Family meals and food insecurity in Spanish adolescents.

The world is not on track to achieve the goal of food security for the global population by 2030. New approaches to understand individuals' food insecurity are needed, especially insecurity related to children and adolescents, since it is associated with health and psychosocial problems. The study aimed to characterise the family dinners among a representative cohort of schooled adolescents (n = 1017) and their parents (n = 261) in Terrassa (Catalonia, Spain) and how family dinners could be related to household food insecurity. The survey findings revealed that in 2022, 19.2% of the adolescents were experiencing household food insecurity. Adolescents with a lower socioeconomic status and of foreign origin showed the highest likelihood of experiencing household food insecurity. Household food security was also associated with some characteristics of family dinners, such as better quality and a higher frequency (seven or more dinners eaten together per week). Based on this finding, possible ways in which family dinners could offer a beneficial effect, alleviating the consequences of food insecurity in adolescents, are discussed. In line with the 2030 Agenda and the Sustainable Development Goal of guaranteeing food security, the promotion of family dinners and their quality, frequency, and duration to leverage the beneficial effect in states of household food insecurity in Spanish adolescents should be taken into account to design actions and public campaigns in Spain.

Obesity stigma and its impact on health: A narrative review.

Weight stigma and weight bias are pervasive in our society and are based on wrong assumption that obesity derives basically from a lack self-discipline and personal responsibility, obviating recent evidence showing that obesity is a prevalent, complex, progressive, and relapsing chronic disease that results from the interaction between behavioural, environmental, genetic, and metabolic factors. This narrative review provides an overview of recent research on this problem, mainly focused on the negative impact of weigh stigma on health. Overall, recent evidence shows that weight stigma can contribute to worsening obesity-related problems and creating additional barriers to effective obesity care and prevention. In addition, a brief description of some of the most important international initiatives to address the weight stigma is provided.

Spanish validation of the Modified Weight Bias Internalization Scale (WBIS-M) for adolescents.

PURPOSE: Weight Bias Internalization (WBI) is pervasive and potentially damaging for health. Little is known about WBI in youth. As negative effects of WBI have been observed when controlling for BMI, measures that allow WBI to be assessed across different weight categories are needed. The Modified Weight Bias Internalization Scale (WBIS-M) is one of the most frequently used scales in this field. Our purpose was to obtain a Spanish validated version of the WBIS-M for adolescents across different weight statuses. METHODS: The data were collected from 298 secondary students (mean age 14.31; 48.32% girls; 18.8% were overweight and 6.4% had obesity). Internal structure was examined by a cross-validation analysis, using both exploratory and confirmatory factor analyses in different subsamples. RESULTS: Item 1 showed a psychometric anomalous functioning and was deleted. The one-factor structure of the 10-item version was confirmed with adequate fit ([EFA (KMO = 0.915, χ2(55) = 1075.633, p < 0.0001)]; [CFA (χ2(35) = 200.515; GFI = 0.995; PGFI = 0.992; NFI = 0.991; SRMR = 0.060)]). Internal consistency was high [Formula: see text] ω = 0.93). Significant correlations with the same set of external variables assessed in the original version (anti-fat bias, self-esteem, mood, body dissatisfaction, drive for thinness, binge eating), all of them correlates of WBI in adolescents, were found. Girls and participants with obesity obtained higher scores. CONCLUSION: The results provide support for the validity and reliability of our WBIS-M version for use with adolescents across weight categories in Spain. LEVEL OF EVIDENCE: Level III, evidence obtained from well-designed cohort studies.

Family Meals, Conviviality, and the Mediterranean Diet among Families with Adolescents.

Two aspects that characterize the Mediterranean diet (MD) are "what" and "how" we eat. Conviviality relates to "how" we eat and to the pleasure of sharing meals with significant people. The most studied concept is "family meals", which includes conviviality, which involves "enjoying" family meals. Given the lack of research on convivial family meals in Mediterranean countries, the purpose of this qualitative study was to analyze the family meal representations and practices of families with 12- to 16-year-old adolescents to assess whether they responded to a pattern of conviviality, and to examine their association with MD adherence. Twelve semi-structured interviews were conducted and food frequency and family meal questionnaires were administered. A food pattern analysis was carried out and digital photos of meals were analyzed to examine eating habits and meal composition, respectively. The findings showed that parents believed family meals are a space for socialization and communication. Items relating to the conviviality of family meals identified in the study were meal frequency, meals at the table, lack of digital distractions, pleasant conversations, and time spent on family meals. Attention should be paid to conviviality in Mediterranean families when designing multi-approach strategies to promote healthy eating among adolescents.

Re-engaging Dropouts of Prolonged Exposure for PTSD Delivered via Home-Based Telemedicine or In Person: Satisfaction with Veteran-to-Veteran Support.

This paper describes feasibility of and patient and peer satisfaction with a Veteran-to-Veteran peer support program purposefully integrated into prolonged exposure (PE) for post-traumatic stress disorder (PTSD) to address barriers contributing to dropout from both in person and telemedicine delivered PE. Specifically, patients who had dropped out of PE were offered the opportunity to return to treatment, this time with a peer who themselves had completed PE, who would join them during a limited number of PE in vivo exposure homework trials. About half of the Veterans who dropped out indicated willingness to return to treatment, noting the peer as central to this decision, and about a third actually returned to treatment. Participants reported high satisfaction with the program, as did peers. Peers reported that their own symptoms were not exacerbated by engaging in exposure homework with the patients. While in the military, service members are trained to leverage the power of the group toward mission-specific tasks; and this training appears relevant to PTSD treatment in the present context.

Longitudinal study of physical activity in Spanish young adolescents: weight status and gender differences / Estudio longitudinal de la actividad física en adolescentes españoles: Diferencias por estatus de peso y género / Estudo longitudinal da atividade física em adolescentes espanhóis: diferenças por status de peso e de gênero

Past research indicates there are marked declines in physical activity (PA) during adolescence. Recent studies are offering new insights. This longitudinal study investigates changes in intensities of PA (moderate-to-vigorous vs. light), by gender and weight-status, in a sample of Spanish adolescents. Students, on average 13.9 years-old (N=833 at baseline), were followed- up a year and two years later (N=474 provided data at the three time points). Self-reported PA was recorded. Analyses revealed that PA prevalence is low, although, overtime, slight increments were observed. Girls showed higher increments in moderate-to-vigorous physical activity (MVPA); boys showed higher increments in light physical activity (LPA). Investigating by weight-status, normal-weight boys showed increments over time in LPA; no changes observed for normal-weight girls. Overweight/obese girls increased their total PA (TPA) and MVPA; overweight/obese boys increased their LPA. Underweight boys and girls decreased their TPA. Interventions targeting specific intensities of PA may be beneficial for different groups based on their gender and weight status

Investigaciones anteriores indican que hay marcadas disminuciones en la actividad física (AF) durante la adolescencia. Estudios más recientes ofrecen nuevos conocimientos. Este estudio longitudinal investiga los cambios en las intensidades de la AF (moderada a vigorosa versus ligera), por género y estatus de peso, en una muestra de adolescentes españoles. Los estudiantes, que en la línea base tenían un promedio de 13.9 años de edad (N = 833 al inicio), fueron seguidos uno y dos años más tarde (N = 474 proporcionaron datos en las tres mediciones de tiempo). La AF fue auto-informada. Los análisis revelaron que la prevalencia de AF es baja, aunque, a lo largo del tiempo, se observaron incrementos leves. Las niñas mostraron incrementos más altos en la actividad física moderada a vigorosa (AFMV); los niños mostraron mayores incrementos en la actividad física leve (AFL). Investigando por estatus de peso, los niños de peso normal mostraron incrementos a lo largo del tiempo en AFL; No se observaron cambios en las niñas de peso normal. Las niñas con sobrepeso/obesidad aumentaron su AF total (AFT) y AFMV; Los niños con sobrepeso / obesidad aumentaron su AFL. Los niños y niñas con bajo peso disminuyeron su AFL. Las intervenciones dirigidas a intensidades específicas de AF pueden ser beneficiosas para diferentes grupos según su género y estatus de peso

Pesquisas anteriores indicam que há declínios acentuados na atividade física (AF) durante a adolescência. Estudos recentes estão oferecendo novos conhecimentos. Este estudo longitudinal investiga mudanças nas intensidades de AF (moderada a vigorosa vs. leve), por sexo e status de peso, em uma amostra de adolescentes espanhóis. Os alunos, em média, 13,9 anos de idade (N = 833 no início do estudo), foram acompanhados por um ano e dois anos mais tarde (N = 474 dados fornecidos nos três pontos de tempo). A AF autorreferida foi registrada. Análises revelaram que a prevalência de AF é baixa, embora, horas extras, pequenos incrementos tenham sido observados. Meninas apresentaram maiores incrementos na atividade física moderada a vigorosa (AFMV); os meninos apresentaram maiores incrementos na atividade física leve (AFL). Investigando por peso-status, meninos com peso normal mostraram incrementos ao longo do tempo em AFL; nenhuma alteração observada para meninas com peso normal. Meninas com sobrepeso / obesidade aumentaram seu AF total (AFT) e AFMV; meninos com sobrepeso / obesos aumentaram seu AFL. Meninos e meninas com baixo peso diminuíram o AFT. Intervenções direcionadas a intensidades específicas de AF podem ser benéficas para diferentes grupos com base em seu gênero e status de peso

Frequency of family meals and risk of eating disorders in adolescents in Spain and Peru / Frecuencia de comidas en familia y riesgo de trastornos de la conducta alimentaria en adolescentes de España y Perú

Abstract The prevalence of eating disorders is between 0.27% and 6.41% in Spain and between 7.3% and 11.4% in Peru. Much research has been focused on the study of the main risk factors for eating disorders, but little is known about the potential protective factors (such as family meals) in samples of young people that include participants from different countries. This study estimates the contribution of the frequency of family meals on the risk for eating disorders in a large sample of adolescents recruited in Spain and Peru (n=916, with a mean age of 14.6 years old and age range of 12 to 17 years old). Results showed a double interaction parameter between the participants' sex and origin with the frequency of family meals: the risk for eating disorders is modified specifically for girls from both countries, and adolescents of both sexes born in Spain. This empirical evidence suggests that sex and cultural differences could be related to disordered eating patterns during adolescence and so could act as moderators for the impact of risk and protective factors for this clinical condition. The study of the contribution of the frequency of family meals on the risk of eating disorders in young people should take cultural differences into consideration with the aim of designing more targeted prevention and intervention programs.

Resumen La prevalencia de los trastornos de la conducta alimentaria en España se encuentra entre 0.27 % y 6.41% y en Perú entre el 7.3% y el 11.4%. Se dispone de numerosas investigaciones sobre los factores de riesgo para estos trastornos, pero escasos estudios han analizado posibles factores protectores, como las comidas familiares, en muestras jóvenes que incluyan participantes de diferentes países. Este artículo analiza la contribución de la frecuencia de las comidas familiares sobre el riesgo de trastornos de conducta alimentaria en una muestra de adolescentes (n = 916, edad media de 14.6 años, rango de edad 12 a 17 años) procedentes de España y Perú. Los principales resultados mostraron un doble parámetro de interacción entre el sexo y el origen de los participantes con la frecuencia de las comidas familiares: el riesgo de estos trastornos se modifica específicamente en mujeres y adolescentes nacidos en España. Estas evidencias empíricas sugieren que el sexo y las diferencias culturales podrían estar influyendo en los desórdenes alimentarios durante la etapa adolescente y podrían actuar moderando el impacto del riesgo y los factores protectores de la patología alimentaria. Se recomienda ampliar la investigación sobre la contribución de las comidas familiares en el riesgo de los trastornos de la conducta alimentaria en adolescentes considerando posibles diferencias culturales con el fin de diseñar programas de prevención e intervención más eficientes.

Spanish adaptation and validation of the Child Food Security Survey Module (CFSSM-S).

OBJECTIVE: The present study aimed to assess the: (i) internal structure of the Spanish Child Food Security Survey Module (CFSSM-S) with exploratory and confirmatory factor analysis (EFA and CFA); (ii) measurement invariance by gender, grade, weight status, socio-economic status (SES) and family affluence; and (iii) relationships with these external variables. DESIGN: A cross-sectional study was conducted. The CFSSM-S and other tools were employed to assess food insecurity, weight status, SES and family affluence, respectively. SETTING: A secondary school (grades 7-10) in the city of Terrassa in Catalonia, Spain. SUBJECTS: Participants included adolescent boys and girls (n 426) aged 12-17 years. RESULTS: The cross-validation design with EFA and CFA captured a single factor, 'food insecurity'. The goodness-of-fit for the one-factor model with CFA (root-mean-square error of approximation=0·038, comparative fit index=0·984, Tucker-Lewis index=0·979) and internal consistency (ω=0·95) were excellent. The measurement invariance indicated that CFSSM-S could be used across genders, grades, weight status, SES and family affluence. Only mean differences for SES and family affluence were found which showed a linear trend, indicating higher CFSSM-S scores for participants with lower SES and family affluence. Of participants, 1·9 % experienced very low food security, 16·4 % low food security and 81·7 % were food secure. CONCLUSIONS: The CFSSM-S is the first validated instrument to assess food insecurity with psychometric guarantees in Spanish adolescents. Researchers and health practitioners in Spain could use this self-reported questionnaire to gain more information about adolescent health in relation to food insecurity.

Body image dissatisfaction, physical activity and screen-time in Spanish adolescents.

This cross-sectional study contributes to the literature on whether body dissatisfaction is a barrier/facilitator to engaging in physical activity and to investigate the impact of mass-media messages via computer-time on body dissatisfaction. High-school students ( N = 1501) reported their physical activity, computer-time (homework/leisure) and body dissatisfaction. Researchers measured students' weight and height. Analyses revealed that body dissatisfaction was negatively associated with physical activity on both genders, whereas computer-time was associated only with girls' body dissatisfaction. Specifically, as computer-homework increased, body dissatisfaction decreased; as computer-leisure increased, body dissatisfaction increased. Weight-related interventions should improve body image and physical activity simultaneously, while critical consumption of mass-media interventions should include a computer component.

Incorporating peer support during in vivo exposure to reverse dropout from prolonged exposure therapy for posttraumatic stress disorder: Clinical outcomes.

Objective Prolonged exposure is characterized by reported dropout rates ranging from 25% to 40%. This premature attrition is also observed in other evidence-based treatments for posttraumatic stress disorder. While home-based telehealth delivery of prolonged exposure resolves logistical barriers to care such as travel time and cost, dropout appears unaffected. A previous study on dropouts from prolonged exposure delivered via telehealth found that Veterans, particularly those receiving care via telehealth, reported problems with in vivo exposure and that having a peer to offer support during in vivo exposure assignments might have prevented their attrition from treatment. Methods The present pilot study treatment was designed in a manner consistent with the aforementioned Veteran suggestions, specifically to involve peers offering verbal support and encouragement during in vivo exposure homework. Such a treatment modification might be particularly useful for those receiving care via telehealth, given increased difficulties with exposure reported when this treatment delivery modality is used. It was hypothesized that dropouts would agree to reengage in treatment with a peer and would subsequently evince improvement in posttraumatic stress disorder and depression scores as a result of this treatment reengagement. Results Of 82 dropouts from prolonged exposure, 29 reentered treatment when offered peer support during exposure (12 in telehealth and 17 in person). Conclusion Treatment reentry was effective insofar as indices of both posttraumatic stress disorder and depression were significantly reduced in both telehealth and in person groups, indicating that using peers in this way may be an effective means by which to return Veterans to care, and ultimately reduce symptomatology.

Roundtable on the Prevention of Eating Disorders: The Catalan public policy initiative.

The field of prevention of body image problems and eating disorders has made major advances in recent years, particularly in the development and evaluation of prevention programmes. However, few programmes achieve good long-term results because, among other reasons, the sociocultural influences affecting the development of these problems do not stop. Moreover, accelerating progress in this field is required, transferring their impact onto a larger scale. These reasons justify the need to progress in the development of public policy interventions. This paper describes a recent Catalan initiative in this sphere: the Roundtable on the Prevention of Eating Disorders, made up of different public and private sectors of Catalan society. It specifically details the main actions carried out, such as: media campaigns to reduce weight-related teasing and encouraging self-esteem, encouraging family meals and promoting help-seeking among those affected; the creation of a new informative website about these matters in the Department of Health; the production of a Decalogue of Best Practices for the promotion of self-esteem and positive body image in social media and advertising; and actions to prevent the promotion of eating disorders on the Internet. The Roundtable is the most comprehensive Catalan (and Spanish) public policy activity undertaken until now for the prevention of eating disorders.

Mediterranean diet adherence among Catalonian adolescents: socio-economic and lifestyle factors.

AIM: This study aims to describe the adherence to the Mediterranean diet (MD), using the KIDMED questionnaire, in a sample of Catalonian adolescents and to assess the association between the MD adherence and socio-economic and lifestyle behaviours. MATERIAL AND METHODS: Data are part of a multi-centre longitudinal study designed for the reduction of risk factors of eating and weight-related problems in adolescents. Here, a cross-sectional analysis was performed with the baseline data, academic period 2010-11. The participants were 1,502 adolescents recruited from 11 schools from the province of Barcelona. RESULTS AND CONCLUSIONS: The results showed a higher level of MD adherence when parents had higher educational level, and when adolescents reported a low level of screen-time, and high weekly physical activity.

Mediterranean diet adherence among Catalonian adolescents: socio-economic and lifestyle factors / Adherencia a la dieta mediterránea en adolescentes catalanes: factores socioeconómicos y de estilo de vida

Aim: This study aims to describe the adherence to the Mediterranean diet (MD), using the KIDMED questionnaire, in a sample of Catalonian adolescents and to assess the association between the MD adherence and socio-economic and lifestyle behaviours. Material and methods: Data are part of a multi-centre longitudinal study designed for the reduction of risk factors of eating and weight-related problems in adolescents. Here, a cross-sectional analysis was performed with the baseline data, academic period 2010-11. The participants were 1,502 adolescents recruited from 11 schools from the province of Barcelona. Results and conclusions: The results showed a higher level of MD adherence when parents had higher educational level, and when adolescents reported a low level of screen-time, and high weekly physical activity (AU)

Objetivo: el objetivo del artículo consiste en describir, mediante el cuestionario KIDMED, la adherencia a la dieta mediterránea (DM) de una muestra de adolescentes catalanes y la asociación entre los niveles de adherencia a la DM y determinadas conductas relacionadas con el estilo de vida y los factores socioeconómicos. Material y métodos: los datos forman parte de un estudio longitudinal multicéntrico diseñado para evaluar los factores de riesgo relacionados con los problemas de la alimentación y el peso. En este trabajo se analizan, en un corte transversal, los datos de la línea base recogidos en el periodo académico 2010-11. Los participantes fueron 1.502 adolescentes reclutados en 11 escuelas de la provincia de Barcelona. Resultados y conclusiones: los resultados indican un elevado nivel de adherencia a la DM cuando los padres tienen un nivel educativo alto y cuando los adolescentes presentan un bajo consumo de tiempo de pantalla y un nivel elevado de actividad física semanal (AU)

The MABIC project: An effectiveness trial for reducing risk factors for eating disorders.

Challenges in the prevention of disordered eating field include moving from efficacy to effectiveness and developing an integrated approach to the prevention of eating and weight-related problems. A previous efficacy trial indicated that a universal disordered eating prevention program, based on the social cognitive model, media literacy educational approach and cognitive dissonance theory, reduced risk factors for disordered eating, but it is unclear whether this program has effects under more real-world conditions. This effectiveness trial tested whether this program has effects when previously trained community providers in an integrated approach to prevention implement the intervention. The research design involved a multi-center non-randomized controlled trial with baseline, post-test and 1-year follow-up measures. The sample included girls in the 8th grade from six schools (n = 152 girls) in a city near Barcelona (intervention group), and from eleven schools (n = 413 girls) in four neighboring towns (control group). The MABIC risk factors of disordered eating were assessed as main outcomes. Girls in the intervention group showed significantly greater reductions in beauty ideal internalization, disordered eating attitudes and weight-related teasing from pretest to 1-year follow-up compared to girls in the control group, suggesting that this program is effective under real-world conditions.

Sociocultural influences and body change strategies in Spanish adolescent boys of different weight status.

The aim of the present study was to examine the association between sociocultural influences to attain an ideal body and body change strategies (BCS) in Spanish adolescent boys of different weight status. A total of 594 Spanish boys (M=13.94 years, SD=0.20) participated. Measures included in the study were weight status according to body mass index (BMI), sociocultural influences (perceived pressures to attain an ideal body, general internalization of an ideal body, internalization of an athletic-ideal body), BCS to lose/control weight (dieting, healthy and unhealthy weight-control behaviors), and BCS to gain weight and muscles. Underweight boys engaged more frequently in weight-gain behaviors. Overweight boys reported higher levels of perceived sociocultural pressures and general internalization compared to normal-weight boys, and were more likely to be engaged in BCS to lose/control weight compared with the other weight-status groups. There were no differences between groups in terms of internalization of an athletic-ideal body and BCS to increase muscles. Future research and prevention programs should consider male-specific behaviors and weight-status differences.

Self-perceived weight status, dieting, and unhealthy weight-control behaviors among Spanish male adolescents.

INTRODUCTION: Self-perceived weight status among adolescents has been associated with weight-control behaviors. However, this relationship varies across weight status. OBJECTIVES: The aim of this study was to examine the effect of self-perceived weight status on dieting and unhealthy weight-control behaviors among Spanish male adolescents, across weight status. METHOD: Participants were 597 Spanish male adolescents (M = 13.94 years old, SD = 0.60). Body weight and height were measured in situ. Self-perceived weight status, dieting, and unhealthy weight-control behaviors were evaluated. RESULTS: The adolescents were inaccurate on estimating their weight status. Those who were overweight or obese, or who perceived themselves to be so, were more likely to report dieting and unhealthy weight-control behaviors. DISCUSSION: There is a need to promote healthier eating behaviors among adolescents, and to take into account the fact that self-perceived weight status may hinder the adoption of such behaviors.

Introducción: El estatus de peso percibido se ha asociado a conductas de control del peso en adolescentes. Esta relación varía de acuerdo al estatus de peso corporal. Objetivos: Explorar el efecto del estatus de peso percibido sobre la práctica de dieta y conductas no saludables de control del peso en adolescentes varones españoles, considerando su estatus de peso. Método: Participaron 597 adolescentes (M = 13,94 años, DS = 0,60). Se registró in situ la talla y peso corporal. Se evaluó el peso percibido, la práctica de dieta y conductas no saludables de control del peso. Resultados: Los adolescentes fueron inexactos al estimar su estatus de peso. Aquellos con sobrepeso, obesidad o los que se percibían como tales, fueron los que más informaron hacer dieta y conductas no saludables de control del peso. Discusión: Es necesario promover conductas alimentarias saludables entre los adolescentes y considerar que el estatus de peso percibido puede limitar la adopción de estos comportamientos.

Self-perceived weight status, dieting and unhealthy weight-control behaviors among Spanish male adolescents / Estatus de peso percibido, dieta y conductas no saludables de control del peso en adolescentes varones españoles

Introduction: Self-perceived weight status among adolescents has been associated with weight-control behaviors. However, this relationship varies across weight status. Objectives: The aim of this study was to examine the effect of self-perceived weight status on dieting and unhealthy weight-control behaviors among Spanish male adolescents, across weight status. Method: Participants were 597 Spanish male adolescents (M = 13.94 years old, SD = 0.60). Body weight and height were measured in situ. Self-perceived weight status, dieting, and unhealthy weight-control behaviors were evaluated. Results: The adolescents were inaccurate on estimating their weight status. Those who were overweight or obese, or who perceived themselves to be so, were more likely to report dieting and unhealthy weight-control behaviors. Discussion: There is a need to promote healthier eating behaviors among adolescents, and to take into account the fact that self-perceived weight status may hinder the adoption of such behaviors (AU)

Introducción: El estatus de peso percibido se ha asociado a conductas de control del peso en adolescentes. Esta relación varía de acuerdo al estatus de peso corporal. Objetivos: Explorar el efecto del estatus de peso percibido sobre la práctica de dieta y conductas no saludables de control del peso en adolescentes varones españoles, considerando su estatus de peso. Método: Participaron 597 adolescentes (M = 13,94 años, DS = 0,60). Se registró in situ la talla y peso corporal. Se evaluó el peso percibido, la práctica de dieta y conductas no saludables de control del peso. Resultados: Los adolescentes fueron inexactos al estimar su estatus de peso. Aquellos con sobrepeso, obesidad o los que se percibían como tales, fueron los que más informaron hacer dieta y conductas no saludables de control del peso. Discusión: Es necesario promover conductas alimentarias saludables entre los adolescentes y considerar que el estatus de peso percibido puede limitar la adopción de estos comportamientos (AU)

CLOCK 3111 T/C SNP interacts with emotional eating behavior for weight-loss in a Mediterranean population.

OBJECTIVE: The goals of this research was (1) to analyze the role of emotional eating behavior on weight-loss progression during a 30-week weight-loss program in 1,272 individuals from a large Mediterranean population and (2) to test for interaction between CLOCK 3111 T/C SNP and emotional eating behavior on the effectiveness of the weight-loss program. DESIGN AND METHODS: A total of 1,272 overweight and obese participants (BMI: 31±5 kg/m2), aged 20 to 65 years, attending outpatient weight-loss clinics were recruited for this analysis. Emotional eating behavior was assessed by the Emotional Eating Questionnaire (EEQ), a questionnaire validated for overweight and obese Spanish subjects. Anthropometric measures, dietary intake and weight-loss progression were assessed and analyzed throughout the 30-week program. Multivariate analysis and linear regression models were performed to test for gene-environment interaction. RESULTS: Weight-loss progression during the 30-week program differed significantly according to the degree of emotional eating behavior. Participants classified as 'very emotional eaters' experienced more irregular (P = 0.007) weight-loss, with a lower rate of weight decline (-0.002 vs. -0.003, P<0.05) in comparison with less emotional eaters. The percentage of weight-loss was also significantly higher in 'non-emotional eaters' (P = 0.009). Additionally, we identified a significant gene-environment interaction associated with weight-loss at the CLOCK 3111 T/C locus (P = 0.017). By dichotomizing the emotional eating behavior score, linear regression analysis indicated that minor C allele carriers with a high emotional score (> = 11), lost significantly less weight than those C carriers with a low emotional score (<11) (P = 0.005). CONCLUSIONS: Emotional eating behavior associates with weight-loss pattern, progression and total weight-loss. Additionally, CLOCK 3111 T/C SNP interacts with emotional eating behavior to modulate total weight loss. These results suggest that the assessment of this locus and emotional eating behavior could improve the development of effective, long-tern weight-management interventions.

A school-based program implemented by community providers previously trained for the prevention of eating and weight-related problems in secondary-school adolescents: the MABIC study protocol.

BACKGROUND: The prevention of eating disorders and disordered eating are increasingly recognized as public health priorities. Challenges in this field included moving from efficacy to effectiveness and developing an integrated approach to the prevention of a broad spectrum of eating and weight-related problems. A previous efficacy trial indicated that a universal disordered eating prevention program, based on the social cognitive model, media literacy educational approach and cognitive dissonance theory, reduced risk factors for disordered eating, but it is unclear whether this program has effects under more real-world conditions. The main aim of this effectiveness trial protocol is to test whether this program has effects when incorporating an integrated approach to prevention and when previously-trained community providers implement the intervention. METHODS/DESIGN: The research design involved a multi-center non-randomized controlled trial with baseline, post and 1-year follow-up measures. Six schools from the city of Sabadell (close to Barcelona) participated in the intervention group, and eleven schools from four towns neighboring Sabadell participated in the control group. A total of 174 girls and 180 boys in the intervention group, and 484 girls and 490 boys in the control group were registered in class lists prior to baseline. A total of 18 community providers, secondary-school class tutors, nurses from the Catalan Government's Health and School Program, and health promotion technicians from Sabadell City Council were trained and delivered the program. Shared risk factors of eating and weight-related problems were assessed as main measures. DISCUSSION: It will be vital for progress in disordered eating prevention to conduct effectiveness trials, which test whether interventions are effective when delivered by community providers under ecologically valid conditions, as opposed to tightly controlled research trials. The MABIC project will provide new contributions in this transition from efficacy to effectiveness and new data about progress in the integrated approach to prevention. Pending the results, the effectiveness trial meets the effectiveness standards set down by the Society for Prevention Research. This study will provide new evidence to improve and enhance disordered eating prevention programs. TRIAL REGISTRATION: Current Controlled Trials ISRCTN47682626.

Unhealthy weight-control behaviours, dieting and weight status: a cross-cultural comparison between North American and Spanish adolescents.

The aim of the current study was to examine and compare dieting and unhealthy weight-control behaviours (UWCB) in population-based samples in two large urban areas in Spain (Barcelona) and in the USA (Twin Cities of Minneapolis and St. Paul, Minnesota). Additionally, use of UWCB across weight categories was explored in both samples. Participants included 1501 adolescents from Barcelona (48% girls, 52% boys) and 2793 adolescents from the Twin Cities (53% girls, 47% boys). The main outcome measures were dieting, UWCB (less extreme and extreme) and weight status. Although dieting and UWCB were prevalent in both samples, particularly among girls, the prevalence was higher in the US sample. In both countries, the report of dieting and use of UWCB was highest among overweight and obese youth. Prevention interventions that address the broad spectrum of eating and weight-related problems should be warranted in light of the high prevalence and co-occurrence of overweight and unhealthy weight-related behaviours.