Intervention in professional dance students to increase mental health- and nutrition literacy: A controlled trial with follow up

Introduction: There is a need to change the culture within the art of dance, as it has been associated with injuries and mental health consequences. This study evaluates an intervention designed to increase mental health literacy, enhance nutritional knowledge, reduce symptoms and effects of low energy availability, and strengthen understanding of sports nutrition and recovery strategies, in dance students of mixed genders. Material and methods: A total of 125 dance students received three workshops, with 39 arts and crafts students serving as references. The results were evaluated by the Eating Disorder Examination questionnaire, the Low Energy Availability in Females questionnaire, the Hopkins Symptom Check List, and questions on mental health literacy, sports nutrition, and recovery knowledge. Results: Dance students achieved sustained improvements in mental health and nutrition knowledge and temporary improvements in driven exercise (i.e., performing exercise because of a compulsive drive). No other benefits were identified from the intervention. Conclusion: Our findings indicate the need for an ongoing education program to reduce the occurrence and development of negative mental health outcomes and low energy availability in professional dance students. Such approaches may not only improve the mental health of dance students but also potentially prevent the high frequency of injuries.publishedVersio

Body figure idealization and body appearance pressure in fitness instructors

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Purpose: The fitness centers are settings for health promotion, yet may serve as a stage for counterproductive figure idealization. Such idealization may take the form of a drive toward the thin, the muscular, or lean body figure ideal, which all hold the potential to impel an experience of body appearance pressure (BAP) and body dissatisfaction. The aim of this study was to explore figure idealization, body dissatisfaction, and experience of BAP in fitness instructors. Materials and Methods: Fitness instructors, 70 (23%) males and 236 (77%) females, were recruited through their facility chief executive officer and social media for a digital survey on mental health. Results are presented for body appreciation (BAS-2), body dissatisfaction (EDI-BD), drive for muscularity (DM), drive for leanness (DLS), questions on BAP, symptoms of eating disorders (EDE-q), and history of weight regulation and eating disorders (EDs). Results: Attempts to gain body weight were reported by 17% of females and 53% of males, whereas ∼76% of males and females, respectively, reported to have attempted weight reduction. Reasons for body weight manipulation were predominantly appearance related, and 10–20% reported disordered eating behavior. Mean BAS-2 and EDI-BD were acceptable, but 28% of females were above clinical cutoff in EDI-BD, and mean DLS were high in both sexes. In total, 8% of females were above clinical cutoff in EDE-q, which corresponded well with the self-reported ED. Approximately 90% of the sample perceived BAP to be a societal issue and reported predominantly customers and colleagues to be the cause of their personal experience of BAP. Fewer than 50% knew of any actions taken by their employer to reduce BAP. There were few differences according to profession or educational level. Conclusion: Fitness instructors report BAP to affect them negatively, which may put them at risk of impaired mental health. Educational level did not protect against figure idealization and BAP. To care for their employees and to optimize their position as a public health promoter, the fitness industry should target BAP in health promotion programs.publishedVersio

Body appreciation and body appearance pressure in Norwegian university students comparing exercise science students and other students

Background: Body image is considered a core issue for public health and associates with university students’ overall health. Due to positive associations between exercise and body image, it has been suggested that students within an exercise science program might be more body appreciative compared to other students. On the other hand, the strong societal idealization of the athletic body may expose them to a pressure of having a specific body appearance, which may result in unfavorable health consequences. Nevertheless, studies investigating these hypotheses are lacking. We therefore aimed to explore the level and associations of body appreciation, body appearance pressure, body image related mental health constructs, physical activity, and exercise, in Norwegian university exercise science and non-health reference students. Method: Male and female exercise science students (n = 517) and reference students (n = 476), from nine large universities in Norway took part in this cross-sectional study. Participants responded to the Body appreciation scale2, a self-developed questionnaire on body appearance pressure, Physical Appearance Comparison Scale-Revised, Sociocultural attitudes towards appearance questionnaire-4R, Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, and questions about physical activity and exercise. Between group differences were analyzed using student independent t-test and ANCOVA for parametric data and Chi-square test for categorical data, and associations were evaluated by Person’s correlation. P-values ≤0.05 were defined as significant. Results: Female exercise science students had higher scores on body appreciation compared to reference students. No group difference was found in males. A high percentage of students reported experiencing body appearance pressure, with 69 and 85% among male and female exercise science students, and 57 and 83% among male and female reference students. Fitness centers were the settings where most respondents experienced body appearance pressure. Body appreciation was strongly associated with favorable scores on body image related mental health constructs, while personally experienced body appearance pressure associated with destructive scores on the same constructs. Conclusion: Body appearance pressure is an issue among university students regardless of study program. Actions to promote body appreciation and prevent body appearance pressure may include an implementation of media literacy, body functionality, and exercise as topics within the education program to safeguard students’ health and well-being.publishedVersio

Does the Healthy Body Image program improve lifestyle habits among high-schoolstudents? A radndomised controlled trial With 12-month follow-up

Objectives - Positive embodiment and healthy lifestyle habits seem to be related; therefore, stimulating positive embodiment should promote healthy lifestyle habits. In the current study, we delivered the Healthy Body Image (HBI) intervention among Norwegian high school students and examined the effects on healthy lifestyle habits. Methods - The HBI intervention comprises three interactive workshops, with three overarching themes related to body image, social media literacy, and lifestyle. A total of 2446 boys (43%) and girls in grade 12 (mean age 16.8 years) from 30 high schools participated in this cluster-randomized controlled study. Schools were randomized to the HBI intervention or control study arm. Data on physical activity, eating habits, and sleep were collected at baseline, post intervention, and 3- and 12-month follow-up and analyzed using linear mixed regression models. Results - The intervention had a minor negative effect on physical activity levels in boys at 12-month follow-up and short-term small-to-moderate positive effects on consumption of breakfast and fruit and vegetables, and sleep duration on school days. Conclusions - In future, the lack of satisfactorily long-term effects might be better addressed using a combination of cognitive and behavioral approaches to more optimally integrate positive embodiment and lifestyle changes in the daily life of adolescents

Does the Healthy Body Image program improve lifestyle habits among high-schoolstudents? A radndomised controlled trial With 12-month follow-up

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Protein, creatine and dieting supplements among adolescents: Use and associations with eating disorder risk factors, exercise- and sports participation, and immigrant status

Objective: This study aimed to estimate the number of weekly users of protein, creatine, and dieting supplements and to explore whether weekly use was related to eating disorder (ED) risk factors, exercise, sports participation, and immigrant status. Methods: In total, 629 and 1,060 high school boys and girls, respectively, self-reported weekly frequency of protein, creatine, and dieting supplement use, and weight and shape concerns, appearance internalization and pressure, self-esteem, mental distress, physical activity level, exercise context, and the type and weekly frequency of sport played. Multiple hierarchical regression analyses were performed to investigate explanatory factors for supplement use. Results: More boys than girls used protein and creatine supplements. Immigrant boys had more frequent use of all supplements than non-immigrant boys, and immigrant girls used creatine supplements more frequently than non-immigrant girls. In total, 23–40 and 5–6% of the variation in the weekly frequency of supplement use in boys and girls, respectively, was explained by immigrant status, ED risk factors, and exercise and sports participation. More frequent use of protein, creatine and dieting supplements in boys was significantly explained by more weight and shape concerns, fitness center exercise, and weight-sensitive sports participation. Depending on the type of supplement, more frequent use of supplements in girls was significantly explained by lower self-esteem, more engagement in weight-sensitive sports, and less engagement in general sport and exercise activities. Conclusion: Weekly supplement use was common and more frequent among boys than girls. The weekly use of protein, creatine, and dieting supplements was related to ED risk factors, exercise and sports participation, and immigrant status in boys but not in girls

The Healthy Body Image intervention and reduction in eating disorder symptomatology and muscle building supplement use in high school students: a study of mediating factors

Background: Mediation analysis is important to test the theoretical framework underpinning an intervention. We therefore aimed to investigate if the healthy body image (HBI) intervention’s effect on eating disorder (ED) symptomatology and use of muscle building supplements was mediated by the change in risk and protective factors for ED development and muscle building supplement use. Methods: This study used data from the HBI intervention: a cluster randomized controlled universal intervention aiming to promote positive body image and embodiment and reduce the risk for ED development including 30 schools in Norway. A total of 1,713 (37% boys) participants were included in the analyses. Conditional latent growth curve analyses were performed to test for indirect effects on ED symptomatology and weekly frequency of protein and creatine supplement use measured at the 12-month follow-up via change in the proposed mediators. Results: In girls, the reduction in ED symptomatology was mediated by positive changes in protective factors (self-esteem and body image flexibility) and reductions in risk factor scores (perceived media pressure and thin appearance internalization). Comparable changes in protective and risk factors among boys played no mediating role. Conclusion: Interventions aiming to reduce the risk of ED development in girls may benefit from aiming to enhance self-esteem and body image flexibility and reduce perceived media pressure and thin appearance internalization. Future studies should investigate the casual relationship between muscle building supplement use and risk and protective factors for ED development in both girls and boys.publishedVersio

Hiking, indoor biking, and body liking: a cross-sectional study examining the link between physical activity arenas and adults’ body appreciation

Background Body appreciation might serve as a protective factor for developing eating disorders and is associated with participation in physical activity. Less is known about whether various arenas for physical activity may be linked to body appreciation. Therefore, the current study sought to (1) identify potential associations between physical activity level and arenas for physical activity, connectedness with nature, self-compassion, and body appreciation in adults, and (2) explore physical activity level and arenas, connectedness with nature, and self-compassion as explanatory factors for body appreciation. Methods A total of 360 adult Norwegian inhabitants (75% women, mean (SD) age 42.58 (12.30) yrs) responded to an online questionnaire. Instruments included the Body Appreciation Scale, the Connectedness with Nature Scale, and the Self-Compassion Scale. Results The percentage of participants who engaged in various physical activity arenas were 98.5% for nature, 57.5% for fitness centers, and 43.0% for organized sports. Small, positive associations were found between body appreciation and the frequency of using fitness centers and nature as physical activity arenas. Self-compassion, connectedness with nature, and frequency of using fitness centers and nature as physical activity arenas explained 39% of the variance in body appreciation. Discussion The importance of both fitness centers and nature as arenas for physical activity to explain body appreciation was surprising and might reflect different use of fitness centers among adults compared to younger age groups. Conclusion Physical activity at fitness centers and in nature were positively associated with body appreciation in adults. Self-compassion, connectedness with nature, and using fitness centers and nature as arenas for physical activity, were found to explain variation in body appreciation in adults.publishedVersio

Associations of changes in physical activity and sedentary time with weight recurrence after bariatric surgery: a 5-year prospective study

Background Increasing physical activity and limiting sedentary time may minimize weight recurrence after bariatric surgery. However, few studies have evaluated potential associations of objectively-measured physical activity and sedentary time with post-surgical weight recurrence over time. Aims To evaluate associations of change in physical activity and sedentary time with weight recurrence after bariatric surgery. Methods Participants from the Oslo Bariatric Surgery Study, a prospective cohort study, wore an ActiGraph monitor for seven days at 1- and 5 years after surgery to assess daily physical activity and sedentary time. Participants’ weight was measured at in-person clinic visits. Chi-square Test and Paired-samples T-test evaluated group differences and change over time, while Pearson’s Correlation, multiple logistic and linear regression investigated associations between variables. Results Five years after surgery 79 participants (70.5% response rate, 81% female) (mean (sd) age: 54.0 (±9.3), BMI: 32.1 (±4.7)) had valid monitor data. Participants increased their sedentary time (71.4 minutes/day (95% CI: 54.2–88.6, p = <0.001)) and reduced daily steps (−1411.1 (95% CI: 737.8–208.4), p = <0.001), light physical activity (−54.1 min/day (95% CI: 40.9–67.2, p = <0.001)), and total physical activity (−48.2 (95% CI: 34.6–63.3), p = <0.001) from 1- to 5 years after surgery. No change was found for moderate-to-vigorous intensity physical activity. No associations were found between changes in steps, physical activity or sedentary time and weight recurrence. Conclusion Participants increased sedentary time and decreased light- and total physical activity between 1- and 5 years post-surgery. Overall, changes in physical activity and sedentary time were not associated with weight recurrence. Interventions to help patients increase physical activity and limit sedentary time after bariatric surgery are needed.publishedVersio

Physical activity level and sedentary time in Norwegian adolescents

Background: Physical activity (PA) is necessary for children and adolescents to obtain a healthy development. The environment, however, facilitates the sedentary lifestyle. World health organization (WHO) defines physical inactivity as the fourth major risk factor for mortality. Still, adolescents in Europe and America are sedentary more than 50 % of their waking hours. Lack of comparability between studies investigating PA level and sedentary time in adolescents creates need for further documentation. Objective: The objective was to investigate PA level and sedentary time in Norwegian 15-year olds. In addition, I wanted to study whether sedentary time and moderate-to-vigorous PA (MVPA) were associated with waist circumference (WC) and body mass index (BMI). Method: Data was drawn from the cross-sectional part of the PANCS2 (2011). A total of 1046 15-year-old boys and girls were included to represent the Norwegian adolescent population. PA and sedentary time were assessed objectively by ActiGraph accelerometers. Measurements of BMI (in kg/m2) and WC were taken by trained investigators. The International Obesity Task Force cut-offs were used to define overweight and obese subjects. Analyzes conducted were independent and dependent t-test, Chisquare test, Pearson’s correlation, univariat, and multivariate regression. Results: The adolescents had a mean (SD) PA level of 456 (160) counts per minute. The mean PA level was higher during the week compared to the weekend. The recommendations of 60 minutes of MVPA were reached by 50.7 %. Boys were significantly more active than girls. The participants spent 71 % of the measured time being sedentary, and girls were more sedentary than boys. Sedentary time was not associated with either WC or BMI, while MVPA was associated with both variables. Conclusion: The adolescent’s PA level is not favorable, and the 2 amount of time spent sedentary is concerning. There is a difference in PA level between week and weekend, and between the sexes. Sedentary time was not associated with WC or BMI, while MVPA was associated with both variables