Biopsychological examination of changes in food reward during weight loss in women

Background: While taste is a main driver of food choice, food reward is more than just the sensation of taste and interacts with the homeostatic system (e.g. hunger) to create pleasure (liking) and motivation (wanting) for food. Food reward is a driver of food intake and therefore commonly thought to be related to obesity. However, liking/wanting have never been targeted to improve weight management strategies. Objectives: This thesis aims to explore the role of food reward during 1) weight management, 2) weight loss (WL) and no-contact follow-up, and 3) its association with appetite control and obesity in women. Methods: Food reward and appetite-related variables (e.g. body composition, energy intake, eating behaviour traits) were investigated during a controlled-feeding WL, 1-year follow-up and a cross-sectional analysis between women with or without overweight/obesity. Liking and implicit wanting were assessed with the Leeds Food Preference Questionnaire. Results: Contrary to expectations, a systematic review showed that liking and wanting decreased after different weight management interventions. The diet intervention added that liking decreased for all food categories independently from diet modality or improvement in appetite control. After 1-year of no-contact, weight was regained, appetite control weakened and liking returned to baseline levels. Lastly, women with overweight/obesity did not have higher wanting for high-fat sweet but lower wanting for low-fat sweet food compared to women within the normal range of BMI. Importantly, wanting for low-fat food was associated with improved appetite control and less fat mass while it was the contrary for high-fat food. Conclusions: The role of food reward in weight management distinguishes between liking and wanting and high-fat vs low-fat, as its components dissociated during WL and had opposite impact on appetite control. Food reward does not differ greatly between women with or without overweight/obesity and other appetite-related factors are needed to understand obesity status

Long COVID Classification: Findings from a Clustering Analysis in the Predi-COVID Cohort Study.

peer reviewedThe increasing number of people living with Long COVID requires the development of more personalized care; currently, limited treatment options and rehabilitation programs adapted to the variety of Long COVID presentations are available. Our objective was to design an easy-to-use Long COVID classification to help stratify people with Long COVID. Individual characteristics and a detailed set of 62 self-reported persisting symptoms together with quality of life indexes 12 months after initial COVID-19 infection were collected in a cohort of SARS-CoV-2 infected people in Luxembourg. A hierarchical ascendant classification (HAC) was used to identify clusters of people. We identified three patterns of Long COVID symptoms with a gradient in disease severity. Cluster-Mild encompassed almost 50% of the study population and was composed of participants with less severe initial infection, fewer comorbidities, and fewer persisting symptoms (mean = 2.9). Cluster-Moderate was characterized by a mean of 11 persisting symptoms and poor sleep and respiratory quality of life. Compared to the other clusters, Cluster-Severe was characterized by a higher proportion of women and smokers with a higher number of Long COVID symptoms, in particular vascular, urinary, and skin symptoms. Our study evidenced that Long COVID can be stratified into three subcategories in terms of severity. If replicated in other populations, this simple classification will help clinicians improve the care of people with Long COVID

Long COVID Symptomatology After 12 Months and Its Impact on Quality of Life According to Initial Coronavirus Disease 2019 Disease Severity.

peer reviewed[en] BACKGROUND: "Long COVID" is characterized by a variety of symptoms and an important burden for affected people. Our objective was to describe long COVID symptomatology according to initial coronavirus disease 2019 (COVID-19) severity. METHODS: Predi-COVID cohort study participants, recruited at the time of acute COVID-19 infection, completed a detailed 12-month symptom and quality of life questionnaire. Frequencies and co-occurrences of symptoms were assessed. RESULTS: Among the 289 participants who fully completed the 12-month questionnaire, 59.5% reported at least 1 symptom, with a median of 6 symptoms. Participants with an initial moderate or severe acute illness declared more frequently 1 or more symptoms (82.6% vs 38.6%, P < .001) and had on average 6.8 more symptoms (95% confidence interval, 4.18-9.38) than initially asymptomatic participants who developed symptoms after the acute infection. Overall, 12.5% of the participants could not envisage coping with their symptoms in the long term. Frequently reported symptoms, such as neurological and cardiovascular symptoms, but also less frequent ones such as gastrointestinal symptoms, tended to cluster. CONCLUSIONS: Frequencies and burden of symptoms present 12 months after acute COVID-19 infection increased with the severity of the acute illness. Long COVID likely consists of multiple subcategories rather than a single entity. This work will contribute to the better understanding of long COVID and to the definition of precision health strategies. CLINICAL TRIALS REGISTRATION: NCT04380987

Measuring food preference and reward: application and cross-cultural adaptation of the leeds food preference questionnaire in human experimental research

Decisions about what we eat play a central role in human appetite and energy balance. Measuring food reward and its underlying components of implicit motivation (wanting) and explicit sensory pleasure (liking) is therefore important in understanding which foods are preferred in a given context and at a given moment in time. Among the different methods used to measure food reward, the Leeds Food Preference Questionnaire (LFPQ) is a well-established tool that has been widely used in the scientific field for over 10 years. The original LFPQ measures explicit liking and implicit wanting for the same visual food stimuli varying along two nutritional dimensions: fat (high or low) and taste (sweet or savoury/non-sweet). With increasing use of the LFPQ (in original or adapted forms) across different cultural and scientific contexts, there is a need for a set of recommendations for effective execution as well as cultural and nutritional adaptations of the tool. This paper aims to describe the current status of the LFPQ for researchers new to the methodology, and to provide standards of good practice that can be adopted for its cultural adaptation and use in the laboratory or clinic. This paper details procedures for the creation and validation of appropriate food stimuli; implementation of the tool for sensitive measures of food reward; and interpretation of the main end-points of the LFPQ. Following these steps will facilitate comparisons of findings between studies and lead to a better understanding of the role of food reward in human eating behaviour

Food Reward after Bariatric Surgery and Weight Loss Outcomes: An Exploratory Study

International audienceChanges in food preferences after bariatric surgery may alter its effectiveness as a treatment for obesity. We aimed to compare food reward for a comprehensive variety of food categories between patients who received a sleeve gastrectomy (SG) or a Roux-en-Y gastric bypass (RYGB) and to explore whether food reward differs according to weight loss. In this cross-sectional exploratory study, food reward was assessed using the Leeds Food Preference Questionnaire (LFPQ) in patients at 6, 12, or 24 months after SG or RYGB. We assessed the liking and wanting of 11 food categories. Comparisons were done regarding the type of surgery and total weight loss (TWL; based on tertile distribution). Fifty-six patients (30 SG and 26 RYGB) were included (women: 70%; age: 44.0 (11.1) y). Regarding the type of surgery, scores were not significantly different between SG and RYGB, except for ‘non-dairy products—without color’ explicit liking (p = 0.04). Regarding TWL outcomes, explicit liking, explicit wanting, and implicit wanting, scores were significantly higher for good responders than low responders for ‘No meat—High fat’ (post-hoc corrected p-value: 0.04, 0.03, and 0.04, respectively). Together, our results failed to identify major differences in liking and wanting between the types of surgery and tended to indicate that higher weight loss might be related to a higher reward for high protein-content food. Rather focus only on palatable foods, future studies should also consider a broader range of food items, including protein reward.Les changements dans les préférences alimentaires après une chirurgie bariatrique peuvent altérer son efficacité en tant que traitement de l'obésité. Notre objectif était de comparer la récompense alimentaire pour une variété complète de catégories d'aliments entre les patients ayant subi une gastrectomie en manchon (SG) ou un pontage gastrique Roux-en-Y (RYGB) et d'explorer si la récompense alimentaire diffère en fonction de la perte de poids. Dans cette étude exploratoire transversale, la récompense alimentaire a été évaluée à l'aide du Leeds Food Preference Questionnaire (LFPQ) chez les patients à 6, 12 ou 24 mois après SG ou RYGB. Nous avons évalué le goût et le désir de 11 catégories d'aliments. Des comparaisons ont été faites concernant le type de chirurgie et la perte de poids totale (TWL; basée sur la distribution tertile). Cinquante-six patients (30 SG et 26 RYGB) ont été inclus (femmes : 70 % ; âge : 44,0 (11,1) ans). Concernant le type de chirurgie,p = 0,04). En ce qui concerne les résultats TWL, l'appréciation explicite, le désir explicite et le désir implicite, les scores étaient significativement plus élevés pour les bons répondeurs que pour les faibles répondants pour "Pas de viande - Haute teneur en matières grasses" ( valeur p corrigée post-hoc : 0,04, 0,03 et 0,04, respectivement) . Ensemble, nos résultats n'ont pas permis d'identifier des différences majeures dans le goût et le désir entre les types de chirurgie et tendaient à indiquer qu'une perte de poids plus élevée pourrait être liée à une récompense plus élevée pour les aliments à haute teneur en protéines. Au lieu de se concentrer uniquement sur les aliments appétissants, les études futures devraient également envisager une gamme plus large d'aliments, y compris la récompense protéique

L’évaluation de la progression de l’interne de médecine générale dans son parcours professionnalisant

Contexte : Les départements de médecine générale français souhaitent proposer une évaluation longitudinale de la progression de l’interne. À l’Université de Toulouse, des objectifs intermédiaires ont été élaborés pour tracer l’évolution de l’interne dans son parcours professionnalisant, démarche indispensable à une certification des compétences. But : Développer et tester un outil d’évaluation des objectifs intermédiaires. Méthodes : Une revue narrative de la littérature a été réalisée pour identifier les méthodes d’évaluation de la progression de l’interne utilisées en France et à l’international. Dans un deuxième temps, un groupe de travail d’experts de la faculté de médecine de Toulouse a été constitué pour : (1) élaborer un outil d’évaluation des objectifs intermédiaires ; (2) proposer une phase test durant le semestre d’été 2019 sur un panel d’internes et de maîtres de stage (MSU) de la région toulousaine. Résultats : Nous n’avons pas retrouvé dans la littérature d’outil permettant une mesure spécifique du processus de résolution en soins premiers. L’outil que nous avons développé permet de tracer l’acquisition des objectifs intermédiaires en deux temps du semestre, au deuxième et au sixième mois de stage. La phase test a évalué sa faisabilité : 87 % des MSU ont trouvé les objectifs pertinents et 89 % la durée de remplissage de l’outil acceptable. Discussion : Cet outil concis permettrait une mesure spécifique de la qualité des interventions par des résidents dans des problématiques rencontrées en médecine générale. Il complèterait les outils d’évaluation existants pour une inférence des compétences indispensables à la certification d’un médecin généraliste

An augmented food strategy leads to complete energy compensation during a 15‐day military training expedition in the cold

International audienceSoldiers on military expeditions usually fail to compensate for the increase in energy expenditure, with potential deleterious consequences. We therefore analyzed the characteristics of energy compensation in 12 male soldiers, during a 15-day expedition in the cold, while alleviating some of the contextual limitations of food intake (~20-MJ daily bags of easy-to-use, highly palatable and familiar foods with multiple and long breaks allowed during the day). Body and fat mass losses were low and moderate, respectively (−1.13 ± 1.42% and −19.5 ± 15.6%, respectively, p < .021). Mean energy intake (EI) was high (~16.3 MJ) and increased at each third of the expedition (15.3 ± 2.1, 16.1 ± 2.1, and 17.6 ± 2.0 for D1–5, D6–10 and D11–15, respectively, p < .012). This resulted in reaching a neutral energy balance as soon as the D6 to 10 period and reaching normal energy availability during D11 to 15. Participants only increased their EI during the mid-day (10:00–14:00) period (p = .002) whereas hunger and thirst only increased in the morning, with higher scores during D11–15 than D1–5 (p < .009). Last, the reward value of sweet foods was also higher during D11–15 than during D1–5 (p = .026). The changes in body mass were positively associated with EI (r = 0.598, p = .040) and carbohydrate intake (r = 0.622, p = .031). This study indicates that complete energy compensation can be reached in challenging field conditions when food intake is facilitated, offering some guidelines to limit energy deficit during operational missions

Les formes prolongées de la COVID-19 ou COVID long : formes cliniques et prise en charge

As a result of an acute symptomatic COVID-19 episode, more than 30% of adult patients still have symptoms at 1-2 months and 10-15% at 6-8 months. These may be persistent symptoms or new symptoms. If the most common are severe fatigue, dyspnea and neurocognitive signs, many other organs may be affected. These symptoms generally evolve in a fluctuating manner and are often aggravated by physical or intellectual effort. Over time they evolve slowly towards improvement. The lack of virological documentation (PCR could not be made at the initial episode and/or serology is negative) does not exclude this diagnosis. The origin of these symptoms is not yet clear: a viral persistence has been demonstrated in some cases, an inflammatory response including excessive mastocyte activation, a defect of innate or adaptive immunity are hypotheses being explored. Genetic and hormonal factors may be associated. Patient management must be initiated at the first point of care. Based on a thorough analysis of the symptoms, diagnoses will be made which leads to a multidisciplinary management where symptomatic treatments and rehabilitation are important. While hospitalization is rare, these protracted forms, now known as” long COVID”, will have a major societal impact requiring the implementation of appropriate public policies

The impact of 16-h heat exposure on appetite and food reward in adults

International audienc