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PubMed2006

Night eating: prevalence and demographic correlates.

OBJECTIVE: To examine the prevalence and correlates of night eating, the core behavioral symptom of night eating syndrome among adolescents and adults, using two public access survey databases of nationally representative samples. RESEARCH METHODS AND PROCEDURES: Data were extracted for individuals age 13 years or older who completed food diary data for the National Health and Nutrition Examination Survey III (N = 18,407) or the Continuing Survey of Food Intakes by Individuals (N = 10,741). Prevalence estimates were calculated for three commonly used definitions of night eating. Logistic regression was used to examine correlates of night eating: type of day, season, gender, age, race/ethnicity, and BMI or obesity. RESULTS: With few exceptions, findings were similar in the two surveys. Night eating is most common during the weekend; prevalence is greatest among young adults (18 to 30 years of age) and least common among individuals age 65 years or older; and is not associated with BMI or obesity. Gender or ethnicity effects were not found to be stable across surveys. DISCUSSION: Experts need to consider type of day, age group, and possibly gender and race/ethnicity when examining population differences in night eating. Longitudinal studies are needed to further examine the link between night eating and obesity.

Adolescent↗

PubMed2000

Dietary intakes, eating style and overweight in the Stanislas Family Study.

OBJECTIVES: To describe the eating patterns of members of French families and to assess the relationships between dietary intakes, eating style and overweight. DESIGN: Cross-sectional analysis of nutritional and behavioural characteristics. SUBJECTS: 1,320 members of 387 families (age 11-65y) attending the Centre for Preventive Medicine for a routine medical check-up. MEASUREMENTS: Individual body weight and height were measured. Food intake was assessed using a three day dietary record. Eating style was measured using the French validated version of the Dutch Eating Behaviour Questionnaire. RESULTS: In each of the four groups (men, women, boys and girls), dietary restraint was positively correlated with overweight (P< or =0.001) and associated with lower energy intakes (P < or = 0.05-P < or = 0.001). A negative association between energy intake and overweight was found in girls only (P< or =0.001). In all cases, overweight and dietary restraint exaggerated any existing macronutrient imbalance in energy intake (ie higher protein and fat contributions, lower carbohydrate contribution). Emotional eating was positively correlated to body mass index in women only (P< or =0.01). External eating was mainly a characteristic of children (P< or =0.001). CONCLUSION: As in overweight subjects, clear relationships were found in this sample of general population between dietary intakes and eating style. The population will be followed up for 10y. In the long term, these results should have implications in the prevention of obesity.

Adolescent↗

PubMed2002

Eating behavior in obese patients with and without type 2 diabetes mellitus.

OBJECTIVE: Aim of this study was the assessment of the prevalence of eating disorders, and of eating disorder symptoms, in obese patients with type 2 diabetes, compared to non-diabetic subjects. DESIGN: Three samples of individuals were studied: a series of 156 (76 male, 80 female) overweight and obese type 2 diabetic patients, aged 30-65 y, with a body mass index (BMI)>28 kg/m(2) (DM); a series of 192 (20 male, 172 female) obese (BMI>30 kg/m(2)) non-diabetic patients aged 30-65 y seeking treatment for weight loss (OC); and a non-clinical sample of 48 (22 male, 26 female) obese (BMI>30 kg/m(2)) subjects aged 30-65 y selected from the lists of two general practices (OP). Eating behavior was assessed using the Eating Disorder Examination (EDE 12.0D). RESULTS: The prevalence of Binge Eating Disorder was lower than 5% in all the three samples. Median EDE scores in females were significantly higher in OC (3.0) and OP (3.4) than in DM (1.7), while diabetic patients showed higher scores on Restraint than both non-diabetic samples. Among diabetic patients, a significant correlation of EDE scores with HbA(1)c was observed. CONCLUSIONS: Type 2 diabetes is unlikely to induce relevant eating disturbances in obese patients, apart from an increase in restraint. Abnormalities of eating attitudes and behavior are associated with an impairment of metabolic control.

Adult↗

PubMed2003

Prevalence of binge-eating disorder in obese children and adolescents seeking weight-loss treatment.

OBJECTIVE: The aim of the present study was to examine the extent to which a population of obese children and adolescents developed binge-eating disorder (BED). METHOD: A sample of 196 obese children and adolescents (aged 10-16 y) seeking weight-loss treatment at two treatment facilities (inpatient and outpatient treatment) was screened using the eating disorder examination. RESULTS: : Only 1% of the subjects met the criteria for BED and 9% were found to have objective bulimic episodes (OBEs, overeating with loss of control), but did not endorse all of the other DSM-criteria that are required for a diagnosis of BED. OBEs were more common in girls than in boys. Episodic overeating was more common than binge eating. Compared to children without OBEs, children engaging in OBEs were more overweight and showed a greater eating-related psychopathology. The age of the first OBE was 10.88 y (s.d.=2.60). It appears that overweight precedes binge eating. DISCUSSION: A subgroup of girls and boys seeking treatment for obesity shows considerable eating difficulties. The results highlight the importance of considering binge-eating symptoms when devising treatment programmes for children and adolescents suffering from obesity.

Adolescent↗

PubMed2003

Children's representation of family mealtime in the context of maternal eating disorders.

BACKGROUND: Recent research provides evidence for specific disturbance in feeding and growth in children of mothers with eating disorders. AIM: To investigate the impact of maternal eating disorders during the post-natal year on the internal world of children, as expressed in children's representations of self and their mother in pretend mealtime play at 5 years of age. METHODS: Children of mothers with eating disorders (n = 33) and a comparison group (n = 24) were videotaped enacting a family mealtime in pretend play. Specific classes of children's play representations were coded blind to group membership. Univariate analyses compared the groups on representations of mother and self. Logistic regression explored factors predicting pretend play representations. RESULTS: Positive representations of the mother expressed as feeding, eating or body shape themes were more frequent in the index group. There were no other significant group differences in representations. In a logistic regression analysis, current maternal eating psychopathology was the principal predictor of these positive maternal representations. Marital criticism was associated with negative representations of the mother. CONCLUSIONS: These findings suggest that maternal eating disorders may influence the development of a child's internal world, such that they are more preoccupied with maternal eating concerns. However, more extensive research on larger samples is required to replicate these preliminary findings.

Adult↗

PubMed2003

Perception of self-physique and eating behavior of high school students in Japan.

The authors investigated the condition of self-physique perception and eating behavior, and the relationship between self-physique perception and eating behavior of high school students in Japan. Regarding self-physique perception, subjects were shown six pictures of physiques and asked to choose one physique each for their actual physique and their ideal physique. With respect to eating behavior, the Japanese version of the Eating Attitudes Test (EAT)-26 was used. Groups of underweight girls, normal girls, and normal boys tended to regard their actual physiques as rather broad, demonstrating that many girls are excessively preoccupied with thinness. The rate of eating problems was 11.2% for the girls and 2.4% for the boys. For both boys and girls, those who idealized the thinner physique scored higher in terms of the EAT score and factor I score. Education regarding body perception and diet must be undertaken as soon as possible in Japan.

Adolescent↗

PubMed2001

Eating and drinking in labor: the influence of caregiver advice on women's behavior.

BACKGROUND: Although there is much debate about eating and drinking during labor, little scientific data about its influence on the course of labor exist. In The Netherlands, most midwives and obstetricians allow women to eat and drink during normal labor. The objective of this study was to examine whether or not women were actively advised to eat and drink and if this advice affected eating and drinking behavior. METHODS: A randomly selected group of midwives and obstetricians from across The Netherlands identified 211 consecutive nulliparous women to participate in the study. In a questionnaire with open-ended questions, women were asked after their delivery whether or not they were advised about eating and drinking during labor, and if so, about the nature of this advice and what they had consumed. Data were analyzed at the Leyenburg Hospital in The Hague. RESULTS: Sixty-six percent of the women were not given advice about eating and drinking during labor. Women who were given advice usually followed it. In the total group, 37 percent of the women had intake other than water and of these, 75 percent ate solid food. After adjusting for other prognostic factors, the incidence of an instrumental delivery due to a nonprogressing second stage was lower in women with caloric intake (13% vs 24%, p = 0.04). CONCLUSION: The study design did not enable us to draw conclusions about the cause and effect between caloric intake and labor progress. Scientific data with respect to the giving of evidence-based advice about eating and drinking during labor are lacking. Should such advice become available, women are likely to follow it.

Drinking↗

PubMed2001

The role of third molar surgery in the exacerbation of eating disorders.

PURPOSE: Eating disorders are a major public health problem. This study was undertaken to investigate the role of dental surgery in the etiology and clinical course of these serious and occasionally life-threatening disorders. METHODS: Three questions concerning dental therapy were included in a pretreatment assessment of 97 consecutive patients entering an eating disorder therapy program during a 22-month period. These questions were designed to determine the influence of dental surgery, including frequency and severity, on eating disorders. RESULTS: All 97 patients, of which 96 were female, complied with the questionnaire. Seventy-five of 97 were 25 years or younger, and 53 of 97 were diagnosed as having anorexia nervosa. Sixteen patients (16.5%) reported having had orthodontic therapy, and 21 (21.6%) had undergone third molar surgery. Nine patients (9.3%) (1 orthodontic, 8 third molar surgery) indicated that dental procedures had caused exacerbation or relapse of their eating disorders; 8 of 21 (38%) who had undergone third molar surgery were positive respondents. None of the patients linked dental care to the initial onset of their eating disorders. CONCLUSIONS: These data reveal that dental procedures, specifically third molar surgery, can significantly alter the course of eating disorders, causing exacerbation or relapse. No patient indicated that dental therapy was the primary cause of these multifactorial psychonutritional disorders. A history of eating disorder should alert the practitioner to the risks of performing third molar surgery without a medical or psychotherapy consultation unless there is documentation of remission. Delay of surgical intervention is recommended if third molars are asymptomatic. If surgery is necessary, the surgeon and other members of the psychotherapy team should establish clear guidelines regarding behavior and postoperative nutrition and should monitor the patient's nutritional status.

Adolescent↗

PubMed2001

Healthy eating in Ukraine: attitudes, barriers and information sources.

OBJECTIVE: To identify the major perceived influences on food choice, to examine the use of and trust in information sources concerning healthy eating, and to assess attitudes towards and barriers to adopting healthy eating practices in a post-USSR country (Ukraine). DESIGN: A survey of an urban adult population. The questions were adopted from the Pan-European Union (EU) Survey of Consumer Attitudes to Food, Nutrition and Health (1995-1996). SETTING: Lviv city, Ukraine. SUBJECTS: The survey included 296 adults (84 males, 212 females) aged 18-55 years; they were primarily college students and subjects with tertiary education--the groups most likely to be both interested in healthy eating and affected by current socioeconomic downturns. RESULTS: The major factors in food choice were: 'quality/freshness' (cited by 80%), 'price' (58%) and 'taste' (47%); only 34% cited 'trying to eat healthily'. More older people cited 'price' than 'quality/freshness', and men were more likely than women to cite 'taste'. Sources of healthy eating information included: 'relatives/friends' (cited by 65%, trusted by 85%) and health professionals (trusted by 92%, but used by only 35%); while advertising was the least trusted source (cited by 28%). Fifty-three per cent of respondents considered their diet to be healthy enough without further changes; 50% thought of the nutritional aspects of the food they ate; fewer women than men considered their diet healthy, and more women than men thought about nutrition. Barriers to healthy eating included: 'cost' (cited by 65%), 'lack of time' (55%), 'self-control' (54%), 'selection influences' (41%), 'lack of knowledge' (32%), 'unpleasant foods' and 'resistance to change' (both 30%). CONCLUSIONS: Strategies to encourage healthy eating in this population should involve word-of-mouth nutrition education concerning low-cost healthy alternatives.

Adolescent↗

PubMed2005

Psychological features are important predictors of functional gastrointestinal disorders in patients with eating disorders.

OBJECTIVE: Gastrointestinal symptoms that occur without evidence of structural gastrointestinal disease are a well-recognized feature of patients with eating disorders (EDs). Despite this, the spectrum and predictors of specific functional gastrointestinal disorders (FGIDs), documented using standardized and validated questionnaires, have received little attention. The aims of the study were to describe the prevalence and type of FGIDs in patients suffering from anorexia nervosa (AN), bulimia nervosa (BN) and eating disorders not otherwise specified (EDNOS), and to determine the relationships between psychological features, eating-disordered attitudes and behaviours, demographic characteristics and the type and number of FGIDs present. MATERIAL AND METHODS: A total of 101 consecutive female patients admitted to an eating disorder unit (AN 44%, BN 22%, EDNOS 34%, mean age 21 years) completed the Rome II modular questionnaire and a range of other validated self-reported questionnaires detailing illness history, psychological features and eating and exercise behaviour. RESULTS: The criteria for at least one FGID were fulfilled by 98% of the sample. The most prevalent FGIDs were irritable bowel syndrome (IBS: 52%), functional heartburn (FH: 51%), functional abdominal bloating (31%), functional constipation (FC: 24%), functional dysphagia (23%) and functional anorectal pain disorder (FAno: 22%); 52% of the sample satisfied the criteria for at least three coexistent FGIDs. Psychological variables (somatization, neuroticism, state and trait anxiety), age and binge eating were significant predictors of specific, and > or =3 coexistent FGIDs. Other disordered eating characteristics, including body mass index, were not predictors. CONCLUSIONS: In patients with EDs, specific psychological traits predict FGID type and the presence of multiple coexistent FGIDs. These findings support the role of specific psychological features as important contributors to certain FGIDs.

Adult↗

PubMed2005

Usefulness of amenorrhoea in the diagnoses of eating disorder patients.

We investigated the usefulness of amenorrhoea as a criterion in eating disorder diagnoses. Menstrual history, eating disordered behavior and weight history of 251 female eating disorder inpatients were assessed on admission to hospital. Menstrual status of 88 (35%) could not be assessed (80 taking hormonal contraception, 5 (< 16 years) had never menstruated, one hysterectomized, 2 postmenopausal). Of the remaining 163; 90 had secondary amenorrhoea (no periods for > 3 months), 19 irregular periods and 54 regular cycles. Some patients with recent changes in energy status, who warranted inpatient treatment for their eating disorder did not develop amenorrhoea until later during their admission. Menstrual disturbance is not limited to anorexia nervosa, 24% of patients with an eating disorder not otherwise specified (EDNOS) and 15% of bulimic patients had amenorrhoea/oligomenorrhoea on admission. The best predictors (82% cases, 83% noncases, R2 = 0.41) of secondary amenorrhoea at admission, were; current BMI < or = 18, and having rules for exercising. Menstrual status of women with an eating disorder diagnosis cannot always be assessed, is mostly measuring low body weight and exercise and is not useful in planning or initiating treatment. There is insufficient evidence to support the use of amenorrhoea as a criterion for any eating disorder.

Adolescent↗

PubMed1999

Eating disorders in adolescent girls with insulin-dependent diabetes mellitus: a population-based case-control study.

In this study the prevalence of eating disorders in a population-based cohort of 89 female patients with type 1 diabetes, 14-18 y of age, was compared with that in age-matched healthy controls. Of all diabetic girls in the study area, 92% participated in the study. The majority were treated with multiple insulin injections and the mean HbA1c of the participants was 8.4%. On average, diabetic girls were 6.8 kg heavier than the controls. A two-stage design was used. The first consisted of a validated self-report questionnaire, the Eating Disorder Inventory (EDI). Girls who had high scores were then interviewed about eating habits and mental health using a semistructured interview, the BAB-T (Assessment of Anorexia-Bulimia - Teenager version). No cases of anorexia or bulimia nervosa were found, but 15 diabetic patients (16.9%) compared with 2 control girls (2.2%), p<0.01, had disturbed eating behaviour according to the questionnaire. In 6 of these 15 diabetic girls an eating disorder was confirmed at the interview, mainly binge eating and self-induced vomiting. None of the control girls showed an eating disorder. Overweight diabetic girls scored higher on EDI than non-overweight diabetic girls (chi2 = 4.9; p = 0.038). No relationships were found between EDI scores and metabolic control (HbA1c), dose of insulin, frequency of hypoglycaemia or diabetic ketoacidosis.

Adolescent↗

PubMed1996

Volatile flavor release from foods during eating.

Classical analyses for volatile flavors (headspace or distillation/extract methods) give information on either the volatiles present in the air above a food before eating or the total volatile composition of the food. When foods are eaten, however, many changes take place (such as hydration/dilution with saliva, increase in surface area, etc.) that affect the release of volatiles from the food and therefore the profile of volatiles that are sensed in the nose. If we wish to study the relationship between flavor volatiles and the sensory properties of a food, it seems logical to measure the volatile profile that exists during eating. Although volatile flavor release during eating has been measured using a variety of sensory and psychophysiological analyses, only recently have instrumental methods been developed to measure the release of volatile compounds in humans as they eat. Whereas the sensory data give an overall measure of flavor perception, instrumental analyses can potentially follow the release of each and every flavor volatile and thus give a full picture of the aroma profiles generated during eating. From these instrumental measurements, a number of key factors have been identified. First, it has been shown that the volatile profile measured during eating is indeed different from the headspace profile of whole foods. Second, it is clear that the volatile profile in-mouth changes with time as the state of the food changes with chewing. Third, the volatile release from low-water foods is affected by the rate and extent of hydration in-mouth. The ability to measure aroma before, during, and after eating may lead to an understanding of the links between aroma release, interaction of volatiles with aroma sensors in the nose, and the overall perception of food flavor.

Eating↗

PubMed2006

The prevalence of eating disorders among university students and the relationship with some individual characteristics.

OBJECTIVE: The purpose of this study was to determine the prevalence of eating disorders (EDs) among university students in a rural area of Turkey and to compare groups based on the sociodemographic data, history of child abuse and neglect, family roles and self-esteem with a normal control group regarding EDs. METHOD: Subjects who were chosen by simple random sampling method were consisted of 980 Cumhuriyet University students who agreed to participate out of the 1003 total students and were given a sociodemographic information form and an Eating Attitudes Test (EAT). Students who scored above a cutoff level on the EAT were interviewed using the Structured Clinical Interview for DSM-IV axis I Disorders (SCID-I), Clinical Version. The Rosenberg Self-Esteem Scale, Family Assessment Device (FAD) and Childhood Abuse and Neglect Questionnaire Form were given to subjects in the control and study groups. RESULTS: Seventy-one of the 951 students (492 female, 459 male) who correctly filled out the EAT had a score above the cutoff level of 30 or higher. Of these 71 students, 21 (2.20%) were found to have an eating disorder based on the SCID-I. No subjects were found to have anorexia nervosa. Eighteen of the 21 subjects were female. Of these 18 female students, 15 (1.57%) were found to have bulimia nervosa and three (0.31%) were found to have binge eating disorder (BED). All of the three male subjects were diagnosed with BED (0.31%). The self-esteem of those in the study group was lower than those in the control group (p < 0.001). Subjects in the study group had more frequent histories of sexual and emotional abuse in childhood (p < 0.05). Also, in the study group scores showing communication in FAD families, unity and emotional attachment were statistically significantly lower than the control group (p < 0.001). CONCLUSIONS: It has been observed from the results of this research that the frequency of bulimia nervosa and BED in this sample is so similar to Western samples. Besides that, self-esteem, child abuse and neglect, and family functions must be examined in detail because they are risk factors for EDs and affect the course of treatment.

Adolescent↗

PubMed2002

Eating behavior in the Old Order Amish: heritability analysis and a genome-wide linkage analysis.

BACKGROUND: Eating behavior and thus dietary intake affect the development of obesity-related diseases such as diabetes, hypertension, and hyperlipidemia. OBJECTIVE: We investigated the genetic underpinnings of eating behavior. DESIGN: We administered a standardized eating behavior inventory to 624 adults from 28 families participating in the Amish Family Diabetes Study. Three quantifiable components of eating behavior were measured: restraint, disinhibition, and hunger. Associations between eating behavior scores and physical characteristics were evaluated. Heritability analysis and a genome-wide multipoint linkage analysis were performed. RESULTS: Eating behavior scores were associated with obesity and obesity-related phenotypes. Heritability estimates were 0.28 +/- 0.09 for restraint, 0.40 +/- 0.10 for disinhibition, and 0.23 +/- 0.09 for hunger (P < 0.001). The linkage analysis showed 4 regions of suggestive linkage. We observed suggestive evidence for linkage of restraint scores to 2 chromosomal regions, near markers D3S1304 [LOD (log of odds) = 2.5, P = 0.0003] and D6S276 (LOD = 2.3, P = 0.0006). We previously reported that D3S1304 is linked to a locus influencing percentage body fat in this same population (LOD = 1.6), suggesting that this behavioral phenotype may be secondary to obesity. The maximum LOD scores for disinhibition were 1.6 (P = 0.003) near marker D7S657 and 1.4 (P = 0.005) near marker D16S752. The maximum LOD score for hunger was 1.4 (P = 0.005) near marker D3S1278. CONCLUSION: Significant familial effects on eating behavior and suggestive genetic linkage were found in Amish adults.

Chromosome Mapping↗

PubMed2002

Eating in the absence of hunger and overweight in girls from 5 to 7 y of age.

BACKGROUND: Eating when exposed to large portions of palatable foods in the absence of hunger has been suggested to contribute to overweight. OBJECTIVE: This research evaluated whether young girls' eating in the absence of hunger was stable across a 2-y period in middle childhood, was associated with an increased risk of overweight, and could be predicted by parents' use of restriction in child feeding. DESIGN: The participants were 192 non-Hispanic white girls and their parents, assessed when the girls were 5 and 7 y of age. The girls' eating when exposed to palatable foods in the absence of hunger was measured after they consumed a standard lunch and indicated that they were no longer hungry. RESULTS: Eating in the absence of hunger showed moderate stability across the 2-y period for most of the girls. The girls who ate large amounts of snack foods in the absence of hunger at 5 and 7 y of age were 4.6 times as likely to be overweight at both ages. Parents' reports of restricting their daughter's access to foods at age 5 y predicted girls' eating in the absence of hunger at age 7 y, even when the girls' weight status and eating in the absence of hunger at age 5 y were controlled for. CONCLUSIONS: This study provides the first evidence that young girls' eating in the absence of hunger may represent a stable phenotypic behavior of young overweight girls. In addition, these findings are consistent with previous work indicating that parents' restrictive feeding practices may contribute to this behavior.

Body Weight↗

PubMed2006

Is restrained eating a risk factor for weight gain in a general population?

BACKGROUND: In modern societies characterized by abundant and accessible foods, restrained eating may become an adaptive behavior to limit weight gain. OBJECTIVE: We assessed the relations between eating behavior (EB) and adiposity in a general population over a 2-y period. DESIGN: We recruited 466 adults and 271 adolescents in 1999 on a geographical basis to participate in a longitudinal study. At the initial examination and 2 y later, they answered an EB questionnaire, the Three-Factor Eating Questionnaire-R18, which measured cognitive restraint (CR), uncontrolled eating, and emotional eating. On the same occasions, several measures of adiposity were also obtained: body mass index (BMI; in kg/m2), waist circumference, the sum of 4 skinfold thicknesses, and percentage body fat. Relations between EB and adiposity were tested separately in adults and adolescents by using mixed linear regressions after adjustment for age, sex, and (in adolescents) Tanner pubertal stage. RESULTS: At baseline, CR was positively associated with BMI in normal-weight subjects (mean BMI: 21.4 in the lowest to 23.3 in the highest CR quintile; P < 0.001) but not in overweight adults (P = 0.25). Initial CR did not predict change in adiposity variables (BMI change: P = 0.79 in adults, P = 0.57 in adolescents and young adults). Conversely, a high initial BMI was associated with a larger increase in CR (beta = 20.1, P < 0.0001 in adults; beta = 21.7, P = 0.003 in adolescents and young adults). CONCLUSIONS: Restrained eating is strongly associated with adiposity in normal-weight subjects but not in overweight subjects. However, restrained eating does not promote weight gain.

Adipose Tissue↗

PubMed2002

The prevalence of eating disorders in female health care students.

Previous research has suggested a raised prevalence of eating disorders amongst female medical students. This study aimed to test the belief, commonly held by occupational physicians, that there is also an increased prevalence of eating disorders amongst female applicants to nurse training. If correct, it implies the need for additional support and may predict increased failure to complete the course. Three groups of female students were compared: applicants to a university nurse training course, first-year medical students and a comparison group of first-year university students on courses not related to health care. Possible eating disorders were identified using two self-report instruments, the EAT-26 and the BITE questionnaires, and the body mass index. No significant statistical difference was found in the prevalence of eating disorders between the three groups, using the above measures. After controlling for age and ethnicity, 20% of the nurse applicants were found to have disordered eating patterns meriting further investigation, compared with 19% of medical students and 21% of arts students. The nursing students are being followed up to compare the progress of those with and without disordered eating patterns.

Adolescent↗