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 by proxy

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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

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

Some thoughts from the new editors.

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Dieta mediterranea e tiroidite di Hashimoto

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Binge Eating Disorder and Body Uneasiness

Debate continues regarding the nosological status of binge eating disorder (BED) and the specific diagnostic criteria, including whether, like anorexia nervosa and bulimia nervosa, it should be characterized by body image disturbances in addition to abnormal eating behaviour. The aims of this article are: a) to concisely review the main points of the literature that has developed on diagnosis and treatment (especially pharmacological) of BED and b) to present the results of an original research on body image in obese patients with BED. The study was aimed to verify the following hypothesis: in persons with obesity, BED is associated with greater body uneasiness independently of some possible modulating factors. We studied a clinical sample of 159 (89 females and 70 males) adult obese patients who fulfilled DSM-IV-TR diagnostic criteria for BED matched to 159 non-BED obese patients for gender, ethnicity, BMI class, age, weight, stature, onset age of obesity, education level, and marital status. We used the Body Uneasiness Test (BUT), a valuable multidimensional tool for the clinical assessment of body uneasiness in subjects suffering from eating disorders and/or obesity. Obese patients with BED reported higher scores than non-BED patients in the General Severity Index (BUT-A GSI) and in every BUT-A subscale. All differences were statistically significant in both sexes. As expected women obtained higher scores than men. According to some other studies, our findings suggest that a negative body image should be included among diagnostic criteria for BED. Consequently, treatment should be focused not simply on eating behaviour and outcome studies should evaluate changes of body image as well

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)

Peripheral Arterial Tonometry to Measure the Effects of Vardenafil on Sympathetic Tone in Men with Lifelong Premature Ejaculation

To elucidate whether adrenergic overtone is involved in the pathophysiology of men with lifelong (LL) premature ejaculation (PE), we investigated differences in reactive hyperemia index (RHI) responses by using peripheral arterial tonometry (PAT). 20 men with LL-PE (18–40 years) were enrolled in an 8-week, double-blind, placebo-controlled, crossover study and compared with 10 age-matched controls without LL-PE. Primary endpoints were PAT modifications induced by vardenafil 10 mg on demand. Secondary endpoints were the improvement in intravaginal ejaculatory latency time (IELT) as measured by the stopwatch technique and variations in anxiety scores at Stai-X1 for state-anxiety and Stai-X2 for trait-anxiety. At baseline, men with LL-PE showed higher RHI variation (), Stai-X1 and Stai X2 scores (, resp.), and prolactin levels () compared with controls. Vardenafil treatment markedly reduced RHI variation in men with LL-PE () when compared with placebo. Mean changes in geometric IELT were higher after taking vardenafil (0.6 ± 0.3 versus 4.5 ± 1.1 min, ) when compared with placebo. STAI-X1 and STAI-X2 scores fell within the normal range after treatment with vardenafil (). Vardenafil was an effective treatment in men with LL-PE; improvements of IELT may be due to increased NO production which is able to reduce adrenergic overactivity and anxiety levels