Orthorexia nervosa: relationship with obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among Italian university students

Introduction: The present study aimed to investigate the relationship between ORTO-15 score and obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among female and male university students and to examine the predictive model of ORTO-15 in both groups. Methods: One hundred and twenty students participated in the present study (mean age 22.74 years, SD 7.31). The ORTO-15 test, the Maudsley Obsessive-Compulsive Questionnaire, the Eating Attitudes Test-26 and the Body Uneasiness Test were used for the present study. Results: Our results revealed no gender differences in ORTO-15 score. Our results show, rather unexpectedly, that in female students lower scores, corresponding to greater severity, were related to less pathological body image discomfort and obsessive-compulsive signs, while in male students, lower ORTO-15 scores were related to less pathological eating patterns, as behaviors and symptoms. Conclusion: Further studies regarding the relationship between ON and anorexia nervosa, as well as obsessive-compulsive symptoms, are needed to better understand the causality. Level of Evidence Level V, descriptive study

Non-alcoholic fatty liver disease connections with fat-free tissues: A focus on bone and skeletal muscle

The estimates of global incidence and prevalence of non-alcoholic fatty liver disease (NAFLD) are worrisome, due to the parallel burden of obesity and its metabolic complications. Indeed, excess adiposity and insulin resistance represent two of the major risk factors for NAFLD; interestingly, in the last years a growing body of evidence tended to support a novel mechanistic perspective, in which the liver is at the center of a complex interplay involving organs and systems, other than adipose tissue and glucose homeostasis. Bone and the skeletal muscle are fat- free tissues which appeared to be independently associated with NAFLD in several cross-sectional studies. The deterioration of bone mineral density and lean body mass, leading to osteoporosis and sarcopenia, respectively, are age-related processes. The prevalence of NAFLD also increases with age. Beyond physiological aging, the three conditions share some common underlying mechanisms, and their elucidations could be of paramount importance to design more effective treatment strategies for the management of NAFLD. In this review, we provide an overview on epidemiological data as well as on potential contributors to the connections of NAFLD with bone and skeletal muscle

Orthorexia nervosa and self-attitudinal aspects of body image in female and male university students.

The present study was designed to investigate orthorexia nervosa, or the phenomenon of being preoccupied with consuming healthy food. Specific aims were to explore relationships between orthorexia features and attitudes towards body image, fitness and health in normal weight female and male university students with high levels of healthy food preoccupation, i.e. orthorexia nervosa. METHODS Participants were 327 female (N = 283) and male (N = 44) students aged 18 to 25 years. All participants completed the Polish adaptation of the 15-item questionnaire assessing orthorexia eating behaviours (the ORTHO-15) and the Multidimensional Body-Self Relations Questionnaire (the MBSRQ). Relationships between scores on the ORTHO-15 and MBSRQ were explored in the 213 students who had high levels of preoccupation with a healthy food intake (68.55% women and 43.18% men, respectively). RESULTS: There were no statistically significant differences in the levels of orthorexia behaviours between females and males. In female students with orthorexia nervosa, preoccupation with consuming healthy food was significantly correlated with the MBSRQ subscale scores for overweight preoccupation, appearance orientation, fitness orientation, health orientation, body areas satisfaction and appearance evaluation. Conversely, in male students with orthorexia nervosa there were no correlations between orthorexic behaviours and the MBSRQ subscales. In female students with orthorexia nervosa multivariable linear regression analysis found high body areas (parts) satisfaction, low fitness orientation, low overweight preoccupation and low appearance orientation were independent predictors of greater fixation on eating healthy food. In male students, we found that aspects of body image were not associated with preoccupation with healthy eating. CONCLUSION: A strong preoccupation with healthy and proper food was not associated with an unhealthy body-self relationship among Polish female student with orthorexia nervosa

Fatty liver index associates with relative sarcopenia and GH/ IGF- 1 status in obese subjects

Recently the association between hepatic steatosis and sarcopenia has been described. GH/IGF-1 axis has been postulated to play a role in linking fatty liver and low muscle mass. The aim of our study was to explore the association between fatty liver index, sarcopenic obesity, insulin sensitivity, and GH/IGF-1 status

Disability, Physical Inactivity, and Impaired Health-Related Quality of Life Are Not Different in Metabolically Healthy vs. Unhealthy Obese Subjects

BACKGROUND: Obesity represents a major health hazard, affecting morbidity, psychological status, physical functionality, quality of life, and mortality. The aim of the present study was to explore the differences between metabolically healthy (MHO) and metabolically unhealthy (MUO) obese subjects with regard to physical activity, disability, and health-related quality of life (HR-QoL). METHODS: All subjects underwent a multidimensional evaluation, encompassing the assessment of body composition, metabolic biomarkers and inflammation, physical activity level (IPAQ questionnaire), disability (TSD-OC test), and HR-QoL (SF-36 questionnaire). MHO and MUO were defined based on the absence or the presence of the metabolic syndrome, respectively. RESULTS: 253 subjects were included (54 men and 199 women; age: 51.7 ± 12.8 vs. 50.3 ± 11.7 years, p = 0.46; BMI: 38.1 ± 5.7 vs. 38.9 ± 6.7 kg/m², p = 0.37). No significant difference was observed in body composition. There was no difference between MHO and MUO considering inflammation (hs-CRP: 6517.1 ± 11,409.9 vs. 5294.1 ± 5612.2 g/L; p = 0.37), physical inactivity (IPAQ score below 3000 METs-min/week in 77.6% of MHO vs. 80% of MUO subjects; p = 0.36), obesity-related disability (TSD-OC score > 33%, indicating a high level of obesity-related disability, in 20.2% of MHO vs. 26.5% of MUO subjects; p = 0.28), and the HR-QoL (SF-36 total score: 60 ± 20.8 vs. 62.8 ± 18.2, p = 0.27). DISCUSSION AND CONCLUSION:The metabolic comorbidity and the impairment of functional ability and psycho-social functioning may have a different timing in the natural history of obesity. Alterations in the physical activity level and mobility disabilities may precede the onset of metabolic abnormalities. (Trial registration 2369 prot 166/12-registered 23 February 2012; Amendment 223/14-registered 13 February 2014)

The decline in muscle strength and muscle quality in relation to metabolic derangements in adult women with obesity

Background & aims: The metabolic and functional characteristics related to sarcopenic obesity have not been thoroughly explored in the earlier stages of the aging process. The aim of the present study was to examine the phenotype of sarcopenic obesity, in terms of lean body mass, muscle strength and quality, in adult women with and without the Metabolic Syndrome (MetS), and its relationship with the features of myosteatosis. Methods: Study participants were enrolled at the Sapienza University, Rome, Italy. Body composition was assessed by DXA. The Handgrip strength test (HGST) was performed. HGST was normalized to arm lean mass to indicate muscle quality; intermuscular adipose tissue (IMAT) and intramyocellular lipid content (IMCL) were measured by magnetic resonance imaging and spectroscopy, as indicators of myosteatosis. Different indices of sarcopenia were calculated, based on appendicular lean mass (ALM, kg) divided by height squared, or weight. The NCEP-ATPIII criteria were used to diagnose the MetS. HOMA-IR was calculated. The physical activity level (PAL) was assessed through the IPAQ questionnaire. Results: 54 women (age: 48 ± 14 years, BMI: 37.9 ± 5.4 kg/m 2 ) were included. 54% had the MetS (metabolically unhealthy, MUO). HGST/arm lean mass was lower in MUO women than women without the MetS (6.3 ± 1.8 vs. 7.8 ± 1.6, p = 0.03). No differences emerged in terms of absolute ALM (kg) or other indices of sarcopenia (ALM/h 2 or ALM/weight) between metabolically healthy (MHO) vs. MUO women (p > 0.05). Muscle quality was negatively associated with HOMA-IR (p = 0.02), after adjustment for age, body fat, hs-CRP levels, and PAL. IMAT, but not IMCL, was significantly higher in obese women with the MetS compared to women without the MetS (p > 0.05). No association emerged between HGST/arm lean mass and IMAT or IMCL when HOMA-IR was included in the models. Conclusion: Insulin resistance, and not sarcopenia or myosteatosis per se, was associated with muscle weakness, resulting in the phenotype of “dynapenic obesity” in middle-aged women with the metabolic syndrome

Sarcopenic Obesity: Correlation with Clinical, Functional, and Psychological Status in a Rehabilitation Setting

Obesity and sarcopenia combination, appropriately defined as sarcopenic obesity (SO), due to disproportionally reduced/low lean body mass compared to excess fat mass, may lead to disability. Aims: The aim of our study was to investigate the relationship among sarcopenic obesity, physical performance, disability, and quality of life in a rehabilitation setting. Methods: Participants were recruited among obese patients (BMI > 30 kg/m2) admitted to the rehabilitation facility at the Department of Experimental Medicine, Medical Physiopatology, Food Science and Endocrinology Section during a 1-year period. A multidimensional evaluation was performed through bioelectrical impedance analysis and anthropometry, handgrip strength test, Short Physical Performance Battery (SPPB), 6-minute walk test (6MWT) and blood chemistry parameters. Psychological status (SCL-90 questionnaire), quality of life, and comorbidity (Charlson comorbidity index score) were also evaluated. Obesity was diagnosed as increased fat mass by 35% in women and by 25% in men. Sarcopenia was defined if lean body mass (LBM) was <90% of the subject’s ideal LBM. Results: 79 patients (48 women and 31 men; mean age: 60.1 ± 11.5 years, and 58.6 ± 10.8 years, respectively) were enrolled. Results showed a high prevalence of SO (54.4%) in our samples of obese subjects. Sarcopenia was present not only among older obese adults but also among younger obese subjects, and was related to reduced functional performance, to inflammatory status and to worse psychological status and quality of life

Relationship between front-of-pack labeling and nutritional characteristics of food products: An attempt of an analytical approach

The adoption of supplementary nutrition information, i.e., front-of-pack labeling (FOPL), on pre-packed food products is advocated as a tool to improve the consumers’ knowledge of the nutrient content or the nutritional quality of foods, but also to drive products reformulation by the food industry. Ultimately, FOPL should help people to select foods in order to compose an overall balanced diet, which is essential for health. However, the extent to which the different FOPL systems proposed in the European Union (EU) (interpretative or informative) are effectively able to convey the information useful to improve both food choices and dietary habits of the consumers is still under debate and needs to be analyzed in detail. The use of 3 FOPL schemes proposed within the EU (Nutri-Score, Keyhole and NutrInform Battery) to compare products available on the Italian market within different food categories, highlights some critical issues: (1) different FOPL provide to consumers different kinds of information; (2) systems based on similar theoretical approaches can provide conflicting information; (3) the algorithms on which interpretative FOPL are based can give the same summary information for products differing in nutrient composition, impact on the overall dietary balance and therefore on the health of people with different characteristics, physiological/pathological conditions, and nutritional requirements; (4) on the other hand, products with similar nutrient composition can obtain different interpretative FOPL; (5) informative systems are generally more complex and require greater both attention and knowledge from the consumer; (6) FOPL based on 100 g of product overlook the role of portion (and frequency of consumption) in determining the nutrient intake without informing on the contribution of a single food to the overall diet; (7) FOPL based on scoring systems could promote the reformulation of selected products, especially with a composition very close to the threshold limits; (8) for the portion-based informative FOPL systems, the incentive for reformulation could essentially involve the reduction of portion size. Finally, the importance of nutritional education interventions, which are required to encourage the use by consumers of informative FOPL systems, cannot be neglected to improve the quality of diets regardless of the FOPL used

Physical activity and hypocaloric diet recovers osteoblasts homeostasis in women affected by abdominal obesity.

Obesity is a multifactorial disease linked to metabolic chronic disorders such as diabetes, and hypertension. Also, it has recently been associated with skeletal alterations and low bone mineral density. We previously demonstrated that exposure of osteoblasts to sera of sedentary subjects affected by obesity alters cell homeostasis in vitro, leading to disruption of intracellular differentiation pathways and cellular activity. Thus, the purpose of the present study has been to evaluate whether sera of sedentary obese women, subjected to physical activity and hypocaloric diet, could recover osteoblast homeostasis in vitro as compared to the sera of same patients before intervention protocol. To this aim, obese women were evaluated at time 0 and after 4, 6, and 12 months of individualized prescribed physical activity and hypocaloric diet. Dual-energy-X-ray absorptiometry measurements were performed at each time point, as well as blood was collected at the same points. Cells were incubated with sera of subjects before and after physical activity as described: obese at baseline and after for 4, 6, and 12 months of physical activity and nutritional protocol intervention. Osteoblasts exposed to sera of patients, who displayed increased lean and decreased fat mass (from 55.5 ± 6.5 to 57.1 ± 5.6% p ≤ 0.05; from 44.5 ± 1.1 to 40.9 ± 2.6% p ≤ 0.01 respectively), showed a time-dependent increase of Wnt/β-catenin signaling, versus cells exposed to sera of obese patients before intervention protocol, suggesting recovery of osteoblast homeostasis upon improvement of body composition. An increase in β-catenin nuclear accumulation and nuclear translocation was also observed, accompanied by an increase in Adiponectin receptor 1 protein expression, suggesting positive effect on cell differentiation program. Furthermore, a decrease in sclerostin amount and an increase of type 1 procollagen amino-terminal-propeptide were depicted as compared to baseline, proportionally to the time of physical activity, suggesting a recovery of bone remodeling modulation and an increase of osteoblast activity induced by improvement of body composition. In conclusion, our results show for the first time that sera of obese sedentary women who increased lean mass and decreased fat mass, by physical activity and hypocaloric diet, rescue osteoblasts differentiation and activity likely due to a reactivation of Wnt/β-catenin-pathway, suggesting that a correct life style can improve skeletal metabolic alteration induced by obesity

Evaluation of Hypocaloric Diet with Protein Supplementation in Middle-Aged Sarcopenic Obese Women: A Pilot Study

Objective: The aim of this study was to evaluate the efficacy of a nutritional program, which is characterized by a different modulation of proteins, in adult patients with sarcopenic obesity. Methods: We studied 18 obese women aged 41-74 years. Obesity was diagnosed as fat mass > 34.8% and sarcopenia was defined when lean body mass was Results: Weight significantly decreased in both groups. Women with high-protein diet preserved lean body mass compared to low-calorie diet and improved significantly muscle strength; SPPB score did not change in both groups. SF-36 test showed a significant change for general health after 4 months in group B. Conclusions: In our study, sarcopenic obese patients with high-protein diet showed an improvement in muscle strength. Furthermore, dietary protein enrichment may represent a protection from the risk of sarcopenia following a hypocaloric diet