Onset of Obsessive Compulsive Disorder in Pregnancy With Pica as the Sole Manifestation.

Onset of obsessive compulsive disorder in pregnancy with pica as the sole manifestation.

Indian J Psychol Med. 2012 Jul; 34(3): 276-8
Upadhyaya SK, Sharma A

Pica refers to eating of non-nutritious substances, which is usually seen in childhood or pregnancy. Here we report a case of an illiterate tribal woman who developed pica as the sole manifestation of obsessive compulsive disorder, with onset during pregnancy. The patient had compulsions of eating uncooked rice or wheat, which resulted in toothache and abdominal discomfort. She had this habit in three pregnancies, consecutively. In the first two pregnancies it resolved spontaneously after puerperium, but persisted in the last one. Probably physical stress of limb edema during the third pregnancy was reason for the persistence. She responded to fluoxetine 40 mg / day after three months of treatment, without behavioral therapy. We conclude that pica may either be only a manifestation of obsessive compulsive disorder during pregnancy or it is an obsessive compulsive spectrum disorder. HubMed – eating


Associations of Food Stamp Participation With Dietary Quality and Obesity in Children.

Pediatrics. 2013 Feb 25;
Leung CW, Blumenthal SJ, Hoffnagle EE, Jensen HH, Foerster SB, Nestle M, Cheung LW, Mozaffarian D, Willett WC

OBJECTIVE:To determine if obesity and dietary quality in low-income children differed by participation in the Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp Program.METHODS:The study population included 5193 children aged 4 to 19 with household incomes ?130% of the federal poverty level from the 1999-2008 NHANES. Diet was measured by using 24-hour recalls.RESULTS:Among low-income US children, 28% resided in households currently receiving SNAP benefits. After adjusting for sociodemographic differences, SNAP participation was not associated with a higher rate of childhood obesity (odds ratio = 1.11, 95% confidence interval [CI]: 0.71-1.74). Both SNAP participants and low-income nonparticipants were below national recommendations for whole grains, fruits, vegetables, fish, and potassium, while exceeding recommended limits for processed meat, sugar-sweetened beverages, saturated fat, and sodium. Zero percent of low-income children met at least 7 of 10 dietary recommendations. After multivariate adjustment, compared with nonparticipants, SNAP participants consumed 43% more sugar-sweetened beverages (95% CI: 8%-89%), 47% more high-fat dairy (95% CI: 7%, 101%), and 44% more processed meats (95% CI: 9%-91%), but 19% fewer nuts, seeds, and legumes (95% CI: -35% to 0%). In part due to these differences, intakes of calcium, iron, and folate were significantly higher among SNAP participants. Significant differences by SNAP participation were not evident in total energy, macronutrients, Healthy Eating Index 2005 scores, or Alternate Healthy Eating Index scores.CONCLUSIONS:The diets of low-income children are far from meeting national dietary recommendations. Policy changes should be considered to restructure SNAP to improve children’s health. HubMed – eating


Comparison of two school-based programmes for health behaviour change: the Belo Horizonte Heart Study randomized trial.

Public Health Nutr. 2013 Feb 26; 1-10
Ribeiro RQ, Alves L

OBJECTIVE: To assess the efficacy of two school-based programmes to promote students’ willingness to engage in lifestyle changes related to eating habits and physical activity behaviours. DESIGN: Elementary school-based health promotion intervention, designed as a multicomponent experimental study, based on a behavioural epidemiological model. SETTING: Nine intervention and eight comparative public and private elementary schools. SUBJECTS: The goal was to determine the impact on the longitudinally assessed outcomes of two programmes that addressed healthy nutrition and active living in a cohort of 2038 children. The evaluations used pre-intervention and follow-up student surveys that were based on the Transtheoretical Model of the stages of behaviour change. RESULTS: In the intervention group, there were significant (P < 0·001) differences between the pre- and post-intervention times in the stages of change, with a reduction in the percentage of children at the pre-contemplation and contemplation stages and increased percentages at the preparation, action and maintenance stages, leading to healthier behaviours in fatty food consumption, fruit and vegetable consumption, physical activity and time spent in sedentary activities. The determinants of the behaviour stage were the intervention programme, the type of school and the presence of motivated teachers. The comparison group did not show significant differences between the pre- and post-intervention times for any of the stages of behaviour. CONCLUSIONS: The intervention programme encouraged the students to make healthy lifestyle choices related to eating habits and physical activity behaviours. HubMed – eating


Amylin and GLP-1 target different populations of area postrema neurons that are both modulated by nutrient stimuli.

Physiol Behav. 2013 Feb 21;
Züger D, Forster K, Lutz TA, Riediger T

The area postrema mediates the hypophagic effect of the pancreatic hormone amylin and is also sensitive to glucagon-like peptide 1 (GLP-1). Protein seems to modulate amylin responsiveness because amylin seems to produce a stronger hypophagic effect and a stronger c-Fos expression when protein is absent from the diet. Accordingly, amylin induces a stronger c-Fos expression in the AP when injected in fasted compared to ad libitum fed rats. Here we tested the hypothesis that diet-derived protein attenuates the amylin dependent suppression of feeding and AP activation using isocaloric diets that differed in their protein content. Moreover, we investigated whether peripheral amino acid injection attenuates amylin-induced c-Fos expression in fasted rats. Since recent evidence suggests that GLP-1 may also reduce eating via the AP we tested whether 24h fasting also increases neuronal AP responsiveness to GLP-1 similar to the fasting-induced increase in amylin responsiveness. Finally, we used the calcitonin receptor (CTR) as an immunohistochemical marker for amylin-receptive AP neurons to investigate whether amylin’s target neurons differ from GLP-1 responsive AP neurons. We also dissociated amylin responsive cells from neurons implicated in other AP-mediated functions such as aversion or blood pressure regulation. For this purpose we conducted c-Fos/CTR double staining after LiCl or angiotensin II treatment, respectively. Amylin (5 ?g/kg sc) was more effective to reduce the intake of a 1% vs. an 8% or 18% protein diet and to induce c-Fos expression in the AP in rats receiving 1% vs. 18% protein diet. Increased protein intake was associated with increased blood amino acid levels. Peripheral injection of amino acids (1g/kg ip) attenuated the amylin-induced AP activation in 24h fasted rats. Similar to amylin, GLP-1 (100 ?g/kg ip) elicited a significant c-Fos response only in fasted but not in ad libitum fed rats. However, in contrast to a high co-localization of amylin-induced c-Fos and CTR (68%), no c-Fos/CTR co-localization occurred after treatment with GLP-1 or the GLP-1R agonist exendin 4 (2 ?g/kg ip). Similarly, LiCl (76mg/kg ip) or AngII (50 ?g/kg sc) lead to c-Fos expression only in CTR negative AP neurons. In conclusion, our findings support a protein-dependent modulation of behavioral and neuronal amylin responsiveness under equicaloric feeding conditions. Amino acids might contribute to the inhibitory effect of diet-derived protein to reduce amylin-induced neuronal AP activation. Neuronal AP responsiveness to GLP-1 is also increased in the fasted state suggesting that diet-derived nutrients may also interfere with AP-mediated GLP-1 effects. Nevertheless, the primary target neurons for amylin appear to be distinct from cells targeted by GLP-1 and by stimuli producing aversion (LiCl) or contributing to blood pressure regulation (AngII) via the AP. Since amylin and GLP-1 analogs are targets for the treatment of obesity, the nutrient-dependent modulation of AP responsiveness might entail implications for such therapeutic approaches. HubMed – eating


Environmental and policy strategies to improve eating, physical activity behaviors, and weight among adolescents.

Adolesc Med State Art Rev. 2012 Dec; 23(3): 589-609
Schwartz MB

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Teens and Eating Disorders – Important information on eating disorders in teens. Dr. Cora Breuner from Seattle Children’s Hosiptal provides parents with warning signs to look for to aide with early detection.