Examining foodwork and eating behaviors among heterosexual and gay male couples.

OBJECTIVES: Spouses play an important role in their partners' eating behaviors, including both promoting and impeding healthy eating. The division of foodwork in the relationship (i.e., if there is individual or shared responsibility for food roles) may vary as a function of gender or sexual orientation and may be important in understanding eating behaviors. METHOD: Using cross-sectional, dyadic data from 462 heterosexual and gay married couples (N = 921 individuals) residing in the United States, we accordingly sought to examine which partner was most responsible for two food roles, food shopping and meal preparation (Aim 1); whether these roles differed by gender (Aim 1a) and sexual orientation (Aim 1b); whether these food roles were related to the frequency of eating healthy and unhealthy foods (Aim 2); and whether these associations differed by gender (Aim 2a) and sexual orientation (Aim 2b). RESULTS: We found that one individual was responsible for these roles in a majority of couples, although meal preparation was more likely to be shared in gay than in heterosexual couples. We also found that, in general, the person responsible for these food roles ate healthy more frequently compared to when their partner was responsible; findings for shared responsibility were more equivocal. These associations did not differ, however as a function of gender or sexual orientation. CONCLUSION: Our findings contribute to a further understanding of food dynamics among heterosexual and gay male couples and have important implications for health promotion and intervention efforts.

Gender, BMI, and eating regulation in the context of same-sex and heterosexual couples.

Research suggests that romantic partners may benefit each other's health, but factors contributing to partners' involvement in eating regulation have been relatively unexplored. In this study, 104 heterosexual couples, 72 female same-sex and 72 male same-sex couples were examined in order to understand how partners' weight statuses were related to attempts to regulate eating behaviors. Weight status was assessed via body mass index and eating regulation was assessed using the Partner Feeding Questionnaire. Actor-Partner Interdependence Models revealed that gay men were particularly likely to regulate their partners' eating behaviors. Additionally, partners were found to regulate their significant others' eating behaviors when their significant others were heavy. Women were most likely to attempt to regulate their partners' eating behaviors when they were thin and their partners were heavy. These findings are discussed in the context of current obesity trends and the role of romantic partners in healthy weight management.

Mental health symptoms and patient-reported diabetes symptom burden: implications for medication regimen changes.

AIMS: To examine the relative contribution of glycaemic control (HbA1C) and depressive symptoms on diabetes-related symptom burden (hypoglycaemia and hyperglycaemia) in order to guide medication modification. METHODS: Secondary analysis of medical records data and questionnaires collected from a racially/ethnically diverse sample of adult patients with type 2 diabetes (n = 710) from seven outpatient clinics affiliated with an academic medical centre over a 1-year period as part of the Reducing Racial Disparities in Diabetes: Coached Care (R2D2C2) study. RESULTS: Results from linear regression analysis revealed that patients with high levels of depressive symptoms had more diabetes-related symptom burden (both hypoglycaemia and hyperglycaemia) than patients with low levels of depressive symptoms (ßs = 0.09-0.17, Ps < 0.02). Furthermore, results from two logistic regression analyses suggested that the odds of regimen intensification at 1-year follow-up was marginally associated with patient-reported symptoms of hypoglycaemia [adjusted odds ratio (aOR) = 1.24, 95% CI: 0.98-1.58; P = 0.08] and hyperglycaemia (aOR = 1.21, 95% CI: 1.00-1.46; P = 0.05), after controlling for patients' HbA1C, comorbidity, insulin use and demographics. These associations, however, were diminished for patients with high self-reported hypoglycaemia and high levels of depressive symptoms, but not low depressive symptoms (interaction terms for hypoglycaemia by depressive symptoms, aOR = 0.98, 95% CI: 0.97-0.99; P = 0.03). CONCLUSIONS: Mental health symptoms are associated with higher levels of patient-reported of diabetes-related symptoms, but the association between diabetes-related symptoms and subsequent regimen modifications is diminished in patients with greater depressive symptoms. Clinicians should focus attention on identifying and treating patients' mental health concerns in order to address the role of diabetes-related symptom burden in guiding physician medication prescribing behaviour.

A dyadic analysis of anti-fat attitudes and partners' diet-related influence among gay married men.

OBJECTIVES: The focus on physical appearance among gay men has potential implications for anti-fat attitudes, including those directed toward romantic partners. Partners often influence each other's behaviors including those linked to weight, but most research has examined the consequences of these influence strategies versus their antecedents. To address this research gap, we examined how men's own and their partners' anti-fat attitudes were related to both health-promoting (control) and health-compromising (undermining) types of diet-related influence and whether these associations differed by weight status. METHODS AND RESULTS: Analyzing data from a cross-sectional online survey of 450 U.S. adult gay married men (225 couples), Actor-Partner Interdependence Models revealed that individuals' own anti-fat attitudes (all types) were positively associated with more frequent receipt of spousal control and undermining. Additionally, partner's fears about gaining weight were positively associated with more frequent receipt of spousal control and dislike of higher weight people and fear of gaining weight (among those of higher weight status) were positively associated with more frequent receipt of spousal undermining. CONCLUSION: Our findings add to the literature on diet-related interactions among gay married men, highlight the value of examining these processes dyadically, and suggest the importance of including both members of couples in health promotion and intervention efforts.

Loneliness and Expanding Social Ties in Later Life: Motivation, Perceived Success, and Implications for Emotional Health.

OBJECTIVE: Social networks undergo changes in later life, reflecting proactive decreases as well as increases in size, but relatively little is known about the factors that motivate older adults to expand their social ties. Loneliness might be expected to motivate older adults to expand their social ties. Paradoxically, however, studies of younger age groups have linked loneliness to a self-protective reluctance to initiate social contact. The current study investigated whether loneliness fosters or inhibits older adults' efforts to expand their social ties and whether successful efforts are related to gains in emotional health. METHOD: Loneliness, motivation to expand social ties, and emotional health were assessed in a subset of older participants (N = 375) from the Later Life Study of Social Exchanges. RESULTS: Greater loneliness was associated with less interest, less investment of effort, and less success in making new ties and rekindling dormant ties. Nonetheless, lonelier older adults who expanded their social ties, particularly by rekindling dormant ties, exhibited some gains in emotional health over a one-year period. DISCUSSION: Greater attention to the role of loneliness in older adults' motivations for making new ties or rekindling dormant ties will broaden our understanding of social network changes in later life.

Motives for spousal involvement in a Partner's diabetes management: Considering the role of gender and links to diet-related involvement.

Using data from 148 middle-aged and older adult spouses whose partners had type 2 diabetes, we sought to examine spouses' motives for involvement in their partners' diabetes management and whether these motives were related to common types of diabetes-related spousal involvement; we also sought to understand gender differences in these dynamics. Spouses indicated being motivated to be involved in their partners' diabetes management due to altruistic motives to the greatest extent and egoistic motives to the least extent. Results from multivariable regression analyses that controlled for gender, marital quality, and spouses' own conditions requiring dietary changes revealed that all types of motives were related to the frequency of providing diet-related spousal support, whereas only egoistic motives were related to the frequency of exerting diet-related spousal control. We did not find gender differences in any motives nor in associations with spousal involvement. Findings have potential implications for couples-oriented chronic illness interventions.

Examining the link between exercise-specific relational processes and physical activity, psychological distress, and relationship satisfaction among heterosexual and gay male couples.

Despite the important role of romantic relationships in physical activity, little research has examined the role of gender and sexual orientation in exercise-specific relational processes. Utilizing cross-sectional, dyadic data from 462 heterosexual and gay couples, the present study examined how exercise encouragement, exercise discouragement, and frequency of exercise disagreements are related to physical activity, psychological distress, and relationship satisfaction. We included important covariates and examined gender and sexual orientation as moderators. Higher exercise encouragement was associated with more frequent physical activity (for gay men only), lower psychological distress (for women only), and higher relationship satisfaction regardless of gender and sexual orientation. Higher exercise discouragement was associated with more physical activity for all participants and higher levels of psychological distress for gay men only. Finally, more frequent exercise disagreements were associated with more psychological distress for all participants. These findings highlight important implications for physical activity promotion, prevention, and intervention.

Exploring typologies of appraisals, involvement, and distress in type 2 diabetes family members.

The present study conducted a latent profile analysis from a US national sample of 446 family members to identify and predict unique clusters of family members' PWD illness appraisals, involvement, and psychological distress. Time since diagnosis, diabetes adherence, the relationship with the PWD, age, gender, race/ethnicity, income, and economic pressure were included as predictors. Class membership was used to predict the family members' own health behaviors (sleep quality, days of physical activity, and diet quality). Results revealed four distinct classes: Moderately Concerned, Involved, and Distressed (32.51%), Least Concerned, Distressed, and Involved (27.13%), Less Concerned and Distressed, Moderately Involved (23.77%), and Most Concerned, Involved, and Distressed (16.82%). The significant predictors and outcomes of class membership revealed interesting patterns in associations with class membership. Consequently, in addition to involving family members, health promotion and intervention efforts must consider the psychological health and illness appraisals of family members rather than a one-size-fits-all approach.

Examining health experiences and body dissatisfaction in two unique samples of patients with type 2 diabetes.

Using cross-sectional data from two samples of adult patients with type 2 diabetes (n = 123 and n = 111), we used an embodiment perspective to examine whether health experiences were related to the extent of individuals' dissatisfaction with their bodies. The nature and strength of associations differed across the two unique samples examined, but weight status had the strongest and most robust association with body dissatisfaction in both samples. None of the associations differed as a function of gender or age. These findings contribute to an understanding of the complex relationship between physical and mental health in the context of diabetes.

Understanding eating disorder symptoms in same-gender couples: social environmental factors.

BACKGROUND: Sexual minority individuals are at disproportionately greater risk for eating disorders, yet little is known about the ways in which factors in the social environment relate to eating disorder symptoms in this population. Utilizing an ecological systems theory framework, we investigated the relative relationships of macro level (i.e., internalization of sociocultural attitudes about appearance) and micro level (i.e., quality of romantic relationship) social environment influences. METHODS: Men (n = 144) and women (n = 144) in committed same-gender relationships were recruited as a dyad and completed study questionnaires, including multiple measures of eating disorder symptoms. Multilevel models controlling for key variables (e.g., body mass index) were used to examine gender differences, main effects, and interactions. RESULTS: Men reported greater internalization of sociocultural attitudes and uncontrolled eating. Greater internalization of sociocultural attitudes was related to greater eating pathology across all measures. For men, greater relationship quality was related to less uncontrolled eating. CONCLUSIONS: Individuals in same-gender relationships experience macro (e.g., sociocultural) level vulnerability factors in relation to disordered eating; however, internalization of sociocultural attitudes may be greater for men. Support at the microsystem level in the form of a high quality committed romantic relationship appears to be helpful protection against uncontrolled eating for men.

Sexual minority individuals are at disproportionately greater risk for eating disorders, yet little is known about the ways in which factors in the social environment relate to eating disorder symptoms in this population. This research investigates sociocultural attitudes and romantic relationship quality as factors in the social environment in relation to eating disorder symptoms for men and women in same-gender relationships. We found differences in the occurrence of eating disorder symptoms, such that sexual minority men had more uncontrolled eating compared to sexual minority women. Across all participants, internalization of sociocultural attitudes was linked to greater disordered eating symptoms. We also investigated a potential buffering role of a romantic partner on eating disorder symptoms, and found that high quality, committed, romantic relationships were beneficially associated with less uncontrolled eating for sexual minority men.

Additive and interactive associations among body appreciation, self-compassion, and gender in understanding college students' health behaviors.

Body appreciation and self-compassion are associated with each other and individually associated with important health behaviors. Less is known about their combined associations with health behaviors, although previous work has examined self-compassion as a moderator of negative body image experiences. Self-compassion may likewise amplify the positive association between body appreciation and engagement in healthy behaviors. In this study, we examined the additive and interactive associations of body appreciation and self-compassion with three health behaviors (physical activity, sleep, stress management activities) among 302 college students from a northeastern university in the United States. We further examined gender differences in key variables and in associations among body appreciation, self-compassion, and health behaviors. We found that body appreciation was independently associated with physical activity and stress management activities, with the association stronger for men than women. We also found that self-compassion was independently associated with sleep and stress management activities. Body appreciation and self-compassion did not interact in predicting any health behaviors. Findings from this study highlight the unique associations of body appreciation and self-compassion with different health behaviors and underscore the need to increase body appreciation and self-compassion among college students to promote overall health and well-being.

Marital Status, Marital Transitions, and Sleep Quality in Mid to Late Life.

This study aimed to understand how marital status and marital transitions were related to sleep quality in mid to late life and whether these findings differed by gender. Data from 2,872 participants 50-74 years old from the ORANJ BOWLSM, a longitudinal panel study in New Jersey, were used. Marital status and sleep quality were examined in two waves that were approximately 10 years apart. Individuals in a significant romantic relationship and women had worse sleep quality than those in other marital status groups and men. Compared to individuals who remained married, individuals who remained divorced or widowed or who became widowed had better sleep quality, whereas those who became divorced had worse sleep quality; individuals who transitioned into marriage had better sleep quality than those who remained divorced or widowed. Marital status and gender appear important for at least some indices of sleep quality, an important predictor of late-life health.

Perceptions of Weight Change Among Romantic Partners: Considering Body Image, Relationship Experiences, Gender, and Sexual Orientation.

Romantic relationship experiences have been found to be relevant to body image and weight in adulthood. In this study, we investigated predictors of heterosexual, lesbian, and gay romantic partners' (N = 500, M age = 29.3) perceptions of their own and their partners' weight at the beginning of their relationship and 4.8 years later, on average. Perceived changes in participants' own weight status was associated with greater body dissastisfaction and longer relationship length. Perceived changes in partners' weight status was associated with their partners' BMI, as well as relationship quality. We also found that gender was important in understanding some of these associations. Implications of weight perceptions for individuals' and their partners' health and well-being and the critical role of relationship quality are discussed in the context of the health regulation model.

Older adults' physical activity-related social control and social support in the context of personal norms.

This study investigated whether perceived physical activity norms moderated the effects of physical activity-related social interactions on intentions to engage in physical activity among community-residing older adults (N = 217). Structural equation modeling tested whether two types of social support and social control interacted with personal norms in predicting intentions to be active. Emotional and informational support were associated with higher intentions, and negative social control was associated with lower intentions to engage in activity. Each of these effects was more prominent in the context of weak personal norms, suggesting future research and interventions should consider joint effects of support and norms.

Racial/ethnic disparities in exercise and dietary behaviors of middle-aged and older adults.

BACKGROUND: Differences in health behaviors may be important contributors to racial/ethnic disparities in the health status of adults. Studies to date have not compared whether there are health behavior differences in exercise and dietary behaviors among middle-age and older adults in the four largest racial/ethnic categories. OBJECTIVE: To investigate racial/ethnic differences in exercise and dietary behaviors of middle-aged and older adults. DESIGN: We used data from the 2007 California Health Interview Survey. Multivariable logistic regression was used to examine interactions between age and race/ethnicity in predicting two categories of health behaviors. Analyses were conducted adjusting for sociodemographic characteristics, health insurance status, and healthcare utilization. PARTICIPANTS: A population-based sample of 33,189 California adults 45 years old and older: 26,522 non-Hispanic whites, 1,686 African American/blacks, 2,565 Asian/Pacific Islanders (1,741 English-proficient; 824 limited English-proficient), and 2,416 Latinos (1,538 English-proficient; 878 limited English-proficient). MAIN MEASURES: Self-report leisure-time physical activity (moderate and vigorous) and daily consumption of fruits and vegetables. KEY RESULTS: Racial/ethnic minorities generally engaged in less healthy exercise and dietary behaviors than whites, with differences more pronounced in middle adulthood. The disparities were the greatest among English-proficient minorities. Specifically, among middle-aged respondents, all racial/ethnic minorities engaged in less vigorous physical activity than whites (ORs range = 0.28 to 0.73; 95% CI range = 0.16-1.00). Additionally, middle-aged, English-proficient minorities engaged in less moderate physical activity compared to whites (ORs range =0.57 to 0.67; 95% CI range = 0.45-0.79). Furthermore, middle-aged, English-proficient Latinos had a poorer diet than whites (OR = 0.54; 0.39-0.75). Few significant racial/ethnic differences emerged in the exercise and dietary behaviors of older adults. CONCLUSIONS: Racial/ethnic disparities in exercise and dietary behaviors are most notable among middle-aged, acculturated minorities. Results highlight the need to promote positive exercise and dietary behaviors during critical preventive ages, when racial/ethnic disparities are large and the potential to prevent chronic disease is great.

When does Spousal Social Control Provoke Negative Reactions in the Context of Chronic Illness?: The Pivotal Role of Patients' Expectations.

Spouses often monitor and seek to alter each other's health behavior, but such social control attempts can provoke behavioral resistance and emotional distress. Expectations regarding spouses' roles in their partners' health may influence reactions to spousal social control, with resistance and hostility less likely to occur among people who believe spouses should be involved in their partners' health. Evidence consistent with this idea emerged in a study of 191 patients with type 2 diabetes. Patients with greater expectations for spousal involvement (particularly females) generally reacted less negatively to spousal control. The findings help to clarify when people with a chronic illness are likely to resist and resent, rather than appreciate, spousal control.

Correlates of diet-related spousal involvement among both members of couples managing diabetes.

INTRODUCTION: Spouses are often involved in facilitating each other's healthy diet through support and regulation (i.e., control), especially when one member has a chronic condition such as type 2 diabetes. This diet-related involvement is likely reciprocal, yet little is known about the implications of this type of involvement for the nonpatient spouse, as well as the implications of providing support or control. This study accordingly focused on the behavioral and emotional correlates of the receipt and provision of diet-related spousal support and control among both members of couples managing type 2 diabetes. METHOD: Both members of middle-aged and older adult married couples (N = 296) in which at least one member had type 2 diabetes completed an online survey. Data were analyzed using multilevel models that controlled for sociodemographic and disease characteristics. RESULTS: The only patient status difference in any of the key variables was that spouses reported more diabetes distress than patients themselves. Receiving more frequent support was related to a healthier diet, whereas receiving more frequent pressure was related to an unhealthier diet. Providing more frequent support and persuasion were related to a healthier diet, but only among spouses without diabetes. Finally, the more frequent provision of all types of diet-related involvement was related to greater diabetes distress. DISCUSSION: Patient status did not seem especially relevant in understanding correlates of diet-related spousal involvement. Findings highlight the importance of examining and focusing intervention efforts on both members of a couple in later life when chronic conditions requiring dietary changes are prevalent. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Main and interactive effects of diabetes distress and stress from life events on overall psychological distress.

This study sought to extend previous research by examining rates of three different types of diabetes distress and whether stress from life events amplified the association between diabetes distress and overall psychological distress in a community-based sample of 119 middle-aged and older adults with type 2 diabetes. Consistent with past research, individuals experienced a moderate level of diabetes distress. However, only some types of diabetes distress were associated with depressive symptoms, independent of stressful life events, whereas all types of diabetes distress were only related to anxious symptoms when stress from life events was also high.

Body image experiences in the context of chronic pain: An examination of associations among perceptions of pain, body dissatisfaction, and positive body image.

Although body image research has recently begun to examine positive body image and ways to improve body image, it remains unclear the extent to which these findings generalize to individuals who experience chronic pain. With this in mind, this study examined individuals with chronic pain conditions (N = 278, Mage = 36.75, SD = 11.56), including their reports of their ability to control, manage, and accept their pain. Participants also completed assessments of four facets of body image: perceptions of body functionality, body appreciation, appearance evaluation, and body satisfaction. Results indicated that pain acceptance was the most consistent, unique predictor of these body image constructs, after controlling for the other pain facets, as well as body mass index, gender, and age. These findings have implications for improving body image among people with chronic pain; it appears that controlling or altering pain may be less relevant to body image than is how individuals cope with pain.

Understanding body image among adults in mid-late life: Considering romantic partners and depressive symptoms in the context of diabetes.

Although our bodies change as we age, there is limited research exploring body image among middle-aged and older adults. This study considered 70 adults with diabetes' (Mage = 60.01 years) body image and revealed relatively high levels of body dissatisfaction in this sample. Furthermore, participants' own and perceptions of their partners' dissatisfaction with their bodies were moderately associated, and participants' body dissatisfaction was associated with higher levels of depressive symptoms. These findings highlight the need for further research, exploring the social and psychological correlates of body image among men and women in mid-late adulthood.