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

Sexual harassment and eating disorders in female elite athletes - A controlled study

The aims were to examine the percentage of female elite athletes and controls reporting sexual harassment and abuse (SHAB), and whether a higher percentage of female athletes with eating disorders (ED) had experienced SHAB. A questionnaire was administered to the total population of female elite athletes (n=660) and controls (n=780) aged 15-39 years. SHAB were measured through 11 questions, ranging from light to severe SHAB. In addition, questions about dietary-, menstrual- and training history and the Eating Disorder Inventory were included. The response rate was 88% for athletes and 71% for controls. Athletes (n=121) and controls (n=81) classified as “at risk” for ED and non-ED controls participated in a clinical interview. A higher percentage of controls, compared with athletes reported experiences of SHAB in general (59% vs. 51%, p<0.001). A lower percentage of athletes had experienced SHAB in sports than outside sport (28% vs.39%, p<0.001). A higher percentage of ED athletes than non-ED athletes had experienced SHAB (66% vs.48%) (p<0.01), both inside sport and outside sport. In spite of the fact that a higher percentage of controls compared with athletes had experienced SHAB, it is necessary to formulate clear guidelines, set up educational workshops and implement intervention programs for both ED and SHAB in sport

Mental Health Symptoms Related to Body Shape Idealization in Female Fitness Physique Athletes

Physical activity relates to optimal health, still the prevalence of mental health issues is high among athletes. Being young, female, and competing in aesthetic sports is a high-risk combination for mental health symptoms. Fitness physique athletes (FA) match this profile but are understudied. We aimed to study the intensity of mental health symptoms (i.e., body image, eating behaviour, relation to and routines for exercise, and perfectionism) in FA and in female references (FR), and to evaluate how preparing for fitness sport competitions affects these mental health symptoms. Before competition, FA had higher levels of drive for leanness (DFL) and eating restraint compared to FR. At the time of competition, eating restraint increased in FA only, concurrent with a reduction in symptoms of disordered eating. The levels of DFL, drive for muscularity, eating restraint, and exercising for figure toning were higher in FA compared to FR. At one-month post-competition, the differences between groups from competition time remained. Generally, perfectionism correlated with eating restrictions in FA and with disordered eating in FR. Overall, FA coped with the dieting, but self-control deteriorated post-competition with higher levels of disordered eating and an increased body shape concern. High DFL generally associated with more disordered eating behaviour, specifically in FR.Mental Health Symptoms Related to Body Shape Idealization in Female Fitness Physique AthletespublishedVersio

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

The neurostructural and neurocognitive effects of physical activity: A potential benefit to promote eating disorder recovery.

Accumulating evidence suggests that supervised and adapted physical activity pro-vides cognitive benefits for individuals with eating disorders (EDs). The mechanismsunderlying the benefits of physical activity are poorly understood. Addressing thisknowledge gap may inform the appropriate integration of structured physical activityinto eating disorders treatment and recovery. We draw attention to recent findingsin the study of the impact of physical activity on the brain, and we describe the neu-rostructural and neurocognitive changes associated with physical activity observed invarious clinical and nonclinical populations. Considering the identified impairment inbrain volume- and/or neurocognitive function in various EDs, we propose that posi-tive effects of physical activity may play a meaningful role in successful ED treat-ment. Accordingly, we outline research steps for closing the knowledge gap on howphysical activity may aid in ED recovery, and emphasize the need to combine mea-sures of cognitive and behavioral responses to physical activity, with technologycapable of measuring changes in brain structure and/or function.publishedVersio

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