Eating Problems Research Articles

Shared associations between histories of victimisation among people with eating disorder symptoms and higher weight.

The success of integrated prevention initiatives for eating disorders and obesity is hampered by a lack of shared risk factor research. Bullying and sexual abuse are potentially potent shared risk factors for the spectrum of eating and weight disorders. A representative sample of N = 3005 South Australian males and females ≥15 years was interviewed about their height, weight, eating disorder symptoms, lifetime experiences of bullying and sexual abuse and mental and physical health-related quality of life. Participants who were currently obese (25.2%) or underweight (2.7%) or who reported current eating disorder symptoms (32.7%) were between 10% and 27% more likely to have experienced bullying, and obese and eating disordered participants were also 47% and 56% more likely to have experienced sexual abuse, respectively. In regard to specific symptoms, a lifetime history of bullying was associated with increased risk of obesity, extreme dieting, purging and overvaluation of body weight and/or shape, whereas a lifetime history of sexual abuse was associated with increased risk of obesity, binge eating and extreme dieting and decreased risk of underweight. Lifetime histories of bullying and sexual abuse were associated with health-related quality of life impairment; however, lifetime bullying was associated with a greater adverse impact among participants with current eating disorder symptoms. Self-reported bullying and sexual abuse victimisation have shared associations with eating and weight spectrum problems. Differences in the symptoms associated with bullying versus sexual abuse are discussed, as well as the clinical and public health implications.

Ethical reasons not to use dogs as food - focused on utilitarian approach -

최근 우리나라에서는 개식용 금지 법안을 놓고 한창 논쟁이 벌어지고 있다. 이와 같은 논쟁이 벌어지는 근본적인 이유는 개를 사랑하는 사람들은 모든 개들을 반려동물로 간주하려 하지만, 그렇지 않은 사람들, 특히 개식용에 이권이 걸려 있는 사람들은 이에 반대하고 있기 때문이다. 그들은 집에서 키우는 개와 식용으로 키우는 개를 구분하면서 후자의 경우는 식용동물로 분류해야 한다고 주장하고 있다. 이 글은 이러한 논쟁에서 개식용화에 반대하는 편에 서서 왜 이를 반대해야 하는지를 비판적으로 고찰하고 있다. 이를 위해 필자는 윤리적인 반대를 위한 잣대로 공리주의를 채택하고, 이를 이용하여 개 식용화의 문제를 지적하고 있다. 이러한 논의는 크게 두 가지로 이루어지고 있다. 첫째, 공리주의를 기준으로 개 식용화가 도덕적인 잘못임을 보인다. 둘째, 개식용화 찬성 논거가 적절하지 못함을 밝힌다. 이와 같은 시도는 현재 격론이 벌어지고 있는 개식용화 쟁점을 정리하는 데에 작은 보탬이 될 수 있을 것이다.Recently, there has been a heated debate in Korea over dog eating. The fundamental reason for such a dispute is that dog lovers try to treat all dogs as pets, but those who do not, especially those who have interest in eating dogs, are opposed. They argue that the latter should be classified as edible, while separating the pet dog from the dog for food. This article is on the other side of the debate, and is critical of why we should oppose dog eating. To that end, I adopt utilitarianism as a yardstick for ethical objections and use it to point out the problem of dog eating. There are two main points of discussion. First, dog eating is morally wrong based on utilitarianism. Second, the argument for favoring the amendment is not proper. Such an attempt could serve as a small help to settle the ongoing debate over the issue of dog eating.

Maternal self-rated health and psychological distress predict early feeding difficulties: Results from the longitudinal study of Australian children.

Drawing from the extended UNICEF model of children's eating and weight problems and growing empirical evidence, exposure to adversity may place mothers at increased risk for child feeding difficulties. The aim of the present study of a community sample of mothers was to examine whether maternal psychological distress, exposure to stressful events, and poor self-rated health in their child's first year of life were associated with breastfeeding duration, as well as concurrent and prospective feeding problems. Participants were 5107 Australian mother-child dyads from the infant cohort of the Longitudinal Study of Australian Children (LSAC). Data for the present study was drawn from questionnaires completed by the mother at Wave 1 and Wave 2 (conducted 2 years apart). On average, at Wave 1, mothers and children (51% male) were aged 31 years and 9 months, respectively; while at Wave 2 their ages were 33 years and 34 months, respectively. Maternal psychological distress and poorer self-rated health were uniquely predictive of concurrent and prospective child feeding difficulties, while poorer self-rated health was also concurrently associated with a shorter duration of breastfeeding. These findings suggest that poorer maternal functioning poses a significant risk for early child feeding difficulties, and highlights the potential benefit of screening and early intervention for mothers experiencing emotional and physical health problems. Further research is needed that takes a broad view of maternal functioning, and examines reciprocal interactions between maternal and child characteristics in understanding the development of child feeding problems.

Experiences and coping strategies related to food and eating up to two years after the termination of treatment in patients with head and neck cancer.

The purpose was to describe how patients with head and neck cancer experience and cope with difficulties related to food and eating up to two years after the termination of treatment. One hundred and thirty-five patients were followed with thematically structured interviews. The patients' responses of nutritional issues were categorised using similarities and differences technique. In the analysis, six categories emerged describing the process of eating and drinking from the end of treatment up to two years after treatment: The constant battle-eating and drinking over time, Food alterations and nutritional support-both pros and cons, Standing aside and not joining in when eating together with others, Finding ways to cope and to make the new a part of everyday life, Relationships and social support-hindrances and facilitators, and Longing for "normality." Results imply that patients struggle with physiological, psychological and social aspects related to food and eating, and use coping mechanisms to facilitate their eating problems. The best practice for rehabilitation and follow-up must be established in order to meet the multifaceted needs of head and neck cancer survivors.

特別支援学校（知的障害）の教員からみた児童・生徒の食べ方の問題点

特別支援学校（知的障害）の教員からみた児童・生徒の食べ方の問題点

Comparison of Long-term Quality of Life in Patients with Esophageal Cancer after Ivor-Lewis, Mckeown, or Sweet Esophagectomy

BackgroundThe aim of this study was to compare the long-term quality of life (QoL) in patients after Sweet, Ivor-Lewis, or Mckeown esophagectomy. MethodsEsophageal cancer patients after Sweet, Ivor-Lewis, or Mckeown esophagectomy from 2010 to 2012 were included. QoL was assessed according to the European Organization for Research and Treatment of Cancer general questionnaire: QLQ-C30 and esophagus-specific questionnaire: QLQ-OES18. ResultsA total of 126 qualified patients who have been alive for more than 3 years without tumor recurrence were divided into three groups: the Sweet group (n = 40), Ivor-Lewis group (n = 38), and Mckeown group (n = 48). Among these three groups, the QLQ-C30 mean scores of global health status, functional and symptom scales, and general QoL were similar. The symptom scales of QLQ-OSE18 showed that patients who had a Mckeown operation experienced more problem of eating (P = 0.029), choking when swallowing (P = 0.010) and coughing (P = 0.016), while patients undergoing Sweet operation complained more symptom of reflux (P = 0.003) and pain (P = 0.000). ConclusionsAll three types of esophagectomy provided a generally good long-term QoL. However, patients in Sweet and Mckeown group tend to suffer from a higher symptomatic burden as compared to Ivor-Lewis approach.

Changes in Symptoms of Problematic Eating Over 6 Months in Infants and Young Children

The purpose of this article is to describe changes in problematic eating symptoms across 6 months in children seen in an outpatient feeding clinic and explore child characteristics associated with symptom changes. Participants were 58 parents of children aged 6 months to 7 years of age who were seen in an outpatient feeding clinic. Parents completed an online survey at 3 time points: enrollment and 3 and 6 months later. The survey consisted of the Pediatric Eating Assessment Tool (PediEAT) and a set of questions assessing demographic information, child's medical and feeding history, medical diagnoses, gastrointestinal function, and medications. Linear mixed modeling was used to examine changes in PediEAT total and subscale scores over time and explore associated child characteristics. The PediEAT total score significantly decreased over time with the greatest change in the Physiologic Symptoms subscale. Several child characteristics were associated with more severe symptoms of problematic feeding: older child age, more symptoms of constipation, and diagnoses of speech–language delay, developmental delay, food allergy, and/or genetic disorder. Parent report of child symptoms of problematic eating decreased across 6 months. Associations with child characteristics highlight the complexity of pediatric eating problems and the need for more research on potential factors influencing symptoms of eating problems.

The Relationship Between Diet Nutrition Knowledge and Demographic Characteristics in Family Caregivers of Patients With Dementia

Although the general-care knowledge of family caregivers related to dementia had been studied, little attention has been given to understanding the knowledge of caregivers related to dementia diet nutrition. This knowledge is important to help caregivers handle the eating and nutrition problems of people with dementia (PwD). The purpose of this study was to explore the dementia diet nutrition knowledge of family primary caregivers and to analyze whether demographic characteristics of caregivers and/or the dementia stages of PwD have a relationship with dementia diet nutrition knowledge. A descriptive and cross-sectional study using a questionnaire survey was conducted. A total of 220 primary family caregivers of people with dementia were recruited. Results showed that the average total score for the 13 questions on diet nutrition knowledge was 71.85%. Moreover, only 28.2% of the participants answered the question "Malnutrition is a significant risk during the early stage of dementia" correctly. In addition, the findings showed significant differences in the diet nutrition knowledge of participants based on education level (F = 3.989, p < .05) and the use of foreign (non-Taiwanese) caregivers (t = -2.919, p < .01). The participants had sufficient overall diet nutrition knowledge of dementia. However, they lacked knowledge in specific areas. Family caregivers with higher levels of education and those who hired foreign caregivers had better knowledge scores. The results may be used as a reference for nurses providing dementia dietary education. It is recommended that special attention be given to dietary education when patients are at the early onset phase of the disease and when caregivers have a lower level of education in order to improve the overall quality of dementia dietary care in the community.

Prevalence of disturbed eating behavior and associated symptoms of anxiety and depression among adult males and females with type 1 diabetes

BackgroundThe increased prevalence of disturbed eating behaviors (DEB), depression, and anxiety in type 1 diabetes (T1D) is generally well established; however the majority of existing research to date has focused on female adolescents and young adults. Data on males and older females is scarce. The aim of this study was to assess prevalence of DEB and symptoms of depression and anxiety among adult males and females with type 1 diabetes, to investigate differences between individuals scoring below and above the cut-off on psychopathology, and to examine patterns of eating disorder psychopathology by age and weight.MethodsA total of 282 adults with type 1 diabetes aged 18–79 years participated in the study. Measures included the Diabetes Eating Problem Survey – Revised (DEPS-R), the Hospital Anxiety and Depression Scale (HADS), and clinical data from the Norwegian Quality Improvement of Laboratory Examinations (NOKLUS) system.ResultsA total of 20.3% of the whole sample (13.3% among males and 24.8% among females) scored above the DEPS-R cut-off score for DEB. As for depression and anxiety, the prevalence in the whole sample was 6.2% and 19.0%, respectively. The prevalence was generally higher in females than males across all psychopathology measures. HbA1c was significantly associated with the DEPS-R total score (p < .01) among females, but not with depression and anxiety. Mean DEPS-R score decreased with increasing age, and when our previous reported data from children and adolescents are included, a peak prevalence in DEB in adolescence and young adult age is demonstrated.ConclusionsThe results of this study point to the need for increased awareness of psychological comorbidity among adults with type 1 diabetes, in particular young adult females. Screening is recommended to secure early detection and subsequent intervention for these individuals.

Disordered eating behaviors in adolescents with type 1 diabetes: A cross-sectional population-based study in Italy.

To evaluate the association of clinical, metabolic and socioeconomic factors with disordered eating behaviors (DEB) among adolescents with type 1 diabetes screened using the Diabetes Eating Problem Survey-Revised (DEPS-R). A cross-sectional, population-based study involved 163 adolescents with type 1 diabetes, aged 11-20years, recruited from the registry for type 1 diabetes of Marche Region, Italy, who completed the DEPS-R (response rate 74.4%). Clinical characteristics, lipid profile, HbA1c , family profile of education and occupation were evaluated. The Italian version of DEPS-R was validated, and the prevalence of DEB estimated. The association of demographic, socioeconomic, and clinical factors with DEB was evaluated by multiple correspondence analysis and multiple logistic regression. The prevalence of DEPS-R-positive (score ≥20) was 27% (95% CI 17-38) in boys and 42% (95% CI 31-53) in girls. A clinical profile of DEPS-R-positive was identified: overweight, little time spent in physical activity, low socioeconomic status, poor metabolic control, skipping insulin injections. Furthermore, the probability of DEPS-R-positive increased 63% for every added unit of HbA1c , 36% for every added number of insulin injections skipped in a week and decreased about 20% for every added hour/week spent in physical activity. Overweight youth were six times more likely to be DEPS-R-positive. A specific clinical profile of DEPS-R-positive was identified. A multidisciplinary clinical approach aimed to normalize eating behaviors and enhance self-esteem should be used to prevent the onset of these behaviors, and continuous educational programs are needed to promote healthy behaviors and lifestyles.

Is There Any Relationship Between Body Image Perception, Eating Disorders, and Muscle Dysmorphic Disorders in Male Bodybuilders?

Bodybuilding has increasingly become popular between males since male body shape has become a subject of interest in the last decades. Bodybuilders have desired to gain more muscle and paid attention to their body shape. Based on this purpose, they have string rules that include restrictive eating and excessive exercise program. Recent research has demonstrated that desiring more muscular body shape exhibits eating behavior problems and body dissatisfaction issues in bodybuilders. Limited research exists on the relationship between body dissatisfaction and eating disorders in male bodybuilders. The aim of this study was to determine the relationship between body image disturbance and eating disorders in 120 male bodybuilders. The Eating Attitude Test (EAT-40) was used to determine eating disorders, the Muscle Dysmorphia Disorder Inventory was used to determine bigorexia symptoms, and Bodybuilder Image Grid-Original (BIG O) and Scaled (BIG S) forms were used to detect the factors associated with body dissatisfaction. There was a positive relationship between Eating Attitude Test and Muscle Dysmorphia Disorder Inventory total scores. Eating Attitude Test was positively correlated with both fat and muscle dissatisfaction. Our results indicated that eating disorder psychopathology is positively related to body dissatisfaction and body dysmorphic disorders in male bodybuilders.

Associations between Executive Dysfunction and Disordered Eating Behavior (DEB) Risk in Teens with Type 1 Diabetes (T1D)

Background: The adolescent brain remains immature with ongoing development in areas such as executive function (EF). DEBs also commonly emerge during adolescence. We explored associations between EF and risk of DEBs in teens, ages 13-17, with T1D. Methods: EF was assessed by the Behavior Rating Inventory of Executive Function (BRIEF), both teen self-report and parent proxy-report versions. Scores ≥60, as total (Global Executive Composite [GEC]) score or on 2 indices (Behavioral Regulation [BRI] and Metacognition [MI]) or 8 subscales, indicate EF problems. DEB risk was assessed by the Diabetes Eating Problem Survey Revised (DEPS-R). DEB risk was categorized by DEPS-R scores: low risk &amp;lt;10; moderate risk 10-19; high risk ≥20. Results: Teens (N=169, 46% female) were aged 15.9±1.3 (M±SD) years and had T1D for 8.4±3.7 years; A1c was 8.5±1.2% and 44% were overweight/obese. Based on teen self-reported DEPS-R score, 59% had low DEB risk, 29% moderate risk, and 12% high risk. Higher DEB risk was significantly associated with EF problems by teen self-report on GEC, BRI, and MI and by parent report on BRI (Figure). EF subscales associated with DEB risk included emotional control, organization, task completion, goal setting, and problem-solving. Conclusion: In teens with T1D, executive dysfunction was associated with DEB risk, suggesting need for future study of the relationship between EF and DEBs. Disclosure R. Cecilia-Costa: None. M. Hansmann: None. K.R. Harrington: None. L. Volkening: None. L.M. Laffel: Consultant; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi US, MannKind Corporation, Roche Diagnostics Corporation, Dexcom, Inc., Insulet Corporation, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Johnson &amp; Johnson Diabetes Institute, LLC..

Longitudinal Assessment of Disordered Eating Behavior (DEB) Risk in Teens with Type 1 Diabetes (T1D)

DEBs in T1D are associated with poor glycemic control and development of diabetes complications. We assessed progression of risk for DEBs over 18 months in 169 teens, ages 13-17, with T1D. Teens completed the Diabetes Eating Problem Survey-Revised (DEPS) every 6 months. Teens were categorized by DEB risk: low, DEPS&amp;lt;10; moderate, DEPS 10-19; high, DEPS≥20. At baseline, teens (54% male) were 14.9±1.3 (M±SD) years old and had T1D for 7.4±3.7 years; 37% were overweight/obese. A1c was 8.5±1.0%; 68% were pump treated. Baseline DEB risk assessment included 60% at low risk, 27% at moderate risk, and 12% at high risk. Initial DEB risk was highly predictive of DEB risk after 18 months (Figure). Most teens (66%) stayed at their same risk level, 14% improved, and 20% progressed. In a multivariate mixed model predicting DEPS scores over 18 months, female sex (p=.0002), overweight/obesity (p=.0004), less frequent BG monitoring (p=.0008), and higher A1c (p=.003) significantly and independently predicted higher DEPS scores. Without intervention, DEB risk appears to remain relatively stable in teens with T1D. Therefore, it is important to prevent onset of DEBs, potentially by targeting teens who are female and overweight/obese as well as teens who are less adherent (e.g., few BG checks/day) and have rising A1c levels. Identifying DEB risk may permit early intervention and prevention of progression to clinical eating disorders. Disclosure R. Cecilia-Costa: None. Z. Guo: None. K.R. Harrington: None. L. Volkening: None. L.M. Laffel: Consultant; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi US, MannKind Corporation, Roche Diagnostics Corporation, Dexcom, Inc., Insulet Corporation, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Johnson &amp; Johnson Diabetes Institute, LLC..

Eating, Activity, and Weight-related Problems From Adolescence to Adulthood

Determining the population-based scope and stability of eating, activity, and weight-related problems is critical to inform interventions. This study examines: (1) the prevalence of eating, activity, and weight-related problems likely to influence health; and (2) the trajectories for having at least one of these problems during the transition from adolescence to adulthood. Project EAT I-IV (Eating and Activity in Teens and Young Adults) collected longitudinal survey data from 858 females and 597 males at four waves, approximately every 5 years, from 1998 to 2016, during the transition from adolescence to adulthood. Analyses were conducted in 2017-2018. Measures included high fast-food intake (≥3 times/week), low physical activity (<150 minutes/week), unhealthy weight control, body dissatisfaction, and obesity status. Among females, the prevalence of having at least one eating, activity, or weight-related problems was 78.1% at Wave 1 (adolescence) and 82.3% at Wave 4 (adulthood); in males, the prevalence was 60.1% at Wave 1 and 69.2% at Wave 4. Of all outcomes assessed, unhealthy weight control behaviors had the highest prevalence in both genders. The stability of having at least one problem was high; 60.2% of females and 34.1% of males had at least one problematic outcome at all four waves. The majority of young people have some type of eating, activity, or weight-related problem at all stages from adolescence to adulthood. Findings indicate a need for wide-reaching interventions that address a broad spectrum of eating, activity, and weight-related problems prior to and throughout this developmental period.

Examining the link between weight suppression and non-suicidal self-injurious behaviors

BackgroundGiven the negative consequences of excess weight, a large portion of the US population is seeking to obtain and maintain weight loss. Weight Suppression (WS) represents the difference between previous highest adult weight and current weight and may have negative psychological consequences. The current study examined the link between WS and lifetime non-suicidal self-injurious (NSSI) behavior and explored indirect effects in this link using survey data in two large samples. MethodsSample 1 included 1011 college students (67% female, mean age = 19 years); Sample 2 included 2461 participants from an epidemiological study (68% female, mean age = 34 years). Models of direct and indirect effects were tested in MPlus using bootstrapping. ResultsAs hypothesized, greater WS was associated with increased likelihood of lifetime NSSI in both samples (OR = 1.05 and 1.02). In both samples, significant indirect effects of drive for thinness (Total R2 = 0.06 and 0.09) and depressive symptoms (Total R2 = 0.13 and 0.29) accounted for this association. Alternative models in which the indirect effect of WS was tested in associations between drive for thinness or depressive symptoms and NSSI were not supported. ConclusionResults suggest that the link between WS and lifetime NSSI may be accounted for by eating or mood-related pathology. Future research should test whether addressing associated eating and mood problems would eliminate the link between WS and NSSI as a means for reducing suicide risk.

Binge eating and other eating-related problems in adolescents undergoing gastric bypass: results from a Swedish nationwide study (AMOS)

Bariatric surgery is established as a treatment option for adolescents with severe obesity. Little is known about binge eating (BE) and other eating-related problems in adolescents undergoing bariatric surgery. BE, emotional eating, uncontrolled eating, and cognitive restraint were assessed at baseline, and one and two years after gastric bypass using questionnaires in 82 adolescents (mean age 16.9 years, 67% girls). BE was assessed with the Binge Eating Scale (BES) and other eating-related problems with the Three Factor Eating Questionnaire. Change in eating-related problems over time, along with the relationship between eating behaviors and other aspects of mental health and weight outcome, were analyzed. At baseline, 37% of the adolescents reported BE (defined as a BES score >17). Two years after gastric bypass, adolescents reported less problems related to BE, emotional eating, and uncontrolled eating. Improvements were moderate to large. Adolescents reporting BE at baseline also reported more general mental health and psychosocial weight-related problems before and/or two years after surgery, compared to adolescents with no BE. After surgery adolescents with BE before surgery reported more suicidal ideation than those with no BE at baseline. None of the eating-related problems assessed at baseline was associated with weight outcome after surgery. More binge eating, emotional eating, and uncontrolled eating two years after surgery were associated with less weight loss. In conclusion, eating-related problems were substantially reduced in adolescents after undergoing gastric bypass. However, pre-operative BE seem to be associated with general mental health problems before and two years after surgery, including suicidal ideation. Pre-operative eating-related problems did not affect weight outcome, and our results support existing guidance that BE should not be considered an exclusion criterion for bariatric surgery in adolescents.

Executive function is associated with diabetes-specific disordered eating in young adults with type 1 diabetes

ObjectivesDisordered eating behavior in young adults with type 1 diabetes is overrepresented and associated with significant negative health consequences. Thus, determining the key correlates of these behaviors is essential. The aim of the present study was to determine the association between executive function and disordered eating in young adults with type 1 diabetes, relative to a control group without diabetes. Methods74 young adults with type 1 diabetes and 201 demographically similar control participants completed an online survey containing the Eating Disorders Examination Questionnaire (EDE-Q), Diabetes Eating Problems Survey- Revised (DEPS-R), Behavior Rating Inventory of Executive Function- Adult version, Depression Anxiety and Stress Scales, and 3 subscales of the Family Environment Scale (independence, control, and cohesion). ResultsHierarchical multiple regressions showed that lower executive function was associated with significantly greater disordered eating (as measured by the DEPS-R) over and above psychological and family functioning in the type 1 diabetes group (ΔR2 = 0.056, β = 0.366, p = .031). The same relationship was not found when disordered eating was measured by the EDE-Q in either the diabetes group (ΔR2 = 0.049, β = 0.342, p = .054), or the control group (ΔR2 = 0.010, β = 0.136, p = .100). ConclusionsExecutive function may play a greater role in the development and/or maintenance of disordered eating in groups with type 1 diabetes relative to those without. This relationship may contribute to the over-representation of eating problems in this clinical group, and may represent a target for prevention or intervention.

Food Selectivity, Gastrointestinal Symptoms and Urine Organic Acids in Autism Spectrum Disorder: A Pilot Study

Background: Autism spectrum disorder (ASD) is characterized by numerous co-morbidities including eating problems, the most common of which is food selectivity, and gastrointestinal (GI) dysfunction, which often occurs concurrently with eating problems. Aim: To investigate the relationships between food selectivity, GI symptoms and various metabolic pathways in children with ASD using parental report and quantitative urine organic acid testing. Methods: An anonymous review of the clinical charts of 68 children aged 1.6 to 11 with a diagnosis of ASD was performed. Demographic and health information from intake forms and urine organic acid test reports were analyzed; descriptive statistics and Chi square tests were conducted. Results: Parents of 60% of children reported food selectivity in their child and parents of 69% of children reported GI symptoms. 47% of parents reported both food selectivity and GI symptoms in their child. 90% of the participants were found to have at least one elevated GI fungal metabolite, and 30% or more had elevated levels of 5 different GI bacterial metabolites. No significant correlation between food selectivity and GI symptoms was identified. Conclusion: This study highlights important trends among FS, GI symptoms and select organic acid metabolites; further studies of the clinical significance of these metabolites and their effect on the behavior, sensory experiences and physical symptoms among children with ASD are suggested.

Disordered eating in a Swedish community sample of adolescent girls: subgroups, stability, and associations with body esteem,\xa0deliberate self-harm and other difficulties

BackgroundThe developmental study of subtypes of disordered eating (DE) during adolescence may be relevant to understand the development of eating disorders. The purpose of the present study was to identify subgroups with different profiles of DE in a community sample of adolescent girls aged 13–15 years, and to study the stability of these profiles and subgroups over a one-year interval in order to find patterns that may need to be addressed in further research and prevention.MethodsCluster analysis according to the LICUR procedure was performed on five aspects of DE, and the structural and individual stability of these clusters was analysed. The clusters were compared with regard to BMI, body esteem, deliberate self-harm, and other kinds of psychological difficulties.ResultsThe analysis revealed six clusters (Multiple eating problems including purging, Multiple eating problems without purging, Social eating problems, Weight concerns, Fear of not being able to stop eating, and No eating problems) all of which had structurally stable profiles and five of which showed stability at the individual level. The more pronounced DE clusters (Multiple eating problems including/without purging) were consistently associated with higher levels of psychological difficulties and lower levels of body esteem. Furthermore, girls that reported purging reported engaging in self-harm to a larger extent.ConclusionsSubgroups of 13–15 year old girls show stable patterns of disordered eating that are associated with higher rates of psychological impairment and lower body esteem. The subgroup of girls who engage in purging also engage in more deliberate self-harm.

The Nourishing Role: Exploratory Qualitative Research Revealing Unmet Support Needs in Family Carers of Patients With Advanced Cancer and Eating Problems.

Family carers of patients with advanced cancer living at home have an important role in providing the patient's food and drink. Little attention has been paid to the support needs, particularly of the nutrition needs, of family carers. The aim of this study was to report support needs of family carers of patients with advanced cancer and eating problems. The research is an inductive secondary analysis of baseline interview data from an exploratory trial conducted in the south of England. The interviews explored the management of eating problems in the home. A sample of 31 patients was selected where the patient's partner/spouse had also agreed to take part in the primary study. The analysis and interpretation reveal family carers to have a nourishing role, which is taken for granted by the patient and the carer themselves. This role is typically seen as an extension of the normal role of wife, mother, or homemaker in the family and no more than what a family carer should do. This obscures a need for information and advice on the nutritional care of patients with cancer with fickle appetite and other eating problems that are difficult to manage. Family carers may also be at a nutritional risk because their own dietary intake was found to mirror the patient's with some of them losing weight. Family cancer carers have a nourishing role that requires knowledge and skill beyond the everyday. Cancer carers need education in how best to provide nutritional care. They also need support in managing their own nutritional risk.