KNUTSEN IR, TERRAGNI L and FOSS C. Nursing Inquiry 2011; 18: 348–358 Morbidly obese patients and lifestyle change: constructing ethical selvesIn contemporary societies, bodily size is an important part of individuals’ self‐representation. As the number of persons clinically diagnosed as morbidly obese increases, programmes are developed to make people reduce weight by changing their lifestyle, and for some, by bariatric surgery. This article presents findings from interviews with 12 participants undergoing a prerequisite course prior to bariatric surgery that (...) is intended both as a preparation for further (surgical) treatment and as a tool to empower individuals regarding lifestyle changes. In this study, we investigate how power operates by looking at how the participants position themselves throughout the course. Findings reveal how participants construct their ability to act in line with norms of lifestyle change. They do this by positioning themselves as both included group members and as ‘morally’ acceptable individuals. Despite some resistance, the participants tend to glide into the role of ‘good patients’ acting in compliance with the aims of the course in their hope and striving for new positions as ‘normal‐sized’. The intention in the course is to empower individuals towards lifestyle changes. The findings provide a basis to question whether these kinds of courses create new forms of compliance and dependency. (shrink)

Portion sizes of meals have been becoming progressively larger which contributes to the onset of obesity. So far, little research has been done on the influence of body weight on portion size preferences. Therefore, we assessed whether Body Mass Index, as well as other selected factors, contribute to the estimation of food portions weight and the subjective perception of portion sizes. Through online questionnaires, the participants were asked to estimate the weight of pictured foods in the first study. In (...) the second study, the participants indicated how the depicted varying portion sizes of different meals relate to their actual consumed real-life portion sizes. A total of 725 and 436 individuals were included in the statistical analysis in the first and second study, respectively. BMI and gender had a small effect on the capacity to estimate the weight of foods. The main predictor for portion size choices was the factor gender with men estimating ideal portion sizes as larger than women. Further, age and hunger together with external and restrictive eating behaviors were among the deciding factors for portion size choices. As expected, externally motivated eaters chose bigger portions while restrictive individual smaller ones. Gender- and age-related differences in portion size preferences likely reflect distinct energy requirements. The individuals with a higher BMI do not differ strongly from other BMI groups in their portion-related preferences. Therefore, other factors such as meal frequency, snacking, or a lifestyle, may contribute more to the onset, development, and maintenance of overweight. (shrink)

ObjectiveTo examine body image perception and the associations of body dissatisfaction with socio-demographic and lifestyle factors among Saudi women attending fitness centers in Riyadh.MethodsSaudi females aged 16 years and older were recruited from 12 randomly selected fitness centers in Riyadh, using stratified clustered sampling technique. Height and weight were measured to calculate actual body mass index. A previously validated instrument was used to collect socio-demographic and lifestyle variables including physical activity, sedentary behaviors, sleep and dietary habits. Stunkard Figure (...) Rating Scale silhouettes were used to assess perceived and desired body shape.ResultsThe participants had a mean age of 29.2. The majority were not married, with no children and had college degrees. While 63% were overweight or obese, nearly 40% of women underestimated their perceived body shape. The majority of respondents were dissatisfied with their body shape including 68% of normal weight women. Females who had BD were significantly older, had higher BMI, reported more weight loss attempt and had expended less time in vigorous and total PA than those who were satisfied with their body shape. However, when adjusting for socio-demographic variables, logistic regression analysis revealed significant associations of BD with higher BMI, shorter membership duration of fitness club, and reduced dairy products and energy drinks consumption.ConclusionExcept for BMI and decreased dairy products and energy drinks consumption, many lifestyle behaviors did not associate with BD among Saudi females attending fitness centers. The findings can inform healthcare providers when intervention strategy is implicated for females with BD. Future studies should compare the associations of BD with lifestyle behaviors between males and females attending fitness centers and seeking weight loss. (shrink)

As the world’s most populous country, China is experiencing unprecedented magnitude and speed of population ageing since it entered the ageing society two decades ago. The rapid population ageing- driven by decreasing fertility rate and prolonged life expectancy- has profound impacts on economic development and poses significant challenges for formal and informal care provision. Although the Chinese government has implemented a series of progressive policy reforms on pension, healthcare, and long-term care systems, the capacity gaps regarding the coverage, adequacy, affordability, (...) and sustainability remain large. At the same time, social and economic changes have eroded the supportive role of family, especially for rural-dwelling, childless, and empty-nest older adults. This chapter documents the statistical and social reality of ageing in China, introduces a series of policy reforms implemented by the Chinese government in response to population ageing, and describes the family dynamics and intergenerational support patterns under the changing socioeconomic background. Besides pressing challenges of ageing for family and society, this chapter also looks at the emerging lifestyle and proactivity for active ageing in China. (shrink)

Introduction. Healthcare workers (HCWs) should theoretically have the necessary education and environment to adopt a healthy lifestyle, and they supposedly also should have a higher participation rate in WHP programmes. HCWs are, for several reasons, considered to be a key group in health promotion, especially due to the fact that the healthcare system reaches a substantial number of people in need of lifestyle changes such as increased physical activity (PA) [5]. Furthermore, healthcare professionals are considered to be the (...) most credible source of health information [6]. HCWs' lifestyles can play an important role in increasing awareness among patients regarding lifestyle changes, because HCWs' own lifestyle habits and interests in lifestyle behaviour have been shown to positively influence their counselling practices and attitudes [6–7]. The international movement 'Health Promoting Hospitals and Health Services', which was initiated by the World Health Organization (WHO), highlights the importance of also focusing on the health and lifestyle of the employees. Methods. We conducted survey based on a standardized and adapted questionnaire that included socio-demographic data and points related to healthy lifestyle. We adhered to the latest recommendations on designing and reporting survey studies. Before conducting the study, the questionnaire was pretested among 5 experts and revised twice. The survey was conducted in Kazakh / Russian for respondents who speak two languages fluently at the choice of participants. The filling of the questionnaire took on average 45 minutes. We reported absolute numbers and percentages. Chi-square tests were used to compare responses between groups. Results were considered significant at a P value of < 0.05. Statistical analyses were performed using the application SAS OnDemand for academia (version 3.81, Carry, North Carolina, USA). Results. Our data revealed that nurses were more likely to adhere to healthy eating principles and to have a regular diet at home. GPs were more likely to consume fast food and add salt when food is not salted enough. Nurses were more likely to eat greens regularly. GPs had a stronger belief in the impact of diet on health. More nurses rated their diet as healthy. Media promotion significantly influenced GPs for changing diet towards healthier options. Eating patterns vary according to the risk of stress. Research shows that chronic stress influences the amount and types of consumed food, contributing to both overeating and malnutrition, and that stress hormones can lead to the development of obesity. GPs are more likely to have used tobacco products compared to nurses. GPs are more likely to smoke more than 10 cigarettes per day. GPs have a slightly higher belief in the necessity of a healthy lifestyle compared to nurses. GPs and nurses have different testing frequencies for Hepatitis B and C, with nurses testing more frequently. GPs are more likely to have sexual activity after drinking alcohol. Conclusion. It is known that a healthy lifestyle of doctors affects the attitude of patients and their motivation to change their lifestyle. Thus, the lifestyle patterns of health workers, as well as the understanding of the motivation of these patterns, are more likely to affect public health. (shrink)

Genetic and lifestyle factors contribute to cognitive ageing. However, the extent to which the public attribute changes in thinking skills to either genetic or lifestyle factors is largely unknown. This may be important if it impacts engagement in activities deemed beneficial to thinking skills. This study, therefore, explored people’s beliefs about determinants of cognitive ageing and whether those beliefs were associated with engagement in potentially beneficial behaviours. Data were collected through a United Kingdom-wide survey of people aged 40 (...) and over. Participants completed questions about their beliefs regarding cognitive ageing, and specifically the extent to which they believed lifestyle or genetic factors influence those changes, and their engagement in specific behaviours that may be cognitively beneficial. Responses from 3,130 individuals were analysed using chi-square tests of independence, principal component analysis and ANCOVAs to investigate whether their attribution of genetic or lifestyle determinants were associated with their beliefs about cognitive ageing and their participation in brain health-related behaviours. Most respondents believed genes and lifestyle contribute equally to age-related changes in cognitive skills. Respondents who believed genetic factors were more influential were less likely to expect cognitive skills might be improved or maintained with age, less sure what behaviours might be associated with brain health, and less likely to engage in behaviours comprising mental challenge/novelty supported as beneficial for brain health. From this United Kingdom-wide survey about beliefs regarding potential determinants of cognitive ageing, some of our respondents’ views were not aligned with the findings from ageing research. It is important for the public to know how to keep their brains healthy. Our results indicate a need for clearer messaging highlighting the role of lifestyle factors for brain health. (shrink)

The aim of this paper is to analyse the people behaviour in different age buildings and different buildings typology. In the city of Kruja (Albania) exists mostly three types of buildings: the historical ones (medieval), the socialist ones (which belongs to the former communist regime) and the modern buildings. Each of them has different social and physics characteristics, different energy exchange and different building materials. The influence of all these characteristics in the exchange of energy and how they reflect in (...) changing the lifestyle of Kruja’s people is going to be analysed. A questionnaire will be undertaken to understand the way of life of Kruja’s people and to draw conclusions. A comparative analysis between all these typology of buildings will be undertaken in order to understand better the behaviour of Kruja’s people lifestyle living in these buildings. Although the conditions are not good, people tend to get a high level of place attachment and loyalty to the building they are living. The biggest energy consumers are the historical buildings and socialist ones; although the bills of the electricity are smaller than the third category they consume alternative energies and have major problems with thermal bridges. The most unfriendly categories are the socialist buildings. They prefer not to socialize much in comparison with the other two categories. (shrink)

Obesity may be the most difficult and elusive public health problem this country has ever encountered. Unlike the classical infectious diseases and plagues that killed millions in the past, it is not caused by deadly viruses or bacteria of a kind amenable to vaccines for prevention, nor are there many promising medical treatments so far. While diabetes, heart disease, and kidney failure can be caused by obesity, it is easier to treat those conditions than one of their causes. (...) I call obesity elusive partly because of the disturbingly low success rate in treating it, but also because it requires changing the patterns, woven deeply into our social fabric, of food and beverage commerce, personal eating habits, and sedentary lifestyles. It also raises the most basic ethical and policy questions: how far can government and business go in trying to change behavior that harms health, what are the limits of market freedom for industry, and how do we look upon our bodies and judge those of others?. (shrink)

The use of contraceptives has become prevalent among females in Thailand in the past 20 years, and oral contraceptive use has been suggested to trigger changes in fat intake, energy expenditure, fat metabolism and blood pressure. Based on field investigations of 391 married women aged 20 years or over in Yasothon Province, North-east Thailand, this study aims to elucidate the effects of oral contraceptive use on body mass index (BMI: kg/m2 ) and blood pressure, taking into account reproductive histories and (...) socioeconomic conditions. The proportion of obese (BMI> 25) subjects was high in the age groups 3049 and 5049, 5069 age groups. Current contraceptive practices in the studied population included sterilization by operation, oral contraception and injection. These methods accounted for 43·0%, 12·8% and 8·2% of the population, respectively. Sociodemographic factors such as reproductive history, years of education and household income were not significantly related to BMI or to blood pressure (ANOVA with age adjustment). In contrast, oral contraceptive users had significantly higher BMIs and diastolic blood pressures (p<0·01, ANOVA with age adjustment). Multiple regression analysis also revealed that oral contraceptive use was a weak but significant contributing factor to both high BMI and blood pressure when sociodemographic factors were taken into account and controlled for statistically. It can thus be concluded that the use of contraceptive pills, which contain oestrogen and progestin and are provided free of charge to Thai women, tend to increase BMI and to elevate blood pressure. (shrink)

The understanding of food cue associated neural activations that predict future weight variability may guide the design of effective prevention programs and treatments for overeating and obesity. The current study investigated the association between brain response to different food odors with varied energy density and individual changes of body mass index (BMI) over two years. Twenty-five participants received high-fat (chocolate and peanut), low-fat (bread and peach) food odors and a nonfood odor (rose) while the brain activation was measured using (...) functional magnetic resonance imaging (fMRI). BMIs were calculated with participant’s self-reported body weight and height collected at the time of fMRI scan and again at two years later. Regression analyses revealed significant negative correlations between BMI increase over 2 years and brain activation of the bilateral precuneus and the right posterior cingulate cortex in response to high-fat versus low-fat food odors. In addition, brain activation of the right supplementary motor area in response to food vs non-food odor was negatively correlated to subsequent BMI increase over 2 years. Taken together, the current findings suggest that individual differences in neural responsivity to (high calorie) food odors in brain regions of the default mode and motor control network serve as a neural marker for future BMI change. (shrink)

Schools have been the main context for physical activity and sedentary behavior interventions among adolescents, but there is inconsistent evidence on whether they also improve dimensions of the health−related quality of life. The aim of this study was to evaluate the effects of a school-based active lifestyle intervention on dimensions of HRQoL. A secondary aim was to verify whether sex, age, and HRQoL at baseline were moderators of the intervention effect. A cluster-randomized controlled trial was conducted at three control (...) and three intervention schools in Florianopolis, Brazil. All students from 7th to 9th grade were invited to participate. A school year intervention, designed primarily to increase PA and reduce SB, included strategies focused on teacher training on PA, SB, and nutrition, and availability of teaching materials related to these contents; environmental improvements ; and education strategies, with the availability of folders and posters regarding PA, SB, and nutrition. Participants and the research staffs were not blinded to group assignment, but a standardized evaluation protocol was applied at baseline and after the intervention using the KIDSCREEN−27 to assess HRQoL across five dimensions. Mixed linear models were performed to evaluate the effect of the Movimente intervention on the five HRQoL dimensions. Of the 921 students who answered the questionnaire at baseline, 300 and 434 completed the study in control and intervention groups, respectively. The results revealed no significant effects of the intervention on any HRQoL dimensions. A reduction of the school environment dimension was observed in both the control and intervention groups. Sensitivity analyses showed that students in the highest baseline tertiles of HRQoL in any dimension had a reduction in their respective scores from pre- to post-intervention in both school groups. In conclusion, our results demonstrated no intervention effect on HRQoL dimensions and those students with the highest levels of HRQoL at baseline on all dimensions reduced from pre to post-intervention.Clinical Trial RegistrationThe trial is registered at the Clinical Trial Registry. (shrink)

Definition of the problem Obesity is a burgeoning challenge for healthcare systems worldwide. In times of demographic change, it also affects an increasing number of older persons, presenting substantial challenges to delivering health and nursing care in both acute and long-term care (LTC) settings. So far, a detailed analysis of the diverse group of 65+ in this field is missing, particularly in the area of LTC. The needs of neither care recipients, nor those of nurses and institutions are monitored, (...) analyzed, or systematically evaluated. Moreover, ethical implications of professional care for older persons with obesity have not yet been discussed in research and policy. Arguments We argue that a needs-based approach is appropriate to address these ethical complexities. We further argue that a comprehensive mapping of the ethical terrain is best from an interdisciplinary and mixed methods perspective. For this, we conduct a scoping review to synthesize the state-of-the-art in both the healthcare and LTC settings; and we focus on challenges reported in case studies from professional care settings in European and North American institutions. Conclusion Our findings point to a lack of research on ethical issues related to the LTC needs of older persons living with obesity and the challenges faced by their professional carers. From the limited number of (case) studies that can be found, however, a series of ethical concerns emerge that have direct import for access, utilization, and quality of care. Accordingly, a new research agenda is needed to inform an ethical approach for policy and practice. It must be rooted in a concern for both care recipients and caregivers in mixed methods studies. Future research should provide criteria for balancing needs, allocating resources and developing practical solutions for people who are confronted with multiple stigma. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Calling Obesity a Disease Is A Terrible DecisionMoose FinklesteinFactsThe medical world struggles to see the difference between health and body weight. It is still mostly combined with the strong belief that there is no way a fat person can be fit and healthy. Despite repeated studies and work to show differently, this prejudice remains. This has become part of what I call “Everyone Knows” pseudoscience, where data that (...) have no scientific basis become “fact” due to constant repetition.Obesity is already the cause of great stigma in our society. Fat people are considered “ugly,” fat jokes are acceptable in everyday life, and being called ‘fat’ is, to many, as big an insult as a racial slur. Fat prejudice can approach the levels of racial prejudice (Puhl, Andreyevea & Brownell, 2008). Fat children are bullied, sometimes to the point of suicide. Some studies have found children as young as five trying to diet for being fat, no matter their actual weight. Fat people are more likely to be unemployed or underemployed, and there are prejudicial beliefs that fat workers are more problematic, despite research saying otherwise (Roehling, Roehling, & Odland, 2008).Obesity is seen by the masses as something people choose. However, science disagrees. There has long been a link between depression and obesity. Mental health is tightly tied to obesity, where those who experience weight discrimination are more likely to gain weight, although unhealthy behaviours such as binge eating and exercise avoidance are sometimes seen as a coping mechanism (Sutin & Teracciano, 2013).It has been reported in a number of journals that 90–95% of the people who lose weight regain the weight within 10 years (Mann et al., 2007; Miller, 1999). “Everyone Knows” claims that this is because people go back to bad habits. Science, however, says that there are complex ways the body wants to regain the weight (Sumithran & Proietto, 2013; Sumithran et al., 2011). Worse, dieting may contribute to obesity. Adolescent girls who diet are at 324% greater risk for obesity than those who do not diet (Stice, Cameron, R. P., Killen, J. D., Hayward, C. & Taylor, C. B. 1999). Weight loss dieting may cause other health problems as well, such as immune system problems (Shade ED, et al. 2004).In the medical world, doctors are encouraged to talk to patients about their weight. Every fat person has heard, “What are we going to do about your weight?” The “we” is supposed encourage the patient to feel that the doctor is on the patient’s side in their battle. Yet what many patients hear is, “I don’t see you as a patient, I see you as fat.” Science says that the higher a patient’s BMI the less respect a doctor has for the patient (Huzinga, Cooper, Bleich, Clark, & Beach, 2009).Horror stories about fat people trying to get decent health care are everywhere. For a good example, see Bruce Taylor Seeman’s piece, “The Perils of Obesity May Include the Doctor” (2006). [End Page E1] There are many blogs and stories on the internet about the way patients are not just shamed for their weight, but actively bullied by medical professionals. One blog, The Well Rounded Mama (wellroundedmama.blogspot.com), discusses the bias of doctors against pregnant fat women, who are told things like, “You cannot have a healthy baby when you are this fat” and encouraged to abort. Tales from people told that their weight is the cause for everything and anything can be found on sites like First Do No Harm (fathealth.wordpress.com). Reading blogs by medical professionals can show the disdain they have for fat people. In one, an emergency room nurse declared that all fat diabetics have poor control, based solely on perceptions from her job. Comments were mostly other nurses agreeing with how “disgusting” fat people are to have to deal with. However, Yale University’s Rudd Center for Food Policy & Obesity not only recognizes the problem but aims to help medical professionals eliminate the bias.If obesity becomes a disease, weight loss surgery (WLS) becomes a bigger gold mine. Medical insurance will be more likely to cover weight loss surgery. WLS is an ever-changing target: there... (shrink)

According to Ibn Khaldūn, man is a social entity deeply influenced by the geo-economics-politics of the environment in which he lives. The effect is seen as so strong that nearly all of these structures in their relationship to human beings are dominated by it. In this system, we see human beings as a creature who is both able to adapt himself to the environment and able to evolve in this harmony. From the perspective of Ibn Khaldūn, man cannot be evaluated (...) or defined separately from the environmental conditions, the technique and architecture he has developed. Ibn Khaldūn sees the primary source of this change to be the desire to make life both more prosperous and bearable. Therefore, the most natural motivations that affect man’s desire to alter the natural world are the environmental challenges that he encounters. The challenges that are imposed upon man in the natural world are those that have led to human progress. From badāwa (nomadic society) to ḥaḍāra (sedentary society) and so to the ceaseless drive of human progress that has served to make life more endurable, every effort in this sense leads to a physical and moral loosening as the incessant struggle to survive that defines human existence is made more bearable. Physical slack by breaking the resistance of man to resist the environmental conditions; and moral looseness by making man more vulnerable to the temptation of desires, pleasures and welfare that are the cause of moral dilemmas. Ibn Khaldūn’s moral thought with its social, political, and other fields of application are all contexts that enable an understanding of the devaluation of money-hedonist morality in all ways. This article aims to analyze the social, political and economic dilemmas and challenges that the capitalist, consumption-based money-hedonist morality (obesity, social media addiction, consumption, and moral devaluation in the face of financial, virtual and imagined valuations, etc.) from the perspective of Ibn Khaldūn. Summary: Man is endowed with both good and evil. Ibn Khaldūn notes that man tends to misuse these two orientations with a higher inclination towards evil, and that social conditions have an effect on this. He sees another characteristic of man, that they develop habits; accordingly, man is the child of his habits. Habits are second nature to man and affects all of his perceptions, particularly notions concerning truth. At the same time, human beings are under the constant influence of both habits, culture, and climate and geography; and all of these together affect our ethics, psychology and characteristics. Thus, man is a historical, social being that is changed, transformed and determined by adapting to these cultural, social, political and ecological conditions. The concept of Money-Hedonism is one that we have created by combining the terms monetarism, an economic concept, and hedonism, a concept in moral philosophy; the resulting term we seek to produce essentially translates as the adoration of Money. As is well known, hedonism refers to a philosophy of life that has its origins in the ancient Greek world which sees the purpose of life as one in which the pursuit of pleasure is the highest good. Whereas, Monetarism is an American-based economic view developed by Milton Friedman in 1970, linking all the balance in the economy to the supply and demand of money. According to this, the demand for money is operation, precaution and motives of speculation of individuals the amount of money they want to keep in cash on them. The power of an exchange tool increases with the amount and quality of what it is achievable in its utilization. In this respect, money has been an unprecedented source of power in modern society as a means by which change can be achieved. The increase in the power of money as an effective means as manifesting power has led to a socio-cultural and socio-economic superstructure around this power. In the life of an individual that is part of such a culture and is unable to isolate himself from the economy in which he lives, the values that can be expressed with money are consequently formed. In this structure, since the measure of life is money, money determines the quality of human life and human pleasure to a far greater degree than at any time in history. Thus, those living in this age have developed a new moral philosophy of value formed by the combination of these two concepts (monetarism and hedonism), which we have defined as Money-Hedonism. The money-hedonist individual is one that is in love with money, the joy of having it, the pleasure of using it, who desires it with immeasurable passion and ambition and is willing to use all legitimate and illegitimate methods of obtaining it. The most prominent characteristics of this type of individual is egoism, a desire to possess, hatred and mistrust. Ibn Khaldūn argues that the inhabitants of a city that live a settled life and who are living in the city have become economically prosperous and absorbed by consumption and pleasure, and, consequently morally degenerate as a result of the abuse of their evil nature. As can be understood from Ibn Khaldūn’s explanations, the basic element that determines the transition of people from the badāwi way of life to ḥaḍāri (settled) is the change in the livelihoods and related needs. He perceives this change as progressing from necessity to luxury, and, with this change, ethical concern in the nature of people being replaced by aesthetic care. In this way, since aesthetic concern reveals the dissatisfaction of the human self, man always pursues what is perceived to be better and more beautiful, and therefore he easily tends to any malignancy that may disrupt his religious and worldly peace. The ḥaḍāra community of Ibn Khaldūn versus the badāwa represent a modern society with a much more heterogeneous population, with a significant increase in lifestyle diversity along with urbanization. However, the determinative effect of the relationship with nature or the way in which society engage in economic activities have not changed. While modern people are urbanized, they are also heterogeneously shaped by psycho-social necessities demanded by urbanization. Man has created a new socio-psychological condition that not only affects the socio-economic but the way of forming a relationship through the accelerated development of new communication methods, facilitating access to information, and the opening of new methods of communication field between institutions. While man’s connection to nature has become disconnected, he no longer perceives himself as human being in nature but as a human within the city, the individual urban life and the law define this perception. The rupture from nature has created an inevitable result of alienation to nature as well as the estrangement of man with his own nature. The liberal policies adopted with capitalism have encouraged competition and free entrepreneurship. In the time that Ibn Khaldūn lived, man who created himself with his struggle in the nature brings himself / herself into the economic structure of competition in the modern period. Unlike in more traditional societies of the past, the modern way of life not only expresses itself in our new way of life and moral values, but also by statistical values. The exploitative and mathematical world, which forms the current economic science, shapes the socio-economic and socio-psychological structure of modern man. It is understood that the life brought by luxury renders the dynamic, subjective, disciplined sense of morality dysfunctional by destroying the moral values of man, particularly by reducing their feeling of shame. As a result, while the world of value of money-hedonism is solid, materialistic and cold; man in trying to exist in this world of value carries a flexible, spiritual and emotional nature. As such, human beings are pushed into social anomaly situations such as a constant conflict, dilemma, suicide, insecurity and solitude in this world of value. (shrink)

Ghosn, Mariam The causes of obesity are complex. Both our attitudes and lifestyles will need to change in order to successfully address this issue.

It is no secret that one of the biggest public health challenges facing this nation is the obesity epidemic. Two-thirds of adults and one-third of children and teens are either obese or overweight. For adults, the number of obese has doubled since 1980, and for children age 6-11 the number of obese has quadrupled. The epidemic has changed what we thought we knew about medicine. For example, until fairly recently, type 2 diabetes was known as “adult-onset” diabetes. But doctors (...) have dropped this moniker as youth account for almost half of new type 2 diabetes in certain communities. Further, there has always been an assumption that life spans and health would improve with advancements in medicine and technology. However, obesity is related to over 20 major chronic diseases, and therefore obese children are more than twice as likely to die before the age of 55 compared to healthy-weight children. In other words, if trends are not reversed, America’s current generation of children are likely to have shorter life spans than their parents. (shrink)

The aim of the study is to determine the association between Behavioral Lifestyles and longevity in the elderly. A search strategy was conducted in the PsycInfo, Medline, PubMed, Web of Science, and Scopus databases. The primary outcome was mortality/survival. Four variables were analyzed to evaluate the role of potential moderators. Ninety-three articles, totaling more than 2,800,000 people, were included in the meta-analysis. We found that the lifestyles analyzed predict greater survival. Specifically, doing regular physical activity, engaging in leisure activities, sleeping (...) 7–8 h a day, and staying outside the BMI ranges considered as underweight or obesity are habits that each separately has a greater probability associated with survival after a period of several years. (shrink)

The obesity epidemic among children and adolescents in the United States continues to worsen. The most recent analysis of data from the National Health and Nutrition Examination Survey showed that the prevalence of overweight among children and adolescents – defined as a Body Mass Index at or above the 95th percentile on gender-specific BMI-for-age growth charts developed by the Centers for Disease Control and Prevention – increased significantly between 1999-2000 and 2003-2004. Over this period, the prevalence of overweight among (...) children and adolescents aged 2-19 increased 23% – from 13.9% to 17.1%. In 2003-2004, 18.8% of children aged 6-11 and 17.4% of adolescents aged 12-19 were overweight. Roughly comparable proportions of each age group were considered to be at risk of becoming overweight. (shrink)

Behavioral interventions have shown promising neuroprotective effects, but the cascade of molecular, brain and behavioral changes involved in these benefits remains poorly understood. Projecte Moviment is a 12-week multi-domain, single-blind, proof-of-concept randomized controlled trial examining the cognitive effect and underlying mechanisms of an aerobic exercise, computerized cognitive training and a combined groups compared to a waitlist control group. Adherence was > 80% for 82/109 participants recruited. In this study we report intervention-related changes in plasma biomarkers and structural-MRI and how they (...) related to changes in physical activity and individual variables and their potential role as mediators in the cognitive changes. Our results show that although there were no significant changes in molecular biomarker concentrations in any intervention group, changes in ICAM-1 and SDF1-α were negatively associated with changes in physical activity outcomes in AE and COMB groups. Brain volume changes were found in the CCT showing a significant increase in precuneus volume. Sex moderated the brain volume change in the AE and COMB groups, suggesting that men may benefit more than women. Changes in molecular biomarkers and brain volumes did not significantly mediate the cognitive-related benefits found previously for any group. This study shows crucial initial molecular and brain volume changes related to lifestyle interventions at early stages and highlights the value of examining activity parameters, individual difference characteristics and using a multi-level analysis approach to address these questions. (shrink)

ObjectiveThis study aimed to analyze the influence and measurement of the relationship and interaction between the elderly lifestyles after the appearance of the SARS-CoV-2 variant and the factors analyzed comprised life satisfaction levels, social relationships, and daily-life activities.MethodsThe study population was ≥ 65 in Castile-La Mancha. The research design was quantitative and arose from primary data collected via an ad hoc survey carried out through the Computer Assisted Telephone Interview system by randomly stratified sampling. The sample size was made up (...) of 1,065 cases, and the participants were selected through a random sampling stratified by gender quotas, age, province, and habitat size.ResultsThe results obtained revealed two main lifestyles, from which a notable behavioral change in personal relationships led to infer toward alternative lifestyles.ConclusionNotwithstanding the variation in lifestyles of the elderly after the pandemic, certain relationships remained unaltered. Thus, from the analyzed variables, relatives and friends relationships were scarcely influenced by the supervened incident. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Experiences of an Obese PatientChristine R. BrassIn the middle of an annual pelvic exam, the gynecologist said to me, “You should apply to be on ‘The Biggest Loser.’” I was too stunned and embarrassed to mutter anything more than a [End Page 88] comment that I didn’t think that, being quite introverted, I was a good candidate for a reality TV show. She argued with me about that. I (...) felt blindsided, intensely vulnerable, and dumbstruck—completely unable to respond—and later, when the shock wore off, incandescent with impotent rage.Four years later, I still don’t have words to adequately describe my outrage at this comment. It was only the second time I’d see this medical professional. The first time was the previous year, when she had been filling in for my regular doctor who was on maternity leave. At neither appointment did this physician ask me any questions about my lifestyle, whether or not I saw a primary care physician, or even if I had any concerns that day. She was very brisk, efficient and did not engage in conversation. Such a statement coming from a health care provider, who did not seek to understand or gather more information, surprised and dismayed me.Other incidents where physicians’ statements were not helpful:• Pediatrician: “Well, my wife has had great success with Weight Watchers.”—I was age 12, about 5’5 and weighted about 145 lbs. at that time. If you look at photos of me at the time, you would see I was not overweight.• Orthopedic Surgeon: “If you want her to look better, make her lose weight.”—This was directed to my mother. I was 19, weighed about 200 lbs., and in his office as per his directions to come back in seven years to see if the surgery he had done on my neck needed more attention.• Internist: “How did you get all those stretch marks?”—I was age 24, weighed approximately 220 lbs., and had lost and gained 50 or so pounds several times as a teenager and in college.• Gynecologist: “Lose weight and your periods will be regular.”—I was age 27, weighed 227 lbs. and my periods, which started at age 15, had never been regular.• Another Orthopedic Surgeon: “You don’t have to worry about osteoporosis; everything you do is a weight–bearing exercise.”—I was age 42 and weighed 300 lbs. This was after follow up surgery to remove pins from a broken ankle that had healed and I had asked about whether or not I should have a bone density test.Coming from a genetic heritage of predominately tall, large–boned people, I was tall and proportionally large compared to other girls my age until high school, when the others caught up. I was told I had to “watch my weight” by family members from my pre–teen years. Enforced dieting ensued, with little result because I wasn’t fat. I did not begin to be overweight until my junior and senior years of high school. I was 5’7” when I graduated from high school and weighed 187. By the time I graduated from college, I was no taller but 50 lbs. heavier. Now, nearing my 40th high school reunion, I am 120 lbs heavier than that. During the intervening years, I have done Weight Watchers®, TOPS®, medically–supervised programs (group and individual), and other popular diets, with periodic but temporary success, and hypnosis and aversion therapy, with no success at all.Over the years, I have been insulted, verbally abused, even bullied, because of my weight. I have been treated as though I am invisible, worthless, and stupid—a pariah. As a result, I have felt invisible, worthless, and stupid, even though I know I am none of those things. I have experienced and been treated for clinical depression. The descent into depression began in my late teen years, which was the time when I started gaining excess weight.In 2004, under medical supervision, I lost 70 lbs. over four–month period. I was delighted to finally lose a substantial amount of weight and feel physical lighter. My diabetes medications were significantly reduced, and... (shrink)

Burnout syndrome and obesity are two growing conditions that affect employees’ health and company productivity. Recently, several studies have pointed to a possible relationship between both phenomena. However, such a relationship has not been clearly defined. This research analyzes the relationship between BS dimensions and body mass index, the latter being treated as a moderator variable among obese senior and middle managers in the Mexican maquiladora industry through a structural equation model. A total of 361 senior and middle managers (...) completed both the Maslach Burnout Inventory-General Survey [with emotional exhaustion, cynicism, and professional efficacy as subscale dimensions] and a sociodemographic questionnaire. The results showed a statistically significant relationship between EE and PE, with BMI acting as a moderator variable. The results showed that when BMI increases as a moderator variable, the strength of the relationship between EE and PE also changes. For example, although PE had a negative value of 0.14 before the moderator effect, the value increased up to 0.32 when the BMI was factored into the relationship. Therefore, maquiladora industries are being advised to increase their investments on the identification and prevention of employees’ EE and obesity. Such interventions would promote a better quality of life and could prevent economic losses resulting from poor employee performance. (shrink)

Smell perception plays an important role in eating behavior and might be involved in body weight gain. Since a body of literature implies that olfactory perception and function is hampered in obesity, we here investigate neuroanatomical correlates of this phenomenon. We assessed olfactory bulb volume with magnetic resonance imaging in 67 healthy participants with a body mass index from 18.9 to 45.4 kg/m2. Moreover, we obtained psychophysiological data on olfactory ability and self-report measurements on eating behavior. Additionally, we collected (...) parameters associated with metabolic health in obesity to investigate recently proposed mechanistic explanatory models of why olfaction may be altered in obesity. We showed that OB volume was significantly lower in participants with obesity when compared to those of normal weight. Moreover, we found weak to moderate negative correlations between OB volume and BMI and related measures of metabolic health, especially leptin, body fat percentage, waist-height ratio and insulin resistance. However, neither OB volume nor BMI were related to olfactory function in our young and healthy sample. Nevertheless, our results provide first indications that obesity is associated with brain anatomical changes in the OBs. (shrink)

Bernard Lonergan's cognitive theory challenges us to raise questions about both the cognitive process through which obesity is perceived as a behaviour change issue and the objectivity of such a moral judgment. Lonergan's theory provides the theoretical tools to affirm that anti-fat discrimination, in the United States of America and in many industrialized countries, is the result of both a group bias that resists insights into the good of other groups and a general bias of anti-intellectualism that tends to (...) set common sense against insights that require any thorough scientific analyses. While general bias diverts the public's attention away from the true aetiology of obesity, group bias sustains an anti-fat culture that subtly legitimates discriminatory practices and policies against obese people. Although anti-discrimination laws may seem to be a reasonable way of protecting obese and overweight individuals from discrimination, obesity bias can be best addressed by reframing the obesity debate from an environmental perspective from which tools and strategies to address both the social and individual determinants of obesity can be developed. Attention should not be concentrated on individuals' behaviour as it is related to lifestyle choices, without giving due consideration to the all-encompassing constraining factors which challenge the social and rational blindness of obesity bias. (shrink)

Type 2 diabetes mellitus (T2DM) is a multifaceted chronic condition characterized by insulin resistance and hyperglycemia. This review synthesizes evidence on the influence of lifestyle factors such as diet, physical activity, and stress on the development and progression of T2DM. It highlights the intricate relationship between obesity, insulin resistance, and β-cell dysfunction, with a particular focus on the role of psychological stress in exacerbating disease outcomes. Through the analysis of recent studies, the review explores how lifestyle interventions, (...) including dietary changes, exercise, and stress management, can improve glycemic control and reduce complications. This comprehensive review underscores the need for integrated, personalized management strategies in T2DM care, emphasizing the importance of addressing both physiological and psychological factors to optimize outcomes and prevent complications. (shrink)

This study aimed to investigate the relationships between physical fitness and academic performance in youth handball players of different BMI classifications. Thirty-three male handball players were recruited from the Qatar handball first league and were assigned to their BMI age-adjusted groups. Measurements included anthropometric data and body fat percentage, and physical performance tests: agility T-half test; squat jump, and countermovement jump, 10 and 15 m sprint; medicine ball throw. Aerobic capacity was evaluated using the Yo-Yo Intermittent Recovery Test level 1. (...) Academic achievement was assessed through school records of grades point average of Mathematics, Science and Arabic. None academic performance parameter and four physical performance parameters were different between BMI related groups. In 43% of performance parameters and all academic parameters, the normal weight group showed the highest performance level, whereas the overweight group had the best performance in both sprint tests. The obese group was only superior in the medicine ball throw, but not at the p 0.5) between academic and physical performance parameters was only found between Yo-Yo IR 1 and science. A relevant correlation were found between CMJ and BMI. The agility T-half test was correlated with CMJ and 10 m sprint. These findings suggest being overweight or obese are related to science academic performance among schoolchildren athletes in Qatar. Possibly, a normal BMI could positively influence academic performance. Physical education teachers, staff, and administrators should be cognizant that health promotion interventions improving composition may have the additional potential to improve dimensions of academic performance. (shrink)

Alzheimer’s disease is an example of age-related dementia, and there are still no known preventive or curative measures for this disease. Obesity and associated metabolic changes are widely accepted as risk factors of age-related cognitive decline. Insulin is the prime mediator of metabolic homeostasis, which is impaired in obesity, and this impairment potentiates amyloid-β accumulation and the formation of neurofibrillary tangles. Obesity is also linked with functional and morphological alterations in brain mitochondria leading to brain insulin resistance (...) and memory deficits associated with AD. Also, increased peripheral inflammation and oxidative stress due to obesity are the main drivers that increase an individual’s susceptibility to cognitive deficits, thus doubling the risk of AD. This enhanced risk of AD is alarming in the context of a rapidly increasing global incidence of obesity and overweight in the general population. In this review, we summarize the risk factors that link obesity with AD and emphasize the point that the treatment and management of obesity may also provide a way to prevent AD. (shrink)

Objectives:Social isolation is increasing in aging societies and several studies have shown a relation with worse cognition in old age. However, less is known about the association in the oldest-old (85+); the group that is at highest risk for both social isolation and dementia. Methods:Analyses were based on follow-up 5 to 9 of the longitudinal German study on aging, cognition, and dementia in primary care patients (AgeCoDe) and the study on needs, health service use, costs, and health-related quality of life (...) in a large sample of oldest-old primary care patients (AgeQualiDe), a multi-center population-based prospective cohort study. Measurements included the Lubben Social Network Scale (LSNS-6), with a score below 12 indicating social isolation, as well as the Mini-Mental Status Examination (MMSE) as an indicator of cognitive function. Results:Dementia-free study participants (n = 942) were M = 86.4 (SD = 3.0) years old at observation onset, 68.2% were women. One third (32.3%) of them were socially isolated. Adjusted linear hybrid mixed effects models revealed significantly lower cognitive function in individuals with smaller social networks (β = 0.5, 95% CI = 0.3-0.7, p <.001). Moreover, changes in an individual's social network size were significantly associated with cognitive changes over time (β = 0.2, 95% CI = 0.1-0.4, p =.003), indicating worse cognitive function with shrinking social networks. Conclusion:Social isolation is highly prevalent among oldest-old individuals, being a risk factor for decreases in cognitive function. Consequently, it is important to maintain a socially active lifestyle into very old age. Likewise, this calls for effective ways to prevent social isolation. (shrink)

SummaryThis study examined the secular changes in height, body weight, body mass index and pubertal development in male children and adolescents in Krakow over the past 80 years, with an emphasis on the last decade. The survey of the population of Krakow is a continuation of observations conducted in that area for many years. The analysis aims to determine whether in the last decade Krakow still witnessed the secular trend, and what form the trend took. The body height and weight, (...) and body mass index, of 1862 boys aged 3.5–18.5 years were analysed, against the background of a survey series from the years 1938, 1971, 1983 and 2000. The mean body height, in almost all age categories, was greater than in the past; however the final height over the last decade remained the same. The mean values of body weight and BMI increased, especially in the last decade. Also, an acceleration of puberty in boys was observed. The last 10 years saw an over 3-month decrease in the age of initial appearance of pubic hair in boys. In conclusion, the last decade saw cessation of the growing taller trend: maximum body height stabilized at approximately 179 cm, but weight and BMI increased. Also, a distinct acceleration of puberty was noticed. Lack of height increase, at the same time as weight gain and puberty acceleration, indicate a progressing developmental disharmony. (shrink)

Objectives: To examine associations of changing employment conditions, specifically switching to working from home or job loss, with mental health, using data collected during the COVID-19 pandemic.Methods: Data from 2,301 US adults in employment prior to COVID-19 were collected April 3rd−7th, 2020. Participants reported whether their employment remained unchanged, they were WFH when they had not been before, or they had lost their job due to the pandemic. Outcomes were symptoms of depression, anxiety, stress, loneliness, and positive mental health assessed (...) using validated questionnaires. Linear regression quantified associations of employment changes with mental health outcomes, controlling for age, sex, race, BMI, smoking status, screen time, physical activity, marital status, chronic conditions, and current COVID-19 containment strategies being followed.Results: Compared to participants whose employment remained unchanged, those who switched to WFH did not differ in any measures of mental health. Participants who had lost their job reported higher symptoms of depression, anxiety, and stress, and lower PMH. Loneliness did not differ between groups.Conclusion: This study demonstrates that concerns around potential adverse mental health effects, particularly increases in loneliness, should not preclude WFH in the general population, while considering each individual's personal circumstances, and the acute adverse association of job loss with mental health. Tailored and sensitive interventions may be required to prevent deteriorations in mental health associated with job loss during periods of societal stress. (shrink)

AimTo examine the association of body mass index (BMI) [kg/m2] and its classifications (underweight [BMI < 18.5], normal [18.5 ≤ BMI < 25], overweight [25 ≤ BMI < 30], and obese [BMI ≥ 30]) with brain structure in individuals with a wide range of BMI group.Materials and methodsThe participants included 382 right-handed individuals (mean age: 46.9 ± 14.3 years, 142 men and 240 women). The intelligence quotient was assessed using the Japanese Adult Reading Test. Voxel-based morphometry (VBM) and diffusion tensor (...) imaging (DTI) were performed to analyze the association of BMI and its classifications with gray and white matter structures, respectively.ResultsAccording to VBM, BMI was significantly and negatively correlated with the bilateral cerebellum exterior volumes. In group comparisons, the right cerebellum exterior volume was significantly lower in the overweight or obese group than in the underweight or normal group, while the bilateral cuneus and calcarine cortex, left cuneus, and left precuneus volume was significantly lower in the underweight group than in the non-underweight group. Sex-related stratification analyses for VBM revealed that BMI was significantly and negatively correlated with the bilateral cerebellum exterior volumes only in women. In group comparisons, the left cerebellum exterior volume was significantly lower in obese women than in non-obese women. The left thalamus proper and the right cerebellum exterior volumes were significantly lower in overweight or obese group than in underweight or normal group in men and women, respectively. The bilateral cuneus and calcarine cortex, left cuneus and carcarine cortex, and bilateral cuneus volume was significantly lower in underweight men than in non-underweight men. In contrast, there were no notable findings on DTI.ConclusionOur results suggest association of continuous BMI, being overweight or obese, and being underweight with decreased gray matter volume in individuals with a wide range of BMI group. Furthermore, sex-related differences are seen in the association of BMI and its classifications with regional gray matter volume reductions. Abnormally high or low BMIs may have a negative influence on regional gray matter volumes. (shrink)

This study investigated the association between Big Five Personality Traits and nutrition-related variables. We used secondary data from the Indonesia Family Life Survey wave 5 involving a total of 14,473 men and 16,467 women aged 15−101 years in Indonesia that was selected by stratified random sampling conducted in the period 2014 to 2015. Data were collected through interviews with the Big Five Index 15 and a questionnaire similar to the Global Physical Activity Questionnaire which was translated into the Indonesian language, (...) and based on measurements of height and weight. Analyses used binary logistic regression test controlled by socio-demographic factors to determine the association between Big Five Personality Traits and eating habits, physical activity, and obesity. Results showed that openness and extraversion were positively associated with recommended and non-recommended foods, conscientiousness was positively associated with only recommended foods, agreeableness was positively associated with recommended foods, and negatively associated with only one non-recommended food. Whereas, neuroticism was positively associated with non-recommended foods and negatively associated with recommended foods. Openness and conscientiousness were associated with physical activity. Conscientiousness, extraversion, and neuroticism were associated with obesity. Although some results were different from previous studies, these associations can be used as strategies of behavioral change due to the adaptation of personality characteristics, which can be modified even though the personality tends to be persistent. Further studies are needed to understand other mechanisms that might underlie this association. (shrink)

Few studies have examined the influence of the food environment on obesity rates among very young, low-income consumers. This research contributes to this growing literature by examining the relationship between modifications to the retail environment and obesity rates for low-income, preschool-aged children. Based on data combined from various secondary sources, this study finds that changes in the retail environment are significantly related to obesity rates. More specifically, the authors find a positive relationship between the number of convenience (...) stores in the retail environment and obesity rates among low-income, preschool-aged children. Results also show that the percent change in grocery stores and supercenters and club stores in the retail environment is negatively related to the obesity rates of low-income, preschool-aged children [i.e., as grocery stores and supercenters/club stores increase, obesity decreases ].Further, the percent change in supercenters and club stores mediates the positive relationship between participation in the Supplemental Nutrition Assistance Program and obesity rates. (shrink)

Epigenetic markers could potentially be used for risk assessment in risk-stratified population-based cancer screening programmes. Whereas current screening programmes generally aim to detect existing cancer, epigenetic markers could be used to provide risk estimates for not-yet-existing cancers. Epigenetic risk-predictive tests may thus allow for new opportunities for risk assessment for developing cancer in the future. Since epigenetic changes are presumed to be modifiable, preventive measures, such as lifestyle modification, could be used to reduce the risk of cancer. Moreover, epigenetic (...) markers might be used to monitor the response to risk-reducing interventions. In this article, we address ethical concerns related to personal responsibility raised by epigenetic risk-predictive tests in cancer population screening. Will individuals increasingly be held responsible for their health, that is, will they be held accountable for bad health outcomes? Will they be blamed or subject to moral sanctions? We will illustrate these ethical concerns by means of a Europe-wide research programme that develops an epigenetic risk-predictive test for female cancers. Subsequently, we investigate when we can hold someone responsible for her actions. We argue that the standard conception of personal responsibility does not provide an appropriate framework to address these concerns. A different, prospective account of responsibility meets part of our concerns, that is, concerns about inequality of opportunities, but does not meet all our concerns about personal responsibility. We argue that even if someone is responsible on grounds of a negative and/or prospective account of responsibility, there may be moral and practical reasons to abstain from moral sanctions. (shrink)

SummaryDuring famines females generally have a mortality advantage relative to males, and the highest levels of mortality occur in the very young and the elderly. One popular hypothesis is that the sex differential in mortality may reflect the greater body fatness combined with lower metabolism of females, which may also underpin the age-related patterns of mortality among adults. This study evaluated the ‘body fat’ hypothesis using a previously published and validated mathematical model of survival during total starvation. The model shows (...) that at a given body weight females would indeed be expected to survive considerably longer than males in the absence of food. At a mass of 70 kg for example a female aged 30 would survive for 144 days compared with life expectancy of only 95 days for a male of the same age and weight. This effect is contributed to by both the higher body fatness and lower metabolism of the females at a given body weight. However, females are generally smaller than males and in addition to a sex effect there was also a major effect of body size – heavier individuals survive longer. When this body size effect was removed by considering survival in relation to BMI the sex effect was much reduced, and could be offset by a relatively small difference in pre-famine BMI between the sexes. Nevertheless, combining these predictions with observed mean BMIs of males and females across 48 countries at the low end of the obesity spectrum suggests that in the complete absence of food females would survive on average about 40% longer than males. The energy balance model also predicted that older adult individuals should survive much longer than younger adult individuals, by virtue of their lower resting metabolic rates and lower activity levels. Observations of the female survival advantage in multiple famines span a much wider range than the model prediction. This suggests in some famines body fatness may be a significant factor influencing the mortality differential between the sexes, but in other famines other factors are likely to be more important. Moreover, the pattern of mortality in relation to age is completely opposite that predicted. These data emphasize the complex nature of famine mortality and suggest that a simple model of energy utilization alone is inadequate to explain the major aspects of this phenomenon. (shrink)

With the ever‐increasing lifespan along with societal changes, women can marry and procreate later than in previous centuries. However, pathogenic genetic variants segregating in the population can lead to female subfertility or infertility well before the average age of normal menopause, leading to counter‐selection of such deleterious alleles. In reviewing this field, we speculate that a logical consequence would be the later occurrence of menopause and the extension of women's reproductive lifespan. We illustrate this point with a simple model that (...) applies to other variants that contribute to female infertility, including epigenetic variation. We also consider the effect of medical interventions and lifestyle. (shrink)

Food choices are a key determinant of dietary intake, with brain regions, such as the mesolimbic and prefrontal cortex maturing at differential rates into adulthood. More needs to be understood about developmental changes in healthy and unhealthy food perceptions and preference. We investigated how food perceptions and preference vary as a function of age and how food attributes impact age-related changes. One hundred thirty-nine participants completed computerized tasks to rate high-calorie and low-calorie food cues for taste, health, and liking, followed (...) by 100 binary food choices based on each participant’s ratings. Dietary self-control was considered successful when the healthier food was chosen. Self-control success ratio was the proportion of success trials over total number of choices. Beta-weights for health and taste were calculated as each attribute’s influence on food preference. Adiposity measurements included BMI z-score and waist-to-height ratio. High-calorie foods were rated more tasty and less healthy with increasing age. Older participants liked high-calorie foods more, and β-taste was associated with age. Significant age-by-WHtR interactions were observed for health and taste ratings of high-calorie foods, β-taste, and marginally for preference of high-calorie foods. Stratifying by WHtR, we found age-related increases in taste and preference ratings of high-calorie foods in the high WHtR group alone. In contrast, age-related decreases in health ratings of high-calorie foods were significant in the low WHtR group alone. Age and β-taste were significantly associated in the high WHtR group and only marginally significant with low WHtR. Although participants rated low-calorie foods as less tasty and less healthy with increasing age, there was no association between age and preference for low-calorie foods. Participants made faster food choices with increasing age regardless of WHtR, with a significant age-by-WHtR interaction on reaction time. There were no age-related effects in self-control success ratio and β-health. These results suggest that individual differences in age and central adiposity play an important role in preference for high-calorie foods, and a higher importance of food tastiness in food choice may contribute to greater preference for high-calorie foods with increasing age. (shrink)

Obesity is now commonly recognised to be a significant public health issue worldwide with its increasing prevalence frequently described as a global epidemic. In the United Kingdom, primary care nurses are responsible for weight management through the provision of healthy eating advice and support with lifestyle change. However, nurses themselves are not immune to the persistent and pervasive global levels of weight gain. Drawing on a Gadamerian informed phenomenological study of female primary care nurses in England, this paper (...) considers the complex gendered understandings and experiences of being overweight, and of food and eating. The nurses’ emotional and injurious experiences of being large is found to be capable of producing embodied caring practices, involving a fusion of horizons with patients over how it feels to inhabit a large body. Yet, even though subjected to similar derogatory stereotypes as patients, they simultaneously reinforce the dominant and damaging individualising psychopathology inherent to anti‐obesity discourses. This suggests an urgent need to expose and challenge harmful discourses surrounding women’s body size and weight in order to avoid nursing practices that unthinkingly reproduce culturally dominant and gendered understandings of weight, body size, food and eating. (shrink)

SummaryEarly onset of menarche has been shown to be associated with breast cancer and ischaemic heart disease. Studies on age at menarche of the Malaysian population are poorly documented. This study aimed to determine the influence of anthropometric and socio-demographic factors on the age at menarche of university students in Malaysia. Data were obtained in 2010–11 from 961 students between the ages of 18 and 25 years from the University of Malaya using stratified sampling, and multiple regression analysis was applied. (...) Sixty-three per cent of students reached menarche at the age of 12 or 13 years, with the mean and median of age at menarche being 12.45±1.17 and 12.01 years, respectively. Menarcheal age was positively associated with height and negatively associated with BMI. Students from urban areas attained menarche earlier than those from rural areas. Students from small-sized families attained menarche earlier than those from larger families. First-born students experienced menarche earlier than those who were seventh-born or later. Obese and overweight students reached menarche earlier than students who were underweight or of normal weight. The variations in age at menarche among the Malaysian ethnic groups were statistically insignificant. The results suggest that heavier and first-born students from small families are more likely to attain menarche earlier than their counterparts. (shrink)

Some recent studies have highlighted a link between a favorable childhood environment and the strengthening of neuronal resilience against the changes that occur in natural aging neurodegenerative disease. Many works have assessed the factors – both internal and external – that can contribute to delay the phenotype of an ongoing neurodegenerative brain pathology. At the crossroads of genetic, environmental and lifestyle factors, these relationships are unified by the concept of cognitive reserve (CR). This review focuses on the protective effects (...) of maintaining this CR through the cognitive aging process, and emphasizes the most essential time in life for the development and strengthening of this CR. The in-depth study of this research shows that early stimulation with regard to social and sensory interactions, contributes to the proper development of cognitive, affective and psychosocial capacities. Childhood thus appears to be the most active phase in the development of CR, and as such we hypothesize that this constitutes the first essential period of primary prevention of pathological aging and loss of cognitive capacities. If this hypothesis is correct, early stimulation of the environment would therefore be considered as a true primary prevention and a public health issue. The earlier identification of neurodevelopmental disorders, which can affect personal and professional development across the lifespan, could therefore have longer-term impacts and provide better protection against aging. (shrink)

BackgroundThe increased risk of developing attention-deficit hyperactivity disorder (ADHD) in extremely preterm infants is well-documented. Better understanding of perinatal risk factors, particularly those that are modifiable, can inform prevention efforts.MethodsWe examined data from the Extremely Low Gestational Age Newborns (ELGAN) Study. Participants were screened for ADHD at age 10 with the Child Symptom Inventory-4 (N = 734) and assessed at age 15 with a structured diagnostic interview (MINI-KID) to evaluate for the diagnosis of ADHD (N = 575). We studied associations (...) of pre-pregnancy maternal body mass index (BMI), pregestational and/or gestational diabetes, maternal smoking during pregnancy (MSDP), and hypertensive disorders of pregnancy (HDP) with 10-year and 15-year ADHD outcomes. Relative risks were calculated using Poisson regression models with robust error variance, adjusted for maternal age, maternal educational status, use of food stamps, public insurance status, marital status at birth, and family history of ADHD. We defined ADHD as a positive screen on the CSI-4 at age 10 and/or meeting DSM-5 criteria at age 15 on the MINI-KID. We evaluated the robustness of the associations to broadening or restricting the definition of ADHD. We limited the analysis to individuals with IQ ≥ 70 to decrease confounding by cognitive functioning. We evaluated interactions between maternal BMI and diabetes status. We assessed for mediation of risk increase by alterations in inflammatory or neurotrophic protein levels in the first week of life.ResultsElevated maternal BMI and maternal diabetes were each associated with a 55–65% increase in risk of ADHD, with evidence of both additive and multiplicative interactions between the two exposures. MSDP and HDP were not associated with the risk of ADHD outcomes. There was some evidence for association of ADHD outcomes with high levels of inflammatory proteins or moderate levels of neurotrophic proteins, but there was no evidence that these mediated the risk associated with maternal BMI or diabetes.ConclusionContrary to previous population-based studies, MSDP and HDP did not predict ADHD outcomes in this extremely preterm cohort, but elevated maternal pre-pregnancy BMI, maternal diabetes, and perinatal inflammatory markers were associated with increased risk of ADHD at age 10 and/or 15, with positive interaction between pre-pregnancy BMI and maternal diabetes. (shrink)

Basic motor competencies are a prerequisite for children to be physically active, participate in sports and thus develop a healthy, active lifestyle. The present study provides a broad screening of BMC and associations with age, sex, body mass index and extracurricular physical activity in 10 different European countries. The different country and regional contexts within Europe will offer a novel view on already established BMC associations. The cross-sectional study was conducted in 11 regions in 10 European countries in 2018. (...) The motor competence areas, object movement and self-movement, were assessed using the MOBAK-1-2 test instrument in 3758 first and second graders during Physical Education classes. Children were questioned about their extracurricular PA and age. Their body weight and height were measured in order to calculate BMI. Statistical analyses included variances and correlations. The results showed significant differences in BMC levels between countries whereas associations between BMC and correlates were similar. Boys performed significantly better in OM while girls performed better in SM. Age was consistently positively related to OM and SM with older children reaching higher levels of BMC than younger ones. While participation rates for extracurricular PA differed widely, participation in ball sports was correlated with OM and SM. Participation in individual sports showed a significant association with SM. In summary, BMC levels of children seem to depend on where they live and are strongly related to their participation in extracurricular PA. Therefore, education and health policies, in order to enhance motor competence development and PA participation, are recommended. Further research on country-specific Physical Education frameworks and their influence on BMC will provide more insights into structural factors and cultural characteristics of BMC development. On a school level, support tools and educational materials for teachers about BMC may enable children to achieve a basic level of motor competencies through Physical Education, contributing to lifelong participation in PA. (shrink)

This is the story of a seductive idea and its sobering consequences. The twentieth century brought a new cultural confidence in the social powers of invention – but also saw the advance of consumerism, world wars, globalisation and human-generated climate change. Techno-Fixers traces how passive optimism and active manipulations were linked to our growing trust in technological innovation. It pursues the evolving idea through engineering hubris, radical utopian movements, science fiction fanzines, policy-maker soundbites, corporate marketing, and consumer culture. It explores (...) how evangelists of technological fixes have proselytised their faith, and critically examines the examples and products of their followers. The new technological confidence mixed together beliefs that were simultaneously compelling and unsettling. As motor vehicles, electricity supplies and radio became part of modern life in the early decades of the century, it was hard to argue against the transformative effects and inevitability of such transitions. Like it or not, social consequences seemed to come inexorably with the Machine Age, the Space Age and the Information Age. This deterministic vision implied an ever more technological future with unavoidable social consequences. For many, innovative technologies promised appealing new lifestyles and powers. But for a narrower band of proponents – the first generation of technological fixers – wise engineering invention was touted as a guaranteed route to positive human benefits and societal progress. Socially-engaged engineers and designers argued that such improvements could be directed, hastened and amplified. These engineering adventurers argued that modern societies could be guided only by rational designers. They contended that adroit technological solutions could solve contemporary problems better than any traditional method, including economic initiatives, citizen education, political ideology, lifestyle changes, legal frameworks and moral guidance. Their seductive claims were tamed by more mainstream American enthusiasts, and eventually boiled down to the concept of the technological fix. Their shared confidence infused policy-makers, broadcasters and science popularisers. Trust in technological fixes shaped a new generation of managers and law-makers, engineers and educators, futurists and citizens – and continues to drive a new generation of techno-fixers today. This cultural wave, its promoters and detractors, have championed the promise and voiced concerns that we have inherited, still unresolved. This book tracks the hubristic influencers and weighs up the confidences and concerns associated with them: the dramatic potential for novel technologies to work alongside longer human traditions to meet our enduring ambitions – or to reshape society for the worse. (shrink)

Kit Pedler, the scientist who co-created the ?DoomwatchOCO television series to warn us of the dangers of technology, presents his vision of a totally different way of being in the world. Mankind, Pedler believes, stands at a critical point in history and has to reassess its relationship and the web of interactions that make up the total life-form of the planet. Pedler calls this life-form Gaia, after the Greek earth mother goddess, a being whose sole concern is the survival of (...) the planet itself. Mankind is provoking the wrath of the life-form by its high technology, accelerating entropy and production of planetary disorder. Can we halt the technological Behemoth and live in harmony with the planet again? Kit Pedler says ?yes, we can, indeed, that we have no choice but to do soOCO. He outlines highly practical ways every individual can change his or her way of life to reduce our personal entropy debt. Do we need to eat factory-farm beef rather than, the sun-product, grain? Must be build homes from steel and concrete rather than, the renewable earth-product, timber? Is there an alternative to expensive, and ecologically destructive, drugs? From experiments with his own lifestyle Kit Pedler comes to some profoundly optimistic conclusions. He demonstrates how low-entropy living can have unexpected rewards, from restoring our respect for the creatures with which we share the earth, greater independence and freedom through learning abandoned skills and, above all, by the recovery of a lost vision, once possessed by our forefathers, which enables us to see and feel in ways forgotten by industrial man. The Quest for Gaia is an exhilarating and optimistic book, and a challenge to capture a rewarding and sustainable future for ourselves and our earth. It is a blueprint for the Age of Gaia.". (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Shame is Not an Effective Diet PlanJudith BrukThe stigma of being obese is so strong that it is assumed that anyone with the condition is (or should be) deeply ashamed. After all, it’s really easy to lose weight, right? Just cut out dessert and walk around the block three times a week. If you can’t even do that, then you are definitely a moral failure, have succumbed to Gluttony (...) and Sloth, and deserve to be shunned by society.The problem is that shame is not a very effective diet plan; quite the opposite. It’s no surprise that recent research shows that shame leads to depression that leads to isolation, which, in the morbidly obese, leads to a suicide rate twelve times that of healthy–weight people.Unfortunately, it is indeed true that many obese people feel a great deal of shame, even if we occasionally put on a façade of bravado or seeming shamelessness, e.g., the “large and in charge” sitcom staple trope. The bottom line is that our shame about our weight does keep us from engaging with other people, limits our willingness to participate in physical activities, and generally makes us reluctant to simply exist out in public. None of these are behaviors conducive to positive lifestyle changes.For years I engineered my life so I would only go out of my house when absolutely necessary: grocery shopping and the occasional meeting at work were pretty much it (I usually work from home). I went for years without going to a movie, shopping for clothes in a store, eating in a restaurant, gardening, or any of the other activities I once enjoyed. I was ashamed to be seen. And since I had tried and tried and tried and tried to lose weight for three decades and only ended up more overweight as the years went by, I finally, truly gave up. I convinced myself my psychological makeup was so flawed (or was missing whatever ingredient it was that made someone succeed at sustained weight loss) that I just hoped my inevitable heart attack would be instantaneously fatal. This thinking is irrational, or at least unhealthy. (I am an otherwise fairly smart person with an advanced degree and am professionally employed.) Yet, it is basically the path that both societal attitudes and medical treatment lead us down at this point in time.Here are a few examples that illustrate how the path to irrationality evolved for me.About twelve years ago, I decided to see a psychotherapist to get to the bottom of my subconscious psychological issue that was keeping me overweight. This therapist suggested I see a nutritionist who gave me a list of detailed thyroid tests to take to my doctor so she could order the labs and we could get a full profile of how my thyroid was functioning. Upon presenting the list to my doctor’s PA (my doctor was not available that day), she rolled her eyes, gave a very deep sigh and said to me, “Every fat woman wants to believe it’s because of her thyroid and it never, ever is.” I was so embarrassed for having even brought the subject up that in an effort to save face, I reacted to my shame by replying, “Yeah, I just assume my extreme lack of energy and excess weight is simply because I eat too much.” She said, “Right, so let’s not even bother running these tests.” It was at least ten years later that I finally had the thyroid panel run and found out it was very low functioning.After about a year of seeing that shrink, she declared me “cured” and sent me on my way, though I had not lost any weight. It was about this time I first began thinking that throwing in the towel [End Page 91] was a good option. That didn’t mean that I went out and ate pizza and ice cream every day. Not at all. In fact, given the fact that I had been vegetarian and general health–food freak beginning in my mid–twenties, I rarely had anything in the house that contained sugar... (shrink)

The presumed lifestyle changes due to the Covid-19 pandemic are the reason for research into the self-assessment of parents of early and preschool children about parental behaviors during lockdown in the first wave of a pandemic. The aim was to explore the quality of parenting through joint activities and behaviors towards children. A relative majority of survey participants estimate that they have not significantly changed individual activities with children while a quarter of parents estimate that they do so more (...) often than before. Nearly half of parents estimate that they play more with their children than before the lockdown. Family relationships have been singled out as the most important dimension of parenting. Age, level of formal education and marital status of research participants as a predictor explains only 2.3 % of the variability of parental self-assessment, so it is reasonable to assume the existence of other, more significant predictors of parenting quality. The collected data indicate the advantages and disadvantages of online research. The size of the sample indicates the involvement of parents on social networks, which indicates the possibility of further research on parenting. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Little Body Hidden WithinTara ChapmanBeing “fat” was not a choice. It was my life and it slowly happened over time. Being obese is a disease that I have struggled with my entire life. I am 36 years old, nearing 37.I might not have eaten the right foods, but I didn’t overeat. I grew up eating typical American food and continued to cook that way into my adult life. I (...) ate eggs and toast for breakfast, sandwiches, chips and a few cookies for lunch, or leftovers, and some kind of meat and potatoes or pasta for dinner, with a canned vegetable. I very seldom ate fresh vegetables, but I did like summer fruits. However, those are filled with natural sugar and are only in season for a few months out of the year. I didn’t eat out, other than having my daily Starbucks Mocha Frappuccino on the way to work five days a week. I didn’t load my plate up with food. I ate less than my brother, sister and parents who are smaller than me. I took exercise and fitness classes all through college and knew what I was supposed to do. I exercised over the years, only to quit because I never lost weight and got discouraged. I would feel [End Page 93] better physically; however, I just kept packing on the pounds, which took a toll emotionally.By November 2012, I topped the scale at 291 pounds and could barely fit into my size 22 jeans and 3xl tops. I would sweat uncontrollably because of all the extra weight I was carrying around and could barely make it up the ramp at work or a flight of stairs without huffing and puffing. Because I would sweat profusely, my wardrobe consisted of white or black shirts. I had to hide the sweat stains. I had high blood pressure and cholesterol. I was on medication for both. My insulin levels were all over the boards. I knew that when I was shaky and my levels were high, it was time to eat. I would control my type II diabetes by eating a small piece of candy, which would instantly control my shakes. I would follow the candy up with a meal. My diet and exercise habits were causing me to have terrible headaches. In my early 20’s, I was diagnosed with Polycystic Ovarian Syndrome (PCOS). Besides having ovarian cysts and unbalanced hormones, the major issue with PSOC is unexplained weight gain and not being able to lose it. My health was spinning out of control and I secretly knew it. I just didn’t know how to fix it or what to do.I had to do something and I needed help. I didn’t want to die by the time I was 40; and the path that I was on was leading me to an early grave. I could hear it in my mom’s voice every time I talked to her. She knew something was wrong; she would try to talk to me about it and tell me I was going to have a heart attack. She would tell me how worried my dad was. I wouldn’t listen. I began to sleep more and more every day after work and on weekends. I had to take naps almost daily because I was so exhausted and had no energy. I didn’t know what to do. I was depressed and felt like I was alone. Nobody in my family understood and my friends couldn’t relate to what I was going through. I was fat and they weren’t.I heard about a special clinic that focused on women’s health issues from a co–worker. Under the close watch of the clinic’s doctor and her medical staff, I began a therapeutic lifestyle change on February 27, 2013. I had no expectations because I had always been obese. I had never lost weight, so why would this be any different? This lifestyle change includes committing to a healthy diet of high protein, vitamins and supplements, balancing hormones for PCOS and exercising. However, before I could begin changing my eating habits... (shrink)

Childhood obesity, linked to a sedentary lifestyle and an unbalanced diet, is one of the main problems in today’s Western societies. In this sense, the aim of the study was to analyze students’ perceived satisfaction in physical education classes with learning strategies and engagement in learning and critical thinking as determinants of healthy lifestyle habits. The study involved 2,439 high school students aged 12–18 years (M= 14.66,SD= 1.78). Structural equation modeling was conducted to analyze the predictive relationships (...) between the study variables. The results showed that teaching, teaching mastery, and cognitive development are precursors to deep thinking on the part of students, indicators of the adoption of healthy lifestyle habits. These results reflect the importance of the methodology adopted by the teacher in order to positively influence the students’ habits. (shrink)

In this article, we use qualitative methodology to explore how 15 low‐income women of diverse sociocultural location construct and experience health and weight gain during pregnancy, as well as how they position themselves in relation to messages pertaining to weight gain, femininity and motherhood that they encounter in their lives. Discussing the findings through a feminist poststructuralist lens, we conclude that the participants are complex, fragmented subjects, interpellated by multiple and at times conflicting subject positions. While the discourse of maternal (...) responsibility (i.e. managing personal behaviours for the baby's health) is very much in evidence in their narratives, embodied experiences of pregnancy, lived experiences of financial constraints and religious beliefs provided some with an alternative discourse and resistant subject position. Participants also had mixed emotions about weight gain; they recognized the need to gain weight in order to have a healthy pregnancy, but weight gain was also not welcome as participants reproduced the dominant discourse of obesity and the discourse of ‘feminine’ bodily norms. Based on our results, we advocate for change to recent clinical guidelines and social discourses around pregnancy and weight gain, as well as for policies that provide pregnant women with a range of health‐promoting resources. (shrink)

Complex diseases involve both a genetic component and a response to environmental factors or lifestyle changes. Recently, genome-wide association studies (GWAS) have succeeded in identifying hundreds of polymorphisms that are statistically associated with complex diseases. However, the association is usually weak and none of the associated allelic forms is either necessary or sufficient for the disease occurrence. We argue that this promotes a network view, centred on functional redundancy. We adapted reliability theory to the concerned sub-network, modelled as a (...) parallel array of functional modules. In our model, as long as one module remains active, the function correlated with the respective disease is ensured and disease does not occur. Genetic factors reduce the initial number of available modules while environment, contingent surroundings, personal history, epigenetics, and some intrinsic stochasticity influence their persistence time. This model reproduces age-specific incidence curves and explains the influence of environmental changes. It offers a new paradigm, according to which disease occurs due to a lack of functional elements, depending on many idiosyncratic factors. Genetic risk assessed from GWAS is only a statistical notion with no direct interpretation at the individual level. However, genomic profiling could be useful at population level in devising models to guide decisions in health care policy. (shrink)