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PubMed1996

Plant wax components: a new approach to estimating intake and diet composition in herbivores.

The nutrient status of the herbivore depends on the nutritive value of the plants available, the botanical composition of the consumed diet and the intake of the animal. It has always been difficult to quantify these last two. At present, intake is usually calculated from separate estimates of fecal output and diet digestibility. In this review we discuss the errors inherent in this approach, especially those associated with the determination and application of digestibility in vitro. We then critically evaluate a new approach to the estimation of intake, based on the use of plant cuticular wax alkanes as markers. Plant alkanes are predominantly odd-chain and substantially indigestible. They can be used, in combination with orally dosed even-chain alkanes, to obtain an intake estimate which is essentially independent of marker recovery in feces and which is more truly "individual" because it accommodates the level of digestibility occurring in individual animals. We present published data which indicate that the method is accurate and can be extended to measure diet composition as well. Previous approaches to estimating diet composition have been based on the laborious microscopic examination of esophageal extrusa, stomach contents or feces. However, most plant species have a characteristic pattern of alkane concentrations in their cuticular wax. This permits the estimation of diet composition from the pattern of alkanes in the feces and in the plants available. We present data to show that this approach can provide accurate estimates of diet composition in terms of either plant species or plant parts. A major advantage of the approach is that, if the animals are also dosed with even-chain alkanes, estimates of total intake and diet composition can be obtained simultaneously. The method is equally applicable to domestic and wild herbivores and to animals receiving supplementary feeds. In future work, the method will be extended to the simultaneous estimation of plant species and plant parts in the diet, and to the use of other wax components as markers.

Alkanes↗
PubMed2005

What is the role of diet in the development of cancer in American Indian and Alaska native populations?

BACKGROUND: The associations between diet and cancer in American Indian and Alaska Native (AIAN) populations are not well understood. METHODS: I review current knowledge of the associations between diet and cancer. RESULTS: Studies of diet and cancer are inconsistent. Underlying characteristics of populations could contribute to observed differences. Dietary patterns and energy balance may importantly relate to cancer in AIAN populations. CONCLUSION: Given the differences in cancer incidence and mortality rates in AIAN populations, it is reasonable that diet and lifestyle patterns could contribute to these differences, although we can only speculate as to specific dietary factors in cancer etiology.

Cultural Characteristics↗
PubMed2006

Effects of ingestion of tomatoes, tomato juice and tomato purée on contents of lycopene isomers, tocopherols and ascorbic acid in human plasma as well as on lycopene isomer pattern.

Tomatoes are an important part of the diet. Lycopene, the predominant carotenoid in tomatoes, is hypothesised to mainly mediate the health benefits of tomato products. Anticancer activity of tomato products and lycopene has been suggested by numerous studies. The aim of the present study was to investigate the effect of ingestion of three different tomato-based foodstuffs on plasma contents of lycopene, tocopherols and ascorbic acid. Because isomers of lycopene may have different biological activities, a special interest was to look how the lycopene isomer pattern is changed depending on the matrix of tomato products. Following a 2-week depletion phase volunteers ingested 12.5 mg lycopene/d for 4 weeks comprising tomatoes, tomato juice or tomato purée. The basal levels of lycopene in plasma were comparable for all groups and decreased significantly during the 2 weeks of depletion to approximately half of the basal values. Following intervention, plasma lycopene concentration increased significantly. Conversely, supplementation did not significantly affect levels of tocopherols and ascorbic acid in plasma. Regarding isomers of lycopene, the (Z)-lycopene:(all-E)-lycopene plasma isomer ratio was significantly changed during the study for all groups. A remarkable enrichment of the relative contents of (5Z)-lycopene was observed during the depletion period, which supports the hypothesis that lycopene (Z)-isomers are formed within the human body after ingestion of (all-E)-lycopene. After dietary intervention with lycopene-rich products the isomer ratios returned to those observed at the start of the study. Further investigations will clarify the process of isomerisation in more detail.

Adult↗
PubMed1991

Large bowel fermentation in rats eating processed potatoes.

Four diets were prepared in which cooked potatoes provided approximately 0.8 of the dry matter (DM) and all the polysaccharides. The potatoes were either boiled conventionally (unprocessed) or prepared by rehydrating a commercial 'instant' potato product with boiling water. The diets were fed to rats (six per diet) immediately after preparation or after storage at 4 degrees for 48 h and observations made on site and extent of digestion and large bowel (LB) fermentation. All diets were equally well digested (overall means 0.95 and 0.96 for DM and organic matter (OM) respectively) with a significant proportion of this digestion occurring in the LB. More OM flowed to the LB with the 'instant' (0.18 of intake) than with the unprocessed potato diets (0.13 of intake) and was associated with markedly different fermentation patterns. When compared with rats fed on the unprocessed potato diets, those given 'instant' potatoes had smaller caecums with much shorter transit times, lower caecal pH, higher total volatile fatty acid (VFA) concentrations and a greater molar proportion of butyrate in these VFA. Storage of the diets for 48 h at 4 degrees had relatively smaller effects on these variables. Possible mechanisms for the observed effects and implications for tissue metabolism and health are discussed. In addition, a simple and apparently novel method for quantifying coprophagy is proposed.

Animals↗
PubMed2003

Role of dietary calcium and dairy products in modulating adiposity.

Dietary calcium plays a pivotal role in the regulation of energy metabolism. High-calcium diets attenuate adipocyte lipid accretion and weight gain during overconsumption of an energy-dense diet and increase lipolysis and preserve thermogenesis during caloric restriction, thereby markedly accelerating weight loss. Our studies of the agouti gene demonstrate a key role for intracellular Ca2+ in regulating adipocyte lipid metabolism and TG storage. Increased intracellular Ca2+ resulting in stimulation of lipogenic gene expression, and lipogenesis and suppression of lipolysis resulting in adipocyte lipid filling and increased adiposity. Moreover, we recently demonstrated that the increased calcitriol produced in response to low-calcium diets stimulates adipocyte Ca2+ influx and, consequently, promotes adiposity. Accordingly, suppressing calcitriol levels by increasing dietary calcium is an attractive target for obesity intervention. In support of this concept, transgenic mice expressing the agouti gene specifically in adipocytes (a human-like pattern) respond to low-calcium diets with accelerated weight gain and fat accretion, whereas high-calcium diets markedly inhibit lipogenesis, accelerate lipolysis, increase thermogenesis, and suppress fat accretion and weight gain in animals maintained at identical caloric intakes. Further, low-calcium diets impede body fat loss, whereas high-calcium diets markedly accelerate fat loss in transgenic mice subjected to caloric restriction. Dairy sources of calcium exert markedly greater effects in attenuating weight and fat gain and accelerating fat loss. This augmented effect of dairy products is likely due to additional bioactive compounds in dairy that act synergistically with calcium to attenuate adiposity. These concepts are confirmed by both epidemiological and clinical data, which demonstrate that increasing dietary calcium results in significant reductions in adipose tissue mass in obese humans in the absence of caloric restriction and markedly accelerates the weight and body fat loss secondary to caloric restriction, whereas dairy products exert significantly greater effects. These data indicate an important role for dairy products in both the prevention and treatment of obesity.

Adipose Tissue↗
PubMed1991

The effect of therapeutic doses of paracetamol on sulphur metabolism in man.

1. This study was designed to investigate the effect of prolonged paracetamol intake on sulphur metabolism in patients. Six patients, taking paracetamol in doses of 2-4 g d-1 and one taking 12 g d-1 took part in the study. Daily (24-h) collections of urine, and also plasma samples from these patients were analysed and in one case a study with additional methionine was performed. 2. The patients showed variable decrease in urinary output of inorganic sulphate but moderately raised plasma levels of inorganic sulphate. 3. Paracetamol metabolism was characterized by dominance of the glucuronidation pathway with the increase of the administered dose of paracetamol. Methionine added to the diet did not change this metabolic pattern. None of the subjects produced more than 0.6 mmol h-1 paracetamol sulphate while total sulphur excretion was 7.5-26.7 mmol d-1. 4. Volunteers taking 3 g d-1 paracetamol were also studied. 5. In persons taking a normal western diet containing over 20 mmol d-1 sulphur amino-acids paracetamol metabolism will not lead to sulphur amino-acid depletion even if high daily doses are used.

Acetaminophen↗
PubMed2006

The response of gastrointestinal microbiota to avilamycin, butyrate, and plant extracts in early-weaned pigs.

An experiment was designed to evaluate the effects of 3 different additives on the gastrointestinal microbiota of early-weaned pigs. Early-weaned (18 to 22 d; n = 32) pigs (6.0 +/- 0.10 kg of BW) from 8 litters were randomly distributed into 8 pens. Each pen was assigned 1 of 4 dietary treatments: a prestarter or control diet, the control diet with 0.04% avilamycin (AB), with 0.3% sodium butyrate, or with 0.03% plant extract mixture (XT; standardized mixture with 5% (wt/wt) carvacrol extracted from Origanum spp., 3% cinnamaldehyde extracted from Cinnamonum spp., and 2% capsicum oleoresin from Capsicum annum). At the end of the experimental period, 8 pigs per treatment were killed, and samples of their intestinal content were taken. The total bacterial load along the gastrointestinal tract (GIT; stomach, jejunum, cecum, and distal colon) and the lactobacilli and enterobacteria in the jejunum and cecum were measured by quantitative PCR. The total microbial counts along the GIT did not differ among the diets, but there was an increase in the lactobacilli:enterobacteria ratio in the cecum of the piglets on the XT diet (P = 0.003). Restriction fragment length polymorphism of the PCR-amplified V3, V4, and V5 regions of the 16S rDNA gene showed changes in the structure of the microbial community in the jejunum. Dendrograms grouped animals by diets; control with 0.3% sodium butyrate was the treatment that promoted the biggest changes in the microbial ecosystem, followed by AB and then XT. Biodiversity increased when using additives compared with the control diet (P = 0.002). Microbial metabolic activity along the hindgut was studied using the concentration of purine bases and carbohydrase activities. Different patterns for purine bases were observed between diets (diet x intestinal section, P = 0.01). The control diet reached a maximum purine base concentration at the end of the colon, whereas that of the AB diet was reached at the cecum. We could not detect any cellulase or xylanase activities in animals of this age. Appreciable amylase and amylopectinase activities were found, but they did not differ between diets. The results suggest that the effects of avilamycin, butyrate, or the plant extract would not be related to a reduction in the number of total bacteria inhabiting different sections of the GIT but rather to changes in the ecological structure and metabolic activity of the microbial community.

Animal Feed↗
PubMed2006

Associations between dietary pattern and lifestyle, anthropometry and other health indicators in the elderly participants of the EPIC-Italy cohort.

INTRODUCTION: Epidemiological studies have shown that dietary behaviour is an important aetiological factor in various chronic diseases. We used principal component factor analysis to identify dietary patterns and to examine the associations of these patterns with health-related variables in a sample of elderly (> or =60 years) Italians participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS AND RESULTS: Exploratory factor analysis was applied to the intake of food groups as estimated by semi-quantitative food questionnaires. Individual participants were assigned factor scores, indicating the extent to which their diet conformed to each of the four dietary patterns identified: prudent (cooked vegetables, pulses, cabbage, seed oil and fish); pasta & meat (pasta, tomato sauce, red meat, processed meat, bread and wine); olive oil & salad (raw vegetables, olive oil, soup and chicken); and sweet & dairy (sugar, cakes, ice cream, coffee and dairy). Highly educated people had high scores on prudent and low scores on pasta & meat. The pasta & meat and prudent patterns were strongly positively associated with body mass index (BMI) and waist-to-hip ratio (WHR) in men and women. Hyperlipidaemic men and women consumed more of the prudent and olive oil & salad patterns and less of the sweet & dairy pattern than those with normal lipids. The olive oil & salad was significantly higher and the pasta & meat and sweet & dairy patterns significantly lower in men and women who had dieted over the previous year, suggesting awareness of the health consequences of these patterns. CONCLUSIONS: Dietary pattern analysis provides a characterization of recurrent dietary behaviour in elderly people, and can be used to provide tangible dietary advice to elderly people.

Anthropometry↗
PubMed1998

Physiological effects of a pea protein isolate in gnotobiotic rats: comparison with a soybean isolate and meat.

Pea proteins have been considered for the introduction into the human diet only recently. This protein source was tested on nutritional and digestive parameters in heteroxenic male Fischer rats inoculated with a human faecal microflora from a methane producer. Compared to soybean proteins, pea proteins have similar effects on the rat's endogenous and bacterial digestive patterns. Compared to the pea proteins, a diet containing a standard meat meal enhanced the pH and the production of ammonia, while a lyophilized beef meat enhanced that of urea. The diet containing the standard meat decreases short-chain fatty acids and modifies the ratio of caecal short-chain fatty acids. Both animal diets decreased the specific activities of pancreatic proteases such as chymotrypsin (EC 3.4.21.1), trypsin (EC 3.4.21.4), and carboxypeptidase A (EC 3.4.17.1) when compared to the diet containing the pea isolate. In conclusion, the whole composition of the diet, more than the origin of the dietary protein, influences the rat's digestive pattern.

Animal Nutritional Physiological Phenomena↗
PubMed1984

Developmental aspects of renal beta-amino acid transport. IV. Brush border membrane response to altered intake of sulfur amino acids.

Taurinuria is characteristic of the immature rat. The capacity of the kidney to accumulate the beta-amino acid taurine and D-glucose was examined using isolated brush border membrane vesicles (BBMV) prepared from 28-day-old rats. Taurine accumulation was inversely proportional to osmolarity, indicating uptake rather than binding, and taurine accumulation was Na+-dependent. BBMV from 28-day rats did not accumulate D-glucose to the same degree as in adult BBMV, and the initial rate of uptake was slower. Taurine uptake had a similar Km and Vmax in BBMV from immature rats. Despite similarities in the kinetics of taurine uptake, higher urinary taurine concentrations are found in younger rats, suggesting that other factors, such as an efflux block, account for the taurinuria of young animals. A diet low in methionine and taurine (LTD) given for 7 days resulted in a lower excretion and fractional excretion of taurine than in animals fed a normal sulfur amino acid diet (NTD). A high taurine diet (HTD) causes excessive taurinuria. These patterns of excretion are reflected at the brush border membrane surface with greater uptake after the LTD and reduced uptake after the HTD. A kinetic analysis of adult and 28-day-old animal BBMV reveals that the Vmax of accumulation is altered by diet, whereas the Km remains unchanged. The Vmax is higher in BBMV from LTD animals and lower in BBMV from HTD animals. The kinetics of uptake are similar in adult and 28-day-old rat vesicles on a given diet. Thus, in addition to ontogenic changes in taurine excretion, there is an adaptive response to dietary alteration present at the brush border surface.

Adaptation, Physiological↗
PubMedDate not supplied

Divergent membrane maturation in rat kidney: exposure by dietary taurine manipulation.

Taurinuria is characteristic of the immature rat. The excessive taurine loss could be the result of brush border or basal lateral membrane immaturity. The beta-amino acid, taurine, and D-glucose were examined using isolated brush border membrane vesicles (BBMV), slices and tubules prepared from 28-day-old rats. In BBMV, taurine accumulation was inversely proportional to osmolarity, indicating uptake rather than binding, and taurine accumulation was Na+-dependent. BBMV from 28-day rats did not accumulate D-glucose to the same degree as in adult BBMV, and the initial rate of uptake was slower. Taurine uptake had a similar Km and Vmax in BBMV from immature rats. Despite similarities in the kinetics of taurine uptake, higher urinary taurine concentrations are found in younger rats. The efflux of taurine from slices and tubules was much slower than in adults and probably accounts for the taurinuria of young animals. A diet low in methionine and taurine (LTD) given for seven days resulted in a lower excretion and fractional excretion of taurine than in animals fed a normal sulfur amino acid diet (NTD). A high-taurine diet (HTD) causes excessive taurinuria. These patterns of excretion are reflected at the brush border membrane surface with greater uptake after the LTD and reduced uptake after the HTD. A kinetic analysis of adult and 28-day-old animal BBMV reveals that the Vmax of accumulation is altered by diet, whereas the Km remains unchanged. The Vmax is higher in BBMV from LTD animals and lower in BBMV from HTD animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed2003

Medical nutrition therapy for the treatment of obesity.

Most physicians do not have the benefit of in-house registered dietitians to facilitate patient evaluation and create treatment plans. Fortunately, with the new tools that are available to physicians and patients, energy balance can be evaluated. Then, a balanced deficit diet can be encouraged to achieve a weight management goal while maintaining healthy food intake patterns. Patients should also be counseled regarding weight maintenance diets to prevent weight gain. A low-fat diet is preferred because the patient will benefit from improved cardiac risk as a result of weight loss and a restricted saturated fat content is healthier. Other diets and approaches are acceptable if they are hypocaloric and do not negatively impact the patient's health (eg, some high-protein, high-fat diets can increase lipid levels; high-carbohydrate diets can increase triglycerides in patients who have type 2 diabetes). As patients lose weight, further increases in physical activity and exercise should be emphasized to help maintain lost weight. It is also helpful from a behavioral perspective to encourage patients to monitor their weight, food intake, and physical activity. Medical offices can support patients by providing weekly or biweekly weigh-ins to track progress and provide ongoing feedback. Patients should be reminded that the ultimate goal of any weight management program is gradual, incremental weight losses that are maintained over time. Sustainable and enjoyable changes in eating practices and physical activity patterns must be made along with a lifelong commitment to health.

Behavior↗
PubMed2001

The orphan nuclear receptor LRH-1 potentiates the sterol-mediated induction of the human CETP gene by liver X receptor.

The human cholesteryl ester transfer protein (CETP) transfers cholesteryl esters from high density lipoproteins to triglyceride-rich lipoproteins, indirectly facilitating cholesteryl esters uptake by the liver. Hepatic CETP gene expression is increased in response to dietary hypercholesterolemia, an effect that is mediated by the activity of liver X receptor/retinoid X receptor (LXR/RXR) on a direct repeat 4 element in the CETP promoter. In this study we show that the orphan nuclear receptor LRH-1 also transactivates the CETP promoter by binding to a proximal promoter element distinct from the DR4 site. LRH-1 potentiates the sterol-dependent regulation of the wild type CETP promoter by LXR/RXR. Small heterodimer partner, a repressor of LRH-1, abolishes the potentiation effect of LRH-1 but not its basal transactivation of the CETP promoter. Since this mode of regulation of CETP is very similar to that recently reported for the bile salt-mediated repression of Cyp7a (encoding the rate-limiting enzyme for conversion of cholesterol into bile acid in the liver), we examined the effects of bile salt feeding on CETP mRNA expression in human CETP transgenic mice. Hepatic CETP mRNA expression was repressed by a diet containing 1% cholic acid in male mice but was induced by the same diet in female mice. Microarray analysis of hepatic mRNA showed that about 1.5% of genes were repressed, and 2.5% were induced by the bile acid diet. However, the sexually dimorphic regulatory pattern of the CETP gene was an unusual response. Our data provide further evidence for the regulation of CETP and Cyp7a genes by similar molecular mechanisms, consistent with coordinate transcriptional regulation of sequential steps of reverse cholesterol transport. However, differential effects of the bile salt diet indicate additional complexity in the response of these two genes.

Animals↗
PubMed2002

Characteristics of tooth wear in relation to different nutritional patterns including contemporary and medieval subjects.

The present study sought to evaluate the characteristics of tooth wear in subjects with an acidic diet in relation to subjects with substantially different nutritional patterns. The evaluation included medieval skulls (group 1, n = 102, abrasive nutrition), study models of individuals living on an acidic diet (group 2, n = 100) and randomly selected subjects (group 3, n = 100, average Western diet). Wear was visually recorded on oral, vestibular and occlusal/incisal surfaces using quantitative and morphological criteria. The mean age was 42.3 +/- 15.3 yr in group 1, 40.9 +/- 11.2 yr in group 2 and 36.7 +/- 11.7 yr in group 3. Group 1 exhibited the most pronounced substance loss, followed by groups 2 and 3. On occlusal surfaces, cupping was common in group 1 followed by group 2, but was rare in group 3. An inverse relation was found for facets. On buccal surfaces, no substance loss was observed in group 1, whereas in group 2, 63% had at least one tooth with a buccal lesion compared to 8% in group 3. The occlusal substance loss observed in subjects exposed to acids may be interpreted as increased abrasion/demastication of acid-softened dental hard tissues. The occurrence of concavities on smooth surfaces appears to be significant for the diagnosis of dental erosion.

Acids↗
PubMed2002

No effect of a high-fat diet on promotion of sex hormone-induced prostate and mammary carcinogenesis in the Noble rat model.

Results of international correlation and migrant studies suggest that dietary fat promotes carcinogenesis in hormone-sensitive sites, but this is disputed. In the present study, we used a Noble rat model of sex hormone-induced cancers to examine the effect of a high-fat diet on the incidence and latency of prostate and mammary cancer in male (n 139) and female (n 72) animals respectively. We also measured alpha-tocopherol levels in female breast tissue to determine whether a high intake of polyunsaturated fatty acids depletes antioxidant defence in target tissues, providing a possible potentiating mechanism for carcinogenesis. Results showed a very high incidence of hormone-induced adenocarcinomas of prostate and mammary gland, irrespective of diet. There was no difference in the pattern of carcinogenesis in different prostatic locations, weight of the prostate, or weight gain between male rats on the high-fat diet compared with the control (standard, low-fat) diet. In female rats, the incidence of mammary cancer and the body-weight gain were the same in both dietary groups, and breast alpha-tocopherol was also unaffected by dietary fat intake. Our present results are supportive of recent cohort studies that reported no significant association between intake of fat and the development of human prostate and breast cancer, and do not support a role for dietary fat in promoting sex hormone-induced prostate and mammary carcinogenesis.

Analysis of Variance↗
PubMed1985

Plasma essential fatty acids in pure and mixed race American Indians on and off a diet exceptionally rich in salmon.

Eskimos on a traditional diet have unusually low prevalences of cardiovascular disease and cancer. One possible reason is the high intake of eicosapentaenoic acid (EPA) which is thought to account for the high EPA and low arachidonic acid (AA) levels in Eskimo plasma. People who also consume a traditional diet exceptionally rich in EPA are the Indians of the west coast of Vancouver Island. There are about 12,000 of these people and their traditional diet has been affected much less than that of the Eskimos. When on their traditional diet the Vancouver Island Indians, like the Eskimos, have high EPA and low AA levels in plasma. When eating European food, EPA levels are in the European range, but AA levels are still exceptionally low, a finding also reported from Eskimos living in Denmark. In a small mixed race group, AA levels were intermediate between those in pure Indians and in Europeans. The high EPA levels in Eskimos and West Coast Indians are related to diet. The low AA levels, in contrast, are probably genetically determined. Unusual disease patterns in these populations cannot be entirely attributed to diet.

Adult↗
PubMed1991

Research note: feed restriction in broiler breeders causes a persistent elevation in corticosterone secretion that is modulated by dietary tryptophan.

The corticosterone response of immature broiler breeder males to feed restriction and the administration of increased levels of dietary Trp was investigated. Corticosterone levels were significantly (P less than .01) higher in birds placed on a skip-a-day (SD) feed restriction regimen from 4 to 15 wk of age than in birds fed an ad libitum intake. Elevated levels in SD birds persisted for the duration of the study. Levels were also higher in SD birds on those days on which feed was withheld (FEED-OFF) than on those days on which feed was delivered (FEED-ON). The SD males consuming a diet containing 1.5% Trp showed a change in the pattern of hormone secretion as compared with SD control birds (.19% Trp), with corticosterone levels increasing on the FEED-ON days and decreasing on the FEED-OFF days. It is concluded that SD feed restriction causes a persistent elevation of plasma corticosterone in broiler breeders. The secretory pattern of corticosterone can be modulated by increasing the Trp content of the diet, possibly as a result of reciprocal interactions between the serotonergic system and the hypothalamic-pituitary-adrenal axis.

Animals↗
PubMed2006

What's so special about eating? Examining unhealthy diet of adolescents in the context of other health-related behaviours and emotional distress.

This study examines to what extent unhealthy diet in adolescents is related to other types of health-risk behaviours (e.g., smoking and alcohol intake). Whereas previous studies have emphasised that adolescents engage in health-risk behaviour because of a tendency to break the rules, the present study hypothesises that unhealthy diet may differ from this general pattern because emotional distress is involved. Data from the cross-sectional Dutch Health Behaviour in School aged Children study (N=5730) were employed to examine this issue. Participants completed questionnaires on eating habits, health-related behaviours, and emotional distress. Factor analysis confirmed the hypothesis that unhealthy diet is only weakly related to other health-risk behaviours. Contrary to our hypothesis, however, emotional distress was not a significant predictor of unhealthy diet. Further research is required to examine which factors other than emotional distress are responsible for engaging in unhealthy diets in adolescence.

Adolescent↗