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PubMed1999

Perceptions of soil-eating and anaemia among pregnant women on the Kenyan coast.

After a clinical study at Kilifi District hospital had shown a high prevalence of geophagy among pregnant women, and a strong association of geophagy, anaemia and iron depletion, 52 pregnant women from the same hospital, and 4 traditional healers from the surroundings of Kilifi in Kenya were interviewed on the topic of soil-eating and its perceived causes and consequences. The findings were substantiated by results from an earlier anthropological study on maternal health and anaemia in the same study area. Most of the pregnant women (73%) ate soil regularly. They mainly ate the soil from walls of houses, and their estimated median daily ingestion was 41.5 g. They described soil-eating as a predominantly female practice with strong relations to fertility and reproduction. They made associations between soil-eating, the condition of the blood and certain bodily states: pregnancy, lack of blood (upungufu wa damu), an illness called safura involving "weak" blood, and worms (minyolo). The relationships the women described between soil-eating and illness resemble to some extent the causalities explored in biomedical research on soil-eating, anaemia and intestinal worm infections. However the women did not conceptualise the issue in terms of the single causal links characteristic of most scientific thought. Instead, they acknowledged the existence of multiple links between phenomena which they observed in their own and other women's bodies. The women's ideas about soil-eating and their bodies shows the significance of both social and cultural context on the ways in which women derive knowledge from, and make sense of their bodily states. The cultural associations of soil-eating with blood, fertility and femininity exist alongside knowledge of its links to illness. Our findings show that soil-eating is more than just a physiologically induced behaviour; it is a rich cultural practice.

Anemia, Iron-Deficiency↗

PubMed2001

Eating disorders: recognition, evaluation, and implications for obstetrician/gynecologists(1).

Eating disorders are a common finding in adolescent females. The lifetime prevalence of anorexia nervosa and bulimia nervosa is as high as 3.7% and 4.2%, respectively. The disease is much more common in females than males and is often associated with depression and other mood disorders. Complications from eating disorders can include amenorrhea, osteoporosis with pathologic fractures, electrolyte disturbances, dehydration, cardiac arrhythmias, and even death. Eating disorders appear not only to increase the risk of miscarriage, but also are associated with preterm delivery and lower infant birth weights. Treatment for eating disorders can be lifesaving and is more effective when instituted before the patient becomes severely underweight. Evaluation of patients with suspected eating disorders includes a thorough history and physical examination as well as baseline screening laboratory tests. A high index of suspicion is needed to detect patients with eating disorders because many are in denial about their illness. Inpatient hospitalization is recommended for significant metabolic abnormalities and for patients who weigh <85% of their estimated healthy body weight. Treatment for eating disorders includes nutritional rehabilitation, behavioral therapy, and often antidepressant therapy. The obstetrician/gynecologist is one of the few health care providers that young, otherwise healthy women who are at risk for eating disorders will see on a regular basis, and they must be diligent to recognize the signs and symptoms of these diseases so that appropriate and timely interventions can be made.

Journal Article↗

PubMed2002

Eating disturbances in female prisoners: the role of anger.

Women in prison have high levels of impulsive damaging behaviours, including disordered eating. In addition, they display pathological levels of the emotional precursors that have been associated with eating disorders, particularly anger. The present study examines levels of disordered eating behaviours in female prisoners, and whether those behaviours are associated with anger. The sample consisted of 91 sentenced women at a medium-sized prison in the UK. The women completed an interview-based screening tool for eating disorders, alongside a standardised measure of anger. Using the established cut-off on the measure concerned, 25% of the women were at risk for an eating disorder. This prevalence rate is exactly twice that observed in a non-eating-disordered community sample, using the same measure. Furthermore, different facets of anger were associated with different aspects of eating psychopathology. The most plausible explanation for this association appears to be that many women enter prison with high levels of anger-driven impulsivity, and that the constraints of the prison environment result in a focus on eating behaviours. Future research directions are discussed.

Journal Article↗

PubMed2003

Eating, mood, and gender in a noneating disorder population.

Recently, eating in relation to emotions has been the focus of much research. The present study evaluates the role of mood, gender, and tendency for emotions to impact on eating (as measured by a revised form of the Emotional Eating Scale-II, EES II) within an analogue mood-related eating paradigm, e.g., Baucom & Aiken [J. Pers. Soc. Psychol. 41 (1981) 577], with a nonclinical population. The results indicate that there is a complex relationship that exists between gender and mood. Males appeared to experience a reduction in the negative component of their overall mood after eating, while females appeared to be more emotionally responsive to eating overall. This effect is not dependent on tendency for emotions to impact on eating as measured by the EES II. This suggests that there is a need to examine the impact of mood on eating in both clinical and nonclinical populations as there appears to be important differences between the populations.

Journal Article↗

PubMedDate not supplied

Barriers to and motivators for healthful eating as perceived by rural and urban Costa Rican adolescents.

OBJECTIVE: To assess the perceptions of rural and urban Costa Rican adolescents about their diet and the factors they consider significant to healthful eating. DESIGN: Data were collected in focus group discussions. PARTICIPANTS: The study sample included 108 male and female adolescents aged 12 to 18 years. Adolescents were recruited among 7th to 11th grade students interested in taking part in the study. SETTING: Two urban and one rural high school in San José, Costa Rica. PHENOMENA OF INTEREST: Diet perceptions and barriers to and motivators for healthful eating. ANALYSIS: Data were reviewed for emerging themes, and themes were coded applying content analysis procedures. The conceptual model for understanding adolescent eating behavior, proposed by Story and colleagues, served as the framework for this study. RESULTS: Factors perceived as barriers to adopting healthful eating practices included unavailability of healthful food in the school environment, inadequate food choices within the family diet, and the peer-group notion among males and females that healthful eating by males is effeminate. Factors perceived as motivators included improving the nutritional quality of foods available at school, adoption of healthful eating practices by the entire family, and healthful eating becoming a peer-group social norm. CONCLUSIONS AND IMPLICATIONS: This study suggests that the family, peer group, and school environment are potential targets for nutrition interventions for Costa Rican adolescents, but further studies are needed to confirm this conclusion. Future studies should explore in depth the factors associated with the family's eating pattern and the influence of adolescent socialization patterns (particularly male) in the establishment of a healthful diet.

Adolescent↗

PubMed2003

The prevalence of DSM-IV personality pathology among individuals with bulimia nervosa, binge eating disorder and obesity.

BACKGROUND: There are numerous reports of personality disorder pathology in different eating disorders. However, few studies have directly compared personality pathology in bulimia nervosa, binge eating disorder and obesity. The present study examines group differences in DSM-IV personality pathology, considering the potential utility of understanding personality disorders in terms of diagnosis and dimensional scores. METHOD: Eating disorder diagnoses were established using the Eating Disorder Examination interview. Thirty-five bulimia nervosa patients, 15 binge eating disorder patients and 37 obese patients were assessed and compared on the International Personality Disorder Examination using categorical and dimensional personality disorder scores. RESULTS: For most personality disorders, there was a dichotomy of binge eaters versus non-binge eaters. In contrast, there was a continuum of severity in borderline personality disorder pathology between the groups. The dimensional system of measurement of personality pathology allowed for clearer differentiation between the groups. CONCLUSION: The study strongly indicates that personality disorder difficulties are present in patients who binge eat, while obese patients who do not binge eat display significantly less personality disorder pathology. Assessment of bulimia nervosa, binge eating disorder and obesity needs to address personality disorders and pathology. Dimensional markers of personality pathology can be used to supplement categorical diagnoses, providing information about the traits that underlie diagnosis.

Adult↗

PubMed1988

Social contagion of binge eating.

A social psychological account of the acquisition of binge eating, analogous to the classic social psychological work, "Social Pressures in Informal Groups" (Festinger, Schachter, & Back, 1950), is suggested and tested in two college sororities. In these sororities, clear evidence of group norms about appropriate binge-eating behavior was found; in one sorority, the more one binged, the more popular one was. In the other, popularity was associated with binging the right amount: Those who binged too much or too little were less popular than those who binged at the mean. Evidence of social pressures to binge eat were found as well. By the end of the academic year, a sorority member's binge eating could be predicted from the binge-eating level of her friends (average r = .31). As friendship groups grew more cohesive, a sorority member's binge eating grew more and more like that of her friends (average r = .35). The parsimony of a social psychological account of the acquisition of binge eating behavior is shown. I argue that there is no great mystery to how bulimia has become such a serious problem for today's women. Binge eating seems to be an acquired pattern of behavior, perhaps through modeling, and appears to be learned much like any other set of behaviors. Like other behaviors, it is under substantial social control.

Adult↗

PubMed2002

Serum leptin concentration in obese patients with binge eating disorder.

BACKGROUND: In steady-state conditions serum leptin concentration is directly related to body fat stores, but is also affected by changes in energy balance. This cross-sectional study investigated the serum leptin concentrations of severely obese patients with binge eating disorder (BED), in whom body fat was greater than normal and, because of eating pattern, rapid and repeated changes in energy balances took place. METHODS: A group of BED obese patients was compared to a group of obese patients with a regular eating pattern with the same body weight, body composition and resting energy expenditure. Serum leptin was measured and the eating attitudes were evaluated by Eating Inventory and Eating Disorder Inventory. RESULTS: In these patients serum leptin concentrations were only weakly correlated to body mass. Furthermore, in BED obese patients serum leptin concentration was higher than in their non binging counterparts. CONCLUSIONS: In obese patients both body fat size and eating behavior influence serum leptin concentration, but BED patients binge eating is not triggered by a low leptin value.

Attitude↗

PubMed2002

Binge eating disorder in extreme obesity.

OBJECTIVE: To determine whether extremely obese binge eating disorder (BED) subjects (BED defined by the Eating Disorder Examination) differ from their extremely obese non-BED counterparts in terms of their eating disturbances, psychiatric morbidity and health status. DESIGN: Prospective clinical comparison of BED and non-BED subjects undergoing gastric bypass surgery (GBP). SUBJECTS: Thirty seven extremely obese (defined as BMI > or = 40 kg/m(2)) subjects (31 women, six men), aged 22-58 y. MEASUREMENTS: Eating Disorder Examination 12th Edition (EDE), Three Factor Eating Questionnaire (TFEQ), Structured Clinical Interview for the Diagnostic and Statistical Manual-IV (SCID-IV), Short-Form Health Status Survey (SF-36), and 24 h Feeding Paradigm. RESULTS: Twenty-five percent of subjects were classified as BED (11% met full and 14% partial BED criteria) and 75% of subjects were classified as non-BED. BED (full and partial) subjects had higher eating disturbance in terms of eating concern and shape concern (as found by the EDE), higher disinhibition (as found by the TFEQ), and they consumed more liquid meal during the 24 h feeding paradigm. No difference was found in psychiatric morbidity between BED and non-BED in terms of DSM-IV Axis I diagnosis. The health status scores of both BED and non-BED subjects were significantly lower than US norms on all subscales of the SF-36, particularly the BED group. CONCLUSION: Our findings support the validity of the category of BED within a population of extremely obese individuals before undergoing GBP. BED subjects differed from their non-BED counterparts in that they had a greater disturbance in eating attitudes and behavior, a poorer physical and mental health status, and a suggestion of impaired hunger/satiety control. However, in this population of extremely obese subjects, the stability of BED warrants further study.

Adult↗

PubMed1996

Association between eating behaviour and current glycaemic control, body mass or autonomic nervous function in long-term type I and type II diabetic patients.

This cross-sectional study was aimed at investigating the association between eating behaviour and current glycaemic control, body mass or autonomic nervous function in patients with type I and type II diabetes mellitus (DM). In 72 patients (31 type I DM, 41 type II DM) we investigated body mass index (BMI), serum cholesterol, serum triglycerides, haemoglobin A1c (HbA1c) and autonomic nervous function (seven standardized tests). The three-factor eating questionnaire was used to investigate cognitive control of eating behaviour (CC) and susceptibility to eating problems (SEP). The mathematical product of CC and SEP provides information about disinhibition of eating control (DEC). In type I DM, there was a correlation between SEP and age (r = -0.536, P < 0.01), SEP and HbA1c (0.438, P < 0.05), and between DEC and duration (-0.371, P < 0.05) and DEC and HbA1c (0.376, P < 0.05). In type II DM, there was a correlation between SEP and BMI (0.401, P < 0.01) and between DEC and BMI (0.429, P < 0.01). Low CC was associated with autonomic nervous dysfunction in type I DM (P = 0.022). In type II DM, autonomic nervous dysfunction was associated with high SEP (P = 0.044). In conclusion, the correlation between eating behaviour and HbA1c or triglycerides in type I DM indicates that the questionnaire is able to address current parameters of diabetes control. Self-assessment of eating behaviour in type I and type II diabetic patients reveals associations between eating behaviour and autonomic nervous function.

Adult↗

PubMed2005

Eating behavior among women with anorexia nervosa.

BACKGROUND: Disturbed eating and severe caloric restriction are characteristic features of patients with anorexia nervosa (AN). Despite the importance of eating behavior in the presentation of AN, there have been relatively few objective laboratory studies of eating behavior among persons with eating disorders. OBJECTIVE: The purpose of the study was to obtain objective measures of eating behavior among patients with AN before and immediately after weight restoration and to compare those measures with measures among control subjects. DESIGN: Twelve patients hospitalized for AN and 12 control subjects participated in the study. Eleven of the 12 patients were retested at 90% of ideal body weight. RESULTS: The average meal consumption was 103.97 +/- 102.08 g for patients at low weight and 178.03 +/- 202.97 g after weight restoration (NS). Control subjects consumed significantly more than did AN patients at both time points, and the average meal size was 489.58 +/- 187.64 g. Patients showed significant decreases in psychological and eating-disordered symptoms after weight restoration. CONCLUSION: These data suggest that patients with AN show a persistent disturbance in eating behavior, despite the restoration of body weight and significant improvements in eating-disordered and psychological symptoms.

Adolescent↗

PubMed1997

Estimated consumption and eating frequency of olestra from savory snacks using menu census data.

Potential chronic (14-d average) and acute (single-day) estimated daily intakes (EDI) were computed for olestra, a fat replacement intended for use in preparing savory snacks. The EDI were computed from eating occasions reported during a 14-d Menu Census survey among 4741 consumers; values were increased by 10% for conservatism. The eating occasions included all meals and in-between meal occasions eaten at home or away. Data from only those individuals who ate savory snacks at least once during the 14 d were used; this included 3820 individuals (81% of the sample) and represented a total of 16,067 eating days (24% frequency). The estimated mean chronic intake ranged from 1.8 to 4.7 g/d, depending on age and gender; at the 90th percentile, the range was 4.1-11.0 g/d. For all ages and both genders, the estimated mean intake was 3.1 g/d. Estimated acute intakes at the mean and 90th percentile ranged from 5.5 to 16.5 g/d and from 10.2 to 24.0 g/d, respectively, depending on age and gender. For all ages and both genders, the estimated mean intake was 10.2 g/d. The lack of parity in the chronic and acute intake estimates indicates that savory snacks are not eaten on a daily basis by the majority of snack eaters. The survey data were analyzed to understand the potential temporal eating patterns of olestra from savory snacks. When snacks were consumed, on average, 69% of the eating occasions were with main meals and 31% were between meals. Savory snacks did not contribute a major fraction of total food to the diet; only 7 and 18% of main meals contained a savory snack food at the 50th and 90th percentile, respectively. For the 50th-percentile consumer (all ages, both genders), savory snacks were eaten four times during the 14-d survey period, and the eating occasions occurred on 3 d. Comparable results for 90th-percentile consumers were 10 eating occasions and 8 eating days.

Adolescent↗

PubMed2006

Binge eating in overweight treatment-seeking adolescents.

OBJECTIVE: To examine the frequency and recency of binge eating in relation to psychopathology in overweight, treatment-seeking adolescents. METHODS: We investigated psychological correlates of the frequency and recency of reported loss of control (LOC) eating episodes in 160 overweight (body mass index [BMI]: 40.7 +/- 8.8 kg/m(2)) adolescents. On the basis of the responses to the eating disorder examination (EDE), participants were categorized into one of four groups: full-syndrome binge eating disorder (BED); recent but infrequent binge eating (episodes within the 3 months before interview; RECENT-BINGE); remote and infrequent LOC eating (episodes occurring >3 months before assessment; PAST-LOC), or no history of LOC episodes (NE). RESULTS: The BED group reported higher EDE scores (global, p < .01), and more negative mood and anxiety than all other groups (p's < .01). Compared with NE, RECENT-BINGE also reported more anxiety and higher EDE scores (p's < .01). CONCLUSIONS: Overweight, treatment-seeking adolescents with BED are clearly distinguishable from teens without the disorder on measures of eating-related psychopathology, mood, and anxiety. RECENT-BINGE, but not PAST-LOC, is also associated with significantly greater eating-related and general psychopathology.

Adolescent↗

PubMed2007

The Leu72Met polymorphism of the ghrelin gene is significantly associated with binge eating disorder.

OBJECTIVES: The pathophysiological mechanisms underlying binge eating disorder are poorly understood. Evidence exists for the fact that abnormalities in peptides involved in the regulation of appetite, including ghrelin, may play a role in binge eating behavior. Genes involved in the ghrelin physiology may therefore contribute to the biological vulnerability to binge eating disorder. METHODS: We examined whether two polymorphisms of the ghrelin gene, the G152A (Arg51Gln) and C214A (Leu72Met), were associated with binge eating disorder. Ninety obese or nonobese women with binge eating disorder and 119 normal weight women were genotyped at the ghrelin gene. RESULTS: Statistical analyses showed that the Leu72Met ghrelin gene variant was significantly more frequent in binge eating disorder patients (chi2=5.940; d.f.=1, P=0.01) and was associated with a moderate, but significant risk to develop binge eating disorder (odds ratio=2.725, 95% confidence interval: 1.168-6.350). CONCLUSIONS: Although these data should be regarded as preliminary because of the small sample size, they suggest that the Leu72Met ghrelin gene variant may contribute to the genetic susceptibility to binge eating disorder.

Adult↗

PubMed2003

How similar are correlates of different subclinical eating problems and bulimia nervosa?

BACKGROUND: This study examined the physical, parental, and psychological correlates of subtypes of high EAT-26 scores and bulimia nervosa (BN) in 155 girls/young women seen at two times over a 6-year period (ages 16 and 22). Participants were from white, upper-middle-class families. METHODS: In young adulthood, participants were interviewed for lifetime history for an eating disorder; participants completed questions assessing subclinical problems and correlates at both times of assessment. Based on their EAT-26 scores and diagnostic status for BN at each time, girls were classified into the following groups: True Positive (BN and high EAT-26 scores), False Positive (high EAT-26 scores and no BN), and True Negative (low EAT-26 scores and no BN). RESULTS: In adolescence, 4% of girls were classified as True Positives BN and 23% were classified as False Positives. Similar distributions were found at young adulthood (i.e., 5% True Positives BN and 21% False Positives). By using cluster analysis, two types of subclinical problems (False Positives) were identified at each time with some girls having only high Eating symptoms and others also having high psychopathology. The 'high Eating symptoms only' cluster was more similar to the True Negative group than was the 'high Psychopathology' cluster at each time. CONCLUSIONS: Individuals in the latter group experienced co-occurrence with depression, resulting in pervasive impairments in psychosocial functioning during both adolescence and young adulthood.

Adolescent↗

PubMed2005

Integration and individuality in healthy eating: meanings, values, and approaches of childless, dual earner couples.

INTRODUCTION AND OBJECTIVES: Although considered to be an important component of food choice, perceptions and practices regarding healthy eating vary between people and change over the life-course. The purpose of this paper is to examine integration and individuality in healthy eating meanings, values, and approaches of individuals in childless, dual earner couples. MATERIALS AND METHODS: Fourteen participants (from seven couples) were recruited using notices and snowball sampling. Food journals and individual interviews were used to explore the nature of and negotiations between partners' healthy eating values and approaches. Data were analysed through iterative procedures that included coding, thematic analysis and memo writing. RESULTS: Participants presented individual healthy eating values and approaches based on their own experiences with food over time. Cohabitation resulted in a continuum of healthy eating negotiation outcomes, including congruent values and approaches, congruent values but divergent approaches, and divergent values and approaches. In combination with other salient factors, cohabitation provides an opportunity for improving healthy eating approaches. DISCUSSION: Cohabitation has the potential to lead to positive changes in healthy eating approaches. Practitioners need to tailor messages for clients' specific needs and encourage change in the direction of the partner with the healthier eating approach.

Adult↗

PubMed2006

Sleep-wake cycles in obese children with and without binge-eating episodes.

AIM: The aim of the study was to assess binge-eating episodes and to characterise sleep-wake cycles among obese children. METHOD: The obese group consisted of 36 children. All participants received a diagnosis of primary obesity. The obese group was subdivided into two groups: obese with binge eating and without binge eating. A normal-weight control group was comprised of 25 normal-weight children. Sleep-wake patterns were monitored for 1 week, using mini-actigraphs and self-report questionnaires. RESULTS: Thirty-seven per cent of the obese children reported uncontrolled binge-eating episodes. Actigraphic monitoring revealed significant differences in sleep quality between all three groups. Self-report questionnaires presented significantly more sleep disturbances in the obese group with binge eating and obese group without binge eating than in the normal-weight group. CONCLUSION: Sleep disruption in obese children with binge eating is significantly more severe than in both obese non-binge-eating children and normal-weight controls.

Child↗

PubMed2001

Frequency of eating and concentrations of serum cholesterol in the Norfolk population of the European prospective investigation into cancer (EPIC-Norfolk): cross sectional study.

OBJECTIVES: To examine the relation between self reported eating frequency and serum lipid concentrations in a free living population. DESIGN: Cross sectional population based study. SETTING: Norfolk, England. PARTICIPANTS: 14 666 men and women aged 45-75 years from the Norfolk cohort of the European prospective investigation into cancer (EPIC-Norfolk). MAIN OUTCOME MEASURES: Concentrations of blood lipids. RESULTS: Mean concentrations of total cholesterol and low density lipoprotein cholesterol decreased in a continuous relation with increasing daily frequency of eating in men and women. No consistent relation was observed for high density lipoprotein cholesterol, body mass index, waist to hip ratio, or blood pressure. Mean cholesterol concentrations differed by about 0.25 mmol/l between people eating more than six times a day and those eating once or twice daily; this difference was reduced to 0.15 mmol/l after adjustment for possible confounding variables, including age, obesity, cigarette smoking, physical activity, and intake of energy and nutrients (alcohol, fat, fatty acids, protein, and carbohydrate). CONCLUSIONS: Concentrations of total cholesterol and low density lipoprotein cholesterol are negatively and consistently associated with frequency of eating in a general population. The effects of eating frequency on lipid concentrations induced in short term trials in animals and human volunteers under controlled laboratory conditions can be observed in a free living general population. We need to consider not just what we eat but how often we eat.

Aged↗