title: "Las penas con pan duelen menos": The role of food and culture in Latinas with disordered eating behaviors.
abstract: This study elucidated the experiences of eighteen Latina adults (mean age = 38.5 years) from "Promoviendo una Alimentación Saludable" Project who received nutritional intervention as part of the clinical trial. Half of the participants were first generation immigrants from Mexico (50%), followed by U.S. born with 16.7%. Remaining nationalities represented were Bolivia, Colombia, Guatemala, Honduras, Peru, and Venezuela with 33.3% combined. The average duration of living in the U.S. was 11.1 years. The mean body mass index (BMI) at baseline was 36.59 kg/m(2) (SD = 7.72). Based on the DSM-IV, 28% (n = 5) participants were diagnosed with binge-eating disorder, 33% (n = 6) with bulimia nervosa purging type and 39% (n = 7) with eating disorder not otherwise specified. Participants received up to three nutritional sessions; a bilingual dietitian conducted 97.8% of sessions in Spanish. In total, fifty nutritional sessions were included in the qualitative analysis. A three step qualitative analysis was conducted. First, a bilingual research team documented each topic discussed by patients and all interventions conducted by the dietitian. Second, all topics were classified into specific categories and the frequency was documented. Third, a consensus with the dietitian was performed to validate the categories identified by the research team. Six categories (describing eating patterns, emotional distress, Latino culture values, family conflicts associated with disturbed eating behaviors, lack of knowledge of healthy eating, and treatment progress) emerged from patients across all nutritional sessions. Considering the background of immigration and trauma (60%, n = 15) in this sample; the appropriate steps of nutritional intervention appear to be: 1) elucidating the connection between food and emotional distress, 2) providing psychoeducation of healthy eating patterns using the plate method, and 3) developing a meal plan.
authors.affiliation: Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA. Electronic address: maelynn_reyes@med.unc.edu.
authors.forename: Mae Lynn
authors.initials: ML
authors.lastname: Reyes-Rodríguez
authors.affiliation: Center for Joyful Eating, Inc., Chapel Hill, NC, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Gulisano
authors.affiliation: Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Yormeri
authors.initials: Y
authors.lastname: Silva
authors.affiliation: Department of Psychology, Colorado State University, USA.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Pivarunas
authors.affiliation: Department of Psychology, University of North Carolina, Greensboro, NC, USA.
authors.forename: Kiara L
authors.initials: KL
authors.lastname: Luna-Reyes
authors.affiliation: Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA; Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
mesh_terms: D000328:Adult; D056912:Binge-Eating Disorder / Q000178:diet therapy* / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000178:diet therapy* / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology; D065246:Culturally Competent Care / Q000208:ethnology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D000072001:Diet, Healthy / Q000208:ethnology / Q000523:psychology; D054242:Emigrants and Immigrants / Q000193:education / Q000523:psychology; D000066498:Emotional Adjustment; D001068:Feeding and Eating Disorders / Q000178:diet therapy / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006630:Hispanic or Latino / Q000193:education / Q000523:psychology; D006801:Humans; D007843:Latin America / Q000208:ethnology; D062407:Meals / Q000208:ethnology / Q000523:psychology; D009657:North Carolina; D052756:Nutritional Sciences / Q000193:education; D009765:Obesity / Q000178:diet therapy* / Q000208:ethnology / Q000209:etiology / Q000523:psychology; D010353:Patient Education as Topic; D010865:Pilot Projects; D013315:Stress, Psychological / Q000628:therapy*; D014754:Violence / Q000208:ethnology / Q000523:psychology
keywords: Culture; Eating disorders; Eating patterns; Food; Latinas; Nutritional