Purpose:This study aimed to identify the associations between social isolation, social contextual factors, and behavioral and psychological health during emerging adulthood.Methods:Participants (n ...

Purpose: Body dissatisfaction and disordered eating are linked to adverse health consequences. Research describing socioeconomic patterns in the prevalence of these problems is important for informing the design of health services and efforts to improve health equity. Methods: Population-based cohort study (EAT 2010–2018: Eating and Activity over Time) of socioeconomically and ethnically/racially diverse U.S. young people who completed surveys as adolescents in 2009–2010 (mean age = 14.5 years) and as emerging adults in 2018 (mean age = 22.0 years). Participants were recruited from 20 schools in Minneapolis-St. Paul, Minnesota. Household socioeconomic status was determined using adolescent report of parental education, employment, and public assistance benefits. Analyses were conducted using data from 1531 participants and regression models that accounted for repeated measures within individuals. Results: Among females, high body dissatisfaction and unhealthy weight control behaviors (e.g., skipping meals) were more prevalent and regular use of lifestyle weight management behaviors (e.g., exercise) was less prevalent in the low SES group as compared to the middle and/or upper SES groups (p ≤ .010). Among males, thinness-oriented dieting, unhealthy weight control behaviors, and extreme weight control behaviors (e.g., taking diet pills) were all more prevalent in the low SES group as compared to the middle and/or upper SES groups (p ≤ .010). Few differences were observed across SES groups in models that adjusted for ethnic/racial identity and body mass index. Conclusions: There is a need for greater attention to the reach and relevance of efforts to prevent disordered eating and improve body satisfaction to ensure efforts benefit young people across SES groups.

Background: A steep rise in food insecurity is among the most pressing US public health problems that has resulted from the COVID-19 pandemic. Objective: This study aimed to (1) describe how food-insecure emerging adults are adapting their eating and child-feeding behaviors during COVID-19 and (2) identify barriers and opportunities to improve local food access and access to food assistance. Design: The COVID-19 Eating and Activity Over Time study collected survey data from emerging adults during April to October 2020 and completed interviews with a diverse subset of food-insecure respondents. Participants/setting: A total of 720 emerging adults (mean age: 24.7 ± 2.0 years; 62% female; 90% living in Minnesota) completed an online survey, and a predominately female subsample (n = 33) completed an interview by telephone or videoconference. Main outcome measures: Survey measures included the short-form of the US Household Food Security Survey Module and 2 items to assess food insufficiency. Interviews assessed eating and feeding behaviors along with barriers to healthy food access. Analyses performed: Descriptive statistics and a hybrid deductive and inductive content analysis. Results: Nearly one-third of survey respondents had experienced food insecurity in the past year. Interviews with food-insecure participants identified 6 themes with regard to changes in eating and feeding behavior (eg, more processed food, sporadic eating), 5 themes regarding local food access barriers (eg, limited enforcement of COVID-19 safety practices, experiencing discrimination), and 4 themes regarding barriers to accessing food assistance (eg, lack of eligibility, difficulty in locating pantries). Identified recommendations include (1) expanding the distribution of information about food pantries and meal distribution sites, and (2) increasing fresh fruit and vegetable offerings at these sites. Conclusions: Interventions of specific relevance to COVID-19 (eg, stronger implementation of safety practices) and expanded food assistance services are needed to improve the accessibility of healthy food for emerging adults.

This study examined kitchen adequacy in a racially/ethnically diverse low-income sample and associations with child diet quality. Families with children age five to seven years old (n = 150) from n...

This study characterized common patterns of weight talk and examined associations with unhealthy weight control behaviors (UWCBs) in young adults. Participants (n = 1298) were from EAT 2018 (Eating and Activity Over Time), a population-based study of emerging adults (mean age = 22.2; 53.6 % women). Latent class analyses (LCA) derived classes based on weight talk exposure for men and women. Generalized linear models examined the association between weight talk classes and extreme/less extreme UWCBs. LCA results revealed 4 patterns of weight talk exposure among young adult women: minimal weight talk (38.8 %), peer weight talk (35.2 %), multi-source weight talk (13.5 %), and parental weight talk (12.6 %). Three classes emerged among men: minimal weight talk (44.0 %), peer weight talk (29.7 %), and multi-source weight talk (26.3 %). Among young adult women, the parental weight talk class reported the highest levels of extreme and less extreme UWCBs. Among young adult men, the multi-source weight talk class reported the highest levels of less extreme UWCBs. Results provide evidence regarding the importance of parental weight talk, even among young adult children, whether or not parental weight talk is accompanied by peer weight talk. Parents have the potential to improve their young adults’ weight-related behaviors through avoiding weight talk.

Many health care providers struggle with if- and how-to discuss weight with their pediatric patients. This study used one-on-one interviews with primary care providers (n=20) to better understand their: (1) perception of risks associated with talking about weight with pediatric patients, (2) commitment to adhering to best practices of pediatric weight management, and (3) approaches to mitigate perceived risks. Providers felt concerned that discussing weight with children during clinic visits may have unintended negative impacts. Despite perceived risks, providers continued regular BMI screening and weight-focused conversations, but took care with regard to language and approach with the goal of mitigating perceived risks. Findings suggest that pediatric primary care providers perceive that engaging in weight-related discussions with their patients has the potential to lead to negative, unintended consequences. Future research is needed to understand if weight-focused conversations should be avoided altogether or if there are approaches that can effectively mitigate risks.

Objective: Assess how intuitive eating relates to dietary intake. Methods: Survey data were collected in Project Eating and Activity in Teens and Young Adults, the fourth wave of a longitudinal cohort study (weighted n = 1,830, 49% women; mean age = 31 years). Intuitive eating was assessed using a 7-item scale adapted from the Intuitive Eating Scale and Intuitive Eating Scale-2. Dietary intake was measured via a semiquantitative food frequency questionnaire. Mean servings were stratified by gender and intuitive eating quartiles and adjusted for sociodemographic characteristics and caloric intake. Results: Women and men in the top intuitive eating quartile consumed 0.6–0.3 servings more fruit and 0.4–0.6 servings more vegetables daily, respectively, compared with the bottom quartile, whereas men in the top quartile also consumed 0.6 servings fewer whole grains (all P < 0.05) than the bottom quartile. Conclusions and Implications: Intuitive eating shows promise as a healthier alternative to practices such as dieting.

Background: This study examined who is engaging in family/shared meals and associations between family/shared meal frequency and home food availability, dietary consumption, and emotional well-being among young adults during the COVID-19 pandemic. Methods: A rapid-response online survey was sent to participants in a ten-year longitudinal study (Eating and Activity over Time: EAT 2010–2018). A total of 585 young adults (mean age = 24.7 ± 2.0 years, 63.3% female) living with at least one family member completed the COVID-EAT (C-EAT) survey during the U.S. outbreak of COVID-19. Items assessed changes in family/shared meal frequency, eating behaviors, and emotional well-being. Regression models adjusting for sociodemographic characteristics examined associations between family/shared meal frequency and home food availability, dietary consumption, and emotional well-being. Results: Participants reported an average of 4.6 ± 3.4 family/shared meals per week during COVID-19, a 0.5 meal/week increase from prior to the pandemic (p =.002). Family/shared meal frequency during COVID-19 differed by race/ethnicity, with Asian American participants being most likely to report only 1–2 family/shared meals per week. Family/shared meals during COVID-19 were associated with higher vegetable intake, greater availability of fruits, vegetables, and whole wheat bread in the home, lower levels of depressive symptoms and perceived stress, and greater perceived ability to manage stress in young adults. Conclusions: Results suggest that engaging in a regular routine, such as family/shared meals, during COVID-19 may have protective associations with dietary health and emotional well-being for young adults. Results may inform practices/routines to offer protective benefits during public health crises such as the current pandemic.

Objective: Sociocultural theories hold that family and peer weight-related teasing increases the risk for unhealthy weight control behaviors (UWCBs) by negatively impacting body image. Although much cross-sectional support exists for these pathways, longitudinal data are lacking. This study tested the longitudinal relationships among peer and family teasing (occurrence and perceived impact) in early adolescence, body satisfaction in late adolescence, and UWCBs in young adulthood among a racially/ethnically and socioeconomically diverse population. Method: Data were drawn from three waves of Project EAT over a 15-year period (Eating and Activity in Teens and Young Adults), and included responses from 1,902 young adults (57% female). Results: Among female participants, a mediated indirect pathway emerged with family weight-related teasing predicting increased engagement in UWCBs in early adulthood via poorer body image in late adolescence. In contrast, peer teasing did not predict body image or UWCBs. Among boys, the mediated indirect pathways were not significant. However, poor body image in late adolescent males predicted higher likelihood of engaging in UCWBs in early adulthood. Discussion: These findings support the long-term impact of family weight-related teasing on greater risk for UWCBs among girls and young women, and poor body image as a mechanism accounting for this relationship. Moreover, the results highlight the poor body image among adolescent boys as a factor for increased risk of engaging in UWCBs in early adulthood. Pending replication in current cohorts, health promotion and prevention involving family members of early adolescents that address family weight teasing and body image are needed.

Background: Self-weighing is widespread among young adults and is sometimes recommended by healthcare providers for weight management. The present study aims to deepen our understanding of who is frequently self-weighing among young adults, and to examine for whom self-weighing impacts mood based on weighing frequency and other eating and weight-related characteristics. Methods: Survey data were collected from a large population-based sample of young adults (31.1 ± 1.6y) participating in Project EAT-IV (n = 1719). Cross-sectional data were stratified across sex and analyzed with chi-square, t-tests, and linear and logistic regressions controlling for age, ethnicity/race, education level, and income. Results: Self-weighing frequency was higher among male and female young adults with a current eating disorder, those trying to lose weight or who endorsed any disordered eating behaviors or cognition, and females with higher BMI. Young adult females were significantly more likely than males to report that self-weighing impacted their mood (53% vs 27%, p < 0.05). Among both male and female young adults, there was a higher probability of participants reporting that self-weighing impacted their mood among those who were self-weighing more frequently, had higher BMI, were trying to lose weight, and endorsed disordered eating behaviors or cognitions. Conclusion: Findings suggest that for many young adults, particularly females and those with weight-related concerns, self-weighing is a behavior that comes with emotional valence. The emotional consequences of self-weighing should be considered when making public health and clinical recommendations regarding the usefulness of self-weighing.

OBJECTIVE The present study aimed to describe the experience of, and factors associated with, disordered eating in a population-based sample of emerging adults during the COVID-19 outbreak. METHOD Participants in the EAT 2010-2018 (Eating and Activity over Time) study were invited to complete the C-EAT (COVID-19 EAT) survey in April-May 2020. There were 720 respondents to the survey (age: 24.7 ± 2.0 years). Psychological distress, stress, stress management, financial difficulties, and food insecurity during the COVID-19 pandemic were examined as cross-sectional correlates of disordered eating in 2020. Open-ended questions assessed the perceived impact of the pandemic on eating behaviors. RESULTS Low stress management was significantly associated with a higher count of extreme unhealthy weight control behaviors (UWCBs). Food insecurity, higher depressive symptoms, and financial difficulties were significantly associated with a higher count of less extreme UWCBs. Higher stress and depressive symptoms were significantly associated with greater odds of binge eating. Six themes pertaining to disordered eating during the pandemic emerged: (a) mindless eating and snacking; (b) increased food consumption; (c) generalized decrease in appetite or dietary intake; (d) eating to cope; (e) pandemic-related reductions in dietary intake; and (f) re-emergence or marked increase in eating disorder symptoms. DISCUSSION Psychological distress, stress management, financial difficulties, and abrupt schedule changes may have contributed to disordered eating during the COVID-19 pandemic. Interventions that target stress management, depressive symptoms, and financial strain and provide tools to develop a routine may be particularly effective for emerging adults at risk of developing disordered eating during public health crises.

Background: Sexual and physical abuse are risk factors for binge eating and overeating, but few studies have examined association of the identity of the perpetrator with survivors' risk of binge eating and overeating. Purpose: To examine the risk of binge eating and overeating by (1) type of abuse and identity of the perpetrators and (2) cumulative abuse experiences/perpetrators. Methods: Data came from Eating and Activity over Time (N = 1407; ages 18–30 during 2017–2018). Sexual abuse perpetrators included family members, non-family members, and intimate partners. Physical abuse perpetrators included family members and intimate partners. Cumulative abuse experiences were defined as the number of types of abuse experienced. Modified Poisson regressions were used to examine the risk of binge eating (overeating with loss of control) and overeating (without loss of control), by (1) abuse type and perpetrator and (2) cumulative abuse experiences. Results: Abuse was more strongly associated with binge eating than overeating. For binge eating, risk factors included familial and intimate partner sexual abuse (RR = 1.48 [95% CI = 1.01–2.17] and 2.41, [95% CI = 1.70–3.41], respectively) and physical abuse (RR = 1.84, [95% CI = 1.33–2.53] and 1.95, [95% CI = 1.35–2.81], respectively), after adjustment for sociodemographic variables. For overeating, associations with physical abuse were close to the null, and those with sexual abuse were modest, with wide CIs that overlapped the null. Abuse experiences were cumulatively associated with binge eating, but not overeating. Conclusion: Assessment of identity of the perpetrator, and cumulative abuse experiences/perpetrators may assist in identifying people at the greatest risk of binge eating.

<p>Emerging adults’ lives have changed because of the COVID-19 pandemic. Physical activity (PA) behaviors need to be examined to inform interventions and improve health. Responses to the C-EAT (COVID-19 Eating and Activity over Time) survey (N = 720; age = 24.7 ± 2.0 yrs) were analyzed. This mixed-methods study quantitatively examined changes in self-reported PA (hours/week of mild PA, moderate-to-vigorous PA (MVPA), and total PA) from 2018 to 2020. Qualitative responses on how COVID-19 impacted PA were analyzed using a grounded theory approach. Hours of PA were lower on average for all intensity levels during COVID-19 than in 2018 (p’s &lt; 0.0001). Over half of the sample reported a decrease in MVPA (53.8%) and total PA (55.6%); 42.6% reported a decrease in mild PA. High SES were more likely to report an increase in total PA (p = 0.001) compared to those of lower SES. Most (83.6%) participants perceived that COVID-19 had influenced their PA. The most common explanations were decreased gym access, effects on outdoor PA, and increased dependence on at-home PA. Results suggest that emerging adults would benefit from behavioral interventions and health promotion efforts in response to the pandemic, with a focus on activities that can be easily performed in the home or in safe neighborhood spaces.</p>

The aim of this study is to identify the prevalence, predictors, and psychosocial well-being (depressive symptoms, stress) and weight-related behavior (eating behaviors, physical activity, and sede...

Objectives. To examine emerging adults' experiences of food insecurity in relation to measures of diet quality, food literacy, home food availability, and health behaviors.Methods. We used EAT 2010-2018 (Eating and Activity over Time) study data on 1568 participants who completed surveys as adolescents in 2009 to 2010 and follow-up surveys in 2017 to 2018 (mean age = 22.0 ±2.0 years; 58% female). At baseline, participants were recruited from 20 urban schools in Minneapolis-St Paul, Minnesota. Food insecurity was defined by emerging adult report of both eating less than they thought they should and not eating when hungry because of lack of money.Results. The prevalence at follow up of experiencing food insecurity in the past year was 23.3% among emerging adults. Food insecurity was associated with poorer diet quality (e.g., less vegetables and whole grains, more sugar-sweetened drinks and added sugars), lower home availability of healthy foods, skipping breakfast, frequently eating at fast-food restaurants, binge eating, binge drinking, and substance use (all P < .01).Conclusions. Assistance programs and policies are needed to address food insecurity among emerging adults and should be coordinated with other services to protect health. (Am J Public Health. Published online ahead of print July 16, 2020: e1-e7. doi:10.2105/AJPH.2020.305783).

BACKGROUND Weight stigma is common for people with obesity and harmful to health. Links between obesity and complications from COVID-19 have been identified, but it is unknown whether weight stigma poses adverse health implications during this pandemic. PURPOSE We examined longitudinal associations between prepandemic experiences of weight stigma and eating behaviors, psychological distress, and physical activity during the COVID-19 pandemic in a diverse sample of emerging adults. METHODS Participants (N = 584, 64% female, mean age = 24.6 ± 2.0 years, mean body mass index [BMI] = 28.2) in the COVID-19 Eating and Activity over Time (C-EAT) study were cohort members of the population-based longitudinal study EAT 2010-2018. Weight stigma reported by participants in 2018 was examined as a predictor of binge eating, eating to cope, physical activity, depressive symptoms, and stress during COVID-19. Data were collected via online surveys during the U.S. outbreak of COVID-19 in 2020. RESULTS Prepandemic experiences of weight stigma predicted higher levels of depressive symptoms (β = 0.15, p < .001), stress (β = 0.15, p = .001), eating as a coping strategy (β = 0.16, p < .001), and an increased likelihood of binge eating (odds ratio = 2.88, p < .001) among young adults during the COVID-19 pandemic but were unrelated to physical activity. Although associations remained after accounting for demographic characteristics and BMI, the magnitude of longitudinal associations was attenuated after adjusting for prior levels of the outcome variables. CONCLUSIONS Young adults who have experienced weight stigma may have increased vulnerability to distress and maladaptive eating during this pandemic. Public health messaging could be improved to support people of diverse body sizes and reduce the harmful consequences of weight stigma.