Head and Neck Cancer and Dysphagia; Caring for Carers.

Head and neck cancer and dysphagia; caring for carers.

Filed under: Eating Disorders

Psychooncology. 2012 Dec 4;
Patterson JM, Rapley T, Carding PN, Wilson JA, McColl E

OBJECTIVES: A diagnosis of head and neck cancer (HNC) is a profound event for patients and family members who play a crucial role in their care. Eating and drinking difficulties affect patients’ quality of life (QOL), but the impact on the carers’ QOL has not been explored. This preliminary mixed method study reports on carer QOL over time and investigates the relationship with dysphagia. METHODS: Two hundred and eight HNC patients referred for (chemo)radiotherapy were asked to identify a carer and complete a health-related QOL and a swallowing QOL questionnaire at pre-treatment, 3 and 12?months post-treatment. Carers were given the Caregiver QOL-Cancer (CQOL-C) questionnaire at the same time points. A purposive sample of patient and carer dyads was observed over mealtimes and interviewed. RESULTS: Seventy per cent of carers returned a questionnaire at least once. There was no change in CQOL-C scores between pre-treatment and 3? months, but a significant improvement was found between 3 and 12?months post-treatment (p?=?0.012). Patient-reported outcomes accounted for 52% of variance in carer QOL measurements (R(2) ?=?0.52, p?HubMed – eating


Depression in obese patients with primary fibromyalgia: the mediating role of poor sleep and eating disorder features.

Filed under: Eating Disorders

Clin Rheumatol. 2012 Dec 4;
Senna MK, Ahmad HS, Fathi W

Depression is a prominent feature in fibromyalgia syndrome. Patients with fibromyalgia syndrome who are obese, with poor sleep quality, and those who have recurrent episodes of binge eating are at greater risk to develop depression. The aim of this cross-sectional study was to examine the hypothesis that the relationship between obesity and depression in patients with primary fibromyalgia syndrome is mediated by poor sleep, binge eating disorder (BED), and weight and shape concern. This study included 131 patients with primary fibromyalgia syndrome. Participants completed the following questionnaires: Pittsburgh Sleep Quality Index, Beck Depression Inventory-II, Eating Disorder questionnaire, and Fibromyalgia Impact Questionnaire. Body mass index (BMI) provided the primary indicator of obesity. Sobel test showed that the conditions for complete mediation were satisfied on the weight and shape concern as mediator between BMI and depression because the association between BMI and depression score became insignificant after controlling of weight and shape concern. However, since the association between BMI and depression remained significant after BED and poor sleep score were controlled, thus for both mediators, the conditions for partial mediation on the depression were satisfied. The findings suggest that in patients with primary fibromyalgia syndrome, weight and shape concern, BED, and poor sleep quality are important mediators of the relationship between obesity and depression. We suggest that a greater focus on these mediators in depression treatment may be indicated.
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Association between fast food purchasing and the local food environment.

Filed under: Eating Disorders

Nutr Diabetes. 2012; 2: e53
Thornton LE, Kavanagh AM

Objective:In this study, an instrument was created to measure the healthy and unhealthy characteristics of food environments and investigate associations between the whole of the food environment and fast food consumption.Design and subjects:In consultation with other academic researchers in this field, food stores were categorised to either healthy or unhealthy and weighted (between +10 and -10) by their likely contribution to healthy/unhealthy eating practices. A healthy and unhealthy food environment score (FES) was created using these weightings. Using a cross-sectional study design, multilevel multinomial regression was used to estimate the effects of the whole food environment on the fast food purchasing habits of 2547 individuals.Results:Respondents in areas with the highest tertile of the healthy FES had a lower likelihood of purchasing fast food both infrequently and frequently compared with respondents who never purchased, however only infrequent purchasing remained significant when simultaneously modelled with the unhealthy FES (odds ratio (OR) 0.52; 95% confidence interval (CI) 0.32-0.83). Although a lower likelihood of frequent fast food purchasing was also associated with living in the highest tertile of the unhealthy FES, no association remained once the healthy FES was included in the models. In our binary models, respondents living in areas with a higher unhealthy FES than healthy FES were more likely to purchase fast food infrequently (OR 1.35; 95% CI 1.00-1.82) however no association was found for frequent purchasing.Conclusion:Our study provides some evidence to suggest that healthier food environments may discourage fast food purchasing.
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The anthropometric status of elderly women in rural ghana and factors associated with low body mass index.

Filed under: Eating Disorders

J Nutr Health Aging. 2012; 16(10): 881-6
Blankson B, Hall A

Objectives: To describe the anthropometric and physical status of a sample of elderly women in rural Ghana and examine factors associated with a low body mass index (BMI). Design: A cross-sectional survey. Setting: Two rural villages in Ashanti Region, Ghana. Participants: Fifty-nine elderly women aged 60 to 92 years. Measurements: The weight, height, half armspan and mid-upper arm circumference (MUAC) of each woman was measured; body mass index (BMI) and body mass for armspan (BMA) were calculated. The state of each woman’s teeth and visual acuity was assessed. Data on food security, eating habits and socio-economic status were collected by questionnaire. Results: 41% (95%CI 27.8, 53.6) of women were underweight and 16.9% (95%CI 7.18, 26.8) were overweight or obese. Factors associated with a low BMI (<18.5 kg/m2) were: age (P=0.001), chewing tobacco (P=0.002), drinking alcohol (P=0.012), a visual acuity score of <30% (P=0.038), using a walking aid (P=0.016) and the number of children who gave the women cash (P=0.005). BMI was strongly positively correlated with BMA (r=0.999, P<0.001) and with MUAC (r=0.91, P<0.001), and a BMI of 18.5 was equivalent to a MUAC of about 23cm. Conclusion: Elderly women in Ghana with poor teeth and eyesight are at risk of undernutrition. Measurements of MUAC, which is simple, or BMA, which is based on weight and half armspan and is more easily measured and calculated than height and BMI, could be used to identify undernourished elderly women in rural Africa. HubMed – eating


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