Insomnia and depressive symptoms in relation to unhealthy eating behaviors in bariatric surgery candidates

Night eating habits, sleep quality, and depression, are they associated with vitamin D status?

INTRODUCTION

In addition to the well-established roles of vitamin D on bone health, it also appears to be an effective factor on mental health and circadian behaviors, that include eating and sleeping habits.

OBJECTIVE

This study aimed to assess the association between vitamin D status with night eating habits, sleep quality and depression in female college students.

MATERIALS AND METHODS

This cross-sectional study studied healthy female students from Shiraz University of Medical Sciences, Iran. Demographic and anthropometric information as well as data on sleep quality and depression were recorded and serum levels of 25-hydroxyvitamin D were measured. A 3-day food record questionnaire was completed to assess night eating habits. Data analyses were undertaken using Chi-square, Mann-Whitney U test and logistic regression. A P-value of <0.05 was considered significant.

RESULTS

The study participants comprised of 272 female students with median (Inter Quartile Range) age of 22 (21-24) years. The majority of the participants (82.3 %) were classified as night eaters, who had higher rates of poor sleep quality compared to non-night eaters (P < 0.05). With 1 ng/ml increase in serum levels of 25-hydroxyvitamin D, the odds of being a night eater fell by 3 % (OR = 0.97; 95%CI = 0.95, 0.99), and the odds of having depression or poor sleep quality decreased by 5 % (OR = 0.95; 95%CI = 0.93, 0.97) and 6 % (OR = 0.94; 95%CI = 0.91, 0.97), respectively.

CONCLUSION

There was an inverse association between serum 25-hydroxyvitamin D level with night eating habits, depression and poor sleep quality. This association needs be confirmed using cohort and interventional studies.

The Diagnostic Value of Gut Microbiota Analysis for Post-Stroke Sleep Disorders

BACKGROUND

Gut microbiota have been associated with many psychiatric disorders. However, the changes in the composition of gut microbiota in patients with post-stroke sleep disorders (PSSDs) remain unclear. Here, we determined the gut microbial signature of PSSD patients.

METHODS

Fecal samples of 205 patients with ischemic stroke were collected within 24 h of admission and were further analyzed using 16 s RNA gene sequencing followed by bioinformatic analysis. The diversity, community composition, and differential microbes of gut microbiota were assessed. The outcome of sleep disorders was determined by the Pittsburgh Sleep Quality Index (PSQI) at 3 months after admission. The diagnostic performance of microbial characteristics in predicting PSSDs was assessed by receiver operating characteristic (ROC) curves.

RESULTS

Our results showed that the composition and structure of microbiota in patients with PSSDs were different from those without sleep disorders (PSNSDs). Moreover, the linear discriminant analysis effect size (LEfSe) showed significant differences in gut-associated bacteria, such as species of Streptococcus, Granulicatella, Dielma, Blautia, Paeniclostridium, and Sutterella. We further managed to identify the optimal microbiota signature and revealed that the predictive model with eight operational-taxonomic-unit-based biomarkers achieved a high accuracy in PSSD prediction (AUC = 0.768). Blautia and Streptococcus were considered to be the key microbiome signatures for patients with PSSD.

CONCLUSIONS

These findings indicated that a specific gut microbial signature was an important predictor of PSSDs, which highlighted the potential of microbiota as a promising biomarker for detecting PSSD patients.

Impact of mental disorders on the risk of heart failure among Korean patients with diabetes: a cohort study

BACKGROUND

Few studies have assessed the correlation between coexisting mental disorders in participants with diabetes mellitus (DM) and the risk of heart failure (HF). Herein, we conducted a cohort study to determine the association between the accumulation of mental disorders in participants with DM and the risk of HF.

METHODS

The Korean National Health Insurance Service records were assessed. 2,447,386 adults with DM who underwent health screening between 2009 and 2012 were analyzed. Participants with major depressive disorder, bipolar disorder, schizophrenia, insomnia, or anxiety disorders were included. In addition, participants were categorized based on the number of coexisting mental disorders. Each participant was followed until December 2018 or until the onset of HF. Cox proportional hazard modelling with confounding factors adjustment was conducted. In addition, a competing risk analysis was conducted. Subgroup analysis assessed the impact of clinical variables on the association between the accumulation of mental disorders and the risk of HF.

RESULTS

The median follow-up duration was 7.09 years. The accumulation of mental disorders was associated with a risk of HF (zero mental disorder (0), reference; 1 mental disorder, adjusted hazard ratio (aHR): 1.222, 95% confidence intervals (CI): 1.207-1.237; 2 mental disorders, aHR: 1.426, CI: 1.403-1.448; ≥3 mental disorders, aHR: 1.667, CI: 1.632-1.70. In the subgroup analysis, the strength of association was the strongest in the younger age group (< 40 years, 1 mental disorder, aHR 1.301, CI 1.143-1.481; ≥2 mental disorders, aHR 2.683, CI 2.257-3.190; 40-64 years, 1 mental disorder, aHR 1.289, CI 1.265-1.314; ≥2 mental disorders, aHR 1.762, CI 1.724-1.801; ≥65 years, 1 mental disorder, aHR 1.164, CI 1.145-1.183; ≥2 mental disorders, aHR 1.353, CI 1.330-1.377; P_inter<0.001). In addition, income, BMI, hypertension, chronic kidney disease, history of cardiovascular disease, insulin use, and duration of DM showed significant interactions.

CONCLUSIONS

Comorbid mental disorders in participants with DM are associated with an increased risk of HF. In addition, the association was stronger in a younger age group. Participants with DM and mental disorders should be monitored with increased frequency for signs of HF; for which they have a higher risk than the general population.

Emotional Regulation Underlies Gender Differences in Pathological Eating Behavior Styles of Bariatric Surgery Candidates

Almost a third of bariatric surgery patients present suboptimal weight loss or important weight regain in the first five postoperative years. While the reasons underlying this are not fully understood, it is known that pathological eating styles (such as emotional or binge eating) can thwart efforts to maintain weight loss. However, detailed characterization and understanding of these eating styles have yet to be achieved. In particular, research on gender differences in pathological eating styles and psychiatric symptoms before bariatric surgery is lacking. To characterize gender differences in eating styles and their association with clinical symptoms, we prospectively enrolled 110 bariatric surgery candidates, collecting eating styles and clinical scores. Women displayed a higher frequency of emotional eating as compared to men (x2 = 9.07, p = 0.003), while men showed a higher frequency of quantitative eating behavioral style (x2 = 4.58, p = 0.044). Binge eating style was associated with higher Difficulties in Emotion Regulation Scale (DERS), Hamilton Depression Scale (HAM-D), and Hamilton Anxiety Scale (HAM-A) scores (p < 0.05). Emotional eating style was associated with higher HAM-D and HAM-A scores (p < 0.05). The present findings highlight the importance of understanding the role of gender differences in emotion regulation processes involved in the development and maintenance of pathological eating styles in bariatric surgery candidates. This paves the way to gender- and symptoms-specific interventions on eating behaviors to improve surgery long-term outcomes.

Sleep quality and sleep-related issues in industrial workers: a global meta-analysis

Objectives. Sleep-related issues are important health issues. This study aimed to investigate the global prevalence of sleep-related issues in industrial workers. Methods. A syntax of keywords was used to search the PubMed, Web of Science and Scopus databases. The search time was limited to articles published until September 2020, and the search range was in English. Events and samples were extracted for each study to calculate the prevalence. For all subgroups, events and samples were extracted to calculate the results of the subgroups. The random-effects method was used in the analysis. Heterogeneity was examined at the levels of all analyses. Results. Forty-eight articles were included in the analysis as eligible studies. Sleep-related issues have 30% prevalence in the 95% confidence interval (CI) [25, 35%]. The prevalence of sleep-related issues in men was 38%, 95% CI [31, 45%] and in women was 32%, 95% CI [14, 50%]. The prevalence of poor sleep quality, insomnia, sleep duration <7 h, snoring and sleepiness was 36, 22, 37, 29 and 10%, respectively. Conclusions. Sleep-related issues have a high prevalence in industrial workers, and the cause of these differences needs to be addressed and increasing insights provided to prevent and treat sleep disorders.

Association between self-reported medical diagnosis of depression and metabolic syndrome in a population-based study: A propensity score-matched analysis

The aim was to compare the metabolic syndrome in adults with and without depression in Korea using the 2013-2015 Korea National Health and Nutrition Examination Survey. A cross-sectional study was conducted involving secondary data analysis. National survey data on the self-reported medical diagnosis of depression and metabolic syndrome were collected between 2013 and 2015 and released for research purposes in 2017. We conducted a propensity score-matched study that included adults (n = 494) with and without depression at a 1:1 ratio, to reduce the impact of potential confounding factors between groups. Depression was not significantly associated with changes in metabolic syndrome. However, participants with depression had significantly higher triglycerides than those without depression (p = .008), highlighting the importance of periodically checking triglycerides in depressed patients. Nurses need to check the subcomponents of metabolic syndrome in depressed patients periodically, especially regarding the management of triglycerides.

[Sleep characteristics of a population of patients seeking bariatric surgery]

INTRODUCTION

Investigation for obstructive sleep apnea syndrome (OSAS) is mandatory before bariatric surgery. Data regarding chronic insomnia and chronic sleep deprivation are scarce in this population.

METHODS

A cross-sectional study assessing the prevalence of chronic insomnia, OSAS and chronic sleep privation in an obese population referred for bariatric surgery.

RESULTS

In all, 88 patients (74% women, median age 41 [33.5-50] years and median body mass index 42 [39.2-45.7] kg/m²) were included. The prevalence of chronic insomnia was 31% in the 87% suffering from OSAS that required continuous positive airway pressure therapy. Comorbid insomnia and sleep apnoea (COMISA) were found in 27% of our population. Chronic insomnia was associated with a lower quality of life (median EQ5D analogue visual scale: 60 [50-70] P=0.04) and a poor sleep quality (median Pittsburgh sleep quality index (PSQI): 8 (6-11 P<0.01) The deleterious combination of sleep privation and insomnia had a higher impact in terms of impairment of quality of life and sleep quality (median EQ5D analogue visual scale: 50 [40-65] P=0.02 et median PSQI: 11 [9-14, P<0.01) CONCLUSION: Chronic insomnia and sleep privation have synergistic deleterious effects in candidates for bariatric surgery. Further studies need to be conducted to evaluate the evolution after surgery.

Self-Persuasion Increases Healthy Eating Intention Depending on Cultural Background

Unhealthy eating behavior has become a global health risk and thus needs to be influenced. Previous research has found that self-persuasion is more effective than direct persuasion in changing attitudes and behavioral intentions, but the influence of the cultural backgrounds of those being persuaded remains unclear. We conducted two studies to investigate the effectiveness of self-persuasion and direct persuasion techniques in promoting healthy eating intention among different ethnicities in the Netherlands. Native Dutch, Moroccan–Dutch, and Turkish–Dutch participated both online and offline. Participants saw a poster with either a self-persuasion message (“Why would you choose healthier food?”) or a direct persuasion message (“Choose healthier food!”), and were then asked to report their intention to eat healthily in the upcoming month. Significant cultural differences were found between native Dutch and Moroccan–Dutch in Study 1, and between the native Dutch and Turkish-Dutch who participated offline in Study 2. Accordingly, cultural background was found to moderate the relationship between persuasion and healthy eating intention among these groups. These results provided preliminary evidence for the moderation effect of persuasion on healthy eating intention: Self-persuasion appears to be more effective for people with an individualistic background, and direct persuasion appears to be more effective for people with a collectivistic background.

Examining Sleep Quality Following Sleeve Gastrectomy Among Patients with Loss-of-Control Eating

BACKGROUND

Sleep is associated with post-bariatric surgical outcomes; however, little is known about sleep in bariatric patients with loss-of-control (LOC) eating, a consistent predictor of poorer weight outcomes. This study examined sleep quality and clinical correlates in sleeve gastrectomy patients with LOC eating.

METHODS

Participants (N = 145) were treatment-seeking post-operative sleeve gastrectomy patients with LOC eating. Eating-disorder features were assessed with the Eating Disorder Examination-Bariatric Surgery Version Interview (EDE-BSV) and participants completed established measures assessing sleep, health-related quality of life, perceived stress, depression, and night eating.

RESULTS

58.6% of participants were characterized with "poor" sleep. Poor sleep quality was significantly associated with greater eating-disorder psychopathology, physical and mental functioning, night eating, perceived stress, and less % excess weight loss (EWL); these findings remained significant after controlling for %EWL and race. Regression analyses, adjusting for correlated variables, revealed that sleep quality significantly predicted mental functioning.

CONCLUSIONS

Poor sleep quality was common among post-operative sleeve gastrectomy patients with LOC eating. Sleep quality was significantly associated with eating-disorder psychopathology, less post-operative weight loss, and psychosocial and physical functioning problems. These findings suggest the importance of assessment and treatment of sleep problems following sleeve gastrectomy.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov identifier NCT02259322.