MEDICAL MORBIDITY RISK IN A SAMPLE OF OLDER WOMEN WITH BINGE EATING

Binge eating (BE; consuming an abnormally large amount of food in one sitting while feeling out of control) is the most common form of disordered eating among older women, and aging may confer greater risk for medical morbidities. While the clinical phenotype of older women with BE is unknown, understanding health impacts of BE on the aging process is important. The objective of this study was to describe physiological characteristics of older women (aged 60+) with clinical levels of BE (i.e., ≥weekly episodes). Participants (N = 21; M age = 66.0±4.59) underwent a DEXA, indirect calorimetry, anthropometric measurements, and fasting blood labs. 76% of participants reported a BE age of onset in midlife or later (age 42+); the sample mean BMI was 35.08±8.64, with an average waist-to-hip ratio of 0.90±.047. DEXA scans indicated 90.48% were classified as overweight or obese. Using age- and gender-matched norms, mean fat percentile was 84.75±17.43; mean total body fat percentage was 47.0±4.5. Mean Resting Energy Expenditure (kcal/lean mass) was 34.2±3.71; average respiratory quotient was 0.81±0.06. HbA1c values indicated that 61.90% had pre-diabetes or diabetes; 47.61% had high fasting blood glucose and 76% had high LDL cholesterol. Mean bone mineral density (BMD) fell within a healthy range (1.11 g/cm2±.14); 33.33% had a BMD z-score of less than zero. Cardiovascular comorbidities were rare in this sample (9.5% had standard hypertension). Overall, metabolic disturbances were prevalent, while a minority had cardiovascular or skeletal morbidities. Findings suggest that BE may interfere with healthy aging predominantly through metabolic morbidities.

THE TOLL OF BINGE EATING ON AGING: THE PHYSICAL FUNCTIONING OF OLDER WOMEN WITH WEEKLY BINGE EATING

Binge eating (BE) is defined as eating an unusually large amount of food while feeling a loss of control; BE prevalence rates range from 12-26% in older adult women. BE is closely linked with obesity, depression, and poor micronutrient intake, as well as with cardiovascular issues and pain in younger populations. Among older adults, such morbidities can negatively affect quality of life and mobility. Yet, little is known about the toll of BE on the aging body in terms of physical function. Thus, the current investigation assessed the physical functioning of older women (60+ years) with clinical levels of BE (i.e., ≥weekly BE). Participants (N = 21) underwent several physical function tests including lower extremity functioning (Short Physical Performance Battery; SPPB), endurance (Six-Minute Walk Test), and grip strength. The majority of participants (76%) had a BE age of onset in midlife or later (age 42+). The average BMI was 35.08±8.64, and 90.48% met criteria for overweight or obesity. On the SPPB, 47.62% scored < 10, suggesting mobility limitations and predicting all-cause mortality. Most women (90.48%) scored >1SD below the age/gender matched norm on the Six-Minute Walk Test (M=355.96±67.04) while 61.9% scored >1SD below the norm for grip strength (M=24.91±6.40). Results indicate that older women struggling with BE also demonstrate diminished physical functioning, which confers risk for future health problems and poorer quality of life. Our findings suggest that intervention development for older populations struggling with BE may need to incorporate physical rehabilitation to promote healthy aging in this population.

Exercise and Creatine Supplementation to Augment the Adaptation of Exercise Training Among Breast Cancer Survivors Completing Chemotherapy: Protocol for an Open-label Randomized Controlled Trial (the THRIVE Study)

BACKGROUND

In breast cancer survivors, chemotherapy-induced muscle loss has been shown to be attenuated with structured resistance exercise. Creatine supplementation can increase bioenergetics in skeletal muscle, which helps to improve overall strength and endurance and reduce muscular fatigue. Therefore, we hypothesize that adding creatinine supplementation to exercise training will accelerate improvements in strength, endurance, and bioenergetics in breast cancer survivors.

OBJECTIVE

The primary objective is to determine the effects of combining creatine supplementation with exercise on modulating strength and physical function in breast cancer survivors by comparing these effects to those of exercise alone. The secondary objectives are to determine if creatine supplementation and exercise can increase the intramuscular storage of creatine and improve body composition by comparing this intervention to exercise alone.

METHODS

We aim to test our hypothesis by conducting an open-label randomized controlled trial of 30 breast cancer survivors who have completed chemotherapy within 6 months of enrollment. Eligible participants will be equally randomized (1:1) to either a creatine and exercise group or an exercise-only group for this 12-week intervention. Individuals who are randomized to receive creatine will be initially dosed at 20 g per day for 7 days to boost the availability of creatine systemically. Thereafter, the dose will be reduced to 5 g per day for maintenance throughout the duration of the 12-week protocol. All participants will engage in 3 center-based exercise sessions, which will involve completing 3 sets of 8 to 12 repetitions on chest press, leg press, seated row, shoulder press, leg extension, and leg curl machines. The primary outcomes will include changes in strength, body composition, and physical function in breast cancer survivors. The secondary outcomes will be intramuscular concentrations of creatine and adenosine triphosphate in the vastus lateralis, midthigh cross-sectional area, and quality of life.

RESULTS

As of October 2021, a total of 9 patients have been enrolled into the study. No unexpected adverse events have been reported.

CONCLUSIONS

Creatine is being studied as a potential agent for improving strength, endurance, and bioenergetics in breast cancer survivors following chemotherapy. The findings from our trial may have future implications for supporting breast cancer survivors in reversing the muscle loss experienced during chemotherapy and improving their physical function and quality of life.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04207359; https://clinicaltrials.gov/ct2/show/NCT04207359.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/26827.

Social Isolation in Older Women during the COVID-19 Pandemic: The impact on Quality of Life and Mental health

To mitigate the spread of COVID-19, countries worldwide enacted quarantines, particularly for older adults, as mortality from COVID-19 is inequitably distributed among this group. Notably, social isolation in older adults is associated with a heightened risk of cardiovascular, autoimmune, and mental health problems (e.g., depression, anxiety). Furthermore, the mental health of women in particular has been greatly impacted by the pandemic. Although previous research indicates that social isolation among older adults is a “serious public health concern”, less is known about the extent to which the COVID-19 pandemic has exacerbated this issue. The primary objective is to investigate the effects of social isolation on mental health indices and health-related quality of life (HRQOL) in older women in the context of the COVID-19 pandemic. Participants include 77 postmenopausal women (aged 60+) who completed self-report measures online during the COVID-19 pandemic. Controlling for education and annual household income in all analyses, we used linear regression models to investigate the effects of social isolation on depression, anxiety, alcohol use, binge eating, and the 8 domains of the SF-36. Results indicate that, when controlling for education and income, social isolation significantly predicted depression, binge eating, and poorer HRQOL in all 8 domains of the SF-36 (all p’s < .01) Social isolation did not predict anxiety and alcohol consumption when controlling for these sociodemographic variables. Enrollment is ongoing; this poster will report updated results. Results indicate the continued need for creative avenues to improve social connectedness during the COVID-19 pandemic.

A Comparison of Mental Health in a Sample of Older Women Before and During the COVID-19 Pandemic

The COVID-19 pandemic has substantially impacted lives globally. Due to age-related risks, the older adult population has uniquely experienced negative changes caused by the pandemic. Research has also shown that the pandemic has disproportionately affected women. Therefore, it is important to understand how the mental health of older women has been impacted during this global crisis. This study aims to examine the differences in mental health indices in a sample of older women before versus during the COVID-19 pandemic. To date, participants include 201 women (aged 60-94) who completed an online survey of self-report measures assessing depression, anxiety, alcohol use, binge eating, positive affect, and emotional quality of life (QOL). We conducted one-way ANOVAs to compare each mental health construct in two samples of older women collected pre- and peri-pandemic. Results indicated that the peri-pandemic group reported significantly higher anxiety (F = 5.25, p = .02), with a trend for more role limitations due to emotional problems (F = 2.79, p = .09), than the pre-pandemic group. No significant differences emerged for levels of depression, alcohol consumption, binge eating, positive affect, or emotional wellbeing between groups. These findings point to the psychological resilience of older adults in the face of extreme adverse events, including this global crisis. Older women, while impacted differently during the COVID-19 pandemic, reported minimal exacerbations of mental health problems compared to older women pre-pandemic. Efforts to identify moderators that may either attenuate or promote further psychological resilience among older adults is warranted.

Psychometric properties of the contextual body image questionnaire for athletes: a replication and extension study in female collegiate athletes

BACKGROUND

Although the link between body dissatisfaction and eating disorder (ED) pathology is well-established in general female samples, less is known about contextual body image (CBI) among female athletes. CBI refers to female athletes' body image concerns in two contexts: sport and daily life. The Contextual Body Image Questionnaire for Athletes (CBIQA) measures four dimensions of body image (Appearance, Thin-Fat Self-Evaluation, Thin-Fat Others' Evaluation, and Muscularity) in both contexts. In a sample of female collegiate athletes, this study sought to A) investigate the psychometric properties of the CBIQA, B) examine the cross-sectional relation of CBI with ED pathology and negative affect, and C) assess the degree to which CBI prospectively predicts ED pathology and negative affect.

METHOD

Using self-report data collected from a multi-site parent trial, we examined the psychometric properties of the CBIQA by confirmatory factor analysis. We assessed construct and criterion validity via cross-sectional bivariate correlation analyses with thin-ideal internalization, negative affect, and ED pathology. Using data from Time 1 and 6 months later (Time 2), we investigated the degree to which CBI prospectively predicted ED pathology and negative affect.

RESULTS

Results from the CFA largely confirmed de Bruin et al.'s (2011) original factor analysis. Two CBIQA dimensions (Thin-Fat Self and Appearance) in both contexts correlated with ED pathology and negative affect. Thin-Fat Others also correlated with ED pathology in both contexts and negative affect in the sport context. The Muscularity dimension was predominantly orthogonal with other measures. CBIQA dimensions were uncorrelated with thin-ideal internalization. When controlling for BMI and Time 1 scores, daily life and sport appearance concerns predicted ED pathology, whereas perceived evaluation of thin-fat by others in the sport context predicted negative affect 6 months later.

CONCLUSIONS

Results support the psychometric validity of the CBIQA and suggest that it captures variance discrete from thin-ideal internalization. The Muscularity dimension largely was not related to other outcomes. Further, specific elements of perceived self- and other-evaluation in both contexts is relevant to risk for ED pathology and negative affect. Future research could examine the impact of dual body image between sports seasons and after transitioning out of sport.

CLINICAL TRIALS REGISTRATION

NCT01735994 .

Older Adults Living With Food Insecurity: The Impact on Psychological Health

Food insecurity (FI) refers to inadequate access to nutritious foods, either in terms of quality or quantity. In older adults, FI is associated with functional impairment, isolation, financial vulnerability, lower quality of life, and poorer health (e.g., diabetes, cardiovascular disease; Fernandes, et al). The effects of FI on psychological health broadly, however, have not been well-documented among older adults. This study sought to examine the impact of FI severity on psychological health indices among older adults. Older adult clients of local food pantries completed self-report measures of FI severity, worry, internalized weight stigma, trauma history, and eating disorder (ED) symptoms/behaviors. Participants (N=124, aged 66+) included: 68.5% women, 67.7% Hispanic, 75.8% □high school education, 51.0% household income < $10,000/year. Controlling for gender in all analyses, results indicated that FI severity predicted increased worry (p < .001, 21.9% variance), greater internalized weight stigma (p = .04, 3.9% variance), and a trend for increased risk for lifetime traumatic event exposure (OR = 1.4, 95% CI [.98, 2.01]). Regarding ED symptoms, male gender (OR = 6.60, 95% CI [1.96, 22.23] and higher FI severity predicted risk for self-induced vomiting in the past month (OR = 2.5, 95% CI [1.15, 5.36], risk for laxative/diuretic use for weight control (OR = 2.16, 95% CI [1.03, 4.52], and greater dietary restraint (p < .001, 16.1% variance). Male gender was associated with higher risk for binge eating in the past month (OR = 3.19, 95% CI [1.10, 9.24], while FI severity was not. Implications will be discussed.