Orangutans That Have Survived Extreme Food Scarcity May Provide Better Understand Of Obesity And Eating Disorders In Humans

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Eating Disorders;  Veterinary
Article Date: 15 Dec 2011 - 0:00 PST

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Rutgers Evolutionary Anthropologist Erin Vogel thinks new research published in Biology Letters, a Journal of the Royal Society, examining how endangered Indonesian orangutans - considered a close relative to humans - survive during times of extreme food scarcity might help scientists better understand eating disorders and obesity in humans.

"There is such a large obesity epidemic today and yet we don't really understand the basis of the obesity condition or how these high-protein or low-protein diets work," said Vogel, whose research, Bornean orangutans on the brink of protein bankruptcy, represents the first time scientists have looked at how these long-haired, orange-colored apes - that depend on low-protein fruit to survive - endure protein cycling, or period bouts of protein deprivation. "I think studying the diets of some of our closest living relatives, the great apes; may help us understand issues with our own modern day diets," she said.

According to Vogel, an assistant professor of anthropology in Department of Anthropology and Center for Human Evolutionary Studies, in the School of Arts and Sciences, the research shows that it is only during high periods of high caloric and protein intake that orangutans put on fat, a scientific fact that is sometimes ignored by those who believe that high protein, low carbohydrate diets are the best way to lose weight. She said it is only when caloric intake is restricted that orangutans use these fat reserves for energy and eventually dip into their protein (muscle) reserves - a condition that is seen with eating disorders like anorexia.

Orangutans in particular are interesting to study, Vogel said, because they are the only documented species of non-human ape to store fat when food is abundant in the wild and use these fat reserves when preferred fruits become scarce, presumably something done by our early hominin ancestors.

Vogel and her research team, analyzed samples collected over a five-year period to study the effects of protein recycling, which included examining urinary metabolites and nitrogen stable isotopes - compounds and byproducts in Orangutan urine. What they determined is that these primates are able to endure prolonged protein deficits without starving to death by consuming higher protein leaves and inner bark and obtaining energy from their stored body fat and even muscles for an extended period of time when low-protein fruit is unavailable.

"We discovered through this research that the daily amount of protein the orangutans take in when fruit is not available is inadequate for humans and one-tenth of the intake of mountain gorillas. But it is sufficient to avert a severe protein deficit," said Vogel. The Bornean orangutan population has fallen drastically in the last 50 years in Indonesia to less than 55,000 and on the island of Sumatra to less than 5,000 due to a massive amount of illegal logging and further clearing of the land to develop palm oil plantations in their now impoverished rainforest habitat. Vogel says that although some palm oil companies argue that clearing partially logged areas of the rainforest for palm oil plantations is not detrimental to the existence of the orangutan because their natural habitat has already been taken away, this research on protein cycling indicates that even areas that have been partially stripped of trees are better for orangutan survival than no forest area at all.

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Anorexia Recommendations Challenged

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Main Category: Eating Disorders
Article Date: 12 Dec 2011 - 7:00 PST

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According to researchers at UCSF, adolescents who are hospitalized with anorexia nervosa do not gain considerable weight during their initial week in hospital by receiving treatment based on current guidelines for refeeding. The study is published in the January issue of the Journal of Adolescent Health with an associated report. The study challenges the current guidelines to feeding adolescents with anorexia nervosa during hospitalization for malnutrition.

Patients should start with approximately 1,200 calories per day and advance slowly by 200 calories every other day, according to The American Psychiatric Association, American Dietetic Association and others. The aim of this "start low and go slow" method is to avoid refeeding syndrome - a potentially deadly condition as a result of rapid electrolyte shifts, a well-known risk when introducing nutrition therapy in a malnourished patient.

This study is the first to test these recommendations, which were established in 2000. Andrea Garber, PhD, RD, associate professor of pediatrics in the Division of Adolescent Medicine at UCSF, who led the study with colleagues in the UCSF Adolescent Eating Disorders Program, explained:

"Our findings show that the current recommendations are
just not effective."

There were 35 teenage female participants in this study; most of them were Caucasian. They had been admitted to hospital with the following malnutrition signs: Low blood pressure Low body mass index (BMI) Low heart rate Low body temperature A large proportion of the participants received low calorie diets based on the current guidelines. Participants received six small meals per day and were given high calorie liquid supplements when they refused food as a replacement. The researchers measured their heart rates continuously and checked electrolyte twice per day.

Even though those who received the low calorie diets did not develop refeeding syndrome, approximately 83% lost significant initial weight loss and no overall weight gain until their eighth day of hospitalization. Garber explained this discovery represents "a missed opportunity"

Garber continues:

"Studies show that weight gain during hospitalization is crucial for patients' long-term recovery, we have to make the most out of their short time in the hospital."

Even though 94% of study participants started on less than 1,400 calories per day, the study included diets that ranged from 800 to 2,200 calories in order for the investigators to analyze the effect of increasing calories.

The team found that: Participants who started on lower calorie diets lost considerably more weight in the hospitalHigher calorie diets resulted in less time in the hospitalIn fact, "we showed that for every 100 calories higher, the hospital stay was almost one day shorter," said Garber.

According to the researchers, the current guidelines are to cautious and the study has raised other questions. For example, while insurances costs may be reduced as a result of shorter hospital stay, patients might not be ready to be discharged.

Garber explains:

"Shorter is not necessarily better. We have to consider the potential implications down the line, both psychological and emotional.

According to Barbara Moscicki, MD, a professor of pediatrics in the Division of Adolescent Medicine at UCSF and senior author on the report, another unanswered question relates to refeeding syndrome, which remains "a very real fear." Moscicki explains that the researchers are proceeding cautiously, as more aggressive strategies to feeding and supplementation have not yet been well investigated.

The team explain that results from the investigation are a promising start, because no adverse events were observed in those on the higher calorie diets.

Garber explains:

"If we can improve weight gain with higher calories,
then we're on the right path."

Other co-authors are Nobuaki Michihata, MD, Katherine Hetnal, and Mary-Ann Shafer, MD, all of UCSF. The study was conducted in the Pediatric Clinical Research Center through UCSF's NIH-funded Clinical and Translational Science Institute (CTSI).?About UCSF Benioff Children's Hospital

Written by: Petra Rattue

Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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In Anorexia Nervosa, Inner Conflicts Over The 'Real' Self Have Treatment Implications

Main Category: Eating Disorders
Also Included In: Psychology / Psychiatry
Article Date: 27 Nov 2011 - 0:00 PST

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"It feels like there's two of you inside - like there's another half of you, which is my anorexia, and then there's the real K, the real me, the logic part of me, and it's a constant battle between the two." - 36 year old study participant with anorexia nervosa.

People with anorexia nervosa struggle with questions about their real, or "authentic," self - whether their illness is separate from or integral to them - and this conflict has implications for compulsory treatment, concludes a study in the Hastings Center Report. The researchers also conclude that exploring ideas of authenticity may help clinicians formulate therapeutic approaches and provides insights into whether compulsory treatment can be justified.

For the study, researchers in the U.K. interviewed 29 women who were being treated for anorexia nervosa at clinics throughout the south of England. The interviews asked questions about how the women view their condition, including their understanding of it, how they feel about compulsory treatment, and their thoughts about the impact of anorexia on decision-making. Although the researchers did not ask about authenticity or identity, almost all of the participants spoke in terms of an "authentic self," the researchers write, "and, for almost all, the relationship between anorexia nervosa and this authentic self was a significant issue."

Participants characterized this relationship in different ways. Many saw anorexia nervosa as separate from their real self. Some expressed the idea of a power struggle between their real and inauthentic self. Others said that other people could provide support to enable the authentic self to gain strength within the struggle.

The researchers interpret the patients' notion of their illness as separate from their authentic self as a sign of hope. "Conceptualizing the anorexic behavior as an inauthentic part of the self may well be a valuable strategy for many in helping to overcome it," the authors write.

The authors also say that, in their view, the distinction between an authentic and an inauthentic self is not necessarily the same as a lack of capacity for decision-making and cannot justify overriding a patient's refusal to consent to treatment, although they believe that their findings give grounds for not simply acquiescing to refusals of help. "Some authorities argue that compulsory treatment should never be used for anorexia nervosa," they write. "We believe, however, that we should take seriously the possibility that a person in the throes of anorexia nervosa may be experiencing substantial inner conflict, even though the person may not be expressing that feeling at the time."

The authors conclude that clinicians need to monitor patients' views over time and that if the inner conflict persists, it suggests a lack of capacity for decision-making and, therefore, a risk of significant harm. In this case, they say, "perhaps the evidence from these accounts is sufficient to override treatment refusal in the person's best interest." An unanswered question is whether patients who regard anorexia nervosa as an inauthentic part of the self are most likely to respond to treatment. "A question of empirical study is whether those who separate the anorexic self from a perceived authentic self are more successful at overcoming anorexia nervosa than those who do not," the researchers write.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our eating disorders section for the latest news on this subject. The authors are Tony Hope, professor of medical ethics at the Ethox Centre in the University of Oxford, a fellow of St. Cross College, and honorary consultant psychiatrist; Jacinta Tan, a child and adolescent psychiatrist and medical ethicist who is a senior research fellow at Swansea University; Anne Stewart, a consultant child and adolescent psychiatrist at the Oxford Health NHS Foundation Trust and honorary senior clinical lecturer in the Department of Psychiatry at Oxford University; and Ray Fitzpatrick, professor of public health and primary care at the University of Oxford.
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posted by Nate on 27 Nov 2011 at 5:14 pm

I am now dating a woman who has battled anorexia in her past. She still eats quite poorly as she only allows herself to eat those things she knows she likes. She has been so honest and forward with me about this that it makes me love her even more. I want to help and want to make sure I am being the absolute best man for her in her life. How do I do this best? I am in unchartered territory but want to be not just a support for her but someone she grows with. Any advice?

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posted by Lia on 28 Nov 2011 at 5:38 am

As someone who has struggled with annorexia and is now in a relationship while trying to recover, I can tell you that the one thing that helps the most is my boyfriend focusing on things OTHER than my body when he complimnets me. When he tries to soothe my body concerns by telling me I look awesome "just the way I am" I know he's trying to help, but I also still need to gain weight to be healthy and knowing he likes me as I am right now makes it even more difficult to change. When he talks about my personality or how he's proud of my academic accomplishments etc. it helps me to recognize that I am so much more than my body and this eating disorder.
As much as I hate it, I also like it when he pushes me to eat a bit more. There is a fine line between what is and isn't ok to say, but a little bit of encouragement helps me at least.
I also think that the fact that he listens without judging has helped me so much. He's one of the only people I feel like I can talk to about what is going on in my head without feeling crazy. He never pretends to understand what I am going through- how could he, but he is supportive and tells me that even though he can't imagine what it's like, he knows how difficult it must be for me.
Hope that helps a bit. She's lucky to have someone like you that cares enough to want to help and loves her despite her imperfections.

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posted by Joy on 28 Nov 2011 at 12:33 pm

I have a history of eating disorders and occasionally the old mental battle comes up during a meal when I am emotionally drained from the circumstances of life. In those cases, it helps to have someone with a positive attitude distracting me away from my thoughts with a story, interesting conversation, or something funny. If your girlfriend is ever having trouble eating, maybe it is because the mental struggle is paralyzing her and she needs to refocus her thoughts on something else and then the eating becomes more of a background activity and less of a terrifying decision.

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posted by Nicole on 5 Dec 2011 at 6:40 pm

I can't help thinking it would be better to integrate the two conflicting parts rather than have the person completely disassociate from something which, whilst they might consider inauthentic, is still a part of them.

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Scaling Up Nutrition Investments Leads To Fewer Child Deaths And Improves Economy

Main Category: Aid / Disasters
Also Included In: Eating Disorders
Article Date: 30 Jun 2011 - 10:00 PDT

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Despite improvements in the past decade, 22 per cent of all deaths among children under-five in the Kyrgyz Republic are still caused by undernutrition, according to a report launched today.

Besides the loss of lives, the burden of undernutrition in the Kyrgyz Republic is also substantial in economic terms: estimated to be US$32 million annually.

Scaling up nutrition interventions, therefore, is crucial to prevent loss of children`s lives and is a strategic economic investment with high returns, according to the Situational Analysis - Improving Economic Outcomes by Expanding Nutrition Programming in the Kyrgyz Republic. The report was released at a meeting jointly organized by the Ministry of Health, UNICEF and the World Bank.

"Undernutrition is a critical public health challenge, although it remains a hidden problem," said Sabyrbek Djumabekov, Minister of Health of the Kyrgyz Republic. "The Government has already taken steps to reduce its direct causes. However, it is obvious that we need to initiate multi-sectoral programmes and from this perspective we are looking forward the recommendations made by this important report."

"We have the chance to greatly reduce the number of children who suffer from stunting - and we must do so. These children learn less, and they will earn less - deepening the cycle of poverty," said Anthony Lake, UNICEF's Executive Director. "Investing in good nutrition is the smart, cost effective thing to do, helping to save more children's lives and accelerate progress towards reaching the Millennium Development Goals with equity," he added.

In Kyrgyzstan, three-quarters of the country's salt is iodized and ten percent of wheat is fortified. But further effort is needed:

- Iodising all salt sold will reduce iodine deficiency resulting in a US$500,000 annual benefit due to increased worker productivity.

- Fortifying all of the country's flour with iron, folic acid, and other B vitamins will improve the quality of the diet. The government's efforts to fortify wheat flour as a public health intervention needs to be further supported.

"At least US$6.2 million of the country's economic losses from undernutrition can be prevented by scaling up existing nutrition programs in the Kyrgyz Republic," said Tamer Rabie, a World Bank Senior Health Specialist. "Development partners need to capitalize on the successes achieved by the Government and assist it in its scaling up of programs such as salt iodization and flour fortification," he added.

Good nutritional practices includes exclusive breastfeeding for the first six months, timely introduction of adequate complementary feeding, increasing vitamin and mineral intake, as well as addressing severe acute malnutrition in children.

The international development community has recognized the need to scale up nutrition interventions; the potential for public-private partnerships, and there is consensus around a common framework for action.

Source:
UNICEF

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New Approach To Management Of Overeating In Children

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Eating Disorders May Impact Brain Function

Main Category: Eating Disorders
Also Included In: Psychology / Psychiatry
Article Date: 12 Jul 2011 - 6:00 PDT

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Bulimia nervosa is a severe eating disorder associated with episodic binge eating followed by extreme behaviors to avoid weight gain such as self-induced vomiting, use of laxatives or excessive exercise. It is poorly understood how brain function may be involved in bulimia.

A new study led by Guido Frank, MD, assistant professor, Departments of Psychiatry and Neuroscience and Director, Developmental Brain Research Program at the University of Colorado Anschutz Medical Campus, studied the brain response to a dopamine related reward-learning task in bulimic and healthy women. Dopamine is an important brain chemical or neurotransmitter that helps regulate behavior such as learning and motivation. Frank found that bulimic women had weakened response in brain regions that are part of the reward circuitry. This response was related to the frequency of binge/purge episodes. Overeating and purging episodes thus could cause such a weaker response and set off a vicious cycle of altered brain function. These findings are important for several reasons. First, they directly implicate the brain reward system and related dopamine function in this disorder. Second, bulimic behavior appears to directly affect brain reward function and it is uncertain whether such alterations return to normal with recovery or not. Third, brain dopamine could be a treatment target in bulimia nervosa using specific medication that targets those abnormalities.

"This is the first study that suggests that brain dopamine related reward circuitry, pathways that modulate our drive to eat, may have a role in bulimia nervosa. We found reduced activation in this network in the bulimic women, and the more often an individual had binge/purge episodes the less responsive was their brain. That suggests that the eating disorder behavior directly affects brain function. These findings are important since the brain dopamine neurotransmitter system could be an important treatment target for bulimia nervosa," said Frank.

This study was published in Biological Psychiatry June 28, 2011.

Source:
Jackie Brinkman
University of Colorado Denver

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The Importance Of Family Meals Throughout The Teen Years

Main Category: Nutrition / Diet
Also Included In: Pediatrics / Children's Health;  Obesity / Weight Loss / Fitness;  Eating Disorders
Article Date: 13 Jul 2011 - 4:00 PDT

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As children become teenagers, it may be more challenging to regularly include them in family meals, but doing so is key to heading off such problems as eating disorders, obesity, and inadequate nutrition in adolescence, said Barbara Fiese, a University of Illinois professor of human development and family studies and director of the U of I's Family Resiliency Center.

"The common belief is that teens don't want to be around their parents very much, and that teens are just too busy for regular meals with the family," she said. "Parents may not be able to get their families together around the table seven days a week, but if they can schedule three family meals a week, they will safeguard their teens' health in significant ways."

She advises family members to pull out their schedules and find out which nights they can commit to, then follow through and make family meals on those nights a priority.

In the June issue of Pediatrics, Fiese and postdoctoral research associate Amber Hammons reviewed 17 recent studies on eating patterns and nutrition involving more than 182,000 children and adolescents.

The results showed that teens who eat at least five meals a week with their families are 35 percent less likely to engage in disordered eating than teens who don't. The researchers defined disordered eating as binging and purging, taking diet pills, self-induced vomiting, using laxatives or diuretics, fasting, eating very little, skipping meals, and/or smoking cigarettes to lose weight.

"For children and adolescents with disordered eating, mealtime provides a setting in which parents can recognize early signs and take steps to prevent detrimental patterns from turning into full-blowing eating disorders," she said.

Children who ate at least three family meals a week were also 12 percent less likely to be overweight than those who ate with their families less often. And they were 24 percent more likely to eat healthy foods and have healthy eating habits than those who didn't share three meals with their families.

The researcher said that families who share meals together are likely to be more connected, which may encourage teens to talk within their families about unhealthy behaviors they've slipped into and other problems they're experiencing.

"If you look at national surveys, the frequency of shared mealtimes does begin to drop off in the teen years, but a lot of that is due to competing demands on teenagers' time due to after-school activities, jobs, and social life, and not for lack of interest," she said.

The study showed that teens are interested in participating in family mealtimes and believe that they eat healthier when they share meals with their families, she said.

According to the expert, research on adolescent development indicates that teens want to stay connected with their parents. "Family meals give them a place where they can go regularly to check in with their parents and express themselves freely," she said.

"If family meals are not a forced activity, if parents don't totally control the conversation, and if teens can contribute to family interaction and feel like they're benefiting from it, older kids are likely to welcome participating," she added.

If you've gotten out of the family meal habit and don't relish the prospect of receiving one-word answers from your teenagers (Q: What happened at school today? A: nothing), Fiese and her colleagues have compiled some conversation starters for both English- and Spanish-speaking families.

Here's one: If you won a million dollars, what would you do with it and why?

Amber J. Hammons is lead author on the USDA-funded study.

Source:
Phyllis Picklesimer
University of Illinois College of Agricultural, Consumer and Environmental Sciences

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