Objectives
Ethnic disparities in childhood overweight are well-documented. In addition, disordered weight control behaviors (DWCB) have been linked to overweight and weight gain in multiple ways, but little is known about DWCB in youth of color, especially boys. We examined the distribution and determinants of ethnic and gender disparities in DWCB in early adolescents.
Methods
In fall 2005, 47 Massachusetts middle schools participating in the Healthy Choices overweight prevention study administered a self-report baseline survey assessing student sociodemographics, height, weight, and DWCB (vomiting or use of laxatives or diet pills in the past month to control weight). Data from 16,978 girls and boys were used in multivariate logistic regression models to estimate the odds of DWCB in youth of color compared to their white peers, controlling for individual- and school-level factors.
Results
Among white youth, 2.7% of girls and 2.3% of boys reported DWCB. The odds of DWCB were elevated 2–10 times in most ethnic group relative to whites. Disparities were attenuated but persisted after controlling for multiple individual- and school-level factors.
Conclusions
Ethnic disparities in DWCB must be considered in efforts to address the epidemic of childhood overweight.
Given that diet, physical activity, and social support are associated with depression, we examined whether a health promotion intervention designed to modify these factors in low-income, postpartum women would reduce depressive symptoms. This study used a randomized, controlled design to examine the effect of the Just for You (JFY) Program, an educational intervention promoting healthy lifestyles through home visits by nutrition paraprofessionals and motivational telephone counseling, on postpartum depressive symptoms. A total of 679 women income-eligible for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were recruited at 6-20 weeks post delivery and randomized to Usual WIC Care or JFY. Using an intention-to-treat analysis, the authors modeled depressive symptoms on the Center for Epidemiologic Studies Depression Scale (CES-D) among 403 women (59%) completing follow-up at a mean of 15 months infant age, adjusting for baseline CES-D, age, household income and randomization strata (body mass index (BMI), race/region). As a secondary analysis, the authors evaluated potential mediators related to social support and self-efficacy to change one or more health behaviors targeted by the intervention. Women randomized to JFY reported 2.5 units lower CES-D score (P = 0.046) compared with those receiving Usual WIC Care alone. This relationship was attenuated by change in self-efficacy (β = -2.3; P = 0.065), suggesting this construct may partially have mediated the effect of JFY on maternal depressive symptoms. A health promotion intervention delivered through home visits and telephone calls can reduce depressive symptoms at 15 months postpartum among low-income, ethnically diverse women.
The authors' findings suggest that major depressive disorder (MDD) may occur as a prodrome to and may delay diagnosis of multiple sclerosis (MS). Lifetime prevalence of MDD was 59%; 14% of subjects reported MDD as a prodrome to MS, and 10% reported a resulting delay in MS diagnosis.
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