Early Food Choices May Signal Future Eating Disorders in Girls

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Doctors may be able to predict which girls are at risk of developing eating disorders based on the food choices they make when they are younger, according to a new study by Cincinnati Children's Hospital Medical Center.

Researchers in the Divisions of Adolescent Medicine and Behavioral Medicine at Cincinnati Children's analyzed food preference data collected from girls over a decade – starting at age nine – to see if their choices affected the development of eating disorder symptoms by the time they reached adolescence.

The study, presented at the International Conference on Eating Disorders, compared the girls' percentage of carbohydrate, fat and protein consumption when they were young to eating disorder symptoms, such as dissatisfaction with body image, erratic eating habits and preoccupation with thinness.

Results varied by age. The percentage of carbohydrate and fat consumption by girls around the age of 11 seemed to predict increases in body dissatisfaction by the age of 14. Girls who consumed a low amount of fat and a high percentage of carbohydrates around the age of 15 were more likely to demonstrate erratic eating habits by age 19 – this was especially true for girls who were characterized as perfectionistic, according to the study.

"We know that perfectionists are at high risk for eating disorders," said Abbigail Tissot, PhD, associate director of the Division of Behavioral Medicine at Cincinnati Children's and lead author of the study. "They are so committed to perfectly conforming to an unhealthy and extreme idea of beauty, that they get carried away. Unfortunately, these girls who are committed to achieving thinness – no matter what it takes – are actually placing themselves at higher risk for being overweight or obese later in life."

"Eating disorders are notoriously difficult to treat, so prevention is critical," said Laurie Dunham, registered dietician at Cincinnati Children's. "By assessing protein and fat consumption as early as age 9, we can detect which girls may go on to develop eating disorders and step in to help before things get out of control."

The study is based on analysis of data from the Cincinnati site of the National Growth and Health Study (NGHS), which collected food diary information from 800 girls, following them annually from 1988–1999.

"The study is rare in that it's based on long-term observation of girls during their transition from pre-puberty through adolescence and into early adulthood," added Tissot. "This study tells us at what age we should be watching for these eating behaviors, giving parents and physicians useful tools for detecting girls at risk for future eating disorder symptoms."

A second study, based on the same data, elaborated upon these initial findings, showing that girls who skipped lunch consumed more calories per day than those who ate lunch.

Plenty of studies have been done on the effects of skipping breakfast," said Tissot. "But at a time when kids' school lunch periods can vary widely, few studies have looked at the impact of skipping lunch."