The association of body weight, dietary intake, and energy expenditure with dietary restraint and disinhibition.

The hypotheses that dieting and/or overeating are associated with adiposity, eating disturbances, and lowered energy expenditure were tested in this study. A sample of 44 premenopausal women scoring high and low on measures of dietary restraint and disinhibition of dietary control, as measured by the Three Factor Eating Questionnaire, was studied. A 2 x 2 factorial design was employed (High/Low restraint x High/Low Disinhibition). Dependent variables were: body composition, dietary intake, activity, resting metabolic rate, and thermic effect of food. Unrestrained overeaters (Low Restraint/High Disinhibition group) were very obese. High Dietary Restraint was associated with intent to diet and controlled eating. High scores on the Disinhibition Scale were associated with episodic overeating. Groups did not differ in resting metabolic rate (controlled for fat-free mass). Lower thermic effect of food was found to be associated with the obesity found in High Disinhibition subjects. Thus, Dietary Restraint was not associated with significant adverse effects upon physical or psychological health. High Disinhibition, however, was associated with adiposity and significant disturbances of eating.

Validity and reliability of reported dietary intake data.

OBJECTIVE: To compare two training techniques for validity and reliability of dietary instruments and the measurement of total energy expenditure (TEE) to determine whether technique could influence the accuracy of food portion estimates. DESIGN: Adult women were randomized into a control group and an experimental group for comparison of training technique. SETTING: University and research center. SUBJECTS: Five hundred women were screened using the Three-Factor Eating Questionnaire to identify restrained eaters or disinhibitors. Other criteria for selection included good health; absence of thyroid, respiratory, or other diseases; normal menstrual cycles; between the ages of 18 and 50 years. Forty-nine were recruited, with an attrition rate of 10% for a total sample of 44 subjects. INTERVENTION: The control group (n = 26) was trained with food models and the experimental group (n = 18) was trained with a combination of food models and life-sized food photographs. All subjects completed two 24-hour recalls and 14 consecutive days of food records. TEE was measured by the doubly-labeled water method. MAIN OUTCOME MEASURES: Training would improve the accuracy of food portion estimates. STATISTICAL ANALYSES PERFORMED: Analysis of variance, the paired t test, Pearson's correlation coefficient, and Wilcoxon's ranking test. RESULTS: The mean reported intake between instruments was found to be reliable; however, the comparison with TEE was underreported by 21.4% and was thus nonvalid. Training technique made no difference in validity or reliability. Both training techniques improved the accuracy of food portion estimates; however, improvement was enhanced with food photographs. APPLICATIONS/CONCLUSION: The findings indicate that training can improve food portion estimates, and dietary instruments may provide reliable but nonvalid results.

The effectiveness of a dental/dietitian team in the assessment of bulimic dental health.

Individuals with bulimia nervosa have been found to experience a variety of dental complications. Because of purging behaviors and erratic food consumption, the oral manifestations of bulimia frequently include irreversible enamel erosion, xerostomia, and oral mucosal irritation. A pilot study was conducted to determine the effectiveness of the dental/dietitian team in assessing the dental health of individuals with bulimia. Control and bulimic subjects were compared. The results demonstrated a significantly different (p less than .05) intake of folacin-412 micrograms in controls compared with 207 micrograms in bulimic subjects. Control subjects were found to have significantly greater (p less than .05) amounts of calculus deposits on teeth; however, subjects with bulimia demonstrated a lower (p less than .05) saliva pH. We conclude that the collaborative effort of the dental/dietitian team was useful in the assessment of dental health. The team approach may also help to identify clients with bulimia and facilitate therapy.

The effect of bulimia upon diet, body fat, bone density, and blood components.

A study was conducted to determine baseline data for dietary intake, percent body fat, bone mineral density, and blood components in women with bulimia. Eight bulimic and 10 control subjects completed the study. Each subject was assessed for a 3-day diet, frequency of purge, menstrual history, percent body fat, bone mineral density, by dual photon absorptiometry, and blood components. Mean age, height, and weight of subjects were similar. Percent body fat was similar for both groups. Vomiting was the predominant method of purge. Folacin intake was found to be significantly (p less than .05) lower in bulimic subjects. Control subjects consumed greater quantities of vitamin/mineral supplements than the bulimic subjects. Bone mineral density (gm/cm2) was found to be lower in bulimic subjects. Mean hemoglobin (gm/L [gm/dL]) levels were found to be significantly (p less than .01) higher in control subject. The data indicate that the method and duration of purge behavior could influence bone mineral density and blood components.

The incidence of bulimic behavior in a secondary and University school population.

A survey questionnaire was instructor administered to high school and university students (n=1500) to assess the incidence of bulimic behavior. The questionnaire was tested and found to be a reliable and valid index for bulimic symptomatology. Respondents included 59% high school and 41% university level students. Data was evaluated by school, grade, sex, race, and interest area. Bulimic behavior was demonstrated at an incidence of 4.30% for the total sample. There was a nonsignificant higher incidence found in university (5.31%) compared to high school (3.98%) respondents. A significantly greater percentage of females responded with bulimic behavior than did males; however, there were no significant differences found between university and high school females. Bulimic behavior appeared to peak at Grades 11 and 13. Significantly more whites reported bulimic behavior than did blacks. Several academic interest areas not previously indicated in the literature may be more vulnerable to bulimic behavior.

Sweat nitrogen losses by and nitrogen balance of preadolescent girls consuming three levels of dietary protein.

A nitrogen balance study was undertaken to determine the effects of three levels of nitrogen intake on the loss of nitrogen through sweat and to assess the impact of sweat nitrogen on the protein needs of preadolescent girls. Values were determined through the collection of 24-hour, total body sweat samples from 15 healthy girls with a mean age of 8 years, 7 months. Mean height and weight of the subjects were 132 cm and 28.9 kg, respectively. Mean sweat nitrogen losses, collected under uncontrolled environmental conditions, were 201 mg, 263 mg and 319 mg/day on 34 g, 57 g and 88 g of protein intake. The environmental conditions throughout the study remained fairly constant. Mean nitrogen balances per day were 0.04 g, 0.55 g and 1.42 g on the respective levels of nitrogen intake, with the inclusion of sweat nitrogen loss, however, a negative nitrogen balance per day was found in 8 and 2 subjects on 34 g and 57 g protein intake. After considering nitrogen retention of 0.3 g which has been recommended by NRC for the minimum nitrogen allowance for growth of preadolescent children, protein intakes higher than that recommended by the NRC-RDA for preadolescent girls may be required for support of normal growth.