Rapid Eating Research Articles

How we eat may be as important as what we eat: eating behaviour and heart rate variability

Objective Diet exerts a crucial role on cardiovascular health. Evidence is mainly based on the content and the amount of dietary intakes. Some recent reports demonstrated that eating behaviour may also be of significant importance in cardiovascular health. In this study we aimed to investigate the effects of eating behaviour on heart rate variability (HRV) in healthy subjects.Methods and results In total, 521 healthy subjects with 24-hour Holter ECG recordings filled out a special questionnaire about their eating behaviour and lifestyles. From these patients, 425 subjects were healthy and had recordings suitable for analysis. Five types of eating behaviour were assessed in the questionnaire: (1) adherence to the Mediterranean diet (using the MedDietScore), (2) skipping breakfast, (3) late night eating, (4) having snacks, and (5) rapid eating. Physical exercise level and active working status of the subjects were also assessed. The root mean square of successive differences (RMSSD) was used for assessment of HRV.RMSSD values were lower in subjects skipping breakfast compared to subjects having breakfast regularly (26.32 vs 31.52 P = 0.02). Other behavioural patterns did not have any effect on the HRV parameters. Ageing, male sex, sedentary lifestyle and no active working were also found to be associated with reduced HRV in univariate analysis. In multivariate regression analysis, age and skipping breakfast were the only parameters significantly associated with a lower RMSSD (β: –0.222, P: 0.008 and β: –0.191, P: 0.020, respectively)Conclusions The findings of this study showed that skipping breakfast may be a cause of cardiac autonomic dysfunction.

A Brief Dietary Assessment Predicts Executive Dysfunction in an Elderly Cohort: Results from the Einstein Aging Study.

To examine the association between diet and executive function, episodic memory and global verbal cognition in the Einstein Aging Study (EAS) cohort and determine whether race modifies this relationship. Cross-sectional. Community. EAS participants without dementia who completed the Rapid Eating and Activity Assessment for Patients (REAP) (N = 492). The previously validated REAP is based on the 2000 U.S. dietary guidelines. REAP scores were dichotomized as less-healthy (<median) or healthier (≥median) diet. Nine neurocognitive tests underwent principle component analysis, revealing three significant orthogonal components: episodic memory, executive function, and global cognition. Impaired cognitive function in each domain was defined as 2 standard deviations (SD) or more below the mean on any task or a total score of 1.5 SD or more below the mean. Using logistic regression, the association between diet and cognitive impairment was assessed, adjusting for age, education, sex, cardiovascular comorbidities, hypertension, body mass index, diabetes mellitus, depressive symptoms, race, and the interaction between race and diet group. The sample was 60% female and 74% white and had a mean age of 80. In the entire sample, impaired executive function was associated with the interaction between race and diet group (P = .08), whereas other cognitive domains were not. In race-stratified analyses, healthier diet was associated with lower odds of impaired executive function in whites (odds ratio (OR) = 0.44, 95% confidence interval (CI) = 0.21-0.93, P = .03), as were healthier scores on the saturated fat subscale (OR = 0.34, 95% CI = 0.16-0.71, P = .004). In blacks, REAP scores were not associated with cognitive domains. Healthy diet was associated with lower risk of executive dysfunction in whites. Race differences may be due to greater vascular risk in blacks or differences in generalizability of the REAP.

Subclinical dysphagia in persons with Prader-Willi syndrome.

Prader-Willi Syndrome (PWS) is caused by a genetic imprinting abnormality resulting from the lack of expression of the paternal genes at 15q11-q13. Intellectual disability, low muscle tone, and life-threatening hyperphagia are hallmarks of the phenotype. The need for the Heimlich maneuver, death from choking, and pulmonary infection occur in a disproportionally high number of persons with PWS. The widely held belief is that eating behaviors are responsible for choking and aspiration; yet, no investigation had sought to determine if swallowing impairments were present in persons with PWS. To address this research and clinical gap, simultaneous videofluoroscopy and nasal respiratory signals were used to record swallowing function and breathing/swallowing coordination in 30 participants with PWS. Subjects consumed thin liquid and barium cookies under two randomized conditions as follows: (i) controlled (cues to swallow and standardized bolus sizes); (ii) spontaneous (no cues or bolus size control). Under videofluoroscopy, the cohort showed disordered pharyngeal and esophageal swallowing in both conditions with disturbances in timing, clearance, and coordination of swallowing with the respiratory cycle. No participant showed a sensory response such as attempting to clear residue or coughing; thereby supporting the lack of overt symptoms. We conclude that the high death rate from choking and pulmonary infection in children and adults with PWS may be related, in part, to underlying, asymptomatic dysphagia. The combination of rapid eating and dysphagia would increase the risk of aspiration-related morbidity and mortality. © 2016 Wiley Periodicals, Inc.

Determinants of health-related lifestyles among university students.

The aim of this study was to investigate students' health-related lifestyles and to identify barriers and social determinants of healthier lifestyles. An online survey, two focus groups and three in-depth interviews across 2014/2015. A stratified by school size and random sample ( n = 468) of university students answered a 67-item questionnaire comprising six scales: Rapid Assessment of Physical Activity, Rapid Eating and Activity Assessment for Patients-Short Version, CAGE, Fagerström Test for Nicotine Dependence, Warwick-Edinburgh Mental Wellbeing Scale short version, and ad hoc scale for drug use/misuse. Stratified by gender, χ2 tests were run to test associations/estimate risks and three multivariate Logistic Regression models were adjusted. A thematic approach guided the analysis of qualitative data. A total of 60% of the respondents were insufficiently physically active, 47% had an unbalanced diet and 30% had low mental wellbeing. Alcohol drinkers versus abstinent were almost equally distributed. A total of 42% of alcohol drinkers reported getting drunk at least once a month. Smokers accounted for 16% of the respondents. Identified risk factors for suboptimal physical activity were as follows: being a woman, not using the university gym and smoking. Risk factors for unbalanced diet were low mental wellbeing and drug use. Poor mental wellbeing was predicted by unbalanced diet, not feeling like shopping and cooking frequently, and a lack of help-seeking behaviour in cases of distress. Qualitative analysis revealed seven thematic categories: transition to new life, university environment and systems, finances, academic pressure, health promotion on campus and recommendations. This study provides robust evidence that the health-related lifestyles of the student population are worrying and suggests that the trend in chronic diseases associated with unhealthy lifestyles sustained over years might be unlikely to change in future generations. University students' health-related lifestyle is a concern. Nine out of the identified 10 predictors of problematic physical activity, nutrition and mental wellbeing, were environmental/societal or institutional barriers. Universities must expand corporate responsibilities to include the promotion of health as part of their core values.

Reduction of Rapid Eating in an Adolescent Female with Autism.

Rapid eating, a potentially dangerous and socially inappropriate behavior, has received relatively little attention in the literature. This study sought to extend the research in this area by further evaluating the effectiveness of a vibrating pager combined with a rule for increasing inter-response time between bites in one adolescent female diagnosed with autism. Results indicated that inter-response time increased from baseline only after a vocal prompt to "wait" was introduced across clinic and home settings. Implications for promoting autonomy in individuals with developmental disabilities are discussed.This antecedent-based intervention can easily be generalized to caregiversThe unobtrusive nature of the intervention allows for implementation in inclusive settingsThere are implications for promoting social skills in naturalistic environmentsThe intervention can promote independence through teaching self-management.

Effectiveness of different memory training programs on improving hyperphagic behaviors of residents with dementia: a longitudinal single-blind study.

BackgroundHyperphagia increases eating-associated risks for people with dementia and distress for caregivers. The purpose of this study was to compare the long-term effectiveness of spaced retrieval (SR) training and SR training combined with Montessori activities (SR + M) for improving hyperphagic behaviors of special care unit residents with dementia.MethodsThe study enrolled patients with dementia suffering from hyperphagia resident in eight institutions and used a cluster-randomized single-blind design, with 46 participants in the SR group, 49 in the SR + M group, and 45 participants in the control group. For these three groups, trained research assistants collected baseline data on hyperphagic behavior, pica, changes in eating habits, short meal frequency, and distress to caregivers. The SR and SR + M groups underwent memory training over a 6-week training period (30 sessions), and a generalized estimating equation was used to compare data of all the three groups of subjects obtained immediately after the training period and at follow-ups 1 month, 3 months, and 6 months later.ResultsResults showed that the hyperphagic and pica behaviors of both the SR and SR + M groups were significantly improved (P<0.001) and that the effect lasted for 3 months after training. The improvement of fast eating was significantly superior in the SR + M group than in the SR group. The improvement in distress to caregivers in both intervention groups lasted only until the posttest. Improvement in changes in eating habits of the two groups was not significantly different from that of the control group.ConclusionSR and SR + M training programs can improve hyperphagic behavior of patients with dementia. The SR + M training program is particularly beneficial for the improvement of rapid eating. Caregivers can choose a suitable memory training program according to the eating problems of their residents.

Associations of eating a late-evening meal before bedtime with low serum amylase and unhealthy conditions

Little is known about the associations of eating a late-evening meal (ELM), a putative unhealthy eating behavior, with low serum amylase, other eating behaviors, and cardiometabolic risk factors. Therefore, we investigated whether ELM before bedtime was associated with low serum amylase or other clinical factors in 2,426 asymptomatic adults aged 20–80 years. Multivariate logistic regression analysis showed that ELM was significantly associated with low serum amylase (<60 IU/l), overweight, smoking, daily alcohol consumption, skipping breakfast, and rapid eating, but not with abnormal glucose metabolism. In conclusion, ELM may be independently associated with low serum amylase and common unhealthy behaviors.

Cross-Sectional Study of Possible Association between Rapid Eating and High Body Fat Rates among Female Japanese College Students

The incidence of excessive body fat among young Japanese females with a normal BMI, which is referred to as normal weight obesity (NWO), has recently increased. Some studies have associated eating rates with BMI. However, an association between body fat rate and dietary habits has not been proven. We compared differences in dietary habits between 72 female Japanese junior college students with normal (<30%; normal body fat ratio, NFR) and high (≥ 30%; excessive body fat ratio, EFR) proportions of body fat. Energy and the intake of many nutrients and foods did not significantly differ between the two groups, but the EFR group consumed significantly less saturated fatty acid, sugar and confectionery. Eating rapidly was significantly associated with body fat ratios. Our findings suggest that eating rapidly increases body fat ratios.

REDUCING RAPID EATING IN ADULTS WITH INTELLECTUAL DISABILITIES

Rapid eating is a frequent problem among individuals with developmental disabilities that can pose a threat to health. This study sought to reduce the rate of eating behaviors in two adults diagnosed with moderate intellectual disability. Assessment of eating rate took place in the participants' group homes during lunch or dinner meals. Procedures included the use of vibrating pagers with and without verbal prompts to prompt eating and prevent rapid eating behaviors. Results demonstrate a clear reduction in rate of eating when using vibrating pagers and verbal prompts for both participants. Copyright © 2012 John Wiley &amp; Sons, Ltd.

Self-reported rate of eating is significantly associated with body mass index in Japanese patients with type 2 diabetes. Japan Diabetes Clinical Data Management Study Group (JDDM26)

We examined whether the rate of eating was associated with the body mass index and glycemic control status in Japanese patients with type 2 diabetes (50% women, mean±SD age 59.4±7.5years). Rapid eating was significantly associated with body mass index (p=0.047). The body mass index of those who reported eating quickly was 0.8kg/m2 higher than in individuals who reported eating at medium speed even after adjustment for known confounders. No significant association was observed between the rate of eating and HbA1c. Our findings suggest an association between self-reported rapid eating and an elevated body mass index in patients with type 2 diabetes.

Both eating till feeling full and rapid eating are associated with clustering of psychosomatic problems and preference for strong tastes

Both eating till feeling full and eating rapidly may increase metabolic risk factors including obesity. The associations of such habits with psychosomatic problems and preference for strong tastes require further exploration. The associations between various eating behaviors and 12 psychosomatic problems (mental burden, sleep disorder, tendency to palpitation, diarrhea, pessimism, amnesia, anger, poor personal relationship, fatigue, epigastric distress, shoulder stiffness, and lumbago), and preference for strong tastes were compared in 8240 men and 2955 women who underwent routine health examinations. The subjects were divided into four groups defined by subjective reporting - G1: not eating till feeling full and not eating rapidly; G2: eating till feeling full only; G3: eating rapidly only; G4: eating both rapidly and till feeling full. Compared to G1, the age-adjusted odds ratios were significantly higher in G2-G4 for mental burden [1.17 (1.01-1.35), 1.26 (1.14-1.41), 1.50 (1.31-1.73) in men; and 1.28 (1.003-1.62), 1.50 (1.21-1.85), 1.94 (1.50-2.51) in women], and for 8, 8, 11 items in men and 9, 6, 11 items in women among 11 psychosomatic problems other than mental burden, and for preference for strong tastes [2.25 (1.91-2.64), 1.89 (1.67-2.14), 3.36 (2.89-3.91) in men; and 3.26 (2.34-4.51), 2.88 (2.10-3.93), 5.59 (4.02-7.78) in women]. Both eating till feeling full and eating rapidly are associated with mental burden, clustering of psychosomatic problems and a preference for strong tastes. Mental consultation and attention to choosing mild tasting foods may alleviate such eating behaviors and improve health.

A Mindfulness-Based Health Wellness Program for Individuals With Prader-Willi Syndrome

Individuals with Prader-Willi syndrome (PWS) are often overweight or obese because of their delayed satiety response. Three individuals with PWS participated in a long-term, multicomponent mindfulness-based health wellness program to reduce their obesity by changing their lifestyles. The components included (a) physical exercise, (b) food awareness, (c) mindful eating to manage rapid eating, (d) visualizing and labeling hunger, and (e) a mindfulness procedure used as a self-control strategy against temptation to eat between meals. The program was implemented within a changing criterion design. All 3 individuals reached their desired body weights, enhanced their lifestyles, and maintained their desired body weights during the 3-year maintenance period. This study suggests that mindfulness-based health wellness programs may be effective in producing sustained lifestyle changes in individuals who are obese, including those with a biological predilection for excessive eating due to delayed satiety response.

The Screening Tool of Feeding Problems applied to children (STEP-CHILD): Psychometric characteristics and associations with child and parent variables

The present study evaluated the 23-item Screening Tool for Feeding Problems (STEP; Matson & Kuhn, 2001) with a sample of children referred to a hospital-based feeding clinic to examine the scale's psychometric characteristics and then demonstrate how a children's revision of the STEP, the STEP-CHILD is associated with child and parent variables. Participants included 142 children (95 boys, 47 girls; mean age = 61.4 months; 43 with autism, 51 with other special needs, 48 with no special needs). Children ranged in age from 24 months to 18 years. Factor analysis revealed a 15-item STEP-CHILD with six subscales of child feeding problems: CHEWING PROBLEMS, RAPID EATING, FOOD REFUSAL, FOOD SELECTIVITY, VOMITING, and STEALING FOOD. Mediation analysis documented that “overly permissive” actions by parents (such as infrequent insistence on eating during meals, or frequent preparation of Special Meals for children different than the family meal) explained over 34% of the links between children's feeding problems and poor weight and diet outcomes.

Eating until feeling full and rapid eating both increase metabolic risk factors in Japanese men and women

To investigate the association between eating behaviour and metabolic risk in the broader population. The association between metabolic risk factors (overweight, hypertension, hyperglycaemia, hypertriacylglycerolaemia, low HDL cholesterol, hyperuricaemia and fatty liver) and various eating behaviours were compared for four groups defined by subjective reporting: not eating until feeling full and not eating rapidly (G1); eating until feeling full only (G2); eating rapidly only (G3); and eating both rapidly and until feeling full (G4). A medical centre for health examinations in Tokyo, Japan. Men (n 8240) and women (n 2955) who underwent health examinations. The distribution of participants in G1 to G4 was 49·8 %, 11·5 %, 26·3 % and 12·4 % among men and 55·3 %, 15·0 %, 19·0 % and 10·7 % among women, respectively. Compared with G1, the age-adjusted OR (95 % CI) for overweight were significantly higher in G2 to G4, being respectively 1·85 (1·58, 2·17), 1·98 (1·76, 2·23) and 3·46 (2·99, 4·01) for men and 2·20 (1·62, 2·97), 2·59 (1·97, 3·39) and 3·12 (2·27, 4·26) for women. The age-adjusted OR were also significantly higher for hypertriacylglycerolaemia, hyperuricaemia and fatty liver in G2 and for all risks in G3 and G4 among men; and for hyperuricaemia in G2, for hyperglycaemia, hypertriacylglycerolaemia and fatty liver in G3 and for hypertriacylglycerolaemia and fatty liver in G4 among women. Both eating until feeling full and eating rapidly increase metabolic risk factors. Although the mechanism between rapid eating and metabolic risk requires further exploration, eating slowly and ending meals shortly before feeling full are important public health messages for reducing metabolic risk factors.

Speed of Eating as a Determinant of the Bulimic Desire to Vomit

ABSTRACT A single-case controlled study found that a bulimic's desire to vomit was virtually eliminated by slowed eating, but not by rapid eating. The present study attempted to determine whether this same relation was exhibited by a larger number (N = 6) of bulimics who were instructed to eat at a fast or a slow rate in a between-subjects reversal design. For all 6 participants, the urge to vomit was found to be greater during fast versus slow eating after comparable amounts of food intake. Clinically, these results suggest that eating slowly might be incorporated into treatment for bulimic vomiting.

Rapid Response May Predict Binge Eating Outcome

Rapid Response May Predict Binge Eating Outcome

A Mindfulness-Based Health Wellness Program for Managing Morbid Obesity

There are numerous methods for reducing obesity; however, often none of these methods prove effective for specific individuals. For individuals who have failed on specific diets and other weight loss programs, finding a good match between their needs and an effective method is often difficult. The authors collaboratively developed a multicomponent mindfulness-based health wellness program with an individual who was morbidly obese and wanted a lifestyle change. The components included physical exercise, a food awareness program, mindful eating to manage rapid eating, visualizing and labeling hunger, and a mindfulness procedure as a self-control strategy. The individual reduced his weight from 315 pounds to 171 pounds, increased his physical activity, ate healthy foods, stopped eating rapidly, substantially reduced serious medical risk factors, eliminated physical discomfort and mobility problems due to his weight, and enhanced his lifestyle over almost a 5-year period. He maintained his health wellness during 12 months of follow-up.

Psychosocial Status in Adolescents Undergoing Bariatric Surgery

Little is known about the psychosocial status of adolescents who undergo bariatric surgery. Our objective was to describe the psychological and behavioral characteristics of patients in this age group who underwent bariatric surgery at our institution. A review of clinical charts of patients aged 14-21 years who had bariatric surgery at our institution between 2000 and 2005 was conducted. Abstracted data included clinical information and the results of a psychosocial evaluation consisting of a clinical interview with a psychologist and self-reported data from the Weight and Lifestyle Inventory and the Beck Depression Inventory-II. Twenty-five patient records were reviewed. Nineteen patients (76%) were female. The mean (+/-SD) age was 18.7 +/- 1.6 years, and mean body mass index was 50.6 +/- 7.9 kg/m(2). Depression was the most common psychiatric comorbidity (68%). Abnormal eating behaviors were frequent and included binge eating (48%), rapid eating (44%), having guilt associated with eating (36%), eating until uncomfortably full (36%), loss of control (24%), eating without hunger (24%), and eating alone (20%). Sixteen patients were judged to be appropriate for surgery by the bariatric surgery team; surgery was delayed for nine patients primarily because of concerns about ability to adhere to the postoperative diet. These patients were recommended for additional dietary counseling and/or psychotherapeutic treatment prior to surgery. Among adolescent bariatric surgery candidates, depression and aberrant eating behaviors were very common. Early identification and management of these conditions may enable most of these patients to undergo bariatric surgery and optimize the likelihood for a successful outcome.

Development and Evaluation of the Nutrition Component of the Rapid Eating and Activity Assessment for Patients (REAP): A New Tool for Primary Care Providers

Objectives 1. To describe the development of a dietary assessment tool (Rapid Eating and Activity Assessment for Patients [REAP]) that quickly assesses a patient’s diet and physical activity and facilitates brief counselling by a primary care provider, and 2. To describe the evaluation of the REAP in terms of its reliability, validity, and ease of use by primary care providers. Design, Setting and Participants The evaluation of REAP included: 1) an implementation feasibility study conducted with 61 medical students and practicing physicians in practice settings at various medical schools; 2) a calibration study with 44 Brown University Medical School students; 3) cognitive assessment testing with 31 consumers in Rhode Island; and 4) a reliability and calibration study of the revised tool with 94 consumers in Rhode Island and Massachusetts. Results The feasibility study revealed moderately high rankings on usefulness, ease, practicality, and helpfulness. The calibration studies demonstrated that REAP has excellent test-retest reliability ( r = 0.86, P < .0001), is correlated with the Healthy Eating Index score ( r = 0.49, P = .0007), and is significantly associated with intake of most nutrients studied. Conclusions and Implications REAP has adequate reliability and validity to be used in primary care practices for nutrition assessment and counselling, and is also user-friendly for providers.

Speed of Eating as a Determinant of Bulimic Desire to Vomit

Studies of self-induced vomiting of retarded persons have found that the rate of eating and the amount eaten alter this problem. The present study attempted to determine whether this same relation was exhibited by the nonretarded bulimic. A nonretarded bulimic woman provided her subjective ratings of her desire to vomit after eating her taboo foods at a fast versus slowed versus normal rate using a within participant experimental design. The desire to vomit was found to be near absent after the slowed eating of the taboo foods but was at a high level that endured after the rapid or normal eating. These results suggest a neglected determinant of adult bulimia that may be used in clinical treatment, pending confirmation by a larger sample with measures of actual vomiting as was previously evidenced by the inpatient retarded vomiters.