Abstract: Abstract The relationship between self-compassion and well-being and health (e.g. a lower proneness for eating-related disturbances) is well stressed in the literature. However, the specific contribution of self-compassionate attributes, actions, and body compassion remains scarcely studied. The main aim of the present study was to examine whether the link between self-compassionate attributes and disordered eating attitudes and behaviours is mediated by self-compassionate actions and body compassion, in a sample of 299 Portuguese women from the general population. The tested model explained 44% of eating psychopathology’s variance and presented excellent fit indices. The most interesting contribution of this study was the suggestion that the ability to act in accordance with self-compassionate attributes is associated with higher levels of body compassion, that is, an attitude of appreciation, acceptance, warmth toward body-related thoughts, perceptions and feelings, which reflects in a lower susceptibility to adopt disordered eating attitudes and behaviours. These results seem to offer an important contribution for research and clinical practice by supporting the importance of including strategies to develop self-compassionate skills and body compassion competencies in prevention and treatment programs in the area of eating psychopathology. Level of evidence Level III, evidence obtained from a well-designed cohort. PubDate: 2018-09-18
Abstract: Purpose The study aimed to assess the prevalence of underweight and overweight or obesity and their sociodemographic, lifestyle, and health factors in a national adult population in Lao People’s Democratic Republic (PDR) (Laos). Methods A national cross-sectional study based on a stratified cluster random sampling was conducted in 2013. The total sample included 2531 individuals 18–64 years, (females = 59.3%; mean age 38.7 years, SD = 12.8) from Laos. Questionnaire interview, blood pressure and anthropometric measurements, and biochemistry tests were conducted. Multinomial logistic regression was utilized to determine the association between sociodemographic, lifestyle and health status factors, and underweight and overweight or obesity relative to normal weight. Results Using Asian criteria for body mass index (BMI) classification, 9.7% of the population was underweight (BMI < 18.5, kg/m2), 47.5% had normal weight (BMI 18.5–22.9 kg/m2), 17.5% overweight (23.0–24.9 kg/m2), 19.6% class I obesity (BMI 25.0–29.9 kg/m2), and 5.6% class II obesity (BMI ≥ 30.0 kg/m2) (or 42.8% overweight, class I or class II obesity). In adjusted multinomial logistic regression, female sex (adjusted relative risk ratio-ARRR 0.67, confidence interval-CI 0.45, 0.99), current tobacco use (ARRR 1.57, CI 1.02, 2.41), and having no hypertension (ARRR 0.50, CI 0.26, 0.97) were associated with underweight, and middle and older age (ARRR 1.79, CI 1.41, 2.25), being Lao-Tai (ARRR 1.37, CI 1.06, 1.76), urban residence (ARRR 1.62, CI 1.20, 2.17), having meals outside home (ARRR 1.36, CI 1.04, 1.77), no current tobacco use (ARRR 0.57, CI 0.34, 0.59), low physical activity (ARRR 1.39, CI 1.01, 1.92), having hypertension (ARRR 2.52, CI 1.94, 3.26), and dyslipidaemia (ARRR 1.56, CI 1.21, 2.00) were associated with overweight or obesity. Conclusion A dual burden of both adult underweight and overweight or obesity was found in Laos. Sociodemographic, lifestyle, and health status risk factors were identified for underweight and overweight or obesity, which can help in guiding public health programmes to address both these conditions. Level of evidence Level V, descriptive cross-sectional survey. PubDate: 2018-09-17
Authors:Rachel W. Goode; Melissa A. Kalarchian; Linda Craighead; Molly B. Conroy; Tiffany Gary-Webb; Elizabeth Bennett; Mariah M. Cowell; Lora E. Burke Abstract: Introduction Binge eating may contribute to the prevalence of obesity in African-American women. Yet, there has been scant intervention research on the treatment of binge eating in this population. We tested the feasibility of an appetite awareness training (AAT) intervention in a sample of African-American women with binge and overeating behaviors. Participants who completed AAT were recruited to participate in focus groups to elicit information about their perceptions and experiences with this intervention to inform the design of future interventions to treat binge eating and obesity in African-American women. Methods African-American women, aged 18–70 years, who had completed an 8-week randomized AAT intervention, were invited to attend a focus group discussion. Session content was recorded and transcribed. Data were analyzed by use of open coding. Themes were identified that described their perceptions and experiences of participating in the intervention. Results Seventeen women participated in three focus group discussions. Pertinent themes identified included: paying attention to internal cues of hunger and satiety, influence of culture on eating patterns, breaking patterns of disordered eating, and perceptions about weight. Overall, participants were satisfied with their experience of AAT, and reported they found it valuable to learn about listening to biological signals of hunger and satiety and to learn specific strategies to reduce maladaptive eating patterns. Conclusion AAT was acceptable and provided helpful eating behavior instruction to African-American women with reported binge and overeating behaviors. Future research should examine the potential of AAT to improve weight management in this underserved population. Level of evidence Level V, qualitative descriptive study. PubDate: 2018-09-16 DOI: 10.1007/s40519-018-0577-z
Authors:Sebastian Jesús Garrido; Paola Noelia Funes; María Emilse Peñaloza Merlo; Marcos Cupani Abstract: Purpose Few studies have been conducted on Latin American population to explore how facets of personality, eating disorders, and obesity are related. The main purpose of this study was to explore the personality traits among patients diagnosed with anorexia nervosa (n = 23), bulimia nervosa (n = 32), and obesity (n = 16), in comparison to control group (n = 82). Methods A total of 153 individuals participated in the study, 125 were female (81.7%) and 28 were male (18.3%). Participants’ ages ranged between 18 and 37 years (mean 24.21, SD 4.84) and they were all native Spanish speakers, living in the city of Córdoba, Argentina. Participants completed the Eating Disorder Inventory-2 and the IPIP-NEO Personality Inventory. Results In this study, the subjects diagnosed with anorexia in comparison to control group showed high and significant scores in neuroticism and openness to experience and low scores on agreeableness, conscientiousness, and extraversion. For their part, the subjects diagnosed with bulimia, in comparison to the control group, had higher and significant scores on neuroticism, extraversion, and conscientiousness. Lastly, the patients with obesity in comparison to the control group presented high and significant scores on neuroticism and low and significant scores on agreeableness, extraversion, conscientiousness, and openness to experience. Conclusions The results obtained from this study support previous research devoted to the study of eating disorders and obesity. This situation favors the valid and relevant nature of the study of personality traits as factors that contribute to explaining behavior disorders associated with eating pathologies. This is a preliminary and necessary step for future research to examine the risky combination of personality traits and anorexia, bulimia, and obesity in the local context using a larger and more generalized sample. PubDate: 2018-09-16 DOI: 10.1007/s40519-018-0546-6
Authors:Dai Miyawaki; Ayako Goto; Tomoko Harada; Tsuneo Yamauchi; Yoshihiro Iwakura; Hiroki Terakawa; Kaoru Hirai; Yusuke Miki; Yuji Harima; Koki Inoue Abstract: Purpose Shoplifting, prevalent in patients diagnosed with bulimia nervosa (BN), is a serious behavioral problem in eating disorder (ED) patients. However, little is known about its overall presence, etiology, and consequences. This study aimed to determine whether shoplifting occurs before or after the onset of ED and to investigate the prevalence and correlates of shoplifting in ED patients. Methods This was a cross-sectional study of 284 treatment-seeking female patients aged 13–45 with EDs [171 anorexia nervosa (AN); 113 BN]. Shoplifting, impulsive behaviors (self-injury, suicide attempt, sexual promiscuity, alcohol, and illicit drug use), depression, self-esteem, and clinical features of EDs were assessed with an interview. Results Lifetime shoplifting prevalence was 28.5% (81/284) with 70.4% (57/81) occurring before ED onset. Multivariate logistic regression analysis revealed that depression [odds ratio (OR), 2.63; 95% confidence interval (CI), 1.24–5.60], alcohol abuse (OR, 3.91; 95% CI 1.34–11.38), illicit substance use (OR, 14.42; 95% CI, 1.65–125.86), and self-esteem (OR, 0.90; 95% CI; 0.82–0.99) were associated with lifetime shoplifting, while illness duration, BN, and ED symptom severity were not. Conclusions Shoplifting is common in ED patients and precedes ED onset in most patients with a shoplifting history, although the causal relationship between shoplifting and EDs remains inconclusive. Shoplifting may be associated with impulsive behaviors (e.g., alcohol and illicit drug use), depression, and low self-esteem, but not with ED severity. Future research should focus on the unrecognized role of shoplifting as a marker to identify patients at risk of impulsive behaviors and consider treatment options. Level of evidence Level V, observational cross-sectional descriptive study. PubDate: 2018-09-16 DOI: 10.1007/s40519-018-0575-1
Authors:Chrissy A. Chard; Carolin Hilzendegen; Friederike Barthels; Nanette Stroebele-Benschop Abstract: Purpose Recently, the concept of orthorexia nervosa (ON) as a potential new variant of disordered eating behavior has gained popularity. However, published prevalence rates appear to be questionable given the lack of validity of the available questionnaires. The Düsseldorf Orthorexie Scale (DOS) is a validated questionnaire only available in German to measure orthorexic behavior. Methods The DOS was translated into English using the back-translation process. Cronbach’s alpha was used to establish internal consistency and an intra-class correlation coefficient was calculated to assess reliability. The Eating Habits Questionnaire (EHQ) was used to test construct validity and the Eating Disorders Inventory was used to test discriminant validity. Principal and confirmatory factor analyses were carried out to test the factor structure. The sample consists of 384 university students in the U.S. Results English (E)-DOS and EHQ were highly correlated (r = 0.76, p < .001) indicating very good construct validity. Cronbach’s alpha coefficient reached 0.88, indicating very good internal consistency. Confirmatory factor analyses revealed a poorly fitted one-factor model, but good results for the standardized coefficients for the 10 items ranging between 0.52 and 0.82 were found. According to the E-DOS, 8.0% of the students exceeded the preliminary cut-off score, while an additional 12.4% would be considered being at risk of developing ON. Conclusions The E-DOS appears to be a valid, reliable measure for assessing ON. The results revealed higher prevalence rates for orthorexic behavior among U.S. students compared to German students. Cultural aspects could play a role in those differences. Level of evidence Descriptive study, Level V. PubDate: 2018-09-08 DOI: 10.1007/s40519-018-0570-6
Authors:María Laura Parra-Fernandez; Teresa Rodríguez-Cano; Maria José Perez-Haro; María Dolores Onieva-Zafra; Elia Fernandez-Martinez; Blanca Notario-Pacheco Abstract: Purpose The ORTO-11-ES questionnaire is a tool to assess the pathological obsession displayed by some individuals regarding healthy eating. The aims of this study were (1) to confirm the factor structure of the Spanish version of ORTO-11-ES using confirmatory factor analysis (CFA) and (2) to examine the possible association between the ORTO-11-ES score, gender and body mass index (BMI). Methods The sample comprised 492 students from the University of Castilla la Mancha, Spain. Of these, 280 were women (56.9%). Participants were surveyed using the ORTO-11-ES questionnaire. Results The confirmatory factor analysis (CFA) supported the 11 elements and 3 domains of this tool as the better fitting model; for the Comparative Fit Index (CFI) and the Tucker–Lewis Index (TLI), the values were 0.94 and 0.91, respectively, and the Root Mean-Square Error of Approximation (RMSEA) was 0.058. The tendency towards orthorexic behavior is more associated with the female gender. The BMI had no influence on the tendency for ON. Conclusions This study is the first attempt to confirm the three-factor structure of a Spanish version of the ORTO-15 questionnaire. These findings suggest that the ORTO-11-ES may be a valuable tool for identifying subjects with specific eating behavior patterns. This information may be useful for health professionals involved in the research, development and implementation of interventions catered to individuals suffering from this eating disorder. Level of evidence Level V, descriptive cross-sectional study. PubDate: 2018-09-08 DOI: 10.1007/s40519-018-0573-3
Authors:Sasha Gorrell; D. Catherine Walker; Drew A. Anderson; James F. Boswell Abstract: Purpose Concerns about caloric intake associated with alcohol use (e.g., fear of weight gain) are positively associated with compensatory eating behaviors (e.g., caloric restriction, self-induced vomiting), a phenomenon that has been identified across gender. Specific motivations for compensatory behaviors differ; some relate to eating disorder (ED) pathology (e.g., shape and weight concerns), and others to alcohol (e.g., enhancing effects). Research examining motivations for alcohol-related compensatory behaviors in men is limited to date. The current study sought to assess how specific types of alcohol-related compensatory behaviors and their association with ED pathology present differently by gender. Methods Undergraduates (N = 530, 48% female) completed the Compensatory Eating Behaviors in Response to Alcohol Consumption Scale (CEBRACS), Eating Disorders Diagnostic Scale (EDDS), and reported height, weight, and frequency and quantity of alcohol consumption. Data were examined using linear regression, and relations between CEBRACS behaviors and eating pathology were compared across gender. Results Factors that were positively associated with EDDS scores for both men and women included alcohol-related dietary restraint, and exercise. For women, but not men, alcohol-related bulimic behavior also contributed to elevations in EDDS scores. Conclusions Findings indicate that specific types of alcohol-related compensatory eating behaviors (i.e., dietary restraint and exercise) are positively related to ED pathology for both male and female participants. In contrast, bulimic behaviors’ association with ED pathology is gender specific. Understanding gender differences in alcohol-related compensatory behaviors and ED risk may inform gender-specific intervention targets. Level of evidence Cross-sectional descriptive study, Level V. PubDate: 2018-09-08 DOI: 10.1007/s40519-018-0545-7
Authors:Youl-Ri Kim; Bo In Hwang; Gi Young Lee; Kyung Hee Kim; Mirihae Kim; Kwang Kee Kim; Janet Treasure Abstract: Purpose The aim of the present study was to describe the clinical features of binge eating disorder (BED) in normal weight and overweight undergraduate Korean women. Methods 117 overweight (BMI ≥ 25 kg/m2) and 346 normal weight (18 kg/m2 ≤ BMI < 25 kg/m2) undergraduate Korean women completed questionnaires to assess for BED. Their emotional eating behaviors, binge eating-related behaviors, a spectrum of compulsive behaviors such as substance abuse and obsessive–compulsive disorder, and psychological profiles were evaluated through personal interviews and questionnaires. The features of those with BED were compared to those without BED in the overweight and normal weight groups. Results Both normal weight and overweight BED women had higher levels of functional impairment, eating disorder psychopathology including emotional and external eating behaviors, and neuroticism than their non-BED counterparts. In the normal weight group, BED women had more frequent alcohol consumption and obsessive–compulsive symptoms than non-BED women. In the overweight group, BED women had higher levels of depression and lower extraversion than non-BED women. Conclusions BED is associated with global functional impairment and mental health problems. Thus, the association with high functional impairments and psychiatric comorbidities suggest that people with BED may benefit from treatment. Level III Evidence obtained from well-designed case–control analytic studies, from more than one center. PubDate: 2018-09-08 DOI: 10.1007/s40519-018-0574-2
Authors:Melinda D. Hale; John V. Logomarsino Abstract: Purpose Enteral nutrition (EN) is frequently used in the treatment of anorexia nervosa (AN), and less commonly, bulimia nervosa (BN); yet, no standardized guidelines for treatment exist at this time. The aim of this review is to investigate the efficacy of EN in the treatment of eating disorders and make recommendations for clinical practice and future research. Methods An exhaustive literature search of 7 databases was completed. The search strategy combined key terms anorexia nervosa, bulimia, and eating disorders with terms associated with EN. There were no restrictions on publication date or language. Studies that assessed the effect of EN on weight restoration, refeeding syndrome, and binge/purge behaviors in the treatment of AN and BN were included. Results Of 73 full-text articles reviewed, 22 met inclusion criteria. Nineteen studies reported that significant short-term weight gain was achieved when EN was used for refeeding malnourished AN patients; however, results varied for the six studies reporting on long-term weight gain, maintenance, and recovery. In studies with a comparator, no significant differences were found between the EN and oral refeeding cohorts regarding gastrointestinal disturbance, refeeding syndrome, or electrolyte abnormalities. Five studies examined the effect of EN on binge/purge behaviors, suggesting that temporary exclusive EN decreases the frequency and severity of binge/purge episodes. Conclusion Although EN is an essential life-saving treatment in severe cases of AN, it does not guarantee long-term success or recovery. The results of this systematic review highlight the need for prospective controlled trials with adequate sample sizes to make comparisons between specific feeding methods, formulations, and defined short and long-term outcomes. Evidence-based standards for clinical practice are needed with specific guidelines for best results for AN and BN treatment. Level of evidence I, systematic review. PubDate: 2018-09-08 DOI: 10.1007/s40519-018-0572-4
Authors:Sara Oliveira; Inês Trindade; Claúdia Ferreira Abstract: Purpose The current study tested a path model that examined the association between early emotional experiences with peers and male body attitudes and whether general feelings of shame and body-focused shame mediate this relationship, while controlling for the effect of body mass index. Methods The sample comprised 241 men from the general community, aged from 18 to 60, who completed an online survey. Results Correlation analyses showed that the recall of positive early emotional experiences with peers is inversely linked to shame and negative body attitudes. Path analysis results indicated that early emotional experiences with peers had a direct effect on external shame, and an indirect effect on male negative body attitudes mediated by external shame and body-focused shame. Results confirmed the plausibility of the tested model, which accounted for 40% of the variance of male body attitudes. Findings suggested that men who recall fewer positive early peer emotional experiences tend to perceive that they are negatively viewed by others and present more body image-focused shame experiences. This in turn seems to explain a negative self-appreciation of one’s muscularity, body fat and height. Conclusions This study contributes to a better understanding of male body attitudes. Findings suggest that the link between early emotional experiences and male body attitudes may depend on the experience of shame feelings and, particularly, on the extent to which one’s body image becomes a source of shame. These data support the relevance of addressing shame experiences when working with men with body image-related difficulties. Level of evidence Level V—cross-sectional descriptive study. PubDate: 2018-09-01 DOI: 10.1007/s40519-018-0569-z
Authors:Stefano Giovinazzo; S. G. Sukkar; G. M. Rosa; A. Zappi; G. P. Bezante; M. Balbi; C. Brunelli Abstract: Abstract Anorexia nervosa (AN) is an eating disorder that most frequently afflicts females in adolescence. In these subjects, cardiovascular complications are the main cause of morbidity and mortality. Aim of this review is to analyze the hemodynamic, pro-arrhythmic and structural changes occurring during all phases of this illness, including re-feeding. A systematic literature search was performed on studies in the MEDLINE database, from its inception until September 2017, with PUBMED interface focusing on AN and cardiovascular disease. This review demonstrated that the most common cardiac abnormalities in AN are bradycardia and QT interval prolongation, which may occasionally degenerate into ventricular arrhythmias such as Torsades des Pointes or ventricular fibrillation. As these arrhythmias may be the substrate of sudden cardiac death (SCD), they require cardiac monitoring in hospital. In addition, reduced cardiac mass, with smaller volumes and decreased cardiac output, may be found. Furthermore, mitral prolapse and a mild pericardial effusion may occur, the latter due to protein deficiency and low levels of thyroid hormone. In anorectic patients, some cases of hypercholesterolemia may be present; however, conclusive evidence that AN is an atherogenic condition is still lacking, although a few cases of myocardial infarction have been reported. Finally, refeeding syndrome (RFS), which occurs during the first days of refeeding, may engender a critically increased risk of acute, life-threatening cardiac complications. PubDate: 2018-09-01 DOI: 10.1007/s40519-018-0567-1
Authors:Ani Agopyan; Emre Batuhan Kenger; Seda Kermen; Mutlu Tuce Ulker; Mustafa Ataberk Uzsoy; Meral Kucuk Yetgin Abstract: This study was carried out to determine the relationship between orthorexia nervosa (ON) and eating disorder and body composition, class level, and place of residence in university students from the Department of Nutrition and Dietetics. The participants (n = 136; 20.9 ± 2.0 years) were all female students, whose scores on the Orthorexia Nervosa Questionnaire (ORTO-11) and the Eating Attitudes Test (EAT-40) indicated a prevalence of ON and eating disorder. Assessment of body composition indices (Tanita bioelectrical impedance; SC-330) of the participants showed there to be no significant difference in the EAT-40 and ORTO-11 scores in terms of body composition, class level, and place of residence. A large majority of the participants (70.6%) had high ORTO-11 scores, and a significant negative correlation (p < 0.05) was identified between the EAT-40 and ORTO-11 scores. Final results from analysis of the data showed that although abnormal orthorexic tendencies were common among the students from the Department of Nutrition and Dietetics, they were nonetheless able to maintain body composition within normal values. Level of evidence V, cross-sectional descriptive study. PubDate: 2018-08-29 DOI: 10.1007/s40519-018-0565-3
Authors:Anna Brytek-Matera; Kamila Czepczor-Bernat; Helena Jurzak; Monika Kornacka; Natalia Kołodziejczyk Abstract: Purpose Although research on vegetarianism is becoming more prevalent, to date, only a few research has been conducted on relationship between vegetarian diet and orthorexia nervosa (ON). The objective of the present study was to examine the orthorexic dietary patterns and eating behaviours among individuals following a vegetarian, vegan, and meat diet. We examined the moderating role of ethical and health reasons for following a meat-free diet on the relation between vegan versus vegetarian diet and eating behaviours and ON. The study aimed to determine the predictors of ON in individuals with differential food preferences. Methods Seventy-nine individuals following a meat-free diet and 41 individuals following an omnivore diet completed the EHQ and the TFEQ-R18. Results Our findings indicated that individuals following a vegan diet showed a higher level of knowledge of healthy eating than those who followed a vegetarian diet and those who followed an omnivore diet. Participants maintaining a vegan diet for health reasons were more likely to have greater knowledge about healthy eating. Cognitive restraint was a predictor of ON among a sample following a meat-free diet. Conclusions Our results could contribute to identify potential risk factors for strict health-oriented eating patterns and to gain a better insight into ON. Level of evidence Level V, descriptive study. PubDate: 2018-08-29 DOI: 10.1007/s40519-018-0563-5
Authors:Rui Lopes; Raquel Melo; Bernardo Dias Pereira Abstract: Abstract Orthorexia nervosa (ON) is a recently proposed eating disordered behaviour characterized by an obsessional or exaggerated fixation on healthy eating. The published literature is scarce regarding its classification, clinical presentation, management and long-term outcomes. Herein, we present the clinical and follow-up findings of an 18-year-old woman with ON comorbid with depression, successfully treated with mirtazapine. The patient had a 12-month history of obsessional behaviours for “healthy food”, characterized by suppression of sugar and fat from her diet, tightly counted meal calorie content, eating only self-made meals, avoidance of eating in public, unacceptance of other person’s opinions on diet, social isolation and a weight loss of 15 kg (body mass index of 16.2 kg/m2). A score of 19-points was initially obtained on the ORTO-15 questionnaire, suggesting the presence of orthorexic tendencies and behaviours. The patient also reported a 1-month history of depressed mood, anxiety, anhedonia, fatigue, insomnia with early morning waking, leading to the presumptive diagnosis of ON with comorbid depression. Treatment with mirtazapine for 11 months resulted in the remission of the disordered eating behaviour, a sustained regain of weight, a score of 41-points on the ORTO-15, and to the resolution of depressive symptomatology (including insomnia). To our knowledge, this is the first description of ON with comorbid depression successfully treated with mirtazapine. This case highlights the possible usefulness of mirtazapine as a treatment option for patients with ON. However, randomized controlled studies are warranted to confirm the current findings. PubDate: 2018-08-28 DOI: 10.1007/s40519-018-0539-5
Authors:Ana Laura Mendes; Cláudia Ferreira; Inês A. Trindade Abstract: Abstract Literature has emphasized the significant role of social acceptance and connectedness in well-being and the benefits of cultivating a positive body image in the prevention and treatment of body and eating-related difficulties. The current study aims to examine whether strategies of self-reassurance and body-image appreciation mediate the association of feelings of social safeness and acceptance with the “core” dimensions of body and eating-related psychopathology (restraint, eating concern, weight concern, and shape concern), while controlling the effects of body mass index (BMI). Participants were 309 Portuguese women, aged between 18 and 50 years that completed self-report measures. Results from the performed path analysis revealed that self-reassurance and body-image appreciation mediated the impact of feelings of social safeness and acceptance on eating psychopathology-related dimensions. Results seem to suggest that women who perceive the self as acceptable and desirable tend to adopt self-reassurance strategies. These strategies in turn seem to predict a protective and caring relationship with one’s own body and decreased severity of eating psychopathology symptoms. This path model explained 22%, 27%, 51%, and 47% of restraint, eating concern, weight concern, and shape concern, respectively, and showed an excellent model fit. Our findings appear to offer significant insights in the field of body and eating-related psychopathology and seem to support the pertinence of creating intervention programs for women from the general community with body and eating-related difficulties that encourage the adoption of self-reassurance strategies and promote a positive and respectful relationship with one’s own body image. Level of evidence V, cross-sectional descriptive study. PubDate: 2018-08-28 DOI: 10.1007/s40519-018-0568-0
Authors:Bahar Azemati; Ramin Heshmat; Mostafa Qorbani; Zeinab Ahadi; Ali Azemati; Gita Shafiee; Hasan Ziaodini; Mohammad Esmail Motlagh; Roya Kelishadi Abstract: Purpose Few studies have assessed the relationship between meal skipping with subjective health complaints in children and adolescents. The aim of our study was to determine the association between meal skipping and subjective health complaints in this population. Methods A total of 14,400 students aged 7–18 years were selected using multistage stratified cluster sampling method from 30 provinces of Iran. Data were collected as a part of the fifth national school-based surveillance program (CASPIAN-V) in Iran. Information about students’ lifestyle, health behaviours, health status and health complaints were gathered through a validated questionnaire. Results The mean (standard deviation) age of participants was 12.3 (3.2) years old. Breakfast skipping was associated with increased odds of stomachache (OR 1.77, 95% CI 1.56, 2.00), backache (OR 1.68, 95% CI 1.46, 1.92), difficulty in getting to sleep (OR 1.66, 95% CI 1.48, 1.86), feeling nervous (OR 1.59, 95% CI 1.43, 1.76) and irritability (OR 1.29, 95% CI 1.02, 1.25). There were 27, 63, 58 and 107% increase in odds of headache, stomachache, backache and difficulty in getting to sleep by lunch skipping, respectively. While dinner skipping was related to 39, 59 and 52% increase in odds of headache, feeling low and difficulty in getting to sleep, respectively, it was associated with decreased odds of stomachache (OR 0.33, 95% CI 0.25, 0.44). Conclusions Our study suggests that meal skipping is associated with some somatic and psychological health complaints among children; therefore, regular meal consumption, at least three times a day, is highly recommended in this population. Level of evidence V, cross-sectional descriptive study. PubDate: 2018-08-28 DOI: 10.1007/s40519-018-0559-1
Authors:Bonnie Dorise; Karen Byth; Therese McGee; Anita Wood; Caron Blumenthal Abstract: Purpose Excessive gestational weight gain is associated with detrimental outcomes to both the mother and baby. Currently, the best approach to prevent excessive gestational weight gain in overweight and obese women is undetermined. The present study aimed to evaluate the effectiveness of a group-based outpatient dietary intervention in pregnancy to reduce excessive gestational weight gain. Methods In this retrospective study, overweight and obese pregnant women who attended a single 90-min group education session were compared to women who received standard care alone. Total gestational weight gain, maternal and neonatal outcomes were compared between the intervention and control groups. Data were analysed using Student t, Mann–Whitney and Chi-squared tests as appropriate. A 24-h dietary recall was analysed and compared to the Australian National Nutrition Survey. Results A significant reduction in gestational weight gain was observed with this intervention (P = 0.010), as well as in the rate of small for gestational age births (P = 0.043). Those who attended the intervention had saturated fat and sodium intake levels that exceeded recommendations. Intake of pregnancy-specific micronutrients including folate, calcium and iron were poor from diet alone. Conclusions A low-intensity antenatal dietary intervention may be effective in reducing excessive gestational weight gain, although multi-disciplinary interventions yield the best success. Further research is required to identify the optimal modality and frequency to limit excessive gestational weight gain. Dietary interventions tailored to ethnicity should also be explored. Level of evidence Level II, controlled trial without randomization. PubDate: 2018-08-28 DOI: 10.1007/s40519-018-0566-2
Authors:Concepción Díaz de León-Vázquez; Aremis Villalobos-Hernández; José Alberto Rivera-Márquez; Claudia Unikel-Santoncini Abstract: Purpose The aim of this study was to analyze the effect of parental criticism of their offspring’s bodies in the development of disordered eating behaviors (DEBs) in university students in Mexico City. Methods A sample of 892 freshmen (502 women and 390 men) was included. The prevalence of the internalization of the aesthetic thin ideal, body dissatisfaction, self-esteem, depressive symptoms, and body mass index was estimated by sex. For each sex, the effect of parental criticism on DEBs, together with that of the other covariates, was measured through ordinal regression models. Results It was found that women received more criticism from their mothers than men. Among the participants, the likelihood of DEBs is increased in the presence of criticism from both parents (OR = 2.5), criticism from the mother alone (OR = 2.0), overweight (OR = 1.7), obesity (OR = 2.1), wanting a slimmer body (OR = 8.3), and depressive symptoms (OR = 3.3). Among men, this risk is increased in the presence of criticism from both parents (OR = 2.7), being obese (OR = 2.4), wanting a slimmer body (OR = 3.4), and depressive symptoms (OR = 2.8). Conclusions It is essential to include issues linked to parental criticism of their bodies in interventions to prevent eating disorders in college students. Level of evidence V, cross-sectional descriptive study. PubDate: 2018-08-28 DOI: 10.1007/s40519-018-0564-4
Authors:Kelly A. Romano; Martin A. Swanbrow Becker; Christina D. Colgary; Amy Magnuson Abstract: Objective The current study evaluated the comparative implications of self-weighing and calorie counting versus intuitive eating (IE) on the eating disorder (ED) severity of college students. Methods In this cross-sectional study, college students in the US [N = 902; 68% female; mean body mass index (BMI) = 24.3] completed the web-based Healthy Bodies Study in 2015. Results A hierarchical multiple regression analysis revealed that elevated BMI, more frequent self-weighing and calorie counting, and lower IE scores predicted increased ED severity. The results of Kruskal–Wallis H tests indicated that participants with elevated weight statuses engaged in self-weighing and calorie counting more frequently, and possessed lower IE scores, than their lower weight counterparts. Conclusion Engaging in self-weighing and calorie counting was adversely associated with ED severity among the present sample of college students. Cultivating IE within health promotion efforts may, instead, lead to favorable eating-related outcomes that may translate to the holistic health of this population. Level of Evidence V cross-sectional descriptive study. PubDate: 2018-08-28 DOI: 10.1007/s40519-018-0562-6
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