Dissertations / Theses on the topic 'Obesity Perception'

Childhood obesity affects children from every socioeconomic level, but there is a higher prevalence of obesity among preschool-age children from low-income families. Some obese children are experiencing symptoms (e.g., high cholesterol and diabetes) generally experienced by adults. As a result, healthcare costs have increased. The purpose of this qualitative phenomenological study was to understand how low-income African American parents contribute to the prevalence of obesity in preschoolers. The conceptual framework and constructs from the health belief model (HBM) guided this study. Interview data were gathered from 8 participants who met the inclusion criteria of being a low-income African American parent with an overweight/obese child living in the Atlanta Region. Creswell's simplified version of Stevick-Colaizzi-Keen's data analysis led to the following themes among the participants. The themes were time restraints for preparing a healthy meal and limited activities-playtime, family time, America's childhood obesity, inappropriate diet, and lack of knowledge. Results demonstrated that parents might not understand that a lack of adequate sleep, physical activity, and healthy meals (consumed with parents) contribute to the prevalence of childhood obesity. Positive social change can be achieved through decreased healthcare costs associated with obesity related diseases by implementing the recommended 60 minutes of structured and unstructured playtime activities at learning centers and parents introducing small dietary changes, with healthy choices, which can start preschoolers eating healthier at a young age.

In the past 30 years, binge eating and obesity has increased among all age groups due to lifestyle, environment, social, and biological reasons. To change eating habits, individuals may have to collaborate with others beyond the medical professional. Societal impacts of binge eating and obesity include increases in insurance rates, medical costs, and increased early-age mortality. The purposes of this study were to assess how individuals are referred to other professionals if they self-identify as binge eaters or obese and to understand personal awareness individuals had of binge eating and obesity. Cognitive behavioral theory was used as the theoretical foundation. A quantitative, non experimental design was used with a nonrandom convenience sampling of residents in a northern US state aged 18 years and older. 166 participants completed a demographic questionnaire and the Eating Attitudes Test (EAT-26). Chi square analyses indicated a significant relationship between individuals who were obese and the lack of referral to another professional beyond the primary care physician. Individuals over identified with binge eating based on elevated EAT-26 scores, and under identified with obesity based on identifying with lower BMI categories than those set by the American Medical Association. Implications for positive social change include an increased awareness of binge eating and obesity, which can result in reduced medical costs and healthier lifestyles. Prevention and intervention programs can be developed to educate children, parents, and communities about lifestyle choices.

The primary purpose of this research was to investigate relationships between physical activity participation, weight change, and selfreports of social physique anxiety, physical self-concept and health-related quality of life. A secondary purpose was to investigate personality as a mediator of self-perceptions and quality of life beliefs following obesity surgery. Two studies with differing methodologies were conducted. The first study was a cross-sectional survey of patients who had participated in a multi-component clinical weight-loss program involving a combination of physical activity, diet modification, and drug therapy. The second study was a longitudinal investigation of laparoscopic adjustable gastric banding patients. Amount of weight lost was not found to be related to changes in social physique anxiety, physical self-concept or health-related quality of life. However, physical activity levels were found to be an important predictor of improvements in physical self-concept and health-related quality of life amongst clinical weight loss patients, but not surgical patients. Improvements over time with respect to social physique anxiety, physical self-concept and health-related quality of life were observed amongst all participants who underwent LABG. Personality factors, whilst not predicting changes over time in social physique anxiety, physical self-concept or health-related quality of life, discriminated between two types of obese adults presenting for obesity surgery. Future research could be undertaken to determine if long-term outcomes differ for these two types of patients.

Master of Science<br>Department of Journalism and Mass Communications<br>Joye Gordon<br>Obesity in the U.S. has become a national epidemic. The military, in particular Military spouses are not exempt from the challenging issue of obesity. Understanding risk perception and health behavior is key to reducing the obesity epidemic, however insufficient research has been conducted among U.S. military spouses to understand their perceived risk and health behaviors. This quantitative study was conducted among 291 military spouses using the Extended Parallel Process Model and Social Cognitive Theory as the conceptual frameworks. The results indicated that perceived susceptibility of obesity and obesity related illness among overweight and obese military spouses while reinforcing both response and self-efficacy is the focal area for communication. Key barriers to weight loss and health goals were identified and the setting of health goals is identified as important. The researcher provides a digital intervention recommendation to address the findings of this study.

This study sought to examine whether participation in physical activity affects the ability to correctly classify body size, based on body mass index classifications. Secondarily, this study determined whether adolescents who incorrectly classified their body size overestimated or underestimated their size. Self-report data from the Youth Risk Behavior Surveillance Survey collected by the Centers for Disease Control and Prevention were analyzed. Logistic regression was performed to examine relationships between self-perception of body size and physical activity, television viewing time, computer/video game use, physical education class time, and extracurricular sports activities. Significance was set to p<0.05. Physical activity was the only statistically significant independent variable (p=0.058, OR = 1.060). Although physical activity was shown to be statistically significant, it did not appear to meaningfully increase the ability of youth to correctly classify body size. Secondary analysis showed that adolescents who incorrectly classified their body size were more likely to underestimate their body size. Females more frequently underestimated their body size (females=673; males=384).

Inequities in body mass index may be driven by where people live, their personal characteristics and perceptions. Multilevel analyses of multiple waves of the Household Income and Labour Market Dynamics in Australia (HILDA) panel survey; a source of data that included self-reported height and weight, weight-related perceptions, a range of socioeconomic indicators and linked to area-level disadvantage. Higher mean BMI was observed among men and (especially) women living in disadvantaged areas after control for confounding. This inequity was present at age 18 to 25 and widened well into middle-age. Behavioural risk factors did not explain the patterning of BMI by area-level disadvantage. People in more affluent areas who were overweight or obese were more likely to have accurate perceived weight status and more likely to be dissatisfied with their weight compared to their peers in disadvantaged areas. Those who were overweight but relatively lighter than the area mean BMI tended to have lower odds of feeling dissatisfied with or perceiving themselves as overweight. No mean weight gain or reduction over a 5-year period was observed among overweight participants who perceived themselves as overweight or expressed dissatisfaction with their weight. These stable weight trajectories were not modified by socioeconomic disadvantage. However, men and women who over-perceived their WHO-classified ‘normal’ BMI experienced a mean increase in BMI across 5-years, especially those in socioeconomically disadvantaged areas. Men and women in disadvantaged areas tend to have higher BMI. If overweight, they appear less likely to perceive they are overweight or express dissatisfaction with their BMI. Early intervention is crucial to prevent widening socioeconomic inequities in adulthood. Correcting under-perceived overweight may not lead to weight loss. Correcting over-perceived BMI to prevent future weight gain may be important, especially among people living in disadvantaged areas.

Children may become overweight or obese for different reasons, and childhood obesity may have health consequences such as Type 2 diabetes and asthma. The purpose of this qualitative phenomenological study was to describe the perceptions of African American parents of elementary-age children with obesity living in Broward County, Florida about the causes and consequences of childhood obesity. The health belief model (HBM) guided this study. Interview data were gathered from 9 participants who met the criteria of being African American parents of elementary-age children with obesity living in Broward County, Florida. Moustakas- steps to analyze the data collected led to the following themes: how parents became aware of the disease, parents- reaction to the diagnosis, whether the condition was related to genetics or lifestyle behavior, what the obese children eat daily, the importance of regular workout, consequences of obesity, actions taken, and type of help needed. Results demonstrated that most of the participants perceived childhood obesity as having 2 primary causes: food consumption and insufficient physical activities. Data also showed that many of the participants regarded childhood obesity as having negative consequences, not only for the children but also for their parents and other stakeholders. Positive social change can be achieved by parental acknowledgment that obesity has adverse health consequences to be considered seriously. Denial may have severe consequences and the commitment of policymakers and others who can affect lives of the overweight or obese children is needed.

Background: Physical activity and childhood obesity have been studied extensively across the globe, but only few studies have been done in children who are aware of their obesity, overweight status and among children who are taking measures to control their weight. The purpose of this study is to examine agreement between perceived weight and ideal weight differences across gender, grade level, race and levels of weight control. METHODS: This study is based on the secondary analysis of the Youth Risk Behavior Surveillance System (YRBSS) conducted in the state of Georgia in 2009 (n=1882). The 2009 YRBS for each state that participated used a two-stage cluster sample design to produce a fairly representative sample of public school students in the grades of 9-12. Agreement between the perceived weight and the ideal weight differences across gender, grade level and race was measured using Kappa statistic. RESULTS: In general, agreement between perceived weight and the ideal weight were better in females compared to males. A much higher degree of concordance between perceived weight and the ideal weight was observed in Whites compared to Blacks and Hispanics. The analysis by grade resulted in 12th grade participants showing a high concordance value between their ideal weight and their perceived weight than the lower grade levels. CONCLUSION: The results are in particular very insightful to the public health professionals who are in the process of promoting healthy behaviors. The study implies that minority groups such as Blacks and Hispanics may be more uninformed about their obesity status. Public health programs that are specifically designed to increase obesity awareness may help to alleviate obesity and its related consequences. Race and gender specific programs may help to increase perception about obesity in at-risk 9-12 children and adolescents.

Thesis (Ed.D.)--Teachers College, Columbia University, 1995.<br>Typescript; issued also on microfilm. Sponsor: Joan Dye Gussow. Dissertation Committee: Isobel Contento. Includes bibliographical references (187-202).

The study was conducted in Dubai, one of the main Emirate states.  It is a cross sectional descriptive study, conducted between January and April 2004.  The sample size was 661(324 males and 337 females).  These were all local national students from preparatory and secondary schools with ages ranging from 12 to 17 years.  A multi-stage stratified, random sampling technique was used to obtain a representative sample of appropriate size for estimating the prevalence of obesity among adolescents.  A short questionnaire was used to obtained information relating to factors which contributed to obesity. The results revealed that there was a high prevalence of obesity in males (22.2%) and females (20.2%).  Boys and girls in early and middle adolescence (12-15years) were more obese than late adolescents (16-17 years).  An increase in body mass index may lead to high blood pressure, high blood sugar level, high cholesterol and triglyceride level.  The girls were  shown to be more likely to follow a dietary programmes and watch television food advertisements.  Television was shown to be the most effective way of transmitting health nutrition information inclusion in the school curriculum being the next most effective way.  Boys participated in physical activity more than girls; reducing the likelihood of obesity.  Boys were more likely to overestimate their current body shape than girls. It was concluded that since obesity cannot be prevented or managed at an individual level, governments, the food industry, international agencies, the media and community should all work together to modify the environment so that it is less conductive to weight gain.

The purpose of this qualitative interpretive descriptive study was to better understand children’s perceptions of the use of motivational interviewing (MI) as a communication style for childhood obesity treatment. Childhood obesity in the United States has reached epidemic proportions and much research effort has been dedicated to reversing this trend. One approach that has demonstrated positive outcomes in the clinical setting is MI. Leading organizations in pediatric healthcare now recommend MI as a communication style to be used for childhood obesity-related behavior change. Although empiric studies have demonstrated improvement in outcomes when this communication style is used with patients and families, no study to date had looked at MI from the perspective of the child. Thorne’s (2008) framework for interpretive descriptive research was used for this study. Individual interviews with children ages 7 through 13 were conducted in an outpatient weight management clinic that utilizes MI as the primary communication style for facilitating behavior change. Qualitative data analysis was conducted utilizing Thorne’s recommendations for interpretive descriptive research. Five themes emerged from the data: 1) Empowerment, 2) Freedom to be Me, 3) Educating without “Educating”, 4) Unconditional Support, and 5) Blossoming. A conceptual model was developed from the research findings to help clinicians working with children in similar contexts glean a deeper understanding of the use of MI with children. Future research endeavors should focus on the implementation of this model in clinical practice to strengthen the conceptual links and determine applicability to practice.

As obesity has reached an epidemic level, the female population age 35 years and older is struggling with increased risks of death from type 2 diabetes, hypertension, coronary heart disease, stroke, and certain cancers. The purpose of this study was to explore the perception of overweight and obesity among African American women 35 years and older in Houston, Texas. A phenomenological approach was adopted for this study to explore the perception of overweight and obesity among African American women 35 years and older in Houston, Texas. This study was also guided by the Health Belief Model as a conceptual framework in relation to overweight prevention and obesity control. Flyers were distributed to recruit participants from church, fitness center, and AllcareMedical Center. Ten African American women 35 years and older living in Houston, Texas were selected to participate for this study. The selected participants were either obese, overweight, at risk of being obese or overweight or had family member who is either overweight or obese. Face-to-face interviews were conducted to collect data, and the information collected was coded for themes. Findings indicated the need to engage in physical exercise and eating right as strategies to reduce the rate of obesity. The study contributes to social change through awareness and education as it encourages health professionals to use the findings to develop relevant strategies to understand the impact of obesity while using the perceptions of overweight and obesity to improve health and well being among African American women 35 years and older.

Overweight and obesity are two of the most important emerging public health issues in our time and regarded by the World Health Organisation [WHO] (1998) as a worldwide epidemic. The prevalence of obesity in the USA is the highest in the world, and Australian obesity rates fall into second place. Currently, about 60% of Australian adults are overweight (BMI „d 25kg/m2). The socio-demographic factors associated with overweight and/or obesity have been well demonstrated, but many of the existing studies only examined these relationships at one point of time, and did not examine whether significant relationships changed over time. Furthermore, only limited previous research has examined the issue of the relationship between perception of weight status and actual weight status, as well as factors that may impact on people¡¦s perception of their body weight status. Aims: The aims of the proposed research are to analyse the discrepancy between perceptions of weight status and actual weight status in Australian adults; to examine if there are trends in perceptions of weight status in adults between 1995 to 2004/5; and to propose a range of health promotion strategies and furth er research that may be useful in managing physical activity, healthy diet, and weight reduction. Hypotheses: Four alternate hypotheses are examined by the research: (1) there are associations between independent variables (e.g. socio -demographic factors, physical activity and dietary habits) and overweight and/or obesity; (2) there are associations between the same independent variables and the perception of overweight; (3) there are associations between the same independent variables and the discrepancy between weight status and perception of weight status; and (4) there are trends in overweight and/or obesity, perception of overweight, and the discrepancy in Australian adults from 1995 to 2004/5. Conceptual Framework and Methods: A conceptual framework is developed that shows the associations identified among socio -demographic factors, physical activity and dietary habits with actual weight status, as well as examining perception of weight status. The three latest National Health Survey data bases (1995 , 2001 and 2004/5) were used as the primary data sources. A total of 74,114 Australian adults aged 20 years and over were recruited from these databases. Descriptive statistics, bivariate analyses (One -Way ANOVA tests, unpaired t-tests and Pearson chi-square tests), and multinomial logistic regression modelling were used to analyse the data. Findings: This research reveals that gender, main language spoken at home, occupation status, household structure, private health insurance status, and exercise are related to the discrepancy between actual weight status and perception of weight status, but only gender and exercise are related to the discrepancy across the three time point s. The current research provides more knowledge about perception of weight status independently. Factors which affect perception of overweight are gender, age, language spoken at home, private health insurance status, and diet ary habits. The study also finds that many factors that impact overweight and/or obesity also have an effect on perception of overweight, such as age, language spoken at home, household structure, and exercise. However, some factors (i.e. private health insurance status and milk consumption) only impact on perception of overweight. Furthermore, factors that are rel ated to people’s overweight are not totally related to people’s underestimation of their body weight status in the study results. Thus, there are unknown factors which can affect people’s underestimation of their body weight status. Conclusions: Health promotion and education activities should provide education about population health education and promotion and education for particular at risk sub -groups. Further research should take the form of a longitudinal study design ed to examine the causal relationship between overweight and/or obesity and underestimation of body weight status, it should also place more attention on the relationships between overweight and/or obesity and dietary habits, with a more comprehensive representation of SES. Moreover, further research that deals with identification of characteristics about perception of weight status, in particular the underestimation of body weight status should be undertaken.

Overweight and obesity are two of the most important emerging public health issues in our time and regarded by the World Health Organisation [WHO] (1998) as a worldwide epidemic. The prevalence of obesity in the USA is the highest in the world, and Australian obesity rates fall into second place. Currently, about 60% of Australian adults are overweight (BMI „d 25kg/m2). The socio-demographic factors associated with overweight and/or obesity have been well demonstrated, but many of the existing studies only examined these relationships at one point of time, and did not examine whether significant relationships changed over time. Furthermore, only limited previous research has examined the issue of the relationship between perception of weight status and actual weight status, as well as factors that may impact on people¡¦s perception of their body weight status. Aims: The aims of the proposed research are to analyse the discrepancy between perceptions of weight status and actual weight status in Australian adults; to examine if there are trends in perceptions of weight status in adults between 1995 to 2004/5; and to propose a range of health promotion strategies and furth er research that may be useful in managing physical activity, healthy diet, and weight reduction. Hypotheses: Four alternate hypotheses are examined by the research: (1) there are associations between independent variables (e.g. socio -demographic factors, physical activity and dietary habits) and overweight and/or obesity; (2) there are associations between the same independent variables and the perception of overweight; (3) there are associations between the same independent variables and the discrepancy between weight status and perception of weight status; and (4) there are trends in overweight and/or obesity, perception of overweight, and the discrepancy in Australian adults from 1995 to 2004/5. Conceptual Framework and Methods: A conceptual framework is developed that shows the associations identified among socio -demographic factors, physical activity and dietary habits with actual weight status, as well as examining perception of weight status. The three latest National Health Survey data bases (1995 , 2001 and 2004/5) were used as the primary data sources. A total of 74,114 Australian adults aged 20 years and over were recruited from these databases. Descriptive statistics, bivariate analyses (One -Way ANOVA tests, unpaired t-tests and Pearson chi-square tests), and multinomial logistic regression modelling were used to analyse the data. Findings: This research reveals that gender, main language spoken at home, occupation status, household structure, private health insurance status, and exercise are related to the discrepancy between actual weight status and perception of weight status, but only gender and exercise are related to the discrepancy across the three time point s. The current research provides more knowledge about perception of weight status independently. Factors which affect perception of overweight are gender, age, language spoken at home, private health insurance status, and diet ary habits. The study also finds that many factors that impact overweight and/or obesity also have an effect on perception of overweight, such as age, language spoken at home, household structure, and exercise. However, some factors (i.e. private health insurance status and milk consumption) only impact on perception of overweight. Furthermore, factors that are rel ated to people’s overweight are not totally related to people’s underestimation of their body weight status in the study results. Thus, there are unknown factors which can affect people’s underestimation of their body weight status. Conclusions: Health promotion and education activities should provide education about population health education and promotion and education for particular at risk sub -groups. Further research should take the form of a longitudinal study design ed to examine the causal relationship between overweight and/or obesity and underestimation of body weight status, it should also place more attention on the relationships between overweight and/or obesity and dietary habits, with a more comprehensive representation of SES. Moreover, further research that deals with identification of characteristics about perception of weight status, in particular the underestimation of body weight status should be undertaken.

Der Geschmackssinn erfüllt eine grundlegende Funktion im Menschen indem er Substanzen auf ihre Essbarkeit überprüft, und beeinflusst Gesundheit, indem er die Lebensmittelauswahl prägt, was angesichts der Adipositas-Epidemie zunehmendes wissenschaftliches Interesse erzeugt. Zuerst habe ich die kortikale Signatur der Geschmacksenkodierung bzgl. synchronisierter neuronaler Aktivität untersucht. Die Ergebnisse zeigen, dass das menschliche Gehirn sehr langsame Delta-Wellen rekrutiert, um Geschmacksinformationen zu verarbeiten, und dass die evozierten neuronalen Antwortmuster geschmackspezifisch und prädiktiv für das Antwortverhalten sind. Anschließend habe ich die Verarbeitungssequenz zur Geschmackserkennung bzgl. unterscheidbarer computationaler Zustände geprüft. Die Verarbeitungssequenz hat mit dem Geschmackskontrast variiert, so dass hedonisch unterschiedliche Geschmäcker gleichzeitig detektiert und kategorisiert wurden. Dies deutet darauf hin, dass die Valenz parallel zu sensorischen Geschmacksinformationen verarbeitet wird, was zu einer Schärfung der Geschmackskategorie führen könnte. Schließlich habe ich die evozierten geschmacklichen Antwortmuster zwischen normalgewichtigen und fettleibigen Individuen verglichen. Angesichts nicht unterscheidbarer Aktivierungsmuster haben beide Gruppen die gleichen mentalen Prozesse rekrutiert, um ein Geschmackserlebnis zu verarbeiten. Die Geschmacksrepräsentationen lassen jedoch bei adipösen Individuen früher nach, und zwar direkt mit dem Ende der Stimulation. Dieser Befund stimmt mit der Beobachtung hypoaktiver neuronaler Reaktionen bei Fettleibigkeit überein, wie bspw. einem abgeschwächten Belohnungserleben durch Essen. Die in der vorliegenden Arbeit dargestellten Ergebnisse vertiefen unser Verständnis des menschlichen Geschmackssystems. Angesichts der ernährungsbedingten Gesundheitskrise in der westlichen Welt bedarf es weiterer Forschung, eines der Schlüsselsysteme für die Geschmackswahrnehmung besser zu verstehen.<br>The sense of taste serves a basic function in human survival by scrutinizing substances as to their edibility, and specifically for health by determining food selection in societies of overabundance. It is a key component of the perception of flavor which, in light of the obesity epidemic, garners increasing scientific interest. First, I investigated the cortical signature of taste information coding, specifically synchronized neural activity which reflects one of the key mechanisms of neuronal communication. I found that the human brain recruits very-slow wave delta oscillations to process taste information, and that the emergent patterns were taste-specific and predictive of response behavior. Subsequently, I examined whether the processing sequence involved in taste recognition unfolds in distinct computational states. The findings were mixed in that the processing sequence varied with taste contrast, such that hedonically distinct tastes were categorized as soon as they were tasted. This suggests that valence may be processed in parallel to sensory taste information, reducing processing times due to a sharpening of the taste category. Finally, I compared the evoked gustatory response patterns between normal-weight and obese individuals. The results suggest based on indistinguishable activation patterns that both groups recruit the same mental processes in order to encode a taste event. However, the taste representations subside earlier in obese individuals, directly coinciding with the offset of stimulation. This finding aligns with the observation of hypoactive neural responses in obesity such as an attenuated experience of reward from food. Altogether, the research laid out in the current thesis furthers our understanding of the human gustatory system. Faced with the food-related health crisis of obesity in the Western world, there is an undeniable urgency to better understand one of the key systems involved in flavor perception.

La patologia dell’obesità attualmente può essere considerata una malattia a eziologia multifattoriale. I dati relativi allo studio delle variabili che sono profondamente radicate nella mente umana e che determinano le abitudini, tuttavia, sono relativamente scarsi. Studi recenti hanno ipotizzato che i fattori legati alla percezione sensoriale forniscono informazioni utili per indagare il fenomeno dell’incremento di peso. La percezione e il gradimento del cibo, infatti, sono il risultato di molteplici stimoli sensoriali, visivi, olfattivi, gustativi, e somatosensoriali. In particolare, gli stimuli olfattivi e gustativi giocano un ruolo centrale nella scelta degli alimenti, nell'accettabilità e, di conseguenza, nell'assunzione di energia. Nonostante la relazione tra percezione sensoriale e assunzione di cibo sia evidente, gli studi disponibili anche su questo argomento sono limitati, i risultati sono contraddittori e non facilmente confrontabili. L'obiettivo generale di questa tesi di dottorato è stato quello di studiare le variabili comportamentali e fisiologiche coinvolte nel fenomeno dell’obesità utilizzando un approccio sensoriale, attraverso: a) la valutazione della sensibilità gustativa, della neofobia alimentare e del gradimento alimentare in soggetti normopeso e obesi; b) lo studio delle interazioni multisensoriali (odore-gusto-consistenza) in un alimento modello (crema dessert) e del gradimento in relazione al sesso e allo stato nutrizionale; c) la valutazione dell'influenza dell'esposizione agli stimoli olfattivi nell’ambiente circostante sulla salivazione, sull’appetito e sull'assunzione di cibo. I risultati hanno dimostrato che i soggetti obesi hanno una distorta sensibilità gustativa rispetto ai soggetti normopeso. In particolare, i soggetti obesi coinvolti sono risultati meno sensibili agli stimoli gustativi rispetto ai soggetti normopeso. Queste differenze nella percezione gustativa potrebbero portare i soggetti con un elevato indice di massa corporea (IMC) ad avere diverse preferenze alimentari rispetto ai soggetti normopeso, prediligendo prodotti alimentari ricchi per esempio di zuccheri e grassi, in grado di sopperire alla ridotta sensibilità. Questa ipotesi è avvalorata dai punteggi di gradimento significativamente più elevati dati dai soggetti obesi ai prodotti ad alta densità energetica rispetto ai soggetti normopeso. Differenze significative non sono state invece riscontrate tra gli indici di neofobia alimentare nei due gruppi di soggetti coinvolti. Le interazioni multisensoriali (odore-gusto-consistenza) si sono dimostrate diverse in relazione all’IMC e, in misura minore, al sesso. Infatti, l’aggiunta di aromi e agenti addensanti a un prodotto modello (crema dessert) ha generato maggiori interazioni sensoriali (odore-gusto, odore-flavor e odore-consistenza) soprattutto nelle donne con elevato IMC rispetto al gruppo di controllo. L’aggiunta di uno stimolo riconducibile a prodotti ad alta densità energetica, come per esempio l’aroma di burro, ha infatti modificato la percezione di caratteristiche sensoriali in modo più efficace nei soggetti obesi rispetto al gruppo di controllo. Gli individui obesi hanno, per esempio, percepito l’aumento della dolcezza in seguito all’aggiunta di aroma burro senza una effettiva aggiunta di zucchero al prodotto. Infine, l'esposizione agli odori nell’ambiente circostante ha influenzato sia le risposte comportamentali sia quelle fisiologiche coinvolte nel consumo alimentare. L'esposizione agli odori riconducibili a prodotti ad alta densità energetica, in particolare, ha aumentato la quantità consumata di un prodotto modello (riso al cioccolato), la salivazione e l’appetito. La capacità degli odori di influenzare la quantità di cibo ingerito e, quindi, la quantità di energia assimilata, potrebbe essere uno strumento utile per prevenire l'eccessivo consumo di cibo da parte degli individui sovrappeso e obesi e guidarli verso scelte più sane. In conclusione, lo studio dell’obesità utilizzando un approccio sensoriale risulta interessante e innovativo per una miglior comprensione del fenomeno e per la messa a punto di strategie che ne contrastino lo sviluppo. Gli stimoli sensoriali, infatti, potrebbero essere utilizzati nell’indirizzare i consumatori a una minore assunzione di cibo e verso scelte di prodotti alimentari più salutari. Inoltre, considerando i meccanismi di integrazione degli stimoli sensoriali a livello cerebrale si potrebbero sviluppare nuovi prodotti alimentari a ridotto apporto calorico, soddisfacenti per il consumatore.<br>It is well known that the pathology of obesity is considered a disease with a multifactorial etiology. However, fairly poor data have been reported on the influence of variables which are deeply-rooted in human mind and determine food habits. Recent evidences have suggested that factors related to the sensory perception may explain weigh excess. Indeed, food perception and food liking are the result of multiple sensory modalities, including visual, olfactory, gustatory, and somatosensory inputs. In particular, the odor and taste cues of foods play a pivotal role in food choice, acceptability and, thus, energy intake. Despite the relationship between sensory perception and food intake is evident, the studies available on this topic are very few in number and results are rather contradictory and not easy to compare. The overall aim of this Ph.D. thesis was to study behavioral and physiological variables involved in the phenomenon of obesity using a sensory approach. Specific goals were: 1) the evaluation of taste sensitivity, food neophobia and food liking in normal-weight and obese subjects; 2) the study of multisensory interactions (odor-taste-texture) in a model food (custard dessert) and food liking in relationship with gender and nutritional status; 3) the evaluation of the influence of ambient odor exposure on salivation, appetite and food intake. The results showed that obese subjects differed in terms of taste sensitivity from normal-weight subjects. More specifically, the obese subjects involved were less sensitive to taste stimuli compared to the lean subjects. These differences may lead subjects with higher BMI to prefer foods rich, for example, in sugar and fat in order to compensate their reduced sensitivity. This hypothesis is supported by the liking scores, provided by obese subjects, to the high energy dense food products which were significantly higher compared to the scores given by the normal-weight subjects. No differences in food neophobia scores have been found in the two groups of subjects. The multisensory interactions (odor-taste-texture) occurred differently in relation to BMI and, to a lesser extent, to gender. Indeed, a model food (custard dessert) modified with aromas and thickener agents produced strongest sensory interactions (odor-taste, odor-flavor and odor-texture) in subjects with higher BMI, especially in women, compared to the control group. The addition of a stimulus signaling high-calorie products, such as butter aroma, modified the perception of different sensory characteristics in a more effective way in obese subjects compared to the normal-weight. For example, obese subjects perceived the modified samples, added with butter aroma, as sweater without the addition of sugar. Finally, the ambient odors exposure affected behavioral and physiological responses involved in eating behavior. In particular, the exposure to odor signalling high-energy dense food products increased the total eaten amount of a model food (chocolate rice), the salivation and the appetite. The ability of odors to influence the amount of food ingested, and therefore the amount of energy assimilated by individuals, could be a useful instrument to prevent overeating in obese individuals steering food intake away from high energy unhealthy foods, towards healthier choices. In conclusion, it is evident that investigate the phenomenon of obesity applying an innovative sensory approach is interesting in order to better understand and stem the complex issue of overeating. Indeed, it could be possible to drive food preferences, food choices and food intake focusing on sensory cues. How the mechanism of brain integration occurs in subjects with different nutritional status might be taken in to account in order to develop new food products with a reduced caloric intake but satisfying for the consumer.

Advertising to children has received regular focus since 1961, yet it remains a controversial topic. When people speak about advertising to children, they are frequently discussing food advertising. Recent concerns about food, nutrition and an increase in childhood obesity have resulted in a resurgence of interest towards advertising to children. Many factors contribute to the rise in childhood obesity; and advertising of unhealthy food to children has been recognised as one such factor. Advertising to children is fraught with ethical concerns. Children are considered to be vulnerable and susceptible to the influence of television advertising, since they do not possess the cognitive ability to comprehend or evaluate the advertisements they enjoy watching. Although there is ample research regarding the advertising of food to children, research on how parents perceive the impact of television food advertising on their children?s food preferences, as well as the overall level of parental concern with regard to this issue is limited. This study, aimed at exploring South African parents' perceptions of television food advertising to children, is in context of the widespread concern about TV food advertising, the increasing incident of obesity among children and a number of initiatives in other countries to limit children?s exposure to food advertising. A literature review was undertaken, which gave rise to the identification of the problem statement and objectives. Following the literature review, an empirical study was conducted with the aid of a questionnaire, as measuring instrument, to identify parents' perceptions of TV food advertising to children, in particular, parents with children aged between 3 and 14 years. The empirical study was conducted at a crèche in Vanderbijlpark, South Africa. The empirical research conducted for this study revealed that parents perceive it to be unacceptable for food to be advertised to children during their TV-viewing hours, in particular unhealthy food, and that advertising does influence their children's food preferences and eating habits. Parents believe that although regulations exist, these are ineffective in protecting children against advertisers. Furthermore, although parents are not in favour of banning all food advertising to children, they would like to see a reduction of food advertising to children and stronger restrictions being applied to TV food advertising during children?s viewing hours. As an outcome of the parents being exposed to the survey questionnaire, their awareness to the topic will be a lot greater than before. It would be interesting to see if those parents' perceptions have changed as a result of the heightened awareness and therefore it is recommended that the survey be repeated on the same parents within the next year. Furthermore, since the results obtained from this study is a representation of the perceptions of the parents from the geographical area of Vanderbijlpark, South Africa; it is recommended that this survey be conducted in other geographical areas around South Africa.<br>Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2011.

The growing childhood obesity epidemic and its association with adverse health outcomes have prompted increasing research in the recent past. Researchers have examined numerous aspects of the obesity epidemic. For example, the impact of parent behavior on child behavior has been considered. Likewise, researchers have examined the connection between parent perceptions of obesity and concern regarding a child’s weight status. Still other research has focused on the influence of a child’s behavior on weight status. Existing research has reported that within the African American community there is an apparent inaccuracy in perceptions regarding weight. Children who would be classified as overweight or obese according to body mass index (BMI) calculations are viewed by parents as having normal or healthy weight. Thus, among African-American parents, there is often no correlation between a child’s weight status and the parent’s perception of a weight concern. Moreover, it is not clear that there is a relation between parent concern regarding a child’s weight status and the amount of physical activity that the child engages in among African-American individuals. Further, it is not clear what relations may exist among parent physical activity level, child physical activity level, and the child’s BMI status. Finally, after conducting a semi-exhaustive study of the research, the links among child dietary habits, parent dietary habits, and the child’s BMI status in the African American population have not been addressed. The purpose of this study is to more closely examine the impact of risk factors such as parental physical activity, dietary habits, and parent concern and perception regarding weight on children’s weight status within an African American sample.

Philosophiae Doctor - PhD<br>Background: Obesity is increasing worldwide, and cultural perception of body image is considered an important contributor to the obesity epidemic among black Africans. Aim: To explore the association between body image perceptions and perceived obesity threat, change in adiposity, and total cardiovascular disease (CVD) mortality risk. Study Design: This is a mixed-methods study embedded in the PURE longitudinal cohort study involving adults aged 35-78 years in South Africa. Data Collection/Analysis: This included analysis of baseline cross-sectional data, the conduct of a qualitative study and a cross-sectional follow-up survey. Sex-specific logistic regression models of excessive adiposity were determined. Body image perception indexes were obtained based on 'Feel- Ideal' difference (FID) and 'Feel-Actual' discordance (FAD). Bivariate analyses and analysis of variance were used to determine the relationships between body image and adiposity, annual changes in weight and adiposity. The correlations between body image indexes (FID and FAD) and total 10- year CVD risk score were determined – controlling for possible confounders. Qualitative data was managed with ATLAS-ti software and analysed thematically. Results: The prevalence of excessive body fat at baseline and at 5-year follow-up based on body fat percent were 96.0% and 79.6% for women, and 44.3% and 62.2% for men respectively. The majority of the obese (85%) and overweight (79%) participants underestimated their weight, and weight discordance status was inversely associated with the willingness to lose weight. Mean total 10-year CVD risk score was 18.7%, and 61% of men and 26% of women with body mass index (BMI) ≥ 25 kg/m2 had CVD risk scores ≥ 20%. Bivariate analyses indicated that FID and FAD were significantly associated with annual changes in weight and adiposity. FAD index had a significant but weak correlation with total CVD risk score (r = 0.13, p-value = 0.001) when adjusted for covariates. Conclusion: Body image discordance was associated with an annual change in adiposity, total 10- year CVD risk scores, and there was poor obesity risk perception, and low motivation towards weight loss among predominantly obese black adults with negative body image. Interventions to reduce obesity need to address negative body image, poor obesity risk perception, self-efficacy and motivation towards weight loss.<br>National Research Foundation; Chromnic Disease Initiative for Africa (CDIA); National Institute of Health (NIH)

A descriptive study was done to determine the difference in life satisfaction of elderly females who were overweight as compared to elderly females of ideal weight. The sample consisted of 30 females, aged 60 to 80, who were living in the community. No differences in life satisfaction scores were found between the overweight and ideal weight elderly females. The elderly females who were identified as being overweight had a mean life satisfaction score of 14.8 with a standard deviation of 2.45. Elderly females of ideal weight had a mean life satisfaction score of 15.9 with a standard deviation of 2.12. Major differences in summated results of selected demographic variables were not found for the elderly females who were overweight as compared to the elderly females of ideal weight. Findings from the study and implications for nursing are discussed. Recommendations for further research are included.

Given the sad state of obesity and lifestyle-related illnesses in the US, nurses, as the largest and most trusted health profession, must take the cause of health promotion seriously and personally. This study seeks to close the gap in knowledge of nurses’ perception of self as a role model of health and personal healthy lifestyle behaviors. This study focuses on four specific behaviors that lead to a healthy lifestyle: limit alcohol, avoid tobacco, improve nutrition, and engage in physical activity. The purpose of this study is to determine the relationship between nurses’ health practices and their perceptions of self as role models for health promotion using constructs of the Social Cognitive Theory. The final sample consisted of 804 registered nurses in the state of Tennessee. In this study, 4% report smoking, 24.9% drink alcohol, 34% are overweight and 30% obese. Approximately 70% do not meet the weekly physical activity recommendations of 150-minutes and 32.8% follow guidelines for a healthy diet only 50% of the time or less. There was a significant correlation between following a healthy diet or physical activity and the Self as a Role Model of Health Promotion (SARMHEP) scores. Based on the regression analysis, working in an acute care or ambulatory setting negatively affected the SARMHEP, as opposed to age and gender having a positive effect on the SARMHEP score. This study has the potential to provide key information that can be used to promote health among nurses.

L'obésité est devenue l'un des problèmes de santé publique les plus importants de ce siècle. Un certain nombre de facteurs génétiques et environnementaux contribuent au développement de cette pathologie. L'apport alimentaire quotidien est également l'un des facteurs cruciaux. Une consommation excessive de graisse alimentaire a été jugée essentielle dans le développement de l'obésité. Au cours des deux dernières décennies, plusieurs études ont montré que la détection de graisse orale joue un rôle important dans le développement de l'obésité. Pour prouver une relation entre l'obésité, la détection de graisse orale et les polymorphismes génétiques, nous avons recruté des enfants, des adolescents et des sujets adultes de trois populations différentes. À ce jour, le gène CD36 code le récepteur du goût gras le plus prometteur. De plus, nous avons étudié une relation possible entre le goût gras et le goût amer. Les résultats globaux montrent que les goûts amers et gras sont modifiés chez les personnes obèses. De plus, les polymorphismes CD36 ont une influence significative à la fois, la détection orale et l'obésité. Nos résultats pourraient aider à mieux comprendre une relation entre l'obésité, le goût et les polymorphismes génétiques<br>Obesity has become one of most important public health issue in this century. A number of genetic and environmental factors contribute to development of this pathology. Daily dietary intake is also one of the crucial factors. Excessive dietary fat intake has been shown to be critical in the development of obesity. In the last two decades, several studies have shown that oral fat sensing plays an important role in the development of obesity. To prove a relationship between obesity, oral fat sensing and genetic polymorphisms, we recruited children, adolescents and adult subjects from three different populations. To date, CD36 gene encodes the most promising fat taste receptor. Furthermore, we studied a possible relationship between fat taste and bitter taste. Overall results show that bitter and fat tastes are altered in obese individuals. Moreover, CD36 polymorphisms have a significant influence in both, oral sensing and obesity. Our results might help better understand a relationship between obesity, taste and genetic polymorphisms

Background: Obesity has exploaded in the last decades and an ongoing increase is to be seen. The disease is rated as a huge epidemia of times and has developed to an economic social problem. Today more people die from obesity and it´s complications than from nutritional diseases and malnutrition. Gastric Bypass has proved to enable a new life including an improved health and quality of life but has also been critized for being a quick solution not resulting in a long term perspective weight loss. Aim: The aim of this study was to describe people´s experiences from going through Gastric Bypass surgery. Method: The method used was a literature study based on qualitative research. The articles were analysed according to Fribergs five step model and resulted in three main themes and nine sub-themes. Results: The main themes were- The last way out, The battle against oneself and On a new adventure. In order to be able to support these people keeping their new life style and weight reduction the nurse must have insight in people´s experiences of having undergone a Gastric Bypass surgery. Conclusion: The result showed that Gastric Bypass can be a last alternative for hope about a better future and a chance to an improved health and quality of life. Though the surgery has to be combined with individually created coping strategies and a genuine, strong will to make a change in order to become a successful action in a long term perspective.

Traditionally, infectious diseases and under-nutrition have been considered major health problems in Sri Lanka with little attention paid to obesity and associated non-communicable diseases (NCDs). However, the recent Sri Lanka Diabetes and Cardiovascular Study (SLDCS) reported the epidemic level of obesity, diabetes and metabolic syndrome. Moreover, obesity-associated NCDs is the leading cause of death in Sri Lanka and there is an exponential increase in hospitalization due to NCDs adversely affecting the development of the country. Despite Sri Lanka having a very high prevalence of NCDs and associated mortality, little is known about the causative factors for this burden. It is widely believed that the global NCD epidemic is associated with recent lifestyle changes, especially dietary factors. In the absence of sufficient data on dietary habits in Sri Lanka, successful interventions to manage these serious health issues would not be possible. In view of the current situation the dietary survey was undertaken to assess the intakes of energy, macro-nutrients and selected other nutrients with respect to socio demographic characteristics and the nutritional status of Sri Lankan adults especially focusing on obesity. Another aim of this study was to develop and validate a culturally specific food frequency questionnaire (FFQ) to assess dietary risk factors of NCDs in Sri Lankan adults. Data were collected from a subset of the national SLDCS using a multi-stage, stratified, random sampling procedure (n=500). However, data collection in the SLDCS was affected by the prevailing civil war which resulted in no data being collected from Northern and Eastern provinces. To obtain a nationally representative sample, additional subjects (n=100) were later recruited from the two provinces using similar selection criteria. Ethical Approval for this study was obtained from the Ethical Review Committee, Faculty of Medicine, University of Colombo, Sri Lanka and informed consent was obtained from the subjects before data were collected. Dietary data were obtained using the 24-h Dietary Recall (24HDR) method. Subjects were asked to recall all foods and beverages, consumed over the previous 24-hour period. Respondents were probed for the types of foods and food preparation methods. For the FFQ validation study, a 7-day weight diet record (7-d WDR) was used as the reference method. All foods recorded in the 24 HDR were converted into grams and then intake of energy and nutrients were analysed using NutriSurvey 2007 (EBISpro, Germany) which was modified for Sri Lankan food recipes. Socio-demographic details and body weight perception were collected from interviewer-administrated questionnaire. BMI was calculated and overweight (BMI ≥23 kg.m-2), obesity (BMI ≥25 kg.m-2) and abdominal obesity (Men: WC ≥ 90 cm; Women: WC ≥ 80 cm) were categorized according to Asia-pacific anthropometric cut-offs. The SPSS v. 16 for Windows and Minitab v10 were used for statistical analysis purposes. From a total of 600 eligible subjects, 491 (81.8%) participated of whom 34.5% (n=169) were males. Subjects were well distributed among different socio-economic parameters. A total of 312 different food items were recorded and nutritionists grouped similar food items which resulted in a total of 178 items. After performing step-wise multiple regression, 93 foods explained 90% of the variance for total energy intake, carbohydrates, protein, total fat and dietary fibre. Finally, 90 food items and 12 photographs were selected. Seventy-seven subjects completed (response rate = 65%) the FFQ and 7-day WDR. Estimated mean energy intake (SD) from FFQ (1794±398 kcal) and 7DWR (1698±333 kcal, P<0.001) was significantly different due to a significant overestimation of carbohydrate (~10 g/d, P<0.001) and to some extent fat (~5 g/d, NS). Significant positive correlations were found between the FFQ and 7DWR for energy (r = 0.39), carbohydrate (r = 0.47), protein (r = 0.26), fat (r =0.17) and dietary fiber (r = 0.32). Bland-Altman graphs indicated fairly good agreement between methods with no relationship between bias and average intake of each nutrient examined. The findings from the nutrition survey showed on average, Sri Lankan adults consumed over 14 portions of starch/d; moreover, males consumed 5 more portions of cereal than females. Sri Lankan adults consumed on average 3.56 portions of added sugars/d. Moreover, mean daily intake of fruit (0.43) and vegetable (1.73) portions was well below minimum dietary recommendations (fruits 2 portions/d; vegetables 3 portions/d). The total fruit and vegetable intake was 2.16 portions/d. Daily consumption of meat or alternatives was 1.75 portions and the sum of meat and pulses was 2.78 portions/d. Starchy foods were consumed by all participants and over 88% met the minimum daily recommendations. Importantly, nearly 70% of adults exceeded the maximum daily recommendation for starch (11portions/d) and a considerable proportion consumed larger numbers of starch servings daily, particularly men. More than 12% of men consumed over 25 starch servings/d. In contrast to their starch consumption, participants reported very low intakes of other food groups. Only 11.6%, 2.1% and 3.5% of adults consumed the minimum daily recommended servings of vegetables, fruits, and fruits and vegetables combined, respectively. Six out of ten adult Sri Lankans sampled did not consume any fruits. Milk and dairy consumption was extremely low; over a third of the population did not consume any dairy products and less than 1% of adults consumed 2 portions of dairy/d. A quarter of Sri Lankans did not report consumption of meat and pulses. Regarding protein consumption, 36.2% attained the minimum Sri Lankan recommendation for protein; and significantly more men than women achieved the recommendation of ≥3 servings of meat or alternatives daily (men 42.6%, women 32.8%; P<0.05). Over 70% of energy was derived from carbohydrates (Male:72.8±6.4%, Female:73.9±6.7%), followed by fat (Male:19.9±6.1%, Female:18.5±5.7%) and proteins (Male:10.6±2.1%, Female:10.9±5.6%). The average intake of dietary fiber was 21.3 g/day and 16.3 g/day for males and females, respectively. There was a significant difference in nutritional intake related to ethnicities, areas of residence, education levels and BMI categories. Similarly, dietary diversity was significantly associated with several socio-economic parameters among Sri Lankan adults. Adults with BMI ≥25 kg.m-2 and abdominally obese Sri Lankan adults had the highest diet diversity values. Age-adjusted prevalence (95% confidence interval) of overweight, obesity, and abdominal obesity among Sri Lankan adults were 17.1% (13.8-20.7), 28.8% (24.8-33.1), and 30.8% (26.8-35.2), respectively. Men, compared with women, were less overweight, 14.2% (9.4-20.5) versus 18.5% (14.4-23.3), P = 0.03, less obese, 21.0% (14.9-27.7) versus 32.7% (27.6-38.2), P < .05; and less abdominally obese, 11.9% (7.4-17.8) versus 40.6% (35.1-46.2), P < .05. Although, prevalence of obesity has reached to epidemic level body weight misperception was common among Sri Lankan adults. Two-thirds of overweight males and 44.7% of females considered themselves as in "about right weight". Over one third of both male and female obese subjects perceived themselves as "about right weight" or "underweight". Nearly 32% of centrally obese men and women perceived that their waist circumference is about right. People who perceived overweight or very overweight (n = 154) only 63.6% tried to lose their body weight (n = 98), and quarter of adults seek advices from professionals (n = 39). A number of important conclusions can be drawn from this research project. Firstly, the newly developed FFQ is an acceptable tool for assessing the nutrient intake of Sri Lankans and will assist proper categorization of individuals by dietary exposure. Secondly, a substantial proportion of the Sri Lankan population does not consume a varied and balanced diet, which is suggestive of a close association between the nutrition-related NCDs in the country and unhealthy eating habits. Moreover, dietary diversity is positively associated with several socio-demographic characteristics and obesity among Sri Lankan adults. Lastly, although obesity is a major health issue among Sri Lankan adults, body weight misperception was common among underweight, healthy weight, overweight, and obese adults in Sri Lanka. Over 2/3 of overweight and 1/3 of obese Sri Lankan adults believe that they are in "right weight" or "under-weight" categories.

Educational Leadership<br>Ed.D.<br>School districts are charged with the task of providing America’s youth with the most well-rounded education so that they can grow into the most productive adult citizens. However, school funding cuts and the unending demand to make AYP often push students out of the center of that focus. As a result, matters like school-based Body Mass Index notifications have been moved to the backburner and are often simplified to only what the law requires. Although researchers have sought the best practice to address this cause, it still remains that those not directly involved in the process are designing and implementing regulations. The perceptions of parents and school personnel are not being addressed. As a result, this exploratory, single-case, qualitative study, researched the best school-based body mass index notification practice according to the perspective of eleven total parents and school personnel. These participants were from a school in Southeastern Pennsylvania, whose process is mandated by the state. Based on the findings, it is recommended that schools collaborate with parents to establish the most informative notification letter that meets their needs, rather than simply address the requirements of the state’s mandate. This collaboration must be inviting and easy to enter into and the findings need to be implemented, instead of just gathered and recorded. Prior notification must also be improved and supplemental materials need to be included in the mailing.<br>Temple University--Theses

Various research studies have indicated that the prevalence of overweight and obesity among children and adolescents has increased worldwide and has, therefore, become a serious health problem. Besides the various health implications of childhood obesity, it can also have psychological consequences for these children and they have a greater risk than a normal weight child to suffer from poor self perception. The effect of a physical activity, diet and behaviour modification intervention on the total energy expenditure, physical activity levels and self perception of 9 to 12 year old overweight and obese children is, however, not clear. The aim of the study was firstly to determine the effect of a physical activity, diet and behaviour modification intervention on the total energy expenditure and physical activity levels of 9 to 12 year old overweight and obese children. Secondly, to determine the effect of such an intervention on the self perception, and more specifically athletic and physical self perception of these children. An availability sample of 20 overweight and obese subjects (13 girls and 7 boys) between the ages of 9 and 12 years with a mean age of 11 years, participated in a 13 week (3 times/week) multidisciplinary intervention programme. Actical® monitors were used to monitor energy expenditure as well as physical activity levels during 2 weekdays and 1 weekend day before and after the intervention programme. From the results, analyzed by means of t-testing and linear regression, it is apparent that the total energy expenditure of the group, when adjusted for the effect of the intervention, showed a significant increase (p < 0.05) and body fat percentage as well as waist and upper arm circumferences decreased significantly. Although not significant, a decrease of 2,9 kg in body mass and 2,00 kg.rh" in body mass index were also indicated. However, the moderate and high intensity physical activity levels of the groups decreased significantly after the intervention programme. A possible reason for this decrease can be ascribed to the fact that the post-test took place during the school holidays. Further analysis of the data also indicated that the group slept longer hours, which increased their hours spent in the sedentary activity zone. The group also spent more time during the day watching television which also contributed to a decrease in the percentage of time spent in the moderate intensity zone. It is, however, concluded that increased total energy expenditure alone could not bring about effective weight loss and must, therefore, be accompanied by activity in the moderate and high intensity zones. For the purpose of the second aim, twenty children (13 girls and 7 boys) between the ages of 9 and 12 years, with a mean age of 11 years, participated in a 13 week multidisciplinary intervention programme (3 times per week). Eighteen children (11 girls and 7 boys) between the ages of 9 and 12 years, with a mean age of 11 years, served as a control group. Self perception, which consisted of 6 subcomponents, was determined by using the Harter Scale for Self Perception (Harter, 1985). It is clear from the results of the t-test (p < 0.05) that all subcomponents of self perception of the experimental group, especially physical, athletic and global self perception, increased significantly in relation to the control group which remained the same in all the subcomponents (p > 0.05), while a decrease in their social self perception was noted (p < 0.05). The experimental and control group did not differ significantly before the intervention programme, therefore the significant differences with regard to the subcomponents during the post-test, confirm the effect of the programme. On the basis of the abovementioned results the assumption can be made that a multidisciplinary intervention programme holds various benefits for overweight and obese children and is, therefore, another strategy in the prevention of overweight and obesity in children in South Africa. A multidisciplinary intervention programme, as used in this programme, is not only advantageous for weight loss in overweight and obese children, but also significantly improves their self perception.<br>Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2009.

Background:Overweight and obesity among children has increased, this is seen to be due to genetic causes in combination with environmental factors. Overweight and obesity is a contributing factor due to diseases such as type 2 diabetes and cardiovascular disease and psychological stress of the individual. Aim: The aim of the present study was to describe the families' perceptions related to their child being overweight or obese. Furthermore, the aim has been to describe the articles included data collection method. Method: Twelve pieces of scientific papers were used as a basis for a literature study with a descriptive design. Main results:This literature study shows that families rarely perceive their child's proper weight. In most cases families underestimated child obesity because they considered them as normal weight. Difference between girls and boys was something that emerged, it turned out that the parents had a higher acceptance regarding overweight boys related to girls being overweight. Socioeconomic differences were also significant when one clearly saw a higher acceptance regarding obesity in parents with low income. The parents felt that in the preventive work with overweight children, it was important that the focus would be on the whole family and not just the overweight child. Articles data collection method consisted of interviews and questionnaires. Conclusion: Families often underestimated their child's obesity. Parents felt that in the preventive work with overweight or obese children, it was important that the focus would be on the whole family and not just on the child. Knowledge of how families perceive their child's overweight and obesity are important to increase understanding of how prevention work should be improved and be made by health care professionals.

Orientadores: Dagmar de Paula Queluz, Marcelo de Castro Meneghim<br>Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba<br>Made available in DSpace on 2018-08-11T17:11:25Z (GMT). No. of bitstreams: 1 Silva_BeatrizBalduinoFerrazda_M.pdf: 1858193 bytes, checksum: b75aa4cca23873c79a5e2891a545ce5a (MD5) Previous issue date: 2008<br>Resumo: O objetivo deste estudo é analisar as condições de saúde bucal dos pacientes submetidos à cirurgia bariátrica, verificando a prevalência de cárie, necessidade de prótese dentária e a autopercepção da saúde bucal dos pacientes relacionado à qualidade de vida. A amostra consistiu de 57 pacientes atendidos pelo ambulatório de obesidade mórbida do Hospital das Clínicas da Unicamp, divididos em faixa etária e tempo de pós-operatório. Uma entrevista contendo questões relativas à saúde geral, saúde bucal e questionário validado OHIP -14; seguido por exame clínico para cárie e necessidade de prótese, segundo critérios da OMS. Após análise dos resultados foi observado: 75,4 % do sexo feminino e 24,6% do sexo masculino; idade média de 40,1 sendo a idade de 35-44 anos (48%) a de maior prevalência; estado civil casado com 58% e 90% com renda familiar de 2 a 6 salários. Em duas dimensões do teste OHIP-14 obteve um p_0,05, sendo limitação funcional (p= 0,008) e incapacidade física (p= 0,032), o escore total (p= 0,049) comprovou a melhora na percepção a saúde bucal por tempo de pós-operatório. A média do CPOD foi de 21,1 sendo o componente perdido de 13,3. Para necessidade de próteses 87,7% dos pacientes necessitava de algum tipo de prótese dentária. O índice de cárie se mostrou similar aos apresentados pela população da região sudeste e nacional. A necessidade de prótese para a amostra é maior, o que nos leva a concluir a necessidade da reabilitação protética visando minimizar os efeitos colaterais pós-operatórios das alterações do processo digestivo, lembrando que a mastigação é o início desse processo e que uma boa capacidade mastigatória torna-se fundamental para os indivíduos com capacidade gástrica reduzida. A melhora na auto-estima e qualidade de vida proporcionada pela redução de peso ocasionada pela cirurgia bariátrica está diretamente ligada a uma melhor percepção das condições de saúde bucal que se verifica com os resultados apresentados pelo índice subjetivo OHIP-14 à medida que o tempo de pós-operatório aumenta. Porém a percepção ainda é baixa, frente a uma alta necessidade de prótese desses pacientes e uma baixa percepção no item incapacidade física<br>Abstract: The objective of this study is to analyze the oral health condition of patients submitted to bariatric surgery, verifying the caries prevalence, the need of dental prosthesis and the self-perception of he oral health of patients relate to the life quality. The sample was consisted by 57 patients who are assisted by the morbid obesity ambulatory of the UNICAMP Clinic Hospital, divided by age ranges and postsurgical time. An interview with questions relative to general health, oral health and the OHIP-14 validated questionnaire; followed by a clinical examination for caries and the need of prosthesis, according to WHO criteria. After analysis of the results it was observed that: 75.5% of females and 24.6 % males; average age of 40.1 years old, being the range of 35-44 years old the most prevalent; 58 % were married and 90% with family income between 2 and 6 minimum salaries. In two dimensions in the OHIP-14 test it was obtained a p_0.05, being functional limitation (p=0.008) and physical incapacity (p= 0.032), and the total score (p= 0.049) corroborated the improvement of the oral health perception by postsurgical time. The average DMF-D was of 21.1 being the missing component of 13.3 . As for the need of prosthesis 87.7% of the patients needed any kind of dental prosthesis. The caries index has shown similar to the presented by the southeastern and national populations. The need of prosthetics for the sample is higher, what leads us to the conclude the need of oral rehabilitation aiming to minimize the postsurgical side effects of the alteration of the digestive process, remembering that the chewing is the beginning of this process and that a good masticatory capacity becomes fundamental for the individuals with reduced gastric capacity. The improvement on the self-esteem and life quality proporcionated by the weight loss caused by the bariatric surgery is directly connected to a better perception of the oral health that is verified with the results presented by the subjective OHIP-14 as the postsurgical time increases. However the perception is still low, compared to a high necessity of prosthetics of those patients and a low perception on the physical incapacity item<br>Mestrado<br>Saude Coletiva<br>Mestre em Odontologia

The prevalence of obesity among Afro-Caribbean women living in the United States Virgin Islands (USVI) is a health care issue that can have detrimental effects on society. To reverse the spread of this disease, factors contributing to its prevalence must be understood so that they can be addressed. The purpose of this cross-sectional study was to examine Afro-Caribbean women's perception of the female body size preferred by Afro-Caribbean men and the influence of that perception on the women's weight control behaviors of diet and physical activity. The reasoned action approach was the basis for the theoretical foundation. The research problem was addressed through the use of a convenience sample (n=183) using an original, validated online survey that included demographic and behavioral information, images of the female Pulvers silhouettes, and information related to diet and physical activity levels. For diet, with the addition of the covariates of income (p=.02) and education level (p=.01), women's perception of the female body size that men preferred was not significant in predicting women's weight control behaviors. For physical activity the perceived body size preferences as indicated by silhouettes 2-3 and 4, were significant predictors of using physical activity for weight control. However, this association was lost with the addition of covariate education level (p=.01). This study may contribute to social change by providing health care professionals and policy makers with a better understanding of factors that influence the weight control behaviors of Afro-Caribbean women in the USVI. The results of this study inform current literature and justify the need for further research on the topic.

[Truncated abstract] Regular engagement in physical activity is proven to decrease the risk of numerous chronic diseases and to improve mental well-being. However, many children and adults around the world fail to engage in sufficient levels of activity required to produce health benefits, with reports showing physical activity levels still on the decline. Perhaps because of this increase in sedentary lifestyles, obesity has become one of the biggest public health threats in the 21st century. Furthermore, both obesity and physical inactivity are closely related to psychological health, and may play an important role in shaping self-perceptions and feeling of general well-being. '...' In the first study, physical status, physical activity levels, and social physique anxiety measures were obtained from an adolescent sample of 259 participants. Partial correlation analyses revealed that physical activity involvement was not directly linked with physical status; however, both factors were significantly associated with social physique anxiety, which suggested evidence of an indirect link between the two constructs. That is, analyses showed that poor physical status was associated with higher levels of physique anxiety, which in turn linked to low engagement in physical activity. In addition, age and gender effects emerged, revealing unique differences in the ways in which these three variables may be related. To cross-validate and further examine these relationships STUDY 2 extended the range of self-perception measures to include a multidimensional assessment of physical self-concept and a global self-esteem measure along with physique anxiety. These variables were assessed in a German adult sample (N = 229), again alongside measures of physical status and physical activity involvement. Consistent with STUDY 1, no direct link was found between physical status and levels of physical activity involvement. However, evidence of an indirect link did emerge as both variables were related to multiple dimensions of physical self-concept, thereby reinforcing and extending the findings from STUDY 1. Furthermore, age effects emerged for physical self-concept, which had not been confirmed in previous research on physical self-concept. STUDY 3 employed a longitudinal design and investigated changes in physical self-concept, global self-esteem and social physique anxiety before, during, and after participation in a 12-week weight management programme. Participants (N = 63) were assigned to one of three conditions: (1) cognitive-behavioural treatment only, (2) cognitive-behavioural treatment and exercise, and (3) non-treatment control. Statistical analyses revealed a small, but significant reduction in weight for members of both treatment groups. Relative to controls, both treatment groups also improved on a variety of physical self-concept dimensions. At the same time, however, significant group main effects suggested that a weight-loss program incorporating exercise involvement may provide physical self-concept benefits that go beyond those obtained with standard CBT regimes. Collectively, these studies add to the growing body of literature on the connections between physical activity, self-perceptions and physical status. They also highlight the importance of involvement in habitual physical activity throughout the lifespan. Findings are discussed with regards to their contribution to the extant literature, and applied implications, limitations, and future directions are considered.

Trata-se de um estudo de abordagem qualitativa que teve o objetivo de compreender como as mulheres com diabetes mellitus (DM) tipo 2 e obesidade vivenciam o seu corpo, realizado no Centro de Pesquisa e Extensão Universitária do interior paulista, em 2009. O referencial teórico utilizado foi a Fenomenologia da Percepção de Maurice Merleau-Ponty. Para coleta de dados foi utilizada a questão norteadora: Como a senhora se sente com o seu corpo? Foram entrevistadas oito mulheres com diabetes mellitus tipo 2 e obesidade (IMC 30) com idade de 40 a 76 anos. A coleta de dados foi realizada no referido Centro, às terças-feiras, das 14 às 17 horas, em ambiente preservado, pelo próprio pesquisador, com entrevistas gravadas. Os dados foram submetidos à técnica de análise de conteúdo, o que possibilitou a elaboração de sete categorias temáticas: A falta de vivência do corpo atual; O corpo com intencionalidade e significação; A dualidade da obesidade da proteção a tragédia; A negação e a fragmentação da obesidade no corpo atual/habitual; A obesidade velada percepção do objeto como razão de todas as experiências; O DM como algo que destrói e desfigura o corpo e O DM incorporado no seu corpo e na sua vida. Os resultados mostraram que nas falas das participantes há falta de percepção em relação às mudanças e de responsabilidade para com o seu corpo. As falas também mostraram que as participantes atribuem ao corpo intencionalidades e significados, percebendo-o como algo vergonhoso, desconfortável, limitador, pesado, fatigado, ruim, desproporcional, preocupante, um inferno na sua vida e em outros, como meio de expressão, afeto, defesa, companheirismo, parte de si, aceitação e conformismo. As participantes expressam a percepção da obesidade no corpo por sentimentos de proteção, ganho, benefício e fazendo parte da personalidade e por outro lado como um veneno, tragédia, peso, incomodo, cansaço, obstáculo, desvantagem, tristeza, insatisfação e promotora de diferenças entre os seres humanos. Nas falas emergiram dificuldades de perceber o corpo atual. A obesidade é atribuída a fatores externos e o DM é percebido como algo amedrontador, ruim, limitador, destruidor, relacionado à luta e a morte. Por outro lado, algumas participantes expressaram percepção de responsabilidade e consciência para com a doença. Nessa direção a equipe multiprofissional de saúde pode (re)significar as atitudes que intensifiquem a valorização dos significados e dos sentimentos, pertencentes às mulheres com DM tipo 2 e obesidade. Ao valorizar os significados e os sentimentos, a equipe multiprofissional de saúde pode incitar os processos psíquicos internos aproximando-as do autocuidado, da autonomia e da responsabilidade para como seu corpo e possibilitando a apropriação das participantes do corpo fenomenal. Dessa forma, espera-se com esse estudo fornecer subsídios para a reflexão dos profissionais de saúde na atenção em saúde às mulheres com DM tipo 2 e obesidade, bem como, para o olhar mais acurado acerca das necessidades não reveladas pelas participantes, mas expressadas pelo seu corpo para pensar um novo fazer em saúde, ou seja, a educação em DM.<br>This is a study with qualitative approach that aimed to understand how women with type 2 diabetes mellitus (DM) and obesity experience their bodies, performed at the Center for Research and University Extension from an inland city of São Paulo state in 2009. The theoretical framework was the Phenomenology of Perception of Maurice Merleau-Ponty. To collect data we used the guiding question \"How do you feel about your body?\". We interviewed eight women with type 2 diabetes mellitus and obesity (BMI 30) aged between 40 and 76 years old. Data collection was done by the researcher at that Center on Tuesdays from 2 p.m. to 5 p.m. in an appropriate room and was audio recorded. The data were subjected to content analysis technique, which enabled the creation of seven thematic categories: The lack of experience of the current body; The body with intentionality and meaning; The duality of obesity from protection to tragedy; The denial and the fragmentation of obesity in the present/habitual body; The veiled obesity - perception of the object as a reason for all experiences; The DM as something that destroys and disfigures the body and The DM incorporated into your body and your life. The results showed that in the speeches of the participants there is a lack of awareness regarding the changes and responsibility to their bodies. Their speeches also showed that the participants attach to the body intentions and meanings, seeing it as something shameful, uncomfortable, limiting, heavy, tired, bad, disproportionate, disturbing, hell in their life and in others, as a mean of expression, affection, protection, companionship, part of oneself, acceptance and conformity. The participants expressed the perception of obesity in the body through protective feelings, gain, benefit and part of the personality and, on the other hand, as a poison, tragedy, weight, discomfort, tiredness, hindrance, disadvantage, sadness, dissatisfaction and promoter of differences between humans. In the speeches also emerged difficulties of perceiving the current body. Obesity is attributed to external factors and the DM is perceived as something scary, bad, limiting, destructive, related to fighting and death. On the other hand, some participants expressed perception of responsibility and awareness regarding the disease. In this direction, the multidisciplinary health care team can (re) signify attitudes that intensify the recovery of meanings and feelings that belong to women with type 2 DM and obesity. By valuing the meanings and feelings, the multidisciplinary health care team may encourage internal mental processes approaching the women to self-care, autonomy and accountability with their bodies and allowing the appropriation of the participants of the phenomenal body. Thus, it is hoped with this study to provide information for consideration of health professionals in health care for women with type 2 DM and obesity, as well as to look more accurate on the needs not revealed by participants, but expressed through their bodies to think a new doing in health, in other words, an education in DM.

Background: Effective interventions to prevent obesity in youth are needed in order to alleviate the public health burden associated with elevated blood pressure (BP). However, interventions designed to prevent obesity through increased physical activity levels have had limited success.<br>Objectives: This thesis has four objectives: 1) to assess the impact of changes in adiposity indicators on increases in systolic blood pressure (SBP) during adolescence; 2) to examine the longitudinal association between declines in physical activity and SBP in youth; 3) to assess whether weight status misperception is associated with exposure to overweight/obese people at home or in school; 4) to examine if weight status misperception is associated with the level of participation in physical activity.<br>Methods: SBP and anthropometry were assessed biannually (1999/2000, 2002, 2004) in a cohort of 1293 Montréal adolescents aged 12-13 years in 1999. Self-report 7-day recalls of physical activity sessions ≥5 minutes were collected every three months over five years. The repeated SBP measurements were analyzed using individual growth models to assess the effect of changes in adiposity indicators on SBP change. Estimates of initial level and rate of decline in number of physical activity sessions per week from individual growth models were used as predictors of BP in linear regression models to assess the effect of declines in physical activity on BP. The hypotheses that youth exposed to obesity at home and in school are more likely to underestimate their weight status, and that those who underestimate their weight status are less likely to engage in physical activity were tested in a provincially representative, school-based sample of 3665 youth (age 9, n = 1267; age 13, n = 1186; age 16, n = 1212). Multi-level linear regression models were used to assess the association between parent and schoolmate BMI, and weight status misperception (i.e., the standardized difference between self-perception of weight status and actual weight status). Poisson regression models were used to assess the association between weight status misperception and physical activity.<br>Results: 1) Despite sex differences in mean SBP changes, the magnitude of the effect of one unit change in each adiposity indicator on SBP change was similar in boys and girls. 2) Physical activity declined during adolescence and a decline of one physical activity session per week with each year of age was associated with higher BP. 3) Majority of overweight youth underestimated their weight status. Higher parent and schoolmate BMI were associated with greater weight status underestimation. 4) Youth who underestimated their weight status were less likely to engage in physical activity.<br>Conclusion: These findings support the need for interventions to prevent excess weight and physical inactivity during adolescence to prevent higher BP in youth. Weight status misperception may reduce motivation among youth to engage in physical activity, and therefore hinder the success of obesity prevention interventions.<br>Problématique : Des interventions efficaces sont nécessaires pour prévenir l'obésité chez les jeunes afin de réduire le fardeau en santé publique associé à la tension artérielle elevée. Par contre, le succès des interventions ayant pour but la prévention de l'obésité par l'augmentation de l'activité physique a été limité dans le passé.<br>Objectifs : Ce mémoire a quatre objectifs : 1) évaluer l'impact des changements d'indices d'adiposité sur l'augmentation de la tension artérielle systolique à l'adolescence; 2) examiner les associations longitudinales entre le déclin d'activité physique et la tension artérielle systolique chez les jeunes; 3) évaluer si la perception erronée du statut pondéral chez les jeunes est associée à l'exposition aux personnes avec surpoids ou obésité à la maison ou à l'école; 4) examiner si la perception erronée du statut pondéral est associée au niveau d'activité physique.<br>Méthodes : La tension artérielle systolique et des mesures anthropométriques furent évaluées de façon biannuelle (1999/2000, 2002, 2004) au sein d'une cohorte de 1293 adolescents de Montréal âgés de 12 à 13 ans en 1999. Un questionnaire auto-administré de rappel des activités physiques de plus de 5 minutes des sept derniers jours fut rempli à tous les trois mois pendant cinq ans. Les mesures répétées de la tension artérielle systolique ont été analysées par des modèles de croissance individuelle afin d'évaluer l'effet des changements des indices d'adiposité sur la tension artérielle systolique. L'effet du déclin de l'activité physique sur la tension artérielle fut estimé par des modèles de régressions linéaires utilisant des modèles de croissance individuelle du niveau initial et du taux de réduction d'activité physique. Les hypothèses selon lesquelles les jeunes exposés à l'obésité à la maison et à l'école ont plus tendance à sous-estimer leur statut pondéral, et que ceux qui sous-estiment leur statut pondéral auront moins tendance à pratiquer de l'activité physique furent testées dans une enquête en milieu scolaire auprès d'un échantillon provincial représentatif de 3665 jeunes âgés de 9 ( n = 1267), 13 (n = 1186), et 16 ans (n = 1212). Des modèles multiniveaux de régression linéaire ont été utilisés pour évaluer l'association entre l'indice de masse corporelle des parents et des pairs et la perception erronée du statut pondéral (c'est-à-dire la différence standardisée entre la perception du statut pondéral et le statut pondéral réel). Les modèles de régressions de Poisson ont été utilisés pour examiner l'association entre la perception erronée du statut pondéral et l'activité physique.<br>Résultats : 1) Malgré une différence selon le sexe de la moyenne des changements de tension artérielle systolique, chaque unité de changement d'indice d'adiposité avait un effet similaire sur la variation de tension artérielle systolique chez les garçons et les filles. 2) L'activité physique a diminué pendant l'adolescence. La réduction d'une session d'activité physique par semaine par année de vie était associée à une augmentation de la tension artérielle. 3) La plupart des jeunes avec un surplus de poids sous-estimaient leur statut pondéral. Un indice de masse corporelle plus élevé chez les parents et les pairs était associé à une plus grande sous-estimation du statut pondéral chez les jeunes. 4) Les jeunes qui sous-estimaient leur statut pondéral étaient moins actifs physiquement.<br>Conclusion : Ces résultats confirment le besoin d'intervenir au niveau des problématiques que sont l'excès de poids et l'inactivité physique à l'adolescence, afin de prévenir l'élévation de la tension artérielle systolique chez les jeunes. La perception erronée du statut pondéral peut réduire la motivation des jeunes quant à l'activité physique. Ceci aura tendance à diminuer le succès des interventions visant à contrer l'obésité.

Bakgrund: Fetma och övervikt är ett tillstånd som ständigt ökar och utgör en risk för följdsjukdomar. I Sverige har antalet personer med fetma och övervikt tredubblats de senaste 40 åren. Att genomgå en gastric bypass operation ses som sista utvägen till ett liv som inte begränsas av fetma. Syfte: Att beskriva hur personer som genomgått gastric bypass upplever hälsa efter operationen. Metod: En kvalitativ ansats användes där det gjordes en analys av narrativer i form av bloggar. Tio bloggar granskades och analyserades. Resultat: Viktnedgången som sker till följd av gastric bypass operationen blev inte som alla hade tänkt sig. De fysiska förändringarna som uppstod var möjligheten till ett rörligare och aktivare liv men medförde även nya kroppskomplex. Självbilden är svår att förändra och psykiska besvär kvarstår. Självkänslan och självförtroendet som förväntades bli bättre blev snarare sämre och hade en inverkan på relationen med vänner och familj. Konklusion: Psykisk och social problematik erfars efter operationen vilket begränsar upplevelsen av fullständig hälsa. Då uppföljning inte är tillräckligt omfattande brister stödet från sjukvården. Genom sjuksköterskans förståelse för upplevda erfarenheter kan bemötandet av dessa personer anpassas och förbättras.

Fetma är ett samhällsproblem i alla åldersgrupper på många håll i världen. Fetma och övervikt hos barn och ungdomar kan ge både fysiskt och psykiskt negativa effekter. Det finns flera orsaker till att fetma uppkommer, olika faktorer som livsstil, miljö, och arv kan samverka i utvecklingen av fetma. I det svenska samhället är risken för fetma ökad eftersom det finns nästintill obegränsad tillgång till fett- och energirik kost samt att de individuella kraven på fysisk aktivitet är låga.<br>Program: Sjuksköterskeutbildning

Childhood obesity is a global concern among all ethnic groups. Childhood obesity is a problem that continues into adulthood, exacerbating the incidence of diseases such as diabetes or heart disease. The purpose of this phenomenological study was to explore, understand, and describe the perceptions and experiences of African American parents in the management and care of their obese or overweight children. This study used the health-belief model (HBM) as its theoretical foundation, focusing on the constructs of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. This research study used an interview tool and an 8-item demographic questionnaire to explore and describe how African American parents managed the care of obese children between the ages of 6 and 11. Interviews were transcribed and then inductively analyzed for themes. Parents reported having a difficult time deciding how to implement successful overweight strategies on a daily basis. Parents felt helpless in supporting their child's efforts to lose weight. Parents shared that their child and family members participated in weight-loss activities such as making diet changes and physical activities. The implication for social change from this study is in providing local public health leaders with increased understanding of the personal experiences of African American parents in the management of overweight children. Findings may assist in effective program development for the targeted population.

Introdução - O hábito alimentar da criança é construído a partir de influências socioculturais; sendo que a mídia atinge um grande número de telespectadores. A TV possui influência sobre as crianças e diversas propagandas são direcionadas para elas, motivo pelo qual é importante investigar este grupo para entender como o público infantil percebe a propaganda de alimentos e bebidas. Objetivo - Investigar a percepção de crianças e mães sobre a propaganda de alimentos e bebidas veiculadas pela TV. Metodologia Utilizou-se pela análise de caráter qualitativo, através de um questionário com questões semiestruturadas com perguntas claras e objetivas para mães e crianças de acordo com o Discurso do Sujeito Coletivo proposto por Lefevré e Lefevré. Resultados/Discussão Verificou-se que todas as crianças afirmaram gostar de assistir TV. A preferência de consumo relatado por elas por meio das propagandas, foram: refrigerante, fast-food, produtos lácteos. As mães por sua vez sentiram dificuldade de controlar o tempo de TV assistido por suas crianças. Nos finais de semana 26 por cento das mães referem que seus filhos assistem TV o dia inteiro, e 54 por cento das crianças assistem 3 horas ou mais por dia de TV durante a semana. Conclusão O fast-food foi o alimento mais veiculado nas emissoras gravadas. Sendo que do total de exibição de propagandas de uma das emissoras (B), os alimentos não saudáveis representaram 100 por cento das propagandas de alimentos e bebidas. As mães foram influenciadas pelos filhos a comprar alimentos não saudáveis, talvez estimulados pela propaganda. Elas sentiram dificuldade de controlar o tempo de TV assistido por suas crianças<br>Introduction - The feeding habits of the child is constructed from sociocultural influences and the media affects a large number of viewers. The influence TV has on children and several advertisements are directed at them, thus it is important to investigate this group to understand how the public perceives the infant food and beverage advertising. Objective - To investigate the perceptions of mothers and children on the advertising of food and drinks carried by the TV. Methodology - We used the for qualitative analysis, with a questionnaire with semistructured questions with clear and objective for mothers and children in accordance with the Collective Subject Discourse proposed by Lefevré and Lefevre. Results/Discussion - It was stated that all children enjoy watching TV. The preference of consumption reported by them through the advertisements were: soft drinks, fast food, dairy products. The mothers in turn found it difficult to control the TV time view for their children. On weekends 26 per cent of mothers reported that their children watch TV all day, and 54 per cent of children attend three or more hours of TV per day during the week. Conclusion - The fast-food was the food most aired on TV stations recorded. Since the total display of advertisements of a station (B) the unhealthy food advertisements accounted for 100 per cent of food and beverages. The mothers were influenced by children to buy unhealthy foods, perhaps stimulated by advertising. They found it difficult to control the time of TV watched by their children

Submitted by LUANA VALERA BOMBARDA null (lvbombarda@gmail.com) on 2016-08-09T22:14:16Z No. of bitstreams: 1 DISSERTAÇÃO FINAL -LUANA BOMBARDA.pdf: 3360499 bytes, checksum: a6ba716fd8ec19b2c0e4fefe88681470 (MD5)<br>Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-08-12T13:54:50Z (GMT) No. of bitstreams: 1 bombarda_lv_me_bot.pdf: 3360499 bytes, checksum: a6ba716fd8ec19b2c0e4fefe88681470 (MD5)<br>Made available in DSpace on 2016-08-12T13:54:50Z (GMT). No. of bitstreams: 1 bombarda_lv_me_bot.pdf: 3360499 bytes, checksum: a6ba716fd8ec19b2c0e4fefe88681470 (MD5) Previous issue date: 2016-07-08<br>Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)<br>Introdução: A obesidade infantil teve considerável aumento em sua prevalência nos últimos anos, acarretando prejuízos físicos, emocionais e sociais, caracterizando-se como um problema de saúde pública. Seu tratamento demanda ações e cuidados em todos os níveis da atenção à saúde, porém ainda são escassos os estudos que caracterizem as variáveis sociais e psicológicas presentes em crianças com diferentes graus de obesidade, estudos estes, que possam contribuir para o desenvolvimento de intervenções voltadas para este grave problema de saúde. Objetivos: Caracterizar, em relação a parâmetros sociodemográficos, clínicos e psicológicos, uma amostra clínica de crianças obesas, classificadas como obesas e super obesas, em tratamento para obesidade em um serviço de referência, de um hospital universitário do interior do estado de São Paulo; comparar os aspectos sociodemográficos, clínicos e psicológicos em relação ao sexo da criança e à gravidade da obesidade e ainda caracterizar e comparar o estilo parental, a percepção corporal e saúde mental materna ou de outros responsáveis pela criança e estudar a associação dessas características com indicadores da gravidade da obesidade da criança. Método: Foi realizado um estudo observacional, de corte transversal, descritivo e analítico, que avaliou 77 crianças com diagnóstico de obesidade e seus responsáveis. Essas crianças foram provenientes do Ambulatório de Obesidade Infantil do HCFMB/Unesp. Foram aplicados aos responsáveis pela criança um formulário que investigou características sociodemográficas e clínicas da criança, o SDQ (Questionário de Capacidades e Dificuldades - Strengths and Difficulties Questionnaire) que visou rastrear a saúde mental da criança (características emocionais e comportamentais), o IEP (Inventário de Estilos Parentais) para avaliar práticas educativas, o IDATE (Inventário de Ansiedade Traço-Estado) e o BDI (Inventário de Depressão de Beck) que medem, respectivamente, sintomas de ansiedade e de depressão do cuidador, e a Escala de Silhuetas, para avaliar a percepção corporal, a insatisfação corporal da crianças e de seus responsáveis em relação ao corpo da criança e ainda a percepção ideal das crianças e de seus responsáveis em relação às crianças da mesma idade do sujeito. Dados clínicos foram obtidos do prontuário médico das crianças (peso, altura, IMC, percentil, escore z, comorbidades e tempo de tratamento). A análise estatística foi efetuada pelo programa STATA 12.0, tendo sido efetuadas análises descritivas, frequências absolutas e porcentagens, médias e respectivos desvios-padrão, mediana e suas faixas de variação; na análise bivariada, utilizou-se o teste de qui-quadrado para as variáveis qualitativas e os testes de Mann- Whitney e Kruskal Wallis para as variáveis quantitativas e, por fim, foi realizada análise multivariada utilizando-se a regressão múltipla. Resultados: As crianças avaliadas apresentaram idade média de 9,1 (DP±1,9) e seus cuidadores idade média de 38,1 (DP±9,6). Os responsáveis eram predominantemente do sexo feminino (96,1%) e mães (88,3%). Segundo o SDQ, 53,2% das crianças apresentaram sintomas emocionais e comportamentais. Na avaliação de estilos parentais, 35,1% apresentaram práticas educativas classificadas como regular ou de risco. Com relação à ansiedade e sintomas depressivos dos responsáveis, constatou-se que 48,1% apresentaram sintomas de ansiedade-estado, e 41,6% ansiedade–traço, 39,0% apresentaram sintomas depressivos. A Escala de Silhuetas indicou que 44,2% possuíam percepção corporal adequada, 48,0% subestimaram o tamanho corporal e 7,8% superestimaram, 94,8% desejavam diminuir o tamanho da silhueta e 51,9% não reconheceram qual seria o tamanho corporal ideal de acordo com a faixa etária. Entre os cuidadores, 53,2% reconheceram adequadamente o tamanho corporal de seus filhos, 94,8% desejavam que seus filhos diminuíssem o tamanho da silhueta e 59,7% reconheceram o tamanho corporal ideal de acordo com a idade de seu filho. Comparando-se as características das crianças em relação ao sexo, constatou-se que meninos e meninas diferiram de forma estatisticamente significativa em relação à renda per capita familiar (p=0,002), percentil do IMC (p=0,01), escore z do IMC (p=0,006), gravidade da obesidade (p=0,02) e percepção do peso ideal da criança (p=0,02). Estudando-se a associação entre o escore z e as variáveis explanatórias deste estudo, constatou-se que foram significativas as associações do escore z, apenas com a faixa etária da criança (p=0,003), situação conjugal do cuidador (p=0,04), SDQ- sintomas emocionais (p=0,02), percepção corporal da criança (p=0,03) e percepção do peso ideal da criança de acordo com a sua faixa etária (p=0,03), embora as médias e medianas do escore z tenham sido quase sistematicamente mais elevadas nas categorias que indicavam risco. O modelo final da regressão múltipla mostrou associação livre de confusão com sexo (masculino), faixa etária (crianças mais novas), ocupação dos pais (trabalha) e situação conjugal do responsável (sem companheiro). Conclusões: O presente estudo indicou que as crianças participantes apresentaram várias características que podem ser consideradas características indicativas de vulnerabilidade social e psicológica: elevadas prevalências de problemas psicológicos, alteração na imagem corporal da criança e dos responsáveis; cuidadores com altas prevalências de dificuldades emocionais e com práticas parentais regulares ou de risco, independentemente da gravidade da obesidade. Esses dados são indicativos da importância de se analisar essas características e desenvolver intervenções que abordem também os aspectos sociais e psicológicos às crianças e seus familiares, visando a integralidade do cuidado no tratamento da criança com obesidade.<br>Introduction: Childhood obesity has considerable increase in its prevalence in recent years, leading to physical, emotional and social damage, characterized as a public health problem. Treatment demand actions and care at all levels of health care, but there are still few studies that characterize the social and psychological variables present in children with different degrees of obesity, studies these, which can contribute to the development of interventions aimed this serious health problem. Objectives: Characterize in relation to sociodemographic, clinical and psychological parameters, a clinical sample of obese children classified as obese and super obese, undergoing treatment for obesity in a reference service of a university hospital in the state of São Paulo; compare sociodemographic, clinical and psychological aspects in relation to the sex of the child and the severity of obesity and further characterize and compare the parenting style, body perception and maternal mental health or others responsible for the child and to study the association of these characteristics with indicators child obesity gravity. Method: An observational study was conducted, cross sectional, descriptive and analytical, which evaluated 77 children diagnosed with obesity and their parents. These children were from the Childhood Obesity Clinic of HCFMB/Unesp. They were applied to those responsible for child a form that investigated sociodemographic and clinical characteristics of the child, the SDQ - Strengths and Difficulties Questionnaire) which aimed to track the child's mental health (emotional and behavioral characteristics), the IEP (Inventory Parental Styles) to evaluate educational practices, the IDATE (Trait anxiety Inventory-State) and the BDI (Beck depression Inventory) that measure, respectively, anxiety symptoms and caregiver depression, and the Silhouette Scale to assess body perception, body dissatisfaction of children and their guardians regarding the child's body and also the ideal perception of children and their caregivers in relation to children of the same age of the subject. Clinical data were obtained from medical records of children (weight, height, BMI, percentile, z score, comorbidities and treatment time). Statistical analysis was performed using STATA 12.0 software, having been made descriptive analysis, absolute frequencies and percentages, averages and standard deviations, median and their variation ranges; in the bivariate analysis, we used the chi-square test for qualitative variables and the Mann-Whitney and Kruskal Wallis test for quantitative variables and, finally, multiple regression analysis was performed. Results: The evaluated children had a mean age of 9,1 (SD±1,9) and their average age caregivers of 38,1 (SD±9,6). Those responsible were predominantly female (96,1%) and mothers (88,3%). According to the SDQ, 53,2% of children had emotional and behavioral symptoms. In the evaluation of parenting styles, 35,1% were classified as regular educational practices or risk. With regard to anxiety and depressive symptoms of those responsible, it was found that 48,1% had symptoms of anxiety-state and 41,6% trait anxiety, 39,0% had depressive symptoms. The Silhouette Scale indicated that 44,2% had adequate body awareness, 48,0% underestimated their body size and 7,8% overestimated, 94,8% wanted to reduce the size of the silhouette and 51,9% did not recognize what the ideal body size according to age. Among the caregivers, 53,2% adequately recognized body size of their children, 94,8% wanted their children reduced the size of the silhouette and 59,7% recognized the ideal body size according to the age of your child. Comparing the characteristics of children about sex, it was found that boys and girls differ statistically significantly in relation to per capita family income (p = 0,002), BMI percentile (p = 0,01), z score BMI (p = 0,006), severity of obesity (p = 0,02) and perceived ideal child's weight (p = 0,02). Studying the association between the score z and the explanatory variables of this study, it was found that the associations of the z score were significant only with the age of the child (p = 0,003), marital caregiver status (p = 0,04 ) SDQ- emotional symptoms (p = 0,02), child's body perception (p = 0,03) and perception of the child's ideal weight according to your age (p = 0,03), although average and medians of the z score were almost systematically higher in categories indicating risk. The final multiple regression model showed free association of confusion with sex (male), age (younger children), parents' occupation (does work) and marital status of the head (without partner). Conclusions: The present study indicated that the participating children showed several features that can be considered indicative features of social and psychological vulnerability: high prevalence of psychological problems, changes in the child's body image and responsible; caregivers with high prevalence of emotional difficulties and with regular or risk parenting, regardless of the severity of obesity. These data are indicative of the importance of analyzing these features and develop interventions that also address the social and psychological aspects of children and their families, aiming at comprehensive care in the treatment of children with obesity.

Public Health<br>Ph.D.<br>The purpose of this study was to improve our understanding of the factors related to parents' intention to make weight-reducing lifestyle changes for their children. Previous research has examined parental perception of weight and adoption of weight loss behaviors, but many determinants remain unknown, including possible psychological and motivational factors that may facilitate self-efficacy and parents' intention to make weight-reducing lifestyle changes for their children. This study was a cross-sectional survey of 100 parents of obese children 6-12 years old attending primary care clinic in an urban academic practice. Parents completed the Family Demographics Questionnaire, the Weight Efficacy Lifestyle Questionnaire (Clark et al., 1991) and the Center for Epidemiological Studies Depression Scale (CES-D) (Radloff, 1977). Parents' height and weight were measured to calculate BMI. Logistic regression analyses of intention to follow provider advice included predictors of parents' self-efficacy for maintaining their child's diet, parents' self-perception of weight and controlling variables of child gender, child age, parents' BMI, ethnicity, and income. Parents' self-efficacy was found to be a significant predictor of parents' intention to follow the provider's recommendations; parents with higher self-efficacy scores were more likely to show intention to follow provider's recommendations (OR = 1.05, p < .001). Parents' level of depressive symptoms was a significant predictor of parents' self-efficacy; as level of depressive symptoms increased, parents' self-efficacy decreased. Depressive symptoms, together with legal guardian status and child's age predicted 16% of the total variance of parents' self-efficacy (B = -17.98, p < .01). The association of parents' self-perception of weight and intention did not achieve statistical significance; however, parents who perceived their provider to be overweight were less likely to intend to follow the provider's instructions (OR = 0.29, p < .03). Parents reporting a child with co-morbid health problems were less likely to show intention to follow weight loss recommendations in every analysis. These study results have implications for the training needs of pediatric providers to enable more effective interventions and improve overall outcome for the obese child, as well as implications for public health programs incorporating family participation into healthy lifestyle interventions for children.<br>Temple University--Theses

The purpose of this study was to determine the effects of a 10 week aerobic movement program for overweight children on cardiovascular fitness, body composition, self-esteem, and body-esteem. The subjects for the study consisted of 20 children (17 females and 3 males) ages 8-12. One group (n=12) consisted of overweight children and one group <n=8) consisted of average weight children. Cardiovascular endurance was measured in seconds with a two mile walk/Jog In the school halls. Self-concept was measured with the Piers-Harris Children's Self-Concept Scale. Body-esteem was measured with Mendelson and White's Body-Esteem Scale. A 2x2 univariate statistical analysis of variance (ANOVA) was employed to determine significance of effect. Overweight and average weight children were the independent variables. Self-esteem, body-esteem, and cardiovascular endurance were the dependent variables. Body composition (tricep skinfold measurement) was used to distinguish the two groups and determine weight loss due to the program. The ANOVA indicated no statistically significant Improvements In cardiovascular endurance, self-esteem and body-esteem in overweight children In comparison with average weight children after a 10 week aerobic movement program.<br>School of Physical Education

Introdução: Este estudo trata da percepção materna sobre o estado nutricional do filho e da autopercepção do estado nutricional de crianças e adolescentes. Há evidências de que as mães apresentam dificuldade em reconhecer adequadamente o estado nutricional do filho, especialmente nos casos de excesso de peso. Crianças e adolescentes também não percebem adequadamente o próprio estado nutricional. A prevenção do excesso de peso, bem como de transtornos alimentares, requer percepção precoce e adequada abordagem dessas condições. A não percepção do real estado nutricional de crianças e adolescentes por suas mães e por elas mesmas representa um importante obstáculo para a busca de assistência profissional. São poucos os estudos que abordam esta temática na no país. Objetivos Principais: Descrever a adequação do reconhecimento do estado nutricional de crianças e adolescentes por eles mesmos e por seus cuidadores principais. Objetivos Secundários: Analisar fatores que interfiram na percepção do estado nutricional das crianças e adolescentes por eles mesmos e por seus cuidadores. Método: estudo transversal analítico realizado no pronto atendimento do Hospital Universitário da Universidade de São Paulo de março de 2009 a abril de 2010. Foram incluídas 1.001 crianças de dois a 14 anos e seu cuidador principal. Foi aplicado questionário que avaliou, através de descritores verbais, a autopercepção nutricional da criança ou adolescente e a percepção materna sobre o estado nutricional do filho. As crianças e seus cuidadores principais tiveram peso e estatura aferidos. Foi analisada a concordância entre o estado nutricional real da criança e as classificações mencionadas pela mãe e pela própria criança ou adolescente através do coeficiente Kappa. Foram avaliados, através de análise multivariada, fatores associados a erro na autopercepção e percepção materna sobre o estado nutricional da criança ou adolescente. Resultados: A concordância entre a percepção materna e da autopercepção nutricional da criança com o estado nutricional real da criança é pobre (Kappa ponderado 0,236 e 0,295 respectivamente). 50,9% das mães acertaram a classificação nutricional do filho. O gênero (OR1,59 1, IC17-2,01 p=0,008) e a idade (OR 1,01, IC1,00-1,01 p < 0,001) da criança influenciaram no acerto de classificação da mãe. Mães que se autoclassificaram como \"peso alto\" acertaram mais o estado nutricional das crianças (OR1,54 IC 1,10-2,15, p=0,011) e mães de crianças com sobrepeso (OR0,17, IC0,11-0,25, p < 0,001) e obesidade (OR 0,28, IC 0,18-0,44, p < 0,001) apresentaram pior percepção do correto estado nutricional do filho. As mães subestimaram mais o estado nutricional dos meninos e superestimaram nas meninas. Mães que apresentavam sobrepeso (p=0,025) ou obesidade (p=0,010) subestimaram mais o estado nutricional dos filhos e mães de crianças com sobrepeso (p < 0,001) e obesidade (p < 0,001) também subestimaram mais o estado nutricional das crianças. A autopercepção nutricional foi correta em 49% das crianças. Das que erraram a maioria (58%) subestimou. O gênero (OR 1,60, IC1,13-2,26 p < 0,007) e a idade (OR 1,01 CI 1,10-1,02, p < 0,001) da criança influenciaram na autopercepção nutricional das mesmas. Crianças com sobrepeso apresentaram menor chance de perceber adequadamente o próprio estado nutricional (OR 0,38, IC 0,23-0,63, p < 0,001). As meninas tendem a superestimar o próprio estado nutricional e os meninos tendem a subestimar (p=0,027). Conclusão: a percepção materna sobre o estado nutricional da criança e adolescente é frequentemente incorreta. Tanto mães quanto crianças tendem a superestimar o estado nutricional nas meninas e subestimar nos meninos. Os resultados evidenciam a importância da avaliação da percepção nutricional da criança e auxílio às famílias para que reconheçam o real estado nutricional do filho, buscando uma efetiva ação preventiva, já que a detecção precoce é o primeiro passo para a prevenção ou recuperação do excesso de peso e para a prevenção de transtornos alimentares<br>Introduction: This study aimed to determine maternal perception regarding the nutritional status of her child and the self-nutritional perception status of children and adolescents. There is evidence that mothers have difficulty in properly recognizing the nutritional status of their children, especially overweight cases. Children and adolescents also do not accurately perceive their own nutritional status. Prevention of overweight and eating disorders requires early and adequate perception of these conditions. The perception failure of the actual nutritional status of children and adolescents by their mothers and themselves is a major barrier to seeking professional assistance. Few studies have addressed this issue in Brazil . Main Objectives: To determine the appropriateness of the recognition of nutritional status of children and adolescents by themselves and their primary caregivers. Secondary Objectives: To analyze factors affecting the perception of the nutritional status of children and adolescents by themselves and their caregivers. Method: A cross-sectional analytical study conducted in the emergency room of the University Hospital of the University of São Paulo from March 2009 to April 2010. We included 1,001 children aged 2-14 years and their primary caregiver. A questionnaire that evaluated self-nutritional perception of the child or adolescent and maternal perception about the nutritional status of her child through verbal descriptors was administered. The weight and height of children and their primary caregivers were measured. The correlation between the actual nutritional status of children and the classifications mentioned by the mother and by the child or adolescent were analyzed using the Kappa coefficient. Factors associated with incorrect self-perception and maternal perception of the nutritional status of children and adolescents were assessed by multivariate analysis. Results: The correlation between maternal perception and nutritional self-perception of children with the actual nutritional status of the child was poor (weighted Kappa, 0.236 and 0.295, respectively). The nutritional classification of the child was judged correctly by 50.9% of mothers. The child\'s gender (OR, 1.59 1; CI, 17-2.01; p = 0.008) and age (OR, 1.01; CI, 1.00-1.01; p < 0.001) influenced the mother\'s classification accuracy. Mothers who classified themselves as \"heavy weight\" were more accurate about the nutritional status of their children (OR, 1.54; CI, 1, 10-2.15; p = 0.011), whereas mothers of children with overweight (OR, 0,17; CI 0,11-0. 25; p < 0.001) and obesity (OR, 0.28; CI, 0.18 to 0.44; p < 0.001) had worse perception of the correct nutritional status of their child. Mothers underestimated the nutritional status of boys and overestimated that of girls. Mothers who were overweight (p = 0.025) or obese (p = 0.010) underestimated the nutritional status of their children more often, and mothers of children with overweight (p < 0.001) and obesity (p < 0.001) also underestimated the nutritional status of children more often. Self-nutritional perception was correct in 49% of children. Of those who were incorrect, the majority (58%) underestimated. The gender (OR, 1.60; CI, 1, 13-2.26; p < 0.007) and age (OR, 1.01; CI, 1.10-1.02; p < 0.001) of the children influenced their self-nutritional perception. Overweight children were less likely to properly perceive their actual nutritional status (OR, 0.38; CI, 0.23-0.63; p < 0.001). Girls tended to overestimate their own nutritional status, whereas boys tended to underestimate it (p = 0.027). Conclusion: The maternal perception of the nutritional status of the child and adolescent is often incorrect. Both mothers and children tend to over- and underestimate the nutritional status in girls and boys, respectively. These results show the importance of evaluating the nutritional perception of children and providing support to families for recognizing the actual nutritional status of their child and seeking an effective preventive action, since early detection is the first step toward preventing overweight or improving and preventing eating disorders

Orientador: Ana Teresa de Abreu Ramos-Cerqueira<br>Resumo: Introdução: A obesidade infantil teve considerável aumento em sua prevalência nos últimos anos, acarretando prejuízos físicos, emocionais e sociais, caracterizando-se como um problema de saúde pública. Seu tratamento demanda ações e cuidados em todos os níveis da atenção à saúde, porém ainda são escassos os estudos que caracterizem as variáveis sociais e psicológicas presentes em crianças com diferentes graus de obesidade, estudos estes, que possam contribuir para o desenvolvimento de intervenções voltadas para este grave problema de saúde. Objetivos: Caracterizar, em relação a parâmetros sociodemográficos, clínicos e psicológicos, uma amostra clínica de crianças obesas, classificadas como obesas e super obesas, em tratamento para obesidade em um serviço de referência, de um hospital universitário do interior do estado de São Paulo; comparar os aspectos sociodemográficos, clínicos e psicológicos em relação ao sexo da criança e à gravidade da obesidade e ainda caracterizar e comparar o estilo parental, a percepção corporal e saúde mental materna ou de outros responsáveis pela criança e estudar a associação dessas características com indicadores da gravidade da obesidade da criança. Método: Foi realizado um estudo observacional, de corte transversal, descritivo e analítico, que avaliou 77 crianças com diagnóstico de obesidade e seus responsáveis. Essas crianças foram provenientes do Ambulatório de Obesidade Infantil do HCFMB/Unesp. Foram aplicados aos responsáveis pela criança ... (Resumo completo, clicar acesso eletrônico abaixo)<br>Abstract: Introduction: Childhood obesity has considerable increase in its prevalence in recent years, leading to physical, emotional and social damage, characterized as a public health problem. Treatment demand actions and care at all levels of health care, but there are still few studies that characterize the social and psychological variables present in children with different degrees of obesity, studies these, which can contribute to the development of interventions aimed this serious health problem. Objectives: Characterize in relation to sociodemographic, clinical and psychological parameters, a clinical sample of obese children classified as obese and super obese, undergoing treatment for obesity in a reference service of a university hospital in the state of São Paulo; compare sociodemographic, clinical and psychological aspects in relation to the sex of the child and the severity of obesity and further characterize and compare the parenting style, body perception and maternal mental health or others responsible for the child and to study the association of these characteristics with indicators child obesity gravity. Method: An observational study was conducted, cross sectional, descriptive and analytical, which evaluated 77 children diagnosed with obesity and their parents. These children were from the Childhood Obesity Clinic of HCFMB/Unesp. They were applied to those responsible for child a form that investigated sociodemographic and clinical characteristics of the child, th... (Complete abstract click electronic access below)<br>Mestre

Cadre théorique. Dans un contexte transitionnel sénégalais, inscrit dans une interface bioculturelle, il est important d'évaluer l'impact de l'urbanisation sur le développement de la surcharge pondérale, mais aussi sur ses conceptions socioculturelles et son ressenti psychosocial en mutation. Méthodologie. Pour ce faire, nous avons réalisé une première enquête qualitative par focus group et une seconde étude qualitative par entretiens semi-directifs (dans l'agglomération de Dakar et à Gandiaye dans le communauté rurale de Thiomby de la région de Kaolack) au sein d'un échantillon représentatif de la population sénégalaise adulte, vivant dans l'espace wolophone du centre du pays ; puis une troisième étude quantitative comparative entre la région de Kaolack et l'agglomération de Dakar. Résultats. Sur le plan qualitatif, le gros n'est plus associé à la richesse (nourriture/alimentation), au bien-être (mort-maladie/santé) et à la puissance reproductive (sexualité/esthétisme) ; mais à l'oisiveté (nourriture/alimentation), la dysfonction (mort-maladie/santé) et l'indésirabilité sexuelle (sexualité/esthétisme). Sur le plan quantitatif, une augmentation significative de la surcharge pondérale se dessine, avec une valorisation sociale de l'embonpoint comme l'un de ses facteurs de risque. Puis, les modèles esthétiques modernes se véhiculent, avec une envie de maigrir associée à une mauvaise estime de son apparence. Conclusion. Les Sénégalais passent d'un régime où le corps soumis à un culte animiste del'énergie vitale ne pouvait qu'être exposé à la maigreur, à un régime où le corps soumis à un culte moderne de la raison ne pourra qu'être exposé à la grosseur<br>Theoretical framework. In a Senegalese transitional context, expressing itself by a biocultural interface, it is important to assess the impact of the phenomenon of urbanization on the development of overweight, but also on its social and cultural conceptions and its psychosocial feeling in a changing process. Methodology. To do this, we first conducted a qualitative focus group survey and a second study by qualitative semi-structured interviews (In the city of Dakar and at Gandiaye in the rural community of Thiomby from the Kaolack region) in arepresentative sample of the senegalese adult population living in the wolophone space from the center of the country ; and a third comparative quantitative study between the region of Kaolack and Dakar agglomeration. Results. By the qualitative aspects, we note that the big person is no longer associated to wealth (food/diet), well-being (death-disease/health) and reproductive output (aesthetics/sexuality), but to idleness (food /diet), dysfunction (death-disease/health) and sexual undesirability (aesthetics/sexuality). By the quantitative aspects, we note a significant increase of overweight with a social valorisation of overweight as a risk factor to the development of this syndrome. In addition, the modern standards of body are spreading, thus, the desire to lose weight is associated with a poor esteem of its appearance.Conclusion. The Senegalese leave a model where the body subjected to an animist cult of vital energy was mostly exposed to thin, for a model where the body subjected to a modern cult of reason will be mostly exposed to overweight

Com a transição nutricional, da desnutrição para a obesidade, característica dos países em desenvolvimento, como é o caso do Brasil, o enfoque das pesquisas sobre o estado nutricional vem se voltando para a questão da obesidade. São escassos, particularmente no Brasil, estudos consistentes na área da nutrição voltados à relação do estado nutricional com o comportamento humano, especificamente no que concerne à percepção subjetiva das pessoas em relação ao seu próprio corpo. A percepção da imagem corporal tem sido sistematicamente associada a transtornos do comportamento alimentar, como a anorexia nervosa, a bulimia e a obesidade. Uma das questões seria qual a relação da percepção da imagem corporal nas atitudes e comportamentos alimentares das pessoas, na comunidade em geral, sem diagnóstico específico de transtornos alimentares. Haveria alguma relação com o estado nutricional, ou com alguma característica específica do comportamento alimentar? Este trabalho tem por objetivo responder estas questões. Para avaliação do estado nutricional foi considerada a classificação do Índice de Massa Corporal (IMC) proposta pela Organização Mundial de Saúde. A escala de figuras de silhuetas foi especialmente construída, assim como a escala tipo Likert. Os métodos psicométricos de aplicação foram criteriosamente selecionados, como validadas as escalas de comportamento alimentar e percepção da imagem corporal. A análise dos resultados sobre a percepção da imagem corporal demonstrou que homens tendem a subestimam seu tamanho corporal independentemente da classe de IMC a que pertençam, enquanto mulheres de IMC normal, ou portadoras de sobrepeso, tendem a superestimar seu tamanho corporal. As mulheres obesas tendem a subestimá-lo, como os homens. Os resultados obtidos sugerem relativa insatisfação tanto de homens como mulheres com o tamanho corporal.<br>With the nutritional transition from malnutrition to obesity, which is a feature of countries like Brazil, that are still going through a growth process, the focus of researches on the nutritional status are now turning to obesity. Studies on the nutritional area that relate the nutritional status with the human behavior are rare, especially when it comes to the subjective perception of one?s own body. The body image perception has been systematically associated with eating behavior distortions, such as anorexia nervosa, bulimia nervosa and obesity. One of the questions that are raised is what would be the relation between one?s body image perception and this person?s attitudes and eating behavior, in subjects without a specific diagnosis for eating disorders. Would it be related to the nutritional status or to any specific characteristic of the nutritional behavior? The objective of this work is to answer these questions. To evaluate the nutritional status, the BMI (body mass index) was considered on the basis of the World Health Organization classification. The Contour Drawing Rating Scale and Likert-type Scale were especially made for the present study. The psychometric methods of application, the eating behavior scales and the body image perception scales have been validated. Results showed that men tend to underestimate their body size, independently from the BMI class to which they belong, while women with regular BMI or with overweight tend to overestimate their body size. Obese women tend to underestimate it, just like men. The results also suggest an apparent dissatisfaction of both men and women with their body sizes.