Disordered eating in college women: associations with the mother-daughter relationship and family weight-related conversations.

PURPOSE: Extensive work in the field has found multiple risk factors of disordered eating among women; however, there is limited research regarding the associations of maternal influence and family weight-related conversations during childhood with eating disorder psychopathology later in adulthood. Thus, the purpose of this study was to explore how the mother-daughter relationship and family weight-related conversations may influence the development of disordered eating in college-aged women. METHODS: A diverse sample of 551 college-aged women completed an online survey with instruments that assessed disordered eating risk (dependent variable) with the following independent variables: aspects of the mother-daughter relationship (maternal regard and responsibility) and family weight-related conversations (emphasis on maternal weight, appearance weight control, and parent weight talk). Mediation analysis was performed using hierarchical regression analyses to examine the influence of maternal factors in combination with family weight-related conversations with disordered eating risk. RESULTS: Using hierarchical regression analyses, aspects of the mother-daughter relationship were significantly associated with risk of disordered eating. However, this significant relationship was diminished in the presence of family weight-related conversations. Furthermore, a test of the mediation suggests that family weight-related conversations may act as a pathway for influencing perceived maternal factors in the development of disordered eating. CONCLUSIONS: Findings illustrate the important role mothers may have in shaping their daughters eating attitudes and behaviors. Future disordered eating prevention programs and interventions may consider developing strategies in educating parents on conversations regarding weight. LEVEL OF EVIDENCE: Descriptive cross-sectional study, Level V.

Relationships of family conflict, cohesion, and chaos in the home environment on maternal and child food-related behaviours.

This study examined how food-related behaviours differed in mothers and their preschool children by levels of family functioning (cohesion and conflict) and household disorganization (chaos). A nationally representative sample of mothers of preschoolers completed an online survey assessing food-related behaviours of themselves and their children. Maternal and child diet, eating behaviours, and health status; household availability of fruits/vegetables, salty/fatty snacks, and sugar-sweetened beverages; family mealtime atmosphere; and family conflict, cohesion, and household chaos were assessed with valid, reliable scales. Cluster analyses assigned families into low, middle, and high conflict, cohesion, and chaos groups. Participants (n = 550) were 72% White, and 82% had some post-secondary education. Regression analysis examining the association of cluster grouping levels on diet-related behaviour measures revealed that positive home environments (i.e., low family conflict, high family cohesion, and low household chaos) were associated with healthier food-related behaviours (e.g., increased fruits/vegetables intake), whereas negative home environments (i.e., high family conflict, low family cohesion, and high household chaos) were associated with unhealthy food-related behaviours (e.g., greater % total calories from fat) even after controlling for sociodemographic and related behavioural factors. Findings suggest family functioning and household chaos are associated with food-related behaviours. This frequently overlooked component of family interaction may affect intervention outcomes and objectives of educational and interventional initiatives.

Systematic review of control groups in nutrition education intervention research.

BACKGROUND: Well-designed research trials are critical for determining the efficacy and effectiveness of nutrition education interventions. To determine whether behavioral and/or cognition changes can be attributed to an intervention, the experimental design must include a control or comparison condition against which outcomes from the experimental group can be compared. Despite the impact different types of control groups can have on study outcomes, the treatment provided to participants in the control condition has received limited attention in the literature. METHODS: A systematic review of control groups in nutrition education interventions was conducted to better understand how control conditions are described in peer-reviewed journal articles compared with experimental conditions. To be included in the systematic review, articles had to be indexed in CINAHL, PubMed, PsycINFO, WoS, and/or ERIC and report primary research findings of controlled nutrition education intervention trials conducted in the United States with free-living consumer populations and published in English between January 2005 and December 2015. Key elements extracted during data collection included treatment provided to the experimental and control groups (e.g., overall intervention content, tailoring methods, delivery mode, format, duration, setting, and session descriptions, and procedures for standardizing, fidelity of implementation, and blinding); rationale for control group type selected; sample size and attrition; and theoretical foundation. RESULTS: The search yielded 43 publications; about one-third of these had an inactive control condition, which is considered a weak study design. Nearly two-thirds of reviewed studies had an active control condition considered a stronger research design; however, many failed to report one or more key elements of the intervention, especially for the control condition. None of the experimental and control group treatments were sufficiently detailed to permit replication of the nutrition education interventions studied. CONCLUSIONS: Findings advocate for improved intervention study design and more complete reporting of nutrition education interventions.

Validity and reliability of HOP-Up: a questionnaire to evaluate physical activity environments in homes with preschool-aged children.

BACKGROUND: Early identification of physical activity (PA) opportunities in the home and neighborhood environment may help obesity prevention efforts in households with young children. This cross-sectional study's purpose was to develop a brief, easy-to-use, self-report inventory called Home Opportunities for Physical activity check-Up (HOP-Up), to evaluate the availability and accessibility of PA space and equipment in and near homes with preschool children, and establish its validity and reliability. METHODS: The HOP-Up was field tested by two trained researchers and parents of preschool-aged children (n = 50; 71% white). To establish criterion validity, researchers were the 'gold standard' and visited participants' homes to assess their PA environments using the HOP-Up, while participants separately completed their HOP-Up. Two weeks later, parents completed the HOP-Up online for test-retest reliability. After minor survey refinements, exploratory and confirmatory factor analysis using a split-half cross validation procedure was conducted in a larger sample of participants (n = 655, 60% white) who completed the HOP-Up online to examine its factor structure. To establish convergent validity, correlations were conducted to compare HOP-Up scales from the factor solution generated with PA behavior and cognitions, and reported screen time. RESULTS: Intra-class correlations (ICCs) examining HOP-Up item agreement between researcher and parents revealed slight to substantial agreement (range 0.22 to 0.81) for all items. ICCs for all HOP-Up items ranged from fair to substantial agreement between parent responses at both time points (range 0.42 to 0.95). Exploratory factor analysis revealed a five factor solution (18 items), supported eigen values, scree plots, review for contextual sense, and confirmatory factor analysis. Additionally, there were significant (p < 0.05) positive correlations among nearly all five HOP-Up scales with parent and child physical activity levels (range 0.08 to 0.35), and values parents placed on PA for self and child (range 0.16 to 0.35), and negative correlations of Neighborhood Space & Supports for PA scale with parent and child reported screen time (r = -0.11, r = -0.13, respectively). CONCLUSIONS: Findings support the psychometric properties of this brief, easy-to-use, HOP-Up questionnaire, which may help parents, prevention researchers, residential planners, and practitioners increase their understanding of how the home environment-inside, outside, and the neighborhood- impacts preschool children's physical activity levels.

Reliability and criterion validity of self-measured waist, hip, and neck circumferences.

BACKGROUND: Waist, hip, and neck circumference measurements are cost-effective, non-invasive, useful markers for body fat distribution and disease risk. For epidemiology and intervention studies, including body circumference measurements in self-report surveys could be informative. However, few studies have assessed the test-retest reliability and criterion validity of a self-report tool feasible for use in large scale studies. METHODS: At home, mothers of young children viewed a brief, online instructional video on how to measure their waist, hip, and neck circumferences. Afterwards, they created a homemade paper measuring tape from a downloaded file with scissors and tape, took all measurements in duplicate, and entered them into an online survey. A few weeks later, participants visited an anthropometrics lab where they measured themselves again, and trained technicians (n = 9) measured participants in duplicate using standard equipment and procedures. To assess differences between self- and technician-measured circumferences, duplicate measurements for participant home self-measurements, participant lab self-measurements, and technician measurements each were averaged and Wilcoxon signed-rank tests conducted. Agreement between all possible pairs of measurements were examined using Intraclass Correlations (ICCs) and Bland-Altman plots. RESULTS: Participants (n = 41; aged 38.05 ± 3.54SD years; 71 % white) were all mothers that had at least one child under the age of 12 yrs. Technical error of measurements for self- and technician- duplicate measurements varied little (0.08 to 0.76 inches) and had very high reliability (≥0.90). Intraclass Correlations (ICC) comparing self vs technician were high (0.97, 0.96, and 0.84 for waist, hip, and neck). Comparison of self-measurements at home vs lab revealed high test-retest reliability (ICC ≥ 0.87). Differences between participant self- and technician measurements were small (i.e., mean difference ranged from -0.13 to 0.06 inches) with nearly all (≥93 %) differences within Bland-Altman limits of agreement and <10 % exceeding the a priori clinically meaningful difference criterion. CONCLUSIONS: This study has demonstrated a simple, inexpensive method for teaching novice mothers of young children to take their own body circumferences resulting in accurate, reliable data. Thus, collecting self-measured and self-reported circumference data in future studies may be a feasible approach in research protocols that has potential to expand our knowledge of body composition beyond that provided by self-reported body mass indexes.

Relationships of Sleep Duration With Weight-Related Behaviors of U.S. College Students.

This study describes sleep behaviors of U.S. college students (N = 1,252; 18-24 years old; 59% female) and examines associations of sleep duration with weight-related behaviors. More than one quarter of participants slept < 7 hr/night and had mean Pittsburgh Sleep Quality Index (PSQI) scores indicating poor sleep quality. There were significant differences for all PSQI scales among sleep duration categories, < 7 hr (n = 344), 7-8 hr (n = 449), ≥ 8 hr (n = 459) sleep/night. Compared to those who slept ≥ 8 hr, those who slept < 8 hr had significantly more negative eating attitudes (2% higher), poorer internal regulation of food (4% lower), and greater binge eating (4% higher) scores. Findings advocate for health care professionals to evaluate sleep behaviors of college students during office visits and promote good sleep behaviors.

Evaluation of a Childhood Obesity Prevention Online Training Certificate Program for Community Family Educators.

Community family educators have the opportunity to incorporate childhood obesity prevention concepts in their programming with families of young children, but often lack formal health and nutrition education. The purpose of this feasibility study was to create an online training certificate program for community family educators and assess the program's effectiveness at improving participant's knowledge, attitudes, and intended and actual behaviors related to healthy lifestyles. Community family educators (n = 68) completed an online pretest, viewed 13 brief videos (8-15 min) focused on childhood obesity related topics and took mini-knowledge self-checks after each video followed by an online posttest. At posttest, paired t tests showed participants' childhood obesity prevention related knowledge (i.e., nutrition, physical activity, screen time and sleep) improved significantly (p < 0.001). Participants' attitudes toward parenting behaviors related to feeding practices, family meals, physical activity, screen time control and parent modeling significantly (p < 0.05) improved. Improvements also were seen in participants' intentions to promote obesity prevention behaviors (i.e., age appropriate portions sizes, adequate physically active, and parental role modeling). Furthermore, changes in personal health behaviors at posttest revealed participants had significantly (p < 0.05) greater dietary restraint, improvements in sleep quality, and reductions of use of electronic devices during meals and snacks. Overall, participants were very satisfied with the training program, felt comfortable with skills acquired, and enjoyed the program. Findings suggest this online training program is a feasible and effective method for improving community family educators' knowledge, attitudes, and intentions for obesity-prevention related parenting practices.

Family meals and disordered eating in adolescents: are the benefits the same for everyone?

OBJECTIVE: To examine the association between family meals and disordered eating behaviors within a diverse sample of adolescents and further investigate whether family-level variables moderate this association. METHOD: Data from adolescents (EAT 2010: Eating and Activity in Teens) and their parents (Project F-EAT: Families and Eating and Activity among Teens) were collected in 2009-2010. Surveys were completed by 2,382 middle and high school students (53.2% girls, mean age = 14.4 years) from Minneapolis/St. Paul, MN, public schools. Parents/guardians (n = 2,792) completed surveys by mail or phone. RESULTS: Greater frequency of family meals was associated with decreased odds of engaging in unhealthy weight control behaviors in boys, and dieting, unhealthy and extreme weight control behaviors in girls. Results indicate that the protective effects of family meals are, in general, robust to family-level variables; 64 interactions were examined and only seven were statistically significant. For example, among girls, the protective nature of family meals against dieting and unhealthy weight control behaviors was diminished if they also reported family weight-related teasing (both p < .01). DISCUSSION: The results confirmed previous research indicating that participation in family meals is protective against disordered eating for youth, particularly girls. However, results suggest that in some cases, the protection offered by family meals may be modified by family-level variables.

Fruit-related terms and images on food packages and advertisements affect children's perceptions of foods' fruit content.

OBJECTIVE: To determine whether food label information and advertisements for foods containing no fruit cause children to have a false impression of the foods' fruit content. DESIGN: In the food label condition, a trained researcher showed each child sixteen different food label photographs depicting front-of-food label packages that varied with regard to fruit content (i.e. real fruit v. sham fruit) and label elements. In the food advertisement condition, children viewed sixteen, 30 s television food advertisements with similar fruit content and label elements as in the food label condition. After viewing each food label and advertisement, children responded to the question 'Did they use fruit to make this?' with responses of yes, no or don't know. SETTING: Schools, day-care centres, after-school programmes and other community groups. SUBJECTS: Children aged 4-7 years. RESULTS: In the food label condition, χ 2 analysis of within fruit content variation differences indicated children (n 58; mean age 4·2 years) were significantly more accurate in identifying real fruit foods as the label's informational load increased and were least accurate when neither a fruit name nor an image was on the label. Children (n 49; mean age 5·4 years) in the food advertisement condition were more likely to identify real fruit foods when advertisements had fruit images compared with when no image was included, while fruit images in advertisements for sham fruit foods significantly reduced accuracy of responses. CONCLUSIONS: Findings suggest that labels and advertisements for sham fruit foods mislead children with regard to the food's real fruit content.

Cover Lines Using Positive, Urgent, Unique Language Entice Moms to Read Health Communications.

Crafting messages that capture consumer interest is a frequent challenge of health communicators. A better understanding of the techniques magazine editors use to create cover lines may aid health communicators in their efforts to arouse interest in their communiqués. This study (a) content-analyzed magazine cover lines, (b) used content analysis findings to create health-related cover lines, and (c) assessed the degree to which the health-related cover lines fostered motivation to read the health communication. Cover lines (N = 867) from 11 magazines published in 2012 frequently read by mothers of young children used a variety of themes, with those focusing on informative/how-to, control/improve, and unique/special being most common. Health communication experts used key descriptor terms corresponding to each theme and wrote 310 cover lines for topics focusing on childhood obesity prevention strategies. Unpaired t tests revealed that mothers of young children (N = 77) reported they were significantly (p < .05) more motivated to read a short, health-related magazine article when cover lines had a happiness/fun, unique/special, or quick/urgency theme and were significantly less motivated to read when cover lines used a control/improve theme. Study findings may help health communicators create cover lines that better attract reader attention.

New Jersey Leaves No Bite Behind: A Climate Change and Food Waste Curriculum Intervention for Adolescents in the United States.

Food waste is a major contributor to climate change. Schools offer a unique opportunity to educate on this issue while also reducing food waste generation; however, few climate-change education curricula that include a food waste component have been developed and tested with fidelity. Thus, the purpose of this cluster randomized controlled study was to assess the effectiveness of a climate change and food waste education program called NJ Leaves No Bite Behind (NJLNBB) among fifth-grade students. Lessons on food waste and sustainable food behaviors were developed that aligned with NJ Student Learning Standards for Climate Change and Next-Generation Science Standards. Participants (n = 162) completed pre- and post-test surveys that assessed knowledge, attitudes, self-efficacy, and behaviors. Post-test, the experimental group (n = 102) had significantly (p < 0.05) higher mean scores in knowledge, social norms, behavioral intentions, and perceived behavioral control compared to the control group (n = 60), with medium effect sizes, as determined by partial eta-squared. There were no significant between-group differences in mean score attitudes, self-efficacy, motivation to comply, or climate-friendly behaviors post-test. Almost three-quarters of participants who received the program agreed or strongly agreed the lessons were fun (75.5%), liked the card games (72.5), and learned a lot (78.4%). These findings are promising in terms of teaching adolescents the impacts of food waste on the climate.

Fatty, fatty, two-by-four: weight-teasing history and disturbed eating in young adult women.

OBJECTIVE: We investigated the long-term effect of weight teasing during childhood. METHODS: Young adult women (n = 1533; aged 18-26 years) from 3 large universities participated in a survey (Fall 2009 to Spring 2010) that assessed disturbed eating behaviors; weight status at ages 6, 12, and 16 years; and weight-teasing history. RESULTS: Nearly half of the participants were weight-teased as a child. Participants who experienced childhood weight teasing were significantly more likely to have disturbed eating behaviors now than non-weight-teased peers. As the variety of weight teasing insults recalled increased, so did disturbed eating behaviors and current body mass index. Those who recalled their weight at ages 6, 12, or 16 years as being heavier than average endured weight teasing significantly more frequently and felt greater distress than their lighter counterparts. CONCLUSIONS: Weight teasing may contribute to the development of disturbed eating and eating disorders in young women. Health care professionals, parents, teachers, and other childcare givers must help shift social norms to make weight teasing as unacceptable as other types of bullying. To protect the health of children, efforts to make weight teasing unacceptable are warranted.

Personal, behavioral and socio-environmental predictors of overweight incidence in young adults: 10-yr longitudinal findings.

BACKGROUND: The objective of this study was to identify 10-year longitudinal predictors of overweight incidence during the transition from adolescence to young adulthood. METHODS: Data were from Project EAT (Eating and Activity in Teens and Young Adults). A diverse, population-based cohort (N = 2,134) completed baseline surveys in 1998-1999 (mean age = 15.0±1.6, 'adolescence') and follow-up surveys in 2008-2009 (mean age = 25.4±1.7, 'young adulthood'). Surveys assessed personal, behavioral and socio-environmental factors hypothesized to be of relevance to obesity, in addition to height and weight. Multivariable logistic regression was used to estimate the adjusted odds for each personal, behavioral and socio-environmental factor at baseline, and 10-year changes for these factors, among non-overweight adolescents (n = 1,643) being predictive of the incidence of overweight (BMI ≥ 25) at 10-year follow-up. RESULTS: At 10-year follow-up, 51% of young adults were overweight (26% increase from baseline). Among females and males, higher levels of body dissatisfaction, weight concerns, unhealthy weight control behaviors (e.g., fasting, purging), dieting, binge eating, weight-related teasing, and parental weight-related concerns and behaviors during adolescence and/or increases in these factors over the study period predicted the incidence of overweight at 10-year follow-up. Females with higher levels of whole grain intake and breakfast and dinner consumption frequency during adolescence were protected against becoming overweight. Among males, increases in vegetable intake protected against the incidence of overweight 10 years later. CONCLUSIONS: Findings suggest that obesity prevention interventions for adolescents should address weight-specific factors from within the domains of personal, behavioral, and socio-environmental factors such as promoting positive body image, decreasing unhealthy weight control behaviors, and limiting negative weight talk.

Accuracy and consistency of weights provided by home bathroom scales.

BACKGROUND: Self-reported body weight is often used for calculation of Body Mass Index because it is easy to collect. Little is known about sources of error introduced by using bathroom scales to measure weight at home. The objective of this study was to evaluate the accuracy and consistency of digital versus dial-type bathroom scales commonly used for self-reported weight. METHODS: Participants brought functioning bathroom scales (n=18 dial-type, n=43 digital-type) to a central location. Trained researchers assessed accuracy and consistency using certified calibration weights at 10 kg, 25 kg, 50 kg, 75 kg, 100 kg, and 110 kg. Data also were collected on frequency of calibration, age and floor surface beneath the scale. RESULTS: All participants reported using their scale on hard surface flooring. Before calibration, all digital scales displayed 0, but dial scales displayed a mean absolute initial weight of 0.95 (1.9 SD) kg. Digital scales accurately weighed test loads whereas dial-type scale weights differed significantly (p<0.05). Imprecision of dial scales was significantly greater than that of digital scales at all weights (p<0.05). Accuracy and precision did not vary by scale age. CONCLUSIONS: Digital home bathroom scales provide sufficiently accurate and consistent weights for public health research. Reminders to zero scales before each use may further improve accuracy of self-reported weight.

What foods are US supermarkets promoting? A content analysis of supermarket sales circulars.

This study compared the types of foods advertised in supermarket newspaper circulars across geographic region (US Census regions: northeast [n=9], midwest [n=15], south [n=14], and west [n=13]), obesity-rate region (i.e., states with CDC adult obesity rates of <25% [n=14], 25 to <30% [n=24], and ≥ 30% [n=13]), and with MyPlate recommendations. All food advertisements on the first page of each circular were measured (±0.12-in.) to determine the proportion of space occupied and categorized according to food group. Overall, ≥ 50% of the front page of supermarket sales circulars was devoted to protein foods and grains; fruits, vegetables, and dairy, combined, were allocated only about 25% of the front page. The southern geographic region and the highest obesity-rate region both devoted significantly more advertising space to sweets, particularly sugar-sweetened beverages. The lowest obesity-rate region and western geographic region allocated the most space to fruits. Vegetables were allocated the least space in the western geographic region. Grains were the only food group represented in ads in proportions approximately equal to amounts depicted in the MyPlate icon. Protein foods exceeded and fruits, dairy, and vegetables fell below comparable MyPlate proportional areas. Findings suggest supermarket ads do not consistently emphasize foods that support healthy weight and MyPlate recommendations. More research is needed to determine how supermarket newspaper circulars can be used to promote healthy dietary patterns.

Eating Disorders Examination Questionnaire (EDE-Q): norms for US college students.

PURPOSE: To present normative data for the Eating Disorders Examination Questionnaire, 6th edition (EDE-Q) from a large (n = 2,448), diverse (56 % White) sample of college students. METHODS: Participants completed the EDE-Q online. Mean scores and percentile ranks for global and subscale (restraint and eating, weight, and shape concerns) scores and binge eating and inappropriate compensatory behavior (dietary restraint, self-induced vomiting, medicine misuse, excessive exercise) frequencies were computed. RESULTS: Women had higher global and subscale scores and tended to engage in inappropriate compensatory behaviors more often than men. Women with clinically significant restraint, and eating, shape, and weight concerns scores equaled 5.4, 2.0, 18.6, and 13.0 %, respectively, and, for men, equaled 3.0, 0.3, 6.0, and 2.0 %. Compared with less diverse samples, women in this study had significantly higher shape concern and lower restraint and eating concern scores and men had lower shape and weight concern scores. CONCLUSIONS: Normative data from this diverse sample can help healthcare professionals and researchers better interpret EDE-Q scores.

Relationships of Maternal Employment and Work Impact with Weight-Related Behaviors and Home Environments of Mothers and Their School-Age Children.

The prevalence of obesity continues to rise. Preventing obesity, especially childhood obesity, is critically important. Parents, especially mothers, play a vital role in preventing childhood obesity. Numerous factors, such as maternal employment, may influence maternal weight-related practices and home environment characteristics that affect the risk of childhood obesity. Given the prevalence of both childhood obesity and maternal employment, this study was conducted to examine how weight-related maternal, child, and household behaviors as well as home environment characteristics differ by maternal employment hours and extends existing research by examining work impact on behaviors and home characteristics. U.S. mothers (n = 527) with at least one school-age child (6 to 11 years), who were between the ages of 25 and 54 years and the main food gatekeeper in the household completed an online survey. ANOVA comparisons of non-working, part-time employed, and full-time employed mothers revealed few differences in any of the variables studied. Cluster analysis of the 336 employed mothers based on six work impact scale scores found three unique clusters characterized as Enthusiastic Earners, Indifferent Earners, and Strained Earners. Few differences in sociodemographic and job characteristics occurred among clusters and the differences noted had small effect sizes. Clusters did not differ by maternal BMI or perceived child weight status. However, the clusters differed in numerous weight-related behaviors and home environment characteristics. Future research should aim to determine the direction of the associations of work impact with weight-related behaviors and home environments as well as identify potential strategies for overcoming the negative effects of employment on weight-related behaviors and environments and weight status as well as clarify other factors that may affect maternal work impact, such as time management, reasons for employment, and stress.

Weight regulation practices of young adults. Predictors of restrictive eating.

Young adults frequently use restrictive eating (i.e., going for long periods [≥ 8h] without eating to influence their shape or weight) to control their weight. The purpose of this study was to determine the prevalence of restrictive eating in young adults, compare eating behaviors of restrictive and non-restrictive eaters, and predict restrictive eaters. A diverse (56% white, 63% female) sample of young adults (n=2449) completed an online survey that included eating behavior scales (Restraint, Eating, Shape, and Weight Concerns, and Inappropriate Compensatory Behaviors from the Eating Disorder Examination-Questionnaire, Emotional and Disinhibited Eating from the Three-Factor Eating Questionnaire, and Night Eating from the Night Eating Questionnaire) and demographics. A quarter of women and 20% of men were classified as restrictive eaters. Independent t-tests revealed restrictive eaters had significantly (p<0.001) higher BMIs than non-restrictive eaters. Restrictive eaters also had significantly higher scores on all eating behavior scales than non-restrictive eaters even after controlling for potential confounding factors (BMI, race). Stepwise binary logistic regression revealed that increased eating, shape, and weight concerns, higher BMI, endorsement of inappropriate compensatory behaviors and night eating, being female, and white increased the odds of participants being restrictive eaters. This study can help healthcare professionals become more aware of weight control practices of young adults and create appropriate interventions.

Disturbed Eating Severity Scale (DESS) places disturbed eating risk on a continuum.

The purpose of this study was to develop a tool for assessing the severity of disturbed eating, use the tool to place disturbed eating behavior severity on a continuum, and to investigate how demographic and psychographic characteristics associated with disturbed eating differ across this continuum. Young adults (n=2438; 58% White; 63% female) from three north coast universities completed an online survey (fall 2009 to summer 2010) assessing eating behaviors and psychographic characteristics. Eating behavior scores were used to calculate the Disturbed Eating Severity Score (DESS), which placed participants along a continuum of four disturbed eating severity (non- disturbed to highly-disturbed) categories. Analysis of covariance and post hoc tests revealed significant differences among DESS categories on all eating behavior scales and nearly all psychographic characteristics. Thus, the DESS scale may help health care practitioners identify patients with varying degrees of disturbed eating behaviors and offer early interventions that could halt progress toward an eating disorder.

Sweet and salty. An assessment of the snacks and beverages sold in vending machines on US post-secondary institution campuses.

This study assessed the nutritional quality of snacks and beverages sold in vending machines. The contents of snack and beverage vending machines in 78 buildings on 11 US post-secondary education campuses were surveyed. Of the 2607 snack machine slots surveyed, the most common snacks vended were salty snacks (e.g., chips, pretzels) and sweets (i.e., candy and candy bars). The 1650 beverage machine slots assessed contained twice as many sugar-sweetened beverages as non-calorie-containing beverages. Only two institutions sold both milk and 100% juice in vending machines. The portion of snacks and beverages sold averaged more than 200 cal. Neither snacks nor beverages were nutrient dense. The majority of snacks were low in fiber and high in calories and fat and almost half were high in sugar. Most beverages were high in calories and sugar. This study's findings suggest that vending machines provide limited healthful choices. Findings from benchmark assessments of components of the food environment, like the vending options reported here, can provide valuable input to campus administrators, health services, food service, and students who want to establish campus policies to promote healthful eating.