Food Avoidance Behavior Research Articles

Food Avoidance beyond the Gluten-Free Diet and the Association with Quality of Life and Eating Attitudes and Behaviors in Adults with Celiac Disease

Background: The only treatment for Celiac Disease (CeD), which affects about 1% of the population, is a gluten-free diet (GFD). Studies have indicated an association between the GFD, a diminished quality of life (QOL), and maladaptive eating patterns. This study aims to explore food avoidance behaviors in adults with CeD. Methods: This cross-sectional study assessed 50 adults with biopsy-confirmed CeD who completed validated surveys evaluating demographics, psychological factors, QOL, eating pathology, and food avoidance. Results: Overall CDQOL scores were good (mean: 62.7 out of 100). However, 58.0% of the participants self-elected to avoid one or more additional foods without diagnosed allergies or intolerances. Those avoiding one or more other foods had lower QOL scores (57.4 (23.2) vs. 70.2 (15.9)) compared to those only avoiding gluten (p = 0.034). The mean depression score (CESD) for the group avoiding foods beyond gluten was in the depressive range, unlike those avoiding only gluten (16.0 (4.9) vs. 13.6 (4.0), p = 0.078), with 77% of those avoiding more than gluten scoring above the CESD cut-off point of 15, indicating clinical depression. Conclusions: Over half of participants (58%) reported avoiding additional foods beyond the GFD, a behavior associated with decreased QOL and increased depression.

Diet and joint symptoms: A survey of Moroccan patients with osteoarthritis

Introduction. Patients with osteoarthritis not only ask about the impact of weight on their symptoms, but also the impact of food. This includes foods that are described as either inflammatory or anti-inflammatory. The aim of our study was to investigate the possible relationship between food and osteoarthritis symptoms. Methods. The study was based on a questionnaire and it was conducted on patients undergoing osteoarthritis treatment in our department between February and September 2022. Results. We included 322 patients with a mean age of 59.57 ± 10.71, of whom 72.9% were women. The median duration of osteoarthritis was 4 years [2-10]. Only 7.9% reported that food affected their symptoms, with 4.4% experiencing improvement and 3.5% experiencing aggravation. The foods most often cited as improving joint symptoms were fish (1.2%), ginger (1.2%), and olive oil (1.2%), while red meat (1.2%) and soda (0.9%) were the most often cited as worsening symptoms. Approximately 2.2% of the patients exhibited food avoidance behaviors, while 3.7% adhered to specific diets and 1.3% tried fasting to alleviate joint symptoms. In this multivariate analysis, we suggest that certain diet practices have an impact on osteoarthritis symptoms. Conclusion. Our study found that only a minority of patients reported associations between some types of food and worsening or improving joint symptoms.

Comparisons between atypical anorexia nervosa and anorexia nervosa: Psychological and comorbidity patterns.

Literature comparing "atypical" anorexia nervosa (atypical AN) and anorexia nervosa (AN) suggests these diagnoses share significant similarities in eating disorder (ED) pathology and psychiatric comorbidities. This study evaluated potential differences in ED pathology, psychiatric comorbidity, associated mechanisms (i.e., ED fears and perfectionism), and demographic factors (i.e., ethnicity and age) between individuals with atypical AN and AN. Data from seven protocols were combined for a total 464 individuals diagnosed with atypical AN (n = 215) or AN (n = 249). Between-group differences in ED severity and behaviors, psychiatric comorbidities, ED fears, perfectionism, and demographic factors were assessed using t-tests, Wilcoxon rank-sum tests, and Fisher's exact test. Participants with atypical AN reported higher levels of overvaluation of weight and shape than those with AN. Participants with AN scored higher on food-related fears (anxiety about eating, food avoidance behaviors, and feared concerns) and fears of social eating, as well as obsessive-compulsive symptoms. Participants with AN were more likely to identify as Asian or Pacific Islander. No other statistically significant differences were found between groups for overall ED severity, ED behaviors, psychiatric comorbidities, general ED fears, perfectionism, or demographic factors. Overall, results support previous literature indicating limited differences between individuals with atypical AN and AN, though individuals with atypical AN reported more overvaluation of weight and shape and those with AN reported higher food and social eating fears and obsessive-compulsive symptoms. Relatively few overall differences between atypical AN and AN highlight the importance of exploring dimensional conceptualizations of AN as an alternative to the current categorical conceptualization. This study assessed differences among individuals with atypical anorexia nervosa and anorexia nervosa in eating disorder severity and behaviors, comorbid psychiatric diagnoses, associated mechanisms, and demographic factors. Few differences emerged, though participants with atypical anorexia nervosa reported more overvaluation of weight and shape, while those with anorexia nervosa reported more food and social eating fears and higher obsessive-compulsive symptoms. Results support exploration of these diagnoses as a spectrum disorder.

Distinct Food Triggers for Migraine, Medication Overuse Headache and Irritable Bowel Syndrome.

Irritable bowel syndrome (IBS) is an under-diagnosed common health problem that impairs quality of life. Migraine and IBS are comorbid disorders that are triggered by foods. We aim to investigate IBS frequency in medication overuse headache (MOH) patients and identify food triggers and food avoidance behavior. Participants who completed the cross-sectional, observational and online survey were included (n = 1118). Demographic data, comorbid disorders, medications used, presence of headache, the diagnostic features of headache and IBS, migraine related subjective cognitive symptoms scale (MigSCog), consumption behavior of patients regarding 125 food/food additives and food triggers were asked about in the questionnaire. Migraine and MOH diagnoses were made in 88% and 30.7% of the participants, respectively. Non-steroidal anti-inflammatory drugs (NSAIDs) were the main overused drug (89%) in MOH patients. IBS symptoms were present in 35.8% of non-headache sufferers, 52% of migraine patients and 65% of MOH patients. Specific food triggers for MOH patients were dopaminergic and frequently consumed as healthy foods such as banana, apple, cherry, apricot, watermelon, olive, ice cream and yogurt. MigSCog scores were significantly higher in episodic migraine and MOH patients when IBS symptoms coexisted. The frequency of IBS was higher in MOH patients compared to migraine patients. Coexistence of IBS seems to be a confounding factor for cognitive functions. MOH specific triggers were mostly dopaminergic foods, whereas migraine specific food triggers were mostly histaminergic and processed foods. Personalized diets focusing on food triggers and interference with leaky gut must be integrated to MOH and migraine treatment to achieve sustainable management of these disorders.

1.42 Food Avoidance Behavior Patterns in Children and Adolescents With Eating Disorders

1.42 Food Avoidance Behavior Patterns in Children and Adolescents With Eating Disorders

To eat or not to eat: type 2 immunity controls food avoidance behavior

Growing evidence suggests that food allergies are regulated by neuroimmune interactions. However, the underlying molecular mechanisms remain unclear. Plum et al. and Florsheim et al. identify IgE-mediated mast cell activation, leukotrienes, and growth differentiating factor 15 (GDF15) as key regulators of the avoidance response to food allergens in mice.

Facing Eating Disorder Fears: An Open Trial Adapting Prolonged Exposure to the Treatment of Eating Disorders

Eating disorders (EDs) are maintained by core fears, which lead to avoidance behaviors, such as food avoidance or compensatory behaviors. Previously tested exposure-based treatments for EDs have generally focused on proximal outcomes (e.g., food), rather than addressing core fears (e.g., fear of weight gain and its consequences). The current study tested the feasibility and initial clinical efficacy of 10 sessions of imaginal and in vivo exposure for core ED fears (termed “Facing Eating Disorder Fears”), mainly fear of weight gain and its associated consequences. Participants were 36 adults with anorexia nervosa (AN), bulimia nervosa, or other specified feeding and eating disorders determined by semistructured diagnostic interviews. ED symptoms, fears, and body mass index (BMI) were assessed at pretreatment, posttreatment, and 1-month follow-up. Treatment involved 10 sessions of imaginal and in vivo exposure to ED fears in combination with in vivo exposures to feared and avoided situations as homework. ED symptoms and fears decreased from pre- to posttreatment and at 1-month follow-up. BMI increased significantly from pre- to posttreatment, particularly for those with AN. Effect sizes ranged from small to very large. ED symptoms and fears decreased and BMI increased following exposure. Increases in BMI occurred without any direct intervention on eating, suggesting that weight gain can be achieved without a specific focus on food during ED treatment. Facing Eating Disorder Fears may be a feasible stand-alone intervention for EDs. Future research must test comparative efficacy through randomized controlled trials.

Valproic Acid is an Effective Anti-Emetic Treatment in Alexander Disease (P10-9.010)

<h3>Objective:</h3> To explore safety and effectiveness of anti-emetic strategies in Alexander disease (AxD). <h3>Background:</h3> Emesis is a frequent symptom in AxD and leads to inadequate intake and food avoidance behaviors. As a result, weight loss and failure to thrive are common in AxD. We explored emesis treatment strategies to determine their relative benefits and side effects in clinical practice. <h3>Design/Methods:</h3> Medical records of patients with AxD (&lt;21 years) participating in a natural history cohort study were reviewed for history of emesis, difficulty with weight gain, and medications. Patients were retrospectively evaluated for response to medication, which was defined as a clinically meaningful decrease in emesis. Treatment failure was defined as no improvement, worsened emesis, clinically significant weight loss, or presence of an intolerable side effect. Deceased patients, patients with a Nissen fundoplication, and patients with insufficient longitudinal data were excluded. Fisher’s exact tests were used to compare response rates of valproic acid to those of anti-reflux medications (proton pump inhibitors, H2 antagonists analyzed together) or cyproheptadine. <h3>Results:</h3> Among 59 subjects with vomiting, 34 subjects met inclusion criteria. Emesis was treated with multiple anti-reflux medications (N=24), cyproheptadine (N=19), and valproic acid (VPA, N=22). Overall, 48% of patients responded to multiple anti-reflux medications, 32% responded to cyproheptadine, and 95% responded to VPA. VPA had a higher success rate in reducing emesis compared to multiple reflux medications (p=0.0001) or cyproheptadine (p&lt;0.0001). Adverse effects from VPA included bone fractures (N=1) in a non-ambulatory patient, hyperammonemia (N=2) which resolved with dose lowering, and mild hair loss (N=2). <h3>Conclusions:</h3> Recognizing the limitations of retrospective review, 95% of AxD patients on VPA showed improvements in emesis and weight gain. Response rates to VPA were greater compared to anti-reflux medications or cyproheptadine. VPA is well tolerated overall, although use should be monitored for known adverse effects. <b>Disclosure:</b> Ms. Sergio has nothing to disclose. Miss Gallison has nothing to disclose. Dr. Porcari has nothing to disclose. The institution of Mr. Joung has received research support from Ionis Pharmaceuticals. Mr. Faig has nothing to disclose. An immediate family member of Geraldine Liu has received publishing royalties from a publication relating to health care. Dr. Waldman has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for SwanBio. An immediate family member of Dr. Waldman has stock in Pfizer. The institution of Dr. Waldman has received research support from Ionis Pharmaceuticals. Dr. Waldman has received publishing royalties from a publication relating to health care.

Prevalence of Eating Behaviors and Their Influence on Metabolic Control of Children With Type 1 Diabetes Mellitus

Background: Since a comprehensive study of eating disorders in children with type 1 diabetes in the Iranian population is necessary, this study aimed to investigate the prevalence of eating behaviors and metabolic control status of children and adolescents with diabetes mellitus. Objectives: The present cross-sectional study aim to explore the prevalence of eating behaviors and their influence on metabolic control of children with type 1 diabetes mellitus. Methods: In this cross-sectional study, all children and adolescents 6 to 12 years old with diabetes were included. First, the prevalence of eating-related behaviors in participants was assessed and recorded. Then the recorded data were statistically analyzed. Results: The Mean±SD age of the study participants was 8.92±1.925 years. One hundred children with food approach scores above 12.29 had food-approach behaviors, and 78 children with food avoidance scores above 11.85 were classified as having food avoidance behaviors. The relationships between food-approach behaviors and hemoglobin A1C (HbA1c) and insulin dose, body mass index (BMI), and lipid profile were significant (P&lt;0.05). Nevertheless, the relationship between these variables and food avoidance behaviors was not significant (P&gt;0.05). Conclusions: High BMI, high insulin dose, increased lipid levels, and high HbA1c are associated with an increased eating tendency in children. Therefore, these children should be evaluated for disordered eating behaviors.

Transdiagnostic fears and avoidance behaviors in self-reported eating disorders

BackgroundFears and avoidance behaviors are common symptoms of eating disorders. It was investigated whether different eating disorder diagnoses are equally characterized by similar fears and avoidance behaviors.MethodsIndividuals with self-reported eating disorders (n = 250) and healthy controls (n = 95) completed online questionnaires assessing general fears, eating related fears, and avoidance behaviors.ResultsAll self-reported eating disorder diagnoses showed more eating related fears, general fears, and avoidance behaviors than healthy controls. Individuals with binge eating disorder showed less specific and general fears on some but by no means all scales, yet they showed less food avoidance behaviors than all other eating disorders and less eating restraint than anorexia nervosa and bulimia nervosa.ConclusionsEating related fears, general fears, and food avoidance behaviors were found to be transdiagnostic symptoms in self-reported eating disorders. Individuals with binge eating disorder also exhibit more fears and avoidance behaviors than healthy controls, but to a lesser extent than the other eating disorders. Specialized interventions targeting fears and avoidance may be promising add-on interventions not only in the treatment of anorexia nervosa, but in the treatment of all eating disorders.

The associations between pathogen disgust sensitivity, meat liking, plant liking and a lifetime prevalence of anorexia nervosa among Finnish women

Anorexia Nervosa (AN) is a debilitating mental illness that often leads to expensive treatment costs and poor health outcomes. Previous studies have found that having AN is associated with a vegetarian diet and that anxiety plays a role in food avoidance behavior. There is also some evidence suggesting that disgust could play a role in the course of the disorder. More research is however needed to uncover how disgust relates to food preferences in AN individuals. The present novel study considered whether the compensatory prophylaxis hypothesis (CPH) could be a sound theoretical framework for understanding the potential associations between pathogen disgust sensitivity, an individual differences variable that captures dispositional motivations to pathogen-related stimuli, and meat and plant liking in AN individuals. According to the CPH, restricted meat intake may function to reduce pathogen risks when the individual is more susceptible to disease. However, a growing body of evidence has failed to find a relationship between vulnerability to disease and pathogen avoidance. The present study tested the hypothesis that AN relates to pathogen disgust sensitivity. To do so, we examined the associations between pathogen disgust sensitivity, meat liking, plant liking, and a lifetime prevalence of anorexia nervosa (AN-LTP) in a sample of 4,098 Finnish women (402 in the AN-LTP group and 3,696 in the non-AN group). According to results, individuals in the AN-LTP group liked meats less than plants, and less than non-AN individuals. The AN-LTP group liked plants more than the non-AN group. However, the difference in meat and plant liking in AN-LTP vs non-AN individuals was not mediated by pathogen disgust sensitivity. Pathogen disgust sensitivity was associated with lower meat and plant liking in the sample as a whole. Our results did not provide support for the compensatory prophylaxis hypothesis, thus adding to the body of evidence that has failed to find a relationship between vulnerability to disease and pathogen avoidance.

Sub-chronic administration of fluoxetine does not alter prey-capture or predator avoidance behaviors in adult South African clawed frogs (Xenopus laevis).

Animals will halt foraging efforts and engage defensive behaviors in response to predator cues. Some researchers have proposed that the switch from appetitive to avoidance behavior resembles anxiety, but most work on this has been performed in a limited number of animal models, primarily zebrafish and rodents. We used adult South African clawed frogs (Xenopus laevis) to determine if the canonical anxiolytic fluoxetine alters predator-induced changes in appetitive and avoidance behavior in a laboratory-based trade-off task that mimics foraging/predator avoidance tradeoffs in the wild. We hypothesized that sub-chronic fluoxetine treatment (20 d) would not affect baseline behavior but would reverse predator-induced changes in food intake, appetitive and avoidance behavior, and the abundance of anxiety related gene transcripts in the optic tectum, a brain area central to ecological decision making in frogs. We found that fluoxetine significantly reduced baseline locomotion compared to vehicle-treated animals. Fluoxetine had no effect on appetitive and avoidance behaviors that were sensitive to predator cues in this assay and did not alter any of the anxiety-related transcripts in the tectum. We conclude that while peripheral sub-chronic administration of fluoxetine significantly reduces locomotion, it does not modify predator-induced changes in approach and avoidance behaviors in this assay. Our findings are not consistent with visual predator cues causing state anxiety in adult frogs.

An exploration of eating behaviours and caregiver mealtime actions of children with Tourette syndrome.

Food avoidant behaviours are common concerns amongst individuals with Tourette syndrome, with high levels of food selectivity reported in children and food neophobia and avoidant restrictive eating behaviours in adults. However, less is known about food approach behaviours. The current study aimed to explore differences in food approach and food avoidant eating behaviours in children with Tourette syndrome (TS) and their relationship to caregiver mealtime actions. Thirty-seven caregivers of children with Tourette syndrome were compared with children with Autism Spectrum Disorders, children with Attention-Deficit/Hyperactivity Disorder and a control group. Caregivers completed the Child Eating Behaviour Questionnaire and Parent Mealtime Action Scale-Revised. Caregiver-reported findings revealed that children with Tourette syndrome exhibited more food approach behaviours, specifically greater food responsiveness, emotional overeating and desire to drink, compared to controls. Children from the three neurodiverse groups had similar levels of emotional overeating and food selectivity, which were all significantly higher than the control group. Positive persuasion was uniquely identified as a mealtime strategy adopted by caregivers of children with Tourette syndrome. The results suggest that children with Tourette syndrome are at more risk of showing a broader array of food difficulties than previously reported, including food avoidant and approach behaviours. It is encouraged that clinicians monitor eating behaviour in appointments with children with Tourette syndrome.

Validation study on the child, adult, and parent version of the ARFID module 2.0 for the Eating Disorder Examination.

This study presents a psychometric evaluation of the avoidant/restrictive food intake disorder (ARFID) module 2.0 for the Eating Disorder Examination (EDE), its child (ChEDE), and parent version. Within a pediatric sample seeking treatment for restrictive feeding or eating disorders and non-treatment-seeking controls, the module's interrater reliability, parent-child agreement, and its convergent, divergent, and discriminant validity were examined. The child, adult, and/or parent version of the German ARFID module was administered to N=176 children and adolescents (0-17 years) and their parents, as were the (Ch)EDE, well-established measures on food-avoidance behaviors, food variety, and body esteem, and objective anthropometric measures. Across all versions of the ARFID module, substantial to almost perfect interrater reliability was shown. Parent-child agreement for ARFID diagnosis was substantial. Based on medium-to-large associations between interview-assessed avoidant/restrictive food intake and questionnaire-assessed food-avoidance behaviors, food variety, and objective weight status, the module showed high convergent validity, especially for the child and parent version. Low associations of avoidant/restrictive food intake with weight and shape concern demonstrated divergent validity. Individuals with ARFID differed significantly from those with anorexia nervosa and individually matched controls in a range of clinical characteristics, indicating discriminant validity. This comprehensive validation supports the EDE ARFID module to be a valuable measure for the assessment and diagnosis of ARFID in 0-17-year-olds based on self- and parent-report. Validation of the ARFID module against other interview-based measures on ARFID and its evaluation in an adult sample are pending. Based on good reliability and validity of the avoidant/restrictive food intake disorder (ARFID) module for the Eating Disorder Examination (EDE) in its child, adult, and parent version, the present study paves the way for the clinical and research use of the interview-based EDE ARFID module for assessing ARFID across childhood and adolescence.

Eating behavior of preschool-age children during social distancing period due to COVID-19

The aim of the study was to investigate the eating behavior of preschool children during the social isolation period of the first wave of COVID-19 in Fortaleza, Ceará. This is a cross-sectional observational study, carried out with caregivers of preschool children aged from 2 to 6 years. The PENSE questionnaire (IBGE) was used to collect socio-economic data and the data referring to eating behavior was used the CEBQ. 286 parents (mother and father) and their children participated in the research, of which 53.8% were female. The preschoolers in the study constituted 5.2% of infant I, 9.8% infant II, 14.7% infant III, 20.6% infant IV, 23.1% infant V, 15.4% 1-year elementary school and 11.2% did not attend school. As for the education of most mothers, 83.9% completed higher education. Regarding the number of people who lived in the household, 44.4% lived with 4 people and 73.1% had 1 child. The highest mean values ​​are present in the dimension "Pleasure to eat" (EF) and "Response to satiety" (SR), while the lowest refer to the dimensions "About Emotional Intake" (EOE) and "Response to food" (FR). The statistical results of the “Food Fussiness” (FF) subscale point out important aspects about the selectivity in the sample of the present study, demonstrating a good tendency to picky eating. The dimension with the lowest mean was “Emotional Overeating”, demonstrating that when confined due to the COVID-19 pandemic, preschoolers still have EOE lower than all other subscales. It follows that children in preschool stage have presented a higher prevalence in subscales that are linked to food avoidance behavior.

High Patient Disease Burden in a Cross-sectional, Multicenter Contact Registry Study of Eosinophilic Gastrointestinal Diseases

To characterize patient-reported symptoms and comorbidities by type of eosinophilic gastrointestinal disease (EGID) and compare the collected data among the evaluated patient population.A total of 715 pediatric and adult patients with a diagnosis of EGID were enrolled in the Consortium of Eosinophilic Gastrointestinal Disease Researchers Contact Registry and completed the study questionnaire between 2015 and 2018. EGIDs consisted of eosinophilic esophagitis (EoE) or non-EoE EGIDs, which consist of eosinophilic gastritis, eosinophilic gastroenteritis, and eosinophilic colitis.This study was a cross-sectional study. A 25-item questionnaire was curated to collect demographic data, types of EGID, symptoms, and management. Additionally, extraintestinal symptoms and various comorbidities were recorded, such as vitamin deficiencies and psychosocial comorbidities.Most patients who completed the questionnaire had EoE only (80%; n = 575), in comparison with those with non-EoE EGIDs with or without EoE (n = 210). The sex-distribution illustrated that boys (57%) and younger patients reported EoE only, in comparison with non-EoE EGIDs (16- vs 19-year-olds), which was statistically significant. Nausea (21%) and upper abdominal pain (23%) were the most prominent symptoms reported. Of note, the frequency of symptoms was higher among those with non-EoE EGIDs. Furthermore, patients with non-EoE EGIDs had a higher percentage of vitamin deficiencies (49.7%) and concomitant gastroparesis (27.3%). Every patient in the study reported extraintestinal symptoms, but those with non-EoE EGID reported an increased frequency (14 to 21% experienced weekly symptoms) and psychosocial concerns (16% to 26% experienced weekly symptoms). Adult EoE patients had a higher proportion of feeling isolated on a daily or weekly basis when treated with specific food-elimination diets. Similar outcomes were seen in both pediatric and adult EoE patients being treated with elemental diet therapy. After adjusting for food avoidance behaviors and diarrhea frequency, both specific food-elimination (odds ratio: 2.4) and elemental diet (odds ratio: 1.9) were still associated with at least weekly feelings of isolation for participants with EoE only.As a whole, patients with EGID have a high frequency of extragastrointestinal symptoms and a high reporting rate of comorbidities. When examining these disorders closely, patients with non-EoE EGIDs had more severe symptoms and a higher occurrence of nutritional, physical, and psychosocial comorbidities, in comparison with those with EoE only.From a diagnostic perspective, with this study, the authors illustrate poignant differences in the symptom presentation and laboratory findings (vitamin deficiencies) that may assist health care providers in determining the accurate diagnosis between EGIDs. Additionally, with this study, the authors are the first to highlight how impactful treatment plans are on patients psychosocially. EoE and other EGID disorders, when treated with restrictive dietary modifications, can have a negative impact on patients, particularly adolescents, and their social interactions. This outcome indicates the importance of a multidisciplinary approach in treatment and encourages more research to look for options that are not perceived as burdensome by the patient.

A comparison of food avoidant behaviours and sensory sensitivity in adults with and without Tourette syndrome

Food selectivity has been shown to be more persistent and severe in children with Tourette syndrome (TS) compared to their typically developing peers. The current study aimed to examine differences in food selectivity, food neophobia and Avoidant Restrictive Food Intake Disorder (ARFID)-associated behaviours, between adults with and without TS. Fifty-three adults diagnosed with TS were compared to 53 neurotypical adults and completed the following measures online: Adult Eating Behaviour Questionnaire (AEBQ), Nine-Item Avoidant/Restrictive Food Intake disorder screen (NIAS), Food Neophobia Scale (FNS) and the Sensory Perception Quotient (SPQ). Higher levels of food avoidant behaviours, in terms of food fussiness, food neophobia and ARFID-associated behaviours, were identified in adults with TS compared to adults without TS. While heightened sensory sensitivity failed to predict food fussiness, greater sensitivity to taste was found to be predictive of food neophobia in TS. These are the first findings to suggest that food avoidant behaviours are more prevalent for adults with TS and signal a need to address health implications.

From Desire to Dread-A Neurocircuitry Based Model for Food Avoidance in Anorexia Nervosa.

Anorexia nervosa is a severe psychiatric illness associated with food avoidance. Animal models from Berridge et al. over the past decade showed that environmental ambience, pleasant or fear inducing, can trigger either appetitive (desire) or avoidance (dread) behaviors in animals via frontal cortex, nucleus accumbens dopamine D1 and D2 receptors, and hypothalamus. Those mechanisms could be relevant for understanding anorexia nervosa. However, models that translate animal research to explain the psychopathology of anorexia nervosa are sparse. This article reviews animal and human research to find evidence for whether this model can explain food avoidance behaviors in anorexia nervosa. Research on anorexia nervosa suggests fear conditioning to food, activation of the corticostriatal brain circuitry, sensitization of ventral striatal dopamine response, and alterations in hypothalamic function. The results support the applicability of the animal neurocircuitry derived model and provide directions to further study the pathophysiology that underlies anorexia nervosa.

Toxic stress-specific cytoprotective responses regulate learned behavioral decisions in C. elegans

BackgroundRecognition of stress and mobilization of adequate “fight-or-flight” responses is key for survival and health. Previous studies have shown that exposure of Caenorhabditis elegans to pathogens or toxins simultaneously stimulates cellular stress and detoxification responses and aversive behavior. However, whether a coordinated regulation exists between cytoprotective stress responses and behavioral defenses remains unclear.ResultsHere, we show that exposure of C. elegans to high concentrations of naturally attractive food-derived odors, benzaldehyde and diacetyl, induces toxicity and food avoidance behavior. Benzaldehyde preconditioning activates systemic cytoprotective stress responses involving DAF-16/FOXO, SKN-1/Nrf2, and Hsp90 in non-neuronal cells, which confer both physiological (increased survival) and behavioral tolerance (reduced food avoidance) to benzaldehyde exposure. Benzaldehyde preconditioning also elicits behavioral cross-tolerance to the structurally similar methyl-salicylate, but not to the structurally unrelated diacetyl. In contrast, diacetyl preconditioning augments diacetyl avoidance, weakens physiological diacetyl tolerance, and does not induce apparent molecular defenses. The inter-tissue connection between cellular and behavioral defenses is mediated by JNK-like stress-activated protein kinases and the neuropeptide Y receptor NPR-1. Reinforcement of the stressful experiences using spaced training forms stable stress-specific memories. Memory retrieval by the olfactory cues leads to avoidance of food contaminated by diacetyl and context-dependent behavioral decision to avoid benzaldehyde only if there is an alternative, food-indicative odor.ConclusionsOur study reveals a regulatory link between conserved cytoprotective stress responses and behavioral avoidance, which underlies “fight-or-flight” responses and facilitates self-protection in real and anticipated stresses. These findings imply that variations in the efficiency of physiological protection during past episodes of stress might shape current behavioral decisions.Graphical abstract

The dietary practices and beliefs of British South Asian people living with inflammatory bowel disease: a multicenter study from the United Kingdom

Background/AimsEpidemiological associations have implicated factors associated with Westernization, including the Western diet, in the development of inflammatory bowel disease (IBD). The role of diet in IBD etiopathogenesis, disease control and symptom management remains incompletely understood. Few studies have collected data on the dietary habits of immigrant populations living with IBD. Our aim was to describe the dietary practices and beliefs of British South Asians with IBD.MethodsA 30-item questionnaire was developed and consecutively administered to 255 British South Asians with IBD attending gastroenterology clinics in the United Kingdom.ResultsFifty-one percent of participants believed diet was the initiating factor for their IBD and 63% felt diet had previously triggered disease relapse. Eighty-nine percent avoided certain dietary items in the belief that this would prevent relapse. The most commonly avoided foods and drinks were spicy and fatty foods, carbonated drinks, milk products, alcohol, coffee, and red meat. A third of patients had tried a whole food exclusion diet, most commonly lactose- or gluten-free, and this was most frequently reported amongst those with clinically active IBD (P = 0.02). Almost 60% of participants avoided eating the same menu as their family, or eating out, at least sometimes, to prevent IBD relapse.ConclusionsBritish South Asians with IBD demonstrate significant dietary beliefs and food avoidance behaviors with increased frequency compared to those reported in Caucasian IBD populations. Studies in immigrant populations may offer valuable insights into the interaction between diet, Westernization and cultural drift in IBD pathogenesis and symptomatology.