Eating Disorders: Unbundling Outcomes of a Multilevel Intervention to Increase Fruit, Vegetables, and Whole Grains Parents Pack for Their Preschool Children in Sack Lunches.

Unbundling outcomes of a multilevel intervention to increase fruit, vegetables, and whole grains parents pack for their preschool children in sack lunches.

Filed under: Eating Disorders

Am J Health Educ. 2012 5; 43(3): 135-142
Briley ME, Ranjit N, Hoelscher DM, Sweitzer SJ, Almansour F, Roberts-Gray C

BACKGROUND: Packing fruit, vegetables, and whole grains in preschool children’s sack lunches is a powerful way for parents to teach their children eating habits and food preferences to support a lifetime of good health. A multilevel intervention pilot-tested in childcare settings increased servings of vegetables and whole grains, but the lunches still fell short of the intervention goals. PURPOSE: Secondary analyses were conducted to identify specific behavior changes underlying achieved increases in servings of vegetables and whole grains. METHODS: Food records from direct observation of 769 parent-packed lunches were investigated to unbundle and measure multiple aspects of lunch packing behavior. Changes from baseline to six week follow-up for the intervention (N=81) and comparison (N=51) parent-child dyads were evaluated in multilevel modeling. RESULTS: The increase for whole grains was explained by more parents packing whole grain items whereas increase for vegetables was explained by parents packing vegetables on more days. DISCUSSION: Tailored options were identified for further strategies to increase vegetables and whole grains in parent-packed sack lunches. TRANSLATION TO HEALTH EDUCATION PRACTICE: Linking achieved outcomes to specific behaviors can be an aid in assessing needs and designing interventions to maximize the chances for success.
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An unusual suspect causing behavioural problems and pituitary failure in a child.

Filed under: Eating Disorders

BMJ Case Rep. 2012; 2012:
Heathcote AC, Wormald JC, Stocks R

A 9-year-old boy presented with feeding and behavioural problems and was diagnosed with Autistic Spectrum Disorder and Attention Deficit Hyperactivity Disorder. By age 11 he was becoming increasingly disinhibited and was refusing almost all oral food intake. Believing the cause to be psychogenic, he was placed in an inpatient eating disorder facility. After 3 days of continuous vomiting and minimal intake, he was admitted back to hospital for further investigations. A hypovolaemic hypernatraemia prompted an MRI brain scan, revealing several tumour masses with suprasellar and pituitary involvement. Histological investigation revealed primary, non-malignant germ-cell tumours. The tumours were treated with craniopharyngeal radiotherapy and permanent pituitary hormone replacement.
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Eating Behaviors of Older African Americans: An Application of the Theory of Planned Behavior.

Filed under: Eating Disorders

Gerontologist. 2012 Dec 14;
O’Neal CW, Wickrama KK, Ralston PA, Ilich JZ, Harris CM, Coccia C, Young-Clark I, Lemacks J

PURPOSE: The study applies the theory of planned behavior to explain the fruit and vegetable eating behaviors, a broad construct consisting of preparing, self-monitoring, and consuming fruits and vegetables, of older African Americans. DESIGN AND METHODS: Structural equation modeling was used to examine the applicability of the theory of planned behavior with data from 211 older African American women and men (73% women, 26% men; median age range of 57-63 years) participating in a larger intervention study. RESULTS: Attitudes about eating fruit and vegetables, subjective social norms, and perceived behavioral control were related to older African Americans’ intentions to consume fruits and vegetables. Social norms and behavioral intentions were associated with fruit and vegetable eating behaviors. Perceived control did not moderate the influence of behavioral intentions on actual behavior. IMPLICATIONS: Results indicated that the theory of planned behavior can be used to explain variation in older African Americans’ eating behavior. This study also emphasizes the value of considering broader behavioral domains when employing the theory of planned behavior rather than focusing on specific behaviors. Furthermore, social service programs aimed at reducing the incidence of diseases commonly associated with poor eating behaviors among older African Americans must consider promoting not only fruit and vegetable consumption but also related behaviors including preparing and self-monitoring by eliminating structural, cognitive, and normative constraints.
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Short- and medium-term impact of a residential weight-loss camp for overweight adolescents.

Filed under: Eating Disorders

Int J Adolesc Med Health. 2012 Dec 15; 1-6
Fonseca H, Palmeira AL, Martins S, Ferreira PD

Abstract Introduction: Management of adolescent obesity in clinical practice has been usually centered on the promotion of healthy eating and an active lifestyle, with a weak evidence base. In search of creative and more effective interventions, our objective was to evaluate the immediate and follow-up effectiveness of a residential camp program for obese adolescents. Methods: A total of 28 obese adolescents (15 girls), mean age 13.3±1.7 years and body mass index (BMI) 30.3±5.4 kg/m2, who were attending a tertiary health unit, enrolled in a 2-week camp. The activities were prepared and supervised by different specialists. All adolescents were assessed for anthropometric and psychosocial variables including body image, self-esteem, quality of life and depressive symptoms. Evaluations were conducted on the first and last day of the camp and at 6 months’ follow-up. The effect of treatment was analyzed using analysis of variance (ANOVA) mixed models. Results: At the end of the camp, weight was reduced by -2.7±1.2%, BMI by -0.8±0.4 units and waist circumference by -2.8±9.8 cm. A reduction in depressive symptoms was identified, with greater reductions in BMI associated with a more significant improvement in depressive symptoms. At the 6 months’ follow-up only girls maintained BMI reduction, with boys having increased their BMI. Discussion: In the short-term the camp was effective in reducing BMI and improving depressive symptoms. Only girls were able to proceed with BMI reduction at 6 months. These gender differences should be further explored. Ongoing research is examining the maintenance of these improvements.
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