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Ramsay S, Allison K, Temples HS, Boccuto L, Sarasua SM. Inclusion of the severe and enduring anorexia nervosa phenotype in genetics research: a scoping review. J Eat Disord 2024; 12:53. [PMID: 38685102 PMCID: PMC11059621 DOI: 10.1186/s40337-024-01009-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/23/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Anorexia nervosa has one of the highest mortality rates of all mental illnesses. For those who survive, less than 70% fully recover, with many going on to develop a more severe and enduring phenotype. Research now suggests that genetics plays a role in the development and persistence of anorexia nervosa. Inclusion of participants with more severe and enduring illness in genetics studies of anorexia nervosa is critical. OBJECTIVE The primary goal of this review was to assess the inclusion of participants meeting the criteria for the severe enduring anorexia nervosa phenotype in genetics research by (1) identifying the most widely used defining criteria for severe enduring anorexia nervosa and (2) performing a review of the genetics literature to assess the inclusion of participants meeting the identified criteria. METHODS Searches of the genetics literature from 2012 to 2023 were performed in the PubMed, PsycINFO, and Web of Science databases. Publications were selected per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The criteria used to define the severe and enduring anorexia nervosa phenotype were derived by how often they were used in the literature since 2017. The publications identified through the literature search were then assessed for inclusion of participants meeting these criteria. RESULTS most prevalent criteria used to define severe enduring anorexia nervosa in the literature were an illness duration of ≥ 7 years, lack of positive response to at least two previous evidence-based treatments, a body mass index meeting the Diagnostic and Statistical Manual of Mental Disorders-5 for extreme anorexia nervosa, and an assessment of psychological and/or behavioral severity indicating a significant impact on quality of life. There was a lack of consistent identification and inclusion of those meeting the criteria for severe enduring anorexia nervosa in the genetics literature. DISCUSSION This lack of consistent identification and inclusion of patients with severe enduring anorexia nervosa in genetics research has the potential to hamper the isolation of risk loci and the development of new, more effective treatment options for patients with anorexia nervosa.
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Affiliation(s)
- Sarah Ramsay
- Healthcare Genetics and Genomics Program, School of Nursing, Clemson University, Clemson, SC 29634, USA.
| | - Kendra Allison
- School of Nursing, Clemson University , Clemson, SC 29634, USA
| | - Heide S Temples
- School of Nursing, Clemson University , Clemson, SC 29634, USA
| | - Luigi Boccuto
- Healthcare Genetics and Genomics Program, School of Nursing, Clemson University, Clemson, SC 29634, USA
| | - Sara M Sarasua
- Healthcare Genetics and Genomics Program, School of Nursing, Clemson University, Clemson, SC 29634, USA
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Suzuki Y, Itagaki S, Nodera M, Suyama K, Yabe H, Hosoya M. Comparison of metabolic parameters between oral and total parenteral nutrition in children with severe eating disorders. Fukushima J Med Sci 2024; 70:75-85. [PMID: 38599829 PMCID: PMC11140198 DOI: 10.5387/fms.2023-02] [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] [Received: 01/17/2023] [Accepted: 01/19/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND This study investigated changes of lipid parameters in children with severe eating disorders during refeeding in order to explore the optimal timing for lipid preparation administration. METHODS We prospectively assessed the physical conditions of patients with eating disorders after the start of nutrition therapy. The assessments were performed at admission and at 2 and 4 weeks. Lipid metabolism was assessed based on triglyceride (TG), total cholesterol (TC), and free carnitine (FC) levels, as well as acylcarnitine/free carnitine (AC/FC) ratio. RESULTS A total of 18 patients were included. Of these, 12 and 6 received an oral diet (OD group) and total parenteral nutrition (TPN group), respectively. The mean body mass indexes at hospital admission were 12.8 kg/m2 in the OD group and 12.7 kg/m2 in the TPN group. At 2 weeks after the start of refeeding, TC, TG, and AC/FC levels were significantly lower in the TPN group than in the OD group. Other blood test results did not show any significant differences between the two groups. CONCLUSIONS Fat-free glucose-based nutrition promoted lipid metabolism over a 2-week period after the start of refeeding, suggesting that balanced energy and lipid intake are essential, even in TPN.
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Affiliation(s)
- Yuichi Suzuki
- Department of Pediatrics, Fukushima Medical University School of Medicine
| | - Shuntaro Itagaki
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine
| | - Maki Nodera
- Department of Pediatrics, Fukushima Medical University School of Medicine
| | - Kazuhide Suyama
- Department of Pediatrics, Fukushima Medical University School of Medicine
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University School of Medicine
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Suzuki Y, Itagaki S, Nodera M, Suyama K, Yabe H, Hosoya M. Comparison of metabolic parameters between oral and total parenteral nutrition in children with severe eating disorders. Fukushima J Med Sci 2024:2023_02. [PMID: 38522893 DOI: 10.5387/fms.2023_02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND This study investigated changes of lipid parameters in children with severe eating disorders during refeeding in order to explore the optimal timing for lipid preparation administration. METHODS We prospectively assessed the physical conditions of patients with eating disorders after the start of nutrition therapy. The assessments were performed at admission and at 2 and 4 weeks. Lipid metabolism was assessed based on triglyceride (TG), total cholesterol (TC), and free carnitine (FC) levels, as well as acylcarnitine/free carnitine (AC/FC) ratio. RESULTS A total of 18 patients were included. Of these, 12 and 6 received an oral diet (OD group) and total parenteral nutrition (TPN group), respectively. The mean body mass indexes at hospital admission were 12.8 kg/m2 in the OD group and 12.7 kg/m2 in the TPN group. At 2 weeks after the start of refeeding, TC, TG, and AC/FC levels were significantly lower in the TPN group than in the OD group. Other blood test results did not show any significant differences between the two groups. CONCLUSIONS Fat-free glucose-based nutrition promoted lipid metabolism over a 2-week period after the start of refeeding, suggesting that balanced energy and lipid intake are essential, even in TPN.
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Affiliation(s)
- Yuichi Suzuki
- Department of Pediatrics, Fukushima Medical University School of Medicine
| | - Shuntaro Itagaki
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine
| | - Maki Nodera
- Department of Pediatrics, Fukushima Medical University School of Medicine
| | - Kazuhide Suyama
- Department of Pediatrics, Fukushima Medical University School of Medicine
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University School of Medicine
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Šarac I, Debeljak-Martačić J, Takić M, Stevanović V, Milešević J, Zeković M, Popović T, Jovanović J, Vidović NK. Associations of fatty acids composition and estimated desaturase activities in erythrocyte phospholipids with biochemical and clinical indicators of cardiometabolic risk in non-diabetic Serbian women: the role of level of adiposity. Front Nutr 2023; 10:1065578. [PMID: 37545582 PMCID: PMC10397414 DOI: 10.3389/fnut.2023.1065578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Fatty acids (FAs) composition and desaturase activities can be altered in different metabolic conditions, but the adiposity-independent associations with clinical and biochemical indicators of cardiometabolic risk are still unclear. This study aimed to analyze the associations of FAs composition and estimated desaturase activities with anthropometric, clinical, and biochemical cardiometabolic risk indicators in non-diabetic Serbian women, and to investigate if these associations were independent of the level of adiposity and other confounders. Methods In 76 non-diabetic, otherwise healthy Serbian women, aged 24-68 years, with or without metabolic syndrome or obesity (BMI=23.6±5.6 kg/m2), FA composition in erythrocyte phospholipids was measured by gas-liquid chromatography. Desaturase activities were estimated from product/precursor FAs ratios (D9D:16:1n-7/16:0; D6D:20:3n-6/18:2n-6; D5D:20:4n-6/20:3n-6). Correlations were made with anthropometric, biochemical (serum glucose, triacylglycerols, LDL-C, HDL-C, ALT, AST, and their ratios) and clinical (blood pressure) indicators of cardiometabolic risk. Linear regression models were performed to test the independence of these associations. Results Estimated desaturase activities and certain FAs were associated with anthropometric, clinical and biochemical indicators of cardiometabolic risk: D9D, D6D, 16:1n-7 and 20:3n-6 were directly associated, while D5D and 18:0 were inversely associated. However, the associations with clinical and biochemical indicators were not independent of the associations with the level of adiposity, since they were lost after controlling for anthropometric indices. After controlling for multiple confounders (age, postmenopausal status, education, smoking, physical activity, dietary macronutrient intakes, use of supplements, alcohol consumption), the level of adiposity was the most significant predictor of desaturase activities and aforementioned FAs levels, and mediated their association with biochemical/clinical indicators. Vice versa, desaturase activities predicted the level of adiposity, but not other components of cardiometabolic risk (if the level of adiposity was accounted). While the associations of anthropometric indices with 16:1n-7, 20:3n-6, 18:0 and D9D and D6D activities were linear, the associations with D5D activity were the inverse U-shaped. The only adiposity-independent association of FAs profiles with the indicators of cardiometabolic risk was a positive association of 20:5n-3 with ALT/AST ratio, which requires further exploration. Discussion Additional studies are needed to explore the mechanisms of the observed associations.
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Affiliation(s)
- Ivana Šarac
- Centre of Research Excellence in Nutrition and Metabolism, Group for Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jasmina Debeljak-Martačić
- Centre of Research Excellence in Nutrition and Metabolism, Group for Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Marija Takić
- Centre of Research Excellence in Nutrition and Metabolism, Group for Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Vuk Stevanović
- Centre of Research Excellence in Nutrition and Metabolism, Group for Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jelena Milešević
- Centre of Research Excellence in Nutrition and Metabolism, Group for Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Milica Zeković
- Centre of Research Excellence in Nutrition and Metabolism, Group for Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Tamara Popović
- Centre of Research Excellence in Nutrition and Metabolism, Group for Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jovica Jovanović
- Department of Occupational Health, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Nevena Kardum Vidović
- Centre of Research Excellence in Nutrition and Metabolism, Group for Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
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Patsalos O, Dalton B, Kyprianou C, Firth J, Shivappa N, Hébert JR, Schmidt U, Himmerich H. Nutrient Intake and Dietary Inflammatory Potential in Current and Recovered Anorexia Nervosa. Nutrients 2021; 13:nu13124400. [PMID: 34959952 PMCID: PMC8708616 DOI: 10.3390/nu13124400] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/04/2021] [Accepted: 12/07/2021] [Indexed: 01/15/2023] Open
Abstract
Anorexia nervosa (AN) is characterised by disrupted and restrictive eating patterns. Recent investigations and meta-analyses have found altered concentrations of inflammatory markers in people with current AN. We aimed to assess nutrient intake in participants with current or recovered AN, as compared to healthy individuals, and explore group differences in dietary inflammatory potential as a possible explanation for the observed alterations in inflammatory markers. We recruited participants with current AN (n = 51), those recovered from AN (n = 23), and healthy controls (n = 49). We used the Food Frequency Questionnaire (FFQ), to calculate a Dietary Inflammatory Index (DII®) score and collected blood samples to measure serum concentrations of inflammatory markers. In current AN participants, we found lower intake of cholesterol, compared to HCs, and lower consumption of zinc and protein, compared to HC and recovered AN participants. A one-way ANOVA revealed no significant group differences in DII score. Multivariable regression analyses showed that DII scores were significantly associated with tumour necrosis factor (TNF)-α concentrations in our current AN sample. Our findings on nutrient intake are partially consistent with previous research. The lack of group differences in DII score, perhaps suggests that diet is not a key contributor to altered inflammatory marker concentrations in current and recovered AN. Future research would benefit from including larger samples and using multiple 24-h dietary recalls to assess dietary intake.
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Affiliation(s)
- Olivia Patsalos
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (B.D.); (C.K.); (U.S.); (H.H.)
- Correspondence:
| | - Bethan Dalton
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (B.D.); (C.K.); (U.S.); (H.H.)
| | - Christia Kyprianou
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (B.D.); (C.K.); (U.S.); (H.H.)
| | - Joseph Firth
- Division of Psychology and Mental Health, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK;
- NICM Health Research Institute, Western Sydney University, Westmead, NSW 2145, Australia
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M25 3BL, UK
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Ulrike Schmidt
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (B.D.); (C.K.); (U.S.); (H.H.)
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (B.D.); (C.K.); (U.S.); (H.H.)
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
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6
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Monteleone AM, Troisi J, Serena G, Fasano A, Dalle Grave R, Cascino G, Marciello F, Calugi S, Scala G, Corrivetti G, Monteleone P. The Gut Microbiome and Metabolomics Profiles of Restricting and Binge-Purging Type Anorexia Nervosa. Nutrients 2021; 13:nu13020507. [PMID: 33557302 PMCID: PMC7915851 DOI: 10.3390/nu13020507] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/23/2021] [Accepted: 01/31/2021] [Indexed: 12/14/2022] Open
Abstract
Alterations in the gut microbiome and fecal metabolites have been detected in anorexia nervosa (AN), but differences in those profiles between restricting AN (ANR) and binge-purging AN (ANBP) type have not been explored. We made a secondary analysis of our previous data concerning microbiome and metabolomics profiles of 17 ANR women, six ANBP women and 20 healthy controls (HC). Twelve fecal metabolites differentiating ANR patients, ANBP patients and HC were identified. Both patient groups showed decreased intra-individual bacterial richness with respect to healthy controls (HC). Compared to ANR subjects, ANBP patients had a significant increase in relative abundances of Bifidobacterium, Bifidobacteriaceae, Bifidobacteriales, and Eubacteriacae and a significant decrease in relative abundances of Odoribacter, Haemophilus, Pasteurellaceae, and Pasteurellales. The heatmaps of the relationships of selected fecal metabolites with microbial families showed different structures among the three groups, with the heatmap of ANBP patients being drastically different from that of HC, while that of ANR patients resulted more similar to HC. These findings, although preliminary because of the relatively small sample size, confirm the occurrence of different gut dysbiosis in ANR and ANBP and demonstrate different connections between gut microorganisms and fecal metabolites in the two AN types.
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Affiliation(s)
| | - Jacopo Troisi
- Theoreo srl, Via Degli Ulivi 3, 84090 Montecorvino Pugliano, Italy; (J.T.); (G.S.)
- European Biomedical Research Institute of Salerno (EBRIS), Via S. De Renzi, 3, 84125 Salerno, Italy; (A.F.); (G.C.)
| | - Gloria Serena
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital—Harvard Medical School, Boston, MA 02114, USA;
| | - Alessio Fasano
- European Biomedical Research Institute of Salerno (EBRIS), Via S. De Renzi, 3, 84125 Salerno, Italy; (A.F.); (G.C.)
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital—Harvard Medical School, Boston, MA 02114, USA;
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, 37016 Verona, Italy; (R.D.G.); (S.C.)
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Neuroscience Section, University of Salerno, 84081 Baronissi, Italy; (G.C.); (F.M.)
| | - Francesca Marciello
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Neuroscience Section, University of Salerno, 84081 Baronissi, Italy; (G.C.); (F.M.)
| | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, 37016 Verona, Italy; (R.D.G.); (S.C.)
| | - Giovanni Scala
- Theoreo srl, Via Degli Ulivi 3, 84090 Montecorvino Pugliano, Italy; (J.T.); (G.S.)
| | - Giulio Corrivetti
- European Biomedical Research Institute of Salerno (EBRIS), Via S. De Renzi, 3, 84125 Salerno, Italy; (A.F.); (G.C.)
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Neuroscience Section, University of Salerno, 84081 Baronissi, Italy; (G.C.); (F.M.)
- Correspondence: ; Tel.: +39-089672833
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Shimizu M, Kawai K, Yamashita M, Shoji M, Takakura S, Hata T, Nakashima M, Tatsushima K, Tanaka K, Sudo N. Correction to: Very long chain fatty acids are an important marker of nutritional status in patients with anorexia nervosa: a case control study. Biopsychosoc Med 2020; 14:18. [PMID: 32831904 PMCID: PMC7422507 DOI: 10.1186/s13030-020-00192-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Miki Shimizu
- Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, 3-1-1 Higashi-ku, Fukuoka, 812-8582 Japan
| | - Keisuke Kawai
- Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, 3-1-1 Higashi-ku, Fukuoka, 812-8582 Japan.,Department of Psychosomatic Medicine, Kohnodai Hospital, National Center for Global Health Medicine, 1-7-1, Kohnodai, Ichikawa City, Chiba 272-8516 Japan
| | - Makoto Yamashita
- Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, 3-1-1 Higashi-ku, Fukuoka, 812-8582 Japan
| | - Masayasu Shoji
- Department of Psychosomatic Medicine, Kohnodai Hospital, National Center for Global Health Medicine, 1-7-1, Kohnodai, Ichikawa City, Chiba 272-8516 Japan
| | - Shu Takakura
- Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, 3-1-1 Higashi-ku, Fukuoka, 812-8582 Japan
| | - Tomokazu Hata
- Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, 3-1-1 Higashi-ku, Fukuoka, 812-8582 Japan
| | - Megumi Nakashima
- Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, 3-1-1 Higashi-ku, Fukuoka, 812-8582 Japan
| | - Keita Tatsushima
- Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, 3-1-1 Higashi-ku, Fukuoka, 812-8582 Japan.,Department of Psychosomatic Medicine, Kohnodai Hospital, National Center for Global Health Medicine, 1-7-1, Kohnodai, Ichikawa City, Chiba 272-8516 Japan
| | - Kazunari Tanaka
- Department of Nutrition, University of Nagasaki, 1-1-1 Manabino, Nagayo-cho, Nishisonogi-gun, Nagasaki, 851-2195 Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, 3-1-1 Higashi-ku, Fukuoka, 812-8582 Japan
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