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Rudner T, Hume DJ, Larmuth K, Atterbury E, Rauch HGL, Kroff J. Substance use disorder and obesogenic eating: Does working memory training strengthen ability to abstain from unwanted behaviors? A systematic review. J Subst Abuse Treat 2021; 137:108689. [PMID: 34952746 DOI: 10.1016/j.jsat.2021.108689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/06/2021] [Accepted: 12/07/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Abstaining from unwanted behaviors requires a sufficient balance between the executive and impulsive cognitive systems. Working memory (WM) is a vital component of both systems, identified in a wide range of research as the central and dominant component of executive function. WM potentially modulates the desires, tendencies, and behaviors specific to and seen in individuals with substance use disorder (SUD) and obesogenic eating (OE). Compared to healthy populations, research has shown individuals with SUD, as well as those who display OE, to have some degree of executive dysfunction, and both conditions have far-reaching health care implications. Additionally, these deficits are associated with impulsive behavior. Research has proposed that impulsive and so-called reward-driven responses could be altered through cognitive therapy and that both SUD and OE could benefit from working memory training (WMT). METHOD In this narrative review, we systematically align extant empirical reasoning and evidence with these assumptions. Our main aim is to ascertain and summarize the value of WMT for the treatment of both SUD and food reward consummatory behaviors. As a means to include detailed narrative accounts of all papers of potential value, our thresholds for meaningful improvements in both WM and unwanted behaviors are broad. RESULTS The results from the eleven qualifying studies are as follows: Nine of ten studies show a significant positive training effect of WMT on one or more components of WM capacity; three of six eligible papers (two on alcohol and one on opioid addiction) deliver notable improvements in SUD in response to WMT. One of two suitable studies showed WMT to be a moderately efficacious form of therapy for OE. Conversely, WMT appears to have negligible therapeutic benefit for cognitive function deficits or psychopathology unrelated to WM, suggesting that WMT has unique treatment efficacy for impulsive human behaviors. CONCLUSION In conclusion, more rigorous and uniform studies on WMT and impulsive harmful behaviors are required to give proof of the benefits of this potential useful treatment.
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Affiliation(s)
- Trinity Rudner
- Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - David J Hume
- Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Kate Larmuth
- Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Elizabeth Atterbury
- Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - H G Laurie Rauch
- Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Jacolene Kroff
- Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Health through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa
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Verzijl CL, Gius B, Schlauch R, Rancourt D. The transdiagnostic role of food craving: An application of substance use models. Appetite 2021; 170:105867. [PMID: 34915105 DOI: 10.1016/j.appet.2021.105867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 09/06/2021] [Accepted: 12/11/2021] [Indexed: 12/15/2022]
Abstract
Food craving is a transdiagnostic process underlying clinically significant disordered eating behaviors and eating disorder diagnoses. However, the lack of literature examining the role of food craving as it relates to the full spectrum of disordered eating behaviors, including restrictive eating and compensatory behaviors, may be due to the traditional definition of food craving as the desire to consume particular foods. Applying motivational models of substance use craving to food craving may help to explain inconsistencies within existing literature. Three motivational models of craving from the substance use literature may be particularly applicable to (1) provide a clear definition of food craving as a motivational process, (2) understand the role of that motivational process as it underlies the full spectrum of disordered eating behavioral patterns, (3) provide insight for the most appropriate ways in which to accurately assess food craving, and (4) establish ways in which food craving may represent a useful motivational process to target in eating disorder treatments. This narrative review describes three models of substance use craving and provides suggestions for utilizing motivational models to understand the transdiagnostic role of food craving as it relates to the full spectrum of disordered eating behaviors in both research and clinical work.
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Affiliation(s)
- Christina L Verzijl
- Department of Psychology, University of South Florida, 4202 East Fowler Ave, Tampa, FL, 33620, USA.
| | - Becky Gius
- Department of Psychology, University of South Florida, 4202 East Fowler Ave, Tampa, FL, 33620, USA
| | - Robert Schlauch
- Department of Psychology, University of South Florida, 4202 East Fowler Ave, Tampa, FL, 33620, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, 4202 East Fowler Ave, Tampa, FL, 33620, USA
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Tserne TA, Borisenkov MF, Popov SV, Bakutova LA, Jongte L, Trivedi AK, Pecherkina AA, Dorogina OI, Martinson EA, Vetosheva VI, Gubin DG, Solovieva SV, Danilova LA, Turovinina EF, Symaniuk EE. Food addiction and weight in students with high academic performance. Public Health Nutr 2021; 24:6027-6033. [PMID: 34034842 PMCID: PMC11148585 DOI: 10.1017/s1368980021002160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to analyse the relationships between food addiction (FA), anthropometric characteristics and academic performance. DESIGN The average age (sd) of the participants was 17·5 (sd 2·7) years (64·1 % female). Each study participant indicated their sex, height, weight and academic performance and completed the Yale Food Addiction Scale. SETTING Syktyvkar, Kirov, Tyumen, Yekaterinburg, Russia; Aizawl, India. PARTICIPANTS The study involved 3426 people. RESULTS FA was found in 8·7 % of participants from Russia and 14·6 % from India. In schoolchildren but not in university students, high academic performance was associated with a higher incidence rate of FA detection (OR = 1·16, 95 % CI 1·07, 1·26) and a lower BMI (OR = 0·72, 95 % CI 0·56, 0·94). CONCLUSIONS These data showed an increased incidence rate of FA detection in adolescents with high academic performance.
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Affiliation(s)
- Tatyana A Tserne
- Department of Molecular Immunology and Biotechnology, Institute of Physiology, Komi Science Centre, Ural Branch of the Russian Academy of Sciences, Pervomaiskaya Str. 50, Syktyvkar167982, Russia
| | - Mikhail F Borisenkov
- Department of Molecular Immunology and Biotechnology, Institute of Physiology, Komi Science Centre, Ural Branch of the Russian Academy of Sciences, Pervomaiskaya Str. 50, Syktyvkar167982, Russia
| | - Sergey V Popov
- Department of Molecular Immunology and Biotechnology, Institute of Physiology, Komi Science Centre, Ural Branch of the Russian Academy of Sciences, Pervomaiskaya Str. 50, Syktyvkar167982, Russia
| | - Larisa A Bakutova
- Department of Molecular Immunology and Biotechnology, Institute of Physiology, Komi Science Centre, Ural Branch of the Russian Academy of Sciences, Pervomaiskaya Str. 50, Syktyvkar167982, Russia
| | | | - Amit K Trivedi
- Department of Zoology, Mizoram University, Aizawl, India
| | - Anna A Pecherkina
- Ural Institute of Humanities, Ural Federal University, Yekaterinburg, Russia
| | - Olga I Dorogina
- Ural Institute of Humanities, Ural Federal University, Yekaterinburg, Russia
| | | | - Valentina I Vetosheva
- Institute of Pedagogy and Psychology, Pitirim Sorokin Syktyvkar State University, Syktyvkar, Russia
| | - Denis G Gubin
- Department of Biology, Tyumen Medical University, Tyumen, Russia
- Tyumen Cardiology Research Centre, Tomsk National Research Medical Center, Russian Academy of Science, Tyumen, Russia
| | | | - Lina A Danilova
- Department of Biology, Tyumen Medical University, Tyumen, Russia
| | | | - Elvira E Symaniuk
- Ural Institute of Humanities, Ural Federal University, Yekaterinburg, Russia
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104
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Validation of the dimensional Yale Food Addiction Scale for Children 2.0 and estimation of the weighted food addiction score in a sample of adolescents from the general population. Eat Weight Disord 2021; 26:2563-2576. [PMID: 33550576 DOI: 10.1007/s40519-021-01113-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/13/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Obesity among adolescents is becoming increasingly prevalent and "food addiction" (addiction-like attraction to foods with high content of fat and refined carbohydrates) may be a potential contributor to this development. This study aimed to investigate the psychometric properties of the dimensional Yale Food Addiction Scale for Children version 2.0 (dYFAS-C 2.0) and to estimate the weighted mean score on the dYFAS-C 2.0 (as a measure of food addiction symptom load) among adolescents from the general Danish population. METHODS A total of 3,750 adolescents aged 13-17 were randomly drawn from the general Danish population and invited to participate in a web-based survey. Data on health and socioeconomic factors from the Danish registers were linked to both respondents and non-respondents, which allowed for analysis of attrition. The total- and sex-stratified weighted mean dYFAS-C 2.0 scores were estimated using augmented inverse probability weighted estimation. RESULTS A total of n = 576 (15.4%) adolescents participated in survey of whom 55.6% were female. The confirmatory factor analysis of the dYFAS-C 2.0 supported a one-factor model. The dYFAS-C 2.0 total score was associated with eating pathology, BMI z-scores, and ADHD symptomatology. The weighted mean dYFAS-C 2.0 score was 12.1 (95% CI: 11.2;12.9), 15.0 (95% CI: 13.9;16.2) for females and 9.5 (95% CI: 8.3;10.6) for males. CONCLUSIONS The dYFAS-C 2.0 appears to be a psychometrically valid tool to assess symptoms of food addiction among adolescents. Food addiction symptom severity correlated positively with eating pathology (including restrained eating), BMI z-scores, and ADHD symptomatology. Level IV, observational cross-sectional descriptive study combined with retrospective register data.
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105
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The Prevalence of ''Food Addiction'' during the COVID-19 Pandemic Measured Using the Yale Food Addiction Scale 2.0 (YFAS 2.0) among the Adult Population of Poland. Nutrients 2021; 13:nu13114115. [PMID: 34836370 PMCID: PMC8623181 DOI: 10.3390/nu13114115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 12/26/2022] Open
Abstract
The announcement of the coronavirus pandemic by the World Health Organization (WHO), ongoing restrictions and isolation led to a break with the daily routine, and suspension of social contacts, but also imposed new challenges on the population related to maintaining healthy eating habits. The purpose of the study was to assess the prevalence of “food addiction” (FA) during the COVID-19 pandemic in Poland in relation to several variables including depression. The method of analysis was a questionnaire containing original questions and the Yale Food Addiction Scale 2.0 (YFAS). A total of 1022 Polish residents aged 18–75 participated in the study (N = 1022; 93.7% women, 6.3% men). The prevalence of FA during the COVID-19 pandemic measured with the YFAS 2.0 scale was 14.1%. The average weight gain during the pandemic in 39% of respondents was 6.53 kg. Along with the increase in the value of the BMI index, the intensity of “food addiction” increased in the study group. People with depression had statistically significantly more FA symptoms than healthy people. This work may motivate future research to evaluate the association and potential overlap of “food addiction” and problem eating behaviors during the pandemic and the obesity problem.
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106
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Wylie A, Zacharoff K. A Perspective from the Field: How Can We Empower the Next Generation of Physician to Heal the Opioid Epidemic? ALCOHOLISM TREATMENT QUARTERLY 2021. [DOI: 10.1080/07347324.2021.2002226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Andrew Wylie
- Departments of Pediatrics and Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kevin Zacharoff
- Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
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107
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The Assessment of Food Addiction and the Yale Food Addiction Scale in Bariatric Surgery Populations. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Food addiction (FA) appears among bariatric weight loss surgery candidates who struggle to control the intake of hyperpalatable/refined foods have high rates of psychopathology and related health problems. Despite this, prevalence rates of FA in the bariatric sector are reported as low or variable. We investigated the prevalence of FA and the applicability of conventionally used metrics for 166 pre-surgery candidates from a weight management centre (USA) and a major metropolitan hospital (Australia). Self-report measures assessed FA (Yale Food Addiction Scale (YFAS)), body mass index (BMI), disordered eating, addictive personality, psychopathology, and diet. Consistent with prior research, standard YFAS scoring, requiring the endorsement of a distress/impairment (D/I) criterion (FA + D/I), yielded a FA prevalence rate of 12.7%, compared to 37.3% when D/I was omitted (FA − D/I). We compared profiles for those with FA using each scoring method against those ‘without’, who did not meet a minimum of three YFAS symptoms (non-FA ≤ 2). Both methods differentiated those with and without FA on addictive traits, disordered eating and hyperpalatable food consumption. Only FA + D/I differentiated markers of psychological distress or impairment, including depression, anxiety and quality of life. Results indicate a need for further FA research in bariatric settings.
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108
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Ihnatowicz P, Wątor P, Gębski J, Frąckiewicz J, Drywień ME. Are Nutritional Patterns among Polish Hashimoto Thyroiditis Patients Differentiated Internally and Related to Ailments and Other Diseases? Nutrients 2021; 13:3675. [PMID: 34835930 PMCID: PMC8624404 DOI: 10.3390/nu13113675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 12/28/2022] Open
Abstract
There is not any diet recommended for Hashimoto's disease, despite that those patients are often undernourished. Because of the high heterogeneity of Hashimoto's patients, insight into dietary patterns might shed some light on the patient-tailored dietary approach, thus improving their treatment and helping to identify patients with the highest probability of particular nutritional deficiencies. The aim of this study was to identify Hashimoto's patients' dietary patterns and their characterization based on both socio-demographic variables and dietary self-assessment. We collected data online from patients with Hashimoto's disease. The questionnaire formula used in the study was developed based on a validated food frequency questionnaire KomPAN®. K-means pattern analyses were used to characterize patients into patterns based on the frequency of particular types of foods consumption and socio-demographic factors. Four patterns were identified. We labeled them as 'Convenient', 'Non-meat', 'Pro-healthy', and 'Carnivores' with participants proportions at approximately one-fourth per each pattern. The patients were mainly of the female gender (94.08%), with a female: male ratio of 15.9. Hashimoto's patients differed in their food product choices, food choice motives, dieting experience, nutritional knowledge, smoking habits, food allergies and intolerances, and lipid disorders, and thus represent different eating patterns. However, these patterns were not determined by comorbidities or the majority of ailments.
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Affiliation(s)
- Paulina Ihnatowicz
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland; (P.I.); (J.F.)
| | - Paweł Wątor
- SanDiet Dietetyka & Lifestyle, Dietary Counseling, Pańska 96, 00-837 Warsaw, Poland;
| | - Jerzy Gębski
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland;
| | - Joanna Frąckiewicz
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland; (P.I.); (J.F.)
| | - Małgorzata Ewa Drywień
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland; (P.I.); (J.F.)
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Calcaterra V, Verduci E, Vandoni M, Rossi V, Di Profio E, Carnevale Pellino V, Tranfaglia V, Pascuzzi MC, Borsani B, Bosetti A, Zuccotti G. Telehealth: A Useful Tool for the Management of Nutrition and Exercise Programs in Pediatric Obesity in the COVID-19 Era. Nutrients 2021; 13:3689. [PMID: 34835945 PMCID: PMC8618189 DOI: 10.3390/nu13113689] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has led to the implementation of policies that mandate various restrictions on daily life, including social distancing, the closure of public services and schools, and movement limitations. Even though these restrictive measures decreased the COVID-19 spread, they may have detrimental effects on various lifestyle components such as physical inactivity, sedentary behavior, and dietary habits, influencing the maintenance of weight and contributing to obesity among children and adolescents. The coexistence of childhood obesity and COVID-19 and changes in the bioecological environment have put children and adolescents at increased risk for developing obesity and exacerbating the severity of this disorder. The use of telehealth technology is a modern approach useful for the delivery of health care services by health care professionals, where distance is a critical factor. Telehealth is effective in promoting increased self-monitoring and behavioral change, and provides the opportunity to perform online nutritional support and exercise training programs to promote a healthy lifestyle and reduce sedentary behaviors in children and adolescents. Telehealth, including tele-exercise and tele-nutrition, has the potential to address many of the key challenges in providing health services, including in patients with obesity during the COVID-19 outbreak. This narrative review aims to describe the role of telehealth as an opportunity in the management of pediatric obesity in the COVID-19 era, and to deliver nutrition and exercise programs for the maintenance of health.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (V.C.P.)
| | - Virginia Rossi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Elisabetta Di Profio
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (V.C.P.)
| | - Valeria Tranfaglia
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Martina Chiara Pascuzzi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Barbara Borsani
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Alessandra Bosetti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
- Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
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de Almeida VBP, Filgueiras AR, Nogueira PCK, Sesso RC, Sawaya AL, Domene SMÁ. The impact of food addiction behaviours on the treatment of overweight students. Br J Nutr 2021; 129:1-8. [PMID: 34657642 DOI: 10.1017/s0007114521004189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The present study evaluated the association of food addiction (FA), the change of the BMI/age z-score and the consumption of ultra-processed foods in overweight students undergoing a 16-month, multicomponent intervention in the school environment. FA was investigated using the Yale Food Addiction Scale for Children, and the dietary assessment was estimated using the semi-quantitative FFQ in overweight 9-11-year-old students (BMI/age z-score ≥ 1) of both sexes at their baseline and after the intervention (n 120). Among the schoolchildren, 33·4 % had FA in at least one of the two assessments. The analysis of mixed-effects models to assess the effect of the intervention and the change of the BMI/age z-score between evaluations showed that the occurrence of FA influenced the maintenance of weight (time#FA, β = 0·30, 95 % CI 0·05, 0·54, P = 0·016). Weight loss was observed only in individuals who did not present FA (BMI/age z-score = -0·3). When evaluating the effect of the intervention and the dietary variables, we verified a reduction in the consumption of sugary milk-based drinks -71·13 kJ (-17 kcal), P = 0·04 only in non-FA students at the end of the study. FA has been identified as an underlying factor with therapeutic relevance, and an enhanced understanding of FA can open new paths for the prevention and management of obesity.
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Affiliation(s)
| | | | | | - Ricardo Cintra Sesso
- Department of Medicine, Federal University of São Paulo UNIFESP, São Paulo, SP, Brazil
| | - Ana Lydia Sawaya
- Department of Physiology, Federal University of São Paulo UNIFESP, São Paulo, SP, Brazil
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111
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Aguirre T, Meier N, Koehler A, Bowman R. Highly processed food addiction: A concept analysis. Nurs Forum 2021; 57:152-164. [PMID: 34657289 DOI: 10.1111/nuf.12662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/17/2021] [Accepted: 10/04/2021] [Indexed: 12/19/2022]
Abstract
AIM This concept analysis aims to clarify the highly processed food addiction (HPFA) concept and discuss its implications for treating obesity. BACKGROUND Emerging empirical evidence suggests addictive-like eating may contribute to obesity in some individuals, increasing interest in HPFA's role in obesity. Clarifying the HPFA concept will aid in developing individualized interventions for patients with obesity and HPFA. DESIGN This concept analysis followed Walker and Avant's approach. The case studies are of participants in a study that included individuals with and without HPFA (Yale Food Addiction Scale 2.0-diagnosed). DATA SOURCE We searched PubMed, CINAHL, PsychInfo, and Ebscohost databases. Keywords were "food addiction" and "food addiction concept." REVIEW METHODS Criteria included recent reviews and empirical studies that measured HPFA and focused on HPFA characteristics and/or treatment implications. RESULTS The model case displayed all 11-substance use disorder (SUD) symptoms and clinical significance, supporting a severe HPFA diagnosis. The contrary case was negative for all YFAS 2.0 symptoms and clinical significance and did not eat compulsively or experience cravings. The borderline case met the minimum symptom criteria for severe HPFA but not clinical significance. Clinical interviews may help determine whether such individuals truly exhibit addictive-like eating behaviors. CONCLUSIONS Growing empirical evidence and our case studies support the HPFA concept and the utility of the YFAS/YFAS 2.0 for identifying a distinct subset of individuals with overweight/obesity who may benefit from interventions developed to treat established SUDs. Future research should examine HPFA separately and in relation to obesity and eating disorders and include longitudinal studies and gender-balanced samples.
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Affiliation(s)
- Trina Aguirre
- College of Nursing-West Nebraska Division, University of Nebraska Medical Center, Scottsbluff, Nebraska, USA
| | - Nancy Meier
- College of Nursing-West Nebraska Division, University of Nebraska Medical Center, Scottsbluff, Nebraska, USA
| | - Ann Koehler
- College of Nursing-West Nebraska Division, University of Nebraska Medical Center, Scottsbluff, Nebraska, USA
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A cross-sectional examination of reported changes to weight, eating, and activity behaviors during the COVID-19 pandemic among United States adults with food addiction. Appetite 2021; 168:105740. [PMID: 34627980 PMCID: PMC8496962 DOI: 10.1016/j.appet.2021.105740] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/20/2021] [Accepted: 10/06/2021] [Indexed: 12/12/2022]
Abstract
Prior studies have demonstrated the effects of the COVID-19 pandemic on weight management and lifestyle behaviors, though identification of who may be at greatest risk for negative consequences has not been fully explored. Addictive-like eating behavior, or food addiction, has been associated with an array of problematic eating behaviors, which may suggest heightened susceptibility to poorer outcomes. In this online, cross-sectional study, adults (ages 18–78; M = 42.36, SD = 13.08) living in the United States (n = 288) completed questionnaires assessing food addiction and reported changes to their weight, eating, and physical activity before and during the COVID-19 pandemic. Individuals with food addiction gained an average of 12.42 lb (5.63 kg) since March 2020, compared to an average weight gain of 2.14 lb (0.97 kg) for those without food addiction (p < .001). Linear regression analyses controlling for age and body mass index (BMI) showed that food addiction was independently associated with higher weight gain (B = 9.28, t = 4.97, p < .001), greater intake of ultra-processed foods before and during COVID-19 (B = 1.08, t = 5.71, p < .001; B = 1.18, t = 6.42, p < .001, respectively), greater attribution of their overall current eating behaviors to COVID-19 circumstances (B = 23.19, t = 4.62, p < .001), and higher distress about their overall current eating behaviors (B = −22.12, t = −2.50, p = .01). Interaction effects demonstrated that individuals with food addiction who are older may be at particularly high risk for weight gain and distress. The present research suggests that food addiction is a uniquely meaningful phenotype, beyond the effects of BMI, to identify risk for the negative consequences of COVID-19. Individuals with food addiction, particularly those who are older, may benefit from support with weight management and addictive-like eating as the COVID-19 pandemic persists and resolves.
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Personality Dimensions Associated with Food Addiction in a Sample of Pre-operative Bariatric Surgery Patients from Turkey. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00663-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Gearhardt AN. Commentary on Minhas et al.: Food addiction--the role of substance and environmental factors. Addiction 2021; 116:2880-2881. [PMID: 34128285 DOI: 10.1111/add.15588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 12/11/2022]
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Koehler A, Aguirre T, Schulte E, Bowman R, Struwe L. Secondary analysis of YFAS 2.0 symptom counts, impairment/distress, and food addiction severity in adults with overweight/obesity. Eat Weight Disord 2021; 26:2393-2399. [PMID: 33389719 DOI: 10.1007/s40519-020-01077-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Understanding the complexities of obesity is important for developing effective interventions. Evidence is growing that addictive-like tendencies toward foods may contribute to obesity in some individuals. The Yale Food Addiction Scale (YFAS, YFAS 2.0) was developed to identify individuals with addictive-like eating behaviors. Diagnosing food addiction (FA) requires meeting a symptom threshold plus clinically significant impairment/distress (self-perceived), but the utility of the impairment/distress criteria remains controversial. This secondary analysis compared individuals who did not meet the FA symptom criteria, met the symptom, but not the impairment/distress criteria, and met both criteria. METHODS This secondary analysis of data from a randomized controlled pilot study involving 83 adults with overweight/obesity used descriptive statistics and Univariate ANOVAS to compare YFAS 2.0 and Weight and Lifestyle Inventory responses among the groups. RESULTS Twenty-eight individuals did not meet the FA symptom criteria, 20 met the symptom, but not the impairment/distress criteria, and 35 met both criteria. Of the latter, 80.0% had severe, 8.6% had moderate, and 11.4% had mild FA. Age at onset of overweight was lower with severe than with mild FA (p = 0.023). CONCLUSIONS The YFAS 2.0 identified a distinct group with severe FA and a group who met the FA symptom threshold, but not the impairment/distress criteria. Few participants perceived impairment/distress unless they endorsed ≥ 6 symptoms. Adding clinical interviews may aid in assessing impairment/distress and addictive-like eating behaviors, particularly in those meeting the FA symptom, but not the impairment/distress criteria. Better characterization of these groups may help targeting obesity interventions. TRIAL REGISTRATION NUMBER NCT03431831, 1/30/2018. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Ann Koehler
- College of Nursing-West Nebraska Division, University of Nebraska Medical Center, 1601 East 27th Street, Scottsbluff, NE, 69361, USA.
| | - Trina Aguirre
- College of Nursing-West Nebraska Division, University of Nebraska Medical Center, 1601 East 27th Street, Scottsbluff, NE, 69361, USA
| | - Erica Schulte
- Department of Psychology, University of Michigan, 1004 East Hall, 530 Church Street, Ann Arbor, MI, 48109, USA.,Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3032, Philadelphia, PA, 19104, USA
| | - Rebecca Bowman
- Regional West Physicians Clinic, Medical Plaza North, 4021 Avenue B, Scottsbluff, NE, 69361, USA.,, River Hills Health, 201 S. Market, Ottumwa, IA, 52501, USA
| | - Leeza Struwe
- College of Nursing-Niedfelt Nursing Research Center, University of Nebraska Medical Center, 550 N 19th Street, Lincoln, NE, 68588, USA
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Food preferences and YFAS/YFAS-C scores in schoolchildren and university students. Eat Weight Disord 2021; 26:2333-2343. [PMID: 33389716 DOI: 10.1007/s40519-020-01064-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/22/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Food addiction (FA) is one of the causes of widespread obesity in modern society. It was shown that there is an age-associated increase in incidence rate of FA in adolescents/young adults. The purpose of this study was to analyze food preferences in schoolchildren and university students with FA. METHODS High school and university students (N = 1607; age: 17.8 ± 2.7 years; girls: 77.0%) located in four settlements of Russia anonymously took part in the study. Study participants provided personal data (age, sex, height, and weight) and completed the Yale Food Addiction Scale, the Zung Self-Rating Depression Scale and the Munich ChronoType Questionnaire. In addition, they indicated food products with which they had problems. RESULTS The frequency of detection of FA among university students was twice as high as among schoolchildren. University students with FA were 20.2% more likely than schoolchildren to report the symptom 'use continues despite knowledge of adverse consequences,' and 13.7% more likely to report the symptom 'tolerance.' Schoolchildren and university students with FA most often noted that foods high in sugar and fat were problematic. University students with FA also reported that foods with a high carbohydrate content were problematic. CONCLUSION In university students with FA, in comparison with schoolchildren with FA, there is an increase in list of problematic food products, mainly due to products with a high carbohydrate content. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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de Ceglia M, Decara J, Gaetani S, Rodríguez de Fonseca F. Obesity as a Condition Determined by Food Addiction: Should Brain Endocannabinoid System Alterations Be the Cause and Its Modulation the Solution? Pharmaceuticals (Basel) 2021; 14:ph14101002. [PMID: 34681224 PMCID: PMC8538206 DOI: 10.3390/ph14101002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 12/11/2022] Open
Abstract
Obesity is a complex disorder, and the number of people affected is growing every day. In recent years, research has confirmed the hypothesis that food addiction is a determining factor in obesity. Food addiction is a behavioral disorder characterized by disruptions in the reward system in response to hedonic eating. The endocannabinoid system (ECS) plays an important role in the central and peripheral control of food intake and reward-related behaviors. Moreover, both obesity and food addiction have been linked to impairments in the ECS function in various brain regions integrating peripheral metabolic signals and modulating appetite. For these reasons, targeting the ECS could be a valid pharmacological therapy for these pathologies. However, targeting the cannabinoid receptors with inverse agonists failed when used in clinical contexts as a consequence of the induction of affective disorders. In this context, new classes of drugs acting either on CB1 and/or CB2 receptors or on synthetic and degradation enzymes of endogenous cannabinoids are being studied. However, further investigation is necessary to find safe and effective treatments that can exert anti-obesity effects, normalizing reward-related behaviors without causing important adverse mood effects.
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Affiliation(s)
- Marialuisa de Ceglia
- UGC Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga-Hospital Universitario Regional de Málaga, 29010 Málaga, Spain;
- Correspondence: (M.d.C.); (F.R.d.F.)
| | - Juan Decara
- UGC Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga-Hospital Universitario Regional de Málaga, 29010 Málaga, Spain;
| | - Silvana Gaetani
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, 00185 Rome, Italy;
| | - Fernando Rodríguez de Fonseca
- UGC Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga-Hospital Universitario Regional de Málaga, 29010 Málaga, Spain;
- Correspondence: (M.d.C.); (F.R.d.F.)
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Hernández-Rivero I, Blechert J, Miccoli L, Eichin KN, Fernández-Santaella MC, Delgado-Rodríguez R. Emotional reactivity to binge food and erotic cues in women with bulimia nervosa symptoms. J Eat Disord 2021; 9:120. [PMID: 34583783 PMCID: PMC8479974 DOI: 10.1186/s40337-021-00475-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/10/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Studies on food cue reactivity have documented that altered responses to high-calorie food are associated with bulimic symptomatology, however, alterations in sexual motivations and behaviors are also associated clinical features in this population, which justify their inclusion as a research target. Here, we study responses to erotic cues-alongside food, neutral and aversive cues-to gain an understanding of specificity to food versus a generalized sensitivity to primary reinforcers. METHODS We recorded peripheral psychophysiological indices -the startle reflex, zygomaticus, and corrugator responses-and self-reported emotional responses (valence, arousal, and dominance) in 75 women completing the Bulimia Test-Revised (BULIT-R). Multiple regression analysis tested whether BULIT-R symptoms were predicted by self-reported and psychophysiological responses to food versus neutral and erotic versus neutral images. RESULTS The results showed that individuals with higher bulimic symptoms were characterized by potentiated eye blink startle response during binge food (vs. neutral images) and more positive valence ratings during erotic (vs. neutral) cues. CONCLUSIONS The results highlight the negative emotional reactivity of individuals with elevated bulimic symptoms toward food cues, which could be related to the risk of progression to full bulimia nervosa and thereby addressed in prevention efforts. Results also point to the potential role of reactivity to erotic content, at least on a subjective level. Theoretical models of eating disorders should widen their conceptual scope to consider reactivity to a broader spectrum of primary reinforcers, which would have implications for cue exposure-based treatments. We examined appetitive and aversive cue responses in college women to investigate how bulimic symptoms relate to primary reinforcers such as food and erotic images. We recorded peripheral psychophysiological indices (the startle reflex, zygomaticus, and corrugator responses) and self-reported emotional responses (valence, arousal, and dominance) in 75 college women that were presented with the Spanish version of the Bulimia Test-Revised. The results showed that bulimic symptoms increase both psychophysiological defensiveness toward food cues and subjective pleasure toward erotic cues. The findings suggest a generalized sensitivity to primary reinforcers in the presence of bulimic symptoms, and emphasize the relevance of adopting a wider framework in research and treatment on bulimia nervosa.
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Affiliation(s)
- Isabel Hernández-Rivero
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Campus de Cartuja s/n, 18071, Granada, España
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunnerstraße 34, 5020, Salzburg, Austria
| | - Laura Miccoli
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Campus de Cartuja s/n, 18071, Granada, España
| | - Katharina Naomi Eichin
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunnerstraße 34, 5020, Salzburg, Austria
| | - M Carmen Fernández-Santaella
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Campus de Cartuja s/n, 18071, Granada, España
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Clinical Features of Gambling Disorder Patients with and Without Food Addiction: Gender-Related Considerations. J Gambl Stud 2021; 38:843-862. [PMID: 34585341 DOI: 10.1007/s10899-021-10071-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
Although food addiction (FA) is a debated condition and it is not currently recognized as a formal diagnosis, it shares features with other addictions, such as gambling disorder (GD). However, the prevalence of FA in GD and the clinical correlates are incompletely understood, especially within women versus men. To investigate FA in patients presenting with GD. The sample included 867 patients diagnosed with GD (798 males and 69 females) attending a specialized behavioral addictions unit. FA was observed in 8.3% of GD patients (18.8% of women, 7.4% of men). More psychopathology and harm avoidance, greater body mass indices and less self-directedness and cooperativeness were associated with FA. In women, FA was associated with a longer GD duration. In men, FA was associated with earlier GD onset, greater GD and problematic alcohol use severities. Among patients with GD, FA was associated with more psychopathology and gambling patterns suggestive of more protracted or severe GD. Screening for and addressing FA condition in patients with GD may help optimize preventive and therapeutic approaches. Future studies should consider testing guidelines to improve healthy eating habits, increase physical exercise and better manage stress and other negative emotions in order to target FA in GD.
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Translation of the Chinese version of the modified Yale Food Addiction Scale 2.0 and its validation among college students. J Eat Disord 2021; 9:116. [PMID: 34530921 PMCID: PMC8444594 DOI: 10.1186/s40337-021-00471-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/06/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Obesity prevalence has substantially increased in China over the past decade. In China, over 1 in 7 individuals meet the criteria for overall obesity, and 1 in 3 meet the criteria for abdominal obesity, obesity has become a significant problem. Studies have shown that food addiction and obesity are inextricably linked. The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) is a brief measurement for assessing food addiction. This study aimed to explore the structure of the Chinese version of the mYFAS 2.0 and assess the occurrence of food addiction in a sample of college students in Northeast China. METHODS A cross-sectional design was conducted in a sample of 1099 undergraduate students in Northeast China. Participants completed the sociodemographic questionnaire, the Chinese version of the mYFAS 2.0, the Barratt Impulsiveness Scale (BIS-8), and the Self-Esteem Scale (SES) to test the hypothesis. Exploratory factor analysis and confirmatory factor analysis were performed to examine the underlying factor structure of the mYFAS 2.0. Two weeks later, 62 students who participated in the first test were recruited to evaluate the test-retest reliability. RESULTS The Chinese version of the mYFAS 2.0 demonstrated adequate internal consistency, good test-retest reliability and satisfactory construct validity. The results of the confirmatory factor analysis found that the Chinese version of the mYFAS 2.0 demonstrated a good fit to the two-factor solution identified by the exploratory factor analysis and showed superior fit indices compared to the one-factor model. The prevalence of food addiction in our sample was found to be in line with rates observed in other Asian and Western samples. The mYFAS 2.0 symptom count scores were correlated with BMI, the idea of dieting to lose weight, the desire to overeat, low self-esteem, and impulsivity. CONCLUSION The results indicate that the Chinese version of the mYFAS 2.0 has good reliability and validity, and that it can be considered a tool to evaluate the addictive eating behaviours of undergraduate students.
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Blum K, Gold MS, Llanos-Gomez L, Jalali R, Thanos PK, Bowirrat A, Downs WB, Bagchi D, Braverman ER, Baron D, Roy AK, Badgaiyan RD. Hypothesizing Nutrigenomic-Based Precision Anti-Obesity Treatment and Prophylaxis: Should We Be Targeting Sarcopenia Induced Brain Dysfunction? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189774. [PMID: 34574696 PMCID: PMC8470221 DOI: 10.3390/ijerph18189774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 12/15/2022]
Abstract
Background: The United States Centers for Disease Control and Prevention (CDC) estimates a total obesity rate of 30% for 12 states and a 20% obesity rate nationwide. The obesity epidemic continues to increase in spite of preventative measures undertaken worldwide. Pharmacological treatments promise to reduce total fat mass. However, medications may have significant side effects and can be potentially fatal. Data Retrieval: This brief review, based on a PUBMED search of the key terms "Obesity" and" Sarcopenia," will present evidence to corroborate the existence of Reward Deficiency Syndrome (RDS) in obesity and the involvement of catecholaminergic pathways in substance seeking behavior, particularly as it relates to carbohydrates cravings. Expert Opinion: The genetic basis and future genetic testing of children for risk of aberrant generalized craving behavior are considered a prevention method. Here we present evidence supporting the use of precursor amino acid therapy and modulation of enkephalinase, MOA, and COMT inhibition in key brain regions. Such treatments manifest in improved levels of dopamine/norepinephrine, GABA, serotonin, and enkephalins. We also present evidence substantiating insulin sensitivity enhancement via Chromium salts, which affect dopamine neuronal synthesis regulation. We believe our unique combination of natural ingredients will influence many pathways leading to the promotion of well-being and normal healthy metabolic functioning. Sarcopenia has been shown to reduce angiogenesis and possible cerebral blood flow. Exercise seems to provide a significant benefit to overcome this obesity-promoting loss of muscle density. Conclusion: Utilization of proposed nutrigenomic formulae based on coupling genetic obesity risk testing promotes generalized anti-craving of carbohydrates and can inhibit carbohydrate bingeing, inducing significant healthy fat loss and relapse prevention.
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Affiliation(s)
- Kenneth Blum
- Center for Psychiatry, Medicine & Primary Care (Office of the Provost), Division of Addiction Research & Education, Western University Health Science, Pomona, CA 91766, USA;
- Institute of Psychology, ELTE Eötvös Loránd University, Kazinczy u. 23-27, 1075 Budapest, Hungary
- Division of Nutrigenomics, Genomic Testing Center Geneus Health, San Antonio, TX 78249, USA
- Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA
- Department of Psychiatry, Wright University Boonshoff School of Medicine, Dayton, OH 45377, USA
- Division of Precision Nutrition, Victory Nutrition International, Bonita Springs, FL 34135, USA; (W.B.D.); (D.B.)
- The Kenneth Blum Behavioral & Neurogenetic Institute, Division of Ivitalize Inc., Austin, TX 78701, USA; (L.L.-G.); (R.J.)
- Division of Clinical Neurology, Path Foundation NY, New York, NY 10010, USA;
- Correspondence:
| | - Mark S. Gold
- Department of Psychiatry, School of Medicine, Tulane University, New Orleans, LA 70118, USA; (M.S.G.); (A.K.R.III)
| | - Luis Llanos-Gomez
- The Kenneth Blum Behavioral & Neurogenetic Institute, Division of Ivitalize Inc., Austin, TX 78701, USA; (L.L.-G.); (R.J.)
| | - Rehan Jalali
- The Kenneth Blum Behavioral & Neurogenetic Institute, Division of Ivitalize Inc., Austin, TX 78701, USA; (L.L.-G.); (R.J.)
| | - Panayotis K. Thanos
- Department of Psychology & Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Research Institute on Addictions, University at Buffalo, Buffalo, NY 14260, USA;
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - William B. Downs
- Division of Precision Nutrition, Victory Nutrition International, Bonita Springs, FL 34135, USA; (W.B.D.); (D.B.)
| | - Debasis Bagchi
- Division of Precision Nutrition, Victory Nutrition International, Bonita Springs, FL 34135, USA; (W.B.D.); (D.B.)
- Department of Pharmaceutical Sciences, College of Pharmacy & Health Sciences, Texas Southern University, Houston, TX 77004, USA
| | - Eric R. Braverman
- Division of Clinical Neurology, Path Foundation NY, New York, NY 10010, USA;
| | - David Baron
- Center for Psychiatry, Medicine & Primary Care (Office of the Provost), Division of Addiction Research & Education, Western University Health Science, Pomona, CA 91766, USA;
| | - Alphonso Kenison Roy
- Department of Psychiatry, School of Medicine, Tulane University, New Orleans, LA 70118, USA; (M.S.G.); (A.K.R.III)
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78249, USA;
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Ajenikoko A, Ide N, Shivashankar R, Ge Z, Marklund M, Anderson C, Atun A, Thomson A, Henry ME, Cobb LK. Core Strategies to Increase the Uptake and Use of Potassium-Enriched Low-Sodium Salt. Nutrients 2021; 13:nu13093203. [PMID: 34579080 PMCID: PMC8466693 DOI: 10.3390/nu13093203] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022] Open
Abstract
Excess sodium consumption and insufficient potassium intake contribute to high blood pressure and thus increase the risk of heart disease and stroke. In low-sodium salt, a portion of the sodium in salt (the amount varies, typically ranging from 10 to 50%) is replaced with minerals such as potassium chloride. Low-sodium salt may be an effective, scalable, and sustainable approach to reduce sodium and therefore reduce blood pressure and cardiovascular disease at the population level. Low-sodium salt programs have not been widely scaled up, although they have the potential to both reduce dietary sodium intake and increase dietary potassium intake. This article proposes a framework for a successful scale-up of low-sodium salt use in the home through four core strategies: availability, awareness and promotion, affordability, and advocacy. This framework identifies challenges and potential solutions within the core strategies to begin to understand the pathway to successful program implementation and evaluation of low-sodium salt use.
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Affiliation(s)
- Adefunke Ajenikoko
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
| | - Nicole Ide
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
| | - Roopa Shivashankar
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
- Indian Council of Medical Research (ICMR), New Delhi 110029, India
| | - Zeng Ge
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
| | - Matti Marklund
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD 21087, USA; (M.M.); (M.E.H.)
- The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia
| | - Cheryl Anderson
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, La Jolla, CA 92093, USA; (C.A.); (A.A.)
| | - Amy Atun
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, La Jolla, CA 92093, USA; (C.A.); (A.A.)
| | - Alexander Thomson
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
| | - Megan E. Henry
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD 21087, USA; (M.M.); (M.E.H.)
| | - Laura K. Cobb
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
- Correspondence: ; Tel.: +1-212-500-5729
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Carrière K, Shireen SH, Siemers N, Preißner CE, Starr J, Falk C, Knäuper B. Development and Validation of the Four Facet Mindful Eating Scale (FFaMES). Appetite 2021; 168:105689. [PMID: 34517074 DOI: 10.1016/j.appet.2021.105689] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 08/02/2021] [Accepted: 09/06/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Previous mindful eating scales stress the attentional domains of eating-specific mindfulness, such as present-moment attention to homeostatic cues of hunger and satiety while discounting other important domains such as non-judgment and decentering. The purpose of the series of studies was to develop and evaluate a multifaceted mindful eating scale that assesses several domains of eating-specific mindfulness. METHODS A multistep process was used to construct the Four Facet Mindful Eating Scale (FFaMES). Study 1 outlined the initial scale construction and the development of a novel item pool (N = 480). Study 2 examined the internal structure of the observed variables using exploratory analysis (N = 445) and confirmatory analysis in a separate sample (N = 445). Reliability and validity were assessed in Study 3 (N = 166). RESULTS The final scale consists of 29 items with 4 factors: Non-Reactance, Non-Judgment, External Awareness, and Internal Awareness. The FFaMES demonstrated good internal consistency, retest reliability as well as preliminary convergent and divergent validity. CONCLUSIONS Our findings provide reliability evidence and initial support for the construct validity of the FFaMES and the continued study of multiple facets of eating-specific mindfulness. Future research should continue to investigate the differential effects of various aspects of eating-specific mindfulness in the prevention and treatment of obesity and its comorbidities.
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Affiliation(s)
- Kimberly Carrière
- McGill University (Department of Psychology), Montreal, Quebec, Canada.
| | | | - Nellie Siemers
- McGill University (Department of Psychology), Montreal, Quebec, Canada
| | | | - Joshua Starr
- McGill University (Department of Psychology), Montreal, Quebec, Canada
| | - Carl Falk
- McGill University (Department of Psychology), Montreal, Quebec, Canada
| | - Bärbel Knäuper
- McGill University (Department of Psychology), Montreal, Quebec, Canada
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Meadows AD, Swanson SA, Galligan TM, Naidenko OV, O’Connell N, Perrone-Gray S, Leiba NS. Packaged Foods Labeled as Organic Have a More Healthful Profile Than Their Conventional Counterparts, According to Analysis of Products Sold in the U.S. in 2019-2020. Nutrients 2021; 13:3020. [PMID: 34578899 PMCID: PMC8469099 DOI: 10.3390/nu13093020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022] Open
Abstract
The organic food market's recent rapid global growth reflects the public's interest in buying certified organic foods, including packaged products. Our analysis shows that packaged foods containing fewer ingredients associated with negative public health outcomes are more likely to be labeled organic. Previous studies comparing organic and conventional foods focused primarily on nutrient composition. We expanded this research by additionally examining ingredient characteristics, including processing and functional use. Our dataset included nutrition and ingredient data for 8240 organic and 72,205 conventional food products sold in the U.S. from 2019 to 2020. Compared to conventional foods, organic foods in this dataset had lower total sugar, added sugar, saturated fat and sodium content. Using a mixed effects logistic regression, we found that likelihood of classification as organic increased as sodium content, added sugar content and the number of ultra-processed ingredients and cosmetic additives on the product label decreased. Products containing no trans-fat ingredients were more likely to be labeled organic. A product was more likely to be classified "organic" the more potassium it contained. These features of organic foods sold in the U.S. are significant because lower dietary ingestion of ultra-processed foods, added sugar, sodium and trans-fats is associated with improved public health outcomes.
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Affiliation(s)
- Aurora Dawn Meadows
- Environmental Working Group, Washington, DC 20009, USA; (S.A.S.); (T.M.G.); (O.V.N.)
| | - Sydney A. Swanson
- Environmental Working Group, Washington, DC 20009, USA; (S.A.S.); (T.M.G.); (O.V.N.)
| | - Thomas M. Galligan
- Environmental Working Group, Washington, DC 20009, USA; (S.A.S.); (T.M.G.); (O.V.N.)
| | - Olga V. Naidenko
- Environmental Working Group, Washington, DC 20009, USA; (S.A.S.); (T.M.G.); (O.V.N.)
| | - Nathaniel O’Connell
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC 27109, USA;
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Camacho-Barcia L, Munguía L, Lucas I, de la Torre R, Salas-Salvadó J, Pintó X, Corella D, Granero R, Jiménez-Murcia S, González-Monje I, Esteve-Luque V, Cuenca-Royo A, Gómez-Martínez C, Paz-Graniel I, Forcano L, Fernández-Aranda F. Metabolic, Affective and Neurocognitive Characterization of Metabolic Syndrome Patients with and without Food Addiction. Implications for Weight Progression. Nutrients 2021; 13:nu13082779. [PMID: 34444940 PMCID: PMC8398101 DOI: 10.3390/nu13082779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/18/2022] Open
Abstract
According to the food addiction (FA) model, the consumption of certain types of food could be potentially addictive and can lead to changes in intake regulation. We aimed to describe metabolic parameters, dietary characteristics, and affective and neurocognitive vulnerabilities of individuals with and without FA, and to explore its influences on weight loss progression. The sample included 448 adults (55-75 years) with overweight/obesity and metabolic syndrome from the PREDIMED-Plus cognition sub-study. Cognitive and psychopathological assessments, as well as dietary, biochemical, and metabolic measurements, were assessed at baseline. Weight progression was evaluated after a 3-year follow up. The presence of FA was associated with higher depressive symptomatology, neurocognitive decline, low quality of life, high body mass index (BMI), and high waist circumference, but not with metabolic comorbidities. No differences were observed in the dietary characteristics except for the saturated and monounsaturated fatty acids consumption. After three years, the presence of FA at baseline resulted in a significantly higher weight regain. FA is associated with worse psychological and neurocognitive state and higher weight regain in adults with metabolic syndrome. This condition could be an indicator of bad prognosis in the search for a successful weight loss process.
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Affiliation(s)
- Lucía Camacho-Barcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain or (L.C.-B.); (L.M.); or (I.L.); (S.J.-M.)
| | - Lucero Munguía
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain or (L.C.-B.); (L.M.); or (I.L.); (S.J.-M.)
| | - Ignacio Lucas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain or (L.C.-B.); (L.M.); or (I.L.); (S.J.-M.)
| | - Rafael de la Torre
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Integrative Pharmacology and Neurosciences Systems, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain
- Department of Experimental and Health Sciences (CEXS-UPF), Universitat Pompeu Fabra, 08002 Barcelona, Spain
| | - Jordi Salas-Salvadó
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Human Nutrition Unit, Reus, 43201 Tarragona, Spain
- Institut d’Investigació Pere Virgili (IISPV), Reus, 43204 Tarragona, Spain
- The Sant Joan University Hospital, Human Nutrition Unit, 43201 Reus, Spain
| | - Xavier Pintó
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Lipids and Vascular Risk Unit, Internal Medicine, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain;
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Dolores Corella
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Roser Granero
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain or (L.C.-B.); (L.M.); or (I.L.); (S.J.-M.)
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Inmaculada González-Monje
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Virginia Esteve-Luque
- Lipids and Vascular Risk Unit, Internal Medicine, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | - Aida Cuenca-Royo
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Integrative Pharmacology and Neurosciences Systems, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain
| | - Carlos Gómez-Martínez
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Human Nutrition Unit, Reus, 43201 Tarragona, Spain
- Institut d’Investigació Pere Virgili (IISPV), Reus, 43204 Tarragona, Spain
| | - Indira Paz-Graniel
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Human Nutrition Unit, Reus, 43201 Tarragona, Spain
- Institut d’Investigació Pere Virgili (IISPV), Reus, 43204 Tarragona, Spain
| | - Laura Forcano
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Integrative Pharmacology and Neurosciences Systems, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain or (L.C.-B.); (L.M.); or (I.L.); (S.J.-M.)
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Hospitalet de Llobregat, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +349-3260-7227
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Legendre M, Bégin C. French validation of the addiction-like eating behavior scale and its clinical implication. Eat Weight Disord 2021; 26:1893-1902. [PMID: 33048328 DOI: 10.1007/s40519-020-01039-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 09/29/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The first conception of food addiction (FA) as substance addiction, measured by the Yale Food Addiction Scale (YFAS), is controversial. Some proposed that FA would be better conceptualized with a behavioral approach. In accordance with this conceptualization, Ruddock and colleagues published a new self-reported scale for food addiction, the Addiction-like Eating Behavior Scale (AEBS). Overall, preliminary validation of the scale demonstrated good psychometric properties with a community sample. The aim of the present study is twofold, to validate the French-Canadian version of the AEBS with a community sample and to examine how well the instrument fits into a clinical sample with overweight/obesity. METHODS A community sample (N = 466) and a clinical sample with overweight/obesity seeking help for their eating difficulties (N = 126) completed an online survey regarding FA, binge eating, dietary restraint, depression, and BMI. Factor analysis, internal consistency, and construct validity were assessed. RESULTS With the community sample, factorial structure, and psychometric properties of the AEBS were replicated. With the clinical sample, proper convergent validity was demonstrated with the YFAS 2.0 and binge eating, and proper divergent validity was demonstrated with dietary restraint. Among the clinical sample, AEBS explain similar variance of BMI and depression level when compared to YFAS 2.0. CONCLUSION This study provided evidence that the French-Canadian version of the AEBS is a valid measure of food addiction, but it did not permit to establish advantages over YFAS 2.0 with a clinical sample. Clinical implications of the AEBS and FA characteristic are discussed. LEVEL OF EVIDENCE Level V, cross-sectional, descriptive study.
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Affiliation(s)
- Maxime Legendre
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada
| | - Catherine Bégin
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada.
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128
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Schulte EM, Gearhardt AN. Attributes of the food addiction phenotype within overweight and obesity. Eat Weight Disord 2021; 26:2043-2049. [PMID: 33128719 DOI: 10.1007/s40519-020-01055-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/14/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Previous studies have demonstrated overlapping behavioral features between substance-use disorders and food addiction, the latter of which is particularly prevalent among individuals with overweight or obesity. However, the unique attributes of food addiction as a possible phenotype within overweight and obesity are not fully understood. METHODS This cross-sectional study recruited participants (n = 46) with overweight or obesity, nearly half (n = 20) of whom met the criteria for food addiction based on the Yale Food Addiction Scale 2.0 (YFAS 2.0) and examined responses to self-report questionnaires that indexed behavioral characteristics relevant to addictive disorders. RESULTS Individuals with food addiction exhibited significantly higher scores on the Palatable Eating Motives Scale overall score (p < .001) and subscales for coping (p < .001) and enhancement (p < .001) of emotions, Dutch Eating Behavior Questionnaire Emotional Eating subscale (p < .001), UPPS-P Impulsivity Scale negative urgency (p < .001) and lack of perseverance (p = .01) subscales, and the Food Craving Inventory overall score (p = .02) and subscales of cravings for sweets (p < .01) and fast food fats (p = .02). CONCLUSION Food addiction appears to represent a distinct phenotype within overweight and obesity, marked by greater emotion dysregulation, impulsivity, and cravings, which have been observed in prior studies examining features of individuals with addictive disorders. LEVEL OF EVIDENCE Level III: Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Erica M Schulte
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA. .,Department of Psychiatry, Perelman School of Medicine, 3535 Market Street, Suite 3032, Philadelphia, PA, 19104, USA.
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA
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130
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Epstein LH, Carr KA. Food reinforcement and habituation to food are processes related to initiation and cessation of eating. Physiol Behav 2021; 239:113512. [PMID: 34217735 DOI: 10.1016/j.physbeh.2021.113512] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/25/2021] [Accepted: 06/28/2021] [Indexed: 01/11/2023]
Abstract
An individual bout of eating involves cues to start eating, as well as cues to terminate eating. One process that determines initiation of eating is food reinforcement. Foods with high reinforcing value are also likely to be consumed in greater quantities. Research suggests both cross-sectional and prospective relationships between food reinforcement and obesity, food reinforcement is positively related to energy intake, and energy intake mediates the relationship between food reinforcement and obesity. A process related to cessation of eating is habituation. Habituation is a general behavioral process that describes a reduction in physiological or affective response to a stimulus, or a reduction in the behavioral responding to obtain a stimulus. Repeated exposure to the same food during a meal can result in habituation to that food and a reduction in consumption. Habituation is also cross-sectionally and prospectively related to body weight, as people who habituate slower consume more in a meal and are more overweight. Research from our laboratory has shown that these two processes independently influence eating, as they can account for almost 60% of the variance in ad libitum intake. In addition, habituation phenotypes show reliable relationships with reinforcing value, such that people who habituate faster also find food less reinforcing. Developing a better understanding of cues to start and stop eating is fundamental to understanding how to modify eating behavior. An overview of research on food reinforcement, habituation and food intake for people with a range of weight status and without eating disorders is provided, and ideas about integrating these two processes that are related to initiation and termination of a bout of eating are discussed.
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Affiliation(s)
- Leonard H Epstein
- Jacobs School of Medicine and Biomedical Sciences, Department of Pediatrics, University at Buffalo, G56 Farber Hall, 3435 Main Street, Building #26, Buffalo, New York 14214-3000, USA.
| | - Katelyn A Carr
- Jacobs School of Medicine and Biomedical Sciences, Department of Pediatrics, University at Buffalo, G56 Farber Hall, 3435 Main Street, Building #26, Buffalo, New York 14214-3000, USA.
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131
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Decoding the Role of Gut-Microbiome in the Food Addiction Paradigm. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136825. [PMID: 34202073 PMCID: PMC8297196 DOI: 10.3390/ijerph18136825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 12/12/2022]
Abstract
Eating behaviour is characterised by a solid balance between homeostatic and hedonic regulatory mechanisms at the central level and highly influenced by peripheral signals. Among these signals, those generated by the gut microbiota have achieved relevance in recent years. Despite this complex regulation, under certain circumstances eating behaviour can be deregulated becoming addictive. Although there is still an ongoing debate about the food addiction concept, studies agree that patients with eating addictive behaviour present similar symptoms to those experienced by drug addicts, by affecting central areas involved in the control of motivated behaviour. In this context, this review tries to summarise the main data regarding the role of the gut microbiome in eating behaviour and how a gut dysbiosis can be responsible for a maladaptive behaviour such as “food addiction”.
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Abstract
As ultraprocessed foods (i.e., foods composed of mostly cheap industrial sources of dietary energy and nutrients plus additives) have become more abundant in our food supply, rates of obesity and diet-related disease have increased simultaneously. Food addiction has emerged as a phenotype of significant empirical interest within the past decade, conceptualized most commonly as a substance-based addiction to ultraprocessed foods. We detail (a) how approaches used to understand substance-use disorders may be applicable for operationalizing food addiction, (b) evidence for the reinforcing potential of ingredients in ultraprocessed foods that may drive compulsive consumptions, (c) the utility of conceptualizing food addiction as a substance-use disorder versus a behavioral addiction, and (d) clinical and policy implications that may follow if ultraprocessed foods exhibit an addictive potential. Broadly, the existing literature suggests biological and behavioral parallels between food addiction and substance addictions, with ultraprocessed foods high in both added fat and refined carbohydrates being most implicated in addictive-like eating. Future research priorities are also discussed, including the need for longitudinal studies and the potential negative impact of addictive ultraprocessed foods on children. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109, USA;
| | - Erica M Schulte
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
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Som M, Constant A, Zayani T, Pabic EL, Moirand R, Val-Laillet D, Thibault R. Food addiction among morbidly obese patients: prevalence and links with obesity complications. J Addict Dis 2021; 40:103-110. [PMID: 34130613 DOI: 10.1080/10550887.2021.1939630] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND In the context of obesity, little is known about the prevalence of food addiction nor about the phenotype of obese patients with food addiction. Objectives: To assess: (i) the prevalence of food addiction among obese patients eligible for obesity surgery; (ii) the relationship between clinical features and the complications of obesity. Methods: Consecutive patients consulting for the first time were included. The Yale Food Addiction Scale (YFAS) 2.0 questionnaire was used to diagnose food addiction and its severity. Demographics, clinical features, and obesity complications were systematically collected. Statistics: Student's test was used for numerical variables and Chi-square test or Fisher's exact test for categorical variables. Results: A total of 292 patients were included: 79% female, age (mean ± SD) 42.6 ± 13.0 yrs., body mass index (BMI) 43.2 ± 6.8 kg/m2. One hundred and eight patients (37%) had food addiction: 58% severe, 33% moderate, 9% mild. Food addiction prevalence was 39% (n = 61/156) among patients eligible for obesity surgery. Food addiction was more frequent among the unemployed, compared to professionally active patients (41.0% vs. 33.5%, p = 0.046). Clinical and metabolic phenotypes and obesity complications were similar between patients with and without food addiction. Conclusion: Food addiction was present in 37% of obese patients, but was not associated with clinical features or obesity complications. Therefore, it should be systemically assessed for appropriate management.
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Affiliation(s)
- Mickaël Som
- INRAE, INSERM, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France.,Unité de Nutrition, service Endocrinologie-Diabétologie-Nutrition, CHU Rennes, Rennes, France
| | - Aymery Constant
- INRAE, INSERM, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France.,EHESP, School of Public Health, Rennes, France
| | - Teycir Zayani
- INRAE, INSERM, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
| | | | - Romain Moirand
- INRAE, INSERM, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France.,Unitéd' Addictologie, service des maladies du foie, CHU Rennes, Rennes, France
| | - David Val-Laillet
- INRAE, INSERM, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
| | - Ronan Thibault
- INRAE, INSERM, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France.,Unité de Nutrition, service Endocrinologie-Diabétologie-Nutrition, CHU Rennes, Rennes, France
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Bansal S, Connolly M, Harder T. Impact of a Whole-Foods, Plant-Based Nutrition Intervention on Patients Living with Chronic Disease in an Underserved Community. Am J Lifestyle Med 2021; 16:382-389. [DOI: 10.1177/15598276211018159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The current study evaluated the impact of a whole-foods, plant-based nutrition intervention on metabolic markers of patients with chronic disease in an underserved community setting. A retrospective analysis of metabolic biomarkers preintervention and postintervention was conducted on 31 patients with metabolic disease who attended an Eating for Life group visit series. Significant decreases were found for body mass index (BMI; −0.66 [−0.91 to −0.40] kg/m2), systolic blood pressure (−12 [−19 to −5] mm Hg), total cholesterol (−20 [−29 to −10] mg/dL), low-density lipoprotein (LDL; −11.6 [−17.5 to −5.5] mg/dL), and high-density lipoprotein (HDL; −3.2 [−5.7 to −0.7] mg/dL, all Ps < .01). In participants with clinically abnormal preintervention data, the mean (95% CI) change significantly decreased for overweight (−0.45 [−0.85 to −0.05]) and obese (−0.76 [−1.13 to −0.39]) BMI, systolic blood pressure (−12 [−19 to −5] mm Hg), total cholesterol −22 [−40 to −4] mg/dL), and LDL (−15.6 [−23.8 to −7.4] mg/dL, all Ps ≤ .03). In conclusion, the Eating for Life model showed significant improvement in BMI, diastolic blood pressure, total cholesterol, and LDL in a federally qualified health center population. Group visits advocating for a whole-foods, plant-based diet may be effective in reducing chronic disease burden in underserved communities.
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Affiliation(s)
- Shipra Bansal
- A.T. Still University, School of Osteopathic Medicine in Arizona, Mesa, Arizona
- North Country HealthCare, Flagstaff, Arizona
| | - Meaghan Connolly
- A.T. Still University, School of Osteopathic Medicine in Arizona, Mesa, Arizona
- North Country HealthCare, Flagstaff, Arizona
| | - Tasha Harder
- A.T. Still University, School of Osteopathic Medicine in Arizona, Mesa, Arizona
- North Country HealthCare, Flagstaff, Arizona
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Leung CW, Peterson KE. Moving the Needle for Vegetable Consumption: Addressing Influences at Both Ends of the Social-Ecologic Model. J Nutr 2021; 151:1373-1374. [PMID: 33979834 DOI: 10.1093/jn/nxab124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Cindy W Leung
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.,Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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136
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The food craving inventory in an Iranian population: post-hoc validation and individual differences. Eat Weight Disord 2021; 26:1529-1539. [PMID: 32749572 DOI: 10.1007/s40519-020-00976-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 07/28/2020] [Indexed: 01/06/2023] Open
Abstract
PURPOSE The present study was performed to develop the Persian version of food craving inventory (FCI) (FCI-P) and to assess food craving in Iranian adult population. In addition, individual differences, including sex and body mass index (BMI) in food craving were assessed. METHODS Eight hundred and twenty subjects who participated in the same study Hill (Proc Nutr Soc 66: 277-285, 2007) were studied (540 women and 280 men). The FCI-P, International Physical Activity Questionnaire (IPAQ), Three-Factor Eating Questionnaire (TFEQ), and a questionnaire pertaining to demographic characteristics were completed for all participants. RESULTS Good content, construct, and convergent validity was observed for the FCI-P. A good reliability was found for both aggregate scores of the FCI-P and scores of its five factors. Exploratory factor analysis showed a five-factor model including "sweets," "high-fat foods," "fast food fats," "carbohydrates/starches" and "high-fat meats". These five factors accounted for 47.31% of the total variance. The scores of "uncontrolled eating" and "emotional eating" of the TFEQ were significantly correlated with the scores of the FCI-P factors and its total score. A significant correlation was found between BMI and the FCI-P score (r = 0.199). Significant differences were observed in the mean age and physical activity score among normal weight, overweight, and obese participants. Normal weight and overweight groups were more active than obese group. Obese participants had higher FCI-P score (P < 0.001) than the normal and overweight groups. FCI-P score was significantly higher in women than men. CONCLUSIONS FCI-P can be used as a valid and reliable measure to assess food craving in Iranian populations. Obese individuals experienced food craving more than normal weight subjects. Similarly, women may experience food craving more than men. LEVEL OF EVIDENCE Level V, cross sectional study.
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137
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Neff KMH, Fay A, Saules KK. Foods and Nutritional Characteristics Associated With Addictive-Like Eating. Psychol Rep 2021; 125:1937-1956. [PMID: 33934668 DOI: 10.1177/00332941211014156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Emerging literature is exploring the contribution of specific nutritional characteristics and food additives to the development of addictive-like eating, implicating highly processed foods and those high in fat and sugar in its pathophysiology. To our knowledge, no mixed methods study has yet aimed to investigate the relationship between food characteristics and addictive-like eating. Towards this end, we applied an a priori classification scheme to open-ended answers to enable us to use quantitative methods to analyze qualitative data. A sample of individuals who endorsed self-perceived "food addiction" (N = 182; 50% female; Mage = 34.1) reported the foods to which they believed they were "addicted." We classified these foods according to their levels of fat, carbohydrates, sugar, and sodium, and evaluated their predictive power on addictive-like eating. Pizza, chocolate, hamburgers, and pasta respectively, were the most reported food items to which participants felt they were addicted. Addictive-like eating was significantly predicted by endorsement of "addiction" to high-sodium foods. In contrast, "addiction" to high-sugar foods negatively predicted addictive-like eating symptoms. Findings support an association between highly processed and high-sodium foods with addictive-like eating behavior among humans, consistent in large part with prior human and animal literature. Results also suggest that people are readily able to report on their experiences of addiction to foods; specifically, they can freely endorse the experience of addictive-like eating and offer experiences of addictive foods that are largely consistent with theory and the literature.
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Affiliation(s)
- Kirstie M Herb Neff
- Department of Psychology, 8759Eastern Michigan University, Ypsilanti, MI, USA
| | - Angela Fay
- Department of Psychology, 8759Eastern Michigan University, Ypsilanti, MI, USA
| | - Karen K Saules
- Department of Psychology, 8759Eastern Michigan University, Ypsilanti, MI, USA
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138
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Banerjee A, Mukherjee S, Maji BK. Worldwide flavor enhancer monosodium glutamate combined with high lipid diet provokes metabolic alterations and systemic anomalies: An overview. Toxicol Rep 2021; 8:938-961. [PMID: 34026558 PMCID: PMC8120859 DOI: 10.1016/j.toxrep.2021.04.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/20/2021] [Accepted: 04/25/2021] [Indexed: 12/13/2022] Open
Abstract
Flavor enhancing high lipid diet acts as silent killer. Monosodium glutamate mixed with high lipid diet alters redox-status. Monosodium glutamate mixed with high lipid diet induces systemic anomalies.
In this fast-food era, people depend on ready-made foods and engage in minimal physical activities that ultimately change their food habits. Majorities of such foods have harmful effects on human health due to higher percentages of saturated fatty acids, trans-fatty acids, and hydrogenated fats in the form of high lipid diet (HLD). Moreover, food manufacturers add monosodium glutamate (MSG) to enhance the taste and palatability of the HLD. Both MSG and HLD induce the generation of reactive oxygen species (ROS) and thereby alter the redox-homeostasis to cause systemic damage. However, MSG mixed HLD (MH) consumption leads to dyslipidemia, silently develops non-alcoholic fatty liver disease followed by metabolic alterations and systemic anomalies, even malignancies, via modulating different signaling pathways. This comprehensive review formulates health care strategies to create global awareness about the harmful impact of MH on the human body and recommends the daily consumption of more natural foods rich in antioxidants instead of toxic ingredients to counterbalance the MH-induced systemic anomalies.
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139
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Horsager C, Faerk E, Lauritsen MB, Østergaard SD. Food addiction comorbid to mental disorders: A nationwide survey and register-based study. Int J Eat Disord 2021; 54:545-560. [PMID: 33458821 DOI: 10.1002/eat.23472] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Substance use disorder is highly prevalent among individuals with mental disorders. However, it remains largely unknown whether this is also the case for "food addiction"-a phenotype characterized by an addiction-like attraction to predominantly highly processed foods with a high content of refined carbohydrates and fat. Therefore, the primary aim of this study was to estimate the weighted prevalence of food addiction among individuals with mental disorders. METHOD A total of 5,000 individuals aged 18-62 were randomly drawn from eight categories of major mental disorders from the Danish Psychiatric Central Research Register and invited to participate in an online questionnaire-based survey, which included the Yale Food Addiction Scale 2.0. Data on health care and sociodemographics from the Danish registers were linked to all invitees-enabling comprehensive attrition analysis and calculation of the weighted prevalence of food addiction. RESULTS A total of 1,394 (27.9%) invitees participated in the survey. Across all diagnostic categories, 23.7% met the criteria for food addiction. The weighted prevalence of food addiction was highest among individuals with eating disorders (47.7%, 95%CI: 41.2-54.2), followed by affective disorders (29.4%, 95%CI: 22.9-36.0) and personality disorders (29.0%, 95%CI: 22.2-35.9). When stratifying on sex, the prevalence of food addiction was higher among women in most diagnostic categories. DISCUSSION Food addiction is highly prevalent among individuals with mental disorders, especially in those with eating disorders, affective disorders and personality disorders. Food addiction may be an important target for efforts aimed at reducing obesity among individuals with mental disorders.
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Affiliation(s)
- Christina Horsager
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Emil Faerk
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark
| | - Marlene Briciet Lauritsen
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Søren Dinesen Østergaard
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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140
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Mason AE, Schmidt L, Ishkanian L, Jacobs LM, Leung C, Jensen L, Cohn MA, Schleicher S, Hartman AR, Wojcicki JM, Lustig RH, Epel ES. A Brief Motivational Intervention Differentially Reduces Sugar-sweetened Beverage (SSB) Consumption. Ann Behav Med 2021; 55:1116-1129. [PMID: 33778854 PMCID: PMC8557363 DOI: 10.1093/abm/kaaa123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Environmental and behavioral interventions hold promise to reduce sugar-sweetened beverage (SSBs) consumption. Purpose To test, among frequent SSB consumers, whether motivations to consume SSBs moderated the effects of (a) a workplace SSB sales ban (environmental intervention) alone, and (b) a “brief motivational intervention” (BI) in addition to the sales ban, on changes in SSB consumption. Methods We assessed whether (1) baseline motivations to consume SSBs (craving, psychological stress, or taste enjoyment) impacted changes in daily SSB consumption at 6-month follow-up among frequent (>12oz of SSBs/day) SSB consumers (N = 214); (2) participants randomized to the BI (n = 109) versus to the sales ban only (n = 105) reported greater reductions in SSB consumption at follow-up; and (3) motivations to consume SSBs moderated any changes in SSB consumption. Results In response to the sales ban alone, individuals with stronger SSB cravings (+1 SD) at baseline showed significantly smaller reductions in daily SSB consumption at 6-month follow-up relative to individuals with weaker (−1 SD) SSB cravings (2.5 oz vs. 22.5 oz), p < .01. Receiving the BI significantly increased reductions for those with stronger SSB cravings: Among individuals with stronger cravings, those who received the BI evidenced significantly greater reductions in daily SSB consumption [M(SE) = −19.2 (2.74) oz] than those who did not [M(SE) = −2.5 (2.3) oz, p < .001], a difference of 16.72 oz. Conclusions Frequent SSB consumers with stronger SSB cravings report minimal reductions in daily SSB consumption with a sales ban only, but report greater reductions if they also receive a motivational intervention. Future multilevel interventions for institutions should consider both environmental and individualized multi-level interventions. Clinical Trial information NCT02585336.
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Affiliation(s)
- Ashley E Mason
- Osher Center for Integrative Medicine, University of California San Francisco (UCSF), San Francisco, USA.,Department of Psychiatry, UCSF, San Francisco, USA
| | - Laura Schmidt
- Phillip R. Lee Institute for Health Policy Studies, UCSF, San Francisco, USA
| | - Laura Ishkanian
- Campus Life Services, UCSF Wellness Program, UCSF, San Francisco, USA
| | - Laurie M Jacobs
- Phillip R. Lee Institute for Health Policy Studies, UCSF, San Francisco, USA
| | - Cindy Leung
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, USA
| | - Leeane Jensen
- Campus Life Services, UCSF Wellness Program, UCSF, San Francisco, USA
| | - Michael A Cohn
- Osher Center for Integrative Medicine, University of California San Francisco (UCSF), San Francisco, USA
| | | | - Alison R Hartman
- Department of Psychology, College of Arts & Sciences, Drexel University, Philadelphia, USA
| | | | - Robert H Lustig
- Phillip R. Lee Institute for Health Policy Studies, UCSF, San Francisco, USA.,Department of Pediatrics, UCSF, San Francisco, USA
| | - Elissa S Epel
- Osher Center for Integrative Medicine, University of California San Francisco (UCSF), San Francisco, USA.,Department of Psychiatry, UCSF, San Francisco, USA.,Phillip R. Lee Institute for Health Policy Studies, UCSF, San Francisco, USA.,Department of Psychiatry, Center for Health and Community, UCSF, San Francisco, USA
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141
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Shim JS, Shim SY, Cha HJ, Kim J, Kim HC. Socioeconomic Characteristics and Trends in the Consumption of Ultra-Processed Foods in Korea from 2010 to 2018. Nutrients 2021; 13:1120. [PMID: 33805412 PMCID: PMC8065678 DOI: 10.3390/nu13041120] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 12/21/2022] Open
Abstract
There is growing evidence for a global transition to a more highly processed diet. While the dietary share of ultra-processed foods depends on a country's economic status, food choice and consumption are also influenced by the socioeconomic situation of individuals. This study investigated whether ultra-processed food consumption differed across socioeconomic subgroups and over time (2010-2018) in Korea. Cross-sectional data from the Korea National Health and Nutrition Examination Survey 2010-2018 were analyzed. Food and beverages reported in a one-day 24 h recall were classified according to the NOVA food classification criteria. The dietary energy contribution of ultra-processed foods was high among men and urban residents, and increased with education and income level; additionally, it reached its peak in adolescents and thereafter decreased with increasing age. After adjusting the socioeconomic variables, such associations remained significant, except for income level. The overall contribution of ultra-processed foods increased from 23.1% (2010-2012) to 26.1% (2016-2018), and the same trend over time was observed in all age groups and socioeconomic strata. In the Korean population, ultra-processed food consumption differed by individual socioeconomic characteristics, but gradually increased over time, and this trend was consistently found in all socioeconomic subgroups. Future strategies to promote healthy food choices are needed for the Korean population.
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Affiliation(s)
- Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.-J.C.); (H.C.K.)
| | - Sun-Young Shim
- Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea;
| | - Hee-Jeung Cha
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.-J.C.); (H.C.K.)
| | - Jinhee Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon 16499, Korea;
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.-J.C.); (H.C.K.)
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142
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Halberg SE, Visek AJ, Blake EF, Essel KD, Sacheck J, Sylvetsky AC. SODA MAPS: A Framework for Understanding Caffeinated Sugary Drink Consumption Among Children. Front Nutr 2021; 8:640531. [PMID: 33777993 PMCID: PMC7988216 DOI: 10.3389/fnut.2021.640531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/16/2021] [Indexed: 12/15/2022] Open
Abstract
Excess sugary drink (SD) consumption is associated with childhood obesity and development of cardiometabolic disease. In addition to having high added sugar content, many SDs also contain caffeine, which may further encourage excess SD consumption among children. The objective of this study was to develop a conceptual framework of children's caffeinated SD consumption using group concept mapping, an applied social research multimethodology that collectively harnesses qualitative and quantitative data from participants to generate a visual representation of their ideas and input. Children, 8–14 years old, who reported consuming ≥12 ounces of caffeinated SDs (e.g., sodas, sweet teas) per day were recruited throughout Washington, D.C. and invited to participate. Concept mapping included three participant-driven activities: (1) brainstorming (n = 51), during which children reported reasons for their SD consumption, from which 58 unique reasons were identified; (2) sorting (n = 70), during which children sorted each of the reported reasons into categories and named each category; and (3) rating (n = 74), during which children rated the influence of each reason on their own caffeinated SD consumption. Similarity matrices, multidimensional scaling, and hierarchical cluster analysis were used to generate concept maps (hereafter “SODA MAPS”), which display the 58 reasons organized within eight overarching clusters. Among these eight clusters, Taste and Feel, Something to Do, and Energy were rated as particularly influential. Children's caffeinated SD consumption is encouraged not only by the palatable taste and reported preferences for these beverages (e.g., Taste and Feel), but also by psychological (e.g., Mood and Focus), biological (e.g., Energy), social (e.g., Something to Do) and environmental reasons (e.g., Nothing Better Available). Thus, the SODA MAPS can inform the development of tailored, multi-level SD reduction interventions that incorporate strategies to address important and currently overlooked reasons for caffeinated SD consumption among children.
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Affiliation(s)
- Sabrina E Halberg
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Amanda J Visek
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Emily F Blake
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States.,Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, United States
| | - Kofi D Essel
- School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States.,Division of General and Community Pediatrics, Children's National Hospital, Washington, DC, United States
| | - Jennifer Sacheck
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Allison C Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
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143
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Voegtle E, Dombret S, Bonabi A, Friederich HC, Brockmeyer T. Approach avoidance training to curb consumption of sugar-sweetened beverages - A pilot randomized controlled trial in healthy volunteers. Appetite 2021; 162:105194. [PMID: 33705891 DOI: 10.1016/j.appet.2021.105194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 11/29/2022]
Abstract
Elevated consumption of sugar-sweetened beverages (SSBs) contributes to overweight and obesity. Automatic action tendencies like an approach bias might promote the consumption of SSBs. We investigated whether an Approach-Avoidance Training (AAT) reduces this approach bias and related behaviors like craving for and consumption of SSBs. Fifty-six healthy participants, with a self-reported SSB consumption of at least 330 ml per day, were randomized to 6 sessions of real or sham AAT. In the real AAT condition, participants were trained to react with avoidance movements to pictures of SSBs in an implicit learning paradigm (i.e. participants were instructed to respond to a task-irrelevant feature), whereas in the sham AAT condition the same pictures were used but no systematic (avoidance) reaction was trained. Approach bias, craving for SSB and SSB intake in a bogus taste test were assessed. Real AAT was not superior to sham AAT in any outcome measure. AAT in its current form and as a stand-alone intervention does not appear to be effective in reducing SSB consumption.
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Affiliation(s)
- Elisabeth Voegtle
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Goettingen, Goettingen, Germany
| | - Sophia Dombret
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Anahita Bonabi
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Goettingen, Goettingen, Germany
| | - Hans-Christoph Friederich
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Timo Brockmeyer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Goettingen, Goettingen, Germany; Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
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144
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Schiestl ET, Rios JM, Parnarouskis L, Cummings JR, Gearhardt AN. A narrative review of highly processed food addiction across the lifespan. Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110152. [PMID: 33127423 PMCID: PMC7750273 DOI: 10.1016/j.pnpbp.2020.110152] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/20/2020] [Accepted: 10/21/2020] [Indexed: 12/17/2022]
Abstract
Evidence is growing that highly processed (HP) foods (i.e., foods high in refined carbohydrates and fat) are highly effective in activating reward systems and may even be capable of triggering addictive processes. Unlike traditional drugs of abuse, exposure to HP foods is common very early in development. HP food addiction has been associated with negative outcomes, including higher body mass index (BMI), more frequent binge eating, greater failure in weight loss treatment trials, and poorer mental and physical health. Although most research on HP food addiction has been conducted using adult samples, research on this topic now spans across the life span beginning in utero and extending through older adulthood. HP food addiction and related reward-based changes are associated with negative outcomes at every life stage, which has important implications for developmentally tailored prevention and treatment efforts. Using a developmentally informed approach, the current study comprehensively reviews the existing research on HP food addiction across the lifespan and highlights important areas of future research.
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Affiliation(s)
| | - Julia M Rios
- University of Michigan, United States of America
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145
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Obesity in COVID-19 era, implications for mechanisms, comorbidities, and prognosis: a review and meta-analysis. Int J Obes (Lond) 2021; 45:998-1016. [PMID: 33637951 PMCID: PMC7909378 DOI: 10.1038/s41366-021-00776-8] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/27/2020] [Accepted: 01/26/2021] [Indexed: 02/07/2023]
Abstract
Background Recent studies have shown that obesity is associated with the severity of coronavirus disease (COVID-19). We reviewed clinical studies to clarify the obesity relationship with COVID-19 severity, comorbidities, and discussing possible mechanisms. Materials and methods The electronic databases, including Web of Science, PubMed, Scopus, and Google Scholar, were searched and all studies conducted on COVID-19 and obesity were reviewed. All studies were independently screened by reviewers based on their titles and abstracts. Results Forty relevant articles were selected, and their full texts were reviewed. Obesity affects the respiratory and immune systems through various mechanisms. Cytokine and adipokine secretion from adipose tissue leads to a pro-inflammatory state in obese patients, predisposing them to thrombosis, incoordination of innate and adaptive immune responses, inadequate antibody response, and cytokine storm. Obese patients had a longer virus shedding. Obesity is associated with other comorbidities such as hypertension, cardiovascular diseases, diabetes mellitus, and vitamin D deficiency. Hospitalization, intensive care unit admission, mechanical ventilation, and even mortality in obese patients were higher than normal-weight patients. Obesity could alter the direction of severe COVID-19 symptoms to younger individuals. Reduced physical activity, unhealthy eating habits and, more stress and fear experienced during the COVID-19 pandemic may result in more weight gain and obesity. Conclusions Obesity should be considered as an independent risk factor for the severity of COVID-19. Paying more attention to preventing weight gain in obese patients with COVID-19 infection in early levels of disease is crucial during this pandemic.
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Appetite self-regulation declines across childhood while general self-regulation improves: A narrative review of the origins and development of appetite self-regulation. Appetite 2021; 162:105178. [PMID: 33639246 DOI: 10.1016/j.appet.2021.105178] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 02/07/2023]
Abstract
This narrative review discusses the origins and development of appetite self-regulation (ASR) in childhood (from infancy to age 6 or 7 years). The origins, or foundations, are the biological infrastructure associated with appetite regulation and appetite self-regulation. Homeostatic regulation in infancy is examined and then evidence about developmental change in components of ASR. The main ASR-related components covered are: delay-of-gratification, caloric compensation, eating in the absence of hunger, food responsiveness/hedonics and fussy eating. The research included behavioral measures, parent-reports of appetitive traits and fMRI studies. There were two main trends in the evidence: a decline across childhood in the components of ASR associated with food approach (and therefore an increase in disinhibited eating), and wide individual differences. The decline in ASR contrasts with general self-regulation (GSR) where the evidence is of an improvement across childhood. For many children, bottom-up automatic reactive processes via food reward/hedonics or food avoidance as in fussy eating, appear not to be matched by improvements in top-down regulatory capacities. The prominence of bottom-up processes in ASR could be the main factor in possible differences in developmental paths for GSR and ASR. GSR research is situated in developmental science with its focus on developmental processes, theory and methodology. In contrast, the development of ASR at present does not have a strong developmental tradition to access and there is no unifying model of ASR and its development. We concluded (1) outside of mean-level or normative changes in the components of ASR, individual differences are prominent, and (2) there is a need to formulate models of developmental change in ASR together with appropriate measurement, research designs and data analysis strategies.
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Moreau M, Benhaddou S, Dard R, Tolu S, Hamzé R, Vialard F, Movassat J, Janel N. Metabolic Diseases and Down Syndrome: How Are They Linked Together? Biomedicines 2021; 9:biomedicines9020221. [PMID: 33671490 PMCID: PMC7926648 DOI: 10.3390/biomedicines9020221] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 12/13/2022] Open
Abstract
Down syndrome is a genetic disorder caused by the presence of a third copy of chromosome 21, associated with intellectual disabilities. Down syndrome is associated with anomalies of both the nervous and endocrine systems. Over the past decades, dramatic advances in Down syndrome research and treatment have helped to extend the life expectancy of these patients. Improved life expectancy is obviously a positive outcome, but it is accompanied with the need to address previously overlooked complications and comorbidities of Down syndrome, including obesity and diabetes, in order to improve the quality of life of Down syndrome patients. In this focused review, we describe the associations between Down syndrome and comorbidities, obesity and diabetes, and we discuss the understanding of proposed mechanisms for the association of Down syndrome with metabolic disorders. Drawing molecular mechanisms through which Type 1 diabetes and Type 2 diabetes could be linked to Down syndrome could allow identification of novel drug targets and provide therapeutic solutions to limit the development of metabolic and cognitive disorders.
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Affiliation(s)
- Manon Moreau
- Laboratoire Processus Dégénératifs, Université de Paris, BFA, UMR 8251, CNRS, Stress et Vieillissemen, F-75013 Paris, France; (M.M.); (S.B.); (R.D.)
| | - Soukaina Benhaddou
- Laboratoire Processus Dégénératifs, Université de Paris, BFA, UMR 8251, CNRS, Stress et Vieillissemen, F-75013 Paris, France; (M.M.); (S.B.); (R.D.)
| | - Rodolphe Dard
- Laboratoire Processus Dégénératifs, Université de Paris, BFA, UMR 8251, CNRS, Stress et Vieillissemen, F-75013 Paris, France; (M.M.); (S.B.); (R.D.)
- Genetics Deptartment, CHI Poissy St Germain-en-Laye, F-78300 Poissy, France;
- Université Paris-Saclay, UVSQ, INRAE, ENVA, BREED, F-78350 Jouy-en-Josas, France
| | - Stefania Tolu
- Laboratoire de Biologie et Pathologie du Pancréas Endocrine, Université de Paris, BFA, UMR 8251, CNRS, F-75013 Paris, France; (S.T.); (R.H.); (J.M.)
| | - Rim Hamzé
- Laboratoire de Biologie et Pathologie du Pancréas Endocrine, Université de Paris, BFA, UMR 8251, CNRS, F-75013 Paris, France; (S.T.); (R.H.); (J.M.)
| | - François Vialard
- Genetics Deptartment, CHI Poissy St Germain-en-Laye, F-78300 Poissy, France;
- Université Paris-Saclay, UVSQ, INRAE, ENVA, BREED, F-78350 Jouy-en-Josas, France
| | - Jamileh Movassat
- Laboratoire de Biologie et Pathologie du Pancréas Endocrine, Université de Paris, BFA, UMR 8251, CNRS, F-75013 Paris, France; (S.T.); (R.H.); (J.M.)
| | - Nathalie Janel
- Laboratoire Processus Dégénératifs, Université de Paris, BFA, UMR 8251, CNRS, Stress et Vieillissemen, F-75013 Paris, France; (M.M.); (S.B.); (R.D.)
- Correspondence: ; Tel.: +33-1-57-27-83-60; Fax: +33-1-57-27-83-54
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Ravichandran S, Bhatt RR, Pandit B, Osadchiy V, Alaverdyan A, Vora P, Stains J, Naliboff B, Mayer EA, Gupta A. Alterations in reward network functional connectivity are associated with increased food addiction in obese individuals. Sci Rep 2021; 11:3386. [PMID: 33564081 PMCID: PMC7873272 DOI: 10.1038/s41598-021-83116-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/07/2021] [Indexed: 12/19/2022] Open
Abstract
Functional neuroimaging studies in obesity have identified alterations in the connectivity within the reward network leading to decreased homeostatic control of ingestive behavior. However, the neural mechanisms underlying sex differences in the prevalence of food addiction in obesity is unknown. The aim of the study was to identify functional connectivity alterations associated with: (1) Food addiction, (2) Sex- differences in food addiction, (3) Ingestive behaviors. 150 participants (females: N = 103, males: N = 47; food addiction: N = 40, no food addiction: N = 110) with high BMI ≥ 25 kg/m2 underwent functional resting state MRIs. Participants were administered the Yale Food Addiction Scale (YFAS), to determine diagnostic criteria for food addiction (YFAS Symptom Count ≥ 3 with clinically significant impairment or distress), and completed ingestive behavior questionnaires. Connectivity differences were analyzed using a general linear model in the CONN Toolbox and images were segmented using the Schaefer 400, Harvard-Oxford Subcortical, and Ascending Arousal Network atlases. Significant connectivities and clinical variables were correlated. Statistical significance was corrected for multiple comparisons at q < .05. (1) Individuals with food addiction had greater connectivity between brainstem regions and the orbital frontal gyrus compared to individuals with no food addiction. (2) Females with food addiction had greater connectivity in the salience and emotional regulation networks and lowered connectivity between the default mode network and central executive network compared to males with food addiction. (3) Increased connectivity between regions of the reward network was positively associated with scores on the General Food Cravings Questionnaire-Trait, indicative of greater food cravings in individuals with food addiction. Individuals with food addiction showed greater connectivity between regions of the reward network suggesting dysregulation of the dopaminergic pathway. Additionally, greater connectivity in the locus coeruleus could indicate that the maladaptive food behaviors displayed by individuals with food addiction serve as a coping mechanism in response to pathological anxiety and stress. Sex differences in functional connectivity suggest that females with food addiction engage more in emotional overeating and less cognitive control and homeostatic processing compared to males. These mechanistic pathways may have clinical implications for understanding the sex-dependent variability in response to diet interventions.
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Affiliation(s)
- Soumya Ravichandran
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
| | - Ravi R Bhatt
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, USA
| | - Bilal Pandit
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
| | - Vadim Osadchiy
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
- David Geffen School of Medicine At UCLA, Los Angeles, USA
| | - Anita Alaverdyan
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
| | - Priten Vora
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
| | - Jean Stains
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
- David Geffen School of Medicine At UCLA, Los Angeles, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, USA
| | - Bruce Naliboff
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
- David Geffen School of Medicine At UCLA, Los Angeles, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, USA
- UCLA Microbiome Center, Los Angeles, USA
| | - Emeran A Mayer
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA
- David Geffen School of Medicine At UCLA, Los Angeles, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, USA
- UCLA Microbiome Center, Los Angeles, USA
- Ahmanson-Lovelace Brain Mapping Center, University of California Los Angeles (UCLA), Los Angeles, USA
| | - Arpana Gupta
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, CHS 42-210 MC737818, 10833 Le Conte Avenue, Los Angeles, USA.
- David Geffen School of Medicine At UCLA, Los Angeles, USA.
- Vatche and Tamar Manoukian Division of Digestive Diseases, Los Angeles, USA.
- UCLA Microbiome Center, Los Angeles, USA.
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Gearhardt AN, Hebebrand J. The concept of "food addiction" helps inform the understanding of overeating and obesity: YES. Am J Clin Nutr 2021; 113:263-267. [PMID: 33448279 DOI: 10.1093/ajcn/nqaa343] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 12/15/2022] Open
Abstract
Addictive substances such as opiates and other drugs are highly reinforcing and some (but not all) individuals consume them compulsively. Highly processed (HP) foods have unnaturally high concentrations of refined carbohydrates and fat. These foods are highly reinforcing and some (but not all) individuals consume them compulsively. HP foods, like addictive substances, are more effective in activating reward-related neural systems than minimally processed foods. More importantly, HP foods are associated with the behavioral indicators of addiction: diminished control over consumption, strong craving, continued use despite negative consequences, and repeated failed attempts to reduce or eliminate intake. Thus, HP foods are key in addictive patterns of food intake. Like addictive drugs, HP foods are complex, human-made substances designed to effectively deliver reinforcing ingredients (e.g., refined carbohydrates, fat). Withdrawal and tolerance are not necessary for an addiction classification; however, HP foods can trigger both these processes. On a public health level, the negative consequences of HP foods are high, even for those without clinically relevant levels of addictive eating. The recognition that some foods can be addictive will inform clinical obesity treatment and underscore the importance of environmentally focused policy interventions.
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Affiliation(s)
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
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150
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Hebebrand J, Gearhardt AN. The concept of "food addiction" helps inform the understanding of overeating and obesity: NO. Am J Clin Nutr 2021; 113:268-273. [PMID: 33448280 DOI: 10.1093/ajcn/nqaa344] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Overeating is a complex behavioral phenotype in terms of both physiology and psychology. The mere transference of the diagnostic criteria for substance use disorders to define food addiction is too simplistic, for the following reasons: 1) a range of somatic and mental disorders require exclusion; 2) food addiction requires distinction from the physiological need to ingest sufficient calories to maintain a high body weight; 3) intentional weight loss can induce an eating behavior mimicking food addiction; 4) the concept lacks validation, especially in light of the high prevalence of "food addiction" in patients with anorexia nervosa; and 5) this construct has not led to novel and successful treatments for overeating and obesity. The concept of food addiction has the potential to distract from the need for focus on environmental influencers to combat the obesity pandemic.
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Affiliation(s)
- Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
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