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The aim of this observational study was to examine how lifestyle health behaviors hypothesized to influence attunement to internal cues (breakfast consumption frequency, physical activity, yoga practice, sleep, and recreational screen time) are cross-sectionally related to intuitive eating (IE). Data from 765 men and 1009 women (M age  = 31.1 ± 1.7 years) who participated in Project EAT-IV (Eating and Activity in Teens and Young Adults) were analyzed with sex-stratified linear regression models adjusted for age, race/ethnicity, socioeconomic background, and parent status. Sociodemographic-adjusted mean levels of each health behavior by sex were generated at low (one standard deviation below the mean), average (at the mean), and high (one standard deviation above the mean) levels of IE to facilitate interpretation of regression results. Among women only, more frequent breakfast consumption (p = .02), more time spent practicing yoga (p = .03), more sleep (p = .004), and less recreational screen time (p = .01) were each significantly associated with higher IE after adjusting for sociodemographic characteristics. Compared to women with low IE, women with high IE reported, on average, eating breakfast 0.3 more days a week, practicing 12 more minutes of yoga per week, getting 12 more minutes of sleep per night, and engaging in 18 fewer minutes of recreational screen time per day. Results suggest that these modifiable health behaviors may be valuable targets for interventions to increase IE among women, though longitudinal research is needed to elucidate the temporality of these associations., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Weight stigma is prevalent among young people and harmful to health. The current study used a health equity lens to examine cross-sectional and longitudinal associations between experiencing weight teasing (a form of weight stigma) with a range of weight-related health behaviors and weight status in an ethnically/racially and socioeconomically diverse sample of young people. We also assessed whether ethnicity/race and adolescent socioeconomic status (SES) operated as effect modifiers in these relationships., Methods: Adolescents (n = 1568) were enrolled in EAT 2010-2018 (Eating and Activity over Time) and followed into young adulthood. Weight teasing; screen time; moderate-to-vigorous physical activity (MVPA); sleep duration; breakfast frequency; fruit, vegetable, sugar-sweetened beverage (SSB), and fast-food intake; and body mass index (BMI) were assessed at baseline (mean age = 14.4 years) and eight-year follow-up (mean age = 22.2 years). Multivariate linear regression estimated marginal means and 95% confidence intervals. All analyses adjusted for BMI and sociodemographic characteristics., Results: Weight teasing was cross-sectionally associated with longer screen time, shorter sleep duration, and higher BMI during adolescence; and cross-sectionally associated with shorter sleep duration, lower breakfast frequency, higher fast-food intake, higher SSB intake, and higher BMI during young adulthood. In the longitudinal analyses, weight teasing was not associated with health behaviors but did predict higher BMI (teased: 28.2 kg/m 2 , not teased: 26.4 kg/m 2 , p < 0.001). White and higher adolescent SES subgroups had higher MVPA, more frequent breakfast intake, lower fast-food intake, and lower BMI than their respective counterparts. The relationships between weight teasing and health behaviors and weight status were largely consistent across ethnic/racial and adolescent SES subgroups., Conclusions: Findings add to growing evidence that weight-based mistreatment poses a threat to weight-related health and that young people across ethnic/racial and SES subgroups are vulnerable to the negative effects of weight teasing. Limitations include attrition at follow-up and the self-reported nature of many measures. Results suggest a need for increased attention to existing recommendations to reduce weight stigma in young people from diverse ethnic/racial and socioeconomic backgrounds including training for healthcare providers to better equip them to address the harms of weight teasing and foster more compassionate care to promote health-supporting behaviors in young people., (© 2022. The Author(s).)

Purpose: The aim of the study was to identify whether parent encouragement to diet as an adolescent predicts subsequent encouragement to diet from significant others/romantic partners as an adult and examine longitudinal associations between cumulative encouragement to diet from close relationships (i.e., parent and significant other) and later weight, weight-related, and psychosocial well-being outcomes in adulthood., Methods: Data from Project EAT I-IV, a 15-year longitudinal population-based study of socioeconomically and racially/ethnically diverse adolescents followed into adulthood (n = 1,116; mean age = 31.1 years; 61% female), were used for this study. Surveys and anthropometric measures were completed at school by adolescents in 1998-1999, and follow-up mailed and online surveys were completed at approximately 5-year intervals between 2003 and 2016., Results: Adolescents who experienced encouragement to diet from their parents were more likely to have a significant other as an adult who also encouraged them to diet. In addition, there was a significant (p < .05) cumulative effect of encouragement to diet, such that experiencing more encouragement to diet from both a parent(s) and significant other was associated with higher weight status, more unhealthy weight-control behaviors (e.g., dieting, binge eating, and unhealthy weight control behaviors), and lower psychosocial well-being (e.g., lower body satisfaction and self-esteem and higher depressive symptoms) as a young adult., Conclusions: Encouragement to diet tracked from one close relationship to another and had a cumulative effect on adult weight, weight-related, and psychosocial well-being outcomes. Future interventions, clinical work, and research should be aware of these patterns and cumulative effects of encouragement to diet to target key relationships to reduce these harmful interpersonal patterns., (Copyright © 2019 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Unhealthy weight control behaviors (UWCBs) have been decreasing for most youth over time, yet little is known whether these behaviors have changed for sexual minority (e.g., non-heterosexual) youth. This is important because many studies have found that sexual minorities report some of the highest rates of UWCBs. To determine whether or not these behaviors have changed over time, given the extreme changes in social contexts over the past two decades, we utilised three waves of the Minnesota Student Survey (N = 55,597, M age  = 17). In doing so, we report trends, disparities, and changes in disparities of UWCBs. Overall, the prevalence of UWCBs has declined from 1999 to 2010 for all youth, but there are alarming disparities by sex of sexual partner. We found that both- and same-sex partnered male youth were more likely to fast, use diet pills, and vomit on purpose to lose weight compared to their opposite-sex partnered counterparts in all three survey years; specifically, both-sex partnered boys were up to 5.5× as likely to vomit on purpose compared to their opposite-sex partnered counterparts. Likewise, both-sex partnered girls were more likely to use diet pills and vomit on purpose to lose weight compared to opposite-sex partnered girls in all three survey years. Additionally, the disparity in fasting to lose weight widened for the same-sex partnered females compared to the opposite-sex partnered females from 1998 to 2004. This has implications for UWCB interventions and preventions targeted specifically towards sexual minorities.

Background: A regular yoga practice may have benefits for young adult health, however, there is limited evidence available to guide yoga interventions targeting weight-related health. The present study explored the relationship between participation in yoga, healthy eating behaviors and physical activity among young adults., Methods: The present mixed-methods study used data collected as part of wave 4 of Project EAT (Eating and Activity in Teens and Young Adults), a population-based cohort study in Minneapolis-St. Paul, Minnesota. Young adults (n = 1820) completed the Project EAT survey and a food frequency questionnaire, and a subset who reported practicing yoga additionally participated in semi-structured interviews (n = 46). Analyses of survey data were used to examine cross-sectional associations between the frequency of yoga practice, dietary behaviors (servings of fruits and vegetables (FV), sugar-sweetened beverages (SSBs) and snack foods and frequency of fast food consumption), and moderate-to-vigorous physical activity (MVPA). Thematic analysis of interview discussions further explored yoga's perceived influence on eating and activity behaviors among interview participants., Results: Regular yoga practice was associated with more servings of FV, fewer servings of SSBs and snack foods, less frequent fast food consumption, and more hours of MVPA. Interviews revealed that yoga supported healthy eating through motivation to eat healthfully, greater mindfulness, management of emotional eating, more healthy food cravings, and the influence of the yoga community. Yoga supported physical activity through activity as part of yoga practice, motivation to do other forms of activity, increased capacity to be active, and by complementing an active lifestyle., Conclusions: Young adult yoga practitioners reported healthier eating behaviors and higher levels of physical activity than non-practitioners. Yoga should be investigated as an intervention for young adult health promotion and healthy weight management.

Objective: Investigate the relationship between use of Nutrition Facts labels on packaged foods and weight-related behaviors., Design: Cross-sectional survey in 2015-2016., Participants: Young adult respondents (n = 1,817; 57% women; average age 31.0 ± 1.6 years) to the Project Eating and Activity in Teens and Young Adults-IV survey, the fourth wave of a longitudinal cohort study., Variables Measured: Use of Nutrition Facts labels on packaged foods; healthy, unhealthy, and extreme weight control behaviors; intuitive eating; binge eating., Analysis: Linear and logistic regression models were adjusted for age, ethnicity/race, education, income, and weight status., Results: In women, greater Nutrition Facts use was associated with a 23% and 10% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a 17% greater chance of engaging in binge eating. In men, greater label use was associated with a 27% and 17% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a lower level of intuitive eating., Conclusions and Implications: Professionals advising patients and clients on weight management may consider possible gender differences in response to weight loss and management guidance. Since label use was related to engagement in some unhealthy behaviors in addition to healthy behaviors, it is important to consider how individuals may use labels, particularly those at risk for, or engaging in, disordered eating behaviors. Future research investigating potential relationships between Nutrition Facts use, intuitive eating, and binge eating is needed., (Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Background: Media use has been shown to contribute to poor dietary intake; however, little attention has been paid to programming content. The portrayal of health behaviors in television (TV) programming contributes to social norms among viewers, which have been shown to influence adolescent behavior., Objective: This study reports on a content analysis of beverages shown in a sample of TV shows popular with a large, diverse group of adolescents, with attention to the types of beverages and differences across shows and characters., Design: Favorite TV shows were assessed in an in-school survey in 2010. Three episodes of each of the top 25 shows were analyzed, using a detailed coding instrument., Key Measures: Beverage incidents (ie, beverage shown or described) were recorded. Beverage types included milk, sugar-sweetened beverages (SSBs), diet beverages, juice, water, alcoholic drinks, and coffee. Characters were coded with regard to gender, age group, race, and weight status. Shows were rated for a youth, general, or adult audience., Statistical Analyses: χ 2 tests were used to compare the prevalence of each type of beverage across show ratings (youth, general, adult), and to compare characteristics of those involved in each type of beverage incident., Results: Beverage incidents were common (mean=7.4 incidents/episode, range=0 to 25). Alcohol was the most commonly shown (38.8%); milk (5.8%) and juice (5.8%) were least common; 11.0% of incidents included SSBs. Significant differences in all types of beverage were found across characters' age groups. Almost half of young adults' (49.2%) or adults' (42.0%) beverage incidents included alcohol., Conclusions: Beverages are often portrayed on TV shows viewed by adolescents, and common beverages (alcohol, SSBs) may have adverse consequences for health. The portrayal of these beverages likely contributes to social norms regarding their desirability; nutrition and health professionals should talk with youth about TV portrayals to prevent the adoption of unhealthy beverage behaviors., (Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Little is known about the exclusive adoption of healthy weight control behaviors in the absence of unhealthy weight control behaviors among adolescents. The current study aimed to determine (i) the prevalence of the exclusive adoption of healthy weight control behaviors, (ii) the pattern of eating behaviors and physical activity reported by those engaging exclusively in healthy weight control behaviors, and (iii) the socio-demographic and psychosocial factors associated with the exclusive use of healthy weight control behaviors among adolescents., Methods: In a large and diverse population-based sample of US adolescents (N = 2793) who participated in EAT 2010 (Eating and Activity in Teens) the current study examined the exclusive use of healthy weight control behaviors, which included healthy eating behaviors (eating more fruits and vegetables, eating less high-fat foods, eating less sweets, drinking less soda, and being aware of portion sizes) and engaging in physical activity for the purpose of weight management. Data were analyzed using multinomial logistic regression in STATA., Results: Overall, 24.0% of girls and 29.2% of boys exclusively used healthy weight control behaviors in the absence of unhealthy weight control behaviors. The exclusive use of healthy weight control behaviors was more prevalent among girls who were not overweight (27.5%) as compared to girls who were overweight (21.0%) or obese (17.5%), controlling for age, socio-economic status, and ethnicity/race. In addition, the exclusive use of healthy weight control behaviors was more prevalent among girls and boys who had lower body dissatisfaction, higher self-esteem and lower depressive symptoms., Conclusion: Findings indicate that psychosocial health and body satisfaction may be important targets for promoting the exclusive use of healthy weight control behaviors among adolescents.

Objectives: To identify and describe homogenous profiles of female college students based on weight-related behaviors and examine differences across 5 sexual orientation groups., Methods: Data from the 2009-2013 College Student Health Survey (Minnesota-based survey of 2- and 4-year college students) were used to fit latent class models., Results: Four profiles were identified across all sexual orientation groups: "healthier eating habits," "moderate eating habits," "unhealthy weight control," and "healthier eating habits, more physically active." Differences in patterns and prevalence of profiles across sexual orientation suggest need for interventions addressing insufficient physical activity and unhealthy weight control behaviors., Conclusions: Future interventions should consider the diversity of behavioral patterns across sexual orientation to more effectively address weight-related behavioral disparities.

This paper aims to describe the prevalence of parent-adolescent conversations about eating, physical activity and weight across sociodemographic characteristics and to examine associations with adolescent body mass index (BMI), dietary intake, physical activity and sedentary behaviors. Data from two linked epidemiological studies were used for cross-sectional analysis. Parents (n = 3,424; 62% females) and adolescents (n = 2,182; 53.2% girls) were socioeconomically and racially/ethnically diverse. Fathers reported more parent-adolescent conversations about healthful eating and physical activity with their sons and mothers reported more weight-focused conversations with their daughters. Parents of Hispanic/Latino and Asian/Hmong youth and parents from lower socioeconomic status categories engaged in more conversations about weight and size. Adolescents whose mothers or fathers had weight-focused conversations with them had higher BMI percentiles. Adolescents who had two parents engaging in weight-related conversations had higher BMI percentiles. Healthcare providers may want to talk about the types of weight-related conversations parents are having with their adolescents and emphasize avoiding conversations about weight specifically.

Previous research has shown strong positive associations between physical and psychological health outcomes and being in a committed relationship, such as marriage; however, little research has investigated whether being in a committed relationship is protective for day-to-day health behaviors such as dietary patterns and physical activity. This research examined associations between relationship status and day-to-day health behaviors (e.g., dietary intake, physical activity) and weight status among a diverse cohort of young adults. This cross-sectional study used data from Project EAT-III, a 10-year longitudinal population-based study (N = 1,853) of Midwest young adults. Young adult participants had an average age of 25.3 years, and were 45% male and 55% female. Participants were socioeconomically and racially/ethnically diverse, including 48.4% White, 18.6% African American, 5.9% Hispanic, 19.6% Asian, 3.3% Native American, and 4.2% mixed or other race/ethnicity. Results indicated that married men were more likely to be overweight/obese (body mass index ≥ 25) compared with single/casually dating and committed dating/engaged men. Married women were more likely to eat breakfast ≥5 times per week compared with women in other relationship categories. No differences were observed in other health behaviors by relationship status. There were no significant interactions by race/ethnicity. Relationship status seems largely unrelated to young adults' participation in physical activity and dietary behaviors. However, findings suggest that being married may be a risk factor for overweight/obesity in young adult men and may be a protective factor for health-related behaviors associated with overweight/obesity such as breakfast intake for young adult women.

Context: Sexual risk behaviors are common among college students, and research examining the environmental context of these behaviors is important for prevention. The presence of college sexual health resources is a potentially important part of that context., Methods: In a 2010-2011 survey, 6,318 undergraduates from 28 two- and four-year Minnesota college campuses provided data on their sexual health behaviors. In addition, a specially designed inventory was used to assess the sexual health resources available on each campus. Multilevel regression was used to test the associations of four types of resources with students' condom use, birth control use, STD or HIV testing, and unplanned pregnancy., Results: In models that controlled for students' personal and demographic characteristics, the higher the level of sexual health resources at a college, the lower the likelihood that students had had intercourse without birth control, intercourse without a condom and involvement in unplanned pregnancy. For example, students attending colleges with the maximum number of general clinic resources had a lower predicted probability of reporting nonuse of reliable birth control at last intercourse than students attending colleges with no resources (7% vs. 14%). After college characteristics were adjusted for, most measures of resources remained significant, although associations were reduced; two measures became significant in unexpected directions., Conclusions: Colleges' provision of sexual health resources may be associated with students' sexual health behaviors. Research using quasi-experimental or experimental designs is needed to assess the mechanisms underlying these associations; such work could lead to interventions that might help reduce students' risky behaviors., (Copyright © 2013 by the Guttmacher Institute.)

Objective: Media images of men and women have become increasingly muscular, and muscle-enhancing techniques are available to youth. Identifying populations at risk for unhealthy muscle-enhancingbehaviors is of considerable public health importance. The current study uses a large and diverse population-based sample of adolescents to examine the prevalence of muscle-enhancing behaviors and differences across demographic characteristics, weight status, and sports team involvement., Methods: Survey data from 2793 diverse adolescents (mean age = 14.4) were collected at 20 urban middle and high schools. Use of 5 muscle-enhancing behaviors was assessed (changing eating, exercising, protein powders, steroids and other muscle-enhancing substances), and a summary score reflecting use of 3 or more behaviors was created. Logistic regression was used to test for differences in each behavior across age group, race/ethnicity, socioeconomic status, BMI category, and sports team participation., Results: Muscle-enhancing behaviors were common in this sample for both boys and girls. For example, 34.7% used protein powders or shakes and 5.9% reported steroid use. Most behaviors were significantly more common among boys. In models mutually adjusted for all covariates, grade level, Asian race, BMI category, and sports team participation were significantly associated with the use of muscle-enhancing behaviors. For example, overweight (odds ratio = 1.45) and obese (odds ratio = 1.90) girls had significantly greater odds of using protein powders or shakes than girls of average BMI., Conclusions: The use of muscle-enhancing behaviors is substantially higher than has been previously reported and is cause for concern. Pediatricians and other health care providers should ask their adolescent patients about muscle-enhancing behaviors.

Dieting, unhealthy weight control and muscle-enhancing behaviors are common among adolescents: friends are a probable source of influence on these behaviors. The present study uses data provided by nominated friends to examine associations between friends' disordered eating and muscle-enhancing behaviors and participants' own behaviors in a diverse sample of American youth. Male and female adolescents (mean age = 14.4) completed surveys and identified their friends from a class roster; friends' survey data were then linked to each participant. Participants (N = 2126) who had at least one nominated friend were included in the analytic sample. Independent variables were created using the same weight control and muscle-enhancing behaviors reported by nominated friends, and were used in logistic regression models to test associations between participants' and their friends' behaviors, stratified by gender. Results indicated that dieting, disordered eating and muscle-enhancing behaviors were common in this sample, and selected friends' behaviors were associated with the same behaviors in participants. For example, girls whose friends reported extreme weight control behaviors had significantly greater odds of using these behaviors than girls whose friends did not report these same behaviors (OR = 2.39). This research suggests that friends' weight- and shape-related behaviors are a feature of social relationships, and is the first report demonstrating these associations for muscle-enhancing behaviors. Capitalizing on the social element may be important to the development of increasingly effective intervention and prevention programs., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Few studies have looked at the relationship between family meals and adult weight and health behaviors. The current study investigates the association between frequency of family meals and mothers' and fathers' body mass index (BMI), dietary intake, dieting behaviors and binge eating. Data from Project F-EAT (Families and Eating and Activity in Teens) were used for the current analysis. Socio-economically and racially/ethnically diverse mothers and fathers (n=3488) of adolescents participating in a multi-level population-based study (EAT 2010) completed surveys mailed to their homes. Predicted means or probabilities were calculated for each outcome variable at each level of family meal frequency. Interactions between race/ethnicity and marital status with family meals were evaluated in all models. Overall, results indicated that having more frequent family meals was associated with increased consumption of fruits and vegetables for mothers and fathers, after adjusting for age, educational attainment, marital status and race/ethnicity. Other findings including less fast food intake for fathers and fewer dieting and binge eating behaviors for mothers were significantly associated with family meal frequency, but not consistently across all family meal categories or with BMI. Interactions by race/ethnicity and marital status were non-significant, indicating that family meals may be important for more healthful dietary intake across race and marital status. Future research should confirm findings in longitudinal analyses to identify temporality and strength of associations., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Background: Having a significant other has been shown to be protective against physical and psychological health conditions for adults. Less is known about the period of emerging young adulthood and associations between significant others' weight and weight-related health behaviors (e.g. healthy dietary intake, the frequency of physical activity, weight status). This study examined the association between significant others' health attitudes and behaviors regarding eating and physical activity and young adults' weight status, dietary intake, and physical activity., Methods: This study uses data from Project EAT-III, a population-based cohort study with emerging young adults from diverse ethnic and socioeconomic backgrounds (n = 1212). Logistic regression models examining cross-sectional associations, adjusted for sociodemographics and health behaviors five years earlier, were used to estimate predicted probabilities and calculate prevalence differences., Results: Young adult women whose significant others had health promoting attitudes/behaviors were significantly less likely to be overweight/obese and were more likely to eat ≥ 5 fruits/vegetables per day and engage in ≥ 3.5 hours/week of physical activity, compared to women whose significant others did not have health promoting behaviors/attitudes. Young adult men whose significant other had health promoting behaviors/attitudes were more likely to engage in ≥ 3.5 hours/week of physical activity compared to men whose significant others did not have health promoting behaviors/attitudes., Conclusions: Findings suggest the protective nature of the significant other with regard to weight-related health behaviors of young adults, particularly for young adult women. Obesity prevention efforts should consider the importance of including the significant other in intervention efforts with young adult women and potentially men.

Objective: To describe changes in calcium and dairy intake during the transition from middle adolescence to young adulthood and to identify baseline correlates of calcium intake in young adulthood., Design: Population-based, 5-year follow-up study (Project EAT: Eating Among Teens)., Setting: Baseline surveys were completed in Minneapolis/St. Paul, MN schools and by mail at follow-up., Participants: Males and females (N = 1521) attending high school at baseline (mean age = 15.9 years) and with a mean age of 20.5 years at follow-up., Main Outcome Measures: Calcium intake., Analysis: Mixed and linear regression methods were used to respectively examine trends and correlates of intake., Results: During the transition to young adulthood, mean daily calcium intakes of females and males decreased by an average of 153 mg and 194 mg respectively. Mealtime milk availability, health/nutrition attitudes, taste preference for milk, healthful weight control behaviors, and peer support for healthful eating at baseline were associated with better follow-up calcium intake. Time spent watching television and lactose intolerance were associated with lower intake at follow-up., Conclusions and Implications: Nutrition interventions are needed to counter longitudinal decreases in calcium intake. Interventions targeted to adolescents should address the availability of milk at meals and other identified supports for healthful eating.

Objective: To determine whether adolescents who participate in a weight-related sport are at increased risk for unhealthful weight-control behaviors and steroid use., Design: This was a population-based study (Project EAT [Eating Among Teens])., Subjects/setting: Subjects were 4,746 adolescents (50.2% males, 49.8% females) from 31 public middle and high schools in the Minneapolis/St Paul area of Minnesota., Statistical Analysis Performed: Descriptive statistics, chi2 analyses, and multiple logistic regression were used. Data were adjusted for sociodemographic variables and body mass index., Main Outcome Variables: Unhealthful weight-control behaviors and steroid use., Results: More males (20.4%) than females (16.2%) reported participation in a weight-related sport. Males who reported participation in a weight-related sport had an increased risk of past-week vomiting (odds ratio [OR]=5.7), laxative use (OR=6.8), as well as past-year vomiting (OR=4.9), laxative use (OR=3.4), diuretic use (OR=6.0), and steroid use (OR=3.7), compared with those males who did not report participation. Females who reported participation in a weight-related sport had an increased risk of past week vomiting (OR=2.1), as well as past year vomiting (OR=2.0), laxative use (OR=2.6), and steroid use (OR=2.6), compared with those who did not report participation in a weight-related sport., Conclusions: The current study shows that participation in a sport that adolescents perceive as emphasizing weight is strongly associated with unhealthful weight-control behaviors and steroid use. Preventive efforts, targeting parents, coaches, and adolescents are needed to decrease this risk.

Objective: Dieting has been found to predict weight gain in adolescents, but reasons for this association remain unclear. This study aimed to explore potential mechanisms by which dieting predicts weight gain over time in adolescents., Design: Population-based, 5-year longitudinal study., Participants: Adolescents (n=2,516) from diverse ethnic and socioeconomic backgrounds who completed Project EAT (Eating Among Teens) surveys in 1999 (Time 1) and 2004 (Time 2)., Main Outcome Measure: Body mass index (BMI) change over 5 years., Statistical Analysis: Multiple regressions were used to examine associations between Time 1 dieting and Time 2 binge eating, breakfast consumption, fruit and vegetable intake, and physical activity. Associations were then examined between these behaviors and BMI change. Finally, to test for mediating effects, associations between dieting and BMI change were examined with and without the inclusion of these behaviors, and regression coefficients were compared., Results: In female adolescents, dieting predicted increased binge eating (P<0.001) and decreased breakfast consumption (P=0.030). In male adolescents, dieting predicted increased binge eating (P<0.001), decreased physical activity (P=0.006), and a trend toward decreased breakfast consumption (P=0.064). These behaviors were also associated with increases in BMI. The association between dieting and BMI increase was weakened, but still remained significant, after binge eating, breakfast consumption, fruit/vegetable intake, and physical activity were included in the model being tested. Thus, the longitudinal association between dieting and BMI increase was partially mediated by these behaviors., Conclusions: In part, dieting may lead to weight gain via the long-term adoption of behavioral patterns that are counterproductive to weight management.

Dieting is common among adolescent girls and may place them at risk of using unhealthy weight-control behaviors (UWCBs), such as self-induced vomiting, laxatives, diet pills, or fasting. Research has suggested that social factors, including friends and broader cultural norms, may be associated with UWCBs. The present study examines the relationship between the school-wide prevalence of current weight loss efforts among adolescent girls, friends' dieting behavior, and UWCBs, and investigates differences in these associations across weight categories. Survey data were collected in 31 middle and high schools in ethnically and socio-economically diverse communities in Minnesota, USA. The response rate was 81.5%. Rates of UWCBs were compared across the spectrum of prevalence of trying to lose weight and friends' involvement with dieting, using chi(2) analysis and multivariate logistic regression, controlling for demographic factors and clustering by school. Girls with higher body mass index (BMI) were more likely to engage in UWCBs than those of lower BMI. Multivariate models indicated that friends' dieting behavior was significantly associated with UWCBs for average weight girls (OR = 1.57, CI = 1.40-1.77) and moderately overweight girls (OR = 1.47, CI = 1.19-1.82). The school-wide prevalence of trying to lose weight was significantly, albeit modestly, related to UWCBs for average weight girls (15th-85th percentile; OR = 1.17, CI = 1.01-1.36), and marginally associated for modestly overweight girls (85th-95th percentile; OR = 1.21, CI = .97-1.50), even after controlling for friends' dieting behaviors. The social influences examined here were not associated with UWCBs among underweight ( < 15th percentile) or overweight ( > 95th percentile) girls. Findings suggest that social norms, particularly from within one's peer group, but also at the larger school level may influence UWCBs, particularly for average weight girls. Implications for school-based interventions to reduce UWCBs are discussed.

Purpose: Few studies have investigated the efficacy of e-mail for promoting behavior change. This study evaluates the participation in and outcomes associated with an e-mail-based health promotion program., Methods: Adolescent girls aged 15 to 17 years were recruited at a shopping mall. Participants with an e-mail address were assigned to the interactive e-mail magazine (Ezine) group (n = 37), whereas those not reporting an e-mail address were assigned to the non-Ezine group (n = 33). Participants in the Ezine group received the health Ezine, which included a quiz and an advice column, on a weekly basis., Results: Results indicate that among the Ezine group, there was a high recall of the Ezine (81.1%), and more than one third of the participants replied to Ezine volumes with quiz answers or an advice question (36.6%). Differences in health behavior change between the Ezine and non-Ezine groups were not significant., Conclusions: E-mails on health-related matters can generate moderate levels of involvement in adolescent girls. Given the widespread use of e-mail, more studies are needed on the effective application of e-mail for health behavior change.

To address gaps in the literature on bisexual youth, we used the first nationally representative sample of high school students from the United States to determine profiles of behaviors related to depressive symptoms, a suicide attempt, and a medically-serious attempt. We examined the data from 922 bisexual students in grades 9-12 who completed the Centers for Disease Control and Prevention's 2015 National Youth Risk Behavior Survey. Latent class analysis derived three classes reflecting unique patterns of 10 risk and protective behaviors. For both the sexes: one group was high on all the risk behaviors and demonstrated the greatest risk of depression, a suicide attempt, and a medically-serious attempt; another was below average on all the risk and protective behaviors and demonstrated average/moderate risk of the outcomes; and the last demonstrated the highest levels of protective behaviors and the lowest risk of depression and suicidal behavior. Bisexual students are not homogenous with regard to the risk of mental health problems. Greater involvement in several risk behaviors and less involvement in protective behaviors, rather than merely a bisexual identity, might contribute to bisexual adolescents' increased risk of depression and suicidal behavior. Findings have implications for prevention programming, clinical interventions, and future research.

Background: Gay-Straight Alliances (GSAs) are school-based clubs that can contribute to a healthy school climate for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. While positive associations between health behaviors and GSAs have been documented, less is known about how youth perceive GSAs. Methods: A total of 58 LGBTQ youth (14-19 years old) mentioned GSAs during go-along interviews in 3 states/provinces in North America. These 446 comments about GSAs were thematically coded and organized using Atlas.ti software by a multidisciplinary research team. Results: A total of 3 themes describe youth-perceived attributes of GSAs. First, youth identified GSAs as an opportunity to be members of a community, evidenced by their sense of emotional connection, support and belonging, opportunities for leadership, and fulfillment of needs. Second, GSAs served as a gateway to resources outside of the GSA, such as supportive adults and informal social locations. Third, GSAs represented safety. Conclusions: GSAs positively influence the physical, social, emotional, and academic well-being of LGBTQ young people and their allies. School administrators and staff are positioned to advocate for comprehensive GSAs. Study findings offer insights about the mechanisms by which GSAs benefit youth health and well-being.

Background: Evidence suggests that sports team participation differentially relates to health-risk behaviors. Few studies have explored relationships among high-risk youth. Purpose: To examine associations between weekly sports team participation and health-risk behaviors (substance use, sexual risk-taking, violence involvement) among alternative high school (AHS) students. Methods: Data for this repeated cross-sectional analysis came from the 2001, 2004, 2007, and 2010 Minnesota Student Surveys (n = 2847 to 4596). Logistic regression was used to examine relationships between sports team participation and 14 outcomes. Interaction terms tested whether associations varied by survey year, gender, and/or race/ethnicity. Results: For males, sports team participation protected against most substance use outcomes and was associated with higher condom use. Female sports participants were less likely than nonparticipants to have ever had sex. For both genders, sports team participation was positively associated with gun carrying. No differences by race/ethnicity or year were found. Discussion: Further research is needed with AHS students who play sports to understand mixed findings from the current study and how to promote healthy behaviors through sports. Translation to Health Education Practice: Health education professionals are in ideal positions to work with school administrators and researchers to facilitate scientific inquiry and translate it into practice.

The objective of this study was to describe prevalent informal sources of information about sex and examine associations between informal sources of information about sex and sexual risk outcomes among sexually experienced adolescents. Work involved the secondary analysis of data from the Minnesota Student Survey, a statewide survey to monitor priority risk and protective health behaviors. The study sample included 22,828 sexually experienced adolescents aged 13-20 years. Multivariate logistic regression analyses examined associations between adolescents' informal sources of information about sex and three sexual risk outcomes. Peers and siblings were the most commonly reported source of information about sex. Ninth-graders who reported parents or parents plus peers/siblings as a source of information about sex had significantly lower odds of having multiple sex partners in the past year. Ninth-graders who reported any informal source of information about sex had significantly lower odds of unprotected intercourse at last sex. Ninth-graders and 12th-graders who reported any informal source of information about sex had significantly lower odds of lifetime pregnancy involvement. Findings suggest information about sex from people in adolescents' everyday lives has the potential to diminish the likelihood of involvement in sexual risk behaviors. To maximize effectiveness, formal sex education programs should engage informal sources of information about sex in adolescents' everyday lives. (Contains 2 tables and 1 figure.)

Individuals with high body mass index (BMI), negative body image, and unhealthy weight control behaviors may be more likely to engage in high-risk sexual behaviors than others. Researchers have not fully investigated these relationships in a sample of college students. The authors collected data regarding several weight-related issues and high-risk sexual behaviors (response rate = 39%) from 1,168 college students. Over half reported at least 1 high-risk sexual behavior. After the authors controlled for several demographic characteristics, they found that higher BMIs were associated with increased odds of having a casual sexual partner (odds ratio [OR] = 2.70) and being intoxicated at last intercourse (OR = 2.25). Among women, unhealthy weight control behaviors were associated with having a casual partner (OR = 2.12), using no or unreliable contraception (OR = 1.98), and being intoxicated at last intercourse (OR = 2.31). Weight-related issues were not associated with sexual behaviors among college men. The authors describe their findings within two health behavior frameworks, and they discuss implications for research and health education. (Contains 1 note.)

Objective: Limited research incorporates an intersectional approach when evaluating disordered eating behaviors among those holding minoritized social positions, such as lesbian, gay, bisexual, queer, questioning, and/or transgender/gender diverse (LGBTQ) adolescents. The current study assessed stigma experiences from peers at school, self‐esteem, LGBTQ pride, and overlapping social positions as they relate to disordered eating behaviors among LGBTQ adolescents. Method: Participants included 11,083 adolescents (Mage = 15.6, SD = 1.3; 34.8% transgender/gender diverse) from a large national survey study of LGBTQ adolescents from 2017. Exhaustive Chi‐square Automatic Interaction Detection analysis was used to identify bias‐based bullying experiences (i.e., weight‐based, identity‐based), self‐esteem, LGBTQ pride, and overlapping social positions (i.e., gender identity, sexual identity, race/ethnicity, body mass index (BMI) percentile) associated with the highest prevalence of unhealthy weight control behaviors, extreme unhealthy weight control behaviors, and past year binge eating. Results: Adolescents in the 28 identified groups with a high prevalence of disordered eating behavior held at least one structurally marginalized social position (e.g., high BMI), bias‐based bullying experience, low self‐esteem, or low LGBTQ pride in addition to being LGBTQ. Weight‐based bullying was a salient risk‐factor for disordered eating across social positions. Among adolescents with the same social positions, levels of self‐esteem, LGBTQ pride, but no bias‐based bullying experience, prevalence estimates of disordered eating were, on average, 23% lower. Discussion: LGBTQ adolescents with multiple marginalized social positions and related factors engage in disproportionately high prevalence disordered eating. Findings underscore the importance of addressing intersecting experiences of stigma to reduce disordered eating and promote health equity among adolescents. Public significance: Multiply marginalized LGBTQ adolescents, most of whom also reported experiencing bias‐based bullying from peers at school, reported disproportionately high prevalence disordered eating. In comparison groups of adolescents with no bias‐based bullying experience, prevalence of disordered eating was, on average, 24% lower. Findings underscore the importance of addressing intersecting experiences of stigma to reduce disordered eating and promote health equity among adolescents. [ABSTRACT FROM AUTHOR]

Objective: Digital technology use and muscle‐building behaviors reflect a wide range of behaviors with associated health risks. However, links between digital technology use and muscle‐building behaviors remain unknown and this study aimed to address this gap. Method: Data were collected from a diverse sample of 1,483 young adults (mean age 22.2 ± 2.0 years) participating in the population‐based Eating and Activity over Time 2018 study. Gender‐stratified‐modified Poisson regression models were used to determine cross‐sectional associations between three types of digital technology use (screen time, social media, weight‐related self‐monitoring apps) and five types of muscle‐building behaviors (changing eating, exercise, protein powders/shakes, pre‐workout drinks, steroids/growth hormone/creatine/amino acids) in young adulthood, adjusted for sociodemographic characteristics and body mass index. Results: Screen time and social media were either not found to be associated with muscle‐building behaviors or in a few instances, associated with less use of these behaviors (e.g., screen time and pre‐workout drinks in men). In contrast, the use of weight‐related self‐monitoring apps was positively associated with all muscle‐building behaviors, including steroids/growth hormone/creatine/amino acids in men (prevalence ratio [PR] = 1.83; 95% confidence interval [CI]: 1.13–2.97) and women (PR = 4.43; 95% CI: 1.68–11.68). Discussion: While most recreational screen time may represent sedentary behaviors not related to muscle‐building behaviors, weight‐related self‐monitoring apps are highly associated with more muscle‐building behaviors and could be a future target for interventions to discourage the use of steroids and other harmful muscle‐building substances. [ABSTRACT FROM AUTHOR]

Objective: This study assessed cross‐sectional and longitudinal relationships between weight teasing and disordered eating in an ethnically/racially and socioeconomically diverse sample of young people and examined these relationships across sociodemographic characteristics. Method: The EAT 2010–2018 study surveyed adolescents (n = 1,534) in the Minneapolis/St. Paul public schools (mean age = 14.4 years) and 8 years later (mean age = 22.2 years). Results: Weight teasing was prevalent in adolescence (34.1%) and young adulthood (41.5%). In analyses adjusted for sociodemographic characteristics and body mass index, weight teasing was cross‐sectionally associated with a higher prevalence of all disordered eating behaviors during both adolescence and young adulthood. For example, 64.5% of young adults who reported being teased about their weight engaged in unhealthy weight control behaviors, compared with 47.9% among those not teased (p <.001). There were fewer observed associations in longitudinal analyses, although weight teasing still predicted prevalent overeating and both prevalent and incident dieting (incident dieting—teased: 48.4% vs. not teased: 38.0%, p =.016). Weight teasing and disordered eating were more prevalent among Black, Indigenous, and People of Color (BIPOC) young people and those from low socioeconomic backgrounds, and the relationship between weight teasing and disordered eating was similar across ethnic/racial, socioeconomic, and gender demographic groups. Discussion: Results indicate that weight teasing is strongly correlated with disordered eating in both adolescence and young adulthood regardless of ethnicity/race, socioeconomic status, or gender. Finding suggest that future research and policy interventions should address weight stigma and prioritize the needs of BIPOC young people and young people from low socioeconomic backgrounds. [ABSTRACT FROM AUTHOR]

Objective: Sociocultural theories hold that family and peer weight‐related teasing increases the risk for unhealthy weight control behaviors (UWCBs) by negatively impacting body image. Although much cross‐sectional support exists for these pathways, longitudinal data are lacking. This study tested the longitudinal relationships among peer and family teasing (occurrence and perceived impact) in early adolescence, body satisfaction in late adolescence, and UWCBs in young adulthood among a racially/ethnically and socioeconomically diverse population. Method: Data were drawn from three waves of Project EAT over a 15‐year period (Eating and Activity in Teens and Young Adults), and included responses from 1,902 young adults (57% female). Results: Among female participants, a mediated indirect pathway emerged with family weight‐related teasing predicting increased engagement in UWCBs in early adulthood via poorer body image in late adolescence. In contrast, peer teasing did not predict body image or UWCBs. Among boys, the mediated indirect pathways were not significant. However, poor body image in late adolescent males predicted higher likelihood of engaging in UCWBs in early adulthood. Discussion: These findings support the long‐term impact of family weight‐related teasing on greater risk for UWCBs among girls and young women, and poor body image as a mechanism accounting for this relationship. Moreover, the results highlight the poor body image among adolescent boys as a factor for increased risk of engaging in UWCBs in early adulthood. Pending replication in current cohorts, health promotion and prevention involving family members of early adolescents that address family weight teasing and body image are needed. [ABSTRACT FROM AUTHOR]

Background: This study explores cross‐sectional associations between yoga and body image, mindful eating, disordered eating, and muscle‐enhancing behaviors among a population‐based sample of ethnically/racially diverse emerging adults. Method: An ethnically/racially diverse population‐based sample of 1,568 emerging adults (18–26 years) completed surveys as part of EAT 2010–2018 (Eating and Activity over Time). Models were adjusted for sociodemographic characteristics and body mass index (BMI). Results: Practicing yoga at least 30 min/week was reported by 12.7% (n = 210) of the sample. Yoga practitioners had higher levels of mindful eating than those not practicing yoga. Although effect sizes were small, yoga practitioners were more likely than non‐yoga practitioners to use steroids (3.8 vs. 0.7%, p <.001, h = 0.22) or protein powder/shakes (35.1 vs. 25.3%, p <.010, h = 0.21) to increase their muscle size/tone. Body satisfaction, unhealthy weight control behaviors, and binge eating tended to be similar among yoga practitioners and non‐yoga practitioners. There was a significant interaction between BMI and yoga in predicting body satisfaction with a trend toward a positive impact among yoga practitioners at higher BMI values. Interactions between yoga practice and all body image attitudes and behaviors across gender and ethnicity/race were not statistically significant. Discussion: Young people from diverse ethnic/racial backgrounds who practice yoga are more likely to engage in mindful eating but have equal or elevated levels of unhealthy body image attitudes and behaviors as compared to non‐yoga practitioners. Further research should explore how yoga is best taught and practiced to ensure that it is beneficial for body image and related behaviors. [ABSTRACT FROM AUTHOR]

Introduction: Mass incarceration is becoming one of this country's most detrimental public health problems. Children are particularly affected by this phenomenon, as parental incarceration is associated with a host of adverse outcomes, including children's engagement in health-risk behaviors that may negatively influence their mental and physical health. This study compares physical health indicators of youth with currently and formerly incarcerated parents with youth with no history of parental incarceration.Method: Using cross-sectional data from the 2016 Minnesota Student Survey (MSS), this secondary data analysis examined behavioral indicators of physical health among 8th, 9th, and 11th grade students (N = 119,029). Self-reported behavioral indicators of physical activity, fruit and vegetable consumption, fast food consumption, sugar-sweetened beverage consumption, and sleep were assessed. We also included a measure of perceived overall health. Logistic regression models controlling for demographic characteristics compared youth with currently and formerly incarcerated parents to youth with no history of parental incarceration.Results: As predicted, parental incarceration was significantly associated with lower levels of healthy behaviors and higher levels of unhealthy behaviors. Contrary to expectations, youth with currently incarcerated parents did not differ significantly from youth with formerly incarcerated parents.Discussion: Parental incarceration was associated with youth engagement in health risk behaviors, even if the parent was not currently incarcerated. These results suggest parental incarceration is associated with poor health behaviors that have implications for future health, and emphasizes the need for practitioners and policymakers to focus on interventions for this high-risk group of children and their families. (PsycINFO Database Record (c) 2019 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the relative importance of dissatisfaction, overvaluation, and preoccupation with body weight and shape in predicting increases in disordered eating behaviors and depressive symptoms from adolescence through to early adulthood. Method: The study involved 1,830 participants (60% female) who completed the Project EAT survey during adolescence (mean age = 14.90 years, SD = 1.65 years) and again, 15 years later, in early adulthood. Participants provided assessments of dissatisfaction, overvaluation and preoccupation with weight and shape, as well as disordered eating and depressive symptoms at both time points. Results: The three aspects of body image had distinct patterns of association with the outcomes both concurrently and longitudinally. Dissatisfaction predicted depressive symptoms as well as a wide range of disordered eating outcomes, including dieting, unhealthy weight control behaviors (UWCBs), and binge eating, particularly in female participants. Preoccupation was associated with all of these disordered eating behaviors (but not with depressive symptoms) and was notably the strongest predictor of dieting and UWCBs in female participants. Overvaluation was associated with both disordered eating and depressive symptoms, although typically was a less potent predictor of difficulties than the other aspects of body image. Discussion Dissatisfaction, overvaluation, and preoccupation are related but make distinct contributions to clinically significant outcomes. Models of eating disorders should move beyond focusing exclusively on dissatisfaction or overvaluation toward a broader conceptualisation of body image. Findings from this study particularly suggest the importance of considering preoccupation with weight and shape. [ABSTRACT FROM AUTHOR]

A variety of social factors are expected to contribute to health behaviors among college students. The goal of this paper is to describe the relationships of two different aspects of the campus social environment, namely the campus resources for gay, lesbian, and bisexual (GLB) students and the campus-wide behavioral norms of substance use, to the individual substance-use behaviors of college students with same-sex experiences. Individual-level data come from 630 college students reporting same-sex experience, who were part of a national random sample returning questionnaires. Current cigarette smoking and binge drinking were examined. College-level data regarding the campus resources designed for GLB students were collected and used with campus-wide substance-use norms to predict individual substance use in logistic regression analyses. One-third to one-half of students reported current smoking and binge drinking, by sex and sex-partner category. The presence of GLB resources was inversely associated with women''s smoking and directly associated with men''s binge drinking behaviors. The proportion of students reporting same-sex behavior on campus was directly associated with these same outcomes, and behavioral norms were not associated with either outcome. Findings provide a glimpse into the influence of the social environment on the use of two of the most widely used substances at American colleges, and suggest that contextual approaches to explaining and controlling substance use may be important. [Copyright &y& Elsevier]

Purpose: To examine personal, home, peer, school, neighborhood, and media correlates of sugar-sweetened beverage (SSB) intake in a diverse sample of adolescents.Methods: Cross-sectional, population-based study (EAT 2010: Eating and Activity in Teens) of 2793 adolescents (54% female, mean age [SD] = 14.5 [2.0], 80% nonwhite) attending public secondary schools in Minneapolis-St. Paul, Minnesota. Adolescents completed a food frequency questionnaire and answered survey questions about their diet/health perceptions and behaviors. Socio-environmental data were collected from parents/caregivers, peers, school personnel, Geographic Information Systems (e.g., distance to food outlet), and a content analysis of favorite TV shows. Individual and mutually adjusted mixed-effects regression models examined associations between multi-contextual factors and estimated daily servings of SSB, controlling for relevant covariates.Results: The contextual factors examined accounted for 24% of the variance in adolescents' SSB consumption. The proportion of variance explained by each context was 13% personal, 16% home/family, 3% peer, 1% school, 0.1% media, and 0% neighborhood. The strongest correlate of SSB intake was home soda availability (adjusted for covariates: β = 0.26, p < 0.01; adjusted for all multi-contextual factors: β = 0.18, p < 0.01). Other significant correlates of SSB intake included personal behaviors (e.g., fast food intake, sleep), home/family factors (e.g., parent modeling) and peer influences (e.g., friends' SSB intake).Conclusions: Public health policies and programs to reduce adolescent SSB intake should target personal behaviors (e.g., limit fast food, encourage adequate sleep), address the home setting (e.g., help parents to reduce SSB availability and model healthy eating habits) and involve peers (e.g., identify and enable peers to model healthy eating behaviors). [ABSTRACT FROM AUTHOR]