A weight stigma-informed model to improve energy intake assessment

1项目概要 2普遍认为超重和肥胖人群的能量摄入不足 3作为营养研究中的一个问题。由于大多数（74%）美国成年人超重/肥胖， 由于大多数超重/肥胖的成年人报告说，他们的体重受到了嘲笑， 5欺凌，歧视，拒绝或其他不公平的待遇，表明社会贬值，由于 6体重，当务之急是改善膳食评估方法，以解决具体因素 7.体重状况，如耻辱，可能影响报告的准确性。体重污名与 8有许多负面的心理和健康后果，包括阻碍体重管理 9努力，并有助于饮食失调行为。对于有体重耻辱史的参与者， 低报能量摄入量可能是减轻预期负面影响的一种应对机制。 体重污名的11个影响。到目前为止，体重耻辱对能量摄入量的影响被低估， 12名超重/肥胖者不详。本R21提案的总体目标是建立 13体重耻辱和能量摄入漏报之间关系的概念验证 14名超重/肥胖的成年人。超重/肥胖（BMI ≥25 kg/m2）成人（n=68; ≥18岁）将 15完成交叉调查，以确定体重耻辱（预期， 16感知和内化的体重耻辱）和能量摄入漏报，由 17比较采访者管理的24小时饮食回忆报告的能量摄入量与客观的 18测量来自10天双标记水期（DLW）的总能量消耗。参与者将 19名被随机分为2个饮食回忆序列期之一，均为10天的DLW，间隔为 20 20天洗脱期：首先使用自动自我管理24小时饮食评估工具（ASA 24）， 21，然后在第二阶段进行采访者管理的饮食回忆，反之亦然。 22参与者将完成对体重耻辱，节食史，社会期望， 23例体型不满意和随机化前暴饮暴食。这项研究可能有助于了解 通过提高对体重耻辱对健康的负面影响的认识，制定了24项肥胖症治疗方案 25和解决自我报告的超重/肥胖成年人的饮食摄入限制。这 26项研究可能通过告知美国的饮食监测方法和 通过提供一个模型来响应体重耻辱对饮食的影响， 28篇准确性这种方法可以提供改进的自我报告能量摄入方法 29，这将允许未来纠正超重/肥胖成年人的漏报。

1 PROJECT SUMMARY 2 Underreporting of energy intake among people with overweight and obesity is widely acknowledged 3 as a problem in nutrition research. As a majority (74%) of U.S. adults experience overweight/obesity, 4 and as most of adults with overweight/obesity report experiencing weight stigma in the form of teasing, 5 bullying, discrimination, rejection, or other unfair treatment that indicates social devaluation due to 6 body weight, it is imperative that dietary assessment methods are improved to address factors specific 7 to weight status, such as stigma, that may influence reporting accuracy. Weight stigma is associated 8 with many negative psychosocial and health consequences, including impeding weight management 9 efforts and contributing to disordered eating behaviors. For participants with a history of weight stigma, 10 underreporting of energy intake may be a coping mechanism for mitigating the anticipated negative 11 effects of weight stigma. To date, the impact of weight stigma on energy intake underreporting among 12 people with overweight/obesity is unknown. The overall objective of this R21 proposal is to establish 13 proof-of-concept for the relationship between weight stigma and energy intake underreporting for 14 adults with overweight/obesity. Adults (n=68; ≥18 yrs) with overweight/obesity (BMI ≥25 kg/m2) will 15 complete a crossover investigation to determine associations between weight stigma (anticipated, 16 perceived, and internalized weight stigma) and energy intake underreporting, determined by 17 comparing reported energy intake from interviewer-administered 24-hr dietary recalls to objectively 18 measured total energy expenditure from a 10-day doubly-labeled water period (DLW). Participants will 19 be randomized into 1 of 2 dietary recall sequence periods, both with 10-days of DLW, separated by a 20 20-day washout: Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) first, 21 followed by interviewer-administered dietary recalls during the second period, or vice versa. 22 Participants will complete validated assessments of weight stigma, dieting history, social desirability, 23 body size dissatisfaction, and binge eating prior to randomization. This research may help to inform 24 obesity treatment protocols by increasing recognition of negative impacts of weight stigma on health 25 and addressing self-reported dietary intake limitations in adults experiencing overweight/obesity. This 26 research could have public health impact by informing U.S. dietary surveillance methods and 27 guidelines by providing a model that is responsive to the impact of weight stigma on dietary 28 assessment accuracy. This approach may provide an improved self-reported energy intake approach 29 that will allow for future correction of underreporting in adults with overweight/obesity.