Weight suppression as a predictor variable in the treatment of eating disorders: a systematic review

Introduction: Weight suppression (WS – the difference between highest body weight and current body weight) has been proposed as a predictor of treatment outcome within eating disorders (EDs), although this hypothesis has not been consistently supported. Aim/Question: Review the association between pre-treatment WS and outcome following psychological treatment for EDs. Method: A comprehensive electronic database search for published and unpublished literature from 1979 to 2017. Reference lists were also inspected. Eligibility criteria were determined according to relevant guidelines and a quality appraisal was conducted. Results: Twelve studies met inclusion criteria (one was subsequently excluded based on insufficient data). Greater WS was generally associated with weight gain at post-treatment although not with other treatment outcomes. Discussion: The existing evidence, with data from 1566 participants, is summarised according to three main post-treatment outcomes: weight change; treatment completion; and symptom abstinence. Patients with disordered eating and greater WS may need to gain more weight than others during treatment to achieve good outcomes. Recommendations for future studies are provided. Implications for Practice: Evidence-based treatments for EDs may benefit from considering WS when planning treatment, such as further psychoeducation on weight changes. Societal interventions regarding promotion of healthy eating may also draw on these findings

Purchasing Behavior, Setting, Pricing, Family: Determinants of School Lunch Participation

Despite growing school lunch availability in Germany, its utilization is still low, and students resort to unhealthy alternatives. We investigated predictors of school lunch participation and reasons for nonparticipation in 1215 schoolchildren. Children reported meal habits, parents provided family-related information (like socioeconomic status), and anthropometry was conducted on-site in schools. Associations between school lunch participation and family-related predictors were estimated using logistic regression controlling for age and gender if necessary. School was added as a random effect. School lunch participation was primarily associated with family factors. While having breakfast on schooldays was positively associated with school lunch participation (ORadj = 2.20, p = 0.002), lower secondary schools (ORadj = 0.52, p < 0.001) and low SES (ORadj = 0.25, p < 0.001) were negatively associated. The main reasons for nonparticipation were school- and lunch-related factors (taste, time constraints, pricing). Parents reported pricing as crucial a reason as an unpleasant taste for nonparticipation. Nonparticipants bought sandwiches and energy drinks significantly more often on school days, whereas participants were less often affected by overweight (OR = 0.66, p = 0.043). Our data stress school- and lunch-related factors as an important opportunity to foster school lunch utilization

Overweight Proxies Are Associated with Atopic Asthma: A Matched Case–Control Study

Background: Many studies have documented a link between overweight and asthma in children with contradictory results regarding the best way to measure overweight. Moreover, often, the dynamic development of atopy, overweight, and asthma is controlled for age dependency insufficiently. Objective: This study assesses and compares the associations of overweight measured as waist circumference, waist to height ratio (WHtR), neck circumference, and body mass index with the occurrence of asthma – best possibly controlling for age-dependencies of these parameters. Methods: From a sample of 2,511 children aged 6–17 years, we matched 157 children with asthma with 2 controls (n = 471) according to age and atopy status and performed conditional logistic regression analyses. We further investigated the role of known influencing factors of asthma occurrence. Results: In children with atopy, all overweight proxies were consistently positively associated with asthma. Statistical significance was reached for WHtR-SD score (OR 1.26, 95% CI 1.03–1.54, p = 0.025) and persisted when further covariates, such as birth weight or social status, were added to the model. Groups of atopic versus nonatopic participants do not differ in levels of interleukin-6 or high-sensitivity C-reactive protein. Conclusion: In our cohort, overweight seems to carry a risk for asthma only if accompanied with atopy. We call for more strict age matching in pediatric cohort studies and longitudinal studies for a better understanding for causal links of overweight, atopy, and asthma

And yet Again: Having Breakfast Is Positively Associated with Lower BMI and Healthier General Eating Behavior in Schoolchildren

Given the high prevalence of childhood overweight, school-based programs aiming at nutritional behavior may be a good starting point for community-based interventions. Therefore, we investigated associations between school-related meal patterns and weight status in 1215 schoolchildren. Anthropometry was performed on-site in schools. Children reported their meal habits, and parents provided family-related information via questionnaires. Associations between nutritional behavior and weight status were estimated using hierarchical linear and logistic regression. Analyses were adjusted for age, socio–economic status, school type, migration background, and parental weight status. Having breakfast was associated with a lower BMI-SDS (βadj = −0.51, p = 0.004) and a lower risk of being overweight (ORadj = 0.30, p = 0.009), while having two breakfasts resulting in stronger associations (BMI-SDS: βadj = −0.66, p < 0.001; risk of overweight: ORadj = 0.22, p = 0.001). Likewise, children who regularly skipped breakfast on school days showed stronger associations (BMI-SDS: β = 0.49, p < 0.001; risk of overweight: OR = 3.29, p < 0.001) than children who skipped breakfast only occasionally (BMI-SDS: β = 0.43, p < 0.001; risk of overweight: OR = 2.72, p = 0.032). The associations persisted after controlling for parental SES and weight status. Therefore, our data confirm the school setting as a suitable starting point for community-based interventions and may underline the necessity of national programs providing free breakfast and lunch to children

Generalized Bottom-Up Query Evaluation

Our goal is to generalize the well known bottom-up, set-oriented query evaluation for deductive databases in two aspects: First, we consider arbitrary clauses as rules in the database, not only Horn clauses or clauses with stratified negation. This allows to represent disjunctive information, in the database as well as in answers to queries. We utilize NF 2 relations for modelling sets of disjunctive facts and operations of the corresponding relational algebra for computing consequences and answers. Thus our algorithm should be of practical importance for applying database techniques in generalized deductions. Second, we parameterize the implicit database completion which underlies query evaluation. The classical rule for Horn clause databases, which only assumes the negation of facts not implied by the database, is not applicable to disjunctive databases. Moreover, the choice of completion often depends on the intended application. Therefore we allow the specification of arbitrary clauses as defaults, and we extend our algorithm to consider such general defaults.

Stadtteildeprivation und Lebensmittelumwelt: Zusammenhänge von sozialen und baulichen Merkmalen der Wohnumgebung und Lebensmittelverfügbarkeit

Zusammenfassung Ziel der Studie Ernährungsgewohnheiten werden maßgeblich durch den individuellen Sozialstatus beeinflusst. Unklar ist, welcher Zusammenhang zwischen der Wohnumgebung und Lebensmittelverfügbarkeit besteht. Ziel der Studie war es, die Lebensmittelumwelt in sozial und baulich verschiedenen Stadtteilen zu untersuchen. Methodik Anhand offizieller Daten der Stadt Leipzig wurden 3 exemplarische Stadtteile ausgewählt, die sich hinsichtlich ihrer sozialen (2 depriviert, 1 privilegiert) und baulichen Struktur (2 Altbau, 1 Plattenbau) unterscheiden. Über Feldbeobachtungen wurden alle Lebensmittelanbieter kartiert und kategorisiert. Ergebnisse Soziale und bauliche Merkmale sind mit der Lebensmittelverfügbarkeit assoziiert. Der Anteil an Fast-Food-Anbietern ist in den deprivierten Gebieten mehr als doppelt so hoch als im privilegierten Vergleichsgebiet (25%, 30,4% vs. 13,5%). Altbauquartiere verfügen über eine 70% höhere Angebotsvielfalt als das Plattenbaugebiet. Schlussfolgerung Die erhöhte Verfügbarkeit von ungesunden Lebensmitteln in deprivierten Gebieten kann zur Entstehung von Adipositas beitragen. Präventionsmaßnahmen sollten den räumlichen und sozialen Kontext berücksichtigen.</jats:p