Eveline J. M. Wouters

Peer influence on snacking behavior in adolescence.

To examine the association of adolescents snack and soft drink consumption with friendship group snack and soft drink consumption, availability of snacks and soft drinks at school, and personal characteristics, snack and soft drink consumption was assessed in 749 adolescents (398 girls, 351 boys, age 12.4-17.6 years), and their friends, and snack and soft drink availability at schools was measured. In regression analysis, consumption by friends, snack and soft drink availability within school, and personal characteristics (age, gender, education level, body mass index) were examined as determinants of snack and drink consumption. Snack and soft drink consumption was higher in boys, soft drink consumption was higher in lower educated adolescents, and snack consumption was higher in adolescents with a lower body weight. Peer group snack and soft drink consumption were associated with individual intake, particularly when availability in the canteen and vending machines was high. The association between individual and peer snack consumption was strong in boys, adolescents with a lower education level, and adolescents with lower body weights. Our study shows that individual snack and soft drink consumption is associated with specific combinations of consumption by peers, availability at school, and personal characteristics.

The Health-Related Quality of Life of Obese Persons Seeking or Not Seeking Surgical or Non-surgical Treatment: a Meta-analysis

BackgroundThis meta-analysis examined differences in health-related quality of life (HRQoL) between seekers of surgical and non-surgical treatment, and non-treatment seekers, over and above differences that are explained by weight, age, and gender.MethodsOur literature search focused on the ‘Impact of Weight on Quality of Life-Lite’ (IWQOL-Lite) and the ‘Short Form-36’ (SF-36) questionnaires. Included were studies published between 1980 and April 2006 providing pre-treatment descriptive statistics of adult overweight, obese or morbidly obese persons. Excluded were elderly and ill patient groups.Results54 articles, with a total number of nearly 100,000 participants, met the inclusion criteria. Persons seeking surgical treatment demonstrated the most severely reduced HRQoL. IWQOL-Lite scores showed larger differences between populations than SF-36 scores. After adjustment for weight, the population differences on the IWQOL disappeared. In contrast, the differences on the SF-36 between the surgical treatment seeking population and the other populations were maintained after adjustment for weight.ConclusionThe IWQOL-Lite questionnaire predominantly reflects weight-related HRQoL, whereas the SF-36 mostly reflects generic HRQoL that is determined by both weight and other factors. Our metaanalysis provides reference values that are useful when explaining or evaluating obesity-specific (IWQOL-Lite) or generic (SF-36) HRQoL, weight, and demographic characteristics of obese persons seeking or not seeking surgical or non-surgical treatment.

Physical Activity After Surgery for Severe Obesity: The Role of Exercise Cognitions

BackgroundPhysical activity after bariatric surgery is associated with sustained weight loss and improved quality of life. Some bariatric patients engage insufficiently in physical activity. This may be due to exercise cognitions, i.e., specific beliefs about benefits of and barriers to physical exercise. The aim of this study was to examine whether and to what extent both physical activity and exercise cognitions changed at 1 and 2xa0years post-surgery and whether exercise cognitions predict physical activity.MethodsForty-two bariatric patients (38 women, 4 men; mean age 38u2009±u20098xa0years, mean body mass index prior to surgery 47u2009±u20096xa0kg/m2) filled out self-report instruments to examine physical activity and exercise cognitions pre- and post-surgery.ResultsA large increase in physical activity and favorable changes in exercise cognitions were observed after surgery, viz. a decrease of fear of injury and embarrassment and an increase of the perception of exercise benefits and confidence in exercising. Perceiving less exercise benefits and having less confidence in exercising before surgery predicted less physical activity 2xa0years after surgery. High fear of injury 1xa0year after surgery predicted less physical activity 2xa0years after surgery.ConclusionsAfter bariatric surgery, favorable changes in physical activity and beliefs about the benefits and barriers of exercising are observed. Our results suggest that targeting exercise cognitions before and after surgery might be relevant to improve physical activity.

Effects of Aquajogging in Obese Adults: A Pilot Study

Aim and Method. To examine in obese people the potential effectiveness of a six-week, two times weekly aquajogging program on body composition, fitness, health-related quality of life, and exercise beliefs. Fifteen otherwise healthy obese persons participated in a pilot study. Results. Total fat mass and waist circumference decreased 1.4u2009kg (P = .03) and 3.1u2009cm (P = .005), respectively. The distance in the Six-Minute Walk Test increased 41 meters (P = .001). Three scales of the Impact of Weight on Quality of Life-Lite questionnaire improved: physical function (P = .008), self-esteem (P = .004), and public distress (P = .04). Increased perceived exercise benefits (P = .02) and decreased embarrassment (P = .03) were observed. Conclusions. Aquajogging was associated with reduced body fat and waist circumference and improved aerobic fitness and quality of life. These findings suggest the usefulness of conducting a randomized controlled trial with long-term outcome assessments.

Suffering Quantified? Feasibility and Psychometric Characteristics of 2 Revised Versions of the Pictorial Representation of Illness and Self Measure (PRISM)

The Pictorial Representation of Illness and Self Measure (PRISM) assesses suffering. In this article, the authors explored the feasibility and psychometric qualities of 2 revised versions of the PRISM—PRISM-R1 and PRISM-R2—that they used in 3 studies of participants with different medical problems. The results showed significant differences between the patient groups in suffering as measured with the revised PRISMs. In addition, the revised PRISMs appeared to be sensitive to change in the predicted direction after an intervention. Last, the 2 measures of the revised PRISM seemed to indicate different aspects of suffering. These findings yield preliminary support for the feasibility and validity of the PRISM-R2.

Physical activity and physical activity cognitions are potential factors maintaining fatigue in patients with primary Sjögren's syndrome

Background Fatigue is a prevalent and debilitating problem in Sjögrens syndrome. It has been suggested that physical activity and cognitions about physical activity can influence fatigue. Objective The aim of this study was to examine fatigue and physical activity levels in patients with Sjögrens syndrome and the associations of physical activity and physical activity cognitions with fatigue. Methods In 300 patients with primary Sjögrens syndrome and 100 demographically matched people from the general population (mean age 57 years, 93% female), fatigue (five dimensions of the multidimensional fatigue inventory) and physical activity (three dimensions of the international physical activity questionnaire) were assessed. The physical activity cognitions ‘activity avoidance’ and ‘somatic focus’ of the Tampa scale of kinesiophobia were assessed in the Sjögrens group only. Results Sjögrens patients had higher scores on all five fatigue dimensions (p<0.001) and lower scores on moderate and vigorous intensity activity (p≤0.001) compared with control participants. In the Sjögrens group, lower physical activity and higher activity avoidance and somatic focus were associated with more severe fatigue on most fatigue dimensions. For general fatigue and physical fatigue, especially the combination of low physical activity and high activity avoidance was associated with more severe fatigue (p<0.05). Conclusions The results suggest that fatigue in patients with Sjögrens syndrome might be reduced by targeting both physical activity and physical activity cognitions. This suggestion requires verification in clinical experimental studies.

Met lichaamsgewicht samenhangende kwaliteit van leven bij adolescenten

SamenvattingDoel. Vaststellen van de psychometrische eigenschappen van de Impact of Weight on Quality of Life-Kids (IWQOL-Kids), een meetinstrument om met lichaamsgewicht samenhangende kwaliteit van leven te meten bij adolescenten van 11 tot 19 jaar.n Methode. De IWQOL-Kids werd door 104 adolescenten ingevuld en van hen werden de lengte en het gewicht gemeten. De Pediatric Quality of Life Inventory (PedsQL), een vragenlijst om algemene kwaliteit van leven te meten, werd afgenomen om de convergente validiteit te bepalen. De gevoeligheid voor verandering na een interventie werd vastgesteld.n Resultaten. Op drie van de vier schalen was de interne consistentie goed (Cronbachs alfa 0,81-0,82) en voor één schaal redelijk (Cronbachs alfa 0,66). Het patroon van correlaties met schalen van de PedsQL ondersteunde de validiteit. De IWQOL-Kids was in staat te discrimineren tussen gewichtsklassen en bleek gevoelig voor verandering na een interventie.n Conclusie. De IWQOL-Kids lijkt een valide meetinstrument voor het meten van met lichaamsgewicht samenhangende kwaliteit van leven van adolescenten.SummaryAim To evaluate the psychometric qualities of the Dutch translation of the Impact of Weight on Quality of Life-Kids (IWQOL-Kids), a measure of body-weight-related quality of life in adolescents (age 11-19 years).Method. The IWQOL-Kids was completed by 104 adolescents for whom weight and height were measured. To examine convergent validity, associations with the Pediatric Quality of Life Inventory (PedsQL), a generic health related quality of life questionnaire, were determined. The sensitivity to change was established after an intervention.Results. Internal consistency coefficients were high for three out of four scales (Cronbach’s alpha 0.81-0.82) and moderate (0.66) for one scale. Convergent validity was confirmed by the pattern of correlations between scales of the IWQOL-Kids and the PedsQL. The IWQOL-Kids discriminated among weight classes and showed responsiveness after an intervention.Conclusie. Results suggest that the IWQOL-Kids is a valid instrument to measure weight-specific quality of life in adolescents.

Setting Overweight Adults in Motion: The Role of Health Beliefs

Objective: Health beliefs of overweight adults who did and did not enter an exercise program were compared to identify possible factors that hamper people to enter such a program. Method: Participants (n = 116, 78 women and 38 men) were overweight adults without comorbidities. Self-report instruments examined the burden of suffering, beliefs related to physical exercise and obesity, somatic complaints, and obesity-related quality of life of new participants of exercise programs versus sedentary non-exercisers. Results: The mean BMI of exercisers and non-exercisers was 34.6 ± 7.0 and 32.8 ± 5.8 kg/m2, respectively. Fear of injury was higher and perceived health benefits of exercise were lower in the non-exercisers who also more often believed their overweight to be irreversible and attributed overweight to physical causes. The burden of suffering, somatic complaints, and quality of life of the groups were not significantly different. Fear of injury remained a significant predictor of belonging to the non-exercise group after controlling for other variables and multiple testing. Conclusion: Research is needed to examine whether the inflow of overweight people in exercise groups increases when health beliefs are recognized, considered, and discussed both in interventions and in public health campaigns promoting physical exercise in sedentary, overweight people.

Different Mechanisms Underlie Post-menarchial Increase in Depression and Weight

BackgroundDepression and being overweight are correlated health problems in adulthood. Adolescence is a significant period for the onset and increase of depression and obesity, especially among girls. Pubertal development also occurs with concomitant increases in weight. Thus, it is not yet clear whether the association between depression and being overweight can be explained by pubertal development.PurposeWe examined the association between depressive mood, body weight, and pubertal status in adolescent girls. MethodThe design was cross-sectional. In 962 young adolescent Dutch girls (age range, 11.9–15.9) weight and height measurements were used to calculate height, age, and gender-standardized body weight (zBMI). Questionnaires assessed depressive mood (the Center for Epidemiological Studies-Depression, CES-D, inventory) and menarcheal status (pre or post).ResultsThe correlation between menarcheal status and body weight (ru2009=u20090.34, pu2009<u20090.001) was not affected by depressive mood, and the correlation between menarcheal status and depressive mood (ru2009=u20090.20, pu2009<u20090.001) was not affected by body weight. A small correlation between depressive mood and body weight (ru2009=u20090.12, pu2009<u20090.01) largely disappeared after controlling for menarche.ConclusionMenarcheal status largely explains the association between weight and depression. It is independently associated with both BMI and depression, suggesting that different mechanisms underlie the post-menarcheal increased prevalence of depression and overweight.

Lijdensdruk en kwaliteit van leven voorspellen uitval bij fysieke trainingsprogramma’s voor volwassenen met obesitas

SummarySuffering and quality of life predict dropout from physical exercise programs in obese adultsObesity and lack of physical activity are risk factors for health problems. Dropout from physical activity interventions in overweight adults is considerable. Suffering and a poor quality of life have been demonstrated to be a cue to initiate exercise interventions. Our aim was to evaluate these variables as predictors of exercise compliance. Of 44 obese adults who participated in two physical exercise programmes, 21 (47%) completed the programme. Suffering was assessed with the Pictorial Representation of Illness and Self Measure, second revised version (PRISM-R2) and quality of life with the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire. As compared to non-completers, completers were older and reported less suffering and a higher quality of life. Our study suggests that intake assessments of suffering and quality of life can be helpful to identify participants who need extra counselling.