Associations between eating behaviors and metabolic syndrome severity in young adults

Differences in metabolic syndrome severity and prevalence across nine waist circumference measurements collected from smartphone digital anthropometrics

BACKGROUND & AIMS

Given the technological advances in 3D smartphone (SP) anthropometry, this technique presents a unique opportunity to improve metabolic syndrome (MetS) screening through optimal waist circumference (WC) landmarking procedures. Thus, the purpose of this study was to evaluate the associations between individual MetS risk factors and nine independent WC sites collected using tape measurement or SP anthropometrics and to determine the differences in MetS severity and prevalence when using these different WC measurement locations.

METHODS

A total of 130 participants (F:74, M:56; age: 27.8 ± 11.1) completed this cross-sectional evaluation. Using traditional tape measurement, WC was measured at the lowest rib (WCRib), superior iliac crest (WCIliac), and between the WCRib and WCIliac (WCMid). Additionally, WC measurements were automated using a SP application at six sites along the torso. MetS risk factors were used to calculate MetS severity (MetSindex) and prevalence. Associations were evaluated using multiple linear regression, the effect of each WC site on MetSindex was analyzed using mixed-models ANCOVA, and differences in MetS prevalence using WCIliac as the current standard were determined using sensitivity, specificity, chi-squared tests, and odds ratios.

RESULTS

The reference SP-WC (SPRef) and WCRib demonstrated the largest associations (all p < 0.001) with HDL cholesterol (SPRef: -0.48; WCRib: -0.49), systolic (SPRef: 0.32; WCRib: 0.30) and diastolic blood pressure (SPRef: 0.34; WCRib: 0.32), and fasting blood glucose (SPRef: 0.38; WCRib: 0.37). SPRef and WCRib were the only WC without significantly different MetSindex; yet demonstrated lower MetSindex and sensitivity (SPRef: 77.8 %; WCRib: 74.1 %) relative to WCIliac, the conventional (or standard) WC measure.

CONCLUSIONS

Compared to the current standard, SPRef and WCRib protocols are more highly associated with individual MetS risk factors and produce different MetSindex and diagnoses; highlighting the need for new MetS WC protocols. Given the surge in remote/mobile healthcare, SPRef may be an alternative to traditional methods in this context but requires further investigation before implementation.

Emotional Eating in Primary Care: Considerations for Assessment and Management

LEARNING OBJECTIVES

After participating in this CME activity, the psychiatrist should be better able to:• Describe how to identify and address emotional eating in the primary care setting.

ABSTRACT

Emotional eating (i.e., eating in response to negative emotional states and stress) is a highly prevalent concern within primary care settings. It is associated with myriad health issues such as the experience of overweight or obesity, increased difficulty losing weight and sustaining weight loss, various eating disorders, diabetes, and heart disease. Given the effects of emotional eating on patient health goals regarding weight loss or management, it is imperative to incorporate interventions that address emotional underpinnings alongside traditional, behaviorally based weight-loss treatment. Ensuring that primary care providers, who represent pivotal frontline touch points for patients interested in weight-related treatment, can identify emotional eating is an important first step in supporting these patients' goals. The primary purpose of this paper is to provide background information and practical guidance for addressing emotional eating in the primary care setting. We summarize theorized biological and psychological mechanisms that underlie emotional eating, and review traditional (i.e., psychological) interventions, with special consideration for adapting available treatments for use in primary care contexts.

Measurements of Abdominal Obesity are Associated with Metabolic Syndrome Severity Independent of Hypertensive Phenotype in White but not Black Young Adults

PURPOSE

This study sought to determine if metabolic syndrome severity (MetSindex) was differentially associated with abdominal obesity based on waist circumference (WC) site and the presentation of hypertensive phenotypes in a group of young White and Black adults.

METHODS

A total of 139 young adult (22.5 ± 3.3 years) non-Hispanic White (n = 73) and non-Hispanic Black (n = 66) males and females (M 53, 86 F) completed this cross-sectional evaluation. Participants had their WC measured at three distinct locations along the abdomen which were used to calculate waist-to-hip and waist-to-height ratios. Systolic (SBP) and diastolic blood pressure (DBP) were collected and used to calculate mean arterial pressure (MAP). In addition to traditional metabolic syndrome (MetS) risk factors, BP values were individually used to produce three separate MetSindex scores representing three specific hypertensive phenotypes (MetSSBP, MetSDBP, MetSMAP), and each of these were evaluated against each abdominal obesity estimate.

RESULTS

MetSDBP and MetSSBP were significantly higher than all other indices for females (all p ≤ 0.002) and males (all p < 0.001), respectively. MetSDBP was significantly higher than MetSMAP for White females (p = 0.039), and MetSSBP was significantly higher than MetSDBP and MetSMAP (both p < 0.001) for Black males. Standalone and joint estimates of abdominal obesity were uniquely associated with MetSindex across hypertensive phenotypes for White, but not Black males and females.

CONCLUSIONS

Specific hypertensive phenotypes may differentially determine MetSindex, but these estimates are not associated with abdominal obesity in young Black adults regardless of measurement location. Healthcare professionals should address this disparity by providing more comprehensive MetS screening procedures for young Black adults.

CLINICAL TRIALS REGISTRATION

NCT05885672.

Emotional Eating and Cardiovascular Risk Factors in the Police Force: The Carolina Blue Project

There is an association between emotional eating and cardiovascular disease (CVD) risk factors; however, little is known about this association in the police force. This study explores the associations between emotional eating and CVD risk factors in law enforcement officers in North Carolina. Four hundred and five officers completed The Emotional Eating Scale, and 221 of them completed the assessment for CVD-related markers. Descriptive statistics, Pearson's correlation, and multiple linear regression analyses were performed. Emotional eating in response to anger was significantly positively associated with body weight (β = 1.51, t = 2.07, p = 0.04), diastolic blood pressure (β = 0.83, t = 2.18, p = 0.03), and mean arterial pressure (β = 0.84, t = 2.19, p = 0.03) after adjusting for age and use of blood pressure medicine. Emotional eating in response to depression was significantly positively associated with triglycerides (β = 5.28, t = 2.49, p = 0.02), while the emotional eating in response to anxiety was significantly negatively associated with triglycerides (β = -11.42, t = -2.64, p = 0.01), after adjusting for age and use of cholesterol medicine. Our findings offer new insights to address emotional eating and lower CVD risk in law enforcement officers.

Exploring gait velocity as a predictor of cardiometabolic disease risk in young adults

Background

The association between poor gait and functional movement ability and metabolic syndrome (MetS) has been well established in older adults. A continuous cardiometabolic risk score, MetSindex, may more easily identify individuals at risk for cardiometabolic disease who do not yet meet the stringent criteria for a formal MetS diagnosis. Although the association between MetS and gait velocity is well established in older adults, no such relationship has been identified in younger adults; a group experiencing a rapid increase in the development of MetS.

Methods

MetSindex was determined for 21 young adults using standard procedures. Gait velocity was measured as participants completed a ten-meter walk test. Spatiotemporal parameters of gait were also derived using a motion capture system. Simple linear regression was used to determine the relationship between MetSindex and gait velocity, as well as MetSindex and spatiotemporal parameters of gait.

Results

There was a large inverse relationship between MetSindex and gait velocity. A large inverse relationship was also observed between MetSindex and cadence, and a large positive relationship was observed between stance time and double limb support time.

Conclusions

Gait velocity slows in young adults who do not necessarily meet the criterion for positive diagnosis of MetS-but demonstrate an increased risk for MetS and cardiovascular disease through higher MetSindex scores. The mechanism underlying reduced gait velocity may be fewer, but not shorter steps. Determining easy-to-use surrogates of MetS (e.g., gait velocity) may help combat the growing prevalence of MetS by increasing access to preventative approaches.