Associations of regular consumption of breakfast, lunch and dinner with Body Mass Index during adolescence: longitudinal findings by weight status among the Eating and Activity over Time 2010-2018 cohort.

OBJECTIVE: To examine how the associations between meal consumption and BMI over 8 years differ by weight status in a sample of adolescents. DESIGN: Longitudinal, population-based study. Breakfast, lunch and dinner consumption and BMI were self-reported. Linear regressions were used to examine how the associations between meal consumption and BMI differed by weight status. SETTING: Adolescents in the Minneapolis/St. Paul metropolitan area. PARTICIPANTS: Adolescents (n 1,471) were surveyed as part of the EAT 2010-2018 in 2009-2010 (Mage = 14·3 years) and 2017-2018 (Mage = 22·0 years). RESULTS: The prevalence of regular breakfast, lunch and dinner consumption (≥ 5 times/week) ranged from 45 to 65 %, 75 to 89 % and 76 to 94 %, respectively, depending on weight status category. Among adolescents with a sex- and age-specific BMI < 15th percentile, regular consumptions of breakfast, lunch and dinner during adolescence were positively associated with BMI in emerging adulthood compared with irregular consumption of breakfast, lunch and dinner (<5 times/week) after adjustment for socio-demographic characteristics (ß = 5·43, ß = 5·39 and ß = 6·46, respectively; all P-values <0·01). Among adolescents in the BMI 15-85th and 85-95th percentiles, regular consumptions of breakfast, lunch and dinner were positively associated with BMI but to a lesser extent (P-values <0·01). For participants with a BMI ≥ 95th percentile, regular consumptions of breakfast, lunch and dinner were positively associated with BMI, but the associations were not statistically significant (P-values > 0·05). CONCLUSIONS: The relationship between meal consumption during adolescence and BMI in emerging adulthood differs by adolescent weight status. Future studies should investigate underlying factors related to meal consumption routines and BMI.

Sex and ethnic/racial differences in disordered eating behaviors and intuitive eating among college student.

Introduction: Eating behaviors encompass disordered eating behaviors (e.g., overeating, binge eating, and associated symptoms of binge eating) and intuitive eating. Certain disordered eating behaviors, including binge eating, are more prevalent among female and ethnic/racial-minority college students than male and/or non-Hispanic White college students. However, sex and ethnic/racial differences among college students with other disordered eating (e.g., associated symptoms of binge eating) and intuitive eating behaviors remain unclear. Methods: In 2022, 887 college students (Mage = 20.9 ± 2.6 years) self-reported their sex, ethnicity/race, disordered eating behaviors (e.g., overeating, binge eating, associated symptoms of binge eating), and intuitive eating. To examine sex and ethnic/racial differences among these students, we used modified Poisson regressions for students who reported disordered eating and linear regressions for students who reported intuitive eating. Results: Except for overeating, disordered eating behaviors were more prevalent among female [adjusted prevalence ratio (aPR) = 1.3-1.8] than male college students after adjusting for sociodemographic variables, whereas intuitive eating scores did not differ by sex. Across ethnic/racial groups, disordered eating was more prevalent among all ethnic/racial-minority college students (aPR = 1.2-2.3) than non-Hispanic White college students after adjusting for sociodemographic variables. Moreover, non-Hispanic Black or African American college students had higher intuitive eating scores than non-Hispanic White college students (adjusted ß = 0.7, 95% CI = -0.2, 1.6). Conclusion: In our sample, notable differences emerged in the prevalence of disordered eating behaviors and mean scores by sex and ethnicity/race, while differences in intuitive eating scores emerged based on ethnicity/race.

Associations of positive childhood experiences with binge-eating disorder characteristics and intuitive eating among college students.

Childhood experiences encompass both adverse and positive childhood events. Adverse childhood experiences are positively associated with binge-eating disorder characteristics and inversely associated with intuitive eating in adults. However, to what extent positive childhood experiences (PCEs) are associated with binge-eating disorder characteristics and intuitive eating remains unclear. This study examined the associations of cumulative and individual PCEs with binge-eating disorder characteristics and intuitive eating among college students. Data were collected from 828 college students in 2022 (54.5% female, Mage 20.9 ± 2.6 years). PCEs were assessed using the Benevolent Childhood Experiences scale. Binge-eating disorder characteristics were assessed with the Questionnaire on Eating and Weight Patterns-5. Intuitive eating was assessed with the Intuitive Eating Scale-2. Associations of PCEs with binge-eating disorder characteristics and intuitive eating were examined using modified Poisson regressions and linear regressions. PCEs were cumulatively associated with binge-eating disorder characteristics and intuitive eating (p for trend <.05). College students in the low PCEs category (0-4 PCEs) had 1.37-1.92 times the prevalence of binge-eating disorder characteristics and had 3.89 points lower intuitive eating score than those in the high PCEs category (9-10 PCEs). Among the individual PCEs, intrapersonal PCE (i.e., feeling comfortable with oneself during childhood) was associated with both a lower prevalence of binge-eating disorder characteristics (aPR = 0.56-0.76) and a higher score of intuitive eating (adjusted ß = 1.87, 95% CI = 1.28-2.46) after adjustment for sociodemographic variables. Findings from this study suggest that PCEs may play a role in eating behaviors of college students. Future studies with nationally representative samples should prospectively examine associations of PCEs with binge-eating disorder characteristics and intuitive eating and explore the underlying mechanisms of the associations between PCEs and eating behaviors.

Adverse childhood experiences and disordered eating among middle-aged adults: Findings from the coronary artery risk development in young adults study.

Adverse childhood experiences (ACEs) include childhood abuse, neglect, and household substance abuse. Childhood abuse is a risk factor for disordered eating (DEB). Less well established are associations of childhood neglect and household substance abuse with DEB, and little research has examined ACE associations with DEB in middle adulthood. The objective of this study was to examine associations between ACEs and DEBs among middle-aged adults and examine sex differences. ACEs prior to age 18 were retrospectively assessed in the Coronary Artery Risk Development in Young Adults study in 2000-2001 (N = 3340, ages 32 to 46). DEB outcomes (i.e., concerns about weight and shape, anxiety about eating or food, unhealthy weight control behaviors, chronic dieting, overeating, and binge eating) were assessed in 1995-1996 (ages 27 to 41). Modified Poisson regressions estimated risk ratios (RRs) for associations of a history of any ACE, each ACE, and cumulative ACEs with DEB outcomes. Among women, emotional abuse, physical neglect, and emotional neglect were each modestly associated with most DEBs (RRs = 1.21-1.35, 1.21-1.45, and 1.23-1.41 across DEBs, respectively) after adjustment for sociodemographic variables, BMI, and depressive symptoms. A cumulative ACE score was associated with all DEBs in a stepwise manner (p for trend ≤0.05) except concerns about weight and shape and overeating. Among men, emotional abuse was most consistently related to the majority of DEBs (RRs = 1.23-1.92); household substance abuse was modestly associated with overeating (RR = 1.26, 95% CI = 1.04-1.53). ACEs were cumulatively associated with unhealthy weight control behaviors, overeating, and binge eating (p for trend <0.01).

Everyday discrimination as a predictor of maladaptive and adaptive eating: Findings from EAT 2018.

Various types of stressors are associated with maladaptive eating, but how the stressor of everyday discrimination (e.g., less respect, poorer service) relates to maladaptive eating and adaptive eating remains unclear. We examined everyday discrimination as a predictor of maladaptive and adaptive eating. Data were collected in a population-based study, Eating and Activity over Time (N = 1410, ages 18-30). Everyday discrimination was categorized as none, low, moderate, or high. Outcomes included maladaptive eating (i.e., overeating and binge eating) and adaptive eating (i.e., intuitive eating and mindful eating). Modified Poisson regressions estimated the prevalence ratios (PRs) for overeating and binge eating associated with everyday discrimination. Linear regressions estimated associations between everyday discrimination and intuitive and mindful eating scores. After adjustment for age, ethnicity/race, gender, and socioeconomic status, moderate and high levels of discriminatory experiences were each associated with a significantly greater prevalence of binge eating (PR = 2.2, [95% CI = 1.3-3.7] and PR = 3.1, [95% CI = 2.0-4.7], respectively) and lower intuitive (ß = -0.4, [95% CI = -0.7, -0.2] and ß = -0.5 [95% CI = -0.8, -0.3], respectively), and mindful eating scores (ß = -0.3, [95% CI = -0.6, -0.1] and ß = -0.5 [95% CI = -0.8, -0.3], respectively) compared to young adults with no discriminatory experience. Public health efforts to prevent maladaptive eating and encourage the adoption of adaptive eating should consider the potential contribution of everyday discrimination and the need to advocate for equity and inclusion.

Adverse experiences as predictors of maladaptive and adaptive eating: Findings from EAT 2018.

Adverse experiences, such as childhood abuse and other violence victimization, are associated with problematic eating. However, whether different types of adversity relate to both maladaptive and adaptive eating behaviors is unclear. This study examined the associations of different adverse experiences with maladaptive (i.e., overeating and binge eating) and adaptive (i.e., intuitive eating and mindful eating) eating by gender. Data were derived from the EAT-2018 (Eating and Activity over Time) study (N = 1411, aged 18-30 years in 2017-2018). Modified Poisson regressions were used to examine the associations between adverse experiences and the prevalence of maladaptive eating. Linear regressions were used to examine the associations between adverse experiences and adaptive eating scores. Each adverse experience was associated with greater prevalence of maladaptive eating and lower adaptive eating scores. Among women, intimate partner sexual violence was strongly associated with more overeating (PR = 2.1 [95% CI = 1.4-3.1]) and binge eating (PR = 2.4 [95% CI = 1.5-3.9]), and less mindful eating (ß = -0.6, [95% CI = -0.8, -0.3]); being attacked, beaten, or mugged was most associated with less intuitive eating (ß = -0.5, [95% CI = -0.8, -0.2]). Among men, being attacked, beaten, or mugged was strongly associated with more overeating (PR = 2.1 [95% CI = 1.2-3.5]) and binge eating (PR = 3.2 [95% CI = 1.6-6.5]); intimate partner physical violence was strongly associated with less intuitive eating (ß = -0.6, [95% CI = -0.9, -0.2]); childhood emotional abuse was strongly associated with less mindful eating (ß = -0.8, [95% CI = -1.0, -0.5]). To improve eating behaviors, adverse life experiences and the potential impact on maladaptive and adaptive eating should be considered.

Sexual and physical abuse and identity of the perpetrator: Associations with binge eating and overeating in Project EAT 2018.

BACKGROUND: Sexual and physical abuse are risk factors for binge eating and overeating, but few studies have examined association of the identity of the perpetrator with survivors' risk of binge eating and overeating. PURPOSE: To examine the risk of binge eating and overeating by (1) type of abuse and identity of the perpetrators and (2) cumulative abuse experiences/perpetrators. METHODS: Data came from Eating and Activity over Time (N = 1407; ages 18-30 during 2017-2018). Sexual abuse perpetrators included family members, non-family members, and intimate partners. Physical abuse perpetrators included family members and intimate partners. Cumulative abuse experiences were defined as the number of types of abuse experienced. Modified Poisson regressions were used to examine the risk of binge eating (overeating with loss of control) and overeating (without loss of control), by (1) abuse type and perpetrator and (2) cumulative abuse experiences. RESULTS: Abuse was more strongly associated with binge eating than overeating. For binge eating, risk factors included familial and intimate partner sexual abuse (RR = 1.48 [95% CI = 1.01-2.17] and 2.41, [95% CI = 1.70-3.41], respectively) and physical abuse (RR = 1.84, [95% CI = 1.33-2.53] and 1.95, [95% CI = 1.35-2.81], respectively), after adjustment for sociodemographic variables. For overeating, associations with physical abuse were close to the null, and those with sexual abuse were modest, with wide CIs that overlapped the null. Abuse experiences were cumulatively associated with binge eating, but not overeating. CONCLUSION: Assessment of identity of the perpetrator, and cumulative abuse experiences/perpetrators may assist in identifying people at the greatest risk of binge eating.

Adverse childhood experiences in relation to mood-, weight-, and eating-related outcomes in emerging adulthood: Does self-compassion play a buffering role?

BACKGROUND: Adverse childhood experiences (ACEs) are associated with a range of health problems, yet protective factors such as self-compassion may help buffer these associations. OBJECTIVE: This study examined associations of distinct patterns of ACEs with depressive symptoms, body mass index (BMI), and disordered eating symptoms and investigated self-compassion as a potential protective factor. PARTICIPANTS AND SETTING: Data from a diverse sample of 1440 emerging adults (Mage = 22.2 years; 53.7% female; 80.3% with race/ethnicity other than non-Hispanic white) came from the population-based EAT 2018 (Eating and Activity over Time) study. METHODS: Seven types of ACEs were retrospectively self-reported and used as model indicators in latent class analysis to identify patterns of ACEs. Self-compassion, depressive symptoms, height and weight (to calculate BMI), and disordered eating symptoms were also assessed. Demographic-adjusted regression models were conducted. RESULTS: Three latent classes emerged: "low ACEs" (66.5% of the sample), "household dysfunction" (24.3%), and "household dysfunction and abuse" (9.1%). Compared to participants in the "low ACEs" class, participants in either latent class involving household dysfunction demonstrated higher levels of depressive and disordered eating symptoms. Participants in the "household dysfunction and abuse" class also had higher BMI. Associations differed by self-compassion for depressive symptoms (pinteraction = 0.01), BMI (pinteraction = 0.03), and disordered eating symptoms (pinteraction = 0.005), such that associations for latent classes characterized by ACEs were weaker with higher levels of self-compassion. CONCLUSIONS: These findings suggest self-compassion may act as a buffer against adverse mood-, weight-, and eating-related outcomes in the face of adversity and therefore may be an important intervention target.

Childhood maltreatment and disordered eating attitudes and behaviors in adult men and women:Findings from project EAT.

This study examined gender differences in the association between childhood maltreatment and disordered eating attitudes and behaviors in adulthood. Data were derived from 1647 adults (ages 27-33) participating in a population-based, longitudinal study (Project EAT-IV: Eating Among Teens and Young Adults, 1998-2016). Childhood maltreatment (sexual abuse, physical abuse, emotional abuse, emotional neglect) and disordered eating attitudes and behaviors (overeating, binge eating, extreme weight control behaviors, unhealthy weight control behaviors, chronic dieting, weight and shape concerns) were assessed. Relative risk regression models were used to examine whether childhood maltreatment was related to individual disordered eating attitudes and behaviors. Gender differences in these associations were explored. A history of any childhood maltreatment was associated with more than 60% greater risk for chronic dieting and overeating, with additional associations found for binge eating, weight and shape concerns, and unhealthy weight control behaviors. All types of abuse and neglect were associated with at least one type of disordered eating outcome. Examination of the point estimates indicated that emotional neglect was most consistently related to higher risk for disordered eating attitudes and behaviors. Although there were no statistically significant gender differences in the association between childhood maltreatment and disordered eating attitudes and behaviors, the patterning of these effects highlighted unique qualitative similarities and differences in these relationships between men and women. Taken together, these findings implicate childhood maltreatment, particularly emotional neglect, as a meaningful risk factor for problematic eating outcomes in both men and women during adulthood.

A single summative global scale of disordered eating attitudes and behaviors: Findings from Project EAT, a 15-year longitudinal population-based study.

OBJECTIVE: The Project EAT Disordered Eating Attitudes and Behaviors (DEAB) scale was created from disordered eating attitudes and behaviors that tend to interrelate. To examine the appropriateness of the scale, we assessed the fit (i.e., how well a single latent factor fits a set of interrelated disordered eating attitudes and behaviors) and the convergent validity over time. METHOD: Five interrelated disordered eating attitudes and behaviors were assessed in a longitudinal cohort (Project EAT, age 11 to 18 in 1998-1999, N = 1492). Confirmatory factor analysis examined the appropriateness of the DEAB scale. To examine whether individual variables function differently in relation to the latent construct across time, two models were compared: one requiring indicator-level factor loadings to remain equivalent across three time points (baseline [EAT-I], five-year follow-up [EAT-II], and 15-year follow-up [EAT-IV]), and the second allowing the factor loadings to vary over time. To examine the convergent validity, Pearson correlation with body satisfaction, self-esteem, depressive symptoms, and BMI was compared across time. RESULTS: The fit indices for a single factor structure supported the use of the DEAB scale over time (standardized loadings: 0.60-0.87, 0.67-0.89, 0.59-0.77 at EAT-I, II, and IV respectively). As hypothesized, compared to fewer number of disordered eating attitudes and behaviors, greater number of attitudes and behaviors was associated with lower body satisfaction and self-esteem, and greater depressive symptoms and BMI (p < .01). DISCUSSION: The Project EAT DEAB scale can be used as a proxy to measure the severity of disordered eating attitudes and behaviors over time in population-based studies.

Disordered Eating Behaviors and 15-year Trajectories in Body Mass Index: Findings From Project Eating and Activity in Teens and Young Adults (EAT).

PURPOSE: Disordered eating behaviors are prevalent among adolescents. Understanding how these behaviors link to body mass index (BMI) across different stages of development and over an extended period may provide insight for designing interventions around eating and weight. This study had two objectives: (1) to assess the distribution of disordered eating behaviors and develop a global score of disordered eating behaviors among adolescents and (2) to examine the association between the number of disordered eating behaviors in adolescence and BMI trajectory over 15 years. METHODS: Project Eating and Activity in Teens and Young Adults (EAT), a longitudinal study of weight-related health and behavior comprising four waves (EAT-I to EAT-IV), measured seven disordered eating behaviors (importance of weight and shape, frequent dieting, extreme unhealthy weight control behaviors, overeating, distress about overeating, loss of control while overeating, and frequency of overeating and loss of control) at baseline (N = 1,230, ages 11 to 18 years, 1998-1999). These behaviors were summed to create a disordered eating behavior score. BMI was self-reported at all four waves (up to age 27-33 years at EAT-IV). Repeated measures with random slope and intercept examined the association between disordered eating behaviors and BMI trajectories over 15 years. RESULTS: At baseline, 50.7% and 33.7% of females and males endorsed disordered eating behaviors. Throughout 15 years of follow-up, sociodemographic-adjusted BMI was higher among adolescents who engaged in disordered eating behaviors. The association remained significant after further adjustment for baseline BMI (p < .05). CONCLUSIONS: Among adolescents, regardless of the type of disordered eating behaviors, engagement in disordered eating behavior predicted higher BMI in a dose-response fashion.

Problematic eating behaviors and attitudes predict long-term incident metabolic syndrome and diabetes: The Coronary Artery Risk Development in Young Adults Study.

BACKGROUND: Problematic relationship to eating and food (PREF) captures a broad range of unhealthy eating behaviors. We previously reported that higher BMI is associated with PREF and graded by the number of PREF endorsed. In this study, we prospectively examined the association between PREF and metabolic syndrome and diabetes. METHOD: Eight PREF behaviors were assessed and summed to form the PREF score in 3800 black and white adults (age 27-41 years) in the Coronary Artery Risk Development in Young Adults Study. Diagnoses of incident metabolic syndrome and diabetes were made through 15 years of follow-up. Logistic regression estimated the association with metabolic syndrome. Proportional hazards regression estimated the association with diabetes. RESULTS: The odds ratio of metabolic syndrome was 1.25 per PREF point through 5 years of follow-up (95% CI: 1.17-1.34) and 1.17 per point from 5 to 10 years of follow-up (95% CI: 1.08-1.27). Hazard of diabetes was 1.20 per PREF point through 15 years of follow-up (95% CI: 1.12-1.28). Both associations attenuated after adjustment for BMI. DISCUSSION: Among participants with PREF, higher scores associate with metabolic syndrome and diabetes, with partial attenuation after adjustment for BMI. Early identification of PREF in middle-aged adults may reduce the burden of metabolic health outcomes.

Questionnaire-based problematic relationship to eating and food is associated with 25 year body mass index trajectories during midlife: The Coronary Artery Risk Development In Young Adults (CARDIA) Study.

OBJECTIVE: Problematic eating behaviors and attitudes are of public health concern. Questionnaire-based assessment of these behaviors is important for large-scale research on eating behaviors. The questionnaire on eating and weight patterns-revised (QEWP-R) measures potential problematic behaviors and attitudes toward food (including anxieties, compensatory actions, overeating and loss of control, dieting, and shape concerns) that in aggregate may indicate diagnosable eating disorders. An important question regards the prevalence of these issues and their longitudinal associations with body mass index (BMI) in generally healthy middle aged adults. METHOD: Based on eight constructs measured on QEWP-R, we created a new problematic relationship to eating and food (PREF) scale by assigning a point for each construct endorsed. Analyses were conducted in 3,892 black and white men and women participating in the community-based Coronary Artery Risk Development in Young Adults (CARDIA) Study. The QEWP-R was administered in CARDIA year 10, when participants were aged 27-41 years. We used linear regression to model the relationship of individual constructs and the PREF scale to BMI over CARDIA follow-up. RESULTS: Fifty-five percent of participants had 1-5 points and 4% had 6-8 points on the PREF scale. Each separate construct was positively associated with BMI, except concern about weight and shape. Adjusting for age, race, sex, education, and study center, mean BMI at CARDIA year 10, the time of PREF assessment, was approximately 1.0-2.5 kg/m2 higher per PREF category. CONCLUSION: In middle age, problematic behaviors and attitudes toward food were common and associated with higher BMI.

Circulating Cellular Adhesion Molecules and Cognitive Function: The Coronary Artery Risk Development in Young Adults Study.

OBJECTIVE: Higher circulating concentrations of cellular adhesion molecules (CAMs) can be used as markers of endothelial dysfunction. Given that the brain is highly vascularized, we assessed whether endothelial function is associated with cognitive performance. METHOD: Within the Coronary Artery Risk Development in Young Adults (CARDIA) Study, excluding N = 54 with stroke before year 25, we studied CAMs among N = 2,690 black and white men and women in CARDIA year 7 (1992-1993, ages 25-37) and N = 2,848 in CARDIA year 15 (2000-2001, ages 33-45). We included subjects with levels of circulating soluble CAMs measured in year 7 or 15 and cognitive function testing in year 25 (2010-2011, ages 43-55). Using multiple regression analysis, we evaluated the association between CAMs and year 25 cognitive test scores: Rey Auditory Verbal Learning Test (RAVLT, memory), Digit Symbol Substitution Test (DSST, speed of processing), and the Stroop Test (executive function). RESULT: All CAM concentrations were greater in year 15 vs. year 7. Adjusting for age, race, sex, education, smoking, alcohol, diet, physical activity, participants in the fourth vs. the first quartile of CARDIA year 7 of circulating intercellular adhesion molecule-1 (ICAM-1) scored worse on RAVLT, DSST, and Stroop Test (p ≤ 0.05) in CARDIA year 25. Other CAMs showed little association with cognitive test scores. Findings were similar for ICAM-1 assessed at year 15. Adjustment for possibly mediating physical factors attenuated the findings. CONCLUSION: Higher circulating ICAM-1 at average ages 32 and 40 was associated with lower cognitive skills at average age 50. The study is consistent with the hypothesis that endothelial dysfunction is associated with worse short-term memory, speed of processing, and executive function.