Mindful Eating Practices in the Adolescent with Hemophilia at Risk for Obesity

Abstract

Purpose The purpose of this Doctor of Nursing Practice (DNP) project is to understand if eating practices contribute to being overweight and obese in 12 to 19 year olds with hemophilia A or B. Background Adolescent obesity rates have quadrupled over the past 30 years. Adolescents are most affected subset. Approximately 20.5% of children 12 to 19 years of age are obese. These statistics bring to light a major health concern in the United States. Hemophilia is a chronic illness complicated by obesity. An X-linked recessive bleeding disorder characterized by episodes of both spontaneous and provoked bleeding into joints, muscles, soft tissues and other organs. In these joints, mechanical stressors (overweight and obesity) accelerate age-related degenerative changes. Activity restrictions and limitations in joint or muscle function may decrease or limit physical activity. Potential limits in physical activity combined with increased risk of emotional eating results in excess calories stored as fat. Key factor in obesity is caloric intake. Emotional eating is eating or overeating in response to negative influences without specific emotion or mood, and a significant cause of overweight and obesity in adolescent populations. Influences (e.g., boredom, loneliness, tiredness, perceived stress, anxiety or depression) may trigger emotional eating. The adolescent population is developmentally capable of completing mindful eating questionnaire (MEQ) and responding to a future mindful eating intervention (Daly, 2016). Identification of mindful eating practices increases awareness of triggers and emotions in food consumption. 10 Being overweight or obese in the adolescent with hemophilia is not understood, obesity poses a grave risk on their already compromised muscular-skeletal function. Emotional eating affects escalation of obesity in adolescents with hemophilia. Methods Quantitative descriptive study design explored and described mindful eating practices in participants aged 12 to 19 years, with BMI percentile, and hemophilia A and B. Setting is a hospital outpatient clinic at scheduled routine hemophilia care visits. After obtaining consent, participants self-administered the MEQ and demographic adolescent questionnaires (DAQ). Anticipated questionnaire completion took less than 10 minutes. MEQ is a validated tool measuring with higher scores indicating more mindful eating and lower scores indicating more mindless eating. DAQ addressed information grade in school, physical activity, food selection preparation and decisions about food choices. Medical record chart review done recording age, height, weight, BMI percentile, type and severity of hemophilia. Approximately 130 participants met eligibility criteria. Sample size for pilot study is 20 participants. Data entered into Research Electronic Data Capture (REDCap), exported to SPSS and Excel for descriptive statistical analysis. Conclusion Data analysis indicates 60% of study sample with hemophilia had BMI percentile greater than 95th percentile. National average of 12 to 19 year olds is 20.6%. Mean BMI (85.65%) indicates participants are overweight. MEQ analysis significant in subscale of distraction p=0.04. Other MEQ scores are not statistically significant. 11 Implications for Clinical or Educational Practice Understanding mindful eating practices, ethnic considerations and BMI percentile is essential to providing care. Anticipating education and designing interventions for adolescents with hemophilia, at risk for obesity, or have met criteria for being overweight and obese.