The effectiveness of contrast-enhanced spectral mammography and magnetic resonance imaging in dense breasts.

PURPOSE: Breast cancer is the most common cause of death from neoplastic disease in women. Among all breast anatomy types, glandular type is the most problematic concerning evaluation. While digital mammography still remains the basic diagnostic tool, one must be aware of its limitations in dense breasts. Although magnetic resonance imaging (MRI) has greatly improved sensitivity, its specificity is low. Moreover, there are contraindications for MRI for some patients, so a substitute has been searched for. This study was performed to check if contrast-enhanced spectral mammography (CESM) can be a viable option for patients with dense breasts. MATERIAL AND METHODS: The study involved 121 patients with abnormalities detected on base-line diagnostic imaging (ultrasound or mammography). The patients had subsequent examinations, both CESM and MRI performed within a maximum 2-month time interval. The sensitivity and specificity of both methods in the whole group as well as in specific breast structure types were measured and compared. RESULTS: Contrast enhancement was visible in all 121 cases on MRI, while on CESM lack of enhancement was noted in 13 cases. All of those 13 lesions turned out to be benign. There were 40 (33%) benign and 81 (69%) malignant tumours. The analysed group included 53 (44%) glandular type breast patients, 39 (32%) mixed type, and 29 (23%) fatty type. Although MRI proved to be slightly more effective in dense breasts, both methods showed similar results in the whole study group. CONCLUSION: CESM can be used with confidence in patients with glandular breast type when MRI is not available or there are reported contraindications to MRI.

Bi-directional associations between parental feeding practices and children's body mass in parent-child dyads.

OBJECTIVE: This study investigated whether parental feeding practices, such as pressure to eat, permitting unhealthy food, and restriction of unhealthy food predict children's body mass index (BMI) percentile or if children's BMI percentiles predict parental feeding practices. DESIGN: Longitudinal data were collected among 526 dyads of children (6-11 years old) and one of their parents. Parents reported parental feeding practices, restriction of unhealthy food, permission of unhealthy food, and pressure to eat. Children's weight and height were assessed objectively. All measurements were conducted twice with a time lag of 10 months. RESULTS: Cross-lagged panel analyses demonstrated that low levels of children's BMI percentiles (measured at the baseline) predicted parental feeding practices (measured at the follow-up) but not vice versa. Only one effect suggesting bi-directionality was found, with parental restriction of unhealthy food preceding higher levels of children's BMI percentiles at the follow-up. CONCLUSIONS: Parental feeding practices seem to be a reaction to the levels of children's BMI percentiles.

At-home environment, out-of-home environment, snacks and sweetened beverages intake in preadolescence, early and mid-adolescence: the interplay between environment and self-regulation.

Obesity-related behaviors, such as intake of snacks and sweetened beverages (SSB), are assumed to result from the interplay between environmental factors and adolescents' ability to self-regulate their eating behaviors. The empirical evidence supporting this assumption is missing. This study investigated the relationships between perceptions of at-home and out-of-home food environment (including SSB accessibility, parental, and peers' social pressure to reduce intake of SSB), nutrition self-regulatory strategies (controlling temptations and suppression), and SSB intake. In particular, we hypothesized that these associations would differ across the stages of preadolescence, early and mid-adolescence. Self-reported data were collected from 2,764 adolescents (10-17 years old; 49 % girls) from 24 schools in the Netherlands, Poland, Portugal, and the United Kingdom. Path analysis indicated that direct associations between peers' social influence and SSB intake increased with age. Direct negative associations between at-home and out-of-home accessibility and SSB intake as well as direct positive associations between parental pressure and intake become significantly weaker with age. Accessibility was related negatively to self-regulation, whereas higher social pressure was associated with higher self-regulation. The effects of the environmental factors were mediated by self-regulation. Quantitative and qualitative differences in self-regulation were observed across the stages of adolescence. The associations between the use of self-regulatory strategies and lower SSB intake become significantly stronger with age. In preadolescence, SSB intake was regulated by means of strategies that aimed at direct actions toward tempting food. In contrast, early and mid-adolescents controlled their SSB intake by means of a combination of self-regulatory strategies focusing on direct actions toward tempting food and strategies focusing on changing the psychological meaning of tempting food.

Cooking together: The IKEA effect on family vegetable intake.

OBJECTIVE: Based on the idea of the 'IKEA effect', assuming that individuals like self-created objects more than objects created by someone else, this study hypothesizes that parents' involvement of their children in meal planning and preparation is positively related to vegetable intake, mediated via liking vegetables. DESIGN: Longitudinal observational study with two time points (10-month interval). METHOD: Nine hundred and twenty-four parent-child dyads filled out questionnaires measuring involvement, vegetable liking, vegetable intake, and further environmental and food-related determinants of vegetable intake. On average, parents were M = 36.10 (SD = 5.43) and children (54.3% girls) M = 8.24 (SD = 1.44; range 6-11) years old. Hypotheses were tested with path analyses, accounting for intra-dyadic associations among respective constructs (e.g., parents' and children's liking vegetables). RESULTS: Two direct effects were found: (1) parents' involvement of their children in cooking activities impacted children's liking of vegetables and vegetable intake, and (2) liking vegetables impacted vegetable intake. The effect of involvement on vegetable intake was mediated via liking vegetables, but only for children and not for parents. CONCLUSIONS: The findings emphasize the importance of parents' encouragement for involving children in the preparation of healthy meals, as this improves liking of vegetables and, thereby, increases their vegetable intake. Statement of contribution What is already known on this subject? Processes behind the effectiveness of shared cooking activities to increase vegetable intake are unclear. Previous research suggests the IKEA effect as an explanation. It assumes a higher consumption of self-created products due to a higher liking compared to third-party products. What does this study add? First test of the IKEA effect for joint cooking activities under consideration of spillover effects in families. Affirmation of the IKEA effect was found for children, not for parents. Interventions should focus on the involvement of children in cooking activities to improve vegetable intake.

Association between Children's Physical Activity and Parental Practices Enhancing Children's Physical Activity: The Moderating Effects of Children's BMI z-Score.

Objective: Parental practices that aim at increasing children's physical activity were found to be related to children's physical activity. So far, however, the association between these two sets of variables was studied without considering the moderating role of children's BMI z-score, which may determine the effectiveness of parental practices. The present study aims at filling this void. Design: Longitudinal data were collected among 879 dyads of children (6-11 years old) and their parents. Seven parental physical activity practices were assessed at baseline. Physical activity, body mass, and height (measured among children) were assessed twice (at baseline and 7-month follow-up). Body mass and height were measured objectively. Seven moderation analyses were conducted. Results: Six parental practices emerged to predict physical activity of children: collaborative social control, overall support, stimulation to be active, general encouragement for physical activity, positive social control, and modeling. Children's BMI z-score moderated three associations. The relationships between parental positive social control, overall parental support, and general parental encouragement for physical activity (at baseline), and children's physical activity (at follow-up) were significant only among children with low and medium BMI z-score. In turn, collaborative social control and modeling predicted children's physical activity at the follow-up regardless child's BMI z-score. Conclusions: Parental positive social control or overall parental support may be ineffective in children with higher body mass who are in need to increase their physical activity.

Planning and self-efficacy interventions encouraging replacing energy-dense foods intake with fruit and vegetable: A longitudinal experimental study.

OBJECTIVE: This longitudinal experimental study compared effects of self-efficacy, planning and education-based conditions, encouraging adolescents to eat fruit and vegetable in place of energy-dense foods. DESIGN: Data were collected among 506 adolescents (13-18 years old) who were randomly assigned to control (n = 181), planning (n = 153) or self-efficacy (n = 172) conditions. Measurements were taken at baseline (T1), at a 2-month follow-up (T2), and at a 14-month follow-up (T3). Interventions/control group procedures were delivered at T1 and T2. OUTCOME MEASURES: Self-reports of fruit and vegetable intake (FVI) and energy-dense foods intake were collected at three times. Cognitive mediators (self-efficacy and planning) were assessed at T1 and T2. Body weight and height were objectively measured at T1 and T3. RESULTS AND CONCLUSIONS: Similar significant increases of FVI were found for planning and self-efficacy interventions (T3). The planning intervention did not influence energy-dense food intake (T3), but the self-efficacy intervention tended to result in stabilising intake (compared to an increase found in the control group). There were no effects on body weight. Similar patterns were found for the total sample and for a subsample of adolescents with overweight/obesity. The effects of interventions on FVI were mediated by respective cognitions.

Social and cognitive predictors of fruit and vegetable intake among adolescents: the context of changes in body weight.

Two studies investigated differences in the relationships between adolescents' fruit and vegetable intake (FVI) and the predictors specified in the Health Action Process Approach and Social-Cognitive Theory. Retrospective (Study 1; N = 502) and prospective (Study 2; N = 668) designs were applied. Among adolescents with overweight/obesity, intention was cross-sectionally associated with FVI (Study 1); no social or cognitive predictors explained FVI at 14-month follow-up (Study 2). The planning - FVI and self-efficacy - FVI relationships were stronger among adolescents who reduced their body weight to normal, compared to effects observed among those who maintained their body weight (Studies 1 and 2).