The Changing Face and Focus of the Adolescent with an Eating Disorder
Pages 21-26
Carly Chason, Krista M. Davis, Lynae J. Hanks and Krista Casazza

DOI: http://dx.doi.org/10.6000/1929-5634.2016.05.01.3

Published: 03 June 2016

Abstract: The classic silhouette of the typical adolescent with an eating disorder (ED) is a white female with extremely low body weight; this has begun to take a new shape. The most apparent shift in the classic views are sex and weight. A trend toward a progressively decreasing age of onset in ED has also emerged. The objective of this paper is to describe the ED patients presenting to Children’s of Alabama’s Adolescent Eating Disorders Clinic, encompassing their age, sex, BMI percentile and muscle function. The data was examined from all first presentations to the clinic from 2013 to 2016. Between May 2013 and March 2016, 102 new patient appointments were scheduled. 88 patient’s charts were reviewed from the time of each initial appointment in the Adolescent Eating Disorders Clinic to obtain the sex, age, race, height, weight, reason for referral/active problems and ED diagnosis for each patient. BMI percentile was calculated according to reference ranges for sex and age. Handgrip strength was measured by dynamometer. As is consistent with previously published data, there were significantly more females than males seen in our population. There were more females than males across all categories of ED diagnoses. The highest number of diagnoses occurred between the ages of 13-16. A positive correlation between BMI percentile and measured handgrip strength was observed. Measured handgrip strength in females was lower in ages 13-18 than expected grip strength for age. When males were grouped by “Males 14 and under” and “Males 15 and over,” a lower measured grip strength compared to the expected grip strength for age was demonstrated. The impact of ED on morbidity and mortality has been well recognized; however the most often reported association was mainly based on changes in body weight. The adverse metabolic consequences perturb nutrient sensing and ultimately delivery and utilization. A shift in the focus of energy balanced towards systemic malnourishment may allow healthy and sustained metabolic improvements.

Easing of America’s Healthcare Burden: The Case for Aggressive Prevention of the Metabolic Syndrome
Pages 119-123
Gerry Lane

DOI: http://dx.doi.org/10.6000/1929-5634.2015.04.04.2

Published: 02 February 2016

Abstract: The term “metabolic syndrome” was used in 1977 by Herman Haller who was studying the risk factors associated with atherosclerosis. In the same year, Dr. Singer used the term to describe the associations between hyperlipoprotenemia and obesity, gout, diabetes mellitus, and hypertension. In1988, Gerald Reaven hypothesized that insulin resistance could be the underlying factor linking this constellation of abnormalities, which he went on to name “syndrome X or Reaven’s syndrome”.

Regardless of the clinical term that is utilized, the global impact on health care resources and humanity is massive.

• 47 million adult patients meeting the criteria for metabolic syndrome which represent over 24% of the adults in the United States.
• National inpatient hospital costs for metabolic syndrome with complications were nearly $400 billion in 2009.
• With appropriate primary care for the complications of metabolic syndrome, nearly $17 billion in hospital costs might have been averted, with significant potential savings obtained in US government health care programs.
• Non-pharmacological approaches to fight the risk factors associated with metabolic syndrome have been known for centuries.
• The scientific evidence supports the efficacy of nutritional remedies.

Metabolic syndrome is a preventable life threatening disease process. With its roots in childhood, this vicious cycle slowly destroys lives while we spend billions in the process. Delegating responsibility of financing our health and wellness to the insurance industry, Americans are ill prepared to deal with the reality that health is neither a luxury nor an entitlement. The impact of accepting the responsibility of prevention through nutritional counseling and education combined with regular exercise could save billions of dollars annually. More importantly aggressively preventing metabolic syndrome would save millions of lives.

The Effects of an Eight Week Weight Loss Program in Obese Adults Utilizing a Nutritional Supplement
Pages 115-118
Gerry Lane

DOI: http://dx.doi.org/10.6000/1929-5634.2015.04.04.1

Published: 02 February 2016

Abstract: A non-placebo controlled, blinded study utilizing a commercially available meal replacement (manufactured by Nutrition Laboratories Inc., Florida) studied 35 adult participants to determine the safety and efficacy of the product (a liquid nutrient concentrate) while measuring weight reduction, lipids, and adipose tissue, liver enzymes and metabolic indices (glucose, cholesterol and triglycerides) over an eight-week period. The average weight loss after 14 days was 18.2 (± 3.7) pounds and 28.4 (± 6.5) pounds at the conclusion of the eight-week trial. This was found to be statistically significant (p<.01). Patient’s metabolic functions were closely monitored in order to document therapeutic benefit, while monitoring for potential side effects. Total cholesterol was lowered in all participants (ave. reduction = 20.6 mg/dL) and every participant with clinically elevated cholesterol (≥ 200) at baseline, reported normal values after eight-weeks. Similarly, all participants with fasting hyperglycemia (s. glu. ≥ 100) returned to normal by the end of the study. This included three patients with NIDDM who were not well controlled prior to the study. There was no evidence of hypoglycemia (s. glu. ≤ 65). Participants with elevated liver enzymes at baseline reported normal SGOT & SGPT levels after two-weeks. No participant developed liver enzyme elevations. Subjective energy level of the participants was reported at baseline as low to average and reported as high to very high at the conclusion of the study. All participants lost total adipose tissue with the average change calculated at a 6.7% loss.

A Review of the Relationship between Wine Consumption and Type 2 Diabetes Mellitus
Pages 124-134
Creina S. Stockley

DOI: http://dx.doi.org/10.6000/1929-5634.2015.04.04.3

Published: 02 February 2016

Abstract: The potential health benefits of moderate alcohol consumption are not limited to a reduced risk of cardiovascular disease but are also observed for type 2 diabetes mellitus. The relationship appears to be J-shaped where moderate alcohol consumption reduces the risk of developing type 2 diabetes mellitus in both men and women, irrespective of age, and in those with a low and a high body mass index. The optimal amount of wine appears to be approximately two drinks per day, where a standard drink in Australia is considered to be 10 g alcohol. Given that the incidence of diabetes is projected to approximately double in the next 15 years, simple dietary supplementation to a healthy diet and lifestyle to reduce the risk will become increasingly important. This paper reviews the association between wine specifically and type 2 diabetes mellitus, and discusses biological mechanisms related to the association..