Identifying pre-bariatric subtypes based on temperament traits, emotion dysregulation, and disinhibited eating: A latent profile analysis

Objective: The efficacy of bariatric surgery has been proven; however, a subset of patients fails to achieve expected long-term weight loss postoperatively. As differences in surgery outcome may be influenced by heterogeneous psychological profiles in pre-bariatric patients, previous subtyping models differentiated patients based on temperament traits. The objective of the present study was to expand these models by additionally considering emotion dysregulation and disinhibited eating behaviors for subtyping, as these factors were associated with maladaptive eating behaviors and poor post-bariatric weight loss outcome. Methods: Within a prospective multicenter registry, N = 370 pre-bariatric patients were examined using interview and self-report questionnaires. A latent profile analysis was performed to identify subtypes based on temperament traits, emotion dysregulation, and disinhibited eating behaviors. Results: Five pre-bariatric subtypes were identified with specific profiles regarding self control, emotion dysregulation, and disinhibited eating behaviors. Subtypes were associated with different levels of eating disorder psychopathology, depression, and quality of life. The expanded model increased variance explanation compared to temperament-based models. Conclusion: By adding emotion dysregulation and disinhibited eating behaviors to previous subtyping models, specific pre-bariatric subtypes emerged with distinct psychological deficit patterns. Future investigations should test the predictive value of these subtypes for post bariatric weight loss and health-related outcomes

To eat or not to eat? Indicators for reduced food intake in 91,245 patients hospitalized on nutritionDays 2006-2014 in 56 countries worldwide: A descriptive analysis

Background: Inadequate nutrition during hospitalization is strongly associated with poor patient outcome, but ensuring adequate food intake is not a priority in clinical routine worldwide. This lack of priority results in inadequate and unbalanced food intake in patients and huge amounts of wasted food. Objectives: We evaluate the main factors that are associated with reduced meal intake in hospitalized patients and the differences between geographical regions. Design: We conducted a descriptive analysis of data from 9 consecutive, annual, and cross-sectional nutritionDay samples (2006-2014) in a total of 91,245 adult patients in 6668 wards in 2584 hospitals in 56 countries. A general estimation equation methodology was used to develop a model for meal intake, and P-value thresholding was used for model selection. Results: The proportion of patients who ate a full meal varied widely (24.7-61.5%) across world regions. The factors that were most strongly associated with reduced food intake on nutritionDay were reduced intake during the previous week (OR: 0.20; 95% CI: 0.17, 0.22), confinement to bed (OR: 0.49; 95% CI: 0.44, 0.55), female sex (OR: 0.53; 95% CI: 0.5, 0.56), younger age (OR: 0.74; 95% CI: 0.64, 0.85) and older age (OR: 0.80; 95% CI: 0.74; 0.88), and low body mass index (OR: 0.84; 95% CI: 0.79, 0.90). The pattern of associated factors was homogenous across world regions. Conclusions: A set of factors that are associated with full meal intake was identified and is applicable to patients hospitalized in any region of the world. Thus, the likelihood for reduced food intake is easily estimated through access to patient characteristics, independent of world regions, and enables the easy personalization of food provision

Age and gender specific estimation of visceral adipose tissue amounts from radiological images in morbidly obese patients OPEN

Best predictions were found at intervertebral spaces L3-L4 for females (σ 5 = 688 ml, σ 1 = 832 ml) and L1-L2 for males (σ 5 = 846 ml, σ 1 = 992 ml), irrespective of age. In conclusion, VAT volumes in morbidly obese patients can be reliably predicted by multiplying the segmented VAT area at a gender-specific lumbar reference level with a fixed scaling factor and effective slice thickness. Obesity is a worldwide increasing healthcare problem. In the United States, for example, over two thirds of the adult population are either overweight (33%, BMI: 25-30 kg/m 2 ), obese (35%, 30-40 kg/m 2 ) or morbidly obese (6%, > 40 kg/m 2 ) 1 . While prevalence of obesity is still rising, in particular the morbid form 2 , more and more is known about its association with an increased overall mortality, often caused by cardiovascular diseases, diabetes or hypertension Quantification of abdominal VAT volumes by cross-sectional imaging, typically by computed tomography (CT) or magnetic resonance imaging (MRI), however, is generally time-consuming 7-9 . Various methods have already been proposed to estimate total VAT volumes from simple measurements on a limited number of slices. Studies using single or five slice VAT areas for VAT volume prediction have mainly focused on patients with BMI values below 40 kg/m 2 and data for the morbidly obese are lackin

ESPEN Practical Guideline: clinical nutrition in liver disease

Desnutrición; Insuficiencia hepática aguda grave; CirrosisMalnutrition; Acute liver failure; CirrhosisDesnutrició; Insuficiència hepàtica aguda greu; CirrosiIntroducción: la Guía Práctica se basa en la actual guía científica de la ESPEN sobre nutrición clínica en las enfermedades hepáticas. Métodos: se ha reducido y transformado en diagramas de flujo para facilitar su uso en la práctica clínica. La guía está dedicada a todos los profesionales, incluidos médicos, dietistas, nutricionistas y enfermeras, que trabajan con pacientes con enfermedad hepática crónica. Resultados: la guía presenta un total de 103 pronunciamientos y recomendaciones con breves comentarios para el manejo nutricional y metabólico de pacientes con (i) insuficiencia hepática aguda grave, (ii) esteatohepatitis alcohólica, (iii) enfermedad hepática grasa no alcohólica, (iv) cirrosis hepática, y (v) cirugía o trasplante de hígado. Conclusión: las recomendaciones relacionadas con enfermedades están precedidas por recomendaciones generales sobre el diagnóstico del estado nutricional en los pacientes hepáticos y sobre las complicaciones hepáticas asociadas a la nutrición médica.Background: the Practical Guideline is based on the current scientifi c ESPEN guide on Clinical Nutrition in Liver Disease. Methods: it has been shortened and transformed into fl ow charts for easier use in clinical practice. The guideline is dedicated to all professionals including physicians, dieticians, nutritionists and nurses working with patients with chronic liver disease. Results: a total of 103 statements and recommendations are presented with short commentaries for the nutritional and metabolic management of patients with (i) acute liver failure, (ii) alcoholic steatohepatitis, (iii) non-alcoholic fatty liver disease, (iv) liver cirrhosis, and (v) liver surgery/ transplantation. Disease-related recommendations are preceded by general recommendations on the diagnosis of nutritional status in liver patients and on liver complications associated with medical nutrition. Conclusion: this Practical Guideline gives guidance to health care providers involved in the management of liver disease on how to offer optimal nutritional care

The germination niches of grassland species targeted for restoration: effects of seed pre-treatments

Restoration of semi-natural grassland communities involves a combination of (1) sward disturbance to create a temporal window for establishment, and (2) target species introduction, the latter usually by seed sowing. With great regularity, particular species establish only poorly. More reliable establishment could improve outcome of restoration projects and increase cost-effectiveness. We investigated the abiotic germination niche of ten poorly establishing calcareous grassland species by simultaneously exploring the effects of moisture and light availability and temperature fluctuation on percentage germination and speed of germination. We also investigated the effects of three different pre-treatments used to enhance seed germination – cold-stratification, osmotic priming and priming in combination with gibberellic acid (GA3) – and how these affected abiotic germination niches. Species varied markedly in width of abiotic germination niche, ranging from Carex flacca with very strict abiotic requirements, to several species reliably germinating across the whole range of abiotic conditions. Our results suggest pronounced differences between species in gap requirements for establishment. Germination was improved in most species by at least one pre-treatment. Evidence for positive effects of adding GA3 to seed priming solutions was limited. In several species, pre-treated seeds germinated under a wider range of abiotic conditions than untreated seeds. Improved knowledge of species-specific germination niches and the effects of seed pre-treatments may help to improve species establishment by sowing, and to identify species for which sowing at a later stage of restoration or introduction as small plants may represent a more viable strategy

Identifying pre-bariatric subtypes based on temperament traits, emotion dysregulation, and disinhibited eating: A latent profile analysis

Objective: The efficacy of bariatric surgery has been proven; however, a subset of patients fails to achieve expected long-term weight loss postoperatively. As differences in surgery outcome may be influenced by heterogeneous psychological profiles in pre-bariatric patients, previous subtyping models differentiated patients based on temperament traits. The objective of the present study was to expand these models by additionally considering emotion dysregulation and disinhibited eating behaviors for subtyping, as these factors were associated with maladaptive eating behaviors and poor post-bariatric weight loss outcome. Methods: Within a prospective multicenter registry, N = 370 pre-bariatric patients were examined using interview and self-report questionnaires. A latent profile analysis was performed to identify subtypes based on temperament traits, emotion dysregulation, and disinhibited eating behaviors. Results: Five pre-bariatric subtypes were identified with specific profiles regarding self control, emotion dysregulation, and disinhibited eating behaviors. Subtypes were associated with different levels of eating disorder psychopathology, depression, and quality of life. The expanded model increased variance explanation compared to temperament-based models. Conclusion: By adding emotion dysregulation and disinhibited eating behaviors to previous subtyping models, specific pre-bariatric subtypes emerged with distinct psychological deficit patterns. Future investigations should test the predictive value of these subtypes for post bariatric weight loss and health-related outcomes

Identifying pre-bariatric subtypes based on temperament traits, emotion dysregulation, and disinhibited eating: A latent profile analysis

Objective: The efficacy of bariatric surgery has been proven; however, a subset of patients fails to achieve expected long-term weight loss postoperatively. As differences in surgery outcome may be influenced by heterogeneous psychological profiles in pre-bariatric patients, previous subtyping models differentiated patients based on temperament traits. The objective of the present study was to expand these models by additionally considering emotion dysregulation and disinhibited eating behaviors for subtyping, as these factors were associated with maladaptive eating behaviors and poor post-bariatric weight loss outcome. Methods: Within a prospective multicenter registry, N = 370 pre-bariatric patients were examined using interview and self-report questionnaires. A latent profile analysis was performed to identify subtypes based on temperament traits, emotion dysregulation, and disinhibited eating behaviors. Results: Five pre-bariatric subtypes were identified with specific profiles regarding self control, emotion dysregulation, and disinhibited eating behaviors. Subtypes were associated with different levels of eating disorder psychopathology, depression, and quality of life. The expanded model increased variance explanation compared to temperament-based models. Conclusion: By adding emotion dysregulation and disinhibited eating behaviors to previous subtyping models, specific pre-bariatric subtypes emerged with distinct psychological deficit patterns. Future investigations should test the predictive value of these subtypes for post bariatric weight loss and health-related outcomes