This study used balance theory to illuminate the relations of eating-related attitudinal consistency between self and friends to psychological well-being and eating behaviors. It was hypothesized that attitudinal inconsistency, relative to consistency, would predict lower well-being and poorer eating habits. A population-based sample of 2287 young adults participating in Project EAT-III (Eating Among Teens and Young Adults) completed measures of psychological well-being, eating behaviors, and eating-related attitudes from the standpoint of self and friends. Of participants who cared about healthy eating, those who perceived that their friends did not care about healthy eating had lower well-being and less-healthy eating behaviors (fewer fruits and vegetables and more sugary beverages per day) than those who perceived that their friends cared about healthy eating. Conversely, among participants who did not care about healthy eating, those who perceived that their friends cared about healthy eating had lower well-being and less-healthy eating behaviors (more snacks per day) than those who perceived that their friends did not care about healthy eating. In accord with balance theory, young adults who perceived inconsistent eating attitudes between themselves and their friends had lower psychological well-being and generally less-healthy eating behaviors than people who perceived consistent eating attitudes.

OBJECTIVE: Media images of men and women have become increasingly muscular, and muscle-enhancing techniques are available to youth. Identifying populations at risk for unhealthy muscle-enhancingbehaviors is of considerable public health importance. The current study uses a large and diverse population-based sample of adolescents to examine the prevalence of muscle-enhancing behaviors and differences across demographic characteristics, weight status, and sports team involvement. METHODS: Survey data from 2793 diverse adolescents (mean age = 14.4) were collected at 20 urban middle and high schools. Use of 5 muscle-enhancing behaviors was assessed (changing eating, exercising, protein powders, steroids and other muscle-enhancing substances), and a summary score reflecting use of 3 or more behaviors was created. Logistic regression was used to test for differences in each behavior across age group, race/ethnicity, socioeconomic status, BMI category, and sports team participation. RESULTS: Muscle-enhancing behaviors were common in this sample for both boys and girls. For example, 34.7% used protein powders or shakes and 5.9% reported steroid use. Most behaviors were significantly more common among boys. In models mutually adjusted for all covariates, grade level, Asian race, BMI category, and sports team participation were significantly associated with the use of muscle-enhancing behaviors. For example, overweight (odds ratio = 1.45) and obese (odds ratio = 1.90) girls had significantly greater odds of using protein powders or shakes than girls of average BMI. CONCLUSIONS: The use of muscle-enhancing behaviors is substantially higher than has been previously reported and is cause for concern. Pediatricians and other health care providers should ask their adolescent patients about muscle-enhancing behaviors.