Biomedical subjects
A E Field
Publications and source records attributed to A E Field.
Comparison of 4 questionnaires for assessment of fruit and vegetable intake.
OBJECTIVE: This study compared fruit and vegetable assessments derived from 4 self-administered questionnaires. METHODS: Among 102 adolescents, servings of fruits and vegetables assessed by 4 questionnaires were compared with estimates from 24-hour recalls. RESULTS: The prevalence of consuming 5 or more servings of fruits and vegetables a day was underestimated by the questionnaires. Questionnaires asking subjects to recall their diet over the previous year were more effective in ranking subjects (r's > or = .42) than those assessing previous-day diet (r's > or = .30). CONCLUSIONS: Brief assessments of fruit and vegetable intake are more useful for ranking subjects than for estimating prevalence of consumption of 5 or more servings per day.
Racial differences in bulimic behaviors among high school females.
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Racial/ethnic and gender differences in concern with weight and in bulimic behaviors among adolescents.
This study examined cross-sectional gender and racial/ ethnic differences in bulimic behaviors among adolescents. Subjects were 704 male and 621 female students at a large urban public high school in the Northeast. Approximately 61% of the girls and 43% of the boys reported trying to lose weight or maintain their current weight; 2.0% of the students reported using laxatives or vomiting to control their weight. The use of these behaviors to control weight was only slightly more common among girls than boys (2.7% vs. 1.4%, p = 0.1). Although more black than white girls used laxatives or vomiting to control weight (odds ratio [OR] = 11.9, 95% confidence interval [CI] 1.5-95.3), there were no racial/ethnic differences in these behaviors among boys. However, Hispanic boys were twice as likely as white boys to binge eat at least monthly (OR = 2.0, 95% CI 1.1-3.6). Our results suggest that bulimic behaviors affect male and female adolescents from a variety of racial/ethnic backgrounds. In addition, in contrast to the large gender differences in the prevalence of dieting and binge eating, more modest differences were documented in the prevalence of using vomiting and laxatives to control weight.
Distinguishing recovery from remission in a cohort of bulimic women: how should asymptomatic periods be described?
BACKGROUND: Empirical definitions of remission and recovery from eating disorders are needed to understand outcome data and compare results across studies. METHOD: 106 treatment-seeking women with bulimia nervosa, who had abstained from binging and purging for at least 4 weeks, were followed prospectively. Relapse was defined as at least 4 consecutive weeks of either binging and purging weekly or binging two or more times per week, regardless of purging. Recovery was differentiated from remission based on the probability of relapse. The minimum number of weeks after which the risk of relapse leveled off was used as the cut-off to distinguish between the two outcomes. Kaplan-Meier methods were used to estimate the weekly probability of relapse. RESULTS: When defining remission as at least 4 weeks of being asymptomatic, a quarter of the women relapsed within 11 weeks. By 37 weeks, only 49% of the women remained asymptomatic (95% CI, 41-61). The probability of relapse was substantial for approximately a year after a woman ceased to binge and purge. CONCLUSION: Bulimia nervosa is an episodic disorder. As a conservative approach, periods of being asymptomatic that last less than 1 year should be labeled as remissions, not recoveries.
A 10-year longitudinal study of body weight, dieting, and eating disorder symptoms.
This article describes a 10-year longitudinal study of eating attitudes and behaviors. A sample of 509 women and 206 men completed a detailed survey in 1982 while they were in college. The authors contacted participants 10 years later and administered a 2nd questionnaire to assess stability and change in eating behaviors that occurred during the transition to early adulthood. Women in the study had substantial declines in disordered eating behavior as well as increased body satisfaction. However, body dissatisfaction and desires to lose weight remained at relatively high levels. Men, who rarely dieted or had eating problems in college, were prone to weight gain following college, and many of them reported increased dieting or disordered eating. The authors conclude that disordered eating generally tends to decline during the transition to early adulthood. However, body dissatisfaction remains a problem for a substantial segment of the adult population.
Disordered eating: can women accurately recall their binging and purging behaviors 10 years later?
OBJECTIVE: To test women's ability to recall their past binging and purging behaviors. DESIGN: Ten-year follow-up study of women who had participated in a cross-sectional survey during college. SUBJECTS: In 1982, a sample of freshman and senior women at a large university in the Boston area were questioned about their weight, dieting history, bulimic symptoms, and eating patterns, attitudes, and concerns. In 1992, all subjects who responded to the 1982 survey were followed up to assess changes in bulimic symptoms and ability to recall past behaviors. RESULTS: Among the 476 women who responded to both surveys, the percentage in 1992 who reported having ever binged and/or purged was less than the percentage in 1982, indicating that the recall of past behaviors was less than perfect. Denial in 1992 of ever having engaged in the behaviors ranged from 22% among the women who were self-inducing vomiting in 1982 to 64% among the women who had reported current fasting or strict dieting in 1982. Recall of past behaviors in 1992 was better among the women who had been current bingers or purgers in 1982. CONCLUSION: Our results demonstrate that ability to recall past binging and purging is only modest. Therefore to better understand the mental and physical health consequences of these behaviors this information should be collected prospectively.
Subtyping eating disorders: is it justified?
OBJECTIVE: DSM-IV subtypes anorexia nervosa by the presence or absence of bulimic symptoms. Assessing whether bulimic symptoms are related to the probability of recovery can provide justification for subtyping of anorexia. METHOD: Two hundred twenty-five treatment-seeking women with anorexia and/or bulimia nervosa were interviewed every 3 months for up to 4 years. Survival methods were used for analyses. RESULTS: Less than half of the entire cohort recovered; however, the great majority of the women became less symptomatic over time. Contrary to findings from previous studies, bulimic anorexics had a higher rate of recovery than restricting anorexics. CONCLUSION: Differences in course provide some support for the subtyping of anorexia nervosa. Additional prospective studies are needed before subtyping can be warranted.
The relation of smoking, age, relative weight, and dietary intake to serum adrenal steroids, sex hormones, and sex hormone-binding globulin in middle-aged men.
The relationships of cigarette smoking, age, relative weight, and dietary intake to serum dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstenedione, cortisol, 3-alpha-androstanediol, 3-alpha-androstanediol-glucuronide, testosterone, albumin-bound testosterone, free testosterone, dihydrotestosterone (DHT), and sex hormone-binding globulin (SHBG) were examined cross-sectionally in 1241 randomly sampled middle-aged U.S. men. Compared with nonsmokers and independent of relative weight (body mass index) and age, cigarette smokers had increased serum levels of DHEA (18% higher, P = 0.0002), DHEAS (13% higher, P = 0.0007), cortisol (5% higher, P = 0.01), androstenedione (33% higher, P = 0.0001), testosterone (9% higher, P = 0.009), DHT (14% higher, P = 0.004), and SHBG (8% higher, P = 0.004). Androstenedione, total plasma testosterone, albumin-bound testosterone, DHT, and SHBG decreased with increasing relative weight. Age was positively associated with serum SHBG and negatively associated with albumin-bound testosterone, DHEA, and DHEAS. An association was found between alcohol intake and DHEA (r = 0.15; P = 0.0001), cortisol (r = 0.10; P = 0.0007), and 3-alpha-androstanediol-glucuronide (r = 0.08; P = 0.0004). Cortisol was the only hormone that was associated with carbohydrate intake (r = -0.09; P = 0.002). The only hormones associated with dietary lipids were DHT (for vegetable fat, r = 0.07; P = 0.02), cortisol (for total fat, r = 0.08; P = 0.007), and SHBG (for animal fat, r = -0.06; P = 0.05). In addition, SHBG was positively associated with dietary (r = 0.07; P = 0.008) and crude (r = 0.08; P = 0.007) fiber. These data suggest that serum adrenal steroid and sex hormone concentrations in middle-aged men are more influenced by cigarette smoking, age, and obesity than by dietary intake; however, serum adrenal steroids were influenced by alcohol intake.
The relationship of caloric intake to frequency of dieting among preadolescent and adolescent girls.
OBJECTIVE: To assess the relationships of concern with weight and shape, frequency of dieting, body mass index (weight/height2), and energy intake among 431 preadolescent and adolescent girls from a working-class New England suburb. METHOD: A cross-sectional study design used self-report measures of concern with weight, frequency of dieting, and average dietary intake. RESULTS: Approximately 30% of the girls in each age stratum were above the national age-standardized 85th percentile for body mass index (BMI). Body mass index was positively associated with concern about weight and shape (r = 0.46, p = 0.0001) and frequency of dieting (r = 0.49, p = 0.0001). Extreme concern with weight and shape was most common among the obese preadolescent and adolescent girls; however, dissatisfaction was also present among the underweight females. Fifty percent of the girls who were below the national age-standardized 15th percentile for BMI reported their ideal weight is less than their current weight, implying that among young women thinness is not adequate protection against dissatisfaction with weight and shape. Frequency of dieting was positively associated with concern about weight and shape (r = 0.53, p = 0.001) but not physical activity (r = -0.04, p = 0.36). Overall, we did not find strong evidence that dieters were eating less than their nondieting peers. Only among high school students was there a significant negative association between frequency of dieting and energy intake (r = -0.20, p = 0.01), suggesting that "dieting" may have a different meaning to preadolescents and adults. CONCLUSIONS: These findings indicate that self-reported frequent dieting in preadolescent and young adolescent girls is more indicative of extreme concern with weight than of decreased energy intake. Furthermore, extreme concern with weight and shape is most common among the obese preadolescent and adolescent girls.
Validation of a youth/adolescent food frequency questionnaire.
BACKGROUND: To address limited longitudinal nutrition data on children and adolescents, a self-administered food frequency questionnaire was designed for older children and adolescents. Initially, the Youth/Adolescent Questionnaire (YAQ) was developed and demonstrated to be reproducible. This study was conducted to evaluate its validity. METHODS: The form was administered twice to a sample of 261 youths (ages 9 to 18) at an approximate interval of 1 year (1993-1994), and three 24-hr dietary recalls were collected during this period. Pearson correlation coefficients were calculated on nutrient data. RESULTS: Validity was first evaluated by comparing the average of the three 24-hr recalls to the average of the two YAQs. Similar mean nutrients were found by both methods. Correlation coefficients between the mean energy-adjusted nutrients computed by the two methods ranged from 0.21 for sodium to 0.58 for folate. After correction for within-person error, the average correlation coefficient was 0.54, similar to that found among adults. CONCLUSION: A simple self-administered questionnaire completed by older children and adolescents can provide nutritional information about this age group.