Impact of Strategies for Preventing Obesity and Risk Factors for Eating Disorders among Adolescents: A Systematic Review.

An effective behavior change program is the first line of prevention for youth obesity. However, effectiveness in prevention of adolescent obesity requires several approaches, with special attention paid to disordered eating behaviors and psychological support, among other environmental factors. The aim of this systematic review is to compare the impact of two types of obesity prevention programs, inclusive of behavior change components, on weight outcomes. "Energy-balance" studies are aimed at reducing calories from high-energy sources and increasing physical activity (PA) levels, while "shared risk factors for obesity and eating disorders" focus on reducing disordered eating behaviors to promote a positive food and eating relationship. A systematic search of ProQuest, PubMed, PsycInfo, SciELO, and Web of Science identified 8825 articles. Thirty-five studies were included in the review, of which 20 regarded "energy-balance" and 15 "shared risk factors for obesity and eating disorders". "Energy-balance" studies were unable to support maintenance weight status, diet, and PA. "Shared risk factors for obesity and eating disorders" programs also did not result in significant differences in weight status over time. However, the majority of "shared risk factors for obesity and eating disorders" studies demonstrated reduced body dissatisfaction, dieting, and weight-control behaviors. Research is needed to examine how a shared risk factor approach can address both obesity and eating disorders.

Unhealthy weight control behaviors, disordered eating, and body image dissatisfaction in adolescents from São Paulo, Brazil

Objective: To identify the frequency of disordered eating (DE) and unhealthy weight control behaviors (UWCB) among adolescents and associations with age, sex, actual weight status, perceived weight status, and body image dissatisfaction. Methods: Cross-sectional study of 1,156 adolescents. DE was assessed using a specific self-report questionnaire, UWCB by specific behaviors that were not typically recommended for weight management, and body dissatisfaction by Stunkard's silhouettes. Results: The frequency of DE was 17.3%, and that of UWCB, 31.9%; 80.1% of participants were dissatisfied with body image. Perception of oneself as overweight was associated with 1.795-fold odds of DE. Those with UWCB had 7.389-fold odds of DE, while DE increased the odds of UWCB 7.280-fold. Girls, participants who perceived themselves as overweight, and those who reported body dissatisfaction were 2.266, 2.381, and 1.752 times more likely to have UWCB, respectively. Conclusion: A high prevalence of UWCB and a moderate prevalence of DE behaviors was found in adolescents from the city of São Paulo, Brazil. Those who perceived themselves as overweight had more DE and UWCB, and both behaviors were related. UWCB was more common in girls and among those dissatisfied with their bodies.

Unhealthy weight control behaviors, disordered eating, and body image dissatisfaction in adolescents from São Paulo, Brazil.

OBJECTIVE: To identify the frequency of disordered eating (DE) and unhealthy weight control behaviors (UWCB) among adolescents and associations with age, sex, actual weight status, perceived weight status, and body image dissatisfaction. METHODS: Cross-sectional study of 1,156 adolescents. DE was assessed using a specific self-report questionnaire, UWCB by specific behaviors that were not typically recommended for weight management, and body dissatisfaction by Stunkard's silhouettes. RESULTS: The frequency of DE was 17.3%, and that of UWCB, 31.9%; 80.1% of participants were dissatisfied with body image. Perception of oneself as overweight was associated with 1.795-fold odds of DE. Those with UWCB had 7.389-fold odds of DE, while DE increased the odds of UWCB 7.280-fold. Girls, participants who perceived themselves as overweight, and those who reported body dissatisfaction were 2.266, 2.381, and 1.752 times more likely to have UWCB, respectively. CONCLUSION: A high prevalence of UWCB and a moderate prevalence of DE behaviors was found in adolescents from the city of São Paulo, Brazil. Those who perceived themselves as overweight had more DE and UWCB, and both behaviors were related. UWCB was more common in girls and among those dissatisfied with their bodies.

Validation of the Disordered Eating Attitude Scale for adolescents / Validação da Escala de Atitudes Alimentares Transtornadas para adolescentes

ABSTRACT Objective To perform the psychometric evaluation of the Disordered Eating Attitude Scale (DEAS) for adolescents. Methods Sample consisted of 1,119 Brazilian adolescents (12-18 years old; 59.6% female) studying at technical schools in São Paulo state-Brazil, who answered an online survey with the DEAS, the Eating Attitude Test (EAT-26), and the Restraint Scale (RS). The internal consistency of the DEAS was assessed using Cronbach’s alpha. The convergent validity of DEAS was evaluated by means of Pearson’s coefficient correlation with EAT-26 and RS. The test-retest reliability was evaluated using a sub-sample of 61 adolescents. Known-groups validity was determined by comparing female student mean scores with scores of 33 female adolescents with eating disorders. Results The reliability of the DEAS was 0.79. EAT-26 and RS scores were positively correlated with DEAS scores (EAT: 0.78 for females and 0.59 for males, p < 0.001; RS: 0.63 for females and 0.48 for males, p < 0.001). The DEAS total and subscale scores differentiated students and patients with eating disorders (p < 0.001). The intra-class correlation coefficient for test-retest reliability was 0.87. Conclusion Results indicate that the DEAS adolescent version showed good internal consistency, convergent validity, known-groups validity, and test-retest reliability, suggesting its potential in identifying disordered eating attitudes among adolescents. It could also be helpful in identifying adolescents at risk from eating disorders, assisting in prevention programs.

RESUMO Objetivo Realizar a avaliação psicométrica da Escala de Atitudes Alimentares Transtornadas (EAAT) para adolescentes. Métodos A amostra foi composta por 1.119 adolescentes (12-18 anos; 59,6% do sexo feminino) estudantes de escolas técnicas do estado de São Paulo, que responderam online à EAAT, ao Teste de Atitudes Alimentares (EAT-26) e à Escala de Restrição (RS). A consistência interna da EAAT foi avaliada usando o alpha de Cronbach e a validade convergente por meio do coeficiente de correlação de Pearson com o EAT-26 e a RS. A confiabilidade teste-reteste foi avaliada usando uma subamostra de 61 adolescentes. A validade known-groups foi determinada pela comparação dos escores médios de estudantes do sexo feminino com os escores de 33 adolescentes do sexo feminino com transtornos alimentares. Resultados A consistência interna foi de 0,79, e as pontuações no EAT-26 e na RS estiveram positivamente correlacionadas com a pontuação da EAAT (EAT: 0,78 para o sexo feminino e 0,59 para o masculino, p < 0,001; RS: 0,63 para o sexo feminino e 0,48 para o masculino, p < 0,001). O escore da EAAT diferenciou estudantes e pacientes com transtornos alimentares (p < 0,001). O coeficiente de correlação intraclasse na confiabilidade teste-reteste foi de 0,87. Conclusão A versão da EAAT para adolescentes mostrou boa consistência interna, validade convergente, known-groups e confiabilidade teste-reteste, sugerindo o seu potencial na identificação de atitudes alimentares transtornadas entre adolescentes. Ela pode, portanto, ser útil na identificação de adolescentes com risco de transtornos alimentares, auxiliando em programas de prevenção.

A cross-cultural comparison of eating behaviors and home food environmental factors in adolescents from São Paulo (Brazil) and Saint Paul-Minneapolis (US).

OBJECTIVE: Describe cross-cultural differences in nutrition-related factors among adolescents from São Paulo, Brazil and St Paul-Minneapolis, US. DESIGN: Two large-population-based studies with cross-cultural comparisons. SETTING: Twelve São Paulo and 10 St Paul-Minneapolis high schools in 2009-2010. PARTICIPANTS: A total of 1,148 adolescents from São Paulo and 1,632 adolescents from St Paul-Minneapolis. MAIN OUTCOME MEASURE(S): Meal consumption, family meals, fast-food consumption, and home food availability. ANALYSIS: Binomial regressions, weighted for age distributions and adjusted for gender, were used to compare identical measures from each sample. RESULTS: Generally, São Paulo adolescents reported healthier nutritional outcomes than St Paul-Minneapolis adolescents. São Paulo adolescents were 7 times less likely to report high fast-food consumption than St Paul-Minneapolis adolescents (P < .001). Whereas most measures of the home environment indicated healthier home environments in São Paulo, more São Paulo adolescents reported that sugar-sweetened beverages were usually available at home than did St Paul-Minneapolis adolescents (P < .001). CONCLUSIONS AND IMPLICATIONS: São Paulo youth tended to have healthier eating behaviors and home food environment factors than St Paul-Minneapolis youth. Brazilian eating patterns tend to be healthier and support a connection with food and culture. Interventions are needed to encourage youth and their families to maintain these patterns.

Propriedades psicométricas da Escala de Atitudes Alimentares Transtornadas para adultos do sexo masculino / Psychometric properties of the Disordered Eating Attitude Scale for adult men

OBJETIVO: Avaliar as propriedades psicométricas da Escala de Atitudes Alimentares Transtornadas (EAAT) para o sexo masculino. MÉTODOS: Duzentos e vinte e oito universitários (18-39 anos) responderam à EAAT, originalmente desenvolvida e validada para o sexo feminino. A consistência interna foi avaliada pelo Alpha de Cronbach e a validade convergente, por meio do coeficiente de correlação de Pearson comparando os escores da EAAT, do Teste de Atitudes Alimentares (EAT) e da Escala de Restrição (RS). A reprodutibilidade foi avaliada aplicando a escala numa subamostra (n = 38) com um mês de intervalo utilizando o coeficiente de correlação intraclasse (CCI). A validade known-groups foi obtida comparando o escore dos universitários na EAAT com o escore de homens com diagnóstico de transtornos alimentares (TA) (n = 28). RESULTADOS: A consistência interna da escala foi de 0,63. O escore da EAAT foi correlacionado com a EAT (r = 0,65) e RS (r = 0,51), e o CCI entre o teste e o reteste foi de 0,948. A análise known-groups diferenciou pacientes com TA de estudantes universitários (p < 0,001). CONCLUSÕES: A escala apresentou propriedades psicométricas adequadas e pode ser utilizada em estudos com homens adultos - uma vez que o constructo é pouco explorado em homens. Recomenda-se, de qualquer forma, uma revisão da escala e desenvolvimento de instrumentos específicos para o público masculino.

OBJECTIVE: To evaluate psychometric properties of the Disordered Eating Attitude Scale (DEAS) for men. METHODS: Two hundred and twenty-eight undergraduate male students (18-39 years old) answered the DEAS, originally developed and validated for women. Internal consistency was evaluated by Cronbach's Alpha; convergent validity by comparing DEAS and the Eating Attitude (EAT) and Restraint Scale (RS) scores using Pearson's coefficient. Test-retest reliability was evaluated with a subsample (n = 38) in a month interval by means of intraclass correlation coefficient (ICC). Known-groups validity was obtained comparing scores in DEAS among undergraduate students and men with eating disorders (ED) (n = 28). RESULTS: Internal consistency of scale was 0.63. DEAS score correlated with EAT (r = 0.65) and RS (r = 0.51); ICC between test and retest was 0.948. Known-groups analysis differentiated ED patients and undergraduate students (p < 0.001). CONCLUSIONS: The scale presented adequate psychometric properties and could be used in studies with adult men, since the construct is not explored among males. Nevertheless, it is recommended to revise the scale and to develop specific instruments for male public.

Ascaris-Trichuris association and malnutrittion in brasilian children / Ascaris-Trichuris association and malnutrittion in brasilian children

This work was designed to evaluate the role intestinal parasites on nutritional status in three rural areas of Brazil. A total of 520 children aged 1-12 years were studied through a questionanaire concerning housing, socio-economic conditions and a 24-h food intake recall. Measurements of weight and height were also performed, and three stool samples were collected on consecutive days for parasitological analysis...