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

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

Self-reported versus diagnosed stress fractures in Norwegian female elite athletes

The aim of this study was to determine the prevalence of selfreported versus diagnosed stress fractures in female elite athletes and non-athletic controls. A random sample of Norwegian elite athletes from the national teams, aged 13-39 years (n = 186) and a random sample of non-athletic controls (n = 145) in the same age group participated in the study. The athletes represented a junior- or senior team, or a recruiting squad for one of these teams, in one of 46 different sports/events. A higher percentage of athletes self-reported stress fractures (14.0%) compared to those diagnosed with stress fractures (8.1%) (p < 0.001). Six controls self-reported stress fractures, but none of them were diagnosed with stress fractures. These results indicate that selfreporting of stress fractures has low validity. This finding has important implications for further research on stress fractures in athletes

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

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

Do we need to change the guideline values for determining low bone mineral density in athletes? [Viewpoint]

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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

Effectiveness and acceptability of the physical exercise and dietary therapy in a healthy life center

Objective: The high burden of eating disorders (EDs) and limited availability of treatment speaks of a need to explore new avenues for treatment delivery. To understand if new treatment avenues are helpful and acceptable to patients, we investigated the effectiveness of Physical Exercise and Dietary Therapy (PED-t) in participants with bulimia nervosa or binge-eating disorder, and acceptability when the PED-t was implemented in a Healthy Life Center in a municipal primary healthcare service. Method: Exercise physiologists and one dietitian were trained in ED literacy and to run PED-t, before screening women for eligibility. Effectiveness (n = 16) of PED-t and participants' experiences (n = 8) were evaluated by a mixed methods study design. Results were analyzed by relevant statistics and reflexive thematic analysis. Results: Of 19 eligible participants, 16 completed treatment. At post-treatment, the Eating Disorder Examination Questionnaire global score, binge-eating frequency, and symptoms of depression were lower, and nine (56% of completers) were in remission. Participants' treatment experiences were classified into two overarching themes: “competence” and “emotional support.” Participants reported high acceptance for PED-t, the local venue and group format, and felt that PED-t provided them with coping tools and increased mental strength. However, many also spoke of an unmet need to address emotional eating. Discussion: Findings point to a potential for making an effective ED therapy more accessible, and that participants find the local low-threshold delivery within a groupformat helpful. With small adjustments, the PED-t could emerge as a promising firstline treatment for bulimic EDs. Public Significance Statement: Limited access to treatment for EDs, patients' high barriers to help-seeking, and the high rates of limited efficacy from psychotherapy speak of a need to explore new therapies and avenues for delivery. In this study, we build on findings from a controlled ED treatment trial and replicate the beneficial effects and find a high patient acceptance of “physical exercise and diet therapy” implemented in a real, non-clinical setting.publishedVersio

Sexual Harassment and Abuse among Young Elite Athletes, Recreational Athletes, and Reference Students: A Prospective Study

Purpose: To examine the 12-months prevalence and 12-months prospective change in reported sexual harassment and abuse (SHA)-victimization among young elite athletes, recreational athletes, and reference students in three different social settings and identify the perpetrators. Methods: In total, 919 adolescents responded to an online questionnaire in 12th grade (T1) and 13th grade (T2). The sample consisted of elite athletes (n = 482) and recreational athletes (n = 233) attending Norwegian elite sport high schools (n = 26), and reference students (n = 200) attending ordinary high schools with no sport specialization (n = 6). Data were analyzed using Independent sample t-test, Pearson Chi-Square for independence/Fisher’s Exact test, McNemar test and logistic regression analysis. Results: The total 12-months prevalence of SHA was 38.6% at T1 and 35.1% at T2. Most of the participants (74.6-85.0%) reported no change in SHA from T1 to T2. The prevalence of SHA was higher for girls compared to boys, and elite athletes reported less SHA than recreational athletes and reference students, respectively. SHA occurred most often in a free time setting. Verbal SH, non-verbal SH, and physical SHA were reported by 24.6%, 27.0%, and 14.0%, respectively. Peers were reported as perpetrators by 83.1%, trainer/teacher/health personnel by 20.1%, and “other” perpetrators by 56.4%. Conclusions: As one in three elite athletes and nearly one in two recreational athletes and reference students, respectively, reported SHA-victimization within a 12-months period, well-targeted preventive measures are needed for both young athletes and non-athletes.Sexual Harassment and Abuse among Young Elite Athletes, Recreational Athletes, and Reference Students: A Prospective StudypublishedVersionPaid open acces

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