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Longhurst P, Burnette CB. Challenges and opportunities for conceptualizing intuitive eating in autistic people. Int J Eat Disord 2023; 56:2189-2199. [PMID: 37794653 PMCID: PMC10840701 DOI: 10.1002/eat.24057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 10/06/2023]
Abstract
Although intuitive eating (IE) has become an increasingly adopted intervention target, current conceptualisations of IE have yet to pivot away from (neuro)normative physiology and phenomenology. Autistic individuals commonly report disordered eating behaviours and/or poorer well-being but appear to benefit from adaptive interventions using an affirmative approach. This article uses autism as a case example to summarise challenges related to IE's prevailing conceptualisation, before proposing how future research and current practice can be extended to the autistic population. Scholars are encouraged to evaluate the full 10-principal IE framework while utilising a participatory-led approach. We argue that research using a mixed methods design is urgently needed to comprehensively explore the (re)conceptualisation of IE in autistic people. While IE shows promise for producing positive outcomes in the autistic population, we discuss the potential challenges for research and practice due to its current emphasis on accurate interoception, emotional awareness and processing, and executive functioning. This suggests the need for research and practice to integrate autistic needs and experiences into future developments with an affirmative approach. Public Significance: IE is an effective intervention for reducing disordered eating behaviours. Autistic individuals commonly present disordered eating behaviours and have unique nutritional needs which often require intervention. However, there is limited understanding of IE among the autistic population. Research-informed definitions involving autistic perspectives will support translating the IE framework to this underrepresented population.
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Affiliation(s)
- Phaedra Longhurst
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK
| | - C Blair Burnette
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
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Basinger ED, Cameron SJ, Allen G. Stigma, Self-Care, and Intuitive Eating in Black Americans with Type 2 Diabetes. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01772-6. [PMID: 37626193 DOI: 10.1007/s40615-023-01772-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/20/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023]
Abstract
Type 2 diabetes is prevalent among Black Americans. Stigma associated with type 2 diabetes, both in general and specific to weight, is damaging to self-care, which is crucial for the effective management of diabetes. Family relationships may buffer the negative impact of stress, especially among Black Americans who have historically relied on informal support networks. Our goal was to investigate how type 2 diabetes stigma (H1) and weight stigma (H2) were related to self-care and intuitive eating - a non-restrictive approach to nutrition; H3 predicted that family relationship satisfaction would moderate the relationships predicted in H1 and H2. Black Americans diagnosed with type 2 diabetes (N = 225) were recruited via Qualtrics panels to complete an online survey of self-report measures. We used multiple linear regression to test our hypotheses. Both chronic illness and weight stigma were related as predicted to one subscale of intuitive eating (eating for physical hunger). Our moderation analyses revealed that family relationship satisfaction was protective against the harms of stigma at moderate to high levels. Intuitive eating is a promising non-restrictive treatment option for type 2 diabetes.
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Affiliation(s)
- Erin D Basinger
- Department of Communication Studies, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC, 28223, USA.
| | - Shanice Jones Cameron
- Department of Communication Studies, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC, 28223, USA
| | - Gracie Allen
- Department of Communication Studies, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC, 28223, USA
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KOÇAK Ö, YILDIRIM Y, ŞARER YÜREKLİ B. The relationship between intuitive eating and eating attitude and glycemic control in patients with type 2 diabetes mellitus. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1167421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Amaç: Bu çalışma, Tip 2 Diabetes Mellitus (T2DM) hastalarında sezgisel yemenin yeme tutumu ve glisemik kontrol ile ilişkisini belirlemek amacıyla yapılmıştır.
Gereç ve Yöntem: Araştırmanın örneklemini; 18 Kasım 2019 – 12 Mart 2020 tarihleri arasında Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı Polikliniği’ne gelen T2DM tanılı ve dahil edilme kriterlerini karşılayan 385 birey oluşturmuştur. Çalışma verileri; bireylerin demografik bilgilerine, sağlık bilgilerine ve biyokimyasal verilerine yönelik sorular ile Sezgisel Yeme Ölçeği (IES-2) ve Yeme Tutum Testinin (EAT-26) yer aldığı bir form kullanılarak yüz yüze görüşme yöntemi ile elde edilmiştir.
Bulgular: Çalışmaya katılan bireylerin yaş ortalaması 59,12±9,78 olup %62,6’sı kadındı. Sezgisel yeme ile bireylerin vücut ağırlığı, BKİ değeri, bel çevresi ve trigliserit değeri arasında istatistiksel olarak negatif yönde ve zayıf düzeyde anlamlı bir ilişki saptandı (p<0,05). EAT-26 puanı ile IES-2 alt ölçeklerinden olan “duygusal sebeplerden ziyade fiziksel sebeplerle yeme” alt ölçeği arasında istatistiksel olarak negatif yönde ve zayıf düzeyde anlamlı bir ilişki belirlendi (p<0,05). Ayrıca EAT-26 puanı ile “açlık ve tokluk işaretlerine güven” alt ölçeği arasında istatistiksel olarak pozitif yönde ve zayıf düzeyde anlamlı bir ilişki bulundu (p<0.05).
Sonuç: Çalışma sonucunda; sezgisel yeme ile T2DM’li bireylerin antropometrik ölçümleri, trigliserit değerleri ve yeme tutumları arasında zayıf düzeyde anlamlı ilişki olduğu belirlenmiştir. Sezgisel yemenin yeme tutumu ve glisemik kontrol ile arasındaki nedensellik ilişkisini daha iyi belirleyebilmek için ileri çalışmalara ihtiyaç vardır.
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Affiliation(s)
- Özlem KOÇAK
- Ege Üniversitesi, Sağlık Bilimleri Enstitüsü, Kronik Hastalıklar Anabilim Dalı, İzmir, Türkiye
| | - Yasemin YILDIRIM
- Ege Üniversitesi, Hemşirelik Fakültesi, İç Hastalıkları Hemşireliği Anabilim Dalı, İzmir, Türkiye
| | - Banu ŞARER YÜREKLİ
- Ege Üniversitesi, Tıp Fakültesi Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı, İzmir, Türkiye
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Jackson A, Sano Y, Parker L, Cox AE, Lanigan J. Intuitive eating and dietary intake. Eat Behav 2022; 45:101606. [PMID: 35231798 DOI: 10.1016/j.eatbeh.2022.101606] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 01/09/2023]
Abstract
Intuitive eating has been associated with positive health benefits, yet the research investigating intuitive eating with dietary intake is minimal, inconsistent, and may differ by sex and food security status. The purpose of this study is to identify relationships between intuitive eating and dietary intake in adults living in the US and explore differences by sex and food insecurity status. We recruited 308 adults 18 years and older living in the US to complete an online survey including demographic data, intuitive eating, a diet screener questionnaire, and food insecurity status. We used structural equation modeling to analyze relationships between intuitive eating subscales, calcium, whole grains, added sugars, vegetables, and fruits. Then, we explored differences by sex and food security status. Unconditional permission to eat was associated with a higher intake of added sugar, while body-food choice congruence was associated with a lower intake of added sugar and calcium, and a higher intake of vegetables and whole grains. Eating for physical rather than emotional reasons was associated with a higher intake of calcium and vegetables. Intuitive eating differed by sex and food security status. While intuitive eating is not consistently related to the intake of more nutritious foods, eating for physical rather than emotional reasons and body-food choice congruence may promote diet quality in a community sample. Men and food secure adults scored higher in intuitive eating suggesting tailored intuitive eating interventions may be essential to increase effectiveness.
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Affiliation(s)
- Alexandra Jackson
- Human Development, Washington State University, 14204 NE Salmon Creek Ave, Vancouver, WA 98686, United States of America.
| | - Yoshie Sano
- Human Development, Washington State University, 14204 NE Salmon Creek Ave, Vancouver, WA 98686, United States of America
| | - Louise Parker
- Extension Youth and Families Unit, Human Development, Washington State University, 3158 Fremont Ave, #361, Seattle, WA, United States of America
| | - Anne E Cox
- Kinesiology & Educational Psychology, College of Education, Washington State University, Smith Gym 213C, Pullman, WA 99164, United States of America
| | - Jane Lanigan
- Human Development, Washington State University, 14204 NE Salmon Creek Ave, Vancouver, WA 98686, United States of America
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Kumar NK, Merrill JD, Carlson S, German J, Yancy WS. Adherence to Low-Carbohydrate Diets in Patients with Diabetes: A Narrative Review. Diabetes Metab Syndr Obes 2022; 15:477-498. [PMID: 35210797 PMCID: PMC8863186 DOI: 10.2147/dmso.s292742] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 01/12/2022] [Indexed: 12/13/2022] Open
Abstract
Evidence suggests that low carbohydrate (<130 g/day of carbohydrate) (LCD) and very low carbohydrate, ketogenic diets (typically <50 g/day of carbohydrate) (VLCKD) can be effective tools for managing diabetes given their beneficial effects on weight loss and glycemic control. VLCKD also result in favorable lipid profile changes. However, these beneficial effects can be limited by poor dietary adherence. Cultural, religious, and economic barriers pose unique challenges to achieving nutritional compliance with LCD and VLCKD. We review the various methods for assessing adherence in clinical studies and obstacles posed, as well as potential solutions to these challenges.
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Affiliation(s)
- Nitya Kalyani Kumar
- Division of Endocrinology, Diabetes, & Metabolism, Duke University, Durham, NC, USA
- Correspondence: Nitya Kalyani Kumar, 30 Duke Medicine Circle Clinic 1A, Durham, NC, 27710, USA, Email
| | - Jennifer D Merrill
- Division of Endocrinology, Diabetes, & Metabolism, Ohio State University, Columbus, OH, USA
| | - Scott Carlson
- Division of Endocrinology, Diabetes, & Metabolism, Duke University, Durham, NC, USA
| | - Jashalynn German
- Division of Endocrinology, Diabetes, & Metabolism, Duke University, Durham, NC, USA
| | - William S Yancy
- Duke Lifestyle and Weight Management Center and Division of General Medicine, Duke University, Durham, NC, USA
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Kato A, Fujimaki Y, Fujimori S, Isogawa A, Onishi Y, Suzuki R, Ueki K, Yamauchi T, Kadowaki T, Hashimoto H. Associations between diabetes duration and self-stigma development in Japanese people with type 2 diabetes: a secondary analysis of cross-sectional data. BMJ Open 2021; 11:e055013. [PMID: 35380981 PMCID: PMC8718458 DOI: 10.1136/bmjopen-2021-055013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES To examine the associations between self-stigma and diabetes duration in a sample of Japanese people with type 2 diabetes. DESIGN A secondary analysis of a cross-sectional study. SETTING Two university hospitals, one general hospital and one clinic in Tokyo, Japan. PARTICIPANTS Outpatients with type 2 diabetes aged 20-74 years and receiving treatment from diabetes specialist physicians (n=209) completed a self-administered questionnaire. PRIMARY AND SECONDARY OUTCOME MEASURES Self-stigma was measured as the primary outcome. Patient Activation Measure, body mass index and haemoglobin A1c were measured as secondary outcomes. RESULTS One-way analysis of covariance showed significant differences in self-stigma levels between the five groups of diabetes duration (≤5 years, 6-10 years, 11-15 years, 16-21 years and 22 years or more) after controlling for age, gender, education, marital status, diabetes treatment (insulin use) and diabetes-related complications, F(4,198)=2.83, p=0.026. Multiple comparisons using Bonferroni correction showed statistically significant differences in self-stigma levels between the groups with ≤5 years (95% CI 59.63 to 69.73) and 11-15 years with diabetes (95% CI 71.12 to 80.82; p=0.020). The highest mean level of self-stigma was observed in the group having diabetes for 11-15 years. CONCLUSIONS Self-stigma was associated with diabetes duration and was lowest after diagnosis and gradually increased, with its highest levels being observed in those having diabetes for 11-15 years. Self-stigma takes time to develop and gradually increases in individuals as it is learnt through direct experiences of diabetes-related stigma after self-administering treatment in everyday social situations.
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Affiliation(s)
- Asuka Kato
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Yuko Fujimaki
- Department of Internal Medicine, School of Medicine, Teikyo University, Tokyo, Japan
| | - Shin Fujimori
- Department of Internal Medicine, School of Medicine, Teikyo University, Tokyo, Japan
| | - Akihiro Isogawa
- Diabetes Care Division, Mitsui Memorial Hospital, Tokyo, Japan
| | - Yukiko Onishi
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
| | - Ryo Suzuki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Diabetes, Endocrinology and Metabolism, Tokyo Medical University, Tokyo, Japan
| | - Kohjiro Ueki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Diabetes Research Center, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Toranomon Hospital, Tokyo, Japan
| | - Hideki Hashimoto
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
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Lee H, Kwon M, Seo K. Validity and Reliability of the Korean Version of the Acceptance and Action Questionnaire-Stigma (AAQ-S-K). Healthcare (Basel) 2021; 9:healthcare9101355. [PMID: 34683035 PMCID: PMC8544514 DOI: 10.3390/healthcare9101355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 11/16/2022] Open
Abstract
This study investigated the validity and reliability of the Korean version of the Acceptance and Action Questionnaire-Stigma (AAQ-S-K) in people with diabetes. A total of 208 patients with diabetes participated in the study. After performing forward and backward translation of the original version of the AAQ-S into Korean, its validity (construct and concurrent validity) and reliability were assessed. Construct validity measured using confirmatory factor analysis showed a good fit. Concurrent validity was confirmed through the significant correlation between the AAQ-S-K, acceptance and action, diabetes self-stigma and diabetes distress. The AAQ-S-K was positively correlated with acceptance and action and had a negative correlation with diabetes self-stigma and diabetes distress. The reliability of the AAQ-S-K ranged from 0.82 to 0.88. The AAQ-S-K can be applied to assess stigma acceptance and action in Korean patients with diabetes and to compare the level of psychological flexibility of patients with diabetes internationally.
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Affiliation(s)
- Hyunjin Lee
- Department of Nursing, College of Nursing, Eulji University, Daejeon 34824, Korea;
| | - Myoungjin Kwon
- Department of Nursing, Daejeon University, Daejeon 34520, Korea
- Correspondence: (M.K.); (K.S.); Tel.: +82-42-280-2665 (M.K.); +82-41-750-6278 (K.S.)
| | - Kawoun Seo
- Department of Nursing, Joongbu University, Goyang 32713, Korea
- Correspondence: (M.K.); (K.S.); Tel.: +82-42-280-2665 (M.K.); +82-41-750-6278 (K.S.)
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Soares FLP, Ramos MH, Gramelisch M, de Paula Pego Silva R, da Silva Batista J, Cattafesta M, Salaroli LB. Intuitive eating is associated with glycemic control in type 2 diabetes. Eat Weight Disord 2021; 26:599-608. [PMID: 32232778 DOI: 10.1007/s40519-020-00894-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 03/21/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The intuitive eating approach has shown promise, but studies on its association with diabetics are scarce. The aim of this study is to identify the association between intuitive eating and glycemic control in individuals with type 2 diabetes mellitus. METHODS This is an observational cross-sectional analytical study in patients at the endocrinology service of a university hospital in Vitória/ES, Brazil. For data collection, a semi-structured questionnaire was used and intuitive eating was assessed by Intuitive Eating Scale-2. RESULTS A total of 179 individuals, mostly female and elderly, and predominantly taking oral antidiabetic drugs without association with insulin were evaluated. In adjusting for the total scale score, the most intuitive eating was associated with lower chances of patients presenting inadequate glycemic control by 89% (OR = 0.114; CI 0.024-0.540; p = 0.006), and a higher score on the Body-Food-Choice Congruence subscale was associated with lower chances of participants presenting this inadequacy by almost 66% (OR = 0.341; CI 0.131-0.891; p = 0.028), regardless of their body mass index. CONCLUSION Eating intuitively, especially in accordance with body needs may be associated with lower chances of type 2 diabetics having inadequate glycemic control. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Fabíola Lacerda Pires Soares
- Department of Integrated Health Education, Federal University of Espírito Santo, Marechal Campos Avenue, 1468, Maruípe, Vitória, ES, 29043, Brazil.
| | | | - Mariana Gramelisch
- Department of Integrated Health Education, Federal University of Espírito Santo, Marechal Campos Avenue, 1468, Maruípe, Vitória, ES, 29043, Brazil
| | - Rhaviny de Paula Pego Silva
- Department of Integrated Health Education, Federal University of Espírito Santo, Marechal Campos Avenue, 1468, Maruípe, Vitória, ES, 29043, Brazil
| | - Jussara da Silva Batista
- Department of Integrated Health Education, Federal University of Espírito Santo, Marechal Campos Avenue, 1468, Maruípe, Vitória, ES, 29043, Brazil
| | - Monica Cattafesta
- Graduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil
| | - Luciane Bresciani Salaroli
- Department of Integrated Health Education, Federal University of Espírito Santo, Marechal Campos Avenue, 1468, Maruípe, Vitória, ES, 29043, Brazil.,Graduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil.,Graduate Program in Nutrition and Health, Federal University of Espírito Santo, Vitória, Brazil
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Ochieng JM, Crist JD. "I put diabetes on the shelf": African-American Women's Perceptions of Risk for Diabetes Complications. Clin Nurs Res 2021; 30:1012-1022. [PMID: 33615849 DOI: 10.1177/1054773821996551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to describe the perceptions of African American (AA) women with Type 2 diabetes mellitus (T2DM) about developing diabetes mellitus (DM) complications and explore how their perceived risk influenced DM self-management. Ten (N = 10) AA women participated in the qualitative description study through semi-structured interviews. Thematic analysis informed by the Health Belief Model and Risk Perception Conceptual Model revealed the perceived probability of DM complications by AA women with T2DM and how they made judgments regarding the seriousness, extent, or severity of complications. Those with high levels of DM knowledge perceived themselves at high risk of developing DM complications and those with low DM knowledge perceived themselves at low risk of DM complications. Risk perceptions and health literacy also influenced DM self-management behaviors.
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Erhardt GA. Intuitive eating as a counter-cultural process towards self-actualisation: An interpretative phenomenological analysis of experiences of learning to eat intuitively. Health Psychol Open 2021; 8:20551029211000957. [PMID: 33786195 PMCID: PMC7961715 DOI: 10.1177/20551029211000957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This research presents an in-depth idiographic study that illustrates how learning to eat intuitively involves socio-cultural challenges, strategies of resistance and self-actualising processes. Interviews were conducted with eight women who had been practising intuitive eating (IE) for at least 1.5 years. Data was analysed using IPA and four themes were drawn inductively from the data: IE as an ongoing process, perceived judgement of others, strategies of resistance and processes of self-actualisation. Further research is needed to explore experiences of learning to eat intuitively amongst different samples and with different cultures, and to further investigate the relationship between IE and the actualising tendency.
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Effects of Fasting-Mimicking Diet and Specific Meal Replacement Foods on Blood Glucose Control in Patients with Type 2 Diabetes: A Randomized Controlled Trial. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:6615295. [PMID: 33376581 PMCID: PMC7744181 DOI: 10.1155/2020/6615295] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/16/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022]
Abstract
Type 2 diabetes represents a serious societal health problem due to the vulnerability to cardiovascular events. Diet therapy is the most basic treatment for type 2 diabetes. The present study was conducted to study the effect of a fasting-mimicking diet and specific meal replacement foods on blood glucose control in patients with type 2 diabetes. Our study included 100 patients with type 2 diabetes who underwent a physical examination which were enrolled and randomly assigned as 50 patients each to the test group (with low energy-specific meal replacement meals during a fasting-mimicking diet) and the control group (with specific meal replacement foods given normal adult doses). After 4 months, efficacy indicators which were fasting blood glucose, 2-hour postprandial venous blood glucose, and glycosylated haemoglobin of the experimental group were all lower than those of the control group (P < 0.05); observation indicators that include body mass index, waist circumference, blood lipids (triglyceride, cholesterol, and low-density lipoprotein), and blood pressure levels were all lower than the control group, and high-density lipoprotein levels were all higher than the control group (all P < 0.05). Both groups of fasting blood glucose, 2-hour postprandial venous blood glucose, and blood pressure had a relatively stable downward trend, but the experimental group had a more significant decline. In conclusion, the study revealed that a fasting-mimicking diet and specific meal replacement foods can safely and effectively reduce weight and improve metabolic syndrome in patients with type 2 diabetes.
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Goode RW, Cowell MM, Mazzeo SE, Cooper-Lewter C, Forte A, Olaiya OI, Bulik CM. Binge eating and binge-eating disorder in Black women: A systematic review. Int J Eat Disord 2020; 53:491-507. [PMID: 31922293 PMCID: PMC8010989 DOI: 10.1002/eat.23217] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/03/2019] [Accepted: 12/05/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Although several effective behavioral treatments for binge-eating disorder (BED) exist, there are racial disparities in treatment access, with African-Americans and/or Black individuals having some of the lowest rates of access to care. Little is known about the experience and treatment of binge eating (BE) and BED among Black women. METHOD This systematic review, conducted according to PRISMA guidelines, synthesizes information related to BE and BED in Black women. RESULTS A total of N = 38 studies met our eligibility criteria. We did not identify any systematic risk of bias across studies. The majority of included studies used cross-sectional survey methodology, and relied on interview (EDE) and self-report measures (particularly the Binge Eating Scale, BES) for the assessment of BE. Outcomes were inconsistently measured across trials, and there are limited data on the results of evidence-based treatments for BE/BED in Black women. DISCUSSION Although Black women have similar or higher rates of BE than White women, most research on BE and BED has focused on White women, with Black individuals underrepresented in clinical trials. Future research should examine evidence-based treatments to prevent and treat BED in this population. OBJETIVO Aunque existen varios tratamientos conductuales que son efectivos para el Trastorno de Atracones (BED, por sus siglas en inglés), existen disparidades raciales en el acceso a tratamiento, con individuos Afroamericanos y/o personas de color teniendo algunas de las tasas más bajas de acceso al cuidado de la salud. Se sabe muy poco acerca de la experiencia y tratamiento del comer en atracones (BE, por sus siglas en inglés) y BED entre mujeres afroamericanas y/o de color. MÉTODO: Esta revisión sistemática, realizada bajo lineamientos de las guías PRISMA, sintetiza información relacionada con BE y BED en mujeres afroamericanas y/o de color. RESULTADOS Un total de N = 38 estudios cumplieron con nuestros criterios de elegibilidad. No identificamos ningún riesgo sistemático de sesgo entre los estudios. La mayoría de los estudios incluidos utilizaron una metodología de encuesta transversal y se basaron en la entrevista (EDE) y las medidas de autoinforme (en particular, la Binge Eating Scale, BES) para la evaluación de BE. Los resultados se midieron de manera inconsistente entre los ensayos, y hay datos limitados sobre los resultados de los tratamientos basados en la evidencia para BE/BED en mujeres afroamericanas y/o de color. DISCUSIÓN: Aunque las mujeres afroamericanas y/o de color tienen tasas similares o más altas de BE que las mujeres blancas, la mayoría de las investigaciones sobre BE y BED se han centrado en las mujeres blancas, con individuos afroamericanos y/o de color subrepresentados en ensayos clínicos. La investigación futura debería examinar los tratamientos basados en la evidencia para prevenir y tratar el BED en esta población.
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Affiliation(s)
- Rachel W. Goode
- School of Social Work, University of North Carolina at
Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Mariah M. Cowell
- School of Social Work, University of North Carolina at
Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Suzanne E. Mazzeo
- Department of Psychology, Virginia Commonwealth University,
Richmond, VA, 23284, USA
| | - Courtney Cooper-Lewter
- School of Social Work, University of North Carolina at
Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Alexandria Forte
- School of Social Work, University of North Carolina at
Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Oona-Ifé Olaiya
- School of Social Work, University of North Carolina at
Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, SE-17177 Stockholm, Sweden,Department of Psychiatry, University of North Carolina,
Chapel Hill, NC, 27599, USA,Department of Nutrition, University of North Carolina,
Chapel Hill, NC, 27599, USA
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Goode RW, Kalarchian MA, Craighead L, Conroy MB, Gary-Webb T, Bennett E, Cowell MM, Burke LE. Perceptions and experiences of appetite awareness training among African-American women who binge eat. Eat Weight Disord 2020; 25:275-281. [PMID: 30221323 PMCID: PMC6420865 DOI: 10.1007/s40519-018-0577-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 09/05/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Binge eating may contribute to the prevalence of obesity in African-American women. Yet, there has been scant intervention research on the treatment of binge eating in this population. We tested the feasibility of an appetite awareness training (AAT) intervention in a sample of African-American women with binge and overeating behaviors. Participants who completed AAT were recruited to participate in focus groups to elicit information about their perceptions and experiences with this intervention to inform the design of future interventions to treat binge eating and obesity in African-American women. METHODS African-American women, aged 18-70 years, who had completed an 8-week randomized AAT intervention, were invited to attend a focus group discussion. Session content was recorded and transcribed. Data were analyzed by use of open coding. Themes were identified that described their perceptions and experiences of participating in the intervention. RESULTS Seventeen women participated in three focus group discussions. Pertinent themes identified included: paying attention to internal cues of hunger and satiety, influence of culture on eating patterns, breaking patterns of disordered eating, and perceptions about weight. Overall, participants were satisfied with their experience of AAT, and reported they found it valuable to learn about listening to biological signals of hunger and satiety and to learn specific strategies to reduce maladaptive eating patterns. CONCLUSION AAT was acceptable and provided helpful eating behavior instruction to African-American women with reported binge and overeating behaviors. Future research should examine the potential of AAT to improve weight management in this underserved population. LEVEL OF EVIDENCE Level V, qualitative descriptive study.
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Affiliation(s)
- Rachel W Goode
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, Campus Box #3550, Chapel Hill, NC, 27599-3550, USA.
| | | | - Linda Craighead
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Molly B Conroy
- Division of General Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Tiffany Gary-Webb
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Mariah M Cowell
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, Campus Box #3550, Chapel Hill, NC, 27599-3550, USA
| | - Lora E Burke
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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Lee LT, Jung SE, Bowen P, Clay OJ, Locher JL, Cherrington AL. Understanding the Dietary Habits of Black Men With Diabetes. J Nurse Pract 2019; 15:365-369. [PMID: 31700501 PMCID: PMC6836436 DOI: 10.1016/j.nurpra.2018.12.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Diabetes is highly prevalent in African American men. To provide nurse practitioners with practice strategies we explored African American men's perceived needs for dietary health and diabetes self-management using the Social Cognitive Theory. Twenty-five African American men participated in four focus groups. The data were analyzed using a combination of inductive/deductive content analysis approach. Focus group analysis identified personal, behavioral and environmental barriers to and facilitators for diabetes self-management. Nurse practitioners may need to provide extra emotional support in the absence of informal social support from families for diabetes self-management and dietary health in African American men with diabetes.
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Affiliation(s)
- Loretta T Lee
- University of Alabama at Birmingham, School of Nursing, Acute, Chronic, and Continuing Care, Birmingham, AL USA. 1-205-996-5826
| | - Seung E Jung
- The University of Alabama, Department of Human Nutrition and Hospitality and Management, Tuscaloosa, AL USA. 1-205-348-6560
| | - Pamela Bowen
- University of Alabama at Birmingham, School of Nursing, Acute, Chronic, and Continuing Care, Birmingham, AL USA. 1-205-934-2778
| | - Olivio J Clay
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL USA 1-205-934-2728
| | - Julie L Locher
- University of Alabama at Birmingham, School of Public Health, Department of Health Care Organization and Policy, Birmingham, AL USA. 1-205-934-7542
| | - Andrea L Cherrington
- University of Alabama at Birmingham, Department of Medicine, Division of Preventive Medicine, Birmingham, AL USA 1-205-996-2885
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15
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Okoro FO, Veri S, Davis V. Culturally Appropriate Peer-Led Behavior Support Program for African Americans With Type 2 Diabetes. Front Public Health 2018; 6:340. [PMID: 30533408 PMCID: PMC6265436 DOI: 10.3389/fpubh.2018.00340] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 11/02/2018] [Indexed: 11/15/2022] Open
Abstract
Current literature poorly defines the specific ways trained peer supporter influences health care behaviors. This study attempts to identify the key defining features of a culturally appropriate peer support program for African Americans with type 2 diabetes by exploring participants experiences related to assistance with daily disease management, emotional support, linkage to clinic care and community resources, and ongoing support. We used a qualitative interpretive descriptive approach to collect data through semi-structured interviews from 20 African Americans with type 2 diabetes participating in a peer support program. Interviews captured participants' background and experiences with the peer supporter and evaluated the cultural appropriateness of the peer support intervention. Data was coded deductively using predetermined codes found in the peer support literature and inductively to identify emergent themes. Three specific themes were identified namely [1] healthy behaviors [2] frequent telephonic contact and [3] emotional support as a by-product of other support activities. These findings mirror the broader literature on what constitutes culturally appropriate peer support programs for ethnic minorities. We recommend the inclusion of culturally appropriate peer support program to complement diabetes management as targeted plan for improvement in clinical care and ultimately, diabetes outcome.
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Affiliation(s)
- Florence O Okoro
- School of Nursing, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Shelby Veri
- Department of Public Health, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Valencia Davis
- Community Care Partners of Greater Mecklenburg, Charlotte, NC, United States
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16
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Goode RW, Kalarchian MA, Craighead L, Conroy MB, Wallace J, Eack SM, Burke LE. The feasibility of a binge eating intervention in Black women with obesity. Eat Behav 2018; 29:83-90. [PMID: 29549863 PMCID: PMC5935580 DOI: 10.1016/j.eatbeh.2018.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 02/20/2018] [Accepted: 03/08/2018] [Indexed: 12/21/2022]
Abstract
INTRODUCTION U.S. Black women have the highest rates of obesity and report frequent binge eating behaviors. To our knowledge, no intervention research has aimed to treat binge eating specifically among Black women. The purpose of this study was to investigate the feasibility and preliminary effect of Appetite Awareness Treatment (AAT), an 8-week cognitive-behavioral binge eating intervention, among Black women with obesity, and who report binge eating. METHODS Participants (N = 31), had a mean (±SD) age of 48.8 ± 12.8 years, a body mass index of 33.7 ± 3.9 kg/m2, and reported at least one binge eating episode monthly over the last three months. Using a randomized controlled trial design, Black women were randomized to AAT or a wait-list control group (WAIT) group. We examined recruitment, attendance, retention, and adherence. Linear mixed models explored preliminary differences between the AAT and WAIT on the primary outcome variables of binge eating and eating self-efficacy measured at baseline and 8-weeks. RESULTS Approximately one-third of screened participants were eligible and did enroll. Participants completed 55% of homework assignments, and attended 59% of intervention sessions. Retention to AAT was 87.5%. Compared to participants in the WAIT group, AAT participants had greater decreases in binge eating scores and greater improvements in eating self-efficacy scores at the end of Week 8. CONCLUSION Results suggest that AAT is feasible among Black women with binge eating behaviors, with evidence of preliminary efficacy, providing a rationale for a trial of AAT in a larger sample of Black women.
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Affiliation(s)
- Rachel W. Goode
- Schools of Social Work and Nursing, 2117 Cathedral of Learning, Pittsburgh, PA 15260 University of Pittsburgh,School of Social Work, University of North Carolina at Chapel Hill; 325 Pittsboro Street; CB #3550; Chapel Hill, NC 27599-3550
| | - Melissa A. Kalarchian
- School of Nursing, Duquesne University; Fisher Hall, 600 Forbes Avenue, Pittsburgh, PA 15282
| | - Linda Craighead
- Department of Psychology, Emory University; 201 Dowman Drive; Atlanta, GA 30322
| | - Molly B. Conroy
- Division of General Internal Medicine, University of Utah, 30 N 1900E.; Room 9R218; Salt Lake City, Utah 84132
| | - John Wallace
- Schools of Social Work and Nursing, 2117 Cathedral of Learning, Pittsburgh, PA 15260 University of Pittsburgh
| | - Shaun M. Eack
- Schools of Social Work and Nursing, 2117 Cathedral of Learning, Pittsburgh, PA 15260 University of Pittsburgh
| | - Lora E. Burke
- Schools of Social Work and Nursing, 2117 Cathedral of Learning, Pittsburgh, PA 15260 University of Pittsburgh
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17
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Abdoli S, Doosti Irani M, Hardy LR, Funnell M. A discussion paper on stigmatizing features of diabetes. Nurs Open 2018; 5:113-119. [PMID: 29599986 PMCID: PMC5867293 DOI: 10.1002/nop2.112] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 10/23/2017] [Indexed: 02/06/2023] Open
Abstract
Aim This manuscript aims to describe stigmatizing features of diabetes. Design This article presents a narrative review of literature pertaining to stigma surrounding diabetes in different contexts. Methods A literature search was conducted in CINAHL, PubMed and Web of Science for qualitative studies published between 2007-2017. The search was completed using various combinations of diabetes, T1DM, T2DM, stigma, social/public stigma, internalized/self-stigma, stigmatization and diabetes-related stigma in English. The reviewers then independently reviewed the eligible studies (N = 18) to extract data. Results From the 18 studies included in this narrative review, seven features related to stigma in diabetes were identified. People with diabetes were most notably considered and stigmatized as being "sick," "death reminder," "rejected marriage candidate," "self-inflicting," "contagiousness," "requiring a dietary modification" and "drunk or drug abuser."
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Affiliation(s)
- Samereh Abdoli
- College of Nursing University of Tennessee Knoxville TN USA
| | | | - Lynda R Hardy
- College of Nursing University of Tennessee Knoxville TN USA
| | - Martha Funnell
- Department of Learning Health Sciences University of Michigan Medical School Ann Arbor MI USA
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"They called me a terrorist": Social and Internalized Stigma in Latino Youth with Type 1 Diabetes. HEALTH PSYCHOLOGY REPORT 2018; 6:307-320. [PMID: 31032396 DOI: 10.5114/hpr.2018.80004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Diabetes-related stigma (DRS) globally affects patients' lives. Over a third of adolescents with type 1 diabetes (T1D) in Puerto Rico reported concerns of others knowing about their diabetes and about being different. Participants and Procedures We examined DRS among 65 T1D Latino youth (aged 12-17). During a depression-treatment study screening, they answered open-ended questions about diabetes-related concerns/difficulties and issues bothering them while interacting with peers, family, and healthcare professionals because of T1D. Using content analysis, we classified responses into Social Stigma (SS), Internalized Stigma (IS), and No Stigma. Four SS and IS sub-categories were developed. Results After coding, inter-rater reliability (Cohen's kappa) ranged from .73 to .1.00 (p≤.001). Forty-four youth (67.69%) reported at least one DRS verbalization, and 25 reported more than one. Both SS and IS were identified in 32 (49.23%) adolescents. Among SS experiences were: "they call me a junkie [because of insulin shots]"; "they call me a terrorist [because of insulin pump]". IS verbalizations included: "I've never wanted to accept that I have T1D, so I don't practice good self-care"; "at times I do not feel the same as others". We found more stigma-related verbalizations among those from urban zones or larger families. DRS was related to increased depressive symptoms and risk of a depressive disorder. Peers were the main source of SS. Conclusion DRS was common, pervasive, and linked to depression. This study innovatively examines DRS in an exclusively T1D Latino and adolescent sample. Understanding its extent and nature is essential for developing interventions to address DRS.
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Vanstone M, Rewegan A, Brundisini F, Giacomini M, Kandasamy S, DeJean D. Diet modification challenges faced by marginalized and nonmarginalized adults with type 2 diabetes: A systematic review and qualitative meta-synthesis. Chronic Illn 2017; 13:217-235. [PMID: 27884930 DOI: 10.1177/1742395316675024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Diet modification is an important part of the prevention and treatment of type 2 diabetes, but sustained dietary change remains elusive for many individuals. This paper describes and interprets the barriers to diet modification from the perspective of people with type 2 diabetes, paying particular attention to the experiences of people who experience social marginalization. Methods A systematic review of primary, empirical qualitative research was performed, capturing 120 relevant studies published between 2002 and 2015. Qualitative meta-synthesis was used to provide an integrative analysis of this knowledge. Results Due to the central role of food in social life, dietary change affects all aspects of a person's life, and barriers related to self-discipline, emotions, family and social support, social significance of food, and knowledge were identified. These barriers are inter-linked and overlapping. Social marginalization magnifies barriers; people who face social marginalization are trying to make the same changes as other people with diabetes with fewer socio-material resources in the face of greater challenges. Discussion A social-ecological model of behavior supports our findings of challenges at all levels, and highlights the need for interventions and counseling strategies that address the social and environmental factors that shape and sustain dietary change.
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Affiliation(s)
- Meredith Vanstone
- 1 Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,2 Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - Alex Rewegan
- 3 MA Program in Social Anthropology, York University, Hamilton, ON, Canada
| | - Francesca Brundisini
- 2 Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.,4 Health Policy PhD Program, McMaster University, Hamilton, ON, Canada
| | - Mita Giacomini
- 2 Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.,5 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Sujane Kandasamy
- 5 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Deirdre DeJean
- 2 Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.,5 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
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20
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Lee LT, Willig AL, Agne AA, Locher JL, Cherrington AL. Challenges to Healthy Eating Practices: A Qualitative Study of Non-Hispanic Black Men Living With Diabetes. DIABETES EDUCATOR 2016; 42:325-35. [PMID: 27036128 DOI: 10.1177/0145721716640904] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to explore current dietary practices and perceived barriers to healthy eating in non-Hispanic black men with type 2 diabetes. METHODS Four 90-minute focus groups held in September and October 2011 were led by a trained moderator with a written guide to facilitate discussion on dietary practices and barriers to healthy eating. Participants were recruited from the diabetes database at a public safety-net health system in Jefferson County, Alabama. Two-independent reviewers performed content analysis to identify major themes using a combined deductive and inductive approach. RESULTS There were 34 male participants aged 18 years and older. Mean years living with diabetes was 9.6 ± 5.9. Sixty-two percent of participants perceived themselves to be in fair or poor health. Participants' self-reported eating practices did not always relate to hunger. Internal cues to eat included habit and response to emotions, and external cues to eat included media messaging, medication regimens, and work schedules. Men identified multiple barriers to healthy eating including hard-to-break habits, limited resources and availability of food at home and in neighborhood grocery stores, and perceived poor communication with health care professionals. CONCLUSION Non-Hispanic black men acknowledged the importance of healthy eating as part of diabetes self-management but reported various internal and external challenges that present barriers to healthy eating. Tailored strategies to overcome barriers to healthy eating among non-Hispanic black men should be developed and tested for their impact on diabetes self-management.
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Affiliation(s)
- Loretta T Lee
- School of Nursing, Acute, Chronic, and Continuing Care, University of Alabama at Birmingham (Dr Lee)
| | - Amanda L Willig
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham (Dr Willig)
| | - April A Agne
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham (Ms Agne, Dr Cherrington)
| | - Julie L Locher
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham (Dr Locher)
| | - Andrea L Cherrington
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham (Ms Agne, Dr Cherrington)
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21
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Wheeler BJ, Lawrence J, Chae M, Paterson H, Gray AR, Healey D, Reith DM, Taylor BJ. Intuitive eating is associated with glycaemic control in adolescents with type I diabetes mellitus. Appetite 2015; 96:160-165. [PMID: 26403933 DOI: 10.1016/j.appet.2015.09.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 07/28/2015] [Accepted: 09/13/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND While there have been considerable advances in the medical management of type 1 diabetes mellitus (T1DM), for many, glycaemic control remains substandard. Nutrition and eating behaviour are important additional factors to consider with regards to T1DM management and outcomes. Intuitive eating is one such factor, and has not previously been investigated in T1DM. With this in mind, we undertook a study examining the relationship between intuitive eating and glycaemic control in adolescents with T1DM. METHODS A case-control study of adolescents with established T1DM, and age/sex matched controls was conducted. Demographic information, the Intuitive Eating Scale (IES), and HbA1c were collected. Statistical analysis was undertaken to explore associations between the IES and HbA1c as a marker of glycaemic control. RESULTS Data on 38 adolescents with T1DM, and 39 age/sex matched controls were obtained. Those with T1DM had significantly lower (by 0.5 SD) IES scores compared to controls (p = 0.009). Higher values of both total IES and the Eating for physical rather than emotional reasons subscale were associated with lower HbA1c: HbA1c 22% lower/whole unit increase in total IES mean score, HbA1c 11% lower/whole unit increase in Eating for physical rather than emotional reasons mean score, p = 0.017 and p = 0.009 respectively. CONCLUSION In adolescents with T1DM, there appears to be a strong association between intuitive eating, in particular the effect of emotion on eating, and glycaemic control. In addition, those with T1DM have lower scores for their intuitive eating behaviour compared to controls. Emotional eating could be a future target for screening and potentially intervening in those with T1DM, as part of a wider treatment package to improve glycaemic control. Continuing efforts are needed to fully understand the important dynamics of diabetes, adolescence, diet, emotion, and how these factors affect long term outcomes in those with T1DM.
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Affiliation(s)
- B J Wheeler
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand; Edgar National Centre for Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand.
| | - J Lawrence
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - M Chae
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - H Paterson
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - A R Gray
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - D Healey
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - D M Reith
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - B J Taylor
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand; Edgar National Centre for Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand
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Barnett TM, Praetorius RT. Knowledge is (not) power: healthy eating and physical activity for African-American women. SOCIAL WORK IN HEALTH CARE 2015; 54:365-382. [PMID: 25905767 DOI: 10.1080/00981389.2015.1005272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
African-American women are more likely to be overweight or obese as compared to other ethnic groups. The purpose of this Qualitative Interpretive Meta-Synthesis (QIMS) was to explore the experiences that African-American women encounter when trying to eat healthily and maintain physical activity to inform practice and research. The QIMS included studies from various disciplines to understand the experiences of African-American women with eating healthily and being physically active. Five themes were identified: family; structured support; translating knowledge into behavior modifications; barriers to physical activity; and God is my healer. These themes enhance understanding of what African-American women know, their support system(s), and how cultural barriers impact nutrition and physical activity.
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Affiliation(s)
- Tracey Marie Barnett
- a School of Social Work , The University of Texas at Arlington , Arlington , Texas , USA
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23
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Anglin JC, Borchardt N, Ramos E, Mhoon K. Diet quality of adults using intuitive eating for weight loss - pilot study. Nutr Health 2013; 22:255-264. [PMID: 26399269 DOI: 10.1177/0260106015601943] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
As the incidence of obesity and related disease steadily increases, researchers and medical practitioners are continuously examining new approaches to prevent and manage the epidemic. Intuitive eating (IE) is a new and innovative approach that uses an individual's response to internal cues of hunger, satiety, and appetite, and replaces calorie restriction (CR). CR is the standard approach for weight reduction. This study was a randomized controlled trial with two groups in which we accessed records of the dietary intake of obese adults using CR and IE to achieve weight loss. The participants were sedentary obese individuals with no history of chronic diseases. They engaged in physical activity three times per week for 30 min and recorded their daily food intake in a food diary. Instructions were given for CR and IE at the start and midpoint of the study. The duration of the study was six weeks. Weight and waist circumference were measured, and body mass index (BMI) calculated. The CR group's total weight loss was significantly (p = 0.03) lower than that of the IE group. The CR group had consistent weight loss throughout the study, while the IE group's weight loss was significantly less at the endpoint compared to the midpoint. CR is a superior approach to weight management than IE.
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Affiliation(s)
- Judith C Anglin
- Department of Human Services and Consumer Sciences, Texas Southern University, USA
| | | | | | - Kendra Mhoon
- Department of Mathematics and Statistics, University of Houston, USA
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