Eating disorders (EDs) refer to a group of diseases characterized by a strong tendency toward chronicity, often involving distortions in body image distortion and other related symptoms The prevalence of EDs has increased in recent years, specifically in athletic populations. Therefore, the purpose of this study was to analyse risky eating attitudes in a sample of 1102 subjects from Se-ville (Spain): 142 women and 960 men aged between 15-25 years old. An online survey, designed using Google Forms, consisted of three questionnaires (EAT-26, SCOFF, and BITE), were com-pleted individually and anonymously. With regards to the cut-off points, the percentage of posi-tive cases with significant scores was 11.43% for EAT-26, 31.22% for SCOFF and 4.36% for BITE. The study found that the probability of testing positive for EDs is significantly higher in women than in men (p < 0.001). Specifically, the risk attitude for EDs in female athletes measured by the EAT-26 test is three times higher than in male athletes, while the risk attitude measured by the SCOFF test is twice as high in females. Risk attitude for EDs in athletes measured by the BITE test is 8 times higher in females than in males. This study’s findings confirm several important as-sumptions made at the outset of the research. There is indeed a higher risk of EDs in athlete populations. Moreover, all three tests therefore show a higher frequency of possible events of EDs in women, with very similar percentages of difference between sexes. The tests also confirm the role played by the coaches in the prevention of EDs in sports and their capacity to reduce ab-normal food-related behaviours. Thus, the future inclusion of these tests in the screening of athletes is highly recommended.

Eating competence can play a role in helping adolescents navigate their food choices and attitudes toward eating in a healthy and balanced way. In the present study, we investigated the psychometric properties of the Dutch translation of the Eating Competence Satter Inventory 2.0TM (ecSI 2.0TM), which was developed to assess eating attitudes and behaviors. A sample of 900 Flemish adolescents completed the ecSI 2.0TM DUTCH and two self-report measures on eating disorder symptoms and identity functioning (i.e., confusion and synthesis). Confirmatory factor analysis confirmed the four-factor structure of the ecSI 2.0TM DUTCH, and the resulting four subscales (Eating Attitudes, Food Acceptance, Internal Regulation, and Contextual Skills) showed acceptable to excellent reliability (α ranging from .69 to .91). The ecSI 2.0TM also showed to be scalar invariant across sex and age (&lt;17 years, ≥ 17 years). Boys reported significantly higher ecSI 2.0TM DUTCH scores than girls on the four subscales and the total scale. The two age groups did not differ significantly on the ecSI 2.0TM DUTCH scales. Finally, scores on the ecSI 2.0TM subscales showed no or small negative correlations with adolescents’ BMI, large negative correlations with eating disorder symptoms and identity confusion, and large positive associations with identity synthesis. The Dutch translation of the ecSI 2.0TM is a valid and reliable instrument to assess eating competence skills in male and female adolescents.

Abstract: Given the links between parental obesity and eating psychopathology in their children, it is important to understand the mechanisms via which unhealthy relationships with eating are passed from parents to children. The aim was to review research focusing on food-related parenting practices (FPPs) used by parents with overweight/obesity. Web of Science, PubMed and PsycINFO were searched. Twenty studies were included in the review. Single studies suggest differences between parents with healthy-weight vs overweight/obesity with respect to; food accessibility, food availability and modelling. Multiple studies suggest that several parenting strategies do not differ according to parental weight status (child involvement, praise, use of food to control negative emotions, use of food-based threats and bribes, pressure, restriction, meal and snack routines, monitoring, and rules and limits). There was inconclusive evidence with respect to differences in parental control, encouragement and use of unstructured FPPs among parents with healthy-weight vs overweight/obesity. The findings of this review imply some differences between parents with overweight/obesity and healthy-weight and the use of some food-related parenting practices, however they should be interpreted with caution since research remains limited and is generally methodologically weak. The review highlights opportunities for further research and to improve current measures of FPPs and help clarify current study findings.

Emotional eating (EE) can be understood as a manifestation of difficulties with emotion regulation (ER) among individuals with eating disorders. Existing interventions do not always successfully treat EE. We developed a novel ER intervention based upon virtual reality to improve EE among adults with an eating disorder diagnosis. The design pivoted to non-immersive virtual delivery to increase access, particularly given heightened demand during COVID-19 for EE treatment. The study aimed to investigate the feasibility, acceptability, and preliminary signals of effectiveness of this novel ER protocol that utilized evidence-based strategies such as mindfulness and imagery rescripting as well as innovative techniques such as virtual reality. Twenty-one adults with a history of an eating disorder diagnosis and self-reported EE were recruited from the Adult Eating Disorders Program within Stanford University to receive seven weekly one-hour virtual experiences (VE) focusing on ER. Participants chose between the novel VE-Emotion Regulation (VE-ER) intervention or continuing with their current treatment as usual. Before and after the seven sessions, participants completed an assessment by filling out online questionnaires. Overall, VE-ER treatment was feasible (100% completion), and participant and therapist acceptability of VE-ER treatment was fairly high. In terms of preliminary effectiveness, the results showed a significant reduction in the frequencies of disordered eating behaviors in both groups, but a greater improvement in EE in the VE-ER group. The VE-ER group also had a significant reduction in emotion dysregulation after the treatment.

Disordered eating is a serious health concern globally. The etiology is complex and multidimensional and differs somewhat for each specific eating disorder. Several risk factors have been identified which include psychological, genetic, biochemical, environmental, and sociocultural factors. Poor body image, low self-esteem, teasing, family dynamics, and exposure to media images have also been identified as risk factors. While it is enticing to consider a single behavioral risk factor, doing so fails to consider the documented environmental, social, psychological, biological, and cultural factors that contribute to the development of an eating disorder in a multidimensional and complex integration that is undoubtedly unique to everyone. Focusing only on any one factor without taking the complex etiology into account is remiss. For example, it has been suggested that the use of dietary supplements may lead to eating disorders, despite a lack of evidence to support this conjecture. Therefore, the purpose of this review is to examine the evidence-based risk factors for eating disorders and discuss why connecting dietary supplements to eating disorder etiology is not supported by the scientific literature and may interfere with treatment. Established, effective prevention and treatment approaches for eating disorders should be the focus of public health initiatives in this domain.

Background: Patients in the postoperative period following bariatric surgery are at risk of developing eating disorders. This study aims to analyse the relation between bariatric surgery and the development and recurrence of eating disorders. Material and methods: Literature review was done on 15th November 2020. Fourteen studies that met the eligibility criteria were included for qualitative synthesis, and 7 studies for meta-analysis. Results: The prevalence of eating disorders in the postoperative period was 7.83%, based on the 7 studies in the meta-analysis. Binge eating disorder alone was 3.81%, which was the most significant factor, and addressed in 6 of these studies. Conclusion: The investigated studies have significant methodological limitations in assessing the relation between bariatric surgery and eating disorders, since they mostly present data on prevalence. PROSPERO CRD42019135614.

Binge-eating disorder (BED) and bulimia nervosa (BN) have adverse psychological and medical consequences. Novel interventions, like the integration of virtual reality (VR) with cue-exposure therapy (VR-CET), enhance outcomes for refractory patients compared to cognitive behavior therapy (CBT). Little is known about the feasibility and acceptability of translating VR-CET into real-world settings. To investigate this question, adults previously treated for BED or BN with at least one objective or subjective binge episode/week were recruited from an outpatient University eating disorder clinic to receive up to eight weekly one-hour VR-CET sessions. Eleven of 16 (68.8%) eligible patients enrolled; nine (82%) completed treatment; 82% (9/11) provided follow-up data 7.1 (SD=2.12) months post-treatment. Overall, participant and therapist acceptability of VR-CET was high. Intent-to-treat objective binge episodes (OBEs) decreased significantly from 3.3 to 0.9/week (p &lt; .001). Post-treatment OBE 7-day abstinence rate for completers was 56%, with 22% abstinent for 28 days at follow-up. Among participants purging at baseline, episodes decreased from a mean of one to zero/week, with 100% abstinence maintained at follow-up. The adoption of VR-CET into real-world clinic settings appears feasible and acceptable, with a preliminary signal of efficacy. Findings, including some loss of treatment gains during follow-up may inform future treatment development.

Mindful Eating (ME) is an increasingly popular dietary practice that may mediate the sympto-matology of Eating Disorders (EDs). Orthorexia Nervosa (ON) is a recently proposed eating dis-order characterized by excessive concern for healthy eating and calorie control. The purpose of this study is to investigate the relationship between ME and Psychological Distress (PD) with EDs and ON. In a cross-sectional study involving 407 adults, this research explored the interplay between ME, PD, and EDs, notably ON. Utilizing validated scales for ME (MES-16), EDs (EDE-QS), ON (ORTO-R), and PD, subcategorized in depression, anxiety, and stress (DASS-21), alongside inquiries into Instagram usage, significant correlations emerged. ME demonstrated a robust negative asso-ciation with both EDE-QS (r=-0.501, p<0.001) and ORTO-R (r=-0.519, p<0.001), while EDE-Q and ORTO-R showed significant correlations with depression, anxiety, and stress (p<0.001). Variations in ORTO-R mean scores were notably distinct across different ME categories (p<0.001), emphasizing the relationship between ME and ON. Additionally, participants with extensive daily Instagram use displayed significantly higher ON scores compared to minimal users (p<0.05). These findings sug-gest a negative link between ME with EDs and ON, highlighting ME's potential role in reducing ON tendencies. Furthermore, Instagram use seems associated with PD and elevated ON levels.

Understanding behavioral factors associated with obesity is of importance in addressing this issue. This study examined the association between cognitive restraint, uncontrolled eating, emotional eating and body mass index (BMI) and amount of food plated, consumed, leftovers, and leftover food thrown into the trash (food wasted) in early adolescent girls nine to 13 years in O’ahu, Hawai’i (n = 93). Food plated, consumed, leftovers, and food wasted were estimated using a three-day mobile food record (mFR). Weight and height were measured to compute BMI (kg/m2). The three-factor eating questionnaire provided a score from 0 to 100 for cognitive restraint, uncontrolled eating, and emotional eating. Higher scores are indicative of greater cognitive restraint, uncontrolled eating, and emotional eating. Pearson’s correlation and general linear models were computed to examine the relationship between three factor eating scores, BMI, and food plated, consumed, leftovers, and food wasted. There was no clinically significant association between cognitive restraint and amount of food wasted. Cognitive restraint was positively correlated with BMI (r=0.36, p<0.001) and with BMI z score (r=0.40, p<0.001). Uncontrolled eating and emotional eating were positively correlated with amount of leftover food at dinner (r=0.30, p=0.006; r=0.33, p=0.003, respectively). Emotional eating was positively associated with percentage of leftover food at dinner (r=0.24, p=0.30). Additional research should examine the specific roles of cognitive restraint, uncontrolled eating, emotional eating and food waste in the development of obesity in adolescents.

Recent studies have shown that the prevalence of vegetarianism among the general population in western societies ranges between 2% and 9%. Information regarding the prevalence of vegetarianism among exercisers is lacking. The aim of the present pilot study was to determine the prevalence of vegetarianism among regular exercisers in Greek gyms, as well as assess their dietary habits, exercise habits, and attitudes toward health and environmental issues. 291 regular gym clients completed an anonymous descriptive online questionnaire containing 65 questions divided into five sections (demographic characteristics, dietary habits, physical activity, dietary supplements, environment). Thirty responders (10.3%) identified themselves as vegetarians, spanning the entire spectrum of vegetarianism, from raw vegan to semi-vegetarian. Compared to omnivores, vegetarians had lower body weight, were more concerned about their health and convinced about the health benefits of their dietary choices, were surrounded by more vegetarians socially, consumed fast food and ate out less often, used more dietary supplements, and were better informed about what a sustainable diet is (all p < 0.05). Vegetarians did not differ significantly from omnivores in demographic characteristics, alcohol consumption, smoking habits, prevalence of psychogenic eating disorders, or exercise practices (except for practicing more yoga/Pilates). In conclusion, we report, for the first time, a considerable prevalence of vegetarianism among regular exercisers in gyms. Our findings demonstrate important similarities and differences between exercising vegetarians and omnivores (partly at odds with those seen in the general population) and highlight nutritional and environmental issues on which both groups should be better educated.

Background: Since the beginning of the 20th century, the importance of creating healthy work environments and promoting the health of workers in the healthcare sector to create Healthy and Resilient Organizations has been emphasized. In this context, self-esteem is an essential construct which influences health and healthy life styles, and therefore, the general wellbeing of nurses. The objective of this study was to analyze the mediating role of reasons for exercising in the effect that self-esteem has on uncontrolled eating by nursing professionals. Methods: The sample was made up of 1094 nurses who were administered the Rosenberg General Self-esteem Scale, the Goal Content for Exercise Questionnaire and the Three-Factor Eating Questionnaire-R18. Results: Bivariate correlation analysis and multiple mediation analysis showed that self-esteem has direct and indirect effects on uncontrolled eating. More so, self-esteem predicts doing physical exercise to improve one’s image, recognition and social affiliation, although the effects on uncontrolled eating were only significant through image. Conclusions: The results have important practical implications in the framework of Positive Occupational Health Psychology (POHP) as it emphasizes self-esteem, physical exercise and eating as essential aspects of the health and wellbeing of employees in the healthcare sector, highlighting the importance of creating organizations committed to promoting the psychosocial health of their workers.

Sleep-related eating disorder (SRED) is a non-REM parasomnia with potentially significant negative effects on general health (dangerous activities during night eating episodes, obesity, or metabolic syndrome, for example). Although the history of SRED encompasses more than six decades, public awareness and even the awareness of the mental health specialists of this disorder is very limited, a phenomenon that hinders the development of research in this field. Therefore, an updated review, based on a narrative methodology, explored the available evidence for SRED found in four electronic databases (PubMed, Cochrane Collaboration, Google Scholar, and Clarivate/Web of Science). A number of 94 primary and secondary reports were retrieved, investigating aspects regarding the risk factors, epidemiology, clinical data and differential diagnosis, epidemiology, structured evaluation, and treatment of SRED. Based on the results of these reports, Z-drugs, but also certain benzodiazepines, antidepressants, antipsychotics, and psychostimulants may trigger the onset of SRED. Psychiatric and neurologic disorders have also been associated with SRED, either as risk factors or comorbid conditions. Cerebral glucose metabolism dysfunctions, neurotransmitter dysfunctions, and genetic factors have been invoked as pathogenetic contributors. Structured assessment of SRED is possible, but there is a dearth of instruments dedicated to this purpose. Data on the prevalence and treatment of SRED exist, but good-quality epidemiological studies and clinical trials are still missing. In conclusion, future research is expected to address the shortcomings of SRED exploration by creating the conditions for better quality and larger group clinical research. The need for such investigation is granted by the importance of this pathology and its negative functional consequences.

(1) Background: The aim of this study was to evaluate the influence of the lockdown due to COVID-19 pandemic, eating and physical activity behaviours, in a University population. A healthy diet such as the Mediterranean Diet (MD) pattern, rich in fruit and vegetables can prevent degenerative diseases such as obesity, diabetes, cardiovascular diseases, etc. (2) Methods: We conducted a cross-sectional study, data were collected by an anonymous online questionnaire. Participants completed a survey consisting of 3 sections: sociodemographic data; dietary and physical activity behaviour; questionnaire of the Mediterranean Diet (MEDAS-14) and the emotional eater questionnaire Garaulet (EEQ). (3) Results: A total of 168 participants completed the questionnaire 66.7% women, from Spain 79.2%, 76.8% students, living in family home 76.2% and in normal weight 66.1% . Our population did the grocery 1 or less per week (76.8%); decreased or stay the same the consumption of fruits (57.1%), vegetables (58.9%), dairy products (74.4%), pulses (73.2%), fish/seafood (76.8%), white meat (83.3%), red and processed meat (91.1%), snacks (78.6%), rice/pasta/potatoes (78.6%), nuts (83.9%), low alcohol drinks (89.3%), spirits (98.8%) and sugary drinks (91.7%) . Increased cooking time (73.2%) and decreased or stay the same their physical activity (63.7%). University Employees increased more weight (1.01±0.02) than students (0.99±0.03) (p<0.05). 79.8% of the participant obtained a Medium/High Adherence to the MD. Emotional and very emotional eaters were higher in women group (p<0.01). (4) Conclusions: In the event of further confinement, strategies should be implemented to promote a balanced and healthy diet together with the practice of physical activity, taking special care of the group of women and University Employees.

There is growing recognition of the adverse effects of body image dissatisfaction (BID) and eating disorder (ED) symptoms on adolescent health. The aim of this study was to estimate the prevalence of ED symptoms, BID, and their relationship in adolescents from public schools in Southern Brazil. A total of 782 schoolchildren (male: n=420, female: n=362); age: 15 ± 0,4 years) answered a self-administrated questionnaire to identify sociodemographic data. Children´s Figure Rating Scale was adopted to identify body image and Eating Attitudes Test (EAT-26) was applied to investigate ED symptoms. Inferential statistics and hierarchical model-controlled logistic regression were used for association between variables. Most of the schoolchildren reported being satisfied with their bodies. However, we observed a higher prevalence of dissatisfaction among girls for being overweight and thinness among boys. Female students and students from schools located in the central area of the city showed higher chances of developing ED symptoms, and the absence of symptoms of ED appeared to act as a protective factor against BID in schoolchildren. Results of this study show the need to reflect on these factors that influence the development of ED and non-acceptance of their own body in a population concerned with their physical appearance.

(1) Background: The prevalence of comorbid psychiatric disorders among the patients with mental disorders is higher than general population. The aim of this study was to estimate the prevalence of comorbid psychiatric disorders among a Mexican adolescent sample diagnosed with eating disorders; (2) Methods: Only Mexican adolescents diagnosed with eating disorders were included in the study. The diagnoses were using the DSM-5 criteria. Adolescents with ages between 12 to 17 years were included. The psychiatric comorbidities were evaluated using MINI-kid and QEWP-R. In addition, the z-score values calculated from BMI; (3) Results: The mean age was 14.08±1.7 years old. In our Mexican sample the diagnoses more frequently were bulimia nervosa (55.61%). We found that 89% of the Mexican adolescents with eating disorders had another psychiatric comorbidity. Major depressive disorder (52.40%) and suicide risk (40%) were the most prevalent comorbidity; (4) Conclusions: Our results showed that bulimia nervosa is the most frequently diagnoses in Mexican adolescent and the suicide and major depressive disorder are the principal comorbidities. This emphasizes the importance that clinicians take in-to consideration the presence of psychiatric comorbidities to achieve an integrative treatment for patients with ED.

Background: The passage through university, as a complex experience, can heighten personal susceptibility to eating disorders. The objective of this research is to determine how gender, age, year of course, and center or faculty can influence the risk of an eating disorder among university students. Method: A transversal and descriptive study with a probabilistic sample of 516 Spanish students from 26 university degrees is performed, by administering the Inventory Eating Disorder-Reference criterion (EDI-3-RF) to the students. Results: It was found that the female students enrolled in second-year grades presented a greater obsession with thinness and body dissatisfaction, that the male students did more physical exercise to control their weight, and that those under 20 years and the students from both the Health and Law Faculties presented greater bulimic behavior. Conclusions: It is necessary to implement preventive measures adapted to the university students.

Eating disorders (EDs) are serious, life-threatening psychiatric conditions associated with physical and psychosocial impairments, as well as high morbidity and mortality. Given the chronic refractory nature of EDs and the paucity of evidence-based treatments, there is a pressing need to identify novel approaches for this population. The noncompetitive N-methyl-D-aspartate receptor (NMDAr) antagonist, ketamine, has recently been approved for treatment-resistant depression, exerting rapid and robust antidepressant effects. It is now being investigated for several new indications, including obsessive-compulsive, post-traumatic, and substance use disorder; and shows transdiagnostic potential for EDs, particularly among clinical non-responders. As such, the aim of this review is to examine contemporary findings on the treatment of EDs with ketamine, whether used as a primary, adjunctive, or combination psychopharmacotherapy. Avenues for future research are also discussed. Overall, results are encouraging and point to therapeutic value, yet are limited to case series and reports on anorexia nervosa. Further empirical work is thus needed to explore ketamine efficacy across ED subgroups; establish safety profiles and optimize dosing; and develop theory-driven, targeted treatment strategies at the individual patient level.

In recent decades, organizational research has given special attention to the mechanisms promoting the health and wellbeing of nursing professionals. In this context, self-esteem is a personal resource which influences wellbeing at work and psychological wellbeing of nurses. The purpose of this study was to analyze the mediating role of eating in the effect of sleep quality on self-esteem in nursing professionals. The sample of 1073 nurses were administered the Rosenberg General Self-Esteem Scale, the Pittsburgh Sleep Quality Index and the Three-Factor Eating Questionnaire-R18. The results show that poor sleep quality and type of eating directly and indirectly affect self-esteem. More so, poor sleep quality deteriorated self-esteem through emotional eating, and even though emotional eating facilitated disinhibited eating, this relationship had no significant effects on self-esteem. The findings of this study suggest that hospital management should implement employee health awareness programs on the importance of healthy sleep and design educational interventions for improving the quality of their diet.

Increasing evidence indicates that the cultivation of mindful eating, adherence to the Mediterranean lifestyle, and the development of psychological resilience may contribute to the enhancement of overall health and well-being. The purpose of this study was to explore the association between mindful eating and the Mediterranean lifestyle in relation to psychological resilience and the maintenance of a healthy weight. In a framework of a cross-sectional study, 288 individuals voluntarily took part in an online research survey conducted in Greece. Results showed that both mindful eating and the Mediterranean diet were significantly correlated (p<0.001) with psychological resilience. Multiple regression models identified mindful eating and the Mediterranean diet as predictive factors of psychological resilience (p<0.001). There was a statistically significant (p<0.05) intercorrelation between mindful eating, the Mediterranean diet and psychological resilience. Following the application of multiple regression model, mindful eating and Mediterranean diet were identified as predictive factors of psychological resilience (p<0.0001). Individuals with a normal Body Mass Index (BMI) displayed stronger adherence to mindful eating and the Mediterranean lifestyle, in contrast to those classified in the overweight and obesity BMI groups. People with higher mindful eating scores had 14% better odds maintaining their weight loss after a weight reducing diet, than those with a lower mindful eating score (OR: 1.142, 95% CI: 1.084, 1.204, p <0.0001). In summary, the integration of mindful eating and the Mediterranean lifestyle may represent a feasible approach to bolstering psychological resilience, overall health, and well-being.

Adolescents’ eating disorders and disordered eating behaviours appear to be a growing public health concern. The aetiology of these conditions is complex, as many different factors interact for their development. Among them, family factors such as parenting styles and comments regarding weight from family members are considered critical and are extensively researched. However, the impact of parental dieting has received less attention. A literature review was conducted in order to examine the relationship between parental engagement in weight-reduction dieting and their adolescent offspring’s disordered eating behaviours. The review was conducted in three databases (PubMed, Scopus and Google Scholar). A number of studies indicated that adolescents whose parents were engaged in dieting in order to lose weight are more likely to showcase disordered eating behaviours. However, research about this relationship is very scarce. More studies on the link between parental eating and dieting habits and the risk of disordered eating in adolescents are needed. Moreover, parents should be informed regarding the possible risks when they choose to follow weight-loss diets and the importance of adopting healthy eating and weight-control habits for the whole family.

Background: Different investigations have shown an association between the eating behavior of children and adolescents, and their nutritional status. The objective is to identify eating behavior patterns associated with nutritional status diagnosed by anthropometry in a sample of Spanish schoolchildren. Methods: A cross-sectional study in 283 Spanish schoolchildren (6 to 16 years old). Methods: The sample was assessed anthropometrically by Body Mass Index (BMI), Waist-to height ratio (WHtR) and body fat percentage (%BF). Eating behavior was analyzed using the CEBQ "Children's Eating Behavior Questionnaire" answered by parents or guardians. Results: A positive association was found between excess weight, abdominal obesity, high adiposity, lower scores in anti-intake subscales and higher scores in pro-intake subscales. These were mainly associated with lower satiety response, higher food intake, higher food enjoyment, higher eating speed, and emotional overeating. Conclusion: Our results support the usefulness of the CEBQ as an easy-to-use tool to identify eating behaviors associated with the development of childhood and adolescent obesity. Its use in future research could help to understand behavioral phenotypes in schoolchildren and guide nutrition education and obesity prevention initiatives

Evidence points to a link between gluten-free diet or celiac disease and eating disorders, but not with orthorexia. This study is the first to examine adults with celiac disease in terms of the prevalence of risk of orthorexia. The study included 130 adults diagnosed with celiac disease. The standardized ORTHO-15 questionnaire was used to assess the risk of orthorexia. Cronbach's alpha test was used to determine the reliability of the ORTHO-15 questionnaire. Eating habits of the subjects were assessed using a questionnaire. The effect of celiac disease on diet was assessed on a 5-point scale. A risk of orthorexia was found in 69% of subjects with celiac disease. A statistically significant (p&lt;0.005) positive correlation was observed between age and ORTHO-15 test scores (rho=0.37). In the group with orthorexia risk, meals were more often self-prepared (93.3%) compared to those without orthorexia (80%) (p=0.023). For 80% of those at risk for orthorexia versus 20% without risk, mood was a factor influencing dietary choices (p=0.001). The study observed a strong association between celiac disease and the presence of orthorexia risk. The numerous risk factors for orthorexia suggest the need for holistic care, including nutritional and psychological support among individuals with celiac disease.

An effective behavior changes program is the first-line of prevention for youth obesity. However, effectiveness in prevention of adolescent obesity requires several approaches, with special attention paid to disordered eating behaviors and psychological support among other environmental factors. The aim of this systematic review was to compare the impact of two types of obesity prevention programs, inclusive of behavior change components on weight outcomes. Energy-balance studies were aimed at reducing calories from high-energy sources and increasing PA levels, while “shared risk factors for obesity and eating disorders” focused on reducing disordered eating behaviors to promote a positive relationship with food and eating. A systematic search of ProQuest, PubMed, PsycInfo, SciELO, and Web of Science identified 8825 articles. Twenty were considered “energy-balance” and fifteen “shared-risk factors for obesity and eating disorders”. Overall, energy-balance studies were unable to support a maintenance weight status, diet, and PA over time. Shared risk factors programs also did not result in significant differences in weight status over time. However, the majority of shared risk factors studies demonstrated reduced body dissatisfaction, dieting, and weight-control behaviors. More research is needed to examine how a shared risk factor approach can address both obesity and eating disorder.

Background: Extremametly lean athletes could have difficulty for adaptive eating (intuitively or consciously) during ad libitum refeed. Aims: we verificate if there is a relation between adaptive eating and coping strategies with energy intake in a model of refeed proposed for bodybuilders. Methods: Fourteen male bodybuilders (29.6±3.1yrs; 85.6±6.8kg, ≥6 competitions) completed the 4-week each consisting of a 5 days of energy restriction following 2 days of refeed. Dietary assessment, body composition (ultrasound), Recovery stress questionnaire (REST-Q) and BRUMS (Brunel mood scale) were accessed pre and post; Coping Function Questionnaire (CFQ), Mindful Eating Scale version 2 (MES 2) and the Intuitive Eating Scale-2 (IES-2) was used at 4th week. Results: The refeed day resulted in a daily caloric increment of ~44% compared to the average energy intake on the energy restriction days, culminating in a weekly calorie deficit of ~27% and a drop in body mass of 3.1±1.4% with relation to initial values. The most reduced body fat and preserved or gained lean mass. The energy consumption during refeed maintained an inverse relationship with the perception of satiety (r=-0.9; p<0.01), total scores of IES 2 (r=-0.82; p<0.01), as well as with the confidence in hunger and satiety cues (r=-0.62; p=0.02) and congruence in food-body choice (r=-0.56; p=0.04) dimensions. Coping based in emotions maintained a relationship with the total scores of IES 2 (r=0.54; p<0.05) and an inverse relationship with energy intake during refeed (r=-0.42; p<0.05). Conclusion: Our results suggest that a higher perception of internal hunger and satiety signals and higher scores in intuitive eating may contribute to energy intake adequate, even when high scores of coping based in emotions are present.

To monitor adherence to diets and to design and evaluate nutritional interventions it is essential to obtain objective knowledge about eating behavior. In most research, measures of eating behavior are based on self-reporting, such as 24-h recalls, food records (food diaries), and food frequency questionnaires. Self-reporting is prone to inaccuracies due to inaccurate and subjective recall and other biases. Recording behavior using non-obtrusive technology in daily life would overcome this. We here provide an up-to-date systematic overview encompassing all (close-to) publicly or commercially available technologies to automatically record eating behavior in real-life settings. 1328 studies were screened and after applying defined inclusion and exclusion criteria, 122 studies were included for in-depth evaluation. Technologies in these studies were categorized by what type of eating behavior they measure and which type of sensor technology they use. In general, we found that relatively simple sensors are often used. Depending on the purpose, these are mainly motion sensors, microphones, weight sensors, and photo cameras. While several of these technologies are commercially available, there is still a lack of publicly available algorithms that are needed to process and interpret the resulting data. We argue that future work should focus on developing robust algorithms and validating these technologies in real-life settings. Combining technologies (e.g., prompting individuals for self-reports at sensed, opportune moments) is a promising route toward ecologically valid studies of eating behavior.

Sleep timing is one of the dimensions of sleep that refers to the time of day when sleep occurs. It was included in sleep-related research because of the potential associations between overweight and consumption of meals and snacks. This cross-sectional study aimed to investigate associations between sleep timing, meal and snack consumption, and weight status in 1333 schoolchildren aged 7-14 years. The midpoint of sleep was used as a sleep timing measure obtained by the midpoint between bedtime and wake-up time and classify as Early, intermediate, and Late. Schoolchildren in the Early group were less likely to be overweight (OR: 0.83, 95% CI 0.69; 0.99), had higher odds of mid-morning snack consumption (OR: 1.95, 95%CI 1.56; 2.44) and lower probability to consume the evening snack (OR: 0.75, 95%CI 0.59; 0.94) compared with the Intermediate group. The Late group had lower odds of mid-morning snack consumption (OR: 0.67, 95%CI 0.55, 0.80) than the Intermediate group. The consumption of mid-morning and evening snacks was associated with the Early and the Late midpoint of sleep. These results suggest that bedtime and wake-up time are relevant to consuming meals and snacks and may also be related to a greater probability of being overweight in children and adolescents.

Atypical Anorexia Nervosa (AAN) had been found to have significant physical and psychological complications at presentation but has not been described in a multi-ethnic Asian population. This retrospective cohort analysis aimed to characterize the baseline presentation of adolescents with Anorexia nervosa (AN) (N=317) and AAN (N=141) in an Asian cohort that presented to a specialist paediatric eating disorder program between January 2010 to October 2020 for assessment. In patients with AAN, there were increased proportions of males (16% vs 7%) and of Malay ethnicity (11% vs 4%) compared to AN. Adolescents with AAN had lower admission rates (61% vs 81%) as well as lower rates of bradycardia (45% vs 75%) and hypotension (7% vs 21%) but higher rate of syncope (13% vs 7%) compared to adolescents with AN. However, adolescents with AAN had higher frequency of psychological complications including self-harm and drug overdose (14% vs 1.5%) requiring admission as well as higher rates of purging (45.1% vs 14.8%) and for Eating Disorder Questionnaire score in the shape domain was more severe. Asian adolescents with AAN manifest with physical complications of malnutrition and had worse eating disorder psychopathology with higher frequency of other psychological co-morbidities underlining the severity of the illness.

Frontal incomes play an important role in human behavioral regulation and can be a determinant of eating behavior. The aim of this study was to analyse the frontal incomes in obese patients with and without Binge Eating Disorder (BED), compared to normoweight (NW) subjects and to analyse the effect of sex and binge disorder on quality of life, with age and BMI as covariates. A total of 114 participants comprised three different groups (obese with BED, obese without BED and NW) completed the Frontal Assessment Battery (FAB) and Impact of Weight on Quality of Life (IWQOL-lite). The results showed that obese patients, with and without BED, have poorer frontal functioning than NW persons. Obese patients with BED have lower performance in frontal income than obese patients without BED. Male participants have a higher perception of quality of life in all dimensions, with women showing lower values in self-esteem and sex life. Obese with BED show greater weaknesses in physical function. These results suggest that low frontal incomes and worse quality of life characterize obese patients, more evident in obese patients with BED.

Eating and drinking difficulties are common in dementia, but little is known about the experiences of ethnic minority groups managing these difficulties at home. We undertook qualitative semi-structured interviews, exploring the meaning of food, the impact of dementia on eating and drinking and carers’ experiences of support. Interviews were audio-recorded and transcribed verbatim. We interviewed 17 carers and people with dementia from ethnic minority backgrounds, using reflexive thematic analysis to analyse data. Food/drink had strong links to identity, culture and emotions. Providing culturally familiar foods, celebrating traditional festivals and supporting previous food-related roles promoted reminiscence, which encouraged people with dementia to eat and drink, as did social interactions. However, these strategies sometimes led to distress in those with more advanced dementia. Food choices were also influenced by carer strain, generational differences and the impact of health conditions. Despite a strong sense of duty to care for relatives at home, there was low awareness of community support services. Carers expressed a need for culturally tailored support for managing dementia-related eating and drinking difficulties at home. Healthcare professionals must provide contextually relevant advice to carers, being mindful of how cultural backgrounds can affect dietary choices.

Over half of adult Americans now have diabetes or prediabetes and worse, this epidemic is now world-wide and shows no signs of slowing, with rates of both diabetes and diabetes-related health complications still rising. When advising patients with diabetes on food choices, many providers rely on nutrition guidelines provided by the American Diabetes Association (ADA), and these guidelines influence other recommendations across the globe. Given the alarming trends in diabetes, it is paramount to review the treatment guidelines to ensure they are based on rigorous and accepted scientific methods. Our review included the evidence cited by the ADA in support of its claims and recommendations for eating patterns to combat diabetes (see Description of Eating Patterns, Supplemental Appendix), as presented in the most current edition of the annual ADA’s Standards of Medical Care in Diabetes (2018 Standards). Our review also includes sources cited in the latest edition of the ADA’s Nutrition Therapy Recommendations for Adults with Diabetes (2014 Recommendations), which also informed the 2018 Standards. In October 2018 low carbohydrate was named as a recommended eating pattern by the ADA and European Association for the Study of Diabetes (EASD)⁵but only citations from the 2014 and early 2018 ADA documents were reviewed.

Obesity has been identified as an emerging health concern for Chinese American children; however, very little is known about diets in Asian American children. The objective of our paper was to describe the dietary intakes of urban Chinese American schoolchildren using a state-of-the-art approach for dietary assessment. Data for this analysis come from the Food Journal Project 2017, a pilot and feasibility study conducted by a multi-sector collaboration. Children aged 8-12 (n=83) completed two dietary assessments using a food diary from January-June 2017. Children were then interviewed using the food diary as a guide and dietary data were entered into the online ASA24 system by study staff. Chinese American children were identified using surname, and were compared to non-Chinese peers with respect to nutrient intake and the Healthy Eating Index 2010 (HEI-2010). Chinese American children consumed more sodium dense diets, more protein, and less sugar compared to non-Chinese children. With regards to the HEI-2010, Chinese American children had less favorable whole grains and sodium scores; and more favorable seafood protein and empty calories scores compared to non-Chinese children. Sodium reduction and increasing whole grain intakes may be warranted in this group, but should be verified with additional studies.

Eating disorder (ED) symptoms often co-occur with nonsuicidal self-injury (NSSI). This comorbidity is consistent with evidence that trait negative urgency increases risk for both of these phenomena. We previously found that impaired late-stage negative emotional response inhibition (i.e., negative emotional action termination or NEAT) might represent a neurocognitive mechanism for heightened negative urgency among people with NSSI history. The current study evaluated whether relations between negative urgency and ED symptoms similarly reflect deficits in this neurocognitive process. One hundred and five community adults completed an assessment of ED symptoms, negative urgency, and an emotional response inhibition task. Results indicated that, contrary to predictions, negative urgency and NEAT contributed independent variance to the prediction of ED symptoms, while controlling for demographic covariates and NSSI history. Worse NEAT was also uniquely associated with restrictive eating, after accounting for negative urgency. Our findings suggest that difficulty inhibiting ongoing motor responses triggered by negative emotional reactions (i.e., NEAT) may be a shared neurocognitive characteristic of ED symptoms and NSSI. However, negative urgency and NEAT dysfunction capture separate variance in the prediction of ED-related cognitions and behaviors, distinct from the pattern of results we previously observed in NSSI.

The study examined eating timing, diet, and the ratio of sleep phases in people with social jetlag (SJL). The study involved 83 participants who filled out a questionnaire, and 21 of them took part in the study of sleep phases by electroencephalography during the week. SJL was associated with a higher incidence rate of eating jetlag, eating phase delays, an increase in calorie intake after 9 p.m., a decrease in dietary fiber intake for breakfast, and melatonin-containing product consumption for dinner. Young people with SJL had a reduction in total sleep and light sleep phase duration by 60 and 36 min on work/school days and an increase in total sleep and REM sleep phase duration by 66 and 60 min on weekends, respectively. Young people consuming foods with more than 4234.5 ng of melatonin for dinner, compared with their peers consuming less than 313.2 ng of melatonin, showed a decrease in SJL and sleep debt by 54 and 90 min and an increase in the total sleep and the deep sleep phase duration by 66 and 30 min, respectively. Thus, the consumption of melatonin-containing foods for dinner is associated with a decrease in circadian misalignment and a sleep quality improvement.

Eating disorders are a global burden and present personal, family, and societal costs. Most evidence in the literature is based on the relationship between a poor family environment and eating disorders, and the evidence of gender interaction in eating disorders is inconsistent. This study aimed to investigate the relationship between family functioning and disordered eating patterns, the mediating role of negative automatic thoughts, and the moderating role of gender. A sample of 440 (70.9% females, aged 18–21) participated in this study. They completed the Eating Attitudes Test (EAT-26), the Automatic Thoughts Questionnaire (ATQ negative), and the Brief Family Relationship Scale (BFRS). PROCESS MACRO was used to study these relationships. The main findings revealed that family functioning was negatively associated with eating disorders, and that this relationship was negatively mediated by automatic thoughts. Moreover, gender moderated those relationships, and more intensely in females. The results of this study postulate that the prevention of eating disorders should be directed at training individuals to challenge negative thoughts and encourage healthy individuals to be gender mindful.

By shifting eating hours from daytime to nighttime, Ramadan intermittent fasting (RIF) illustrates how religious beliefs influence human dietary behavior and subsequent anthropometric and metabolic measures. This study aimed to investigate socioeconomic characteristics and examine how observing RIF affects dietary intake, anthropometric indices, and metabolic markers in healthy premenopausal (PRE-M) and post-menopausal (POST-M) Saudi women. Before starting the study, the authors hypothesized that the RIF improves some nutritional aspects and health in respondents, but not after breaking the fast.. The study includes 62 women (31 PRE-M, 21-43 years, and 31 POST-M, 44-68 years). A structured questionnaire was used to collect socioeconomic data. Physical activity, anthropometric, dietary, and biochemical assessments were undertaken before RIF and at the end of the third week of Ramadan fasting month. Socioeconomic data varied among respondents. Observing RIF was associated with significantly (at either p ≤ 0.01 or p ≤ 0.05) lower intake of calories, macronutrients, minerals (except for Na), and vitamins than before RIF for both groups. In terms of body mass index (BMI), and waist-to-height ratio (WHtR) for PRE-M, the percentage of overweight decreased significantly (p≤0.01) while obesity remained unchanged. In contrast, for POST-M, the percentage of overweight increased significantly (p≤0.05), but obesity decreased after RIF. Both groups' waist-to-hip ratio (WHR), body fat (BF), and fat mass (FM) decreased after RIF. High-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), triglycerides (TG), and blood pressure (SBP, DBP) were generally maintained at acceptable normal levels in most responders before and after RIF. However, low-density lipoprotein cholesterol (LDL-C) was significantly decreased during RIF than before, especially for POST-M. Age, occupation, and monthly income were the most important factors influencing women’s nutritional status and body fat. In conclusion, observing RIF by PRE- and POST-M Saudi women was associated with significant improvements in variable health indicators, with a few exceptions, particularly POST-M, and may help lower risk factors for chronic diseases.

TThe passion of bodybuilding athletes for a symmetric, lean, heavily muscled body leads them to carry out exhausting exercise programs and restrictive eating regimens, sometimes resulting in disordered eating behaviors. This study investigates potential exacerbators on the development of disordered eating in bodybuilding and strength athletes. The study involved 103 Cypriot bodybuilding athletes of both sexes, performing at three levels: professional, recreational and strength athletes. The Eating Attitude Test 26 (EAT-26) and The Three Factor Eating Question-naire (TFEQ-R21) were used to evaluate disordered eating and eating behaviors respectively. The current study was performed under the auspices of the Hellenic Center of Education & Treatment of Eating Disorders (KEADD). The degree of deviation between the perceived ideal body weight and the actual body weight was associated with increased risk of eating disorder. Athletes who desired a lower body weight recorded higher scores on EAT-26 overall, (p=0.001), and the subscales of dieting (p=0.01) and bulimia. (p=0.001). Cognitive restraint and emotional eating scales of TFEQ-R21 were more pronounced in the non-professional athletes. (p=0.01). The emotional eating score was higher in women. There is a need for appropriate sport-specific, gender-specific preventive intervention to deescalate the risk of eating disorder, in both profes-sional and non-professional bodybuilding athletes.

The passion of bodybuilding athletes for a symmetric, lean, heavily muscled body leads them to carry out exhausting exercise programs and restrictive eating regimens, sometimes resulting in disordered eating behaviors. This study investigates potential exacerbators on the development of disordered eating in bodybuilding and strength athletes. The study involved 103 Cypriot bodybuilding athletes of both sexes, performing at three levels: professional, recreational and strength athletes. The Eating Attitude Test 26 (EAT-26) and The Three Factor Eating Questionnaire (TFEQ-R21) were used to evaluate disordered eating and eating behaviors respectively. The current study was performed under the auspices of the Hellenic Center of Education & Treatment of Eating Disorders (KEADD). The degree of deviation between the perceived ideal body weight and the actual body weight was associated with increased risk of eating disorder. Athletes who desired a lower body weight recorded higher scores on EAT-26 overall, and the subscales of dieting and bulimia. Cognitive restraint and emotional eating scales of TFEQ-R21 were more pronounced in the non-professional athletes. The emotional eating score was higher in women. There is a need for appropriate sport-specific, gender-specific preventive intervention to deescalate the risk of eating disorder, in both professional and non-professional bodybuilding athletes.

As consequence of COVID-19, millions of households suffered mobility restrictions and changes in their lifestyle during several months. The aim of this study was to evaluate the effects of COVID-19 home confinement in food habits, lifestyle and emotional balance of the Spanish population. This cross-sectional study used data collected via an anonymous online questionnaire during the last month before lockdown finished in Spain in a total of 675 participants. 38.8% of the respondents experienced weight gain while 31.1% lost weight during confinement. The increase in body weight was positively correlated with the age (Rs = 0.14, p &lt;0.05) and BMI (Rs = 0.20, p &lt;0.05). We also identified that 39.7% reported poorer quality sleep, it was positively correlated with BMI (Rs = -0.18, p &lt;0.05) and with age (Rs = -0.21, p &lt;0.05). 44.7% of the participants had not performed physical exercise during confinement with differences by sex (p &lt;0.05), by age (p &lt;0.05), by BMI (p &lt;0.05) and sleep quality (p &lt;0.05). According to emotional-eater questionnaire, 21.8% and 11% were classified as emotional eater and very emotional eater, respectively. We emphasize the importance of adopting a healthy lifestyle, as the COVID-19 pandemic nowadays is ongoing.

The prevalence of obesity and eating disorders varies by sex, but the extent to which sex influences eating behaviors, especially in childhood, has received less attention. The purpose of this paper is to review the literature on sex differences in eating behavior in children and present new findings supporting the role of sex in child appetitive traits and neural responses to food cues. In children, the literature shows sex differences in basic taste response, food acceptance, eating self-regulation, and appetitive traits. New analyses demonstrate that sex interacts with child weight status to differentially influence appetitive traits and neural responses to food cues. Further, neuroimaging results suggest that obesity in female children is positively related to brain reactivity to higher-energy-dense food cues in regions involved with learning, memory, and object recognition, while the opposite was found in males. In addition to differences in how the brain processes information about food, other factors that may contribute to sex differences include parental feeding practices, societal emphasis on dieting, and peer influences. Future studies are needed to confirm these findings, as they may have implications for the development of effective intervention programs to improve dietary behaviors and prevent obesity.

Objectives: 1) To describe the cardiovascular health of the construction workers in Hong Kong, 2) to examine the demographic differences in cardiovascular health, and 3) to examine the association between modifiable lifestyle behaviors and cardiovascular conditions. Methods: 626 registered construction workers were included in the analysis. Blood chemistry, blood pressure, weight and height were measured. Face-to-face questionnaire interview was conducted. T-tests and One-way ANOVAs were used to compare the cardiovascular health score, cardiovascular outcomes, and lifestyle behaviors by demographic characteristics. Logistic regressions were performed to assess the cardiovascular outcomes by lifestyle behaviors. Results: Two-thirds of the construction workers failed to achieve three out of the seven “ideal” cardiovascular health indicators. The younger, more educated, and female subjects had better cardiovascular health scores than their counterparts. The ideal fish and seafood consumption was associated with 1) ideal weight status and 2) ideal cholesterol level, whereas less soft drink consumption was associated with ideal cholesterol level. Conclusions: The findings highlighted the importance of promoting cardiovascular health in the construction industry. This study provided insights for future interventions, which should include increasing fish and seafood intake, decreasing soft drink consumption, and enhancing the health literacy amongst older, less educated, and male construction workers.

Objectives: We compared housing and the eating habits of Roma. Contemporary findings (2013) were compared with those from the first monothematic work on Roma (1775) depicting their housing and eating habits. Methods: Data come from a journal (1775) and from semi-structured interviews (2013) with more than 70 Roma women and men who live segregated in excluded settlements at the edges of villages or scattered among the majority. Data were collected in two villages and one district town in the Tatra region, where data from the 1775 measurements originate. We used classical sociological theory and new ethnography to interpret the obtained data. Results: The main findings showed differences between specific social classes then and now regarding housing as well as eating habits, related to both conditions among Roma in the Tatra. The national Roma foods gója or marikľa are traditional foods of Slovak ancestors living in poverty in the country. The houses of Roma do not greatly differ from those of the majority. Conclusions: We conclude that life strategies of the citizens of poor settlements now are similar to two centuries ago, typical for the culture of poverty in various countries of the world even after the centuries.

COVID-19 pandemic and its restrictive measures have present serious unprecedented challenges to human eating behavior. Given that Google Search has become a valuable information resource to examine, predict, and estimate human online interests and behavior, that somehow linked to real people concerns. This study aimed to investigate the features and evaluate the impacts of the COVID-19 pandemic and its lockdown on consumer worldwide interest in eating behavior and its related factors. Google Trends-Relative Search Volumes (RSV) of distinct keywords related to eating behavior, were obtained from a timeframe before and during the COVID-19 pandemic, from January 1, 2018, to December 13, 2020. During the global lockdown from March 11, 2020, to June 30, 2020, RSV curves exhibited a short-term fluctuation of interest in multiple keywords related to eating behavior and its related factors such as food purchasing, food security, food poisoning, panic buying, stocking up, health awareness and mental illness. Spearman’s correlation analysis showed a strong correlation between daily confirmed cases and examined keywords. Univariate repeated measures ANOVA following with Bonferroni Post-hoc test revealed that during the year with the presence of COVID-19 pandemic, people worldwide pay more concerns in each keyword (1) environmental and economic factors (unemployment: +269%, food shortage: +180%, food bank: +50%); (2) health- and food-safety concerns (immunity: +138%, vitamin C: +90%, vitamin D: +55%, zinc: +47%, food storage containers: +40%, food packaging: +31%); (3) food choices and interest (local meat: +84%, frozen food: +67%, CSA: +65%, flour: +66%, bread: +53%, soybean oil: +45%, local fruit: +43%, canned tomato: +42%, refrigerated food: +41%, canned meat: +39%, pancake: +37%, cookie: +29%, butter: +29%, canned fish: +29%, liquior: +20%); (4) social and individual factors (take-out: +128%, deliver: +53%), (6) lifestyle factors (stationary bicycle: +110%, dumbbell: +89%, yoga mat: +84%, treadmill: +65%, grocery store: +51%); (6) psychological factors (isolation: +113%). COVID-19 pandemic and its lockdown have had far-reaching effects on global concerns in many factors related to human eating behavior. Swift action is necessarily performed to strengthen the resilience of the food supply chain system, support and adapt to the new normal behavior, and mitigation the profound negative changes, especially targeting those in high-risks and vulnerable groups and food-insecure regions.

Veganism and the interest towards a plant-based diet are experiencing exponential growth worldwide, and in Italy more and more individuals and families are adopting this lifestyle and diet, too.Such a change in eating habits also imperatively implies the support and expertise of medical and health care professionals, who to date are still often unprepared and skeptical about this dietary pattern, despite scientific evidence.

Background: The effect of the COVID-19 pandemic has transformed medical education and is likely to have long-lasting effects on student learning, mental well-being, and eating behaviour. This study aimed to examine the learning behaviors of medical students at the American University of Integrative Sciences (AUIS), Barbados, during the COVID-19 pandemic. Methods: A cross-sectional web-based online survey was administered to medical students at AUIS from July until November 2021. The data collecting instrument recorded students’ demographic and learning behaviour information (Meo et al. 2020), and eating disorders (SCOFF questionnaire). Results: The overall response rate was 55% (n=120). In relation to learning behaviour, students agreed with the following statements: ‘deterioration in work performance and studying’ (48.4%), ‘remember subject’s contents appropriately’ (40.4%), ‘concentration on the studies’ (40.3%), ‘difficulty in performing two tasks simultaneously’ (38.7%), ‘difficulty in performing mental calculations’ (33.9%), ‘difficulty in recalling recent information’ (32.3%), and ‘difficulty in recalling old information’ (38.7%). Among the 8 dimensions of learning behaviors, deterioration in work performance or studying, and difficulties in recalling recent information were found to be significantly associated with the gender of the students. For SCOFF questionnaire, approximately 24.2% screened positive for eating disorders. Screening with the SCOFF test demonstrated that female, older (>25 years), overweight + obese, Clinical Sciences + PreMed, and non-USA-based students were at more risk of eating disorders. Conclusions: The results indicate that during the COVID-19 pandemic AUIS students have developed learning difficulties, and are likely to have eating disorders. University policymakers should take appropriate measures to support a healthy learning environment and improve students' mental well-being and eating behaviours.

Eating disorders (ED) are characterized by alterations in eating behavior. The genetic factors shared between ED diagnoses have been underexplored. The present study aimed to perform a genome-wide association study on individuals with disordered eating behaviors in the Mexican population, blood methylation quantitative trait loci (blood-meQTL) analysis, and in silico function prediction by different algorithms. The analysis included a total of 1803 individuals. Genome-wide association study and blood-meQTL analysis were performed by logistic and linear regression. In silico functional variant prediction, phenome-wide, and transcriptome-wide association studies by different algorithms were analyzed. In the genome-wide association study, we identified 44 single-nucleotide polymorphisms (SNP) associated at a nominal value and 7 blood-meQTL at a genome-wide umbral. The SNPs were enriched in genome-wide associations of the metabolic and immunologic domains. In the in silico analysis, the SNP rs10419198 located on an enhancer mark could change the expression of PRR12 on blood, adipocytes, and brain areas that regulate food intake. The present study supports the previous associations of genetic variation in the metabolic domain with ED.

This article aims to review the screening and diagnostic tools for eating disorders (ED). Eating disorders represent a complex pathology defined by an imbalance between hunger and satiety, installed in an emotional, traumatic, or conflictive context. Recently, the emphasis regarding ED is focused on the link between genetics, mental pathology, and the somatic and metabolic phenotype and early detection. Early detection and intervention can assure a better recovery and can improve a lot the quality of life of these patients. Methods: We selected ten articles of central importance on the topic in a systematic search on eight databases, articles selected on the type of scales, and size of the study. Results: We identified eight questionnaire scales used in large trials in ED disorders in the scanned literature, choose because we consider it the most accurate and the ones that evaluate best the pathology and the elements that are important as specific traits in ED. There are interview-type scales and self-administered scales. Interview scales are characterized by assessments of symptoms and diagnosis, while self-administered assess particular traits and the possibility of further development of eating disorders. The majority of the scales evaluated were described and used in adult populations. From all the scales assessed and analyzed, only three are described at the child population – it is EAT-26 (> 16 years), EDI-3 (>13 years), and ANSOCQ (> 13 years). Conclusions: It is essential to develop specific scales for people under 18 years of age, given the increasing incidence of ED among children and the need for early detection and appropriate intervention. Early detection of ED in children implies a simple and accurate evaluation at the primary care level or in schools, as the course of the disease can be subclinical for several years. Moreover, the need for accurate scales and telemedicine testing and diagnosis is of high importance during the COVID-19 pandemic as youth are at particular risk being psychologically affected due to disrupted education and social interactions - at a critical time.

Background and Objectives: Acculturation is associated with excessive weight gain among immigrants to the U.S. Whether dietary factors mediate this association is unclear. This study aimed to examine whether overall diet quality or specific component(s) of diet quality mediate the association between acculturation and Body Mass Index (BMI) among Mexican American (MA) men and women. Material and Methods: This is a secondary data analysis using dietary intake data from 24-hour dietary recalls, measured height and weight, and self-reported acculturation from the National Health and Nutrition Examination Survey (NHANES) cycles 1999-2000 to 2011-2012. A total of 6848 MA adults (≥20 yrs) with reliable dietary recall status and body measures were included in the study. Path analyses was performed in Mplus with complex survey design effects adjusted. Results: HEI components of whole grains and sodium were found to play meditating roles in the acculturation-BMI association, and their effects on BMI were opposing [indirect effect were -0.01 (SE 0.00) and 0.02 (0.01), respectively]. In gender-specific analysis, sodium [0.01 (0.00)] was a significant mediator only in MA men; whereas, whole grains [-0.01 (0.00)] was a significant mediator only in MA women. Conclusions: HEI components of whole grains and sodium appeared to be significant dietary mediators in the acculturation-BMI association. Understanding the variations of dietary components and their relationship with acculturation as well as BMI is useful for developing dietary interventions and obesity reduction.

Aim: This study aimed to evaluate the sociodemographic, behavioral, and biological profile and its relationship with the emergence of chronic non-communicable diseases in riverside populations in the Xingu region, Pará, Brazil. Methods: Characteristics related to health indicators and which risk factors are considered most important were also analyzed. This is a cross-sectional, exploratory, and descriptive study. The sample consisted of riverside people over 18 years of both sexes. The sample size (n.86) was calculated with a confidence level of 95% and a sample error of 5%. To divide the groups, the K-means clustering algorithm was adopted through an unsupervised method and the values were expressed as median. For continuous and categorical data, the Mann-Whitney and Chi-square tests were used, respectively, and the significance level was set at p<5%. To classify the degree of importance of each variable, the multi-layer perceptron algorithm was applied. Results: Based on this information, the sample was divided into two groups: the group with low or no education, with bad habits and worse health conditions, and the group with opposite characteristics. The risk factors considered for cardiovascular diseases and diabetes in the groups were low education (p < 0.001), sedentary lifestyle (p < 0.01), smoking, alcoholism, body mass index (p < 0.05) and the waist-hip ratio, with values above the expected, in both groups. Conclusions: The factors considered important to have a good health condition or not were the educational and social conditions of these communities and a part of the riverside population was considered healthier than the other.

Changes in food preferences after bariatric surgery may alter its effectiveness as a treatment for obesity. We aimed to compare food reward for a comprehensive variety of food categories between patients who received a sleeve gastrectomy (SG) or a Roux-en-Y gastric bypass (RYGB) and to explore whether food reward differs according to weight loss. In this cross-sectional exploratory study, food reward was assessed using the Leeds Food Preference Questionnaire (LFPQ). We assessed liking and wanting of eleven food categories. Comparisons were done regarding type of surgery and Total Weight Loss (TWL; based on tercile distribution). Fifty-six patients (30 SG and 26 RYGB) were included (women: 70%; age: 44.0 (11.1) y). Regarding the type of surgery, scores were not significantly different between SG and RYGB, except for ‘non-dairy products – without color’ explicit liking (p = 0.04). Regarding TWL outcomes, explicit liking, explicit wanting and implicit wanting, scores were significantly higher for Good responders than Low responders for ‘No meat – High fat’ (post-hoc corrected p-value: 0.04, 0.03 and 0.04, respectively). Together, our results failed to identify major differences in liking and wanting regarding the type of surgery and tended to indicate that higher weight loss might be related to a higher reward for high protein-content food. Rather to focus only on palatable foods, future studies should also consider a broader range of food items, including protein reward.

Front-of-pack labelling (FoPL) systems, such as the Nutri-Score, play a crucial role in promoting healthy diets and raising consumer awareness. Our study aimed to gather the opinions of Polish experts on the Nutri-Score and its relation to an ideal information system. We conducted a survey with 75 experts, who had an average of 18.1±12.7 years of experience and were mainly employed at medical and agricultural universities. The results showed that the most important features of an FoPL system were clarity, simplicity, consistency with healthy eating recommendations, and the ability to objectively compare products within the same group. While more than half of the respondents believed that the Nutri-Score provides an overall assessment of a product’s nutritional value and facilitates quick purchasing decisions, it falls short in helping consumers compose a balanced diet and cannot be applied to all product groups. The experts also expressed concerns about the system’s ability to account for a product’s degree of processing, full nutritional value and carbon footprint. In conclusion, Poland’s current labelling system needs expansion, but the Nutri-Score requires significant and deep changes and validation against national guidelines and expert expectations before implementation.

Diet influences, and is influenced by, a wide range of socioeconomic, cultural, geographic, and genetic variables. Here we survey a matrix of such interactions as well as their connection to a variety of health outcomes, in a cohort of 689 diverse adults employed at Emory University and enrolled in the Center for Health Discovery and Well-Being (CHDWB) study. Principal component analysis (PCA) of the Block Food Frequency Questionnaire revealed seven PC cumulatively explaining 25.8% and each individually at least 2% of the proportional consumption of 110 food items. PC1 is strongly correlated with the Healthy Eating Index-2015 measure, and accordingly healthier scores associate with multiple measures of physical and mental health. It, as well as PC2 (likely a measure of food expense) and PC3 (carbohydrate versus protein consumption) show significant geographic structure across the Atlanta metropolitan area, correlating with race and ethnicity, income level, age and sex. Notably, a polygenic score for body mass index (BMI) consisting of 281 SNPs explains 2.8% of the variance in PC5, which is as strong as its association with BMI itself. PC5 appears to differentiate participants with respect to conscious eating behavior related to the choice of diet or comfort foods. Our analysis adds to the growing literature on factor analysis of socio-demographic influences on nutrition and health.

Eating Disorders (ED) constitute a serious public health issue affecting predominantly women and appearing typically in adolescence or early adulthood. EDs are extremely difficult to treat as these disorders are ego-syntonic and many patients do not seek treatment. It is vital to focus on the development of successful early-intervention programs for individuals presenting at-risk and are on a trajectory towards developing EDs. This study is a randomized controlled trial evalu-ating an innovative digital gamified Acceptance and Commitment early-intervention program (AcceptME) for young females showing signs and symptoms of an ED and at high-risk for an ED. Participants (N=92; Mage=15.30 years, SD=2.15) received either AcceptME (N=62) or a waitlist control (N=30). Analyses indicated that the AcceptME program effectively reduced weight and shape concerns, with large effects when compared to waitlist controls. Most participants scored below the at-risk cut-off (WCS score<52) in the AcceptME at end-of-intervention (57.1%) com-pared to controls (7.1%) with odds of falling into the at-risk group being 14.5 times higher for participants in the control group. At follow-up, 72% of completers reported scores below the at-risk cut-off in the AcceptME group. The intervention also resulted in a decrease in ED symp-tomatology and increased body image flexibility. Overall, results suggest that the AcceptME program holds promise for early-intervention of young women at-risk for developing an ED.

The purpose of this Individually Randomized Group Treatment Trial was to compare an Acceptance and Commitment Therapy-based (ACT) group intervention and a Cog-nitive Behavioral Therapy-based (CBT) group intervention for weight loss maintenance in a sample of adult patients with obesity seeking treatment for weight loss. 155 over-weight adults (BMI: Kg/m2= 43.8[6.8]) attending a multidisciplinary rehabilitation program for weight loss were randomized into two conditions: ACT and CBT. Demo-graphical, physical, and clinical data were assessed at the beginning of the program (t0), at discharge (t1), and at 6-month follow-up (t2). The following measures were ad-ministered: The Acceptance and Action Questionnaire-II (AAQ-II) and the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). Generalized linear mixed models were performed to assess differences between groups. Moderation ef-fects for gender and eating disorders (ED) have been considered. From baseline to dis-charge no significant differences between interventions were found, with the only ex-ception of an improvement in the CORE-OM total score and in the CORE-OM subjective well-being subscale for those in the CBT condition. From discharge to follow-up ACT group participants showed significant results in terms of weight loss maintenance, CORE-OM total score, and CORE-OM and AAQ-II’s wellbeing, symptoms, and psy-chological problems subscales. Gender moderated the effects of time and intervention on the CORE-OM’ subscale reporting the risk for self-harm or harm others. The pres-ence of an eating disorder moderated the effect of time and intervention on the CORE-OM total score, on the CORE-Om’ symptoms and psychological problems sub-scales, and on the AAQ-II. Patients who received the ACT intervention were more likely to achieve a ≥5% weight loss from baseline to follow-up and to maintain the weight loss after discharge. The ACT intervention was thus effective in maintaining weight loss over time.

The Food Boost Challenge (FBC) was developed using a participatory action research approach to enhance healthy eating behaviors, here vegetable and fruit products (V&amp;F-products) among adolescents, particularly those with lower education levels. FBC is a quadruple helix innovation process, involving adolescents, (peer)researchers, and food system partners of non-governmental and commercial organizations. In 2021-2022, 34 partners provided both cash and in-kind contributions to join the FBC-community. Phase 1 involved 200 students identifying barriers and drivers for consumption of F&amp;V-products among 1000 pre-vocational adolescents, aged 12-20 years. In phase 2, student teams submitted innovative ideas, resulting in 25 concepts fitting into ≥1 of 4 routes: I) innovative technology for a healthy diet, II) new food products/concepts for adolescents, III) hotspots improving F&amp;V-product experience, and IV) new routes to market. In phase 3 consortia of adolescents, students and partners were formed to develop 10 selected concepts into prototypes, and phase 4 offered teams a national platform. Results show FBC resonates with all stakeholders, generating valuable insights to increase F&amp;V-intake. Prototypes in all 4 routes have been developed, with some already in the implementation stage. Additionally, other regions in the Netherlands have adopted the FBC approach. Overall, FBC is an approach that transforms ideas into actionable measures and shows potential to be adapted to promote various healthy eating behaviors among school students.

The is a sequential article to an initial review suggesting that Microbiome First medical approaches to human health and wellness could both aid the fight against noncommunicable diseases and conditions (NCDs) and help to usher in sustainable healthcare. This current review article specifically focuses on public health programs and initiatives and what has been termed by medical journals as a catastrophic record of recent failures. Included in the review is a discussion of the four priority behavioral modifications (food choices, cessation of two drugs of abuse, and exercise) advocated by the World Health Organization as the way to stop the ongoing NCD epidemic. The lack of public health focus on the majority of cells and genes in the human superorganism, the microbiome, is highlighted as is the “regulatory gap” failure to protect humans, particularly the young, from a series of mass population toxic exposures (e.g., asbestos, trichloroethylene, dioxin, polychlorinated biphenyls, triclosan, bisphenol A and other plasticizers, polyfluorinated compounds, herbicides, food emulsifiers, high fructose corn syrup, certain nanoparticles, endocrine disruptors, obesogens). The combination of early life toxicity for the microbiome and connected human physiological systems (e.g., immune, neurological), plus a lack of attention to the importance of microbial rebiosis has facilitated rather than suppressed, the NCD epidemic. This review article concludes with a call to place the microbiome first and foremost in public health initiatives as a way to both rescue public health effectiveness and reduce the human suffering connected to co-morbid NCDs.

Obesity is a global public health problem and the environment as its major determinant. To identify interventions an evidence base is warranted. To this aim we investigate the relationship between the consumption of foods and eating locations (like home, school/work and others) in British adolescents, using data from the UK National Diet and Nutrition Survey Rolling Program (2008–2012 and 2013-2016). Cross-sectional analysis of 62,523 food diary entries from this nationally representative sample then focused on foods contributing up to 80% total energy to the daily adolescent´s diet. Correspondence Analysis (CA) was first used to generate food-location relationship hypotheses and Logistic Regression (LR) to quantify the evidence in terms of odds ratios and formally test those hypotheses. The less-healthy foods that emerged from CA were chips, soft drinks, chocolate and meat pies. Adjusted Odds Ratios (99% CI) for consuming specific foods at a location “Other” than home (H) or school/work (S) in the 2008-12 survey sample were: for soft drinks 2.8 (2.1 to 3.8) vs. H and 2.0 (1.4 to 2.8) vs. S; for chips 2.8 (2.2 to 3.7) vs. H and 3.4 (2.1 to 5.5) vs. S; for chocolates 2.6 (1.9 to 3.5) vs. H and 1.9 (1.2 to 2.9) vs. S; and for meat pies 2.7 (1.5 to 5.1) vs. H and 1.3 (0.5 to 3.1) vs. S. These trends were confirmed in the 2013-16 survey sample. Interactions between location and BMI were not significant in either sample. In conclusion, our study showed that adolescents are more likely to consume specific less-healthy foods at locations away from home and school/work, irrespective of BMI. Such locations include leisure places, food outlets and “on the go”, hence public health policies to discourage less-healthy food choices in these locations is warranted for all adolescents.

Dietary restrictions or reductions such as fasting for weight loss, are often difficult to adhere to in the long term due to increased appetite and food cravings. Recently, gastrointestinal delivery of bitter hops extract has been shown to be effective at reducing appetite in men. Our aim was to determine the effect of bitter hops on appetite and cravings in women, using a day-long, water-only fast. Thirty adult women were recruited and required to fast for 24 h from 1800 h to 1800 h on three occasions and given an ad libitum meal to break each fast. Treatments of either a placebo or one of two doses (high dose; HD: 250 mg or low dose; LD: 125 mg) of a bitter hops-based appetite suppressant (Amarasate®) were given twice per day at 16 and 20 h into the fast. Treatment with both the HD and LD treatment groups exhibited a significant (p < 0.05) reduction in appetite and cravings for food. Two participants reported loose stools and one reported heart-burn while on the HD treatment, and one participant reported loose stools while on the LD treatment. These data suggest that appetite suppressant co-therapy may be useful in reducing hunger during fasting in women and shows that gastrointestinal delivery of bitter compounds may also be an effective method of reducing cravings for food.

Home confinement during the COVID-19 pandemic has been accompanied by dramatic changes in household food dynamics that can significantly influence health. This systematic literature review presents parental perspectives of the impact of COVID-19 lockdown on food preparation and meal routines, as well as other food-related behaviors, capturing both favorable and unfavorable changes in the family food environment (FFE). Themes and trends are identified and associations with other lifestyle factors are assessed. In overall, families enjoyed more time together around food, including planning meals, cooking, and eating together. Eating more diverse foods and balanced meals was combined with overeating and increased snacking, as parents became more permissive towards food; however, food insecurity increased among families with the lowest income. Adoption of meal planning skills and online shopping behavior emerged alongside behaviors aimed at self-sufficiency, such as bulk purchasing and stockpiling. These results are an important first step in recognizing how this pandemic may be affecting the FFE, including low-income families. Future obesity prevention and treatment initiatives, but also ongoing efforts to address food management, parental feeding practices, and food insecurity, can account for these changes moving forward.