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BackgroundEfforts to improve snacking and drinking habits are needed to promote a healthy body mass index (BMI) in adolescents. Although commercial fitness and nutrition mobile phone apps are widely used, little is known regarding their potential to improve health behaviors, especially in adolescents. In addition, evidence on the mechanisms through which such fitness and nutrition apps influence behavior is lacking. ObjectivesThis study assessed whether the use of commercial fitness or nutrition apps was associated with a lower BMI and healthier snacking and drinking habits in adolescents. Additionally, it explored if perceived behavioral control to eat healthy; attitudes to eat healthy for the good taste of healthy foods, for overall health or for appearance; social norm on healthy eating and social support to eat healthy mediated the associations between the frequency of use of fitness or nutrition apps and BMI, the healthy snack, and beverage ratio. MethodsCross-sectional self-reported data on snack and beverage consumption, healthy eating determinants, and fitness and nutrition app use of adolescents (N=889; mean age 14.7 years, SD 0.8; 54.8% [481/878] boys; 18.1% [145/803] overweight) were collected in a representative sample of 20 schools in Flanders, Belgium. Height and weight were measured by the researchers. The healthy snack ratio and the healthy beverage ratio were calculated as follows: gram healthy snacks or beverages/(gram healthy snacks or beverages+gram unhealthy snacks or beverages)×100. Multilevel regression and structural equation modeling were used to analyze the proposed associations and to explore multiple mediation. ResultsA total of 27.6% (245/889) of the adolescents used fitness, nutrition apps or both. Frequency of using nutrition apps was positively associated with a higher healthy beverage ratio (b=2.96 [1.11], P=.008) and a higher body mass index z-scores (zBMI; b=0.13 [0.05], P=.008. A significant interaction was found between the frequency of using nutrition and for the zBMI (b=−0.03 [0.02], P=.04) and the healthy snack ratio (b=−0.84 [0.37], P=.03). Attitude to eat healthy for appearance mediated both the fitness app use frequency-zBMI (a × b=0.02 [0.01], P=.02) and the nutrition app use frequency-zBMI (a × b=0.04 [0.01], P=.001) associations. No mediation was observed for the associations between the frequency of use of fitness or nutrition apps and the healthy snack or beverage ratio. ConclusionsCommercial fitness and nutrition apps show some association with healthier eating behaviors and BMI in adolescents. However, effective behavior change techniques should be included to affect key determinants of healthy eating.

The present study investigated whether associations exist between attachment dimensions toward mother and different forms of eating pathology (EP) in a group of early adolescent boys and girls, and whether these associations were mediated by maladaptive emotion regulation (ER) strategies. Developmentally appropriate self-report questionnaires were administered to a community sample of 952 early adolescents (X[bar][subscript age] = 12.19, 54.6% female). The results demonstrated associations between the insecure attachment dimensions and the different forms of EP. Moreover, the relationships between both attachment anxiety and attachment avoidance toward mother on the one hand and restraint and EP concerns on the other hand, were partially mediated by maladaptive ER. These results assign an important role to maladaptive ER, in explaining the relationship between insecure attachment and EP. Future longitudinal research should replicate and elaborate on these findings.

Eating problems are highly prevalent and seem to show continuity in children. Nevertheless, the effect of different maternal and paternal feeding practices on changes in these problems is not fully understood yet. This study examines short-term continuity in primary school children's overeating, loss of control (over eating), restraint and concerns (about eating, body shape and weight) and the predictive value of parental feeding strategies on change in these eating problems. Children (8-12 years, n = 613, 46.5% girls) completed the Child Eating Disorder Examination Questionnaire (ChEDE-Q) twice with the second measurement (T2) taking place 6 months after the first (T1). Parents (n = 714, 57.7% mothers) completed the Child Feeding Questionnaire (CFQ) at T1 to assess the level of controlling feeding strategies. More overeating, restraint and concerns at T1 predicted higher levels of the same eating problems 6 months later, whereas more of loss of control at T1 predicted lower levels of loss of control 6 months later. Additionally, the interaction between maternal pressure and the gender of the child was predictive for increases in overeating, whereas the interaction between paternal monitoring and gender of the child was a marginally significant predictor for decreases in overeating. These findings point to the possible negative and positive effects of parental feeding practices as well as to the possible larger influence of mothers on their daughters' and of fathers on their sons' eating behaviors. The importance of studying mothers and fathers, as well as daughters and sons, and of including different feeding strategies and eating problems is discussed.

The present study examined the role of attachment toward mother and father as a predictor of eating pathology and weight gain among preadolescent boys and girls. Self-report questionnaires and adjusted body mass index (BMI) were administered from a community sample of 601 preadolescents (8-11 years; 48% female) at baseline and once again 1 year later. Significant baseline associations were found between attachment toward both parents and several features of eating pathology. No baseline correlations were found between the attachment variables and adjusted BMI. However, after controlling for gender and baseline levels of eating pathology and weight, an insecure attachment toward mother significantly predicted increases in dietary restraint, eating concerns, weight concerns, and shape concerns, and adjusted BMI in the children 1 year later. An insecure attachment toward father was predictive for persistence in children's subjective binge eating episodes. The present study provides preliminary evidence for the longitudinal association between attachment and eating pathology and weight gain in preadolescents. Moreover, attachment toward mother and attachment toward father appear to be differently associated with their children's disordered eating attitudes and adjusted BMI. Future research should further elucidate the mechanisms underlying this differential association. (Contains 6 tables and 1 footnote.)

This study aimed to (a) assess relationships between the Children's Depression Inventory (CDI) and "DSM"-oriented depression and anxiety scales of the Youth Self Report, (b) develop reliable norms for the CDI, and (c) determine CDI cutoff scores for selecting youngsters at risk for depression and anxiety. A total of 3,073 nonclinical and 511 clinically referred children and adolescents from The Netherlands and Belgium were included. Results showed that CDI scores were significantly related to "DSM"-oriented symptoms of both depression and anxiety. CDI scores correlated highly with depression symptoms and moderately with anxiety symptoms. Norms for the CDI were determined by means of multiple regression analysis and depended on sex, age, and country. CDI cutoff scores for selecting individuals at risk for depression and anxiety as measured by the "DSM"-oriented depression and anxiety scales of the Youth Self Report were determined by means of multiple regression analysis and receiver operating characteristic analysis. A CDI score of 16 was found to have the most optimal balance between sensitivity and specificity for depression, whereas a score of 21 provided the best sensitivity and specificity for anxiety in a subsample of children. We conclude that the CDI is an effective instrument for screening depression and to a lesser extent anxiety in primary and secondary care centers, before applying further assessment of high-risk individuals. (Contains 6 tables and 2 figures.)

The objective of this article was to investigate the prevalence and psychological correlates of binge eating among adolescents. Self-report questionnaires were administered to a community sample of 708 adolescents (M[subscript age] = 14 years). Adolescents reporting loss of control over eating (17% of the sample) reported more eating pathology and more general maladjustment compared to those without loss of control. The combined presence of subjective and objective binge episodes was related to the most severe pattern of eating pathology. The results suggest that loss of control over eating is a relatively frequent experience among adolescents from the general population and it is related to eating pathology and maladjustment. (Contains 2 footnotes and 4 tables.)

The phenomenology of childhood and adolescent loss of control (LOC) eating is unknown. The authors interviewed 445 youths to assess aspects of aberrant eating. LOC was associated with eating forbidden food before the episode; eating when not hungry; eating alone; and experiencing secrecy, negative emotions, and a sense of "numbing" while eating (ps[less than]0.01). Hierarchical cluster analysis revealed a subgroup, most of whom reported LOC eating. Cluster members reported having a trigger initiate episodes, eating while watching television, and having decreased awareness regarding the amount consumed. The authors conclude that aspects of LOC eating during youth are similar to aspects of adult episodes, but a youth-specific presentation may exist. Findings may provide an intervening point to prevent excessive weight gain and eating disorders.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.brat.2006.01.006 Byline: Lien Goossens (a), Caroline Braet (a), Veerle Decaluwe (b) Abstract: Objective: To investigate loss of control over eating in a sample of obese youngsters seeking treatment. Method: Obese youngsters (aged 10-16) were categorized into those having experienced loss of control (LC) and those who had not (NoLC) using the child version of the Eating Disorder Examination. Furthermore, the LC group was subdivided into an objective binge eating (OBE) and a subjective binge eating (SBE) group. The groups were compared on psychological measures. Results: LC subjects (17.9%) showed more concern about eating, weight and shape. They also reported more emotional and external eating behaviors and more depression. Youngsters who report SBE show resemblances to both NoLC and OBE subjects. Discussion: LC subjects are characterized by more eating-related psychopathology and higher levels of depression. Especially obese youngsters with OBE turned out to be a pathological group. Author Affiliation: (a) Ghent University, Belgium (b) Ghent University Hospital, Belgium Article History: Received 8 June 2005; Revised 23 December 2005; Accepted 19 January 2006 Article Note: (footnote) [star] Grant sponsor: Special Research Funds, Ghent University.