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Edwards KL, Blissett J, Croker H, Farrow C, Herle M, Kininmonth A, Llewellyn C, Pickard A, Haycraft E. Examining parents' experiences and challenges of feeding preschool children with avid eating behaviour. Appetite 2024; 198:107372. [PMID: 38657683 DOI: 10.1016/j.appet.2024.107372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 04/10/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
Avid eating behaviours, including greater responsiveness to food cues and emotional over-eating, have been linked to child overweight and obesity. Parental feeding practices are modifiable components of a child's food environment and may be key levers for behaviour change in tailored interventions to support parents of children with avid eating behaviour. However, there is a lack of research examining parents' experiences in this context. This study aimed to explore parents' experiences of feeding children with avid eating behaviour and to understand any challenges experienced in this context. Semi-structured interviews with parents (N = 15) of a preschool child (3-5 years) identified as having an avid eating behaviour profile explored how children's avid eating manifests, the parental feeding practices used to manage avid eating, and the perceived effectiveness of these strategies. Data were analysed using reflexive thematic analysis. Four core themes were generated. Theme one, 'Have they got worms? Children's insatiable hunger', captures parents' interpretation of the complex ways in which avid eating behaviour manifests. Theme two, 'Parenthood as a duty', illustrates how parents' perceived responsibilities shape their feeding practices. Theme three, 'Lifelong habits', captures parents' use of responsive feeding practices to support children's healthy relationship with food. Theme four, 'Picking battles', captures the structure- and coercive-based feeding strategies commonly used to manage children's avid eating. This novel study provides an in-depth understanding of the complex ways that children's avid eating behaviour manifests, and the strategic and creative parental feeding practices used to manage these behaviours. Such findings are valuable for informing the development of future support resources for parents/caregivers to help their children with avid eating behaviours to develop a healthy relationship with food.
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Affiliation(s)
- Katie L Edwards
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, UK.
| | - Jacqueline Blissett
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Helen Croker
- World Cancer Research Fund International, London, UK
| | - Claire Farrow
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Moritz Herle
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alice Kininmonth
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Abigail Pickard
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Edwards K, Croker H, Farrow C, Haycraft E, Herle M, Llewellyn C, Pickard A, Blissett J. Examining Parent Mood, Feeding Context, and Feeding Goals as Predictors of Feeding Practices Used by Parents of Preschool Children With Avid Eating Behavior: Protocol for an Ecological Momentary Assessment Study. JMIR Res Protoc 2024; 13:e55193. [PMID: 38502178 PMCID: PMC10988368 DOI: 10.2196/55193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND An avid eating behavior profile is characterized by a greater interest in food and a tendency to overeat in response to negative emotions. Parents use specific strategies to manage feeding interactions with children with avid eating behavior. While momentary and contextual factors, such as parental mood, have been found to influence parental feeding practices, there is a lack of research examining parents' daily experiences of feeding children with avid eating behavior. Examining this is important because parental feeding practices are key levers in tailored interventions to support children's healthy eating behavior. OBJECTIVE We aim to describe the ecological momentary assessment methods and procedures used in the APPETItE (Appetite in Preschoolers: Producing Evidence for Tailoring Interventions Effectively) project, which aims to examine how variation in parental mood, feeding goals, and the context of eating occasions affect the parental feeding practices used to manage feeding interactions with children with an avid eating behavior profile. METHODS Participants are primary caregivers from the APPETItE cohort who have a preschool-age child (aged 3-5 years) with an avid eating behavior profile. Caregivers complete a 10-day ecological momentary assessment period using signal- and event-contingent surveys to examine (1) mood and stress, (2) parental feeding goals, and (3) contextual factors as predictors of parental feeding practices. RESULTS Recruitment and data collection began in October 2023 and is expected to be completed by spring 2024. The data have a 3-level structure: repeated measurements (level 1) nested within days (level 2) nested within an individual (level 3). Thus, lag-dependent models will be conducted to test the main hypotheses. CONCLUSIONS The findings from this study will provide an understanding of caregivers' daily experiences of feeding preschool children with avid eating behavior, who are at greater risk for the development of obesity. Understanding the predictors of feeding practices at the moment they occur, and across various contexts, will inform the development of tailored resources to support caregivers in managing children's avid eating behavior. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55193.
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Affiliation(s)
- Katie Edwards
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
| | - Helen Croker
- World Cancer Research Fund International, London, United Kingdom
| | - Claire Farrow
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Moritz Herle
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Abigail Pickard
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
| | - Jacqueline Blissett
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
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Hübel C, Abdulkadir M, Herle M, Palmos AB, Loos RJF, Breen G, Micali N, Bulik CM. Persistent thinness and anorexia nervosa differ on a genomic level. Eur J Hum Genet 2024; 32:117-124. [PMID: 37474786 PMCID: PMC10772076 DOI: 10.1038/s41431-023-01431-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 06/15/2023] [Accepted: 07/04/2023] [Indexed: 07/22/2023] Open
Abstract
Thinness and anorexia nervosa are both characterised by persistent low weight. Individuals with anorexia nervosa concurrently report distorted perceptions of their body and engage in weight-loss behaviours, whereas individuals with thinness often wish to gain weight. Both conditions are heritable and share genomics with BMI, but are not genetically correlated with each other. Based on their pattern of genetic associations with other traits, we explored differences between thinness and anorexia nervosa on a genomic level. In Part 1, using publicly available data, we compared genetic correlations of persistent thinness/anorexia nervosa with eleven psychiatric disorders. In Part 2, we identified individuals with adolescent persistent thinness in the Avon Longitudinal Study of Parents and Children (ALSPAC) by latent class growth analysis of measured BMI from 10 to 24 years (n = 6594) and evaluated associations with psychiatric and anthropometric polygenic scores. In Part 1, in contrast to the positive genetic correlations of anorexia nervosa with various psychiatric disorders, persistent thinness showed negative genetic correlations with attention deficit hyperactivity disorder (rgAN = 0.08 vs. rgPT = -0.30), alcohol dependence (rgAN = 0.07 vs. rgPT = -0.44), major depressive disorder (rgAN = 0.27 vs. rgPT = -0.18) and post-traumatic stress disorder (rgAN = 0.26 vs. rgPT = -0.20). In Part 2, individuals with adolescent persistent thinness in the ALSPAC had lower borderline personality disorder polygenic scores (OR = 0.77; Q = 0.01). Overall, results suggest that genetic variants associated with thinness are negatively associated with psychiatric disorders and therefore thinness may be differentiable from anorexia nervosa on a genomic level.
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Affiliation(s)
- Christopher Hübel
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK.
- National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
- Department of Pediatric Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Mohamed Abdulkadir
- National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Moritz Herle
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alish B Palmos
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK
| | - Ruth J F Loos
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Gerome Breen
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Centre Ballerup, Ballerup, Denmark
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Davies HL, Peel AJ, Mundy J, Monssen D, Kakar S, Davies MR, Adey BN, Armour C, Kalsi G, Lin Y, Marsh I, Rogers HC, Walters JTR, Herle M, Glen K, Malouf CM, Kelly EJ, Eley TC, Treasure J, Breen G, Hübel C. The network structure of mania symptoms differs between people with and without binge eating. Bipolar Disord 2023; 25:592-607. [PMID: 37308319 PMCID: PMC10768381 DOI: 10.1111/bdi.13355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES People with bipolar disorder who also report binge eating have increased psychopathology and greater impairment than those without binge eating. Whether this co-occurrence is related to binge eating as a symptom or presents differently across full-syndrome eating disorders with binge eating is unclear. METHODS We first compared networks of 13 lifetime mania symptoms in 34,226 participants from the United Kingdom's National Institute for Health and Care Research BioResource with (n = 12,104) and without (n = 22,122) lifetime binge eating. Second, in the subsample with binge eating, we compared networks of mania symptoms in participants with lifetime anorexia nervosa binge-eating/purging (n = 825), bulimia nervosa (n = 3737), and binge-eating disorder (n = 3648). RESULTS People with binge eating endorsed every mania symptom significantly more often than those without binge eating. Within the subsample, people with bulimia nervosa most often had the highest endorsement rate of each mania symptom. We found significant differences in network parameter statistics, including network structure (M = 0.25, p = 0.001) and global strength (S = 1.84, p = 0.002) when comparing the binge eating with no binge-eating participants. However, network structure differences were sensitive to reductions in sample size and the greater density of the latter network was explained by the large proportion of participants (34%) without mania symptoms. The structure of the anorexia nervosa binge-eating/purging network differed from the bulimia nervosa network (M = 0.66, p = 0.001), but the result was unstable. CONCLUSIONS Our results suggest that the presence and structure of mania symptoms may be more associated with binge eating as a symptom rather than any specific binge-type eating disorder. Further research with larger sample sizes is required to confirm our findings.
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Affiliation(s)
- Helena L. Davies
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
| | - Alicia J. Peel
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
| | - Jessica Mundy
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Dina Monssen
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Saakshi Kakar
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Molly R. Davies
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Brett N. Adey
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Chérie Armour
- Research Centre for Stress, Trauma and Related Conditions (STARC), School of PsychologyQueen's University Belfast (QUB)Belfast, Northern IrelandUK
| | - Gursharan Kalsi
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Yuhao Lin
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Ian Marsh
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Henry C. Rogers
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - James T. R. Walters
- Division of Psychiatry and Clinical Neurosciences, National Centre for Mental Health and MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | - Moritz Herle
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- Department of Biostatistics and Health InformaticsKing's College LondonLondonUK
| | - Kiran Glen
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Chelsea Mika Malouf
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Emily J. Kelly
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Thalia C. Eley
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological MedicineInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- South London and Maudsley NHS Foundation TrustMaudsley HospitalLondonUK
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Christopher Hübel
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
- National Centre for Register‐based Research, Aarhus Business and Social SciencesAarhus UniversityAarhusDenmark
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Pickard A, Croker H, Edwards K, Farrow C, Haycraft E, Herle M, Kininmonth AR, Llewellyn C, Blissett J. Identifying an avid eating profile in childhood: Associations with temperament, feeding practices and food insecurity. Appetite 2023; 191:107050. [PMID: 37793473 DOI: 10.1016/j.appet.2023.107050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023]
Abstract
This study aimed to identify distinct eating behaviour profiles in young children and examine how other key predictors of children's eating behaviour, including child temperament, the experience of food insecurity, or parental feeding practices, may vary by identified profiles. An online survey was conducted with 995 parents/carers living in England and Wales (N = 995, Mage = 35.4 years, 80% female, 88% White). Participants reported on their child's eating behaviour using the Child Eating Behaviour Questionnaire and completed measures of child temperament, household food security and parental feeding practices. Latent Profile Analysis (LPA) was carried out to identify distinct eating profiles amongst the children (36-72 months, Mage = 48.8 months, 52% female). Four eating profiles emerged from the sample of children: (a) avid eating, (b) avoidant eating, (c) happy eating, and (d) typical eating. Avid eating (21.9% of children) was characterised by higher levels of food responsiveness, enjoyment of food, and emotional over-eating in combination with lower satiety responsiveness, slowness in eating and food fussiness. Children with an avid eating profile were reported to be more surgent and experienced greater food insecurity than all other eating profiles. Parents of children belonging to the avid eating profile showed significantly greater use of food for emotional regulation, varied and balanced food provision, restriction of food for health, and restriction of food for weight feeding practices than the three other eating profiles.
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Affiliation(s)
- Abigail Pickard
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom.
| | - Helen Croker
- World Cancer Research Fund International, London, United Kingdom
| | - Katie Edwards
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
| | - Claire Farrow
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Moritz Herle
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Alice R Kininmonth
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Jacqueline Blissett
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
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Kininmonth AR, Herle M, Haycraft E, Farrow C, Tommerup K, Croker H, Pickard A, Edwards K, Blissett J, Llewellyn C. Reciprocal associations between parental feeding practices and child eating behaviours from toddlerhood to early childhood: bivariate latent change analysis in the Gemini cohort. J Child Psychol Psychiatry 2023; 64:1432-1445. [PMID: 37183771 PMCID: PMC10953001 DOI: 10.1111/jcpp.13819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Parental feeding practices (PFPs) are a key component of a child's food environment. Parent-child feeding relationships are hypothesised to be bidirectional; however, to date, few large prospective studies have examined this, instead focussing on unidirectional relationships. As such, the direction of relationships between PFPs and children's eating behaviours remains unclear. METHODS Data were from Gemini, a population-based sample of children born in England and Wales in 2007. Children's eating behaviours and PFPs were measured at 15/16 months and 5 years using validated psychometric measures (n = 1,858 children). Bivariate Latent Change Score Modelling was used to examine the nature of relationships between PFPs and children's eating behaviours at 15/16 months and 5 years. Models were adjusted to account for clustering of twins within families and for sex of the child, socioeconomic status, gestational age and age of the child at measurement time points. RESULTS A reciprocal relationship was observed between instrumental feeding and emotional overeating, with greater instrumental feeding predicting greater increases in emotional overeating (β = .09; 0.03-0.15; p = .004) and vice versa (β = .09; 0.03-0.15; p = .005). Reciprocity was also observed between encouragement to eat nutritious foods and children's enjoyment of food, with greater encouragement predicting greater increases in enjoyment of food (β = .08; 0.02-0.13; p = .006) and vice versa (β = .07; 0.02-0.11; p = .003). Parent-child associations and child-parent associations were also observed. CONCLUSION These findings are consistent with the hypothesis that certain feeding practices are used as a 'natural' response to a child expressing a greater interest in and enthusiasm for food, but at the same time, such practices impact the development of eating behaviours by nurturing and encouraging the expression of higher emotional overeating and greater enjoyment of food in preschool years. The findings provide important insights into the PFPs and eating behaviour traits that could be targeted as part of a tailored feeding intervention to support parents of children during the preschool formative years.
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Affiliation(s)
- Alice R. Kininmonth
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUK
| | - Moritz Herle
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Emma Haycraft
- School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Clare Farrow
- School of Psychology, Institute of Health and NeurodevelopmentAston UniversityBirminghamUK
| | - Kristiane Tommerup
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUK
| | - Helen Croker
- World Cancer Research Fund InternationalLondonUK
| | - Abigail Pickard
- School of Psychology, Institute of Health and NeurodevelopmentAston UniversityBirminghamUK
| | - Katie Edwards
- School of Psychology, Institute of Health and NeurodevelopmentAston UniversityBirminghamUK
| | - Jacqueline Blissett
- School of Psychology, Institute of Health and NeurodevelopmentAston UniversityBirminghamUK
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUK
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7
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Llewellyn CH, Kininmonth AR, Herle M, Nas Z, Smith AD, Carnell S, Fildes A. Behavioural susceptibility theory: the role of appetite in genetic susceptibility to obesity in early life. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220223. [PMID: 37482774 PMCID: PMC10363697 DOI: 10.1098/rstb.2022.0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Excess weight gained during the early years and, in particular, rapid weight gain in the first 2 years of life, are a major risk factors for adult obesity. The growing consensus is that childhood obesity develops from a complex interaction between genetic susceptibility and exposure to an 'obesogenic' environment. Behavioural susceptibility theory (BST) was developed to explain the nature of this gene-environment interaction, and why the 'obesogenic' environment does not affect all children equally. It hypothesizes that inherited variation in appetite, which is present from birth, determines why some infants and children overeat, and others do not, in response to environmental opportunity. That is, those who inherit genetic variants promoting an avid appetite are vulnerable to overeating and developing obesity, while those who are genetically predisposed to have a smaller appetite and lower interest in food are protected from obesity-or even at risk of being underweight. We review the breadth of research to-date that has contributed to the evidence base for BST, focusing on early life, and discuss implications and future directions for research and theory. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'.
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Affiliation(s)
- C H Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, UK
| | - A R Kininmonth
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, UK
| | - M Herle
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Z Nas
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, UK
| | - A D Smith
- MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0SL, UK
| | - S Carnell
- Department of Psychiatry and Behavioural Sciences, Johns Hopkins University School of Medicine, Baltimore, MD21287, USA
| | - A Fildes
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
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Hübel C, Birgegård A, Johansson T, Petersen LV, Isomaa R, Herle M. Latent anxiety and depression dimensions differ amongst patients with eating disorders: A Swedish nationwide investigation. Int J Methods Psychiatr Res 2023; 32:e1961. [PMID: 36775941 PMCID: PMC10485306 DOI: 10.1002/mpr.1961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/02/2022] [Accepted: 12/17/2022] [Indexed: 02/14/2023] Open
Abstract
OBJECTIVE Anxiety and depression symptoms are common in individuals with eating disorders. To study these co-occurrences, we need high-quality self-report questionnaires. The 19-item self-rated Comprehensive Psychopathological Rating Scale for Affective Syndromes (CPRS-S-A) is not validated in patients with eating disorders. We tested its factor structure, invariance, and differences in its latent dimensions. METHOD Patients were registered by 45 treatment units in the Swedish nationwide Stepwise quality assurance database for specialised eating disorder care (n = 9509). Patients self-reported their anxiety and depression symptoms on the CPRS-S-A. Analyses included exploratory and confirmatory factor analyses (CFA) in split samples, and testing of invariance and differences in subscales across eating disorder types. RESULTS Results suggested a four-factor solution: Depression, Somatic and fear symptoms, Disinterest, and Worry. Multigroup CFA indicated an invariant factor structure. We detected the following differences: Patients with anorexia nervosa binge-eating/purging subtype scored the highest and patients with unspecified feeding and eating disorders the lowest on all subscales. Patients with anorexia nervosa or purging disorder show more somatic and fear symptoms than individuals with either bulimia nervosa or binge-eating disorder. CONCLUSION Our four-factor solution of the CPRS-S-A is suitable for patients with eating disorders and may help to identify differences in anxiety and depression dimensions amongst patients with eating disorders.
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Affiliation(s)
- Christopher Hübel
- Social, Genetic & Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental HealthSouth London and Maudsley HospitalLondonUK
- National Centre for Register‐based ResearchAarhus BSS Business and Social SciencesAarhus UniversityAarhusDenmark
- Department of Pediatric NeurologyCharité Universitätsmedizin BerlinBerlinGermany
| | - Andreas Birgegård
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Therese Johansson
- Department of Immunology, Genetics and PathologyScience for Life LaboratoryUppsala UniversityUppsalaSweden
- Centre for Women's Mental Health During the Reproductive Lifespan—WomherUppsala UniversityUppsalaSweden
| | - Liselotte V. Petersen
- National Centre for Register‐based ResearchAarhus BSS Business and Social SciencesAarhus UniversityAarhusDenmark
| | - Rasmus Isomaa
- The Wellbeing Services County of OstrobothniaAboFinland
- Faculty of Education and Welfare StudiesÅbo Akademi UniversityVasaFinland
| | - Moritz Herle
- Social, Genetic & Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Department of Biostatistics & Health InformaticsInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
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9
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Kininmonth AR, Herle M, Tommerup K, Haycraft E, Farrow C, Croker H, Pickard A, Edwards K, Blissett J, Llewellyn C. Parental feeding practices as a response to child appetitive traits in toddlerhood and early childhood: a discordant twin analysis of the Gemini cohort. Int J Behav Nutr Phys Act 2023; 20:39. [PMID: 37016417 PMCID: PMC10074660 DOI: 10.1186/s12966-023-01440-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/15/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Parental feeding practices (PFPs) have been implicated in the development of children's eating behaviours. However, evidence suggests that feeding practices may also develop in response to their child's weight or emerging appetitive traits. We used the twin design to test the hypothesis that parents develop their feeding practices partly in response to their child's appetite. METHODS Data were from Gemini, a population-based cohort of 2402 British families with twins born in 2007. Psychometric measures of PFPs and appetite were completed by parents when their twins were 16-months and 5-years. Within-family analyses including all twins with available data in the sample (n = 1010-1858 pairs), examined if within-pair differences in PFPs were associated with differences in appetitive traits, controlling for differences in birth weight-SDS, early feeding method and child sex. In a subsample of twin pairs who were considerably discordant for appetitive traits by ≥ 1SD (n = 122-544 pairs), the direction and magnitude of within-pair differences in feeding practices was explored. RESULTS Within-family variation in parental feeding practices in toddlerhood and early childhood was low (discordance ranged from 0.1 to 6% of the sample), except for pressure to eat (toddlerhood: 19%; early childhood: 32%). Within-pair differences in all appetitive traits were associated with differential use of 'pressure to eat' at both 16-months and 5-years. In the subsample of twins most discordant for appetitive traits, parents used more pressure with the twin expressing lower food responsiveness, lower emotional overeating, lower food enjoyment, higher satiety responsiveness, slower speed of eating, higher emotional undereating and greater fussiness in toddlerhood and early childhood (p-values < 0.001). Effect sizes were small to large at 16-months (η2=0.02-0.09) and 5-years (η2=0.05-0.21). CONCLUSION Parents rarely varied their feeding practices between twins in toddlerhood and early childhood, except for pressure. Parents exerted greater pressure on their twin who expressed a poorer appetite compared to their co-twin, suggesting that parents develop a pressuring feeding style when their child expresses a poorer appetite or lower interest in, and enthusiasm for, eating. These findings could be used to guide interventions seeking to support parents in feeding their children in a way that nurtures the development of healthy eating behaviours.
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Affiliation(s)
- Alice R Kininmonth
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK.
| | - Moritz Herle
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kristiane Tommerup
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Claire Farrow
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Helen Croker
- World Cancer Research Fund International, London, UK
| | - Abigail Pickard
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Katie Edwards
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Jacqueline Blissett
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
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10
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Herle M, Pickles A, Pain O, Viner R, Pingault JB, De Stavola BL. Could interventions on physical activity mitigate genomic liability for obesity? Applying the health disparity framework in genetically informed studies. Eur J Epidemiol 2023; 38:403-412. [PMID: 36905531 PMCID: PMC10082115 DOI: 10.1007/s10654-023-00980-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 02/24/2023] [Indexed: 03/12/2023]
Abstract
Polygenic scores (PGS) are now commonly available in longitudinal cohort studies, leading to their integration into epidemiological research. In this work, our aim is to explore how polygenic scores can be used as exposures in causal inference-based methods, specifically mediation analyses. We propose to estimate the extent to which the association of a polygenic score indexing genetic liability to an outcome could be mitigated by a potential intervention on a mediator. To do this this, we use the interventional disparity measure approach, which allows us to compare the adjusted total effect of an exposure on an outcome, with the association that would remain had we intervened on a potentially modifiable mediator. As an example, we analyse data from two UK cohorts, the Millennium Cohort Study (MCS, N = 2575) and the Avon Longitudinal Study of Parents and Children (ALSPAC, N = 3347). In both, the exposure is genetic liability for obesity (indicated by a PGS for BMI), the outcome is late childhood/early adolescent BMI, and the mediator and potential intervention target is physical activity, measured between exposure and outcome. Our results suggest that a potential intervention on child physical activity can mitigate some of the genetic liability for childhood obesity. We propose that including PGSs in a health disparity measure approach, and causal inference-based methods more broadly, is a valuable addition to the study of gene-environment interplay in complex health outcomes.
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Affiliation(s)
- Moritz Herle
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK.
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, 16 De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
| | - Andrew Pickles
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - Oliver Pain
- Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Russell Viner
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Jean-Baptiste Pingault
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, 16 De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
- Division of Psychology and Language Sciences, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Bianca L De Stavola
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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11
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Kininmonth AR, Herle M, Haycraft E, Farrow C, Croker H, Pickard A, Edwards K, Blissett J, Llewellyn C. Prospective associations between parental feeding practices used in toddlerhood and preschool children's appetite vary according to appetite avidity in toddlerhood. Appetite 2023; 185:106541. [PMID: 36948251 DOI: 10.1016/j.appet.2023.106541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/24/2023]
Abstract
Parental feeding practices are a key modifiable component of children's food environments. Evidence suggests that certain feeding practices may differentially influence children's eating behaviour or weight, depending on the child's temperament (e.g. emotionality). Building on this work, we tested the hypothesis that feeding practices during toddlerhood influence children's developing eating behaviours differently, depending on their appetite avidity (which is characterised by a larger appetite and greater interest in food). Data were from Gemini, a population-based cohort of British twin children born in 2007. Parental feeding practices were assessed at 15-months, and child appetite at 15-months and 5-years, using validated psychometric measures (n = 1858 children). Complex samples general linear models examined prospective associations between PFPs at 15-months and child appetitive traits at 5-years, adjusting for clustering of twins within families and for the corresponding child appetitive trait at 15-months, difference in age between timepoints, child sex, gestational age, and socioeconomic status. Moderation analyses revealed that pressuring a child to eat led to greater increases in emotional overeating from 15-months to 5-years, only for children with high (1 SD above the mean: B = 0.13; SE± = 0.03,p < 0.001) or moderate emotional overeating (mean: B = 0.07 ± 0.03,p < 0.001) in toddlerhood. Greater covert restriction predicted greater reductions in emotional overeating and food responsiveness from 15-months to 5-years, only for children with high emotional overeating (1 SD above the mean: B = -0.06 ± 0.03,p = 0.03) and low food responsiveness (1 SD below the mean: B = -0.06 ± 0.03,p = 0.04) in toddlerhood. These findings are consistent with the hypothesis that children with a more avid appetite in toddlerhood are differentially affected by parental feeding practices; caregivers of toddlers may therefore benefit from feeding advice that is tailored to their child's unique appetite.
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Affiliation(s)
- Alice R Kininmonth
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom.
| | - Moritz Herle
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Claire Farrow
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
| | - Helen Croker
- World Cancer Research Fund International, London, United Kingdom
| | - Abigail Pickard
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
| | - Katie Edwards
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
| | - Jacqueline Blissett
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
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12
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Micali N, Herle M. Gone too soon: Studying mortality in eating disorders. Acta Psychiatr Scand 2023; 147:119-121. [PMID: 36657102 DOI: 10.1111/acps.13527] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 01/21/2023]
Abstract
Eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified feeding and eating disorder) are not only common mental health disorders but they also affect an individual's physical, psychological, and social well-being, with high impact and burden. Importantly, previous research has found that eating disorders have high mortality, higher than many other psychiatric disorders. Here, we discuss findings from Castellini and colleagues in the context of previous studies.
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Affiliation(s)
- Nadia Micali
- Eating Disorders Research Unit, Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,Great Ormond Street Institute of Child Health, University College London, London, UK.,Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Moritz Herle
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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13
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Davies HL, Hübel C, Herle M, Kakar S, Mundy J, Peel AJ, ter Kuile AR, Zvrskovec J, Monssen D, Lim KX, Davies MR, Palmos AB, Lin Y, Kalsi G, Rogers HC, Bristow S, Glen K, Malouf CM, Kelly EJ, Purves KL, Young KS, Hotopf M, Armour C, McIntosh AM, Eley TC, Treasure J, Breen G. Risk and protective factors for new-onset binge eating, low weight, and self-harm symptoms in >35,000 individuals in the UK during the COVID-19 pandemic. Int J Eat Disord 2023; 56:91-107. [PMID: 36315390 PMCID: PMC9874817 DOI: 10.1002/eat.23834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The disruption caused by the COVID-19 pandemic has been associated with poor mental health, including increases in eating disorders and self-harm symptoms. We investigated risk and protective factors for the new onset of these symptoms during the pandemic. METHOD Data were from the COVID-19 Psychiatry and Neurological Genetics study and the Repeated Assessment of Mental health in Pandemics Study (n = 36,715). Exposures were socio-demographic characteristics, lifetime psychiatric disorder, and COVID-related variables, including SARS-CoV-2 infection/illness with COVID-19. We identified four subsamples of participants without pre-pandemic experience of our outcomes: binge eating (n = 24,211), low weight (n = 24,364), suicidal and/or self-harm ideation (n = 18,040), and self-harm (n = 29,948). Participants reported on our outcomes at frequent intervals (fortnightly to monthly). We fitted multiple logistic regression models to identify factors associated with the new onset of our outcomes. RESULTS Within each subsample, new onset was reported by: 21% for binge eating, 10.8% for low weight, 23.5% for suicidal and/or self-harm ideation, and 3.5% for self-harm. Shared risk factors included having a lifetime psychiatric disorder, not being in paid employment, higher pandemic worry scores, and being racially minoritized. Conversely, infection with SARS-CoV-2/illness with COVID-19 was linked to lower odds of binge eating, low weight, and suicidal and/or self-harm ideation. DISCUSSION Overall, we detected shared risk factors that may drive the comorbidity between eating disorders and self-harm. Subgroups of individuals with these risk factors may require more frequent monitoring during future pandemics. PUBLIC SIGNIFICANCE In a sample of 35,000 UK residents, people who had a psychiatric disorder, identified as being part of a racially minoritized group, were not in paid employment, or were more worried about the pandemic were more likely to experience binge eating, low weight, suicidal and/or self-harm ideation, and self-harm for the first time during the pandemic. People with these risk factors may need particular attention during future pandemics to enable early identification of new psychiatric symptoms.
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Affiliation(s)
- Helena L. Davies
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Christopher Hübel
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Moritz Herle
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Department of Biostatistics and Health InformaticsInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Saakshi Kakar
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Jessica Mundy
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Alicia J. Peel
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Abigail R. ter Kuile
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Johan Zvrskovec
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Dina Monssen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Kai Xiang Lim
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Molly R. Davies
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Alish B. Palmos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Yuhao Lin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Gursharan Kalsi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Henry C. Rogers
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Shannon Bristow
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Kiran Glen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Chelsea Mika Malouf
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Emily J. Kelly
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Kirstin L. Purves
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Katherine S. Young
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Matthew Hotopf
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
- Department of Psychological MedicineInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Cherie Armour
- Research Centre for Stress, Trauma and Related Conditions (STARC), School of PsychologyQueen's University BelfastBelfastUK
| | - Andrew M. McIntosh
- Division of Psychiatry, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Thalia C. Eley
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological MedicineInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health and Care Research (NIHR) Biomedical Research CentreSouth London and Maudsley HospitalLondonUK
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Pickard A, Croker H, Farrow C, Haycraft E, Herle M, Kininmonth A, Llewellyn C, Blissett J. Appetite in Preschoolers: Producing Evidence for Tailoring Interventions Effectively - the APPETItE Study Protocol. Appetite 2022. [DOI: 10.1016/j.appet.2022.106228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Abdulkadir M, Hübel C, Herle M, Loos RJF, Breen G, Bulik CM, Micali N. The impact of anorexia nervosa and BMI polygenic risk on childhood growth: A 20-year longitudinal population-based study. Am J Hum Genet 2022; 109:1242-1254. [PMID: 35705101 PMCID: PMC9300758 DOI: 10.1016/j.ajhg.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/09/2022] [Indexed: 12/03/2022] Open
Abstract
Growth deviating from the norm during childhood has been associated with anorexia nervosa (AN) and obesity later in life. In this study, we examined whether polygenic scores (PGSs) for AN and BMI are associated with growth trajectories spanning the first two decades of life. AN PGSs and BMI PGSs were calculated for participants of the Avon Longitudinal Study of Parents and Children (ALSPAC; n = 8,654). Using generalized (mixed) linear models, we associated PGSs with trajectories of weight, height, body mass index (BMI), fat mass index (FMI), lean mass index (LMI), and bone mineral density (BMD). Female participants with AN PGSs one standard deviation (SD) higher had, on average, 0.004% slower growth in BMI between the ages 6.5 and 24 years and a 0.4% slower gain in BMD between the ages 10 and 24 years. Higher BMI PGSs were associated with faster growth for BMI, FMI, LMI, BMD, and weight trajectories in both sexes throughout childhood. Female participants with both a high AN PGS and a low BMI PGS showed slower growth compared to those with both a low AN PGS and a low BMI PGS. We conclude that AN PGSs and BMI PGSs have detectable sex-specific effects on growth trajectories. Female participants with a high AN PGS and low BMI PGS likely constitute a high-risk group for AN, as their growth was slower compared to their peers with high PGSs on both traits. Further research is needed to better understand how the AN PGS and the BMI PGS co-influence growth during childhood and whether a high BMI PGS can mitigate the effects of a high AN PGS.
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Affiliation(s)
- Mohamed Abdulkadir
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Christopher Hübel
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK; National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Moritz Herle
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ruth J F Loos
- Novo Nordisk Foundation Center for Basic Metabolic Research, Department of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gerome Breen
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nadia Micali
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Great Ormond Street Institute of Child Health, University College London, London, UK; Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Centre Ballerup, Ballerup, Denmark.
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Carter Leno V, Micali N, Bryant-Waugh R, Herle M. Associations between childhood autistic traits and adolescent eating disorder behaviours are partially mediated by fussy eating. Eur Eat Disord Rev 2022; 30:604-615. [PMID: 35388530 PMCID: PMC9542277 DOI: 10.1002/erv.2902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/12/2022]
Abstract
Objective Previous literature shows an increased risk for eating disorders in autistic individuals. This study tested whether fussy eating contributes to the association between childhood autistic traits and adolescent eating disorder behaviours. Method Using data from the Avon Longitudinal Study of Parents and Children, we estimated the intercept and slope of parent‐rated autistic traits and fussy eating between 7 and 14 years (N = 8982) and their association with self‐reported eating disorder behaviours at age 14 years, including the indirect path from autistic traits to eating disorder behaviours via fussy eating. Analyses were adjusted for child sex, maternal age at delivery, maternal body mass index and maternal education. Results Analyses found a small indirect pathway from autistic traits intercept to eating disorder behaviours via fussy eating slope (b = 0.017, 95% CI = 0.002–0.032, p = 0.026), with higher levels of autistic traits at age 7 years being associated with a shallower decline in fussy eating, which in turn was associated with greater eating disorder behaviours. Conclusion Findings point towards fussy eating as a potential link between childhood autistic traits and later disordered eating. Addressing fussy eating patterns before they become entrenched may decrease risk for eating disorders later in development. There is evidence that high levels of autistic traits are associated with an increased likelihood of experiencing an eating disorder. The current study sought to test whether the link between autism and eating disorders could in part be explained by variation in fussy eating. In a large prospective cohort study, we found a significant indirect effect of fussy eating, such that higher childhood autistic traits were associated with a shallower decline in fussy eating between childhood and adolescence, which in turn was associated with higher levels of eating disorder behaviours in adolescence.
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Affiliation(s)
- Virginia Carter Leno
- Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Nadia Micali
- Department of Pediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Rachel Bryant-Waugh
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Moritz Herle
- Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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17
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Abdulkadir M, Hübel C, Herle M, Loos RJF, Breen G, Bulik CM, Micali N. Eating disorder symptoms and their associations with anthropometric and psychiatric polygenic scores. Eur Eat Disord Rev 2022; 30:221-236. [PMID: 35178801 PMCID: PMC9149768 DOI: 10.1002/erv.2889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/17/2021] [Accepted: 01/21/2022] [Indexed: 11/21/2022]
Abstract
Background Eating disorder (ED) symptoms are prevalent in the general population, but their shared genetic underpinnings with psychiatric, metabolic, and anthropometric traits are not known. Here, we examined if polygenic scores (PGSs) of traits associated with anorexia nervosa are also associated with adolescent ED symptoms in the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods A total of 8654 participants with genotype data and at least one phenotypic measure were included from the ALSPAC study. We associated PGS from 25 traits (16 psychiatric, 4 metabolic, and 5 anthropometric) with eight ED symptoms, including behaviours such as fasting for weight loss and cognitions such as body dissatisfaction. Results Higher attention deficit hyperactivity disorder PGS and lower educational attainment PGS were associated with fasting for weight loss. Higher insomnia PGS was associated with increased body dissatisfaction. We found no evidence of an association between metabolic trait PGS and any ED symptom. Fat‐free mass, fat mass, and body fat percentage PGSs, were positively associated with binge eating, excessive exercise, fasting for weight loss, body dissatisfaction, and weight and shape concern. Conclusions ED symptoms are genetically associated with psychiatric and anthropometric, but not with metabolic traits. Our findings provide insights for future genetic research investigating on why some individuals with ED symptoms progress to develop threshold EDs while others do not. Several eating disorder symptoms (i.e., binge eating, fasting for weight loss, and body dissatisfaction) in this study were significantly associated with both psychiatric and anthropometric polygenic scores emphasising the genetic complexity of these traits. Eating disorder symptoms as present in the general population and threshold eating disorders may be partially etiologically related (i.e., psychiatric and anthropometric origins), but metabolic genetic factors may differentiate between symptoms and threshold eating disorders. Metabolic disturbances could therefore be the catalyst that puts some individuals on a developmental trajectory leading to threshold eating disorders.
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Affiliation(s)
- Mohamed Abdulkadir
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christopher Hübel
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK.,National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Moritz Herle
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ruth J F Loos
- Icahn School of Medicine at Mount Sinai, Charles Bronfman Institute for Personalized Medicine, New York, New York, USA
| | - Gerome Breen
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nadia Micali
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Great Ormond Street Institute of Child Health, University College London, London, UK
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18
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Jewell T, Herle M, Serpell L, Eivors A, Simic M, Fonagy P, Eisler I. Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa. Eur Child Adolesc Psychiatry 2021:10.1007/s00787-021-01930-3. [PMID: 34967934 DOI: 10.1007/s00787-021-01930-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/17/2021] [Indexed: 11/26/2022]
Abstract
Anorexia nervosa-focussed family therapy (FT-AN) is the first-line treatment for adolescent anorexia nervosa (AN), but the predictors of poor treatment response are not well understood. The main aim of this study was to investigate the role of attachment and mentalization in predicting treatment outcome. The secondary aims of the study were to investigate therapeutic alliance at 1 month as a predictor of outcome, and to test the associations between alliance and baseline attachment and mentalization. 192 adolescents with AN and their parents were recruited as they began family therapy in out-patient specialist eating disorder services. Self-report measures of attachment, mentalization, and emotion regulation were completed at the start of treatment by adolescent patients and one of their parents. Self-reported alliance scores were collected at one month. Higher scores on the Certainty Scale of the Reflective Functioning Questionnaire, completed by parents, which indicate over-certainty about mental states, were the strongest predictor of poor outcome (Odds Ratio: 0.42, CI: 0.20-0.87). Similarly, for adolescents, higher Lack of Clarity scores on the Difficulties in Emotion Regulation Scale, representing being unclear about one's feelings, were predictive of positive treatment outcome (OR: 1.10, CI: 1.00-1.21). Higher alliance scores at 1 month predicted positive outcome, and were associated with attachment security and mentalization. These novel findings suggest that, particularly in parents, a tendency towards excessive certainty about mental states in others may predict poor outcome in FT-AN. Further research is warranted to replicate the finding and characterise families at risk of poor outcome.
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Affiliation(s)
- Tom Jewell
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.
| | - Moritz Herle
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - Lucy Serpell
- North East London NHS Foundation Trust, London, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Alison Eivors
- Leicestershire Partnership NHS Foundation Trust, Leicester, UK
| | - Mima Simic
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud Centre, London, UK
| | - Ivan Eisler
- South London and Maudsley NHS Foundation Trust, London, UK
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19
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Hübel C, Herle M, Santos Ferreira DL, Abdulkadir M, Bryant-Waugh R, Loos RJF, Bulik CM, Lawlor DA, Micali N. Childhood overeating is associated with adverse cardiometabolic and inflammatory profiles in adolescence. Sci Rep 2021; 11:12478. [PMID: 34127697 PMCID: PMC8203659 DOI: 10.1038/s41598-021-90644-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 05/07/2021] [Indexed: 12/15/2022] Open
Abstract
Childhood eating behaviour contributes to the rise of obesity and related noncommunicable disease worldwide. However, we lack a deep understanding of biochemical alterations that can arise from aberrant eating behaviour. In this study, we prospectively associate longitudinal trajectories of childhood overeating, undereating, and fussy eating with metabolic markers at age 16 years to explore adolescent metabolic alterations related to specific eating patterns in the first 10 years of life. Data are from the Avon Longitudinal Study of Parents and Children (n = 3104). We measure 158 metabolic markers with a high-throughput (1H) NMR metabolomics platform. Increasing childhood overeating is prospectively associated with an adverse cardiometabolic profile (i.e., hyperlipidemia, hypercholesterolemia, hyperlipoproteinemia) in adolescence; whereas undereating and fussy eating are associated with lower concentrations of the amino acids glutamine and valine, suggesting a potential lack of micronutrients. Here, we show associations between early behavioural indicators of eating and metabolic markers.
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Affiliation(s)
- Christopher Hübel
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Moritz Herle
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diana L Santos Ferreira
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mohamed Abdulkadir
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Rachel Bryant-Waugh
- Maudsley Centre for Child and Adolescent Eating Disorders, Michael Rutter Centre for Children and Young People, Maudsley Hospital, London, UK
| | - Ruth J F Loos
- Icahn School of Medicine At Mount Sinai, New York, NY, USA
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Deborah A Lawlor
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol National Institute of Health Research Biomedical Research Centre, Bristol, UK
| | - Nadia Micali
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Great Ormond Street Institute of Child Health, University College London, London, UK.
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20
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Hübel C, Abdulkadir M, Herle M, Loos RJF, Breen G, Bulik CM, Micali N. One size does not fit all. Genomics differentiates among anorexia nervosa, bulimia nervosa, and binge-eating disorder. Int J Eat Disord 2021; 54:785-793. [PMID: 33644868 PMCID: PMC8436760 DOI: 10.1002/eat.23481] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Genome-wide association studies have identified multiple genomic regions associated with anorexia nervosa. No genome-wide studies of other eating disorders, such as bulimia nervosa and binge-eating disorder, have been performed, despite their substantial heritability. Exploratively, we aimed to identify traits that are genetically associated with binge-type eating disorders. METHOD We calculated genome-wide polygenic scores for 269 trait and disease outcomes using PRSice v2.2 and their association with anorexia nervosa, bulimia nervosa, and binge-eating disorder in up to 640 cases and 17,050 controls from the UK Biobank. Significant associations were tested for replication in the Avon Longitudinal Study of Parents and Children (up to 217 cases and 3,018 controls). RESULTS Individuals with binge-type eating disorders had higher polygenic scores than controls for other psychiatric disorders, including depression, schizophrenia, and attention deficit hyperactivity disorder, and higher polygenic scores for body mass index. DISCUSSION Our findings replicate some of the known comorbidities of eating disorders on a genomic level and motivate a deeper investigation of shared and unique genomic factors across the three primary eating disorders.
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Affiliation(s)
- Christopher Hübel
- Social, Genetic & Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental HealthSouth London and Maudsley HospitalLondonUK
- National Centre for Register‐based Research, Aarhus Business and Social SciencesAarhus UniversityAarhusDenmark
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Mohamed Abdulkadir
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of MedicineUniversity of GenevaGenevaSwitzerland
- Department of Psychiatry, Faculty of MedicineUniversity of GenevaGenevaSwitzerland
| | - Moritz Herle
- Department of Biostatistics and Health InformaticsInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Ruth J. F. Loos
- Charles Bronfman Institute for Personalized MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Gerome Breen
- Social, Genetic & Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental HealthSouth London and Maudsley HospitalLondonUK
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Nadia Micali
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of MedicineUniversity of GenevaGenevaSwitzerland
- Department of Psychiatry, Faculty of MedicineUniversity of GenevaGenevaSwitzerland
- Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
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21
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Herle M, Abdulkadir M, Hübel C, Ferreira DS, Bryant-Waugh R, Loos RJF, Bulik CM, De Stavola B, Micali N. Author Correction: The genomics of childhood eating behaviours. Nat Hum Behav 2021; 5:663. [PMID: 33594233 DOI: 10.1038/s41562-021-01072-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Moritz Herle
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mohamed Abdulkadir
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christopher Hübel
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- NIHR Biomedical Research Centre, South London and Maudsley Hospital, London, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Diana Santos Ferreira
- Medical Research Council Integrative Epidemiology, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rachel Bryant-Waugh
- Maudsley Centre for Child and Adolescent Eating Disorders, Michael Rutter Centre for Children and Young People, Maudsley Hospital, London, UK
| | - Ruth J F Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn Mount Sinai School of Medicine, New York, NY, USA
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bianca De Stavola
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Nadia Micali
- Great Ormond Street Institute of Child Health, University College London, London, UK.
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Child and Adolescent Psychiatry Division, Department of Child and Adolescent Health, Geneva University Hospital, Geneva, Switzerland.
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22
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Herle M, Smith AD, Bu F, Steptoe A, Fancourt D. Trajectories of eating behavior during COVID-19 lockdown: Longitudinal analyses of 22,374 adults. Clin Nutr ESPEN 2021; 42:158-165. [PMID: 33745572 PMCID: PMC7871880 DOI: 10.1016/j.clnesp.2021.01.046] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/20/2021] [Accepted: 01/30/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND & AIMS The COVID-19 pandemic has led to the implementation of stay-at-home and lockdown measures. It is currently unknown if the experience of lockdown leads to long term changes in individual's eating behaviors. The objectives of this study were: i) to derive longitudinal trajectories of change in eating during UK lockdown, and ii) to identify risk factors associated with eating behavior trajectories. METHOD Data from 22,374 UK adults from the UCL COVID-19 Social study (a panel study collecting weekly data during the pandemic) were analyzed from 28th March to 29th May 2020. Latent Class Growth Analysis was used to derive trajectories of change in eating. These were then associated with prior socio-economic, health-related and psychological factors using multinomial regression models. RESULTS Analyses suggested five trajectories, with the majority (64%) showing no change in eating. In contrast, one trajectory was marked by persistently eating more, whereas another by persistently eating less. Overall, participants with greater depressive symptoms were more likely to report any change in eating. Loneliness was linked to persistently eating more (OR = 1.07), whereas being single or divorced, as well as stressful life events, were associated with consistently eating less (OR = 1.69). Overall, higher education status was linked to lower odds of changing eating behavior (OR = 0.54-0.77). Secondary exploratory analyses suggest that participants self-reported to have overweight were more commonly categorised into the group consistently eating more, whereas participants with underweigh persistently ate less. CONCLUSION In this study, we found that one third of the sample report changes in quantities eaten throughout the first UK lockdown period. Findings highlight the importance of adjusting public health programs to support eating behaviors in future lockdowns both in this and potential future pandemics. This is particularly important as part of on-going preventive efforts to prevent nutrition-related chronic diseases.
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Affiliation(s)
- Moritz Herle
- Department of Biostatistics & Health Informatics, King's College London, London, UK
| | - Andrea D Smith
- Department of Behavioural Science and Health, University College London, London, UK
| | - Feifei Bu
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK.
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Abstract
PURPOSE OF REVIEW Eating behaviours are hypothesised to be the behavioural expression of genetic risk of obesity. In this review, we summarise findings from behavioural genetic research on the association between genetic risk for obesity and validated psychometrics measures of eating behaviours in children and adults (published in the past 10 years). RECENT FINDINGS Twin studies have produced some evidence for a shared genetic aetiology underlying body mass index and eating behaviours. Studies using measured genetic susceptibility to obesity have suggested that increased genetic liability for obesity is associated with variation in obesogenic eating behaviours such as emotional and uncontrolled eating. More research on this topic is needed. Especially longitudinal studies using genetically sensitive designs to investigate the direction of genetic pathways between genetic liability of eating behaviours to weight and vice versa, as well as the potential subsequent link to eating disorders.
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Affiliation(s)
- Moritz Herle
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, University College London, London, UK
| | | | - Clare Llewellyn
- Research Department of Behavioural Science and Health, University College London, London, UK
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Herle M, Kan C. Longitudinal Analyses Suggest Genomic and Psychological Origins of Disordered Eating and Comorbidities. JAMA Netw Open 2020; 3:e2027188. [PMID: 33263758 DOI: 10.1001/jamanetworkopen.2020.27188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Moritz Herle
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, London, United Kingdom
| | - Carol Kan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
- Now with Community Mental Health Team, St. Ann's Hospital, London, United Kingdom
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25
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Kan C, Herle M, Treasure J, Jones A, Rijsdijk F, Llewellyn C. Common etiological architecture underlying reward responsiveness, externally driven eating behaviors, and BMI in childhood: findings from the Gemini twin cohort. Int J Obes (Lond) 2020; 44:2064-2074. [PMID: 32467612 PMCID: PMC7610375 DOI: 10.1038/s41366-020-0605-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/15/2020] [Accepted: 05/14/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Studies have reported that impulsivity predicts childhood BMI and that the association is mediated by eating behaviors. One aspect of impulsivity-potentially crucial in the obesity context-is reward responsiveness, which may predispose to responsiveness to palatable food cues. The behavioral susceptibility theory hypothesizes that genetic susceptibility to obesity operates partly via genetically determined differences in appetite regulation. Reward responsiveness may therefore be one of the neuro-endophenotypes that mediates genetic susceptibility to obesity. OBJECTIVE To test whether reward responsiveness, eating behaviors, and child BMI share common genetic architecture. METHODS We examined reward responsiveness, eating behaviors, and BMI in 5-year-old children from Gemini, a UK birth cohort of 2402 twin pairs born in 2007. All measures were collected by parent report. Reward responsiveness was derived from the Behavioral Approach System. Compulsion to eat and eating for pleasure was measured with the "food responsiveness" scale of the Child Eating Behavior Questionnaire. Wanting to eat in response to environmental food cues was measured with the "external eating" scale of the Dutch Eating Behavior Questionnaire. Maximum-likelihood structural equation modeling was used to establish underlying common genetic and environmental influences. RESULTS There were significant positive phenotypic correlations between all traits except for reward responsiveness and BMI. Genetic factors explained the majority of the association between food responsiveness and external eating (74%, 95% CI: 61, 87), whereas common shared environmental factors explained the majority of the associations between reward responsiveness with both food responsiveness (55%, 95% CI: 20, 90) and external eating (70%, 95% CI: 39, 100). CONCLUSIONS Our study demonstrates the importance of common environmental factors in the shared etiology between reward responsiveness and childhood eating behaviors. However, the common etiology underlying both reward responsiveness and BMI is unclear, as there was no phenotypic correlation between reward responsiveness and BMI at this age. Further longitudinal research needs to detangle this complex relationship throughout development.
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Affiliation(s)
- Carol Kan
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Moritz Herle
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Janet Treasure
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Andrew Jones
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Frühling Rijsdijk
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Clare Llewellyn
- Research Department of Behavioral Science and Health, University College London, London, UK
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26
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Herle M, Stavola BD, Hübel C, Ferreira DLS, Abdulkadir M, Yilmaz Z, Loos RJF, Bryant-Waugh R, Bulik CM, Micali N. Eating behavior trajectories in the first 10 years of life and their relationship with BMI. Int J Obes (Lond) 2020; 44:1766-1775. [PMID: 32461555 PMCID: PMC7610465 DOI: 10.1038/s41366-020-0581-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 03/03/2020] [Accepted: 04/29/2020] [Indexed: 02/08/2023]
Abstract
Background Child eating behaviors are highly heterogeneous and their longitudinal impact on childhood weight is unclear. The objective of this study was to characterize eating behaviors during the first ten years of life and evaluate associations with BMI at age 11 years. Method Data were parental reports of eating behaviors from 15 months to age 10 years (n=12,048) and standardized body mass index (zBMI) at age 11 years (n=4884) from the Avon Longitudinal Study of Parents and Children. Latent class growth analysis was used to derive latent classes of over-, under-, and fussy eating. Linear regression models for zBMI at 11 years on each set of classes were fitted to assess associations with eating behavior trajectories. Results We identified four classes of overeating; “low stable” (70%), “low transient” (15%), “late increasing” (11%), and “early increasing” (6%). The “early increasing” class was associated with higher zBMI (boys: β=0.83, 95%CI:0.65, 1.02; girls: β=1.1; 0.92, 1.28) compared to “low stable”. Six classes were found for undereating; “low stable” (25%), “low transient” (37%), “low decreasing” (21%), “high transient” (11%), “high decreasing” (4%), and “high stable” (2%). The latter was associated with lower zBMI (boys: β=-0.79; -1.15, -0.42; girls: β=-0.76; -1.06, -0.45). Six classes were found for fussy eating; “low stable” (23%), “low transient” (15%), “low increasing” (28%), “high decreasing” (14%), “low increasing” (13%), “high stable” (8%). The “high stable”class was associated with lower zBMI(boys: β =-0.49; -0.68 -0.30; girls: β =-0.35;-0.52, -0.18). Conclusions Early increasing overeating during childhoodis associated with higher zBMI at age 11. High persistent levels of undereating and fussy eating are associated with lower zBMI. Longitudinal trajectories of eating behaviors may help identify children potentially at risk of adverse weight outcomes.
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Affiliation(s)
- Moritz Herle
- Great Ormond Street Institute of Child Health, University College London, London, UK.,Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK
| | - Bianca De Stavola
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Christopher Hübel
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Diana L Santos Ferreira
- Medical Research Council Integrative Epidemiology, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mohamed Abdulkadir
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ruth J F Loos
- Icahn Mount Sinai School of Medicine, New York, NY, USA
| | - Rachel Bryant-Waugh
- Maudsley Centre for Child and Adolescent Eating Disorders, Michael Rutter Centre for Children and Young People, Maudsley Hospital, London, UK
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nadia Micali
- Great Ormond Street Institute of Child Health, University College London, London, UK. .,Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland. .,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Child and Adolescent Psychiatry Division, Department of Child and Adolescent Health, Geneva University Hospital, Geneva, Switzerland.
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Herle M, Micali N, Abdulkadir M, Loos R, Bryant-Waugh R, Hübel C, Bulik CM, De Stavola BL. Identifying typical trajectories in longitudinal data: modelling strategies and interpretations. Eur J Epidemiol 2020; 35:205-222. [PMID: 32140937 PMCID: PMC7154024 DOI: 10.1007/s10654-020-00615-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 02/17/2020] [Indexed: 11/06/2022]
Abstract
Individual-level longitudinal data on biological, behavioural, and social dimensions are becoming increasingly available. Typically, these data are analysed using mixed effects models, with the result summarised in terms of an average trajectory plus measures of the individual variations around this average. However, public health investigations would benefit from finer modelling of these individual variations which identify not just one average trajectory, but several typical trajectories. If evidence of heterogeneity in the development of these variables is found, the role played by temporally preceding (explanatory) variables as well as the potential impact of differential trajectories may have on later outcomes is often of interest. A wide choice of methods for uncovering typical trajectories and relating them to precursors and later outcomes exists. However, despite their increasing use, no practical overview of these methods targeted at epidemiological applications exists. Hence we provide: (a) a review of the three most commonly used methods for the identification of latent trajectories (growth mixture models, latent class growth analysis, and longitudinal latent class analysis); and (b) recommendations for the identification and interpretation of these trajectories and of their relationship with other variables. For illustration, we use longitudinal data on childhood body mass index and parental reports of fussy eating, collected in the Avon Longitudinal Study of Parents and Children.
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Affiliation(s)
- Moritz Herle
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
| | - Nadia Micali
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Child and Adolescent Psychiatry Division, Department of Child and Adolescent Health, Geneva University Hospital, Geneva, Switzerland
| | - Mohamed Abdulkadir
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ruth Loos
- The Charles Bronfman Institute for Personalized Medicine, The Mindich Child Health and Development Institute, Icahn Mount Sinai School of Medicine, New York, NY, USA
| | - Rachel Bryant-Waugh
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
| | - Christopher Hübel
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bianca L De Stavola
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
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Herle M, Stavola BD, Hübel C, Abdulkadir M, Ferreira DS, Loos RJF, Bryant-Waugh R, Bulik CM, Micali N. A longitudinal study of eating behaviours in childhood and later eating disorder behaviours and diagnoses. Br J Psychiatry 2020; 216:113-119. [PMID: 31378207 PMCID: PMC7000294 DOI: 10.1192/bjp.2019.174] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Eating behaviours in childhood are considered as risk factors for eating disorder behaviours and diagnoses in adolescence. However, few longitudinal studies have examined this association. AIMS We investigated associations between childhood eating behaviours during the first ten years of life and eating disorder behaviours (binge eating, purging, fasting and excessive exercise) and diagnoses (anorexia nervosa, binge eating disorder, purging disorder and bulimia nervosa) at 16 years. METHOD Data on 4760 participants from the Avon Longitudinal Study of Parents and Children were included. Longitudinal trajectories of parent-rated childhood eating behaviours (8 time points, 1.3-9 years) were derived by latent class growth analyses. Eating disorder diagnoses were derived from self-reported, parent-reported and objectively measured anthropometric data at age 16 years. We estimated associations between childhood eating behaviours and eating disorder behaviours and diagnoses, using multivariable logistic regression models. RESULTS Childhood overeating was associated with increased risk of adolescent binge eating (risk difference, 7%; 95% CI 2 to 12) and binge eating disorder (risk difference, 1%; 95% CI 0.2 to 3). Persistent undereating was associated with higher anorexia nervosa risk in adolescent girls only (risk difference, 6%; 95% CI, 0 to 12). Persistent fussy eating was associated with greater anorexia nervosa risk (risk difference, 2%; 95% CI 0 to 4). CONCLUSIONS Our results suggest continuities of eating behaviours into eating disorders from early life to adolescence. It remains to be determined whether childhood eating behaviours are an early manifestation of a specific phenotype or whether the mechanisms underlying this continuity are more complex. Findings have the potential to inform preventative strategies for eating disorders.
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Affiliation(s)
- Moritz Herle
- Research Associate, Great Ormond Street Institute of Child Health, University College London, UK
| | - Bianca De Stavola
- Professor of Medical Statistics, Great Ormond Street Institute of Child Health, University College London, UK
| | - Christopher Hübel
- PhD Student, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London; UK National Institute for Health Research Biomedical Research Centre, South London and Maudsley Hospital, UK; and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Mohamed Abdulkadir
- PhD Student, Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland
| | - Diana Santos Ferreira
- Senior Research Associate, Medical Research Council Integrative Epidemiology Unit, University of Bristol; and Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Ruth J F Loos
- Professor, The Charles Bronfman Institute for Personalized Medicine, The Mindich Child Health and Development Institute, Icahn Mount Sinai School of Medicine, New York, USA
| | - Rachel Bryant-Waugh
- Consultant Clinical Psychologist, Great Ormond Street Institute of Child Health, University College London, UK
| | - Cynthia M Bulik
- Professor of Eating Disorders, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; Department of Psychiatry, University of North Carolina at Chapel Hill; and Department of Nutrition, University of North Carolina at Chapel Hill, USA
| | - Nadia Micali
- Senior Lecturer and Honorary Consultant Psychiatrist, Great Ormond Street Institute of Child Health, University College London, UK; Department of Psychiatry, Faculty of Medicine, University of Geneva; and Child and Adolescent Psychiatry Division, Department of Child and Adolescent Health, Geneva University Hospital, Switzerland
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Santos Ferreira DL, Hübel C, Herle M, Abdulkadir M, Loos RJF, Bryant-Waugh R, Bulik CM, De Stavola BL, Lawlor DA, Micali N. Associations between Blood Metabolic Profile at 7 Years Old and Eating Disorders in Adolescence: Findings from the Avon Longitudinal Study of Parents and Children. Metabolites 2019; 9:metabo9090191. [PMID: 31546923 PMCID: PMC6780115 DOI: 10.3390/metabo9090191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 11/29/2022] Open
Abstract
Eating disorders are severe illnesses characterized by both psychiatric and metabolic factors. We explored the prospective role of metabolic risk in eating disorders in a UK cohort (n = 2929 participants), measuring 158 metabolic traits in non-fasting EDTA-plasma by nuclear magnetic resonance. We associated metabolic markers at 7 years (exposure) with risk for anorexia nervosa and binge-eating disorder (outcomes) at 14, 16, and 18 years using logistic regression adjusted for maternal education, child’s sex, age, body mass index, and calorie intake at 7 years. Elevated very low-density lipoproteins, triglycerides, apolipoprotein-B/A, and monounsaturated fatty acids ratio were associated with lower odds of anorexia nervosa at age 18, while elevated high-density lipoproteins, docosahexaenoic acid and polyunsaturated fatty acids ratio, and fatty acid unsaturation were associated with higher risk for anorexia nervosa at 18 years. Elevated linoleic acid and n-6 fatty acid ratios were associated with lower odds of binge-eating disorder at 16 years, while elevated saturated fatty acid ratio was associated with higher odds of binge-eating disorder. Most associations had large confidence intervals and showed, for anorexia nervosa, different directions across time points. Overall, our results show some evidence for a role of metabolic factors in eating disorders development in adolescence.
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Affiliation(s)
- Diana L Santos Ferreira
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK.
| | - Christopher Hübel
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
- UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London SE5 8AF, UK.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Moritz Herle
- University College London, Great Ormond Street Institute of Child Health, London WC1N 1EH, UK.
| | - Mohamed Abdulkadir
- Department of Psychiatry, Faculty of Medicine, University of Geneva, CH-1205 Geneva, Switzerland.
| | - Ruth J F Loos
- Icahn Mount Sinai School of Medicine, New York, NY 10029, USA.
| | - Rachel Bryant-Waugh
- University College London, Great Ormond Street Institute of Child Health, London WC1N 1EH, UK.
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Bianca L De Stavola
- University College London, Great Ormond Street Institute of Child Health, London WC1N 1EH, UK.
| | - Deborah A Lawlor
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK.
- Bristol National Institute of Health Research Biomedical Research Centre, Bristol BS1 3NU, UK.
| | - Nadia Micali
- University College London, Great Ormond Street Institute of Child Health, London WC1N 1EH, UK.
- Department of Psychiatry, Faculty of Medicine, University of Geneva, CH-1205 Geneva, Switzerland.
- Child and Adolescent Psychiatry Division, Department of Child and Adolescent Health, Geneva University Hospital, CH-1205 Geneva, Switzerland.
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Schrempft S, Herle M, Llewellyn CH. Additional Data to Explain Childhood Obesity-Reply. JAMA Pediatr 2019; 173:605-606. [PMID: 30933242 DOI: 10.1001/jamapediatrics.2019.0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Stephanie Schrempft
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Moritz Herle
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Clare H Llewellyn
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Schrempft S, van Jaarsveld CHM, Fisher A, Herle M, Smith AD, Fildes A, Llewellyn CH. Variation in the Heritability of Child Body Mass Index by Obesogenic Home Environment. JAMA Pediatr 2018; 172:1153-1160. [PMID: 30285028 PMCID: PMC6396810 DOI: 10.1001/jamapediatrics.2018.1508] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/23/2018] [Indexed: 12/24/2022]
Abstract
Importance The early obesogenic home environment is consistently identified as a key influence on child weight trajectories, but little research has examined the mechanisms of that influence. Such research is essential for the effective prevention and treatment of overweight and obesity. Objective To test behavioral susceptibility theory's hypothesis that the heritability of body mass index (BMI) is higher among children who live in more obesogenic home environments. Design, Setting, and Participants This study was a gene-environment interaction twin study that used cross-sectional data from 925 families (1850 twins) in the Gemini cohort (a population-based prospective cohort of twins born in England and Wales between March and December 2007). Data were analyzed from July to October 2013 and in June 2018. Exposures Parents completed the Home Environment Interview, a comprehensive measure of the obesogenic home environment in early childhood. Three standardized composite scores were created to capture food, physical activity, and media-related influences in the home; these were summed to create an overall obesogenic risk score. The 4 composite scores were split on the mean, reflecting higher-risk and lower-risk home environments. Main Outcomes and Measures Quantitative genetic model fitting was used to estimate heritability of age-adjusted and sex-adjusted BMI (BMI SD score, estimated using British 1990 growth reference data) for children living in lower-risk and higher-risk home environments. Results Among 1850 twins (915 [49.5%] male and 935 [50.5%] female; mean [SD] age, 4.1 [0.4] years), the heritability of BMI SD score was significantly higher among children living in overall higher-risk home environments (86%; 95% CI, 68%-89%) compared with those living in overall lower-risk home environments (39%; 95% CI, 21%-57%). The findings were similar when examining the heritability of BMI in the separate food and physical activity environment domains. Conclusions and Relevance These findings support the hypothesis that obesity-related genes are more strongly associated with BMI in more obesogenic home environments. Modifying the early home environment to prevent weight gain may be particularly important for children genetically at risk for obesity.
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Affiliation(s)
- Stephanie Schrempft
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Cornelia H. M. van Jaarsveld
- Departments for Health Evidence and Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Abigail Fisher
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Moritz Herle
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Andrea D. Smith
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Clare H. Llewellyn
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Herle M, Fildes A, Llewellyn CH. Emotional eating is learned not inherited in children, regardless of obesity risk. Pediatr Obes 2018; 13:628-631. [PMID: 29931803 PMCID: PMC6220812 DOI: 10.1111/ijpo.12428] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/23/2018] [Accepted: 05/02/2018] [Indexed: 01/29/2023]
Abstract
BACKGROUND Emotional over-eating (EOE) and emotional under-eating (EUE) are common behaviours that develop in early childhood and are hypothesised to play a role in weight status. Data from a British twin cohort demonstrated that environmental, rather than genetic, factors shape individual differences in both behaviours in early childhood. OBJECTIVE The aim of this current study was to replicate this finding in a subsample (n = 398) of 4-year-old twins selected for high or low risk of obesity from another population-based cohort of British twins (the Twins Early Development Study). METHODS Parental ratings of child EOE and EUE were analysed using genetic model fitting. RESULTS Genetic influence was not significant, while shared environmental factors explained 71% (52-79%) of the variance in EOE and 77% (62-85%) in EUE. The two behaviours correlated positively (r = 0.53, 95% CI: 0.44, 0.61), and about two-thirds of the shared environmental factors influencing EOE and EUE were the same (rC = 0.67, 95% CI: 0.51, 0.85). CONCLUSIONS Emotional eating in childhood is shaped by the home family environment; parents are therefore promising intervention targets.
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Affiliation(s)
- M. Herle
- Institute of Child HealthUniversity College LondonLondonUK
| | - A. Fildes
- School of PsychologyUniversity of LeedsLeedsUK
| | - C. H. Llewellyn
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
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Herle M, Fildes A, Steinsbekk S, Rijsdijk F, Llewellyn CH. Emotional over- and under-eating in early childhood are learned not inherited. Sci Rep 2017; 7:9092. [PMID: 28831105 PMCID: PMC5567210 DOI: 10.1038/s41598-017-09519-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 07/27/2017] [Indexed: 01/03/2023] Open
Abstract
Emotional overeating (EOE) has been associated with increased obesity risk, while emotional undereating (EUE) may be protective. Interestingly, EOE and EUE tend to correlate positively, but it is unclear whether they reflect different aspects of the same underlying trait, or are distinct behaviours with different aetiologies. Data were from 2054 five-year-old children from the Gemini twin birth cohort, including parental ratings of child EOE and EUE using the Child Eating Behaviour Questionnaire. Genetic and environmental influences on variation and covariation in EUE and EOE were established using a bivariate Twin Model. Variation in both behaviours was largely explained by aspects of the environment completely shared by twin pairs (EOE: C = 90%, 95% CI: 89%-92%; EUE: C = 91%, 95% CI: 90%-92%). Genetic influence was low (EOE: A = 7%, 95% CI: 6%-9%; EUE: A = 7%, 95% CI: 6%-9%). EOE and EUE correlated positively (r = 0.43, p < 0.001), and this association was explained by common shared environmental influences (BivC = 45%, 95% CI: 40%-50%). Many of the shared environmental influences underlying EUE and EOE were the same (rC = 0.50, 95% CI: 0.44, 0.55). Childhood EOE and EUE are etiologically distinct. The tendency to eat more or less in response to emotion is learned rather than inherited.
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Affiliation(s)
- Moritz Herle
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Alison Fildes
- Department of Behavioural Science and Health, University College London, London, United Kingdom.,School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Silje Steinsbekk
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Fruhling Rijsdijk
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Clare H Llewellyn
- Department of Behavioural Science and Health, University College London, London, United Kingdom.
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Affiliation(s)
- Moritz Herle
- Department of Behavioural Science and Health; University College London
| | - Alison Fildes
- Department of Behavioural Science and Health; University College London
| | | | | | - Clare Llewellyn
- Department of Behavioural Science and Health; University College London
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Smith AD, Herle M, Fildes A, Cooke L, Steinsbekk S, Llewellyn CH. Food fussiness and food neophobia share a common etiology in early childhood. J Child Psychol Psychiatry 2017; 58:189-196. [PMID: 27739065 PMCID: PMC5298015 DOI: 10.1111/jcpp.12647] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND 'Food fussiness' (FF) is the tendency to be highly selective about which foods one is willing to eat, and emerges in early childhood; 'food neophobia' (FN) is a closely related characteristic but specifically refers to rejection of unfamiliar food. These behaviors are associated, but the extent to which their etiological architecture overlaps is unknown. The objective of this study was to quantify the relative contribution of genetic and environmental influences to variation in FF and FN in early childhood; and to establish the extent to which they share common genetic and environmental influences. METHOD Participants were 1,921 families with 16-month-old twins from the Gemini birth cohort. Parents completed the Child Eating Behaviour Questionnaire which included three FF items and four FN items. Bivariate quantitative genetic modeling was used to quantify: (a) genetic and environmental contributions to variation in FF and FN; and (b) the extent to which genetic or environmental influences on FF and FN are shared across the traits. RESULTS Food fussiness and FN were strongly correlated (r = .72, p < .001). Proportions of variation in FF were equally explained by genetic (.46; 95% CI: 0.41-0.52) and shared environmental influences (.46; 95% CI: 0.41-0.51). Shared environmental effects accounted for a significantly lower proportion of variation in FN (.22; 95% CI: 0.14-0.30), but genetic influences were not significantly different from those on FF (.58, 95% CI: 0.50-0.67). FF and FN largely shared a common etiology, indicated by high genetic (.73; 95% CI: 0.67-0.78) and shared environmental correlations (.78; 95% CI: 0.69-0.86) across the two traits. CONCLUSIONS Food fussiness and FN both show considerable heritability at 16 months but shared environmental factors, for example the home environment, influenced more interindividual differences in the expression of FF than in FN. FF and FN largely share a common etiology.
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Affiliation(s)
- Andrea D. Smith
- Department of Epidemiology and Public HealthHealth Behaviour Research CentreUniversity College LondonLondonUK
| | - Moritz Herle
- Department of Epidemiology and Public HealthHealth Behaviour Research CentreUniversity College LondonLondonUK
| | - Alison Fildes
- Department of Epidemiology and Public HealthHealth Behaviour Research CentreUniversity College LondonLondonUK
| | - Lucy Cooke
- Department of Epidemiology and Public HealthHealth Behaviour Research CentreUniversity College LondonLondonUK
| | - Silje Steinsbekk
- Department of PsychologyNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | - Clare H. Llewellyn
- Department of Epidemiology and Public HealthHealth Behaviour Research CentreUniversity College LondonLondonUK
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Smith AD, Fildes A, Cooke L, Herle M, Shakeshaft N, Plomin R, Llewellyn C. Genetic and environmental influences on food preferences in adolescence. Am J Clin Nutr 2016; 104:446-53. [PMID: 27385609 PMCID: PMC4962164 DOI: 10.3945/ajcn.116.133983] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 05/31/2016] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Food preferences vary substantially among adults and children. Twin studies have established that genes and aspects of the shared family environment both play important roles in shaping children's food preferences. The transition from childhood to adulthood is characterized by large gains in independence, but the relative influences of genes and the environment on food preferences in late adolescence are unknown. OBJECTIVE The aim of this study was to quantify the contribution of genetic and environmental influences on food preferences in older adolescents. DESIGN Participants were 2865 twins aged 18-19 y from the TEDS (Twins Early Development Study), a large population-based cohort of British twins born during 1994-1996. Food preferences were measured by using a self-report questionnaire of 62 individual foods. Food items were categorized into 6 food groups (fruit, vegetables, meat or fish, dairy, starch foods, and snacks) by using factor analysis. Maximum likelihood structural equation modeling established genetic and environmental contributions to variations in preferences for each food group. RESULTS Genetic factors influenced a significant and substantial proportion of the variation in preference scores of all 6 food groups: vegetables (0.54; 95% CI: 0.47, 0.59), fruit (0.49; 95% CI: 0.43, 0.55), starchy foods (0.32; 95% CI: 0.24, 0.39), meat or fish (0.44; 95% CI: 0.38, 0.51), dairy (0.44; 95% CI: 0.37, 0.50), and snacks (0.43; 95% CI: 0.36, 0.49). Aspects of the environment that are not shared by 2 twins in a family explained all of the remaining variance in food preferences. CONCLUSIONS Food preferences had a moderate genetic basis in late adolescence, in keeping with findings in children. However, by this older age, the influence of the shared family environment had disappeared, and only aspects of the environment unique to each individual twin influenced food preferences. This finding suggests that shared environmental experiences that influence food preferences in childhood may not have effects that persist into adulthood.
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Affiliation(s)
- Andrea D Smith
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Alison Fildes
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Lucy Cooke
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom; Great Ormond Street Hospital, Children's NHS Foundation Trust, London, United Kingdom; and
| | - Moritz Herle
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Nicholas Shakeshaft
- Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Robert Plomin
- Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Clare Llewellyn
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom;
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Herle M, Fildes A, van Jaarsveld C, Rijsdijk F, Llewellyn CH. Parental Reports of Infant and Child Eating Behaviors are not Affected by Their Beliefs About Their Twins' Zygosity. Behav Genet 2016; 46:763-771. [PMID: 27406596 PMCID: PMC5075016 DOI: 10.1007/s10519-016-9798-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 06/15/2016] [Indexed: 12/12/2022]
Abstract
Parental perception of zygosity might bias heritability estimates derived from parent rated twin data. This is the first study to examine if similarities in parental reports of their young twins’ behavior were biased by beliefs about their zygosity. Data were from Gemini, a British birth cohort of 2402 twins born in 2007. Zygosity was assessed twice, using both DNA and a validated parent report questionnaire at 8 (SD = 2.1) and 29 months (SD = 3.3). 220/731 (8 months) and 119/453 (29 months) monozygotic (MZ) pairs were misclassified as dizygotic (DZ) by parents; whereas only 6/797 (8 months) and 2/445 (29 months) DZ pairs were misclassified as MZ. Intraclass correlations for parent reported eating behaviors (four measured at 8 months; five at 16 months) were of the same magnitude for correctly classified and misclassified MZ pairs, suggesting that parental zygosity perception does not influence reporting on eating behaviors of their young twins.
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Affiliation(s)
- Moritz Herle
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London, London, WC1E 6BT, UK
| | - Alison Fildes
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London, London, WC1E 6BT, UK
| | - Cornelia van Jaarsveld
- Department for Health Evidence & Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Fruhling Rijsdijk
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - Clare H Llewellyn
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London, London, WC1E 6BT, UK.
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Fidika A, Herle M, Knaevelsrud C, Lehmann C, Weiss C, Goldbeck L. 326 Parent's satisfaction with an internet-based supportive intervention for parents of children with cystic fibrosis. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60467-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Goldbeck L, Herle M, Fidika A. 318 Prediction of lung function by psychological symptoms and life satisfaction in patients with cystic fibrosis. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60486-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mercimek-Mahmutoglu S, Moeslinger D, Häberle J, Engel K, Herle M, Strobl MW, Scheibenreiter S, Muehl A, Stöckler-Ipsiroglu S. Long-term outcome of patients with argininosuccinate lyase deficiency diagnosed by newborn screening in Austria. Mol Genet Metab 2010; 100:24-8. [PMID: 20236848 DOI: 10.1016/j.ymgme.2010.01.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Accepted: 01/24/2010] [Indexed: 11/16/2022]
Abstract
Twenty-three patients with late onset argininosuccinate lyase deficiency (ASLD) were identified during a 27-year period of newborn screening in Austria (1:95,600, 95% CI=1:68,036-1:162,531). One additional patient was identified outside the newborn screening with neonatal hyperammonemia. Long-term outcome data were available in 17 patients (median age 13 years) ascertained by newborn screening. Patients were treated with protein restricted diet and oral arginine supplementation during infancy and childhood. IQ was average/above average in 11 (65%), low average in 5 (29%), and in the mild intellectual disability range in 1 (6%) patients. Four patients had an abnormal EEG without evidence of clinical seizures and three had abnormal liver function tests and/or evidence of hepatic steatosis. Plasma citrulline levels were elevated in four patients. Plasma ammonia levels were within normal range prior and after a protein load in all patients. Seven different mutations were identified in the 16 alleles investigated. Four mutations were novel (p.E189G, p.R168C, p.R126P, and p.D423H). All mutations were associated with low argininosuccinate lyase activities (0-15%) in red blood cells. Newborn screening might be beneficial in the prevention of chronic neurologic and intellectual sequelae in late onset ASLD, but a proportion of benign variants might have contributed to the overall favorable outcome as well.
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Affiliation(s)
- S Mercimek-Mahmutoglu
- Department of Pediatrics, Division of Biochemical Diseases, British Columbia University, Vancouver, BC, Canada
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St�ckler-Ipsiroglu S, Herle M, Nennstiel U, Wendel U, Burgard P, Plecko B, Ipsiroglu OS. Angeborene Stoffwechselerkrankungen. Monatsschr Kinderheilkd 2005. [DOI: 10.1007/s00112-004-1072-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Schubert MT, Herle M, Wurst E. [ICD-10 diagnosis and quality of life. A pilot study of quality of life of children and adolescents with psychiatric disorders]. Z Kinder Jugendpsychiatr Psychother 2004; 31:285-91. [PMID: 14694845 DOI: 10.1024/1422-4917.31.4.285] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The present study examined whether the quality of life in children and adolescents with psychological disorders, as judged by the patients themselves and their mothers, differed according to the various ICD-10 diagnoses or the number of axes involved. METHODS 151 children/adolescents and 125 mothers, referred consecutively to the clinic, completed the Inventory for Evaluation of Quality of Life in Children and Adolescents (Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen; ILK) by Mattejat et al. ICD-10 diagnoses were grouped for evaluation. RESULTS No significant interaction between the five diagnostic axes and the several domains of quality of life was found. However, mothers of children and adolescents with attention deficit/hyperactivity disorders and/or conduct disorder more often tended to judge their children's quality of life as unsatisfactory in all domains, while the patients themselves did not. Thus, rather than the children themselves it seems to be the children's environment which considers "external disorders" to be distressing. CONCLUSIONS The authors conclude that the quality of life as measured by the ILK cannot be captured by ICD-10 criteria. Apparently it is not so much the diagnosis itself but its subjective meaning that has the most essential impact on an individual's assessment of quality of life.
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Affiliation(s)
- M T Schubert
- Univ. Klinik für Kinder und Jugendheilkunde, Wien.
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Wurst E, Herle M, Fuiko R, Hajszan M, Katkhouda C, Kieboom A, Schubert MT. [The quality of life of chronically ill and psychiatrically disturbed children. Initial experiences with an inventory for assessing quality of life in children and adolescents]. Z Kinder Jugendpsychiatr Psychother 2002; 30:21-8. [PMID: 11876078 DOI: 10.1024/1422-4917.30.1.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
OBJECTIVES The assessment of the quality of life in chronically ill children as well as in children with emotional and behavioural problems. METHODS A series of questionnaires (Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen, ILK, Mattejat et al.) were administered to 360 patients and 288 mothers at the Vienna University Children's Hospital. RESULTS The results clearly show that patients with diabetes rate themselves as the most emotionally burdened and impaired in nearly all aspects of life: a picture which is confirmed by their mothers. Children and adolescents with psychological problems judge the initial problem as well as their social environment as significantly more burdensome. The respective mothers of these psychologically ill children feel that their impairments are greater in more aspects of life than do mothers of children who are chronically ill. The children generally pinpoint most of their difficulties in the areas "ability to occupy myself" and "psychological health". Among adolescents the most negative ratings occur in the areas "school", "psychological health", and "initial problem". CONCLUSIONS The child's problems seem to weigh heavily upon the mothers. Interventions aimed at adolescents and mothers should be based on problem solving: supportive and anxiety-reducing approaches seem best suited for chronically ill children. Children with psychological problems primarily need problem-centred and practical support.
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Affiliation(s)
- E Wurst
- Univ. Klinik für Kinder und Jugendheilkunde, Wien
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Wurst E, Fuiko R, Hajszan M, Katkhouda C, Kieboom A, Schubert M, Herle M. Zur Lebensqualität chronisch kranker und psychisch auffälliger Kinder. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie 2002. [DOI: 10.1024//1422-4917.30.1.21] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung: Fragestellung: Erhebung der Lebensqualität chronisch kranker bzw. psychisch beeinträchtigter Kinder, Jugendlicher und ihrer Mütter. Methode: Das Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen (ILK) von Mattejat et al. wurde 360 Patienten der Universitätsklinik für Kinder- und Jugendheilkunde Wien und 288 Müttern vorgegeben. Ergebnisse: Aus den Ergebnissen geht hervor, dass - sich unter den chronisch kranken Kindern/Jugendlichen die diabetischen Patienten in nahezu allen Lebensbereichen als am meisten belastet beurteilen. Ein ähnliches Bild ergibt sich in der Stichprobe der Mütter. - Kinder und Jugendliche mit psychischen Auffälligkeiten signifikant erhöhte Beeinträchtigungen den Vorstellungsgrund und ihre sozialen Kontakte betreffend angeben. Ihre Mütter führen in mehreren Lebensbereichen stärkere Beeinträchtigungen der Lebensqualität des Kindes an als Mütter chronisch kranker Kinder. - dass Kinder in den Bereichen «Fähigkeit, sich allein zu beschäftigen» und «psychische Gesundheit» die meisten Probleme sehen. Chronisch kranke Kinder fühlen sich zusätzlich durch die Untersuchung/Behandlung, psychisch auffällige durch das Problem an sich belastet. Jugendliche geben in den Bereichen «Schule», «psychische Gesundheit» und «Problem» die negativsten Bewertungen ab. Mütter erleben sich durch das Problem des Kindes stark belastet. Schlussfolgerungen: Problemverarbeitende Interventionen sollten vorrangig für Jugendliche und Mütter, untersuchungsbegleitende, angstreduzierende Maßnahmen insbesondere für chronisch kranke Kinder vorgesehen sein. Psychisch auffällige Kinder bedürfen problemzentrierter, konkreter Hilfestellungen.
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Affiliation(s)
- E. Wurst
- 1 Univ. Klinik für Kinder und Jugendheilkunde, Wien (Vorstand: Prof. Dr. A. Pollak)
| | - R. Fuiko
- 1 Univ. Klinik für Kinder und Jugendheilkunde, Wien (Vorstand: Prof. Dr. A. Pollak)
| | - M. Hajszan
- 1 Univ. Klinik für Kinder und Jugendheilkunde, Wien (Vorstand: Prof. Dr. A. Pollak)
| | - C. Katkhouda
- 1 Univ. Klinik für Kinder und Jugendheilkunde, Wien (Vorstand: Prof. Dr. A. Pollak)
| | - A. Kieboom
- 1 Univ. Klinik für Kinder und Jugendheilkunde, Wien (Vorstand: Prof. Dr. A. Pollak)
| | - M.T. Schubert
- 1 Univ. Klinik für Kinder und Jugendheilkunde, Wien (Vorstand: Prof. Dr. A. Pollak)
| | - M. Herle
- 2 Psychologisches Institut der Universität Wien
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