Healthy Weight Students Research Articles

Health, health behaviors, and medical care utilization among college students with obesity

Objective: The study assessed perceived health, health behaviors and conditions, and medical care utilization among students of different weight categories. Participants: Participants were college students (n = 37,583) from 58 institutions who responded to a national survey of student health behaviors. Methods: Chi-squared and mixed model analyses were completed. Results: Compared to healthy weight students, those with obesity were less likely to report excellent health and meet dietary and physical activity recommendations, and more likely to have obesity-related chronic conditions and to have attended a medical appointment in the prior 12 months. Students with obesity (84%) and overweight (70%) were more likely to be attempting weight loss compared to students of healthy weight (35%). Conclusions: Students with obesity have poorer health and health behaviors relative to students of healthy weight; students with overweight were in between. Adapting and implementing evidence-based weight management programs within colleges/universities may be beneficial for student health.

Does schoolbag carriage equally affect obese/overweight and healthy-weight children?

Discrepancies exist in backpack load recommendations for obese/overweight children, and the recommendations do not consider school trolleys. This study analysed obese/overweight and healthy-weight students’ perceived load and fatigue when carrying schoolbags and their gait kinematics and rate of perceived exertion (RPE) when carrying backpacks or pulling school trolleys with different loads. Twelve obese/overweight and 36 healthy-weight students were asked about their perceived load and fatigue in carrying their schoolbags to school. Then, a kinematic gait analysis was completed in students walking unloaded or transporting 10%, 15% or 20% of their bodyweight (BW) in a backpack or trolley. RPE was recorded after each condition.The average hip rotation and knee adduction angles differed between body mass index (BMI) groups. The healthy-weight group reported higher RPEs than the overweight/obese group when pulling a trolley with 10–15% BW.In conclusion, both BMI groups responded similarly to load and schoolbag type.

P19 Emotion- and Stress-Related Eating is Related to Weight Status Among College Students

<h3>Background</h3> The Transactional Model of Stress and Coping proposes that stress occurs when one perceives that a particular stressor outweighs one's resources to cope. Emotion- and stress-related eating may be used as a measure to cope, which can lead to an increase in caloric intake and weight gain. <h3>Objective</h3> The purpose of this study was to understand the relationship between constructs of The Transactional Model of Stress and Coping and weight status among college students. <h3>Study Design, Setting, Participants</h3> Six hundred and ninety college students participated in an online survey. <h3>Outcome Measure/Analysis</h3> The survey included the Emotion- and Stress-related Eating and the Appraisal of Ability and Resources to Cope sub-scales from the Eating and Appraisal Due to Emotions and Stress (EADES) Questionnaire, the Perceived Stress Scale (PSS), self-report of height and weight, and demographic questions. Responses were captured on a 5 point Likert scale where lower scores represent greater emotion- and stress-related eating, lower appraisal of skills and resources to cope, and less stress. Logistic regression analysis was used to test the relationship between weight status and emotion- and stress-related eating, appraisal of resources to cope, and PSS while adjusting for demographics. <h3>Results</h3> In univariate analysis, when compared with healthy weight students, overweight/obese students had significantly lower Emotion-and Stress-related Eating scores (3.3 ± 0.7 vs 3.7 ± 0.8, <i>P</i> < .001) but similar PSS (17.4 ± 6.2 vs 16.9 ± 6.2, <i>P</i> = .23) and appraisal scores (3.6 ± 0.7 vs 3.7 ± 0.7, <i>P</i> = .10). After adjusting for demographics, overweight/obese individuals had significantly lower Emotion- and Stress-related Eating scores than their healthy weight counterparts regardless of perceived stress and appraisal to cope with stress (OR, 0.36; 95% CI, 0.28-0.49). <h3>Conclusions</h3> Overweight and obese college students report more emotion- and stress-related eating compared to normal weight students; however, their perceived stress levels were similar. Emotion- and stress-related eating should be included in educational interventions.

The relationship between obesity and tertiary education outcomes: a systematic review.

Previous reviews have documented an overall weak or uncertain association between obesity and school-based educational attainment in children and young people. However, up to half of young adults will go on to further college or university education by age 30. The study aim was to systematically review evidence on the association between obesity and tertiary education outcomes in young men and women. A search of multiple databases, including Embase, Global Health, ERIC, Medline, PsycInfo, and Science Citation Index was conducted in March 2018. Cross-sectional and longitudinal studies were included that reported on young people aged 16+, an association between obesity and academic achievement, and a comparison to healthy weight students. Risk of bias was assessed using criteria from the STROBE checklist. From 1297 records, 16 studies met all inclusion criteria. All six cross-sectional studies and 8/10 longitudinal studies reported lower educational achievement by students with obesity. All longitudinal studies were at low risk of bias but four cross-sectional studies were at medium risk and two at high risk of bias. Three of four studies showed reduced enrolment, in 6/8 graduation was less likely, and all 6 studies reporting on performance showed this was lower in those with obesity. Five of nine studies reported that obesity had a greater impact on educational achievement for women. Overall, there is compelling evidence of weight bias in that students with obesity do less well in tertiary education than their healthy weight peers. It is likely that university/college attainment is less impacted by socio-economic factors than school-based achievement. A better understanding of the processes that underpin this weight bias is needed, including stakeholder (student, staff) experiences of weight stigma, perceived or enacted. Responsive actions could mirror those to address disability or gender bias, or in health promotion in tertiary education settings.

Estimating the Effects of Subsidized School Meals on Child Health: Evidence from the Community Eligibility Provision in Georgia Schools

We estimate the effect of providing universal free school meals through the Community Eligibility Provision (CEP) on the percentage of healthy weight students attending a school and average Body Mass Index (BMI) score among the population of K-12 schools in the state of Georgia. Different specifications of school CEP eligibility are used as instruments for CEP participation in our analysis. We find that CEP participation leads to an increase in the percentage of healthy weight students attending a school and a decrease in average student BMI. Furthermore, we find no statistically significant evidence to support a deleterious effect from CEP participation on our aggregate measures of child weight. Subsample analyses suggest that the effect of CEP participation varies by school grade and location type, with smaller overall effects for schools serving older students and schools in suburbs/towns. We also show that our results are generally robust to different modeling specifications and key variable assumptions. Overall, the beneficial aggregate weight effects caused by CEP participation indicate that providing universal free meals in low-income schools may be a valuable tool in the fight against increasing rates of childhood overweight and obesity.

Self-Reported Change in Physical Activity and Screen Time in 4th Graders Shows Gender, Seasonal and Weight Status Differences Even in Absence of an Intervention Effect

Examine changes in student self-reported mild (MPA), moderate (MoPA), and strenuous (SPA) physical activity (PA) and screen time (ST) as part of the Fuel for Fun (FFF) intervention. Two cohorts were enrolled in a controlled study with measures at baseline (BL, beginning of school year), follow-up-1 (FU1, end of school year), and follow-up-2 (FU2, beginning of following school year). Cohort one (C1, n=288) served as control; cohort two (C2, n=278) participated in FFF, an elementary school-based nutrition and PA education program including SPARK active recess targeting 4th graders. PA and ST were measured with an adapted version of the Godin Leisure-Time Exercise Questionnaire. 2x3 repeated measure ANOVA’s considered the effect of gender, baseline weight status (overweight/obese; healthy weight), and cohort. Cohorts did not differ in baseline PA, ST or weight status. All PA levels were significantly lower at BL than FU1 and FU2 (MPA BL 130±146, FU1 163±159, FU2 175±165; MoPA BL 156±139, FU1 189±145, FU2 183±147; SPA BL 229±141, 246±140, 234±137 minutes/week; all P<.05) with no significant differences between FU1 and FU2. Patterns of change did not differ between cohorts. Overweight/obese students reported significantly higher levels of ST than healthy weight students (3.4±3.1, 3.4±2.8, 2.5±2.3 vs. 2.5±2.4, 2.7±2.3, 2.5±2.1 hours/week; p<.001). Males reported significantly higher levels of SPA (247±147, 269±140, 248±136 vs 210±135, 224±137, 220±136 minutes/week; p<.01). A non-significant decrease in ST was noted for overweight/obese in c2, but not in c1. Findings demonstrated seasonal, weight, and gender differences in PA and ST. Further analyses to investigate subjects that responded to the FFF intervention are warranted.

Differences in Health Behaviors of Overweight or Obese College Students Compared to Healthy Weight Students

Background: Obesity continues to be an epidemic in college students, yet research is warranted to determine whether obesity increases the likelihood of risky health behaviors in this population. Purpose: The purpose of this study was to examine the association between body mass index (BMI) and health behaviors in college students. Methods: A sample of 758 college students who completed an online health behavior survey were categorized based on their BMI. Chi-square analysis was used to examine the association between health behaviors and BMI. Summative health risk scores were compared using independent samples t test. Results: With the exception of sexual practices, there were few differences in reported health behaviors between BMI classification; however, a statistical significance (P = .024) was found between BMI groups on the Health Risk subscale. Discussion: The results of this study revealed little differences between BMI and health behaviors in college students and reinforced previous findings that college students, in general, do not seem to be concerned with meeting recommendations for improved health. Translation to Health Education Practice: The findings support the need for cost-effective, comprehensive programming aimed at improving health behaviors in all college students, not just a particular subgroup.

Mood and food at the University of Turku in Finland: nutritional correlates of perceived stress are most pronounced among overweight students

We examined perceived stress and food intake at University of Turku, Finland. This study was conducted as an online survey (1189 students). We computed two composite food intake pattern scores (sweets, cakes and snacks; fruits and vegetables), a dietary guideline adherence index, and the subjective importance of healthy eating. We assessed the correlations between perceived stress, and two food intake pattern scores, dietary guideline adherence index and subjective importance of healthy eating. We tested the associations between stress and the same variables, controlling for potential confounders for the whole sample, by gender, and by Body Mass Index (BMI). Fruits and vegetables intake and dietary guideline adherence were both negatively associated with stress. These negative associations were more pronounced in overweight and less pronounced in underweight compared to healthy weight students. Sweets, cookies and snacks consumption were not associated with stress. Stress was associated with lower subjective importance of healthy eating, independent of gender and BMI. Perceived stress might have relationships of different magnitudes in overweight vs. normal BMI or underweight persons. BMI could be an effect modifier of the stress-food habits association.

Associations of Weight Status, Social Factors, and Active Travel Among College Students

Background: Active travel (AT) is associated with various health benefits and may help prevent the decline in physical activity during college years. Purpose: The purpose of this study was to examine the relationship of several factors with AT to campus by weight status. Methods: Students at a large northeastern US campus completed an online survey about demographics, height/weight, frequency and mode of travel to/around campus, and environmental influences for travel choices. Participants were dichotomized into healthy weight ( < 25 kg/m2, n = 552, 72.3%) and overweight ( ≥ 25 kg/m2, n = 211, 27.7%) categories. Descriptive and inferential analyses examined relationships and differences between weight categories. Logistic regression models examined the associations with demographic, psychological, residential, social, and environmental variables with participation in AT. Results: Participants were primarily white (85.3%) and female (62.7%). Healthy weight students were more likely to report AT to campus and AT as their primary mode of travel on campus compared to overweight students. Discussion: These findings provide insight on the association of weight status with environmental and community influences for AT and identifies possible targets for intervention. Translation to Health Education Practice: College health educators can use these findings to set relevant policy and environment goals to target student AT participation.

Inaccurate Weight Perception Is Associated With Extreme Weight‐Management Practices in US High School Students

The objective of the present study was to examine whether adolescents' weight perception accuracy (WPA) was associated with extreme weight-management practices (EWPs) in differing body mass index (BMI) categories. WPA, overassessment, and underassessment were determined by comparing self-reported BMI and weight perception among U.S. high school students in the 2009 National Youth Risk Behavior Survey. BMI was classified as follows: underweight (<5th percentile), healthy weight (5th to <85th), overweight (≥85th to <95th), and obese (≥95th). WPA was considered inaccurate if BMI and weight perception were discordant. Overassessors thought they were heavier than they were (among underweight/healthy groups); underassessors thought they were lighter than they were (among healthy/overweight/obese groups). EWPs included ≥1 of fasting, use of diet pills, or purging/laxative use. Logit models were fitted for different BMI sex strata. In the final sample of 14,722 US high school students with complete data, 20.2%, 85.7%, 5.8%, and 80.9% of those who were underweight, healthy weight, overweight, and obese, inaccurately assessed their weight, respectively. In turn, 11.4% and 17.6% of accurate and inaccurate assessors engaged in EWPs, respectively. After adjustment, underweight girls who overassessed their weight had 12.6 times higher odds of EWPs (95% confidence interval 3.4-46.6). Moreover, there were elevated odds of EWPs among healthy weight students who overassessed their weight. Overassessing healthy weight students and underweight girls had higher odds of ≥1 EWPs, likely related to an unhealthy desire to lose weight. The present study demonstrates a need to further educate clinicians on WPA and its relation to EWPs even among those of healthy weight who may be seen as not at risk.

Prevalence of Severe Obesity among New Zealand Adolescents and Associations with Health Risk Behaviors and Emotional Well-Being

To describe the prevalence of severe obesity among New Zealand young people attending secondary school and the associations of severe obesity with health risk behaviors and emotional well-being. A random sample of 9107 secondary school students in New Zealand participated in a 2007 health survey. Participants had their height and weight measured and answered an anonymous survey on multiple aspects of their health and well-being. Overall, 2.5% of students met the International Obesity Task Force definition of severe obesity. Students with severe obesity had more weight-related concerns, were more likely to have used unhealthy weight control strategies, and were more likely to experience bullying compared with healthy weight students. For example, students with severe obesity were 1.7 times more likely to have been bullied at school (95% CI 1.2-2.7) and 1.9 times more likely to vomit for weight loss (95% CI 1.1-3.3) than were healthy weight students. Indicators of emotional well-being and most health risk behaviors were similar among young people with severe obesity and a healthy weight. Clinicians who work with young people with severe obesity should prioritize discussing issues of bullying and healthy weight control strategies with families and their children.

Association Between Depressed Mood and Perceived Weight in Middle and High School Age Students: Texas 2004–2005

Research exploring the relationship between weight perception and depressed mood among adolescents is limited in the United States. The purpose of this study is to examine the association of perceived versus actual body weight and depressed mood in a representative sample of 8th and 11th grade public school students in Texas. Using data from the 2004-2005 School Physical Activity and Nutrition (SPAN) study, logistic regression analyses were conducted to assess the association of weight perception with depressed mood. Healthy weight students who perceived themselves to be a healthy weight were the reference group for all analyses. A high prevalence of misperception of body weight was observed. Overweight and obese 8th grade girls and boys who perceived themselves to be overweight had increased odds of depressed mood [Girls: OR 1.70 (95% CI: 1.07-2.69), Boys: OR 2.05 (95% CI: 1.16-3.62)]. Healthy weight 8th grade girls who perceived themselves to be overweight had 2.5 times greater odds of depressed mood (OR 2.63, 95% CI: 1.54-4.50). Healthy weight boys who perceived themselves to be underweight had more than twice the odds (OR 2.18, 95% CI: 1.23-3.89) of depressed mood. No weight category was significantly associated with depressed mood in boys or girls in 11th grade. The present study suggests that weight misperceptions are associated with depressed mood in young adolescents. Education about healthy body size is necessary to correct the common weight misperceptions observed. The high prevalence rates of depressed mood suggest a greater need for research into understanding factors that may contribute to depressed mood in adolescents.

Comfort and utility of school-based weight screening: the student perspective.

BackgroundWeight screening in schools has been proposed as one strategy to address childhood obesity. Students' response to such screening is unexplored, however. In this study we evaluated the perceived comfort, utility and impact of school-based weight screening from the perspective of middle school-aged students.MethodsA cross-sectional study of 852 ethnically diverse 5th–8th grade students. Associations were investigated between measured height and weight screening data and responses to a self-administered questionnaire completed immediately following weight screening in physical education class. BMI categories were based on the revised 2000 CDC growth chart and definitions: 5th–85th BMI percentile = healthy weight, 85th–95th BMI percentile = at risk for overweight, and >95th percentile BMI = overweight.ResultsOverall, students' comfort level with weight screening varied depending on the student's own weight status. More overweight students (38.1%) reported being uncomfortable than healthy weight students (8.1%) (p < 0.001). In particular, overweight female students (54.8%) compared to healthy weight female students (21.6%) reported being uncomfortable (p < 0.01). About half (54.9%) of all students reported knowing their weight prior to screening, and 58.9% reported that it was useful to learn their height and weight. Compared to healthy weight students, overweight students were significantly more likely to report the intention to perform weight modification related activities such as visiting a doctor (Odds ratio (OR) = 2.0, 95% CI = 1.3, 3.1), eating more fruits and vegetables (OR = 2.7, 95% CI = 1.7, 4.1), and increasing physical activity (OR = 4.3, 95% CI = 2.7, 7.0).ConclusionOverall, the majority of the middle school students did not report discomfort with school-based weight screening, did report that receiving height and weight information was useful, and generally report appropriate weight control intentions. These proportions varied across weight status categories, however, with students who were at risk for overweight or overweight reporting higher levels of discomfort. For schools that conduct weight screening, it is essential that they also provide comfortable and private settings as well as education or counseling regarding healthy weight control practices.

Examination of Weight Status and Dietary Behaviors of Middle School Students in Kentucky

Objective There is growing interest in understanding the roles that fruit, vegetable, milk, breakfast, and soft drink consumption play in relation to adolescents’ weight status. This study examines the relationship between weight status and dietary practices of middle school students. Design This study consists of secondary analysis of a cross-sectional survey given to 4,049 middle school students in central Kentucky. Methods Students’ self-reported height and weight data, as well as 7-day recall of fruits, vegetables, milk, soft drinks, and breakfast consumption prior to completion of the survey, were collected. Self-reported height and weight were converted to body mass index (BMI) percentile according to Centers for Disease Control and Prevention’s classification criteria. Outcome measures Measures included dietary consumption of fruits, vegetables, milk, soft drinks, and breakfast in relation to students’ BMI percentile. Statistical analyses performed Descriptive statistics were extracted on demographics, BMI percentile, and food consumption. Bivariate analyses included χ 2 tests of association and Spearman rank correlation. Results Healthy weight was associated with consuming fruits, vegetables, breakfast, and milk. Underweight and healthy-weight students consumed more fruits than students who were at risk of being overweight and overweight. Healthy-weight students consumed more “other vegetables” than students who were at risk of being overweight and more “other vegetables” and carrots than overweight students. Underweight students consumed breakfast more often than all other students, and healthy-weight students consumed breakfast significantly more frequently than students at risk of being overweight and overweight. Finally, overweight students had a significantly lower consumption of milk than all other students. Conclusions Parents and school foodservice personnel should take these factors into consideration by developing menu strategies and tactics to encourage more healthful eating behaviors in children.