Eating Disorders: [Epidemiology of Anorexia Nervosa: A Review.]

[Epidemiology of anorexia nervosa: A review.]

Filed under: Eating Disorders

Encephale. 2012 Sep 25;
Roux H, Chapelon E, Godart N

A critical review of the literature was conducted to provide answers to three questions: firstly, are we facing a national and/or international epidemic of anorexia nervosa (AN) as claimed in the media by certain professionals? Secondly, is AN simply an ordinary crisis of adolescence? Thirdly, is it a pathology that solely affects the higher socio-professional categories? METHOD: A Medline search was conducted and backed up by a manual search to find all the studies or literature reviews published on prevalence, incidence rates, outcomes, morbidity and mortality in AN and its links with social class, covering the period 2000-2011. RESULTS: The differing methodologies of the studies on these themes have a considerable impact on the interpretation of results. For each indicator retained, the results observed in the different studies are detailed and commented in the light of these differences. The prevalence of AN in women aged 11 to 65 in non-clinical population ranges from 0 to 2.2 %. It varies in particular with the age of the studied subjects, the measurements used, and the definition criteria for AN. Among men, the lifetime prevalence is around 0.3%. The marked disparities in incidence rates observed are related to the nature of the samples considered: subjects consulting in hospital, whether in a specialised department or in any department, those consulting general practitioners (GPs), or subjects from general population samples recruited in different surveys (girls in schools for example). The incidence of female cases is low in general medicine or specialised consultation in town (whatever the speciality): from 4.2 and 8.3/100,000 individuals per year. It is much higher in the general population, ranging from 109 to 270/100,000 individuals per year. In fact, the studies reporting variations in the incidence of AN were conducted on samples from clinical populations in certain countries (United States and United Kingdom). They are probably more a reflection of variations in detection rates and use of healthcare, than of variations in the incidence in the general population. The mean duration of AN appears shorter in the general population than in clinical populations. On average, 47% of the individuals treated for AN recovered, 34% improved, 21% had a chronic eating disorder, and 5% died. The outcome is better for subjects treated during adolescence. Mortality is frequently expressed in crude mortality rate (CMR), which is not very informative on account of the heterogeneous natures of the cohorts followed; only the studies reporting standardised mortality rate (SMR) are informative. AN appears as having one of the highest mortality rates among psychiatric pathologies. Mortality varies according to the population considered. Rates observed are 6.2 to 10.6 times greater than that observed in the general population for a follow-up duration ranging respectively from 13 to 10years. It is lower for longer follow-up periods, only 3.7 times more frequent than in the general population for follow-up periods of 20 to 40years. It appears lower for subjects treated before the age of 20. The main causes of death are eating disorder complications, suicide and cancer. One review of the literature concluded in the absence of any significant link between this pathology and social class. DISCUSSION: There is nothing in the incidence and prevalence data to back up the notion of a recent “epidemic” of AN. AN is not simply a crisis of adolescence: morbidity and mortality are considerable in this pathology. The relationship between AN and social class is not established.
HubMed – eating


The Acute Salivary Ghrelin Response to a Psychosocial Stress Is Enhanced in Symptomatic Patients with Bulimia Nervosa: A Pilot Study.

Filed under: Eating Disorders

Neuropsychobiology. 2012 Oct 23; 66(4): 230-236
Monteleone P, Tortorella A, Scognamiglio P, Serino I, Monteleone AM, Maj M

Background: Stress is a precipitating factor for both binge eating and bulimia nervosa (BN); however, the biological mechanisms through which it may trigger binge eating are poorly understood. There is evidence that the adrenal hormone cortisol and the gastric peptide ghrelin might be involved in stress-induced food ingestion. We hypothesized that symptomatic patients with BN might disclose deranged responses of ghrelin and/or cortisol to stressors and that this could be related to their binge-eating behaviour. Methods: Here we investigated salivary cortisol and ghrelin responses to the Trier Social Stress Test (TSST) in 10 women with acute BN and 10 age-matched healthy females. Eating-related psychopathology and behaviours were assessed by self-report measures. Results: No significant differences emerged between bulimic patients and healthy controls in the pre-stress salivary levels of both cortisol and ghrelin. The BN patients displayed normal cortisol but enhanced ghrelin responses to TSST. No significant correlations emerged between stress-induced salivary hormone changes and self-report measures of binge eating. Conclusion: To our knowledge, this is the first study showing deranged salivary ghrelin reactivity to a psychosocial stressor in symptomatic patients with BN. The extent to which this could contribute to the binge-eating behaviour of BN subjects awaits clarification.
HubMed – eating


Effects of High-Pressure Processing on Inactivation of Salmonella Typhimurium, Eating Quality, and Microstructure of Raw Chicken Breast Fillets.

Filed under: Eating Disorders

J Food Sci. 2012 Oct 24;
Tananuwong K, Chitsakun T, Tattiyakul J

? High-pressure inactivation of Salmonella Typhimurium DMST 28913, eating quality, and microstructure of pressurized raw chicken breast meat was determined. The inoculated samples (approximately 7 log CFU/g initial load) were processed at 300 and 400 MPa, using pressurized medium of 25 to 35 °C during pressurization. Weibull model was well fitted to the survival curves with tailing. Least severe conditions with acceptable inactivation levels were 300 MPa, 35 °C, 1 min (approximately 2 log reduction) and 400 MPa, 30 °C, 1 min (approximately 4 log reduction). Based on these 2 conditions, the 400 MPa treatment yielded the raw chicken meat with higher L* value, greater cooking loss, and lower water holding capacity. Cooked chicken breast meat prepared from the pressurized samples had firmer texture than the control. Scanning electron microscopic images showed that higher pressure resulted in increasing extent of protein coagulation and the contraction of the muscle bundles. Practical Application:? For raw chicken breast fillet, 300 MPa, 35 °C, 1 min was the condition that reasonably reduced the load of Salmonella Typhimurium. However, the pressurized samples had greater cooking loss. Marination with brine containing sodium chloride and phosphate prior to pressurization might help improve this eating quality.
HubMed – eating


Eating habits in the turn of the 19th and 20th century: exhibition of menu cards at the Sarajevo City Museum.

Filed under: Eating Disorders

Acta Med Hist Adriat. 2012; 10(1): 101-10
Omanic A, Serdarevic M, Ovcina A

Through a selection of menu cards exhibited at the Sarajevo City Museum, this article looks into the eating habits in Bosnia and Herzegovina in the second half of the 19th and the first half of the 20th century (period before the World War I). These menu cards offer a specific overview of eating habits of all ranks of society in Bosnia and Herzegovina, where there are no essential differences between dinner tables of prelates and ordinary people. The paper gives a short comparison of traditional eating habits in Bosnia and Herzegovina with nowadays eating habits, especially concerning the problem of obesity.
HubMed – eating



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