Do children with recurrent abdominal pain grow up to become adolescents who control their weight by fasting? Results from a UK population-based cohort

Kate Stein*, Naomi Warne, Jon E Heron, Nancy Zucker*, Helen E Bould

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)
2 Downloads (Pure)

Abstract

OBJECTIVE Gastrointestinal (GI) problems are common in eating disorders, but it is unclear whether these problems predate the onset of disordered eating. Recurrent abdominal pain (RAP) is the most prevalent GI problem of childhood, and this study aimed to explore longitudinal associations between persistent RAP (at ages 7 and 9) and fasting for weight control at 16. 
METHODS The Avon Longitudinal Study of Parents and Children (ALSPAC) is a UK population cohort of children. Childhood RAP was reported by mothers and defined as RAP 5+ (5 pain episodes in the past year) in our primary analysis, and RAP 3+ (3 pain episodes) in our sensitivity analysis. Fasting for weight control was reported by adolescents at 16. We used logistic regression models to examine associations, with adjustments for potential confounders.

RESULTS After adjustments, we found no association between childhood RAP 5+ and adolescent fasting for weight control at 16 (OR 1.30 (95% Confidence Intervals (CI) 0.87, 1.94) p= 0.197). However, we did find an association between RAP 3+ and later fasting, in the fully adjusted model (OR 1.50 (95% CI 1.16, 1.94) p= 0.002), and after excluding those with pre-existing anxiety (OR 1.52 (95% CI 1.17, 1.97) p= 0.002).

CONCLUSIONS Our findings suggest a possible independent contribution of RAP to later risk of fasting for weight control, and RAP should be enquired about in the assessment of eating disorders. However, frequency of childhood abdominal pain (as captured by ALSPAC) may be less important to long term outcomes than functional impairment.
Original languageEnglish
Pages (from-to)915-924
Number of pages10
JournalInternational Journal of Eating Disorders
Volume54
Issue number6
Early online date3 May 2021
DOIs
Publication statusPublished - 3 May 2021

Bibliographical note

Funding Information:
We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses. The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and Dr. Kate Stein and Dr Helen Bould will serve as guarantors for the contents of this paper. A comprehensive list of grants funding is available on the ALSPAC website (http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf); This research was funded in whole, or in part, by the Wellcome Trust (Grant ref: 217065/Z/19/Z). For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. This research was specifically funded by the NIH (Grant ref: MH087786-01). Dr Kate Stein is an NIHR funded Academic Clinical Fellow. We are grateful to Oxford University Clinical Academic Graduate Scheme (OUCAGS) for their financial support in allowing us to access the ALSPAC dataset. Dr Naomi Warne is supported by funding from the Medical Research Council/Medical Research Foundation (MRC/MRF grant number MR/S020292/1). Dr Zucker received funding from the National Science Foundation/National Institute of Mental Health (NIMH), Grant R01MH122370.

Funding Information:
Medical Research Council, Grant/Award Number: MR/S020292/1; National Institute of Mental Health, Grant/Award Number: R01MH122370; NIH Clinical Center, Grant/Award Number: MH087786‐01; The UK Medical Research Council and Wellcome Trust, Grant/Award Number: 217065/Z/19/Z; University of Bristol Funding information

Funding Information:
We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses. The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and Dr. Kate Stein and Dr Helen Bould will serve as guarantors for the contents of this paper. A comprehensive list of grants funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf ); This research was funded in whole, or in part, by the Wellcome Trust (Grant ref: 217065/Z/19/Z). For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. This research was specifically funded by the NIH (Grant ref: MH087786‐01). Dr Kate Stein is an NIHR funded Academic Clinical Fellow. We are grateful to Oxford University Clinical Academic Graduate Scheme (OUCAGS) for their financial support in allowing us to access the ALSPAC dataset. Dr Naomi Warne is supported by funding from the Medical Research Council/Medical Research Foundation (MRC/MRF grant number MR/S020292/1). Dr Zucker received funding from the National Science Foundation/National Institute of Mental Health (NIMH), Grant R01MH122370.

Publisher Copyright:
© 2021 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.

Structured keywords

  • ALSPAC

Keywords

  • abdominal pain
  • fasting
  • longitudinal
  • prospective
  • child
  • adolescent
  • eating disorders
  • cohort study
  • United Kingdom

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