Binge eating behavior in patients with eating disorders

The purpose of this study was to determine whether the objectively observed binge eating behavior of obese subjects meeting the proposed DSM-IV criteria for binge eating disorder would be similar to that observed in patients with bulimia nervosa. Non-obese patients with bulimia nervosa (BN), obese subjects with binge eating disorder (BED), obese and non-obese women without eating disorders were each instructed to binge eat single- and multiple-item meals. In the multiple-item meal, the obese subjects with BED ate significantly more (1515 kcal) than obese subjects without BED (1115 kcal), but they ate less than the normal-weight bulimic patients (2680 kcal). The non-obese controls ate amounts similar to the obese non-binge-eating-disordered group (1093 and 1115.2 kcal, respectively). In the single-item meal, consisting of ice cream, patients with BN ate significantly more than any other group (1307 kcal), while obese subjects with or without binge-eating disorder ate significantly more (762 kcal) than non-obese controls (308 kcal). This study has demonstrated that although both BN and BED are characterized by recurrent episodes of binge eating, quantitatively there appear to be differences between the eating disturbances in the two disorders. Because single- and multiple-item meals differ in external cues, these results also suggest that the obese subjects with BED may be disinhibited by external cues, while obese subjects without BED may be inhibited by external cues.     

The role of breakfast in the treatment of obesity: a randomized clinical trial.

Fifty-two moderately obese adult women were stratified according to their baseline breakfast-eating habits and randomly assigned a weight-loss program. The no-breakfast group ate two meals per day and the breakfast group ate three meals per day. The energy content of the two weight-loss programs was identical. After the 12-wk treatment, baseline breakfast eaters lost 8.9 kg in the no-breakfast treatment and 6.2 kg in the breakfast treatment. Baseline breakfast skippers lost 7.7 kg in the breakfast treatment and 6.0 kg in the no-breakfast treatment. This treatment-by-strata-by-time interaction effect (P less than 0.06) suggests that those who had to make the most substantial changes in eating habits to comply with the program achieved better results. Analyses of behavioral data suggested that eating breakfast helped reduce dietary fat and minimize impulsive snacking and therefore may be an important part of a weight-reduction program.     

Staple food intake in a rural village in Verata,Fiji

An assessment of food intake and body composition in twenty women in a relatively isolated rural village in Fiji was made. Subcutaneous fat distribution was assessed by the measurement of subscapular and triceps skin folds. Compared with measurements made on Polynesian and European women in New Zealand it was found that the Fiji women had relatively more central subcutaneous fat than Polynesian or European. Diet was assessed by two 7 day periods of diet diaries and analysed by food type. The two main foods eaten were cassava and flour based goods.     

The effect of pretreatment eating patterns on the completion of a very low calorie diet

Pretreatment eating patterns of severely obese patients (n = 209) were investigated as predictors of attrition from a very low calorie diet. Subjects who ate three meals per day prior to the program were significantly more likely to complete the 6 month program than were those who reported skipping breakfast and consuming most of their calories in the evening. Those who ate mainly in the evening dropped out most frequently during the fasting phase of the program, possibly indicating an inability to conform to the requirements of a supplemented fast.     

Eating away from home is associated with overweight and obesity among Ugandan adults: the 2014 Uganda non-communicable disease risk factor survey

BACKGROUND/OBJECTIVESWe investigated the associations between eating away from home (EAFH) and overweight and obesity among Ugandan adults using the 2014 Uganda non-communicable disease risk factor survey.SUBJECTS/METHODSIn total, 3,025 participants aged 18–69 years were included in the analysis. The frequency of EAFH was assessed by asking participants the number of meals eaten per week that were not prepared at a home. EAFH frequency was categorized as; less than once/week, 1-2 times/week, or ≥ 3 times/week. Logistic regression was used to evaluate the associations between overweight, obesity, and EAFH. We also tested whether sex and age modified these associations.RESULTSParticipants that ate away from home ≥ 3 times/week were 2.13 times more likely to be obese than those that ate away from home less than once/week (odds ratio [OR], 2.13; 95% confidence interval [CI], 1.28–3.54). However, when the analysis was stratified by sex, women that ate away from home ≥ 3 times/week were 42% less likely to be overweight than those that ate away from home less than once/week (OR, 0.58; 95% CI, 0.36–0.94). Men that ate away from home ≥ 3 times a week were 3.89 times and 2.23 times more likely to be obese and overweight, respectively, than those that ate away from home less than once/week (obesity: OR, 3.89; 95% CI, 1.50–10.09; overweight: OR, 2.23; 95% CI, 1.42–3.51). Age-stratified analysis showed that among participants aged 31–50 years, those that ate away from home ≥ 3 times a week were 3.53 times more likely to be obese than those that ate away from home less than once/week (OR, 3.53; 95% CI, 1.69–7.37).CONCLUSIONSFrequent EAFH was positively associated with overweight and obesity among men, and obesity among young/middle-aged adults, but negatively associated with overweight in women. Nutritional interventions for obesity reduction in Uganda should include strategies aimed at reducing the frequency of eating meals prepared away from home, and specifically target men and young/middle-aged adults.     

Higher eating frequency,but not skipping breakfast,is associated with higher odds of abdominal obesity in adults living in Puerto Rico

Puerto Ricans have a high prevalence of obesity, yet little information is available regarding its association with eating patterns in this population. We hypothesized that higher eating frequency and skipping breakfast would be associated with increased odds of abdominal obesity among adults living in Puerto Rico (PR). In a cross-sectional study of adults living in PR aged 30-75 years (N = 310), participants reported their frequency of eating meals per day including snacks and breakfast. Trained interviewers measured waist (WC) and hip circumferences. We calculated the waist-to-hip ratio (WHR) dividing the waist by the hip measurement. Abdominal obesity was defined as either high WC (men ≥94 cm; women ≥80 cm) or high WHR (men ≥0.90; women ≥0.85). We used logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) to assess the association of eating frequency (≤1.5; 1.5-3; ≥3 times/day) and breakfast consumption (vs none) with abdominal obesity. Models were adjusted for age, sex, income, smoking, physical activity, TV watching, energy intake, diet quality, and eating frequency (only for breakfast consumption). Most participants consumed breakfast (70%), ate 1.5-3 times/d (47%), and had high WC (75%) and WHR (77%). Participants who ate 1.5-3 (OR: 2.75, 95% CI: 1.23-6.15) and ≥3 times/day (OR: 2.88; 95% CI: 1.14-7.31) were more likely to have high WC compared with participants who ate ≤1.5 times/d (P trend = .04). Breakfast consumption was not associated with abdominal obesity. In conclusion, higher eating frequency, but not skipping breakfast, is associated with abdominal obesity among adults in PR. Consuming less frequent meals may help prevent abdominal obesity in this population.     

Eating behaviours and obesity in the adult population of Spain

To examine the association between several eating behaviours and obesity, data were taken from a cross-sectional study conducted with 34,974 individuals aged 25-64 years, representative of the non-institutionalised Spanish population. Obesity was defined as BMI >or= 30 kg/m2. Study associations were summarised with OR obtained from logistic regression, with adjustment for socio-demographic and lifestyle factors. The results showed that those skipping breakfast were more likely to be obese, both in men (OR 1.58; 95 % CI 1.29, 1.93) and women (OR 1.53; 95 % CI 1.15, 2.03). Moreover, obesity was more prevalent in those having only two meals per day than in those having three or four meals in men (OR 1.63; 95 % CI 1.37, 1.95) and women (OR 1.30; 95 % CI 1.05, 1.62). Also, snacking was associated with obesity in women (OR 1.51; 95 % CI 1.17, 1.95). However, no association was observed between obesity and having one or more of the main meals away from home, in either sex. In conclusion, skipping breakfast and eating frequency were associated with obesity. The lack of association between eating away from home and obesity is in contrast to most previous research conducted in Anglo-Saxon countries. Differences in the type of establishment frequented when eating out or in the characteristics of restaurant customers in a Mediterranean population might explain these conflicting results.     

Impact of moods and social context on eating behavior

The relationship of moods and social context to energy and nutrient intakes was examined to ascertain if these variables interact or function independently. The subjects were 78 predominantly white, obese women participating in weight-loss studies. Mean age was 36.7 (SD=7.6) and mean Body Mass Index was 32.1 (SD=3.6). Subjects completed 2-week baseline food diaries recording everything they ate, including moods and people present during the meals. Meals eaten in positive and negative moods were significantly larger than meals eaten in a neutral mood. Meals eaten with other people were significantly larger than meals eaten alone. There were no significant moods by social context interactions for total energy intake. Moods and social context functioned additively to increase the risk of over-eating. Macro nutrient analysis revealed only a main effect for social context. Percentage of calories from fat and protein were greater, whereas the percentage of carbohydrate was less in social context meals compared to meals eaten alone. Clinicians should conduct a functional analysis to assess exposure to the frequency and types of risky situations. Teaching people to cope more effectively with social situations and moods may increase the efficacy of weight loss and maintenance programs.     

Breakfast is the Lowest Fat Meal for Young Adult Women

Breakfast consumption and the contribution of breakfast foods to the daily fat and fiber intakes of young adults were evaluated in a sample of 2628 young adults (mean ± SD age = 19.6 ± 3.0 years).The subjects (males = 817, females = 1811) completed 24-hour dietary records for a college introductory nutrition class. The 1-day dietary intake data were analyzed for the following: (1) differences in daily fat and fiber intake between breakfast eaters (80%) and skippers (20%) by gender; (2) fat and fiber content of breakfast compared to other meals; and (3) foods most frequently consumed for breakfast by gender. More women who ate breakfast had daily fat intakes ≤30% energy from fat compared to the women who skipped breakfast (40% vs. 28%, p < .001). For both genders, the breakfast meal contained the lowest mean percent energy from fat compared to other eating occasions (p < .05). The ratio of fat to fiber was lowest for the breakfast meal, although fiber intakes were low overall. For men, the major sources of fat for breakfast were milk, eggs, sausage/ham, cream cheese, and butter/margarine; cereal, bread, and bagels were the major sources of fiber for both genders. Eating breakfast, especially breads and cereals and skim and 1% fat milk, can reduce fat intake and help increase fiber intakes of young adults.     

Timing and duration of sleep and meals in obese and normal weight women. Association with increase blood pressure

The aim was to evaluate the efficiency and duration of sleep and meals in normal-weight and obese women and the impact of these factors on metabolic syndrome (MetS) variables. The study was conducted in 70 women, normal-weight women (n=20) and obese women (n=50). Anthropometric variables, plasma glucose, lipids and ghrelin concentrations were determined. Blood pressure measurement was performed before lunch and before dinner for a week on alternate days. Subjects were instructed to keep a sleep and feeding diary. In general, obese women displayed longer and a significantly higher number of awakenings per week than normal-weight women and a higher duration of naps. Sleep efficiency was significantly lower in obese women. The higher intake in energy in the obese women was due to snacking differences. Moreover, higher sleep efficiency was correlated with a decrease in the diastolic blood pressure evening/morning ratio. Interestingly, among normal-weight women, visceral fat increased with the number of awakenings while plasma ghrelin was inversely correlated with meal duration (P=0.027). In conclusion, obese women had lower sleep efficiency, ate more quickly and spent more time eating and sleeping during the daytime hours than normal-weight women. Of note, sleep efficiency was associated with MetS features. Further interventions in obesity could include educating patients in food timing and in healthier sleep-hygiene practices, helping them to modify bad sleep habits.     

Effects of binge eating on satiation, satiety, and energy intake of overweight children

BACKGROUND: Children who report episodes of binge eating gain more weight than do children not reporting binge eating. However, how binge eating affects children's food intake at meals is unknown. OBJECTIVE: We compared the energy intake and postmeal satiety of children with and without a history of binge eating during buffet meals. DESIGN: Sixty overweight children aged 6-12 y were categorized into those reporting past binge-eating episodes (n = 10) and those reporting no such episodes (n = 50). Children selected lunch twice from a multiple-item, 9835 kcal, buffet meal: after an overnight fast and after a standardized breakfast. Children ate ad libitum, until they reported they were full. The main outcome measures were energy intake during meals and duration of postmeal satiety, after adjustment for covariates, including age, race, sex, socioeconomic status, and body composition. RESULTS: After the overnight fast, children in the binge-eating group consumed more energy [x (+/-SD): 1748 +/- 581 compared with 1309 +/- 595 kcal; P = 0.04] and exhibited a shorter satiety duration (194 +/- 84 compared with 262 +/- 89 min; P = 0.03) than did children in the non-binge-eating group. After the standardized breakfast, binge-eating children reported a shorter satiety duration (75 +/- 62 compared with 132 +/- 62 min; P = 0.01) and consumed more energy at the postbreakfast meal (1874 +/- 560 compared with 1275 +/- 566 kcal; P = 0.004). CONCLUSION: The ability to consume large quantities of palatable foods, coupled with decreased subsequent satiety, may play a role in the greater weight gain found in binge-eating children.     

The relationship between eating behaviors and obesity in African American and Caucasian women

The primary goal of this study was to determine the relevance of four self-reported eating behaviors (eating before bedtime, eating between meals, feeling hungry within 3 h of eating, and eating beyond satiation) as risk factors for overweight and obesity. The sample consisted of 35- to 49-year-old, premenopausal African American (n=580) and Caucasian (n=398) women, randomly selected from the membership of a large urban prepaid health plan. Eating beyond satiation was the only behavior associated with body mass index (BMI). The odds of becoming obese increased 6-fold for Caucasian women and 15-fold for African American women who ate beyond satiation everyday compared to those who rarely or never ate beyond satiation. Additionally, eating beyond satiation was also the only eating behavior associated with the age of obesity onset. Focusing on this eating behavior in weight loss programs may be important.     

Insight into the origins of intrusions (reports of uneaten food items) in children's dietary recalls, based on data from a validation study of reporting accuracy over multiple recalls and school foodservice production records

BACKGROUND: Intrusions in dietary recalls may originate in confusion of episodic memories manifested as temporal dating errors. OBJECTIVE: Data from a validation study (concerning reporting accuracy over multiple recalls) and school foodservice production records were used to investigate origins of intrusions in school meals in children's 24-hour recalls. DESIGN/SUBJECTS/SETTING: During the 1999-2000 school year, 104 fourth-grade children were observed eating school meals on 1 to 3 nonconsecutive days separated by >or=25 days, and interviewed about the previous day's intake in the morning on the day after each observation day. STATISTICAL ANALYSES PERFORMED: For breakfast and lunch separately, logistic regression was used to investigate the effect of time (ie, days) before the interview day on the probability that intrusions referred to items available in the school foodservice environment. Exploratory analyses were conducted for breakfast options observed and/or reported eaten. RESULTS: For interviews in which reported meals met criteria to be considered school meals and that contained intrusions, of 634 and 699 items reported eaten at breakfast and lunch, respectively, 394 and 331 were intrusions. Availability in the school foodservice environment of items referred to by intrusions in reports of lunch, but not breakfast, decreased as days increased before the interview day (P=0.031 and P=0.285, respectively). Concerning breakfast, children observed eating a cold option (ie, ready-to-eat cereal, milk, juice, crackers [graham or animal]) almost always reported a cold option, whereas children observed eating a hot option (ie, non-ready-to-eat cereal entrée [eg, sausage biscuit], milk, and fruit or juice) reported a cold option in approximately 50% of interviews. CONCLUSIONS: In children's 24-hour recalls, confusion of episodic memories contributes to intrusions in school lunch, and generic dietary information (eg, cold option items available daily) or confusion of episodic memories may contribute to intrusions in school breakfast. Understanding the origins of intrusions may help in developing interview methods to decrease the occurrence of intrusions.     

Second-meal effect: low-glycemic-index foods eaten at dinner improve subsequent breakfast glycemic response

The effects of the glycemic index (GI) of carbohydrate eaten the previous night on the glycemic response to a standard test meal eaten subsequently in the morning (breakfast) was studied. On separate evenings normal subjects ate low- or high-GI test meals of the same nutrient composition. The dinners consisted of single foods in two experiments and mixed meals containing several foods in the third. The differences between the observed glycemic responses to low- and high-GI dinners were predicted by their GIs. The glycemic responses to breakfast were significantly lower on mornings after low-GI dinners than after high-GI dinners. Eating, at dinner, foods with different fiber contents but the same GI had no effect on postbreakfast glycemia. We conclude that the GI predicts the difference between glycemic responses of mixed dinner meals; breakfast carbohydrate tolerance is improved when low-GI foods are eaten the previous evening.     

Family Meals among New Zealand Young People: Relationships with Eating Behaviors and Body Mass Index

ObjectiveTo examine the relationship between family meals and nutrition behaviors of adolescents.DesignSecondary analysis of Youth'07, a nationally representative survey.SettingSecondary schools in New Zealand.ParticipantsRandomly selected adolescents (aged 13-17 years, n = 9,107) completed a multimedia and anonymous survey about their health.Variables MeasuredBody mass index and eating behaviors.AnalysisMultiple logistic regression equations were used to determine the associations between family meals and body size and dietary behaviors, controlling for demographic variables.ResultsNearly 60% of young people shared a meal with their families 5 or more times in the previous week. Frequent family meals were associated with greater consumption of fruits and vegetables (P < .001), and breakfast (P < .001). Adolescents who frequently shared family meals were also more likely to report that what they ate in the past week was healthy than adolescents who did not (P < .001). There was no relationship between frequency of family meals and body mass index (P = .60).Conclusions and ImplicationsData from the current study suggest that family meals cannot be used as a single strategy for obesity prevention, but they may provide an important opportunity for young people to consume healthy food.     

Eating breakfast and its impact on children's daily diet

Objective: To describe the impact of breakfast eating on the nutrient intakes of New Zealand children aged 5–14 years. Design: Secondary data analysis of a cross‐sectional national survey. Subjects: A total of 3275 children aged 5–14 years. Setting: Dietary data were collected primarily in the homes of the children. Main outcome measures: ‘Breakfast consumption’ was based on whether any food items were consumed between 6 and 9 a.m. from 24‐hour diet recall data. Nutrient intake was also based on 24‐hour diet recall. Data analyses: Demographic profile of breakfast eaters was determined. Difference in daily nutrient intakes between breakfast and non‐breakfast eaters was determined. Results: In total, 84% of New Zealand children reported eating breakfast. Younger children were more likely to eat breakfast than older children. Breakfast habits differed between Māori, Pacific and ‘New Zealand European & Others’ children. When intakes were adjusted for the demographic variables that significantly affected breakfast consumption patterns, daily nutrient intake of children who ate breakfast compared with those who did not, was significantly better. This was true for all ethnic groups. Cereal (including cold, ready‐to‐eat and cooked) was the most common breakfast food. Conclusion: Although the majority of New Zealand children consume breakfast, a significant improvement in daily nutrient intake could be achieved for children of all ethnic groups who currently do not consume breakfast.     

Correlations of Physical Activity,Body Mass Index,Shift Duty,and Selected Eating Habits among Nurses in Riyadh,Saudi Arabia

Nurses are the largest group of direct health providers and can serve as role models for their patients. In this cross sectional study we assessed the relationship among physical activity and barriers, shift duty, elevated BMI, and selected eating habits among 362 non-Saudi female nurses in Riyadh, Saudi Arabia. Results showed that 46.7% were either overweight or obese. Marital status, shift duty, education level, and BMI were significant predictors of physical activity. Weather was the most frequently reported barrier to physical activity (88.3%), followed by a lack of transportation (82.6%), and a lack of time (81.3%). Nurses who worked shift duty had significantly (p = 0.004) higher BMIs compared with day shift nurses. Nurses who rarely ate breakfast (p = 0.004) and meals (p = 0.001) and often eat fast food (p = 0.001) were more likely to be overweight or obese. Nurses should be encouraged for a better healthy lifestyles.     

Skipping meals and alcohol consumption. The regulation of energy intake and expenditure among weight loss participants

Research suggests that specific eating patterns (e.g., eating breakfast) may be related to favorable weight status. This investigation examined the relationship between eating patterns (i.e., skipping meals; consuming alcohol) and weight loss treatment outcomes (weight loss, energy intake, energy expenditure, and duration of exercise). Fifty-four overweight or obese adults (BMI>/=27kg/m(2)) participated in a self-help or therapist-assisted weight loss program. Daily energy intake from breakfast, lunch, dinner, and alcoholic beverages, total daily energy intake, total daily energy expenditure, physical activity, and weekly weight loss were assessed. On days that breakfast or dinner was skipped, or alcoholic beverages were not consumed, less total daily energy was consumed compared to days that breakfast, dinner, or alcoholic beverages were consumed. On days that breakfast or alcohol was consumed, daily energy expenditure (breakfast only) and duration of exercise were higher compared to days that breakfast or alcohol was not consumed. Individuals who skipped dinner or lunch more often had lower energy expenditure and exercise duration than individuals who skipped dinner or lunch less often. Individuals who consumed alcohol more often had high daily energy expenditure than individuals who consumed alcohol less often. Skipping meals or consuming alcoholic beverages was not associated with weekly weight loss. In this investigation, weight loss program participants may have compensated for excess energy intake from alcoholic beverages and meals with greater daily energy expenditure and longer exercise duration.     

Children eat their school lunch too quickly: an exploratory study of the effect on food intake

ABSTRACT: BACKGROUND: Speed of eating, an important aspect of eating behaviour, has recently been related to loss of control of food intake and obesity. Very little time is allocated for lunch at school and thus children may consume food more quickly and food intake may therefore be affected. Study 1 measured the time spent eating lunch in a large group of students eating together for school meals. Study 2 measured the speed of eating and the amount of food eaten in individual school children during normal school lunches and then examined the effect of experimentally increasing or decreasing the speed of eating on total food intake. METHODS: The time spent eating lunch was measured with a stop watch in 100 children in secondary school. A more detailed study of eating behaviour was then undertaken in 30 secondary school children (18 girls). The amount of food eaten at lunch was recorded by a hidden scale when the children ate amongst their peers and by a scale connected to a computer when they ate individually. When eating individually, feedback on how quickly to eat was visible on the computer screen. The speed of eating could therefore be increased or decreased experimentally using this visual feedback and the total amount of food eaten measured. RESULTS: In general, the children spent very little time eating their lunch. The 100 children in Study 1 spent on average (SD) just 7 (0.8) minutes eating lunch. The girls in Study 2 consumed their lunch in 5.6 (1.2) minutes and the boys ate theirs in only 6.8 (1.3) minutes. Eating with peers markedly distorted the amount of food eaten for lunch; only two girls and one boy maintained their food intake at the level observed when the children ate individually without external influences (258 (38) g in girls and 289 (73) g in boys). Nine girls ate on average 33% less food and seven girls ate 23 % more food whilst the remaining boys ate 26% more food. The average speed of eating during school lunches amongst groups increased to 183 (53) % in the girls and to 166 (47) % in the boys compared to the speed of eating in the unrestricted condition. These apparent changes in food intake during school lunches could be replicated by experimentally increasing the speed of eating when the children were eating individually. CONCLUSIONS: If insufficient time is allocated for consuming school lunches, compensatory increased speed of eating puts children at risk of losing control over food intake and in many cases over-eating. Public health initiatives to increase the time available for school meals might prove a relatively easy way to reduced excess food intake at school and enable children to eat more healthily.