Sweet craving and ghrelin and leptin levels in women during stress

Understanding the experiences of ketogenic metabolic therapy for people living with varying levels of depressive symptoms: a thematic analysis

Background

Evidence suggests that a ketogenic diet (KD) may help to alleviate psychiatric symptoms, including depression and anxiety. Positive changes have been reported such as improvements in cognition, concentration, and sleep, a reduction in hunger, and an increase in well-being, energy, confidence, and resilience. This research aims to understand the impact of a non-calorie-restricted KD on depression and aspects of psychological well-being in those with varying degrees of depressive symptoms. Though there are a few studies directly exploring the experiences of those following a KD, this will be the first study to explore the narrative from a mental health and psychological well-being viewpoint.

Method

A sample of nine participants who had followed a non-calorie restricted KD intervention of 50 g of carbohydrates or less per day for at least 12 weeks were recruited. Participants were split into 'healthy adults' group who had no to low depressive symptoms and 'depressive symptoms' group who had mild to moderate depressive symptoms. A reflexive thematic analysis was considered suitable for this study.

Findings

Five core themes and 24 subthemes were created. These were, (1) Poor health prior to program; (2) Hunger and cravings-the food and mood connection; (3) Psychological well-being improvements; (4) It becomes a lifestyle; and (5) Implementation difficulties. Participants experienced mental health improvements such as increased self-esteem, confidence, motivation, and achievement. Some experienced more control in life and a greater sense of reward. Those with depressive symptoms who initially reported low self-worth and hopelessness later reported increased self-esteem and renewed meaning and purpose in life. The findings from this study reflect the previous reports that the diet implementation can be difficult initially, but soon becomes easy to follow and turns into a lifestyle.

Conclusion

In the literature, there are very few qualitative studies that explore the accounts and lived experiences of those following a KD. From the participants' accounts in this study, it appears that the benefits and positive outcomes of this diet outweigh any negative side-effects experienced. This is encouraging for those who are looking for adjunctive therapies to address and improve their depressive symptoms and overall mental health.

Leptin-dependent differential remodeling of visceral and pericardial adipose tissue following chronic exercise and psychosocial stress

Obesity is driven by an imbalance between caloric intake and energy expenditure, causing excessive storage of triglycerides in adipose tissue at different sites around the body. Increased visceral adipose tissue (VAT) is associated with diabetes, while pericardial adipose tissue (PAT) is associated with cardiac pathology. Adipose tissue can expand either through cellular hypertrophy or hyperplasia, with the former correlating with decreased metabolic health in obesity. The aim of this study was to determine how VAT and PAT remodel in response to obesity, stress, and exercise. Here we have used the male obese Zucker rats, which carries two recessive fa alleles that result in the development of hyperphagia with reduced energy expenditure, resulting in morbid obesity and leptin resistance. At 9 weeks of age, a group of lean (Fa/Fa or Fa/fa) Zucker rats (LZR) and obese (fa/fa) Zucker rats (OZR) were treated with unpredictable chronic mild stress or exercise for 8 weeks. To determine the phenotype for PAT and VAT, tissue cellularity and gene expression were analyzed. Finally, leptin signaling was investigated further using cultured 3T3-derived adipocytes. Tissue cellularity was determined following hematoxylin and eosin (H&E) staining, while qPCR was used to examine gene expression. PAT adipocytes were significantly smaller than those from VAT and had a more beige-like appearance in both LZR and OZR. In the OZR group, VAT adipocyte cell size increased significantly compared with LZR, while PAT showed no difference. Exercise and stress resulted in a significant reduction in VAT cellularity in OZR, while PAT showed no change. This suggests that PAT cellularity does not remodel significantly compared with VAT. These data indicate that the extracellular matrix of PAT is able to remodel more readily than in VAT. In the LZR group, exercise increased insulin receptor substrate 1 (IRS1) in PAT but was decreased in the OZR group. In VAT, exercise decreased IRS1 in LZR, while increasing it in OZR. This suggests that in obesity, VAT is more responsive to exercise and subsequently becomes less insulin resistant compared with PAT. Stress increased PPAR-γ expression in the VAT but decreased it in the PAT in the OZR group. This suggests that in obesity, stress increases adipogenesis more significantly in the VAT compared with PAT. To understand the role of leptin signaling in adipose tissue remodeling mechanistically, JAK2 autophosphorylation was inhibited using 5 μM 1,2,3,4,5,6-hexabromocyclohexane (Hex) in cultured 3T3-derived adipocytes. Palmitate treatment was used to induce cellular hypertrophy. Hex blocked adipocyte hypertrophy in response to palmitate treatment but not the increase in lipid droplet size. These data suggest that leptin signaling is necessary for adipocyte cell remodeling, and its absence induces whitening. Taken together, our data suggest that leptin signaling is necessary for adipocyte remodeling in response to obesity, exercise, and psychosocial stress.

Exploring the pathways from the power of food to food cravings in a sample of Brazilian young adults

The present study has three main objectives: a) to analyse, for the first time, the factor structure of the Control of Eating Questionnaire (CoEQ) in a Brazilian sample; b) to explore, through in-depth interviews, motivators and consequences of food cravings among participants with high scores on the CoEQ; and c) to analyse whether and how the power of food is related to food cravings. The study involved 335 young adults aged 18-30 years, balanced for sex. The CoEQ and the Power of Food Scale (PFS) were used in an online survey. The CoEQ and PFS were subjected to confirmatory factor analysis. Semi-structured interviews were also conducted with a subsample (n = 20) with high CoEQ scores. The Socratic questioning method was used for the interviews. The interviews were transcribed and analysed according to thematic content analysis. The PFS and the CoEQ showed adequate factor structure with reliable factors. The results of the qualitative analysis showed that both food availability and seeking relief from stressors serve as motives for food cravings. Concern for health and weight gain were cited as consequences of cravings, as was seeking distraction to cope with these cravings. It was found that the PFS aggregate factor was a significant influencing factor for craving control (β = 0.604; p < 0.001), craving for savoury (β = 0.382; p < 0.001), craving for sweet (β = 0.414; p < 0.001) and positive mood (β = -0.198; p < 0.001). The findings suggest that the relationship between food cravings and the power of food is significant in today's obesogenic environment.

Ugly food, not eat: the eating intention of emotional eater for different esthetic food

BACKGROUND

Emotional eaters eat to relieve their emotions. However, food also contains esthetic information. People generally perceive ugly food as unhealthy and unpalatable. Does the esthetic information of food influence an emotional eater's desire for food in a negative emotional state? In particular, do they have the same lower eating intentions for low esthetic food as non-emotional eaters?

OBJECTIVE/DESIGN/MEASURES

Based on these questions, the present study examined whether the esthetic value of food influences emotional eaters' desires for food. The experiment used a 2 (eating type: emotional eating vs. non-emotional eating) × 2 (food style: high esthetic vs. low esthetic) mixed experimental design. We measured the emotional and non-emotional eaters' eating intentions for different esthetic foods when experiencing negative emotions.

RESULTS

The results showed that emotional eaters have higher intention to eat high esthetic foods. However, they did not have a high eating intention for all foods, and their eating intention did not differ from that of non-emotional eaters when faced with low esthetic food.

CONCLUSION

In conclusion, food esthetic value can affect individual eating intentions. Even for emotional eaters who are in a negative mood, they also did not have a higher eating intention for low esthetic food compared with no-emotional eater.

LEVEL OF EVIDENCE

Level II: controlled trial without randomization.

Solid or Liquid Food-The Intention to Eat Different Foods under Negative Emotions

Food can relieve an individual's emotions, especially for emotional eaters. For instance, chewing alleviates negative emotions. Solid and liquid foods comprise a huge part of our daily lives, and the chewiness of solid foods is always high. Here, we explored whether people, especially emotional eaters, have higher eating intentions to eat highly chewy foods while experiencing negative emotions by comparing their eating intentions toward solid and liquid foods. To this end, we conducted a survey of 147 participants using a questionnaire (Experiment 1) to understand their eating intention toward five types of food (purple potato, maize, black soya bean, mango, and soybean; each food group contained a solid food and a liquid food) while experiencing negative emotions. The results showed that individuals exhibited higher eating intention toward solid food compared with liquid food while experiencing negative emotions. In Experiment 2, we selected 85 and 65 high-emotional and low-emotional eaters, respectively, and further explored their preference for solid foods. The results showed that individuals with high levels of emotional eating exhibited higher intentions toward solid food while experiencing negative emotions compared with those with low levels of emotional eating. In conclusion, this study proved that individuals' higher eating intentions toward highly chewable food were pronounced among individuals with high levels of emotional eating under negative emotion conditions.

Negative emotion-related eating behaviours in young women with underweight status, overweight status, anorexia nervosa, and bulimia nervosa in Korea

OBJECTIVE

This study aimed at investigating the negative emotion-related eating behaviours of young women with extreme weights or eating disorders (EDs).

METHOD

A total of 808 young women participated including 144 with underweight (UW), 364 with normal-weight (NW) and 137 with overweight (OW; including 27 with obesity) from universities, and 63 patients with anorexia nervosa (AN), and 100 patients with bulimia nervosa (BN) from a hospital. Participants were interviewed and completed questionnaires on eating behaviours related to negative emotions.

RESULTS

While both OW and BN groups ate more in response to negative emotions, UW and AN groups ate less compared to NW group. Negative feelings after overeating were prominent in OW group and patients with ED. In negative emotions, patients with EDs preferred sweet tastes, but BN group preferred spicy tastes less. Patients with EDs had increased external eating, and BN group also showed increased restrained eating. Neuroticism had indirect impacts on OW status via emotional eating unlike BN.

CONCLUSIONS

The results suggest that UW and OW status were on the spectrum of emotional eating, and AN and BN were on the extremes of external eating, which may be integrated into the development of interventions targeting each status.

Does odour priming influence snack choice? - An eye-tracking study to understand food choice processes

Awareness of food sensory cues in our surroundings may influence our eating behaviour in different ways. For example, exposure to non-consciously perceived odours may influence food choice but not appetite. Moreover, this type of exposure may mainly influence the food choice of starters or desserts but not of main courses. This infers that odour priming may influence impulsive or rewarding food choice but may not overrule our habits concerning the choice of a main meal. It is crucial to understand the role of odour priming on eating behaviour and how people can be steered towards healthier options. Implicit measures, such as visual attention, may be central to understand the food choice process. Therefore, we aimed to determine how non-conscious exposure to odours affect congruent snack choice (i.e. with similar taste characteristics) and whether this is modulated by visual attention. A total of 53 healthy young adults took part in a cross-over study which consisted of two test sessions. In each test session, they were non-consciously exposed to an odour that is associated to a sweet or savoury food. Visual attention was investigated by means of a wearable eye-tracker and subsequent snack choice was (covertly) measured. Our results showed that congruent snacks were fixated on first. However, sweet snacks were fixated on more frequently, and for a longer period of time, and were chosen most often, irrespective of the type of odour exposure. Our findings indicate that odour priming might steer the initial orientation towards congruent foods, but other factors (e.g. cognitive) may overrule its effect on the final choice.

IgG antibodies reacting with ghrelin and leptin are correlated with body composition and appetitive traits in young subjects

Appetitive traits are important behavioural characteristics affecting eating and body composition. Ghrelin and leptin are two key hormones regulating appetite and metabolism. Recent studies have reported the presence of autoantibodies (autoAbs) directed to ghrelin and leptin in healthy individuals as well as affinity alterations in eating disorders such as anorexia nervosa and hyperphagic obesity. Nevertheless, the relationship of these autoAbs with appetitive traits is unknown. The goals of this exploratory study were to analyze circulating IgG autoAbs reacting to ghrelin and leptin and evaluate their relationship with body composition parameters and appetitive traits. This cross-sectional study included 180 young subjects (20 ± 2 years) that underwent body composition evaluation. Seven appetitive traits were assessed with AEBQ-Esp and were classified as low-score or high-score. A validated in-house ELISA test was performed to measure IgG ghrelin and leptin-reactive autoAbs in its free, total, and immune complexes fractions. Free IgG ghrelin-reactive were significantly higher in women than in men. Immune complexes of IgG-ghrelin were positively correlated with waist-hip ratio in the total cohort. In women, free IgG leptin-reactive were positively correlated with body fat percentage and waist-hip ratio, whereas in men, immune complexes of IgG-leptin were positively correlated with body fat percentage. Women with a low-score for 'enjoyment of food', exhibited higher levels of IgG ghrelin-reactive autoAbs on its free form than the high-score group. Men with a high-score for 'emotional undereating' had higher levels of free IgG leptin-reactive autoAbs than the low-score group. The correlation of these autoAbs with anthropometric parameters and appetitive traits in young subjects support its role as carriers and modulators of the biologic functions of ghrelin and leptin and suggest a novel role in eating behaviour through appetitive traits.

The food craving inventory in an Iranian population: post-hoc validation and individual differences

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.

Relationship of negative emotion with leptin and food intake amongoverweight women

Negative emotions can influence food intake. Leptin (an anorectic hormone) levels may change in response to psychological stressors. This study aimed to explore the relationship between leptin and food intake triggered by negative emotions in overweight women. Two groupswere studied: normal weight women (n = 21) and overweight women (n = 23). Both groups were exposed to videos to stimulate negative and neutral emotions followed by application ofthe Subjetive Analog Scale. Plasma leptin levels were evaluated before and after exposure to the videos. Subsequently, a brunch containing sweet and salty foods was offered to simulatea high food availability environment. Results show that when exposed to negative emotions there was an increase in food intake (normal weight: p=.010 / overweight: p=.005). There was no change in plasma leptin levels in normal weightand overweight women. Negative emotions promotedan increase in energy intake in both groups. The results reinforce the integration of biopsychosocial aspects involving emotions and food intake.

Perceived daily tension and food cravings and consumption: A within- and between-person investigation

Previous research examining the relationship between negative states such as tension/anxiety and food intake has typically overlooked the naturally occurring variability of day-to-day experiences and the subsequent consequences for eating behavior. In this study, the relationship of within- and between-person perceived daily tension with food cravings and consumption was assessed. One hundred and forty-two men and women (M_age=21.3, SD_age=5.3) completed a survey daily for 7 consecutive days. Levels of perceived daily tension, food cravings, and consumption were assessed. Linear and logistic mixed effect regression models were used to examine associations between tension and food cravings and consumption variables, respectively. Individuals reported greater cravings (for sweets, OR 95% CI 1.05-1.26; carbohydrates/starches, OR 95% CI 1.02-1.26; and fast foods, OR 95% CI 1.01-1.19) and consuming more carbohydrates/starches (b 95% CI 0.05-0.79) on days when they felt more tension. Individuals with higher tension had more cravings (total OR 95% CI 1.09-1.71; and specifically for sweets, OR 95% CI 1.04-1.42; and fast foods, OR 95% CI 1.15-1.54) and reported consuming more sweet (b 95% CI 0.21-1.10) and fast foods (b 95% CI 0.55-1.66). These findings suggest that greater perceived tension (both within and between individuals) is associated with increased food cravings and consumption.

The Relationship Between Food Craving, Appetite-Related Hormones and Clinical Parameters in Bipolar Disorder

Obesity and weight gain in bipolar disorder (BD) have multifactorial underlying causes such as medication side effects, atypical depressive symptomatology, genetic variants, and disturbances in the neuro-endocrinal system. Therefore, we aim to explore the associations between food craving (FC), clinical parameters, psychotropic medication, and appetite-related hormones. In this cross-sectional investigation, 139 individuals with BD and 93 healthy controls (HC) completed the food craving inventory (FCI). In addition, blood samples (including leptin and acylated ghrelin) were analyzed and sociodemographic and anthropometric data were collected. Individuals with BD reported higher frequencies of total FC as well as craving for fat and fast food than HC. Additionally, we found a significant negative correlation between FC and ghrelin levels in BD. Smokers with BD reported significantly more craving for high fat foods than non-smokers. Age was significantly associated with FC independent of group. Individuals with BD taking olanzapine and quetiapine reported higher frequencies of craving for sweet food, while patients currently taking lithium reported less total FC compared to those without lithium therapy. Likewise, patients currently taking valproate reported less total FC and less craving for sweets than those not taking valproate. FC appears to be of clinical relevance in individuals with BD. Contrary to previous data, this does not seem to be a female phenomenon only and might encompass more than the specific craving for carbohydrates. Although due to the cross sectional design, causality cannot be determined, the association between depressive symptomatology and fast food craving warrants further research.

History of child maltreatment and excessive dietary and screen time behaviors in young adults: Results from a nationally representative study

Child maltreatment is common and has been associated with substance use addictions, yet few studies have examined associations with potentially addictive dietary and screen time behaviors. The goal of this study was to assess associations between retrospectively self-reported child maltreatment (sexual abuse, physical abuse, emotional abuse, and neglect) and excessive self-reported dietary (sugar sweetened beverage and fast food consumption) and screen time behaviors (television/video watching and leisure time computer use) in early adulthood, overall and by sex and race/ethnicity. Associations were examined using data from 10,813 participants 24-32 years old from the National Longitudinal Study of Adolescent to Adult Health. We used predicted marginal proportions accounting for the complex sample design to obtain prevalence ratios (PRs) and adjusted for demographic characteristics and physical activity. In females, exposure to poly-maltreatment (2+ types of child maltreatment) was associated with excessive sugar sweetened beverage consumption, television/video watching, and leisure time computer use; in males, exposure to poly-maltreatment was associated with excessive sugar sweetened beverage consumption, television/video watching, and fast food consumption. Some associations were particularly strong in racial/ethnic minorities, especially Latina females (poly-maltreatment-sugar sweetened beverage association: aPR = 6.14, 95% CI:2.12, 17.75; poly-maltreatment-computer use association: aPR = 3.08, 95% CI:1.44, 6.58). These findings show that child maltreatment is associated with excessive dietary and screen time behaviors into adulthood, and these associations are present in racial/ethnic groups at high risk of cardiometabolic disease. Extension of an addiction paradigm to include dietary and screen time behaviors may inform health risks and disease prevention efforts in child maltreatment survivors.

Alteration Pattern of Taste Perception After Bariatric Surgery: a Systematic Review of Four Taste Domains

BACKGROUND

Efforts continue to understand the underlying mechanism of weight loss after bariatric surgery. Taste perception has shown to be a contributing factor. However, the alteration pattern in different taste domains and among bariatric procedures has not been sufficiently investigated.

OBJECTIVES

To study the alteration pattern in the perception of four taste domains after different bariatric procedures.

SETTINGS

Private Research Institute, USA.

METHODS

A systematic review was conducted to pool available data in the literature on post-operative changes in the perception of sensitivity to four taste domains after Roux-en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (LSG), and adjustable gastric banding (AGB).

RESULTS

Our study showed that bariatric surgery is associated with significant change in sensitivity to all four taste domains especially salt taste, sweetness, and sourness. LSG patients showed an increased sensitivity to all four taste domains. However, RYGB patients had a variable alteration pattern of taste perception but more commonly a decreased sensitivity to sweetness and an increased sensitivity to salt taste and sourness. Additionally, AGB patients had a decreased sensitivity to sweetness, salt taste, and sourness.

CONCLUSION

Bariatric surgery is associated with taste change in a way which results in less preference for high-calorie food and possibly reduced calorie intake. This may explain one of the mechanisms by which bariatric surgery produces weight loss. However, data are heterogeneous, the potential effect dilutes over time, and the alteration varies significantly between different procedures.

Eat to avoid negative self-awareness: Locus of control and core self-evaluation as serial mediators in the effect of stress on food intake

The primary hypothesis of escape theory lies in that those who are under stress eat to escape from negative self-awareness. Although escape theory has been well cited in the eating literature, relatively few studies have directly tested its applicability to stress-induced eating. The aim of the present study is to provide causal evidence on using escape theory to explain the effect of stress on food intake. Specifically, we examined whether locus of control (LOC) and core self-evaluation (CSE) are serial mediators in the effect of stress on food intake. By a longitudinal experimental design, participants were randomly assigned to a stress group or a control group, and data on LOC, CSE, and food intake were collected at 3 waves. The results indicated that LOC and CSE are serial mediators in the effect of stress on food intake, though the direct effect of stress conditions remained significant. Our findings support the applicability of escape theory to interpret why stress increases food intake, and exclusion of LOC as an indicator of CSE. Thus, the present study provides causal evidence on escape theory by shedding light on the sequential mediating effect of LOC and CSE. Future research need to pay more attention to the evaluative process in stress-induced eating.

Dietary quality differences between women with and without weight loss in nutritional treatment

BACKGROUND & AIMS

The obesity nutritional treatment is structured to weight loss and diet is considered an important indicator of treatment effectiveness. The purpose of this study is to compare the diet quality among women who lost weight to women who maintained or gained weight during the nutritional treatment.

METHODS

This is a retrospective study that included 66 obese women in nutritional treatment for weight loss, over six months, divided in tercile according to their weight loss. The diet quality was evaluated by score, which was obtained with a food frequency questionnaire.

RESULTS

The diet quality comparison was made among the group with weight loss (GL; n = 22) and the group that maintained or gained weight during the nutritional treatment (GG; n = 22) showed that both groups had improvement in their diet quality scores from pre-treatment to post-treatment. Nevertheless, the GG had higher sugar consumption than the GL in the pre-treatment (p = 0.02) and in the post-treatment (p 0.01) periods. In the post-treatment, GL increased their scores for leafy vegetables (0.013), fruit (0.004), sweets (p 0.03), and soft drinks (p 0.02). GL improved their scores for fried food (p 0.01) and sweets (p 0.008).

CONCLUSION

This indicates that in the weight loss treatment special attention should be given to the incentive to the fruit and leafy vegetables consumption and, to reduce the consumption of sweets.

Smartphone use while eating increases caloric ingestion

The use of smartphones during meals may possibly influence the number of ingested calories. We evaluated the influence of smartphones' distraction during eating on caloric intake. Physical (masticatory parameters, sex and body mass index - BMI); environmental (with or without distraction) and psychological (stress levels) variables were evaluated as confounding factors. Sixty-two adults were recruited for experimental snack tests performed on four different days. At baseline, we evaluated masticatory performance, swallowing threshold, masticatory frequency and body mass index (BMI). In the following three sessions, volunteers were presented a snack test in which participants ate under three experimental conditions: no distraction, using their smartphones, or reading a printed text. At the end of each session, total and nutritional compound stratified caloric intake was measured. Three-way mixed model ANOVA was used to test the effect of experimental condition on the total, carbohydrate and lipid caloric intakes. Hierarchical multiple linear regression models were used to estimate the influence of confounding factors on the total caloric intake. We found an effect of the condition (no distraction, smartphone or reading) on the total caloric (p = .007) and lipid intake (p = .002). When eating without distraction, the mean caloric intake was 535 (±164) kcal, in comparison to 591 (±203) kcal using smartphone (p = .05) and 622 (±226) kcal (p = .002) reading a text (no significant difference between distracters). Eating with distracters increased approximately 15% caloric ingestion. An interaction condition*sex effect was observed on lipid intake (p = .020). Energy intake was found to be dependent on sex and age, in which older men ingested more calories. Smartphone use during a meal increased caloric and lipid intake, depending on sex and age in young adults with complete dentition.

Mindfulness-based program for stress reduction in infertile women: Randomized controlled trial

Infertile women often experience chronic stress, which may have a negative impact on general well-being and may increase the burden of infertility. In this open-label, parallel, randomized controlled trial, infertile women aged 18-50 years (median 37 years) were assigned to an 8-week mindfulness-based program (MBP) or no intervention. The primary outcome was stress severity measured by the Lipp's Stress Symptoms Inventory (ISSL). Data were analyzed by modified intent-to-treat principle, which included all cases available to follow-up regardless of adherence to the intervention (62 participants from the MBP group and 37 from the control group). The median number of symptoms of chronic stress recorded in the past month decreased from six (interquartile range 2 to 9) before the MBP to two (interquartile range 1 to 4) after the intervention (p < 0.001, repeated measures analysis of variance with Time × Group interaction). Depressive symptoms also decreased after MBP, whereas general well-being improved (p < 0.01 for both outcomes). Hair cortisol and serum brain-derived neurotrophic factor (BDNF) did not change significantly between preintervention and postintervention. None of the outcomes changed significantly in the control group. MBP was effective in reducing stress and depressive symptoms while increasing general well-being in infertile women.

Anxiety symptoms and emotional eating are independently associated with sweet craving in young adults

Sweet craving (SC), defined as a strong desire for sweet foods, seems to be closely related to negative emotions, such as anxiety and unhealthy eating behaviors. The objective was to investigate factors that are associated with SC and to assess the relationships among SC, anxiety symptoms, and eating behavior in university students. This was a cross-sectional study involving 300 students of both sexes (20.5 ± 4.4 years) who were freshmen in a Brazilian public university. Eating behavior was evaluated using the Three Factor Eating Questionnaire, anxiety symptoms were assessed using the Beck Anxiety Inventory, SC was identified by a yes/no question ("Have you had a very strong desire to eat sweet food over the last three months?"), and characterized by the Questionnaire for Assessment of Sweet Substance Dependence. Individuals with SC scored significantly higher for uncontrolled eating (UE), emotional eating (EE), and anxiety symptoms. Logistic regression analysis revealed that anxiety symptoms are independently associated with SC. In conclusion, negative emotions, like anxiety, and eating guided by these emotions can contribute to the SC phenomenon.

Eating Experiences, Sweet Preference, and Weight Gain in Women During Chemotherapy for Breast Cancer: A Mixed Methods Study

Weight gain during breast cancer treatment has not been explained yet. This study aimed to explore eating experience and its relationship with weight gain and sweet preference and intake in women in chemotherapy treatment for breast cancer. Thirty-one patients indicated for adjuvant (n = 16) or neoadjuvant (n = 15) chemotherapy containing anthracyclines were evaluated. Weight, sweet preference in cashew juice (weight/volume, 3, 6, 12, 24, and 36%), and sweet food intake frequency ["healthy sweets" (HS) for fruits and natural juices and "nonhealthy sweets" (NHS) for other sweets] were assessed prior to initiating (T0) and after the fourth chemotherapy cycle (T1). A semistructured interview was applied at T1. At baseline, patients were 46.7 ± 11.6 years old and the mean body mass index (BMI) was 29.3 ± 7.1 kg/m². The patients' weight and BMI increased, as did the HS intake, with positive correlation between HS intake and weight change (r = 0.38; P = 0.039). Baseline sweet preference is correlated to NHS intake at T0 (r = 0.51; P = 0.004) and influences NHS intake change. The interview analysis showed opposite food behaviors: at times driven by self-care and, at other times, driven by the emotional vulnerability, which may contribute to the weight gain observed.

Socioeconomic status differences in food consumption following a laboratory-induced stressor

We examined food consumption in response to a laboratory-induced stressor (two challenging neuropsychological tasks) among non-Hispanic White women categorized as lower or higher in socioeconomic status based on education. The two socioeconomic status groups did not differ with respect to current hunger or baseline dietary habits. Perceived stress was measured pre- and post-challenge. Snacks were offered post-challenge; food consumption was measured by weighing snack bowls pre- and post-offering. Perceived stress increased pre- to post-challenge for both groups, but this effect was stronger for women lower in socioeconomic status. In addition, women lower versus higher in socioeconomic status consumed more food overall and more high-fat sweet food in particular (large effect sizes). These findings provide evidence of socioeconomic status differences in food consumption following an acute stressor.

Eating behavior of schizophrenic patients

ABSTRACT Objective To assess the eating behavior, food practices, nutritional and metabolic profiles of patients with schizophrenia undergoing treatment. Methods Cross-sectional exploratory descriptive qualitative study used a semi-structured questionnaire on the eating behavior, food practices, and perception of changes after the initiation of drug therapy and a quantitative method using anthropometric and body composition measurements, metabolic parameters, and 5-day dietary records to analyze nutrient ingestion of patients with schizophrenia in an outpatient clinic at a tertiary hospital (n=33). The qualitative data were analyzed and coded by three researchers and quantitative data were analyzed using descriptive exploratory statistics. Results The results of this study showed that schizophrenic patients presented high prevalence of excess weight (71.0%), metabolic syndrome (42.0%), dyslipidemia (62.0%), changes in appetite (76.0%), and increase in energy intake (74.2%), associated with important irregularities in eating behavior and food practices (such as irregularity of meals, emotional intake, high carbohydrate and fat intake, and low energy expenditure) and lifestyle (changes in social and work routines). Conclusion This eating profile may interact synergistically with psychotropic drugs to contribute to weight gain and metabolic changes in schizophrenia. Nutrition education may prevent and monitor the risk of metabolic and nutrition problems, irrespective of the medications used.

Influence of emotions evoked by life events on food choice

PURPOSE

Considering the importance of replicating real-life experiences in studying emotional eating, this study investigated the influence of emotions evoked by life events on food choice in normal-weight and overweight women.

METHODS

Normal-weight (n = 21) and overweight women (n = 23) aged 25-42 years were assigned to one of two different conditions: in one, they were shown a video with scenes of daily activities to elicit neutral responses; in the other, they were shown a video with scenes of common problems to evoke negative emotions. The participants were then offered a brunch containing sweet, salty, and healthy food items to evaluate their consumption and food choice.

RESULTS

Exposure to negative emotions evoked by life problems increased energy intake in both groups, but they differed in terms of food choice. The normal-weight women increased only the consumption of sweet food (p = 0.044), whereas the overweight women significantly increased ingestion of sweet and salty foods (sweet food p = 0.031; salty food p = 0.008).

CONCLUSIONS

The results show that common problems of life might trigger food consumption in the presence of high availability. Both groups increased food consumption after negative emotions and the normal-weight group had a higher increase than the overweight group. However, normal-weight women increased consumption of sweet foods, whereas overweight women consumed more salty, fried, and sweet foods. Healthy food was not chosen under these conditions. This should serve as a warning for the risks of excess exposure to high-sugar or high-fat food as everyday problems will not cease to exist.

LEVEL OF EVIDENCE

Level II: evidence obtained from well-designed controlled trials without randomization.

Estradiol, SHBG and leptin interplay with food craving and intake across the menstrual cycle

OBJECTIVE

To understand the association between ovarian hormones, non-acute satiety hormones and craving calorie dense foods in the luteal phase.

METHODS

17 premenopausal women, mean age 23.2 y, mean BMI 22.4kg/m(2) with regular menstrual cycles were studied during late follicular (FP) and luteal phases (LP). Estradiol, progesterone, DHEAS, SHBG, insulin and leptin, were measured in fasting samples. The validated Food Craving Inventory was used to record the types of foods volunteers habitually ate - rich in fat, carbohydrate or sweet taste, as well as craved during the LP of their menstrual cycle.

RESULTS

Estradiol was inversely associated with leptin in FP (r=-0.62, p=0.01). Leptin was inversely associated with habitual intake of sweet foods, in both phases (FP: r=-0.64, p=0.01; LP: r=-0.63, p=0.01). SHBG in LP was positively associated with craving sweet and carbohydrate rich foods. Hierarchical cluster analysis revealed two groups of women, one with high estradiol, high estradiol/leptin ratio, high sweet and carbohydrate cravings (p<0.05); the other group had lower estradiol, lower estradiol/leptin ratio, and reported less craving.

CONCLUSIONS

The estradiol-leptin axis may be a determinant of luteal phase craving and habitual food intake in menstruating women.

CLINICAL TRIAL REGISTRATION NUMBER

NCT01407692.

Attenuation of stress-induced gastrointestinal motility disorder by gentiopicroside, from Gentiana macrophylla Pall

AIM

The current study was designed to explore the mechanism of the prokinetic activity of Gentiopicroside (Ge), from Gentiana macrophylla Pall which is widely used to strengthen gastric motility in clinic.

METHODS

Gastrointestinal motility disorder rats were induced by stress stimulation and the rats were treated with Ge. The functions of gastric emptying and intestinal propelling were measured after blood was obtained to assay the levels of plasmatic motilin (MTL), vasoactive intestinal peptide (VIP), somatostatin (SST), gastrin (GAS), neurotensin (NT) and substance of P (SP). The expressions of MTL receptor (MTLR), VIP receptor 2 (VIPR2) and SST receptor 2 (SSTR2) were measured also. In addition, an isolated guinea pig ileum was applied to evaluate the influences of Ge on M-R, H1-R, 5-HT4-R and D-R in vitro.

RESULTS

Ge increased gastric emptying and intestinal propelling obviously. It also decreased the level of SST and increased GAS in plasma significantly. Moreover, it promoted the expressions of MTLR in gastric antrum, duodenum, jejunum and ileum, and restrained the expression of VIPR2 in duodenum. Piboserod and loratadine had no obvious restrain to Ge' exciting ileum effect and Ge also didn't affect dopamine paralyzing ileum. However, Ge failed to improve the hypofunction of guinea pigs ileums pre-treated with atropine sulfate.

CONCLUSION

The mechanisms of Ge' prokinetic effect were associated with modulating the levels of SST and GAS in plasma, raising the expressions of MTLR in gastric antrum, duodenum, ileum and jejunum, reducing the expression of VIPR2 in duodenum and activating M-R.