Weight Loss Attempts and Attitudes toward Body Size,Eating, and Physical Activity in American Indian Children: Relationship to Weight Status and Gender

Objective: This study examined dieting, weight perceptions, and self‐efficacy to eat healthy foods and engage in physical activity and their relationships to weight status and gender among American Indian elementary schoolchildren. Research Methods and Procedures: Data for this study were collected as part of the baseline examination for the Pathways study. Participants were 1441 second‐ through third‐grade American Indian children in 41 schools representing seven tribes in Arizona, New Mexico, and South Dakota who filled out a questionnaire and had heights and weights taken. Results: Forty‐two percent of the children were overweight or obese. No differences were found between overweight/obese and normal weight children for healthy food intentions or self‐efficacy. Heavier children (especially those with body mass index > 95th percentile) were more likely to have tried to lose weight or were currently trying to lose weight. No gender differences were found. Normal weight children chose a slightly heavier body size as most healthy compared with overweight/obese children. Discussion: The results indicate that children are concerned about their weight and that weight modification efforts are common among overweight American Indian children. School, community, and family‐based programs are needed to help young people adopt lifelong healthful eating and physical activity practices.     

Weight-Related Attitudes and Behaviors of Women Who Diet to Lose Weight: A Comparison of Black Dieters and White Dieters

Obesity is a significant health problem among black women in the United States. Black women are two to three times more likely than white women to be obese. The present study sought to examine race differences in attitudes and beliefs about dieting, motivations underlying dieting efforts, and actual dieting strategies and behaviors. To achieve this aim, a subset of female survey respondents (n = 324) was drawn from a pool of more than 20,000 subscribers to Consumer Reports. All survey respondents had made at least one dieting effort within 3 years of the time of the study. For this study, we used all black female respondents (n = 162) and a matched sample (i.e., matched on age, educational attainment, and personal income) of white women (n = 162). Black women did weigh significantly more than Caucasian women, therefore, BMI was used as a covariate in all subsequent analyses. Black and white women were significantly different in a number of domains. Compared to white women, black women experienced less social pressure about their weight, initiated dieting later in life, and were significantly less likely to diet at each developmental milestone. However, the two groups of women did not differ in reasons for undertaking their most recent dieting efforts, or in the types of weight loss strategies they had employed. Nor were there differences between the black and white women in methods for coping responses with dietary relapse or in rates of disordered eating. These findings are discussed in terms of their implications for both treatment and prevention of obesity in black women.     

Body Dissatisfaction and Binge Eating in Obese Women: The Role of Restraint and Depression

Objective: This study examined the association between body dissatisfaction and binge eating, and the mediating role of restraint and depression among obese women. Research Methods and Procedures: Participants were obese women taking part in a cognitive-behavioral treatment program who completed self-report measures at baseline (n = 89) and post-treatment follow-up (n = 69). Results: At baseline, body dissatisfaction was strongly correlated with binge eating score. This was partly a direct effect and partly mediated by depression. No mediating effect of restraint was observed. Over the treatment period, a reduction in body dissatisfaction was associated with a reduction in binge-eating score. As in the cross-sectional data, there was evidence for mediation by change in depression with the greatest improvement in binge eating among those who became more restrained and less depressed. Discussion: These results suggest that it would be valuable to address psychological well-being, and especially body image, as part of the management of binge-eating behavior in obesity.     

Cultural Specificity and Comparison in Psychiatric Epidemiology: Walking the Tightrope in American Indian Research

Increasingly, the mental health needs of populations are measured using large-sample surveys with standardized measures and methods. Such efforts, however, rarely include sufficient number of smaller, culturally defined populations to draw defensible conclusions about their needs. Furthermore, without some adaptation, the standardized methods and measures may yield invalid results in such populations. Using a recently completed psychiatric epidemiology and services study with American Indian populations as a case example, this paper outlines issues facing epidemiologists working in such culturally diverse contexts. The issues discussed include the following: (1) persuading the scientific community and potential sponsors that work with distinct or culturally defined populations is important; (2) framing research questions and activities to meet the needs of communities; (3) defining a population of inference; (4) balancing the needs for comparability and cultural specificity; (5) maximizing scientific validity in light of the challenges in sample acquisition; and (6) developing and implementing data collection methods that uphold scientific standards but are also realistic given the context. The authors draw on their experiences—most recently in the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP)—to illustrate these issues and suggest ways to address each. A goal of this paper is to challenge those invested in conducting culturally valid epidemiologic work in such populations to better articulate the nature of these efforts.     

On the Relation of Attempting to Lose Weight,Restraint, and Binge Eating in Outpatients with Binge Eating Disorder

Objective: To examine the relationship among attempts to lose weight, restraint, and eating behavior in outpatients with binge eating disorder (BED). Research Methods and Procedures: Participants were 93 consecutive outpatients evaluated for a clinical trial who met Diagnostic and Statistical Manual, Fourth edition criteria for BED. The Eating Disorder Examination Interview was administered to assess attempts at weight loss, restraint, different forms of overeating, and the attitudinal psychopathology of eating disorders (i.e., concerns regarding eating, shape, and weight). In addition, the Three‐Factor Eating Questionnaire was used to assess cognitive restraint, hunger, and disinhibition. Psychometrically established measures were given to assess body dissatisfaction, depression, and self‐esteem. Results: The majority of participants (75.3%; N = 70) reported attempting to lose weight, but only 37.6% (N = 35) reported dietary restraint on at least half the days of the month. Dietary restraint and cognitive restraint were not associated with any form of binge eating or overeating. Dietary restraint and cognitive restraint were positively correlated with weight concern, shape concern, and body dissatisfaction, and negatively correlated with body mass index. To further examine the interplay between attempting to lose weight and restraint, three study groups were created: unrestrained nonattempters (21.5%, N = 20), unrestrained attempters (40.9%; N = 38), and restrained attempters (34.4%; N = 32). The three groups did not differ significantly on binge eating or other eating behaviors; however, significant differences were observed for weight concern, shape concern, and body dissatisfaction. Discussion: Attempts to lose weight and restraint are not synonymous for patients with BED. Although 75.3% of BED patients reported that they were attempting to lose weight, only 37.6% reported dietary restraint on at least half the days of the previous month. While restraint was negatively associated with body mass index, it was not related to binge eating or overeating. Our findings raise questions about prevailing models that posit restraint as a predominant factor in the maintenance of binge eating in BED.     

The Role of Education in American Indian Self-Determination: Lessons from the Ramah Navajo Community School

Since 1975 the Indian Self-Determination and Educational Assistance Act has enabled American Indian communities to enact self-determination through community-based schooling. In this study conducted by a Navajo researcher, the Ramah Navajo community defined self-determination and how it was operationalized within the community and school. The study demonstrates how education based on Navajo epistemology has been integral to self-determination at Ramah, underscoring the importance of incorporating Native American epistemologies in schooling for Indigenous students.     

Body‐Image Perceptions among Urban Native American Youth

Objective: This study investigated body‐image perceptions among Native American youth. Research Methods and Procedures: A modified and validated body‐image measure for use with Native American youth was utilized in a cross‐sectional assessment of 155 urban Native American youth attending an after‐school program in Minneapolis, Minnesota. The youth (ages 5 to 18 years) expressed their perceptions of current and ideal body image, which allowed assessment of satisfaction or dissatisfaction. Body sizes perceived as healthy or most likely to develop diabetes were also communicated. Heights and weights were measured, and body mass index was calculated. Results: When asked to identify their ideal body figure, younger children selected thinner figures than adolescents, and overweight youth chose ideal figures similar to those of normal‐weight youth. The mean body dissatisfaction of the youth was ±0.99 and ±1.49 body figures for boys and girls, respectively. Examination of the direction of body dissatisfaction revealed that 41% of the boys and 61% of the girls expressed a desire to be thinner. Those expressing the greatest dissatisfaction were overweight girls (>95th percentile). On a scale from one to eight, the median of the body image viewed as the healthiest was 4.0, whereas that most likely to develop diabetes was 8.0. Discussion: These results suggest that urban Native American youth are dissatisfied with their body size and that most acknowledge the diabetes risk associated with overweight, which implies that they may be receptive to obesity prevention measures.     

Physical Activity as a Predictor of Body Composition in American Indian Children

Objective: To examine physical activity in second grade American Indian children as a predictor of percentage body fat 3 years later. Research Methods and Procedures: Physical activity was assessed as average vector magnitude (AVM) counts from an accelerometer in 454 second grade children as part of the Pathways study. BMI was assessed, and skinfolds and bioelectrical impedance were used to estimate fat mass, fat‐free body mass, and percentage body fat in validated prediction equations. Associations were examined using mixed models regression controlling for baseline body composition. Results: In normal‐weight children, higher AVM counts were significantly associated with decreases in percentage body fat. Among overweight children, higher AVM counts were significantly associated with increases in BMI, fat mass, and fat‐free mass but not percentage body fat. Discussion: Higher physical activity levels in second grade were associated with lower levels of percentage body fat in fifth grade in normal‐weight but not in overweight children. BMI showed no association with physical activity among normal‐weight children, and increases in BMI were associated with increasing amounts of physical activity among overweight children. These findings emphasize the importance of valid body composition measures and may indicate important differences in associations between physical activity and adiposity in normal‐weight as compared with overweight children.     

Intergenerational Perceptions of Body Image in Hispanics: Role of BMI,Gender, and Acculturation

Objective: To assess role of BMI, gender, and acculturation on maternal and children's perception of body size, body ideal, and attractiveness. Research Methods and Procedures: Eighty mothers and their 6‐ to‐ 12‐year‐old children (41 boys, 39 girls) participated. Maternal and children's perceptions of body size (actual and ideal) and attractiveness were assessed through a pictorial instrument. Mother and child height and weight, demographic, and acculturation characteristics were also assessed. Results: Seventy‐nine percent of the mothers were overweight, and 32% of the boys and 34% of the girls were overweight or at‐risk for overweight. BMI influenced the children's selection of perceived ideal size. Overweight or at‐risk for overweight children were more likely to select thinner figures as the ideal size than non‐overweight children. Gender and acculturation differences concerning children's perceptions of body size and attractiveness were also found. Girls perceived the obese figure as being less attractive than did the boys. More acculturated children were likely to select thinner figures as more attractive than their less acculturated counterparts. Maternal acculturation was associated positively with the girls’ choice of thinner figures as an ideal body size, but not with the boys. Mothers viewed their daughters’ actual body size and BMI as ideal, although 34% of the girls were at‐risk for overweight. Mothers perceived average body size figures as more attractive for their sons. Discussion: Findings from this study provide empirical data about the role of BMI, gender, acculturation, and familial influences on children's perceptions of actual and ideal body sizes and attractiveness.     

Influence of Leptin on Changes in Body Fat during Growth in African American and White Children

Objective: The aim of this study was to determine whether initial levels or temporal changes in fasting leptin were associated with longitudinal changes in body‐fat mass in children. Research Methods and Procedures: The study group consisted of 85 children (42 white and 43 African American) with a mean initial age of 8.1 ± 0.1 years. The children had between three and six annual visits for repeated measurements of body composition by DXA and fasting leptin level. Fat mass and fasting leptin level were not normally distributed and were log‐transformed. Data were analyzed using SAS Proc mixed growth models, with log fat as the dependent variable. Results: Initial leptin level was a significant predictor of the change in fat mass over time (p < 0.0001), with high initial leptin levels resulting in increased fat gain, independent of initial fat levels. This relationship remained significant when the data were analyzed separately by race (whites, p < 0.0001; African Americans, p = 0.008). The relationship between the initial level of leptin and the change in fat mass was not modified by race, sex, or Tanner Stage. The rate of change in leptin during the study was significantly related to the rate of change in fat mass in African Americans (p = 0.008) but not in whites (p = 0.490). Discussion: In conclusion, high fasting leptin level at the start of the study was significantly associated with increasing fat mass in this cohort, indicating that the children may be developing resistance to the effects of leptin.     

Obesity Prevention in Preschool Native‐American Children: A Pilot Study Using Home Visiting

Objective : To determine whether maternal participation in an obesity prevention plus parenting support (OPPS) intervention would reduce the prevalence of obesity in high‐risk Native‐American children when compared with a parenting support (PS)‐only intervention. Research Methods and Procedures : Forty‐three mother/child pairs were recruited to participate. Mothers were 26.5 ± 5 years old with a mean BMI of 29.9 ± 3 kg/m². Children (23 males) were 22 ± 8 months old with mean weight‐for‐height z (WHZ) scores of 0.73 ± 1.4. Mothers were randomly assigned to a 16‐week OPPS intervention or PS alone. The intervention was delivered one‐on‐one in homes by an indigenous peer educator. Baseline and week 16 assessments included weight and height (WHZ score and weight‐for‐height percentile for children), dietary intake (3‐day food records), physical activity (measured by accelerometers), parental feeding style (Child Feeding Questionnaire), and maternal outcome expectations, self‐efficacy, and intention to change diet and exercise behaviors. Results : Changes in WHZ scores showed a trend toward significance, with WHZ scores decreasing in the PS condition and increasing among the OPPS group (?0.27 ± 1.1 vs. 0.31 ± 1.1, p = 0.06). Children in the OPPS condition also significantly decreased energy intake (?316 ± 835 kcal/d vs. 197 ± 608 kcal/d, p < 0.05). Scores on the restriction subscale of the Child Feeding Questionnaire decreased significantly in the OPPS condition (?0.22± 0.42 vs. 0.08± 0.63, p < 0.05), indicating that mothers in the OPPS group were engaging in less restrictive child feeding practices over time. Discussion : A home‐visiting program focused on changing lifestyle behaviors and improving parenting skills showed promise for obesity prevention in high‐risk Native‐American children.     

Prevalence of Overweight among Inner City Hispanic‐American Children and Adolescents

Objective: National surveys have pointed to a particularly high risk of pediatric overweight among U.S. Hispanics. However, the data have been primarily from the Mexican‐American community. We studied the prevalence of overweight and clinical comorbidities in children and youth of predominantly El Salvadoran ancestry. Research Methods and Procedures: A sample of 309 Hispanic youth, 6–18 years was surveyed from two inner city Washington, DC, clinics. BMI; triceps skinfold (TSF) and subscapular skinfold thickness (SSSF); bioelectrical impedance analysis (BIA); and blood pressure measures were obtained, along with information regarding physical activity, sedentary behavior, dietary history, family, and personal medical history. Results: Thirty‐eight percent were overweight (BMI ≥ 95th percentile) and 22% at risk for overweight (BMI 85–94th percentile). Thirty‐four percent had TSF ≥ 90th percentile and 29% had SSSF ≥ 90th percentile. Fifty‐one percent of males and 70% of females had body fat > 30%. Compared to their nonoverweight counterparts, overweight youth had significantly higher systolic blood pressure (111.4 ± 1.3 vs. 104.5 ± 0.9 mm Hg, p < 0.0001). Among children younger than 11 years, overweight was associated with onset of adrenarche (23% vs. 10%, p = 0.01). Participation in one or more sports teams was negatively correlated with overweight) p = 0.04). Discussion: The prevalence of overweight and at risk for overweight in this sample was twice the national average for U.S. children and 1.7 times greater than that of Mexican‐American children in national surveys. Overweight was associated with advanced pubertal development, high body fat, elevated blood pressure, and decreased sports participation.     

Body Size Perceptions and Eating Attitudes in Elderly Men

The majority of studies on eating attitudes, dieting and body size perceptions have focused on young adults and women. This study examined these attitudes in 334 black and white men, ages 55 to 98 years, who were members of the Charleston Heart Study cohort. Associations of the eating attitude variable with race, education and weight status were examined. Eighty-two percent of the overweight white men studied had dieted to lose weight, whereas only 49% of slimmer white men had dieted. In contrast, overweight black men did not diet more than slimmer black men. Overall black men dieted less than white men (37% reported dieting). Black men who were high school graduates were 1.3 times more likely to have dieted than were less educated black men. Overweight white men were over twice as likely as slimmer white men to feel guilty after overeating. This difference was not found in overweight versus slimmer black men. Education was not associated with measured body mass index (BMI) or perceived or ideal body size. However, there were some racial differences in these variables. White men preferred to be slightly thinner than black men (ideal BMI 25.6 vs. 26.1 kg/m²), and the difference between actual and desired BMI was 0.6 kg/m² greater in white than in black men. These results indicate that effects of race and weight status on eating restraint and body size perceptions seen in younger subjects and in women are also present, at least to some degree, in elderly men.     

Attitudes toward Animals among German Children and Adolescents

ABSTRACT

This is the first study about attitudes toward animals among German children and adolescents. A sample of 543 pupils (261 boys, 282 girls) aged 11 to 17 (mean age = 13.37 ± 2.01 years) completed a questionnaire based on different established scales, for example, the Animal Attitude Scale (AAS) and the Intermediate Attitude Scale (IAS). Several aspects of attitudes toward animals and various dimensions of human–animal relationships were measured, including gender, age, grade, pet ownership, animal-related activities, meat consumption, and fear of and disgust toward animals. Gender and age were important factors in determining attitudes toward animals: pro-animal attitudes decreased with age and girls showed more positive attitudes compared with boys. Pet ownership and animal-related activities were associated with more positive attitudes toward animals, whilst meat consumption was related to lower pro-animal attitudes. There were no correlations between fear and general attitudes toward animals. The correlations between disgust and attitudes toward animals were weak. We found significant correlations among the different scales and subscales in animal attitudes.     

Pathological traits observed in a historic Great Basin Native American Indian Skeleton

During the excavation of an irrigation ditch in Churchill County, Nevada, a burial was encountered, with associated artifacts indicative of historical provenience. The pattern of occlusal attrition, the lack of dental work, and the skeletal morphology indicate the individual was a Great Basin Native American Indian. Sex determination was female and age at death estimated as 40±. The skeleton is nearly complete and several of the long bones, as well as the vertebrae, scapulae, sternum and xiphoid process have minor pathologies, either osteophytic growths or areas of porosities and pitted appearances. The left sacroiliac joint is extensively affected by an unusual pathology, with the auricular surfaces of both the sacrum and ilium having a scooped out or hollowed appearance. Although the other pathologies are interpreted as being related to both age and possibly the lifestyle of a female Great Basin Indian during historic times, the sacroiliac pathological condition is construed as a manifestation of a more severe affliction.     

Resemblance for Body Mass Index in Families of Obese African American and European American Women

Objective: We determined the levels of resemblance in body mass index (BMI) in large samples of families selected through obese African American and European American women. Research Methods and Procedures: We examined correlations among relatives in 1185 European American and African American families ascertained through age-matched obese women (BMI ≥ 30 kg/m²). A subset of 801 families were ascertained through extremely obese women (BMI ≥ 40 kg/m²). Results: Parent-offspring and sibling correlations ranged from 0.19 to 0.15, suggesting a moderate level of heritability in both groups. Mean BMI values for female relatives were lower for European Americans than for African Americans even though probands were matched, perhaps because the European American relatives regress to a lower population mean. We found significantly higher family correlations for height in European Americans, suggesting greater environmental variability among African Americans for factors affecting growth and physical development. Discussion: Our results suggest a similar level of heritability of BMI in families of obese African American and European American women. Other genetic studies will be needed to determine the extent to which the same or different genes and environmental conditions contribute to an overall similar heritability in the two racial groups.     

Television,Disordered Eating,and Young Women in Fiji: Negotiating Body Image and Identity during Rapid Social Change

Although the relationship between media exposure and risk behavior among youth is established at a population level, the specific psychological and social mechanisms mediating the adverse effects of media on youth remain poorly understood. This study reports on an investigation of the impact of the introduction of television to a rural community in Western Fiji on adolescent ethnic Fijian girls in a setting of rapid social and economic change. Narrative data were collected from 30 purposively selected ethnic Fijian secondary school girls via semi-structured, open-ended interviews. Interviews were conducted in 1998, 3 years after television was first broadcast to this region of Fiji. Narrative data were analyzed for content relating to response to television and mechanisms that mediate self and body image in Fijian adolescents. Data in this sample suggest that media imagery is used in both creative and destructive ways by adolescent Fijian girls to navigate opportunities and conflicts posed by the rapidly changing social environment. Study respondents indicated their explicit modeling of the perceived positive attributes of characters presented in television dramas, but also the beginnings of weight and body shape preoccupation, purging behavior to control weight, and body disparagement. Response to television appeared to be shaped by a desire for competitive social positioning during a period of rapid social transition. Understanding vulnerability to images and values imported with media will be critical to preventing disordered eating and, potentially, other youth risk behaviors in this population, as well as other populations at risk.     

Assessing Psychopathology in American Indian and Alaska Native Children and Adolescents

The purpose of this study was to investigate a) the relations between different types of civic behaviors and middle school students' perceptions of school climate, and b) the compositional effects of student civic engagement on setting-level school climate perceptions. Using a sample of 4,073 students in 11 public schools from a southeastern state, multilevel regression analyses found that, in general, civic behaviors were positively associated with school climate outcomes at the individual and setting level. However, certain types of civic behavior were negatively associated with desired school climate outcomes at both levels. These findings suggest a complicated relationship between student civic engagement and school climate, and imply that schools and adult leaders may need to carefully consider the types of opportunities for civic engagement provided to students.     

American Indians without tribes in the twenty-first century

Among American Indians and Alaska Natives, most aspects of ethnicity are tightly associated with the person's tribal origins. Language, history, foods, land and traditions differ among the hundreds of tribes indigenous to the USA. With this in mind, we ask why almost one million American Indians failed to respond to the tribal affiliation part of the Census 2000 race question. We investigate four hypotheses about why one-third of multiracial American Indians and one-sixth of single-race American Indians did not write any response to the tribal affiliation question: (1) survey item non-response that undermines all fill-in-the-blank questions; (2) a non-salient tribal identity; (3) a genealogy-based affiliation; and (4) a mestizo identity, which does not require a tribe. We use multivariate logistic regression models and high-density restricted-use Census 2000 data. We find support for the first two hypotheses and note that predictors differ substantially for single-race versus multiple-race American Indians.     

Influence of Total vs. Visceral Fat on Insulin Action and Secretion in African American and White Children

Objective: To examine whether total body fat (FAT) in general or visceral fat (VFAT) in particular is associated with greater metabolic risk in white and African American children. Research Methods and Procedures: A total of 68 white and 51 African American children had measures of insulin sensitivity (Si) and acute insulin response (AIR) by a frequently sampled intravenous glucose tolerance test, total body fat by DXA and abdominal fat distribution (visceral vs. subcutaneous) by computed tomography. The influence of FAT and VFAT on insulin parameters were examined by comparing subgroups of children with high or low FAT vs. high or low VFAT and by multiple regression analysis. Results: In whites, fasting insulin, Si, and AIR were significantly influenced by FAT, but not VFAT (e.g., for Si, 9.8 ± 0.8 in low FAT vs. 4.6 ± 0.7 × 10^?4/min/[μIU/mL] in high FAT, p < 0.05; 6.8 ± 0.7 in low VFAT vs. 7.5 ± 0.8 × 10^?4/min/[μIU/mL] in high VFAT, p > 0.1). In African Americans, fasting insulin and Si were also primarily influenced by FAT (e.g., for Si, 4.9 ± 0.4 in low FAT vs. 2.8 ± 0.5 × 10^?4/min/[μIU/mL] in high FAT, p < 0.05) but not by VFAT, and there were no significant effects of either fat compartment on AIR. In multiple regression analysis, Si was significantly influenced by FAT (negative effect), ethnicity (lower in African Americans), and gender (lower in females), whereas fasting insulin was significantly influenced by VFAT (positive effect), ethnicity (higher in African Americans), and fat free mass (positive effect). Discussion: Body fat in general is the predominant factor influencing Si, but VFAT may have additional effects on fasting insulin. The lack of major effects of VFAT on Si in children may be explained by lower levels of VFAT or because VFAT affects aspects of whole body insulin action that are not measured by the minimal model.