Association of Dysfunctional

Eating Patterns and Metabolic

Risk Factors for
Cardiovascular Disease
among Latinos
By Emily Compton

Lopez-Cepero, A., Frisard, C. F., Lemon, S. C., & Rosal, M. C. (2017).

Association of Dysfunctional Eating Patterns and Metabolic Risk
Factors for Cardiovascular Disease among Latinos. Journal of the
Academy of Nutrition and Dietetics, 1-7. doi:10.1016/j.jand.
2017.06.007
Why and How I Found the Article
Passionate about eating disorders and health
behaviors correlation between specific eating
behaviors and cardiovascular disease (CVD)
First thought of emotional eating (EE)
Many people struggle with emotional eating so I
wanted to understand their risk for CVD

Searched cardiovascular disease AND emotional

eating in PubMed
117 results came up, this was #2
Published in June 2017 and was printed in the
Journal of the Academy of Nutrition and Dietetics
 The Study
Cross sectional study design
Population based study looking at Latino Americans
from the Northeastern part of the USA

First study to examine dysfunctional eating

behaviors and risk factors for CVD among Latinos
 The Question
What are the associations between dysfunctional
eating behaviors and metabolic risk factors for CVD
in Latino men and women compared to those
without dysfunctional eating?
Dysfunctional eating Metabolic Risks for
behaviors: CVD:
Emotional eating (EE) Obesity/Central Obesity
Uncontrolled eating (UC) Type 2 Diabetes
Eating with cognitive Hypertension
restraint (CR) (restricting) Hyperlipidemia
 Why is this Important?
Latino Americans are at a disproportionately higher risk
for many chronic diseases, including CVD
Condition Latino Non- Latino Non-
Men Latino Women Latino
Men Women
Obesity 38.4 34.2 42.9 32.5
Rate (%)
Diabetes 12.5 7.6 11.8 6.1
Rate (%)

Latinos are the fastest-growing ethnic minority group in

the USA, Latinos currently comprise 18% of the total
US Population but are expected to grow to 24% by 2065
CVD will disproportionately affect some of our patients
more than others WHY?
 Methods
Using data from the Latino Health and Well-Being Project cohort study,
individuals were recruited using electronic health records
Inclusion criteria: Latino or Hispanic ethnicity, able to consent to participation
in study, and not pregnant
N= 578 of 3,067 patients evaluated for eligibility

A survey assed the following covariates: sex, age, ethnicity (Dominican,

Puerto Rican or other), education, perceived income, employment status,
stress levels (via Perceived Stress Scale) and physical activity

Independent variable tested was dysfunctional eating patterns via the

Three Factor Eating Questionnaire (TFEQ). The subscales were EE, UE
and CR. These results were categorized into No, Low and High
The No participants served as the control group

Dependent variables were the metabolic CVD risk factors of type 2

diabetes, hypertension and hyperlipidemia which were obtained using
ICD9 codes from electronic medical records. Anthropometrics measuring
BMI and waist circumference were calculated during in person visits.

Using SPSS, multivariable logistic and Poisson regression models were

performed, statistical significance was set at P=<.05
 Primary Results
Most participants reported engaging in dysfunctional eating
behaviors (EE=61.59%, UE=78.2%, CR=68.86%)

74.39% of participants had at least one risk factor

Dose-response relationship noted w/ EE scores and T2D, and

with CR and # of risk factors
 Is it Valid?
The good: The bad:
Relatively large sample, Cross sectional study
N=578 indicates you cannot imply
causation
Demographic data well
represented (50/50 males Bias:
and females) Selection bias: participants
came from EMRs from a
Used surveys and tools clinic, likely already sick
that have been validated Response bias in selection:
already who didnt respond?
Social desirability bias for
the eating behavior
questions

Not generalizable to
broader population
 How the Results Apply to
Our Patients
Are we doing CVD prevention all wrong?
High amounts of emotional eating, uncontrolled
eating and cognitive restraint eating in the sample
(EE=61.59%, UE=78.2%, CR=68.86%)
Address the underlying eating behavior problems
(emotional eating, etc.), instead of the result of the
behaviors (obesity, hypertension, etc.)
 Conclusion
May be internally valid, probably not externally
valid

More research!!
To assess dysfunctional eating behaviors and CVD
risk factors (a cohort studies or RCTs to determine
causation)
To apply to a broader population population (not just
Latinos!)
On the food choices people make during emotional or
uncontrolled eating- foods with high sugar, salt and
fat contents?