The contribution of nutrients from animal pollinated world crops has not previously been evaluated as a biophysical measure for the value of pollination services. This study evaluates the nutritional ...composition of animal-pollinated world crops. We calculated pollinator dependent and independent proportions of different nutrients of world crops, employing FAO data for crop production, USDA data for nutritional composition, and pollinator dependency data according to Klein et al. (2007). Crop plants that depend fully or partially on animal pollinators contain more than 90% of vitamin C, the whole quantity of Lycopene and almost the full quantity of the antioxidants β-cryptoxanthin and β-tocopherol, the majority of the lipid, vitamin A and related carotenoids, calcium and fluoride, and a large portion of folic acid. Ongoing pollinator decline may thus exacerbate current difficulties of providing a nutritionally adequate diet for the global human population.
Garber presents an editorial on the study of Whitelaw et al that examined weight loss as a marker of illness severity in adolescents with restrictive eating disorders. The study participants were 171 ...adolescents age 12 to 19 on their first admission to hospital with malnutrition secondary to anorexia nervosa (AN) or atypical anorexia nervosa (AAN). The authors utilized changes in body mass index (BMI) z-score to account for potential changes in linear height during adolescence and allow weight changes to be compared across age and sex. They found that greater total and recent weight loss were stronger predictors of aberrant vital signs than admission weight. This finding has major healthcare implications, given that these vital signs comprise the hospitalization criteria for adolescents with restrictive eating disorders. They found that total weight loss predicted risk for the refeeding syndrome and longer hospital admission.
Background
Clinical and community samples indicate that eating disorders (EDs) and disordered eating behaviors (DEBs) may co-occur among adolescents and young adults at a weight status classified as ...overweight or obese.
Objective
To determine the prevalence of EDs and DEBs among young adults at a weight status classified as overweight or obese using a nationally representative sample and to characterize differences in prevalence by sex, race/ethnicity, sexual orientation, and socioeconomic status.
Design
Cross-sectional nationally representative data collected from Wave III of the National Longitudinal Study of Adolescent to Adult Health (Add Health).
Participants
Young adults ages 18–24 years old.
Main Measures
ED diagnosis and DEBs (self-reported binge eating or unhealthy weight control behaviors including vomiting, fasting/skipping meals, or laxative/diuretic use to lose weight). Covariates: age, sex, race/ethnicity, sexual orientation, weight status, and education.
Key Results
Of the 14,322 young adults in the sample, 48.6% were at a weight status classified as overweight or obese. Compared to young adults at a weight status classified as underweight or normal weight, those at a weight status classified as overweight or obese reported a higher rate of DEBs (29.3 vs 15.8% in females, 15.4 vs 7.5% in males). Logistic regression analyses demonstrated that odds of engaging in DEBs were 2.32 (95% confidence interval 2.05–2.61) times higher for females compared to males; 1.66 (1.23–2.24) times higher for Asian/Pacific Islander compared to White; 1.62 (1.16–2.26) times higher for homosexual or bisexual compared to heterosexual; 1.26 (1.09–1.44) times higher for high school or less versus more than high school education; and 2.45 (2.16–2.79) times higher for obesity compared to normal weight, adjusting for all covariates.
Conclusions
The high prevalence of DEBs particularly in young adults at a weight status classified as overweight or obese underscores the need for screening, referrals, and tailored interventions for DEBs in this population.
The aim of the study was to determine the association between food insecurity, mental health, and sleep outcomes among young adults. Young adulthood represents an important developmental period when ...educational and economic transitions may increase the risk for food insecurity; however, little is known about associations between food insecurity and health outcomes in this period.
Cross-sectional nationally representative data of U.S. young adults aged 24–32 years from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health were analyzed in 2018. Multiple logistic regression analysis was conducted with food insecurity as the independent variable and self-reported mental health (depression, anxiety, and suicidality) and sleep (trouble falling and staying asleep) outcomes as the dependent variables.
Of the 14,786 young adults in the sample, 11% were food insecure. Food-insecure young adults had greater odds of mental health problems including a depression diagnosis (1.67, 95% confidence interval CI 1.39–2.01), anxiety or panic disorder diagnosis (1.47, 95% CI 1.16–1.87), and suicidal ideation in the past 12 months (2.76, 95% CI 2.14–3.55). Food insecurity was also associated with poorer sleep outcomes including trouble falling (adjusted odds ratio 1.78, 95% CI 1.52–2.08) and staying (adjusted odds ratio 1.67, 95% CI 1.42–1.97) asleep.
Food insecurity is associated with poorer mental and sleep health in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate. Future research should test interventions to simultaneously combat food insecurity and mental health problems in young adulthood.
Abstract The medical practitioner has an important role to play in the management of adolescents with eating disorders, usually as part of a multidisciplinary team. This article reviews the role of ...the medical practitioner in the diagnosis and treatment of eating disorders, updating the reader on the changing epidemiology of eating disorders, revised diagnostic criteria, newer methods of assessing degree of malnutrition, more aggressive approaches to refeeding, and current approaches to managing low bone mass.
Background
Food insecurity, or the limited or uncertain access to food resulting from inadequate financial resources, is associated with a higher prevalence of chronic disease in adulthood. Little is ...known about these relationships specifically in young adulthood, an important time for the development of chronic disease.
Objective
To determine the association between food insecurity and chronic disease including diabetes, hypertension, obesity, and obstructive airway disease in a nationally representative sample of US young adults.
Design
Cross-sectional nationally representative data collected from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health was analyzed using multiple logistic regression models.
Participants
US young adults ages 24–32 years old
Main Measures
Food insecurity and general health; self-reported diabetes, hypertension, hyperlipidemia, “very overweight,” and obstructive airway disease; measured obesity derived from body mass index; and inadequate disease control (hemoglobin A1c ≥ 7.0%, blood pressure ≥ 140/90 mmHg) among those with reported diabetes and hypertension.
Key Results
Of the 14,786 young adults in the sample, 11% were food insecure. Food-insecure young adults had greater odds of self-reported poor health (2.63, 95% confidence interval (CI) 1.63–4.24), diabetes (1.67, 95% CI 1.18–2.37), hypertension (1.40, 95% CI 1.14–1.72), being “very overweight” (1.30, 95% CI 1.08–1.57), and obstructive airway disease (1.48, 95% CI 1.22–1.80) in adjusted models compared with young adults who were food secure. Food insecurity was not associated with inadequate disease control among those with diabetes or hypertension.
Conclusions
Food insecurity is associated with several self-reported chronic diseases and obesity in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate. Future research should evaluate the impact of early interventions to combat food insecurity on the prevention of downstream health effects in later adulthood.
Lower weight has historically been equated with more severe illness in anorexia nervosa (AN). Reliance on admission weight to guide clinical concern is challenged by the rise in patients with ...atypical anorexia nervosa (AAN) requiring hospitalization at normal weight.
We examined weight history and illness severity in 12- to 24-year-olds with AN (
= 66) and AAN (
= 50) in a randomized clinical trial, the Study of Refeeding to Optimize Inpatient Gains (www.clinicaltrials.gov; NCT02488109). Amount of weight loss was the difference between the highest historical percentage median BMI and admission; rate was the amount divided by duration (months). Unpaired
tests compared AAN and AN; multiple variable regressions examined associations between weight history variables and markers of illness severity at admission. Stepwise regression examined the explanatory value of weight and menstrual history on selected markers.
Participants were 16.5 ± 2.6 years old, and 91% were of female sex. Groups did not differ by weight history or admission heart rate (HR). Eating Disorder Examination Questionnaire global scores were higher in AAN (mean 3.80 SD 1.66 vs mean 3.00 SD 1.66;
= .02). Independent of admission weight, lower HR (β = -0.492 confidence interval (CI) -0.883 to -0.100;
= .01) was associated with faster loss; lower serum phosphorus was associated with a greater amount (β = -0.005 CI -0.010 to 0.000;
= .04) and longer duration (β = -0.011 CI -0.017 to 0.005;
= .001). Weight and menstrual history explained 28% of the variance in HR and 36% of the variance in serum phosphorus.
Weight history was independently associated with markers of malnutrition in inpatients with restrictive eating disorders across a range of body weights and should be considered when assessing illness severity on hospital admission.
We recently reported the short-term results of this trial revealing that higher-calorie refeeding (HCR) restored medical stability earlier, with no increase in safety events and significant savings ...associated with shorter length of stay, in comparison with lower-calorie refeeding (LCR) in hospitalized adolescents with anorexia nervosa. Here, we report the 1-year outcomes, including rates of clinical remission and rehospitalizations.
In this multicenter, randomized controlled trial, eligible patients admitted for medical instability to 2 tertiary care eating disorder programs were randomly assigned to HCR (2000 kcals per day, increasing by 200 kcals per day) or LCR (1400 kcals per day, increasing by 200 kcals every other day) within 24 hours of admission and followed-up at 10 days and 1, 3, 6, and 12 months post discharge. Clinical remission at 12 months post discharge was defined as weight restoration (≥95% median BMI) plus psychological recovery. With generalized linear mixed effect models, we examined differences in clinical remission over time.
Of 120 enrollees, 111 were included in modified intent-to-treat analyses, 60 received HCR, and 51 received LCR. Clinical remission rates changed over time in both groups, with no evidence of significant group differences (
= .42). Medical rehospitalization rates within 1-year post discharge (32.8% 19 of 58 vs 35.4% 17 of 48,
= .84), number of rehospitalizations (2.4 SD: 2.2 vs 2.0 SD: 1.6;
= .52), and total number of days rehospitalized (6.0 SD: 14.8 vs 5.1 SD: 10.3 days;
= .81) did not differ by HCR versus LCR.
The finding that clinical remission and medical rehospitalization did not differ over 1-year, in conjunction with the end-of-treatment outcomes, support the superior efficacy of HCR as compared with LCR.
Objective
To determine adolescent predictors of muscularity‐oriented disordered eating behaviors in young men and women using a nationally representative longitudinal sample in the United States and ...to examine differences by sex.
Method
We used nationally representative longitudinal cohort data collected from baseline (11–18 years old, 1994–1995) and 7‐year follow‐up (18–24 years old, 2001–2002) of the National Longitudinal Study of Adolescent to Adult Health. We examined adolescent demographic, behavioral, and mental health predictors of young adult muscularity‐oriented disordered eating behaviors defined as eating more or differently to gain weight or bulk up, supplements to gain weight or bulk up, or androgenic anabolic steroid use at 7‐year follow‐up.
Results
Of the 14,891 included participants, 22% of males and 5% of females reported any muscularity‐oriented disordered eating behavior at follow‐up in young adulthood. Factors recorded at adolescence that were prospectively associated with higher odds of muscularity‐oriented disordered eating in both sexes included black race, exercising to gain weight, self‐perception of being underweight, and lower body mass index z‐score. In addition, participation in weightlifting; roller‐blading, roller‐skating, skate‐boarding, or bicycling; and alcohol among males and depressive symptoms among females during adolescence were associated with higher odds of muscularity‐oriented disordered eating in young adulthood.
Conclusions
Interventions to prevent muscularity‐oriented disordered eating behaviors may target at‐risk youth, particularly those of black race or who engage in exercise to gain weight. Future research should examine longitudinal health outcomes associated with muscularity‐oriented disordered eating behaviors.
Three-dimensional optical (3DO) body scanning has been proposed for automatic anthropometry. However, conventional measurements fail to capture detailed body shape. More sophisticated shape features ...could better indicate health status.
The objectives were to predict DXA total and regional body composition, serum lipid and diabetes markers, and functional strength from 3DO body scans using statistical shape modeling.
Healthy adults underwent whole-body 3DO and DXA scans, blood tests, and strength assessments in the Shape Up! Adults cross-sectional observational study. Principal component analysis was performed on registered 3DO scans. Stepwise linear regressions were performed to estimate body composition, serum biomarkers, and strength using 3DO principal components (PCs). 3DO model accuracy was compared with simple anthropometric models and precision was compared with DXA.
This analysis included 407 subjects. Eleven PCs for each sex captured 95% of body shape variance. 3DO body composition accuracy to DXA was: fat mass R2 = 0.88 male, 0.93 female; visceral fat mass R2 = 0.67 male, 0.75 female. 3DO body fat test-retest precision was: root mean squared error = 0.81 kg male, 0.66 kg female. 3DO visceral fat was as precise (%CV = 7.4 for males, 6.8 for females) as DXA (%CV = 6.8 for males, 7.4 for females). Multiple 3DO PCs were significantly correlated with serum HDL cholesterol, triglycerides, glucose, insulin, and HOMA-IR, independent of simple anthropometrics. 3DO PCs improved prediction of isometric knee strength (combined model R2 = 0.67 male, 0.59 female; anthropometrics-only model R2 = 0.34 male, 0.24 female).
3DO body shape PCs predict body composition with good accuracy and precision comparable to existing methods. 3DO PCs improve prediction of serum lipid and diabetes markers, and functional strength measurements. The safety and accessibility of 3DO scanning make it appropriate for monitoring individual body composition, and metabolic health and functional strength in epidemiological settings.
This trial was registered at clinicaltrials.gov as NCT03637855.
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