Factors influencing obesity in people with an intellectual disability

These studies indicate that obesity levels, best measured by weight not the Body Mass Index, are high among people with an intellectual disability. Poor knowledge of nutrition and exercise, together with a body image that says "I'm OK", and carers' tolerance for overweight, are indicators of obesity in this population.

The relationship between primary and secondary control and eating behaviour

Two studies were conducted investigating Australian women's management of their life goals. Although engagement with goals was generally positive for psychological well-being, the propensity to disengage from appearance-related goals was beneficial for body image and protective against disordered eating, suggesting strategies for promoting goal disengagement in women with eating disordered behaviour. The portfolio presents four case studies reviewing empirical research demonstrating the efficacy of adjuvant psychological therapy in relieving psychological distress in cancer patients.

Women in exercise to music : individual experiences of influences to be slim

This qualitative study explores reasons why women who participate in exercise to music continue to do so long-term. Thirteen women were interviewed. Generational differences of body perceptions were easily identifiable.

Biopsychosocial life-span perspective of menopause

Examines the role of biological, psychological and social factors within the individual menopausal experiences of women and the aging process. Sexual function, well-being, role, interpersonal relationships and body image were researched in a series of thre studies in a community sample of women aged 35 to 65 years.

Older women and sternotomy

Explores the experiences of older women having a sternotomy incision following cardiac surgery. Older women account for a large proportion of patients undergoing cardiac surgery each year in Australia. The context from which they face cardiac surgery is unlike that of men and of younger women, and there has been limited exploration of their experiences.

The process evaluation of it's your move!, an Australian adolescent community-based obesity prevention project

Background
Evidence on interventions for preventing unhealthy weight gain in adolescents is urgently needed. The aim of this paper is to describe the process evaluation for a three-year (2005-2008) project conducted in five secondary schools in the East Geelong/Bellarine region of Victoria, Australia. The project, 'It's Your Move!' aimed to reduce unhealthy weight gain by promoting healthy eating patterns, regular physical activity, healthy body weight, and body size perception amongst youth; and improve the capacity of families, schools, and community organisations to sustain the promotion of healthy eating and physical activity in the region.

Methods
The project was supported by Deakin University (training and evaluation), a Reference Committee (strategic direction, budgetary approval and monitoring) and a Project Management Committee (project delivery). A workshop of students, teachers and other stakeholders formulated a 10-point action plan, which was then translated into strategies and initiatives specific to each school by the School Project Officers (staff members released from teaching duties one day per week) and trained Student Ambassadors. Baseline surveys informed intervention development. Process data were collected on all intervention activities and these were collated and enumerated, where possible, into a set of mutually exclusive tables to demonstrate the types of strategies and the dose, frequency and reach of intervention activities.

Results
The action plan included three guiding objectives, four on nutrition, two on physical activity and one on body image. The process evaluation data showed that a mix of intervention strategies were implemented, including social marketing, one-off events, lunch time and curriculum programs, improvements in infrastructure, and healthy school food policies. The majority of the interventions were implemented in schools and focused on capacity building and healthy eating strategies as physical activity practices were seen by the teachers as already meeting students' needs.

Conclusions
While substantial health-promoting activities were conducted (especially related to healthy eating), there remain further opportunities for secondary schools to use a whole-of-school approach through the school curriculum, environment, policies and ethos to improve healthy eating, physical activity and healthy body perceptions in youth. To achieve this, significant, sustained leadership will be required within the education sector generally and within schools specifically.

Social ideological influences on food consumption, physical activity and BMI

We investigated relationships between ideological beliefs (i.e., diaphanous body image and environmental concerns), food attitudes, evening meal patterns, physical activity, and Body Mass Index (BMI). A behavioural model was hypothesized based on the Theory of Reasoned Action. A survey was conducted among shoppers aged 40–70 years at Eastland Shopping Centre, Melbourne, Australia. The hypothesized model was tested among female baby boomers (n = 547) for younger (n = 245) and older (n = 302) age groups using structural equation modeling. Findings showed that diaphanous body image had a direct and positive influence on negative food attitudes, which is likely to lead to higher BMI for both age groups. Body image beliefs were positively related to physical activity only for women aged 56–70 years. In contrast, among women aged 40–55 years, strong pro-environmental concerns suggested less consumption of both healthy (e.g., fruit and vegetables) and unhealthy (e.g., sugar and fats) foods. Moreover, strong pro-animal concerns resulted in higher BMI for the younger women. As expected, increased physical activity negatively influenced BMI. Importantly, the associations between ideological beliefs, attitudes, evening meal patterns, and BMI differed between younger and older female baby boomers.

Erotic capital, popular pedagogy, and healthy adolescent female sexuality

The sexualization of the female body in contemporary media has created considerable anxiety about its impact on girls. Much of the resulting research focuses on the influence of visual media on body image and the flow-on effects for girls' health. Rather less attention is paid to the pedagogical role of popular romance fiction in teaching girls about their sexuality. Given the pronounced increase in eroticized fiction for girls over the past decade, this is a significant oversight. This article applies Hakim's (2010) concept of erotic capital to two chick lit novels for girls. The elements of erotic capital—assets additional to economic, cultural and social capital—are used to explore the lessons these novels teach about girl sexual subjectivities and sociality in a sexualized culture.

Promoting fit bodies, healthy eating and physical activity among Indigenous Australian men : a study protocol

Background: Overall the physical health of Indigenous men is among the worst in Australia. Research has indicated that modifiable lifestyle factors, such as poor nutrition and physical inactivity, appear to contribute strongly to these poor health conditions. To effectively develop and implement strategies to improve the health of Australia’s Indigenous peoples, a greater understanding is needed of how Indigenous men perceive health, and how they view and care for their bodies. Further, a more systematic understanding of how sociocultural factors affect their health attitudes and behaviours is needed. This article presents the study protocol of a communitybased investigation into the factors surrounding the health and body image of Indigenous Australian men.
Methods and design: The study will be conducted in a collaborative manner with Indigenous Australian men using a participatory action research framework. Men will be recruited from three locations around Australia (metropolitan, regional, and rural) and interviewed to understand their experiences and perspectives on a number of issues related to health and health behaviour. The information that is collected will be analysed using modified grounded theory and thematic analysis. The results will then be used to develop and implement community events in each location to provide feedback on the findings to the community, promote health enhancing strategies, and determine future action and collaboration.
Discussion: This study will explore both risk and protective factors that affect the health of Indigenous Australian men. This knowledge will be disseminated to the wider Indigenous community and can be used to inform future health promotion strategies. The expected outcome of this study is therefore an increased understanding of health and health change in Indigenous Australian men, the development of strategies that promote healthy eating and positive patterns of physical activity and, in the longer term, more effective and culturally-appropriate interventions to improve health.

Interventions for preventing obesity in children (review)

Background

Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies that governments, communities and families can implement to prevent obesity, and promote health, has been accumulating but remains unclear.
Objectives

This review primarily aims to update the previous Cochrane review of childhood obesity prevention research and determine the effectiveness of evaluated interventions intended to prevent obesity in children, assessed by change in Body Mass Index (BMI). Secondary aims were to examine the characteristics of the programs and strategies to answer the questions "What works for whom, why and for what cost?"
Search methods

The searches were re-run in CENTRAL, MEDLINE, EMBASE, PsychINFO and CINAHL in March 2010 and searched relevant websites. Non-English language papers were included and experts were contacted.
Selection criteria

The review includes data from childhood obesity prevention studies that used a controlled study design (with or without randomisation). Studies were included if they evaluated interventions, policies or programs in place for twelve weeks or more. If studies were randomised at a cluster level, 6 clusters were required.
Data collection and analysis

Two review authors independently extracted data and assessed the risk of bias of included studies. Data was extracted on intervention implementation, cost, equity and outcomes. Outcome measures were grouped according to whether they measured adiposity, physical activity (PA)-related behaviours or diet-related behaviours. Adverse outcomes were recorded. A meta-analysis was conducted using available BMI or standardised BMI (zBMI) score data with subgroup analysis by age group (0-5, 6-12, 13-18 years, corresponding to stages of developmental and childhood settings).
Main results

This review includes 55 studies (an additional 36 studies found for this update). The majority of studies targeted children aged 6-12 years. The meta-analysis included 37 studies of 27,946 children and demonstrated that programmes were effective at reducing adiposity, although not all individual interventions were effective, and there was a high level of observed heterogeneity (I2=82%). Overall, children in the intervention group had a standardised mean difference in adiposity (measured as BMI or zBMI) of -0.15kg/m2 (95% confidence interval (CI): -0.21 to -0.09). Intervention effects by age subgroups were -0.26kg/m2 (95% CI:-0.53 to 0.00) (0-5 years), -0.15kg/m2 (95% CI -0.23 to -0.08) (6-12 years), and -0.09kg/m2 (95% CI -0.20 to 0.03) (13-18 years). Heterogeneity was apparent in all three age groups and could not explained by randomisation status or the type, duration or setting of the intervention. Only eight studies reported on adverse effects and no evidence of adverse outcomes such as unhealthy dieting practices, increased prevalence of underweight or body image sensitivities was found. Interventions did not appear to increase health inequalities although this was examined in fewer studies.
Authors' conclusions

We found strong evidence to support beneficial effects of child obesity prevention programmes on BMI, particularly for programmes targeted to children aged six to 12 years. However, given the unexplained heterogeneity and the likelihood of small study bias, these findings must be interpreted cautiously. A broad range of programme components were used in these studies and whilst it is not possible to distinguish which of these components contributed most to the beneficial effects observed, our synthesis indicates the following to be promising policies and strategies:

· school curriculum that includes healthy eating, physical activity and body image

· increased sessions for physical activity and the development of fundamental movement skills throughout the school week

· improvements in nutritional quality of the food supply in schools

· environments and cultural practices that support children eating healthier foods and being active throughout each day

· support for teachers and other staff to implement health promotion strategies and activities (e.g. professional development, capacity building activities)

· parent support and home activities that encourage children to be more active, eat more nutritious foods and spend less time in screen based activities

However, study and evaluation designs need to be strengthened, and reporting extended to capture process and implementation factors, outcomes in relation to measures of equity, longer term outcomes, potential harms and costs.

Childhood obesity prevention research must now move towards identifying how effective intervention components can be embedded within health, education and care systems and achieve long term sustainable impacts.

Characterization of the improvement in depressive symptoms following Bariatric surgery

Background : The Beck Depression Inventory (BDI) has been frequently employed as a measure of depression in studies of obesity, with the majority of studies reporting an improvement in scores following weight loss. Given the potential similarity in obesity-related and depressive symptoms, it is uncertain whether all components of depression would improve equally with weight loss.

Method : The study included obese patients who had undergone laparoscopic adjustable gastric banding (LAGB) surgery and had completed BDIs at baseline and 1 year after surgery. Two groups of patients were included, a general background group (N = 191, mean age = 41 ± 9, mean BMI = 43 ± 8) and a group identified as experiencing elevated depressive symptoms based on BDI scores ≥23 (EDS group; (N = 67, mean age = 40 ± 9, mean BMI = 45 ± 7).

Results : Overall, BDI scores fell for both groups, background group at baseline 17 ± 9–8 ± 7 at 1 year and for the EDS group at baseline 30 ± 5–14 ± 10 at 1 year. Patient scores on the negative self-attitude subscale were significantly greater than the two other subscales and showed the greatest improvement 1 year following LAGB. Preexisting antidepressant therapy had little or no association on the BDI scores or on its change following weight loss.

Conclusion : High rates of depression are continually reported in obesity, as is a remarkable decrease in depressive symptoms following weight loss. Negative attitudes towards one’s self appears to be driving elevated BDI scores rather than the overlap in physical symptoms between obesity and depression.

Acculturation and obesity among migrant populations in high income countries - a systematic review

Background:
There is evidence to suggest that immigrant populations from low or medium-income countries to high income countries show a significant change in obesogenic behaviors in the host society, and that these changes are associated with acculturation. However, the results of studies vary depending on how acculturation is measured. The objective of this study is to systematically review the evidence on the relationship between acculturation - as measured with a standardized acculturation scale - and overweight/obesity among adult migrants from low/middle countries to high income countries.

Methods:

Supplement use among male university students

 Introduction and Aims: The aim of this study was to investigate patterns of supplement use among male university students, who have been identified as high consumers of these substances.

Design and Methods: An online survey investigating supplement use was conducted over four weeks. Participants were sent a link to the survey via email and through posts on the online homepages of units from the School of Exercise and Nutrition Sciences at Deakin University.

Results: Sixty-one males completed the survey (median age 21 years). All participants had used at least one supplement in their lifetime, with most having used legal supplements; the most commonly used supplement was sports drinks (80%), followed by protein (80%), and vitamins and minerals (80%). Although no participants reported use of anabolic-androgenic steroids, 18% would consider using them in the future. Motivations for use differed according to substance; for instance, vitamins and minerals were used for general health purposes while creatine was used to gain muscle. Friends were a common source of information about supplements (57%), followed by online (36%) and a supplement store staff member (22%). Participants reported few negative side effects from supplement use.

Discussion and Conclusions: Supplement use is common among this group, and some indicate intentions to use more serious substances such as steroids. This study presents valuable findings about supplement use habits and patterns among male university students. However, more research is needed among this population to determine whether body image and exercise habits can influence supplement use.