The Role of Self-Regulating Abilities in Long-Term Weight Loss in Severely Obese Children and Adolescents Undergoing Intensive Combined Lifestyle Interventions (HELIOS); Rationale, Design and Methods.

The role of self-regulating abilities in long-term weight loss in severely obese children and adolescents undergoing intensive combined lifestyle interventions (HELIOS); rationale, design and methods.

BMC Pediatr. 2013 Mar 25; 13(1): 41
Halberstadt J, Makkes S, de Vet E, Jansen A, Nederkoorn C, van der Baan-Slootweg OH, Seidell JC

BACKGROUND: Adequate treatment of severe childhood obesity is important given its serious social, psychological and physical consequences. Self-regulation may be a crucial determinant of treatment success. Yet, little is known about the role that self-regulation and other psychosocial factors play in the long-term outcome of obesity treatment in severely obese children and adolescents.In this paper, we describe the design of a study that aims to determine whether the ability to self-regulate predicts long-term weight loss in severely obese children and adolescents. An additional objective is to identify other psychosocial factors that may modify this relation.Methods/design: The study is designed as a prospective observational study of 120 severely obese children and adolescents (8–19 years) and their parents/caregivers undergoing an intensive combined lifestyle intervention during one year. The intervention uses behavior change techniques to improve the general ability to self-regulate.Measurements will be taken at three points in time: at baseline (start of treatment), at the end of treatment (1 year after baseline) and at follow-up (2 years after baseline). The primary outcome measurement is the gender and age-specific change in SDS-BMI.The children’s general self-regulation abilities are evaluated by two behavioral computer tasks assessing two distinct aspects of self-regulation that are particularly relevant to controlling food intake: inhibitory control (Stop Signal Task) and sensitivity to reward (Balloon Analogue Risk Task). In addition to the computer tasks, a self-report measure of eating-specific self-regulation ability is used. Psychosocial factors related to competence, motivation, relatedness and outcome expectations are examined as moderating factors using several questionnaires for the patients and their parents/caregivers. DISCUSSION: This study will provide knowledge about the relation between self-regulation and long-term weight loss after intensive lifestyle interventions over a two-year period in severely obese children and adolescents, a growing but often overlooked patient group. We aim to investigate to what extent (changes in) the general ability to self-regulate predicts weight loss and weight loss maintenance. This study will also contribute to the knowledge on how this association is modified by other psychosocial factors. The results may contribute to the development of more successful interventions.Trial registration: Netherlands Trial Register (NTR1678, registered 20-Feb-2009). HubMed – eating


Cross-sectional study of self-reported physical activity, eating habits and use of complementary medicine in breast cancer survivors.

BMC Cancer. 2013 Mar 25; 13(1): 153
Templeton AJ, Thürlimann B, Baumann M, Mark M, Stoll S, Schwizer M, Dietrich D, Ruhstaller T

BACKGROUND: Besides conventional adjuvant therapies, many breast cancer survivors engage in various activities like exercise, diet and complementary and alternative medicine (CAM) in order to improve their prognosis. Little is known about specific interests and willingness to participate in institutional programs (e.g. exercise classes). METHODS: We conducted a cross-sectional study in patients with early breast cancer assessing current physical activity (PA, e.g. 30 minutes brisk walking), attention to eating habits (“diet”), use of CAM, and interest in learning more about these fields. Patients indicating interest in PA counselling received a voucher for a free instruction by a certified physiotherapist. Data were analysed for factors predictive for engagement in the three fields using a stepwise multivariate logistic approach. RESULTS: Of 342 consecutive patients, 232 (69%) reported to be physically active more than once per week, 299 (87%) paying special attention to nutrition (in most cases fruits, “balanced diet”, low fat), and 159 (46%) use of CAM (vitamins, special teas, homeopathy, herbal medicine, mistletoe). Factors predictive for PA were use of CAM, higher age, and fewer worries about the future. Swiss nationality at birth, physical activity and higher education were predictive for diet; whereas physical activity, higher education and lower age were predictive for use of CAM. No associations between any of the above variables and breast cancer characteristics were found. Around half of the patients reported interest in receiving more information and willingness to attend special counselling. Of 166 vouchers, only 7 (4%) were eventually utilized. CONCLUSIONS: A high proportion of breast cancer survivors report PA, following a specific diet and use of CAM. There were no disease related factors associated with such pursuits, but an association between patient related factors and these fields was observed suggesting general health awareness in some patients. Around half of the patients were interested in more information and indicated willingness to participate in institutional programs. Impact on disease specific and general health including health economic aspects warrants further research. HubMed – eating


Food responsiveness, parental food control and anthropometric outcomes among young American Indian children: cross-sectional and prospective findings.

Ethn Dis. 2013; 23(2): 136-42
Fulkerson JA, Hannan P, Rock BH, Smyth M, Himes JH, Story M

Assess cross-sectional and prospective associations between food responsiveness and parental food control and anthropometric outcomes among American Indian children.Parents/caregivers completed psychosocial surveys and trained staff measured children’s anthropometry at baseline (kindergarten) and at follow-up (1st grade) as part of a school-based obesity prevention trial (Bright Start).On/near the Pine Ridge Indian reservation.422 child (51% female, mean age=5.8 years, 30% overweight/obese) and parent/caregiver (89% mothers) dyads.Two independent variables (child’s Food Responsiveness and Parental Control scales) and six child anthropometric dependent variables (overweight status, body mass index z-score, % body fat, waist circumference, triceps skinfold, subscapular skinfold). Linear regression analyses, stratified by sex and adjusted for age and treatment condition.Baseline Food Responsiveness scale scores were positively associated with all six baseline anthropometric outcomes among boys (P’s all <.01), but not girls. Parental Control scale scores were not significantly associated with outcomes and no prospective associations were statistically significant.Responsiveness to food may be associated with excess adiposity in young American Indian boys, however, the effects are not detectable over time. Obesity prevention programs for American Indian children may benefit by addressing eating without hunger among boys. HubMed – eating



The Unspoken – Short Film about Eating Disorders – A short film that explores the mind of a young girl suffering with anorexia nervosa. ————————————————————————…