Tag: eating disorders

Categories : Diet and Nutrition PaediatricsTags :

Parents’ Eating Behaviour Influences how Their Children Respond to Food

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Young children often display similar eating behaviour as their parents, with a parent’s own eating style influencing how they feed their children, research at Aston University has shown.

The work, published in the journal Appetite, suggests that parents can help to shape healthy eating behaviour in their children both by how they themselves eat, as well as how they feed their children.

A team led by Professor Jacqueline Blissett at Aston University, asked parents to assess their own eating behaviour and looked for associations between those behaviours and those of their children.

The team grouped parents into four eating styles – ‘typical eating’, ‘avid eating’, ‘emotional eating’ and ‘avoidant eating’. Typical eaters, who made up 41.4% of the sample, have no extreme behaviours. Avid eaters (37.3%) have high food approach traits such as eating in response to food cues in the environment and their emotions, rather than hunger signals. Emotional eaters (15.7%) also eat in response to emotion but do not enjoy food as much as avid eaters. Avoidant eaters (5.6%) are extremely selective about food and have a low enjoyment of eating.

The direct links between child and parent behaviour were particularly clear in parents with avid or avoidant eating behaviours, whose children tended to have similar eating behaviour. Parents who had avid or emotional eating styles were more likely to use food to soothe or comfort a child, who then in turn displayed avid or emotional eating traits. Where parents with avid or emotional eating traits provided a balanced and varied range of foods, the child was less likely to display the same behaviour.

The research follows on from previous work by the team, which identified the four main types of eating behaviour in children and linked parental feeding practices to those traits.

Dr Abigail Pickard, the lead researcher on the project, said:

“Parents are a key influence in children’s eating behaviour but equally, parents have the perfect opportunity to encourage a balanced diet and healthy eating from a young age in their children. Therefore, it is important to establish how a parent’s eating style is associated with their children’s eating style and what factors could be modified to encourage healthy relationships with food.”

She and the team will now look at developing an intervention to support parents to use other ways to regulate emotions, model healthy eating, and create a healthy home food environment. This could help to prevent less favourable eating behaviours being passed down the generations from parent to child.

Source: Aston University

Categories : Diet and NutritionTags :

Time to Debunk Four Persistent Myths about Intermittent Fasting

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In a new article published in Nature Reviews Endocrinology, researchers at the University of Illinois Chicago debunk four common myths about the safety of intermittent fasting. 

Intermittent fasting as a weight loss method has grown increasingly popular, with a large body of research demonstrating its safety. Despite this, several myths about fasting have spread among clinicians, journalists and the general public: that fasting can lead to a poor diet or loss of lean muscle mass, cause eating disorders, or decrease sex hormones. 

In a new commentary, UIC researchers debunk each of these. They base their conclusions on clinical studies, some of which they conducted and some done by others. 

“I’ve been studying intermittent fasting for 20 years, and I’m constantly asked if the diets are safe,” said lead author Krista Varady, professor of kinesiology and nutrition at UIC. “There is a lot of misinformation out there. However, those ideas are not based on science; they’re just based on personal opinion.”  

There are two main types of intermittent fasting. With alternate-day eating, people alternate between days of eating a very small number of calories and days of eating what they want. With time-restricted eating, people eat what they want during a four- to 10-hour window each day, then don’t eat during the rest of the day. The researchers conclude both types are safe despite the popular myths.

Their conclusions: 

Intermittent fasting does not lead to a poor diet: The researchers point to studies showing the intake of sugar, saturated fat, cholesterol, fibre, sodium and caffeine do not change during fasting compared with before a fast. And the percentage of energy consumed in carbohydrates, protein and fat doesn’t change, either.  

Intermittent fasting does not cause eating disorders: None of the studies show that fasting caused participants to develop an eating disorder. However, all the studies screened out participants who had a history of eating disorders, and the researchers say that those with a history of eating disorders should not try intermittent fasting. They also urge paediatricians to be cautious when monitoring obese adolescents if they start fasting, because this group has a high risk of developing eating disorders. 

Intermittent fasting does not cause excessive loss of lean muscle mass: The studies show that people lose the same amount of lean muscle mass whether they’re losing weight by fasting or with a different diet. In both cases, resistance training and increased protein intake can counteract the loss of lean muscle. 

Intermittent fasting does not affect sex hormones: Despite concerns about fertility and libido, neither oestrogen, testosterone nor other related hormones are affected by fasting, the researchers said. 

Source: University of Illinois Chicago

Categories : Mental Health NeurologyTags :

Scientists may have Found the Specific Neurons Behind Anorexia Nervosa

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Anorexia nervosa, a mental health disorder in which people dangerously restrict their eating or purge their stomachs soon after a meal, is one of the deadliest psychological diseases. Yet, the neural mechanisms behind this have remained unclear, and therapies are limited.

Scientists have been tailing a lead for years, though. They’ve known that the disorder is often associated with anxiety and depression, hinting that the biological basis for anorexia could be regulated by neurons somewhere in the brain region that controls emotion – the amygdala.

That’s exactly where Haijiang Cai, a University of Arizona associate professor in the Department of Neuroscience and BIO5 Institute member, and his team found it: Anorexia is caused by a combination of two subregions in the amygdala, according to new research published in Cell Reports.

One knot of neurons in the central nucleus of the amygdala curbs appetite when a person gets full, feels nauseous or tastes something bitter. The other is in the oval region of the bed nucleus of the stria terminalis, which also halts eating due to inflammation and sickness.

Cai and his research team found that when they destroyed a certain type of brain cell, called PKC-delta neurons, in both of these regions, they could prevent anorexia development.

They also found that PKC-delta neurons become more active in response to eating during the anorexia development. What’s more, when they artificially activated these neurons, they caused a suppression in eating habits and increased exercise.

“This study suggests two important insights to treat anorexia,” Cai said. “One is that we need to target multiple brain regions to develop therapies. We also need to treat multiple conditions. For example, maybe one drug will target nausea and another drug target will target inflammation, and you have to combine them, like a cocktail therapy, to have better therapeutic effects.”

The team relied on mice models for their research.

“There’s no animal model that can mimic human disease completely, but this is as close as we can get,” Cai said. “For example, there are multiple common features, including a warped body image, a very low body weight, limited food intake and excessive exercise. We can’t know if an animal has a warped body image, but we can measure the other three features.”

One future step – since researchers cannot destroy neurons for human treatment – is to develop a method to silence the neurons temporarily, using drugs or some other method to test if that can prevent anorexia development or speed up recovery for people who have already developed the disorder.

Source: University of Arizona

Categories : Substance UseTags :

The Effect of Cannabis Use in Binge Eating Disorder

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New research published in the journal Experimental and Clinical Psychopharmacology examined how often people experiencing binge eating are also using cannabis recreationally, and whether patients who use cannabis experience more severe eating disorder symptoms or symptoms of struggling with mental health. The results indicated that many cannabis users with binge eating disorder feel a strong desire to use cannabis, as well as having greater risks for drinking problems.

Though much research has focused on the impact of cannabis on eating habits, less is known about the effects of cannabis use on individuals with a binge eating disorder. Binge eating is the experience of feeling out of control when eating or unable to stop eating. Cannabis may play a particular role in maintaining binge eating as research suggests cannabis can increase how pleasurable or rewarding people find high sugar or high fat foods.

The research from Drexel University’s Center for Weight, Eating and Lifestyle Science (WELL Center) found that more than 23% of the 165 study participants reported using cannabis in the past three months – either “once or twice” or “monthly.” These participants were individuals seeking treatment for binge eating and reported their cannabis and alcohol use as part of that process.

“Distinguishing the relationship between cannabis use, eating disorder severity and other psychiatric symptoms in binge eating patients is necessary for informing screening and clinical recommendations,” said lead author Megan Wilkinson, a doctoral student in Drexel’s College of Arts and Sciences.

While study participants who used cannabis reported “a strong desire or urge to use cannabis” and they also drank alcohol more frequently and reported more problems related to their alcohol use; the research team noted that participants with binge eating disorders who used cannabis did not have more severe eating disorder or depression symptoms.

“Both alcohol and cannabis can impact an individual’s appetite and mood. Our finding that patients with binge eating who use cannabis also drink more alcohol may suggest that these individuals are at a higher risk for binge eating, given the compounded effects on appetite and mood from these substances,” said Wilkinson. “Treatments for binge eating should explore how substance use affects hunger, mood, and eating for patients.”

Participants also completed surveys and interviews about their binge eating, other eating disorder symptoms and depression. The research team compared individuals who reported cannabis use to individuals who did not report cannabis use to see if there were statistically significant differences in their alcohol use, eating disorder symptoms, or depression symptoms.

The findings indicate that a notable subset of the participants with binge eating disorders use cannabis and experience strong desires or urges to use cannabis. Additionally, using cannabis appears to be related to drinking patterns and problems with drinking (eg, needing more alcohol to feel intoxicated, inability to control drinking) for patients with binge eating.

“We hope this research is helpful for clinicians treating patients with binge eating, as it can provide them with updated information about the prevalence of cannabis use in their patients,” said Wilkinson. “We recommend that clinicians screen for cannabis and alcohol use in all their patients and assess any potential problems the patient may be experiencing related to their substance use.”

Wilkinson also noted that updated research on cannabis use in patients with binge eating will be required regularly due to changing social norms and laws related to cannabis in the United States. Next, Wilkinson and her colleagues are planning to explore the ways that cannabis use may impact hunger and mood for patients with binge eating, and therefore potentially exacerbate their binge eating symptoms.

Source: Drexel University

Categories : Diet and Nutrition PaediatricsTags :

Study Classifies Four Eating Eating Behaviours of Children

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Children fall broadly into four eating categories, according to new research at Aston University, and parents feed their children differently depending on those categories.

The four categories identified by Dr Abigail Pickard and the team in the School of Psychology are ‘avid’, ‘happy’, ‘typical’, and ‘fussy’. The results, which showed specific temperaments and carer feeding patterns associated with overeating, are published in the journal Appetite.

In the UK, around a fifth of children are overweight or obese when they begin school, rising to around a third by the time they leave primary school at age 11. The team sought to identify eating behaviour patterns and how these are associated with temperament, feeding practices and food insecurity, as a way to predict which children are more at risk of becoming overweight.

Typical eaters made up 44% of the children in the study, while fussy eaters accounted for 16%. But of greatest interest to the team was that around one in five young children in the study were found to show “avid eating,” including greater enjoyment of food, faster eating speed, and weaker sensitivity to internal cues of ‘fullness’. The behaviours that distinguish children with avid eating from those who show ‘happy’ eating (17.7% of children in the study), who have similarly positive responses to food, are wanting to eat (or eating more) in response to the sight, smell or taste of palatable food, and a higher level of emotional overeating. In combination, these eating behaviours can lead to overeating and subsequent weight gain.

Dr Pickard and the team have also shown that there are significant differences in children’s temperament and caregivers’ feeding practices between each of the four eating behaviour patterns. Children with avid eating are more likely to be active and impulsive, and their caregivers are more likely to give them food to regulate their emotions or to restrict food for health reasons. Children with avid eating were also less food secure than children who showed happy or typical eating behaviours.

Principal investigator of the project, Professor Jackie Blissett, said: “Whilst feeding practices are key intervention targets to change children’s eating behaviour and child weight outcomes, there has been little evaluation of how feeding practices interact with children’s food approach behaviours to predict eating behaviour.”

She explained that despite the knowledge of the influence of feeding practices on children’s weight, current public health advice is generic and does not reflect variability in children’s appetites. Parents and caregivers can be left feeling frustrated when trying to manage their child’s food intake. By defining the four eating behaviour profiles, this research project, which is funded by the Economic and Social Research Council and co-developed by Professor Claire Farrow, Dr Clare Llewellyn, Dr Moritz Herle, Professor Emma Haycraft and Dr Helen Croker will make it easier to identify the best feeding practices for each eating pattern and provide tailored, effective advice for parents.

Dr Pickard said: “Parents can use this research to help them understand what type of eating pattern their child presents. Then based on the child’s eating profile the parent can adapt their feeding strategies to the child. For example, children in the avid eating profile may benefit more from covert restriction of food, i.e., not bringing snacks into the home or not having foods on display, to reduce the temptation to eat foods in the absence of hunger. Whereas, if a child shows fussy eating behaviour it would be more beneficial for the child to have a balanced and varied selection of foods on show to promote trying foods without pressure to eat.”

The team has planned further research investigating avid eating behaviour and will invite the caregivers and their children into the specialist eating behaviour lab at Aston University to get a better picture of what avid and typical eating behaviours look like in a real-life setting. All the findings will be integrated and the researchers will work with parents to develop feasible and helpful feeding guidelines to reduce children’s intake of palatable snack foods.

Source: Aston University

Categories : Genetics Mental HealthTags :

Serious Eating Disorder ARFID is Highly Heritable

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A twin study of the relatively newly described eating disorder ARFID has found that it is strongly influenced by genetic factors. The study, perfomed by researchers at Karolinska Institutet, has been published in the journal JAMA Psychiatry.

An estimated 1 to 5% of people suffer from an eating disorder that few are even aware exists. Avoidant/restrictive food intake disorder (ARFID) is a serious eating disorder that leads to malnutrition and nutritional deficiencies, and is a relatively new diagnosis only introduced to the World Health Organization’s ICD-11 this year.

Unlike anorexia, ARFID is not about the patient’s experience of their own body and fear of gaining weight. Instead, the disease is characterised by the avoidance of certain types of food due to a sensory discomfort because of the characteristics or appearance of food, or for example, the fear of choking, a food poisoning phobia or lack of appetite.

17 000 twin pairs involved in the study 

Researchers at Karolinska Institutet have now investigated the importance of genetic factors for developing ARFID. A cohort of almost 17 000 pairs of twins in Sweden born between 1992 and 2010 participated in the study. A total of 682 children with ARFID between the ages of six and 12 years could be identified.  

The researchers used the twin method to determine the influence of genes and the environment on the onset of the disease.

“We know that identical twins share all genes and that fraternal twins share about half of their genes that make people different. When we then see that a certain trait is more common in both members of identical twin pairs than in fraternal twin pairs, it is an indication that there is a genetic influence. We can then estimate the degree to which a trait is influenced by genetic factors,” says Lisa Dinkler, a postdoctoral researcher at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet. 

The genetic component for developing ARFID was high, 79%.

“This study suggests that ARFID is highly heritable. The genetic component is higher than that of other eating disorders and on par with that of neuropsychiatric disorders such as autism and ADHD,” says Lisa Dinkler. 

The findings are important, says Lisa Dinkler, because an increased understanding of what causes the disease can make it easier for those affected and their relatives. 
 
“I hope that the results can reduce stigma and guilt, which is a big problem with eating disorders. A child does not choose to develop ARFID, nor can a parent cause it in a child. That is important to remember.”, says Lisa Dinkler.

Possible connections with other conditions 

The next step in Lisa Dinkler’s research is to study the extent to which ARFID is associated with other psychiatric diagnoses, such as anxiety and depression, neurodevelopmental disorders, and gastrointestinal problems.

“We will use twin studies to test the extent to which ARFID shares underlying genetic and environmental factors with these conditions,” says Lisa Dinkler.

ARFID is a relatively new diagnosis. In 2013, the disorder was included in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, and this year it was included in the World Health Organization’s diagnostic manual ICD. The latest edition, ICD-11, will be introduced to the Swedish healthcare system in a couple of years, consequently, the diagnosis is not an official part of Swedish health and medical care yet.

Source: Karolinska Institutet

Categories : Mental Health PaediatricsTags :

Boys can Also be at Risk for Eating Disorders

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Depression, young man
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In the public mind, eating disorders are associated mainly with girls from wealthy backgrounds. Now, a new study on twins published in the Journal of Psychopathology and Clinical Science has found that boys living in disadvantaged circumstances are at an increased risk for disordered eating – particularly if they have underlying genetic risk factors.

“This is critical information for health care providers who might not otherwise screen for or recognize disordered eating in this population,” said Megan Mikhail, lead author of the study and Ph.D. candidate in the MSU Clinical Psychology program. “It is also important for the public to recognize that eating disorders can affect everyone, including people who do not fit the historical stereotypes.”

The study from Michigan State University, is the first to look at associations between multiple forms of disadvantage and risk for disordered eating in boys, as well as how disadvantage may interact with biological risks to impact disordered eating in boys.

Using a large population-based sample of male twins from the Michigan State University Twin Registry, the researchers found that boys from more disadvantaged backgrounds reported greater disordered eating symptoms and had earlier activation of genetic influences on disordered eating, which could lead to increased long-term risk.

By using population-based sample, the researchers could avoid overlooking those unable to afford mental health care. They examined factors such as parental income, education and neighbourhood disadvantage to see how those factors related to disordered eating symptoms in the boys. Since all the participants were twins, researchers were also able to study genetic influences on disordered eating.

“This research is particularly relevant following the COVID pandemic when many families experienced financial hardship,” said Kelly Klump, MSU Foundation Professor of Psychology and co-author of the study. “Those financial stressors are putting many young people at risk for an eating disorder, so it’s vital that there be increased screening and access to care for these young people.”

Source: Michigan State University

Categories : COVID Mental HealthTags :

COVID Saw a Surge in Young Patients with Eating Disorders

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According to a study published in JAMA Pediatrics, cases of young people seeking care for eating disorders greatly increased in the months of the pandemic.

Eating disorders (EDs), such as anorexia nervosa and bulimia nervosa, impact a wide range of individuals. In the developmental stages of adolescent and young adulthood, EDs – especially restrictive ones – can have particularly negative impacts. Furthermore, EDs commonly co-occur with other mental health conditions which can influence the trajectory of illness. Individuals with EDs have greater mortality rates, partly due to increased suicidality.

EDs requires intensive specialist care, which is not often available in many settings. A rise in rates of anxiety and depression have been attributed to the COVID pandemic, as well as a worsening of ED. Possible reasons for this include uncertainty about the future, disruptions in daily routines, inconsistent access to food, more time spent in triggering environments, influence from the media, and changes in access to treatment.

Reports from hospitals indicated increasing numbers of diagnoses and hospital admissions for ED, but there was little geographically widespread data.

Therefore, the researchers set out to investigate trends in patient volume for inpatient medical hospitalisation as well as volume of patients seeking outpatient subspecialty care, both before and after the pandemic.

The researchers used an an observational case series design to compare changes in volume in inpatient and outpatient ED-related care at 15 sites between January 2018 and December 2021.

Before the COVID pandemic, the relative number of pooled inpatient ED admissions were increasing over time by 0.7% per month. After onset of the pandemic, there was a significant increase in admissions over time of 7.2% per month through April 2021, then a decrease of 3.6% per month through December 2021. Before the pandemic, relative outpatient ED assessment volume was stable over time, with an immediate 39.7% decline in April 2020. Thereafter, new assessments increased by 8.1% per month through April 2021, then decreased by 1.5% per month through December 2021. The nonhospital-based ED program did not demonstrate a significant increase in the absolute number of admissions after onset of the pandemic but did see a significant increase of 8.2 additional inquiries for care per month in the first year after onset of the pandemic.

“Given inadequate ED care availability prior to the pandemic, the increased postpandemic demand will likely outstrip available resources. Results highlight the need to address ED workforce and program capacity issues as well as improve ED prevention strategies.”

Categories : Diet and Nutrition General Interest Mental HealthTags :

Bulimia Experience as a Teen Shaped Man’s Healthy Recipe Project

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A UK man who started a project coming up with gut-healthy-recipes said that it was “shaped” by his having had bulimia in his teenage years.

Clinician and scientist Dr Sunni Patel, 35, said as a teen he thought he was “chubby” and experienced the eating disorder when he was aged 15 to 18.

Binge eating was his “solace” he said, and he used religious fasting “as a cover”.

Dr Patel started a website sharing recipes, and he urged people not to underestimate how gut health affects mental health.

“I’d find comfort and my escapism via food.”
Dr Sunni Patel

He said he would fast for four days a week, eating fruit at the end of the day.

Being from a traditional Asian background, the way “one looks and acts tends to be judged a lot more”, he said.

“Because I’d got bulimia as a get out, I’d binge eat. I might eat six or seven crisp packets at one sitting. I’d find comfort and my escapism via food.”

Suffering bullying at school, Dr Patel said that there was “pressure as a teenager to look cool”. He said that “the thinner I got, the more attractive I felt”. Bulimia became the “solution”, he added.

As he lost weight, he began receiving compliments which would “feed the beast”.

At least 1.5 million people in the UK have an eating disorder, experts estimate, with 25% being male. Bulimia nervosa is a condition that occurs most commonly in adolescent females, though it can appear in just about any patient. It is characterised by indulgence in binge-eating, and inappropriate compensatory behaviours to prevent weight gain.

Dr Patel said after he went to university he stopped, “I wasn’t able to find the safe space to have the… episodes, I didn’t want the truth to come out.”

From around the age of 24, he received cognitive behavioural therapy and in recent years has had psychotherapy.

“I was diagnosed with gut issues in 2014 and that’s when I started exploring the link between gut health and depression. As my diet became healthier so did my mind.”

A business director as well as a clinician, he now comes up with gut-healthy-recipes that are shared on his Dish Dash Deets website, set up during the COVID pandemic, where he also keeps a blog.

Included in his recipes are his top foods to combat depression and low mood, such as bananas, berries, beans and lentils.

He said to anyone that is in a similar position to his, “find a safe person to talk to”, who would not judge, adding: “Don’t feel any shame. You’re human.”

“The more that you rely on it, you use it as your way of escaping, the more it becomes your norm,” he said.

He also currently does live cook-alongs on Instagram with invited celebrities and chefs.

“Food is still my escapism. Now I enjoy being in the kitchen and making things that will serve my needs, not make things worse.”

Source: BBC News

Categories : Mental Health PaediatricsTags :

Playing with Ultra-thin Dolls Skews Girls’ Ideal Body Size

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A small-scale study led by Durham University in the UK, has shown that play with ultra-thin dolls may negatively affect body image in girls as young as five years old.

The researchers warn that the dolls, combined with exposure to ‘thin ideals’ in the media, could lead to body dissatisfaction in young girls, which has been shown to be a factor in the development of eating disorders. A Dutch study showed that girls randomised to receive an ultra-thin doll to play with ate less than those who received a realistic adult doll.

The study had 30 girls aged between 5-9 years old play with an ultra-thin doll, a realistic childlike doll or a car. Before and after each play session, the girls were asked about their perceived own body size and ideal body size via an interactive computer test using pictures.

Playing with the ultra-thin dolls reduced girls’ ideal body size immediately after play. There was no improvement even when they subsequently played with the childlike dolls or cars afterwards, demonstrating that playing with other toys cannot quickly counteract the effects. The realistic children’s dolls had a neutral effect on body ideals.

Lead author Professor Lynda Boothroyd, from Durham University’s Department of Psychology, said: “Body dissatisfaction is a huge problem, particularly amongst young girls. It can have serious consequences for girls’ wellbeing and lead to eating disorders and depression.

“The results from our study indicate that playing with ultra-thin dolls, which are sold in the millions each year, could have a real negative impact on girls’ body image. This is on top of all the images of unrealistic body sizes they see on TV, in films and on social media. This is something that needs to be addressed in order to reduce the pressure on girls and women to aspire to a ‘thin ideal body’.”

The psychologists had found in previous research that the more TV we watch, the more we prefer thinner female bodies. Of the girls who took part in the study, 80% said they had ultra-thin dolls at home or with their friends, and nearly all watched films which tend to portray very thin female bodies. Dolls available in shops tend to have a projected BMI of 10 to 16 (underweight). The study used realistically proportioned dolls resembling healthy children of 7 and 9.

Dr Elizabeth Evans, from Newcastle University’s School of Psychology, said: “This study isn’t intended to make parents feel guilty about what’s in their child’s toy box, and it certainly isn’t trying to suggest that ultra-thin dolls are ‘bad’.

“What our study provides is useful information that parents can take into account when making decisions about toys. Ultra-thin dolls are part of a bigger picture of body pressures that young children experience, and awareness of these pressures is really important to help support and encourage positive body image in our children.”

The study, though small, tested the children before and after doll play, an unusual approach which nevertheless adds to growing evidence that doll play affects young girls’ beauty ideals.

Professor Martin Tovee, from Northumbria University’s Department of Psychology, said: “Our study shows how perception of ideal body size and shape is moulded from our earliest years to expect unrealistic ideals. This creates an inevitable body image dissatisfaction which is already known to lead towards disordered eating.”

Source: Medical Xpress

Journal information: Can realistic dolls protect body satisfaction in young girls?, Boothroyd et al, Body Image, 11 March 2021.