Moria Golan | Tel Hai College (original) (raw)

Papers by Moria Golan

Journal of community medicine & health education, 2011

Failure in self-regulation has been proposed as a moderator in the development of overweight and ... more Failure in self-regulation has been proposed as a moderator in the development of overweight and obesity, primarily through its effects on deregulated eating behavior. As a result, it might cause regulatory problems in the energy balance, as well as rapid weight gain from early childhood through adolescence. Self-control is the exertion of control over the self by the self. Self-control occurs when a person (or other organism) attempts to change the way he or she would otherwise think, feel, or behave. Thus, self-control may be view as part of self-regulation. Parents and health care providers face the challenge of helping children practice regulation and develop coping skills alongside the ability to take care of their own well-being. This paper attempts to bridge the gap between self-control theories and interventions for the management of childhood obesity. The dietary restriction approach will be compared with the trust paradigm, which emphasizes children’s internal hunger, satiety cues and a division of responsibilities between parents and children.

Nutrition Reviews, Feb 4, 2008

With the incidence of eating disorders increasing in recent years, the role of parents in the pat... more With the incidence of eating disorders increasing in recent years, the role of parents in the pathology of these illnesses is of great interest, particularly the impact of their parenting style. Few studies have investigated the connection between parenting styles and adolescent eating disorders. Reviewed here are key studies on parenting style categorized into the following four broad areas related to eating disorder pathology: food-related symptoms, feeding style, research on ethnic populations, and populations with eating disorders. The results reflect previous findings on the benefits of the authoritative parenting style. Suggestions for parenting programs and further research are included.

Small Ruminant Research, Jul 1, 1990

― Five-7 day-old Friesen bull calves, raised in Israel received twice a day a mixture of 4... more ― Five-7 day-old Friesen bull calves, raised in Israel received twice a day a mixture of 40 g of soybean concentrate (65% protein) and 80 g of one of the following carbohydrates : glucose (G), expanded (heat-treated) (ES) or untreated (US) corn starch. In the afternoon the calves received in addition 400 g of milk replacer. Until weaning at experimental day 25, ES calves showed better growth and food utilization than their counterparts. Daily weight gain for the entire growing period up to slaughter was higher for the starch than for the glucose-fed group (P < 0.05 for ES vs G). Heat treatment of starch increased its in vitro availability to amylase and its in vivo digestibility. Bypass of the rumen was complete in all G calves. In the ES and US groups, partial diversion of the liquid feed into the rumen was evident. The G group showed hyperglycemia after meals, while almost no increase in blood glucose level was observed after soy-starch meals (either US or ES). calf / milk replacer / soy-protein / starch / digestiblity / blood glucose Résumé ― Utilisation de l'amidon cru ou traité à la chaleur chez les préruminants. 1. Veaux. Des veaux israéliens de race Frisonne âgés de 5-7 j ont reçu 2 fois par jour un mélange liquide contenant 40 g de concentré de soja (65°/ de protides) et 80 g d'un des glucides suivants : glucose (G), amidon de maïs traité à la chaleur (ES) ou non traité à la chaleur (US). Dans l'après-midi, les veaux ont reçu en supplément 400 g d'un aliment d'allaitement. Au sevrage, les veaux ES étaient plus lourds que les veaux G ou US et leur indice de consommation meilleur. Le gain de poids moyen quotidien durant toute la période de croissance, jusqu'à l'abattage, était supérieur dans le groupe ES. Le traitement thermique appliqué à l'amidon de maïs a amélioré sa digestibilité in vivo et in vitro. La fermeture de la gouttière cesophagienne était complète chez les veaux du groupe G contrairement aux veaux recevant de l'amidon. Dans le groupe G, une hyperglycémie postprandiale a été constatée, alors que chez les veaux ES et US la concentration du glucose dans le sang n'a pas augmenté après le repas.

Eating Behaviors, Dec 1, 2018

Positive self-image and body image as well as high self-esteem and media literacy are considered ... more Positive self-image and body image as well as high self-esteem and media literacy are considered protective factors against health-compromising behaviours. Investigation of the optimal setting for body image prevention programmes is important to maximize outcomes from such programmes. Most universal wellness programmes are school based and thus delivered to a "captive" population. Only a few reports have been published about wellness programmes delivered in after-school settings, and none of them compared delivery after school to delivery in a school-based setting. Aims: To assess the acceptability, feasibility and efficacy of an interactive wellness preventive programme (In Favour of Myself) when delivered in a school-based setting versus an after-school setting. Methods: A randomized controlled multi-arm trial with 224 adolescent girls aged 13-15 years old was conducted. There were 102 girls participating in the after-school setting and 102 girls in the school-based setting. The programme contained nine 90-minute lessons, delivered weekly over 2 months. An intention-to-treat assessment was performed three times: at baseline, at the programme's conclusion (two months) and at follow-up (3 months). Results: At programme termination and follow-up, the impact of In Favour of Myself was higher among participants in the after-school setting than in the school-based setting with respect to advertisement strategies, media pressure, gap between current and ideal body image, drive for thinness and self-esteem. Conclusions: This study provides support for a community-led approach to promote health behaviours, an approach that currently is a significant feature of health improvement policy and practice.

Journal of Nutrition Education, Mar 1, 2001

This model for the management of childhood obesity uses a family-based approach. Change is delive... more This model for the management of childhood obesity uses a family-based approach. Change is delivered through the parents (instead of the obese child) emphasizing a healthy lifestyle and not weight reduction as in previously published, family-based management of childhood obesity. This intervention integrates behavioral, social learning, and family system approaches. The proposed approach includes changes in parental cognition, emphasizing &quot;parenthood presence&quot;; parents serve both as a source of authority and a role model for the obese child, providing a family environment that fosters healthy practices related to weight control issues and de-emphasizing personal responsibility for control of health behavior.

The American Journal of Clinical Nutrition, Jun 1, 1998

Background: Excessive weight in childhood is a serious public health concern because of its costl... more Background: Excessive weight in childhood is a serious public health concern because of its costly health consequences and its increasing prevalence. Objective: Our objective was to compare the efficacy of a family-based approach for the treatment of childhood obesity, in which the parents served as the exclusive agents of change, with that of the conventional approach, in which the children served as the agents of change. Design: This study had a randomized, longitudinal prospective design and lasted 1 y. Sixty obese children aged 6-11 y were randomly allocated to the experimental (parents as agents of change) or control (children as agents of change) group. Anthropometric and biochemical measurements were determined at the start and end of the study. A sociodemographic questionnaire and a family eating and activity habits questionnaire were completed by both parents. Hour-long support and educational sessions were conducted by a clinical dietitian: 14 sessions for the parents in the experimental group and 30 sessions for the children in the control group. Results: The dropout rate was nine times greater in the control group (n = 9) than in the experimental group (n = 1). Mean percentile weight reduction was significantly (P < 0.03) higher in children in the experimental group (14.6%) than in the control group (8.1%). Conclusions: Treatment of childhood obesity with parents as the exclusive agents of change was superior to the conventional approach, as indicated by the dropout rate and the percentage weight loss of the children during the 1-y intervention.

Obesity Research, Feb 1, 2004

GOLAN, MORIA, AND SCOTT CROW. Targeting parents exclusively in the treatment of childhood obesity... more GOLAN, MORIA, AND SCOTT CROW. Targeting parents exclusively in the treatment of childhood obesity: long-term results. Obes Res. 2004;12:357-361. Objective: To report the long-term change in children's overweight following a family-based health-centered approach where only parents were targeted compared with a control intervention where only children were targeted. Research Methods and Procedures: Fifty of the 60 children who participated in the original study were located 7 years later, and their weight and height were measured. At the point of the 7-year follow-up, the children were 14 to 19 years of age. Repeated measure ANOVA was used to test differences between the groups in percent overweight at different time-points. Results: Mean reduction in percent overweight was greater at all follow-up points in children of the parent-only group compared with those in the children-only group (p Ͻ 0.05). Seven years after the program terminated, mean reduction in children's overweight was 29% in the parent-only group vs. 20.2% in the children-only group (p Ͻ 0.05). Discussion: Over the long term, treatment of childhood obesity with the parents as the exclusive agents of change was superior to the conventional approach.

Motivational interviewing, Mar 23, 2012

Preventive Medicine, Dec 1, 1999

in addition award parents with the benefit of changing Background. Family-based approaches using ... more in addition award parents with the benefit of changing Background. Family-based approaches using the their own eating and activity patterns, thus making parents as agents of change to treat childhood obesity this program ideal for treatment of obesity in children are superior to programs targeting only children in and their overweight parents. ᭧ 1999 American Health Foundaachieving weight reduction and have a lower droption and Academic Press out rate.

European Journal of Clinical Nutrition, Sep 30, 1998

The purpose of this work was to develop and test an instrument that will identify the factors tha... more The purpose of this work was to develop and test an instrument that will identify the factors that facilitate childhood obesity and monitor the environmental changes and family behavior modi®cations associated with weight loss. Design and methods:The relevant factors that affect obesity and weight loss in children were divided into four scales: activity level, stimulus exposure, eating related to hunger, and eating style. We designed a questionnaire to be completed by the parents of the obese child aged 6 ± 11 years. Scores accumulated were calculated separately for each member of the family. Higher numerical scores re¯ected less appropriate eating patterns. The questionnaire reliability (test ± retest), internal consistency and ability to discriminate obese vs normal-weight children's behaviors was tested using a pilot population of 40 mothers not enrolled in a formal weight loss program. The questionnaire reliability (parents' report and spouse report) and predictive validity was tested using a selective population: 60 parents of obese children enrolled in a clinical intervention intended to treat childhood obesity with an environmental approach vs a dietary approach. Results: The content validity of the questionnaire was evaluated by a team of ten experts. Cronbach's a was calculated to test internal consistency. Mean r was 0.83. Pearson's correlation coef®cients were computed between test and retest scores for individual items and for the total score, and ranged from 0.78 to 0.90 (median 0.84) (P`0.01 for all). Total score test ± retest r was 0.85 (P`0.01). The total family score was also higher in the families with an obese child compared to families with a normal-weight child, P`0.01. No signi®cant differences were noted between parent report and spouse report scores. The construct validity of the questionnaire was also supported by its high sensitivity to weight loss treatment. Weight loss in the child correlated highly with improvement in questionnaire score. Conclusions: The Family Activity and Eating Habits Questionnaire is reliable and internally consistent, and it is useful as an optional tool for planning an intervention program for childhood obesity.

Pediatric Obesity, 2006

The home environment is undoubtedly the most important setting in relation to shaping children&am... more The home environment is undoubtedly the most important setting in relation to shaping children&amp;amp;amp;amp;#39;s eating and physical activity behaviors. Family-based behavioral treatment is the most well-established intervention for the treatment of childhood obesity. Historically, family based interventions target the obese child and at least one or both parents. Presented here is a review of the literature on parents as exclusive agents of change, with the addition of some recent results indicating the effectiveness of this approach when implemented in public health programs. Targeting parents as the exclusive mediator has resulted in a better reduction in children&amp;amp;amp;amp;#39;s percentage overweight, and improvement in the obesogenic environment and behaviors, in comparison to a setting in which parents attended sessions with the obese child, or only children attended sessions. The findings from these studies were subsequently implemented in a national community-based survey. Both children&amp;amp;amp;amp;#39;s and parents&amp;amp;amp;amp;#39; weight status were significantly improved, although only parents attended the group sessions. A significant reduction in the obesogenic load at home was also found. Permissive parenting style was associated with less reduction in obesogenic load at home (p &amp;amp;amp;amp;lt; 0.01) and with less weight loss (p &amp;amp;amp;amp;lt; 0.05). Omitting the obese child from direct intervention and targeting parents only is a cost-effective approach with integrated messages for the management of weight-related problems.

Nutrition Reviews, 2004

There is growing agreement among experts that an obesogenic environment, which encourage excess f... more There is growing agreement among experts that an obesogenic environment, which encourage excess food intake and idealizes thinness, plays a crucial role in the epidemic of childhood obesity and eating disorders. Because parents provide a child's contextual environment, they should be considered key players in interventions aimed at preventing or treating weight-related problems. Parenting style and feeding style are crucial factors in fostering healthy lifestyle and awareness of internal hunger and satiety cues and deemphasizing thinness. Effective interventions for prevention and treatment of weight-related problems should be approached from a health-centered rather than a weight-centered perspective, with the parents as central agents of change. This paper reviews the environmental risk factors and parents' role in the prevention and treatment of children's weight-related problems.

Research Square (Research Square), Sep 17, 2021

Background: This study assessed the feasibility and effect of two mobile modes (WhatsApp vs. a sp... more Background: This study assessed the feasibility and effect of two mobile modes (WhatsApp vs. a specially designed app) in their delivery of updates and assignments to parents.Methods: Two three-armed, randomized, controlled feasibility studies were conducted. Participants were randomly allocated to the control arm, youth-only arm, or youth &amp; parental component arm. In the parental component, parents received updates and were requested to complete shared assignments with their children. In the first year, the assignments were sent through WhatsApp and in the following year via the specially designed smartphone application. Students and parents filled out questionnaires at three measure points: pre and post intervention and at three months follow-up. Mixed-methods assessments were performed using semi-structured interviews with parents and school staff members, as well as a computerized self-report questionnaire.Results: The addition of the concurrent parental component via WhatsApp was associated with superior improvement in self-esteem and identification of advertisement strategies, compared with the youth-only program. However, adolescents in the youth-only program delivered via the specially designed application demonstrated superior improvement compared to those in the youth &amp; parental component arm.Conclusions: Although the addition of the concurrent parenting component was praised by the actively participating parents, overall, this intervention was not statistically superior to the youth-only arm. Only a few variables demonstrated statistically significant improvement, usually with a small effect size. The use of WhatsApp had higher feasibility and uptake than the use of the specially designed application. Under the chosen structure and population, it seems that the program did not have the intended impact. Parents who expressed specific resistance may have negatively affected their children, causing them to be less engaged. A cost-benefit analysis of programs with parental components as well as the development of strategies to enhance parent-school partnership are warranted.Trial registrations: NCT04129892 (1.11.2017) and NCT03540277 (26.4.2018)

Frontiers in Psychiatry, May 13, 2022

Background: Clinicians need an instrument that helps their patients with eating disorders (ED) to... more Background: Clinicians need an instrument that helps their patients with eating disorders (ED) to explore their agent's inner intentions and confront negative behaviour and control styles. Objectives: To assess the feasibility and impact of an eating and control styles axis (ECOSA) during the first 8 months of mentalisation-based psychotherapy with a community-based sample of ED patients. Methods: Six experienced therapists and their consecutively admitted patients were randomly allocated to the intervention and control groups. A total of 94 women, M age = 24 were recruited between June 2020 and October 2021. Ninety completed it. Both groups received mentalisation-based psychotherapy, but only the intervention group used the ECOSA repeatedly. Therapists and participants were blinded to the study aims and hypothesis. Fidelity assessment was applied to ensure that the two groups differed mainly in terms of ECOSA usage. Results: The use of ECOSA, although less than advised, was reported as feasible. The effect size of the improvement in reflective functioning was larger than that of the control group and correlated significantly only in the intervention group with EDE-Q score (r = 0.46; p = 0.001). Conclusion: Although the study limitations: selective population, relatively small sample size and the lack of controlled confounder, the combined quantitative and qualitative results lend preliminary evidence for the validity and contribution of ECOSA as a possible instrument that may upgrade the clinician's toolbox in the treatment of ED. A more rigorous study design is needed to explore the potential usage of ECOSA as a clinical tool to enhance mentalisation among people with ED.

Pediatric obesity, Feb 28, 2013

What is already known about this subject • The FEAHQ was originally developed in Israel and desig... more What is already known about this subject • The FEAHQ was originally developed in Israel and designed for use in family-based weight-management interventions that emphasized changes in the environment and in parents' knowledge, behaviors, and modeling. • A key distinction of the FEAHQ from other tools is the ability to evaluate the overall obesogenic environment and, at the same time, each of the family members' eating and activity patterns, reflecting the importance of parenting behaviors and modeling in child weight status. • The FEAHQ is a useful clinical tool for identifying target behaviors for treatment and monitoring treatment progress. What this study adds • FEAHQ-R includes adjustments made to improve the tool use. • New data supporting the psychometric properties of the Revised FEAHQ.

British Journal of Nutrition, May 1, 2006

There is a consensus that interventions to prevent and treat childhood obesity should involve the... more There is a consensus that interventions to prevent and treat childhood obesity should involve the family; however, the extent of the child's involvement has received little attention. The goal of the present study was to evaluate the relative efficacy of treating childhood obesity via a familybased health-centred intervention, targeting parents alone v. parents and obese children together. Thirty-two families with obese children of 6-11 years of age were randomised into groups, in which participants were provided for 6 months a comprehensive educational and behavioural programme for a healthy lifestyle. These groups differed in their main agent of change: parents-only v. the parents and the obese child. In both groups, parents were encouraged to foster authoritative parenting styles (parents are both firm and supportive; assume a leadership role in the environmental change with appropriate granting of child's autonomy). Only the intervention aimed at parents-only resulted in a significant reduction in the percentage overweight at the end of the programme (P¼ 0•02) as well as at the 1-year follow-up meeting. The differences between groups at both times were significant (P,0•05). A greater reduction in food stimuli in the home (P,0•05) was noted in the parents-only group. In both groups, the parents' weight status did not change. Regression analysis shows that the level of attendance in sessions explained 28 % of the variability in the children's weight status change, the treatment group explained another 10 %, and the improvement in the obesogenic load explained 11 % of the variability. These results suggest that omitting the obese child from active participation in the health-centred programme may be beneficial for weight loss and for the promotion of a healthy lifestyle among obese children.

International Journal of Environmental Research and Public Health, Apr 2, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Journal of community medicine & health education, 2018

Aim: To assess the feasibility and impact of an innovative M.Sc. academic course addressing the i... more Aim: To assess the feasibility and impact of an innovative M.Sc. academic course addressing the issue of body image among nutrition students while delivering the course, entitled "Group Theory and Practice". Design: A non-randomized controlled trial was conducted between 2014 and 2016 to assess a body image intervention that was nested within an academic course (groups-theories and practices) of thirteen 3 hr sessions. Participants: In total, 72 active students participated in the course, with 67 participants in the control group (mean age=25 years, SD=1.9, 90% females). Methods: The participants completed computerized scales before the course started and immediately after it ended. The following scales were validated for the local language and used for this study: the Rosenberg Self-Esteem questionnaire, Body Image States Scale, Eating Disorders Inventory, Body Appreciation Scale and Body Esteem Scale. Differences between the pre-and post-outcomes were analyzed with the GLM Repeated Measures Analysis of Variance. Results: The results revealed statistically significant improvements in the intervention group compared to the control group in terms of Body Image States Scale (p<0.01, ɳ 2 =0.23), the Eating Disorders Inventory subscales asceticism and social insecurity (p<0.01), the Body Appreciation Scale (p=0.007) and the Body Esteem Scale (p<0.05, ɳ 2 =0.26) Conclusions: Meaningful teaching of group dynamics, through experiential participation in a nested body image group, is a powerful strategy to create meaningful teachable moments in group dynamics while also challenging well-being risk factors and addressing protective factors.

Small Ruminant Research, Jul 1, 1990

― Five-7 day-old Friesen bull calves, raised in Israel received twice a day a mixture of 4... more ― Five-7 day-old Friesen bull calves, raised in Israel received twice a day a mixture of 40 g of soybean concentrate (65% protein) and 80 g of one of the following carbohydrates : glucose (G), expanded (heat-treated) (ES) or untreated (US) corn starch. In the afternoon the calves received in addition 400 g of milk replacer. Until weaning at experimental day 25, ES calves showed better growth and food utilization than their counterparts. Daily weight gain for the entire growing period up to slaughter was higher for the starch than for the glucose-fed group (P < 0.05 for ES vs G). Heat treatment of starch increased its in vitro availability to amylase and its in vivo digestibility. Bypass of the rumen was complete in all G calves. In the ES and US groups, partial diversion of the liquid feed into the rumen was evident. The G group showed hyperglycemia after meals, while almost no increase in blood glucose level was observed after soy-starch meals (either US or ES). calf / milk replacer / soy-protein / starch / digestiblity / blood glucose Résumé ― Utilisation de l'amidon cru ou traité à la chaleur chez les préruminants. 1. Veaux. Des veaux israéliens de race Frisonne âgés de 5-7 j ont reçu 2 fois par jour un mélange liquide contenant 40 g de concentré de soja (65°/ de protides) et 80 g d'un des glucides suivants : glucose (G), amidon de maïs traité à la chaleur (ES) ou non traité à la chaleur (US). Dans l'après-midi, les veaux ont reçu en supplément 400 g d'un aliment d'allaitement. Au sevrage, les veaux ES étaient plus lourds que les veaux G ou US et leur indice de consommation meilleur. Le gain de poids moyen quotidien durant toute la période de croissance, jusqu'à l'abattage, était supérieur dans le groupe ES. Le traitement thermique appliqué à l'amidon de maïs a amélioré sa digestibilité in vivo et in vitro. La fermeture de la gouttière cesophagienne était complète chez les veaux du groupe G contrairement aux veaux recevant de l'amidon. Dans le groupe G, une hyperglycémie postprandiale a été constatée, alors que chez les veaux ES et US la concentration du glucose dans le sang n'a pas augmenté après le repas.

Journal of community medicine & health education, 2011

Failure in self-regulation has been proposed as a moderator in the development of overweight and ... more Failure in self-regulation has been proposed as a moderator in the development of overweight and obesity, primarily through its effects on deregulated eating behavior. As a result, it might cause regulatory problems in the energy balance, as well as rapid weight gain from early childhood through adolescence. Self-control is the exertion of control over the self by the self. Self-control occurs when a person (or other organism) attempts to change the way he or she would otherwise think, feel, or behave. Thus, self-control may be view as part of self-regulation. Parents and health care providers face the challenge of helping children practice regulation and develop coping skills alongside the ability to take care of their own well-being. This paper attempts to bridge the gap between self-control theories and interventions for the management of childhood obesity. The dietary restriction approach will be compared with the trust paradigm, which emphasizes children’s internal hunger, satiety cues and a division of responsibilities between parents and children.

Nutrition Reviews, Feb 4, 2008

With the incidence of eating disorders increasing in recent years, the role of parents in the pat... more With the incidence of eating disorders increasing in recent years, the role of parents in the pathology of these illnesses is of great interest, particularly the impact of their parenting style. Few studies have investigated the connection between parenting styles and adolescent eating disorders. Reviewed here are key studies on parenting style categorized into the following four broad areas related to eating disorder pathology: food-related symptoms, feeding style, research on ethnic populations, and populations with eating disorders. The results reflect previous findings on the benefits of the authoritative parenting style. Suggestions for parenting programs and further research are included.

Small Ruminant Research, Jul 1, 1990

― Five-7 day-old Friesen bull calves, raised in Israel received twice a day a mixture of 4... more ― Five-7 day-old Friesen bull calves, raised in Israel received twice a day a mixture of 40 g of soybean concentrate (65% protein) and 80 g of one of the following carbohydrates : glucose (G), expanded (heat-treated) (ES) or untreated (US) corn starch. In the afternoon the calves received in addition 400 g of milk replacer. Until weaning at experimental day 25, ES calves showed better growth and food utilization than their counterparts. Daily weight gain for the entire growing period up to slaughter was higher for the starch than for the glucose-fed group (P < 0.05 for ES vs G). Heat treatment of starch increased its in vitro availability to amylase and its in vivo digestibility. Bypass of the rumen was complete in all G calves. In the ES and US groups, partial diversion of the liquid feed into the rumen was evident. The G group showed hyperglycemia after meals, while almost no increase in blood glucose level was observed after soy-starch meals (either US or ES). calf / milk replacer / soy-protein / starch / digestiblity / blood glucose Résumé ― Utilisation de l'amidon cru ou traité à la chaleur chez les préruminants. 1. Veaux. Des veaux israéliens de race Frisonne âgés de 5-7 j ont reçu 2 fois par jour un mélange liquide contenant 40 g de concentré de soja (65°/ de protides) et 80 g d'un des glucides suivants : glucose (G), amidon de maïs traité à la chaleur (ES) ou non traité à la chaleur (US). Dans l'après-midi, les veaux ont reçu en supplément 400 g d'un aliment d'allaitement. Au sevrage, les veaux ES étaient plus lourds que les veaux G ou US et leur indice de consommation meilleur. Le gain de poids moyen quotidien durant toute la période de croissance, jusqu'à l'abattage, était supérieur dans le groupe ES. Le traitement thermique appliqué à l'amidon de maïs a amélioré sa digestibilité in vivo et in vitro. La fermeture de la gouttière cesophagienne était complète chez les veaux du groupe G contrairement aux veaux recevant de l'amidon. Dans le groupe G, une hyperglycémie postprandiale a été constatée, alors que chez les veaux ES et US la concentration du glucose dans le sang n'a pas augmenté après le repas.

Eating Behaviors, Dec 1, 2018

Positive self-image and body image as well as high self-esteem and media literacy are considered ... more Positive self-image and body image as well as high self-esteem and media literacy are considered protective factors against health-compromising behaviours. Investigation of the optimal setting for body image prevention programmes is important to maximize outcomes from such programmes. Most universal wellness programmes are school based and thus delivered to a "captive" population. Only a few reports have been published about wellness programmes delivered in after-school settings, and none of them compared delivery after school to delivery in a school-based setting. Aims: To assess the acceptability, feasibility and efficacy of an interactive wellness preventive programme (In Favour of Myself) when delivered in a school-based setting versus an after-school setting. Methods: A randomized controlled multi-arm trial with 224 adolescent girls aged 13-15 years old was conducted. There were 102 girls participating in the after-school setting and 102 girls in the school-based setting. The programme contained nine 90-minute lessons, delivered weekly over 2 months. An intention-to-treat assessment was performed three times: at baseline, at the programme's conclusion (two months) and at follow-up (3 months). Results: At programme termination and follow-up, the impact of In Favour of Myself was higher among participants in the after-school setting than in the school-based setting with respect to advertisement strategies, media pressure, gap between current and ideal body image, drive for thinness and self-esteem. Conclusions: This study provides support for a community-led approach to promote health behaviours, an approach that currently is a significant feature of health improvement policy and practice.

Journal of Nutrition Education, Mar 1, 2001

This model for the management of childhood obesity uses a family-based approach. Change is delive... more This model for the management of childhood obesity uses a family-based approach. Change is delivered through the parents (instead of the obese child) emphasizing a healthy lifestyle and not weight reduction as in previously published, family-based management of childhood obesity. This intervention integrates behavioral, social learning, and family system approaches. The proposed approach includes changes in parental cognition, emphasizing &quot;parenthood presence&quot;; parents serve both as a source of authority and a role model for the obese child, providing a family environment that fosters healthy practices related to weight control issues and de-emphasizing personal responsibility for control of health behavior.

The American Journal of Clinical Nutrition, Jun 1, 1998

Background: Excessive weight in childhood is a serious public health concern because of its costl... more Background: Excessive weight in childhood is a serious public health concern because of its costly health consequences and its increasing prevalence. Objective: Our objective was to compare the efficacy of a family-based approach for the treatment of childhood obesity, in which the parents served as the exclusive agents of change, with that of the conventional approach, in which the children served as the agents of change. Design: This study had a randomized, longitudinal prospective design and lasted 1 y. Sixty obese children aged 6-11 y were randomly allocated to the experimental (parents as agents of change) or control (children as agents of change) group. Anthropometric and biochemical measurements were determined at the start and end of the study. A sociodemographic questionnaire and a family eating and activity habits questionnaire were completed by both parents. Hour-long support and educational sessions were conducted by a clinical dietitian: 14 sessions for the parents in the experimental group and 30 sessions for the children in the control group. Results: The dropout rate was nine times greater in the control group (n = 9) than in the experimental group (n = 1). Mean percentile weight reduction was significantly (P < 0.03) higher in children in the experimental group (14.6%) than in the control group (8.1%). Conclusions: Treatment of childhood obesity with parents as the exclusive agents of change was superior to the conventional approach, as indicated by the dropout rate and the percentage weight loss of the children during the 1-y intervention.

Obesity Research, Feb 1, 2004

GOLAN, MORIA, AND SCOTT CROW. Targeting parents exclusively in the treatment of childhood obesity... more GOLAN, MORIA, AND SCOTT CROW. Targeting parents exclusively in the treatment of childhood obesity: long-term results. Obes Res. 2004;12:357-361. Objective: To report the long-term change in children's overweight following a family-based health-centered approach where only parents were targeted compared with a control intervention where only children were targeted. Research Methods and Procedures: Fifty of the 60 children who participated in the original study were located 7 years later, and their weight and height were measured. At the point of the 7-year follow-up, the children were 14 to 19 years of age. Repeated measure ANOVA was used to test differences between the groups in percent overweight at different time-points. Results: Mean reduction in percent overweight was greater at all follow-up points in children of the parent-only group compared with those in the children-only group (p Ͻ 0.05). Seven years after the program terminated, mean reduction in children's overweight was 29% in the parent-only group vs. 20.2% in the children-only group (p Ͻ 0.05). Discussion: Over the long term, treatment of childhood obesity with the parents as the exclusive agents of change was superior to the conventional approach.

Motivational interviewing, Mar 23, 2012

Preventive Medicine, Dec 1, 1999

in addition award parents with the benefit of changing Background. Family-based approaches using ... more in addition award parents with the benefit of changing Background. Family-based approaches using the their own eating and activity patterns, thus making parents as agents of change to treat childhood obesity this program ideal for treatment of obesity in children are superior to programs targeting only children in and their overweight parents. ᭧ 1999 American Health Foundaachieving weight reduction and have a lower droption and Academic Press out rate.

European Journal of Clinical Nutrition, Sep 30, 1998

The purpose of this work was to develop and test an instrument that will identify the factors tha... more The purpose of this work was to develop and test an instrument that will identify the factors that facilitate childhood obesity and monitor the environmental changes and family behavior modi®cations associated with weight loss. Design and methods:The relevant factors that affect obesity and weight loss in children were divided into four scales: activity level, stimulus exposure, eating related to hunger, and eating style. We designed a questionnaire to be completed by the parents of the obese child aged 6 ± 11 years. Scores accumulated were calculated separately for each member of the family. Higher numerical scores re¯ected less appropriate eating patterns. The questionnaire reliability (test ± retest), internal consistency and ability to discriminate obese vs normal-weight children's behaviors was tested using a pilot population of 40 mothers not enrolled in a formal weight loss program. The questionnaire reliability (parents' report and spouse report) and predictive validity was tested using a selective population: 60 parents of obese children enrolled in a clinical intervention intended to treat childhood obesity with an environmental approach vs a dietary approach. Results: The content validity of the questionnaire was evaluated by a team of ten experts. Cronbach's a was calculated to test internal consistency. Mean r was 0.83. Pearson's correlation coef®cients were computed between test and retest scores for individual items and for the total score, and ranged from 0.78 to 0.90 (median 0.84) (P`0.01 for all). Total score test ± retest r was 0.85 (P`0.01). The total family score was also higher in the families with an obese child compared to families with a normal-weight child, P`0.01. No signi®cant differences were noted between parent report and spouse report scores. The construct validity of the questionnaire was also supported by its high sensitivity to weight loss treatment. Weight loss in the child correlated highly with improvement in questionnaire score. Conclusions: The Family Activity and Eating Habits Questionnaire is reliable and internally consistent, and it is useful as an optional tool for planning an intervention program for childhood obesity.

Pediatric Obesity, 2006

The home environment is undoubtedly the most important setting in relation to shaping children&am... more The home environment is undoubtedly the most important setting in relation to shaping children&amp;amp;amp;amp;#39;s eating and physical activity behaviors. Family-based behavioral treatment is the most well-established intervention for the treatment of childhood obesity. Historically, family based interventions target the obese child and at least one or both parents. Presented here is a review of the literature on parents as exclusive agents of change, with the addition of some recent results indicating the effectiveness of this approach when implemented in public health programs. Targeting parents as the exclusive mediator has resulted in a better reduction in children&amp;amp;amp;amp;#39;s percentage overweight, and improvement in the obesogenic environment and behaviors, in comparison to a setting in which parents attended sessions with the obese child, or only children attended sessions. The findings from these studies were subsequently implemented in a national community-based survey. Both children&amp;amp;amp;amp;#39;s and parents&amp;amp;amp;amp;#39; weight status were significantly improved, although only parents attended the group sessions. A significant reduction in the obesogenic load at home was also found. Permissive parenting style was associated with less reduction in obesogenic load at home (p &amp;amp;amp;amp;lt; 0.01) and with less weight loss (p &amp;amp;amp;amp;lt; 0.05). Omitting the obese child from direct intervention and targeting parents only is a cost-effective approach with integrated messages for the management of weight-related problems.

Nutrition Reviews, 2004

There is growing agreement among experts that an obesogenic environment, which encourage excess f... more There is growing agreement among experts that an obesogenic environment, which encourage excess food intake and idealizes thinness, plays a crucial role in the epidemic of childhood obesity and eating disorders. Because parents provide a child's contextual environment, they should be considered key players in interventions aimed at preventing or treating weight-related problems. Parenting style and feeding style are crucial factors in fostering healthy lifestyle and awareness of internal hunger and satiety cues and deemphasizing thinness. Effective interventions for prevention and treatment of weight-related problems should be approached from a health-centered rather than a weight-centered perspective, with the parents as central agents of change. This paper reviews the environmental risk factors and parents' role in the prevention and treatment of children's weight-related problems.

Research Square (Research Square), Sep 17, 2021

Background: This study assessed the feasibility and effect of two mobile modes (WhatsApp vs. a sp... more Background: This study assessed the feasibility and effect of two mobile modes (WhatsApp vs. a specially designed app) in their delivery of updates and assignments to parents.Methods: Two three-armed, randomized, controlled feasibility studies were conducted. Participants were randomly allocated to the control arm, youth-only arm, or youth &amp; parental component arm. In the parental component, parents received updates and were requested to complete shared assignments with their children. In the first year, the assignments were sent through WhatsApp and in the following year via the specially designed smartphone application. Students and parents filled out questionnaires at three measure points: pre and post intervention and at three months follow-up. Mixed-methods assessments were performed using semi-structured interviews with parents and school staff members, as well as a computerized self-report questionnaire.Results: The addition of the concurrent parental component via WhatsApp was associated with superior improvement in self-esteem and identification of advertisement strategies, compared with the youth-only program. However, adolescents in the youth-only program delivered via the specially designed application demonstrated superior improvement compared to those in the youth &amp; parental component arm.Conclusions: Although the addition of the concurrent parenting component was praised by the actively participating parents, overall, this intervention was not statistically superior to the youth-only arm. Only a few variables demonstrated statistically significant improvement, usually with a small effect size. The use of WhatsApp had higher feasibility and uptake than the use of the specially designed application. Under the chosen structure and population, it seems that the program did not have the intended impact. Parents who expressed specific resistance may have negatively affected their children, causing them to be less engaged. A cost-benefit analysis of programs with parental components as well as the development of strategies to enhance parent-school partnership are warranted.Trial registrations: NCT04129892 (1.11.2017) and NCT03540277 (26.4.2018)

Frontiers in Psychiatry, May 13, 2022

Background: Clinicians need an instrument that helps their patients with eating disorders (ED) to... more Background: Clinicians need an instrument that helps their patients with eating disorders (ED) to explore their agent's inner intentions and confront negative behaviour and control styles. Objectives: To assess the feasibility and impact of an eating and control styles axis (ECOSA) during the first 8 months of mentalisation-based psychotherapy with a community-based sample of ED patients. Methods: Six experienced therapists and their consecutively admitted patients were randomly allocated to the intervention and control groups. A total of 94 women, M age = 24 were recruited between June 2020 and October 2021. Ninety completed it. Both groups received mentalisation-based psychotherapy, but only the intervention group used the ECOSA repeatedly. Therapists and participants were blinded to the study aims and hypothesis. Fidelity assessment was applied to ensure that the two groups differed mainly in terms of ECOSA usage. Results: The use of ECOSA, although less than advised, was reported as feasible. The effect size of the improvement in reflective functioning was larger than that of the control group and correlated significantly only in the intervention group with EDE-Q score (r = 0.46; p = 0.001). Conclusion: Although the study limitations: selective population, relatively small sample size and the lack of controlled confounder, the combined quantitative and qualitative results lend preliminary evidence for the validity and contribution of ECOSA as a possible instrument that may upgrade the clinician's toolbox in the treatment of ED. A more rigorous study design is needed to explore the potential usage of ECOSA as a clinical tool to enhance mentalisation among people with ED.

Pediatric obesity, Feb 28, 2013

What is already known about this subject • The FEAHQ was originally developed in Israel and desig... more What is already known about this subject • The FEAHQ was originally developed in Israel and designed for use in family-based weight-management interventions that emphasized changes in the environment and in parents' knowledge, behaviors, and modeling. • A key distinction of the FEAHQ from other tools is the ability to evaluate the overall obesogenic environment and, at the same time, each of the family members' eating and activity patterns, reflecting the importance of parenting behaviors and modeling in child weight status. • The FEAHQ is a useful clinical tool for identifying target behaviors for treatment and monitoring treatment progress. What this study adds • FEAHQ-R includes adjustments made to improve the tool use. • New data supporting the psychometric properties of the Revised FEAHQ.

British Journal of Nutrition, May 1, 2006

There is a consensus that interventions to prevent and treat childhood obesity should involve the... more There is a consensus that interventions to prevent and treat childhood obesity should involve the family; however, the extent of the child's involvement has received little attention. The goal of the present study was to evaluate the relative efficacy of treating childhood obesity via a familybased health-centred intervention, targeting parents alone v. parents and obese children together. Thirty-two families with obese children of 6-11 years of age were randomised into groups, in which participants were provided for 6 months a comprehensive educational and behavioural programme for a healthy lifestyle. These groups differed in their main agent of change: parents-only v. the parents and the obese child. In both groups, parents were encouraged to foster authoritative parenting styles (parents are both firm and supportive; assume a leadership role in the environmental change with appropriate granting of child's autonomy). Only the intervention aimed at parents-only resulted in a significant reduction in the percentage overweight at the end of the programme (P¼ 0•02) as well as at the 1-year follow-up meeting. The differences between groups at both times were significant (P,0•05). A greater reduction in food stimuli in the home (P,0•05) was noted in the parents-only group. In both groups, the parents' weight status did not change. Regression analysis shows that the level of attendance in sessions explained 28 % of the variability in the children's weight status change, the treatment group explained another 10 %, and the improvement in the obesogenic load explained 11 % of the variability. These results suggest that omitting the obese child from active participation in the health-centred programme may be beneficial for weight loss and for the promotion of a healthy lifestyle among obese children.

International Journal of Environmental Research and Public Health, Apr 2, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Journal of community medicine & health education, 2018

Aim: To assess the feasibility and impact of an innovative M.Sc. academic course addressing the i... more Aim: To assess the feasibility and impact of an innovative M.Sc. academic course addressing the issue of body image among nutrition students while delivering the course, entitled "Group Theory and Practice". Design: A non-randomized controlled trial was conducted between 2014 and 2016 to assess a body image intervention that was nested within an academic course (groups-theories and practices) of thirteen 3 hr sessions. Participants: In total, 72 active students participated in the course, with 67 participants in the control group (mean age=25 years, SD=1.9, 90% females). Methods: The participants completed computerized scales before the course started and immediately after it ended. The following scales were validated for the local language and used for this study: the Rosenberg Self-Esteem questionnaire, Body Image States Scale, Eating Disorders Inventory, Body Appreciation Scale and Body Esteem Scale. Differences between the pre-and post-outcomes were analyzed with the GLM Repeated Measures Analysis of Variance. Results: The results revealed statistically significant improvements in the intervention group compared to the control group in terms of Body Image States Scale (p<0.01, ɳ 2 =0.23), the Eating Disorders Inventory subscales asceticism and social insecurity (p<0.01), the Body Appreciation Scale (p=0.007) and the Body Esteem Scale (p<0.05, ɳ 2 =0.26) Conclusions: Meaningful teaching of group dynamics, through experiential participation in a nested body image group, is a powerful strategy to create meaningful teachable moments in group dynamics while also challenging well-being risk factors and addressing protective factors.

Small Ruminant Research, Jul 1, 1990

― Five-7 day-old Friesen bull calves, raised in Israel received twice a day a mixture of 4... more ― Five-7 day-old Friesen bull calves, raised in Israel received twice a day a mixture of 40 g of soybean concentrate (65% protein) and 80 g of one of the following carbohydrates : glucose (G), expanded (heat-treated) (ES) or untreated (US) corn starch. In the afternoon the calves received in addition 400 g of milk replacer. Until weaning at experimental day 25, ES calves showed better growth and food utilization than their counterparts. Daily weight gain for the entire growing period up to slaughter was higher for the starch than for the glucose-fed group (P < 0.05 for ES vs G). Heat treatment of starch increased its in vitro availability to amylase and its in vivo digestibility. Bypass of the rumen was complete in all G calves. In the ES and US groups, partial diversion of the liquid feed into the rumen was evident. The G group showed hyperglycemia after meals, while almost no increase in blood glucose level was observed after soy-starch meals (either US or ES). calf / milk replacer / soy-protein / starch / digestiblity / blood glucose Résumé ― Utilisation de l'amidon cru ou traité à la chaleur chez les préruminants. 1. Veaux. Des veaux israéliens de race Frisonne âgés de 5-7 j ont reçu 2 fois par jour un mélange liquide contenant 40 g de concentré de soja (65°/ de protides) et 80 g d'un des glucides suivants : glucose (G), amidon de maïs traité à la chaleur (ES) ou non traité à la chaleur (US). Dans l'après-midi, les veaux ont reçu en supplément 400 g d'un aliment d'allaitement. Au sevrage, les veaux ES étaient plus lourds que les veaux G ou US et leur indice de consommation meilleur. Le gain de poids moyen quotidien durant toute la période de croissance, jusqu'à l'abattage, était supérieur dans le groupe ES. Le traitement thermique appliqué à l'amidon de maïs a amélioré sa digestibilité in vivo et in vitro. La fermeture de la gouttière cesophagienne était complète chez les veaux du groupe G contrairement aux veaux recevant de l'amidon. Dans le groupe G, une hyperglycémie postprandiale a été constatée, alors que chez les veaux ES et US la concentration du glucose dans le sang n'a pas augmenté après le repas.