Comparison of eating habits and inappropriate weight control efforts of secondary school students enrolled in a weight control program

BACKGROUND/OBJECTIVESNumerous school-based weight control programs have been initiated for weight loss among adolescents. However, the relationship between these programs and inappropriate weight control efforts, dietary habits and behavior of students, have not been investigated sufficiently. This study was undertaken to investigate the association between body mass index (BMI) of adolescents, and their health status and inappropriate weight-control efforts. We further examined the relationship between attendance to school-based weight-control programs and attempting inappropriate weight-control efforts, dietary habits, and behavior.SUBJECTS/METHODSA survey of 1,742 students was conducted in Korea. Logistic regression was used to assess differences in the health status (grouped by BMI and improper weight control) and dietary habits, based on attendance to the weight-control programs.RESULTSObese students were significantly more dissatisfied with physical, mental and spiritual health. Students who attended weight-control programs were likely to be underweight (P < 0.001), whereas those who did not attend weight-control programs were likely to attempt weight control improperly (P < 0.001). Students who participated in the program also had relatively healthy dietary habits (P < 0.001–0.027), and students who did not attend had comparatively unhealthy dietary habits (P < 0.001–0.008). Students who attended weight-control programs were likely to be underweight (P < 0.001) with relatively healthy dietary habits (P < 0.001–0.027), whereas students who did not attend the programs were likely to attempt weight control improperly (P < 0.001) and had comparatively unhealthy dietary habits (P < 0.001–0.008).CONCLUSIONSAttending school-based weight-control programs was significantly associated with not attempting inappropriate weight-control efforts, as well as following healthy dietary habits. Our data indicates that offering school-based weight-control programs is valuable to student health, and is anticipated to reducing the public health burden.     

Factors influencing fast food consumption behaviors of middle-school students in Seoul: an application of theory of planned behaviors

Fast food is popular among children and adolescents; however, its consumption has often been associated with negative impacts on nutrition and health. This study examined current fast food consumption status among middle school students and explored factors influencing fast food consumption by applying Theory of Planned Behavior. A total of 354 (52.5% boys) students were recruited from a middle school. The subjects completed a pre-tested questionnaire. The average monthly frequency of fast food consumption was 4.05 (4.25 for boys, 3.83 for girls). As expected, fast food consumption was considered to be a special event rather than part of an everyday diet, closely associated with meeting friends or celebrating, most likely with friends, special days. The Theory of Planned Behavior effectively explained fast food consumption behaviors with relatively high R² around 0.6. Multiple regression analyses showed that fast food consumption behavior was significantly related to behavioral intention (b = 0.61, P < 0.001) and perceived behavioral control (b = 0.19, P < 0.001). Further analysis showed that behavioral intention was significantly related to subjective norm (b = 0.15, P < 0.01) and perceived behavioral control (b = 0.56, P < 0.001). Attitude toward fast food consumption was not significantly associated with behavioral intention. Therefore, effective nutrition education programs on fast food consumption should include components to change the subjective norms of fast food consumption, especially among peers, and perceived behavioral control. Further studies should examine effective ways of changing subjective norms and possible alternatives to fast food consumption for students to alter perceived behavioral control.     

Determinants of influenza vaccination among young Taiwanese children

ObjectiveAccording to the Health Belief Model (HBM), individual perceptions of susceptibility, severity, benefit, barrier, self-efficacy, and cues to action are associated with health actions. In this study, we investigated the perceptions and social factors that influence the intention to vaccinate children against influenza among parents of young Taiwanese children.MethodsA nationwide survey was performed using stratified random sampling to explore the beliefs, attitudes, and intentions of parents/main caregivers with regard to vaccinating children aged 6 months to 3 years against influenza. A questionnaire was developed based on the HBM and multivariate logistic regression analyses of 1300 eligible participants were used to identify significant predictors of the intention to vaccinate.ResultsGreater perceived benefit, cues to action, and self-efficacy of childhood vaccination against influenza were positively associated with the intention to vaccinate. Children's experience of influenza vaccinations in the past year was also a positive predictor. However, perceived susceptibility, perceived severity regarding influenza and perceived barriers to vaccination were not predictive of the intention to vaccinate.ConclusionIn addition to perceived benefits and cues to action, self-efficacy of parents/main caregivers was significantly predictive of their intention to accept influenza vaccination for their young children. These components of the HBM could be used in formulating strategies aimed at promoting the use of influenza vaccine.     

Dietary factors related to body weight in adult Vietnamese in the rural area of Haiphong, Vietnam: the Korean Genome and Epidemiology Study (KoGES)

The objectives of this study were to examine the association between dietary factors and underweight and overweight adult Vietnamese living in the rural areas of Vietnam. A cross-sectional study of 497 Vietnamese aged 19 to 60 years (204 males, 293 females) was conducted in rural areas of Haiphong, Vietnam. The subjects were classified as underweight, normal weight, and overweight based on BMI. General characteristics, anthropometric parameters, blood profiles, and eating habits were obtained and dietary intake was assessed using 24-hour recalls for 2 consecutive days. A high prevalence of both underweight (BMI < 18.5 kg/m²) and overweight (BMI ≥ 23 kg/m²) individuals was observed (14.2% and 21.6% for males and 18.9% and 20.6% for females, respectively). For both genders, the overweight group were older than the under- and normal weight groups (P = 0.0118 for males and P = 0.0002 for females). In female subjects, the overweight group consumed significantly less cereals (P = 0.0033), energy (P = 0.0046), protein (P = 0.0222), and carbohydrate (P = 0.0017) and more fruits (P = 0.0026) than the underweight group; however, no such differences existed in males. The overweight subjects overate more frequently (P = 0.0295) and consumed fish (P = 0.0096) and fruits (P = 0.0083) more often. The prevalence of both underweight and overweight individuals pose serious public health problems in the rural areas of Vietnamese and the overweight group was related to overeating and high fish and fruit consumption. These findings may provide basic data for policymakers and dieticians in order to develop future nutrition and health programs for rural populations in Vietnam.     

Stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake and related psychosocial factors

BACKGROUND/OBJECTIVES

Understanding individual''s intention, action and maintenance to increase fruit and vegetable intake is an initial step in designing nutrition or health promotion programs. This study aimed to determine stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake, self-efficacy, perceived benefits and perceived barriers.

SUBJECTS/METHODS

This cross-sectional study was conducted among 348 public university staff in Universiti Putra Malaysia. A pre-tested self-administered questionnaire and two days 24-hour diet recall were used.

RESULTS

Half of the respondents (50%) were in preparation stage, followed by 43% in action/maintenance, 7% in pre-contemplation/contemplation stages. Respondents in action/maintenance stages had significantly higher self-efficacy (F = 9.17, P < 0.001) and perceived benefits (F = 5.07, P < 0.01) while respondents in pre-contemplation/contemplation and preparation stages had significantly higher perceived barriers (F = 4.83, P < 0.05). Perceived benefits tend to outweigh perceived barriers pre-ceding to taking action. Self-efficacy is important in motivating individuals to increase fruit and vegetable intake as self-efficacy and perceived barriers crossed over between preparation and action/maintenance. Respondents in action/maintenance stages had the highest adjusted mean serving of fruit and vegetable intake (F = 4.52, P < 0.05) but the intake did not meet recommendation.

CONCLUSION

Intervention strategies should emphasize on increasing perceived benefits and building self-efficacy by providing knowledge and skills to consume a diet high in fruits and vegetables in order to promote healthy changes in having high fruit and vegetable intake.     

Evaluation of the health status of preschool children stratified based on the weight-length index (WLI)

This study was conducted to prepare basic materials and offer advice regarding dietary habits to prevent and cure childhood obesity by comparing and analyzing dietary habit, nutritional status, blood factors, and mineral contents of hair. All subjects were stratified by their weight-length index (WLI). According to the standard WLI values, 64.9% of children were within the normal value, 13.5% of children were underweight, and 21.6% of children were overweight and obese (WLI ≥ 110%). Overall, the score assessed dietary habit for all children was 21.32 ± 2.55 point (921 subjects), with 5.1% of children having excellent dietary habits and 3.1% having poor dietary habits. Additionally, 37.9% of underweight children, 37.6% of normal weight children, and 43.2% of overweight and obese children consumed higher amounts of protein than underweight children did (meat, fish, eggs, and soy products) (P < 0.05). Overweight and obese children consumed more fried foods than underweight or normal weight children (P < 0.05). Moreover, 38.0% of the children had hemoglobin levels of 12 g/dl, while 7.6% were anemic (11.1 g/dl). When a hematocrit level of 33% was taken as the standard, 11.0% of children were anemic. The plasma transferrin content was 263.76 ± 54.52 mg/dl in overweight and obese children. The mean values of Fe, Cu, Ca, Cr, Mn, Se, Na, K, Li, V, Co, and Mo were within the reference values, but the Zn concentrations of underweight, normal weight, and overweight and obese children were 67.97 ± 28.51 ppm, 70.09 ± 30.81 ppm, and 73.99 ± 30.36 ppm, respectively. The Zn concentration of overweight and obese children (73.99 ± 30.36 ppm) was lower than that of the standard value (180~220 ppm). Therefore, a nutritional education program and new guidance for dietary pattern should be developed to reduce the number of underweight and overweight and obese children.     

A study on dietary habits, health related lifestyle, blood cadmium and lead levels of college students

This study was performed in order to investigate dietary habits, health related lifestyle and blood cadmium and lead levels in female college students. 80 college students (43 males and 37 females) participated in the survey questionnaires. Body weight and height, blood pressure, and body composition were measured. The systolic blood pressure of male and female students were 128.9 ± 13.9 and 109.8 ± 12.0, respectively. The diastolic blood pressure of male and female students were 77.1 ± 10.3 and 66.0 ± 6.9, respectively, showing that male students had significantly higher blood pressure than female students (P < 0.001). The BMI of male and female students were 23.4 ± 3.3 and 20.2 ± 2.3, respectively. Most male students were in the range of being overweight. The dietary habits score of female students was significantly higher than that of male students (P < 0.01).The blood cadmium level of male and female students were 0.54 ± 0.23 and 0.52 ± 0.36, respectively. There was no significant difference between male and female students. The blood lead level of male and female students were 1.09 ± 0.49 and 0.59 ± 0.45, respectively. The blood lead level of male students was significantly higher than that of female students (P < 0.001). The blood cadmium level of smokers and nonsmokers were 0.69 ± 0.29 and 0.49 ± 0.29 respectively (P < 0.05). The blood cadmium level of smokers was significantly higher than that of nonsmokers (P < 0.05). The blood lead level of smokers and nonsmokers were 1.09 ± 0.43 and 0.80 ± 0.54, respectively. The blood lead level of smokers was significantly higher than that of nonsmokers (P < 0.05). Therefore, proper nutritional education programs are required for college students in order to improve their dietary and health related living habits.     

Validation of self-reported height and weight in fifth-grade Korean children

Height and weight are important indicators to calculate Body Mass Index (BMI); measuring height and weight directly is the most exact method to get this information. However, it is ineffective in terms of cost and time on large population samples. The aim of our study was to investigate the validity of self-reported height and weight data compared to our measured data in Korean children to predict obese status. Four hundred twenty-two fifth-grade (mean age 10.5 ± 0.5 years) children who had self-reported and measured height and weight data were final subjects for this study. Overweight/obese was defined as a BMI of or above the 85th percentile of the gender-specific BMI for age in the 2007 Korean National Growth Charts or a BMI of 25 or higher (underweight : < 5th, normal : ≥ 5th to < 85th, overweight : ≥ 85th to < 95th). The differences between self-reported and measured data were tested using paired t-test. Differences based on overweight/obese status were tested using analysis of variance (ANOVA) and linear trends. Pearson''s correlation and Cohen''s kappa were tested to examine agreements between the self-reported and measured data. Although measured and self-reported height, weight and BMI were significantly different and children tended to overreport their height and underreport their weight, the correlation between the two methods of height, weight and BMI were high (r = 0.956, 0.969, 0.932, respectively; all P < 0.001), and both genders reported their overweight/non-overweight status accurately (Cohen''s kappa = 0.792, P < 0.001). Although there were differences between the self-reported and our measured methods, the self-reported weight and height was valid enough to classify overweight/obesity status correctly, especially in non-overweight/obese children. Due to bigger underestimation of weight and overestimation of height in obese children, however, we need to be aware that the self-reported anthropometric data were less accurate in overweight/obese children than in non-overweight/obese children.     

The effects of food safety education on adolescents' hand hygiene behavior: an analysis of stages of change

The hand hygiene behavior of 400 middle school students (grades 1-3) in Seoul and Gyeonggi-Do was studied to determine how stages of change were affected by food safety education, focusing on hand hygiene and general food safety. Subjects were 51.3% male and 44.3% of study subjects were first graders of middle school. Approximately 40% of subjects were at the stage of action, 42.7% were at the stage of contemplation, and 16.4% were at pre-contemplation. The most important factor that influenced proper hand washing was self efficacy (P < 0.001). Proper hand washing was also correlated significantly with positive belief (P < 0.01) and stages of change (P < 0.01). After food safety education by high-school mentors, middle-school students who were in the stages of pre-contemplation (11.1%) and contemplation (88.9%) showed significant progression toward the action stage (P < 0.001). Proper hand washing (P < 0.01) and food safety knowledge (P < 0.05) were also significantly increased after educational intervention.     

Eating habits, obesity related behaviors, and effects of Danhak exercise in elderly Koreans

The aims of this study were to evaluate obesity-related dietary behaviors and to determine long-term exercise effects on obesity and blood lipid profiles in elderly Korean subjects. A total of 120 subjects, aged 60-75 yr, were recruited, and obesity-related dietary behaviors were determined. An exercise intervention was conducted with 35 qualified elderly females for 6 months, and body composition and blood lipids were measured 6 times at 4 week intervals. At baseline, mean BMI (kg/m²) was 24.8 for males and 23.1 for females. The females had better eating habits than the males and were more concerned with reading nutrition labels on food products (P < 0.001); they also preferred convenience foods less than the male subjects (P < 0.05). Obese individuals were more likely than overweight or normal weight individuals to misperceive their weight (P < 0.001). Those with a high BMI responded feeling more depressed (P < 0.01), lacking self-confidence (P < 0.01), and feeling isolated (P < 0.01), as well as having more difficulty doing outdoor activities (P < 0.01). After exercise, body fat (%) and WHR were significantly reduced (P < 0.05), while body weight and BMI were also decreased without statistical significance. Total cholesterol and blood HDL were significantly improved (207.1 mg/dl vs. 182.6 mg/dl, HDL: 45.6 mg/dl vs. 50.6 mg/dl, P < 0.05). Other benefits obtained from exercise were improvements in self-confidence (26.4%), movement (22.6%), stress-relief (18.9%), and depression (13.2%). In conclusion, elderly females had better eating habits and were more concerned with nutrition information and healthy diets compared to elderly males. However, misperceptions of weight and obesity-related stress tended to be very high in females who were overweight and obese, which can be a barrier to maintain normal weight. Long-term Danhak practice, a traditional Korean exercise, was effective at reducing body fat (%) and abdominal obesity, and improved lipid profiles, self-confidence, and stress.     

Effect of educating mothers on injury prevention among children aged <5 years using the Health Belief Model: a randomized controlled trial

Objectives

To assess the effect of the Health Belief Model (HBM) on the education of mothers for promoting safety and preventing injury among children aged <5 years.

Study design

Randomized controlled trial.

Methods

This study was conducted in Hamadan City, West Iran in 2012. One hundred and twenty mothers participated in this study, divided into intervention and control groups (60 mothers in each group). The intervention group participated in an educational programme consisting of four 1-hour sessions twice per week. The education programme was based on the HBM. The participants of both groups were evaluated before the intervention and two months after the intervention using a questionnaire. The validity and reliability of the questionnaire were tested with a pilot study. The questionnaire consisted of three parts: demographic characteristics; knowledge, practices and HBM constructs (perceived sensitivity, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy); and history of recent injuries to the child. Student's t-test was used to compare the mean differences, and P < 0.05 was considered to indicate significance.

Results

None of the 120 participants dropped out of the study. The mean differences in knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy and practices after the intervention, between the two groups, were 3.98, 3.57, 3.97, 1.57, −7.08, 0.82, 2.95 and 2.47, respectively. All differences were statistically significant (P = 0.001).

Conclusions

Educational programmes based on the HBM can be used as an effective approach in planning and developing preventive programmes for injury prevention and safety promotion in children aged <5 years.     

Overestimation of own body weights in female university students: associations with lifestyles, weight control behaviors and depression

The study aimed to analyze the lifestyles, weight control behavior, dietary habits, and depression of female university students. The subjects were 532 students from 8 universities located in 4 provinces in Korea. According to percent ideal body weight, 33 (6.4%), 181 (34.0%), 283 (53.2%), 22 (4.1%) and 13 (2.5%) were severely underweight, underweight, normal, overweight and obese, respectively, based on self-reported height and weight. As much as 64.1% and only 2.4%, respectively, overestimated and underestimated their body weight status. Six overweight subjects were excluded from overestimation group for the purpose of this study, resulting in overestimation group consisting of only underweight and normal weight subjects. Compared to those from the normal perception group, significantly more subjects from the overestimation group were currently smoking (P = 0.017) and drank more often than once a week (P = 0.015), without any significant differences in dietary habits. Despite similar BMIs, subjects who overestimated their own weight statuses had significantly higher weight dissatisfaction (P = 0.000), obesity stress (P = 0.000), obsession to lose weight (P = 0.007) and depression (P = 0.018). Also, more of them wanted to lose weight (P = 0.000), checked their body weights more often than once a week (P = 0.025) and had dieting experiences using ''reducing meal size'' (P = 0.012), ''reducing snacks'' (P = 0.042) and ''taking prescribed pills'' (P = 0.032), and presented ''for a wider range of clothes selection'' as the reason for weight loss (P = 0.039), although none was actually overweight or obese. Unlike the case with overestimating one''s own weight, being overweight was associated with less drinking (P = 0.035) and exercising more often (P = 0.001) and for longer (P = 0.001) and healthier reasons for weight control (P = 0.002), despite no differences in frequency of weighing and depression. The results showed that weight overestimation, independent of weight status, is associated with risky lifestyles, weight control behaviors, and mental conditions. Preventive interventions should focus not only on obesity, but also on body weight overestimation.     

Meeting 24-Hour Movement and Dietary Guidelines: Prevalence,Correlates and Association with Weight Status among Children and Adolescents: A National Cross-Sectional Study in China

China is confronted with a “double burden” of underweight and overweight/obesity in children and adolescents. This study aimed to investigate the prevalence and correlates of meeting 24 h movement and dietary guidelines among Chinese children and adolescents. Further, the study aimed to examine the association of meeting 24 h movement and dietary guidelines with weight status in Chinese children and adolescents. A total of 34,887 Chinese children and adolescents were involved. Only 2.1% of participants met the 24 h movement guidelines. Compared to those who met all three 24 h movement guidelines, those who only met the sleep duration guideline was significantly associated with a higher risk of underweight (p < 0.05), and those who only met the moderate-to-vigorous physical activity, or screen time guidelines were significantly associated with a higher risk of overweight/obesity (p < 0.05). Compared with those meeting the dietary guidelines, those who did not meet the soft drink intake guideline had a significantly lower risk of underweight (p < 0.05), those who did not meet the fruit intake guideline had a significantly lower risk of overweight/obesity (p < 0.05), and those who did not meet the milk intake guideline showed a significantly higher risk of overweight/obesity (p < 0.001). These findings indicate a significant association between meeting the 24 h movement and dietary guidelines and weight status among Chinese children and adolescents.     

Eating habits,lifestyle factors,and body weight status among Turkish private educational institution students

ObjectiveThe purposes of this study were to assess the prevalence of underweight, overweight, and obesity and to evaluate the effects of eating habits, lifestyle, and sociodemographic characteristics on students' weight.MethodsThis cross-sectional study was carried out from February to May 2008 in the city of Eskisehir, western Turkey. A total of 2258 students 15–20 y of age (1137 boys and 1121 girls) were examined. The questionnaires, including items related to eating habits, lifestyle, and sociodemographic characteristics, were completed by the students. The data were evaluated using chi-square test and percent ratios. In addition, Student's t test for means and reliability analysis was employed to test the reliability of the questionnaire scale. Differences were considered statistically significant at P < 0.05.ResultsAbout 70% of the students (69.9%) were of normal weight; more than one-fourth (25.7%) were underweight; and 4.4% were overweight/obese students, with just 0.6% being obese (n = 14). According to 21 of the 29 items in the questionnaire found to be positively significant, girls had more accurate habits than boys (13 versus 7 items, respectively). Compared with those underweight or of normal weight, the proportion of those overweight/obese was smaller for those having milk or juice at breakfast (P < 0.05), special meals prepared at least once daily at home (P < 0.05), and not selecting fast food such as hamburgers at meals (P < 0.01).ConclusionThe results of this study suggest that the prevalence of overweight and obesity is much lower than the prevalence of underweight in Turkish school-based adolescents, important data that merit consideration. Health professionals, teachers, and family environment may play a key role in the promotion of a healthy lifestyle.     

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.     

Assessments of nutrient intake and metabolic profiles in Korean adolescents according to exercise regularity using data from the 2008 Korean National Health and Nutrition Examination Survey

The purpose of this study was to assess the metabolic profile and nutrient intake data in Korean adolescents according to exercise regularity using the forth Korean National Health and Nutrition Examination Survey from 2008 data. A total of 834 Korean adolescents (440 boys, 394 girls) aged 12 to 18 years were classified into exercising male (EM), non-exercising male (NM), exercising female (EF), and non-exercising female (NF) groups. EM exhibited significantly higher weight (P < 0.001), waist circumference (WC) (P < 0.01) and body mass index (BMI) (P < 0.001) than NM. EF showed significantly greater height (P < 0.01), weight (P<0.001), WC (P < 0.001), and BMI (P < 0.001) than NF. Although ratios of macronutrient intake were within the appropriate range in all groups, energy, riboflavin, vitamin C and calcium were assessed as in adequate by the nutritional adequacy ratio (NAR) in all groups. Moreover, EF and NF had inadequate intake of vitamin A and iron according to NAR, respectively. There were significant correlations between height and NAR protein (r = 0.249, P < 0.001), and mean adequacy ratio (MAR) (r = 0.177, P < 0.01), and between weight and NAR protein (r = 0.180, P < 0.01), and MAR(r = 0.136, P < 0.05) in EM. On the other hand, there were significant correlations between weight and NAR protein (r = 0.270, P < 0.01), WC and NAR protein (r = 0.271, P < 0.01), and BMI and NAR protein (r = 0.326, P < 0.01) in NM. There were significant correlations height and NAR Fe (r = 0.153, P < 0.05) in EF. However, there were no significant correlations between metabolic factors and nutritional adequacy in NF. Although we noted no significant differences in MAR between the groups, the exercising groups showed higher MAR values than the non-exercising groups. Therefore, practicing of ideal dietary behaviors appears to be induced through physical activity and regular exercise in Korean adolescents.     

Health Belief Model applied to non-compliance with HPV vaccine among female university students

Objectives

To investigate the reasons for refusal of human papillomavirus (HPV) vaccination, and to explore participants' perceptions and attitudes about Health Belief Model (HBM) constructs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy) among a sample of female university students.

Study design

Cross-sectional. A self-administered questionnaire based on the HBM was used.

Methods

Confirmatory factor analysis was applied to the data to examine the construct validity of the six factor models extracted from the HBM. The predictors of non-HPV vaccination were determined by logistic regression models, using non-HPV vaccination as the dependent variable.

Results

The sample included 2007 students. The participation rate was 88.9% and the percentage of non-vaccination was 71.65%. Participants who had high scores for ‘general perceived barriers’, ‘perceived barriers to vaccination’, ‘no perceived general benefits’, ‘no perceived specific benefits’ and ‘no general benefits’ were more likely to report being unvaccinated.

Conclusions

The findings demonstrated the utility of HBM constructs in understanding vaccination intention and uptake. There is an urgent need to improve health promotion and information campaigns to enhance the benefits and reduce the barriers to HPV vaccination.     

The association between weight perception and BMI among high school students

OBJECTIVE: To assess the association between weight perception and BMI among a large, diverse sample of adolescents. This study used both measured and self-reported height and weight to calculate BMI. RESEARCH METHODS AND PROCEDURES: A convenience sample of students (n = 2032) in grades 9 through 12 completed a questionnaire assessing demographic characteristics, self-reported height and weight, and body weight perception. These students were then weighed and had their height measured using a standard protocol. RESULTS: Using BMI calculated from measured height and weight, 1.5% of students were classified as underweight or at risk for underweight, 51.2% of students were normal weight, and 47.4% were overweight or at risk for overweight. Among this same sample of students, however, 34.8% perceived themselves as underweight, 42.9% perceived themselves as about the right weight, and 22.3% perceived themselves as overweight. Even when using BMI calculated from self-reported height and weight, >20% of students who were overweight or at risk for overweight perceived themselves as underweight. DISCUSSION: Because perception of overweight is a key determinant of adolescent nutritional habits and weight management, many students who are overweight or at risk for overweight but who do not perceive themselves as such are unlikely to engage in weight control practices. Increasing awareness of medical definitions of overweight might improve accuracy of weight perceptions and lead to healthier eating and increased physical activity.     

Pilot testing of WHO Child Growth Standards in Chandigarh: implications for India��s child health programmes

Objective

To compare the prevalence of underweight as calculated from Indian Academy of Paediatrics (IAP) growth curves (based on the Harvard scale) and the new WHO Child Growth Standards.

Methods

We randomly selected 806 children under 6 years of age from 45 primary anganwadi (childcare) centres in Chandigarh, Punjab, India, that were chosen through multistage stratified random sampling. Children were weighed, and their weight for age was calculated using IAP curves and WHO growth references. Nutritional status according to the WHO Child Growth Standards was analysed using WHO Anthro statistical software (beta version, 17 February 2006). The χ² test was used to determine statistical significance at the 0.05 significance level.

Findings

The prevalence of underweight (Z score less than –2) in the first 6 months of life was nearly 1.6 times higher when calculated in accordance with the new WHO standards rather than IAP growth curves. For all ages combined, the estimated prevalence of underweight was 1.4 times higher when IAP standards instead of the new WHO standards were used. Similarly, the prevalence of underweight in both sexes combined was 14.5% higher when IAP standards rather than the new WHO growth standards were applied (P < 0.001). By contrast, severe malnutrition estimated for both sexes were 3.8 times higher when the new WHO standards were used in place of IAP standards (P < 0.001).

Conclusion

The new WHO growth standards will project a lower prevalence of overall underweight children and provide superior growth tracking than IAP standards, especially in the first 6 months of life and among severely malnourished children.     

Nutrition knowledge,outcome expectations,self-efficacy,and eating behaviors by calcium intake level in Korean female college students

BACKGROUND/OBJECTIVES

Calcium is important but deficient in diets of young adult women. This study aimed to examine if cognitive factors and eating behaviors differ according to calcium intake based on the Social Cognitive Theory.

SUBJECTS/METHODS

Subjects were female college students in Seoul, Korea. Three hundred students completed the questionnaire regarding calcium intake, nutrition knowledge, outcome expectations, self-efficacy and eating behaviors. Data on 240 students were analyzed using t-test or χ²-test. Subjects were categorized into two groups, high calcium intake (HC, ≥ 650 mg/day) and low calcium intake (LC, < 650 mg/day), according to recommended intakes of calcium for women aged 19-29 years.

RESULTS

The LC group constituted 77.9% of total subjects. Nutrition knowledge was not different according to calcium intake. Three out of 12 outcome expectations items were significantly different between the HC and LC groups. Subjects in the HC group agreed more strongly with the practical benefits of consuming calcium-rich foods, including ''taste'' (P < 0.01) and ''going well with other snacks'' (P < 0.05), compared to those in the LC group. Negative expectations of ''indigestion'' were stronger in the LC group than HC group (P < 0.001). Among self-efficacy items, perceived ability of ''eating dairy foods for snacks'' (P < 0.001), ''eating dairy foods every day'' (P < 0.01), and ''eating calcium-rich side dishes at meals'' (P < 0.05) differed significantly between the HC and LC groups. Eating behaviors including more frequent consumption of dairy foods, fruits or fruit juice (P < 0.001), anchovy, seaweeds, green vegetables, protein-rich foods (P < 0.05), and less frequent consumption of sweets or soft drinks (P < 0.01) were significantly related to calcium intake.

CONCLUSIONS

This study found that outcome expectations, self-efficacy in consuming calcium-rich foods, and eating behaviors are important in explaining calcium intake. Nutrition education needs to address practical benefits, reduce negative expectations of calcium-rich foods, increase self-efficacy, and modify eating behaviors contributing to calcium intake.