Body Image and Affective Experiences of Subjectively Underweight Females: Implications for Exercise Behavior

The purpose of the present study was to determine whether subjectively underweight females reported similar psychosocial experiences as women who perceived themselves as being overweight. Twenty-eight college-aged females were assessed via a questionnaire consisting of measures of social physique anxiety, body dissatisfaction, depression proneness, and self-esteem. Similar to previous research completed on college-aged women who perceived themselves as being overweight, females in the present study reported low to moderate degrees of social physique anxiety, body dissatisfaction, depression proneness, and self-esteem. Additionally, higher feelings of physique anxiety were modestly associated with lower levels of self-esteem and higher levels of body dissatisfaction and depression. It was concluded that women who perceived themselves as being too thin experienced similar psychosocial issues as women who perceived themselves as being overweight in previous studies.     

Perceived body image among African Americans with type 2 diabetes

OBJECTIVE: To assess current, desired and best body image in the opposite sex and examine correlates of body image dissatisfaction. METHODS: We conducted a cross-sectional analysis at baseline of 185 (141 women, 44 men) African Americans with type 2 diabetes in Project Sugar 1, a randomized controlled trial of primary care-based interventions to improve diabetic control. RESULTS: Women had a significantly lower desired body image compared to their current body image (BMI approximately 27.7 versus approximately 35.3). Men preferred a body image for women that was similar to the body image that women desired for themselves (BMI approximately 28.3 versus approximately 27.7). Significant correlates of body image dissatisfaction included self-perception of being overweight and attempting weight-loss (P < 0.05). PRACTICAL IMPLICATIONS: Among overweight and obese African-American women with diabetes, it is important to first address an individual's perceived body image, perceived risk of disease, desired body image, and weight-loss perceptions. In addition to the aesthetic benefits of weight-loss, there is a need to focus on the health benefits in order to intervene among African Americans with diabetes.     

A nomothetic-idiographic study of daily psychological stress and blood glucose in women with Type I diabetes mellitus

Although there has been some study of the extralaboratory generality of stress effects on diabetic metabolism, analysis of the diabetic response to everyday life stress is needed. The secondary objective of this study was to investigate whether personal characteristics moderate the daily stress-glucose relationship. Twenty-five women with Type I diabetes completed measures of internality and self-esteem and subsequently monitored daily stress and blood glucose for 30 consecutive days. Data were analyzed by both time-series and conventional correlational analyses. Glucose was higher on high-stress days than on low-stress days, with one-third of the sample showing significant positive associations between stress and same-day glucose. However, stress showed little relation to next-day glucose. Personal characteristics failed to explain differences in stress-glucose associations. Implications for practice and future research are presented.This work was funded by a grant and fellowship from the Medical Psychology Program at the University of Alabama at Birmingham and NIH/NICH Grants HD24322, HD25310, and HD00867. LifeScan Incorporated (a Johnson & Johnson Company, Mountainview, CA) and Missy Atkins, Professional Representative, donated the necessary instruments and related supplies.     

Sex differences in weight loss among adults with Type II diabetes mellitus

The treatment of choice for Type II or non-insulin-dependent diabetes mellitus is a behavioral program for the management of weight. However, compliance with this lifelong dietary regimen is often poor. In the current investigation male and female adults with diagnosed Type II diabetes were randomly assigned to either a behavior modification, a cognitive modification, a cognitive-behavior modification, or a control group. Patients were evaluated in terms of weight, percentage of body fat, and glycosylated hemoglobin measures. Men lost signficantly more weight than women and subjects in the behavior modification group lost more weight and demonstrated greater decreases in diabetes control than subjects in the cognitive-behavior modification, cognitive, and control groups. A significant interaction indicated that diabetic men may benefit more from behavioral weight reduction programs than diabetic women. Several explanations for these findings are considered.This work was supported by Grants K04 HL 00809 and R01 AM 27901 from the National Institutes of Health to Robert M. Kaplan.     

The mediating effects of self-esteem and coronary-prone behavior on problem solving and affect under low and high stress

Self-esteem and coronary-prone behavior were identified as two personality constructs related to different stress responses. It was hypothesized that in the case of low self-esteem Type A subjects the conflicting stress responses would have a particularly adverse effect on problem-solving behavior, mood, and self-perception. Subjects were 32 Type A and 32 Type B males evenly divided into high and low self-esteem groups. Half of the subjects in each group solved 10 matrix problems under high stress, half under low stress. Compared with high self-esteem Type As, low self-esteem Type As under high stress became more hostile and perceived themselves as more tense and more hurried. They also tended to make more errors. Results are interpreted as implying that low and high self-esteem Type A subjects are not psychologically homogeneous. It is suggested that the two groups may differ substantially in terms of cardiovascular risk.     

自尊对进食障碍的影响:身体不满的中介作用

目的:考查自尊对进食障碍的影响并探讨身体不满的中介作用。方法:对1147名成都市初中女生施测进食症状检测表-21、自尊量表、身体不满量表,同时收集被试的身高、体重等人口学资料。结果:初中女生的自尊水平对进食障碍症状有显著的负向预测作用,自尊水平越低,进食障碍症状越多。初中女生的身体不满对进食障碍有显著的正向预测作用,身体不满在自尊和进食障碍症状之间起了的中介作用,身体不满是自尊与进食障碍症状关系的中介变量。结论:自尊以身体不满为中介,对进食障碍症状对进食障碍症状有负向的预测作用。     

Active insulin infusion using optimal and derivative-weighted control

Close control of blood glucose levels significantly reduces vascular complications in Type I diabetes. A control method for the automation of insulin infusion that utilizes emerging technologies in blood glucose biosensors is presented. The controller developed provides tighter, more optimal control of blood glucose levels, while accounting for variation in patient response, insulin employed and sensor bandwidth. Particular emphasis is placed on controller simplicity and robustness necessary for medical devices and implants.

A PD controller with heavy emphasis on the derivative term is found to outperform the typically used proportional-weighted controllers in glucose tolerance and multi-meal tests. Simulation results show reductions of over 50% in the magnitude and duration of blood glucose excursions from basal levels. A closed-form steady state optimal solution is also developed as a benchmark, and results in a flat glucose response. The impact and trade-offs associated with sensor bandwidth, sensor lag and proportional versus derivative-based control methods are illustrated. Overall, emerging blood glucose sensor technologies that enable frequent measurement are shown to enable more effective, automated control of blood glucose levels within a tight, acceptable range for Type I and II diabetic individuals.     

层级护理在妊娠期糖尿病孕妇剖宫产中的应用研究

目的 探讨层级护理在妊娠期糖尿病（GDM）孕妇剖宫产中的应用效果。方法 将186例妊娠期糖尿病孕妇随机分为对照组和观察组各93例,对照组给予常规护理,观察组采用常规护理联合层级护理模式,比较两组护理质量评分和护理前后血糖指标。结果 观察组较对照组质量评分各方面评分均显著升高,差异有统计学意义（P＜0.05）;护理前,两组孕妇血糖各指标比较差异无统计学意义（P＞0.05）;护理后,观察组较对照组空腹血糖、餐后2 h血糖均明显降低,胰岛素用量明显减少,差异有统计学意义（P＜0.05）。结论 对GDM孕妇进行层级护理,有助于控制患者血糖水平,值得临床推广。     

Type A behavior pattern and blood glucose control in diabetic children

We studied the relationship between presence of Type A behavior pattern and glycemic response to stress in children with insulin dependent diabetes mellitus (IDDM). Twelve male (six Type A and six Type B) and nine female (four Type A and five Type B) insulin-dependent diabetic patients between the ages of 8 and 16 years received a standard meal and blood glucose values were assessed two hours later. All subjects then played a competitive videogame for 10 minutes following which blood glucose was assessed again. Preprandial and postprandial blood glucose values did not differ between the groups. However, only Type A subjects showed a hyperglycemic response to the videogame stress. Type A subjects also demonstrated significantly higher glycohemoglobin values. In order to assure that this effect was due to a differential response to stress and not simply a difference in metabolic response to a meal, a second study was conducted in which blood glucose values were assessed at one, two and three hours following a standard meal. No significant differences in postprandial blood glucose values were observed between Type A and Type B subjects. These data support previous research which has suggested that some but not all patients with IDDM show a hyperglycemic response to stress.     

Erythrocyte count and hemoglobin levels in diabetic women

Summary Fasting blood glucose, erythrocyte counts hemoglobin levels of 131 Libyan diabetic women of Tripoli, Libya were determined. The respective mean values were 223±7 mg·dl^–1, 4.97±0.034× 10⁶·mm^–3 and 14.4±0.127 g·dl^–1. Sixty-five percent of these diabetic women were obese. The highest percent of diabetics belong to the age group 46–55 years. The increase in prevalence of diabetes correlates with an increase in obesity.A significant positive correlation was found between body surface area and fasting blood glucose levels (r=0.65;P<0.001). Elevated levels of erythrocyte count and hemoglobin were present in these diabetic patients. Significant correlations were found between body surface area and erythrocyte count, as well as between fasting blood glucose levels and erythrocyte count, indicating the effect of obesity and diabetes on erythrocyte numbers.A significant correlation was found between fasting blood glucose levels and hemoglobin (r=0.35;P<0.001). The elevated levels of hemoglobin present in these patients may be the result of haemoconcentration due to polyuria, which is always present in poorly controlled diabetic patients.The results suggest a close relationship between diabetes and obesity. Regulation of body weight/surface area is an important factor in the control of diabetes. The elevated levels of erythrocyte count and hemoglobin reflect poor control of blood glucose levels in these diabetic patients.     

Negative affect as a mediator between body dissatisfaction and extreme weight loss and muscle gain behaviors

Negative affect has been found to mediate the relationship between body dissatisfaction and bulimia. However, it is unknown if this relationship also applies to disordered eating, excessive exercise and strategies to increase muscle for men or women. The aim of this study was to investigate whether negative and positive affect mediate the relationship between body dissatisfaction, and these body change strategies. Respondents were 93 men and 97 women (age range: 18-25 years), who completed measures of body dissatisfaction, positive and negative affect and body change strategies to lose weight or increase muscles. Body dissatisfaction was associated with strategies to lose weight, dietary restraint and bulimia for both genders. Negative affect mediated the relationship between dissatisfaction with muscles and strategies to lose weight, dietary restraint and bulimia for women only. The results confirm previous findings related to the association between negative affect and disordered eating for women. They also demonstrate the need to further investigate the impact of negative affect on body change strategies, particularly among men, and those strategies related to increasing muscles.     

Peer influences, body-image dissatisfaction, eating dysfunction and self-esteem in adolescent girls

A sample of 344 adolescent girls completed a variety of measures designed to index the associations among peer influences, body-image dissatisfaction, eating dysfunction and self-esteem. Results indicated that participants were significantly similar to their nominated friends on self-esteem, but not body image or eating disturbance. Peer measures were significantly associated with body dissatisfaction, eating problems and self-esteem. Peer suppression of feelings, internalization of the thin-ideal and appearance comparison were significant mediators in path analyses testing the direct and indirect role of peer influences on outcome variables. Implications for intervention and prevention programs are discussed.     

Differences in body composition and cardiovascular and Type 2 diabetes risk factors between migrant and British‐born British Pakistani women

There is a high prevalence of cardiovascular disease and Type 2 diabetes in people of South Asian origin living in affluent western countries. We do not know whether or how risk factors for these diseases change in subsequent generations born in the west. Findings that birth‐weight is inversely associated with abdominal obesity and risk of cardiovascular disease and Type 2 diabetes in later life suggest that those born in the west may have lower levels of risk than migrants. We assessed 30 migrants from Pakistan to the UK, 30 British‐born British Pakistani women, and 25 British‐born women of European origin. British‐born British Pakistani women were taller (P = 0.05), had a lower waist to hip ratio (P = 0.04), lower mean fasting glucose levels (P = 0.03), lower mean triglyceride levels (P = 0.03), and higher mean HDL levels (P < 0.001) than migrant British Pakistani women. Levels of fasting insulin, HOMA‐IR, and blood pressure were not significantly different in the two British Pakistani groups. Thus, we found healthier levels of several cardiovascular and Type 2 diabetes risk factors in British‐born British Pakistani women than in migrant British Pakistani women. These findings might be related to the effects of early environment or to other factors, such as differences in health behaviors. British‐born British Pakistani women also differed from British‐born European women, having a more adverse body composition, but healthier levels of HDL cholesterol and blood pressure. Am. J. Hum. Biol., 2008. © 2008 Wiley‐Liss, Inc.     

Postprandial glucose and insulin responses to meals containing different carbohydrates in normal and diabetic subjects

To examine whether the form of dietary carbohydrate influences glucose and insulin responses, we studied the glucose and insulin responses to five meals--each containing a different form of carbohydrate but all with nearly identical amounts of total carbohydrate, protein, and fat--in 10 healthy subjects, 12 patients with Type I diabetes, and 10 patients with Type II diabetes. The test carbohydrates were glucose, fructose, sucrose, potato starch, and wheat starch. In all three groups, the meal containing sucrose as the test carbohydrate did not produce significantly greater peak increments in the plasma concentration of glucose or greater increments in the area under the plasma glucose-response curves than did meals containing potato, wheat, or glucose as test carbohydrates. Urinary excretion of glucose in patients with diabetes was not significantly greater after the sucrose meal. The meal containing fructose as the test carbohydrate produced the smallest increments in plasma glucose levels, but the differences were not always statistically significant. In healthy subjects and patients with Type II diabetes, peak serum concentrations of insulin were not significantly different in response to the five test carbohydrates. Our data do not support the view that dietary sucrose, when consumed as part of a meal, aggravates postprandial hyperglycemia.     

Association of a microsatellite in FASL to type II diabetes and of the FAS-670G>A genotype to insulin resistance

Type II diabetes is caused by a failure of the pancreatic beta-cells to compensate for insulin resistance leading to hyperglycaemia. There is evidence for an essential role of an increased beta-cell apoptosis in type II diabetes. High glucose concentrations induce IL-1beta production in human beta-cells, Fas expression and concomitant apoptosis owing to a constitutive expression of FasL. FASL and FAS map to loci linked to type II diabetes and estimates of insulin resistance, respectively. We have tested two functional promoter polymorphisms, FAS-670 G>A and FASL-844C>T as well as a microsatellite in the 3' UTR of FASL for association to type II diabetes in 549 type II diabetic patients and 525 normal-glucose-tolerant (NGT) control subjects. Furthermore, we have tested these polymorphisms for association to estimates of beta-cell function and insulin resistance in NGT subjects. We found significant association to type II diabetes for the allele distribution of the FASL microsatellite (P-value 0.02, Bonferroni corrected). The FAS-670G>A was associated with homeostasis model assessment insulin resistance index and body mass index (P-values 0.02 and 0.02). We conclude that polymorphisms of FASL and FAS associate with type II diabetes and estimates of insulin resistance in Danish white subjects.     

Blood glucose, glucose tolerance and manifest diabetes in relation to cardiovascular disease and death in women. A 12-year follow-up of participants in the population study of women in Gothenburg, Sweden

A longitudinal population study of 1462 women, aged 38-60, was carried out in Gothenburg, Sweden in 1968-69. Women with initially manifest diabetes mellitus had significantly increased 12-year incidence of myocardial infarction and increased mortality while no increased incidence of angina pectoris, ECG changes indicating ischaemic heart disease or stroke was observed. The association to myocardial infarction remained in multivariate analyses and was independent of age, body fat distribution, smoking, serum cholesterol and systolic blood pressure. The association to mortality was independent of these factors and also of serum triglycerides. Women who were diagnosed as "new diabetics" during the 12-year follow-up had a significantly increased 12-year incidence of myocardial infarction but no significant increase was observed for any of the other end-points studied. When women with initially manifest diabetes mellitus were excluded, no association was found between initial fasting blood glucose concentration and the end-points studied. A negative significant association was found between initial fasting blood glucose concentration and smoking.     

利拉鲁肽联合基础胰岛素对初诊2型糖尿病合并肥胖患者 血糖控制及体质量指数的影响

目的 观察利拉鲁肽联合基础胰岛素对初诊2型糖尿病合并肥胖患者血糖控制及体质量指数的影响。方法 收集我院自2016年12月~2018年1月收治的94例初诊2型糖尿病合并肥胖患者作为观察对象,按数字奇偶法分为研究组与对照组,每组47例。对照组给予基础胰岛素治疗,研究组则在对照组的基础上加用利拉鲁肽治疗。观察并比较两组血糖控制及体质量指数变化情况,低血糖事件发生率。结果 治疗后,两组血糖指标水平及BMI均低于治疗前,且研究组降低幅度大于对照组,差异具有统计学意义（P＜0.05）。研究组低血糖事件发生率为2.13%,低于对照组的14.89%,差异具有统计学意义（P＜0.05）。结论 利拉鲁肽联合基础胰岛素对初诊2型糖尿病合并肥胖患者疗效确切,可有效控制血糖,调节体质量指数。     

Correlates of body image dissatisfaction among overweight women seeking weight loss

Predictors of body image dissatisfaction (BID) among obese people are poorly understood. In 79 obese women seeking weight reduction, associations with BID of self-esteem, youth teasing, adult teasing, and internalization of sociocultural appearance standards (ISAS) were studied. Analyses revealed that only self-esteem, adult teasing, and ISAS predicted BID. Results highlight the importance of adulthood self-esteem and interpersonal-cultural context--rather than childhood experiences--in predicting adulthood BID.     

Effects of weight stigma on exercise motivation and behavior: a preliminary investigation among college-aged females

This study examined the relation between weight stigma, exercise motivation and exercise behavior. One hundred female undergraduates (BMIs [kg/m(2)] 17-38) completed measures of experiences with weight stigma, body dissatisfaction, self-esteem and exercise motivation, and reported on their exercise behavior. Stigma experiences were positively correlated with BMI and body dissatisfaction. Importantly, stigma experiences were related to increased desire to avoid exercise, even when controlling for BMI and body dissatisfaction. Exercise avoidance was in turn related to less frequent strenuous and moderate exercise. These findings suggest that weight stigma (through its impact on avoidance motivation) could potentially decrease physical activity levels.     

Obesity,appearance, and psychosocial adaptation in young African American children

OBJECTIVE: To evaluate the contributions of weight status, skin tone, peer teasing, and parental appraisals of child's size to self-esteem and psychosocial adjustment in overweight African American children. METHOD: Overweight to very obese 5- to 10-year-old African American children (N = 117) completed measures of self-esteem, skin tone satisfaction, peer teasing, and body size perception. Caregivers completed the Child Behavior Checklist and rated their child's body size. RESULTS: Overweight was associated with low appearance self-esteem, and body size dissatisfaction with low global self-worth and low appearance self-esteem in children 8 and older. Appearance self-esteem but not global self-worth was lower in girls than boys. Parental perception of child's size as heavier than average was associated with low child appearance self-esteem. Heavier children also had more parental report of behavior and psychosocial problems, but their scores were in the nonclinical range. Child skin tone dissatisfaction was associated with low global self-worth. Weight-related peer teasing was associated with low self-esteem. CONCLUSIONS: The relationship between obesity and self-esteem in African American children depends upon age, gender, and children's experiences with teasing and parental evaluation of their size. Other factors, like skin tone satisfaction, contribute to a child's sense of self-worth.