Dissertations / Theses on the topic 'Nutritional aspects of Eating disorders'

For the purposes of this study, eating disturbances were placed on a continuum ranging from disordered to normal, and family factors were examined via this framework. Research on anorectics and bulimics indicates that a variety of family variables contribute to the etiology of eating disorders. Research suggests the presence of a subgroup of persons who experience some disturbance in their relationships with food but not to the severity observed among eating disordered individuals. This study examined the relationship between family factors and eating disturbances.

Research indicates the existence of an eating disorder continuum. The two-component model of disordered eating suggests that certain personality traits may increase an individual's vulnerability to develop more severe variants of disordered eating symptomatology. The present study investigates pre-clinical elevations on a measure of personality based on the Five-Factor Model (FFM) and pre-clinical elevations on a measure of eating disorder symptomatology in a sample of nonclinical undergraduates. The personality dimensions Neuroticism, Extraversion, and Agreeableness accounted for 7% of the variability in Body Dissatisfaction. Subcomponents comprising the personality dimensions of the FFM as determined by Saucier (1998) (see Appendix A) were analyzed. The Self-Reproach and Intellectual Interests subcomponents were the strongest predictors of Drive for Thinness and Body Dissatisfaction. The subcomponent Sociability was the strongest predictor of Bulimia. Findings present implications for prevention and treatment interventions. Longitudinal studies are needed to determine the temporal directionality of personality and disturbed eating.

Thesis (MScMedSc) -- Stellenbosch University, 2001.
ENGLISH ABSTRACT: Osteopenia is a well documented complication of anorexia nervosa (AN). The pathogenesis of this bone loss is presently poorly defined in the literature. Pathogenetic mechanisms that have been implicated include certain nutritional factors, exercise abuse, hypogonadism, hypercortisolism and/or vitamin 0 deficiency. We studied, 59 Caucasian eating disorder patients aged 15-45yr. The eating disorder was classified by a single, qualified psychiatrist according to OSM IV R criteria as either anorexia nervosa (AN: n =25), bulimia nervosa (BN: n = 17) or eating disorder not otherwise specified (EONOS: n = 17). All patients were subjected to a detailed dietary and general history. We assessed the prevalence and severity (OEXA), the nature (osteocalcin, deoxypyridinoline) and site (vertebral versus hip) of osteopenla in these patients. he role of nutritional factors (energy intake, weight, height, BMI, plasma albumin, lipids), physical activity, hypercortisolemia (plasma and urinary free cortisol), vitamin 0 deficiency (plasma 250HD) and hypogonadism (amenorrhoea, E2, LH, FSH) in the pathogenesis of bone loss were also evaluated. Mild osteopenia (BMO decreased by more than 1SO below age-matched controls) was documented in 46% of the total study population, with more marked osteopenia (Z-Score < -2 SO) present in 15%. Both vertebral and hip osteopenia were documented. In the study population those patients with AN (Lumbar BMO (q/cm") = 0.869 ± 0.121) were most likely to develop osteoporosis, although a significant percentage of patients with BN (Lumbar BMO (q/crn") = 0.975 ± 0.16) and EONOS (Lumbar BMO (g/cm2) = 0.936 ± 0.10) were also osteopenic (29% and 35% respectively). Twenty four percent (24%) of the total patient population had a history of fragility fractures. These fractures were reported more commonly amongst patients with AN and EONOS (28% and29.4%). Fracture prevalence was however similar in patients with normal and low bone mass. Conventional risk factors were similar in patients with normal and low bone mass, except for a significantly longer duration of amenorrhoea (p = 0.009), a lower BMI (p = 0.0001) and greater alcohol consumption (p = 0.05) in the osteopenic patients. Nutritional parameters (S-albumin, protein, Ca, and P04 intakes), physical activity, as well as 25(OH) vitamin D levels were similar in AN and BN subjects, as well as in patients with a low versus normal BMD. Plasma and urine cortisol levels were also similar in these subgroups. With the exception of two patients with borderline osteopenia, significant bone loss was only documented in those patients with a past or current history of amenorrhoea. In the total patient population the duration of amenorrhoea was significantly (p<0.009) longer in patients with osteopenia versus those with a normal bone mass. A significant negative correlation between BMD (Z-Score) and duration of amenorrhoea was also documented in the total patient population (r = -0.4, P = 0.001) as well as in all three eating disorder groups (AN r - -0.4, P = 0.03; BN r = - 0.6, P = 0.008; EDNOS r = -0.6, P = 0.005). In the total patient population, those patients with amenorrhoea, had lower BMD and BMI values and lower estrogen levels compared to those with a normal menstrual cycle. We conclude that osteopenia commonly attends AN, as well as BN and EDNOS. Nutritional (with the exception of alcohol consumption) and mechanical factors as well as hypercortisolemia did not appear to contribute significantly to bone loss in this study population. Hypogonadism appeared to be the main cause of the bone loss observed in these patients.
AFRIKAANSE OPSOMMING: Osteopenie is In welbekende komplikasie van anorexia nervosa (AN). Die patogenese van hierdie beenverlies is swak in die huidige literatuur omskryf en nutrisiele faktore, 'n vita mien 0 gebrek, oormatige oefening, hiperkortisolemie en hipogonadisme word onder andere qeimpliseer. Vir die doel van die studie is In totaal van 59 Kaukasier eetsteurnis pasiente patients volledig ondersoek. Die tipe eetsteurnis is deur In enkel gekwalifiseerde psigiater volgens die DSM IV R kriteria geklassifiseer as anorexia nervosa (AN: n =25) of bulimia nervosa (BN: n = 17) of eetsteurnis nie anders gespesifiseer (EDNOS: n = 17). Elke pasient is ook aan In gedetailleerde dieet en algemene risikofaktor vraelys vir osteoporose onderwerp. Die voorkoms en graad (DEXA), die aard (osteokalsien, deoksipiridinolien) asook die tipe (werwelkolom/heup) osteopenie is ondersoek. Die rol van nutrisiele faktore (totale kalorie-inmame, gewig ,Iente LMI, plasma albumien, lipiede) en vitamien 0 gebrek, oefening, hiperkortisolemie (plasma en urinere kortisol) en hipogonadisme (amenoree, plasma E2, LH,FSH) in die patogenese van die beenverlies is ook evalueer. Matige osteopenie (BMD meer as 1 SO onder die van ouderdomskontrole) is in 46% van die totale pasientpopulasie gedokumenteer, met erge osteopenie (Z-Telling < -2) in 15%. Aantasting van beide werwelkolom en heup is aangetoon. In hierdie studiepopulasie kom osteopenie meer algemeen voor in die AN (Lumbaal BMD (g/cm2) = 0.869 ± 0.121) groep (64%) in vergelyking met BN (Lumbaal BMD (g/cm2) = 0.975 ± 0.16) (29%) en (EDNOS) (Lumbaal BMD (g/cm2) = 0.936 ± 0.10) (32%). Vier-en-twintig persent van die totale pasientpopulasie het In geskiedenis van frakture gehad. Frakture het meer algemeen in AN en EDNOS pasiente voorgekom (28% en 29%). Pasiente met 'n lae beenmassa was gekenmerk deur In betekenisvolle laer LMI (p = 0.0001), hoer alkolholverbruik (p = 0.05) en langer duurte van amenoree(p = 0.009). Nutrisiele parameters (s-albumien, protetene, Ca, P04 inname) oefening, asook 25(OH) vitamien 0 vlakke was soortgelyk in AN en BN pasiente. Hierdie parameters het ook nie verskil tussen pasiente met osteopenie en die met In normale BMD nie. Plasma en urinere vry kortisolvlakke was ook soortgelyk in hierdie twee groepe. Betekenisvolle beenverlies (met die uitsondering van twee pasiente met grenslyn osteopenie) het slegs voorgekom in pasiete met 'n huidige of In vorige geskiedenis van amenoree. In die totale pasientpopulasie was die duurte van amenoree (p< 0.009) betekenisvollanger in die pasiente met osteopenie. In Betekenisvolle negatiewe korrelasie tussen BMD (Z-Telling) en die duurte van amenoree in die toale pasient populasie (r = -0.4; P = 0.001) asook in al drie eetsteurnis groepe (AN: r = -0.4; P = 0.03; BN: r = -0.06; P = 0.008; EDNOS: r = - 0.6, P = 0.005) is aangetoon. In die groep as 'n geheel, het die amenoree pasiente In laer LMI, E2vlakke en BMD gehad in vergelyking met die pasiente met normale menses. Opsommend dus, kom osteopenie algemeen in pasiente met AN, asook BN en EDNOS voor. In Betekenisvolle bydrae van nutrisiele (met die uitsondering van alkoholinname) en meganiese faktore asook hiperkortisolemie tot been verlies, kon nie in hierdie tudie populasie gedemonstreer word nie. Hipogonadisme is as die hoofoorsaak van osteopenie in die pasiente qefdentifiseer.

The purpose of this study is to investigate the difference between athletes and non-athletes by addressing prevalence of disordered eating and eating disorders, the risk factors associated with the disease(s), and health concerns for those suffering with disordered eating.

This project discusses the problem of eating disorders in dancers. The development of eating disorders can be attributed to sociocultural development, and psychological factors. Dance places an emphasis on thinness, and the pressure to obtain ideal standards of thinness appear to be particularly salient in the development of eating disorders in dancers.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2010.
ENGLISH ABSTRACT: Background: Poor body image perception and body dissatisfaction has been found to be a risk factor for eating disorders. Studies have found that signs of distorted body image perception and body dissatisfaction can be detected in children as young as 8 or 9 years old. Aim: The current study served to assess the extent of this problem in Northeastern Johannesburg, South Africa, in order to allow for the necessary intervention steps (e.g. development of school-based programmes) to deal with this problem to be put in place. Method: The study was a cross-sectional analytical study with a descriptive component. Two hundred and four girls (81.37% Black, 15.20% White and 3.43% Coloured or Indian) aged between 96 and 119 months in primary schools in Northeastern Johannesburg were selected for this study using systematic random sampling. They were required to complete a questionnaire about their body image perception and weight control behaviours, as well as undergo anthropometric measurements (i.e. weight and height). Results: This study found that the subjects placed much importance on being thin, with subjects stating that they thought if a girl was thin she would be more popular (63.96%), have better self esteem (69.63%), be more attractive (69.11%), be more feminine (73.80%) and be healthier (66.84%). When asked to identify the girl from a silhouette drawing that most resembled themselves, 45.00% of the subjects were able to accurately identify which girl’s size most resembled their own, whereas 48.50% saw themselves as thinner than they are and 6.50% saw themselves as fatter than they are. In addition, the majority of subjects (69.61%) said that they were very happy with their weight and the majority (74.88%) classified it as “just right.” However, despite these findings, there was still significant body dissatisfaction evident in the group with 50.25% of the subjects wanting to be thinner, 28.57% wanting to be fatter and only 21.18% not wanting to be thinner or fatter than they currently are. Of the subjects participating in the study, 50.98% had tried to lose weight in the past and 28.71% had tried to gain weight. Also, various factors (i.e. media, cultural, family and peer influences), were shown to have a significant influence on the subjects’ body image perception. Other factors such as socioeconomic status and physical activity level had no significant link with the subjects’ body image perception. Conclusion: There is a significant problem with poor body image perception and resultant weight control behaviours in this age group. Clearly, there is a need for body image improvement programmes to be put in place in primary schools so as to prevent preadolescent girls from moving towards a lifetime of suffering with body dissatisfaction or, even worse, developing a life-threatening eating disorder.
AFRIKAANSE OPSOMMING: Agtergrond: ’n Swak liggaamsbeeld en liggaamsontevredenheid is bekende risikofaktore vir die ontwikkeling van eetsteurnisse. Volgens studies kan tekens van ’n verwronge liggaamsbeeld en liggaamsontevredenheid reeds by jong kinders, van 8 of 9 jaar, bespeur word. Doel: Hierdie studie het gepoog om die omvang van dié probleem in die noordooste van Johannesburg, Suid-Afrika, te bepaal ten einde die nodige intervensiemaatreëls te tref (byvoorbeeld om skoolgebaseerde programme te ontwikkel) om die probleem die hoof te bied. Metode: Die studie is ’n dwarssnit analitiese studie met ’n beskrywende komponent. Met behulp van sistematiese, ewekansige steekproefneming is 204 laerskoolmeisies (81.37% Swart, 15.20% Wit en 3.43% Bruin of Indiër) van tussen 96 en 119 maande uit die noordooste van Johannesburg as proefpersone vir die studie gekies. Die meisies moes elk ’n vraelys oor hul liggaamsbeeld en gewigsbeheergedrag invul sowel as antropometriese meting van gewig en lengte ondergaan. Resultate: Die studie het gevind dat die proefpersone baie waarde daaraan heg om maer te wees. Hulle reken onder meer dat, indien ’n meisie maer is, sy waarskynlik gewilder sal wees (63.96%), ’n beter selfbeeld sal hê (69.63%), aantrekliker sal wees (69.11%), vrouliker (73.80%) en gesonder sal wees (66.84%). Toe hulle op ’n profielskets ’n meisie moes uitwys na wie hulle dink hulle die meeste lyk, kon 45.00% van die proefpersone akkuraat uitwys watter meisie se grootte die meeste met hulle s’n ooreenstem, terwyl 48.50% hulself as maerder en 6.50% hulself as vetter beskou het as wat hulle werklik is. Die meerderheid van die proefpersone (69.61%) was oënskynlik gelukkig met hul gewig en die meeste (74.88%) het hul gewig as “net reg” beskryf. Tog, ondanks dié bevindinge, was daar steeds beduidende liggaamsontevredenheid by die groep: 50.25% van die subjekte wil maerder wees, 28.57% vetter en slegs 21.18% nie maerder óf vetter as wat hulle tans is nie. Van die studiedeelnemers het 50.98% al voorheen probeer gewig verloor, terwyl 28.71% al probeer gewig aansit het. Verskeie faktore (soos media-, kulturele, gesins- en portuurinvloede) blyk ook ’n beduidende impak op die proefpersone se liggaamsbeeld te hê. Daarenteen toon ander faktore, soos sosio-ekonomiese status en vlak van fisieke aktiwiteit, geen wesenlike verband met die proefpersone se liggaamsbeeld nie. Gevolgtrekking: Hierdie ouderdomsgroep blyk ’n beduidende probleem met ’n gebrekkige liggaamsbeeld en gevolglike gewigsbeheergedrag te hê. Daar is duidelik ’n behoefte aan programme om laerskoolmeisies se liggaamsbeeld te verbeter ten einde te voorkom dat preadolessente meisies weens liggaamsontevredenheid ’n leeftyd van swaarkry tegemoetgaan of, selfs erger, ’n lewensgevaarlike eetsteurnis ontwikkel.

This project investigates the many influences throughout the life span that interact to cause obesity. Heredity factors, overfeeding in infancy and childhood, repeated dieting, inactivity, lifestyle and psychosocial conditions all contribute to the incidence of obesity.

The affectional bond that develops between caregiver and child during infancy can lead to the development of emotional distress and the manifestation of psychological disturbance if the relationship is severed and a sense of loss is experienced. Furthermore, the caregiver-child relationship formed during infancy can have implications for the development of interpersonal relationships in later life. The secure or insecure attachment relationships developed influence the capacity to form affectional bonds in later life and may lead to the manifestation of psychological disturbance, such as depression. The focus of this thesis is on four case studies of three children and one adolescent who have suffered negative early life experiences. Harrison is an 8 year old Koori boy who has suffered from maternal deprivation. Diana is a 10 year old girl who has a Mild Intellectual Disability and Epilepsy. The influence of second generational trauma on the caregiver-infant attachment relationship will also be explored in the case study of Diana. The third case study focuses on Melanie who is a 9 year old girl who has suffered from paternal sexual abuse and exhibits indiscriminate attachment relationships. Finally, the fourth case study focuses on Tammie who is a 16 year girl who exhibits depressive symptomatology which may have developed as a result of early insecure attachment relationships. The case studies are described with reference to attachment theory, the language and social deficits associated with negative early life experiences, and implications for therapeutic interventions.

The high level of weight and shape concerns amongst preadolescent children has prompted interest in the development of prevention programs for this age group. In the 1990s weight and shape concerns were considered primarily an adolescent phenomenon. However, prevention programs which have been designed with adolescent and adult populations have been found to show limited success. Some researchers have argued that programs which target preadolescent children are more likely to be effective than programs that target adolescents, as by adolescence many attitudes and behaviours have become entrenched so they may be more difficult to modify. On the other hand, children's weight and shape concerns are believed to be more malleable and amenable to change. To date there have been limited controlled studies implementing prevention programs designed to reduce weight and shape concerns with preadolescent populations. The new study conducted as part of this thesis involves the development and implementation of the ‘Everybody’ s Different, Nobody Else Is Me’ preadolescent prevention program. The program was designed to address some of the methodological biases of past research and incorporate three risk factors, social comparisons, negative affect, and self-esteem, to reduce and/or prevent the development of weight and muscle concerns among children. These three risk factors have been found to be associated with weight and shape concerns of adolescents and adults, and there is also increasing evidence that they are important factors among children. Research also suggests that social comparisons, negative affect, and self-esteem are interrelated, which highlights the importance of targeting the variables in one program. The new five session prevention initiative was implemented with 156 grade four children. Both the treatment and control conditions consisted of 78 children. Preliminary evidence from the new prevention initiative indicated that the program reduced muscle bulk and exercise (ie. An over-emphasis on exercise to lose weight rather than health promotion), and negative affect in the long term as assessed by the six month follow-up. At the six month follow-up, children in both the treatment and control conditions reported reduced negative affect, dieting, and muscle bulk and exercise scores and increased positive affect. Consistent with short term follow-up results, boys reported greater muscle bulk and exercise scores than girls at the six month follow-up. Girls, in both conditions, were also found to report greater positive affect than boys. These findings are discussed in relation to past research, and suggestions for future prevention initiatives are highlighted.

Eating disorders (ED) usually develop during adolescence, and intervention to stop further weight loss is believed to improve outcome and long-term prognosis. Adolescents with ED who do not receive effective treatment risk poor outcome and even untimely death as adults. The first aim of this thesis was to investigate long-term mortality and causes of death in a series of female adults with chronic ED. The second aim was to study the one-year outcome of an unselected series of adolescent girls with anorexia nervosa (AN) and “other restrictive eating disorders” who had been treated within a specialist ED out-patient service focused on nutritional rehabilitation based on family therapy and without planned hospitalization. The third aim was to investigate the possible metabolic and hormonal side effects of olanzapine when used as an adjunct to facilitate nutritional rehabilitation. The fourth aim was to investigate the relationship between polyunsaturated fatty acid (PUFA) status and depression. In adult women with chronic ED, a very low body mass index and psychiatric co-morbidity confer a substantially increased risk of premature death. A treatment programme for adolescent ED with rapid access to assessment and prompt start of treatment with initial emphasis on nutritional rehabilitation proved efficient. The outcome was encouraging, as 43% of all patients with ED and 19% of those with AN did not have an ED at one-year follow-up. Of the remaining patients the vast majority had gained weight and regained menstruation, and were back in school on a full-time basis. Olanzapine was used to reduce anxiety, excessive exercise and rumination over weight and shape. Side effects were similar to those observed in normal-weight individuals, and do not preclude its use in underweight adolescents with ED. Low ω3 PUFA were associated with depression. The ω3 PUFA status improved during nutritional rehabilitation with ordinary foods and without supplementation. The investigations indicate that adolescent ED can be successfully treated in an out-/day-patient setting. An essential feature of the service is rapid handling and weight gain. Further weight loss can be avoided, and chronic disease hopefully prevented.

Eating disorders are notoriously difficult to treat, and anorexia nervosa has the highest mortality rate of all the psychiatric illness (Gremillion, 2003). Therefore this client group can present challenges to clinicians working with them. Those working in the area of eating disorders require research with clear clinical implications, to improve treatment and outcomes. The thesis will attempt to provide such research, with clearly stated clinical implications for treatment. The first paper in this thesis reviews the literature on the link between shame and eating disorders. This paper defines shame, then explores studies identifying the differences or similarities between shame and other self-conscious emotions, such as guilt, embarrassment and humiliation. The paper then explores the link between shame and eating disorders. The second and main paper is an empirical paper exploring shame and pride in a clinical population with a diagnosed eating disorder. The third paper explores 'pro-anorexia' websites to access whether such sites offer any advice or support that could be considered positive. The final paper is a reflective paper which explores my research journey.

The research presented here is an exploratory investigation of the potential role of psychosexual factors in the development of the eating disorders anorexia and bulimia. The study sample involved 41 female eating disordered patients (16 anorexics and 25 bulimics), diagnosed using the DSM-III-R criteria. These patients were recruited from The Eating Disorders Program at St. Albans Psychiatric Hospital in Radford, Virginia. Five hypotheses were tested concerning the following psychosexual factors: sexual knowledge and attitudes; sexual experience and functioning; sex roles; gender identity (sexual orientation); and history of sexual abuse or incest. The hypotheses postulated that the psychosexual factors would exist or be perceived by eating disordered patients as significantly different than would be statistically expected according to available normative data. The instrumentation for measuring these factors included the Derogatis Sexual Functioning Inventory, the Bern Sex Role Inventory, and the Klein Sexual Orientation Grid. Compared to normative data, significant results were found in the total sample for all psychosexual factors except Sexual Knowledge and Gender Identity. However, no significant differences were found between the anorexic and bulimic subsamples. These results are discussed along with their implications for therapy and research.
Ph. D.

The National Institute for Clinical Excellence (NICE) recommends that the treatment of eating disorders should generally be managed on an outpatient basis using psychologically informed approaches (Clinical Guideline 9, NICE, 2004). As such, carers and psychological therapists are crucial in providing support to individuals with eating disorders. Although there is a wealth of research literature focusing on the understanding and treatment of eating disorders, further consideration of carers and therapists in this area is warranted. This thesis therefore gives prominence to these two groups. Chapter 1 reviews the literature on education and support interventions for carers of those with eating disorders. Findings suggest that face-to-face and self-help interventions show effectiveness in reducing negative carer symptoms and meeting carers’ needs. Methodological limitations, research recommendations and clinical implications are outlined. Chapter 2 presents an empirical study which explores the impact of eating disorders work on eight psychological therapists, including the effects on their eating and body image. A grounded theory approach is adopted. Findings illustrate that therapists are affected by the complexity of their day-to-day work in many ways and that they have a number of means of coping. Recommendations are made for clinical practice and future research. Chapter 3 provides a reflective account of the research journey. It gives an overview of the research process and provides an opportunity for the researcher to be considered in this.

Undernutrition and dysphagia in the institutionalized elderly are well documented in the literature. However, the clinical efficacy of diets to treat dysphagia have not been established. To offer a better understanding of the textural characteristics of the new Sainte-Anne's Hospital (SAH) modified texture reformed foods, rheological evaluations were performed. Apparent viscosity, consistency coefficient, flow behavior index and yield stress values were calculated for the thickened beverages. Texture profile analyses were performed on the reformed foods. Secondly, to evaluate the impact of SAH's reformed foods on nutritional intake and weight, a 12-week clinical trial was undertaken. Dysphagic frail elderly subjects (n = 17) of a long-term care facility of Montreal were randomly assigned to receive SAH reformed foods or traditional care. The experimental group demonstrated a significant increase in nutritional intake resulting in significant weight gain. These findings suggest that dysphagic frail elderly could reach healthy weight when adequately fed.

The performances of 114 eating disordered females on measures of individual and family functioning were examined via t-tests, analyses of variance, and chi squares analyses. Subjects met DSM-III-R criteria for anorexia nervosa, anorexia nervosa with bulimia nervosa, bulimia nervosa, or eating disorder not otherwise specified. Measures included selected scales of the MMPI, Rotter's Internal-External Locus of Control Scale, the Bem Sex Role Inventory, the Eating Disorder Questionnaire, the Moos Family Environment Scale, and the Berren-Shisslak Family Dynamics Survey. First, performances on the measures were compared to normative samples and across diagnostic groups. As expected, the subjects differed from normative samples on many dependent measures, but the diagnostic groups differed little among themselves. Next, an examination of 45 clinical features suggested that subjects were not as symptomatically distinct as diagnosis might imply. Finally, diagnosis was set aside to examine the relationships of specific clinical features to the measures of individual and family functioning. These features included age, weight history, food binges, vomiting, laxative and diuretic use, food restriction, menstrual history, exercise, drug and alcohol abuse, symptom severity, inpatient treatment history, and additional diagnosis. Surprisingly, a history of anorectic weight was not related to any of the measures, but amenorrhea emerged as a clinical feature of some import, not just among the anorectic subjects but among subjects generally. Other findings suggested that patients who binge have difficulty with separation, that binges may be a metaphor for unsatisfied cravings for nurturance, and that vomiting and exercise may enhance a sense of separateness while laxative use may represent the private expulsion of anger. The need for family involvement in treatment was highlighted by many relationships between the clinical features and indices of family dysfunction.

Research efforts in the area of eating disorders have been numerous and varied. However, few studies have investigated the existence of specific predisposing factors that could render a young female adolescent more susceptible to developing an eating disorder. The present study was attempted in an effort to fill this knowledge gap. One hundred and fifty nine, 12 to 14 year old female students not known as having an eating disorder, were surveyed at a public school in Roanoke County, Virginia. The participants were asked to complete four different instruments which were: The Piers-Harris Children's Self-Concept Scale, the Children's Assertiveness Inventory, the Nutrition Questionnaire designed by the researchers and the Eating Disorder Inventory or EDl. Correlational statistics were used to identify any significant relationships between the first three instruments and the ED!. Significant relationships were identified, suggesting the existence of specific factors related to tendencies toward eating disorders as assessed by the EDI. Among these factors were: poor self-concept and body image, obesity and weight problems, active interest or involvement in dieting as well as certain familial behaviors. The results of this research effort will hopefully be used in designing educational programs for the prevention of eating disorders, as well as for enhancing the detection of these disorders. Further research needs will also be suggested.
Master of Science

Providing adequate nutrition to children with severe neurological disabilities is extremely difficult due to the high prevalence of oral-motor dysfunction in this group. Short stature and light weight for height are common in disabled children and undernutrition is believed to play a role in this poor growth. This programme of study investigated the effect of gastrostomy-tube feeding in disabled children with oral-motor dysfunction and evaluated the energy balance and body composition of disabled children fed both orally and via gastrostomy-tube over twelve months. The Quality of Life of the children and their carers was also evaluated. Energy intake was measured using three-day dietary diaries and energy expenditure with indirect calorimetry and doubly labelled water. Total body water using oxygen-18 dilution was used to evaluate body composition along with standard anthropometry. Improved growth, nutritional status and general health were seen at six and twelve months after gastrostomy-tube placement. The Quality of Life of the children and their carers also significantly increased. Both energy intake and energy expenditure were found to be lower than reference standards, but energy balance was positive indicating that inadequate nutrition was not the sole cause of poor growth. Body composition was also found to be significantly different from reference. Fat-free mass was significantly low for age and for height. Fat mass was higher in gastrostomy-tube fed children, but lower or normal in disabled children fed orally. Physical activity levels were low for the entire group of disabled children yet the gastrostomy-tube fed children displayed much higher levels of disability. Gastrostomy-tube feeding has a positive impact upon the growth, health and Quality of Life of disabled children and their carers. Careful follow-up is critical in order to optimize health and body composition.

Women with exercise associated amenorrhea display a disturbance in basal and exercise levels of reproductive, anti-reproductive and stress hormones. Co-incident with chronic exercise are other factors, which alone, also affect the menstrual cycle. Therefore, amenorrheic runners (AR), regularly menstruating runners (RMR) and regularly menstruating sedentary controls (RMSC) were compared for plasma progesterone levels, plasma lipid levels, menstrual cycle characteristics, physical characteristics and nutritional adequacy to determine if the difference in menstrual status could be explained, and to determine whether exercise alone could be attributed as the cause of menstrual cycle disturbances.Plasma progesterone levels were significantly lower in the AR group (. 28 + .02 ng/ml) than in the RMR group (.41 + .06 ng/ml) and the RMSC group (.49 + .06 ng/ml) in the follicular phase. Regularly menstruating runners demonstrated lower plasma progesterone levels in the luteal phase (9.76 + 1.05 ng/ml) than RMSC subjects (10.24 + 2.21 ng/ml). Regularly menstruating runners had a significantly shorter luteal phase length relative to their cycle length (.35 + .01) than RMSC subjects (.46 + .01). Mean age, incidence of parity, age of menarche, height, weight, body composition, max V02 and number of miles run per week did not differ between the RMR and AR subjects. Amenorrheic runners took in significantly less fat, red meat, phosphorous and total calories than the RMR subjects. Serum LDL-C was significantly higher in the AR subjects (89.2 + 9.7 mg/dl) than in the RMR subjects in both the luteal (67.8+ 3.4 mg/dl) and follicular (66.8+ 5.6 mg/dl) phases. Serum HDL-C was significantly higher in the RMR subjects in both the luteal (62.9+ 4.1 mg/dl) and follicular (59.2+ 2.9 mg/dl) phase, and in the AR subjects (63.9+ 4.2 mg/dl), than in the RMSC subjects in the luteal (49.2+ 5.9 mg/dl) and follicular (47.2+ 2.4 mg/dl) phase. Serum VLDL-C did not differ between any groups.This investigation demonstrates that hormonal and lipid level alterations with exercise are significantly different in the amenorrheic runner. However, regularly menstruating runners display alterations which may represent and intermediate or potential phase of menstrual cycle disturbances. The nutritional inadequacy or energy imbalance separates amenorrheic runners from regularly menstruating runners. Thus, it appears that exercise alone is not enough to cause the hormonal disturbances that trigger amenorrhea, and, that exercise associated amenorrhea is not unlike other amenorrheas of hypothalamic origin.

Psychological and behavioral characteristics of female undergraduates with varying levels of disordered eating, as measured by the Questionnaire for Eating Disorder Diagnoses (Q-EDD; Mintz, O'Halloran, Mulholland, & Schneider, 1997), were investigated. Results suggest that the Q-EDD is an appropriate instrument for measuring eating disorder symptomatology. Greater disordered eating was associated with more bulimic, dieting, and weight fluctuation symptoms, higher impression management and approval-seeking needs, more dichotomous thinking, self control, and rigid weight regulation, and increased concern with body shape and dissatisfaction with facial features. Eating-disordered and symptomatic women evidenced more severe eating disorder behaviors and psychological distress than asymptomatic women. Findings are congruent with a redefined discontinuity perspective of eating disorder symptomatology. Treatment implications and campus-wide preventions are suggested.

This thesis examines the problem of disordered eating based on ethnographic fieldwork in emergency shelters, soup kitchens, and eating disorder support groups, as well as interviews with medical professionals, and other residents of a Canadian city. This person-centered ethnography that explores the eating behaviors of not only those who have been diagnosed with 'eating disorders', but also those who are unable at times to provide themselves with food reveals that in spite of a prevailing discourse that determines eating as an independent act, food choices and eating patterns are dependent social 'works of the imagination' affected and shaped by social determinants and cultural norms. From eating disorders to type 2 diabetes and 'food as gift,' the lived experience of individuals indexes the ways in which food, power, and identity are enmeshed and embedded within culture. This critical perspective argues that disordered eating is socially and culturally produced and reproduced.
vi, 182 leaves ; 29 cm.

Eating disorder symptoms are serious and prevalent problems in industrialized societies. Although many studies have individually investigated the influence of environmental factors on the development of eating disorder symptoms, few have considered the relative and cumulative impact of various contexts within the same study. The current study was conducted to examine the influence of the mass media, mothers, and peers on the development of eating disorder symptomology in male and female adolescents using an ecological model proposed by Bronfenbrenner (1977, 1979, 1986, 1988, 1995). Specifically investigated were students' perceptions of pressures exerted by the media and significant others to lose weight and be physically attractive. Tenth, eleventh, and twelfth grade adolescents in a suburban community were surveyed through self-report questionnaires; the Eating Attitudes Test (EAT), select subscales of the Eating Disorder Inventory-2 (EDI-2), and a modified version of the Multidimensional Media Influence Scale (MMIS). Multivariate analyses of variance indicated that female students acknowledged higher levels of eating disorder symptomology and higher perceived pressures from mothers and the media than did males. Significant grade level differences were found only in levels of body dissatisfaction between sophomores and juniors. Canonical correlations showed that those students who perceived greater pressures across environmental contexts also reported more eating disorder symptomology. Further analyses of these findings are described. Implications for future research and prevention programs are discussed.
Department of Educational Psychology

Acquired Immune Deficiency Syndrome (AIDS) and impaired or threatened nutritional status seem to be closely related. It is now known that AIDS results in many nutritional disorders including anorexia, vomiting, protein-energy malnutrition (PEM), nutrient deficiencies, and gastrointestinal, renal, and hepatic dysfunction (1-7, 8). Reversibly, nutritional status may also have an impact on the development of AIDS among HIV-infected people. Not all individuals who have tested antibody positive for the Human Immunodeficiency Virus (HIV) have developed AIDS or have even shown clinical symptoms (9, 10). A poor nutritional status, especially PEM, has a depressing effect on immunity which may predispose an individual to infection (11). It has been proposed that a qualitatively or quantitatively deficient diet could be among the factors precipitating the transition from HIV-positive to AIDS (12, 13). The interrelationship between nutrition and AIDS reveals the importance of having a multidisciplinary health care team approach to treatment (11), including having a registered dietitian on the medical team. With regards to alimentation, the main responsibility of a dietitian is to inform the public concerning sound nutritional practices and encourage healthy food habits (14). In individuals with inadequate nutritional behavior, a positive, long-term change has been seen when nutrition education tailored to specific physiological and emotional needs was provided along with psychological support through counseling (14). This has been the case for patients with various illnesses and may also be true in AIDS patients as well. Nutritional education specifically tailored for each AIDS patient could benefit the patient by improving the quality of life and preventing or minimizing weight loss and malnutrition (15-17). Also, it may influence the progression of the disease by delaying the onset of the most severe symptoms and increasing the efficacy of medical treatment (18, 19). Several studies have contributed to a dietary rationale for nutritional intervention in HIV-infected and AIDS patients (2, 4, 20-25). Prospective, randomized clinical research in AIDS patients have not yet been published to support this dietary rationale; however, isolated case reports show its suitability (3). Furthermore, only nutrition intervention as applied by a medical team in an institution or hospital has been evaluated. Research is lacking concerning the evaluation of nutritional education of either non-institutionalized or hospitalized groups of persons who are managing their own food choice and intake. This study compares nutrition knowledge and food intakes in HIV-infected individuals prior to and following nutrition education. It was anticipated that education would increase the knowledge of nutritional care of AIDS patients and lead to better implementation of nutrition education programs.

This study utilized both qualitative and quantitative procedures to examine the relationship between religiosity and eating disorders among a sample of nineteen eating disordered individuals who sought treatment at one of two college counseling centers, or at a hospital unit which specializes in treating eating disorders. Following theoretical works that point to asceticism as the link between religion and eating disorders, it was hypothesized that subject scores on the Shepherd Scale, a measure of religiosity from a Christian perspective, would positively correlate with scores on the Eating Disorder Inventory, a measure of eating disorder symptomatology, which includes a subscale that assesses asceticism. Analysis of subject scores shows no statistically significant correlation between religiosity and asceticism, though statistically significant negative correlations were found between religiosity and other Eating Disorder Inventory subscales. A marked difference in asceticism scores was found between subjects treated at the college counseling centers and those treated at the hospital unit.
Department of Counseling Psychology and Guidance Services

This research, based on a random sample of undergraduates at the University of Arizona, is an exploration of the relationships between normative conformity, self-perception, and eating behavior. The goal of this study was to examine how norms governing appearance and sex roles contribute to a view of self that may result in serious eating problems. Three dimensions of self were included in the study: body image, control, and orientation to others. Specifically, it was hypothesized that overconformity would contribute to a self-concept defined in terms of negative body image, including a high degree of weight consciousness, strong need to exercise self-constraint, and high degree of orientation to others. In turn, this negative self image is likely to be associated with eating behavior which may be described as "weight obsessed," although not necessarily meeting clinical criteria for eating disorders. One of the major purposes of this research was to examine gender differences in the processes contributing to disturbances in eating behavior. It was hypothesized that definitions of the female and male self would have different outcomes in terms of eating behavior. It was also hypothesized that conformity to norms would be a more salient issue for females than for males. Findings of this research indicate that females experience more disturbed eating than males; that societal standards of appearance do affect eating behavior of both females and males, although this effect is greater for females; and that a self-concept defined in terms of negative body image, high weight consciousness, need for constraint, and feelings of failure/inadequacy contribute to problematic eating among females. These results imply that solutions to the problem of disordered eating must be examined in terms of social causes: specifically, current definitions of femininity, attractiveness, and self-concept.

Thesis (MNutr)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Introduction and Objectives: Schools can serve as a supportive environment for the promotion of healthy eating in order to prevent childhood overweight and obesity and the development of noncommunicable diseases such as cardiovascular diseases, type 2 diabetes mellitus, fatty liver disease, muscoskeletal disorders and some cancers. Tuck shops at schools often offer unhealthy items that are energy dense and high in fat and/or sugar with a low content of vitamins, minerals and dietary fibre. The availability of unhealthy items in tuck shops prevents learners from making healthy food choices, since children tend to choose unhealthy foods when given a choice. In addition to unhealthy items offered by tuck shops, learners also bring unhealthy items to school in their lunchboxes. The aim of the study was to investigate the influence of a nutritionally-regulated tuck shop on primary school learners’ perceptions, attitudes and behaviour towards healthy eating in a Bloemfontein, Afrikaans medium, co-education primary school, and compare it to learners of a school with a conventional tuck shop. Methods: In a cross-sectional survey with an analytical component, grade 2 to 7 learners in a school with a nutritionally-regulated tuck shop (n=116) and a school with a conventional tuck shop (n=141) completed a questionnaire. Six learners per grade also took part in focus group discussions. Questions related to lunchbox contents and perceptions, attitudes and behaviour towards the tuck shop and healthy eating. Nutritional information of the items available for purchase at each of the school tuck shops was collected. Results: The lunchboxes of learners in the school with a nutritionally-regulated tuck shop contained significantly (p<0.05) more healthy items (fruit, water and muffins), as well as significantly more unhealthy items (sweets and chips). The items offered by the nutritionally-regulated tuck shop contained approximately half the kilojoules compared to items offered by the conventional tuck shop. Learners in the school with a nutritionally-regulated tuck shop liked certain fruits and vegetables significantly (p<0.05) more than learners in the school with a conventional tuck shop. Statistical significant differences (p<0.05) between different grades and gender showed that grade 2 learners in both schools had a less positive attitude towards certain fruit and vegetables compared to the older learners, while girls in both schools were more positive towards certain fruits and vegetables compared to boys. Younger learners had a more positive attitude towards their nutritionally-regulated tuck shop than older learners. In both schools learners had similar perceptions regarding the particular school’s tuck shop and healthy eating. Conclusion: The hypothesis that learners in a school with a nutritionally-regulated tuck shop have positive attitudes, perceptions and behaviour towards healthy eating was rejected. The availability of healthier items in a school tuck shop had a positive influence on certain behaviours and attitudes of learners, but the potential value of controlling the type of items available for purchase at schools might be counteracted by lunchbox contents, certain fixed eating patterns, perceptions of learners and previous exposure to a conventional tuck shop. Recommendations include a multi-pronged approach such as the Health Promoting Schools concept.
AFRIKAANSE OPSOMMING: Inleiding en doelwitte: Skole bied ‘n omgewing waar goeie eetgewoontes bevorder kan word ten einde oorgewig en vetsug in kinders te voorkom, asook die ontwikkeling van nie-oordraagbare siektes soos kardiovaskulêre siektes, tipe-2 diabetes mellitus, lewervervetting sindroom, ortopediese komplikasies en sekere soorte kanker. Snoepies in skole voorsien meestal ongesonde items met ‘n hoë energie, vet- en/of suikerinhoud en wat laag is in vitamiene, minerale en dieetvesel. Die beskikbaarheid van ongesonde items in snoepies verhoed dat leerders gesonde voelselkeuses uitoefen, omdat kinders geneig is om voorkeur aan ongesonde kos te gee as hulle 'n keuse gebied word. Benewens die ongesonde items wat snoepies aanbied, neem leerders boonop ongesonde kos in hul kosblikke skooltoe. Die doel van die studie was om by 'n Afrikaans dubbelmedium laerskool in Bloemfontein die invloed van ‘n voedingkundig-gereguleerde snoepie op leerders se persepsies, houdings en gedrag teenoor gesonde eetgewoontes te ondersoek en te vergelyk met leerders in 'n skool met 'n konvensionele snoepie. Metodes: In ‘n deursnit-opname met ‘n analitiese komponent, het graad 2 tot 7 leerders in ‘n skool met ‘n voedingkundig-gereguleerde snoepie (n=116) en ‘n skool met ‘n konvensionele snoepie (n=141), ‘n vraelys ingevul. Ses leerders in elke graad in elk van die skole het ook aan fokusgroepbesprekings deelgeneem. Vrae het oor die inhoud van kosblikke, asook persepsies, houding en gedrag teenoor die snoepie en gesonde eetgewoontes, gehandel. Voedingsinligting rakende die items wat in elk van die skole se snoepies verkoop word, is ook ingesamel. Resultate: Die kosblikke van leerders in ‘n skool met ‘n voedingkundig-gereguleerde snoepie het statisties beduidend (p<0.05) meer gesonde items bevat (vrugte, water en muffins), maar ook beduidend meer ongesonde items (lekkergoed en aartappelskyfies). Voedsel-items wat in die voedingkundig-gereguleerde snoepie beskikbaar was, het omtrent die helfte minder energie bevat as voedsel-items wat in die konvensionele snoepie beskikbaar was. Leerders in ‘n skool met ‘n voedingkundig-gereguleerde snoepie het beduidend (p<0.05) meer van sekere groente en vrugte gehou as leerders in ‘n skool met ‘n konvensionele snoepie. Statisties beduidende (p<0.05) verskille tussen verskillende grade en die houding van verskillende geslagte dui daarop dat graad 2 leerders in albei skole minder positief gevoel het oor sekere groente en vrugte as ouer leerders, terwyl meisies in albei skole ‘n meer positiewe houding teenoor sekere groente en vrugte getoon het as seuns. Jonger leerders het ‘n meer positiewe houding teenoor hulle voedingkundig-gereguleerde snoepie getoon as ouer leerders. In albei skole het leerders soortgelyke persepsies rondom hul onderskeie skole se snoepies en gesonde eetgewoontes openbaar. Gevolgtrekking: Die hipotese dat leerders in ‘n skool met ‘n voedingkundig-gereguleerde snoepie positiewe persepsies, houding en gedrag teenoor gesonde eetgewoontes toon is nie aanvaar nie. Die beskikbaarheid van gesonder items in ‘n skoolsnoepie het 'n positiewe invloed op sekere eetgewoontes en houdings van die leerders, maar die potensiële waarde daarvan om die tipes voedsel wat by skole te koop aangebied word te reguleer mag egter teengewerk word deur kosblikke se inhoud asook sekere vaste eetpatrone, persepsies van leerders en vorige blootstelling aan ‘n konvensionele snoepie. ‘n Veelvoudige benadering soos die konsep van ‘n Gesondheidbevorderingskool word aanbeveel.

Thesis (M. Tech. (Biomedical Technology)) -- Central University of Technology, Free State, [2014]
Pica is the habitual eating of non-food substances by humans and animals. It has different subgroups and these are defined by the ingested substance. Moreover, geophagia is a type of pica that refers to the consistent eating of mostly earth and earth-like substances such as clay and soil. It is observed in both sexes, all age groups and in different ethnic groups around the world. There are many reasons people give for the practice of geophagia, such as culture, hunger and health being the most prominent. Geophagic materials differ in texture, colour and taste. Soil colour classification according to the Munsell soil classification, which uses hues, values and chroma, sometimes differ with the soil colour being noticeable with the naked eye. However, geophagic clays from Qwa-Qwa are white and contain kaoline. Geophagic materials are believed to augment mineral deficiency, especially magnesium, calcium and iron. Geophagia is practised mainly by females, especially during their child bearing years. Females are more prone to iron deficiency anaemia due to their monthly menstruation cycle. Iron deficiency is the most common cause of anaemia and is classified as hypochromic microcytic anaemia (HMA). This study focused on the health aspect of geophagia. The research question seeks to explore whether there is an association between geophagia and the haematological parameters of iron deficiency anaemia. Geophagia seems to be linked with the occurrence of anaemia, but not iron deficiency anaemia, although it is implied. It is not known if the practice of geophagia causes iron deficiency anaemia or if it is because of iron deficiency anaemia that people practise geophagia. A pilot study was done in 2007, and the results of that study prompted that this study be performed on a bigger scale. The lack of information regarding the quantity, frequency and type of geophagic material consumed the impact of geophagia on haematological parameters and the iron status of the geophagists made it important that the primary existence of the iii relationship be investigated. In addition, research to establish whether there is a relationship between geophagia and haematological parameters of iron deficiency anaemia, has not been undertaken in South Africa, especially on non-pregnant women. Geophagia seems to always be accompanied by the subject of iron deficiency anaemia and especially its prevalence in females. The bigger geophagia project was therefore an ideal opportunity to do a specific survey on geophagic women. This was a cross-sectional study, consisting of 36 control women and 47 geophagic women, aged between 18-45 years. The participants completed a questionnaire to determine the geophagic practices, which included the colour of the clay, how frequent the clay was consumed, how much was consumed and for how long it has been consumed. Nutritional status was assessed using a food frequency questionnaire. Blood was drawn to assess the haematological and iron status of the participants. The participants of the study were within the required age range, with no significant difference between the groups (p-value=0.7914). The most consumed colour of clay was white and white clay contains kaoline, which has the ability to absorb iron in the duodenum. The majority of the participants consumed 40 grams of clay on a daily basis, with most of the participants having done so for 5 years. Diet was ruled out as the cause of iron deficiency. The haematological parameters indicated that the geophagic group (43%) were inclined to have hypochromic microcytic anaemia, while a small percentage of control groups (8%) had HMA; this was revealed by the red cell parameters and red cell indices. In addition, the odds ratio for the haematological results revealed that the probability of a geophagic person developing anaemia was two times greater than that of a non-geophagic person. Platelet results partially ruled out bleeding as a cause of anaemia. The median red cell distribution width indicated that the iv geophagic group was inclined to have anisocytosis. The geophagic group was found to have iron deficiency (75%), whilst the control group had a small percentage with iron deficiency (22%), which was validated by the serum ferritin, serum iron and saturated transferrin (chemical analysis). The odds ratio revealed that the probability of a geophagic person being iron deficient is 3 times greater than that of a non-geophagic person. The strongest association is seen with iron study findings, because being iron deficient showed the highest odd ratio than the association with red cell morphology and even haemoglobin. Thus, participants were more iron deficient than suffering from iron deficiency anaemia. Inflammatory and parasitic indicators proved that inflammation and infection was uncommon in both groups, and therefore did not compromise the credibility of the iron study results. Inflammatory indicators (white blood cells, erythrocyte sedimentation rate and C-reactive protein) ruled out inflammation, whilst eosinophil count showed no indication of parasitic infection for both geophagic and control groups. To conclude, the study found that an association exists between geophagia and haematological parameters of iron deficiency anaemia amongst geophagic women in Qwa-Qwa, in that geophagic material contributes to iron deficiency anaemia.

[EN] In recent years, persimmon crop has become very relevant in Mediterranean Spain, where the production of this fruit centres on only one variety, persimmon cv. Rojo Brillante, majorly located in the Valencian Community. The main postharvest disorders manifested by 'Rojo Brillante' persimmons are flesh browning, which is associated with mechanical damage and chilling injury displayed after low-temperature storage. Previous research has determined the postharvest conditions that lead fruit to develop such alterations. However, the biochemical process behind flesh browning and chilling injury disorders is still unknown. Currently, there is special interest in introducing cultivars from other countries to broaden the varietal range. Besides, prolonging the fruit storage period to supply the markets according to the demand is one of the main challenges. In this context, the present Thesis approached three main objectives: 1) Studying the biochemical process implied in the main physiological postharvest disorders manifested in persimmon fruits by focusing on changes in the fruit redox state; 2) Evaluating postharvest treatments to preserve fruit quality during cold storage; 3) Assessing the physico-chemical and nutritional quality of persimmon cultivars introduced from other countries to increase the varietal range. Biochemical, chromatographic and microstructural studies have revealed that flesh browning manifested by fruits submitted to mechanical damage after removing astringency is associated with a tannins oxidation process caused by a stress oxidative situation. A new flesh disorder, "pinkish bruising", has been described on fruits submitted to mechanical impacts while showing high astringency levels. Sensitiveness to the flesh browning disorder has also been evaluated on different cultivars introduced from other countries. The implication of the redox system in the chilling injury manifestation on 'Rojo Brillante' persimmon has been determined. Moreover, we described the changes in this system associated with chilling injury alleviation by 1-MCP treatment. The effect of a controlled atmosphere based on 4-5% O2 + N2 to prolong the storage of cultivars 'Rojo Brillante' and 'Triumph' has been seen to strongly depend on variety. The results were highly positive on cultivar 'Triumph', in which the evaluated atmosphere extended the storage period up to 3 months. The use of short-term high CO2 treatments was another technology assayed to alleviate chilling injury in non-astringent cultivar 'Fuyu'. This treatment significantly reduced the main chilling injury symptom manifested by this cultivar, which is flesh gelling. This effect was related to cell structure preservation. Recent studies have shown that ethyl formate treatment is highly effective for pest control of persimmon 'Fuyu'. However, this treatment induces fruit softening, which causes quality loss. This Thesis revealed that ethyl formate treatment induces the activity of ethylene synthesis-related genes and that flesh softening is mediated by this hormone. It also demonstrated that by applying 1-MPC pretreatment, fruit softening associated with ethyl formate can be controlled. Therefore, the combined used of both treatments is seen as a potential treatment to disinfect persimmon fruits while preserving quality. Finally, the study of ten cultivars introduced from other countries helped select the most interesting cultivars to broaden the varietal range according to their maturation date and their response to deastringency treatment. The main nutritional compounds of persimmon and how they are affected by CO2 deastringency treatment are described.
[ES] El caqui es un cultivo de gran relevancia en el área mediterránea de España, estando la producción centrada en una única variedad, el cv. Rojo Brillante, y localizada principalmente en la Comunidad Valenciana. Las principales alteraciones presentadas por el caqui 'Rojo Brillante' durante el periodo postcosecha son el pardeamiento de la pulpa asociado a los daños mecánicos y los daños por frío manifestados tras la conservación a bajas temperaturas. Las investigaciones previas han determinado las condiciones de manejo bajo las cuales se desarrollan dichas alteraciones, sin embargo los procesos bioquímicos involucrados en la manifestación de estos desórdenes no se conocen en profundidad. Actualmente uno de los principales retos es la introducción de nuevas variedades que permitan ampliar la gama varietal, así como prolongar los periodos de conservación del caqui con el fin de poder escalonar la puesta en el mercado en función de la demanda. En la presente Tesis se han abordado tres objetivos principales: 1) Estudiar los procesos bioquímicos implicados en los principales desórdenes postcosecha del caqui, prestando especial atención a los cambios en el sistema redox del fruto; 2) Evaluar diferentes tratamientos postcosecha para preservar la calidad del fruto durante la conservación frigorífica; 3) Evaluar la calidad físico-química y nutricional de diferentes variedades de caqui introducidas desde otros países para ampliar la gama varietal. Estudios bioquímicos, cromatográficos y microestructurales, han revelado que el pardeamiento de la pulpa o "browning", manifestado por la fruta que ha sufrido daños mecánicos tras la eliminación de la astringencia está asociado a un proceso de oxidación de taninos motivado por una situación de estrés oxidativo. Además se ha descrito una nueva alteración de la pulpa, "pinkish bruising", manifestada por los frutos sometidos a daño mecánico con alto nivel de astringencia. También se ha evaluado la sensibilidad al pardeamiento de diferentes variedades introducidas desde otros países. Con el objetivo de prolongar la conservación del fruto se ha ensayado el uso de la atmósfera controlada basada en 4-5% O2 + N2 sobre las variedades 'Rojo Brillante' y 'Triumph', observándose que la respuesta a esta tecnología depende de manera muy importante de la variedad. Los resultados fueron especialmente positivos en el caso del cultivar 'Triumph', en el que la atmósfera ensayada permitió prolongar la conservación frigorífica hasta tres meses. Otra tecnología ensayada para el control de los daños por frío fue la aplicación de choques con altas concentraciones de CO2 en el cultivar no astringente 'Fuyu'. Este tratamiento alivió el principal síntoma de daño por frío manifestado por esta variedad, la gelificación de la pulpa. Este efecto se ha relacionado con la preservación de la estructura celular de la pulpa del fruto. Estudios recientes han mostrado que el tratamiento con etil formato es altamente efectivo en el control de insectos durante la conservación y comercialización del caqui 'Fuyu', sin embargo este tratamiento provoca un ablandamiento del fruto mermando su calidad. En esta Tesis se ha demostrado que las aplicaciones de etil formato activan los genes de síntesis de etileno, siendo está hormona mediadora del ablandamiento. Los estudios también revelaron que la aplicación de un tratamiento previo con 1-MCP reduce el ablandamiento del fruto asociado al etil formato, por lo que el uso combinado de ambos tratamientos puede ser considerado una alternativa para la desinfección de los frutos sin detrimento de su calidad. Por último, el estudio de diez variedades introducidas desde otros países permitió seleccionar en base a su momento de maduración y respuesta al tratamiento de desastringencia aquellas variedades de mayor interés para ampliar la gama varietal. Además, se identificaron los principales compuestos nutricionales del caqui y
[CAT] El caqui s'ha convertit en els últims anys en un cultiu de gran rellevància en l'àrea mediterrània d'Espanya, estant la producció centrada en una única varietat, el cv. Rojo Brillante, i localitzada principalment a la Comunitat Valenciana. Les principals alteracions presentades pel caqui 'Rojo Brillante' durant el període postcollita són l'enfosquiment de la polpa associat als danys mecànics i els danys per fred manifestats després de la conservació a baixes temperatures. Les investigacions prèvies han determinat les condicions de maneig sota les quals es desenvolupen estes alteracions, però els processos bioquímics involucrats en la manifestació d'estos desordres no es coneixen en profunditat. D'altra banda, actualment un dels principals reptes és la introducció de noves varietats que permetin ampliar la gamma varietal, així com prolongar els períodes de conservació del caqui per tal de poder escalonar la posada en el mercat en funció de la demanda. En este context, en la present Tesi s'han abordat tres objectius principals: 1) Estudiar els processos bioquímics implicats en els principals desordres postcollita del caqui, posant especial atenció als canvis en el sistema redox del fruit; 2) Avaluar diferents tractaments postcollita per preservar la qualitat del fruit durant la conservació frigorífica; 3) Avaluar la qualitat fisicoquímica i nutricional de diferents varietats de caqui introduïdes des d'altres països per ampliar la gamma varietal. Estudis bioquímics, cromatogràfics i microestructurals, han revelat que l'enfosquiment de la polpa o "Browning", manifestat per fruita que ha patit danys mecànics després de l'eliminació de l'astringència està associat a un procés d'oxidació de tanins motivat per una situació d'estrès oxidatiu. A més s'ha descrit una nova alteració de la polpa, "pinkish bruising", manifestada pels fruits sotmesos a dany mecànic amb alt nivell d'astringència. També s'ha avaluat la sensibilitat a l'enfosquiment de diferents varietats introduïdes des d'altres països. Amb l'objectiu de perllongar la conservació del fruit s'ha assajat l'ús de l'atmosfera controlada basada en 4-5% O2 + N2 sobre les varietats 'Rojo Brillante' i 'Triumph', observant-se que la resposta a esta tecnologia depèn de manera molt important de la varietat. Els resultats van ser especialment positius en el cas del cultivar 'Triumph', en què l'atmosfera assajada va permetre prolongar la conservació frigorífica fins a tres mesos. Una altra tecnologia assajada per al control dels danys per fred va ser l'aplicació de xocs amb altes concentracions de CO2 en el cultivar no astringent 'Fuyu'. Este tractament va alleujar el principal símptoma de dany per fred manifestat per esta varietat, la gelificació de la polpa. Este efecte s'ha relacionat amb la preservació de l'estructura cel¿lular de la polpa del fruit. Estudis recents han mostrat que el tractament amb etil format és altament efectiu en el control d'insectes durant la conservació i comercialització del caqui 'Fuyu', però este tractament provoca un estovament del fruit minvant la seua qualitat. En esta Tesi s'ha demostrat que les aplicacions d'etil format activen els gens de síntesi d'etilè, sent esta hormona mediadora de l'estovament. Els estudis també van revelar que l'aplicació d'un tractament previ amb 1-MCP redueix l'estovament del fruit associat a l'etil format, per la qual cosa l'ús combinat de tots dos tractaments pot ser considerat una alternativa per a la desinfecció dels fruits sense detriment de la seua qualitat. Finalment, l'estudi de deu varietats introduïdes des d'altres països va permetre seleccionar en base al seu moment de maduració i resposta al tractament de desastringència aquelles varietats de més interès per ampliar la gamma varietal. A més, es van identificar els principals compostos nutricionals del caqui i es va avaluar l'efecte del tractament de desastringència amb CO2 sobre els mat
Novillo Borrás, P. (2015). HARVEST AND POSTHARVEST QUALITY OF PERSIMMON FRUIT:PHYSICOCHEMICAL AND NUTRITIONAL ASPECTS [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/58270
TESIS

This study extended earlier research supporting discrepancy theory by including a multidimensional conceptualization of gender including attitudes, behaviors, and characteristics. Analyses revealed that gender discrepancy when assessed multidimensionally or unidimensionally (as in past research) was not significantly related to eating disordered symptomatology.

In this thesis I explore women's engagement with body, weight and eating from a socio-cultural perspective. I discuss the limitations of current research on body dissatisfaction and propose that women's negative appraisal of their body needs to be understood as an active engagement with their social context. Research that focuses on the interaction of ethnic/cultural differences and body dissatisfaction seeks to clarify the interrelationship between femininity, gender and culture and suggests that women's dissatisfaction with their body is linked to levels of global Westernisation. My criticism of this research is that it conceptualises culture and social knowledge in a simplistic way. I propose social representations theory and the principles of dialogicality as an alternative research paradigm and argue that such an approach can overcome the dichotomy of individual and social, inner and outer. In order to explore the interaction of the subjective with the social in relation to the negative and positive appraisal of the body an interview study was conducted in two distinct cultural contexts. In depth interviews were conducted with 14 women in the UK and 12 women in Tobago, WI. The thema recognition/disrespect was used as an interpretative frame. The results show that the meanings that were assigned to the body interlinked with socially enacted representations of self, other and femininity. While the thema recognition/disrespect could be seen to be problematised through contradictory conditions of worth in the UK, it was the notion of 'disrespect' in interrelation with representations of others that was foregrounded in women's reflections in Tobago. In both research locations women negotiated constraining or contradictory demands of femininity and 're-presented' themselves through the construction of alternative identities.

In this study, the relationship between the risk factors of perfectionism and depression and eating disorder symptomatology was examined. A sample of female undergraduates completed the following three measures: the Beck Depression Inventory-II (BDI-II), the Multidimensional Perfectionism Scale (MPS), and the Questionnaire for Eating Disorder Diagnoses (Q-EDD). Results indicated that perfectionism is significantly positively correlated with depression. Higher levels of perfectionism were also associated with the presence of eating disorder symptoms, whereas lower levels of perfectionism were associated with the absence of eating disorder symptoms. Finally, an increase in perfectionism levels was predictive of eating disorder symptoms. Directions for future research and clinical implications are discussed.
Department of Counseling Psychology and Guidance Services

Includes bibliographical references (leaves [287]-309). Concerned with a group of people's everyday experiences of anorexia. The fieldwork on which the thesis is based was conducted in multiple sites (Vancouver, Edinburgh, and Adelaide) over 15 months (August 1998-October 1999) and deals with 44 women and 3 men ranging in ages from 14-55. Primarily concerned with the processes that propelled them towards and away from this phenomenon: the desires, connections, disconnections, practice, contested performances and struggles of becoming and unbecoming 'anorexic'.

The emerging consensus among investigators seems to be that bulimia is a multidetermined disorder with a number of contributing factors, including biological components, sociocultural factor, personality, and family characteristics (Garfinkel & Garner, 1982). An etiological model was examined in this study integrating two important theoretical perspectives in the bulimia literature: the stress-coping perspective (Cattanach & Rodin, 1988) and the family systems perspective (Minuchin et al., 1978). Five latent variables: Family Characteristics, Coping Resources, Psychological Disturbance, Environmental Stressors, and Bulimia were represented by twelve measured variables. Structural Equation Modeling analysis allowed for the simultaneous examination of the hypothesized interrelationships between model variables. Findings confirmed a direct impact of psychological disturbances on bulimic symptoms. Hypothesized indirect relationships of family characteristics, coping resources and environmental stressors to bulimia were confirmed. Treatment implications as well as directions for future research were discussed.

The purpose of the study is to articulate the phenomenology of the anorexic body. In order to describe the complex meaning of the anorexic body, the present research adopts the qualitative and exploratory approach of Seidman's (1991) in-depth phenomenologically based interviewing method. This involves a series of three separate interviews, with three research participants who have had personal experience of anorexia. The method of data analysis used is essentially on editing style of analysis (Miller and Crabtree, 1992) and is based on a hybrid of the grounded theory approach of Glaser and Strauss (1967) and Heidegger's (1927) ontological hermeneutics to form what Addison (1992) calls grounded interpretive research. Anorexic embodiment is conceptualised as precipitating a fundamental disturbance between the interactions of embodied consciousness and the world. The body is no longer taken-for-granted, and becomes an object for scrutiny. As an object, the body is experienced as a thing exterior to the self, and this awareness contributes to the sense of qisorder which permeates anorexic embodiment. Bodily intentionality is frustrated when the sphere of bodily actions and habitual acts become circumscribed. The character of lived temporality and lived spatiality are also effected with the anorexic's focus on the now, ushering in a spatiality of the here. These findings indicate that anorexic embodiment is experienced primarily as a disruption of the 'lived body' rather than that of the biological body. The prevailing discourses of anorexic embodiment are shown to be split between the naturalized discourses that provide a model of the body that is biologically determined and ahistorical, and the denaturalized discourses that provide a model of the body that is culturally constructed and lacks embodied givenness. It is argued that Merleau-Ponty's phenomenology of the body offers a renaturalization of the body that overcomes the nature/culture dichotomy of the naturalized and denaturalized discourses, thereby providing a solid foundation that more directly addresses the phenomenology of the anorexic body. The theoretical and treatment implications of Merleau-Ponty's renaturalization of the anorexic body are highlighted, and suggestions for further research are presented.

This study explored three areas believed to play a central role in the pathogenesis and presenting clinical picture of the eating disorders, anorexia nervosa and bulimia. Measures of personal effectiveness, family dynamics, and traditional sex-role beliefs were assessed in groups of restricted anorexics, bulimic anorexics, normal weight bulimics and controls. Control subjects manifested the highest degree of psychological adjustment, resourcefulness, and self-direction, while restricting anorexics obtained the lowest score on this measure. Bulimics experienced the highest degree of personal effectiveness of the patient groups, with bulimic anorexics falling in-between restricting anorexics and bulimics. Control subjects also reported that they felt more independent, accepted and tolerated in their family than any of the eating disorder groups. Bulimic subjects scored closest to controls on this measure, with bulimic anorexics experiencing the least degree of acceptance, tolerance and independence of all groups. Finally, control subjects defined themselves in a more traditionally masculine role than did any of the eating disorder groups. Restricting anorexics were most likely to describe themselves as passive, submissive, constricted and sensitive; bulimic subjects were more likely to endorse such self-descriptive adjectives as assertive, uninhibited, self-confident and competitive. Bulimic anorexics perceived themselves to be less traditionally feminine than did restricting anorexics, but more than bulimics or controls. The results of this study support the theory that ego deficits contribute to the development of eating disorders.

There is a lack of clarity in the current literature in how potential etiological factors interact and result in disordered eating. The purpose of this study was to examine an expanded model of Personality, Social Support, Appraisal/Coping Processes, Abuse History, Internalization of Sociocultural Standards, Psychological Disturbances, and Body Disparagement in the development of disordered eating. The current model was evaluated using 276 women in their transition to college, a time period highly associated with symptoms believed to increase a woman's risk for the development of disordered eating including perceived difficulty coping, weight gain, and negative affect. Structural equation modeling was used to allow simultaneous examination of the causal relationships between the factors. Structural analyses confirmed that college women with previous stressful experiences appraised the adjustment to college as more stressful and reported feeling less able to cope with the transition. Those women who identified the transition as overwhelming were also aware of increased negative mood and psychological states since beginning the school semester. Further, women with previous traumatic sexual experiences appeared to be at additional risk for increased negative affective symptoms. The resulting model confirmed that those women who experience negative mood states and those that endorse strong internalization of cultural values regarding attractiveness encountered increased dissatisfaction and disapproval of their bodies. Finally, women with higher levels of body concern engaged in more eating behaviors associated with disordered eating. The roles of personality functioning and perceived social support could not be identified in the developmental model. The predictive links between constructs in the resulting model provide meaningful information regarding the transition to college and associated risks for development of disordered eating. Validation of the model in an independent sample would provide confirmation of these relationships and longitudinal research examining females' attitudes across crucial developmental periods might provide important information regarding which individuals are most at risk for development of disordered eating.

The purpose of this study was to test the effectiveness of a cognitive-dissonance based intervention in reducing disordered eating attitudes and behaviors. The intervention program created dissonance through discussion, exercises, and homework aimed at addressing and countering internalized sociocultural pressures, beliefs and values about women's bodies, attractiveness, and worth in the U.S. Seventy-seven female undergraduates were randomly assigned to one of four conditions: cognitive-dissonance, combined cognitive-dissonance, healthy weight placebo control, and wait-list control To determine effectiveness of the intervention, MANCOVA procedures were used, with Time 1 scores serving as the covariate. Overall, the women who received the dissonance based interventions produced the strongest effects among measures assessing sociocultural pressures, internalization, and body dissatisfaction in comparison to the control group, and experienced significant reductions in dieting behaviors and bulimic symptoms over the course of the study, suggesting that the creation of dissonance via the intervention assisted the women in reducing eating disorder risk factors.