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

Dietary counselling plus omega-3 supplementation in the treatment of generalized anxiety disorder: protocol for a randomized wait-list controlled pilot trial (the "EASe-GAD Trial")

BACKGROUND

Anxiety disorders are prevalent and disabling conditions involving excessive worry and tension. Generalized anxiety disorder (GAD), the most common anxiety disorder, affects 5% of individuals from high-income countries and many individuals report that treatment options are not accessible, effective, or tolerable. Clinical evidence suggests that nutrition interventions, based on the Mediterranean diet and supplementation of omega-3 fatty acids, can significantly improve symptoms of depression; however, the effect of nutrition interventions on anxiety symptoms has not been studied in a clinical population. The primary objective of the present study is to assess the feasibility and acceptability of a dietary counselling and omega-3 fatty acid supplementation intervention delivered to adult women with GAD. The secondary objectives include assessing changes in anxiety symptom severity, assessing changes in quality of life, assessing changes in biomarkers, and evaluating the components of the program.

METHODS

This study is a randomized, wait-list controlled pilot trial delivering a 12-week, dietary counselling intervention and omega-3 supplementation to 50 adult women with GAD. Participants will complete seven individual counselling sessions which include education, personalized recommendations, mindful eating techniques, motivational interviewing, and goal setting. They will be provided with recipes, instructional videos, and food items. The intervention is designed based on the Social Cognitive Theory and previous research that has been done by the author team to identify dietary constituents with the most evidence to support their use in the treatment of anxiety disorders. Questionnaires and blood work will be completed at baseline, after the waiting period (for those in the waitlist group), and after the intervention.

DISCUSSION

Results from this study will lay the foundation for future large-scale studies in this area and may provide preliminary evidence of the role of diet counselling and omega-3 supplementation in the management of GAD. Research on the role of nutrition in psychiatric care has been identified as a priority by a number of international organizations. The present trial directly addresses the call for the research that is most needed to advance the field.

TRIAL REGISTRATION

This protocol was registered at ClinicalTrials.gov on October 10, 2022; NCT05573672 . Trial sponsor: The Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, Toronto, ON M2K 1E2, 416-498-1255. Steering committee: Composed of MA, LL, KC, IvdW, SM, UN, AJ. The committee meets monthly to oversee the trial. Protocol identifier: CCNM_EASe-GADCT_2201v4.

Anxiety, depression, perceived executive function and sugar sweetened beverages: a causal mediation analysis in Mexican young adults

There is the notion that dysregulation of executive function (EF), which disrupts behavior and cognitive processes, may explain the emotional impairment which leads to increasing sugar sweetened beverages (SSBs) intake. We aimed to test whether anxiety and depression mediate the association between self-reported problems in EF and sugar sweetened beverage intake in Mexican adults between 18-40 years. An open survey advertised as a 'mental health and sugar sweetened beverages study' was conducted, participants were recruited through Facebook ads. Males and females, between 18-40 years, able to read and write, and currently residing in Mexico were included. We analyzed data using causal mediation analysis with latent variables using a structural equation modelling framework. Significant indirect effects were found for somatic symptoms of depression (β = 6.601, SE = 2.657, p < .05) and anxiety (β = .679, SE =.334, p < .05). In depression model no significant direct effects of EF were found in the depression model, however they were found in the anxiety model (β = 1.335 SE =.566, p < .05). Somatic symptoms of depression were a total mediator, and anxiety a partial mediator. The results suggest that EF increased the probability of emotional symptoms, which led to a higher consumption of SBBs.

Are Emotional Eating and Other Eating Behaviors the Missing Link in the Relationship between Inadequate Sleep and Obesity? A Systematic Review

Evidence is emerging to explain that the relationship between inadequate sleep and obesity could be influenced by emotional eating and other eating behaviors such as disinhibition. Therefore, our aim was to conduct a systematic review to analyze the potential role of emotional eating and other eating behaviors in the relationship between inadequate sleep and obesity. We conducted a comprehensive search on 2 databases (Medline and Scopus) looking for records from 1 January 2011 until 31 December 2022 without language restrictions. Cross-sectional, longitudinal, and interventional studies were included if they assessed the association between sleep and emotional eating, as well as the role of emotional eating on the relationship between inadequate sleep and obesity. Secondary outcomes included studies analyzing the link between sleep and other eating behaviors as well as their role in the sleep-obesity relationship. Our results showed that emotional eating and disinhibition play a significant role in the relationship between inadequate sleep and obesity, especially in women. Furthermore, we provide evidence of other eating behaviors (e.g., external eating, eating competence, and hunger), which are also associated with poor sleep outcomes. However, these behaviors do not seem to be determinants of the association between sleep and obesity. In conclusion, our results suggest that individuals with inadequate sleep who are prone to emotional eating and/or disinhibition may require tailored approaches for obesity prevention and treatment.

Brief emotional eating scale: A multinational study of factor structure, validity, and invariance

Emotional eating or the tendency to eat in response to emotional states can be assessed using self-report measures. The Emotional Eating Scale-II is a commonly used and reliable instrument that measures the desire to eat in response to a range of unpleasant and pleasant emotions. The current study aimed to corroborate the validity of the EES-II and expand its utility by investigating its dimensionality and testing its measurement invariance in samples from English-speaking and non-English-speaking countries. Convergent and predictive validity in respect of food craving, eating, and health indicators were also examined. This cross-national study included a total of 2485 adult participants recruited from Finland, North America, Philippines, United Kingdom, China, Italy, Spain, and South Korea, who completed the EES-II in six different languages. Factor analyses supported a four-factor structure including valence (pleasant, unpleasant) and activation (high, low) for a 12-item English version and slightly modified non-English adaptations. The model exhibited good fit in all samples, and convergent validity was demonstrated. Full invariance of factor loadings and partial invariance of factor loading, intercepts, and error variances was established across samples. Structural equation models revealed that high activation (pleasant and unpleasant) states predicted food cravings and reported eating. Overall findings across multiple samples and countries supported the factorial structure, reliability, invariance, and validity of the resulting Brief Emotional Eating Scale (BEES).

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

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

Mitochondrial Stress in Metabolic Inflammation: Modest Benefits and Full Losses

Energy intake and metabolic balance are the pillars of health preservation. Overnutrition causes nonspecific, persistently low inflammatory state known as metabolic inflammation. This condition contributes to the pathophysiology of various metabolic disorders, such as atherosclerosis, obesity, diabetes mellitus, and metabolic syndrome. The mitochondria maintain the balance of energy metabolism. Excessive energy stress can lead to mitochondrial dysfunction, which promotes metabolic inflammation. The inflammatory environment further impairs mitochondrial function. Accordingly, excellent organism design keeps the body metabolically healthy in the context of mitochondrial dysfunction, and moderate mitochondrial stress can have a beneficial effect. This review summarises the research progress on the multifaceted characterisation of mitochondrial dysfunction and its role in metabolic inflammation.

Association between anxiety and eating behaviors in patients with obesity

Background

Given the link between eating behavior and obesity, it is critical to identify individuals who have eating behaviors which contribute to obesity etiology. This study aimed to investigate the potential relationship between symptoms of anxiety and eating behaviors in patients with obesity.

Methods

This was a cross-sectional study analyzing baseline characteristics of 438 patients with obesity (BMI>30). Patients completed the Hospital Anxiety and Depression Scale (HADS) questionnaire, the Three-Factor Eating Questionnaire R21 (TFEQ-R21), and the Weight Efficacy Lifestyle Questionnaire (WEL). Pearson correlation coefficients were used to evaluate the association between questionnaires. Two-sample independent t-test were conducted to examine differences in the TFEQ-R21 and WEL between low and moderate to severe levels of symptoms of anxiety.

Results

Anxiety scores (HADS-A) positively correlated with two factors of the TFEQ, emotional eating (r = 0.36) and uncontrolled eating (r = 0.27). The HADS-A score was negatively correlated with self-efficacy to resist eating in all five situational factors on the WEL (p < 0.01). Patients with symptoms of anxiety additionally showed higher mean scores for emotional eating and uncontrolled eating (p < 0.001, respectively),and lower levels of cognitive restraint (p = 0.04)) on the TFEQ-R21.

Conclusion

Patients with obesity who reported having anxiety symptoms had lower self-confidence to manage their eating and more emotional eating than patients with low anxiety symptoms. Clearly more needs to be learned about symtoms of anxiety and eating behaviors.

Gastrointestinal distress, State and Trait anxiety, and dietary intake among college students during the COVID-19 pandemic

OBJECTIVE

This study examined the impact of State and Trait anxiety and dietary intake on college students' gastrointestinal symptoms during the COVID-19 pandemic.

PARTICIPANTS

A total of 455 students, aged 18-23, from two residential colleges in the midwestern United States participated in the study during April 2021.

METHODS

An online questionnaire that included the National Cancer Institute Dietary Screener, State-Trait Inventory for Cognitive and Somatic Anxiety, and an adapted version of the Gastrointestinal Symptoms Questionnaire was used. Stepwise multiple regression analyses and Spearman rho correlation coefficients were used to analyze the data.

RESULTS

High rates of State-somatic, State-cognitive, and Trait-somatic anxiety were present in our study population. These anxiety subscales and dietary intake predicted 26% and 3.8% of the GI symptoms variance, respectively.

CONCLUSION

State-anxiety and Trait-somatic anxiety are large factors in predicting GI symptoms compared to dietary intake. College students could seek anxiety-reducing techniques to ease GI symptoms.

Emotional eating and cognitive restraint mediate the association between sleep quality and BMI in young adults

This cross-sectional study was designed to investigate whether diet quality and eating behaviors could mediate the association between sleep quality and body mass index (BMI) in young adults. For all participants (n = 925; aged 21.4 ± 2.5 years; 77.8% women) we evaluated: BMI, sleep quality, diet quality, and eating behavior dimensions (emotional eating, cognitive restraint, and uncontrolled eating). Linear regression models were used to test associations between exposure and outcome variables. Path analysis was conducted with all potential mediators and covariates entered at the same time. Results showed that emotional eating (β = 0.04 [95% CI: 0.03; 0.06]), cognitive restraint (β = 0.03 [95% CI: 0.01; 0.04]), uncontrolled eating (β = 0.02 [95% CI: 0.01; 0.04]) and diet quality (β = -0.14 [95% CI: 0.19;-0.08]) were significantly associated with sleep quality. Additionally, BMI was significantly associated with PSQI score (β = 0.09 [95% CI: 0.01; 0.17]), emotional eating (β = 0.89 [95% CI: 0.60; 1.18]), and cognitive restraint (β = 1.37 [95% CI: 1.02; 1.71]). After testing for mediation, results revealed that emotional eating and cognitive restraint evidenced a significant mediating effect on the association between sleep quality and BMI. Additionally, diet quality was significantly associated with emotional eating (β = -0.35 [95% CI: 0.56;-0.13]), cognitive restraint (β = 0.53 [95% CI: 0.27; 0.79]), and uncontrolled eating (β = -0.49 [95% CI: 0.74;-0.25]). In conclusion, young adults with poor sleep quality are more likely to deal with negative emotions with food, which, in turn, could be associated with higher cognitive restraint, becoming a vicious cycle that has a negative impact on body weight. Our results also emphasize the role of eating behaviors as determinants of diet quality, highlighting the importance of considering sleep quality and eating behaviors when designing obesity prevention strategies in this population.

Life history strategy and overeating during COVID-19 pandemic: a moderated mediation model of sense of control and coronavirus stress

BACKGROUND

This study examined the mediating effect of sense of control and the moderating effect of coronavirus stress on the relationship between life history strategy and overeating among Chinese college students during the COVID-19 period.

METHODS

3310 Chinese students (Mage = 19.74, SD = 1.50; 47% males) completed self-reported questionnaires regarding life history strategy, sense of control, overeating, and coronavirus stress. The data were analyzed using Pearson's r correlations and moderated mediation analysis.

RESULTS

The results revealed that control sense mediated the link between life history strategy and college students' overeating. College students' coronavirus stress moderated the associations between life history strategy and college students' sense of control and between control sense and overeating. The association between life history strategy and sense of control was stronger for those with lower coronavirus stress, and the association between sense of control and overeating was stronger for those with lower coronavirus stress.

CONCLUSIONS

This study identified that the critical factors were associated with overeating. On the one hand, the research deepens the application and interpretation of life history theory in the field of eating; on the other hand, it provides evidence for the prevention of overeating, and provides theoretical basis for psychological assistance among Chinese college students.

Negative Impacts of COVID-19 Induced Lockdown on Changes in Eating Behavior, Physical Activity, and Mental Health as Modified by Digital Healthy Diet Literacy and eHealth Literacy

Background: The COVID-19-induced lockdown has been implemented in many countries, which may cause unfavorable changes in lifestyles and psychological health. People's health literacy, healthy diet, and lifestyles play important roles in mitigating the negative impacts of the pandemic. Therefore, we aimed to examine associations of COVID-19 lockdown with changes in eating behavior, physical activity, and mental health; and the modification effects by digital healthy diet literacy (DDL) and eHealth literacy (eHEALS) on the associations.

Methods: We conducted an observational study on 4,348 outpatients from 7th April to 31st May 2020. Data from 11 hospitals in Vietnam included demographic characteristics, DDL, eHEALS, eating behavior, physical activity, and mental health changes. Multiple logistic regression and interaction models were performed to examine associations.

Results: Patients under lockdown had a lower likelihood of having “unchanged or healthier” eating behavior (odds ratio, OR, 0.38; 95% confidence interval, 95%CI, 0.29 to 0.51; p < 0.001), “unchanged or more” physical activity (OR, 0.79; 95% CI, 0.69 to 0.90; p < 0.001), and “stable or better” mental health (OR, 0.77; 95% CI, 0.67 to 0.89; p < 0.001), as compared to those after lockdown. In interaction models, as compared to patients after lockdown and with the lowest DDL score, those under lockdown and with a one-score increment of DDL had a higher likelihood of having “unchanged or healthier” eating behavior (OR, 1.05; 95% CI, 1.02 to 1.07; p < 0.001), and “stable or better” mental health (OR, 1.02; 95% CI, 1.01 to 1.04; p < 0.001). Similarly, as compared to patients after lockdown and with the lowest eHEALS score, those under lockdown and with a one-score increment of eHEALS had a higher likelihood of having an “unchanged or more” physical activity (OR, 1.03; 95% CI, 1.01 to 1.05; p < 0.001).

Conclusion: The COVID-19 lockdown measure could negatively affect eating behavior, physical activity, and mental health among outpatients. Better DDL and eHEALS were found to mitigate the negative impacts of the lockdown, which may empower outpatients to maintain healthy lifestyles and protect mental health. However, this study holds several limitations that may undermine the certainty of reported findings.

Anxiety, Anhedonia, and related food consumption at the beginning of the COVID-19 quarantine in populations of Spanish-speaking Ibero-American countries: An online cross-sectional survey study

•

In Ibero-American, the anxiety and anhedonia are related to the consumption of food.

•

The anxiety is related to the consumption of palatable foods during confinement.

•

The different type of foods had a different probability of increasing serving size.

•

An increase in average body weight was observed during confinement for COVID-19.

Dysfunctional Patterns of Food Intake by Anxiety during Isolation by COVID-19 in Chile, Colombia and Mexico

The aim of this research was to compare food intake dysfunctional patterns score with the subjective perception of anxiety and sociodemographic characteristics of the participants in isolation by COVID-19 from Chile, Colombia, and Mexico. A cross-sectional research was carried out, with a virtual questionnaire of subjective perception of anxiety and the questionnaire of three 18-item feeding factors. 958 people of both sexes participated (F = 83%, M = 17%), mainly in the 18 to 35 age range. Dysfunctional eating patterns presented high scores in people who perceived anxiety, as well as in participants from Chile. Additionally, it was found that women present greater cognitive restriction and emotional intake, and college students showed greater disinhibition. In conclusion, the scores of the three dysfunctional eating patterns were higher in people with subjective perception of anxiety during social isolation due to COVID-19, and there were also differences according to country, sex, and educational level.

The impact of COVID-19 confinement on the eating habits and lifestyle changes: A cross sectional study

Novel coronavirus (COVID-19) emerged in December 2019 in the city of Wuhan, China causing severe respiratory infections and resulting in millions admissions to hospital and over a million deaths worldwide. Authorities imposed protective measures including confinement to flatten curves of casualties resulted in sudden lifestyle and eating habit changes. The objectives of this study were to observe the impact of the COVID-19 lockdown on eating behavior and lifestyle of the Kurdish population in Iraqi Kurdistan. A structured cross-sectional study was conducted from 1st to 14th of June when the lockdown finished with three different sections. Section one (6 questions) included socio-demographic information section two (11 questions) composed of dietary behavior information including a) Mediterranean diet (MD) adherence using 14-scaled items with a MD screener tool ranging from 0 to 14 b) and sections three (12 questions) composed of lifestyle habit changes such as physical activity, sleeping behavior, and smoking habit. The total number of included respondents was 2,137. The results showed that 12.0% (256) of participants stated that their lifestyle was improved, whereas 50.9% (1,087) declared their lifestyle deteriorated. In particular, the frequency of physical activity was decreased (McNemar value = 60.53, p <.001) and sleeping hours were significantly increased during lockdown (McNemar value = 447.93, p <.001). Regarding eating habits, it was noticed that 29.3% and 14.3% felt that appetite increased and decreased, respectively. The appetite change during lockdown was significantly associated with age (p =.0001), gender (p =.001), city (p =.007), and BMI (p =.001). Similarly, 32.4% reported weight gain. In conclusion, this study is among the earliest studies showing the effect of COVID-19 on eating behavior and lifestyle changes. COVID-19 confinement had a significant effect on lifestyle particularly reducing physical activity and changing eating habits.

Eating Habits and Lifestyles during the Initial Stage of the COVID-19 Lockdown in China: A Cross-Sectional Study

Due to the outbreak of coronavirus disease 2019 (COVID-19), the Chinese government implemented strict lockdown measures to control the spread of infection. The impact of the COVID-19 lockdown on eating habits and lifestyles in the general population is unclear. This cross-sectional study was conducted via an online survey to obtain an overview of the food access, food intake, and physical activity of Chinese residents during the initial stage of the COVID-19 lockdown, and to investigate the association between staying at home/working from home and changes in eating habits and lifestyles. A total of 2702 participants (70.7% women) were included. Most of the participants maintained their habitual diet, while 38.2% increased their snack intake, 54.3% reported reduced physical activity, and 45.5% had increased sleep duration. Most people (70.1%) reported no change in body weight, while 25.0% reported an increase. Always staying at home/working from home was associated with an increase in animal product, vegetable, fruit, mushroom, nut, water, and snack intake, as well as sleep duration and frequency of skipping breakfast (odds ratio (OR) 1.54, 1.62, 1.58, 1.53, 1.57, 1.52, 1.77, 2.29, and 1.76 respectively). Suggestions should be made to encourage people to reduce their snack intake, maintain the daily consumption of breakfast, and increase physical activity during future lockdown periods.

Application of three different coaching strategies through a virtual coach for people with emotional eating: a vignette study

BACKGROUND

Around 13% of the world's population suffers from obesity. More than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress). It is an alternate to more effective coping strategies for negative emotions. Our study explored the opportunities for helping adults with emotional overeating using a virtual coach, aiming to identify preferences for tailored coaching strategies applicable in a personal virtual coach environment. Three different coaching strategies were tested: a validating, a focus-on-change, and a dialectical one - the latter being a synthesis of the first two strategies.

METHODS

A qualitative study used vignettes reflecting the two most relevant situations for people with emotional eating: 1. experiencing negative emotions, with ensuing food cravings; and 2. after losing control to emotional eating, with ensuing feelings of low self-esteem. Applied design: 2 situations × 3 coaching strategies.

PARTICIPANTS

71 adult women (Mage 44.4/years, range 19-70, SD = 12.86) with high scores on the DEBQ-emotional eating scale (Memo 3.65, range 1.69-4.92, SD = .69) with mean BMI 30.1 (range 18-46, SD = 6.53). They were recruited via dieticians' practices, were randomly assigned to the conditions and asked how they would face and react to the presented coaching strategies. Data were transcribed and a thematic analysis was conducted.

RESULTS

Qualitative results showed that participants valued both the validating coaching strategy and the focus-on-change strategy, but indicated that a combination of validation and focus-on-change provides both mental support and practical advice. Data showed that participants differed in their level of awareness of the role that emotions play in their overeating and the need for emotion-regulation skills.

CONCLUSION

The design of the virtual coach should be based on dialectical coaching strategies as preferred by participants with emotional eating behaviour. It should be tailored to the different stages of awareness of their emotions and individual emotion-regulation skills.

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

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

Factor Structure and Psychometric Properties of Emotional Eater Questionnaire (EEQ) in Spanish Colleges

Emotional eating (EE) patterns have been shown to play a relevant role in the development of overweight problems. However, there is a gap in research aimed at validating questionnaires to assess EE in specific populations. The aim of the study was to analyze factor structure and psychometric properties of Emotional Eater Questionnaire (EEQ) in Spanish universities. EEQ, state-anxiety subscale of STAI and a questionnaire about health habits were filled out by 295 students. Exploratory Factor Analysis (EFA) by using Unweight Least Squares (ULS) method was carried out. To determine factor numbers we used eigenvalues, parallel analysis, and goodness of fit statistics. Cronbach’s alpha and Spearman correlations were used to analyze reliability, convergent, and concurrent validity. The parallel analysis and goodness of fit statistics showed that unifactorial structure of seven items was the most appropriate what accounted for 57% of the variance. Internal consistency was good (α = 0.753), as well as convergent validity (r = 0.317; p < 0.001). Concurrent validity was significant for three of the five criteria (r = −0.224; p < 0.001 and r = −0.259; p < 0.001). The results suggest some differences in the structure of the psychometric assessment of EE in sub-clinical population in comparison with previous studies carried on with an overweight population, what could be relevant to obesity prevention.

Reward and psychopathological correlates of eating disorders: The explanatory role of leptin

It has been hypothesized that leptin level alterations in Eating Disorders (EDs) represent a maintaining factor for pathological reward-related ED behaviors, given leptin role in the dopaminergic reward systems. The aim of the present study was to evaluate the role of leptin in EDs as a mediator for the relationship between Body Mass Index (BMI) and several pathological behaviors, such as dietary restraint, compensatory exercise, vomiting, binge eating and emotional eating. Sixty-two patients with EDs and 41 healthy controls (HC) had their blood drawn and completed psychometric tests for the evaluation of general psychopathology, ED psychopathology and emotional eating. Moderated linear regression models showed that, in the presence of high levels of ED psychopathology, leptin levels were negatively associated with dietary restraint and compensatory exercise, and positively with emotional eating and binge eating. Finally, leptin showed an indirect effect on the association between BMI and all these reward-related behaviors. These results suggest that a variation of BMI maintains these pathological ED behaviors through a variation in leptin levels. Considering the role of leptin in reward circuits, the results seem to confirm an aberrant food-related reward mechanism in ED patients.

Percepción subjetiva de manejo emocional, ansiedad y patrones de ingesta relacionados con aislamiento por COVID-19

El periodo de aislamiento social se considera un detonante de ansiedad, y genera alteraciones en la forma de alimentarse. El objetivo de esta investigación fue determinar la relación entre la percepción subjetiva del manejo de las emociones y la ansiedad con los patrones disfuncionales de la ingesta en el periodo de aislamiento social por COVID-19, en participantes colombianos. La investigación es exploratoria de tipo transversal analítico. Un total de 450 colombianos mayores de 18 años (sexo: 82 % femenino y 18 % masculino) respondieron un cuestionario virtual sobre la percepción subjetiva del manejo de las emociones y la ansiedad; también, se aplicó el cuestionario de tres factores de alimentación para identificar patrones disfuncionales de la ingesta. Se reportó un riesgo 3 veces mayor de presentar ansiedad en las personas que manifestaron un manejo inadecuado de sus emociones. Asimismo, aquellos cuya percepción fue un inadecuado manejo de emociones y ansiedad presentaron mayor nivel de patrones disfuncionales de ingesta como la desinhibición (p < 0.0001) e ingesta emocional (p < 0.0001). Se concluyó que la percepción subjetiva del manejo inadecuado de las emociones y de ansiedad, incrementan la ingesta emocional y la desinhibición, en colombianos en aislamiento social.

Examining the Role of Anxiety and Depression in Dietary Choices among College Students

This study examines the role of anxiety and depression symptoms in predicting dietary choices in emerging adults while accounting for sex differences in these relationships. Participants were 225 English speaking undergraduates enrolled in a university in southeastern United States. Participants were recruited through an online research recruitment application utilized by the university. Participants volunteered for a two-phased anonymous survey monitoring the effects of eating habits and gastrointestinal health in young adults. As part of this effort, participants completed self-reporting measures related to anxiety and depression, as well as an automated, self-administered 24-h diet recall. Multigroup path analysis was used to test primary hypotheses. Overall, a decrease in total caloric intake and an increase in sugar consumption were found as self-reported symptoms of anxiety and depression increased. In addition, there were sex differences in the relationship between depression and food choices. Men consumed more saturated fat as well as less fruits and vegetables as self-reported symptoms of depression increased. Results suggest symptoms of depression are a greater risk factor for poor nutrition in male college students than females. The findings provide another justification to screen for psychological distress in student health services given the implications on behavioral lifestyle and health.

Mediterranean Diet and the Emotional Well-Being of Students of the Campus of Melilla (University of Granada)

A certain link exists between the consumption of particular groups of food and well-being. In this study, we analyzed in depth the relationship between strict adherence to the Mediterranean diet (MD) and emotional well-being through a descriptive, exploratory, transversal, and correlational study of students from the Campus of Melilla, University of Granada, Spain. The sample consisted of 272 individuals. Adherence to the MD was measured with the PREvención con DIetaMEDiterránea (PREDIMED) questionnaire, emotional well-being (both positive and negative affection) with the Spanish version of the Positive and Negative Affect Schedule (PANAS), the state of perceived health with the Short Form-36 (SF36), and the degree of physical activity using the International Physical Activity Questionnaire Short Form (IPAQ-SF). A strict adherence to the MD was found to be significantly related to positive emotional state (β = 0.018, p = 0.009). The perceived state of health (β = 0.192, p < 0.001), mental role (β = 0.346, p < 0.001), and physical activity (β = 0.155, p = 0.007) were found to be predictive factors of a positive emotional state. Conversely, the relationship between the adherence to the MD and a negative emotional state was not significant. Various components of the MD were found to be independently connected to well-being. The results suggest that adopting a nutritional pattern such as the MD is linked to an improvement in emotional well-being.

Effects of chronic stress on reinstatement of palatable food seeking: Sex differences and relationship to trait anxiety

Previous research in our lab has established a causal role for chronic stress exposure in subsequent increases in relapse-like behaviors in male rats with a history of palatable food self-administration. Given that many of the neurobehavioral consequences of stress are sex dependent, we aimed to determine whether sex differences exist with regard to the effects of chronic stress on relapse. Additionally, because high trait anxiety confers vulnerability to stress-related disorders, we examined whether individual differences in trait anxiety were related to differences in relapse-like behavior after chronic stress exposure. Following elevated plus maze testing for classification into high- or low-anxiety phenotypes, male and female rats responded for highly palatable food pellets. During subsequent extinction training, stress was manipulated (0 or 90 min restraint/day for 7 days). Rats were then tested for cue- and pellet priming-induced reinstatement of palatable food seeking. Results showed that female rats displayed higher levels of responding during cue-induced reinstatement tests compared to males, and that a history of chronic stress caused an attenuation of cue-induced reinstatement in female, but not male, rats. Regarding pellet priming-induced reinstatement, there was a three-way interaction such that neither stress history nor anxiety phenotype was related to reinstatement in females, but a history of stress in males caused increased and decreased responding in low- and high-anxiety rats, respectively. These results suggest that biological sex and trait anxiety level may help to explain differences in vulnerability to relapse among individuals exposed to chronic stress. Such information may be useful in designing more personalized and effective treatments for obesity and eating disorders.