Obesities

The latest national and global data highlight the increasing prevalence of overweight and obesity in Romania, in all age groups, and the predictions for the future are not encouraging. General eating patterns are formed in preschool age, mainly influenced by the feeding practices of the children’s caregivers. The Comprehensive Feeding Practices Questionnaire (CFPQ) is a useful self-report tool for assessing parental feeding practices, validated across various age groups in several countries, but not in Romania. This study aimed to validate the CFPQ among 443 caregivers of children aged 2 to 7 years in Romania. An Exploratory factor analysis (EFA) and a Confirmatory factor analysis (CFA) were conducted to examine the factor structure of the CFPQ. The original factor structure (12 factors, 49 items) of the CFPQ was not confirmed among Romanian caregivers. The EFA supported a four-factor model with 14 items (Monitoring, Restriction for Weight Control, Modelling, Food as a Reward), which CFA indicated fit well (χ²/df = 1.78, GFI = 0.961, CFI = 0.981, RMSEA = 0.042). The findings support using the 14-item CFPQ among caregivers of 2- to 7-year-old children in Romania. This study highlights the potential of this abbreviated version to inform future tailored interventions designed to help caregivers address child obesity among Romanian children.

Concerns about weight gain may influence hormonal contraception selection, satisfaction, and discontinuation, yet no validated patient-centered instrument assesses perceived weight-related effects across methods. We developed the Perceived Changes with Hormonal Birth Control (PERCH-BC) survey using sequential face-validity and content-validity phases. Initial items were informed by the literature, questionnaires, and expertise. Fifteen premenopausal women aged 20–45 years—purposively sampled across normal-weight, overweight, and obesity categories—evaluated Versions 1–3 over three rounds of cognitive interviews. Participants completed the survey before retrospective probing focused on comprehension, interpretation, response processes, response-option fit, format, and usability. Interviews were audio-recorded, transcribed, and qualitatively coded; round-specific findings informed sequential revisions. Participants found the survey understandable and acceptable. However, limited contraceptive-method familiarity, difficulty responding under uncertainty, and interpretation of items as factual knowledge questions reduced response confidence. Revisions included a contraceptive-method visual aid, uncertainty response options, belief- and experience-focused instructions, revised wording, and side-effect items. The resulting 25-item Version 4 underwent structured content review by eight interdisciplinary experts evaluating 27 prompts for relevance, clarity, and completeness. All prompts met the prespecified relevance threshold (item-level content validity index [I-CVI], 0.875–1.00); the scale-level average content validity index (S-CVI/Ave) was 0.98. Expert feedback informed minor refinements before subsequent quantitative psychometric validation.

Whether the association between UPF intake and body weight persists after accounting for dietary quality remains unclear. This analysis examined whether UPF intake is associated with BMI after adjustment for diet quality and whether a threshold exists above which diet quality deteriorates. Demographic and anthropometric data were collected from 307 adults in Greece (December 2022 to January 2024). Dietary intake was assessed using 24 h recalls. UPF intake was expressed as a percentage of energy, and diet quality was evaluated using the Healthy Diet Indicator 2020 (HDI-2020). Multivariable regression examined UPF intake and HDI associations with BMI, adjusting for age, gender, energy intake, smoking, and education. Linear, quadratic, and segmented models examined UPF–HDI associations and thresholds. Higher UPF intake was associated with higher BMI after adjusting for HDI and covariates (B = 0.022 kg/m² per 1% of energy from UPF, 95% CI 0.005–0.040, p = 0.013), whereas HDI was not associated with BMI (p = 0.081). No significant UPF × HDI interaction emerged (p = 0.267). UPF was inversely associated with HDI (p < 0.001), with no threshold within the observed exposure range. Findings suggest an association of UPF intake with BMI after diet-quality adjustment, while its inverse association with HDI appears linear.