A weight stigma-informed model to improve energy intake assessment

1个项目摘要 人们普遍认为，超重和肥胖者的能量摄入少报了。 3作为营养学研究中的一个问题。由于大多数(74%)的美国成年人超重/肥胖， 4正如大多数超重/肥胖的成年人报告的那样，他们以取笑的形式经历了体重污名， 5欺凌、歧视、拒绝或其他表明社会因以下原因而贬值的不公平待遇 6体重，必须改进饮食评估方法，以解决特定的因素 7体重状况，如污名，可能会影响报告的准确性。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努力并促成无序的饮食行为。对于有体重污名病史的参与者， 10少报能量摄入可能是缓解预期负面影响的一种应对机制 11体重污名的影响。到目前为止，体重污名对能量摄入量的影响被低估了 超重/肥胖的12人不为人知。该R21提案的总体目标是建立 13体重污名与能量摄入之间关系的概念验证 14名超重/肥胖的成年人。超重/肥胖(≥≥25 kg/m2)的成年人(n=68；体重指数18岁)将 15完成交叉调查以确定体重污名之间的关联(预期， 16感知和内化的体重耻辱)和能量摄入不足，由以下因素决定 17将采访者实施的24小时饮食召回报告的能量摄入量与客观的 18测量了10天双标记水期(DLW)的总能量消耗。参与者将 19人被随机分成2个饮食回忆序列时期中的1个，两者都有10天的DLW，由 20 20天洗涤：自动24小时自我管理饮食评估工具(ASA24)首先， 然后是面试者在第二阶段进行的饮食召回，反之亦然。 22名参与者将完成体重污名、节食史、社会合意性、 23体型不满意，随机前暴饮暴食。这项研究可能有助于了解 通过增加对体重污名对健康的负面影响的认识，制定24项肥胖治疗方案 25并解决经历超重/肥胖的成年人自我报告的饮食摄入量限制。这 26项研究可能会通过告知美国饮食监测方法和 27指南，通过提供一个模型，响应体重污名对饮食的影响 28评估准确率。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/肥胖成年人的低报。

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.