Transdiagnostic Perspective of Impulsivity and Compulsivity in Obesity: From Cognitive Profile to Self-Reported Dimensions in Clinical Samples with and without Diabetes

Impulsivity; Compulsivity; Diabetes type 2Impulsivitat; Compulsivitat; Diabetis tipus 2Impulsividad; Compulsividad; Diabetes tipo 2Impulsive and compulsive behaviors have both been observed in individuals with obesity. The co-occurrence of obesity and type 2 diabetes (T2D) is more strongly associated with impulsivity, although there are no conclusive results yet. A multidimensional assessment of impulsivity and compulsivity was conducted in individuals with obesity in the absence or presence of T2D, compared with healthy, normal-weight individuals, with highly impulsive patients (gambling disorders), and with highly compulsive patients (anorexia nervosa). Decision making and novelty seeking were used to measure impulsivity, and cognitive flexibility and harm avoidance were used for compulsivity. For impulsivity, patients with obesity and T2D showed poorer decision-making ability compared with healthy individuals. For compulsivity, individuals with only obesity presented less cognitive flexibility and high harm avoidance; these dimensions were not associated with obesity with T2D. This study contributes to the knowledge of the mechanisms associated with diabetes and its association with impulsive-compulsive behaviors, confirming the hypothesis that patients with obesity and T2D would be characterized by higher levels of impulsivity.This manuscript and research were supported by grants from the Instituto de Salud Carlos III (ISCIII) (FIS PI14/00290, PI17/01167 and PI20/132) and (PI13/00462, PI16/00501, PI19/00576), by the SLT006/17/00246 grant, funded by the Department of Health of the Generalitat de Catalunya by the call “Acció instrumental de programes de recerca orientats en l’àmbit de la recerca i la innovació en salut” (PERIS) and co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBERObn is an initiative of ISCIII. This research was also partially funded by EU-H2020 grants (Eat2beNICE/H2020-SFS-2016-2, Ref 728018; PRIME/H2020-SC1-BHC-2018-2020, Ref: 847879). CG-M receives a predoctoral grant from the University of Rovira i Virgili (2020PMFPIPF- 37). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript

Circulating Metabolites Associated with Body Fat and Lean Mass in Adults with Overweight/Obesity

The interplay between fat mass and lean mass within human metabolism is not completely understood. We aimed to identify specific circulating metabolomic profiles associated with these body composition compartments. Cross-sectional analyses were conducted over 236 adults with overweight/obesity from the Satiety Innovation (SATIN) study. Body composition was assessed by dual-energy X-ray absorptiometry. A targeted multiplatform metabolite profiling approach was applied. Associations between 168 circulating metabolites and the body composition measures were assessed using elastic net regression analyses. The accuracy of the multimetabolite weighted models was evaluated using a 10-fold cross-validation approach and the Pearson's correlation coefficients between metabolomic profiles and body compartments were estimated. Two different profiles including 86 and 65 metabolites were selected for % body fat and lean mass. These metabolites mainly consisted of lipids (sphingomyelins, phosphatidylcholines, lysophosphatidylcholines), acylcarnitines, and amino acids. Several metabolites overlapped between these body composition measures but none of them towards the same direction. The Pearson correlation coefficients between the metabolomic profiles and % body fat or lean mass were 0.80 and 0.79, respectively. Our findings suggest alterations in lipid metabolism, fatty acid oxidation, and protein degradation with increased adiposity and decreased lean body mass. These findings could help us to better understand the interplay between body composition compartments with human metabolic processes

Food addiction in Bulimia Nervosa: Analysis of body composition, psychological and problematic foods profile

IntroductionFood Addiction (FA) has been related with eating disorders (ED), especially Bulimia Nervosa (BN). BN + FA may have different physical characteristics than patients with BN without the comorbidity, such as body mass index (BMI) or body composition, and psychological as emotion regulation. However, the relationship between psychological and physical aspects, connected by problematic food and its influence on body composition, has been barely studied. Therefore, the aims of the present study are: Aims(a) To explore the differences in body composition between FA positive (FA+) and negative (FA-) in women with BN; (b) to identify problematic relationship with certain food types, according with the foods mentioned in the YFAS scale questionnaire, between FA+ and FA- patients; (c) to know the psychological characteristic differences between FA+ and FA- patients, considering emotion regulation, personality traits and general psychopathological state; (d) to identify the relationship between physical and psychological traits, and the identified problematic foods, in patients with BN and FA. MethodologyN = 81 BN women patients, with a mean age of 29.73 years +/- 9.80 SD, who completed the questionnaires: Yale Food Addiction Scale V 1.0 (YFAS 1.0), Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90 Items-Revised (SCL-90-R), and Difficulties in Emotion Regulation Strategies (DERS). YFAS problematic foods were grouped considering their principal nutrients sources. Body composition and difference in metabolic age was determined using bioimpedance analyzer. ResultsThe 88% of patients with BN presented FA+. Patients with BN who were FA+ self-reported more problematic relationships with sweets and starches. Also presented higher emotion regulation difficulties, general psychopathology and eating symptomatology severity, than those without FA. Finally, emotional regulation difficulties were positively associated with higher eating disorder symptomatology and more types of foods self-reported as problematic, which increased indirectly fat mass. ConclusionThe results suggest that BN + FA presented more eating and psychopathology symptomatology and higher problems with specific food types. As well, the path analysis emphasized that emotion regulation difficulties might be related with problematic food relationship in BN, impacting over the ED severity. ImplicationsThe results may impact the development of precise therapies for patients with BN + FA

Athletes with Eating Disorders: Analysis of Their Clinical Characteristics, Psychopathology and Response to Treatment

Eating disorders (ED) have frequently been described among athletes. However, their specific features and therapy responses are lacking in the literature. The aims of this article were to compare clinical, psychopathological and personality traits between ED patients who were professional athletes (ED-A) with those who were not (ED-NA) and to explore differences in response to treatment. The sample comprised n = 104 patients with ED (n = 52 ED-A and n = 52 matched ED-NA) diagnosed according to DSM-5 criteria. Evaluation consisted of a semi-structured face-to-face clinical interview conducted by expert clinicians and a psychometric battery. Treatment outcome was evaluated when the treatment program ended. ED-A patients showed less body dissatisfaction and psychological distress. No differences were found in treatment outcome among the groups. Within the ED-A group, those participants who performed individual sport activities and aesthetic sports presented higher eating psychopathology, more general psychopathology, differential personality traits and poor therapy outcome. Individual and aesthetic sports presented more severity and worse prognosis. Although usual treatment for ED might be similarly effective in ED-A and ED-NA, it might be important to develop preventive and early detection programs involving sports physicians and psychologists, coaches and family throughout the entire athletic career and afterwards

Food addiction in anorexia nervosa: implications for the understanding of crossover diagnosis

Objective: Food addiction (FA) construct was introduced to reflect abnormal eating patterns that resemble behavioural ones found in substance use disorders. FA has been barely explored in anorexia nervosa (AN). This study evaluated FA occurrence and associated factors in a sample of patients with AN, distinguishing between restrictive and binge-purging subtypes and focussing on the influence of FA in the crossover diagnosis between them. Method: A sample of 116 patients with AN admitted for treatment seeking at an Bellvitge Hospital Eating Disorders Unit were included (72 restrictive [AN-R]; 44 binge-purge AN [AN-BP]), and eating-related, personality and psychopathological variables were assessed. Most participants were women (92.2%), mean age 27.1 years old (SD = 10.5). Results: FA was more prevalent in patients with AN-BP compared to the AN-R group (75.0% and 54.2%, respectively). The patients with AN-R FA+, presented more similar ED symptomatology, general psychopathology and personality traits, with the AN-BP patients, than with the AN-R FA-. Conclusions: Patients with AN-R FA+, exhibit more similarities with the AN-BP subgroup than with the AN-R FA-. Thus, it is possible to hypothesise that the presence of FA might be an indicator of the possible crossover from AN-R to AN-BP

Motherhood and Treatment Outcome in Female Patients with Compulsive Buying–Shopping Disorder

Motherhood has been proposed as an internal facilitating factor for the recovery of women with mental disorders. However, at the same time, there are significant barriers that may be interfering with the access and adherence to treatment for these women. The present longitudinal study aimed to deepen the sociodemographic and clinical profile of women with children and compulsive buying-shopping disorder (CBSD), and to explore the association between motherhood and response to treatment. The total sample included 77 women with a diagnosis of CBSD (n = 49 mothers) who received cognitive behavioral therapy (CBT) for 12 weeks. No association between psychopathology and motherhood was observed. The group of mothers reported an older age of onset of the CBSD, a lower amount of money spent per compulsive-buying episode, and a higher likelihood of family support for the CBSD. Moreover, this group showed lower risk of relapse. The findings support the theoretical proposal that considers motherhood as an internal facilitating factor for recovery and treatment adherence of mothers with addictions

Impulsive Personality Traits Predicted Weight Loss in Individuals with Type 2 Diabetes after 3 Years of Lifestyle Interventions

Impulsivity has been associated with type 2 diabetes (T2D) and may negatively impact its management. This study aimed to investigate impulsive personality traits in an older adult population with T2D and their predicting role in long-term weight control and glycemic management, through glycated hemoglobin (HbA(1c)), following 3 years of intervention with a Mediterranean diet. The Impulsive Behavior Scale (UPPS-P) was administered as a measure of impulsive traits at baseline. Results showed higher total baseline scores of UPPS-P, and higher positive urgency in individuals with T2D, compared with those without T2D. The regression analysis in patients with T2D showed that sensation seeking and lack of perseverance predicted weight loss at follow-up. By contrast, impulsive traits did not predict follow-up levels of HbA(1c). In conclusion, the present findings suggest that higher impulsive traits in individuals with T2D seem to affect long-term weight control, but not glycemic control

Vitamin K & healthy ageing

La transició demogràfica cap a una societat més envellida ha esdevingut un desafiament per l’economia social global, especialment pels sistemes de salut públics. Per tal de millorar la qualitat de vida fins un procés d’envelliment més saludable, son necessàries evidències que suportin diferents promotors de salut en condicions relacionades amb l’edat. Prèviament, s’ha suggerit que la vitamina K podria desenvolupar un paper modulador en el procés de l’envelliment i els mecanismes relacionats amb l’edat, com l’estrès oxidatiu, la inflamació i la resistència a la insulina. No obstant, l’evidència actual sobre l’associació de la ingesta de vitamina K i el risc de malalties associades a l’envelliment és escassa. L’objectiu principal d’aquest treball va ser avaluar l’associació entre la ingesta dietètica de vitamina K1 i el risc de cataractes, nefropatia i retinopatia diabètica, el deteriorament de la funció cognitiva i la demència. La present tesi doctoral s’ha realitzat en el marc dels estudis PREDIMED i PREDIMED-plus, ambdós grans assajos clínics aleatoritzats, multicèntrics i paral·lels, realitzats en poblacions mediterrànies d’edat avançada amb elevat risc cardiovascular. Els resultats derivats del present treball van mostrar associacions positives significatives entre el consum dietètic de vitamina K1 i el risc de cataractes, nefropatia diabètica i demència. Tanmateix, un increment en la ingesta de la vitamina K1 es va associar amb una millor puntuació en índexs de funció cognitiva. La conclusió principal obtinguda d’aquesta tesi doctoral és que, en comparació amb una ingesta baixa, un consum dietètic elevat de vitamina K1 s’associa amb un envelliment saludable al disminuir el risc de diferents patologies associades a l’envelliment d’una població mediterrània d’edat avançada amb elevat risc cardiovascular. La transición demográfica hacia una sociedad más envejecida se ha convertido en un desafío para la economía social global, especialmente para los sistemas públicos de salud. Evidencia que soporte diferentes promotores de salud en condiciones relacionadas con la edad son necesarias para mejorar la calidad de vida hacia un proceso de envejecimiento más saludable. Se ha sugerido previamente que la vitamina K podría desempeñar un papel modulador en el proceso de envejecimiento y los mecanismos relacionados con la edad, como el estrés oxidativo, la inflamación y la resistencia a la insulina. Sin embargo, la evidencia actual sobre la asociación del consumo de vitamina K y el riesgo de enfermedades asociadas al envejecimiento es aún escasa. El objetivo principal de este trabajo fue evaluar la asociación entre la ingesta dietética de vitamina K1 y el riesgo de cataratas, nefropatía y retinopatía diabética, el deterioro de la función cognitiva y la demencia. El presente trabajo se realizó en el marco de los estudios PREDIMED y PREDIMED-plus, ambos grandes ensayos clínicos aleatorizados, multicéntricos, paralelos realizados en poblaciones Mediterráneas de edad avanzada con alto riesgo cardiovascular. Los resultados derivados del presente trabajo mostraron asociaciones positivas significativas entre el consumo dietético de vitamina K1 y el riesgo de cataratas, nefropatía diabética y demencia. Asimismo, un incremento en el consumo de vitamina K1 se asoció con un mejor desempeño en los scores de función cognitiva. La conclusión principal derivada de esta Tesis Doctoral es que, en comparación con una ingesta baja, un alto consumo dietético de vitamina K1 se asocia con un envejecimiento saludable al disminuir el riesgo de diferentes patologías asociadas al envejecimiento en una población Mediterránea de edad avanzada con alto riesgo cardiovascular.The demographic transition headed for an older society is becoming a challenge for the global social economy, especially for the public health care systems. Evidence, supporting different promoters of health on age-related conditions is necessary in order to improve the quality of life towards a heathier ageing process. Vitamin K has been suggested to play a modulatory role in ageing and age-related mechanisms such as oxidative stress, inflammation and insulin resistance. However, the current evidence regarding vitamin K’s association with the risk of age-related diseases is still scarce. The main objective of this work was to evaluate, the association between the dietary vitamin K1 intake and the risk of cataracts, diabetic nephropathy and retinopathy, cognitive function decline and dementia. The present work was conducted in the framework of the PREDIMED and the PREDIMED-plus studies, both large multicentre, parallel, randomized clinical trials carried out on elderly Mediterranean populations at high cardiovascular risk. Results derived from the present work showed significant positive associations between dietary vitamin K1 intake and the risk of cataracts, diabetic nephropathy and dementia. Likewise, an increment in the consumption of vitamin K1 was associated with better performance in cognitive functioning scores. The main conclusion derived from this Doctoral Thesis is that compared to a low intake, a high dietary vitamin K1 intake is associated with healthy ageing through decreasing the risk of different age-related diseases among an elderly Mediterranean population at high cardiovascular risk

Athletes with eating disorders : analysis of their clinical characteristics, psychopathology and response to treatment

Eating disorders (ED) have frequently been described among athletes. However, their specific features and therapy responses are lacking in the literature. The aims of this article were to compare clinical, psychopathological and personality traits between ED patients who were professional athletes (ED-A) with those who were not (ED-NA) and to explore differences in response to treatment. The sample comprised n = 104 patients with ED (n = 52 ED-A and n = 52 matched ED-NA) diagnosed according to DSM-5 criteria. Evaluation consisted of a semi-structured face-to-face clinical interview conducted by expert clinicians and a psychometric battery. Treatment outcome was evaluated when the treatment program ended. ED-A patients showed less body dissatisfaction and psychological distress. No differences were found in treatment outcome among the groups. Within the ED-A group, those participants who performed individual sport activities and aesthetic sports presented higher eating psychopathology, more general psychopathology, differential personality traits and poor therapy outcome. Individual and aesthetic sports presented more severity and worse prognosis. Although usual treatment for ED might be similarly effective in ED-A and ED-NA, it might be important to develop preventive and early detection programs involving sports physicians and psychologists, coaches and family throughout the entire athletic career and afterwards

Motherhood and Treatment Outcome in Female Patients with Compulsive Buying-Shopping Disorder

Motherhood has been proposed as an internal facilitating factor for the recovery of women with mental disorders. However, at the same time, there are significant barriers that may be interfering with the access and adherence to treatment for these women. The present longitudinal study aimed to deepen the sociodemographic and clinical profile of women with children and compulsive buying-shopping disorder (CBSD), and to explore the association between motherhood and response to treatment. The total sample included 77 women with a diagnosis of CBSD (n = 49 mothers) who received cognitive behavioral therapy (CBT) for 12 weeks. No association between psychopathology and motherhood was observed. The group of mothers reported an older age of onset of the CBSD, a lower amount of money spent per compulsive-buying episode, and a higher likelihood of family support for the CBSD. Moreover, this group showed lower risk of relapse. The findings support the theoretical proposal that considers motherhood as an internal facilitating factor for recovery and treatment adherence of mothers with addictions