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Radin RM, Epel ES, Mason AE, Vaccaro J, Fromer E, Guan J, Prather AA. Impact of digital meditation on work stress and health outcomes among adults with overweight: A randomized controlled trial. PLoS One 2023; 18:e0280808. [PMID: 36857330 PMCID: PMC9977041 DOI: 10.1371/journal.pone.0280808] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 12/16/2022] [Indexed: 03/02/2023] Open
Abstract
Mindfulness meditation may improve well-being at work; however, effects on food cravings and metabolic health are not well known. We tested effects of digital meditation, alone or in combination with a healthy eating program, on perceived stress, cravings, and adiposity. We randomized 161 participants with overweight and moderate stress to digital meditation ('MED,' n = 38), digital meditation + healthy eating ('MED+HE,' n = 40), active control ('HE,' n = 41), or waitlist control ('WL,' n = 42) for 8 weeks. Participants (n = 145; M(SD) BMI: 30.8 (5.4) kg/m2) completed baseline and 8-week measures of stress (Perceived Stress Scale), cravings (Food Acceptance and Awareness Questionnaire) and adiposity (sagittal diameter and BMI). ANCOVAs revealed that those randomized to MED or MED+HE (vs. HE or WL) showed decreases in perceived stress (F = 15.19, p < .001, η2 = .10) and sagittal diameter (F = 4.59, p = .03, η2 = .04), with no differences in cravings or BMI. Those high in binge eating who received MED or MED+HE showed decreases in sagittal diameter (p = .03). Those with greater adherence to MED or MED+HE had greater reductions in stress, cravings, and adiposity (ps < .05). A brief digital mindfulness-based program is a low-cost method for reducing perceptions of stress and improving abdominal fat distribution patterns among adults with overweight and moderate stress. Future work should seek to clarify mechanisms by which such interventions contribute to improvements in health. Trial registration: Clinical trial registration http://www.ClinicalTrials.gov: identifier NCT03945214.
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Affiliation(s)
- Rachel M. Radin
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Elissa S. Epel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Ashley E. Mason
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - Julie Vaccaro
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Elena Fromer
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Joanna Guan
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Aric A. Prather
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
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Radin RM, Epel ES, Daubenmier J, Moran P, Schleicher S, Kristeller J, Hecht FM, Mason AE. Do stress eating or compulsive eating influence metabolic health in a mindfulness-based weight loss intervention? Health Psychol 2019; 39:147-158. [PMID: 31724424 DOI: 10.1037/hea0000807] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE We aimed to understand the associations of compulsive eating (CE) and stress eating (SE) with metabolic health among adults with obesity and whether mindfulness-based weight loss training may buffer these associations. METHOD We used data from a trial in which we randomized 194 participants with obesity to a diet-exercise weight loss intervention with either mindful eating training plus mindfulness-based eating awareness and stress management training (n = 100) or active control components (n = 94). We measured CE, SE, weight, and fasting blood glucose (FBG) at baseline, and 6, 12 months, and 18 months. We tested CE and SE as both moderators and mediators of intervention effects on changes in metabolic health. RESULTS Participants higher (+ 1 SD) in CE at baseline randomized to the mindfulness (vs. control) intervention had greater improvements in FBG at 18 months (p = .05). Twelve-month reductions in CE mediated the effect of the intervention on changes in FBG and weight at 12 and 18 months postbaseline (p ≤ .05). Furthermore, those higher (+ 1 SD) in SE at baseline were nearly 2 BMI points higher than those lower (-1 SD) in SE (p < .01). Decreases in SE (B = 3.42; p < .001; 95% CI [2.55, 4.30]) and CE (B = 0.45; p < .001; 95% CI [0.36, 0.54]) in all participants at 6 months were associated with greater weight loss at 18 months. CONCLUSIONS Those with greater compulsive eating may reduce risk for metabolic decline by participating in a mindfulness-based weight loss program. Future obesity interventions should consider tailoring treatment toward trait-level characteristics, such as compulsive eating. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Radin RM, Mason AE, Laudenslager ML, Epel ES. Maternal caregivers have confluence of altered cortisol, high reward-driven eating, and worse metabolic health. PLoS One 2019; 14:e0216541. [PMID: 31075126 PMCID: PMC6510426 DOI: 10.1371/journal.pone.0216541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 04/23/2019] [Indexed: 01/01/2023] Open
Abstract
Animal models have shown that chronic stress increases cortisol, which contributes to overeating of highly palatable food, increased abdominal fat and lower cortisol reactivity. Few studies in humans have simultaneously examined these trajectories. We examined premenopausal women, either mothers of children with a diagnosis of an autism spectrum disorder (n = 92) or mothers of neurotypical children (n = 91). At baseline and 2-years, we assessed hair cortisol, metabolic health, and reward-based eating. We compared groups cross-sectionally and prospectively, accounting for BMI change. Caregivers, relative to controls, had lower cumulative hair cortisol at each time point, with no decreases over time. Caregivers also had stable levels of poor metabolic functioning and greater reward-based eating across both time points, and evidenced increased abdominal fat prospectively (all ps ≤.05), independent of change in BMI. This pattern of findings suggest that individuals under chronic stress, such as caregivers, would benefit from tailored interventions focusing on better regulation of stress and eating in tandem to prevent early onset of metabolic disease, regardless of weight status.
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Affiliation(s)
- Rachel M. Radin
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States of America
- * E-mail:
| | - Ashley E. Mason
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - Mark L. Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Elissa S. Epel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States of America
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Skoranski A, Kelly NR, Radin RM, Thompson KA, Galescu O, Demidowich AP, Brady SM, Chen KY, Tanofsky-Kraff M, Yanovski JA, Shomaker LB. Relationship of Mindfulness to Distress and Cortisol Response in Adolescent Girls At-Risk for Type 2 Diabetes. J Child Fam Stud 2018; 27:2254-2264. [PMID: 30100695 PMCID: PMC6085111 DOI: 10.1007/s10826-018-1065-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Altered stress response theoretically contributes to the etiology of cardiometabolic disease. Mindfulness may be a protective buffer against the effects of stress on health outcomes by altering how individuals evaluate and respond to stress. We engaged adolescent girls at risk for developing Type 2 diabetes in a cold-pressor test in order to determine the relationship of dispositional mindfulness to cortisol response and subjective stress, including perceived pain and unpleasantness during the stressor, and negative affect following the stressor. We also evaluated mindfulness as a moderator of psychological distress (depressive/anxiety symptoms) and stress response. Participants were 119 girls age 12-17 years with overweight/obesity, family history of diabetes, and mild-to-moderate depressive symptoms. Greater mindfulness was associated with less perceived pain and negative affect, but was unrelated to cortisol response to the stressor. Regardless of mindfulness, greater depressive/anxiety symptoms related to a more blunted cortisol response. Mindfulness might promote better distress tolerance in adolescents at risk for diabetes by altering how youth perceive and relate to acute stress, rather than through altering the physiological stress response. At all levels of mindfulness, depressive/anxiety symptoms relate to greater blunting of cortisol response. Findings contribute to emerging literature on the role of mindfulness in promoting the mental and physical health and well-being of individuals at risk for Type 2 diabetes.
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Affiliation(s)
- Amanda Skoranski
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - Nichole R. Kelly
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD, USA
- Department of Counseling Psychology and Human Services and the Prevention Science Institute, College of Education, University of Oregon, Eugene, OR, USA
| | - Rachel M. Radin
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, Bethesda, MD, USA
| | - Katherine A. Thompson
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD, USA
| | - Ovidiu Galescu
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD, USA
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD, USA
| | - Kong Y. Chen
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, DHHS, Bethesda, MD, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, Bethesda, MD, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD, USA
| | - Lauren B. Shomaker
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD, USA
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Shank LM, Tanofsky-Kraff M, Radin RM, Shomaker LB, Wilfley DE, Young JF, Brady S, Olsen CH, Reynolds JC, Yanovski JA. Remission of loss of control eating and changes in components of the metabolic syndrome. Int J Eat Disord 2018; 51:565-573. [PMID: 29607525 PMCID: PMC6002918 DOI: 10.1002/eat.22866] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Pediatric loss of control (LOC) eating prospectively predicts the worsening of metabolic syndrome components. However, it is unknown if remission of LOC eating is associated with improvements in metabolic health. Therefore, we conducted a secondary analysis of a trial that enrolled adolescent girls with LOC eating, examining whether LOC remission (vs. persistence) at end-of-treatment was associated with changes in metabolic syndrome components at 6-month follow-up. METHOD One hundred three adolescent girls (age 14.5 ± 1.7 years; BMI-z 1.5 ± 0.3; 56.3% non-Hispanic White, 24.3% non-Hispanic Black) with elevated weight (75th-97th BMI %ile) and reported LOC eating were assessed for metabolic syndrome components at baseline and again six months following the interventions. The main effects of LOC status at end-of-treatment (persistence vs. remission) on metabolic syndrome components (waist circumference, lipids, glucose, and blood pressure) at 6-month follow-up were examined, adjusting for baseline age, depressive symptoms, LOC frequency, fat mass, and height, as well as race, change in height, change in fat mass, and the baseline value of each respective component. RESULTS Youth with LOC remission at end-of-treatment had lower glucose (83.9 ± 6.4 vs. 86.5 ± 5.8 mg/dL; p = .02), higher high-density lipoprotein cholesterol (50.3 ± 11.8 vs. 44.8 ± 11.9 mg/dL; p = .01), and lower triglycerides (84.4 ± 46.2 vs. 96.9 ± 53.7 mg/dL; p = .02) at 6-month follow-up when compared with youth with persistent LOC, despite no baseline differences in these components. No other component significantly differed by LOC eating status (ps > .05). DISCUSSION Reducing LOC eating in adolescent girls may have a beneficial impact on some components of the metabolic syndrome.
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Affiliation(s)
- Lisa M Shank
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland.,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland.,Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, Maryland
| | - Marian Tanofsky-Kraff
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland.,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland
| | - Rachel M Radin
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland.,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland
| | - Lauren B Shomaker
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland.,Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Penninsylvania
| | - Sheila Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland
| | - Cara H Olsen
- Preventive Medicine and Biostatistics Department, USUHS, Bethesda, Maryland
| | - James C Reynolds
- Radiology and Imaging Sciences Department, Clinical Center, NIH, Bethesda, Maryland
| | - Jack A Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland
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Cassidy O, Eichen DM, Burke NL, Patmore J, Shore A, Radin RM, Sbrocco T, Shomaker LB, Mirza N, Young JF, Wilfley DE, Tanofsky-Kraff M. Engaging African American Adolescents and Stakeholders to Adapt Interpersonal Psychotherapy for Weight Gain Prevention. Journal of Black Psychology 2017. [DOI: 10.1177/0095798417747142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Developing culturally appropriate obesity prevention programs for African American (AA) adolescent girls that account for psychological risk factors is paramount to addressing health disparities. The current study was part of an investigation utilizing a community-based participatory research framework to gather qualitative data from urban AA girls, their caregivers, and community health liaisons to develop a novel obesity prevention program based on interpersonal psychotherapy for the prevention of excessive weight gain (IPT-WG). In the current study with urban AAs, data from seven focus groups (total sample size, N = 40) were analyzed using thematic analysis. Participants identified problematic eating behaviors, including binge or loss of control eating; highlighted the importance of interpersonal relationships, mood functioning, and eating; and supported the tenets of IPT-WG. While features of IPT-WG generally resonated with participants, culturally based modifications were suggested. These data will be used to inform the development of a culturally relevant IPT-WG program.
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Affiliation(s)
- Omni Cassidy
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Dawn M. Eichen
- Washington University School of Medicine, St. Louis, MO, USA
| | - Natasha L. Burke
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Allison Shore
- Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel M. Radin
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Tracy Sbrocco
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Nazrat Mirza
- Children’s National Health System, Washington, DC, USA
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Shomaker LB, Kelly NR, Radin RM, Cassidy OL, Shank LM, Brady SM, Demidowich AP, Olsen CH, Chen KY, Stice E, Tanofsky-Kraff M, Yanovski JA. Prevention of insulin resistance in adolescents at risk for type 2 diabetes with depressive symptoms: 1-year follow-up of a randomized trial. Depress Anxiety 2017; 34:866-876. [PMID: 28370947 PMCID: PMC5623599 DOI: 10.1002/da.22617] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/24/2017] [Accepted: 02/07/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Depression is associated with poor insulin sensitivity. We evaluated the long-term effects of a cognitive behavioral therapy (CBT) program for prevention of depression on insulin sensitivity in adolescents at risk for type 2 diabetes (T2D) with depressive symptoms. METHODS One-hundred nineteen adolescent females with overweight/obesity, T2D family history, and mild-to-moderate depressive symptoms were randomized to a 6-week CBT group (n = 61) or 6-week health education (HE) control group (n = 58). At baseline, posttreatment, and 1 year, depressive symptoms were assessed, and whole body insulin sensitivity (WBISI) was estimated from oral glucose tolerance tests. Dual energy X-ray absorptiometry assessed fat mass at baseline and 1 year. Primary outcomes were 1-year changes in depression and insulin sensitivity, adjusting for adiposity and other relevant covariates. Secondary outcomes were fasting and 2-hr insulin and glucose. We also evaluated the moderating effect of baseline depressive symptom severity. RESULTS Depressive symptoms decreased in both groups (P < .001). Insulin sensitivity was stable in CBT and HE (ΔWBISI: .1 vs. .3) and did not differ between groups (P = .63). However, among girls with greater (moderate) baseline depressive symptoms (N = 78), those in CBT developed lower 2-hr insulin than those in HE (Δ-16 vs. 16 μIU/mL, P < .05). Additional metabolic benefits of CBT were seen for this subgroup in post hoc analyses of posttreatment to 1-year change. CONCLUSIONS Adolescent females at risk for T2D decreased depressive symptoms and stabilized insulin sensitivity 1 year following brief CBT or HE. Further studies are required to determine if adolescents with moderate depression show metabolic benefits after CBT.
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Affiliation(s)
- Lauren B. Shomaker
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS),Department of Human Development and Family Studies and Colorado School of Public Health, Colorado State University
| | - Nichole R. Kelly
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Counseling Psychology and Human Services and the Prevention Science Institute, College of Education, University of Oregon
| | - Rachel M. Radin
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Omni L. Cassidy
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Lisa M. Shank
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Sheila M. Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)
| | - Cara H. Olsen
- Biostatistics, Department of Preventive Medicine, Uniformed Services University of the Health Sciences
| | - Kong Y. Chen
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, NIH
| | | | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Jack A. Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)
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Radin RM, Shomaker LB, Kelly NR, Pickworth CK, Thompson KA, Brady SM, Demidowich A, Galescu O, Altschul AM, Shank LM, Yanovski SZ, Tanofsky-Kraff M, Yanovski JA. Cortisol response to an induction of negative affect among adolescents with and without loss of control eating. Pediatr Obes 2016; 11:513-520. [PMID: 26667312 PMCID: PMC4909600 DOI: 10.1111/ijpo.12095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 11/11/2015] [Accepted: 11/12/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Adults with binge eating disorder may have an exaggerated or blunted cortisol response to stress. Yet, limited data exist among youth who report loss of control (LOC) eating, a developmental precursor to binge eating disorder. METHODS We studied cortisol reactivity among 178 healthy adolescents with and without LOC eating. Following a buffet lunch meal adolescents were randomly assigned to watch a neutral or sad film clip. After, they were offered snacks from a multi-item array to assess eating in the absence of hunger. Salivary cortisol was collected at -80, 0, 30 and 50 min relative to film administration, and state mood ratings were reported before and after the film. RESULTS Adolescents with LOC had greater increases in negative affect during the experimental paradigm in both conditions (ps > 0.05). Depressive symptoms, but not LOC, related to a greater cortisol response in the sad film condition (ps > 0.05). Depressive symptoms and state LOC were related to different aspects of eating behaviour, independent of film condition or cortisol response (ps > 0.05). CONCLUSIONS A film clip that induced depressed state affect increased salivary cortisol only in adolescents with more elevated depressive symptoms. Adolescents with and without LOC were differentiated by greater increases in state depressed affect during laboratory test meals but had no difference in cortisol reactivity. Future studies are required to determine if adolescents with LOC manifest alterations in stress reactivity to alternative stress-inducing situations.
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Affiliation(s)
- Rachel M. Radin
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Lauren B. Shomaker
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA,Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, 80523, USA
| | - Nichole R. Kelly
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA,Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, 80523, USA
| | - Courtney K. Pickworth
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA
| | - Katherine A. Thompson
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA
| | - Andrew Demidowich
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA
| | - Ovidiu Galescu
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA
| | - Anne M. Altschul
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA
| | - Lisa M. Shank
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA,Office of Obesity Research, Division of Digestive Diseases and Nutrition, National Institute of Diabetes, Digestive, and Kidney Disorders, NIH, DHHS, Bethesda, Maryland, 20892, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892, USA
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Kelly NR, Shomaker LB, Radin RM, Thompson KA, Cassidy OL, Brady S, Mehari R, Courville AB, Chen KY, Galescu OA, Tanofsky-Kraff M, Yanovski JA. Associations of sleep duration and quality with disinhibited eating behaviors in adolescent girls at-risk for type 2 diabetes. Eat Behav 2016; 22:149-155. [PMID: 27289521 PMCID: PMC4983254 DOI: 10.1016/j.eatbeh.2016.06.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 04/01/2016] [Revised: 04/28/2016] [Accepted: 06/01/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Short sleep duration and daytime sleepiness have been associated with an increased risk for the onset of type 2 diabetes in adults. There has been far less attention to the characterization of sleep in adolescents at-risk for diabetes or to the possible behavioral mechanisms, such as disinhibited eating, through which sleep may affect metabolic functioning. METHODS We evaluated the associations of sleep duration and daytime sleepiness with a multi-modal assessment of disinhibited eating in 119 adolescent girls at-risk for type 2 diabetes based upon being overweight/obese and having a family history of diabetes. Girls also endorsed mild-to-moderate depressive symptoms. Adolescents reported sleep duration and daytime sleepiness with the Sleep Habits Survey and Children's Sleep Habits Questionnaire. They were administered a series of successive test meals to measure total energy intake and eating in the absence of hunger (EAH). Adolescent binge eating was assessed with the Eating Disorder Examination interview. RESULTS Accounting for age, race, puberty, body composition, depressive symptoms, and perceived stress, reported sleep duration was positively related to test meal total energy intake (p=0.04), but not to EAH. Adjusting for the same covariates, daytime sleepiness was associated with a greater odds of objective binge eating in the previous month (p=0.009). CONCLUSIONS In adolescent girls at-risk for type 2 diabetes, reported sleep characteristics are associated with disinhibited eating behaviors that have been linked to excessive weight and adverse metabolic outcomes. Future studies are called for to evaluate these links using objective measures of sleep.
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Affiliation(s)
- Nichole R Kelly
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, MD 20814, United States
| | - Lauren B Shomaker
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States; Department of Human Development and Family Studies, Colorado State University, 410 Pitkin Street, Campus Delivery 1570, Fort Collins, CO 80523, United States.
| | - Rachel M Radin
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, MD 20814, United States
| | - Katherine A Thompson
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States
| | - Omni L Cassidy
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, MD 20814, United States
| | - Sheila Brady
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States
| | - Rim Mehari
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States
| | - Amber B Courville
- Nutrition Department, NIH Clinical Center, DHHS, 10 Center Drive, MSC 1078, Bethesda, MD 20892, United States
| | - Kong Y Chen
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, DHHS, 10 Center Drive, Bethesda, MD 20814, United States
| | - Ovidiu A Galescu
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, MD 20814, United States
| | - Jack A Yanovski
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States
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Radin RM, Tanofsky-Kraff M, Shomaker LB, Kelly NR, Pickworth CK, Shank LM, Altschul AM, Brady SM, Demidowich AP, Yanovski SZ, Hubbard VS, Yanovski JA. Metabolic characteristics of youth with loss of control eating. Eat Behav 2015. [PMID: 26210388 PMCID: PMC4644474 DOI: 10.1016/j.eatbeh.2015.07.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Preliminary data in adults suggest that binge eating is associated with greater prevalence of metabolic syndrome (MetS) components. However, there are limited data in youth, and little is known of the role of binge episode size in these relationships. METHODS We examined the relationship between loss of control eating and metabolic characteristics in a convenience sample of 329 treatment-seeking and non-treatment-seeking adolescent boys and girls. The sample was enriched by design with adolescents who were overweight or obese and with individuals who reported episodes of loss of control over their eating (either objectively large binge episodes, OBEs or subjectively large binge episodes, SBEs, in the past month), as assessed by clinical interview. MetS components (blood pressure, lipids, glucose, and waist circumference) were the primary variables of interest. RESULTS 46% of the cohort reported loss of control eating; among those, 53% reported SBEs only and 47% reported OBEs. Youth with loss of control eating had higher systolic blood pressure (p=.001) and higher low-density lipoprotein cholesterol (LDL-c) (p=.002) compared to those without loss of control eating, in analyses adjusted for intervention-seeking status, fat mass and sociodemographic characteristics. Youth reporting OBEs had higher LDL-c (p=.013) compared to those reporting only SBEs. CONCLUSIONS Adolescents reporting loss of control episodes had greater dysfunction in some components of the MetS compared to youth without loss of control; episode size may contribute to metabolic dysfunction.
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Affiliation(s)
- Rachel M. Radin
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892-1103,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892-1103,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Lauren B. Shomaker
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892-1103,Colorado State University, Fort Collins, Colorado, 80523, USA
| | - Nichole R. Kelly
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892-1103,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Courtney K. Pickworth
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892-1103
| | - Lisa M. Shank
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892-1103,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Anne M. Altschul
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892-1103
| | - Sheila M. Brady
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892-1103
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892-1103
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892-1103,Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, NIH
| | - Van S. Hubbard
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, NIH,Division of Nutrition Research Coordination, NIH
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892-1103,Corresponding Author: Jack A. Yanovski, MD, PhD, Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, NICHD, NIH, 10 Center Drive, Hatfield Clinical Research Center, Room 1E-3330, MSC 1103, Bethesda, Maryland, 20892-1103, USA; Phone: 301-496-0858; Fax: 301-402-0574;
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Pivarunas B, Kelly NR, Pickworth CK, Cassidy O, Radin RM, Shank LM, Vannucci A, Courville AB, Chen KY, Tanofsky-Kraff M, Yanovski JA, Shomaker LB. Mindfulness and eating behavior in adolescent girls at risk for type 2 diabetes. Int J Eat Disord 2015; 48:563-9. [PMID: 26172157 PMCID: PMC4544599 DOI: 10.1002/eat.22435] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [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: 05/25/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The purpose of this investigation was to examine the relationship of dispositional mindfulness to binge eating and associated eating attitudes and behaviors among adolescent girls at risk for type 2 diabetes (T2D). METHODS Participants were 114 overweight or obese adolescents enrolled in a study of girls with a family history of T2D and mild depressive symptoms. Adolescent self-reports of mindfulness, eating in the absence of hunger, and depressive symptoms were collected. An interview was administered to determine presence of binge eating episodes and a behavioral task was used to assess the reinforcing value of food relative to other nonsnack food rewards. Body composition was assessed using dual-energy X-ray absorptiometry. RESULTS In analyses accounting for race, percent body fat, lean mass, height, age, and depressive symptoms, dispositional mindfulness was associated with a lower odds of binge eating (p = .002). Controlling for the same potential confounds, mindfulness was also inversely associated with eating concern, eating in the absence of hunger in response to fatigue/boredom, and higher food reinforcement relative to physical activity (all p < .05). DISCUSSION In girls with a family history of T2D, independent of body composition and depressive symptoms, intraindividual differences in mindfulness are related to binge eating and associated attitudes and behaviors that may confer risk for obesity and metabolic problems. Further research is needed to determine the extent to which mindfulness plays a role in the etiology and/or maintenance of disinhibited eating in adolescents at risk for T2D.
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Affiliation(s)
- Bernadette Pivarunas
- Department of Psychology, Colorado State University, 410 Pitkin Street, Fort Collins, Colorado 80524
| | - Nichole R. Kelly
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892
- Department of Human Development and Family Studies, Colorado State University, 410 Pitkin Street, Campus Delivery 1570, Fort Collins, Colorado 80523
| | - Courtney K. Pickworth
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892
| | - Omni Cassidy
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, Maryland 20814
| | - Rachel M. Radin
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, Maryland 20814
| | - Lisa M. Shank
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, Maryland 20814
| | - Anna Vannucci
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, Maryland 20814
| | - Amber B. Courville
- Nutrition Department, NIH Clinical Center, DHHS, 10 Center Drive, MSC 1078, Bethesda, Maryland 20892
| | - Kong Y. Chen
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, DHHS, 10 Center Drive, Bethesda, Maryland 20892
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, Maryland 20814
| | - Jack A. Yanovski
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892
| | - Lauren B. Shomaker
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892
- Department of Human Development and Family Studies, Colorado State University, 410 Pitkin Street, Campus Delivery 1570, Fort Collins, Colorado 80523
- Correspondence to: Lauren B. Shomaker, Ph.D.; Colorado State University, Department of Human Development and Family Studies, 410 Pitkin Street, Campus Delivery 1570, Fort Collins, Colorado 80523.
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12
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Kelly NR, Shomaker LB, Pickworth CK, Grygorenko MV, Radin RM, Vannucci A, Shank LM, Brady SM, Courville AB, Tanofsky-Kraff M, Yanovski JA. Depressed affect and dietary restraint in adolescent boys' and girls' eating in the absence of hunger. Appetite 2015; 91:343-50. [PMID: 25936291 DOI: 10.1016/j.appet.2015.04.072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 08/28/2014] [Revised: 04/08/2015] [Accepted: 04/26/2015] [Indexed: 10/23/2022]
Abstract
Data suggest that depressed affect and dietary restraint are related to disinhibited eating patterns in children and adults. Yet, experimental research has not determined to what extent depressed affect acutely affects eating in the absence of physiological hunger (EAH) in adolescents. In the current between-subjects experimental study, we measured EAH in 182 adolescent (13-17 y) girls (65%) and boys as ad libitum palatable snack food intake after youth ate to satiety from a buffet meal. Just prior to EAH, participants were randomly assigned to view either a sad or neutral film clip. Dietary restraint was measured with the Eating Disorder Examination. Adolescents who viewed the sad film clip reported small but significant increases in state depressed affect relative to adolescents who viewed the neutral film clip (p < .001). Yet, there was no main effect of film condition on EAH (p = .26). Instead, dietary restraint predicted greater EAH among girls, but not boys (p < .001). These findings provide evidence that adolescent girls' propensity to report restrained eating is associated with their greater disinhibited eating in the laboratory. Additional experimental research, perhaps utilizing a more potent laboratory stressor and manipulating both affective state and dietary restraint, is required to elucidate how state affect may interact with dietary restraint to influence EAH during adolescence.
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Affiliation(s)
- Nichole R Kelly
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Department of Health and Human Services (DHHS), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Colorado State University, 303A Behavioral Sciences Building, Campus Delivery 1570, 410 Pitkin Street, Fort Collins, CO 80523, USA
| | - Lauren B Shomaker
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Department of Health and Human Services (DHHS), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Colorado State University, 303A Behavioral Sciences Building, Campus Delivery 1570, 410 Pitkin Street, Fort Collins, CO 80523, USA.
| | - Courtney K Pickworth
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Department of Health and Human Services (DHHS), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Mariya V Grygorenko
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Department of Health and Human Services (DHHS), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Rachel M Radin
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Department of Health and Human Services (DHHS), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Department of Health and Human Services (DHHS), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Department of Health and Human Services (DHHS), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Sheila M Brady
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Department of Health and Human Services (DHHS), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Amber B Courville
- Nutrition Department, Clinical Center, NIH, 10 Center Drive, Bethesda, MD 20892, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Department of Health and Human Services (DHHS), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Department of Health and Human Services (DHHS), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
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Tanofsky-Kraff M, Shomaker LB, Wilfley DE, Young JF, Sbrocco T, Stephens M, Ranzenhofer LM, Elliott C, Brady S, Radin RM, Vannucci A, Bryant EJ, Osborn R, Berger SS, Olsen C, Kozlosky M, Reynolds JC, Yanovski JA. Targeted prevention of excess weight gain and eating disorders in high-risk adolescent girls: a randomized controlled trial. Am J Clin Nutr 2014; 100:1010-8. [PMID: 25240070 PMCID: PMC4163791 DOI: 10.3945/ajcn.114.092536] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The high prevalence and incidence of obesity and eating disorders in US adolescent girls are serious health problems. Because of the shared risk factors for obesity and eating disorders, a targeted prevention of both conditions is a priority. OBJECTIVE We determined whether an adapted interpersonal psychotherapy prevention program is more efficacious for reducing excess weight gain and worsening disordered eating than health education in adolescent girls at high risk of obesity and eating disorders. DESIGN A parallel-group, randomized controlled trial was conducted between September 2008 and January 2013 in a university-based laboratory and a federal research hospital. The study included 113 adolescent (12-17-y-old) girls deemed at high risk of adult obesity and eating disorders because of a body mass index (BMI) between the 75th and 97th percentiles and reports of episodes of a loss of control over their eating. Girls were randomly assigned to participate in an adapted interpersonal psychotherapy or a health-education group program for 12 weekly 90-min group sessions. Follow-up assessments occurred immediately after group programs and at 6 and 12 mo. RESULTS Participation in both conditions was associated with decreases in expected BMI gain, age-adjusted BMI metrics, the percentage of fat by using dual-energy X-ray absorptiometry, symptoms of depression and anxiety, and the frequency of loss-of-control eating over 12 mo of follow-up (Ps < 0.001) with no group difference. In follow-up analyses, interpersonal psychotherapy was more efficacious than health education at reducing objective binge eating at the 12-mo follow-up (P < 0.05). CONCLUSIONS The intervention with adolescent girls with loss-of-control eating is associated with lower age-adjusted BMI and percentage of adiposity as well as improved mood symptoms over 1 y. Interpersonal psychotherapy further reduced objective binge eating. Additional research is needed to elucidate the mechanisms by which physical and psychological improvements were observed. This trial was registered at clinicaltrials.gov as NCT00680979.
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Affiliation(s)
- Marian Tanofsky-Kraff
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Lauren B Shomaker
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Denise E Wilfley
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Jami F Young
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Tracy Sbrocco
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Mark Stephens
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Lisa M Ranzenhofer
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Camden Elliott
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Sheila Brady
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Rachel M Radin
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Anna Vannucci
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Edny J Bryant
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Robyn Osborn
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Sarah S Berger
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Cara Olsen
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Merel Kozlosky
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - James C Reynolds
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Jack A Yanovski
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
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