When does food refusal require professional intervention?

Food refusal can have the potential to lead to nutritional deficiencies, which increases the risk of a variety of communicable and non-communicable diseases. Deciding when food refusal requires professional intervention is complicated by the fact that there is a natural and appropriate stage in a child's development that is characterised by increased levels of rejection of both previously accepted and novel food items. Therefore, choosing to intervene is difficult, which if handled badly can lead to further food refusal and an even more limited diet. Food refusal is often based on individual preferences; however, it can also be defined through pathological behaviours that require psychological intervention. This paper presents and discusses several different types of food refusal behaviours; these are learningdependent, those that are related to a medical complication, selective food refusal, fear-based food refusal and appetiteawareness-autonomy-based food refusal. This paper describes the behaviours and characteristics that are often associated with each; however, emphasis is placed on the possibility that these different types of food refusal can often be co-morbid. The decision to offer professional intervention to the child and their family should be a holistic process based on the level of medical or psychological distress resulting from the food refusal

What have human experimental overfeeding studies taught us about adipose tissue expansion and susceptibility to obesity and metabolic complications

What have human experimental overfeeding studies taught us about adipose tissue expansion and susceptibility to obesity and metabolic complication

Systematic review of the evidence for sustained efficacy of dietary interventions for reducing appetite or energy intake

We assessed evidence for changes in efficacy of food-based interventions aimed at reducing appetite or energy intake (EI), and whether this could be used to provide guidance on trial design. A systematic search identified randomized controlled trials testing sustained efficacy of diets, foods, supplements or food ingredients on appetite and/or EI. Trials had to include sufficient exposure duration (≥3 days) with appetite and/or EI measured after both acute and repeated exposures. Twenty-six trials met the inclusion criteria and reported data allowing for assessment of the acute and chronic effects of interventions. Most (21/26) measured appetite outcomes and over half (14/26) had objective measures of EI. A significant acute effect of the intervention was retained in 10 of 12 trials for appetite outcomes, and six of nine studies for EI. Initial effects were most likely retained where these were more robust and studies adequately powered. Where the initial, acute effect was not statistically significant, a significant effect was later observed in only two of nine studies for appetite and none of five studies for EI. Maintenance of intervention effects on appetite or EI needs to be confirmed, but seem likely where acute effects are robust and replicable in adequately powered studies

A guide to analysing Universal Eating Monitor data: Assessing the impact of different analysis techniques

Cumulative intake curves and within-meal changes in subjective feelings of fullness can provide researchers with detailed data on the effects of psychological, nutritional or pharmacological manipulations on the expression of human appetite. However, a number of different approaches to the collection and analysis of within-meal data exist resulting in potential to produce contrasting findings. The current study measured cumulative intake and change in appetite using a Universal Eating Monitor (UEM). Three different techniques (area under the curve, visual ascription, and a coefficient approach) were used to analyse the same cumulative intake curves produced in a study of stress on food intake. Twenty-three adult participants (mean age 21 years) consumed ameal comprised of pasta and marinara sauce and, with the aid of the Sussex Meal Pattern Monitor (SMPM), were periodically interrupted to measure subjective feelings of fullness. As hypothesised, analysing cumulative intake curves with differing techniques affected the overall study findings. No significant betweencondition differences in the cumulative intake or fullness curves were found using either the visual ascription or the area under the curve approaches. In contrast, the coefficient approach found a significant difference in the fullness curves between relaxation and cold pressor conditions (p=0.012). This discrepancy in findingswas due to the presence of a quadratic component in the cumulative intake curve in the stress condition whichwas not present in control (p=0.017). Whilst the relative merits of various approaches to microstructural analysis of eating behaviour remain to be fully evaluated, the case for some form of standardised analytic approach may need to be addressed

Measuring food intake, hunger, satiety and satiation in the laboratory

This handbook is a comprehensive collection of measures and assessment tools intended for use by researchers and clinicians that work with people with problem eating behaviors, obese clients, and the associated psychological issues that underlie these problems. It is a reference for researchers who specialize in obesity research and individuals that specialize in working with clients with problem eating behaviors and how to measure and assess their attitudes, beliefs and behaviors with regard to food. It is much broader than eating disorders as it deals with obesity (an area that has reached epidemic proportions in the US) and problem eating behaviors. Its collection is truly unique as no other volume offers such a comprehensive collection all in one place dealing with and focusing on assessments and measures related to eating behaviours. The assessment tools included in this volume include:\ud \ud - General Personality Assessment and psychopathology of persons with eating and weight related concerns \ud \ud - Measures of quality of life assessments \ud \ud - Methods for measuring attitudes and beliefs about obese people \ud \ud - Assessment of Body Image \ud \ud - Measures of Restrained Eating \ud \ud - Measures of Physical Activity \ud \ud - Measuring Food Intake \ud \ud - Binge Eating and Purging \ud \ud - Assessment of Eating and Weight related problems with Children \ud \ud - Identification of Psychological Problems of patients with eating disorders. \u