UConn Rudd Center for Food Policy and Health

The purpose of this mixed methods study was to assess the relationship between body image and refusal to be weighed by a healthcare provider among women in the United States, including examination of their reasons for refusal. Of the 384 respondents, 32.3 % reported refusing to be weighed by a healthcare provider.  The most common reasons for refusing to be weighed were having a negative impact on emotions, self-esteem, or mental health (52.4 %). Reasons for refusing to be weighed ranged from shame and embarrassment to lack of provider trust, personal autonomy, and concerns about discrimination. Identifying interventions and alternatives such as telehealth to provide healthcare services that are weight-inclusive may mediate these negative experiences.

Full citation: Ramseyer Winter, V., Trout, K., Harrop, E., O’Neill, E., Puhl, R., Bartlett-Equilant, G. (2023). Women’s refusal to be weighed during healthcare visits: Links to body image. Body Image, 46, 41-47. https://doi.org/10.1016/j.bodyim.2023.04.006

US Department of Agriculture (USDA) Foods programs for households – The Emergency Food Assistance Program (TEFAP), The Food Distribution Program on Indian Reservations (FDPIR), and the Commodity Supplemental Food Program (CSFP) – provide nutritious foods at no cost to income-eligible individuals. The Healthy Eating Research (HER) Nutrition Guidelines for the Charitable Food System were used to evaluate the quality of foods in each program. Foods are categorized into a three-tiered system based on levels of saturated fat, sodium, and added sugar per serving, and presence of whole grains: Green (choose often,) Yellow (choose sometimes,) and Red (choose rarely.)

This document provides an outline that charitable food organizations can use to prepare data for HER analyses using FANO categories.

Rules of thumb to help rank food utilizing the HER Guidelines for the Charitable Food System.

Participants (N = 8100 adults who reported having ever experienced weight stigma; 95% female; 94% White) completed an identical online survey in their country’s dominant language that assessed their experiences of weight stigma from 16 different family member sources, as well as internalized weight bias, body image, eating behaviors, perceived stress, and self-rated health. Family-based weight stigma, especially from mothers (49%-62%), spouses/romantic partners (40%-57%), and fathers (35%-48%), was highly prevalent across countries. Weight stigma from one’s immediate family members was associated with indices of poorer psychosocial health across the six countries

Full citation: Lawrence, S. E., Puhl, R. M., Watson, R. J., Schwartz, M. B., Lessard, L. M., & Foster, G. D. (2023). Family‐based weight stigma and psychosocial health: A multinational comparison. Obesity. https://doi.org/10.1002/oby.23748

In this paper, we conducted a pilot randomized trial of a technology-driven family beverage choice intervention that aimed to reduce sugar-sweetened beverage (SSB) and fruit juice (FJ) consumption in 60 parent–child dyads, in which children were 1–8 years old. The pediatrician-initiated intervention consisted of a water promotion toolkit, a video, a mobile phone application, and 14 interactive voice-response phone calls to parents over 6 months. Children in both the intervention and the control groups substantially decreased their consumption of SSB and FJ over follow-up and increased water consumption, but constrained linear mixed-effects models showed no differences between groups on these measures. Compared to parents in the control group, intervention parents had larger decreases in SSB intake at 3 months, but these differences were not sustained at 6 months.

Full citation: Lewis KH, Hsu F-C, Block JP, Skelton JA, Schwartz MB, Krieger J, Hindel LR, Ospino Sanchez B, Zoellner J. A Technology-Driven, Healthcare-Based Intervention to Improve Family Beverage Choices: Results from a Pilot Randomized Trial in the United States. Nutrients. 2023; 15(9):2141. https://doi.org/10.3390/nu15092141

As many as two-thirds of parents talk to their teens about weight, but these conversations can leave Adolescents feeling criticized, ashamed, and distressed. A new study from the UConn Rudd Center for Food Policy & Health highlights the barriers in these conversations between parents and adolescents, and the need for more parent education and supportive communication. Study findings, published in the journal Pediatric Obesity, show that parents want guidance on how to communicate about weight-related topics with their adolescents, while adolescents want their parents to be more supportive and accepting of their weight.

To identify ways to improve supportive parent–child communication about weight, we assessed parent and youth perspectives of barriers to weight communication, preferences for educational resources and support, and whether perspectives differ across demographic groups and weight status. In Fall 2021, online surveys were completed by two independent, unrelated samples of parents (N = 1936) and youth (N = 2032). Parent and youth-reported barriers to weight communication included discomfort and lack of knowledge about weight, and views that weight does not need to be discussed. Most parents wanted guidance on how to navigate multiple weight related topics with their children. Youth preferences for how their parents can be more supportive of their weight included avoiding weight-related criticism and pressures, increasing sensitivity and encouragement, and emphasizing healthy behaviours rather than weight.

Full citation: Puhl, RM, Lessard, LM, Foster, GD, Cardel, MI. Parent–child communication about weight: Priorities for parental education and support. Pediatric Obesity. 2023;e13027. DOI:10.1111/ijpo.13027

In this paper, we suggest ways that the public health community can tap the system’s potential to strengthen community health and voices. We highlight (a) strategies to prioritize access to nutritious food and provide a dignified experience; (b) examples of how food pantries can be a portal to federal benefits, health care, and other resources; and (c) ideas on how these non-profit agencies can increase civic engagement and raise community voices.

Full citation: Schwartz, M., & Caspi, C. (2023). The Charitable Food System as a Change Agent. Frontiers in Public Health, 11, 1201. https://doi.org/10.3389/fpubh.2023.1156501

In this paper, we: (a) describe how written food, nutrition, and physical activity district and state policies were strengthened in the United States in response to specific concerns about childhood obesity; (b) present how schools have historically addressed policies concerning children’s social, emotional, and behavioral health; and (c) propose using the Whole School, Whole Community, Whole Child (WSCC) model to strengthen the coordination and integration of school wellness policies. We conclude by describing recently developed tools to assist school districts in implementing the WSCC model.

Full citation: Schwartz, M. B., Chafouleas, S. M., & Koslouski, J. B. (2023). Expanding School Wellness Policies to Encompass the Whole School, Whole Child, Whole Community Model. Frontiers in Public Health, 11, 1090. https://doi.org/10.3389/fpubh.2023.1143474