Nutritional, hormonal and genetic factors in the development of overeating tendency toward food addiction

Overeating is believed to be the primary factor responsible for the increasing prevalence of human obesity. A proportion of people develops a chronic obsessive/compulsive relationship to foods that is defined as food addiction (FA). The degree that FA contributes to obesity in the general population, and the key factors involved in FA, are unknown. The aims of the thesis were to assess and to find: 1) The prevalence of FA in the general population; 2) If clinical symptom counts of FA were significantly correlated with body composition measurements; 3) If food addicts were significantly more obese than controls, 4) If any macronutrient intake is associated with FA, 5) The link of hormones and neuropeptides that regulate appetite and metabolism with FA, 6) The differences of dietary nutrient intakes (micro- and macro-nutrients) between obese individuals with FA (FAO) or without FA (NFO), and 7) Discovery of novel FA associated candidate genes. The current thesis consists of three phases. In phase I, I found that the prevalence of FA in the general NL population was 5.4% and women had double the prevalence relative to men. FA was significantly associated with obesity (vs normals). Additionally, FA was positively correlated with severity of obesity. In phase II, compared to NFO, FAO individuals had lower levels of TSH, TNF-α, and amylin, but higher levels of prolactin. The total calorie intake, the dietary intake of fat and the percent calorie intake from fat and carbohydrates was higher in the FAO. FAO subjects consumed more sugar, minerals (including sodium, potassium, calcium and selenium), fat and its components, omega 3 and 6 fatty acids, vitamin D and gamma-tocopherol than NFO. The phase III by combining exome sequencing technology with genetic association analysis in 2 equally obese but with opposite extreme phenotype of FA, we discovered and validated two FA candidate genes: DRD2 and TIRAP. Our discoveries suggest that FA may represent a sub-group of obese individuals with unique nutritional, hormonal and genetic factors

The Effect of Vitamin E Therapy on Post Chemotherapy Mucositis in Leukemic Patients

Introduction: Chemotherapy is one of the most common treatment modalities for blood malignancies such as leukemia, with several potential complications. Mucositis is one of the complications of chemotherapy, manifested with different severities. The aim of this study was to evaluate the prophylactic effect of vitamin E on reducing the severity of chemotherapy-induced mucositis. Materials & Methods: This randomized clinical trial was performed in Ahvaz’s Shafa Hospital on 56 leukemic patients, undergoing chemotherapy. The patients were divided into 3 groups: 1) systemic treatment group, case group 1; 2) topical treatment group, the case group 2; and 3) control group. The oral mucosa of the patients was evaluated for the severity of mucositis and the patient’s response to pain. Data were analyzed with Mann-Whitney test and t-test (α = 0.05). Results: In relation to the severity of mucositis, based on the results of Mann-Whitney test, there was a significant difference between the case group 2 and control group (p value ≤ 0.01). There was no significant difference between the two case groups (p value = 0.2). In relation to the patient’s response to pain, there was a significant difference between the case group 2 and control group (p value ≤ 0.01). There was no significant difference between the two case groups (p value = 0.4). Therefore, vitamin E decreased the incidence of thermotherapy-induced mucositis. Conclusion: Within the limitations of this study, vitamin E in its topical form is an effective medicament for reducing the severity and pain of chemotherapy-induced mucositis

Six-year time-trend analysis of dyslipidemia among adults in Newfoundland and Labrador: findings from the laboratory information system between 2009 and 2014

Background: Dyslipidemia, an increased level of total cholesterol (TC), triglycerides (TG), low-density-lipoprotein cholesterol (LDL-C) and decreased level of high-density-lipoprotein cholesterol (HDL-C), is one of the most important risk factors for cardiovascular disease. We examined the six-year trend of dyslipidemia in Newfoundland and Labrador (NL), a Canadian province with a historically high prevalence of dyslipidemia. Methods: A serial cross-sectional study on all of the laboratory lipid tests available from 2009 to 2014 was performed. Dyslipidemia for every lipid component was defined using the Canadian Guidelines for the Diagnosis and Treatment of Dyslipidemia. The annual dyslipidemia rates for each component of serum lipid was examined. A fixed and random effect model was applied to adjust for confounding variables (sex and age) and random effects (residual variation in dyslipidemia over the years and redundancies caused by individuals being tested multiple times during the study period). Results: Between 2009 and 2014, a total of 875,208 records (mean age: 56.9 ± 14.1, 47.6% males) containing a lipid profile were identified. The prevalence of HDL-C and LDL-C dyslipidemia significantly decreased during this period (HDL-C: 35.8% in 2009 [95% CI 35.5-36.1], to 29.0% in 2014 [95% CI: 28.8-29.2], P = 0.03, and LDL-C: 35.2% in 2009 [95% CI: 34.9-35.4] to 32.1% in 2014 [95% CI: 31.9-32.3], P = 0.02). A stratification by sex, revealed no significant trend for any lipid element in females; however, in men, the previously observed trends were intensified and a new decreasing trend in dyslipidemia of TC was appeared (TC: 34.1% [95% CI 33.7-34.5] to 32.3% [95%CI: 32.0-32.6], p < 0.02, HDL-C: 33.8% (95%CI: 33.3-34.2) to 24.0% (95% CI: 23.7-24.3)], P < 0.01, LDL-C: 32.9% (95%CI:32.5-33.3) to 28.6 (95%CI: 28.3-28.9), P < 0.001). Adjustment for confounding factors and removing the residual noise by modeling the random effects did not change the significance. Conclusion: This study demonstrates a significant downward trend in the prevalence of LDL-C, HDL-C, and TC dyslipidemia, exclusively in men. These trends could be the result of males being the primary target for cardiovascular risk management

Hormonal and Dietary Characteristics in Obese Human Subjects with and without Food Addiction

The concept of food addiction (FA) is a potentially important contributing factor to the development of obesity in the general population; however, little is known about the hormonal and dietary differences between obesity with and without FA. Therefore, the aim of our study was to explore potential biomarkers, including various hormones and neuropeptides, which regulate appetite and metabolism, and dietary components that could potentially differentiate obesity with and without FA. Of the 737 adults recruited from the general Newfoundland population, 58 food-addicted and non-food-addicted overweight/obese individuals (FAO, NFO) matched for age, sex, BMI and physical activity were selected. A total of 34 neuropeptides, gut hormones, pituitary polypeptide hormones and adipokines were measured in fasting serum. We found that the FAO group had lower levels of TSH, TNF-α and amylin, but higher levels of prolactin, as compared to NFO group. The total calorie intake (per kg body weight), the dietary intake of fat (per g/kg body weight, per BMI and per percentage of trunk fat) and the percent calorie intake from fat and carbohydrates (g/kg) was higher in the FAO group compared to the NFO group. The FAO subjects consumed more sugar, minerals (including sodium, potassium, calcium and selenium), fat and its components (such as saturated, monounsaturated and trans fat), omega 3 and 6, vitamin D and gamma-tocopherol compared to the NFO group. To our knowledge, this is the first study indicating possible differences in hormonal levels and micro-nutrient intakes between obese individuals classified with and without food addiction. The findings provide insights into the mechanisms by which FA could contribute to obesity

The Role of Ultrasound in Diagnosis of the Causes of Low Back Pain: a Review of the Literature

Context: Low back pain (LBP) is among the most prevalent musculoskeletal conditions in the developed countries. It is a common problem causing disability and imposing a huge economic burden to individuals and state organizations. Imaging plays an important role in diagnosis of the etiology of LBP. Evidence Acquisition: The electronic databases included: PubMed (1950 to present), Ovid SP Medline (1950 to present) and ISI (1982 to present) and Google Scholar. In every search engine another search was performed using various permutations of the following keywords: ultrasonography, ultrasound imaging, low back pain, back muscles, paraspinal muscles, multifidus, transverse abdominis, muscle size, spinal canal, sacroiliac joint and spondylolisthesis. Results: Magnetic resonance imaging (MRI) is widely used in evaluation of patients with LBP; however, high costs, limited availability and contraindications for its use have restricted MRI utilization. In a quest for a less expensive and readily available tool to investigate LBP, clinicians and researchers found ultrasonography (US) as an alternative. In this review we discuss the US application in diagnosis of some common causes of non-specific chronic LBP. Discussed topics include evaluation of spinal canal diameter, paraspinal and transabdominal muscles, sacroiliac joint laxity, pregnancy related LBP, sacroiliitis, and spondylolisthesis using US in patients with LBP. Conclusions: While the first researches on employing ultrasound in diagnosis of patients with LBP had been focused on spinal canal diameter, recent studies have been mostly performed to evaluate the role of transabdominal and paraspinal muscles on core stability and thereby LBP occurrence. On the other side, Doppler ultrasonography has recently played an important role in objective measurement of joint laxity as a common etiology for LBP. Doppler imaging also in pregnant patients with LBP has been recommended as a safe and sensitive method. As conclusion, according to recent and most prestigious studies, focusing more on transabdominal muscle thickness can be considered as future approach in investigations

Self-Reported Lifetime History of Eating Disorders and Mortality in the General Population: A Canadian Population Survey with Record Linkage

Eating disorders (EDs) are often reported to have the highest mortality of any mental health disorder. However, this assertion is based on clinical samples, which may provide an inaccurate view of the actual risks in the population. Hence, in the current retrospective cohort study, mortality of self-reported lifetime history of EDs in the general population was explored. The data source was the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2), linked to a national mortality database. The survey sample was representative of the Canadian household population (mean age = 43.95 years, 50.9% female). The survey inquired about the history of professionally diagnosed chronic conditions, including EDs. Subsequently, the survey dataset was linked to the national mortality dataset (for the date of death) up to 2017. Cox proportional hazards models were used to explore the effect of EDs on mortality. The unadjusted-hazard ratio (HR) for the lifetime history of an ED was 1.35 (95% CI 0.70–2.58). However, the age/sex-adjusted HR increased to 4.5 (95% CI 2.33–8.84), which was over two times higher than age/sex-adjusted HRs for other mental disorders (schizophrenia/psychosis, mood-disorders, and post-traumatic stress disorder). In conclusion, all-cause mortality of self-reported lifetime history of EDs in the household population was markedly elevated and considerably higher than that of other self-reported disorders. This finding replicates prior findings in a population-representative sample and provides a definitive quantification of increased risk of mortality in EDs, which was previously lacking. Furthermore, it highlights the seriousness of EDs and an urgent need for strategies that may help to improve long-term outcomes

Food Addiction: Its Prevalence and Significant Association with Obesity in the General Population

Background: ‘Food addiction’ shares a similar neurobiological and behavioral framework with substance addiction. However whether, and to what degree, ‘food addiction’ contributes to obesity in the general population is unknown. Objectives: to assess 1) the prevalence of ‘food addiction’ in the Newfoundland population; 2) if clinical symptom counts of ‘food addiction’ were significantly correlated with the body composition measurements; 3) if food addicts were significantly more obese than controls, and 4) if macronutrient intakes are associated with ‘food addiction’. Design: A total of 652 adults (415 women, 237 men) recruited from the general population participated in this study. Obesity was evaluated by Body Mass Index (BMI) and Body Fat percentage measured by dual-energy X-ray absorptiometry. ‘Food addiction’ was assessed using the Yale Food Addiction Scale and macronutrient intake was determined from the Willet Food Frequency Questionnaire. Results: The prevalence of ‘food addiction’ was 5.4% (6.7% in females and 3.0% in males) and increased with obesity status. The clinical symptom counts of ‘food addiction’ were positively correlated with all body composition measurements across the entire sample (p,0.001). Obesity measurements were significantly higher in food addicts than controls; Food addicts were 11.7 (kg) heavier, 4.6 BMI units higher, and had 8.2% more body fat and 8.5% more trunk fat. Furthermore, food addicts consumed more calories from fat and protein compared with controls. Conclusion: Our results demonstrated that ‘food addiction’ contributes to severity of obesity and body composition measurements from normal weight to obese individuals in the general population with higher rate in women as compared to men

Higher Dietary Choline and Betaine Intakes Are Associated with Better Body Composition in the Adult Population of Newfoundland, Canada.

BACKGROUND:Choline is an essential nutrient and betaine is an osmolyte and methyl donor. Both are important to maintain health including adequate lipid metabolism. Supplementation of dietary choline and betaine increase muscle mass and reduce body fat in animals. However, little data is available regarding the role of dietary choline and betaine on body composition in humans. OBJECTIVE:To investigate the association between dietary choline and betaine intakes with body composition in a large population based cross-sectional study. DESIGN:A total of 3214 subjects from the CODING (Complex Disease in Newfoundland population: Environment and Genetics) study were assessed. Dietary choline and betaine intakes were computed from the Willett Food Frequency questionnaire. Body composition was measured using dual-energy X-ray absorptiometry following a 12-hour fast. Major confounding factors including age, sex, total calorie intake and physical activity level were controlled in all analyses. RESULT:Significantly inverse correlations were found between dietary choline and betaine intakes, with all obesity measurements: total percent body fat (%BF), percent trunk fat (%TF), percent android fat (%AF), percent gynoid fat (%GF) and anthropometrics: weight, body mass index, waist circumference, waist-to-hip ratio in both women and men (r range from -0.13 to -0.47 for choline and -0.09 to -0.26 for betaine, p<0.001 for all). Dietary choline intake had stronger association than betaine. Moreover, obese subjects had the lowest dietary choline and betaine intakes, with overweight subjects in the middle, and normal weight subjects consumed the highest dietary choline and betaine (p<0.001). Vice versa, when subjects were ranked according to dietary choline and betaine intakes, subjects with the highest intake of both had the lowest %TF, %AF, %GF, %BF and highest %LM among the groups in both sexes. CONCLUSION:Our findings indicate that high dietary choline and betaine intakes are significantly associated with favorable body composition in humans