Exercise has been shown to relieve depressive symptoms, yet optimal exercise intensity for treating depression has not been established. The mechanisms that explain the antidepressant effect of exercise also require investigation. The purpose of this study was to test (a) the effect of two different exercise intensities prescribed for aerobic training on depressive symptoms, and (b) a previously proposed psychological mechanism for this effect: self-efficacy. Sedentary women scoring ≥14 on the Beck Depression Inventory-II (BDI-II) were randomized to one of two aerobic training groups that differed on exercise intensity (high [65–75% MaxVO₂ reserve] or low [40–55% MaxVO₂ reserve]), or to a stretching control group for 10 weeks. Main outcome variables included depressive symptoms (BDI-II) and self-efficacy (exercise self-efficacy [ESE] and depression coping self-efficacy [DCSE]), which were measured at study entry, 5 and 10 weeks later. Participants in all groups (high, n = 18; low, n = 18; stretching, n = 18) had significant reductions in depressive symptoms at Week 5 (p < .001) and Week 10 (p < .001). The BDI-II change scores did not differ significantly among the groups (p = .066). Follow-up analyses controlling for baseline BDI-II scores showed that the high intensity group had significantly fewer depressive symptoms than the low intensity and stretching control groups at weeks 5 and 10 (p < .05). There was no significant association between changes in aerobic capacity and changes in depressive symptoms (r = ?.099, p = .491). At 10 weeks, both ESE (p = .013) and DCSE (p < .001) increased significantly for the whole sample, with no significant group difference (p = .613 for ESE, p = .277 for DCSE). Controlling for baseline scores, the increase remained significant for ESE (p = .005) but not for DCSE (p = .629). Partial correlations showed significant negative relationships between both types of self-efficacy and depressive symptoms at Week 5 and Week 10 (p < .02). We concluded that both high and low intensity aerobic exercise, as well as stretching exercise were associated with reductions in mild to moderate depressive symptoms in initially sedentary women. Changes in depression were associated with changes in ESE and DCSE.     

Impact of a community-based exercise programme on physical fitness in middle-aged and older patients with type 2 diabetes

ObjectivesPhysical fitness is related to all-cause mortality, quality of life and risk of falls in patients with type 2 diabetes. This study aimed to analyse the impact of a long-term community-based combined exercise program (aerobic + resistance + agility/balance + flexibility) developed with minimum and low-cost material resources on physical fitness in middle-aged and older patients with type 2 diabetes.MethodsThis was a non-experimental pre-post evaluation study. Participants (N = 43; 62.92 ± 5.92 years old) were engaged in a community-based supervised exercise programme (consisting of combined aerobic, resistance, agility/balance and flexibility exercises; three sessions per week; 70 min per session) of 9 months’ duration. Aerobic fitness (6-Minute Walk Test), muscle strength (30-Second Chair Stand Test), agility/balance (Timed Up and Go Test) and flexibility (Chair Sit and Reach Test) were assessed before (baseline) and after the exercise intervention.ResultsSignificant improvements in the performance of the 6-Minute Walk Test (Δ = 8.20%, p < 0.001), 30-Second Chair Stand Test (Δ = 28.84%, p < 0.001), Timed Up and Go Test (Δ = 14.31%, p < 0.001), and Chair Sit and Reach Test (Δ = 102.90%, p < 0.001) were identified between baseline and end-exercise intervention time points.ConclusionsA long-term community-based combined exercise programme, developed with low-cost exercise strategies, produced significant benefits in physical fitness in middle-aged and older patients with type 2 diabetes. This supervised group exercise programme significantly improved aerobic fitness, muscle strength, agility/balance and flexibility, assessed with field tests in community settings.     

Feasibility and effects of a group-based resistance and aerobic exercise program for individuals with severe schizophrenia: A multidisciplinary approach

PurposePeople with schizophrenia/schizoaffective disorders have a higher risk of morbidity and premature mortality compared to the general population in part due to sedentary lifestyles. The aim of this pilot study was to investigate the feasibility and effects of aerobic (AT) and resistance training (RT) on individuals with schizophrenia/schizoaffective disorders.MethodsEight males and five females (mean age 44.6 ± 3 years) were randomized to either twice weekly exercise (n = 7) or usual care (control) (n = 6). Functional exercise capacity (six minute walk distance (6MWD)), muscular strength, anthropometric measures, and domains of mental health were measured at baseline and after 12 weeks. Data are presented as means ± SEM.ResultsThe exercise group demonstrated a 27.7 ± 22.3 m increase in 6MWD while the control group showed a decrease of 28.3 ± 26.6 m (between-group difference, p = 0.1). There was a significant strength increase for exercise (28.3 ± 8.8%, p = 0.01) but not for control (12.5 ± 8.5%, p = 0.2). The exercise group had a significant improvement in total Mental Health Inventory (MHI) score (p < 0.03) with no change for control. Gain in 6MWD was directly associated with improvement in total MHI score (r = 0.8, p = 0.009) as was reduction in depressive symptoms (r = ?0.9, p < 0.001) among all participants. Attendance at exercise sessions averaged 72 ± 4.4% with no dropouts. Reduction in depressive symptoms correlated with greater adherence to exercise (r = ?0.93, p = 0.02).ConclusionsA 12-week community-based AT and RT program results in significant improvements in overall mental health, muscular strength and a trend for improvement in functional exercise capacity. Among all participants, improvement in functional exercise capacity was associated with improvement in overall mental health as well as a reduction in depressive symptoms. Reduction in depressive symptoms was associated with greater adherence to exercise. A group exercise program for individuals with schizophrenia/schizoaffective disorder is feasible when implemented by a multidisciplinary team.     

Electronic dietary recording system improves nutrition knowledge,eating attitudes and habitual physical activity: A randomised controlled trial

ObjectiveThis study's objective was to investigate whether use of an electronic dietary recording system improves nutrition knowledge, eating attitudes and habitual physical activity levels compared to use of a food diary and no self-monitoring.MethodsSixty adults aged 20–60 with a body mass index ≥ 25 were recruited and randomly assigned to one of three groups: a group using an electronic system (EG), a group using a food diary (FD) and a control group using nothing (CG) to record food intake. All participants took part in three 60–90 nutrition seminars and completed three questionnaires on general nutrition knowledge, habitual physical activity levels and eating attitudes at the beginning and end of the 12-week study. The pre- and post-test scores for each questionnaire were analysed using a paired sample t-test.ResultsSignificant improvements in the domain of ‘dietary recommendations’ were found in the EG (p = 0.009) and FD groups (p = 0.046). Great improvements were found in ‘sources of nutrients’, ‘choosing everyday foods’ and ‘diet–disease relationships’ in EG and FD groups. EG group showed greater improvement in the work index and sport index.ConclusionAn electronic dietary recording system may improve eating and exercise behaviour in a self-monitoring process.     

The impact of physical activity on physical health functioning – A prospective study among middle-aged employees

ObjectiveTo examine whether physical activity contributes to physical health functioning five to seven years later among middle-aged employees.MethodsBaseline data were collected in 2000–2002 by questionnaire surveys among 40–60-year-old employees of Helsinki City. A follow-up survey was conducted among baseline respondents in 2007 (n = 7330, response rate 83%). Physical activity during leisure time or commuting within the previous 12 months was asked at baseline. Physical health functioning was measured by physical component summary (PCS) of the Short-Form 36 questionnaire. PCS mean scores were examined, as were poor and good PCS scores.ResultsVigorously active and conditioning exercisers had better subsequent physical health functioning than did the inactive and moderately active. Baseline health and functioning explained a major part of the differences found. Smoking, alcohol use and BMI further explained some of the differences. No clear differences in physical health functioning mean scores emerged during follow-up. In good physical health functioning, however some differences between conditioning and inactive women remained after adjustments.ConclusionsProspective associations between physical activity and physical health functioning were relatively weak, but high physical activity may help in maintaining good physical health functioning. Vigorous activity may be more beneficial than moderate activity.     

Proxy reports of physical activity were valid in older people with and without cognitive impairment

ObjectiveTo determine the validity of proxy reports of physical activity in people with symptoms of cognitive impairment.Study Design and SettingIn the Canadian Study of Health and Aging, a multicenter prospective cohort study, someone close to the participant (proxy) reported exercise levels for people who screened positive for cognitive impairment or were institutionalized (n = 2421), some of whom were subsequently diagnosed with cognitive impairment (n = 1612) and some of whom were diagnosed as having no cognitive impairment (n = 809). The reliability and validity of proxy reports of physical activity were examined by agreement with self-reports of physical activity (intraclass correlation coefficient) and by association with adverse health markers (Mantel–Haenzel χ²) and survival time (Cox proportional hazards).ResultsProxy reports of physical activity had moderate interrater reliability (0.55, 95% confidence interval: 0.49–0.61, P < 0.001). People in higher physical activity group had fewer adverse health outcomes than those in lower physical activity groups. Predictive validity was confirmed as people who had higher proxy-reported physical activity survived longer that those with lower physical activity.ConclusionProxy-reported physical activity appears to be a valid estimate of physical activity in people with symptoms or a diagnosis of cognitive impairment.     

Effects of aerobic exercise on sexual functioning in depressed adults

ObjectiveExercise appears to be generally comparable to antidepressant medication in reducing depressive symptoms. The current study examines the effects of aerobic exercise, compared to antidepressant medication and placebo pill, on sexual function among depressed adults.MethodsTwo hundred clinically depressed adults, aged 40 years and over, who were sedentary and generally overweight, were randomized to 4 months of Aerobic Exercise, Sertraline (Zoloft), or Placebo pill, for the treatment of depression. Exercise condition participants engaged in walking, running, or biking, 30 min/day, 3 days/week, to 70–85% of their heart rate reserve, in either a supervised group setting or independently at home. Before and following treatment, participants completed the Arizona Sexual Experiences Questionnaire (ASEX) and the Hamilton Rating Scale for Depression (HAM-D). An ANCOVA was performed to test the effects of treatment on post-treatment sexual function, controlling for age, sex, body mass index, diabetes, hypertension, pretreatment HAM-D scores, and pretreatment ASEX scores.ResultsThe treatment group main effect was significant (p = .02); exercisers had better post-treatment ASEX scores (adjusted ASEX M = 16.6) compared to the placebo group (adjusted ASEX M = 18.3; p = .01). Exercisers had post-treatment ASEX scores that were marginally better compared to the sertraline group, but this difference did not reach statistical significance (adjusted ASEX M = 17.9; p = .05).ConclusionAerobic exercise, which has been associated with reduced symptoms of depression comparable to antidepressant medication, appears to result in greater improvement in sexual function compared to placebo pill. A nonsignificant trend towards better sexual function among exercisers compared to antidepressant medication may be attributable to medication-related sexual side effects.     

An internet-delivered exercise intervention for workplace health promotion in overweight sedentary employees: A randomized trial

ObjectiveTo evaluate the effect of structured vs. non-structured internet-delivered exercise recommendations on aerobic exercise capacity and cardiovascular risk profile in overweight sedentary employees.Methods140 employees of an automobile company (11% female, median age 48 years (range 25–60), BMI 29.0 kg/m² (25.0–34.8)) were randomized in a 3:2 ratio to an intervention group receiving structured exercise schedules or a control group choosing workouts individually via an interactive website. The 12-week intervention took place in Munich, Germany, during summer 2008. Main outcome measure was performance at the lactate anaerobic threshold (P_AT/kg) during ergometry.Results77 participants completed the study. The intervention group (n = 50) improved significantly in P_AT/kg ((mean (SD)) 1.68 (0.31) vs. 1.81 (0.33) W/kg; p = 0.002), VO₂peak (3.21 (0.63) vs. 3.35 (0.74) L/min; p = 0.04), and waist circumference (100.5 (7.9) vs. 98.0 (7.8) cm; p = 0.001). The control group (n = 27) improved significantly in P_AT/kg (1.59 (0.38) vs. 1.80 (0.49); p < 0.001) and waist circumference (101.9 (8.7) vs. 98.3 (8.5) cm; p < 0.001), but not in VO₂peak. No significant between group differences in these outcome measures were noted.ConclusionStructured, internet-delivered exercise recommendations are not superior to internet-delivered non-structured exercise recommendations in a workplace setting. Both lifestyle intervention strategies are, however, limited by high dropout rates.     

Exercise facilitates smoking cessation indirectly via improvements in smoking-specific self-efficacy: Prospective cohort study among a national sample of young smokers

ObjectiveThe purpose of this study was to examine whether exercise is associated with 2-year follow-up smoking status through its influence on smoking-specific self-efficacy.MethodsLongitudinal data from the 2003–2005 National Youth Smoking Cessation Survey were used, including 1,228 participants (16–24 years). A questionnaire was used to examine baseline exercise levels, baseline smoking-specific self-efficacy, follow-up smoking status, and the covariates.ResultsBaseline exercise was associated with baseline self-efficacy (β = 0.04, p < 0.001) after adjusting for age category, sex, race–ethnicity, education, and nicotine dependence. Baseline self-efficacy, in turn, was associated with 2-year smoking status (β = 0.23, p < 0.001) after adjustments. There was no adjusted direct effect of baseline exercise on 2-year smoking status (β = 0.001, p = 0.95); however, the adjusted indirect effect of baseline self-efficacy on the relationship between exercise and 2-year smoking status was significant (β = 0.008, bootstrapped lower and upper CI: 0.002–0.02; p < 0.05). The mediation ratio was 0.837, which indicates that smoking-specific self-efficacy mediates 84% of the total effect of exercise on smoking status.ConclusionsAmong daily smokers, exercise may help to facilitate smoking cessation via exercise-induced increases in smoking-specific self-efficacy.     

Changes in leisure-time physical activity and subsequent sickness absence: A prospective cohort study among middle-aged employees

ObjectiveThe aim of this study was to examine how changes over time in leisure-time physical activity are associated with subsequent sickness absence.MethodsHelsinki Health Study cohort baseline questionnaire survey data were collected in 2000–2002 among 40–60-year-old employees of the City of Helsinki, Finland. A follow-up survey was conducted in 2007. 4182 (83% women) respondents were available for the analyses. Leisure-time physical activity was asked using identical questions in both surveys. Sickness absence data were derived from the employer's registers (mean follow-up time 2.8 years). Associations of changes over time in leisure-time physical activity with self-certified (≤ 3 days) and medically certified (> 3 days) sickness absence spells were examined, using Poisson regression analysis.ResultsInactive women and men who increased their physical activity to vigorously active had a significantly lower risk of both self-certified (RR = 0.80, 95% CI 0.65–0.97) and medically certified (RR = 0.63, 95% CI 0.49–0.83) subsequent sickness absence spells compared with the persistently inactive. The persistently active with vigorous intensity had the lowest risk of sickness absence. Adjusting for changes in physical health functioning attenuated but did not abolish the lowered risk found.ConclusionsFor reducing sickness absence more emphasis should be given to the potential contribution of vigorous physical activity.     

Predictability of cardiorespiratory fitness on the risk of developing metabolic syndrome and diabetes mellitus in Taiwan adults: Preliminary analysis of a cohort study

ObjectiveTo explore the prediction of aerobic exercise and resistance training on incidental metabolic syndrome (MetS) and diabetes in a Taiwanese cohort.MethodsThe participant underwent annual health examinations and physical fitness tests, including 2-min push-up, 2-min sit-up, and endurance 3000-m none weight-bearing running exercise test from 2013 to 2015, were recruited. The cohort study involved 27,787 participants aged ≥20 years in military services. Multivariate logistic regression odd ratios models were used to explore the associations between the performance of physical fitness and the development of MetS and diabetes.ResultsThe male participants without MetS at baseline with poor performance in aerobic and resistance exercise tests were likely to develop the MetS and diabetes two years later; while the female participants did not show the same results in statistical significance. Additionally, only poor performance measuring by resistance training exercise test was significantly associated with increased risk of metabolic components numbers at follow-up in all subjects without MetS (all P < 0.05).ConclusionsThe poor performance in aerobic and resistance exercise tests might be predicting tools for MetS and diabetes in Taiwanese men without MetS at baseline. And resistance exercise displayed a substantial predicting ability in development of metabolic abnormality, MetS and diabetes in our study.     

Effect of dairy products on oxidative stress in type 2 diabetic patients: A randomized controlled clinical trial

ObjectiveThe aim of this randomized control trial was to assess the effect of dairy product (milk and yogurt) consumption on oxidative stress biomarkers in diabetic patients.Material and methodsNinety-one diabetic patients were randomly assigned to one of the three following intervention groups: group A (<1 serving of dairy products), group B (2 to 3 servings), and group C (4 to 5 servings). Biomarkers of oxidative stress including, serum total antioxidant capacity, catalase activity, malondialdehyde (MDA) were measured at baseline and after the 8-week intervention.ResultsNo significant difference was found in oxidative stress between groups, except for MDA that significantly decreased in group C.ConclusionsConsumption of dairy products including milk and yogurt, ≥ 4 servings per day, reduced MDA concentration, however consumption ≤ 3 serving per day had no significant effect on oxidative stress among diabetic patients.     

The effects of moderate and vigorous exercise on desire to smoke,withdrawal symptoms and mood in abstaining young adult smokers

Previous research has reported reductions in desire to smoke and withdrawal symptoms following exercise. However, studies have thus far failed to consider whether vigorous intensity exercise can influence the potential for exercise to reduce cigarette cravings. The present study investigated the effects of short bouts of moderate and vigorous exercise on strength of desire to smoke, withdrawal symptoms and mood, relative to control, in temporarily abstinent young adult smokers. Following overnight abstinence from smoking, 45 regular smokers (aged 18–25 years, smoking 13.6 (±3.5) cigarettes per day) were assigned to 10 min of either (i) moderate intensity cycle ergometry (n = 15), (ii) vigorous intensity cycle ergometry (n = 15), or (iii) passive waiting (n = 15). A strength of desire to smoke item, the Mood and Physical Symptoms Scale (MPSS) and Subjective Exercise Experiences Scale (SEES) were administered at baseline, 5 min during, 5 min after and 30 min after all conditions. Both moderate and vigorous intensity exercise were beneficial in alleviating the desire to smoke during and 5 min after exercise, relative to the control group, but only moderate intensity exercise appeared to reduce withdrawal symptoms and improve mood up to 5 min after exercise. No effects lasted for 30 min. Vigorous exercise was associated with adverse mood outcomes during exercise, but not afterwards. Thus, moderate intensity exercise may be generally preferential in reducing cravings and improving mood in abstaining smokers.     

A tailored internet-plus-email intervention for increasing physical activity among ethnically-diverse women

ObjectiveTo evaluate the feasibility and efficacy of an individually tailored, Internet-plus-email physical activity intervention designed for adult women.MethodHealthy and ethnically-diverse adult females (N = 156) (mean age = 42.8 years, 65% Caucasian) from California were randomly assigned to an intervention (access to a tailored website and weekly emails) or wait-list control group. Participants completed web-based assessments of physical activity, stage of behavior change, and psychosocial variables at baseline, one month, two months, and three months. Data were collected during 2006–2007. Multilevel random coefficient modeling examined group differences in rates of change.ResultsAs compared to the control condition, the intervention group increased walking (+ 69 versus + 32 min per week) and total moderate-to-vigorous physical activity (+ 23 versus − 25 min per week) after three months. The intervention did not impact stage of behavior change or any of the other psychosocial variables.ConclusionA tailored, Internet-based intervention for adult women had a positive effect on walking and moderate-to-vigorous physical activity in an ethnically-diverse sample. However, given the lack of comparable research contact in the control group, these findings should be taken cautiously.     

Symptoms of depression are longitudinally associated with sedentary behaviors among young men but not among young women

ObjectiveA habitual sedentary lifestyle is associated with adverse health outcomes; however, the predictors of sedentary behaviors have not been sufficiently explored to inform the development and delivery of effective interventions to reduce sedentary behaviors. This study examined whether reports of symptoms of depression could predict weekly time spent in sedentary behaviors (i.e., television watching, computer use) 4 years later.MethodSelf-reported symptoms of depression were assessed at age 20 years (2007–08), and television watching time and computer use were assessed at age 24 years (2011–12) in 761 adults (45% men) participating in the Nicotine Dependence in Teens study. Data were analyzed using linear regression analysis, with separate models for men and women.ResultsAfter controlling for past sedentary behavior, symptoms of depression at age 20 years predicted more computer use 4 years later in men (R² = .21, β = .13, p < .05), but not in women. Symptoms of depression did not predict television watching.ConclusionsResults highlight the need to distinguish between types of sedentary behaviors as their predictors may differ. Further, they provide support for the hypothesis that psychological factors, in this case symptoms of depression, may relate to select sedentary behaviors in young men.     

Weight control success and depression by gender with respect to weight control behaviors

Background/ObjectiveThere are many methods for weight loss and they vary among people. Some are yet to be proven as appropriate regarding its physical or mental side effect. The aim of this study was to investigate the relationship between weight control success and depression by weight control behaviors (WCB) dividing them into appropriate and inappropriate.Subjects/MethodsWe used data from the 2016 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 4506 people were included in the study. The depression was measured by the 9-item Patient Health Questionnaire as a dependent variable. Using multiple regression analysis to determine the association between weight control success and depression with appropriate and inappropriate WCB, in men and women, separately.ResultsWe found that appropriate WCB was associated with decreased depression in women who had both success and fail (success: β = −0.16, S.E = 0.50, p < .001; fail: β = −0.09, S.E = 0.04, p = 0.04), whereas inappropriate WCB increased depression in men regardless of success or failure at weight control (success: β = 0.41, p = 0.02; fail: β = 0.22, p = 0.02). Thus, women who are successful at weight control and use appropriate WCB are more likely to have a decrease in depressive symptoms. However, men are most affected by using inappropriate WCB and can have an increase in depressive symptoms as a result.ConclusionThe findings have implications for encouraging the use of appropriate WCB for those attempting to control weight, especially in women.     

Moderators of health behavior initiation and maintenance in a randomized telephone counseling trial

ObjectiveThis study compares moderators of initiation and maintenance of health behavior changes.MethodsData come from a cluster-randomized, 12-month telephone counseling intervention for physical activity and diet, targeting type 2 diabetes or hypertension patients (n = 434, Australia,2005–2007). Demographic and health-related characteristics, theoretical constructs, and baseline behavioral outcomes were considered as moderators. Mixed models, adjusting for baseline values, assessed moderation of intervention effects for trial outcomes (physical activity, intakes of fat, saturated fat, fiber, fruit, vegetables) at end-of-intervention (12 months/initiation) and maintenance follow-up (18 months), and compared moderation between these periods.ResultsSocial support for physical activity and baseline physical activity were significant (p < 0.05) moderators of physical activity at 12 months. Gender, marital status, social support for healthy eating, BMI, and number of chronic conditions were significant moderators of dietary changes at 12- and/or 18 months. Instances of moderation differing significantly between 12- and 18 months were: baseline physical activity for physical activity (initiation) and marital status for fat intake (maintenance).ConclusionsThis exploratory study showed that moderation of physical activity and diet effects sometimes differed between initiation and maintenance. To identify unique moderators for initiation and/or maintenance of behavior changes, future studies need to report on and statistically test for such differences.     

Relationships between depression,gender, and unhealthy weight loss practices among overweight or obese college students

IntroductionUnhealthy weight loss practices are common among female college students. It is unknown if these practices are also most common among women in the subset of overweight or obese college students or if these practices are related to depression. We examined the relationship between gender, depression, and unhealthy weight loss practices among overweight or obese college students.MethodsStudents (body mass index between 25.0 and 34.9 kg/m²) from three Southern California universities (M_age = 22 years, SD = 4; 70% women) were recruited from May 2011 to May 2012 for participation in a weight loss clinical trial (N = 404). Logistic regressions were performed with baseline data to assess the cross-sectional relationship between self-reported unhealthy weight loss practices and gender and depression as measured by the Center for Epidemiologic Studies Depression short form.ResultsTwenty-nine percent of participants reported engaging in at least one unhealthy weight loss behavior (e.g., fasting, purging) over the last 30 days, with no differences by gender. Self-report of at least one unhealthy weight loss behavior was associated with report of symptoms of depression (e^B = 1.14 [confidence interval, CI: 1.08–1.20]), adjusting for potential confounders. Interactions between gender and depression were not significant (e^B = 1.04 [CI: 0.93–1.16]).ConclusionAmong an overweight or obese sample of college students, unhealthy weight loss practices were equally common in both genders, and students with depressive symptomatology were at greatest risk. Obesity interventions targeting overweight or obese college students should educate both men and women about the dangers of unhealthy weight loss practices. In addition, screening for depression can help identify students who would benefit from additional supportive and coping strategies and resources.