Background and Purpose Accurate identification of risk factors for stroke is important for public health promotion and disease prevention. HDL cholesterol is a potential risk factor, yet its role in stroke risk is unclear, as is whether HDL cholesterol content or particle number might be a better indicator of stroke risk. Furthermore, the degree to which ethnicity moderates the risk is unknown. As such, the current study examines the associations between incident stroke and both HDL cholesterol concentration and particle number, and assesses the moderating role of race and ethnicity. Methods The sample is a racially diverse cohort of US adults between the ages of 45 - 84 years enrolled in the Multi-Ethnic Study of Atherosclerosis between 2000 - 2002 and followed until December 2011. The associations among cholesterol content and stroke risk, particle number and stroke risk, and the interaction with race were explored. Results The incidence of stroke was 2.6%. HDL cholesterol concentration (mmol/L) (Hazard Ratio (HR) = 0.56; 95% Confidence Interval (CI): 0.312 - 0.988) and number of large HDL particles (μmol/L) (HR = 0.52, CI: 0.278 - 0.956) were associated with lower stroke risk. When interactions with race were evaluated, the relationship between both HDL variables and stroke were significant in Blacks, but not other races. Conclusions Higher HDL cholesterol and a higher concentration of large particles are associated with lower risk of stroke in Blacks. Further research is needed to elucidate the mechanisms by which HDL subfractions may differentially affect stroke outcome in different races/ethnicities.
Objective To compare the characteristic meal patterns of adolescents with and without loss of control (LOC) eating episodes. Method The Eating Disorder Examination was administered to assess self-reported LOC and frequency of meals consumed in an aggregated sample of 574 youths (12-17 y; 66.6% female; 51.2% Caucasian; BMI-z: 1.38 ± 1.11), among whom 227 (39.6%) reported LOC eating. Results Compared to those without LOC, youth with LOC were less likely to consume lunch and evening meals (ps<.05), but more likely to consume morning, afternoon, and nocturnal snacks (ps≤.05), accounting for age, sex, race, socio-economic status, BMI-z, and treatment-seeking status. Discussion Adolescents with reported LOC eating appear to engage in different meal patterns compared to youth without LOC, and adults with binge eating. Further research is needed to determine if the meal patterns that characterize adolescents with LOC play a role in worsening disordered eating and/or excessive weight gain.
Depressive symptoms in youth may be a risk factor for obesity, with altered eating behaviors as one possible mechanism. We tested whether depressive symptoms were associated with observed eating patterns expected to promote excessive weight gain in two separate samples. In Study 1, 228 non-treatment-seeking youth, ages 12–17y (15.3 ± 1.4y; 54.7% female), self-reported depressive symptoms using the Beck Depression Inventory. Energy intake was measured as consumption from a 10,934-kcal buffet meal served at 11:00am after an overnight fast. In Study 2, 204 non-treatment-seeking youth, ages 8–17y (13.0 ± 2.8; 49.5% female), self-reported depressive symptoms using the Children’s Depression Inventory. Energy intake was measured as consumption from a 9,835-kcal buffet meal served at 2:30pm after a standard breakfast. In Study 1, controlling for body composition and other relevant covariates, depressive symptoms were positively related to total energy intake in girls and boys. In Study 2, adjusting for the same covariates, depressive symptoms among girls only were positively associated with total energy intake. Youth high in depressive symptoms and dietary restraint consumed the most energy from sweets. In both studies, the effects of depressive symptoms on intake were small. Nevertheless, depressive symptoms were associated with significantly greater consumption of total energy and energy from sweet snack foods, which, over time, could be anticipated to promote excess weight gain.
Objective-We used latent profile analysis (LPA) to classify children and adolescents into subtypes based on the overlap of disinhibited eating behaviors-eating in the absence of hunger, emotional eating, and subjective and objective binge eating.Method-Participants were 411 youth (8-18y) from the community who reported on their disinhibited eating patterns. A subset (n=223) ate ad libitum from two test meals.Results-LPA produced five subtypes that were most prominently distinguished by objective binge eating (OBE; n=53), subjective binge eating (SBE; n=59), emotional eating (EE; n=62), a mix of emotional eating and eating in the absence of hunger (EE-EAH; n=172), and no disinhibited eating n=64). Accounting for age, sex, race, BMI-z, the four disinhibited eating groups had more problem behaviors than no disinhibited eating (p=.001). OBE and SBE subtypes had greater BMI-z, percent fat mass, disordered eating attitudes, and trait anxiety than EE, . However, the OBE subtype reported the highest eating concern (p<.001) and the OBE, SBE, and EE subtypes reported higher depressive symptoms than EE-EAH and No-DE subtypes. Across both test meals, OBE and SBE consumed less percent protein and higher percent carbohydrate than the other subtypes (ps<.02), adjusting for age, sex, race, height, lean mass, percent fat mass, and total intake. EE also consumed greater percent carbohydrate and lower percent fat compared than . The SBE subtype consumed the least total calories (p=.01).Discussion-We conclude that behavioral subtypes of disinhibited eating may be distinguished by psychological characteristics and objective eating behavior. Prospective data are required to determine whether subtypes predict the onset of eating disorders and obesity. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptKeywords loss of control eating; emotional eating; eating in the absence of hunger; obesity; eating disorders Pediatric obesity (Ogden, Carroll, Kit, & Flegal, 2012) and disordered eating (Swanson, Crow, Le Grange, Swendsen, & Merikangas, 2011) are serious public health problems associated with psychiatric and medical comorbidity and reduced quality of life. Disinhibited eating-defined as bouts of overeating prompted by feelings of letting go or a lack of self-regulation-may represent an important set of modifiable behaviors that elevate risk for eating disorders and obesity in youth (Shomaker, Tanofsky-Kraff, & Yanovski, 2010). Research has revealed the presence of several types of disinhibited eating behaviors among youth, including eating in the absence of hunger, emotional eating, and loss of control eating. Laboratory studies have demonstrated that these behaviors can be observable in controlled settings among children and adolescents (Birch, Fisher, & Davison, 2003;Fisher & Birch, 2002;Fisher et al., 2007;Hilbert, Tuschen-Caffer, & Czaja, 2010;Shomaker, Tanofsky-Kraff, Zocca, et al., 2010;Tanofsky-Kraff, McDuffie, et al., 2009;Vannucci et al., 2011). Despite the likely centrality of aberrant eating ...
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