Jennifer A. O'Dea

Why do kids eat healthful food? Perceived benefits of and barriers to healthful eating and physical activity among children and adolescents

The goal was to have children and adolescents identify and rank the major perceived benefits of and barriers to healthful eating and physical activity and to suggest strategies for overcoming barriers. Semistructured, in-depth focus groups were undertaken using standardized questions and prompts. Students in grades 2 through 11(ages 7 through 17; N=213) from 34 randomly selected schools participated in 38 focus groups. Major benefits of healthful eating included improvements to cognitive and physical performance, fitness, endurance, psychological benefits, physical sensation (feeling good physically), and production of energy. Barriers included convenience, taste, and social factors. Benefits of physical activity included social benefits, enhancement of psychological status, physical sensation, and sports performance. Barriers included a preference for indoor activities, lack of energy and motivation, time constraints, and social factors. Suggested strategies for overcoming barriers included support from parents and school staff, better planning, time management, self-motivation, education, restructuring the physical environment, and greater variety of physical activities.

Eating and Exercise Disorders in Young College Men

Abstract The authors used the computerized Eating and Exercise Examination to investigate eating, weight, shape and exercise behaviors in a convenience sample of 93 male college students. One fifth of the men worried about their weight and shape, followed rules about eating, and limited their food intake. Between 9% and 12% were unhappy with their body shape, felt fat, and seriously wanted to lose weight. Exercise was important for the self-esteem of 48% of the students. Thirty-four percent were distressed when they could not exercise as much as they wanted, 27% followed rules about exercising, and 14% worried about the amount of exercise they were doing. The respondents met clinical diagnoses for objective binge eating (3%), self-induced vomiting (3%), bulimia nervosa (2%), and exercise disorders (8%). Although 9% reported disordered eating, none had sought treatment. Health professionals should be aware that eating and exercise disorders may be present in college men and that screening may help in the early identification of these problems.

Prevention programs for body image and eating disorders on University campuses: a review of large, controlled interventions

Body dissatisfaction, dieting, eating disorders and exercise disorders are prevalent among male and female university students worldwide. Male students are also increasingly adopting health-damaging, body-image-related behaviors such as excessive weight lifting, body building and steroid abuse. Given the severity and difficulty of treating eating disorders, prevention of these problems is a recognized public health goal. Health promotion and health education programs have been conducted in the university setting since the mid 1980s, but few have achieved significant improvements in target health attitudes and behaviors. In this paper, 27 large, randomized and controlled health promotion and health education programs to improve body dissatisfaction, dieting and disordered eating and exercise behaviors of male and female college students are reviewed. In general, health education programs to improve body image and prevent eating disorders in the university setting have been limited by small sample sizes and the exclusion of male students. The majority of studies were conducted among either female undergraduate psychology students or women that were recruited using on-campus advertising. The latter reduces the ability to generalize results to the whole university population, or the general community. In addition, there has been a paucity of longitudinal studies that are methodologically sound, as only 82% (22/27) of interventions included in the review used random assignment of groups, and only 52% (n = 14) included follow-up testing. Information-based, cognitive behavioral and psycho-educational approaches have been the least effective at improving body image and eating problems among university students. Successful elements for future initiatives are identified as taking a media literacy- and dissonance-based educational approach, incorporating health education activities that build self-esteem, and using computers and the internet as a delivery medium. A newly designed program for Australian university students is described.

Body image and eating disorders amongst Japanese adolescents. A review of the literature

This review describes the prevalence of eating disorders and disordered eating behaviors as well as factors influencing body image disturbance amongst Japanese adolescents and compares the prevalence and trends with those of Westernized countries. Although eating disorders have been previously regarded as peculiar to Western society, they are now a more global issue with reports of non-Western countries including Japan having increasing rates of eating disorders. As the aetiology of eating disorders is related to societal norms, culture and ethnicity, their study requires an understanding of body image disturbance within different cultural contexts. Although considered less prevalent than in the West, Japan has an early history of eating disorder research and trends outlined in this review suggest that, as in Western countries the interest in, and study of eating disorders in Japan has increased during the 1980s. The prevalence of eating disorders in Japan based on available reviews, epidemiological studies and clinical reports ranges from 0.025% to 0.2% for AN and from 1.9% to 2.9% for BN. Studies suggest that the prevalence of eating disorders has increased significantly during the past two decades but the prevalence is still quite low compared to those in Western countries. Strategies for culturally appropriate prevention are discussed.

Knowledge, beliefs, attitudes, and behaviors related to weight control, eating disorders, and body image in Australian trainee home economics and physical education teachers.

OBJECTIVE To examine the knowledge, beliefs, and attitudes about weight control and eating disorders among trainee home economics and physical education teachers and to assess their body image and weight control practices. The association between actual body weight and body image was also examined. DESIGN Survey research was undertaken using a self-report questionnaire. Height and weight were measured. SUBJECTS/SETTINGS Trainee home economics and physical education teachers (N = 216, 96% participation rate) in their last month of training at three major state teacher training universities completed a questionnaire during their regular class times. MAIN OUTCOME MEASURES Advice teachers give to overweight adolescents knowledge and beliefs about eating disorders, body image, desired weight, food habits, dieting, body appearance ratings, weight control practices, and diagnosed and self-reported eating disorders. STATISTICAL ANALYSIS PERFORMED Descriptive statistics, chi square, and analyses of variance compare gender and Body Mass Index differences. RESULTS Males (85%) and females (87%) advised young overweight adolescents to diet to lose weight. Twenty percent of females and 13% of males regularly skipped breakfast. The advise given showed a lack of specific nutrition education about weight control, adolescent nutritional needs, and fad diets. Participants held misconceptions about eating disorders, and a range of 14% to 72% answered these questions incorrectly. Fourteen percent of females self-reported that they currently had an eating disorder, but only 6% had received treatment. Some females used potentially dangerous methods of weight loss, including 19% who abused laxatives and 10% who induced vomiting. IMPLICATIONS Trainee home economics and physical education teachers need specific nutrition information and training about eating disorders, weight control, and suitable advice for overweight students. The female trainee teachers in our study had a poor body image and disordered eating similar to other young women in Western countries, and this should be taken into account by teacher training institutions.

The Role of Teachers and Other Educators in the Prevention of Eating Disorders and Child Obesity: What Are the Issues?

This paper examines the important contribution that teachers and other educators (including health educators, school nurses, school counselors, school psychologists, and sports coaches) have to offer in the prevention of eating disorders and child obesity. Our paper notes the important contribution of school educators whilst warning of the current need to specifically examine how teachers and school personnel may be best trained and prepared for such a preventive role, whether they currently feel willing and able to undertake such a role, and whether some groups of teachers may be personally susceptible to body image and eating problems. It is vital to understand the knowledge, behaviors, attitudes, and expectations of educators implementing prevention programs in order to ensure that they are personally and professionally capable of carrying out prevention initiatives in schools. Individuals involved in food and exercise-related careers have been identified as being at environmental and situational risk for body image and eating problems, and it may be possible that they chose their career path due to their own personal experience with eating disorders or weight issues. In such cases, specific training or assistance may be required in order to enable the educators to conduct effective preventive activities. Discussion focuses on what needs to be done in order to enable teachers and other school-based educators to perform most effectively in the implementation of school based eating disorder and child obesity prevention programs.

Childhood Obesity Prevention

Physical Activity and Nutrition Programs Improve Health Walk Across Texas encourages teams to walk 832 miles in an 8-week period, with an estimated impact of

School‐based health education strategies for the improvement of body image and prevention of eating problems

186 million from savings in cost of lost wages. The program reached 47,751 and showed an average increase of 3.96 miles per week. Michigan’s Fuel Up to Play 60 was taught 36 times to 10,800 youth with 36 partners. After the intervention, 25% of schools promoted the benefits of consuming low-fat/fat-free dairy, fruits, vegetables, and whole grains to students, and 27% of school districts have a policy on time requirements for students to participate in physical activity. West Virginia’s Healthy Children Project was offered 53 times to 1,178 children through 79 childcare providers. North Carolina’s Steps to Health School-Based Nutrition was offered 243 times to 19,910 limited resource audiences to promote positive behavior/environmental changes concerning nutrition/physical activity. At least 1 Policy, Systems and Environmental change was implemented at 156 sites. Improving Fruit and Vegetable Intake With 74 partners, Oklahoma’s CNEP Food and Fun for Everyone reached 9,646 youth participants, who improved their abilities to choose healthy foods by 73%. CNEP OrganWise Guys was offered 17 times to 4,148 Oklahoma participants with 75% of youth improving their abilities to choose healthy foods. In 2018, an interactive travelling exhibit taught 13,129 students in grades K to 5 about the importance of a healthy lifestyle. Illinois offered OrganWise Guys programs at 361 sites for 62,328 participants. Surveys (1,501) showed students were able to identify 4 out of 5 MyPlate food groups. The Color Me Healthy class series was offered 248 times to 17,696, improving fruit and vegetable intake and increasing physical activity among 4and 5-year-olds. Surveys showed that 91% were willing to taste fruits and 85% were willing to taste vegetables. Nine lessons in Nevada’s Pick a Better Snack were offered to 4,642 youth, which helped 22 elementary schools meet wellness goals. Students increased intake of fruits and vegetables, and 12 schools showed an average 7-point improvement in Smarter Lunchroom Assessments. IMPACT 2019

Body mass index, menarche, and perception of dieting among peripubertal adolescent females

Purpose – The purpose of this paper is to review current programmes and major issues surrounding preventive interventions for body image and obesity in schools.Design/methodology/approach – A literature review was carried out by analysing papers cited in major literature databases from the last 50 years. This review describes and summarises activities from body image programmes and eating disorder prevention programmes in schools and outlines self esteem and media literacy approaches that have produced positive results in some large, randomised and controlled interventions.Findings – A total of 21 programmes met the inclusion criteria. Of these, four included males and 17 reported at least one improvement in knowledge, beliefs, attitudes or behaviours. The most effective programmes were interactive, involved parents, built self esteem and provided media literacy.Practical implications – Body image concerns, eating problems and obesity among children and adolescents are becoming increasingly targeted for p...

Can Body Image Education Programs Be Harmful to Adolescent Females

OBJECTIVE To examine perceptions of dieting among pre and postmenarchial female school students. METHOD All 51 female students of mean (SD) age 12.6 (0.6) years from a state school volunteered to complete a questionnaire about general health, eating and weight control behaviors, and menstrual status. Height and weight were measured. Focus groups using structured questions and discussion were used to elicit responses about the meaning of dieting and its association with menarche. RESULTS Postmenarchial females were significantly more likely than the same age premenarchial students to have increased their body mass index (BMI), to clearly articulate the meaning of dieting, to report trying to lose weight, and to use diet and exercise to lose weight. Premenarchial females did not have a clear perception of dieting. Premenarchial females who reported trying to lose weight equated dieting with healthy eating and did not include losing weight or the behaviors and feeling associated with the concept of dieting unless their BMI had increased and menarche was imminent. DISCUSSION The concept of dieting that may result in weight loss and the behaviors and feelings associated with dieting did not develop until menarche and is likely to be associated with the rapid increase in height, weight, and body fat that precedes menarche. Educational interventions aimed at preventing eating disorders among premenarchial adolescents may therefore be inappropriate, ineffective, and potentially dangerous.