Eating Disorders: Dietary Intake Among Native Hawaiian, Filipino, and White Children and Caregivers in Hawai’i.

Dietary Intake Among Native Hawaiian, Filipino, and White Children and Caregivers in Hawai’i.

Filed under: Eating Disorders

Hawaii J Med Public Health. 2012 Dec; 71(12): 353-8
Novotny R, Vijayadeva V, Grove J, Gittelsohn J, Avila J, Su Y, Murphy S

Little is published about dietary intake of children of ethnic populations found in Hawai’i, due to an absence of national statistics collected on Hawai’i’s population. This information is needed to focus planning of food, agriculture and health programs aimed to prevent obesity and related chronic disease and to improve health. Dietary patterns of 156 Native Hawaiian (n=110), Filipino (n=28) and White (n=18) children and their caregivers were compared using socio-demographic, annual “food season,” and 24 hour dietary recall data from a baseline survey of four lower income communities selected for an intervention program in rural Hawai’i. Ethnic differences were found in the Healthy Eating Index (HEI) dairy component, and in calcium and vitamin C nutrient intakes among caregivers only (adjusting for food season). Whites always had higher intakes of these foods and nutrients than Filipinos or Native Hawaiians. Vitamin C intake remained significantly different among ethnic groups after further adjusting for dairy food group intake. Dietary patterns showed low intake of fruits and vegetables, fiber and dairy foods among these understudied populations.
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Assessment of physician practices in adult attention-deficit/hyperactivity disorder.

Filed under: Eating Disorders

Prim Care Companion CNS Disord. 2012; 14(4):
Goodman DW, Surman CB, Scherer PB, Salinas GD, Brown JJ

Objective: Adult attention-deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric disorder, yet only 1 in 10 affected adults receives treatment. The study objective was to assess gaps in knowledge and describe current practice patterns of primary care physicians and psychiatrists in the United States in the management of adult patients with ADHD.Method: Primary care physicians and psychiatrists completed an Internet survey as a needs assessment of customary care related to management of adults with ADHD. Adult clinical case vignettes were followed by practice, confidence, and barrier questions. Survey data were collected from April 15, 2010, to August 22, 2010, and were deidentified and analyzed in aggregate to maintain confidentiality. ?(2) and t tests were used to compare responses of primary care physicians with those of psychiatrists.Results: The survey was completed by 1,924 physicians: 1,216 primary care physicians and 708 psychiatrists. Fewer primary care physicians than psychiatrists were “extremely confident” in diagnosis (8% vs 28%, respectively, P < .001) and treatment (8% vs 27%, respectively, P < .001). Limited experience with ADHD diagnosis was more of a barrier in primary care than in psychiatry (44% vs 19%, respectively, P < .001). Mean scores on 12 evidence-based questions were lower for primary care physicians than for psychiatrists (6.1 vs 6.8 correct, respectively, P < .001). Awareness of adult ADHD prevalence was lower among primary care physicians than among psychiatrists (32% vs 47% correct, respectively, P < .001). Fewer primary care physicians than psychiatrists recognized comorbid substance use disorder (76% vs 82%, respectively, P = .002), but more primary care physicians than psychiatrists recognized eating disorders (35% vs 21%, respectively, P < .001).Conclusions: The self-assessment survey results indicate physician practices in primary care and psychiatry differ and show areas in which further education will be useful to improve care for adults with ADHD. HubMed – eating


Nivalenol and deoxynivalenol affect rat intestinal epithelial cells: a concentration related study.

Filed under: Eating Disorders

PLoS One. 2012; 7(12): e52051
Bianco G, Fontanella B, Severino L, Quaroni A, Autore G, Marzocco S

The integrity of the gastrointestinal tract represents a crucial first level defence against ingested toxins. Among them, Nivalenol is a trichotecenes mycotoxin frequently found on cereals and processed grains; when it contaminates human food and animal feed it is often associated with another widespread contaminant, Deoxynivalenol. Following their ingestion, intestinal epithelial cells are exposed to concentrations of these trichothecenes high enough to cause mycotoxicosis. In this study we have investigated the effects of Nivalenol and Deoxynivalenol on intestinal cells in an in vitro model system utilizing the non-tumorigenic rat intestinal epithelial cell line IEC-6. Both Nivalenol and Deoxynivalenol (5-80 µM) significantly affected IEC-6 viability through a pro-apoptotic process which mainly involved the following steps: (i) Bax induction; (ii) Bcl-2 inhibition, and (iii) caspase-3 activation. Moreover, treatment with Nivalenol produced a significant cell cycle arrest of IEC-6 cells, primarily at the G(0)/G(1) interphase and in the S phase, with a concomitant reduction in the fraction of cells in G(2). Interestingly, when administered at lower concentrations (0.1-2.5 µM), both Nivalenol and Deoxynivalenol affected epithelial cell migration (restitution), representing the initial step in gastrointestinal wound healing in the gut. This reduced motility was associated with significant remodelling of the actin cytoskeleton, and changes in expression of connexin-43 and focal adhesion kinase. The concentration range of Nivalenol or Deoxynivalenol we have tested is comparable with the mean estimated daily intake of consumers eating contaminated food. Thus, our results further highlight the risks associated with intake of even low levels of these toxins.
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From Morbid Obesity to a Healthy Weight Using Cognitive-Behavioral Methods: A Woman’s Three-Year Process With One and One-Half Years of Weight Maintenance.

Filed under: Eating Disorders

Perm J. 2012; 16(4): 54-9
Annesi JJ, Tennant GA

Background: Obesity is a national health problem regularly confronting medical professionals. Although reduced-energy (kilocalorie [kcal]) eating and increased exercise will reliably reduce weight, these behaviors have been highly resistant to sustained change.Objective: To control eating using theory-based cognitive-behavioral methods that leverage the positive psychosocial effects of newly initiated exercise as an alternate to typical approaches of education about appropriate nutrition.Method: A woman, age 48 years, with morbid obesity initiated exercise through a 6-month exercise support protocol based on social cognitive and self-efficacy theory (The Coach Approach). This program was followed by periodic individual meetings with a wellness professional intended to transfer behavioral skills learned to adapt to regular exercise, to then control eating. There was consistent recording of exercises completed, foods consumed, various psychosocial and lifestyle factors, and weight.Results: Over the 4.4 years reported, weight decreased from 117.6 kg to 59.0 kg, and body mass index (BMI) decreased from 43.1 kg/m(2) to 21.6 kg/m(2). Mean energy intake initially decreased to 1792 kcal/day and further dropped to 1453 kcal/day by the end of the weight-loss phase. Consistent with theory, use of self-regulatory skills, self-efficacy, and overall mood significantly predicted both increased exercise and decreased energy intake. Morbid obesity was reduced to a healthy weight within 3.1 years, and weight was maintained in the healthy range through the present (1.3 years later).Conclusion: This case supports theory-based propositions that exercise-induced changes in self-regulation, self-efficacy, and mood transfer to and reinforce improvements in corresponding psychosocial factors related to controlled eating.
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