Sydney Bryn Austin

Snack food intake does not predict weight change among children and adolescents

OBJECTIVE: To assess whether intake of snack foods was associated with weight change among children and adolescents.METHODS: Prospective study of 8203 girls and 6774 boys, 9–14 y of age in 1996, in an ongoing cohort study who completed at least two questionnaires between 1996 and 1999. Intake of snack foods was assessed in 1996–1998 with a validated food frequency questionnaire designed specifically for children and adolescents. The outcome measure was change in age- and gender-specific z-score of body mass index (BMI).RESULTS: Boys consumed more snack foods than girls during the entire study period. After controlling for Tanner stage of development, age, height change, activity, and inactivity, there was no relation between intake of snack foods and subsequent changes in BMI z-score among the boys (β=−0.004), but snack foods had a weak inverse association (β=−0.007, P<0.05) with weight change among the girls. However, the results were confounded by dieting status, which had a significant positive independent association with BMI change. After controlling for dieting status and whether the mother was overweight, the association between servings per day of snack foods and subsequent changes in BMI z-score were not significant in either gender.DISCUSSION: Our results suggest that although snack foods may have low nutritional value, they were not an important independent determinant of weight gain among children and adolescents.

Exposure to the Mass Media, Body Shape Concerns, and Use of Supplements to Improve Weight and Shape Among Male and Female Adolescents

Objective. To assess the prevalence and correlates of products used to improve weight and shape among male and female adolescents. Methods. A cross-sectional study was conducted of 6212 girls and 4237 boys who were 12 to 18 years of age and enrolled in the ongoing Growing Up Today Study. The outcome measure was at least weekly use of any of the following products to improve appearance, muscle mass, or strength: protein powder or shakes, creatine, amino acids/hydroxy methylbutyrate (HMB), dehydroepiandrosterone, growth hormone, or anabolic/injectable steroids. Results. Approximately 4.7% of the boys and 1.6% of the girls used protein powder or shakes, creatine, amino acids/HMB, dehydroepiandrosterone, growth hormone, or anabolic/injectable steroids at least weekly to improve appearance or strength. In multivariate models, boys and girls who thought a lot about wanting more defined muscles (boys: odds ratio [OR]: 1.6; 95% confidence interval [CI]: 1.1–2.2; girls: OR: 2.3; 95% CI: 1.2–3.2) or were trying to gain weight (boys: OR: 3.0; 95% CI: 2.0–4.6; girls: OR: 4.3; 95% CI: 1.6–11.4) were more likely than their peers to use these products. In addition, boys who read men’s, fashion, or health/fitness magazines (OR: 2.3; 95% CI: 1.1–4.9) and girls who were trying to look like women in the media (OR: 2.9; 95% CI: 1.4–4.0) were significantly more likely than their peers to use products to improve appearance or strength, but hours per week watching television, watching sports on television, and participation in team sports were not independently associated with using products to improve appearance or muscle mass. Conclusions. Girls and boys who frequently thought about wanting toned or well-defined muscles were at increased risk for using potentially unhealthful products to enhance their physique. These results suggest that just as girls may resort to unhealthful means to achieve a low body weight, girls and boys may also resort to unhealthful means to achieve other desired physiques.

Childhood Gender Nonconformity: A Risk Indicator for Childhood Abuse and Posttraumatic Stress in Youth

OBJECTIVES: Childhood gender nonconformity has been associated with poorer relationships with parents, but it is unknown if childhood gender nonconformity is associated with childhood abuse or risk of posttraumatic stress disorder (PTSD) in youth. METHODS: We examined whether gender nonconformity before age 11 years was associated with childhood sexual, physical, and psychological abuse and lifetime risk of probable PTSD by using self-report questionnaire data from the 2007 wave of the Growing Up Today Study (n = 9864, mean age = 22.7 years), a longitudinal cohort of US youth. We further examined whether higher exposure to childhood abuse mediated possible elevated prevalence of PTSD in nonconforming children. Finally, we examined whether association of childhood gender nonconformity with PTSD was independent of sexual orientation. RESULTS: Exposure to childhood physical, psychological, and sexual abuse, and probable PTSD were elevated in youth in the top decile of childhood gender nonconformity compared with youth below median nonconformity. Abuse victimization disparities partly mediated PTSD disparities by gender nonconformity. Gender nonconformity predicted increased risk of lifetime probable PTSD in youth after adjustment for sexual orientation. CONCLUSIONS: We identify gender nonconformity as an indicator of children at increased risk of abuse and probable PTSD. Pediatricians and school health providers should consider abuse screening for this vulnerable population. Further research to understand how gender nonconformity might increase risk of abuse and to develop family interventions to reduce abuse risk is needed.

Body Satisfaction, Weight Gain, and Binge Eating Among Overweight Adolescent Girls

Objective:To examine if body satisfaction is associated with body mass index (BMI) change and whether it protects against the development of frequent binge eating among overweight and obese adolescent girls.Methods:We used prospective data from nine waves of an ongoing cohort study of adolescents, the Growing Up Today Study. At enrollment in 1996, participants were 9–14 years old. Questionnaires were mailed to participants annually until 2001, then biennially through 2007. Girls who were overweight or obese in 1996 were included in the analysis (n=1559). Our outcomes were annual change in BMI and incident frequent binge eating, defined as binge eating at least weekly and no use of compensatory behaviors.Results:At baseline, 57.2% of the overweight and obese girls were at least somewhat satisfied with their bodies. During 11 years of follow-up, 9.5% (95% confidence interval (CI) (7.8, 10.8)) of the girls started to binge eat frequently. Controlling for BMI and other confounders, overweight and obese girls who reported being at least somewhat satisfied with their bodies made smaller BMI gains (β=−0.10 kg m−2, 95% CI (−0.19, −0.02)) and had 61% lower odds of starting to binge eat frequently (odds ratio (OR)=0.39, 95% CI (0.24, 0.64)) than their less satisfied peers. Compared with girls who were the least satisfied with their bodies, girls who were the most satisfied had 85% lower odds of starting to binge eat frequently (OR=0.15, 95% CI (0.06, 0.37)). The association between body satisfaction and starting to binge eat frequently was stronger for younger adolescents than older adolescents.Conclusions:Whereas body dissatisfaction is common among overweight and obese girls, body satisfaction may protect against excessive weight gain and binge eating. Prevention of body dissatisfaction must begin early and should be considered as a component of both obesity and eating disorder prevention programs.

Development of Muscularity and Weight Concerns in Heterosexual and Sexual Minority Males

OBJECTIVE To examine the development of muscularity and weight concerns among heterosexual and sexual minority males in adolescence. METHOD Participants were 5,868 males from the Growing Up Today Study, a U.S. prospective cohort spanning ages 9-25 years. Generalized estimating equations were used to test sexual orientation differences in the development of muscularity concerns, weight gain attempts, and weight and shape concern. RESULTS Desire for bigger muscles increased slightly each year across adolescence (β = .10, 95% C.I. = .09, .11) regardless of sexual orientation, but gay and bisexual participants reported greater desire for toned muscles than completely and mostly heterosexual males (β = .39, 95% C.I. = .21, .57). Desire for toned muscles did not change with age. Attempts to gain weight increased threefold across adolescence, with up to 30% reporting weight gain attempts by age 16. Although underweight males (the smallest weight status class) were most likely to attempt to gain weight, most of the observed weight gain attempts were by healthy (69%) and overweight/obese (27%) males, suggesting that most attempts were medically unnecessary and could lead to overweight. Sexual minority participants were 20% less likely to report weight gain attempts than completely heterosexual participants. Weight and shape concern increased with age, with gay and bisexual participants experiencing a significantly greater increase than heterosexual males. CONCLUSIONS Sexual orientation modifies the development and expression of male weight and muscularity concerns. The findings have implications for early interventions for the prevention of obesity and eating disorder risk in heterosexual and sexual minority males.

Family dinner and disordered eating behaviors in a large cohort of adolescents.

We aimed to examine longitudinal associations between family dinner and disordered eating behaviors among adolescents. We studied 7535 females and 5913 males, 9 to 14 years of age in 1996. We performed multivariable logistic regression to assess the associations of previous year family dinner with 1-year incidence of each of 3 outcomes: purging, binge eating, and frequent dieting. Compared to those who ate family dinner “never or some days,” female adolescents who ate family dinner at least most days were less likely to initiate purging, binge eating, and frequent dieting. Estimates of association among males were similar in direction and magnitude, although lower frequency of the outcomes resulted in less precise estimates and fewer statistically significant results.

Racial/ethnic differences in accuracy of body mass index reporting in a diverse cohort of young adults

Surveillance data describing the weight status of the US population often rely on self-reported height and weight, despite likely differences in reporting accuracy by demographics. Our objective was to determine if there were racial/ethnic differences in accuracy of self-reported body mass index (BMI) in a diverse nationally representative sample of young people. Using data from Wave III (data collected in 2001–2002) of the National Longitudinal Study of Adolescent Health when respondents were aged 18–26, we used gender-stratified multivariable linear regression models to examine the association of race/ethnicity and self-reported BMI controlling for measured BMI while also adjusting for factors known to be associated with weight self-perception. Black males and females (bFemale=0.45, confidence interval (CI): 0.19, 0.71; bMale=0.34, CI: 0.17, 0.51) and Hispanic females (bFemale=0.30, CI: 0.08, 0.52) and Native American males (bNative American=0.87, CI: 0.15, 1.58) reported higher BMIs than their similarly weighted White peers, leading to more accurate BMI reporting in these groups at higher BMIs. Caution should be taken in interpreting results from studies relying on self-reported BMI, as they may exaggerate racial/ethnic differences in weight status.

Maternal experience of abuse in childhood and depressive symptoms in adolescent and adult offspring: a 21-year longitudinal study

Intergenerational effects of child abuse have been documented, but it is unknown whether maternal childhood abuse influences offspring mental health in adolescence or adulthood.

Family ties: maternal-offspring attachment and young adult nonmedical prescription opioid use.

BACKGROUND Nonmedical prescription drug use is prevalent among young adults, yet little is known about modifiable determinants of use. We examined whether maternal-offspring attachment reported at mean age 21 was associated with nonmedical prescription opioid use at mean age 26, and investigated whether a history of depressive symptoms and substance use played a role in associations between maternal-offspring attachment and nonmedical prescription opioid use. METHODS We used data from the Growing Up Today Study, a longitudinal cohort of United States adolescents followed into young adulthood. Maternal-offspring attachment was reported by young adults and their mothers, and defined as mutual low, mutual medium or high, and dissonant. Analyses were carried out in the full sample using generalized estimating equation models, and in a sibling subsample, using conditional fixed effects models to control for stable aspects of the family environment. RESULTS Analyses with the full sample and the sibling subsample both showed that mutual medium/high maternal-offspring attachment at age 21 was associated with lower odds of nonmedical prescription opioid use at age 26 (RR=0.74; 95% CI=0.57-0.97 in full sample). The association was partly mediated by mean age 23 offspring smoking, heavy episodic drinking, and illicit drug use. CONCLUSIONS Promoting reciprocal attachment in the maternal-offspring dyad should be investigated as a strategy to prevent nonmedical prescription opioid use by young adulthood. Even in young adulthood, programs that target both parents and offspring may have greater impact on offspring substance use than programs that target offspring alone.

MATERNAL EXPERIENCE of ABUSE in CHILDHOOD and DEPRESSIVE SYMPTOMS in ADOLESCENT and ADULT OFFSPRING

Intergenerational effects of child abuse have been documented, but it is unknown whether maternal childhood abuse influences offspring mental health in adolescence or adulthood.