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Objective: We used latent profile analysis (LPA) to classify children and adolescents into subtypes based on the overlap of disinhibited eating behaviors--eating in the absence of hunger, emotional eating, and subjective and objective binge eating. Method: Participants were 411 youths (8-18 years) from the community who reported on their disinhibited eating patterns. A subset (n = 223) ate ad libitum from two test meals. Results: LPA produced five subtypes that were most prominently distinguished by objective binge eating (OBE; n = 53), subjective binge eating (SBE; n = 59), emotional eating (EE; n = 62), a mix of emotional eating and eating in the absence of hunger (EE-EAH; n = 172), and no disinhibited eating (No-DE; n = 64). Accounting for age, sex, race, and body mass index z score (BMI-z), the four disinhibited eating groups had more problem behaviors than the no disinhibited eating group (p = 0.001). OBE and SBE subtypes had greater BMI-z, percent fat mass, disordered eating attitudes, and trait anxiety than EE, EE-EAH, and No-DE subtypes (ps less than 0.01). However, the OBE subtype reported the highest eating concern (p less than 0.001), and the OBE, SBE, and EE subtypes reported higher depressive symptoms than the EE-EAH and No-DE subtypes. Across both test meals, OBE and SBE subtypes consumed a lesser percentage of protein and a higher percentage of carbohydrate than the other subtypes (ps less than 0.02), adjusting for age, sex, race, height, lean mass, percent fat mass, and total intake. EE subtypes also consumed a greater percentage of carbohydrate and a lower percentage of fat than the EE-EAH and No-DE subtypes (ps less than 0.03). The SBE subtype consumed the least total calories (p = 0.01). Discussion: We conclude that behavioral subtypes of disinhibited eating may be distinguished by psychological characteristics and objective eating behavior. Prospective data are required to determine whether subtypes predict the onset of eating disorders and obesity. (Contains 3 tables and 1 figure.)

Background: U.S. Hispanics/Latinos experience high lifetime risk for Type 2 diabetes and concurrent psychological depression. This comorbidity is associated with poorer self-management, worse disease outcomes, and higher mortality. Syndemic theory is a novel social epidemiological framework that emphasizes the role of economic and social adversity in promoting disease comorbidity and health disparities.Purpose: Informed by the syndemic framework, this study explored associations of socioeconomic and psychosocial adversity (low income/education, trauma history, adverse childhood experiences, ethnic discrimination, neighborhood problems [e.g., violence]) with comorbidity of diabetes and depression symptoms in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and Sociocultural Ancillary Study.Methods: Participants were 5,247 Latino adults, aged 18-74, enrolled in four U.S. cities from 2008 to 2011. Participants completed a baseline physical exam and measures of depression symptoms and psychosocial adversity. Multinomial logistic regression analyses were conducted to examine associations of adversity variables with comorbid diabetes and high depression symptoms.Results: Household income below $30,000/year was associated with higher odds of diabetes/depression comorbidity (odds ratio [OR] = 4.61; 95% confidence interval [CI]: 2.89, 7.33) compared to having neither condition, as was each standard deviation increase in adverse childhood experiences (OR = 1.41; 95% CI: 1.16, 1.71), ethnic discrimination (OR = 1.23; 95% CI: 1.01, 1.50), and neighborhood problems (OR = 1.53; 95% CI: 1.30, 1.80).Conclusion: Low household income, adverse childhood experiences, ethnic discrimination, and neighborhood problems are related to comorbid diabetes and depression in U.S. Latinos. Future studies should explore these relationships longitudinally. [ABSTRACT FROM AUTHOR]

Approximately 1% to 2% of women suffer from posttraumatic stress disorder (PTSD) following childbirth, with obstetric emergencies being a key risk factor for birth-related PTSD. The current study augmented prolonged exposure (PE) with cognitive behavioral therapy (CBT) to treat symptoms of PTSD, anxiety, depression, panic disorder, and agoraphobia in a 28-year-old married Hispanic female following a life-threatening case of postpartum preeclampsia. To target distressing symptoms and reach treatment goals, the patient engaged in two preparatory sessions, 12 active PE sessions, and five supplementary CBT sessions. Posttreatment assessment indicated a significant reduction of anxiety and depressive symptoms. Panic attacks reduced in frequency and severity, and by the end of treatment, the patient no longer met criteria for PTSD, major depressive disorder (MDD), or agoraphobia. In the case of postpartum PTSD, CBT can augment PE treatment to reduce symptomatology. [ABSTRACT FROM AUTHOR]

To compare cardiovascular risk and disease prevalence in U.S. Hispanics/Latinas with and without a history of gestational diabetes mellitus (GDM). Cross-sectional data from 2008 to 2011 were analyzed for 8,262 (305 with GDM history) parous women, aged 20–73 years, from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Women with and without a history of GDM were compared on sociodemographic, cardiovascular risk factor, and disease data from standardized interviews and fasting blood tests, using chi-square tests, t-tests, and logistic regressions to determine odds ratios (ORs) and 95 percent confidence intervals (CIs). Adjusting for covariates, compared to those without a history of GDM, women with a history of GDM were younger (M = 39.1 years [95 percent CI = 37.8, 41.6] vs. 45.5 years [95 percent CI = 44.9, 46.1]) and more likely to have health insurance (68.1 percent [95 percent CI = 60.3 percent, 76.0 percent] vs. 54.9 percent [95 percent CI = 52.8 percent, 57.1 percent]), had greater waist circumference (M = 102.3 cm, [95 percent CI = 100.2, 104.3] vs. 98.1 cm [95 percent CI = 97.4, 98.5]) and higher fasting glucose (116.0 mg/dL [95 percent CI = 107.8, 124.3] vs. 104.2 mg/dL [95 percent CI = 103.4, 105.1]), and had higher odds of having metabolic syndrome (OR = 1.7 [95 percent CI = 1.2, 2.6]) or diabetes (OR = 3.3 [95 percent CI = 2.2, 4.8]). Prevalences of heart and cerebrovascular disease were similar. GDM history was positively associated with diabetes but not with cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS), a cluster of cardiovascular risk factors, is being diagnosed in youth. Specific diagnostic criteria used to define MetS influence prevalence estimates and populations considered at risk for cardiovascular disease. The National Cholesterol Education Program's Adult Treatment Panel III (ATP), the World Health Organization (WHO), and the International Diabetes Federation (IDF) provide three MetS definitions used in medical research. This study examined concordance among these definitions in 1137 children 10-16 years of age, who participated in the Hispanic Community Children's Health Study/Study of Latino Youth. Methods: Prevalence of MetS and of individual components was estimated using SAS. Mplus was used to test a single-factor model of MetS components (triglycerides, high-density lipoprotein cholesterol, systolic and diastolic blood pressure, waist circumference, and fasting glucose). Results: The ATP definition identified most MetS cases in 10-15 ( N = 19, 4.7%) and 16-year-old girls ( N = 3, 7.3%). The IDF definition identified most cases of MetS in 10-15 ( N = 16, 3.1%) and 16-year-old boys ( N = 2, 2.8%). Fewest cases of MetS were identified with the WHO definition across age and sex groups. Conclusion: Only one participant was classified as having MetS across all three definitions. Confirmatory factor analysis indicated fasting glucose and systolic blood pressure did not reliably cluster with other risk factors that define MetS in Hispanic/Latino adolescents. We conclude that prevalence estimates of MetS in youth are unstable across current criteria, calling into question the accuracy of defining and diagnosing MetS in youth. [ABSTRACT FROM AUTHOR]

Objective Eating in the absence of hunger (EAH) typically was assessed by measuring snack intake after consumption of a meal. There were no validated self-report measures of EAH. The relationship of adolescent self-report and parent-reported EAH to adolescents' measured intake in the absence of hunger was examined. Design and Methods Ninety adolescents completed the Eating in the Absence of Hunger Questionnaire for Children and Adolescents (EAH-C) to describe eating when not hungry. Parents described children's EAH on a parallel version designed for parents (EAH-P). In a randomized crossover study, adolescent EAH in response to external cues was measured as snack intake after a lunch meal standardized to provide 50% of daily energy requirements and after a large array (>10,000 kcal). Results Parents' reports of children's EAH in response to external cues were associated with greater EAH after both meals, adjusting for body composition, sex, age, race, puberty, and meal intake. Adolescent-reported EAH was unrelated or showed an inverse association with observed EAH. Conclusions Parent-reported EAH showed a positive association with adolescents' observed EAH and may be a useful research and clinical tool for assessing EAH in response to external cues in conditions when laboratory assessments are not feasible. [ABSTRACT FROM AUTHOR]

Objective: A healthy diet is important for diabetes prevention and control; however, few studies have assessed dietary intake among US Hispanics/Latinos, a diverse population with a significant burden of diabetes. To address this gap in the literature, we determined intake of energy, macro/micronutrients, and vitamin supplements among Hispanics/Latinos by glycemic status and heritage., Research Design and Methods: Cross-sectional study of adults aged 18-74 years from the Hispanic Community Health Study/Study of Latinos (2008-2011) with complete baseline data on glycemic status and two 24-hour dietary recalls (n=13 089). Age-adjusted and sex-adjusted and multivariable-adjusted measures of intake were determined by glycemic status and heritage., Results: Mean age-adjusted and sex-adjusted energy intake was significantly lower among Hispanics/Latinos with diagnosed diabetes compared with those with normal glycemic status (1665 vs 1873 kcal, P<0.001). Fiber intake was higher among those with diagnosed diabetes versus normal glycemic status (P<0.01). Among those with diagnosed diabetes, energy intake was highest among those with Cuban heritage compared with most other heritage groups (P<0.01 for all, except Mexicans), but there was no difference after additional adjustment. Fiber intake was significantly lower for those of Cuban heritage (vs Dominican, Central American, and Mexican), and sodium intake was significantly higher (vs all other heritage groups) (P<0.01 for all); findings were null after additional adjustment. There was no difference in supplemental intake of vitamin D, calcium, magnesium, or potassium by glycemic status., Conclusions: As part of the care of Hispanics/Latinos with diabetes, attention should be made to fiber and sodium consumption., Competing Interests: Competing interests: None declared.