Feeling Bad in More Ways than One: Comorbidity Patterns of Medically Unexplained and Psychiatric Conditions

Considerable overlap in symptoms and disease comorbidity has been noted among medically unexplained and psychiatric conditions seen in the primary care setting, such as chronic fatigue syndrome, low back pain, irritable bowel syndrome, chronic tension headache, fibromyalgia, temporomandibular joint disorder, major depression, panic attacks, and posttraumatic stress disorder

Regional brain response to visual food cues is a marker of satiety that predicts food choice

ABSTRACT Background: Neuronal processes that underlie the subjective experience of satiety after a meal are not well defined. Objective: We investigated how satiety alters the perception of and neural response to visual food cues. Design: Normal-weight participants (10 men, 13 women) underwent 2 fMRI scans while viewing images of high-calorie food that was previously rated as incompatible with weight loss and "fattening" and low-calorie, "nonfattening" food. After a fasting fMRI scan, participants ate a standardized breakfast and underwent reimaging at a randomly assigned time 15-300 min after breakfast to vary the degree of satiety. Measures of subjective appetite, food appeal, and ad libitum food intake (measured after the second fMRI scan) were correlated with activation by "fattening" (compared with "nonfattening") food cues in a priori regions of interest. Results: Greater hunger correlated with higher appeal ratings of "fattening" (r = 0.46, P = 0.03) but not "nonfattening" (r = 20.20, P = 0.37) foods. Fasting amygdalar activation was negatively associated with fullness (left: r = 20.52; right: r = 20.58; both P # 0.01), whereas postbreakfast fullness was positively correlated with activation in the dorsal striatum (right: r = 0.44; left: r = 0.45; both P , 0.05). After breakfast, participants with greater activation in 4 regions-medial orbital frontal cortex (r = 0.49, P , 0.05), left amygdala (r = 0.49, P , 0.05), left insula (r = 0.47, P , 0.05), and nucleus accumbens (right: r = 0.57, P , 0.01; left: r = 0.43, P , 0.05)-chose buffet foods with higher fat content. Conclusions: Postmeal satiety is shown in regional brain activation by images of high-calorie foods. Regions including the amygdala, nucleus accumbens, and dorsal striatum may alter perception of, and reduce motivation to consume, energy-rich foods, ultimately driving food choice. This trial was registered at clinicaltrials.gov as NCT01631045. Am J Clin Nutr 2012;96:989-99

Factors Affecting European Farmers’Participation in Biodiversity Policies

This article reports the major findings from an interdisciplinary research project that synthesises key insights into farmers’ willingness and ability to co-operate with biodiversity policies. The results of the study are based on an assessment of about 160 publications and research reports from six EU member states and from international comparative research.We developed a conceptual framework to systematically review the existent literature relevant for our purposes. This framework provides a common structure for analysing farmers’ perspectives regarding the introduction into farming practices of measures relevant to biodiversity. The analysis is coupled and contrasted with a survey of experts. The results presented above suggest that it is important to view support for practices oriented towards biodiversity protection not in a static sense – as a situation determined by one or several influencing factors – but rather as a process marked by interaction. Financial compensation and incentives function as a necessary, though clearly not sufficient condition in this process

Age at dieting onset, body mass index, and dieting practices. A twin study

•Nine-hundred and fifty adult female twins retrospectively reported age at first weight loss attempt.•Outcomes were self-reported adult BMI and dieting behaviors.•Early dieting was associated with higher adult BMI and more risky dieting behaviors.•These associations were not present in within-pair analyses.•Genetic/familial factors influence associations of early dieting with poor outcomes. Objective: Using a twin study design, we sought to determine whether an early age at dieting onset is a risk factor for higher adult body mass index (BMI) or use of risky dieting practices, independent of genetic and familial factors. Method: Female twins ages 18–60years (N=950) from the University of Washington Twin Registry completed 2 surveys an average of 3years apart. Analyses of individual twins and within-twin pairs tested associations of self-reported age at dieting onset with (1) adult BMI at baseline, (2) change in BMI between the two surveys and (3) risky dieting behaviors at baseline. Results: In analyses mimicking studies of unrelated individuals, an earlier age at dieting onset was associated with greater adult BMI (p=0.003), higher Restraint Scale scores (p<0.001), greater use of risky dieting behaviors (p=0.04) and more weight cycling episodes (p<0.001). In within-pair models that control for genetic and familial factors, the only significant association was between an earlier age at dieting onset and more weight cycling episodes (p=0.006). Discussion: Underlying genetic and familial factors may influence associations of early dieting with higher adult BMIs and risky dieting practices in women

Strategies to Understand the Weight‐Reduced State: Genetics and Brain Imaging

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167080/1/oby23101.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167080/2/oby23101_am.pd

Pilot clinical trial of macimorelin to assess safety and efficacy in patients with cancer cachexia

Abstract Background Cancer cachexia is associated with reduced body weight, appetite and quality of life (QOL) with no approved treatments. Growth hormone secretagogues like macimorelin have potential to mitigate these effects. Methods This pilot study assessed the safety and efficacy of macimorelin for 1 week. Efficacy was defined a priori as 1‐week change in body weight (≥0.8 kg), plasma insulin‐like growth factor (IGF)‐1 (≥50 ng/mL) or QOL (≥15%). Secondary outcomes included food intake, appetite, functional performance, energy expenditure and safety laboratory parameters. Patients with cancer cachexia were randomized to 0.5 or 1.0 mg/kg macimorelin or placebo; outcomes were assessed non‐parametrically. Results Participants receiving at least one of either macimorelin dose were combined (N = 10; 100% male; median age = 65.50 ± 2.12) and compared with placebo (N = 5; 80% male; median age = 68.00 ± 6.19). Efficacy criteria achieved: body weight (macimorelin N = 2; placebo N = 0; P = 0.92); IGF‐1 (macimorelin N = 0; placebo N = 0); QOL by Anderson Symptom Assessment Scale (macimorelin N = 4; placebo N = 1; P = 1.00) or Functional Assessment of Chronic Illness Therapy‐Fatigue (FACIT‐F; macimorelin N = 3; placebo N = 0; P = 0.50). No related serious or non‐serious adverse events were reported. In macimorelin recipients, change in FACIT‐F was directly associated with change in body weight (r = 0.92, P = 0.001), IGF‐1 (r = 0.80, P = 0.01), and caloric intake (r = 0.83, P = 0.005), and inversely associated with change in energy expenditure (r = −0.67, P = 0.05). Conclusions Daily oral macimorelin for 1 week was safe and numerically improved body weight and QOL in patients with cancer cachexia compared with placebo. Longer term administration should be evaluated for mitigation of cancer‐induced reductions in body weight, appetite and QOL in larger studies

Hypothalamic gliosis in obese children and adolescents

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