The Development of Eating Disorders in Males and Females

这项建议将跟踪9039名女孩和7843名男孩，目前年龄在14-19岁之间，从青春期晚期到成年期早期。这些女孩和男孩是1996年成立的Growing Up Today研究的成员，当时参与者的年龄在9到14岁之间。该队列最初由NIDDK资助，以评估四年期间饮食摄入、活动和体重增加的预测因素。我们现在寻求再跟踪队列五年，以调查通便(即使用呕吐或泻药)和至少亚综合征严重程度的饮食失调的决定因素。这些儿童的母亲是正在进行的第二次护士健康研究的参与者，自1989年以来每两年跟踪一次。我们将每年从参与者那里获得信息，并继续从母亲那里收集关于她们的体重、对体重的关注、体重控制行为以及对孩子体重的关注的信息。使用这些数据，我们将评估个人因素、同伴影响、家庭影响和媒体影响对至少亚综合征严重程度的排泄和饮食障碍的发展和进程的预测性。饮食失调很难治疗，因此，我们认为识别和量化它们的风险因素至关重要，以便能够开发更好的预防手段。饮食失调不仅会造成严重的身体健康后果，而且其前兆--体重问题--与肥胖有关，并可能导致年轻人采取不健康的体重控制行为，如吸烟。因此，饮食失调及其前驱疾病与美国年轻人中的两个严重的公共卫生问题有关。由于前瞻性队列研究的缺乏，对年轻女性饮食失调的病因和发展过程知之甚少，对男性的了解更少。这项研究将有足够的力量来检测至少中等程度的关联(例如，RR&gt；1.7)。通过对今日成长研究中的大约16,000名青少年再跟踪五年，我们将获得最大规模的前瞻性队列研究，以捕捉发生饮食紊乱风险最高的时期。队列的规模和随访时间(9年)将使我们能够回答许多关于排泄和饮食障碍的发展和过程的问题，而其他前瞻性研究无法解决这些问题。此外，由于这是唯一一项评估男性饮食失调发展的大型前瞻性队列研究，我们的结果将对该领域做出持久的贡献。

This proposal is to follow 9,039 girls and 7,843 boys, currently ages 14- 19., through their transition to late adolescence and early adulthood. The girls and boys are members of the Growing Up Today Study, which was established in 1996 when the participants were 9 to 14 years of age. The cohort was initially funded by NIDDK to assess predictors of dietary intake, activity, and weight gain during a four year period. We now seek to follow the cohort for five additional years to investigate determinants of purging (i.e., use of vomiting or laxatives) and eating disorders of at least sub-syndromal severity. The mothers of the children are participants in the ongoing Nurses' Health Study II and have been followed biennially since 1989. We will obtain information annually from the participants, as well as continue to collect information from the mothers on their weight, concern with weight, weight control behaviors, and concern with their child's weight. Using this data we will assess the predictiveness of personal factors, peer influences, family influences and media influences on the development and course of purging and eating disorders of at least subsyndromal severity. Eating disorders are difficult to treat, Therefore, we believe it is essential to identify and quantify their risk factors so that better means of prevention can be developed. Not only do eating disorders have serious physical health consequences, but also their precursors, weight concerns, are associated with obesity and can lead young people to adopt unhealthy weight control behaviors, such as smoking. Thus eating disorders and their precursors are associated with two serious public health problems among young people in the United States. Due to the paucity of prospective cohort studies, little is known about the etiology and course of development of eating disorders in young women and much less is known in men. This study will have sufficient power to detect associations of at least moderate magnitude (e.g., RR> 1.7). By following the approximately 16,000 adolescents in the Growing Up Today Study for five additional years we will have the largest prospective cohort study capturing the time periods of highest risk of developing disordered eating. The size of the cohort and the length of follow-up (9 years) will enable us to answer many questions about the development and course of purging and eating disorders that no other prospective study has the statistical power to address. Moreover, since this is the only large prospective cohort study to assess the development of eating disorders in males, our results will make a lasting contribution to the field.