1 eating habits, physical activity and risky behaviors of youth practicing weight control julie...
TRANSCRIPT
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Eating habits, physical activity and risky behaviors of youth
practicing weight control
Julie Chmielewski
M.S. Candidate
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Objective
1. Evaluate a nationally representative sample of adolescents to determine the prevalence of weight control methods according to youth’s weight status.
2. Confirm that overweight youth are using recommended methods of weight control according to Healthy People 2010.
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Rationale•Obesity
NHANES 11%, YRBS 16% •Weight control
YRBS 43% of youth•Health consequences of inappropriate weight control
Growth retardation, acute gastric dilation, metabolic alkalosis, cardiac arrhythmia, death•Risky health behaviors associated with wt. control
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Data
• National Longitudinal Study of Adolescent Health (Add Health) – Chapel Hill, N.C.
• Funded by: National Institute of Child Health and Human Development & 17 other agencies
• Wave II from 1995-1996• Major topics: nutrition, daily activity, health
service use, violence, sexual behavior, substance abuse, injury
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Data source
News Search Site Map Contact Us
© 1998 The National Longitudinal Study of Adolescent HealthLast modified 28 April 2000
http://www.cpc.unc.edu/projects/addhealth/addhealth_home.html
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Research Question #1
a. What is the frequency of weight control use among adolescents who have already started puberty and grouped by underweight, average weight or overweight/obese?
b. Are there differences in frequency of weight control use among pubescent youth by weight category, grade, race and age categories?
c. What types of weight control methods are used?
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Research Question #2a. Are pubescent youth who use weight control
methods at increased risk for participating in other risky health behaviors such as smoking, drug use, alcohol consumption and/ or suicide thoughts?
b. Is there a difference in risky health behaviors among pubescent youth who use weight control as grouped by weight category?
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Research Question #3
Do underweight, average weight and overweight pubescent youth who use weight control methods have healthy eating and exercise behaviors (as recommended by HP2010)?
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Variable selection (n=13, 568)
Menarche YES
Sexual Maturation
Stage 3YES
Underweight Average Overweight Underweight Average Overweight
Nutrition
Fast FoodBeverage Breakfast
Food GroupsPhysical Activities
Risky behavior (Yes/No) – suicide, substance use, tobacco use, drug use, dangerous weight control
Types of weight control behaviors – diet, exercise, laxative, vomiting, diet pills
Health-promoting Behaviors
Weight Control(Yes/No)
Weight Control(Yes/No)
Weight Control(Yes/No)
Weight Control(Yes/No)
Weight Control(Yes/No)
Weight Control(Yes/No)
MalesFemales
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Definitions
Weight control: includes everything reported to lose weight or to keep from gaining weight
Dangerous weight control: using vomiting, diet pills, or laxatives to lose weight or keep from gaining weight
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Definitions
Weight categories: calculated from measured height and weights and BMIs compared to age- and gender-specific growth charts for underweight, average weight, at risk for overweight, overweight
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2000 NCHS
Growth Chart
95th
85th
5th
95th
85th
5th
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Definitions
Puberty status:
1) boys secondary sex characteristics
2) girls - menarche
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How puberty status determined for boys in Add Health Wave II Sexual Maturation Stagea Question from Add Health Stage 1 Prepubescent No hair under arms at all.
No hairs on face. Voice not lower.
Stage 2 Pubic hair appears Genitalia growth Sweat gland action
I have little facial and underarm hair. Yes, voice is a little lower than grade school.
Stage 3 Pubic hair extends Genitalia growth Begin acne Voice changes
I have some underarm hair, but not a lot. The hair is thick on my face. My voice is somewhat lower than grade school.
Stage 4 Pubic hair thickens Genitalia growth Acne may be severe Voice deepens
I have lots of hair under my arms and it is thick. The hair is thick on my face like a grown man’s. Yes my voice is a lot lower than grade school.
Stage 5 Hair distribution increases Genitalia fully mature Acne may persist or increase
I have a whole lot of hair that is very thick, as much underarm hair as a grown man.
The hair is very thick, like a grown man’s facial hair.
My voice is a whole lot lower than when I was in grade school; it is as low as an adult man’s voice.
aTanner, 1984
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Analyses
• SPSS – Statistical Package for Social Sciences
• SUDAAN statistical analysis software• Cross tabulations & Logistic Regression• Odds ratios and confidence intervals
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Demographic characteristics (N=11,012) Girls Boys
Characteristics No.
% Yes, Wt. Control
(weighted %) No.
% Yes, wt. Control
(weighted %) Adolescent Total 6063 100 74 4958 100 44 Weight category *** *** Underweight 161 3 31 119 2 30 Average weight 4115 69 77 3328 68 46 Overweight 922 15 91 722 15 70 Obese 741 13 94 757 15 86
Age category *** <14 years 1120 18 82 769 16 63 15-16 years 2459 41 81 1941 39 56 17-18 years 2484 41 78 2248 45 51
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Demographic characteristics (N=11,012) cont. Girls Boys
Characteristics No.
% Yes, Wt. Control
(weighted %) No.
% Yes, wt. Control
(weighted %) Adolescent Total 6063 100 74 4958 100 44 Ethnicity ** ** White 3315 55 82 2887 58 57 African American
1379 23 78 857 17 46
American Indian 95 2 80 75 2 56 Asian 373 6 71 355 7 58 Hispanic 844 14 77 740 15 59 Other 48 1 74 40 1 57
Grade * 9th or younger 1903 34 81 1438 31 60 10th grade 1202 21 83 1000 22 57 11th grade 1313 23 78 1183 25 53 12th or beyond 1236 22 79 1010 22 52
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Privacy issue with weight control questions
When 20% of participants reported a third person in the room -
• Girls less likely to report dieting or diet pill use• Boys less likely to report diet pill use
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Type of weight control used by adolescents
Girls (n=4777) Boys (n=2182)
Exercise 43% 52%
Dieting and exercise
18% 9%
Dieting alone 7% 3%
Laxatives, vomiting, diet pills*
3% <1%
* 50% girls using these methods were average weight.
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Logistic regression analyses of demographic variables by wt control Girls (n=4094) Boys (n=3861) OR 95% CI OR 95% CI
Weight Category Average weight 1.0 1.00/1.00 1.0 1.00/1.00 Underweight 0.1** 0.04/.015 0.2** 0.07/0.37 Overweight 3.6** 2.50/5.23 3.9** 2.96/5.02 Obese 5.6** 3.45/9.18 11.5** 8.54/15.60 Ethnicity White 1.0 1.00/1.00 1.0 1.00/1.00 African American 0.6** 0.47/0.79 0.5* 0.32/0.97 Hispanic 0.6* 0.44/0.86 1.2 0.81/2.02 Other 0.7* 0.48/0.98 1.4 0.91/2.14 Age category <=14 years 1.0 1.00/1.00 1.0 1.00/1.00 15-16 years 1.1 0.79/1.44 0.4** 0.22/0.65 >=17 years 0.8 0.53/1.28 0.4* 0.20/0.92
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Eating and exercise behaviors
• Fruit & vegetable intake: 5+ servings• Milk intake: > 1 serving milk• Fast food intake: < 2 times per week• Breakfast intake: > 5 times a week and 3 or
more food groups• Variety of food: 1 serving of each food group• Exercise: > 3 times a week for > 30 minutes
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GIRLS: Eating and exercise behaviors associated with weight control
Positive behaviors• 1.6 x more likely to eat less fast food• 1.6 x more likely to get exercise > 3x/wk for 30 min.• Less likely to use drugsNegative behaviors• 1.4 x more likely to eat an inadequate breakfast• 1.6 x more likely to skip breakfast• 1.6 x more likely to consume alcoholNot significant • Fruit and vegetable intake, dairy, food group variety
* Odds ratios reported were significant.
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BOYS: Eating and exercise behaviors associated with weight control
Positive behaviors• 1.9 x more likely to eat less fast food
Negative behaviors• No significant findings
Not significant • Fruit and vegetable intake, dairy, food group
variety, breakfast consumption, exercise
ns = not significant 24
Likelihood of weight control (after controlling for all these variables)
Odds ratio; p<0.05 Average Weight Overweight
Girls Boys Girls Boys
Fast food (< 2x/wk) 1.6 2.1 ns Ns
Inadequate Breakfast ns ns 2.3 ns
Exercise (3x/wk@30min)
1.6 ns ns ns
African American 0.5 0.37 ns ns
Grade1.8 (11th )
2.6 (12th)2.5 (10th)
0.2 (11th )
0.1 (12th )0.4 (11th ) 0.2 (12th )
Age (yr) 2.6 (17+) 0.3 (15-16) ns ns
Alcohol (yes) 1.6 ns 2.2 ns
Drug (yes) 0.6 ns 0.4 ns
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ConclusionsHealth People 2010:Overweight adolescents should be practicing
adequate exercise and eating a balanced diet.
89% overweight youth using weight control– OW boys eating less fast food– OW girls eating inadequate breakfast– 49% of those using dangerous weight control
methods were OW
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Conclusions55% of average wt. youth using weight control
– AW girls less likely to eat fast food and more likely to exercise
– AW boys less likely to eat fast food– 51% of those using dangerous methods were
AW
30% of underweight youth using weight control
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Thank youDr. Hoerr
Dr. Weatherspoon
Dr. Kallen
My parents
My lab group
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Recent newspaper
articles in the Lansing State
Journal