Contingency management for smoking cessation for individuals with overweight or obesity: A randomized controlled trial.

BACKGROUND: Interventions for quitting smoking and weight control among individuals with excess weight are scarce. Our study evaluated the effectiveness of cognitive behavioral therapy (CBT) plus contingency management (CM) in this population, and examined whether CM for smoking cessation improved CBT treatment outcomes at end of treatment (EOT) and at 1-, 3-, 6-, and 12-month follow-ups (FU). METHODS: In an 8-week randomized clinical trial, 120 adults who smoke with overweight or obesity (54.16% females; MBMI = 31.75 ± 4.31) were randomly assigned to CBT for both quitting smoking and weight control (n = 60) or the same treatment plus CM for smoking cessation (n = 60). Outcome variables were compared (i.e., treatment completion, smoking abstinence, weight change and secondary outcomes). RESULTS: At EOT, the CBT + CM group achieved 78.33% 7-day point-prevalence abstinence rates compared to 61.67% in the CBT group (p = .073), and rates declined over time (12-month FU: 18% vs 12%). Participants who attained abstinence weighed more compared to baseline at EOT (Mkg = 1.07; SD = 1.88) and over time (12-month FU: Mkg = 4.19; SD = 4.31). No differences were found between the two groups in outcome variables. CONCLUSIONS: Both interventions were effective in promoting abstinence and reducing tobacco use over time. Combining CBT with CM for smoking cessation did not improve treatment outcomes in individuals with overweight or obesity compared to CBT only. Future studies should evaluate whether implementing CM for weight maintenance helps control post-cessation weight gain in this population.

State-level working memory and dysregulated eating in children and adolescents: An exploratory ecological momentary assessment study.

BACKGROUND: Children with loss of control (LOC) eating and overweight/obesity have relative deficiencies in trait-level working memory (WM), which may limit adaptive responding to intra- and extra-personal cues related to eating. Understanding of how WM performance relates to eating behavior in real-time is currently limited. METHODS: We studied 32 youth (ages 10-17 years) with LOC eating and overweight/obesity (LOC-OW; n = 9), overweight/obesity only (OW; n = 16), and non-overweight status (NW; n = 7). Youth completed spatial and numerical WM tasks requiring varying degrees of cognitive effort and reported on their eating behavior daily for 14 days via smartphone-based ecological momentary assessment. Linear mixed effects models estimated group-level differences in WM performance, as well as associations between contemporaneously completed measures of WM and dysregulated eating. RESULTS: LOC-OW were less accurate on numerical WM tasks compared to OW and NW (ps < .01); groups did not differ on spatial task accuracy (p = .41). Adjusting for between-subject effects (reflecting differences between individuals in their mean WM performance and its association with eating behavior), within-subject effects (reflecting variations in moment-to-moment associations) revealed that more accurate responding on the less demanding numerical WM task, compared to one's own average, was associated with greater overeating severity across the full sample (p = .013). There were no associations between WM performance and LOC eating severity (ps > .05). CONCLUSIONS: Youth with LOC eating and overweight/obesity demonstrated difficulties mentally retaining and manipulating numerical information in daily life, replicating prior laboratory-based research. Overeating may be related to improved WM, regardless of LOC status, but temporality and causality should be further explored. PUBLIC SIGNIFICANCE STATEMENT: Our findings suggest that youth with loss of control eating and overweight/obesity may experience difficulties mentally retaining and manipulating numerical information in daily life relative to their peers with overweight/obesity and normal-weight status, which may contribute to the maintenance of dysregulated eating and/or elevated body weight. However, it is unclear whether these individual differences are related to eating behavior on a moment-to-moment basis.

Physical activity status among adolescents in Southern Ethiopia: A mixed methods study.

BACKGROUND: Adolescents physical activity is associated with current and future health benefits, reduction of cardio-vascular risk factors, improved bone mineral density, and mental health. The aim of the current study is to assess physical activity status and its factors among adolescents in Arba Minch and Jinka towns, Southern Ethiopia. METHODS: The study was conducted on 1255 randomly selected schools adolescents of Arba Minch and Jinka town by employing a mixed method. The qualitative data was obtained by Focus Group Discussion. Multiple linear regressions were done to identify factors affecting physical activity. Codes, sub-categories, and main categories were derived from the transcripts and presented in narrative ways to describe adolescent student's perception on physical activity, its barriers and facilitators by comparing with quantitative findings. RESULTS: The mean physical activity level was 2.08 (95% CI: 2.04-2.12). A student's self-perception about being physically active, being a member of a sport or fitness team, and engaging in after-school activity to earn money, being older, sex, a self-perception of being healthy, higher levels of vegetable and fruit consumption, having someone who encouraged physical activity, perceiving one's family as being active, self-perception of not being overweight and attending schools that have a sports/playground were factors associated with physical activity. The qualitative finding showed a related finding. Poor awareness on the recommended physical activity, benefits of physical activity, lack of interest, restrictions from family members, peers and the community, uncomfortable environment were barriers to physical activity. CONCLUSION AND RECOMMENDATION: The physical activity level of adolescents was low. Age, sex, a positive self-perception about PA and general health, and perception about one's family PA, healthy eating practice, and the presence of role model were associated factors. Lack of self-motivation, interest and family restrictions were barriers to physical activity. PA promotion should be made by incorporating PA into school health programs and strengthening the existing school curriculum.

Association between maternal eating and young child feeding in a community sample.

BACKGROUND: Early childhood is a pivotal period for the development of healthy eating practices. One way to promote child health is to identify early modifiable factors that affect child eating and weight. Given the intergenerational transmission of eating behaviors, this study examined how mothers' eating behaviors were associated with child feeding practices, and whether child weight-for-length (z-WFL) moderated this relation, in a community sample. METHODS: Participants were 72 mother-child dyads. Maternal eating behaviors-emotional, external and restrained-were assessed 9-months postpartum, using the Dutch Eating Behavior Questionnaire. Child feeding-restrictive, pressure, and concern about overeating/overweight or undereating/underweight-was measured using the Infant Feeding Questionnaire, and child z-WFL were assessed 18-months postpartum. Linear regressions were used to test the main effect of maternal eating and the interaction effect of maternal eating and child z-WFL, on child feeding practices. RESULTS: Maternal restrained eating was associated with child pressure feeding, and contrarily with concerns about overeating/overweight. However, a significant interaction between child z-WFL and both maternal emotional and external eating were found with regard to concern about child undereating/underweight. Paradoxically, among children who weighed more, greater maternal emotional and greater external eating were associated with greater concern about child undereating/underweight. CONCLUSIONS: In this community sample, mothers were more likely to report contradictory feeding practices and concerns, suggesting complicated relations among a mother's own eating behavior, her child's weight, and her perceptions of child eating and weight. This may indicate a need for better communication and support of infant feeding practices. TRIAL REGISTRATION: Data was collected as part of two grants (MAMAS Grant ID: HL097973-01; SEED Grant ID: HL116511-02) conducted at the University of California, San Francisco (UCSF). All subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by institutional review board at UCSF.

Youth and Peer Mentor Led Interventions to Improve Biometric-, Nutrition, Physical Activity, and Psychosocial-Related Outcomes in Children and Adolescents: A Systematic Review.

The utilization of youth (older) and peer (same age) mentor-led interventions to improve nutrition and physical activity has been an emerging trend in recent years. This systematic review is intended to synthesize the effectiveness of these intervention programs on participants and mentors based on biometric, nutrition, physical activity, and psychosocial outcomes of youth and peer mentor-led interventions among children and adolescents. Online databases, including PubMed, ScienceDirect, EBSCOhost and Google Scholar, were searched, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A three-step screening process was used to meet the proposed eligibility criteria, and the risk-of-bias tool for randomized trials (RoB 2) was used to assess bias for the included studies. Nineteen unique intervention programs and twenty-five total studies were deemed eligible when considering the criteria required for review. Multiple studies demonstrated positive evidence of the biometric and physical activity outcomes that were considered significant. The findings regarding the nutritional outcomes across the included studies were mixed, as some studies reported significant changes in eating habits while others did not find a significant change. Overall, the utilization of youth and peer mentor-led models in nutrition- and physical-activity-related interventions may be successful in overweight and obesity prevention efforts for those children and adolescents receiving the intervention and the youths and peers leading the interventions. More research is needed to explore the impact on the youths and peers leading the interventions and disseminating more detailed implementation strategies, e.g., training mentors would allow for advancements in the field and the replicability of approaches. Terminology: In the current youth- and peer-led nutrition and physical activity intervention literature, a varying age differential exists between the targeted sample and the peers, and varying terminology with regards to how to name or refer to the youth. In some instances, the youth mentors were individuals of the same grade as the target sample who either volunteered to serve in the peer role or were selected by their fellow students or school staff. In other cases, the youth mentors were slightly older individuals, either in high school or college, who were selected based upon their experience, leadership skills, passion for the project, or demonstration of healthy lifestyle behaviors.

Polyphenol supplementation and executive functioning in overweight and obese adults at risk of cognitive impairment: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: Increasing evidence indicates a link between obesity and cognitive impairment. Furthermore, there is limited literature regarding the effect of polyphenols, a plant derived compounds, on executive functioning in an overweight/obese population at-risk of cognitive impairment. The aim of the present systematic review and meta-analysis of randomized controlled trials is to examine the effect of polyphenol supplementation on executive functions in overweight and/or obese populations at risk of cognitive impairment. METHODS: A comprehensive literature search was conducted from inception to March 2023 using four electronic databases: PubMed/Medline, PsycInfo, Scopus and Cochrane trials library. Published primary research studies in English that compared the effect of polyphenols with placebo on executive function in overweight/obese adults were considered eligible for the meta-analysis. Jadad scale was used for the methodological quality rating of the included studies. Hedges g with 95% confidence intervals (CI) for endpoints were calculated using random effect model where applicable. Rosenthal's Fail-safe N, funnel plots, the Begg and Mazumdar's rank correlation test (Kendall's S statistic P-Q), Egger's linear regression test, and Duval and Tweedie's trim-and-fill test were identified for potential use as appropriate, to examine publication bias. Sensitivity analysis was conducted to examine the robustness of the results. RESULTS AND CONCLUSION: A total of 23 RCT studies involving N = 1,976 participants were included in the review. The results of the meta-analysis revealed a non-significant effect for polyphenol supplementation on executive function (g = 0.076, CI = -0.018 to 0.170). Observations from primary studies within the meta-analysis showed a potential positive effect of polyphenol supplementation in a younger population at-risk of cognitive impairment and it is recommended to investigate this further in future studies. Moreover, the variability of the tasks used to examine executive functions as well as the adequate reporting of supplement's phenolic composition is a limitation that future work should also consider.

How the Presence of a Doctor Known to Patients Impacts a Web-Based Intervention to Promote Physical Activity and Healthy Eating Behaviour in Individuals with an Overweight/Obesity-Hypertension Phenotype: A Randomised Clinical Trial.

(1) Background: The 'Living Better' web-based programme has shown short- and long-term benefits for body composition and psychological variables in obese patients with hypertension by promoting a healthier lifestyle. To further explore the potential of this programme, in this work we aimed to explore the possible effect of the patient's 'own doctor' appearing in the video content of the Living Better intervention. (2) Methods: A total of 132 patients were randomly assigned either to the experimental (EG, n = 70) or control (CG, n = 62) group (with a doctor the patient knew as 'their own' or an 'unknown doctor', respectively). The body mass index (BMI), motivation towards physical activity (PA), PA levels, motivation to change one's eating habits, adherence to the Mediterranean diet, and eating behaviour were all assessed and compared at baseline and post-intervention (12 weeks). (3) Results: The results of this study confirmed the positive effects of the Living Better programme on BMI and external eating style, with significant improvements in these variables in both groups. In addition, in the EG there was higher intrinsic motivation to change eating behaviour (mean difference of 0.9, 95% CI [0.1, 1.6], p = 0.032) and lower amotivation (mean difference of -0.6, 95% CI [-1.2, -0.1], p = 0.027) compared to the CG. (4) Conclusions: This study suggests that the presence of the patients' own doctor in the audiovisual content of the Living Better intervention did not have significant additional benefits in terms of BMI or external eating style. However, their presence did improve intrinsic motivation and amotivation related to eating habits.

[Obesity, weight-related stigma and its association with the perception of quality of life in Chilean university students]. / Obesidad, estigma relacionado con el peso y su asociación con la percepción de la calidad de vida en estudiantes universitarios chilenos.

Introduction: Introduction: little attention has been paid to the effect of exposure to weight-related stigma on the quality of life of young Chileans with obesity. Objective: to identify the prevalence of weight-related stigma and to analyze its association with obesity and the perception of quality of life in university students from Valparaíso, Chile. Methods: correlational type study and cross-sectional design. Two hundred and sixty-two university students participated, from 18 to 29 years old, matriculated in the Faculty of Health Sciences of a public university in Valparaíso, Chile. Quality of life was assessed with the WHOQOL-BREF scale, weight-related stigma with the Brief Stigmatizing Situations Inventory (SSI), and nutritional status with body mass index (BMI) classification. The application of the questionnaires was on-line and the answers were anonymous. Multiple logistic regression models were used to evaluate the association between the variables, adjusted for gender and age. Results: the prevalence of stigma related to weight was 13,2 % in eutrophic, 24,4 % in overweight and 68,0 % in obese. Weight-related stigma, rather than obesity itself, is associated with poorer perceived physical health (OR: 4.30; 95 % CI: 2.10-8.80), psychological health (OR: 4.51; 95 % CI: 2.20-9.26), social relationships (OR: 3.21; 95 % CI: 1.56-6.60) and environment (OR: 2.86; 95 % CI: 1.33-6.14). Conclusion: students exposed to stigmatizing situations related to weight had a worse perception of their quality of life compared to those not stigmatized.

Introducción: Introducción: el efecto de la exposición al estigma relacionado en la calidad de vida de los jóvenes con obesidad ha recibido poca atención. Objetivo: identificar la prevalencia de estigma relacionado con el peso y analizar su asociación con la obesidad y la percepción de la calidad de vida en estudiantes universitarios de Valparaíso, Chile. Metodología: estudio de tipo correlacional y diseño transversal. Participaron 262 estudiantes universitarios, de 18 a 29 años de edad, matriculados en la Facultad de Ciencias de la Salud de una universidad pública de Valparaíso, Chile. La calidad de vida se evaluó con la escala WHOQOL-BREF; el estigma relacionado con el peso, con el Inventario breve de Situaciones Estigmatizantes (SSI); y el estado nutricional, con la clasificación del índice de masa corporal (IMC). La aplicación de los cuestionarios fue en línea y las respuestas fueron anónimas. Se realizaron modelos de regresión logística múltiple para evaluar la asociación entre las variables, ajustados por sexo y edad. Resultados: la prevalencia de estigma relacionado con el peso fue del 13,2 % en eutróficos, 24,4 % en sobrepesos y 68,0 % en obesos. El estigma relacionado con el peso, más que la obesidad en sí misma, se asoció con una peor salud física percibida (OR: 4,30; 95 % IC: 2,10-8,80), salud psicológica (OR: 4,51; 95 % IC: 2,20-9,26), relaciones sociales (OR: 3,21; 95 % IC: 1,56-6,60) y ambiente (OR: 2,86; 95 % IC: 1,33-6,14). Conclusiones: los estudiantes expuestos a situaciones estigmatizantes relacionadas con el peso tuvieron una peor percepción de su calidad de vida en comparación con aquellos no estigmatizados.

[Relation between weight stigma and emotional eating: an approach from structural equation modeling]. / Relación entre estigma de peso y alimentación emocional: una aproximación desde el modelo de ecuaciones estructurales.

Introduction: Introduction: dietary intake has been shown to be one of the main factors influencing weight gain, and weight stigma contributes to increased emotional eating. However, the factors that mediate this relationship have been less studied. Objective: the aim of this study was to identify the relationship between weight stigma and emotional eating, and whether this relationship is mediated by internalizing weight bias and psychological distress. Methods: a non-probabilistic sample of 332 people from the general population (192 women and 140 men) answered self-report psychological instruments and provided anthropometric measurements. Results: through structural equation analysis (SEM), direct relationships were identified, among which the relationship between weight stigma and emotional eating stands out (ß = 0.422, p < 0.001), in addition to the indirect relationship between these variables mediated by internalized weight bias and psychological distress (ßindirect = 0.016, p = < 0.05). The model had good indicators of goodness of fit and explained 85 % of the variance. Conclusion: the results show the importance of including psychological and behavioral variables in the treatment of emotional eating in people with overweight and obesity, as well as addressing these issues from public policies to reduce the associated stigma that still prevails in society.

Introducción: Introducción: se ha demostrado que la ingesta alimentaria es uno de los principales factores que influyen en el incremento del peso y que el estigma de peso contribuye a una mayor alimentación emocional. Sin embargo, los factores que median esta relación han sido menos estudiados. Objetivo: el objetivo de este estudio fue identificar la relación que existe entre estigma de peso y alimentación emocional, y si esta relación está mediada por la internalización del sesgo de peso y el malestar psicológico. Métodos: una muestra no probabilística de 332 personas de población general (192 mujeres y 140 hombres) respondió instrumentos psicológicos de autorreporte y proporcionó medidas antropométricas. Resultados: por medio de un análisis de ecuaciones estructurales (SEM), se identificaron relaciones directas, entre las que destaca la relación del estigma de peso y alimentación emocional (ß = 0,422, p < 0,001), además de la relación indirecta entre estas variables mediante la internalización del sesgo de peso y malestar psicológico (ßindirecto = 0,016, p = < 0,05). El modelo tuvo buenos indicadores de bondad de ajuste y explicó un 85 % de la varianza. Conclusión: los resultados muestran la importancia de incluir variables psicológicas y conductuales en el tratamiento de la alimentación emocional en personas con sobrepeso y obesidad, así como de abordar estos temas desde políticas públicas para disminuir el estigma asociado que aún impera en la sociedad.

Psychosocial Factors Associated With Physical Activity Among Low-Income Overweight or Obese Mothers with Young Children.

PURPOSE: Investigate the associations between psychosocial factors and physical activity. DESIGN: Secondary data analysis utilizing baseline data of a large-scale community-based randomized controlled lifestyle behavior intervention. SETTING: The Special Supplemental Program for Women, Infants, and Children in Michigan, USA. SUBJECTS: Low-income overweight or obese mothers with young children (N = 740, 65% response rate). MEASURES: Survey data were collected via phone interview. Predictors included self-efficacy, autonomous motivation, emotional coping, and social support. Self-reported leisure physical activity was the outcome variable. Covariates were age, race, smoking, employment, education, body mass index, and postpartum status. ANALYSIS: A multiple linear regression model was applied. RESULTS: Self-efficacy (ß = .32, 95% CI = .11, .52, P = .003) and autonomous motivation (ß = .10, 95% CI = .03, .17, P = .005) were positively associated with physical activity. However, emotional coping and social support were not associated with physical activity. CONCLUSION: Future research should examine the longitudinal association of key psychosocial factors with physical activity.

Effects of neuromodulation on executive functions and food desires in individuals with obesity: a systematic review.

Introduction: Objective: to describe the effects of neuromodulation on the performance of executive functions in overweight and/or individuals with obesity. Methods: articles published in PubMed, ScienceDirect, BIREME, and Web of Science databases were selected using the following combination of descriptors: ("problem solving" OR "executive function" OR memory) AND (tDCS OR TMS) AND obesity. After applying the selection criteria, 08 articles were included for analysis. Results: the articles included had an average of 30.1 participants per study, with a minimum of 12 and a maximum of 76. The overall nutritional status ranged from underweight to grade 3 obesity, and the general mean body mass index was 28,1 kg/m2. Regarding the instruments used to assess executive functions, the most frequent were: the flanker paradigm; binocular rivalry for Continuous Flash Suppression (bCFS/NoCFS); Stroop task; Go/No-Go task; and N-back task. The primary outcomes were dependent on the neuromodulation target site. Reduced food craving and improved performance in the active group were observed from decreased response time and increased precision in cognitive tasks. Conclusion: neuromodulation can generate changes in executive functions, reducing food cravings in overweight and individuals with obesity.

Introducción: Objetivo: describir los efectos de la neuromodulación en el desempeño de funciones ejecutivas en pacientes con sobrepeso y/o obesidad. Métodos: se seleccionaron artículos publicados en las bases de datos PubMed, ScienceDirect, BIREME y Web of Science utilizando la siguiente combinación de descriptores: ("resolución de problemas" O "función ejecutiva" O memoria) Y (tDCS O TMS) Y obesidad. Después de aplicar los criterios de selección, 08 artículos fueron incluidos para el análisis. Resultados: los artículos incluidos tuvieron un promedio de 30,1 participantes por estudio, con un mínimo de 12 y un máximo de 76. El estado nutricional general osciló entre bajo peso y obesidad grado 3, y el índice de masa corporal promedio general fue de 28,1 kg/m2. En cuanto a los instrumentos utilizados para evaluar las funciones ejecutivas, los más frecuentes fueron: paradigma del flanqueador; rivalidad binocular para la supresión continua de flash (bCFS/NoCFS); tarea de Stroop; Tarea Go/No-Go; y tarea N-back. Los resultados primarios dependieron del sitio objetivo de la neuromodulación. Se observó una reducción del antojo de alimentos y un mejor rendimiento en el grupo activo debido a la disminución del tiempo de respuesta y al aumento de la precisión en las tareas cognitivas. Conclusión: la neuromodulación puede generar cambios en las funciones ejecutivas, reduciendo el antojo de alimentos en personas con sobrepeso y obesidad.

Psychometric properties of the Eating in the Absence of Hunger Questionnaire in treatment-seeking adults with overweight and obesity.

Understanding eating behaviors that contribute to overweight and obesity (OW/OB) is an important public health objective. One eating behavior known to contribute to overeating is eating in the absence of hunger (EAH). The Eating in the Absence of Hunger Questionnaire for Children was developed to assess external events and internal experiences that lead children to overeat. Despite the measure's adaptation for use with adults (i.e., EAH-A), its psychometric properties within this population have not been explored. This study assessed the psychometric properties of the EAH-A in sample of 311 treatment-seeking adults with OW/OB (mean BMI = 34.5 [5.1]; mean age = 46.3 [12.1]; 81.7% female; 20.6% Latinx, 59.2% white). The EAH-A contains 14 items and assesses three domains: negative affect eating (EAH-NAE), external eating, and fatigue/boredom eating, through two parallel sets of items assessing initiating EAH and continuing EAH. Exploratory Factor Analysis was performed with promax rotation and maximum likelihood factor extraction. Results supported a unitary factor of EAH, with scale responses driven by EAH-NAE items. Results may be explained in part by scale structure and domain imbalance favoring EAH-NAE items, or the true internal structure of EAH may consist of a singular latent construct. Follow-up analyses indicated redundancy of the scale's parallel sections. If researchers are primarily interested in EAH-NAE, only the three "start eating" or "keep eating" items may be needed. This study highlights the importance of validating the psychometric properties of a measure within intended populations to ensure interpretations are valid.

Sex differences in the associations between psychological symptoms and tumor necrosis factor-alpha levels among obese and nonobese children aged 6-13 in Taiwan.

BACKGROUND: Evidence of associations between psychological symptoms and tumor necrosis factor (TNF)-α level is scant, as is evidence on sex differences in associations for children and adolescents with obesity. This study examined sex differences in associations between psychological symptoms (self-concept, anxiety, depression, anger, and disruptive behavior) and TNF-α level in Taiwanese children and adolescents with healthy weight, overweight, or obesity. METHODS: In 2010, 564 first, fourth, and seventh graders-comprising 250 children with overweight or obesity (44.3 %), 330 adolescents (58.5 %), and 303 males (53.7 %)-underwent a health examination and blood sampling and completed a questionnaire. RESULTS: A significantly higher TNF-α level was found in children and adolescents with healthy weight than in those with overweight or obesity (median: 14.5 vs. 4.1 (pg/mL); p < 0.001). In multiple linear regression models, anxiety was significantly positively associated with TNF-α level in female participants with healthy weight (ß = 0.11 per 10 increments in anxiety, 95 % confidence interval = 0.01-0.22). LIMITATIONS: Given the cross-sectional nature of the study, no inferences of causal relationships among TNF-α level, obesity, and psychological symptoms could be made. CONCLUSIONS: The findings enrich the literature on the TNF-α-psychological symptom association. Sex differences were found in children and adolescents without obesity rather than in those without obesity, and a higher TNF-α level was associated with increased anxiety in girls without obesity. The role of sex differences in the complex associations among psychological symptoms, TNF-α level, and overweight or obesity requires further investigation.

Overweight and executive functions, psychological and behavioral profile of Spanish adolescents.

The prevalence of overweight and obesity among children and adolescents has risen dramatically increasing a major risk factor for non-communicable diseases and cognitive dysfunctions. This study aimed to analyze differences in the executive function´s development between overweight and normal-weight adolescents. As a secondary objective, we aimed to assess differences in adolescents' psychological and behavioral profiles between groups. In order to achieve the study's aim, 105 adolescent students (17.61 ± 7.43 years) completed an online questionnaire that analyzed variables regarding their executive functions' processes, their psychological and physical health as well as lifestyle habits. Results showed that executive functions development is associated with adolescent weight. A higher range of weight presents a lower ability to assess abstract reasoning and to shift cognitive strategies. Nevertheless, no differences were found between groups in the capacity to hold information in mind nor the ability to control impulsive responses. Furthermore, groups showed differences in the number of meals and gastritis, but no significant differences have been found in lifestyle variables such as mobile usage, smoking, physical activity, and hours of sleep per day. The results from the present study could be used to implement multidisciplinary programs to develop healthier habits.

[Effects of overweight and obesity on cognitive functions of children and adolescents]. / Efectos del sobrepeso y la obesidad en las funciones cognitivas de niños y adolescentes.

INTRODUCTION: Recent findings suggest that overweight and obesity in children and adolescents affect cognitive processes and can alter school learning. The so-called executive functions, such as response inhibition capacity, impulsivity control, cognitive flexibility, planning, and decision making, have been inversely related to body mass index. AIM: This work aims to examine the neurobiological and psychological hypothesis that explain why overweight, and obesity alter the cognitive functions of children and adolescents. DEVELOPMENT: Diets rich in fats and sugars can cause hyperinsulinemia, dyslipidemia, hypertension, augmented abdominal adipose tissue and resistance to insulin and leptin. These metabolic alterations induce a peripheral systemic inflammatory process that can affect the blood-brain barrier and the brain functioning of regions linked to attention and learning and memory processes. Some metabolic disorders of the pregnant mother, obesity during pregnancy and pre- and postnatal traumatic experiences can trigger changes in the control of food intake in children and adolescents and induce overweight in critical stages of their development. Obesity affects the functioning of the hippocampus and produces a decrease in the prefrontal cortex gray matter, thereby modifying cognitive abilities, especially executive functions. CONCLUSIONS: Overweight and obesity in childhood and adolescence are a risk factor not only for general health but also for proper brain development and cognitive functions and can therefore lead to school failure.

TITLE: Efectos del sobrepeso y la obesidad en las funciones cognitivas de niños y adolescentes.Introducción. Investigaciones recientes sugieren que el sobrepeso y la obesidad en niños y adolescentes afectan a los procesos cognitivos y pueden alterar el aprendizaje escolar. En particular, las denominadas funciones ejecutivas, como la capacidad de inhibición de la respuesta, el control de la impulsividad, la flexibilidad cognitiva, la planificación y la toma de decisiones, se han relacionado de forma inversa con el índice de masa corporal. Objetivo. Este trabajo pretende examinar las hipótesis neurobiológicas y psicológicas que explican por qué el sobrepeso y la obesidad alteran las funciones cognitivas de niños y adolescentes. Desarrollo. Las dietas ricas en grasas y azúcares pueden provocar hiperinsulinemia, dislipidemia, hipertensión, aumento del tejido adiposo abdominal y resistencia a la insulina y a la leptina. Estas alteraciones metabólicas inducen un proceso inflamatorio sistémico periférico que puede afectar a la barrera hematoencefálica y al funcionamiento cerebral de regiones vinculadas a los procesos de atención y de aprendizaje y memoria. Algunos trastornos metabólicos de la madre gestante, la obesidad durante el embarazo y las experiencias traumáticas pre- y posnatales pueden desencadenar cambios en el control de la ingesta de comida en niños y adolescentes e inducir sobrepeso en sus etapas críticas del desarrollo. La obesidad afecta al funcionamiento del hipocampo y produce disminución de la sustancia gris de la corteza prefrontal, modificando con ello las capacidades cognitivas, especialmente las funciones ejecutivas. Conclusiones. El sobrepeso y la obesidad en la infancia y la adolescencia son un factor de riesgo no sólo para la salud general, sino también para el correcto desarrollo cerebral y de las funciones cognitivas, y pueden, por tanto, conducir al fracaso escolar.

Do inhabitants profit from integrating a public health focus in urban renewal programmes? A Dutch case study.

BACKGROUND: Urban renewal traditionally involves policy sectors such as housing, transport, and employment, which potentially can enhance the health of residents living in deprived areas. Additional involvement of the public health sector might increase the health impact of these urban renewal activities. This study evaluates the health impact of an additional focus on health, under the heading of Healthy District Experiments (HDE), within districts where an urban renewal programme was carried out. METHODS: We evaluated changes in health outcomes before the start of the HDE and after implementation, and compared these changes with health changes in control areas, e.g. districts from the urban renewal programme where no additional HDE was implemented. Additionally, we gathered information on the content of the experiments to determine what types of activities have been implemented. RESULTS: The additional activities from the HDE were mostly aimed at strengthening the health care in the districts and at promoting physical activity. When we compared the prevalence in general health, mental health, overweight, obesity, smoking, and physical activity during the study period between the HDE districts and control districts, we found no significant differences in the rate of change. The study is limited by a small sample size and the cross-sectional nature of the data. These and other limitations are discussed. CONCLUSION: We found no evidence for a beneficial health impact of the activities that were initiated with a specific focus on health, within a Dutch urban renewal programme. Specific attention for network management and the integration of such activities in the wider programme, as well as an allocated budget might be needed in order to sort a health impact.

Effectiveness of multicomponent lifestyle intervention programs on adiposity indicators in schoolchildren from vulnerable groups: a review article.

Introduction: Vulnerable groups are those who, due to their age, sex, race/ethnicity, health status, income level, etc., are at higher risk of poor health. Vulnerable school populations are distinguished by having predisposing factors to overweight and obesity, which results in a greater risk of suffering from the disease and its ravages. Additionally, the effects of the COVID-19 contingency can worsen the situation. Previous reviews of prevention, treatment and control of the disease have focused on schoolchildren from high- and middle-income countries. The objective of this review was to gather the evidence from the studies that evaluate the effectiveness of multicomponent lifestyle intervention programs (MLIP) on adiposity indicators in vulnerable populations. Five electronic databases were searched: PubMed, MEDLINE, Cochrane Library, EMBASE, and Google Scholar. The eligibility criteria were schoolchildren (5 to 12 years old), inhabitants of rural area, with low socioeconomic level and/or belonging to an indigenous community. Randomized and quasi-experimental controlled trials were included. Interventions that included two or more of the following components were considered: physical activity, nutrition, psychology, school meals and/or family/community involvement. Of the 11 interventions included 73 % had significant improvements in at least one variable related to adiposity. The most successful interventions had components of nutrition, physical activity and family/community involvement, the majority (80 %) had a duration of ≥ 6 months and were provided, in 80 % of the cases, by previously trained teachers. In conclusion, there is evidence that MLIPs are effective in improving indicators of adiposity in vulnerable schoolchildren.

Introducción: Los grupos vulnerables son aquellos que, debido a sus condiciones de edad, sexo, raza/etnia, estado de salud, ingresos, etc., tienen un riesgo mayor de presentar una salud deficiente. Las poblaciones escolares vulnerables se distinguen por tener factores predisponentes de sobrepeso y obesidad, lo que redunda en mayor riesgo de padecer la enfermedad y sus complicaciones. Adicionalmente, los efectos de la contingencia por COVID-19 podrían agravar la situación. Revisiones previas sonre la prevención, tratamiento y control de la enfermedad se han enfocado en escolares de países de altos y medianos ingresos. Esta revisión tuvo como objetivo reunir la evidencia que evalúa la efectividad de los programas multicomponentes de intervención de estilo de vida (PMIEV) sobre los indicadores de adiposidad en poblaciones vulnerables. Se exploraron cinco bases de datos electrónicas: PubMed, MEDLINE, Cochrane Library, EMBASE y Google Scholar. Los criterios de elegibilidad fueron escolares (5-12 años), habitantes rurales, con bajo nivel socioeconómico y/o pertenecientes a comunidades indígenas. Se incluyeron ensayos controlados aleatorizados y cuasi-experimentales. Se consideraron intervenciones con dos o más de los siguientes componentes: actividad física, nutrición, psicología, comidas escolares y/o participación familiar/comunitaria. De las 11 intervenciones incluidas, el 73 % obtuvieron mejoras en al menos una variable relacionada con la adiposidad. Las intervenciones más exitosas incluyeron componentes de nutrición, actividad física y participación familiar/comunitaria, la mayoría (80 %) tuvo una duración ≥ 6 meses y las llevaron a cabo en un 80 % de los casos profesores entrenados. En conclusión, la evidencia indica que los PMIEV son efectivos para mejorar los indicadores de adiposidad en los escolares vulnerables.

The moderating role of sleep duration on momentary relations between negative affect and loss-of-control eating in children and adolescents.

OBJECTIVE: Loss-of-control (LOC) eating is associated with eating disorders and obesity, and thus it is imperative to understand its momentary risk factors in order to improve intervention efforts. Negative affect has been proposed as a momentary risk factor for LOC eating, but the evidence for its effects in children and adolescents is mixed. Short sleep duration (which is very common in youth), may be one variable that moderates the relation between negative affect and subsequent LOC eating. As such, we aimed to examine the moderating role of within-person sleep duration on the momentary relations between negative affect and subsequent LOC eating. METHOD: We recruited children (N = 30) with overweight/obesity ages 8-14, who completed a 2-week ecological momentary assessment protocol assessing negative affect and LOC eating several times per day, while also wearing a sleep actigraphy device and completing sleep diaries. RESULTS: Consistent with hypotheses, within-person sleep duration moderated the next-day momentary relation between within-person negative affect and LOC eating, such that shorter sleep duration strengthened the positive relation between negative affect and loss-of-control eating. CONCLUSIONS: Results suggest that, in children and adolescents, fluctuations in sleep duration may influence susceptibility to losing control over eating after experiencing negative affect. Future research should further investigate other metrics of sleep disturbance as they relate to emotion regulation and LOC eating. Such research will set the stage for augmenting paediatric interventions to better target maintenance factors for LOC eating.

Affective responses to overeating episodes in women participating in a behavioral weight loss program.

BACKGROUND: Much research has focused on precursors to dietary lapses in weight loss programs, but less is known about how individual responses to lapses may influence future non-adherence and program success. The current study examined affective responses to overeating lapses and their influence on subsequent overeating and overall weight loss. METHODS: Women (n = 60) with overweight or obesity (BMI (mean ± SD): 34.3 ± 3.9 kg/m2; age: 48.1 ± 10.1 years) participated in a 3-month group behavioral weight loss intervention (BWLI). At baseline and 3 months, participants completed anthropometric assessments and a 10-day ecological momentary assessment protocol sent 5 times per day reporting on overeating and affect (stress, shame, anxiety, and feeling good about oneself). Across time points, multilevel models were used to examine affective responses to overeating and to predict likelihood of subsequent overeating. Linear regression models were used to examine the effect of affective responses to overeating (at baseline and collapsed across time points) on weight loss. RESULTS: Following self-reported overeating episodes, compared to non-overeating episodes, feeling good about oneself decreased. These decreases lessened with time from overeating. Overeating predicted subsequent overeating episodes, with decreases in feeling good about oneself following overeating marginally predicting increased likelihood (p = 0.065). Neither overeating frequency at baseline nor change in overeating frequency predicted weight loss; however, greater decreases in anxiety following overeating were associated with less weight loss. CONCLUSIONS: Self-reported overeating during a BWLI was associated with negative affective responses and may have increased the likelihood of subsequent overeating, but did not affect overall weight loss in this sample.

Typology of eating episodes in children and adolescents with overweight/obesity.

BACKGROUND: Research suggests that youth with overweight/obesity can be subtyped according to disinhibited eating tendencies. No research has attempted to subtype classes of eating episodes along sensational, psychological, and hedonic dimensions. METHODS: Youth (N = 39; 55% female) aged 8-14 y with overweight/obesity completed a 2-week ecological momentary assessment protocol in which they reported on all eating episodes and their sensational, environmental, affective, and interpersonal contexts. Latent profile analysis (LPA) was used to classify episodes based on loss of control (LOC) while eating, self-reported overeating, food palatability, hunger, and cravings. Classes were compared on affective, interpersonal, appearance-related, and environmental correlates using Wald chi-square tests. RESULTS: LPA identified three classes of eating episodes involving high levels of LOC/self-reported overeating ("binge-like" class), low levels of hunger ("eating-in-the-absence-of-hunger" class), and high hunger and cravings ("appetitive eating" class). Binge-like eating was associated with the highest levels of body dissatisfaction, interpersonal distress, and positive affect, and was most likely to occur in the after-school hours. CONCLUSIONS: Binge-like eating tends to occur in a psychological context relative to other types of eating episodes in youth with overweight/obesity. Future research should explore whether certain classes of eating episodes are associated with distinct weight trajectories over time.