2. 1 Eating habits, physical activity and risky behaviors of youth practicing weight control Julie Chmielewski M.S. Candidate

3. 2 Objective 1.Evaluate a nationally representative sample of adolescents to determine the prevalence of weight control methods according to youth’s weight status. 2.Confirm that overweight youth are using recommended methods of weight control according to Healthy People 2010.

4. 3 Rationale Obesity NHANES 11%, YRBS 16% Weight control YRBS 43% of youth Health consequences of inappropriate weight control Growth retardation, acute gastric dilation, metabolic alkalosis, cardiac arrhythmia, death Risky health behaviors associated with wt. control

5. 4 Data National Longitudinal Study of Adolescent Health (Add Health) – Chapel Hill, N.C. Funded by: National Institute of Child Health and Human Development & 17 other agencies Wave II from 1995-1996 Major topics: nutrition, daily activity, health service use, violence, sexual behavior, substance abuse, injury

6. 5 Data source NewsSearchSite MapContact Us © 1998 The National Longitudinal Study of Adolescent Health Last modified 28 April 2000 http://www.cpc.unc.edu/projects/addhealth/addhealth_home.html

7. 6 Research Question #1 a.What is the frequency of weight control use among adolescents who have already started puberty and grouped by underweight, average weight or overweight/obese? b.Are there differences in frequency of weight control use among pubescent youth by weight category, grade, race and age categories? c. What types of weight control methods are used?

8. 7 Research Question #2 a.Are pubescent youth who use weight control methods at increased risk for participating in other risky health behaviors such as smoking, drug use, alcohol consumption and/ or suicide thoughts? b.Is there a difference in risky health behaviors among pubescent youth who use weight control as grouped by weight category?

9. 8 Research Question #3 Do underweight, average weight and overweight pubescent youth who use weight control methods have healthy eating and exercise behaviors (as recommended by HP2010)?

10. 9 Variable selection (n=13, 568) Menarche YES Sexual Maturation Stage 3 YES Underweight Average Overweight Nutrition Fast Food Beverage Breakfast Food Groups Physical Activities Risky behavior (Yes/No) – suicide, substance use, tobacco use, drug use, dangerous weight control Types of weight control behaviors – diet, exercise, laxative, vomiting, diet pills Health-promoting Behaviors Weight Control (Yes/No) Weight Control (Yes/No) Weight Control (Yes/No) Weight Control (Yes/No) Weight Control (Yes/No) Weight Control (Yes/No) Males Females

11. 10 Definitions Weight control: includes everything reported to lose weight or to keep from gaining weight Dangerous weight control: using vomiting, diet pills, or laxatives to lose weight or keep from gaining weight

12. 11 Definitions Weight categories: calculated from measured height and weights and BMIs compared to age- and gender-specific growth charts for underweight, average weight, at risk for overweight, overweight

13. 12 2000 NCHS Growth Chart 95th 85th 5th 95th 85th 5th

14. 13 Definitions Puberty status: 1)boys secondary sex characteristics 2)girls - menarche

15. 14

16. 15 Analyses SPSS – Statistical Package for Social Sciences SUDAAN statistical analysis software Cross tabulations & Logistic Regression Odds ratios and confidence intervals

17. 16

18. 17

19. 18 Privacy issue with weight control questions When 20% of participants reported a third person in the room - Girls less likely to report dieting or diet pill use Boys less likely to report diet pill use

20. 19 Type of weight control used by adolescents Girls (n=4777)Boys (n=2182) Exercise43%52% Dieting and exercise 18%9% Dieting alone7%3% Laxatives, vomiting, diet pills* 3%<1% * 50% girls using these methods were average weight.

21. 20

22. 21 Eating and exercise behaviors Fruit & vegetable intake: 5+ servings Milk intake: > 1 serving milk Fast food intake: < 2 times per week Breakfast intake: > 5 times a week and 3 or more food groups Variety of food: 1 serving of each food group Exercise: > 3 times a week for > 30 minutes

23. 22 GIRLS: Eating and exercise behaviors associated with weight control Positive behaviors 1.6 x more likely to eat less fast food 1.6 x more likely to get exercise > 3x/wk for 30 min. Less likely to use drugs Negative behaviors 1.4 x more likely to eat an inadequate breakfast 1.6 x more likely to skip breakfast 1.6 x more likely to consume alcohol Not significant Fruit and vegetable intake, dairy, food group variety * Odds ratios reported were significant.

24. 23 BOYS: Eating and exercise behaviors associated with weight control Positive behaviors 1.9 x more likely to eat less fast food Negative behaviors No significant findings Not significant Fruit and vegetable intake, dairy, food group variety, breakfast consumption, exercise

25. ns = not significant 24 Likelihood of weight control (after controlling for all these variables) Odds ratio; p<0.05Average WeightOverweight GirlsBoysGirlsBoys Fast food (< 2x/wk)1.62.1nsNs Inadequate Breakfastns 2.3ns Exercise (3x/wk@30min) 1.6ns African American0.50.37ns Grade 1.8 (11 th ) 2.6 (12 th ) 2.5 (10 th ) 0.2 (11 th ) 0.1 (12 th ) 0.4 (11 th ) 0.2 (12 th ) Age (yr)2.6 (17+)0.3 (15-16)ns Alcohol (yes)1.6ns2.2ns Drug (yes)0.6ns0.4ns

26. 25 Conclusions Health People 2010: Overweight adolescents should be practicing adequate exercise and eating a balanced diet. 89% overweight youth using weight control –OW boys eating less fast food –OW girls eating inadequate breakfast –49% of those using dangerous weight control methods were OW

27. 26 Conclusions 55% of average wt. youth using weight control –AW girls less likely to eat fast food and more likely to exercise –AW boys less likely to eat fast food –51% of those using dangerous methods were AW 30% of underweight youth using weight control

28. 27 Thank you Dr. Hoerr Dr. Weatherspoon Dr. Kallen My parents My lab group

29. 28 Recent newspaper articles in the Lansing State Journal