Associations of adolescent emotional and loss of control eating with 1-year changes in disordered eating, weight, and adiposity.

OBJECTIVE: Adolescent emotional-eating, referring to eating in response to negative affective states, is frequently reported by those with loss of control (LOC) eating. Although LOC eating has been shown to predict exacerbated disordered eating and excess weight/adiposity gain, the extent to which emotional-eating, either alone or in combination with LOC, predicts adverse outcomes has not been determined. Thus, we examined associations of baseline emotional-eating with changes in disordered eating, BMI, and adiposity over 1-year, and to what degree the presence or absence of baseline LOC moderated these associations. METHODS: 189 non-treatment-seeking youth (15.4 ± 1.4y; 66% female; 67% non-Hispanic White, 38% overweight [BMI ≥ 85th %ile]) completed the emotional-eating Scale for Children/Adolescents and the Eating Disorder Examination interview at baseline and again at 1-year. Air displacement plethysmography assessed adiposity at both time points. RESULTS: Baseline emotional-eating alone was not significantly associated with the development of objective binge eating or changes in disordered eating attitudes, BMI or adiposity 1-year later. However, baseline emotional-eating interacted with the presence of baseline LOC in the prediction of 1-year outcomes. Among adolescents with LOC eating, greater baseline emotional-eating was related to increased disordered eating attitudes (p = .03), BMI (p = .04), and adiposity (p = .04) at 1-year, after correcting for false discovery rate. DISCUSSION: Emotional-eating among youth also reporting LOC was associated with adverse outcomes over 1-year. Adolescents who report both behaviors may represent a subset of individuals at especially high risk for exacerbated disordered eating and excess weight gain. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:551-560).

Measurement invariance of the Eating Disorder Examination in black and white children and adolescents.

OBJECTIVE: The Eating Disorder Examination (EDE) was originally developed and validated in primarily white female samples. Since data indicate that eating pathology impacts black youth, elucidating the psychometric appropriateness of the EDE for black youth is crucial. METHODS: A convenience sample was assembled from seven pediatric obesity studies. The EDE was administered to all youth. Confirmatory factor analyses (CFA) were conducted to examine the original four-factor model fit and two alternative factor structures for black and white youth. With acceptable fit, multiple-group CFAs were conducted. For measurement invariant structures, the interactive effects of race with sex, BMIz, adiposity, and age were explored (all significance levels p < .05). RESULTS: For both black and white youth (N = 820; 41% black; 37% male; 6-18 years; BMIz -3.11 to 3.40), the original four-factor EDE structure and alternative eight-item one-factor structure had mixed fit via CFA. However, a seven-item, three-factor structure reflecting Dietary Restraint, Shape/Weight Overvaluation, and Body Dissatisfaction had good fit and held at the level of strict invariance. Girls reported higher factor scores than boys. BMIz and adiposity were positively associated with each subscale. Age was associated with Dietary Restraint and Body Dissatisfaction. The interactional effects between sex, BMIz, and age with race were not significant; however, the interaction between adiposity and race was significant. At higher adiposity, white youth reported greater pathology than black youth. CONCLUSION: An abbreviated seven-item, three-factor version of the EDE captures eating pathology equivalently across black and white youth. Full psychometric testing of the modified EDE factor structure in black youth is warranted.

A randomized, comparative pilot trial of family-based interpersonal psychotherapy for reducing psychosocial symptoms, disordered-eating, and excess weight gain in at-risk preadolescents with loss-of-control-eating.

OBJECTIVE: Preadolescent loss-of-control-eating (LOC-eating) is a risk factor for excess weight gain and binge-eating-disorder. We evaluated feasibility and acceptability of a preventive family-based interpersonal psychotherapy (FB-IPT) program. FB-IPT was compared to family-based health education (FB-HE) to evaluate changes in children's psychosocial functioning, LOC-eating, and body mass. METHOD: A randomized, controlled pilot trial was conducted with 29 children, 8 to 13 years who had overweight/obesity and LOC-eating. Youth-parent dyads were randomized to 12-week FB-IPT (n = 15) or FB-HE (n = 14) and evaluated at post-treatment, six-months, and one-year. Changes in child psychosocial functioning, LOC-eating, BMI, and adiposity by dual-energy-X-ray-absorptiometry were assessed. Missing follow-up data were multiply imputed. RESULTS: FB-IPT feasibility and acceptability were indicated by good attendance (83%) and perceived benefits to social interactions and eating. Follow-up assessments were completed by 73% FB-IPT and 86% FB-HE at post-treatment, 60% and 64% at six-months, and 47% and 57% at one-year. At post-treatment, children in FB-IPT reported greater decreases in depression (95% CI -7.23, -2.01, Cohen's d = 1.23) and anxiety (95% CI -6.08, -0.70, Cohen's d = .79) and less odds of LOC-eating (95% CI -3.93, -0.03, Cohen's d = .38) than FB-HE. At six-months, children in FB-IPT had greater reductions in disordered-eating attitudes (95% CI -0.72, -0.05, Cohen's d = .66) and at one-year, tended to have greater decreases in depressive symptoms (95% CI -8.82, 0.44, Cohen's d = .69) than FB-HE. There was no difference in BMI gain between the groups. DISCUSSION: Family-based approaches that address interpersonal and emotional underpinnings of LOC-eating in preadolescents with overweight/obesity show preliminary promise, particularly for reducing internalizing symptoms. Whether observed psychological benefits translate into sustained prevention of disordered-eating or excess weight gain requires further study.

The influence of chemical interactions at the human surface on breathing zone levels of reactants and products.

UNLABELLED: Using computational fluid dynamics simulations of an occupant in a ventilated room, we find that breathing zone ozone levels can be substantially lower and ozone reaction products associated with human surfaces (ORPHS) levels considerably higher than room levels. For air exchange rates <3/h, the ratio of the breathing zone to the ozone concentration 1 m from the body (bulk air), r(ozone), ranges from 0.59 to 0.75 for floor or ceiling air supply. ORPHS are enriched in the breathing zone, with concentrations for these conditions ranging from 1.2 to 2.5 greater than bulk air concentrations. At high air exchange rates (>8/h), the breathing zone concentrations approach bulk air concentrations (r(ozone) > 0.9) with a floor supply, whereas large concentration gradients occur between breathing zone and bulk air with a ceiling supply. At these high air exchange rates, ORPHS levels are 1.6-2.0 and 2.9-6.0 times the bulk air concentrations for floor and ceiling supply, respectively. The extent of depletion of ozone or enrichment of ORPHS is large enough that reliance on micro-environmental measurements alone, to assess the intake of ozone or ORPHS, is undesirable. PRACTICAL IMPLICATIONS: Chemical reactions between ozone and human and clothing surfaces are predicted to significantly reduce ozone concentrations, and increase ozone reaction products associated with human surfaces (ORPHS) concentrations, in the breathing zone, relative to those concentrations in the larger microenvironment of a room. Existing measurements may overestimate ozone exposure and intake in typical indoor environments.

Pediatric Loss of Control Eating and High-Sensitivity C-Reactive Protein Concentrations.

BACKGROUND: Loss of control (LOC) eating in youth is associated with excess body weight and adiposity. After adjusting for fat mass, youth with LOC eating have higher blood pressure and higher low-density lipoprotein cholesterol compared to youth without LOC eating. Increased inflammation may account for this relationship, although few data have examined this hypothesis. Therefore, this study explored the association between LOC eating and high-sensitivity C-reactive protein (hsCRP), a marker of inflammation. METHODS: We investigated hsCRP concentrations in relation to LOC eating in a convenience sample of 194 youth (age 14.3 ± 2.1 years; 63.9% female; BMI-z 1.64 ± 1.06). The presence of LOC eating in the past month was assessed by the Eating Disorder Examination interview. Serum hsCRP was measured by enzyme-linked immunosorbent assay. Adiposity was measured by air displacement plethysmography or dual-energy x-ray absorptiometry. We compared hsCRP in those with and without LOC eating in analyses accounting for sex, adiposity, height, depressive symptoms, and eating psychopathology. RESULTS: Youth with LOC eating had significantly greater hsCRP than youth without LOC eating (p = 0.02), after accounting for all covariates. The number of LOC eating episodes in the past month was positively associated with hsCRP (p = 0.01). The relationship between LOC eating and hsCRP was not mediated by depressive symptoms or eating psychopathology (ps > 0.05). CONCLUSIONS: Youth with disinhibited eating may manifest increased chronic inflammation. Those with LOC eating may be an important subgroup at risk for adverse health outcomes associated with both chronic inflammation and obesity. Future research should examine whether hsCRP concentrations mediate the relationship between LOC eating and its association with cardiometabolic risk.

The selective T3 sympathicotomy in patients with essential palmar hyperhidrosis.

BACKGROUND: Selective T3 thoracoscopic sympathicotomy in patients with essential palmar hyperhidrosis may produce successful results with fewer side effects. We report preliminary results in comparison with those of conventional T2, T3 thoracoscopic sympathicotomy. METHODS: Twenty-four patients underwent a conventional T2, T3 sympathicotomy (group A) from Jan 1997 to Dec 1997 and 30 patients a selective T3 sympathicotomy (group B) from Jan 1998 to Dec 1999. To assess postoperative success and complications all patient charts were reviewed. FINDINGS: No recurrence was observed in either group. However, the rates of compensatory sweating were significantly (p=0.020) different: 11 patients (45.8%) in group A and 5 patients (16.73%) in group B. Horner's syndrome was observed in only 4 patients of group A. INTERPRETATION: Selective T3 thoracoscopic sympathicotomy results in a decrease in the rate of disturbing side effects compared to conventional T2, T3 thoracoscopic sympathicotomy without recurrence of symptoms. We suggest that selective T3 thoracoscopic sympathicotomy is the treatment of choice in essential palmar hyperhidrosis.

Effects of calcium depletion and loading on injury during metabolic inhibition of isolated adult rat myocytes.

The hypothesis that calcium influxes from the extracellular space play an important role in the pathogenesis of irreversible anoxic injury was tested using isolated adult rat myocytes. Myocytes treated with 6 mM amytal and 3 mM iodoacetate and subsequently incubated in either calcium-containing (1.12 mM) or calcium-free media (with or without 1 mM EGTA) developed rigor contracture (cell squaring) and cell death (trypan blue permeability) at the same rate. The rates of cell death in both calcium-containing and calcium-free media were increased by incubation in hypotonic media even though the rates of contracture development remained unaltered. Cells developed osmotic fragility prior to membrane permeability increases. The calcium ionophore, A23187 (10 microM), induced rapid rounding of rod-shaped cells subjected only to mitochondrial inhibition in calcium containing media, confirming its ability to cause an increase in cellular permeability to calcium. However, A23187 did not alter the rates of cell death of totally metabolically inhibited myocytes in either calcium-containing or calcium-free media with EGTA. The results indicate that influxes of calcium are not necessary for the development of irreversible injury in metabolically inhibited, isolated myocytes.

An in vitro model of myocardial ischemia utilizing isolated adult rat myocytes.

Isolated adult rat myocytes were used to develop an in vitro model of myocardial ischemia. Freshly isolated myocytes were spun into a cell pellet to limit extracellular volume. Excess supernatant was removed and the pellet was covered with mineral oil and incubated in a temperature controlled water bath. After various periods of incubation, cells were analyzed for adenine nucleotide levels, lactate accumulation, rate of cell death, and cell morphology. Adenine nucleotide profiles after 60 min incubation at 37 degrees C showed marked depletion of adenosine triphosphate (ATP) and large increases in adenosine monophosphate (AMP), adenosine, inosine, and lactate and no significant difference in levels of inosine monophosphate. These results are consistent with ischemic conditions. Reduction of the incubation temperature to 34 and 30 degrees C slowed the rate of cell squaring and the onset of cell death. Resuspension of ischemic cells after 30, 45, 60 and 90 min incubation in hypotonic buffer (170 mosmol) to induce acute cell swelling caused an increase in the number of non-viable cells at each time point. Control cells and ischemic cells incubated less than 30 min did not show increases in non-viable cells when subjected to hypotonic swelling. Morphological analysis revealed that isolated myocytes respond to ischemia in a heterogeneous fashion and exhibit changes at both light and electron microscopic levels similar to those seen in other ischemic models. These results indicate that pelleted isolated adult rat myocytes may be a useful in vitro model to study myocardial ischemic cells injury.