Variable Name Description Exposure Variable: Chronic Health Condition “For each condition, indicate whether you have been diagnosed in your lifetime.” Conditions included asthma, type I diabetes, or type II diabetes, and responses were yes/no for each. Asthma and diabetes were chosen because they are common chronic health conditions, are most likely to be linked to other health problems, and have the greatest health implications if young adults have other unhealthy behaviors [12]. Type I and type II diabetes were combined, given the lack of clarity in distinguishing between these conditions in young adults in particular [14]. Participants that answered yes to both diabetes and asthma were assigned to the diabetes category because the daily treatment regimen to maintain healthful blood glucose levels potentially takes more time and effort than the daily treatment regimen for asthma, thus, diabetes was thought to be a more salient life experience for these young adults. Study participants who did not report a lifetime diagnosis of diabetes or asthma were included in the no chronic conditions group. Outcome Variables: Body Mass Index (BMI) and weight status Height and weight were assessed by self-report and BMI and weight status were calculated. Self-reported height and weight have been shown to be highly correlated with objectively measured values in adults [15]. BMI was calculated using the standard formula, weight (kg)/height (meters)2. Among a sub-sample of 127 Project EAT-III participants, the correlation between measured and self-reported BMI values was r=0.95 for men and r=0.98 for women. Centers for Disease Control and Prevention cut-points were used to categorize participants into those who were normal weight (BMI<25) or overweight/obese (BMI≥25). Fruit & Vegetable Intake and Sugar-Sweetened Beverage Consumption A food frequency questionnaire (FFQ 2007 grid form) was used to assess past year intake of fruit and vegetables in young adults [16]. Daily servings were defined as the equivalent of one-half cup for fruits and vegetables. A serving of sugar-sweetened beverages (e.g. soda pop, sports drinks) was defined as the equivalent of one glass, bottle, or can. Previous studies have examined reliability and validity of the FFQ intake estimates in young adults and found them to be acceptable [17]. Fast Food Intake “In the past week, how often did you eat something from a fast food restaurant?” Response options ranged from never to more than 7 times. Responses were coded numerically as 0, 1.5, 3.5, 5.5, 7 and 10. (Test-retest r = .48). Breakfast Frequency “During the past week, how many days did you eat breakfast?” Response options ranged from never to every day. Responses were coded numerically as 0, 1.5, 3.5, 5.5, and 7. (Test-retest breakfast r = .82). Family Meals “During the past seven days, how many times did all, or most, of your family living in your house eat a meal together?” Response options included: never, one to two times, three to four times, five to six times, seven times, and more than seven times. Reponses were coded numerically as 0, 1.5, 3.5, 5.5, 7 and 10. (Test-retest r = .83). Weight Control Behaviors “Have you done any of the following things in order to lose weight or keep from gaining weight during the past year? (yes or no for each method).” Unhealthy weight control behaviors (UWCB) included (1) fasted, (2) ate very little food, (3) used a food substitute (powder or a special drink), (4) skipped meals, and (5) smoked more cigarettes. Extreme weight control behaviors included (1) took diet pills, (2) made myself vomit, (3) used laxatives, and (4) used diuretics. Respondents were classified as using unhealthy weight-control behaviors if they reported any of the unhealthy weight control behaviors and were categorized as using extreme weight-control behaviors if they reported any of the extreme weight control behaviors. (Test-retest % agreement UWCB = 83%; extreme = 97%). Binge Eating Binge eating was assessed using items adapted from a scale by Yanovski [18]. The two questions included: “In the past year, have you ever eaten so much food in a short period of time that you would be embarrassed if others saw you (binge-eating)?” [Yes/No], and “During the times when you ate this way, did you feel you couldn’t stop eating or control what or how much you were eating?” [Yes/No]. Those who replied “yes” to both items were considered binge eaters. (Test-retest r = 0.92). Physical Activity Physical activity questions were adapted from the Godin Leisure-Time Exercise Questionnaire [11]. Young adults were asked: “In a usual week, how many hours do you spend doing the following activities: (1) strenuous exercise (e.g. biking fast, aerobics, jogging, basketball, swimming laps, soccer, rollerblading) (2) moderate exercise (e.g. walking quickly, easy bicycling, volleyball, skiing, dancing, skateboarding, snowboarding)”. Response options ranged from “none” to “6+ hours a week”. (Test-retest r = .80). Depressive Symptoms A scale by Kandel and Davies [19] was used to measure depressive mood. Participants responded “not at all,” “somewhat,” or “very much” to the following symptoms: fatigue, sleep disturbance, dysthymic mood, hopelessness, feeling tense/nervous, worry. Higher values indicate more severe depressive mood. (Cronbach’s alpha reliability α = 0.83; Test-retest r = 0.73). Body Satisfaction Body satisfaction was measured with a five-point (very dissatisfied to very satisfied) modified version of the Body Shape Satisfaction Scale [20]. Young adults rated their level of satisfaction with height, weight, body shape, waist, hips, thighs, stomach, face, body build, shoulders, muscles, chest and overall body fat. Higher scores indicated higher levels of body satisfaction. (Chronbach’s alpha reliability α = 0.93; Test-retest r = 0.89). Self-esteem Self-esteem was assessed with six items from the Rosenberg Self-Esteem Scale [21], including such items as “on the whole, I am satisfied with myself.” Response options ranged from strongly disagree to strongly agree on a 4-point scale. Higher scores indicated higher levels of self-esteem. (Chronbach’s alpha reliability α = 0.83 respectively; test-retest r = 0.85). Teasing To assess frequency of weight-teasing, respondents were asked how often “you are teased about your weight” and “you are teased about your appearance” [22]. Response categories were: (1) never; (2) less than once a year; (3) a few times a year; (4) a few times a month; and (5) at least once a week. A dichotomous variable was created with those answering that they were teased less than once a year or less categorized as having not experienced teasing, and those answering a few times a year or greater categorized as having experienced teasing [23]. (Test-retest r = 0.88). Educational Attainment “What is the highest level of education that you have completed?” Response options included: less than high school, high school/GED, vocational/technical/trade school, associate degree, bachelor degree, graduate or professional degree [24]. Educational attainment was transformed into a continuous measure. (Test-retest % agreement = 97%). Significant Other Status Young adults were asked the following question adapted from a previous measure [25]: “Do you have a significant other (for example, boyfriend/girlfriend, spouse, partner)?” (yes/no). (Test-retest % agreement = 100%). Children “How many children do you have (including step-children and adopted children)?” Response options ranged from “none” to “three or more”. This item was dichotomized into < 1 or >1 child. (Test-retest r = 1.0). Covariates: Race/Ethnicity “Do you think of yourself as 1) white, 2) black or African-American, 3) Hispanic or Latino, 4) Asian-American, 5) Hawaiian or Pacific Islander, or 6) American Indian or Native American” and respondents were asked to check all that apply. Participants who checked “white” and another option were included in the other category. Socio-economic Status (SES) Classification tree methodology [26] was used to generate five categories of SES (Low SES, Low-Middle SES, Middle SES, Middle-High SES, High SES) based upon survey responses.

Table 1: Exposure variables, outcome variables and covariates.