Effects of participation level and physical activity on eating behavior and disordered eating symptoms in the Brazilian version of the New Moves intervention: data from a cluster randomized controlled trial

Abstract

BACKGROUND: Childhood and adolescent obesity is a worldwide public health concern. The New Moves program aims to change eating behavior (EB) and physical activity (PA). OBJECTIVE: To evaluate the effectiveness of an intervention and predictors of better outcomes relating to EB and PA levels. DESIGN AND SETTING: Secondary data from a cluster randomized controlled trial in 10 public schools in São Paulo, Brazil. METHODS: 270 female adolescents, aged 12 to 14 years, were analyzed. Participation levels were categorized as presence in 1 to 9 sessions or 10 to 17 sessions, or control. Effectiveness was evaluated through improvement in disordered EB (DEB) and EB. Predictors of better outcomes relating to PA levels were evaluated through clustering of individual characteristics that affected changes in PA scores. RESULTS: Participation level was not significantly associated with changes in DEB or EB. Girls with higher body mass index percentile (BMI-P) percentile tended to have increases in sedentary lifestyles through the program. Girls with less body image dissatisfaction presented higher increases in daily PA. Girls with higher BMI-P percentile and higher self-esteem showed reductions in sedentary lifestyles. The program seemed to have more effect on daily PA among older girls than among younger girls. CONCLUSIONS: This program could be used as a structured action plan in schools, with the aims of improving eating behaviors and physical activity, in addition to promoting self-acceptance. The results indicate the importance of evaluating determinants of adherence, as these metrics might influence the effectiveness and future design of lifestyle programs. BRAZILIAN REGISTRY OF CLINICAL TRIALS: RBR-6ddpb3.

Eating disorders prevention programs in Latin American countries: A systematic review

“…The integrated Brazilian version of the “New Moves” (Dunker & Claudino, 2018) also uses this approach with adolescent girls, with sessions based on nutrition, social support, and physical activity. Although the researchers did not find significant changes for ED risk factors, in a secondary analysis Dunker et al (2021) found that girls with less body image dissatisfaction reported higher daily physical activity levels. Therefore, the authors suggest that engagement in physical activity could be a protective factor against body dissatisfaction, given that it has been inversely associated with several risk factors for EDs and other psychological benefits.…”

“…In addition, although the effects of integrative prevention on ED risk factors are promising, only two studies (Castillo et al, 2016, 2019) found the desired effects on body dissatisfaction and disordered eating risk behaviors, with effect sizes from small to medium (see Table 1). Two studies did not found significant effects for these measures, but had a small to medium effect size for physical activity practice (Dunker et al, 2021; Leme et al, 2019). Given these results, further research is strongly recommended because integrative prevention programs may be more cost‐effective, reducing the costs related to the development of two separate prevention programs and avoiding the iatrogenic effects of conflicting messages from obesity and ED‐only prevention programs (Ferrari, 2015; Leme et al, 2019; Sánchez‐Carracedo et al, 2012).…”

Disordered eating during COVID-19 pandemic is associated with nutritional status, negative mood changes, and body image in university students

“…Our data also showed that having obesity tripled the chances of a higher score on the disordered eating scale. Silveira, cited by Dunker et al (2021), states that “[. .…”

Translation, Cultural Adaptation, and Reproducibility of the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+): The Brazilian Portuguese Version

“…The prevalence of obesity has been dramatically increasing in the country, with 12% of the youth population, as well as 20% of adults and 21% of older adults being considered obese in Brazil ( 43 , 44 ). In large part, this scenario is due to sedentary lifestyles ( 45 ). Physical inactivity, a preeminent behavioral risk factor for chronic diseases and early mortality, is one of the most prevalent unhealthy behaviors in Brazilians ( 46 , 47 ).…”