High Cognitive Dietary Restraint Is Associated With Increased Cortisol Excretion in Postmenopausal Women

Association Between Maladaptive Eating Behaviors Among Black Women and Vicarious Racial Discrimination Following a High-Profile Event

OBJECTIVE

Evidence suggests that racial discrimination causes stress among non-Hispanic Black women, and some Black women may cope with exposure to vicarious racial discrimination by engaging in maladaptive eating behaviors.

METHODS

We examined eating behaviors among Black women (N = 254) before and after Freddie Gray's death while in police custody. Maladaptive eating behaviors were assessed using the three-factor eating questionnaire. Our independent variables included the following: (1) time period and (2) geographic proximity to the event. Three two-way analysis of covariance tests were conducted to assess potential effects of geographic proximity (close, distant), time period in relation to unrest (before, after unrest), and their interaction on emotional eating, uncontrolled eating, and cognitive restraint controlling for participant age.

RESULTS

There was a statistically significant main effect of proximity to the unrest on emotional eating, F (1, 252) = 5.64, p = .018, and partial η2 = .022 such that women living in close geographic proximity to the unrest reported higher mean levels of emotional eating as compared to those living more distant to the unrest. There was also a borderline statistically significant interaction between geographic proximity and time period on cognitive restraint, F (1, 252) = 3.89, p = .050, and partial η2 = .015.

CONCLUSION

Our study found a relationship between vicarious racial discrimination and maladaptive eating behaviors among Black women. Future work should examine stress related to vicarious racial discrimination and maladaptive eating behaviors longitudinally.

What Is the Profile of Overweight Individuals Who Are Unsuccessful Responders to a Low-Energy Diet? A PREVIEW Sub-study

This study was performed to evaluate the profile of overweight individuals with pre-diabetes enrolled in PREVIEW who were unable to achieve a body weight loss of ≥8% of the baseline value in response to a 2-month low-energy diet (LED). Their baseline profile reflected potential stress-related vulnerability that predicted a reduced response of body weight to a LED programme. The mean daily energy deficit maintained by unsuccessful weight responders of both sexes was less than the estimated level in successful female (656 vs. 1,299 kcal, p < 0.01) and male (815 vs. 1,659 kcal, p < 0.01) responders. Despite this smaller energy deficit, unsuccessful responders displayed less favorable changes in susceptibility to hunger and appetite sensations. They also did not benefit from the intervention regarding the ability to improve sleep quality. In summary, these results show that some individuals display a behavioral vulnerability which may reduce the ability to lose weight in response to a diet-based weight loss program. They also suggest that this vulnerability may be accentuated by a prolonged diet restriction.

Effects of Health Behavior Interventions on Psychosocial Outcomes and Cortisol Regulation Among Chronically Stressed Midlife and Older Adults

BACKGROUND

Altered cortisol dynamics have been associated with increased risk for chronic health problems among midlife and older adults (≥ 45 years of age). Yet, studies investigating the impact of health behavior interventions on cortisol activity in this age group are limited.

OBJECTIVE AND METHODS

The current study examined whether 48 midlife and older adults (50% family caregivers, 69% women) randomized to one of four telephone-based health behavior interventions (stress management (SM), exercise (EX), nutrition (NUT), or exercise plus nutrition (EX+NUT)) showed improvements in their perceived stress, mood, and cortisol dynamics at 4 months post-intervention. Participants collected four salivary cortisol samples (waking, 30 min after waking, 4 p.m., and bedtime) across two collection days at baseline and at 4 months post-intervention to assess for total cortisol, cortisol awakening response (CAR), and diurnal cortisol slope.

RESULTS

Participants in SM showed lower levels of total cortisol and a smaller CAR compared with those in EX, NUT, or EX+NUT from baseline to 4 months post-intervention. Participants in EX showed lower levels of perceived stress, depression, and anxiety compared with those in NUT or SM. Finally, participants in NUT showed a greater diurnal decline in cortisol and lower levels of anxiety compared with those in SM.

CONCLUSIONS

These findings provide support for the efficacy of telephone-based, health behavior interventions in improving different stress outcomes among chronically stressed midlife and older adults and suggest the need to test the longer-term effects of these interventions for improving health outcomes in this population.

Four Weeks of Time-Restricted Feeding Combined with Resistance Training Does Not Differentially Influence Measures of Body Composition, Muscle Performance, Resting Energy Expenditure, and Blood Biomarkers

Recently, interest in time-restricted feeding (TRF) has increased from reports highlighting improvements in body composition and muscular performance measures. Twenty-six recreationally active males were randomly assigned to either TRF (n = 13; ~22.9 years; 82.0 kg; 178.1 cm; 8 h eating window, 25% caloric deficit, 1.8 g/kg/day protein) or normal diet (ND; n = 13; ~22.5 years; 83.3 kg; 177.5 cm; normal meal pattern; 25% caloric deficit, 1.8 g/kg/day protein) groups. Participants underwent 4-weeks of supervised full body resistance training. Changes in body composition (fat mass (FM), fat free mass (FFM), and body fat percentage (BF%)), skeletal muscle cross sectional area (CSA) and muscle thickness (MT) of the vastus lateralis (VL), rectus femoris, (RF), and biceps brachii (BB) muscles, resting energy expenditure (REE), muscular performance, blood biomarkers, and psychometric parameters were assessed. Significant (p < 0.05) decreases were noted in BM, FM, BF%, testosterone, adiponectin, and REE, along with significant increases in BP_1RM, LP_1RM, VJ_HT, VJ_PP, VL_CSA, BB_CSA, and BB_MT in both groups. Plasma cortisol levels were significantly elevated at post (p = 0.018) only in ND. Additionally, FFM was maintained equally between groups. Thus, a TRF style of eating does not enhance reductions in FM over caloric restriction alone during a 4-week hypocaloric diet.

Increasing Dietary Carbohydrate as Part of a Healthy Whole Food Diet Intervention Dampens Eight Week Changes in Salivary Cortisol and Cortisol Responsiveness

It is largely unknown whether and how whole food diets influence psychological stress and stress system responsiveness. To better understand the effects of whole diets on stress system responsiveness, we examined randomized control trial effects of a whole food diet based on the Dietary Guidelines for Americans (DGA) on cortisol responsiveness. A randomized, double-blind, controlled 8-week intervention was conducted in overweight and obese women to examine differentiated effects between two diet intervention groups: one based on the 2010 DGA and the other one based on a typical American diet (TAD). During a test week that occurred at baseline and again after 8 weeks of the intervention, we assessed salivary cortisol collected at 14 selected times across the day, including upon awakening, at bedtime, and during a test visit, and administered a standardized social stress task (Trier Social Stress Test, TSST). There were no statistical differences between the diet groups in salivary cortisol at baseline or after 8 weeks. However, when considering differences in dietary carbohydrate, but not fat or protein, from the pre-intervention (habitual) to the intervention period, there was a significant (P = 0.0001) interaction between diet group, intervention week, saliva sample, and level of intervention-based change in carbohydrate consumption. This interaction was reflected primarily by an 8-week reduction in salivary cortisol during a period just prior to (log Δ −0.35 ± 0.12 nmol/L) and 30 (log Δ −0.49 ± 0.12 nmol/L), 60 (log Δ −0.50 ± 0.13 nmol/L), 90 (log Δ −0.51 ± 0.13 nmol/L), and 120 (log Δ −0.4476 ± 0.1231 nmol/L) min after the TSST in the DGA group having the highest increase (90th percentile) in carbohydrate consumption. In support of this finding, we also found significant (P < 0.05) and inverse linear associations between dietary carbohydrate and log salivary cortisol, with the strongest negative association (β: −0.004 ± 0.0015, P = 0.009) occurring at 30 min post-TSST, but only in the DGA group and at week 9 of the intervention. Together, increasing dietary carbohydrate as part of a DGA-based diet may reduce circulating cortisol and dampen psychological stress-related cortisol responsiveness.

Diet Quality for Sodium and Vegetables Mediate Effects of Whole Food Diets on 8-Week Changes in Stress Load

Very little is known about how whole food diets, such as those based on the Dietary Guidelines for Americans (DGA), influence psychological stress and physiological stress load. To better understand the effects of whole food diets on stress, we examined in a randomized control trial the effects of a DGA-based diet on markers of psychological and physiological stress. A randomized, double-blind, controlled 8-week intervention was conducted in overweight and obese women randomly assigned to one of two diet groups: a diet based on the 2010 DGA or a diet based on a Typical American Diet (TAD). The Perceived Stress Scale and allostatic load were used to assess stress load. Eight-week change in perceived stress did not significantly (p = 0.45) differ between the DGA (+0.53 ± 0.99) and TAD (-0.57 ± 0.99) groups. Likewise, 8-week change in allostatic load did not significantly (p = 0.79) differ between the two diet intervention groups (DGA: +0.001 ± 0.26 vs. TAD: +0.105 ± 0.28). However, we did find strong inverse associations between 8-week change in stress and intervention-based improvements in diet quality (lower sodium and higher vegetable consumption). When statistically accounting for these inverse associations, we found that perceived stress and allostatic load were higher (p < 0.04) in the DGA group. These findings suggest that improvements in dietary vegetable and sodium intake mediated effects of the diet intervention on psychological and physiological stress load. That is, adopting and adhering to a diet of higher quality (DGA) for 8 weeks may have been generally more stressful in the absence of improvements in vegetable or sodium consumption. This study provides further evidence for the mental health benefits of maximizing vegetable and minimizing sodium consumption.

Impact of Experimentally Induced Cognitive Dietary Restraint on Eating Behavior Traits, Appetite Sensations, and Markers of Stress during Energy Restriction in Overweight/Obese Women

Weight loss has been associated with changes in eating behaviors and appetite sensations that favor a regain in body weight. Since traditional weight loss approaches emphasize the importance of increasing cognitive dietary restraint (CDR) to achieve negative energy imbalance, it is difficult to untangle the respective contributions of energy restriction and increases in CDR on factors that can eventually lead to body weight regain. The present study aimed at comparing the effects of energy restriction alone or in combination with experimentally induced CDR on eating behavior traits, appetite sensations, and markers of stress in overweight and obese women. We hypothesized that the combination of energy restriction and induced CDR would lead to more prevalent food cravings, increased appetite sensations, and higher cortisol concentrations than when energy restriction is not coupled with induced CDR. A total of 60 premenopausal women (mean BMI: 32.0 kg/m2; mean age: 39.4 y) were provided with a low energy density diet corresponding to 85% of their energy needs during a 4-week fully controlled period. At the same time, women were randomized to either a condition inducing an increase in CDR (CDR+ group) or a condition in which CDR was not induced (CRD- group). Eating behavior traits (Three-Factor Eating Questionnaire and Food Craving Questionnaire), appetite sensations (after standardized breakfast), and markers of stress (Perceived Stress Scale; postawakening salivary cortisol) were measured before (T = 0 week) and after (T = 4 weeks) the 4-week energy restriction, as well as 3 months later. There was an increase in CDR in the CDR+ group while no such change was observed in the CDR- group (p=0.0037). No between-group differences were observed for disinhibition, hunger, cravings, appetite sensations, perceived stress, and cortisol concentrations. These results suggest that a slight increase in CDR has no negative impact on factors regulating energy balance in the context of energy restriction.

The Relationship of Disordered Eating Attitudes with Stress Level, Bone Turnover Markers, and Bone Mineral Density in Obese Adolescents

OBJECTIVE

To investigate the effect of stress caused by disordered eating attitudes on bone health in obese adolescents.

METHODS

A cross-sectional study comprising 80 obese adolescents was performed from November 2013 to September 2014. Twenty-four-hour urinary free cortisol levels were measured as a biological marker of stress. Bone turnover was evaluated using bone-specific alkaline phosphatase, serum osteocalcin, and urinary N-telopeptide concentrations. Bone mineral density was measured using dual-energy X-ray absorptiometry. The Eating Disorder Examination Questionnaire, Dutch Eating Behavior Questionnaire, Children's Depression Inventory, and the State-Trait Anxiety Inventory for Children were used to assess eating disorders, depression, and anxiety. Psychiatric examinations were performed for binge eating disorders.

RESULTS

In the Pearson's correlation test, a positive correlation was found between the 24-hour urinary cortisol level and Dutch Eating Behavior Questionnaire total and restrained eating subscale scores (p<0.05 for both). In linear regression analyses, the Dutch Eating Behavior Questionnaire total and restrained eating subscale scores were found to be significant contributors for urinary cortisol level (β=1.008, p=0.035; β=2.296, p=0.014, respectively). The femoral neck areal bone mineral density was found to be significantly higher in subjects who had binge eating disorder compared with those without binge eating disorder (p=0.049).

CONCLUSION

Despite the lack of apparent effects on bone turnover and bone mineral density in our obese adolescents at the time of the study, our results suggest that disordered eating attitudes, and especially restrained eating attitudes, might be a source of stress. Therefore, studies in this area should continue.

THE ENDOCRINOLOGY OF AGING: A KEY TO LONGEVITY "GREAT EXPECTATIONS"

ABBREVIATIONS

AMP = adenosine monophosphate CETP = cholesteryl ester transfer protein FOXO = Forkhead box O GH = growth hormone HDL = high-density lipoprotein IGF-1 = insulin-like growth factor 1 LDL = low-density lipoprotein miRNA = microRNA mTOR = mammalian target of rapamycin SIRT = sirtuin T4 = thyroxine TSH = thyroid-stimulating hormone "The Moving Finger writes; and, having writ, Moves on: nor all thy Piety nor Wit Shall lure it back to cancel half a Line, Nor all thy Tears wash out a Word of it." Omar Khayyam ( 1 ).

The paradox of overnutrition in aging and cognition

Populations of many countries are becoming increasingly overweight and obese, driven largely by excessive calorie intake and reduced physical activity; greater body mass is accompanied by epidemic levels of comorbid metabolic diseases. At the same time, individuals are living longer. The combination of aging and the increased prevalence of metabolic disease is associated with increases in aging-related comorbid diseases such as Alzheimer's disease, cerebrovascular dementia, and sarcopenia. Here, correlative and causal links between diseases of overnutrition and diseases of aging and cognition are explored.

Associations between weight-related eating behaviors and adiposity in postmenopausal Japanese American and white women

The purpose of this study was to test the associations between cognitive and psychological eating behavior traits and detailed measures of adiposity and body fat distribution using imaging-based methods in a cross-sectional study. Eating behavior traits (compensatory and routine restraint, external eating, and emotional eating) were assessed using the validated Weight-Related Eating Questionnaire, and measures of adiposity using anthropometry, dual energy X-ray absorptiometry (DXA), and magnetic resonance imaging (MRI). Each adiposity outcome of interest (total fat, ratio of trunk fat to periphery fat, visceral and subcutaneous fats as % of abdominal area, and % liver fat) was regressed on the four eating behaviors while adjusting for age and race/ethnicity. This study included a total of 60 postmenopausal Japanese American (n=30) and white (n=30) women (age: 60-65 years, BMI: 18.8-39.6 kg/m(2)). Weight-related eating behavior traits did not differ by ethnicity. Higher external eating scores were associated with measures of total adiposity, including higher BMI (β=0.36, p=0.02) and DXA total fat mass (β=0.41, p=0.001), and with MRI abdominal subcutaneous fat (β=0.55, p=0.001). Higher routine restraint scores were associated with visceral adiposity (β=0.42, p=0.04). Our findings suggest that different weight-related eating behavior traits might increase not only total adiposity but also abdominal and visceral fat deposition associated with higher metabolic risks. Future research, preferably in a prospective study of men and women and including biomarkers related to psychological stress, will be needed to explore potential underlying biological mechanisms.

Healthy eating perceptions of older adults living in Canadian rural and northern communities

Aging produces physiologic changes that can affect the nutritional health of the older adult. It is estimated that 80% of community-dwelling older adults have inadequate intakes of four or more nutrients. Socioeconomic factors, such as income and geographic location, can also play an important role in nutritional status; however, limited research is available that specifically explores this. The purpose of this qualitative study was to examine the healthy eating perceptions of older adults residing in rural and northern communities in one Canadian province. Five focus groups were conducted in three rural and two northern Manitoba communities. Thirty-nine older adults participated in audio-recorded focus groups. Five themes emerged from the discussions. All respondents stated that healthy eating was important, but knowledge deficits were observed regarding label reading, understanding and visualizing portion sizes, and vitamin D recommendations and sources. Food programs were not commonly attended by participants due to availably and resistance. Regularly delivered nutrition education programs would assist in providing current nutrition information to older adults and their families in rural settings.

Eating attitudes and behaviours in elite Canadian athletes with a spinal cord injury

Athletes with a spinal cord injury (SCI) appear to have relatively modest energy requirements despite demanding training regimes. Virtually nothing is known about the factors which influence the energy intake of those with a SCI including food related attitudes and behaviours. Using a cross-sectional observational design, three aspects of eating attitudes were measured using the Three-Factor Eating Questionnaire (TFEQ) along with six days of self-reported dietary intake and anthropometrics. Between March 2007 and May 2009, a total of 32 Canadian athletes with a SCI (n=24 men, n=8 women) completed the study. The TFEQ scales showed a cognitive dietary restraint score of 10.8±4.7, disinhibition score of 2.8±1.8 and hunger score of 3.1±2.2. When the group was split into high and low restraint groups using a median of 11.5, no differences were detected in any of the absolute parameters of reported dietary intake although the higher restraint group had protein intakes account for a greater proportion of total energy. Those with higher restraint scores also had a relatively higher disinhibition score. While the cognitive dietary restraint scores for the women were similar to other able-bodied populations, the scores for men were higher than population norms from other studies. The scores for disinhibition and hunger were lower than reported ranges from able-bodied subjects. These athletes may be actively monitoring or limiting dietary intake to avoid the high prevalence of obesity associated with a SCI or perhaps to maintain an ideal body composition for their sport performance.

Appetite-regulating hormones cortisol and peptide YY are associated with disordered eating psychopathology, independent of body mass index

OBJECTIVE

Disordered eating occurs in women at both weight extremes of anorexia nervosa (AN) and obesity. Cortisol, peptide YY (PYY), leptin, and ghrelin are hormones involved in appetite and feeding behavior that vary with weight and body fat. Abnormal levels of these hormones have been reported in women with AN, functional hypothalamic amenorrhea (HA), and obesity. The relationship between appetite-regulating hormones and disordered eating psychopathology is unknown. We therefore studied the relationship between orexigenic and anorexigenic hormones and disordered eating psychopathology in women across a range of weights.

DESIGN

A cross-sectional study of 65 women, 18-45 years: 16 with AN, 12 normal-weight with HA, 17 overweight or obese, and 20 normal-weight in good health.

METHODS

Two validated measures of disordered eating psychopathology, the Eating Disorders Examination-Questionnaire (EDE-Q) and Eating Disorders Inventory-2 (EDI-2), were administered. Fasting PYY, leptin, and ghrelin levels were measured; cortisol levels were pooled from serum samples obtained every 20 min from 2000 to 0800 h.

RESULTS

Cortisol and PYY levels were positively associated with disordered eating psychopathology including restraint, eating concerns, and body image disturbance, independent of body mass index (BMI). Although leptin levels were negatively associated with disordered eating psychopathology, these relationships were not significant after controlling for BMI. Ghrelin levels were generally not associated with EDE-Q or EDI-2 scores.

CONCLUSIONS

Higher levels of cortisol and PYY are associated with disordered eating psychopathology independent of BMI in women across the weight spectrum, suggesting that abnormalities in appetite regulation may be associated with specific eating disorder pathologies.

The relationship between 24-h urinary cortisol and bone in healthy young women

BACKGROUND

Cortisol within the normal range has been associated with reduced bone density in the elderly, but little is known about this relationship in healthy young women.

PURPOSE

The purpose of this study is to assess whether 24-h urinary free cortisol excretion (UFC) is related to bone density in 132 healthy, non-obese, regularly menstruating women, aged 19-35.

METHOD

Participants completed questionnaires (food frequency, demographics, physical activity, dietary restraint, perceived stress, and daily stress) and a 24-h urine collection. UFC was determined by high-throughput liquid chromatography and tandem mass spectrometry. Anthropometrics were completed and a dual energy X-ray absorptiometry scan measured areal bone mineral density (aBMD, g/cm(2)) and bone mineral content (BMC, g) at the lumbar spine (L1-4), hip, and total body (TB) as well as total body lean (LBM) and fat mass.

RESULTS

aBMD and BMC were significantly positively associated with height, LBM, physical activity, calcium intake, and duration of previous oral contraceptive use (except L1-4) and negatively with perceived stress. UFC was not correlated with any measured variables except urine volume (r = 0.17, p = 0.046). After adjusting for urine volume, height, LBM, ethnicity, and prior oral contraceptive use, UFC was significantly inversely associated with TB BMC (r = -0.30, p < 0.001) and aBMD (r = -0.27, p = 0.003), L1-4 aBMD (r = -0.19, p = 0.035) and BMC (r = -0.18, p = 0.049), and hip BMC (r = -0.23, p = 0.011). Further adjustment for sport activity, calcium intake and perceived stress did not change these relationships meaningfully except that L1-4 became nonsignificant (p < 0.07).

CONCLUSION

Cortisol within the normal range appears to have a minor negative influence on bone density in healthy young women.

A prospective exploration of cognitive dietary restraint, subclinical ovulatory disturbances, cortisol, and change in bone density over two years in healthy young women

CONTEXT

Cross-sectional studies have found associations among elevated cognitive dietary restraint (CDR), increased ovulatory disturbances, and lower bone mass, possibly mediated by cortisol.

OBJECTIVE

To determine whether healthy young women with higher CDR have more menstrual cycles with subclinical ovulatory disturbances (SOD), elevated 24-h urinary free cortisol (UFC), and less positive 2-yr areal bone mineral density change (Delta-aBMD).

DESIGN, SETTING, AND PARTICIPANTS

We conducted a 2-yr longitudinal study of 123 healthy, community-dwelling, nonobese, regularly menstruating women aged 19-35 yr.

MAIN OUTCOME MEASURES

Key variables were Three Factor Eating Questionnaire Restraint score, percent of cycles with anvoluation and/or luteal phase length <10 d (%SOD), UFC, and Delta-aBMD at the lumbar spine (L1-L4), total hip, and whole body. Anthropometrics, general stress, physical activity, and energy intake were measured. Adjusting for potential confounders, differences were examined by general linear modeling using median split of CDR score and %SOD.

RESULTS

Women with higher CDR had higher %SOD (56 vs. 34%, P < 0.001) and higher UFC (28.0 vs. 24.0 microg/d, P = 0.021). Delta-aBMD did not differ by CDR. Women with higher %SOD had less positive Delta-aBMD at L1-L4 (0.7 vs. 1.9%, P = 0.034) and hip (-0.6 vs. 0.9%, P = 0.001), and higher CDR score (8.7 vs. 7.1, P = 0.04). Physical activity, general stress, body mass index, and energy intake did not explain differences by CDR or %SOD. UFC was not associated with %SOD or Delta-aBMD.

CONCLUSION

Women with more frequent SOD reported higher CDR and experienced less positive Delta-aBMD. Although women with higher CDR had higher UFC, the mechanism linking CDR, SOD, and aBMD is not clear.

Low calorie dieting increases cortisol

OBJECTIVE

To test the hypothesis that dieting, or the restriction of caloric intake, is ineffective because it increases chronic psychological stress and cortisol production--two factors that are known to cause weight gain; and to examine the respective roles of the two main behaviors that comprise dieting--monitoring one's caloric intake and restricting one's caloric intake--on psychological and biological stress indicators.

METHODS

In a 2 (monitoring vs. not) x 2 (restricting vs. not) fully crossed, controlled experiment, 121 female participants were assigned randomly to one of four dietary interventions for 3 weeks. The monitoring + restricting condition tracked their caloric intake and restricted their caloric intake (1200 kcal/day); the monitoring only condition tracked their caloric intake but ate normally; the restricting only condition was provided 1200 kcal/day of food but did not track their calories, and the control group ate normally and did not track their intake. Before and after the interventions, participants completed measures of perceived stress and 2 days of diurnal saliva sampling to test for cortisol.

RESULTS

Restricting calories increased the total output of cortisol, and monitoring calories increased perceived stress.

CONCLUSIONS

Dieting may be deleterious to psychological well-being and biological functioning, and changes in clinical recommendations may be in order.

"Restrained eating" vs "trying to lose weight": how are they associated with body weight and tendency to overeat among postmenopausal women?

In an effort to control body weight, many women diet or adopt a restrained approach to eating. Although common, dieting and dietary restraint remain poorly understood. Clarification of their association with health-related factors, such as body weight and overeating, is required. In this study, we explored how dieting and dietary restraint were associated with body mass index (BMI; calculated as kg/m2) and disinhibition (tendency to overeat) in a sample of 1,071 postmenopausal women aged 45 to 75 years. In a survey of dietary attitudes and body image, we asked about current dieting status and measured restrained eating and disinhibition. Self-reported height and weight were used to calculate BMI, which was confirmed in a subset. Participants were classified by dieting status (yes/no) and level of dietary restraint (high/low by median split).We examined the independent effects of dieting and restrained eating on BMI and disinhibition. More than half of the sample (53%) reported current dieting. Dieting and dietary restraint showed opposite associations with BMI. Among dieters, BMI was 4.1 higher (95% confidence interval: 3.6 to 4.6) than among nondieters. In contrast, BMI of restrained eaters was 1.0 lower (95% confidence interval: -1.6 to -0.5) than unrestrained eaters. Dieters had higher scores for disinhibition, but disinhibition scores of restrained eaters did not differ from those of unrestrained eaters. Our results suggest that dieting and dietary restraint are not equivalent. Finding that dietary restraint is associated with lower BMI (when considered independently of dieting) suggests that restrained eating, rather than dieting, may contribute to successful weight management.

Dietary restraint and telomere length in pre- and postmenopausal women

BACKGROUND

Leukocyte telomere shortening can serve as a biomarker of aging, as telomere length (TL) can decline with age and shortening is positively associated with morbidity and mortality. It is therefore important to identify psychological and behavioral factors linked to accelerated telomere shortening. Stress and poorer metabolic health (greater adiposity, insulin resistance, and cortisol) correlate with shorter telomeres. Self-reported dietary restraint (DR), defined as chronic preoccupation with weight and attempts at restricting food intake, is linked to greater perceived stress, cortisol, and weight gain, when assessed in community studies (versus in weight loss programs).

OBJECTIVE

To test for an association between DR and TL in healthy women across a range of ages.

METHODS

We examined whether DR is linked to TL in two samples, one of premenopausal women (aged 20-50 years;N = 36) and one of postmenopausal women (aged 53-69 years; N = 20).

RESULTS

In both samples, higher levels of DR were associated with shorter leukocyte TL, independent of body mass index, smoking, and age.

CONCLUSIONS

Chronic DR, as assessed by self-report (i.e. not caloric restriction), may be a risk factor for premature telomere shortening. Potential mechanisms are discussed.

Awakening cortisol response in relation to psychosocial profiles and eating behaviors

Awakening cortisol response was measured in 78 men and women, on 3 mornings within a 2-month period. Psychosocial and eating behavior variables were assessed using self-administered questionnaires on anxiety (State-Trait Anxiety Inventory), depression (Beck Depression Inventory), body esteem (Body Esteem Scale for Adolescents and Adults), and eating behaviors (Three-Factor Eating Questionnaire and Eating Disorder Inventory-2). Data on food intake and appetite sensations were also collected using a buffet-type meal test, a 3-day food record and visual analog scales measured before and after a standardized breakfast meal test. In women, high anxiety, disinhibition and hunger scores, as well as poor body esteem and a high weight preoccupation, were negatively correlated to ACR. The factor that appeared to account the most for this inverse relation was emotional susceptibility to disinhibition (r=-0.61, p=0.003). The latter was also negatively associated with the satiety quotient for fullness in response to the standardized breakfast (r=-0.48, p=0.010). In men, ACR was negatively associated with flexible (r=-0.33, p=0.020) and strategic (r=-0.28, p=0.049) restraint behaviors. This study highlights a gender-dependent relationship between ACR, hence the activity of the hypothalamic-pituitary-adrenal axis, and eating behaviors and psychological profiles.

Stress, eating and the reward system

An increasing number of people report concerns about the amount of stress in their life. At the same time obesity is an escalating health problem worldwide. Evidence is accumulating rapidly that stress related chronic stimulation of the hypothalamic-pituitary-adrenal (HPA) axis and resulting excess glucocorticoid exposure may play a potential role in the development of visceral obesity. Since adequate regulation of energy and food intake under stress is important for survival, it is not surprising that the HPA axis is not only the 'conductor' of an appropriate stress response, but is also tightly intertwined with the endocrine regulation of appetite. Here we attempt to link animal and human literatures to tease apart how different types of psychological stress affect eating. We propose a theoretical model of Reward Based Stress Eating. This model emphasizes the role of cortisol and reward circuitry on motivating calorically dense food intake, and elucidating potential neuroendocrine mediators in the relationship between stress and eating. The addiction literature suggests that the brain reward circuitry may be a key player in stress-induced food intake. Stress as well as palatable food can stimulate endogenous opioid release. In turn, opioid release appears to be part of an organisms' powerful defense mechanism protecting from the detrimental effects of stress by decreasing activity of the HPA axis and thus attenuating the stress response. Repeated stimulation of the reward pathways through either stress induced HPA stimulation, intake of highly palatable food or both, may lead to neurobiological adaptations that promote the compulsive nature of overeating. Cortisol may influence the reward value of food via neuroendocrine/peptide mediators such as leptin, insulin and neuropeptide Y (NPY). Whereas glucocorticoids are antagonized by insulin and leptin acutely, under chronic stress, that finely balanced system is dysregulated, possibly contributing to increased food intake and visceral fat accumulation. While these mechanisms are only starting to be elucidated in humans, it appears the obesity epidemic may be exacerbated by the preponderance of chronic stress, unsuccessful attempts at food restriction, and their independent and possibly synergistic effects on increasing the reward value of highly palatable food.

Self-reported lifetime physical activity and areal bone mineral density in healthy postmenopausal women: the importance of teenage activity

Girls who exercise athletically have higher bone mass than their sedentary counterparts, and this difference may be sustained in adulthood. However, whether moderate physical activity during youth confers lasting benefits for bone is unclear. We explored lifetime physical activity and current areal bone mineral density (aBMD) in 78 postmenopausal women with no known history of osteoporosis. Subjects reported physical activity for four age periods (12-18, 19-34, 35-49, > or = 50 years) using the Historical Leisure Activity Questionnaire, completed two 3-day food records, had measurements of height and weight, and aBMD assessed using dual-energy X-ray absorptiometry at the lumbar spine (L1-4) and proximal femora. Low aBMD was detected at the lumbar spine in 43 (56%) women and at the proximal femora in 38 (49%) women. Teenage physical activity, but not activity during other age periods, was associated with current aBMD at both sites (lumbar spine r = 0.31, P < 0.01; mean proximal femora r = 0.33, P < 0.01). Weight-bearing physical activity (WBPA) at age 12-18 years was the only predictor of current lumbar spine aBMD (R (2) = 0.110, P = 0.004). Current proximal femoral aBMD was positively predicted by physical activity at age 12-18 years and negatively predicted by current age (R (2) = 0.175, P = 0.001). Subjects above the median of teen WBPA had 5-8% higher current aBMD than those reporting less teen WBPA and were less likely to be classified with osteopenia or osteoporosis. Moderate physical activity during years of peak bone acquisition appears to have lasting benefits for lumbar spine and proximal femoral aBMD in postmenopausal women.