Eating Episode Research Articles

Controlled and Real-Life Investigation of Optical Tracking Sensors in Smart Glasses for Monitoring Eating Behavior Using Deep Learning: Cross-Sectional Study.

The increasing prevalence of obesity necessitates innovative approaches to better understand this health crisis, particularly given its strong connection to chronic diseases such as diabetes, cancer, and cardiovascular conditions. Monitoring dietary behavior is crucial for designing effective interventions that help decrease obesity prevalence and promote healthy lifestyles. However, traditional dietary tracking methods are limited by participant burden and recall bias. Exploring microlevel eating activities, such as meal duration and chewing frequency, in addition to eating episodes, is crucial due to their substantial relation to obesity and disease risk. The primary objective of the study was to develop an accurate and noninvasive system for automatically monitoring eating and chewing activities using sensor-equipped smart glasses. The system distinguishes chewing from other facial activities, such as speaking and teeth clenching. The secondary objective was to evaluate the system's performance on unseen test users using a combination of laboratory-controlled and real-life user studies. Unlike state-of-the-art studies that focus on detecting full eating episodes, our approach provides a more granular analysis by specifically detecting chewing segments within each eating episode. The study uses OCO optical sensors embedded in smart glasses to monitor facial muscle activations related to eating and chewing activities. The sensors measure relative movements on the skin's surface in 2 dimensions (X and Y). Data from these sensors are analyzed using deep learning (DL) to distinguish chewing from other facial activities. To address the temporal dependence between chewing events in real life, we integrate a hidden Markov model as an additional component that analyzes the output from the DL model. Statistical tests of mean sensor activations revealed statistically significant differences across all 6 comparison pairs (P<.001) involving 2 sensors (cheeks and temple) and 3 facial activities (eating, clenching, and speaking). These results demonstrate the sensitivity of the sensor data. Furthermore, the convolutional long short-term memory model, which is a combination of convolutional and long short-term memory neural networks, emerged as the best-performing DL model for chewing detection. In controlled laboratory settings, the model achieved an F1-score of 0.91, demonstrating robust performance. In real-life scenarios, the system demonstrated high precision (0.95) and recall (0.82) for detecting eating segments. The chewing rates and the number of chews evaluated in the real-life study showed consistency with expected real-life eating behaviors. The study represents a substantial advancement in dietary monitoring and health technology. By providing a reliable and noninvasive method for tracking eating behavior, it has the potential to revolutionize how dietary data are collected and used. This could lead to more effective health interventions and a better understanding of the factors influencing eating habits and their health implications.

Detecting Eating Episodes From Wrist Motion Using Daily Pattern Analysis.

This paper presents new methods to detect eating from wrist motion. Our main novelty is that we analyze a full day of wrist motion data as a single sample so that the detection of eating occurrences can benefit from diurnal context. We develop a two-stage framework to facilitate a feasible full-day analysis. The first-stage model calculates local probabilities of eating P(Ew) within windows of data, and the second-stage model calculates enhanced probabilities of eating P(Ed) by treating all P(Ew) within a single day as one sample. The framework also incorporates an augmentation technique, which involves the iterative retraining of the first-stage model. This allows us to generate a sufficient number of day-length samples from datasets of limited size. We test our methods on the publicly available Clemson All-Day (CAD) dataset and FreeFIC dataset, and find that the inclusion of day-length analysis substantially improves accuracy in detecting eating episodes. We also benchmark our results against several state-of-the-art methods. Our approach achieved an eating episode true positive rate (TPR) of 89% with 1.4 false positives per true positive (FP/TP), and a time weighted accuracy of 84%, which are the highest accuracies reported on the CAD dataset. Our results show that the daily pattern classifier substantially improves meal detections and in particular reduces transient false detections that tend to occur when relying on shorter windows to look for individual ingestion or consumption events.

Contextual Specificity of (Un)Healthy Food/Drink Intake in Everyday Life: A Study Based on Episodic Memories

Abstract Identifying the contexts of episodes of (un)healthy food/drink intake could inform strategies for eating more healthily. This study assessed memories of recent episodes of healthy and unhealthy eating from adults in Mexico. For each (un)healthy eating episode participants recalled place, time of day, people present and food/drink intake. Categories were formed for the contextual features and foods/drinks that were reported, then the relative frequency of each category was tested between healthy and unhealthy eating episodes. Overall, there was a large set of categories of (un)healthy food/drink choices, and there were more healthy eating episodes with family at home and unhealthy eating episodes with friends out of home. However, as expected, a more specific context as well as food/drink intake was identified for each sort of recalled (un)healthy eating episode of the day. Additionally, eating out of home, later in the day and with people present were features related to higher estimated energy content across (un)healthy eating episodes. These findings support the assessment of self-reported memories of recent eating episodes to generate evidence that contribute to contexts that support healthy eating habits.

Neural Response to Low Energy and High Energy Foods in Bulimia Nervosa and Binge Eating Disorder: A Functional MRI Study.

ObjectiveBulimia nervosa (BN) and binge eating disorder (BED) are eating disorders (EDs) characterized by recurrent binge eating (BE) episodes. Overlap exists between ED diagnostic groups, with BE episodes presenting one clinical feature that occurs transdiagnostically. Neuroimaging of the responses of those with BN and BED to disorder-specific stimuli, such as food, is not extensively investigated. Furthermore, to our knowledge, there have been no previous published studies examining the neural response of individuals currently experiencing binge eating, to low energy foods. Our objective was to examine the neural responses to both low energy and high energy food images in three emotive categories (disgust; fear; and happy) in BN and BED participants.MethodsNineteen females with BN (n = 14) or BED (n = 5), comprising the binge eating group (BEG; N = 19), and 19 age-matched healthy control (HC)’s completed thorough clinical assessment prior to functional MRI (fMRI). Neural response to low energy and high energy foods and non-food images was compared between groups using whole-brain exploratory analyses, from which six regions of interest (ROI) were then selected: frontal, occipital, temporal, and parietal lobes; insula and cingulate.ResultsIn response to low energy food images, the BEG demonstrated differential neural responses to all three low energy foods categories (disgust; fear; and happy) compared to HCs. Correlational analyses found a significant association between frequency of binge episodes and diminished temporal lobe and greater occipital lobe response. In response to high energy food images, compared to HC’s, the BEG demonstrated significantly decreased neural activity in response to all high energy food images. The HC’s had significantly greater neural activity in the limbic system, occipital lobe, temporal lobe, frontal lobe, and limbic system in response to high energy food images.ConclusionResults in the low energy food condition indicate that binge frequency may be related to increased aberrant neural responding. Furthermore, differences were found between groups in all ROI’s except the insula. The neural response seen in the BEG to disgust food images may indicate disengagement with this particular stimuli. In the high energy food condition, results demonstrate that neural activity in BN and BED patients may decrease in response to high energy foods, suggesting disengagement with foods that may be more consistent with those consumed during a binge eating episode.

Clock Time of First Eating Episode and Prospective Risk of All-Cause Mortality in US Adults

BackgroundThere is increasing recognition that a morning or evening preference is associated with time of eating, metabolic health, and morbidity. However, few studies have examined the association of time of eating with mortality. ObjectivesTo examine the association of time of first recalled ingestive episode with the prospective risk of all-cause mortality. MethodsWe used mortality-linked data from the NHANES conducted in 1988–1994 and 1999–2014 (n = 34,609; age ≥ 40 years). The exposure was quartiles (Q1–Q4) of clock time of first eating episode self-reported in the baseline 24-hour dietary recall. The outcome was follow-up time from the date of NHANES examination to the date of death or end of the follow-up period (31 December 2015). We used proportional hazards regression methods to determine the independent association of time of first eating episode with relative hazard of all-cause mortality, with adjustments for multiple covariates and the complex survey design. Multiple linear regression methods were used to examine the associations of time of first eating episode with baseline cardiometabolic biomarkers and dietary attributes. ResultsIn this national cohort, with a median age of ∼55 years (95% CI: 54.6–55.4 years) at baseline and a median follow-up of 8.3 years (IQR, 8.75 years), there were 10,303 deaths. The median times of first eating episodes in Q1–Q4 were 05:45, 07:00, 08:00, and 10:00, respectively. Covariate-adjusted relative hazards of mortality in Q1 to Q3 of the time of the first eating episode were 0.88 (95% CI: 0.81–0.96), 0.88 (95% CI: 0.81–0.95), 0.94 (95% CI: 0.87–1.02), with Q4 as the referent (P = 0.0008). Qualitative dietary attributes were inversely related with the time of the first eating episode; however, BMI and serum concentrations of glycemic biomarkers increased with later times of first eating episode (P ≤ 0.0001). ConclusionsRecall of an earlier time of the first eating episode by ≥40-year-old US participants was suggestive of a small relative survival advantage in this observational study.

Exploring the role of momentary positive and negative affect in overeating and binge eating: Evidence for different associations among men and women

Momentary positive and negative emotions have shown to affect eating behaviour. In this study, we used experience sampling method (ESM) to assess how momentary positive affect (PA) and negative affect (NA) relate to overeating (OE) and binge eating (BE) episodes among men and women compared to no OE/BE episodes. We additionally looked at how situational and social context moderate these relationships. For this purpose, 87 women and 94 men participated in the study where they were instructed to rate their levels of various positive and negative emotions, situational whereabouts, and the presence of OE/BE 7 times a day for 3 consecutive days. We found that men and women greatly differed in how momentary PA and NA relate to OE and BE. In women, NA was highest before BE, followed by OE compared to no OE/BE. Further, an interaction between the type of an eating episode and situational context demonstrated that this relationship was significant when at home, but not away from home. No differences in the momentary NA between the types of eating episodes were found in men. In men, PA was significantly higher before OE compared to BE and no OE/BE. Additionally, an interaction between the type of eating episode and situational context showed that this relationship was significant when at home, but not when away from home. Our results further confirm the role of negative affect in overeating and binge eating in women, whereas also suggesting that the role of positive affect in eating behaviour is warranted more research, particularly in men.

132 Impact of Experimentally Shortened Sleep on Meal Timing in Adolescents

Abstract Introduction Short sleep increases the risk for obesity in adolescents. One potential mechanism relates to when eating occurs, rather than what or how much is eaten. This study investigated the impact of shortened sleep on meal timing and late evening eating in adolescents. Methods 93 healthy 14- to17-year-olds (62% female) completed a within-subject counterbalanced experimental sleep manipulation, engaging in shortened sleep (SS; 6.5 hours/night in bed) or healthy sleep (HS; 9.5 hours/night in bed), each for five nights, with order randomized. Sleep timing was verified through wrist-worn actigraphy. During each sleep period, adolescents completed 2-3 dietary recalls. Repeated-measure T-tests assessed the sleep manipulation effect on averaged times of the first and last eating episode, number of eating episodes after 8:00pm, and range of the daily eating period. Results Youth averaged 2.2 hours/night longer sleep during HS than SS (p&amp;lt;.001). The timing of the first eating episode was similar across conditions, relative to the clock (SS=08:51, HS=08:52) and to time since waking (SS=1.8hr, HS=1.9hr). The timing of the last eating episode averaged later on the clock during SS (20:34) than HS (19:38; p&amp;lt;.001), resulting in a longer eating period (SS=11.7hr, HS=10.8hr, p&amp;lt;.001). Youth averaged more eating episodes after 8:00pm during SS (0.87) than HS (0.59, p&amp;lt;.001). The gap between last eating episode and sleep onset was larger in SS (4.1hr) than HS (2.8hr; p&amp;lt;.001). Notably, on average, adolescents last eating episodes during SS (20:34) were earlier than sleep onset in either condition, and were even 2 hours earlier than when they fell asleep during HS (M=22:30). In exploratory analyses, these effects did not systematically vary by experimental order of the sleep conditions, family income, or participant age, sex, or norm-referenced body mass index. Conclusion Shortened sleep resulted in adolescents eating later and lengthening the daily period of time in which they ate, despite typically stopping eating well before sleep onset during healthy sleep. Late evening eating and long daily eating periods have been strongly associated with weight gain, which may help explain the link between shortened sleep and increased obesity risk in adolescents. Support (if any) R01HL120879

Networks of stress, affect and eating behaviour: anticipated stress coping predicts goal-congruent eating in young adults

BackgroundMany people aim to eat healthily. Yet, affluent food environments encourage consumption of energy dense and nutrient-poor foods, making it difficult to accomplish individual goals such as maintaining a healthy diet and weight. Moreover, goal-congruent eating might be influenced by affects, stress and intense food cravings and might also impinge on these in turn. Directionality and interrelations of these variables are currently unclear, which impedes targeted intervention. Psychological network models offer an exploratory approach that might be helpful to identify unique associations between numerous variables as well as their directionality when based on longitudinal time-series data.MethodsAcross 14 days, 84 diet-interested participants (age range: 18–38 years, 85.7% female, mostly recruited via universities) reported their momentary states as well as retrospective eating episodes four times a day. We used multilevel vector autoregressive network models based on ecological momentary assessment data of momentary affects, perceived stress and stress coping, hunger, food craving as well as goal-congruent eating behaviour.ResultsNeither of the momentary measures of stress (experience of stress or stress coping), momentary affects or craving uniquely predicted goal-congruent eating. Yet, temporal effects indicated that higher anticipated stress coping predicted subsequent goal-congruent eating. Thus, the more confident participants were in their coping with upcoming challenges, the more they ate in line with their goals.ConclusionMost eating behaviour interventions focus on hunger and craving alongside negative and positive affect, thereby overlooking additional important variables like stress coping. Furthermore, self-regulation of eating behaviours seems to be represented by how much someone perceives a particular eating episode as matching their individual eating goal. To conclude, stress coping might be a potential novel intervention target for eating related Just-In-Time Adaptive Interventions in the context of intensive longitudinal assessment.

Novel Highly Potent and Selective Sigma1 Receptor Antagonists Effectively Block the Binge Eating Episode in Female Rats.

In this paper, the benzo-cracking approach was applied to the potent sigma1 (σ1) receptor antagonist 1 to afford the less conformationally constrained 1,3-dioxane derivatives 2 and 3. To evaluate the effect of the increase in the distance between the two hydrophobic structural elements that flank the basic function, the cis and trans diastereomers of 4 and 5 were also prepared and studied. Compounds 2 and 3 showed affinity values at the σ1 receptor significantly higher than that of the lead compound 1. In particular, 3 displayed unprecedented selectivity over the σ2 receptor, the phencyclidine site of the NMDA receptor, and opioid receptor subtypes, as well as over the dopamine transporter. Docking results supported the structure–activity relationship studies. Due to its interesting biological profile, derivative 3, selected for an in vivo study in a validated preclinical model of binge eating, was able to counteract the overeating of palatable food only in binging rats, without affecting palatable food intake in the control group and anxiety-like and depression-related behaviors in female rats. This result strengthened the involvement of the σ1 receptor in the compulsive-like eating behavior and supported the σ1 receptor as a promising target for the management of eating disorders.

Momentary changes in heart rate variability can detect risk for emotional eating episodes

Emotion dysregulation is a known risk factor for a variety of maladaptive eating behaviors, including emotional eating (Crockett, Myhre, & Rokke, 2015; Lavender et al., 2015). New passive sensing technologies offer the prospect of detecting emotion dysregulation in real-time through measurement of heart rate variability (HRV), a transdiagnostic bio-signal of emotion regulation, which may in turn signal risk of engaging in a maladaptive eating behavior. In the current study, our primary aim was to test the hypothesis that momentary changes in HRV can be used to detect risk of experiencing an emotional eating episode in an ecologically valid setting using a wrist worn sensor with acceptable classification accuracy. Participants were 21 adults with clinically significant emotional eating behaviors. Participants wore the Empatica E4 wrist-sensor and tracked all emotional eating episodes using ecological momentary assessment for four weeks. Time and frequency domain features of HRV were extracted in the 30-min period preceding emotional eating episodes and control cases (defined as the 30 min prior to an EMA survey that did not contain an emotional eating episode). Support vector machine (SVM) learning models were implemented using time domain and frequency domain features. SVM models using frequency domain features achieved the highest classification accuracy (77.99%), sensitivity (78.75%), and specificity (75.00%), consistent with standards deemed acceptable for the prediction of event-level health behavior. SVM models using time domain features still performed above chance, though were less accurate at classifying episodes (accuracy 63.48%, sensitivity 62.68%, and specificity 70.00%) and did not meet acceptable classification accuracy. Wearable sensors that assess HRV show promise as a tool for capturing risk of engaging in emotional eating episodes.

Investigation of the Role of Chirality in the Interaction with σ Receptors and Effect on Binge Eating Episode of a Potent σ1 Antagonist Analogue of Spipethiane.

The enantiomers of the potent σ1 receptor antagonist (±)-1 were synthesized and evaluated for their affinity at σ1, σ2 receptors and dopamine transporter (DAT). Analogously to (±)-1, both of the enantiomers showed very high affinity for the σ1 receptor and unprecedented selectivity over both the σ2 receptor and DAT. The lack of enantioselectivity between (+)-1 and (-)-1 indicated that the center of chirality in the 2-position of the benzothiochromane nucleus does not play a crucial role in the interaction with any of the studied targets. Docking studies confirmed that the configuration of the enantiomers has only marginal effects on the molecular interactions with the σ1 receptor. In in vivo studies in a female rat model of binge eating, (±)-1 dose-dependently decreased the binge eating episode elicited by a history of intermittent food restriction and stress, confirming and strengthening the important role played by the σ1 receptor in bingeing-related eating disorders.

Medical synopsis: Nightly fasting may assist breast cancer patients and other people with cancer

DesignA multi-site randomised clinical trial. ParticipantsThe Women's Healthy Eating and Living (WHEL) study of patients with breast cancer. Data was collected from 2413 women with breast cancer but without diabetes mellitus, aged 27–70 years at diagnosis. A total of 2064 participants (85.5%) were Caucasian with 1335 (55.3%) college educated. InterventionDietary analysis including timing of consumption at baseline, year 1 and year 4.A 24-h dietary recall collected by telephone on random days during a 3-week period, stratified for weekends vs weekdays.Nightly fasting duration was estimated by calculating the elapsed hours between the first and last eating episode for each day and subtracting that time from 24h.Potential confounders were identified including daily intake (kilocalories), eating episodes per day and eating after 8pm. ComparatorNo comparator was used in this study. Major outcomesParticipants reported a mean (SD) nightly fasting duration of 12.5h and 4.4 eating episodes per day.One-third of the sample consumed 25kcal or more after 8pm.A short nightly fasting duration (<13h per night) was significantly associated with college education, a lower BMI, shorter sleep duration, higher self-reported kilocalorie intake, more eating episodes, and eating after 8pm.A short nightly fast (<13h) was significantly associated with an increased risk for breast cancer recurrence (36% higher risk).Each 2-h increase in nightly fasting duration was statistically significant for lower HbA1c level (0.37mmol/mol lower) and more hours of sleep per night.Nightly fasting was not associated with BMI or CRP concentrations.Eating after 8pm was significantly associated with increased higher CRP and BMI. SettingsThe United States of America: Clinical sites included University of California, San Diego; University of California, Davis; Stanford University; Kaiser Permanente, Northern California; M.D. Anderson Cancer Centre; Arizona Cancer Centre; and Kaiser Permanente Center for Health Research. ConclusionProlonged nightly fasting duration (13h or more), may be a simple, non-pharmacologic strategy for reducing the risk of breast cancer recurrence. In addition, improvements in gluco-regulation and sleep may be mechanisms of action linked with nightly fasting and breast cancer prognosis.

Eating behaviors and negative affect in college women's everyday lives.

A growing body of research seeks to understand the relationship between mood and eating behaviors. Ecological Momentary Assessment (EMA) methods provide a method for assessing these processes in natural settings. We used EMA to examine the relationship between mood and eating behaviors in everyday life among women with subclinical disordered eating behaviors. Participants (N = 127, age M = 19.6 years, BMI M = 25.5) completed five daily EMA reports on palmtop computers for 1 week. Assessments included measures of negative affect (NA) and eating-related behavior during eating (eating large amounts of food, loss of control over eating, and restricting food intake) and noneating episodes (skip eating to control weight/shape). Time-lagged multilevel models tested mood-eating behavior relationships. Higher NA did not precede any unhealthy eating and weight control behaviors. However, NA was higher when women reported eating large quantities of food, losing control over eating, and restricting food intake during their most recent eating episode, but not after skipping eating to control weight/shape. These findings elucidate the processes in daily life that may influence the development and maintenance of unhealthy eating and weight control behaviors that, in turn, can inform interventions.

Is the Relationship Between Binge Eating Episodes and Personality Attributable to Genetic Factors?

Aspects of disordered eating and personality traits, such as neuroticism, are correlated and individually heritable. We examined the phenotypic correlation between binge eating episodes and indices of personality (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness, and control/impulsivity). For correlations ≥|0.20|, we estimated the extent to which genetic and environmental factors contributed to this correlation. Participants included 3,446 European American same-sex female twins from the Missouri Adolescent Female Twin Study (median age = 22 years). Binge eating episode was assessed via interview questions. Personality traits were assessed by self-report questionnaires. There was a significant moderate phenotypic correlation between binge eating episode and neuroticism (r = 0.33) as well as conscientiousness (r = -0.21), while other correlations were significant but smaller (r ranging from -0.14 to 0.14). Individual differences in binge eating episodes, neuroticism, and conscientiousness were attributed to additive genetic influences (38% [95% CI: 21-53%], 45% [95% CI: 38-52%], and 44% [95% CI: 0.33-0.55%] respectively), with the remaining variance attributed to individual-specific environmental influences. Covariance was attributable to genetic (neuroticism r g = 0.37; conscientiousness r g = -0.22) and individual-specific environmental (neuroticism r e = 0.28; conscientiousness r e = -0.19) influences. Personality traits may be an early indicator of genetic vulnerability to a variety of pathological behaviors, including binge eating episode. Furthermore, prior research documenting phenotypic correlations between eating disorder diagnoses and personality may have stemmed from etiological overlap between these personality traits and aspects of disordered eating, such as binge eating episode.

Counseling and Guided Self‐Help Outcomes for Clients With Bulimia Nervosa: A Meta‐Analysis of Clinical Trials From 1980 to 2010

This meta‐analysis included 111 clinical trials exploring the effectiveness of counseling/psychotherapy and guided self‐help approaches in the treatment of bulimia nervosa. In general, single‐group studies supported higher efficacy of counseling/psychotherapy, whereas wait‐list, treatment‐as‐usual, and placebo studies indicated both approaches were equally effective at termination (posttest) and follow‐up in altering binging, purging, laxative use, and self‐reported bulimia or body dissatisfaction perceptions in nearly all comparisons.

Perceptions of emotional eating behavior. A qualitative study of college students

Approximately one-third of college students are overweight or obese and the average student gains 5kg during college. Previous research has identified a relationship between emotional eating and weight gain in young adults, but outside the realm of eating disorders, few studies qualitatively capture why individuals cope with emotions by eating. Exploratory qualitative research was conducted, including 3-day food journals and indepth interviews, with proportionate quota sampling of eight male and eight female undergraduate students to gain an understanding of students’ perceptions of their emotional eating behaviors. Participants were purposively selected based on their emotional eating scores on the Weight Related Eating Questionnaire from a larger survey assessing student eating behaviors. Participants’ (n=16) mean age was 19.6±1.0years and all self-reported their race to be white. Mean Body Mass Index (BMI) for females and males was 24.1±1.2kg/m2 and 24.8±1.7kg/m2, respectively. Findings from the qualitative analyses indicated gender differences and similarities. Females identified stress as the primary trigger for emotional eating, frequently followed by guilt. Males were primarily triggered by unpleasant feelings such as boredom or anxiety turning to food as a distraction; however, males were less likely to experience guilt after an emotional eating episode than females. During emotional eating episodes, both genders chose what they defined as unhealthful foods. These findings indicate a multidisciplinary intervention focusing on emotion and stress management in addition to dietary behavior change should be developed to reduce the potential for weight gain associated with emotional eating in the college-aged population.

Abstract P067: Association of Number of Eating Episodes per Day with Blood Pressure: INTERMAP Study

Background: Greater meal frequency per day may relate favorably to blood pressure (BP) levels of individuals. Aims: Explore associations of BP with frequency of food intake and meal timing among American participants of the INTERMAP Study. Whether differential nutrient intakes are contributing to observed BP differences is also explored. Methods: The INTERMAP Study is a cross-sectional epidemiologic investigation of 4,680 men and women ages 40–59 years in China, Japan, United Kingdom and United States (US). Data include findings from four 24-hour dietary recalls, two 24-hour urine collections, 8 BP measurements and health history questionnaires. Meals and snacks will be referred to as “eating episodes” (EP), where an eating episode is an intake of energy separated from the previous intake of food by a period of time. Results: Among 2,195 US participants, mean number of EP was 5.8 (SD 1.7) and average energy/EP was 423.0 kcal (SD 160.6) per day. About 57% of participants had less than 6 EP per day and had significantly higher systolic BP (SBP) compared to 43% of participants having 6 or more EP per day (119.3 mmHg, SD 13.9 vs. 117.7 mmHg, SD 13.9 P=0.01). Mean energy/EP, adjusted for sex, age, population sample and body mass index (BMI), was significantly higher among those having less than 6 EP per day then those with 6 or more EP per day (P&lt;0.0001). Association of average number of EP with SBP was consistently negative in linear regression models adjusted for energy, sex, age, BMI, special diet, physical activity, cigarette smoking, and family history of hypertension (b=−0.04, P=0.04). Conclusions: Smaller more frequent intake of meals/snacks relates favorably to BP levels. Several mechanisms may be involved, e.g., improved glucose tolerance and insulin sensitivity, with spreading food intake throughout the day.

Der Essanfall: Ursache oder Konsequenz negativer Affekte?

According to empirical literature an increasein shame, guilt, and disgust seems to play an importantrole in the maintenance of binge eating episodes inbulimic patients. Yet, the extent of these negative affectivestates compared to those experienced by a controlgroup without eating disorder has not yet been studied.Patients and Methods: 66 female bulimic inpatients and50 healthy women participated in the study and rated theextent of 10 affective states before and after a ‘typical’binge eating episode using the German version of thedifferential emotional scale. Results: Before a typicalbinge eating episode bulimic patients reported markedlyhigher levels of negative affects than the healthy controls.Both groups experienced increased feelings of guiltafter binge eating, additionally, bulimics reported an increasein disgust and contempt. Discussion: Increasedfeelings of disgust and contempt after a typical binge eatingepisode seem to be specific for patients with bulimianervosa. Results concerning the extent of negative affectivestates suggest them to be both cause and consequenceof binge eating. The results are discussed withregard to current cognitive models of bulimia nervosa.

An experimental test of the effects of dieting on bulimic symptoms: The impact of eating episode frequency

Prospective studies suggest dieting increases bulimic symptoms, but experiments suggest that dieting decreases bulimic symptoms. One possible explanation for the conflicting findings is that real world dieting involves less healthy dieting techniques, such as meal skipping, than prescribed diets. We tested whether the manipulation of eating episode frequency during dieting impacted bulimic symptoms. We expected that people on a diet involving fewer eating episodes would exhibit greater increases in bulimic symptoms than people on a diet involving more frequent eating episodes or waitlist controls. Participants on both 6-week diets lost more weight than controls, confirming dieting was manipulated, and showed greater reductions in bulimic symptoms than controls; however, the dieting conditions did not differ on either outcome. Results provide further experimental evidence that dieting does not increase bulimic symptoms, but suggests that eating episode frequency has little impact on this outcome.

Transtorno da compulsão alimentar periódica

O transtorno da compulsão alimentar periódica (TCAP) foi descrito pela primeira vez nos anos 1950. Contudo, sua elevação à categoria diagnóstica apenas ocorreu em 1994, quando foi incluído no apêndice B do DSM IV, com critérios provisórios para seu diagnóstico. Trata-se de uma síndrome caracterizada por episódios recorrentes de compulsão alimentar, sem qualquer comportamento de compensação para evitar um possível ganho de peso. Incertezas quanto a seus parâmetros diagnósticos como caracterização da quantidade de alimentos ingeridos, duração de um episódio de comer compulsivo, ou mesmo o valor da perda de controle sobre a ingestão alimentar, tornam difíceis uma homogeinização de um grupo sindrômico. Desta forma, estudos epidemiológicos podem revelar diferentes dados de caracterização da população portadora deste transtorno. Isto reforça a necessidade da manutenção de estudos para avaliação desta patologia.