Habitual Rapid Food Intake and Ineffective Esophageal Motility.

Habitual rapid food intake and ineffective esophageal motility.

World J Gastroenterol. 2013 Apr 14; 19(14): 2270-2277
Li KL, Chen JH, Zhang Q, Huizinga JD, Vadakepeedika S, Zhao YR, Yu WZ, Luo HS

AIM: To study non-cardiac chest pain (NCCP) in relation to ineffective esophageal motility (IEM) and rapid food intake. METHODS: NCCP patients with a self-reported habit of fast eating underwent esophageal manometry for the diagnosis of IEM. Telephone interviews identified eating habits of additional IEM patients. Comparison of manometric features was done among IEM patients with and without the habit of rapid food intake and healthy controls. A case study investigated the effect of 6-mo gum chewing on restoration of esophageal motility in an IEM patient. The Valsalva maneuver was performed in IEM patients and healthy controls to assess the compliance of the esophagus in response to abdominal pressure increase. RESULTS: Although most patients diagnosed with NCCP do not exhibit IEM, remarkably, all 12 NCCP patients who were self-reporting fast eaters with a main complaint of chest pain (75.0%) had contraction amplitudes in the mid and distal esophagus that were significantly lower compared with healthy controls [(23.45 mmHg (95%CI: 14.06-32.85) vs 58.80 mmHg (95%CI: 42.56-75.04), P < 0.01 and 28.29 mmHg (95%CI: 21.77-34.81) vs 50.75 mmHg (95%CI: 38.44-63.05), P < 0.01, respectively)]. In 7 normal-eating IEM patients with a main complaint of sensation of obstruction (42.9%), the mid amplitude was smaller than in the controls [30.09 mmHg (95%CI: 19.48-40.70) vs 58.80 mmHg (95%CI: 42.56-75.04), P < 0.05]. There was no statistically significant difference in manometric features between the fast-eating and normal-eating groups. One NCCP patient who self-reported fast eating and was subsequently diagnosed with IEM did not improve with proton-pump inhibition but restored swallow-induced contractions upon 6-mo gum-chewing. The Valsalva maneuver caused a markedly reduced pressure rise in the mid and proximal esophagus in the IEM patients. CONCLUSION: Habitual rapid food intake may lead to IEM. A prospective study is needed to validate this hypothesis. Gum-chewing might strengthen weakened esophageal muscles. HubMed – eating


Factors Associated With Screen Time Among School-Age Children in Korea.

J Sch Nurs. 2013 Apr 18;
Ham OK, Sung KM, Kim HK

The purpose of this study was to investigate the association of sociodemographic, psychosocial, and behavioral characteristics with screen time among school-age children in Korea. This study employed a nonexperimental, cross-sectional study design. A total of 370 children attending four elementary schools participated in the study. Self-report method was used, and instruments included screen time (time spent on TV/video/computer/video games), sleep duration, eating behavior, pros and cons of exercise, and exercise self-efficacy. According to the results, 45.7% of the children had screen time of 1-2.9 hr/day and 8.9% had 3 or more hr/day. Increased screen time showed an association with gender (boy), higher body mass index, fast food consumption, higher cons of exercise, having a working mother, and attendance at a school in an inner city area (p < .05). Understanding the factors associated with screen time may provide useful information in the development of health promotion programs aimed at decreasing sedentary behaviors. HubMed – eating


Understanding the influence of urban- or rural-living on cardiac patients’ decisions about diet and physical activity: Descriptive decision modeling.

Int J Nurs Stud. 2013 Apr 15;
King-Shier KM, Mather C, Leblanc P

BACKGROUND: It is challenging to assist people to attend to risk factors for coronary artery disease (CAD). There is potential for cultural elements associated with place of residence (i.e., urban- or rural-living) to have an effect on peoples’ decision-making about managing CAD risk. AIM: To better understand patient’s decision-making processes regarding having a heart-healthy diet and engaging in regular physical activity (major CAD risk factors), and the potential influence of urban- or rural-living. METHODS: Based on a previous series of qualitative interviews with 42 cardiac patients (21 urban-living, 21 rural-living), hierarchical decision-models regarding eating a heart-healthy diet and engaging in regular physical activity were developed, and a survey based on the decision-models generated. The models were then tested for ‘fit’ with another group of 42 cardiac patients, and were revised to make them more parsimonious. The final models were tested with a novel group of 647 CAD patients from Alberta, Canada (327 urban-living, 320 rural-living). The primary analysis was focused on determining the extent to which patients completing the survey fell in the correct behavioral group. Thereafter individual nodes were examined to determine decision-making constructs that were different between urban- and rural-living patients. RESULTS: When tested, the models had overall accuracy of 93.5% for diet and 97.5% for physical activity. The most salient model nodes that led to differing behavioral outcomes reflected these constructs: perception of control over health; time, effort, or competing priorities; receipt of appropriate information; and appeal of the activity. CONCLUSIONS: This information is potentially useful to assist healthcare providers to: (1) understand patients’ decisions regarding their cardiac risk factor modification behavior, and (2) better direct conversations about risk factor modification and educational activities. HubMed – eating


Weight-Related Child Behavioral Interventions in Brazil: A Systematic Review.

Am J Prev Med. 2013 May; 44(5): 543-549
Marshall SJ, Simoes EJ, Eisenberg CM, Holub CK, Arredondo EM, Barquera S, Elder JP

CONTEXT: Between 1974 and 1997, the prevalence of overweight increased 300% among Brazilian children and adolescents. A systematic review was conducted between January 2010 and December 2011 of obesity-related interventions targeting Brazilian children and adolescents. EVIDENCE ACQUISITION: Manuscripts from 1965 to December 2010 were evaluated based on inclusion criteria including evaluating obesity-related outcomes and at least 50% of participants living in Brazil. Methods were adapted from the CDC’s Community Guide. Evidence was based on the number of available studies, study design, execution, quality, and effect size. EVIDENCE SYNTHESIS: Sixteen articles were abstracted; five met final inclusion criteria. All intervention samples (range n=14-78; mean n=40.6) included overweight or obese children aged 8-17 years. The intervention duration range was 3-6 months, and dose frequency ranged from two to five times per week. Three of the five interventions included healthy eating and physical activity; two included only physical activity. Two interventions studies were rated as having greatest design suitability. Only one intervention had the greatest design suitability and a large effect size. CONCLUSIONS: Intervention approaches that combined physical activity and healthy eating had the strongest effects. However, small sample bias, 95% CIs of primary effects, and poor-to-moderate quality of research designs and implementation suggest the combined evidence is best rated as Insufficient. This prohibits the recommendation of specific strategies or settings. Findings suggest that more well-designed evidence-based childhood obesity interventions in Brazil are needed and that promising, but yet unproven, interventions should be evaluated rigorously. HubMed – eating


Obesity Control in Latin American and U.S. Latinos: A Systematic Review.

Am J Prev Med. 2013 May; 44(5): 529-537
Holub CK, Elder JP, Arredondo EM, Barquera S, Eisenberg CM, Sánchez Romero LM, Rivera J, Lobelo F, Simoes EJ

CONTEXT: Latinos are the largest and fastest-growing ethnically diverse group in the U.S.; they are also the most overweight. Mexico is now second to the U.S. in experiencing the worst epidemic of obesity in the world. Objectives of this study were to (1) conduct a systematic review of obesity-related interventions targeting Latinos living in the U.S. and Latin America and (2) develop evidence-based recommendations to inform culturally relevant strategies targeting obesity. EVIDENCE ACQUISITION: Obesity-related interventions, published between 1965 and 2010, were identified through searches of major electronic databases in 2010-2011. Selection criteria included evaluation of obesity-related measures; intervention conducted in a community setting; and at least 50.0% Latino/Latin American participants, or with stratified results by race/ethnicity. EVIDENCE SYNTHESIS: Body of evidence was based on the number of available studies, study design, execution, and effect size. Of 19,758 articles, 105 interventions met final inclusion criteria. Interventions promoting physical activity and/or healthy eating had strong or sufficient evidence for recommending (1) school-based interventions in the U.S. and Latin America; (2) interventions for overweight or obese children in the healthcare context in Latin America; (3) individual-based interventions for overweight or obese adults in the U.S.; (4) individual-based interventions for adults in Latin America; and (5) healthcare-based interventions for overweight or obese adults in Latin America. CONCLUSIONS: Most intervention approaches combined physical activity and healthy eating to address both sides of the energy-balance equation. Results can help guide comprehensive evidence-based efforts to tackle the obesity epidemic in the U.S. and Latin America. HubMed – eating