Attachment and eating: A meta-analytic review of the relevance of attachment for unhealthy and healthy eating behaviors in the general population

Attachment relationships play an important role in people's wellbeing and affliction with physical and mental illnesses, including eating disorders. Seven reviews from the clinical field have consistently shown that higher attachment insecurity—failure to form trusting and reliable relationships with others—systematically characterized individuals with eating disorders. Nevertheless, to date, it is unclear whether (and if so how) these findings apply to the population at large. Consequently, the objective of the present meta-analysis is to quantify the relationship between attachment and unhealthy and healthy eating in the general population. Data from 70 studies and 19,470 participants were converted into r effect sizes and analysed. Results showed that higher attachment insecurity (r = 0.266), anxiety (r = 0.271), avoidance (r = 0.119), and fearfulness (r = 0.184) was significantly associated with more unhealthy eating behaviors, ps = 0.000; conversely, higher attachment security correlated with lower unhealthy eating behaviors (r = −0.184, p = 0.000). This relationship did not vary across type of unhealthy eating behavior (i.e., binge eating, bulimic symptoms, dieting, emotional eating, and unhealthy food consumption). The little exploratory evidence concerning healthy eating and attachment was inconclusive with one exception—healthy eating was associated with lower attachment avoidance (r = −0.211, p = 0.000). Our results extend previous meta-analytic findings to show that lack of trusting and reliable relationships does not only set apart eating disordered individuals from controls, but also characterize unhealthy eating behaviors in the general population. More evidence is needed to determine how attachment and healthy eating are linked and assess potential mechanisms influencing the attachment–eating relationship

Intergenerational Study on the Effects of Attachment Style on Eating Behaviors

Families face many challenges with regard to healthy diets and patterns of exercise. This research combines recent psychology research on self-regulation with that of attachment style to examine from an intergenerational perspective the effect of attachment styles on eating behavior in a sample of child-parent dyads. Results showed more secure attachment in parents and children alike to be linked with knowing more fruits and vegetables and having healthier diets. Furthermore, we found that attachment had a positive impact on males' food knowledge and diets. Lastly, the mediating role of parents' attachment on their children's diets is discussed

Mapping the role of attachment in eating behaviors

Attachment relationships are bonds individuals forge with significant others who act as a safe haven (a place where people can seek comfort) in times of distress. Previous work has established a link between attachment orientations and stress, disease, and negative health outcomes. However, less than a handful of studies have documented the contribution of attachment to everyday food consumption, none with regard to children. This dissertation remediates the above mentioned gap across three essays.Specifically, Essay 1 uses data from 71 publications and 245 effect sizes from 25,350 participants to map the attachment-eating relationship strength using meta-analysis. Results showed positive small to medium size associations between insecure, anxious, avoidant, and fearful attachment bonds, respectively, and maladaptive eating behaviors. Conversely, a negative medium-small association was found between secure attachment bonds and maladaptive eating behaviors. The systematic literature review performed in Essay 1 revealed a lack of evidence regarding the role of attachment in everyday food consumption. Focusing on early forged relationships, Essay 2 aims to address the above gap. Results from survey data with 213 children (Study 1) and 216 adults (Study 2) showed high attachment insecurity scores positively predicted unhealthy food consumption even after controlling for the effects of important confounding variables. Essay 2 is the first study to validate the link between attachment and everyday food consumption in children and to extend it to adults where previous findings showed conflicting evidence.Using data from 616 children enrolled in a broader Brain-to-Society Study, Essay 3 examines the role of peer attachment in predicting unhealthy but also healthy food consumption and explores the moderating effects of gender. Findings showed that peer attachment security predicted lower consumption frequency of unhealthy food items, particularly for girls. In boys, peer attachment avoidance predicted lower vegetable consumption while attachment anxiety was unexpectedly associated with higher vegetable consumption. Together, these essays show that attachment is linked to maladaptive eating and everyday food consumption. The most important contribution of the present dissertation is its focus on everyday food consumption, which provides an important opportunity to build new consumer behavior research and bring this line of work to marketing.Selon la théorie de l’attachement, tous les humains développent des liens avec d’autres êtres humains (figures d’attachement) qui agissent comme un havre de paix (un endroit où nous pouvons chercher du réconfort) en cas de détresse. Des études antérieures ont établi un lien entre l’attachement et le stress, la maladie et les impacts négatifs sur la santé. Toutefois, l’impact des liens d’attachement sur les habitudes alimentaires quotidiennes n’a été que très peu étudié et aucune étude n’a documenté ce lien chez les enfants. Cette thèse vise à combler cette lacune avec trois essais.Plus précisément, le premier essai recueille les données de 71 publications et un total de 245 effets basés sur 25 350 participants pour évalue l’intensité et la profondeur de la relation entre les liens d’attachement et les différentes facettes de l'alimentation en utilisant une méta-analyse. Les résultats ont démontré des associations positives de petite à moyenne tailles entre l’attachement insécure, anxieux, évitant, et désorganisé, respectivement, et les comportements alimentaires inadéquats. En revanche, des associations négatives de moyenne-petite taille ont été observées entre un attachement sécure et les comportements alimentaires inadéquats. La revue systématique de cet essai illustre l'absence de littérature documentant le rôle de l'attachement sur les habitudes alimentaires quotidiennes.En mettant l'accent sur les relations forgées dans l’enfance, le deuxième essai vise à améliorer cette lacune. Des résultats d'enquête comprenant 213 enfants (Étude 1) et 216 adultes (Étude 2) ont démontrés qu’un attachement de type insécure prédit une plus grande consommation d’aliments malsains, même après avoir contrôlé l’effet d’importantes variables. Essai 2 est la première étude à valider le lien entre l'attachement et la consommation de malbouffe chez les enfants, et à confirmer ce lien chez les adultes, où les résultats antérieurs démontraient des effets contradictoires.Basé sur des données d’enquête de 616 enfants, le troisième essai examine le rôle de l'attachement envers les pairs sur la consommation d'aliments sains et malsains, et explore les effets modérateurs du sexe de l’enfant dans cette relation. Les résultats démontrent que des scores plus élevés en termes de «sécurité envers les pairs» ont un impact négatif sur la consommation d’aliments malsains, en particulier chez les filles. Chez les garçons, des scores plus élevées d’attachement de type «évitant envers leurs pairs» ont un effet négatif sur la consommation de légumes. Par contre, des scores plus élevés d’attachement de type «anxieux envers leurs pairs» ont un effet positif sur la consommation de légumes des garçons. Ensemble, ces trois essais démontrent que l'attachement est relié à une alimentation inadéquate. La principale contribution de cette thèse est son focus sur l’alimentation quotidienne, ce qui permettra de générer de nouvelles recherches dans le domaine du comportement du consommateur et d’intégrer ce savoir dans le domaine du marketing

Convergent innovation for sustainable economic growth and affordable universal health care: innovating the way we innovate

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109961/1/nyas12548.pd

Multi-behavioral obesogenic phenotypes among school-aged boys and girls along the birth weight continuum.

Evidence shows that extremes of birth weight (BW) carry a common increased risk for the development of adiposity and related cardiovascular diseases, but little is known about the role of obesogenic behaviors in this process. Moreover, no one has empirically examined whether the relationship between BW, obesogenic behaviors and BMI along the full low-to-high birthweight continuum reflects the U-shape pattern expected from common risk at both BW extremes. Our objective was to characterize physical activity, screen time, and eating behavior and their relationship to BMI as a function of BW among school-aged boys and girls. In this cross-sectional study, 460 children aged 6 to 12 years (50% boys) from Montreal, Canada provided information on sleeping time, screen time, physical activity levels, eating behavior (emotional, external and restrained eating) and anthropometrics (height, weight, BW) through parent reported questionnaires. BMI was normalized using WHO Standards (zBMI), and BW expressed as ratio using Canadian population standards (BW for gestational age and sex). Analyses were conducted using generalized linear models with linear and quadratic terms for BW, stratified by sex and adjusted for age, ethnicity and household income. In boys, physical activity and screen time showed U-shaped associations with BW, while physical activity had an inverted U-shaped in girls. Emotional and restrained eating had positive linear relations with BW in boys and girls. Sleep time and external eating were not associated with BW. A U-shaped relationship between BW and zBMI was found in boys but no association was found in girls. Only sleep (in boys and girls), and emotional eating (girls only) were related to zBMI and mediation of the BW-zBMI relationship was only supported for emotional eating. In conclusion, BW relates to obesogenic behaviors and BMI in both non-linear and linear ways, and these associations differed by sex

Second autologous stem cell transplantation for relapsed/refractory Hodgkin lymphoma after a previous autograft: a study of the lymphoma working party of the EBMT.

The purpose of this study was to analyze the results of second autologous hematopoietic stem cell transplantation (ASCT2) for patients with relapsed/refractory Hodgkin lymphoma (HL) after a first transplantation (ASCT1). Outcomes for 56 patients receiving an ASCT2 registered in the EBMT database were analyzed. The 4-year cumulative incidences of non-relapse mortality and disease relapse/progression were 5% and 67%, respectively. The 4-year overall survival (OS) and progression-free survival (PFS) were 62% and 28%. In univariate analysis, relapse of HL within 12 months of ASCT1 was associated with a worse OS (35% versus 76%,  = 0.01) and PFS (19% versus 29%,  = 0.059). Chemosensitivity at ASCT2 predicted better outcomes (4-year OS 72% versus 29%,  = 0.002; PFS 31% versus 12%,  = 0.015). This series shows that ASCT2 is a safe procedure and a relatively effective option for patients with late relapses after ASCT1 and with chemosensitive disease who are not eligible for an allogeneic transplant