Television consumption influences perceptions of attractive female body size. However, cross-cult... more Television consumption influences perceptions of attractive female body size. However, cross-cultural research examining media influence on body ideals is typically confounded by differences in the availability of reliable and diverse foodstuffs. 112 participants were recruited from 3 Nicaraguan villages that differed in television consumption and nutritional status, such that the contribution of both factors could be revealed. Participants completed a female figure preference task, reported their television consumption, and responded to several measures assessing nutritional status. Communities with higher television consumption and/or higher nutritional status preferred thinner female bodies than communities with lower television consumption and/or lower nutritional status. Bayesian mixed models estimated the plausible range of effects for television consumption, nutritional status, and other relevant variables on individual preferences. The model explained all meaningful differences between our low-nutrition villages, and television consumption, after sex, was the most likely of these predictors to contribute to variation in preferences (probability mass >95% when modelling only variables with zero-order associations with preferences, but only 90% when modelling all possible predictors). In contrast, we found no likely link with nutritional status. We thus found evidence that where media access and nutritional status are confounded, media is the more likely predictor of body ideals.
Lifestyle interventions delivered during the retirement transition might promote healthier ageing... more Lifestyle interventions delivered during the retirement transition might promote healthier ageing. We report a pilot randomised controlled trial (RCT) of a web-based platform (Living, Eating, Activity and Planning through retirement; LEAP) promoting healthy eating (based on a Mediterranean diet (MD)), physical activity (PA) and meaningful social roles. A single blinded, two-arm RCT with individual allocation. Seventy-five adult regular internet users living in Northeast England, within two years of retirement, were recruited via employers and randomised in a 2:1 ratio to receive LEAP or a 'usual care' control. Intervention arm participants were provided with a pedometer to encourage self-monitoring of PA goals. Feasibility of the trial design and procedures was established by estimating recruitment and retention rates, and of LEAP from usage data. At baseline and 8-week follow-up, adherence to a MD derived from three 24-hour dietary recalls and seven-day PA by accelerometry ...
Research into the antecedents of disordered eating attitudes and body dissatisfaction in preadole... more Research into the antecedents of disordered eating attitudes and body dissatisfaction in preadolescent girls is lacking, despite the physical and psychological developmental risks these phenomena pose. In response, two separate studies of school-based samples of young girls were undertaken, investigating a range of biopsychosocial risk factors using longitudinal and cross-sectional methodologies. Study 1 examined prospective predictors of disordered eating attitudes and body dissatisfaction. 138 girls completed measures of adiposity, perfectionism, anxiety, body dissatisfaction and disordered eating attitudes at 7 to 9 years old and two years later at 9 to 11 years old. Across-time predictors of body dissatisfaction and disordered eating attitudes, adjusted for other across- and within-time relationships, were assessed using regression analyses. Initial adiposity predicted subsequent body dissatisfaction with only borderline significance when adjusted for subsequent adiposity. Initial disordered eating attitudes and perfectionism predicted subsequent disordered eating attitudes. These data suggest novel prospective factors in the pathogenesis of disordered eating and body image for young girls. Study 2 cross-sectionally examined the utility of an adult sociocultural model of body dissatisfaction and disordered eating attitudes in young girls for the first time. According to the model, internalising an unrealistically thin ideal body increases the risk of disordered eating via body dissatisfaction, dietary restraint, and depression. 127 girls aged 7-11 years old completed measures of adiposity, thin-ideal internalisation, body dissatisfaction, dieting, depression, and disordered eating attitudes. Thin-ideal internalisation predicted disordered eating attitudes indirectly via body dissatisfaction, dietary restraint, and depression; it also predicted disordered eating attitudes directly (a novel parameter). Exploratory path analyses showed that this revised sociocultural model fit well with the data. These data indicate a sociocultural framework of disordered eating and body dissatisfaction in adults is useful, with minor modifications, in understanding related attitudes in young girls. Together, these studies provide a detailed picture of factors involved in the development and maintenance of body dissatisfaction and disordered eating attitudes during middle childhood. They suggest the importance of early, targeted interventions for this age group as a means to reduce girls’ current and subsequent concerns about eating, shape and weight.
Internalization of a thin ideal has been posited as a key risk factor in the development of patho... more Internalization of a thin ideal has been posited as a key risk factor in the development of pathological eating attitudes. Cross-culturally, studies have found a preference for heavier bodies in populations with reduced access to visual media compared to Western populations. As yet, however, there has been little attempt to control for confounding variables in order to isolate the effects of media exposure from other cultural and ecological factors. Here, we examined preferences for female body size in relation to television consumption in Nicaraguan men and women, while controlling for the potential confounding effects of other aspects of Westernization and hunger. We included an urban sample, a sample from a village with established television access, and a sample from a nearby village with very limited television access. The highest BMI preferences were found in the village with least media access, while the lowest BMI preferences were found in the urban sample. Data from the rural sample with established television access were intermediate between the two. Amongst rural women in particular, greater television consumption was a stronger predictor of body weight preferences than acculturation, education, hunger, or income. We also found some evidence for television consumption increasing the likelihood of women seeking to lose weight, possibly via body shape preferences. Overall, these results strongly implicate television access in establishing risk factors for body image disturbances in populations newly gaining access to Western media.
Effective weight loss interventions are widely available but, after weight loss, most individuals... more Effective weight loss interventions are widely available but, after weight loss, most individuals regain weight. This article describes the protocol for the NULevel trial evaluating the effectiveness and cost-effectiveness of a systematically developed, inexpensive, scalable, technology-assisted, behavioural intervention for weight loss maintenance (WLM) in obese adults after initial weight loss. A 12-month single-centre, two-armed parallel group, participant randomised controlled superiority trial is underway, recruiting a total of 288 previously obese adults after weight loss of ≥5 % within the previous 12 months. Participants are randomly assigned to intervention or control arms, with a 1:1 allocation, stratified by sex and percentage of body weight lost (<10 % vs ≥10 %). Change in weight (kg) from baseline to 12 months is the primary outcome. Weight, other anthropometric variables and 7-day physical activity (assessed via accelerometer) measures are taken at 0 and 12 months. ...
Weight loss outcomes in overweight and obese individuals may be influenced by individual weight l... more Weight loss outcomes in overweight and obese individuals may be influenced by individual weight loss expectations (WLEs). Research on these phenomena in older women is lacking. This cross-sectional study compared groups of younger and older women on their WLEs and related attitudes (body dissatisfaction and disordered eating). Twenty-six younger (18-38 years) and 33 older (60-78 years) overweight and obese women were recruited from a weight loss clinic, prior to treatment. Disordered eating attitudes and body dissatisfaction were assessed using validated questionnaires and a pictorial figure-choice scale. Participants reported 10 WLEs categorized according to personal, lifestyle and social factors. Overall, women with a higher body mass index had greater WLEs. Older women reported lower WLEs than younger women (-14.5 kg vs. -22.4 kg) in all categories except past weight. Older women perceived that career success would necessitate the greatest level of weight loss (-18.5 kg), whereas...
There is a need for development of more effective interventions to achieve healthy eating, enhanc... more There is a need for development of more effective interventions to achieve healthy eating, enhance healthy ageing, and to reduce the risk of age-related diseases. The aim of this study was to identify the behaviour change techniques (BCTs) used in complex dietary behaviour change interventions and to explore the association between BCTs utilised and intervention effectiveness. We undertook a secondary analysis of data from a previous systematic review with meta-analysis of the effectiveness of dietary interventions among people of retirement age. BCTs were identified using the reliable CALO-RE taxonomy in studies reporting fruit and vegetable (F and V) consumption as outcomes. The mean difference in F and V intake between active and control arms was compared between studies in which the BCTs were identified versus those not using the BCTs. Random-effects meta-regression models were used to assess the association of interventions BCTs with F and V intakes. Twenty-eight of the 40 BCTs...
Television consumption influences perceptions of attractive female body size. However, cross-cult... more Television consumption influences perceptions of attractive female body size. However, cross-cultural research examining media influence on body ideals is typically confounded by differences in the availability of reliable and diverse foodstuffs. 112 participants were recruited from 3 Nicaraguan villages that differed in television consumption and nutritional status, such that the contribution of both factors could be revealed. Participants completed a female figure preference task, reported their television consumption, and responded to several measures assessing nutritional status. Communities with higher television consumption and/or higher nutritional status preferred thinner female bodies than communities with lower television consumption and/or lower nutritional status. Bayesian mixed models estimated the plausible range of effects for television consumption, nutritional status, and other relevant variables on individual preferences. The model explained all meaningful differences between our low-nutrition villages, and television consumption, after sex, was the most likely of these predictors to contribute to variation in preferences (probability mass >95% when modelling only variables with zero-order associations with preferences, but only 90% when modelling all possible predictors). In contrast, we found no likely link with nutritional status. We thus found evidence that where media access and nutritional status are confounded, media is the more likely predictor of body ideals.
Lifestyle interventions delivered during the retirement transition might promote healthier ageing... more Lifestyle interventions delivered during the retirement transition might promote healthier ageing. We report a pilot randomised controlled trial (RCT) of a web-based platform (Living, Eating, Activity and Planning through retirement; LEAP) promoting healthy eating (based on a Mediterranean diet (MD)), physical activity (PA) and meaningful social roles. A single blinded, two-arm RCT with individual allocation. Seventy-five adult regular internet users living in Northeast England, within two years of retirement, were recruited via employers and randomised in a 2:1 ratio to receive LEAP or a 'usual care' control. Intervention arm participants were provided with a pedometer to encourage self-monitoring of PA goals. Feasibility of the trial design and procedures was established by estimating recruitment and retention rates, and of LEAP from usage data. At baseline and 8-week follow-up, adherence to a MD derived from three 24-hour dietary recalls and seven-day PA by accelerometry ...
Research into the antecedents of disordered eating attitudes and body dissatisfaction in preadole... more Research into the antecedents of disordered eating attitudes and body dissatisfaction in preadolescent girls is lacking, despite the physical and psychological developmental risks these phenomena pose. In response, two separate studies of school-based samples of young girls were undertaken, investigating a range of biopsychosocial risk factors using longitudinal and cross-sectional methodologies. Study 1 examined prospective predictors of disordered eating attitudes and body dissatisfaction. 138 girls completed measures of adiposity, perfectionism, anxiety, body dissatisfaction and disordered eating attitudes at 7 to 9 years old and two years later at 9 to 11 years old. Across-time predictors of body dissatisfaction and disordered eating attitudes, adjusted for other across- and within-time relationships, were assessed using regression analyses. Initial adiposity predicted subsequent body dissatisfaction with only borderline significance when adjusted for subsequent adiposity. Initial disordered eating attitudes and perfectionism predicted subsequent disordered eating attitudes. These data suggest novel prospective factors in the pathogenesis of disordered eating and body image for young girls. Study 2 cross-sectionally examined the utility of an adult sociocultural model of body dissatisfaction and disordered eating attitudes in young girls for the first time. According to the model, internalising an unrealistically thin ideal body increases the risk of disordered eating via body dissatisfaction, dietary restraint, and depression. 127 girls aged 7-11 years old completed measures of adiposity, thin-ideal internalisation, body dissatisfaction, dieting, depression, and disordered eating attitudes. Thin-ideal internalisation predicted disordered eating attitudes indirectly via body dissatisfaction, dietary restraint, and depression; it also predicted disordered eating attitudes directly (a novel parameter). Exploratory path analyses showed that this revised sociocultural model fit well with the data. These data indicate a sociocultural framework of disordered eating and body dissatisfaction in adults is useful, with minor modifications, in understanding related attitudes in young girls. Together, these studies provide a detailed picture of factors involved in the development and maintenance of body dissatisfaction and disordered eating attitudes during middle childhood. They suggest the importance of early, targeted interventions for this age group as a means to reduce girls’ current and subsequent concerns about eating, shape and weight.
Internalization of a thin ideal has been posited as a key risk factor in the development of patho... more Internalization of a thin ideal has been posited as a key risk factor in the development of pathological eating attitudes. Cross-culturally, studies have found a preference for heavier bodies in populations with reduced access to visual media compared to Western populations. As yet, however, there has been little attempt to control for confounding variables in order to isolate the effects of media exposure from other cultural and ecological factors. Here, we examined preferences for female body size in relation to television consumption in Nicaraguan men and women, while controlling for the potential confounding effects of other aspects of Westernization and hunger. We included an urban sample, a sample from a village with established television access, and a sample from a nearby village with very limited television access. The highest BMI preferences were found in the village with least media access, while the lowest BMI preferences were found in the urban sample. Data from the rural sample with established television access were intermediate between the two. Amongst rural women in particular, greater television consumption was a stronger predictor of body weight preferences than acculturation, education, hunger, or income. We also found some evidence for television consumption increasing the likelihood of women seeking to lose weight, possibly via body shape preferences. Overall, these results strongly implicate television access in establishing risk factors for body image disturbances in populations newly gaining access to Western media.
Effective weight loss interventions are widely available but, after weight loss, most individuals... more Effective weight loss interventions are widely available but, after weight loss, most individuals regain weight. This article describes the protocol for the NULevel trial evaluating the effectiveness and cost-effectiveness of a systematically developed, inexpensive, scalable, technology-assisted, behavioural intervention for weight loss maintenance (WLM) in obese adults after initial weight loss. A 12-month single-centre, two-armed parallel group, participant randomised controlled superiority trial is underway, recruiting a total of 288 previously obese adults after weight loss of ≥5 % within the previous 12 months. Participants are randomly assigned to intervention or control arms, with a 1:1 allocation, stratified by sex and percentage of body weight lost (<10 % vs ≥10 %). Change in weight (kg) from baseline to 12 months is the primary outcome. Weight, other anthropometric variables and 7-day physical activity (assessed via accelerometer) measures are taken at 0 and 12 months. ...
Weight loss outcomes in overweight and obese individuals may be influenced by individual weight l... more Weight loss outcomes in overweight and obese individuals may be influenced by individual weight loss expectations (WLEs). Research on these phenomena in older women is lacking. This cross-sectional study compared groups of younger and older women on their WLEs and related attitudes (body dissatisfaction and disordered eating). Twenty-six younger (18-38 years) and 33 older (60-78 years) overweight and obese women were recruited from a weight loss clinic, prior to treatment. Disordered eating attitudes and body dissatisfaction were assessed using validated questionnaires and a pictorial figure-choice scale. Participants reported 10 WLEs categorized according to personal, lifestyle and social factors. Overall, women with a higher body mass index had greater WLEs. Older women reported lower WLEs than younger women (-14.5 kg vs. -22.4 kg) in all categories except past weight. Older women perceived that career success would necessitate the greatest level of weight loss (-18.5 kg), whereas...
There is a need for development of more effective interventions to achieve healthy eating, enhanc... more There is a need for development of more effective interventions to achieve healthy eating, enhance healthy ageing, and to reduce the risk of age-related diseases. The aim of this study was to identify the behaviour change techniques (BCTs) used in complex dietary behaviour change interventions and to explore the association between BCTs utilised and intervention effectiveness. We undertook a secondary analysis of data from a previous systematic review with meta-analysis of the effectiveness of dietary interventions among people of retirement age. BCTs were identified using the reliable CALO-RE taxonomy in studies reporting fruit and vegetable (F and V) consumption as outcomes. The mean difference in F and V intake between active and control arms was compared between studies in which the BCTs were identified versus those not using the BCTs. Random-effects meta-regression models were used to assess the association of interventions BCTs with F and V intakes. Twenty-eight of the 40 BCTs...
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and cross-sectional methodologies.
Study 1 examined prospective predictors of disordered eating attitudes and body
dissatisfaction. 138 girls completed measures of adiposity, perfectionism, anxiety, body dissatisfaction and disordered eating attitudes at 7 to 9 years old and two years later at 9 to 11 years old. Across-time predictors of body dissatisfaction and disordered eating attitudes, adjusted for other across- and within-time relationships, were assessed using regression analyses. Initial adiposity predicted subsequent body dissatisfaction with only borderline significance when adjusted for subsequent adiposity. Initial disordered eating attitudes and perfectionism predicted subsequent disordered eating attitudes. These data suggest novel prospective factors in the pathogenesis of disordered eating and body image for young girls.
Study 2 cross-sectionally examined the utility of an adult sociocultural model of body dissatisfaction and disordered eating attitudes in young girls for the first time. According to the model, internalising an unrealistically thin ideal body increases the risk of disordered eating via body dissatisfaction, dietary restraint, and depression. 127 girls aged 7-11 years old completed measures of adiposity, thin-ideal internalisation, body dissatisfaction, dieting, depression, and disordered eating attitudes. Thin-ideal internalisation predicted disordered eating attitudes indirectly via body dissatisfaction, dietary restraint, and depression; it also predicted disordered eating attitudes directly (a novel parameter). Exploratory path analyses
showed that this revised sociocultural model fit well with the data. These data indicate a sociocultural framework of disordered eating and body dissatisfaction in adults is useful, with minor modifications, in understanding related attitudes in young girls.
Together, these studies provide a detailed picture of factors involved in the
development and maintenance of body dissatisfaction and disordered eating attitudes during middle childhood. They suggest the importance of early, targeted interventions for this age group as a means to reduce girls’ current and subsequent concerns about eating, shape and weight.
and cross-sectional methodologies.
Study 1 examined prospective predictors of disordered eating attitudes and body
dissatisfaction. 138 girls completed measures of adiposity, perfectionism, anxiety, body dissatisfaction and disordered eating attitudes at 7 to 9 years old and two years later at 9 to 11 years old. Across-time predictors of body dissatisfaction and disordered eating attitudes, adjusted for other across- and within-time relationships, were assessed using regression analyses. Initial adiposity predicted subsequent body dissatisfaction with only borderline significance when adjusted for subsequent adiposity. Initial disordered eating attitudes and perfectionism predicted subsequent disordered eating attitudes. These data suggest novel prospective factors in the pathogenesis of disordered eating and body image for young girls.
Study 2 cross-sectionally examined the utility of an adult sociocultural model of body dissatisfaction and disordered eating attitudes in young girls for the first time. According to the model, internalising an unrealistically thin ideal body increases the risk of disordered eating via body dissatisfaction, dietary restraint, and depression. 127 girls aged 7-11 years old completed measures of adiposity, thin-ideal internalisation, body dissatisfaction, dieting, depression, and disordered eating attitudes. Thin-ideal internalisation predicted disordered eating attitudes indirectly via body dissatisfaction, dietary restraint, and depression; it also predicted disordered eating attitudes directly (a novel parameter). Exploratory path analyses
showed that this revised sociocultural model fit well with the data. These data indicate a sociocultural framework of disordered eating and body dissatisfaction in adults is useful, with minor modifications, in understanding related attitudes in young girls.
Together, these studies provide a detailed picture of factors involved in the
development and maintenance of body dissatisfaction and disordered eating attitudes during middle childhood. They suggest the importance of early, targeted interventions for this age group as a means to reduce girls’ current and subsequent concerns about eating, shape and weight.