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Background: Past research has surveyed primary care physicians (PCP) about their attitudes and practices towards obese patients, yet less is known about the patients receiving advice., Methods: The Primary Care Weight Control Project (PCWC) enrolled 18 PCPs in a randomized clinical trial and asked 255 of their patients who were either overweight or obese at baseline about past weight control advice., Results: At baseline, 66.4% of patients reported that their physician previously told them they were overweight. Body mass index (BMI) was a strong predictor of being identified as obese. While 65.1% received information on the health benefits of weight loss, only 36.6% of patients were ever given specific weight control advice, and 28.2% were advised to increase their physical activity. A history of type 2 diabetes, high cholesterol, or hypertension was associated with physician-delivered weight control advice. Stages of change and number of prior visits with the PCP were also associated with physician advice., Conclusions: Patients were more likely to receive education about weight loss than specific behavioral advice on how to lose weight. Physicians were more likely to provide weight control advice to their patients who had obesity-related comorbidities than to patients who were overweight or obese and without risk factors.

Objective: To compare the weight losses of black and white patients with NIDDM treated in a year-long behavioral weight loss program., Research Design and Methods: Subjects were randomly assigned to a behavioral program that either used a low-calorie diet throughout or included two 12-week periods of a very-low calorie diet (VLCD). Weight, dietary intake, and exercise were measured at 0, 6, and 12 months of treatment, and attendance and self-monitoring records were assessed weekly throughout the year., Results: Blacks had smaller weight losses than whites regardless of treatment condition. Overall weight losses (baseline to 1 year) were 7.1 kg in blacks vs 13.9 kg in whites. The differences in overall outcome resulted primarily from greater weight regain in blacks during months 6-12 than in whites. There was a trend for blacks to have poorer attendance than whites during the latter half of the program and for blacks to report smaller changes in calorie intake from baseline to 6 months., Conclusions: The results confirm prior studies with nondiabetic patients showing smaller weight losses in blacks than in whites and suggest that these differences may result primarily from faster weight regain in blacks. Further research is needed to more carefully examine the variables that may explain this difference and to develop more effective programs for blacks with NIDDM.

Objective: Eating pathology is more prevalent among women compared to men, but prevalence and correlates associated with eating pathology likely vary among subgroups of women. This study examines prevalence and correlates of restrictive and weight control‐related eating pathology in sexual minority women. Method: Data were collected from the Pittsburgh Girls Study (PGS). Participants reported on sexual orientation, and race, and body mass index (BMI) was derived from interviewer collected height and weight. Participants completed the Body Image Measure and the Eating Attitudes Test‐26. Results: Sexual minority women reported higher BMIs [F (1, 862) = 14.69, p < .001], higher levels of body dissatisfaction [F (1, 960) = 3.12, p < .01], and higher levels of eating pathology [F (1, 950) = 14.21, p < .001] than heterosexual women. Body dissatisfaction mediated the relationship between BMI and eating pathology, and levels of associations were not attenuated by sexual minority status. Race moderated the association between sexual orientation and eating pathology; compared to all other groups, White sexual minority women had the highest level of eating pathology. Discussion: Results indicate that White sexual minority women have higher levels of eating pathology than Black sexual minority women and both Black and White heterosexual women. Future studies that draw from larger and more diverse, community‐based samples are needed. [ABSTRACT FROM AUTHOR]

Background: The transtheoretical model is an influential theoretical model in health psychology, particularly in its application to smoking cessation research. Decisional Balance (DB) and Temptations are key constructs within this framework. Purpose: This study examines the psychometric properties of the DB and Temptations scales for smoking in a predominantly African-American sample of urban adolescent girls. Methods: We used confirmatory factor analysis to compare the fit of previously published factor structures in smokers ( n = 233) and nonsmokers ( n = 598). External validity was tested by examining stages of change differences in the retained subscales. Results: Results supported the internal and external validity of the DB scale for smokers and nonsmokers. Notably, previously published three-factor (Social Pros, Coping Pros, Cons) and four-factor (Cons split into 'Aesthetic Cons' and 'Health Cons') models fit equally well, with Cons subscales correlating highly. For Temptations, a previously published three-factor (Negative Affect, Social, Weight Control) hierarchical model fit well in nonsmokers. In smokers, previously published subscales were reliably measured, but their structural relationship remained unclear. Stage difference tests showed medium to large effect sizes of DB and Temptation subscales in smokers and nonsmokers. Conclusions: The use of DB was validated for both smokers and nonsmokers in this sample of primarily African-American adolescent females, where Cons can be combined or separated into 'Aesthetic Cons' and 'Health Cons' based on practical utility and preference. For Temptations, more research is needed but large stage differences in Temptations subscales underscore the importance of this concept in smoking acquisition and cessation. [ABSTRACT FROM AUTHOR]

Aim To investigate the association between changes in oestradiol and follicle-stimulating hormone levels during the menopausal transition and incident diabetes. Methods We followed 1407 pre-menopausal women, aged 42-52 years at baseline, who experienced natural menopause, from baseline to the 12th annual follow-up visit in the Study of Women's Health Across the Nation ( SWAN). Diabetes was defined based on fasting glucose level, medication use and self-report of physician diagnosis. Cox proportional hazards regression was used to evaluate the associations of incident diabetes with three components of the rate of change in hormones: the intercept (pre-menopausal levels) and two piece-wise slopes representing change during the early and late transition, respectively. Results During 15 years of follow-up, 132 women developed diabetes. After adjusting for potential confounders, a higher oestradiol intercept, but not its rate of change, was borderline significantly associated with lower risk of diabetes [hazard ratio for an interquartile range increase (75.2 pmol/L) 0.53, 95% CI 0.27-1.06]. For follicle-stimulating hormone, a greater rate of increase in the early transition, but not the intercept or late transition, was significantly associated with lower risk of diabetes [hazard ratio for an interquartile range increase (5.9 IU/L/year) 0.31, 95% CI 0.10-0.94]. Conclusions Lower pre-menopausal oestradiol levels and a slower rate of follicle-stimulating hormone change during the early transition were associated with higher risk of developing diabetes. Given that obesity plays an important role in diabetes risk and in the levels and changes in oestradiol and follicle-stimulating hormone over the menopausal transition, weight control in earlier mid-life is important to prevent future diabetes development. [ABSTRACT FROM AUTHOR]

Purpose: To explore perspectives of participants in the WISEWOMAN program in Pennsylvania (PA-WISE) on challenges and facilitators of reducing cardiovascular disease risk as low-income and un-/under-insured middle-aged women. Approach: Researchers conducted this 2 year qualitative data collection as one component of a broader, 5 year PA-WISE process and outcome evaluation. Setting: Women from across Pennsylvania, primarily from rural communities. Participants: Interviewees were low-income, un-/under-insured women aged 40-64 years who had recently participated in PA-WISE-facilitated health coaching and lifestyle programs (HC/LSPs). Methods – data collection and analysis: Researchers conducted individual telephone interviews with 38 women from four discrete samples of PA-WISE participants at 4 time points. Three researchers used grounded theory, and an iterative process of line-by-line coding, data display, and reanalysis to identify emerging themes, sub-themes, and their relationships. Results: Participants shared the important benefits of specific PA-WISE program traits. However, participants described significant financial constraints, difficult schedules, caregiving responsibilities, and insufficient social support as persistent challenges in their lives, making lifestyle changes in general, and program participation specifically, difficult. Conclusion: The challenges that low-income and un-/under-insured women identified amplify the importance of having interventions that offer flexibility, options, and tailoring of supports and resources. The timeless challenges articulated by participants in this study completed just before the COVID-19 pandemic, remain relevant to be addressed through the pandemic and beyond. [ABSTRACT FROM AUTHOR]

A rising number of low-income African-American mothers gain more weight in pregnancy than is recommended, placing them at risk for poor maternal and fetal health outcomes. Little is known about the perceptions of mothers in this population that may influence excessive gestational weight gain. In 2010-2011, we conducted 4 focus groups with 31 low-income, pregnant African-Americans in Philadelphia. Two readers independently coded the focus group transcripts to identify recurrent themes. We identified 9 themes around perceptions that encouraged or discouraged high gestational weight gain. Mothers attributed high weight gain to eating more in pregnancy, which was the result of being hungrier and the belief that consuming more calories while pregnant was essential for babies' health. Family members, especially participants own mothers, strongly reinforced the need to 'eat for two' to make a healthy baby. Mothers and their families recognized the link between poor fetal outcomes and low weight gains but not higher gains, and thus, most had a greater pre-occupation with too little food intake and weight gain rather than too much. Having physical symptoms from overeating and weight retention after previous pregnancies were factors that discouraged higher gains. Overall, low-income African-American mothers had more perceptions encouraging high gestational weight gain than discouraging it. Interventions to prevent excessive weight gain need to be sensitive to these perceptions. Messages that link guideline recommended weight gain to optimal infant outcomes and mothers' physical symptoms may be most effective for weight control. [ABSTRACT FROM AUTHOR]

Background The present study aimed to explore facilitators and barriers to weight loss ( WL) and weight loss maintenance ( WLM) in women who participated in a primary, 18-week comparative trial that promoted WL with an energy-restricted diet. Methods Twenty-three women participated in seven focus groups conducted by a moderator and co-facilitator using open-ended questions and probes. Focus groups were held in a private room and audio tape-recorded. Tapes were transcribed verbatim and thematic analysis was used to evaluate transcripts for common themes. Results Accountability to others, social support, planning ahead, awareness and mindfulness of food choices, basic nutrition education, portion control, exercise, and self-motivation were perceived as key facilitators for WL and WLM by women. Identified barriers included life transitions, health status changes, internal factors, environmental pressures, lack of accountability and an absence of social support. Conclusions Future interventions should address these salient facilitators and barriers to promote sustainable changes in women across their WL and WLM journeys. [ABSTRACT FROM AUTHOR]

Background: Increased consumption of nuts has been advocated because of their health benefits, but the role of nuts in the treatment of obesity is unclear given their high energy density. Objective: This study was designed to evaluate the effects of a hypocaloric, almond-enriched diet (AED) compared with a hypocaloric nut-free diet (NFD) on body weight and cardiovascular disease risk factors in the context of an 18-mo behavioral weight-management program. Design: Overweight and obese individuals [n = 123; age = 46.8 y, BMI (in kg/m2) = 34.0] were randomly assigned to consume an AED or NFD and instructed in traditional behavioral methods of weight control. Anthropometric and metabolic measurements were made at baseline, 6 mo, and 18 mo. Results: Those in the AED group lost slightly but significantly less weight than did those in the NFD group at 6 mo (-5.5 compared with -7.4 kg; P = 0.04), but there were no differences at 18 mo. No significant differences in body composition were found between the groups at 6 or 18 mo. The AED, compared with the NFD, was associated with greater reductions in total cholesterol (P = 0.03), total:HDL cholesterol (p = 0.02), and triglycerides (P = 0.048) at 6 mo, and no differences were observed between the groups at 18 mo. Conclusions: The AED and NFD groups experienced clinically significant and comparable weight loss at 18 mo. Despite smaller weight loss in the AED group at 6 mo, the AED group experienced greater improvements in lipid profiles. This trial was registered at clinical- trials.gov as NCT00I94428. [ABSTRACT FROM AUTHOR]

Objective To assess whether exposure to pro-eating disorder (pro-ED) websites influences college women's eating behaviours. Method Female college students with a body mass index (BMI) higher than 18 and no history of an ED were exposed to either pro-ED websites, healthy/exercise websites or tourist websites for 1.5 hours and were given quantitative and qualitative measures designed to assess changes in eating behaviour. Results The pro-ED website group experienced a significant one-week decrease in caloric intake from pre- to post-exposure (12 167 calories vs. 9697 calories). Following exposure, participants reported using techniques on the websites to aid with food reduction and had strong emotional reactions to the websites. These changes persisted for 3 weeks following the study's end. Discussion Even modest exposure to pro-ED websites may encourage significant changes in caloric intake and increased disordered eating behaviours. By extension, even greater exposures to these websites by at-risk females may contribute to the development of EDs. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

The article presents information on a two-year community cardiovascular risk reduction program which was organized in Lycoming County, Pennsylvania. The program was conducted by the County Health Improvement Program (CHIP) in the media, worksites, health sector and community organizations. The most important aspects of the evaluation of a program is documentation of the time course of change. The evaluation also points to its relative success in increasing awareness more successfully through some channels rather than others.

Infants and children are particularly vulnerable to in utero and early-life exposures. Thus, a mother's exposures before and during pregnancy could have important consequences for her child's health, including cancer development. We examined whether birth certificate–derived maternal anthropometric characteristics were associated with increased risk of subsequent childhood cancer development, accounting for established maternal and infant risk factors. Pennsylvania birth and cancer registry files were linked by the state Department of Health, yielding a virtual cohort of births and childhood cancers from 2003 through 2016. The analysis included 1,827,875 infants (13,785,309 person-years at risk), with 2,352 children diagnosed with any cancer and 747 with leukemia before age 14 years. Children born to mothers with a body mass index (weight (kg)/height (m)2) of ≥40 had a 57% (95% confidence interval: 12, 120) higher leukemia risk. Newborn size of ≥30% higher than expected was associated with 2.2-fold and 1.8-fold hazard ratios for total childhood cancer and leukemia, respectively, relative to those with expected size. Being <30% below expected size also increased the overall cancer risk (P for curvilinearity < 0.0001). Newborn size did not mediate the association between maternal obesity and childhood cancer. The results suggest a significant role of early-life exposure to maternal obesity- and fetal growth–related factors in childhood cancer development. [ABSTRACT FROM AUTHOR]

Introduction: While for adults in Pennsylvania, obesity rates tripled from less than 10% in 1990 to 30% in 2015, the combined rates of overweight, obese, and severely obese children and adolescents in Pennsylvania are projected to approach 37.11% by the end of 2018. Method: Pediatric obesity rates in rural areas tend to be even higher than those in urban areas. Pediatric obesity needs to be addressed, since it is strongly correlated with several chronic diseases. Given the scarcity of resources to manage this trend, innovative population-based approaches are needed. Web-based telehealth, telemedicine, mobile health (mHealth), and telephone conferences have been proposed as solutions to treat and prevent childhood obesity in rural areas; the most suitable solution is through a family-based telemedicine intervention. The purpose of this study is to explore the feasibility of such a telehealth application especially for rural Pennsylvania. Results: Telehealth use in healthcare organizations in Pennsylvania is scarce; however, 92% of Pennsylvania's school districts meet the minimum internet connectivity standards. Discussions: This article, while acknowledging barriers to the adoption of the internet-based telemedicine resources, discusses solutions for increasing their availability and dissemination in rural Pennsylvania. Current internet connectivity standards in Pennsylvania schools reflect ability to participate in telehealth programs in terms of technological background, but schools are not engaged in such programs. An appraisal of the real-life challenges to implement this modality is critical and will pave the way for advocacy and implementation of useful telehealth services in low-resource areas. [ABSTRACT FROM AUTHOR]

Background In 2006, United States public schools participating in federal school meal programs were required to adopt school wellness policies. The effect of these policies on school nutrition environments is well documented; however, evaluation of physical activity policies has received less investigation. We aimed to evaluate how district wellness policies aligned to practice for physical activity implementation in 40 schools with high obesity rates (>24%). Methods Wellness policies were evaluated using the validated Wellness School Assessment Tool (WellSAT). Concurrently, schools completed the validated Alliance for a Healthier Generation's Healthy Schools Program (HSP) self-assessment to evaluate physical activity practices. Overall, 13 of 20 physical activity measures from WellSAT and 12 of 13 physical activity measures from HSP were aligned to match policy with practice. Results Most policy items scored 0 or 1, indicating either 'no mention in the policy' or 'containing weak or vague language'. Corresponding HSP results indicated that school physical activity practices are 'not in place' or 'under development'. A strong, positive, correlation (r = 0.92, P < 0.001) indicated that a significant relationship exists between policy and implementation. Conclusions Results indicate that most districts currently have weak policies regarding physical activity, limiting the potential to positively influence school-based physical activity. [ABSTRACT FROM AUTHOR]

The purpose of the study was to describe participants’ experience of daily weighing and to explore factors influencing adherence to daily weighing among individuals who were successful in losing weight during a behavioral weight loss intervention. Participants completed a 12-month weight loss intervention study that included daily self-weighing using a Wi-Fi scale. Individuals were eligible to participate regardless of their frequency of self-weighing. The sample (N = 30) was predominantly female (83.3%) and White (83.3%) with a mean age of 52.9 ± 8.0 years and mean body mass index of 33.8 ± 4.7 kg/m2. Five main themes emerged: reasons for daily weighing (e.g., feel motivated, being in control), reasons for not weighing daily (e.g., interruption of routine), factors that facilitated weighing, recommendations for others about daily weighing, and suggestions for future weight loss programs. Our results identified several positive aspects to daily self-weighing, which can be used to promote adherence to this important weight loss strategy. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to determine sex/gender differences in smoke exposure and to quantify the role of potential predictors including puffing behaviors, nicotine dependence, and non-nicotinic factors. Methods: The Pennsylvania Adult Smoking Study (PASS) of 332 adult cigarette smokers utilized portable handheld topography devices to capture the smokers' profiles in a naturalistic environment. Sex/gender differences in salivary biomarkers were modeled using ANCOVA to account for measures of dependence (Fagerstrom Test for Nicotine Dependence, nicotine metabolite ratio [3-hydroxycotinine/cotinine]), and nondependence covariates including anthropomorphic factors and stress. The Blinder-Oaxaca method was used to decompose the sex/gender differences in nicotine uptake due to covariates. Results: Men had significantly higher cotinine levels (313.5 ng/mL vs. 255.8 ng/mL, p < 0.01), cotinine +3-hydroxycotinine levels, (0.0787 mol/L vs. 0.0675 mol/L, p = 0.01), puff volumes (52.95 mL vs. 44.77 mL, p < 0.01), and a lower nicotine metabolite ratio (0.396 vs. 0.475, p = 0.01) than women. The mean Fagerström Test for Nicotine Dependence score did not differ between men and women ( p = 0.24). Women had a higher mean Hooked on Tobacco Checklist score than men (7.64 vs. 6.87, p < 0.01). In multivariate analysis, nicotine metabolite levels were not significantly different by sex. Decomposition results show that ten predictors can explain 83% of the sex/gender differences in cotinine uptake. Height was the greatest contributor to these differences, followed by average puff volume. Conclusion and Impact: The higher levels of nicotine metabolites in men, compared to women, can be explained by height, weight, puff volume, and nicotine metabolism. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Project Connect is a national program to build partnerships among public health agencies and domestic violence services to improve the health care sector response to partner and sexual violence. Pennsylvania piloted the first school nurse-delivered adolescent relationship abuse intervention in the certified school nurses' office setting. The purpose of this study was to assess the feasibility of implementing this prevention intervention. METHODS In 5 schools in Pennsylvania, school nurses completed a survey before and 1 year after receiving training on implementing the intervention as well as a phone interview. Students seeking care at the nurses' offices completed a brief anonymous feedback survey after their nurse visit. RESULTS The school nurses adopted the intervention readily, finding ways to incorporate healthy relationship discussions into interactions with students. School nurses and students found the intervention to be acceptable. Students were positive in their feedback. Barriers included difficulty with school buy-in and finding time and private spaces to deliver the intervention. CONCLUSIONS A school nurse healthy relationships intervention was feasible to implement and acceptable to the students as well as the implementing nurses. While challenges arose with the initial uptake of the program, school nurses identified strategies to achieve school and student support for this intervention. [ABSTRACT FROM AUTHOR]

Background: Parents shape children's eating environments and act as powerful socialization agents, impacting young children's behavioral controls of food intake. Most feeding measures assess parents' use of control to manage children's intake of energy dense foods. The Structure and Control in Parent Feeding (SCPF) questionnaire was developed to assess more positive aspects of feeding practices with their young children --setting limits, providing routines--that promote self-regulation, as well as controlling feeding practices. Methods: A mixed method approach was used to develop the SCPF. In 2013, cognitive interviews informed the modification, deletion and/or replacement of items. In 2014, the survey was distributed statewide to mothers of toddlers aged 12 to 36 months participating in the Women, Infants, and Children program. In 2016, exploratory factor analyses was conducted to test our theoretical parenting model and content validity and criterion validity were assessed (n = 334). Results: Exploratory factor analysis (EFA) and second-order EFA revealed a 2-factor, 22-item Structure model and a 2-factor, 12-item Control model. Internal consistencies for all factors exceeded 0.70. As predicted, the Structure superfactor was positivity associated with responsiveness, whereas the Control superfactor was positively associated with demandingness on the Caregiver's Feeding Styles Questionnaire. The Structure subscales were also positively associated with mealtime behaviors and Control subscales were positively associated with control-oriented feeding measures from the Control in Parent Feeding Practices questionnaire. Conclusion: The SCPF questionnaire is a reliable tool that can be used to assess aspects of structure- and control-based feeding practices to better understand how parents feed their toddlers. [ABSTRACT FROM AUTHOR]

Tanning during adolescence increases skin cancer risk. Relatively few studies have examined the association between thinness attitudes and tanning attitudes and behaviors. The purpose of the current study was to examine psychosocial predictors of sunbathing and tanning bed use, specifically thin ideal internalization (TII) and motives for tanning among high school girls. Adolescent girls (N = 229) completed a 10-minute questionnaire designed to assess sunbathing and indoor tanning, TII and motives to tan (appearance, social and well-being). Hierarchical regression analyses showed that TII,β = .05,p < .05, appearance motives,β = .11,p < .01 and well-being motives,β = .11,p < .01 were all independently positively associated with sunbathing. Social motives were negatively associated with sunbathing,β = −.07,p < .05. A three-way interaction was found between the three types of motives on indoor tanning, in that appearance and well-being motives interacted to increase indoor tanning levels, especially among those who strongly endorsed social motives for tanning,β = .22,p < .05. Motives for tanning, specifically those associated with appearance and well-being, can interact to increase tanning bed use. When designing tailored interventions for skin cancer prevention in young people, researchers should consider tailoring based on motivation. Researchers and healthcare professionals who work with adolescents should attend to tanners who are motivated for both appearance and mood-related reasons, as they may be most at risk for tanning dependence and skin cancer. [ABSTRACT FROM AUTHOR]

CONTEXT Intimate partner violence and reproductive coercion are associated with unintended pregnancies and STDs. Greater condom negotiation self-efficacy among young women may mediate these associations. METHODS A sample of 841 female adolescents (aged 16-19) and 1,387 young adult women (aged 20-24) recruited from 24 family planning clinics in western Pennsylvania in 2011-2012 reported on intimate partner violence, reproductive coercion, condom negotiation self-efficacy and sexual health outcomes at baseline and four- and 12-month follow-ups. Mixed models were used to test associations of intimate partner violence and reproductive coercion with unintended pregnancy and STD diagnosis. The Sobel test of mediation was used to measure indirect effects of condom negotiation self-efficacy. RESULTS At baseline, 15% of adolescents and 11% of young adults reported recent intimate partner violence victimization; 7% and 6%, respectively, reported recent reproductive coercion. For both age-groups, intimate partner violence and reproductive coercion were associated with a reduced level of condom negotiation self-efficacy (coefficients, −0.27 to −0.13) and increased odds of STD diagnosis (odds ratios, 1.03-1.1). However, only reproductive coercion was associated with unintended pregnancy (odds ratios, 1.1 for each group). The only association that condom negotiation self-efficacy mediated was between reproductive coercion and unintended pregnancy among young adults (17% of total effect). CONCLUSIONS Targeting condom negotiation self-efficacy alone in abusive relationships would likely not translate into improved sexual health outcomes in this population. Other strategies are needed to prevent unintended pregnancy and STDs. [ABSTRACT FROM AUTHOR]

Background: The County Health Rankings (CHR) system provides health rankings for U.S. counties. These factors may have utility for evaluating and predicting health outcomes. This study examined the association between CHR factors and the prevalence of child overweight/obesity (OWOB) in the state of Pennsylvania over 3 years.Methods: The prevalence of childhood OWOB was obtained for all Pennsylvania school districts for the 2009-10 through 2011-12 school years. Correlational and inferential statistical analyses were used to examine the associations between the prevalence of OWOB in grades K-6 (OWOB1) and 7-12 (OWOB2) and z-score for the overall CHR Health Factors rank, as well as for individual predictive factors (Health Behaviors, Clinical Care, Social and Economic Factors and Physical Environment).Results: Low to moderate correlations (0.29-0.43) were found between OWOB1 and CHR factors. Weaker and less consistent correlations were found for adolescents. There was a significantly higher prevalence of OWOB in counties with poorer CHR scores.Conclusions: County-level adult indicators of health are significantly associated with levels of child obesity. Future studies should examine the relationship between CHR and other health outcomes. [ABSTRACT FROM AUTHOR]

Objective: Assessment of the joint and independent relationships of gestational weight gain and prepregnancy body mass index (BMI) on risk of infant mortality was performed.Methods: This study used Pennsylvania linked birth-infant death records (2003-2011) from infants without anomalies born to mothers with prepregnancy BMI categorized as underweight (n = 58,973), normal weight (n = 610,118), overweight (n = 296,630), grade 1 obesity (n = 147,608), grade 2 obesity (n = 71,740), and grade 3 obesity (n = 47,277). Multivariable logistic regression models stratified by BMI category were used to estimate dose-response associations between z scores of gestational weight gain and infant death after confounder adjustment.Results: Infant mortality risk was lowest among normal-weight women and increased with rising BMI category. For all BMI groups except for grade 3 obesity, there were U-shaped associations between gestational weight gain and risk of infant death. Weight loss and very low weight gain among women with grades 1 and 2 obesity were associated with high risks of infant mortality. However, even when gestational weight gain in women with obesity was optimized, the predicted risk of infant death remained higher than that of normal-weight women.Conclusions: Interventions aimed at substantially reducing preconception weight among women with obesity and avoiding very low or very high gestational weight gain may reduce risk of infant death. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the effects of web-based information on parental self-efficacy in managing obesity risk in preschoolers. Design and Methods The project included a literature review and the development and field testing of an information website that presented information on how to manage nine obesity risk factors for childhood obesity. Results Parents stated that they had no problems using the website, and 69% reported improved self-efficacy on at least two risk factors. Practice Implications Many parents access the Internet to obtain health information. A website that offers practical information on managing childhood obesity risk factors is a valuable resource for obesity prevention efforts. [ABSTRACT FROM AUTHOR]

Background Genetic variation in chemosensory genes can explain variability in individual's perception of and preference for many foods and beverages. To gain insight into variable preference and intake of alcoholic beverages, we explored individual variability in the responses to sampled ethanol (EtOH). In humans, EtOH elicits sweet, bitter, and burning sensations. Here, we explore the relationship between variation in EtOH sensations and polymorphisms in genes encoding bitter taste receptors ( TAS2Rs) and a polymodal nociceptor ( TRPV1). Methods Caucasian participants ( n = 93) were genotyped for 16 single nucleotide polymorphisms ( SNPs) in TRPV1, 3 SNPs in TAS2R38, and 1 SNP in TAS2R13. Participants rated sampled EtOH on a generalized Labeled Magnitude Scale. Two stimuli were presented: a 16% EtOH whole-mouth sip-and-spit solution with a single time-point rating of overall intensity and a cotton swab saturated with 50% EtOH on the circumvallate papillae ( CV) with ratings of multiple qualities over 3 minutes. Area-under-the-curve ( AUC) was calculated for the time-intensity data. Results The EtOH whole-mouth solution had overall intensity ratings near 'very strong.' Burning/stinging had the highest mean AUC values, followed by bitterness and sweetness. Whole-mouth intensity ratings were significantly associated with burning/stinging and bitterness AUC values on the CV. Three TRPV1 SNPs (rs224547, rs4780521, rs161364) were associated with EtOH sensations on the CV, with 2 (rs224547 and rs4780521) exhibiting strong linkage disequilibrium. Additionally, the TAS2R38 SNPs rs713598, rs1726866, and rs10246939 formed a haplotype, and were associated with bitterness on the CV. Last, overall intensity for whole-mouth EtOH associated with the TAS2R13 SNP rs1015443. Conclusions These data suggest genetic variation in TRPV1 and TAS2Rs influence sensations from sampled EtOH and may potentially influence how individuals initially respond to alcoholic beverages. [ABSTRACT FROM AUTHOR]

Background:Chronic disease risk factors tend to cooccur.Purpose:This study examined the cooccurrence of 8 negative health behaviors in a representative sample of urban adolescents to inform educational interventions.Methods:The prevalence, cooccurrence, and clustering of suicide attempt, lifetime history of sexual activity, tobacco use, cell phone use while driving, risky weight loss, daily soda consumption, sedentary behavior, and extreme video game use were examined among 1354 high school students.Results:Fifty-three percent of the sample were female and 61% were black. Most (80.3%) engaged in 1 to 3 risk behaviors, 10.4% reported none, and 0.5% had engaged in 6 to 8. Ever having sex was the most common cooccurring risk behavior and 4 distinct clusters of risk behaviors emerged: cluster 1 (N = 325) ever having sex; cluster 2 (N = 236): frequent soda drinking; cluster 3 (N = 402): sedentary + extreme video game use; cluster 4 (N = 391): current smoking + attempted suicide + cell phone use while driving + risky weight loss.Discussion:Adoption of multiple risk behaviors is common in youth. A history of sexual activity may be a risk behavior that is shared across different clusters of risk behaviors.Translation to Health Education Practice:Programming designed to address multiple risk behaviors concurrently in youth may be warranted. [ABSTRACT FROM AUTHOR]

The article presents information on a study on the prevalence and thee risk factors of carpal tunnel syndrome in pregnancy. The study was conducted on 17,623 prenatal visits between 2003 and 2007 from the Hospital of the University of Pennsylvania. The study found that mothers with carpal tunnel syndrome had greater rates of overweight, obesity, as well as excessive gestational weight gain.

The article discusses a study that evaluates the impact of single or combined risk factors as defined by the female athlete triad with the incidence of bone stress injuries (BSI) in a multicenter prospective sample of four cohorts of physically active girls and women. Dual-energy X-ray absorptiometry was used. It is reported that 28 participants incurred a BSI. A table is shown that outlines baseline descriptive attributes among participants in overall sample and according to injury status.

The purpose of this study was to profile characteristics of people with traumatic brain injury (TBI) who self-reported arthritis 7 to 24 yr. post-injury. Pre- and post-injury socio-demographic factors, injury-related factors, and post-injury standardized assessments measuring health, activity, and participation outcomes were assessed in a retrospective cohort study of 274 participants. The group self-reporting arthritis had significantly more sleep disturbances, poorer overall health, lower mental health and physical function, and decreased productivity. Also, they were older and reported a shorter length of loss of consciousness from TBI. These results suggest that musculoskeletal complaints from long-term survivors of TBI should be addressed in post-acute care and could guide future research on arthritis in the TBI population. [ABSTRACT FROM AUTHOR]

What is already known about this subject Adolescence is an important period of physiological growth., Loss of central adiposity with preservation of lean mass during weight loss is optimal., There are discrepancies in the literature concerning changes in lean mass during weight loss in adolescents., What this study adds This study provides information of regional and total body composition change in adolescents during weight loss., This study controls for important factors that impact body composition in growing adolescents such as age, sex, height, baseline weight and race., This study provides correlations of changes in waist circumference and body mass index (BMI) with total and trunk fat mass during weight loss in adolescents., Summary Background Changes in body composition during weight loss among obese adolescents are poorly understood. This study characterized the composition of weight loss and its association with changes in waist circumference ( WC) in obese adolescents. Methods Total ( Tot), trunk ( Tr) and appendicular ( Ap) fat mass ( FM) and lean mass ( LM) were measured by dual-energy X-ray absorptiometry in 61 obese adolescents (40 girls) who participated in a randomized controlled weight loss trial. Changes in body composition were assessed at 0, 6 and 12 months using mixed-effects regression models. Correlation analysis of change in WC and total and regional compartments of FM and LM were assessed. Results Weight loss for adolescents was 90.3% FM and 15.9% LM at 0-6 months, and 98.2% FM and 7% LM at 0-12 months. At 12 months, girls lost 2.67 kg more Tot FM than boys in models adjusted for height, age, race and baseline weight. Boys gained LM in all compartments in all models. At 12 months, girls lost TotLM (2.23 ± 0.74, P < 0.004) and ApLM (0.69 ± 0.31, P = 0.03) and gained TrLM (0.37 ± 0.35, P = 0.29). The percentage LM, increased for boys and girls in all models. TotFM was correlated with body mass index ( BMI) change with TotFM ( R = 0.70-0.91, P = 0.001) and WC change ( R = 0.53-0.55, P < 0.001). Conclusions Weight loss in obese adolescents during a weight loss trial using lifestyle management and sibutramine was primarily from trunk FM. Although absolute LM increased in boys and decreased in girls, the percentage of weight that is LM increased for both boys and girls. Changes in BMI were more reflective of changes in FM than changes in WC. [ABSTRACT FROM AUTHOR]

In the current study, we investigated the relevance of women’s own and their romantic partners’ weight status to the development of weight concerns. Seventy-two female same-sex couples (n = 144 women) completed the Weight Concerns Scale and a researcher measured their height and weight to compute body mass index as a measure of weight status. Using the Actor–Partner Interdependence Model, which accounts for the dependency in these data, analyses revealed a significant link between women’s own weight status, their weight concerns, and their partners’ weight status and their weight concerns. Further, an interaction indicated that women who were heavier and who had thinner female partners were most at risk of experiencing weight concerns. These findings are discussed as evidence for the importance of partner comparisons in the context of romantic relationships and should inform research examining links between romantic relationships and health, particularly among sexual minority couples. Clinical implications of our research include the potential role of couples’ therapy in treating not only relationship problems but also potential health challenges. [ABSTRACT FROM PUBLISHER]

Aims and objectives To identify factors associated with health-related quality of life among overweight or obese adults. Background The obesity epidemic presents a global challenge. Obesity is associated with lower health-related quality of life; however, no study has comprehensively examined correlates of health-related quality of life in this population. Design A cross-sectional design. Methods The physical component score, mental component score and eight domain scores of the Short Form-36 v2 were used to assess health-related quality of life. We identified 23 possible correlates of health-related quality of life, including age, body mass index, health and weight histories, perceived stress, cholesterol-lowering diet self-efficacy, problem-solving, binge eating, dietary intake and physical activity. Correlational analyses were used to examine the bivariate associations between correlates and health-related quality of life variables. All possible subsets regression was used to develop predictive models of health-related quality of life. Results The sample ( n = 210) was predominantly White (84·8%), female (78·1%) and middle-aged (average age = 46·80 years). Age, body mass index, education, having children at home, and being hypertensive were identified as the best predictors of physical component score, explaining about 9% of the variance. Age, marital status, having hyperlipidaemia, perceived stress, problem-solving, self-efficacy, binge eating and barriers to healthy eating predicted mental component score, explaining approximately 48% of the variance. Physical functioning and role physical domains of health-related quality of life had similar sets of predictors, with 15% and 13% of the variance explained, respectively, while similar predictors were identified for bodily pain (6%), general health (26%), vitality (40%), social functioning (32%), role emotional (42%) and mental health (46%) domains. Conclusions Psychosocial factors were associated with the mental-related quality of life. Further exploration of factors related to physical-related quality of life is warranted in this population. Relevance to clinical practice When working with overweight/obese adults who are trying to lose weight, nurses need to consider socio-demographic and psychosocial factors in the development of a treatment plan that will improve health-related quality of life in this population. [ABSTRACT FROM AUTHOR]

Aims Social norms are a key source of influence on health behaviors. This study examined changes in social norms and relationships between HIV injection risk behaviors and social norms among injection drug users ( IDUs) involved in an experimental intervention. Design Randomized clinical trial. Setting An HIV Prevention Trials Network study, Philadelphia, USA. Participants IDUs, called indexes, and their social network members, who were drug or sex partners, were recruited for an HIV prevention intervention and followed for up to 30 months ( n = 652). Indexes were randomized into a peer education intervention or control condition. Measurements Outcomes of injection-related HIV risk behaviors (sharing needles, sharing cookers, sharing cotton, front-/back-loading) were measured every 6 months and the social norms of these four risk behaviors were assessed every 12 months. Findings There was a statistically significant intervention effect on all four social norms of injection behaviors, with participants in the intervention reporting less risky social norms compared with controls (changes in mean score: needles, −0.24, P = 0.007; cookers, −0.33, P = .004; cottons, −0.28, P = .0165; front-/back-loading, −0.23, P = .002). There was also a statistically significant bidirectional association with social norms predicting injection risk behaviors at the next assessment and risk behaviors predicting social norms at the subsequent visit. Conclusions Through social network interventions it is feasible to change both injection risk behaviors and associated social norms. However, it is critical that social network interventions focus on publically highlighting behavior changes, as changing social norms without awareness of behaviors change may lead to relapse of risk behaviors. [ABSTRACT FROM AUTHOR]

Objective Obesity is a demonstrated barrier to obtaining health care. Its impact on obtaining prenatal care (PNC) is unknown. Our objective was to determine if obesity is an independent barrier to accessing early and adequate PNC. Study Design We performed a retrospective cohort study of women who initiated PNC and delivered at our institution in 2005. Body mass index (BMI) was categorized by World Health Organization guidelines: underweight (<18.5 kg/m2), normal weight (18.5 to 24.9 kg/m2), overweight (25.0 to 29.9 kg/m2), and obese (≥30 kg/m2). Maternal history and delivery information were obtained through chart abstraction. Differences in gestational age at first visit (GA-1) and adequate PNC were evaluated by BMI category. Data were compared using X2 and nonparametric analyses. Results Overall, 410 women were evaluated. The median GA-1 was 11.1 weeks and 69% had adequate PNC. There was no difference in GA-1 or adequate PNC by BMI category (p = 0.17 and p = 0.66, respectively). When BMI groups were dichotomized into obese and nonobese women, there was no difference in GA-1 or adequate PNC (p =0.41). Conclusion In our population, obesity is not an independent barrier to receiving early and adequate PNC. Future work is warranted in evaluating the association between obesity and PNC and the perceived barriers to obtaining care. [ABSTRACT FROM AUTHOR]

Abstract: Background: Standard behavioral obesity treatment produces poor long-term results. Focusing on healthy eating behaviors rather than energy intake may be an alternative strategy. In addition, important behaviors might differ for short- vs long-term weight control. Objective: Our aim was to describe and compare associations between changes in eating behaviors and weight after 6 and 48 months. Design: We performed secondary analysis of data collected during a randomized weight-loss intervention trial with 48-month follow-up. Participants: We studied 481 overweight and obese postmenopausal women enrolled in the Women on the Move through Activity and Nutrition (WOMAN) Study. Main outcome measures: We measured changes in weight from baseline to 6 and 48 months. Statistical analyses performed: Linear regression models were used to examine the associations between 6- and 48-month changes in eating habits assessed by the Conner Diet Habit Survey and changes in weight. Analyses were conducted in the combined study population and stratified by randomization group. Results: At 6 months in the combined population, weight loss was independently associated with decreased desserts (P<0.001), restaurant eating (P=0.042), sugar-sweetened beverages (P=0.009), and fried foods (P<0.001), and increased fish consumption (P=0.003). Results were similar in intervention participants; only reduced desserts and fried foods associated with weight loss in controls. At 48 months in the combined population, weight loss was again associated with decreased desserts (P=0.003) and sugar-sweetened beverages (P=0.011), but also decreased meats/cheeses (P=0.024) and increased fruits/vegetables (P<0.001). Decreased meats/cheeses predicted weight loss in intervention participants; desserts, sugar-sweetened beverages, and fruits/vegetables were independently associated in controls. Conclusions: Changes in eating behaviors were associated with weight change, although important behaviors differed for short- and long-term weight change and by randomization group. Future studies should determine whether interventions targeting these behaviors could improve long-term obesity treatment outcomes. [Copyright &y& Elsevier]

Lifestyle-related chronic diseases such as cancer and cardiovascular disease are the greatest public health concerns. Evidence shows Japanese immigrants to a westernized environment have higher incidence of lifestyle-related diseases. However, little is known about lifestyle characteristics related to chronic diseases for Japanese in a westernized environment. This study is examining the gap in lifestyle by comparing the lifestyle prevalence for Japanese in the US with the Japanese National Data (the National Health and Nutrition Survey in Japan, J-NHANS) as well as the Japan National Health Promotion in the twenty-first Century (HJ21) goals. Japanese adults were surveyed in Pittsburgh, USA, regarding their lifestyle (e.g., diet, exercise, smoking, stress, alcohol, and oral hygiene). The prevalence was compared with J-NHANS and HJ21 goals. Ninety-three responded (response rate; 97.9%). Japanese men ( n = 38) and women ( n = 55) in Pittsburgh smoke less than Japanese in Japan ( P < 0.001 for both genders). Japanese in Pittsburgh perform less physical activity in daily life and have lower prevalence of walking more than 1 h per day ( P < 0.001 for both genders). Japanese women in Pittsburgh have significantly higher prevalence of stress than in Japan ( P = 0.004). Japanese men in Pittsburgh do not reach HJ21 goal in weight management, BMI, use of medicine or alcohol to sleep, and sleep quality. Japanese women in Pittsburgh do not reach HJ21 goal in weight management and sleep quality. In conclusion, healthy lifestyle promotion including exercise and physical activity intervention for Japanese living in a westernized environment is warranted. [ABSTRACT FROM AUTHOR]

BACKGROUND: Insufficient attention has been paid to the process of conducting the Centers for Disease Control and Prevention's School Health Index (SHI) to promote collaboration between universities and urban school districts when developing adolescent health promotion initiatives. This article provides an overview of the real-world contextual challenges and opportunities this type of collaboration can pose. METHODS: The SHI and selected collaboration principles were used to facilitate partnership and increase stakeholder buy-in, which led to developing and implementing an 8-year health promotion campaign. RESULTS: The focus on planning brought together key stakeholders to allow for health promotion programming to take place, despite the competing demands on the schools. The SHI allowed for input from stakeholders to develop campaign activities and inform school- and district-wide policy. Universities and school districts desiring to develop and implement school-based, adolescent health promotion programs should (1) identify the hierarchical structure of the school district, (2) establish credibility for the program and the university staff, (3) emphasize the benefits to all partners, (4) maintain a cooperative partnership with teachers and administrators, (5) appreciate the need for planning, and (6) provide as many resources as possible to aid an already overburdened school system. CONCLUSIONS: Promoting healthy behaviors among students is an important part of the fundamental mission of schools. The significance of collaboration using the SHI, with direct input from students, teachers, administrators, and university partners, is critical in the development of institutional support for implementation of adolescent health promotion initiatives. [ABSTRACT FROM AUTHOR]

Various affective and personality variables may impact the relationship between body dissatisfaction and disordered eating symptomatology. The current study was a post-hoc analysis examining potential moderators (depression, anxiety, and impulsivity) of this relationship in college women. Four-hundred and seventy-two (472) enrolled college women between the ages of 18 and 55 participated in this study. Moderation analyses indicated that anxiety, depression, and dieting significantly moderated the relationship between body dissatisfaction and disordered eating, whereas impulsivity did not. Findings can be used to generate hypotheses for education and prevention programs on college campuses. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe the trends, themes, and outcomes of interventions over time within and between two academic nurse-managed Wellness center (NMWC) sites. Documentation of Wellness interventions and outcomes of these interventions presented ongoing challenges. The Omaha System was used as a documentation system to capture both interventions and client outcomes. A retrospective chart analysis revealed that the most commonly reported problems were circulation and nutrition. Interventions focused on teaching, guidance, and counseling; subsequently, the outcomes of knowledge, behavior, and status increased modestly with time for the older adult clients who attended these NMWC sites. [ABSTRACT FROM AUTHOR]

This article traces the development of a consortium-based consumer health information site that grew out of a continuing education program and which focuses on local health concerns. The article discusses the key steps in the project, challenges, and lessons learned. [ABSTRACT FROM AUTHOR]

Objective: To evaluate 3-month tobacco quit rates of young adult tobacco users randomized to 2 intervention conditions. Methods: Overall 192 non-treatment-seeking 18-to-24-year-old tobacco users received educational information and advice to quit smoking. Participants were then block randomized to 2 brief intervention conditions: (1) a telephone quit-line (TQ) N=90; or (2) a brief direct treatment intervention (BDTI) N=102. Results: A 90-day follow-up evaluation found that 19.6% of BDTI and 10.2% of TQ participants reported 30-day point prevalence tobacco quit rates (chisquare = 2.37, P=.09). Conclusions: BDTI can help non-treatment-seeking, low SES, young adult tobacco users quit smoking. [ABSTRACT FROM AUTHOR]

To identify promoters of and barriers to fruit, vegetable, and fast-food consumption, we interviewed low-income African Americans in Philadelphia. Salient promoters and barriers were distinct from each other and differed by food type: taste was a promoter and cost a barrier to all foods; convenience, cravings, and preferences promoted consumption of fast foods; health concerns promoted consumption of fruits and vegetables and avoidance of fast foods. Promoters and barriers differed by gender and age. Strategies for dietary change should consider food type, gender, and age. (Am J Public Health. 2010;100:631635. doi:10.2105/ AJPH.2009.172692) [ABSTRACT FROM AUTHOR]

Aim: To identify and describe gender-related differences in the self-esteem and optimism levels of rural adolescents. Background: Self-esteem and optimism have been broadly examined and are associated with health-practices, social interaction, attachment, resiliency, and personal identity. Information describing the relationship of self-esteem and optimism as it relates to gender is limited. Methods: Using a cross-sectional survey design, students (N = 193) from three high-schools in rural Pennsylvania, USA completed the Rosenberg Self-Esteem Scale and the Optimism Scale-Life Orientation Test-Revised as part of a National Institute of Health, National Institute of Nursing Research funded study. Results: Both instruments' mean scores were in the range of average for this population, with females scoring lower than males in both self-esteem (p < 0.0001) and optimism (p < 0.0001). The results of this study have nursing implications for evidenced based interventions that target self-esteem and optimism. Attention to self-esteem and optimism in female youth is recommended. [ABSTRACT FROM AUTHOR]

This study sought to determine individual factors that may influence adolescents' interests in various health behaviors and, by extension, their potential interest in programs that promote healthy lifestyles and reduce obesity. The sample consisted of 737 rural Pennsylvania (United States) middle and high school students not involved in either healthy exercise or dietary behaviors (a target group for health-promoting interventions). Participants completed a self-report measure of their general health functioning, including their interests in sports programs, outdoor recreation programs, weightlifting, weight loss and healthy eating/cooking. Nurses measured body mass indices (BMIs). The vast majority of the sample endorsed self-efficacy in healthy eating and physical activity, and this self-efficacy was associated with interest in a healthy diet and outdoor recreation. Interest in healthy activities was consistently higher among 7th graders (age mean = 12.6 years) than 11th graders (age mean = 16.3 years). Females were more interested in weight loss and healthy eating/cooking, whereas males were more interested in weightlifting. Higher BMI only predicted interest in weight loss. These results indicate that adolescent health interests vary on the basis of their gender, grade level, BMI and self-efficacy. These trends are potentially important to consider when seeking to match intervention programs to adolescent interests. [ABSTRACT FROM AUTHOR]

The purpose of this project was to develop a bidimensional measure of mindfulness to assess its two key components: present-moment awareness and acceptance. The development and psychometric validation of the Philadelphia Mindfulness Scale is described, and data are reported from expert raters, two nonclinical samples (n = 204 and 559), and three clinical samples including mixed psychiatric outpatients (n = 52), eating disorder inpatients (n = 30), and student counseling center outpatients (n = 78). Exploratory and confirmatory factor analyses support a two-factor solution, corresponding to the two constituent components of the construct. Good internal consistency was demonstrated, and relationships with other constructs were largely as expected. As predicted, significant differences were found between the nonclinical and clinical samples in levels of awareness and acceptance. The awareness and acceptance subscales were not correlated, suggesting that these two constructs can be examined independently. Potential theoretical and applied uses of the measure are discussed. [ABSTRACT FROM AUTHOR]

Nicotine dependence has a complex multifactorial etiology, underscoring the value of applying a transdisciplinary research model. The important goal of treating nicotine dependence can be realized by transdisciplinary research that translates discoveries in basic neuroscience, pharmacology, genetics, and behavioral science to develop new treatment models that can be translated readily into the clinic and community. As part of this special issue highlighting work at the Transdisciplinary Tobacco Use Research Centers (TTURCs), we describe transdisciplinary research at the University of Pennsylvania TTURC aimed at elucidating the neurobiological and genetic basis of nicotine dependence, the development of novel medications, and the translation of this research to practice. [ABSTRACT FROM AUTHOR]

Objective: To assess whether parental overweight status and disinhibited overeating are predictive of daughters' accelerated weight gain and disinhibited overeating.Research Methods and Procedures: Participants were part of a longitudinal study of girls (N = 197) and their parents. Measured height and weight were used to calculate BMI [weight (kilograms)/height (meters)(2)]. Parents' disinhibited eating behavior was assessed using the Eating Inventory. Girls' disinhibited eating was assessed using a behavioral protocol to measure eating in the absence of hunger. Girls were classified based on parental overweight at study entry into four groups: neither, mother only, father only, or both parents overweight.Results: Girls with both parents overweight had the most rapid increases in BMI from 5 to 13 years of age; BMI increased most slowly among the neither parent overweight group, with intermediate increases in BMI among mother only and father only overweight groups. Daughters with both parents overweight at study entry were eight times more likely to be overweight at age 13, controlling for daughters' weight at age 5. Girls with both parents overweight had higher levels of disinhibited eating across all ages than all other groups. Although girls in all parental weight status groups showed increases in disinhibited eating over time, girls with both parents overweight had larger increases in disinhibited eating over time compared with all other groups.Discussion: Girls growing up in families differing in parental overweight had divergent developmental trajectories for BMI and disinhibited overeating. Findings reveal the need to focus prevention efforts on overweight parents of young children. [ABSTRACT FROM AUTHOR]