Elsevier

Eating Behaviors

Volume 13, Issue 2, April 2012, Pages 174-178
Eating Behaviors

Loss of control eating in African-American and Caucasian youth

https://doi.org/10.1016/j.eatbeh.2012.01.003Get rights and content

Abstract

Loss of control (LOC) eating, a disinhibited eating behavior shown to predict excessive weight gain in youth, has been reported by African-American children and adolescents. Yet, little is known about how LOC-eating manifests in this population. To investigate potential racial differences in LOC-eating, the Eating Disorder Examination was administered to 185 non-Hispanic African-American and Caucasian youth ages 8–17 y. Objective eating was assessed at two test meals during which youth ate ad libitum from a multi-item lunchtime food array. African-American and Caucasian youth reported a similar prevalence of LOC episodes (24.2% vs. 28.9%, p = .75). Yet, accounting for sex, age, fat-free mass, percent fat mass, height, and socioeconomic status, African-Americans consumed more total energy at both laboratory meals (1608 ± 57 kcal vs. 1362 ± 44 kcal; p < .001). Furthermore, African-American youth reporting LOC consumed the most total energy across both meals (1855 ± 104 kcal) compared to African-Americans without LOC (1524 ± 60 kcal), Caucasians with LOC (1278 ± 68 kcal), and Caucasians without LOC (1399 ± 46 kcal; p < .001). Future research is required to examine whether LOC-eating contributes to the high rates of obesity in African-American youth.

Highlights

► Investigated prevalence of loss of control in African-American and Caucasian youth. ► Examined energy intake in the laboratory in African-American and Caucasian youth. ► African-Americans and Caucasians reported similar rates of loss of control eating. ► African-American youth consumed more total energy than Caucasian youth ► African-American youth with loss of control consumed the most total energy.

Introduction

Childhood obesity rates have increased dramatically among African-American youth (Ogden et al., 2010, Ogden et al., 2008). Thirty-six percent of African-Americans (2-19y) are currently overweight or obese compared to 32% of Caucasian youth (CDC, 2000, Ogden et al., 2010). Although these percentages do not statistically differ, they are clinically relevant as African-Americans remain at a higher risk for serious obesity-related health comorbidities (Brancati et al., 2000, Sriwattanakomen et al., 2010). Given the weight and health disparities among African-Americans, it is critical to elucidate modifiable, behavioral risk-factors that may contribute to excess weight gain in this vulnerable population.

One such risk-factor may be loss of control (LOC) eating, which refers to the perceived experience of being unable to control what or how much is eaten, regardless of the reported amount of food consumed (Tanofsky-Kraff, 2008). By definition, LOC encompasses both classic episodes of binge-eating (i.e., large amounts of food consumed with LOC) and subjective binge-eating episodes (i.e., perceived, but not objective, overeating with LOC) (Tanofsky-Kraff, 2008). Rates of pediatric LOC range from 6 to 40% (Tanofsky-Kraff, 2008). Racial differences in prevalence are mixed with some studies reporting, relative to Caucasian youth, more (Swanson, Crow, Le Grange, Swendsen, & Merikangas, 2011), less (Story, French, Resnick, & Blum, 1995), or similar (Austin et al., 2008, Glasofer et al., 2007, Pernick et al., 2006, Shaw et al., 2004) rates of LOC/binge-eating in African-American youth. LOC-eating is associated with excess weight (Tanofsky-Kraff, 2008). Even infrequent reports of LOC-eating among youth prospectively predict excessive weight gain (Tanofsky-Kraff et al., 2009) and the development of exacerbated disordered eating and psychological distress (Tanofsky-Kraff et al., 2011). While there are several proposed theoretical models of binge-eating, (Heatherton and Baumeister, 1991, Polivy and Herman, 1985, Stice, 2001) data (Brown et al., 1999, Chui et al., 2007, Wilson et al., 2010) suggest that the interpersonal model of LOC (Tanofsky-Kraff et al., 2007) may be most suitable when describing such behaviors in minority groups. The model posits that interpersonal problems lead to negative affect, which precipitates LOC-eating and ultimately exacerbated disordered eating and excess weight gain. Given that interpersonal familial connectivity is highly valued in racial and ethnic minorities (Hill, 1999), it is likely that difficult interpersonal relationships may cause particular distress that leads to LOC-eating.

Youth with LOC-eating self-report and exhibit specific eating patterns that may illuminate the impact of LOC on weight. Compared to those without LOC, youth endorsing LOC consume more total energy (Hilbert et al., 2010, Mirch et al., 2006), fat (Hilbert et al., 2010), carbohydrates, and palatable foods, while consuming less protein (Tanofsky-Kraff, McDuffie, et al., 2009, Theim et al., 2007). There has been no investigation into how LOC differentially relates to food consumption in African-Americans and Caucasians.

We examined whether measured energy intake and food selection in the laboratory would differ among African-American and Caucasian youth with and without reported LOC. Based upon the higher rates of obesity in African-Americans, we hypothesized that LOC-eating would be more strongly tied to greater food intake in African-Americans than Caucasians. We expected to observe these differences after adjusting for body composition, sex, age, and socioeconomic status (SES).

Section snippets

Participants

The present investigation is a secondary analysis of a published study and therefore recruitment and inclusion/exclusion criteria are previously reported (Tanofsky-Kraff, McDuffie, et al., 2009). In brief, healthy 8–17-year-olds participated in a study investigating eating behaviors in youth of all weight strata. Written child assent and parent consent were obtained. The study was approved by the Eunice Kennedy Shriver NICHD Institutional Review Board.

Procedures

The study involved three outpatient visits

Results

Data from 185 youth (M ± SD, 12.98 ± 2.82y; Table 1) were analyzed. The sample was 34.1% African-American and 65.9% Caucasian. Among youth who reported SES (4 were missing), 12% of African-American and 5% of Caucasian youth were categorized as lower SES (Hollingshead 4–5). As previously reported, all youth consumed more energy at the binge meal compared to the normal meal, with no main effect of LOC status (Tanofsky-Kraff, McDuffie, et al., 2009). A similar percentage of African-American (24.2%)

Discussion

In this examination of racial differences in LOC-eating, we found that similar rates of LOC were reported by African-American and Caucasian youth. In contrast, African-American youth consumed more energy than Caucasians in the laboratory, regardless of type of meal. Moreover, even after relevant adjustments for age, sex, and body composition, African-Americans with LOC consumed the most total energy compared to other youth, including those without LOC and Caucasian youth with LOC.

The finding

Role of funding sources

Funding for this study was provided by the Intramural Research Program, NIH, grant 1ZIAHD000641 from the NICHD with supplemental funding from NIMHD (to Jack A. Yanovski). Neither NICHD or NIMHD had any role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

Contributors

Drs. Tanofsky-Kraff and Yanovski designed the study and wrote the protocol. Ms. Cassidy and Dr. Tanofsky-Kraff developed the hypotheses for the current study. Ms. Matheson, Dr. Osborn and Ms. Vannucci conducted literature searches and provided summaries of previous research studies. Dr. Shomaker conducted the statistical analysis. Ms. Cassidy wrote the first draft of the manuscript and all authors contributed to and have approved the final manuscript.

Conflict of interest

All authors declare that they have no conflicts of interest.

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    Research support: Intramural Research Program, NIH, grant 1ZIAHD000641 from the NICHD with supplemental funding from NIMHD (to Jack A. Yanovski). ClinicalTrials.gov ID: NCT00320177.

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