Child ; Adolescent ; Humans ; Feeding and Eating Disorders/diagnosis*

Child ; Adolescent ; Humans ; Feeding and Eating Disorders/diagnosis*

Eating disorders are often underdiagnosed. Orthorexia nervosa (ON), a new type of eating disorder, is defined as excessive preoccupation with healthy eating, causing significant nutritional deficiencies and social and personal impairments. The ORTO-15 is a 15-item instrument widely used to evaluate orthorexia nervosa. It was developed by Donini et al (2005) in Italian and has been translated and adapted in other languages. In this study, the validity and reliability of the Indonesian version of ORTO-15 were assessed. The Indonesian version of the instrument was then reviewed by experts after translation. The back-translation was assessed for consistency with the original instrument. The instrument was then statistically-tested for validity and reliability on 50 randomly selected subjects. The subjects were balanced in gender and the mean age was 19.4 + 0.8 years. The reliability was tested using Cronbach’s alpha. The validity was tested using Pearson's product-moment correlation and confirmatory factor analyses (CFA). The Pearson product moment verified good validity for the instrument (r = 0.369 – 0.881). CFA analyses confirmed good communalities (extraction > 0.5) and revealed three components construct (cumulative 73.5%). Reliability test confirmed that the instrument had good reliability (Cronbach's alpha = 0.915). The ORTO-15 Indonesian version is a valid and reliable instrument for the assessment of ON.
Reproducibility of Results ; Feeding and Eating Disorders

OBJECTIVES: This study investigates the current state of consuming breakfast among elementary school students residing in Malang, East Java, Indonesia, and to identify factors that influence breakfast behavior.METHODS: The research model was set up as per the health belief model, and slightly modified by adding the subjective normative factors of the theory of planned behavior. The survey was conducted from July 17 to August 15, 2017 using a questionnaire, after receiving the permission PNU IRB (2017_60_HR).RESULTS: The subjects were 77 boys (49.4%) and 79 girls (50.6%) suffering from malnutrition with anemia (21.2%) and stunting ratio of Height for Age Z Score (HAZ) (11.5%). Furthermore, moderate weakness (14.8%) and overweight and obesity (12.3%) by Body Mass Index for Age Z Score (BMIZ) were coexistent. According to the results obtained for breakfast, 21.8% did not eat breakfast before school, with 18.8% of the reasons for skipping breakfast being attributed to lack of food. Even for subjects partaking breakfast, only about 10% had a good balanced diet. The average score of behavioral intention on eating breakfast was 2.60 ± 0.58. The perceived sensitivity, perceived severity, perceived benefits, and self-efficacy of the health belief model correlated with breakfast behavior. Of these, self-efficacy (β=0.447, R²=0.200) and perceived sensitivity (β=0.373, R²=0.139) had the greatest effect on breakfast behavior. Mother was the largest impact person among children.CONCLUSIONS: In order to increase the level of breakfast behavior intention among children surveyed in Indonesia, we determined the effectiveness by focus on education which helps the children recognize to be more likely to get sick when they don't have breakfast, and increase their confidence in ability to have breakfast on their own. We believe there is a necessity to seek ways to provide indirect intervention through mothers, as well as impart direct nutrition education to children.
Anemia ; Body Mass Index ; Breakfast ; Child ; Diet ; Eating ; Education ; Ethics Committees, Research ; Female ; Growth Disorders ; Humans ; Indonesia ; Intention ; Malnutrition ; Mothers ; Obesity ; Overweight

OBJECTIVES: The epidemic of coronavirus disease 2019 (COVID-19) brought psychological stress to the public, especially to patients. This study aims to investigate the mental health of patients with COVID-19 in Changsha. METHODS: We took cross-section investigation for the mental health of 112 patients with COVID-19 via questionnaires. Mann-Whitney test, Chi-square test, and Fisher's exact test were performed to compare general and clinical data between the slight-ordinary patients and severe patients. Single sample -tests were used to compare the difference between the factor scores of the Symptom Check-List 90 (SCL-90) in COVID-19 patients with the norm of 2015 and factor scores of SCL-90 in patients with the severe acute respiratory syndrome (SARS). RESULTS: The obsessive-compulsive, depression, sleep and eating disorders had the highest frequency among the positive symptoms of SCL-90 in patients with COVID-19 in Changsha. The factor scores of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 were higher than those of the norm (≤0.001 or <0.05). Slight-ordinary patients with COVID-19 in Changsha showed lower factor scores of somatization, depression, anxiety, and hostility compared with the patients with SARS (<0.001 or <0.05). There was no difference in factor scores of SCL-90 between the patients with severe COVID-19 and those with SARS(>0.05). CONCLUSIONS The levels of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 in Changsha are higher than those of the norm. However, the mental health of slight-ordinary patients with COVID-19 is better than that of patients with SARS. It needs to provide targeting psychological interventions depending on the severity of patients.
Anxiety ; Betacoronavirus ; China ; Coronavirus Infections ; psychology ; Depression ; Feeding and Eating Disorders ; Health Status ; Humans ; Mental Health ; Pandemics ; Pneumonia, Viral ; psychology ; Sleep Wake Disorders ; Surveys and Questionnaires

Over the last 5 years, the Korean Ministry of Food and Drug Safety has approved four anti-obesity drugs for long-term weight management. In this review, the mechanisms of action and clinical applications of lorcaserin, naltrexone/bupropion, liraglutide, and phentermine/topiramate have been clarified. Lorcaserin stimulates proopiomelanocortin/cocaine- and amphetamine-regulated transcript neurons in the arcuate nucleus. Naltrexone/bupropion reduces body weight by controlling the hedonic reward system of food intake. The hypophagic effect of liraglutide depends on the direct activation of the proopiomelanocortin/cocaine- and amphetamine-regulated transcript neurons and indirect suppression of neuropeptide Y/agouti-related peptide neurons through gammaaminobutyric acid-dependent signaling, with an additional thermogenic effect. Phentermine/topiramate induces weight loss by elevating the norepinephrine levels in the hypothalamus, reducing energy deposition in the adipose tissue and skeletal muscle, and elevating the corticotropin-releasing hormone in the hypothalamus. In patients with high cardiovascular risks or type 2 diabetes mellitus, lorcaserin and liraglutide are appropriate. In patients with mood disorders, naltrexone/bupropion could be considered as the first choice of therapy. Notably, lorcaserin and liraglutide are neutral in the aspect of sleep disorder. In case of obese individuals with obstructive sleep apnea, liraglutide or phentermine/topiramate would be selected as the treatment option. These four drugs should be used after considering the patients' co-morbidities of obesity.
Adipose Tissue ; Anti-Obesity Agents ; Arcuate Nucleus of Hypothalamus ; Body Weight ; Corticotropin-Releasing Hormone ; Diabetes Mellitus, Type 2 ; Eating ; Humans ; Hypothalamus ; Korea ; Liraglutide ; Mood Disorders ; Muscle, Skeletal ; Neurons ; Neuropeptides ; Norepinephrine ; Obesity ; Pharmacology ; Reward ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Weight Loss

5-HT₆ receptor (5-HT₆R) is implicated in cognitive dysfunction, mood disorder, psychosis, and eating disorders. However, despite its significant role in regulating the brain functions, regulation of 5-HT₆R at the molecular level is poorly understood. Here, using yeast two-hybrid assay, we found that human 5-HT₆R directly binds to neuro-oncological ventral antigen 1 (Nova-1), a brain-enriched splicing regulator. The interaction between 5-HT₆R and Nova-1 was confirmed using GST pull-down and co-immunoprecipitation assays in cell lines and rat brain. The splicing activity of Nova-1 was decreased upon overexpression of 5-HT₆R, which was examined by detecting the spliced intermediates of gonadotropin-releasing hormone (GnRH), a known pre-mRNA target of Nova-1, using RT-PCR. In addition, overexpression of 5-HT₆R induced the translocation of Nova-1 from the nucleus to cytoplasm, resulting in the reduced splicing activity of Nova-1. In contrast, overexpression of Nova-1 reduced the activity and the total protein levels of 5-HT₆R. Taken together, these results indicate that when the expression levels of 5-HT₆R or Nova-1 protein are not properly regulated, it may also deteriorate the function of the other.
Animals ; Brain ; Cell Line ; Cytoplasm ; Eating ; Gonadotropin-Releasing Hormone ; Humans ; Immunoprecipitation ; Mood Disorders ; Psychotic Disorders ; Rats ; RNA Precursors ; RNA-Binding Proteins ; Serotonin ; Two-Hybrid System Techniques

Anorexia nervosa (AN) affects 2.9 million people, many of whom experience bone loss and increased fracture risk. In this article, we review data on the underlying pathophysiology of AN-related osteoporosis and possible approaches to disease management. Available research suggests that low body weight and decreased gonadal function are the strongest predictors of bone loss and fractures in patients with AN. Additionally, other metabolic disturbances have been linked to bone loss, including growth hormone resistance, low leptin concentrations, and hypercortisolemia, but those correlations are less consistent and lack evidence of causality. In terms of treatment of AN-related bone disease, weight gain has the most robust impact on bone mineral density (BMD). Restoration of gonadal function seems to augment this effect and may independently improve BMD. Bisphosphonates, insulin-like growth factor 1 supplementation, and teriparatide may also be reasonable considerations, however need long-term efficacy and safety data.
Anorexia Nervosa ; Anorexia ; Body Weight ; Bone Density ; Bone Diseases ; Diphosphonates ; Disease Management ; Feeding and Eating Disorders ; Gonads ; Growth Hormone ; Humans ; Leptin ; Osteoporosis ; Teriparatide ; Weight Gain

OBJECTIVE: Currently, there are no established dietary guidelines for patients with swallowing difficulties in Korea. Therefore, this study was conducted to develop an organized set of dietary guidelines listing simple yet diverse ingredients that are safe for consumption and have high nutritional quality. METHOD: Ninety patients with swallowing and masticatory dysfunction admitted in hospitals A and B were enrolled in this study. The initial study phase encompassed a 6-month period at each site from May 2016 to June 2017. The patients fed according to the dietary guidelines developed in this study were observed. The before- and after-care variances were observed by measuring the patients' weight, and TLC as well as the levels of serum albumin and food intake. This observation was based on the classification of swallowing difficulty and masticatory dysfunction into four scales. RESULT: The before- and after-care weight measurements of the study patients revealed a shift from 48.60±10.17 to 49.32±10.23 kg, and a change in the BMI from 20.04±3.91 to 20.33±3.93. The variances were deemed statistically significant, indicating that the nutrition index of the administered diet was adequate. An analysis of the types of food intake of side dishes and snacks before- and after- dietary administration per study revealed 3.58±1.01 to 4.19±0.83 and 2.77±0.98 to 3.49±1.21, respectively. CONCLUSION: The food intake level and the weight and BMI of patients in both hospitals increased during the 1-year study period. Furthermore, increasing the dietary level from the third to the fourth tier on an institutional basis enabled a systematic configuration of dietary formulations for each stage of this disorder.
Classification ; Deglutition ; Deglutition Disorders ; Dementia ; Diet ; Eating ; Food, Formulated ; Humans ; Korea ; Methods ; Nutrition Assessment ; Nutrition Policy ; Nutritive Value ; Serum Albumin ; Snacks ; Weights and Measures

As the physical abnormalities seen in eating disorders seem to be largely secondary to these patients' disturbed eating habits and their compromised nutritional state, most physical abnormalities associated with eating disorders are reversed by restoring healthy eating habits and sound nutrition. However, some medical consequences of eating disorders are irreversible or have later repercussions on health, especially those affecting the skeleton, the reproductive system, and the brain. Early medical intervention and psychiatric treatment are particularly important for those with or at risk of severe emaciation. Eating disorders are common among adolescent girls and young women and are associated with potentially serious medical complications, yet they often go undetected and untreated. All patients with eating disorders should be evaluated and treated for medical complications of the disease at the same time that psychotherapy and nutritional counseling are undertaken.
Adolescent ; Anorexia Nervosa ; Binge-Eating Disorder ; Brain ; Bulimia Nervosa ; Counseling ; Early Medical Intervention ; Eating ; Emaciation ; Feeding and Eating Disorders ; Female ; Humans ; Psychotherapy ; Skeleton