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Bidopia T, Carbo AV, Ross RA, Burke NL. Food insecurity and disordered eating behaviors in children and adolescents: A systematic review. Eat Behav 2023; 49:101731. [PMID: 37150094 PMCID: PMC10361576 DOI: 10.1016/j.eatbeh.2023.101731] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/09/2023]
Abstract
This study is the first systematic review to investigate the relationship between food insecurity (FI) and disordered eating behaviors exclusively in children and adolescents. Database searches were conducted in PUBMED, Embase, PsycINFO, ProQuest, and Gale OneFile: Informe Académico using English and Spanish search terms. Studies were included if they were published before August 2022, included youth aged 18 years and below, included either parent- or child-report of food security status, included either parent- or child-report of child disordered eating behaviors, and examined the relationship between food security status and child disordered eating behaviors. Following independent title/abstract and full-text screening, 20 studies were included in the review. There were 13 cross-sectional studies, five longitudinal studies, and two qualitative studies, from the United States (19 studies), and Bangladesh (1 study). Sample sizes ranged from 33 to 6077. Findings generally indicated a relationship between FI and behaviors such as binge eating, loss-of-control eating, eating in the absence of hunger, unhealthy weight control behaviors, and picky eating in children and adolescents, though this association varied depending on the type of disordered eating behavior assessed and FI severity. Results highlight the importance of screening for disordered eating behaviors among youth with FI towards eating disorder prevention and intervention. However, given the limited number of primary research articles examining this relationship in youth, further hypothesis-driven research is needed. In addition, more global representation and additional longitudinal studies are needed to further examine the generalizability and temporality of FI and disordered eating in children and adolescents.
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Affiliation(s)
- Tatyana Bidopia
- Department of Psychology, Fordham University, 441 East Fordham Road, Dealy Hall, Bronx, NY 10458, USA
| | - Alejandra Vivas Carbo
- Department of Psychiatry, Montefiore Medical Center, 3331 Bainbridge Ave, Bronx, NY 10467, USA
| | - Rachel A Ross
- Department of Psychiatry, Neuroscience and Medicine, Albert Einstein College of Medicine, 1410 Pelham Pkwy S, Bronx, NY 10461, USA
| | - Natasha L Burke
- Department of Psychology, Fordham University, 441 East Fordham Road, Dealy Hall, Bronx, NY 10458, USA.
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Ralph AF, Brennan L, Byrne S, Caldwell B, Farmer J, Hart LM, Heruc GA, Maguire S, Piya MK, Quin J, Trobe SK, Wallis A, Williams-Tchen AJ, Hay P. Management of eating disorders for people with higher weight: clinical practice guideline. J Eat Disord 2022; 10:121. [PMID: 35978344 PMCID: PMC9386978 DOI: 10.1186/s40337-022-00622-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The prevalence of eating disorders is high in people with higher weight. However, despite this, eating disorders experienced by people with higher weight have been consistently under-recognised and under-treated, and there is little to guide clinicians in the management of eating disorders in this population. AIM The aim of this guideline is to synthesise the current best practice approaches to the management of eating disorders in people with higher weight and make evidence-based clinical practice recommendations. METHODS The National Eating Disorders Collaboration Steering Committee auspiced a Development Group for a Clinical Practice Guideline for the treatment of eating disorders for people with higher weight. The Development Group followed the 'Guidelines for Guidelines' process outlined by the National Health and Medical Research Council and aim to meet their Standards to be: 1. relevant and useful for decision making; 2. transparent; 3. overseen by a guideline development group; 4. identifying and managing conflicts of interest; 5. focused on health and related outcomes; 6. evidence informed; 7. making actionable recommendations; 8. up-to-date; and, 9. accessible. The development group included people with clinical and/or academic expertise and/or lived experience. The guideline has undergone extensive peer review and consultation over an 18-month period involving reviews by key stakeholders, including experts and organisations with clinical academic and/or lived experience. RECOMMENDATIONS Twenty-one clinical recommendations are made and graded according to the National Health and Medical Research Council evidence levels. Strong recommendations were supported for psychological treatment as a first-line treatment approach adults (with bulimia nervosa or binge-eating disorder), adolescents and children. Clinical considerations such as weight stigma, interprofessional collaborative practice and cultural considerations are also discussed. CONCLUSIONS This guideline will fill an important gap in the need to better understand and care for people experiencing eating disorders who also have higher weight. This guideline acknowledges deficits in knowledge and consequently the reliance on consensus and lower levels of evidence for many recommendations, and the need for research particularly evaluating weight-neutral and other more recent approaches in this field.
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Affiliation(s)
| | - Leah Brennan
- School of Psychology and Public Health, La Trobe University, Wodonga, Australia
| | - Sue Byrne
- Department of Psychology, University of Western Australia, Perth, Australia
| | | | - Jo Farmer
- Lived Experience Advocate, Melbourne, Australia
| | - Laura M. Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Gabriella A. Heruc
- Eating Disorders and Nutrition Research Group (ENRG), School of Medicine, Western Sydney University, Sydney, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia
- Sydney Local Health District, NSW Health, Sydney, Australia
| | - Milan K. Piya
- School of Medicine, Western Sydney University, Macarthur Clinical School, Sydney, Australia
- Camden and Campbelltown Hospitals, Sydney, Australia
| | - Julia Quin
- Lived Experience Advocate, Melbourne, Australia
| | - Sarah K. Trobe
- National Eating Disorders Collaboration, Sydney, Australia
| | - Andrew Wallis
- Sydney Children’s Hospitals Network, The Children’s Hospital Westmead, Sydney, Australia
| | | | - Phillipa Hay
- Eating Disorders and Body Image (EDBI), Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- South Western Sydney Local Health District, Sydney, Australia
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Garrido-Miguel M, Torres-Costoso A, Martínez-Andrés M, Notario-Pacheco B, Díez-Fernández A, Álvarez-Bueno C, García-Prieto JC, Martínez-Vizcaíno V. The risk of eating disorders and bone health in young adults: the mediating role of body composition and fitness. Eat Weight Disord 2019; 24:1145-54. [PMID: 29134506 DOI: 10.1007/s40519-017-0458-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To analyze the independent relationship between the risk of eating disorders and bone health and to examine whether this relationship is mediated by body composition and cardiorespiratory fitness (CRF). METHODS In this cross-sectional study, bone-related variables, lean mass, fat mass (by DXA), risk of eating disorders (SCOFF questionnaire), height, weight, waist circumference and CRF were measured in 487 university students aged 18-30 years from the University of Castilla-La Mancha, Spain. ANCOVA models were estimated to test mean differences in bone mass categorized by body composition, CRF or risk of eating disorders. Subsequently, linear regression models were fitted according to Baron and Kenny's procedures for mediation analysis. RESULTS The marginal estimated mean ± SE values of total body bone mineral density for the categories "no risk of eating disorders" and "risk of eating disorders" were 1.239 ± 0.126 < 1.305 ± 0.089, P = 0.021. However, this relationship disappeared after adjustment for any of the parameters of body composition or CRF. Therefore, all body composition parameters (except for lean mass) and CRF turned out to be full mediators in the association between the risk of eating disorders and bone health in young adults. CONCLUSIONS Body composition and CRF mediate the association between the risk of eating disorders and bone health. These findings highlight the importance of maintaining a healthy weight and good CRF for the prevention of the development of eating disorders and for the maintenance of good bone health in young adults. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Abstract
Binge eating disorder (BED) is the most common eating disorder and is accompanied by multiple medical comorbidities, many of which are associated with obesity-related diseases. However, the BED itself is likely to confer additional risk factors. BED presents with medical symptoms in virtually every body system and can have devastating consequences on both quality and length of life. This review covers the major comorbidities of BED and highlights areas of ongoing research in this disorder.
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Affiliation(s)
| | - Julie Friedman
- Binge Eating Treatment and Recovery, Eating Recovery Center, Northwestern University Medical School, Department of Psychiatry, Eating Recovery Center Insight, 333 North Michigan Avenue, 19th Floor, Chicago, IL 60601, USA
| | - Philip S Mehler
- Eating Recovery Center, ACUTE @ Denver Health, Glassman Professor of Medicine, University of Colorado School of Medicine, 7351 East Lowry Boulevard, Suite 200, Denver, CO 80230, USA
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Hohman EE, Balantekin KN, Birch LL, Savage JS. Dieting is associated with reduced bone mineral accrual in a longitudinal cohort of girls. BMC Public Health 2018; 18:1285. [PMID: 30466435 PMCID: PMC6251190 DOI: 10.1186/s12889-018-6206-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/08/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Peak bone mass accrual occurs during adolescence, a time when dieting and related eating behaviors are common. Impaired bone mineral accrual is a known consequence of eating disorders in adolescents, but the effects of subclinical dieting behaviors on bone mineral content (BMC) have not been described in this age group. The goal of this analysis was to determine whether dieting behavior in preadolescence and adolescence is associated with bone mineral accrual in adolescent girls. METHODS Non-Hispanic white girls (n = 139) were followed in a longitudinal cohort study. BMC was assessed at ages 9 and 15y. Dieting to lose weight was reported every 2 years, and dietary restraint and disinhibition, eating attitudes, weight concerns, and body esteem were assessed at age 11y. Girls were classified as "early dieters" if they first dieted by age 11y (31.7%), "adolescent dieters" if they first dieted after 11y (46.8%), or non-dieters if they did not report dieting by 15 y (21.6%). The effect of dieting related variables on BMC at 15y and change in BMC from 9 to 15y was assessed using linear regression, controlling for height, weight, BMI, physical activity, and pubertal status. RESULTS Girls who first reported dieting to lose weight by age 11y had a 4.2% lower bone mineral accrual across adolescence (p = 0.02) and 3.1% lower BMC at age 15y (p = 0.005) than girls who first reported dieting after 11y or not at all. Number of weight control behaviors used, dietary restraint, and weight concerns were also negatively associated with BMC (p < 0.05). CONCLUSIONS Dieting behavior in preadolescence is associated with reduced bone mineral accrual. Strategies to promote optimal bone development should include prevention of dieting. TRIAL REGISTRATION Clinicaltrials.gov NCT03342430, November 17, 2017. Retrospectively registered.
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Affiliation(s)
- Emily E Hohman
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA.
| | - Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, University at Buffalo, 12 Sherman Hall, Buffalo, NY, 14214, USA
| | - Leann L Birch
- Department of Foods and Nutrition, The University of Georgia, 172 Dawson Hall, Athens, GA, 30602, USA
| | - Jennifer S Savage
- Center for Childhood Obesity Research and Department of Nutritional Sciences, The Pennsylvania State University, 103 Noll Laboratory, University Park, PA, 16802, USA
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Abstract
OBJECTIVE A cross-sectional study of first-year college students was conducted to identify the prevalence and predictors of disordered eating (DE). METHODS College freshmen students, aged 18 years, (n = 106) completed the Eating Disorder Examination Questionnaire (EDE-Q) and a supplemental survey. A subset of the sample (n = 77) underwent measurements of height, weight, and body composition. DE was defined as an elevated (3) weight, shape, eating concern, or dietary restraint EDE-Q subscale score. RESULTS The sample, consisting of 56.6%, 15.1%, 11.3%, and 11.3% Latino/a, Asian, African American, and Caucasian students, respectively (37% male), reported a 31.1% prevalence of DE. The current desire to lose weight was the strongest predictor of DE (odds ratio = 15.3; 95% confidence interval = 2.8, 82.5). Other variables linked to DE or elevated EDE-Q subscale scores included body mass index (BMI) 25.0 kg/m2, vegetarianism, weight loss in the past year, female gender, and eating breakfast < 5 d/wk. Participants with BMI 25.0 kg/m2 and the current desire to lose weight (n = 23) or following a vegetarian diet (n = 5) exhibited the highest prevalence of DE (78.3% and 80.0%, respectively). A higher proportion of Latinas reported binge episodes compared to female Caucasian, Asian, and African American students (36.4% vs. 0.0%, 6.7%, and 28.6%, respectively, p = 0.056, χ2 = 7.6). Males, versus females, were more likely to report excessive exercise (56.4% vs. 37.3%, p = 0.056, χ2 = 3.6). CONCLUSIONS This study adds to the current body of literature on DE by providing a diverse sample and potentially novel predictors and risk factors for DE.
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Affiliation(s)
- Michelle T Barrack
- a Department of Family and Consumer Sciences , California State University , Long Beach , California , USA
| | - Jazmine West
- a Department of Family and Consumer Sciences , California State University , Long Beach , California , USA
| | - Michele Christopher
- b Department of Family and Consumer Sciences , California State University , Northridge , California , USA
| | - Ann-Marie Pham-Vera
- b Department of Family and Consumer Sciences , California State University , Northridge , California , USA
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Okbay Güneş A, Alikaşifoğlu M, Şen Demirdöğen E, Erginöz E, Demir T, Kucur M, Ercan O. The Relationship of Disordered Eating Attitudes with Stress Level, Bone Turnover Markers, and Bone Mineral Density in Obese Adolescents. J Clin Res Pediatr Endocrinol 2017; 9:237-245. [PMID: 28196789 PMCID: PMC5596805 DOI: 10.4274/jcrpe.3794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To investigate the effect of stress caused by disordered eating attitudes on bone health in obese adolescents. METHODS A cross-sectional study comprising 80 obese adolescents was performed from November 2013 to September 2014. Twenty-four-hour urinary free cortisol levels were measured as a biological marker of stress. Bone turnover was evaluated using bone-specific alkaline phosphatase, serum osteocalcin, and urinary N-telopeptide concentrations. Bone mineral density was measured using dual-energy X-ray absorptiometry. The Eating Disorder Examination Questionnaire, Dutch Eating Behavior Questionnaire, Children's Depression Inventory, and the State-Trait Anxiety Inventory for Children were used to assess eating disorders, depression, and anxiety. Psychiatric examinations were performed for binge eating disorders. RESULTS In the Pearson's correlation test, a positive correlation was found between the 24-hour urinary cortisol level and Dutch Eating Behavior Questionnaire total and restrained eating subscale scores (p<0.05 for both). In linear regression analyses, the Dutch Eating Behavior Questionnaire total and restrained eating subscale scores were found to be significant contributors for urinary cortisol level (β=1.008, p=0.035; β=2.296, p=0.014, respectively). The femoral neck areal bone mineral density was found to be significantly higher in subjects who had binge eating disorder compared with those without binge eating disorder (p=0.049). CONCLUSION Despite the lack of apparent effects on bone turnover and bone mineral density in our obese adolescents at the time of the study, our results suggest that disordered eating attitudes, and especially restrained eating attitudes, might be a source of stress. Therefore, studies in this area should continue.
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Affiliation(s)
- Aslı Okbay Güneş
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatrics, İstanbul, Turkey
| | - Müjgan Alikaşifoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, İstanbul, Turkey
,* Address for Correspondence: İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, İstanbul, Turkey E-mail:
| | - Ezgi Şen Demirdöğen
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Child and Adolescent Psychiatry, İstanbul, Turkey
| | - Ethem Erginöz
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Public Health, İstanbul, Turkey
| | - Türkay Demir
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Child and Adolescent Psychiatry, İstanbul, Turkey
| | - Mine Kucur
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Biochemistry, İstanbul, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine and Endocrinology, İstanbul, Turkey
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Sokoloff NC, Eguiguren ML, Wargo K, Ackerman KE, Baskaran C, Singhal V, Clarke H, Slattery M, Lee H, Eddy KT, Misra M. Bone parameters in relation to attitudes and feelings associated with disordered eating in oligo-amenorrheic athletes, eumenorrheic athletes, and nonathletes. Int J Eat Disord 2015; 48:522-6. [PMID: 25823597 PMCID: PMC4747111 DOI: 10.1002/eat.22405] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 02/27/2015] [Accepted: 03/01/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Disordered eating may negatively impact bone in athletes. However, it is not known whether this effect is independent of the associated amenorrhea and relative hypercortisolemia. We aimed to compare attitudes, feelings, and cognitions associated with disordered eating using the Three-Factor Eating Questionnaire (TFEQ) and Eating Disorder Inventory-2 (EDI-2) in normal-weight oligomenorrheic athletes (OA), eumenorrheic athletes (EA), and nonathletes, and determine the associations with bone independent of confounders. METHOD 109 OA, 39 EA, and 36 nonathletes (14-25 years) completed the TFEQ and EDI-2. Dual-energy X-ray absorptiometry was used to assess spine bone mineral density (BMD), and high-resolution pQCT to assess radius microarchitecture. We measured integrated cortisol (q 20', 11 PM-7 AM), bone formation (procollagen Type 1 N-terminal propeptide, P1NP), and resorption (C-telopeptide, CTX) markers in a subset. RESULTS OA had lower spine BMD Z-scores than EA. Cognitive eating restraint (CER), drive for thinness (DT), ineffectiveness, and interoceptive awareness (IA) were higher in OA than EA (p < 0.05); CER was higher in OA versus nonathletes (p = 0.03). Pulsatile cortisol was positively associated with DT, ineffectiveness, and IA (p < 0.03). CER was inversely associated with BMD Z-scores and P1NP, and ineffectiveness with radius cross-sectional area even after controlling for age, BMI, amenorrhea duration, and cortisol (p < 0.03). DISCUSSION Higher CER in athletes independently predicts lower BMD.
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Affiliation(s)
- Natalia Cano Sokoloff
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School,Correspondence to: Natalia Cano Sokoloff, Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Neuroendocrine Unit, Boston, MA. ,
| | - Maria L. Eguiguren
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School
| | - Katherine Wargo
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School
| | - Kathryn E. Ackerman
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School,Division of Sports Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Charumathi Baskaran
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School,Pediatric Endocrine Unit, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts
| | - Vibha Singhal
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School,Pediatric Endocrine Unit, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts
| | - Hannah Clarke
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School
| | - Meghan Slattery
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School
| | - Hang Lee
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kamryn T. Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Madhusmita Misra
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School,Pediatric Endocrine Unit, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts
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Abstract
PURPOSE OF REVIEW To assess recent research findings on various biochemical bone turnover markers and to assess their use in monitoring bone growth in children and adolescents. RECENT FINDINGS There are very few recent studies that investigate various serum and urine analytes that reflect bone formation and resorption to monitor bone health during longitudinal growth. In infants and young children, the measurement of bone markers in serum is suggested because of the practical difficulties associated with urine collection and by the circadian and intraindividual variation in urinary markers. During the prepubertal growth, bone turnover values are similar in age-matched boys and girls. The increase in different bone turnover markers coincides with the pubertal growth spurt. This starts later in boys and the increase in bone turnover markers also occurs later, is greater and lasts longer when compared with girls. Recent studies demonstrated that bone size increases and bone turnover decreases until mid-twenties. SUMMARY More than one bone formation and resorption marker should be measured to monitor longitudinal growth and bone mineral accrual, because sensitivities and predictive values of single markers are still poor. It is important to find new and more sensitive markers that could better characterize linear growth.
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Liechty JM. Body image distortion and three types of weight loss behaviors among nonoverweight girls in the United States. J Adolesc Health 2010; 47:176-82. [PMID: 20638010 DOI: 10.1016/j.jadohealth.2010.01.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 01/03/2010] [Accepted: 01/06/2010] [Indexed: 11/27/2022]
Abstract
PURPOSE To examine the relationship between body image distortion (BID) and onset of three types of weight loss behavior among nonoverweight girls in the United States. METHODS Data were from the National Longitudinal Study of Adolescent Health (Add Health) (n = 20,745) and included 5,173 nonoverweight (body mass index [BMI] < 85th percentile) adolescent females aged 11-19 years who completed Wave I and II interviews. Actual and perceived weight statuses were compared to assess BID. Logistic regression was used to predict onset of three types of weight loss behaviors at Wave II from BID at Wave I, adjusting for Wave I weight loss behaviors and demographics. RESULTS At Wave I, 85% of nonoverweight girls engaged in weight control behaviors, and 29% displayed BID (i.e., overestimation of weight status). When compared to girls without BID, those with BID at Wave I had 4.3 times greater odds of onset of extreme weight loss behavior (e.g., vomiting, laxatives, diet pills) (OR = 4.5, CI = 2.44-7.42) and 2.3 times higher odds of onset of dieting to control weight (OR = 2.30, CI = 1.72-3.06) 1 year later. Girls who practiced extreme weight loss had 10.7 times greater odds of continuing unsafe practices 1 year later than girls who did not (OR = 10.67, CI = 4.27-26.63). BID was unrelated to exercise for weight control. CONCLUSIONS BID predicts onset of unsafe, but not safe, weight loss behavior among nonoverweight girls. Brief assessment of BID may help identify nonoverweight girls at risk for unsafe weight loss practices and strengthen prevention efforts.
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Affiliation(s)
- Janet M Liechty
- School of Social Work and College of Medicine, University of Illinois at Urbana Champaign, Champaign, Illinois 61801, USA.
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Sabiston C. We are what we (think we) eat. J Adolesc Health 2009; 45:3-5. [PMID: 19541242 DOI: 10.1016/j.jadohealth.2009.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Accepted: 04/23/2009] [Indexed: 11/19/2022]
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