A pilot study to examine eating behaviors of children with attention-deficit/hyperactivity disorder

Thesis (M.A.)--Boston UniversityBackground: In the past decade, a growing body of research has shown a link between attention-deficit/hyperactivity disorder (ADHD) and obesity. Recently, studies in adults and children began exploring the possible neurobiological and behavioral mechanisms responsible for the association of ADHD with obesity. Stimulant medications used to treat ADHD might also play a protective role against weight gain in individuals with ADHD. Objective: The current pilot study set out to create and test a protocol that explores differences in obesogenic eating behaviors between typically developing (TD) children and children with ADHD who are either taking ADHD medication (ADHD-M) or have been off of ADHD medication (ADHD-NM) for the past 3 months. Given that children with ADHD are often on medication, this pilot also allowed us the opportunity to assess the feasibility of recruiting children with ADHD-NM. Methods: The Children's Eating Behaviour Questionnaire (CEBQ) was used to measure eating behaviors between three groups of 6-11 year old children; TD (n=6), ADHD-M (n=9), and ADHD-NM (n=3). To our knowledge this is the first study to use the CEBQ as a measure of eating behaviors in children with ADHD. The protocol consisted of a telephone screen for inclusion and exclusion criteria, followed by one study visit where the CEBQ was administered along with 4 other questionnaires that will be analyzed as part of a larger study. Information was also collected on recruitment efforts, effectiveness of screening tools, and duration of study visit. Results: We found statistically significant differences in satiety responsiveness (p=0.008) among children with ADHD-M and ADHD-NM, and difference (p=0.022) among children with ADHD-M and typically developing (TD) in the desire to drink domain. We observed in the fussiness domain, borderline significant differences among children with ADHD-M and TD children (p=0.079) and in the emotional under-eating domain differences for children with ADHD-M and children with ADHD-NM (p=0.066). Also, there was a trend in the food responsiveness domain that suggested children with ADHD-NM were more responsive to food cues than the other two groups. There were no statistically significant differences seen between ADHD-NM and TD groups in the following three domains; slowness in eating, enjoyment of food, and emotional over-eating. As suspected, it was difficult to recruit children with ADHD-NM therefore; the small sample size may have limited our ability to detect significant differences. Conclusion: The pilot study showed statistically significant differences in one obesogenic CEBQ domain, satiety responsiveness, and a possible trend in the food responsiveness, which is another obesogenic domain. The differences suggest that children with ADHD-NM might be less responsive to internal satiety cues than children with ADHD-M, and more responsive to food cues than TD children or children with ADHD-M. The pilot also suggested differences between groups in three other domains; desire to drink, fussiness, and emotional undereating. Exploring these possible differences further could give insight into the mechanism contributing to the observed higher obesity risk in individuals with ADHD compared to individuals without ADHD

Fecal Microbiota Transplantation Is Highly Effective in Real-World Practice: Initial Results From the FMT National Registry

Background & Aims Fecal microbiota transplantation (FMT) is used commonly for treatment of Clostridioides difficile infections (CDIs), although prospective safety data are limited and real-world FMT practice and outcomes are not well described. The FMT National Registry was designed to assess FMT methods and both safety and effectiveness outcomes from North American FMT providers. Methods Patients undergoing FMT in clinical practices across North America were eligible. Participating investigators enter de-identified data into an online platform, including FMT protocol, baseline patient characteristics, CDI cure and recurrence, and short and long-term safety outcomes. Results Of the first 259 participants enrolled at 20 sites, 222 had completed short-term follow-up at 1 month and 123 had follow-up to 6 months; 171 (66%) were female. All FMTs were done for CDI and 249 (96%) used an unknown donor (eg, stool bank). One-month cure occurred in 200 patients (90%); of these, 197 (98%) received only 1 FMT. Among 112 patients with initial cure who were followed to 6 months, 4 (4%) had CDI recurrence. Severe symptoms reported within 1-month of FMT included diarrhea (n = 5 [2%]) and abdominal pain (n = 4 [2%]); 3 patients (1%) had hospitalizations possibly related to FMT. At 6 months, new diagnoses of irritable bowel syndrome were made in 2 patients (1%) and inflammatory bowel disease in 2 patients (1%). Conclusions This prospective real-world study demonstrated high effectiveness of FMT for CDI with a good safety profile. Assessment of new conditions at long-term follow-up is planned as this registry grows and will be important for determining the full safety profile of FMT

Fecal Microbiota Transplantation Is Highly Effective in Real-World Practice: Initial Results From the FMT National Registry

Background & aimsFecal microbiota transplantation (FMT) is used commonly for treatment of Clostridioides difficile infections (CDIs), although prospective safety data are limited and real-world FMT practice and outcomes are not well described. The FMT National Registry was designed to assess FMT methods and both safety and effectiveness outcomes from North American FMT providers.MethodsPatients undergoing FMT in clinical practices across North America were eligible. Participating investigators enter de-identified data into an online platform, including FMT protocol, baseline patient characteristics, CDI cure and recurrence, and short and long-term safety outcomes.ResultsOf the first 259 participants enrolled at 20 sites, 222 had completed short-term follow-up at 1 month and 123 had follow-up to 6 months; 171 (66%) were female. All FMTs were done for CDI and 249 (96%) used an unknown donor (eg, stool bank). One-month cure occurred in 200 patients (90%); of these, 197 (98%) received only 1 FMT. Among 112 patients with initial cure who were followed to 6 months, 4 (4%) had CDI recurrence. Severe symptoms reported within 1-month of FMT included diarrhea (n = 5 [2%]) and abdominal pain (n = 4 [2%]); 3 patients (1%) had hospitalizations possibly related to FMT. At 6 months, new diagnoses of irritable bowel syndrome were made in 2 patients (1%) and inflammatory bowel disease in 2 patients (1%).ConclusionsThis prospective real-world study demonstrated high effectiveness of FMT for CDI with a good safety profile. Assessment of new conditions at long-term follow-up is planned as this registry grows and will be important for determining the full safety profile of FMT