Authors:Reihaneh Pirjani; Nooshin Shirzad; Mostafa Qorbani; Mina Phelpheli; Ensieh Nasli-Esfahani; Fatemeh Bandarian; Mahboubeh Hemmatabadi Pages: 445 - 450 Abstract: Purpose The aim of this study was to investigate the association between pre-pregnancy body mass index (BMI) and gestational diabetes mellitus (GDM). Methods This prospective study was conducted on 256 pregnant women without diabetes referred for prenatal care in the first trimester of pregnancy to two referral University Hospitals (Shariati and Arash Hospitals) during the years 2012 and 2013. Eligible participants were selected consecutively and were followed until delivery and 6 weeks after that. Body weight and fasting plasma glucose were measured in each trimester, and BMI was calculated. Incidence of GDM was recorded, and BMI in this group was compared with those without GDM. Results Mean age of women was 28.70 ± 5.57 years and among them, 78 women (30.5 %) developed GDM of which 21 were obese (52.5 %), 25 overweight (27.8 %), and 32 (25.4 %) were normal weight (p = 0.004). Pre-pregnancy obesity (OR 2.74, 95 % CI 1.28–5.88, p = 0.009), family history of diabetes (OR 2.01, 95 % CI 1.13–3.56, p = 0.016), and maternal age more than 30 years (OR 2.20, 95 % CI 1.25–3.88, p = 0.006) were three independent predictors for GDM, and pre-pregnancy obesity was the most potent predictor of GDM. Conclusion Women with high BMI and obesity have a significantly higher risk for developing GDM. Pre-pregnancy obesity, family history of diabetes, and age more than 30 years are three independent risk factors for GDM. PubDate: 2017-09-01 DOI: 10.1007/s40519-016-0332-2 Issue No:Vol. 22, No. 3 (2017)
Authors:Ana Laura Mendes; Cláudia Ferreira; Joana Marta-Simões Pages: 467 - 474 Abstract: Abstract In modern western societies, the female body is a predominantly used dimension in self and social evaluations. In fact, the perceived discrepancy between one’s current and ideal body image may act as a pathogenic phenomenon on women’s well-being. Furthermore, significant differences in the tendency to engage in disordered eating attitudes and behaviours have been verified between women sharing similar characteristics and perceptions about body's weight and shape, which suggests that different emotion regulation processes may be involved in this association. This study thus aims to clarify the mediational effect of two different emotional regulation processes, experiential avoidance and decentering, on the association of weight and body shape-related variables and shame with disordered eating, in a sample of 760 women. The tested path model explained 44 % of disordered eating attitudes and behaviours, and showed an excellent model fit. Results demonstrated that body mass index had a direct effect, albeit weak, on disordered eating behaviours, and that body-image discrepancy and shame presented indirect effects through the mechanisms of experiential avoidance and decentering. Results also revealed that experiential avoidance and decentering showed significant mediator effects on the relationship of weight and body shape and shame with disordered eating behaviours. These findings suggested that while experiential avoidance exacerbates the impact of weight and body shape and shame on disordered eating attitudes and behaviours, decentering seems to attenuate this association. Our findings appear to offer significant clinical and research implications, highlighting the importance of targeting maladaptive emotion processes and of the development of decentering abilities. PubDate: 2017-09-01 DOI: 10.1007/s40519-016-0291-7 Issue No:Vol. 22, No. 3 (2017)
Authors:Terrill Bravender; Hannah Elkus; Hannah Lange Pages: 483 - 489 Abstract: Purpose The serious physical complications of eating disorders in adolescents may necessitate inpatient medical stabilization, yet little is known about how patients and their parents perceive the hospitalization experience. Methods We identified 82 patients admitted to a large urban hospital for medical stabilization between January 1, 2010 and June 30, 2013. Twenty-three patients and 32 parents completed directed telephone interviews. Respondents rated components of the inpatient protocol using five-point Likert scales and answered open-ended questions regarding hospitalization. Quantitative and qualitative analyses were performed. Results The mean age of patients at admission was 14.9 years (range 9–21) and the average stay was 8.4 days (range 2–25). Patients rated “massage therapy” most helpful and “cell phone limits” least helpful. Parents rated “nursing staff” most helpful and “seeing other patients in the hospital” least helpful. Protocol components viewed differently by parents and patients included parents more strongly endorsing “staff supervision of meals” (4.34 vs 2.82, p < 0.001) and “limits on physical activity” (4.34 vs 3.23, p = 0.001). The two most common themes identified in open-ended questions were need for hospitalization as a signifier of eating disorder severity and desire for mental health services on the medical unit. Parents emphasized the value of dietician-directed meal planning. Conclusions Inpatient medical stabilization for adolescent eating disorders may play an important role not only in addressing acute medical complications, but also in activating the patient and family regarding the need for ongoing treatment. Parents particularly appreciate staff supervision of meals and having a respite from meal planning. PubDate: 2017-09-01 DOI: 10.1007/s40519-016-0270-z Issue No:Vol. 22, No. 3 (2017)
Authors:Silvio Buscemi; Davide Corleo; Carola Buscemi; Carla Giordano Abstract: Abstract Irisin, a novel myokine produced in response to physical activity, promotes white-to-brown fat transdifferentiation. The name irisin referred to the ancient Greek goddess Iris, the messenger who delivered (bad) news from the gods. In mice, it has been demonstrated that irisin plays a key role in metabolic regulation, energy expenditure and glucose homeostasis. New findings from various studies carried out in both animals and humans suggest that irisin might also have other favorable effects, such as increasing bone cortical mass, preventing hepatic lipid accumulation, and improving cognitive functions, thus mediating many exercise-induced health benefits. However, data on the role and function of irisin in humans have prompted controversy, due mostly to the only recent confirmation of the presence of irisin in humans. Another strong limitation to the understanding of irisin mechanisms of action is the lack of knowledge about its receptor, which until now remains unidentified in humans and in animals. This review presents an overall analysis of the history of irisin, its expression, and its involvement in health, especially in humans. Level of Evidence Level V, review. PubDate: 2017-09-20 DOI: 10.1007/s40519-017-0431-8
Authors:Rhonda F. Brown; Einar B. Thorsteinsson; Michael Smithson; C. Laird Birmingham; Hessah Aljarallah; Christopher Nolan Abstract: Purpose Overweight/obesity, sleep disturbance, night eating, and a sedentary lifestyle are common co-occurring problems. There is a tendency for them to co-occur together more often than they occur alone. In some cases, there is clarity as to the time course and evolution of the phenomena. However, specific mechanism(s) that are proposed to explain a single co-occurrence cannot fully explain the more generalized tendency to develop concurrent symptoms and/or disorders after developing one of the phenomena. Nor is there a clinical theory with any utility in explaining the development of co-occurring symptoms, disorders and behaviour and the mechanism(s) by which they occur. Thus, we propose a specific mechanism—dysregulation of core body temperature (CBT) that interferes with sleep onset—to explain the development of the concurrences. Methods A detailed review of the literature related to CBT and the phenomena that can alter CBT or are altered by CBT is provided. Results Overweight/obesity, sleep disturbance and certain behaviour (e.g. late-night eating, sedentarism) were linked to elevated CBT, especially an elevated nocturnal CBT. A number of existing therapies including drugs (e.g. antidepressants), behavioural therapies (e.g. sleep restriction therapy) and bright light therapy can also reduce CBT. Conclusions An elevation in nocturnal CBT that interferes with sleep onset can parsimoniously explain the development and perpetuation of common co-occurring symptoms, disorders and behaviour including overweight/obesity, sleep disturbance, late-night eating, and sedentarism. Nonetheless, a significant correlation between CBT and the above symptoms, disorders and behaviour does not necessarily imply causation. Thus, statistical and methodological issues of relevance to this enquiry are discussed including the likely presence of autocorrelation. Level of evidence Level V, narrative review. PubDate: 2017-09-19 DOI: 10.1007/s40519-017-0439-0
Authors:Ruth Bartelli Grigolon; Karin Louise Lenz Dunker; Mireille Coelho Almeida; Denise Claudino Achôa; Angélica Medeiros Claudino Abstract: Background Female adolescents with type I diabetes mellitus (TIDM) have an increased risk of developing eating disorders (ED) due to the dietary recommendations. Objective Investigate the association between dietary intake and increased risk of ED. Methods Case-control study with 50 T1DM female adolescents (11–16 years) and 100 healthy peers (CG). Measures included food frequency questionnaire (FFQ-PP), Child-EDE.12, economic and anthropometric data. Results Comparing female adolescents with T1DM vs CG, the first had higher intake of: bread, cereal, rice, and pasta (29.7 vs 23.8%, p = 0.001), vegetables (6.5 vs 2.8%, p < 0.001), milk yogurt and cheese (9.9 vs 7.6%, p = 0.032), fat, and oils (8.2 vs 5.9%, p = 0.003), besides higher fiber intake (19.2 vs 14.7%, p = 0.006) and lower consumption of sweets (13.6 vs 30.7%, p < 0.001). No differences on ED psychopathology (Child-EDE subscales and global score) were found between groups. In unadjusted association between the ED psychopathology and dietary intake, a diet rich in fiber was significantly associated with both the global and eating concern scores. Among CG, increased intake of meat, poultry, fish, and eggs and decreased bread, cereal, rice, and pasta consumption were significantly associated with higher ED psychopathology. When BMI and age are adjusted, the association between fiber intake and ED psychopathology is no longer significant among diabetic participants; however, in the CG, this association remains. Conclusions The study suggests that an association between dietary intake and ED psychopathology might exist in female adolescents with and without TIDM and that careful evaluation of the dietary profile and risk of developing an ED should be considered in clinical practice. Level of evidence Level III, case-control study. PubDate: 2017-09-14 DOI: 10.1007/s40519-017-0442-5
Authors:Sabrina Rudolph Abstract: Purpose The combination of physical activity and healthy eating habits has potentially positive effects on health. However, both practices can also lead to pathological behaviors such as exercise addiction (EA) and orthorexia nervosa (ON), thus generating negative effects. So far, studies analyzing the connection between these two phenomena cannot be found. The current paper is aiming to close this gap. Methods The sample (n = 1.008) consisted of 559 male and 449 female active members of three fitness studios, and was analyzed in a cross-sectional study design. The Exercise Addiction Inventory (EAI) was used to establish exercise addiction and the Düsseldorfer Orthorexie Skala (DOS) was used to evaluate orthorectic eating behavior. Results Out of the whole sample, 10.2% exhibit EA, while ON is prevalent in 3.4%. Twenty-three (2.3%) individuals suffer from both. There is a significant positive correlation between DOS and EAI (p < .001, r = .421). Female participants (p < .001, r = .452) show a higher correlation compared to male participants (p < .001, r = .418). Conclusion The results suggest a positive correlation between ON and EA in the context of German fitness sports. Both seem to be serious phenomena and require further investigation. Level of evidence Level V (cross-sectional descriptive study). PubDate: 2017-09-07 DOI: 10.1007/s40519-017-0437-2
Authors:Haruki Komatsu; Karin Hayashi; Fukiko Higashiyama Abstract: Abstract Leukopenia is frequently observed in patients with anorexia nervosa (AN). However, serious infectious diseases are infrequent in patients with AN. We present the case of a 13-year-old girl with AN complicated with severe neutropenia and sepsis upon refeeding. Her body mass index was 11 kg/m2 and her absolute neutrophil count (ANC) was 1555/µL on admission. After the initiation of refeeding, her ANC gradually declined to 346/µL. High fever occurred and a blood culture tested positive for Enterobacter cloacae. Although fever subsided with administration of antibiotics, human recombinant granulocyte colony-stimulating factor (G-CSF) was administered to improve her severe neutropenia. After administration of G-CSF, initially for 5 days and again for 3 days, her ANC became normal and stable. The combination of neutropenia and low body mass index may contribute to severe bacterial infection. Usually, hematological abnormalities such as neutropenia improve spontaneously with the recovery of nutritional status in AN patients. Therefore, it is difficult to determine the indication for treatment with G-SCF. Although a careful consideration is required, treatment with G-CSF is effective in AN patients with sepsis caused by severe neutropenia. PubDate: 2017-09-04 DOI: 10.1007/s40519-017-0435-4
Authors:Yuanyuan Duan; Xiaona Wang; Jiao Zhang; Ping Ye; Ruihua Cao; Xu Yang; Yongyi Bai; Hongmei Wu Abstract: Background The effects of overweight and obesity on kidney function have since been identified and become a subject of increased study and concern. But the association between body mass index (BMI) and estimated glomerular filtration rate (eGFR) is not well characterized. The aim of this study was to determine the relationship between BMI and eGFR. Methods To better understand the relationship between BMI and kidney function, we investigated the association between BMI and eGFR using both the baseline BMI level and the follow-up eGFR level and investigated the relationship between the change in BMI and the change in eGFR in 1447 patients from a 4.8-year prospective study in Beijing, People’s Republic of China. Results In multiple linear regression analysis, age, antihypertensive treatment, and BMI were negatively associated with the follow-up eGFR levels in all participants (R = −0.622, −0.926, and −0.266, respectively; P < 0.05), or in the elderly (R = −0.883, −1.035, and −0.630, respectively; P < 0.05); sex was found to be associated with the follow-up eGFR levels independently not only in all participants (R = 6.783; P < 0.001), but also in the elderly (R = 3.518; P < 0.05). In addition, the change in eGFR levels was positively related to age, the change in LDL-C, the change in TC, and the change in SBP, but negatively related to the change in BMI and the change in HDL-C (all P < 0.05). Conclusions The present study clearly indicated that BMI is an independent predictive factor for kidney function evaluated by the eGFR level during a median 4.8 years of follow-up in Chinese population. Level of evidence Level III, prospective cohort study. PubDate: 2017-09-04 DOI: 10.1007/s40519-017-0434-5
Authors:Nevin Sanlier; Semra Navruz Varli; M. Sedanur Macit; Hande Mortas; Tugba Tatar Abstract: Purpose It was aimed to determine the prevalence of high disordered eating tendencies and its relationship with food addiction, emotional eating and self esteem in participants at 18 and 33 years age group. Methods This study was planned as a cross-sectional study and conducted with 1359 young adult volunteers (M = 386, F = 973) with an average age of 22.4 ± 2.84 years. Eating Attitudes Test-26 (EAT-26), Yale Food Addiction Scale (YFAS), Emotional Appetite Questionnaire (EMAQ) and Rosenberg Self-Esteem Scale (RSES) were used. EAT-26 score above 20 was considered as eating disorders risk cutoff. Results Participants with disordered eating tendencies have higher rates (22.4%) of food addiction compared to participants without high disordered eating tendencies (7.2%). There is no difference for EMAQ and YFAS scores; however, there is a significant difference for RSES and EAT-26 scores according to gender. A positive association of EAT-26 with YFAS and EMAQ-negative scores and a negative association of EAT-26 with RSES and EMAQ-positive were found. Discussion There is association among EAT-26, YFAS, and Rosenberg Self-Esteem Scale, and Emotional Appetite Questionnaire scores. This study provides information for future studies about high disordered eating tendencies, food addiction and mood that are thought to be important in young adults. Level of evidence Level V (cross-sectional descriptive study). PubDate: 2017-09-04 DOI: 10.1007/s40519-017-0430-9
Authors:Gi Young Lee; Eun Jin Park; Youl-Ri Kim; Kyung Hwa Kwag; Jin Hong Park; So Hyun An; Ji Hyun Lee; Jeong Hun Sim; Janet Treasure Abstract: Purpose The aim of this study was to assess the adaptability and acceptability of a prevention program. Methods A total of 169 Korean students (83 boys and 86 girls) with a mean age of 12.3 years from a 6th grade class at an elementary school participated in the study. Mental health social workers delivered Me, You and Us, a school-based body image intervention program originally developed in the UK, through a set of six sessions. The participants were assessed in terms of their body satisfaction and self-esteem before the program, after the program, and at 1-month follow-up. They were also surveyed about their satisfaction and acceptability levels after the program. Results At baseline, girls had lower body satisfaction and self-esteem than boys, and their body satisfaction and self-esteem improved after the program. The improved body satisfaction was maintained at the 1-month follow-up. The efficacy of the program on body satisfaction was positively correlated with the frequency of their baseline level of “fat talk.” The program was more effective in girls with possible symptoms of an eating disorder at baseline. 93.7% of boys and 77.4% of girls responded that they enjoyed the program. Conclusions The program Me, You and Us was well-accepted by early adolescents in Korea and it can play a role in increasing body satisfaction and self-esteem by reducing “fat talk” in 6th grade students. Level of evidence Level III, cohort study with intervention. PubDate: 2017-09-04 DOI: 10.1007/s40519-017-0436-3
Authors:Shae-Leigh C. Vella; Nagesh B. Pai Abstract: Abstract The concept of food addiction (FA) remains controversial with research being in the nascent stages; FA like any addiction can have a devastating impact on the lives of those afflicted. There exists a clinical need for treatment strategies for those affected. This article reviews potential treatment strategies for FA. The treatment strategies target four core behaviours of the addiction phenotype specifically craving through the opioid system, impulsivity as a personality trait, compulsivity through the serotonergic system and lastly motivation through the dopaminergic system. A range of pharmacological and psychological interventions are reviewed. Future research should seek to test and validate the proposed clinical treatment strategies. PubDate: 2017-06-06 DOI: 10.1007/s40519-017-0400-2
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