Problematic Eating Research Articles

Psychological and Physical Correlates of Body Image Dissatisfaction among High School Egyptian Students

Background: Body image is one of the most important psychological factors that affects adolescents’ personality and behavior. Body image can be defined as the person’s perceptions, thoughts, and feelings about his or her body.
 Objectives: to identify the prevalence of body image concerns among secondary school students and its relation to different factors.
 Subjects and methods: A cross-sectional study conducted in which 796 secondary school students participated and body shape concerns was investigated using the body shape questionnaire (BSQ-34).
 Results: The prevalence of moderate/marked concern was (21.6%). Moderate/ marked body shape concern was significantly associated with unemployed fathers and mothers, low level of maternal education, lower socioeconomic status, concern with body weight or problematic eating, increased BMI, increased anxiety and depression.
 Conclusions: The high prevalence of moderate/marked dissatisfaction with body shape and its possible relation to subsequent hazards such as eating disorders, depression, and anxiety should be of concern.

Feeding difficulties in Asian children with autism spectrum disorder

To characterize the nature and severity of feeding difficulties in Asian young children with Autism Spectrum Disorders (ASD) and identify potential predictors of poorer feeding outcomes. Cross sectional study of children aged 1-7 years with ASD. Parents completed the following: demographic information, brief autism mealtime behavior inventory, aberrant behavior checklist (ABC), behavioral pediatrics feeding assessment scale (BPFAS) and caregiver feeding style questionnaire. Additional information (medical data, cognitive and developmental assessment results, e.g., Autism Diagnostic Observation Schedule Second Edition, Autism Diagnostic Interview, Revised, Vineland Adaptive Behaviour Scales, etc.) were subsequently obtained from electronic medical records retrospectively by one of the study team members. Of the 67 children, 28.4% had feeding difficulties (high BPFAS total frequency score). Caregiver feeding styles were authoritarian (34.8%) or indulgent (39.4%). Child characteristics did not significantly predict for the severity of feeding difficulties. Univariate analysis revealed that authoritarian feeding style (p=0.001) and ABC hyperactivity score (p=0.006) were significantly associated with BPFAS severity score. Multivariate analysis revealed that ABC hyperactivity score remained significantly associated with BPFAS severity score after controlling for all other ABC subscale scores. A final regression model including all child characteristics and ABC scores did not reveal any significant predictors of BPFAS total frequency score (R2=0.557). Our findings suggest an association between hyperactivity, authoritarian feeding style and feeding difficulties. Children with ASD who have significant hyperactivity behaviors in the context of parents with an authoritarian feeding style should be actively screened for problematic feeding behaviors.

Birth order effects on breastfeeding self-efficacy, parent report of problematic feeding and infant feeding abilities

The goal of this prospective study was to identify effects of birth order on breastfeeding self-efficacy, parental-report of infant feeding behaviors, infant non-nutritive sucking and oral feeding skills in full-term infants at 3-months. Mothers were separated into primipara and multipara groups, and infants were grouped into siblings and no siblings groups. Parents completed the Breastfeeding Self-Efficacy Scale-Short Form, and Neonatal Eating Assessment Tool–Breastfeeding and Bottle-feeding scales. Non-nutritive sucking was assessed using a custom research pacifier and researchers completed the Oral Feeding Skills scale to assess feeding performance. Fifty-six mother-infant dyads (55% male infants) were included. Primipara mothers reported significantly lower breastfeeding self-efficacy and more feeding problems across breast and bottle-feeds on the Neonatal Eating Assessment Tool. There were no significant differences in non-nutritive sucking or oral feeding skills between infant groups. First-time mothers require more feeding support as they exhibited lower breastfeeding self-efficacy and reported more problematic infant feeding behaviors.

A systematic review of resting-state functional connectivity in obesity: Refining current neurobiological frameworks and methodological considerations moving forward.

Obesity is the second most common cause of preventable morbidity worldwide. Resting-state functional magnetic resonance imaging (fMRI) has been used extensively to characterise altered communication between brain regions in individuals with obesity, though findings from this research have not yet been systematically evaluated within the context of prominent neurobiological frameworks. This systematic review aggregated resting-state fMRI findings in individuals with obesity and evaluated the contribution of these findings to current neurobiological models. Findings were considered in relation to a triadic model of problematic eating, outlining disrupted communication between reward, inhibitory, and homeostatic systems. We identified a pattern of consistently increased orbitofrontal and decreased insula cortex resting-state functional connectivity in individuals with obesity in comparison to healthy weight controls. BOLD signal amplitude was also increased in people with obesity across studies, predominantly confined to subcortical regions, including the hippocampus, amygdala, and putamen. We posit that altered orbitofrontal cortex connectivity may be indicative of a shift in the valuation of food-based rewards and that dysfunctional insula connectivity likely contributes to altered homeostatic signal processing. Homeostatic violation signals in obesity may be maintained despite satiety, thereby 'hijacking' the executive system and promoting further food intake. Moving forward, we provide a roadmap for more reliable resting-state and task-based functional connectivity experiments, which must be reconciled within a common framework if we are to uncover the interplay between psychological and biological factors within current theoretical frameworks.

Cortisol in relation to problematic eating behaviours, adiposity and symptom profiles in Major Depressive Disorder

AimsMajor Depressive Disorder (MDD) is associated with an increased risk of chronic disease related to weight gain, problematic eating behaviours and neuroendocrine changes. MDD is frequently associated with altered hypothalamic-pituitary-adrenal axis activity and cortisol secretion, where cortisol has been implicated in regulating energy balance, food intake and depressogenic weight changes. However, little research has examined the relationships between cortisol, adiposity and depressogenic problematic eating behaviours. MethodPlasma cortisol concentrations were compared between 37 participants with MDD reporting appetite/weight loss, 43 participants with MDD reporting appetite/weight gain, and 60 healthy controls, by sex. Associations between cortisol, indices of adiposity and problematic eating behaviours were then assessed after accounting for demographic variables and depressive symptoms. Depressive symptoms were assessed using the Depression subscale of the Depression, Anxiety and Stress Scale, and eating behaviours with the Dutch Eating Behaviours Questionnaire and Yale Food Addiction Scale. ResultsParticipants with MDD reporting appetite/weight loss had higher cortisol compared to controls, and marginally higher cortisol than those with MDD reporting appetite/weight gain. Cortisol negatively and significantly accounted for unique variance in body mass index and waist circumference after accounting for variance associated with age, sex and depressive symptoms, however it was not a significant predictor of problematic eating behaviours, such as emotional eating or food addiction. Cortisol concentrations did not differ between sexes. ConclusionThe results indicate that cortisol is related to lower indices of adiposity and depressogenic symptoms of appetite/weight loss but is not related to problematic eating behaviours and appetite increases in MDD. These findings provide further evidence that the melancholic and atypical subtypes of MDD are associated with differential neuroendocrine and anthropometric indices, as well as behavioural and symptom profiles. Further research investigating the temporal nature of the identified relationships may assist in facilitating the development of improved interventions for individuals affected by weight changes in MDD.

Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases.

Feeding problems are associated with the consumption of a limited amount or restricted variety of foods and often occur in children with gastrointestinal diseases. The majority of studies to date do not use valid and reliable measurements to detect feeding problems. The aim of this cross-sectional study was to assess behavioral and skill-based feeding problems in young children with gastrointestinal diseases by using a well-established parent-reported feeding measure and identify demographic, anthropometric, and environmental factors associated with maladaptive feeding behaviors in this pediatric population. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and self-reported questionnaires assessing mealtime environment and parental feeding practices. It was found that 18.6% of the sample had abnormal Total Frequency Score (TFS) (frequency of problematic feeding behaviors) and 39.5% had abnormal Total Problem Score (TPS) (number of behaviors perceived as problematic by parents). Younger children, with lower body mass index, lower birth weight, and only children were more likely to have feeding problems. The study showed that parent-reported feeding problems are increased in young children with gastrointestinal diseases and are associated with specific aspects of mealtime environment and parental feeding practices.

Patterns of Eating Associated with Sleep Characteristics: A Pilot Study among Individuals of Mexican Descent at the US-Mexico Border

ABSTRACT Introduction: Previous studies have linked sleep to risk of diabetes and obesity, at least partially via alterations in food intake. Diabetes and obesity are common among Hispanics/Latinos, and studies are needed to better clarify the role of sleep in health among this group. Utilizing the revised TFEQ-R-18, this study will examine whether eating behaviors such as cognitive restraint, emotional eating and uncontrolled eating are related to self-reported sleep experiences. Specifically, we hypothesized that poor eating habits would be associated with (1) more insomnia symptoms, (2) overall worse sleep quality, (3) increased daytime sleepiness, and (4) shorter sleep duration. Methods: Data were collected from N = 100 adults (age 18–60, 47% female) of Mexican descent in the city of Nogales, AZ (34% not born in the US). Surveys were presented in English or Spanish. Eating Patterns were assessed with the Three-Factor Eating Questionnaire (TFEQ), which resulted in a total score and subscales for “cognitive restraint,” “uncontrolled eating,” and “emotional eating.” Insomnia was assessed with the use of the Insomnia Severity Index (ISI), Sleepiness with the use of the Epworth Sleepiness Scale (ESS), Sleep quality with the use of the Pittsburgh Sleep Quality Index (PSQI), and weekday and weekend sleep duration with the use of the Sleep Timing Questionnaire (STQ). Covariates included age, sex, Body Mass Index (BMI), education and immigrant status. Results: Overall TFEQ score (problematic eating) was positively associated with greater insomnia, poorer sleep quality, more sleepiness, and less weekend (but not weekday) sleep. Mean TFEQ score in the sample was 18.7 (range 0–51). In adjusted analyses, every point on the TFEQ was associated with 0.6 ISI points, 0.8 PSQI points, 0.5 ESS points, and 1.1 minutes of less weekend sleep duration. Regarding subscale scores, relationships were generally seenbetween sleep and emotional eating and unrestricted eating, and not cognitive restraint. Conclusions: Greater insomnia, poorer sleep quality, increased daytime sleepiness and decreased weekend sleep duration were associated with eating patterns at the US-Mexico border, particularly in the area of unrestricted eating and emotional eating. This suggests possible mechanisms linking sleep and obesity in Hispanic/Latinos.

Efficacy of Dialectical Behavior Therapy on Decreasing Weight in Obese Women with Emotional and Behavioral Disorders: A Quasi Experimental Study

Objective: The growing worldwide prevalence of overweight and obesity, despite treatment strategies remain the health problem. Over the past decade, increasing attention has been paid to psychological factors and a potentially comprehensive, multimodal skills-based treatment. The purpose of this study was to evaluate the efficacy of dialectical behavior therapy (DBT) on weight loss in obese women with emotional and behavioral disorders. Materials and Methods: In this quasi-experimental study, statistical population from convenience sampling consisted of 42 obese women with body mass index (BMI) more than 29.9 kg/m2 divided in 3 groups, behavioral, emotional and control. Descriptive and analytic statistics were computed according to demographic information, emotional eating scale and Dutch eating behavior questionnaire. Intervention included 13 sessions of 1.5hr group therapy, DBT-skills training from April to September 2019. Mixed-effect modeling ANOVA with repeated measurements was performed by statistical analyses, IBM SPSS version 24 to study changes in variables over time. Results: The results demonstrated that the emotional such as anger, anxiety and depression, significantly decrease during the study period. (P-value<0.001) As well as behavioral eating demonstrated significant improvement in restrained eating and decrease in emotional and external eating behaviors right after the end of intervention while trial group experienced significant weight loss. Conclusion: The present study provides some evidence that DBT-skills training can be effective in decreasing problematic eating behaviors, emotion dysregulations, decreasing BMI.

Prevalence of problematic feeding in young children born prematurely: a meta-analysis

BackgroundDifficulties related to eating are often reported in children born preterm. The objective of this study was to quantitatively synthesize available data on the prevalence of problematic feeding in children under 4 years of age who were born preterm.MethodsLiterature was identified from PubMed, CINAHL, and PsycInfo. The search was limited to English language and publication years 2000–2020. To be included in the meta-analysis, the article had to report the prevalence of problematic oral feeding within a population of children born prematurely (< 37 weeks’ gestation), and the child age at the time of study had to be between full-term corrected age and 48 months. For studies meeting inclusion criteria, the following data were extracted: sample size and subsamples by gestational age and/or child age at time of study; definition of problematic feeding; measures used for assessment of feeding; gestational age at time of birth of sample; child age at time of study; exclusion criteria for the study; and prevalence of problematic feeding. Random-effects meta-analyses were performed to estimate the prevalence of problematic feeding across all studies, by gestational age at birth, and by child age at time of study.ResultsThere were 22 studies that met inclusion criteria. Overall prevalence of problematic feeding (N = 4381) was 42% (95% CI 33–51%). Prevalence was neither significantly different across categories of gestational age nor by child age at the time of study. Few studies used psychometrically-sound assessments of feeding.ConclusionProblematic feeding is highly prevalent in prematurely-born children in the first 4 years of life regardless of degree of prematurity. Healthcare providers of children born preterm should consider screening for problematic feeding throughout early childhood as a potential complication of preterm birth.Systematic review registration numberNot applicable.

The Influence of Trait Compulsivity and Impulsivity on Addictive and Compulsive Behaviors During COVID-19.

Background: The COVID-19 pandemic has resulted in high levels of psychological distress worldwide, with experts expressing concern that this could result in corresponding increases in addictive behaviors as individuals seek to cope with their distress. Further, some individuals may be at greater risk than others for developing problematic addictive behaviors during times of high stress, such as individuals with high trait impulsivity and compulsivity. Despite the potential of such knowledge to inform early detection of risk, no study to date has examined the influence of trait impulsivity and compulsivity on addictive behaviors during COVID-19. Toward this aim, the current study examined the association between impulsive and compulsive traits and problematic addictive and compulsive behaviors during the first COVID-19 lockdown in Australia.Methods: Eight hundred seventy-eight adults completed a cross-sectional online survey during the first lockdown, between late May to June 2020. Participants completed scales for addictive and compulsive behaviors for the period prior to and during lockdown for problematic eating, pornography, internet use, gambling, drinking, and obsessive-compulsive behaviors. Negative binomial regressions examined the associations between impulsivity, compulsivity, and their interaction with problematic behaviors during lockdown, controlling for age, gender, sample, psychological distress, exposure to COVID-related stressors, and pre-COVID problems.Results: Greater trait compulsivity was associated with more problematic obsessive-compulsive behaviors (p < 0.001) and less problematic drinking (p = 0.038) during lockdown. Further, trait compulsivity interacted with trait impulsivity in relation to problematic eating behaviors (p = 0.014) such that greater trait compulsivity was associated with more problems among individuals with low impulsivity only (p = 0.030). Finally, psychological distress and/or exposure to COVID-related stressors were associated with greater problems across all addictive and compulsive behaviors, as was severity of pre-COVID problems.Discussion: Trait compulsivity was associated with addictive and compulsive behaviors in different ways. Further, the finding that stress-related variables (psychological distress and COVID-related stressors) were associated with greater problems across all lockdown behaviors supports the idea that stress may facilitate, or otherwise be associated with, problematic behaviors. These findings highlight the need for interventions that enhance resilience to stress, which in turn may reduce risk for addictive and compulsive disorders.

Six-year bariatric surgery outcomes: the predictive and incremental validity of presurgical psychological testing.

Research identifying preoperative psychosocial predictors of bariatric surgery outcomes has yielded inconsistent results with minimal examination of longer-term outcomes. Utilizing a broadband measure of personality and psychopathology during the preoperative evaluation helps to identify preoperative risk factors for suboptimal bariatric surgery outcomes. Examine predictors of outcome and the incremental contribution of presurgical psychological testing to various long-term bariatric surgery outcomes. Academic medical center. A total of 168 postoperative patients (average of 6 postoperative years) consented to participate in the outcome study. Participants were weighed by the trained research/clinical staff and completed a battery of self-report questionnaires, including measures assessing eating attitudes and behaviors and weight-related quality-of-life (QoL). Patients had completed the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) as part of the institution's routine preoperative psychosocial evaluation. Weight loss was calculated as percent total weight loss (%TWL) and percent weight regain (%WR) was calculated as a percentage of maximum weight loss. Other preoperative data were obtained from a review of each patient's electronic medical record (EMR). From the initial sample, 145 patients were retained for analyses in the present study. Preoperative problematic eating variables predicted long-term postoperative problematic eating behaviors and body image concerns. Scores on preoperative MMPI-2-RF scales measuring Demoralization, Dysfunctional Negative Emotions, Antisocial Behaviors, and Hypomanic Activation were consistent incremental predictors of 6-year outcomes, accounting for an additional 3%-24% of the variability in postoperative eating behaviors and QoL. The preoperative psychological evaluation can be used to identify predictors of long-term bariatric surgery outcomes. Identification of these risk factors provides important targets for pre- and postoperative clinical interventions to maximize surgical outcomes.

Problematic eating behaviors in patients undergoing bariatric surgery: Studying their relationship with psychopathology.

This study explored the associations between individuals presenting different problematic eating behaviors (Objective/Subjective binge-eating-OBE/SBE-and Compulsive/Non-compulsive grazing-C_Grazing/NC_Grazing) and eating disorder related symptoms. About 163 pre- and 131 post-bariatric patients were assessed. Assessment included: Face-to-face clinical interview to assess binge-eating and grazing episodes, and self-report measures to assess eating disorder symptomatology, psychological distress, and negative urgency. OBE and NC_Grazing were the problematic eating behaviors most and least associated with psychopathology, respectively. OBE and C_Grazing uniquely accounted for the significant variance in the most disordered eating variables. Our findings emphasize the need for the conceptualization of grazing behavior in the spectrum of disordered eating.

Correlates and Trajectories of Preterm Infant Sucking Patterns and Sucking Organization at Term Age.

Premature infants may experience increased difficulty with nutrition and growth. Successful oral feeding is an important factor associated with discharge readiness. Despite the importance of feeding as a growth-fostering process, little empiric evidence exists to guide recommendations for early interventions. Evaluate whether specific elements of sucking, during preterm initiation of oral feeding, predict sucking organization at corrected term age. Sucking performance of 88 preterm infants born between 24 and 34 weeks of post-menstrual age was measured at baseline and term (33-35 and 40 ± 1.5 weeks). Participants were divided into 4 groups (quartiles) based on initial measures of performance including number of sucks, number of bursts, sucks per burst, and maximum pressure. Stability in sucking organization was assessed by comparing changes in infant's quartile location from baseline to term. A correlation between quartile location was observed for mean maximum pressure (PMAX): infants with PMAX in the lowest quartile (poorest performance) were significantly more likely to remain in the lowest quartile at term (P < .000); infants in the highest quartile (best performance) at baseline were significantly more likely to be in the highest quartile at term (P < .000). Infants with the weakest sucking pressures at 34 weeks of post-menstrual age continue to be at risk for less than optimal feeding skills at 40 weeks of post-menstrual age. Early identification of at-risk infants may allow for effective interventions to potentially decrease long-term feeding problems. Future research should focus on the development of personalized interventions to address attributes of problematic feeding such as sucking efficiency.

Abstract 14053: Problematic Feeding is Common and Related to Gastroesophageal Reflux in the First 6 Months After Neonatal Cardiac Surgery

Introduction: Feeding problems are often reported in infants after cardiac surgery. To date, no studies have followed the development of feeding after cardiac surgery using valid and reliable measures. Purpose: To describe feeding problems and the relationship between feeding and gastrointestinal tract symptoms in infants over the first 6 months (mos) after neonatal cardiac surgery. Methods: Parents of neonates requiring cardiac surgery were invited to complete surveys when their infant was 2, 4, and 6 mos old. The survey included the Neonatal Eating Assessment Tool (NeoEAT), Infant Gastroesophageal Reflux Questionnaire – Revised (I-GERQ-R), and Infant Gastrointestinal Symptoms Questionnaire (IGSQ). Scores on the NeoEAT subscales ( Infant Regulation, Energy &amp; Physiologic Stability, Gastrointestinal Tract Function, Sensory Responsiveness , and Compelling Symptoms of Problematic Feeding) were categorized as problematic (≥ 90 th percentile) or not problematic (&lt; 90 th percentile) based on reference data. Percent of the sample with problematic feeding at each time point was determined. Bivariate correlations were calculated between the NeoEAT, IGSQ, and I-GERQ-R. Results: 27 parents completed the surveys, reporting on 6 infants with single ventricle and 21 with two ventricle conditions. Problematic feeding scores were common at all times and in both cardiac conditions. Problematic scores were reported on Compelling Symptoms of Problematic Feeding for 52% of the sample at 2 mos, 36% at 4 mos, and 22% at 6 mos. Problematic scores occurred in Gastrointestinal Tract Function for 22% at 2 mos, 10% at 4 mos, and 39% at 6 mos. Problems occurred in Sensory Responsiveness in 17% at 2 mos, 24% at 4 mos, and 33% at 6 mos. Energy &amp; Physiologic Stability problems occurred in 13%, 10%, and 22%, respectively. None reported problems in Infant Regulation . Symptoms of gastroesophageal reflux (I-GERQ-R) were significantly correlated with the NeoEAT ( p &lt; .05), but gastrointestinal symptoms (IGSQ) were not. Conclusions: Problematic feeding is common in the first 6 mos after neonatal cardiac surgery and is related to gastroesophageal reflux symptoms. Some areas of feeding improved over time, while others worsened, likely related to developmental and disease-related changes.

Sexual orientation concealment and mental health: A conceptual and meta-analytic review.

Identity concealment affects all sexual minority individuals, with potentially complex mental health implications. Concealing a sexual minority identity can simultaneously generate the stress of hiding, protect against the stress of discrimination, and keep one apart from sexual minority communities and their norms and supports. Not surprisingly, existing studies of the association between sexual orientation concealment and mental health problems show contradictory associations-from positive to negative to null. This meta-analysis attempts to resolve these contradictions. Across 193 studies (n = 92,236) we find a small positive association between sexual orientation concealment and internalizing mental health problems (i.e., depression, anxiety, distress, problematic eating; ESr = 0.126; 95% CI [0.102, 0.151]) and a small negative association between concealment and substance use problems (ESr = -0.061; 95% CI [-0.096, -0.026]). The association between concealment and internalizing mental health problems was larger for those studies that assessed concealment as lack of open behavior, those conducted recently, and those with younger samples; it was smaller in exclusively bisexual samples. Year of data collection, study location, and sample gender, education, and racial/ethnic composition did not explain between-study heterogeneity. Results extend existing theories of stigma and sexual minority mental health, suggesting potentially distinct stress processes for internalizing problems versus substance use problems, life course fluctuations in the experience of concealment, distinct experiences of concealment for bisexual individuals, and measurement recommendations for future studies. Small overall effects, heavy reliance on cross-sectional designs, relatively few effects for substance use problems, and the necessarily coarse classification of effect moderators in this meta-analysis suggest future needed methodological advances to further understand the mental health of this still-increasingly visible population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Spontaneous Transformation and Recovery From Problematic Eating: A Heuristic Inquiry

Health care professionals agree that there are countless individuals with problematic eating habits that detract from health and well-being but do not directly meet the criteria for diagnosis of disorder. Previous research identifies that problematic eating patterns are notoriously challenging to address and that positive changes in behavior are difficult to maintain. This qualitative study contributes to the literature identifying potential mechanisms for transformative and lasting change for individuals exhibiting problematic eating patterns. Utilizing heuristic methodology, the lived experience of spontaneous transformation as a mechanism of change in the development of, and recovery from, problematic eating habits was illuminated and explored by the primary researcher, SS, and six female coresearchers. The data for this study were obtained through in-depth, informal conversational interviews. Heuristic analysis of the data revealed six core themes relevant to the experience of the phenomenon of spontaneous transformation and the recovery from problematic eating habits: (a) early messaging in environment of origin, (b) moments of suffering as gateways to change, (c) perceived loss of control, (d) implicit awareness resulting in transformation, (e) physical expressions of expansion and constriction, (f) and the necessity for a new definition of recovery. The findings of this study point toward the experience of spontaneous transformation as a mechanism for enhanced self-awareness and potential for generating transformational change in patterns of problematic eating.

Neonatal Eating Assessment Tool-Mixed Breastfeeding and Bottle-feeding: Reference values and factors associated with problematic feeding symptoms in healthy, full-term infants.

The Neonatal Eating Assessment Tool-Mixed Breastfeeding and Bottle-feeding (NeoEAT-Mixed Feeding) is a parent-report assessment of symptoms of problematic feeding in infants who are feeding by both breast and bottle. To establish reference values for the NeoEAT-Mixed Feeding and evaluate factors that contribute to symptoms of problematic feeding in healthy, full-term infants. Parents of 409 infants less than 7 months old completed an online survey. Median and percentile scores are presented for infants aged 0-2, 2-4, 4-6, and 6-7 months old. Neonatal Eating Assessment Tool-Mixed Feeding total score and scores for the Gastrointestinal Tract Function and Energy & Physiologic Stability subscales decreased with increasing infant age. Infant Regulation and Feeding Flexibility subscale scores remained stable over time, whereas Sensory Responsiveness subscale scores increased with increasing infant age. Infants with more gastrointestinal symptoms had higher NeoEAT-Mixed Feeding total scores. The reported reference values may be used to identify infants in need of further assessment, referral, and intervention. In healthy, full-term infants with concurrent gastrointestinal symptoms and problematic feeding, interventions targeted at gastrointestinal symptoms may help to improve symptoms of problematic feeding as well.

Symptoms of problematic feeding in infants under 1year of age undergoing frenotomy: A review article.

The aims of this systematic review were to first identify and summarise original research that compared symptoms of problematic feeding in infants with tongue tie before and after frenotomy and then evaluate the quality of measures used to assess problematic feeding. CINAHL and PubMed were searched for ((tongue-tie) or (ankyloglossia)) and ((feeding) or (breastfeeding) or (bottle-feeding)) and ((frenotomy) or (frenectomy) or (frenulectomy) or (frenulotomy)). Original research reporting on feeding before and after frenotomy in infants under 1year old was included. Maternal nipple pain, breastfeeding self-efficacy and LATCH scores improved after frenotomy. Few data are available on the effect of frenotomy on infant feeding. The measures used to assess infant feeding were not comprehensive and did not possess strong psychometric properties. Literature suggests that maternal nipple pain, self-efficacy and LATCH scores improve in breastfeeding mother-infant dyads after frenotomy. However, current literature does not provide adequate data regarding the effect of frenotomy on the infant's ability to feed or which infants benefit from the procedure. Future research should utilise comprehensive, psychometrically sound measures to assess infants for tongue tie and to evaluate infant feeding to provide stronger evidence for the effect of frenotomy on feeding in infants with tongue tie.

Effects of Mindfulness-Based Intervention on the Treatment of Problematic Eating Behaviors: A Systematic Review.

Objectives: Emerging research interest focused on mindfulness-based interventions (MBIs) as a complementary approach for the treatment of problematic eating behaviors. This systematic review aims to comprehensively evaluate current evidence from randomized-controlled trials (RCTs) that have used the MBIs as the treatment for problematic eating concerns. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method for systematic reviews, electronic databases, including Ovid MEDLINE, Ovid Embase, AMED, Web of Knowledge, PsycINFO, Scopus, and The Cochrane Library, were systematically searched to identify up to June 2017. Hand search of the reference lists of related systematic reviews was also conducted for detecting additional studies. Eligible studies were RCTs that employed MBIs as the primary intervention for people with problematic eating or body image concerns. Results: A total of nine RCTs were included in this systematic review. In the majority of included studies, participants in MBI groups showed significant reduction in emotional eating, external eating, binge eating, and weight and shape concern. Findings also suggest that increasing mindful awareness of internal experiences and automatic patterns could be effective for the improvement of self-acceptance and emotional regulation, thereby reducing the problematic eating behaviors. Conclusion: This systematic review advances the understanding of MBIs as an complementary approach for problematic eating behavior treatment. Despite the variable trial qualities and some small sample sizes, this study provides initial evidence supporting the efficacy of the application of MBIs to a range of problematic eating concerns. The application of MBIs remains a promising approach for the treatment of problematic eating and merits further investigations.

NeckSense: A Multi-Sensor Necklace for Detecting Eating Activities in Free-Living Conditions.

We present the design, implementation, and evaluation of a multi-sensor, low-power necklace, NeckSense, for automatically and unobtrusively capturing fine-grained information about an individual's eating activity and eating episodes, across an entire waking day in a naturalistic setting. NeckSense fuses and classifies the proximity of the necklace from the chin, the ambient light, the Lean Forward Angle, and the energy signals to determine chewing sequences, a building block of the eating activity. It then clusters the identified chewing sequences to determine eating episodes. We tested NeckSense on 11 participants with and 9 participants without obesity, across two studies, where we collected more than 470 hours of data in a naturalistic setting. Our results demonstrate that NeckSense enables reliable eating detection for individuals with diverse body mass index (BMI) profiles, across an entire waking day, even in free-living environments. Overall, our system achieves an F1-score of 81.6% in detecting eating episodes in an exploratory study. Moreover, our system can achieve an F1-score of 77.1% for episodes even in an all-day-long free-living setting. With more than 15.8 hours of battery life, NeckSense will allow researchers and dietitians to better understand natural chewing and eating behaviors. In the future, researchers and dietitians can use NeckSense to provide appropriate real-time interventions when an eating episode is detected or when problematic eating is identified.