Higher Emotional Eating Research Articles

Validation of the Japanese Version of the Yale Food Addiction Scale 2.0 (J-YFAS 2.0).

The Yale Food Addiction Scale 2.0 (YFAS 2.0) is used for assessing food addiction (FA). Our study aimed at validating its Japanese version (J-YFAS 2.0). The subjects included 731 undergraduate students. Confirmatory factor analysis indicated the root-mean-square error of approximation, comparative fit index, Tucker–Lewis index, and standardized root-mean-square residual were 0.065, 0.904, 0.880, and 0.048, respectively, for a one-factor structure model. Kuder–Richardson α was 0.78. Prevalence of the J-YFAS 2.0-diagnosed mild, moderate, and severe FA was 1.1%, 1.2%, and 1.0%, respectively. High uncontrolled eating and emotional eating scores of the 18-item Three-Factor Eating Questionnaire (TFEQ R-18) (p < 0.001), a high Kessler Psychological Distress Scale score (p < 0.001), frequent desire to overeat (p = 0.007), and frequent snacking (p = 0.003) were associated with the J-YFAS 2.0-diagnosed FA presence. The scores demonstrated significant correlations with the J-YFAS 2.0-diagnosed FA symptom count (p < 0.01). The highest attained body mass index was associated with the J-YFAS 2.0-diagnosed FA symptom count (p = 0.026). The TFEQ R-18 cognitive restraint score was associated with the J-YFAS 2.0-diagnosed FA presence (p < 0.05) and symptom count (p < 0.001), but not with the J-YFAS 2.0-diagnosed FA severity. Like the YFAS 2.0 in other languages, the J-YFAS 2.0 has a one-factor structure and adequate convergent validity and reliability.

Depression, emotional eating and long-term weight changes: a population-based prospective study

BackgroundEmotional eating (i.e. eating in response to negative emotions) has been suggested to be one mechanism linking depression and subsequent development of obesity. However, studies have rarely examined this mediation effect in a prospective setting and its dependence on other factors linked to stress and its management. We used a population-based prospective cohort of adults and aimed to examine 1) whether emotional eating mediated the associations between depression and 7-year change in body mass index (BMI) and waist circumference (WC), and 2) whether gender, age, night sleep duration or physical activity moderated these associations.MethodsParticipants were Finnish 25- to 74-year-olds who attended the DILGOM study at baseline in 2007 and follow-up in 2014. At baseline (n = 5024), height, weight and WC were measured in a health examination. At follow-up (n = 3735), height, weight and WC were based on measured or self-reported information. Depression (Center for Epidemiological Studies - Depression Scale), emotional eating (Three-Factor Eating Questionnaire-R18), physical activity and night sleep duration were self-reported. Age- and gender-adjusted structural equation models with full information maximum likelihood estimator were used in the analyses.ResultsDepression and emotional eating were positively associated and they both predicted higher 7-year increase in BMI (R2 = 0.048) and WC (R2 = 0.045). The effects of depression on change in BMI and WC were mediated by emotional eating. Night sleep duration moderated the associations of emotional eating, while age moderated the associations of depression. More specifically, emotional eating predicted higher BMI (P = 0.007 for the interaction) and WC (P = 0.026, respectively) gain in shorter sleepers (7 h or less), but not in longer sleepers (9 h or more). Depression predicted higher BMI (P < 0.001 for the interaction) and WC (P = 0.065, respectively) increase in younger participants, but not in older participants.ConclusionsOur findings offer support for the hypothesis that emotional eating is one behavioural mechanism between depression and development of obesity and abdominal obesity. Moreover, adults with a combination of shorter night sleep duration and higher emotional eating may be particularly vulnerable to weight gain. Future research should examine the clinical significance of our observations by tailoring weight management programs according to these characteristics.

From Socioeconomic Disadvantage to Obesity: The Mediating Role of Psychological Distress and Emotional Eating.

ObjectiveLower socioeconomic status is robustly associated with obesity; however, the underpinning psychological mechanisms remain unclear. The current study sought to determine whether the relationship between lower socioeconomic status and obesity is explained by psychological distress and subsequent emotional eating as a coping strategy. It also examined whether psychological resilience plays a protective role in this pathway.MethodsParticipants (N = 150) from a range of socioeconomic backgrounds completed questionnaire measures of psychological distress, emotional eating, and resilience. They reported their income and education level as an indicator of socioeconomic status and their height and weight in order to calculate BMI.ResultsThere was a significant indirect effect of socioeconomic status on BMI via psychological distress and emotional eating; specifically, lower socioeconomic status was associated with higher distress, higher distress was associated with higher emotional eating, and higher emotional eating was associated with higher BMI (b [SE] = −0.02 [0.01]; 95% CI: −0.04 to −0.01). However, resilience was not a significant moderator of this association.ConclusionsPsychological distress and subsequent emotional eating represent a serial pathway that links lower socioeconomic status with obesity. Targeting these maladaptive coping behaviors may be one strategy to reduce obesity in low‐income populations.

Comparison of Anthropometric Profile and Eating Behavior of Polycystic Ovarian Syndrome (PCOS) Patients with Healthy Controls

Introduction: Polycystic ovarian syndrome affects 4% to 23% women, worldwide. Obesity, insulin resistance and uncontrolled eating are usually reported in PCOS. However, there is paucity of data describing associations between eating disorder and PCOS. Aim: To compare the anthropometric profile and eating behavior polycystic ovarian syndrome cases with those of healthy age-matched women. Method: Eighty-five PCOS cases and 85 controls were selected for the study from Gyne OPD of PGIMER, Chandigarh. Anthropometric assessments were performed on the cases and controls. Three-Factor Eating Questionnaire (TFEQ-R21) was used for determining the eating behavior. In addition, the frequency of eating processed food from outside was recorded. Results: The average weight of the cases and controls was 65.16 kg and 57.07 kg, respectively. The average frequency of eating processed food in a month was 15 in cases and 4.41 among controls. The average raw score of uncontrolled eating was 23.26 (cases) in comparison to 18.97 (controls). Average raw scores of emotional eating were 12.67 in cases and 10.76 in controls. The cognitive restraint average raw scores were 11.34 (cases) and 13.62 (controls). The cases had higher BMI than the controls. Monthly consumption of processed food was three times higher than the controls in cases. Uncontrolled eating and emotional eating scores were significantly higher in cases. Conclusion: More of PCOS cases were overweight/ obese with higher BMI, and higher emotional eating and uncontrolled eating scores in comparison to the healthy controls.

Food addiction, in obese patients seeking bariatric surgery, is associated with higher prevalence of current mood and anxiety disorders and past mood disorders

The current cross-sectional study investigates the prevalence of the food addiction (FA) phenotype and its association with psychiatric disorders in bariatric surgery candidates. It also investigates the eating behavior characteristics associated with FA and the association between FA and loss of control over specific foods high in sugar, salt and/or fat. We included 128 bariatric surgery candidates and we assessed FA (YFAS 2.0), mood and anxiety disorders, suicidality, eating disorders (current bulimia nervosa and current anorexia nervosa), alcohol and tobacco use disorders (MINI 5.0.0, beck depression inventory, AUDIT, Fagerström Test for Nicotine Dependence) and eating behavior (DEBQ). Prevalence of FA in our sample was 25%. FA was significantly associated with higher prevalence of current mood and anxiety disorders and past mood disorders, higher current suicidality but not with eating disorders and alcohol use disorder. FA was significantly associated with higher emotional eating, and with loss of control over consumption of foods high in fat, sugar and/or salt, but not of fruits, vegetables or grain products. Our results provide arguments for considering psychiatric disorders and suicidality in FA and for considering FA as an addictive disorder in obese patients, with many risk factors in common with other addictions.

Development and validation of the Child Three-Factor Eating Questionnaire (CTFEQr17).

To develop and validate a child and adolescent version of the Three-Factor Eating Questionnaire (CTFEQr17) and to assess its psychometric properties and factor structure. We also examined associations between the CTFEQr17 and BMI and food preferences. A two-phase approach was utilized, employing both qualitative and quantitative methodologies. Primary and secondary schools, UK. In phase 1, seventy-six children (thirty-nine boys; mean age 12·3 (sd 1·4) years) were interviewed to ascertain their understanding of the original TFEQr21 and to develop accessible and understandable items to create the CTFEQr17. In phase 2, 433 children (230 boys; mean age 12·0 (sd 1·7) years) completed the CTFEQr17 and a food preference questionnaire, a sub-sample (n 253; 131 boys) had their height and weight measured, and forty-five children (twenty-three boys) were interviewed to determine their understanding of the CTFEQr17. The CTFEQr17 showed good internal consistency (Cronbach's α=0·85) and the three-factor structure was retained: cognitive restraint (CR), uncontrolled eating (UE) and emotional eating (EE). Qualitative data demonstrated a high level of understanding of the questionnaire (95 %). High CR was found to be significantly associated with a higher body weight, BMI and BMI percentile. High UE and EE scores were related to a preference for high-fat savoury and high-fat sweet foods. The relationships between CTFEQr17, anthropometry and food preferences were stronger for girls than boys. The CTFEQr17 is a psychometrically sound questionnaire for use in children and adolescents, and associated with anthropometric and food preference measures.

Eating styles in major depressive disorder: Results from a large-scale study

Depressed persons have been found to present disturbances in eating styles, but it is unclear whether eating styles are different in subgroups of depressed patients. We studied the association between depressive disorder, severity, course and specific depressive symptom profiles and unhealthy eating styles. Cross-sectional and course data from 1060 remitted depressed patients, 309 currently depressed patients and 381 healthy controls from the Netherlands Study of Depression and Anxiety were used. Depressive disorders (DSM-IV based psychiatric interview) and self-reported depressive symptoms (Inventory of Depressive Symptomatology) were related to emotional, external and restrained eating (Dutch Eating Behavior Questionnaire) using analyses of covariance and linear regression. Remitted and current depressive disorders were significantly associated with higher emotional eating (Cohen's d = 0.40 and 0.60 respectively, p < 0.001) and higher external eating (Cohen's d = 0.20, p = 0.001 and Cohen's d = 0.32, p < 0.001 respectively). Little differences in eating styles between depression course groups were observed. Associations followed a dose-response association, with more emotional and external eating when depression was more severe (both p-values <0.001). Longer symptom duration was also associated to more emotional and external eating (p < 0.001 and p = 0.001 respectively). When examining individual depressive symptoms, neuro-vegetative depressive symptoms contributed relatively more to emotional and external eating, while mood and anxious symptoms contributed relatively less to emotional and external eating. No depression associations were found with restrained eating. Intervention programs for depression should examine whether treating disordered eating specifically in those with neuro-vegetative, atypical depressive symptoms may help prevent or minimize adverse health consequences.

Emotional eating and instructed food-cue processing in adolescents: An ERP study

We examined the P3 (250–500ms) and Late Positive Potential (LPP; 500–2000ms) event-related potentials (ERPs) to food vs. nonfood cues among adolescents reporting on emotional eating (EE) behavior. Eighty-six adolescents 10–17 years old were tested using an instructed food versus nonfood cue viewing task (imagine food taste) during high-density EEG recording. Self-report data showed that EE increased with age in girls, but not in boys. Both P3 and LPP amplitudes were greater for food vs. nonfood cues (food-cue bias). Exploratory analyses revealed that, during the LPP time period, greater EE was associated with a more positive food-cue bias in the fronto-central region. This heightened fronto-central food-cue bias LPP is in line with a more activated prefrontal attention system. The results suggest that adolescents with higher EE may engage more top-down cognitive resources to regulate their automatic emotional response to food cues, and/or they may exhibit greater reward network activation to food cues than do adolescents with lower EE, even in the absence of an emotional mood induction.

Mediation of self-regulation and mood in the relationship of changes inhigh emotional eating and nutritional behaviors: Moderating effects ofphysical activity.

High emotional eating (EE) is prevalent in women with obesity. A previous study's subsample of obese women classified as high emotional eaters participated in either a physical activity-focused experimental (n=29) or an educationally focused comparison (n=22) behavioral treatment and was assessed over phases of expected weight loss (baseline-month 6) and short- and long-term regain (months 6-12 and 6-24, respectively). The study's aim was to assess theory-based psychological and behavioral mediation and moderation of changes in nutritional behaviors via emotional eating change in order to inform behavioral weight-loss treatments. During the weight-loss phase, significant improvements in eating self-regulation and mood significantly mediated the relationship of reduced EE and intake of both fruits and vegetables (FV) and sweets. Self-regulation was a significant independent mediator. Physical activity significantly moderated the relationship between EE and self-regulation changes. All variables demonstrated large positive effects and significant time×group interactions favoring the experimental group. During the short and long-term phases of expected weight regain, there were no significant changes in FV intake, although consumption of sweets significantly increased during months 6-24. Change in FV and sweets significantly predicted weight change, which was significantly greater in the experimental vs. comparison group over both the initial 6months (-6.1% vs. -2.6%) and full 24months of the study (-7.6% vs. -1.3%). Findings suggest that behavioral treatments should address EE through improvements in self-regulation and mood, and supported physical activity will aid in that process. The need for an improved understanding of weight-loss maintenance remains.

‘I ate too much so I must have been sad’: Emotions as a confabulated reason for overeating

BackgroundEmotional eating (i.e., overeating in response to negative affect) is a commonly accepted explanation for eating behaviors that are not in line with personal eating-norms. However, the empirical evidence for a causal link between self-reported emotional eating and overeating is mixed. The present study tested an alternative hypothesis stating that high emotional eating scores are indicative of a susceptibility to use negative affect as a confabulated, post-hoc reason to explain overeating. MethodsFemale students (N = 46) participated in a ‘taste-test’ and came back to the lab a day later to receive feedback that they either ate too much (norm-violation condition) or an acceptable amount of food (control condition), whereafter emotional eating was assessed. Negative affect was measured several times throughout the study. ResultsIn the norm-violation condition, participants with high emotional eating scores retrospectively rated their affect prior to eating as more negative than participants with low emotional eating scores. In the control condition, no effect of emotional score on affect ratings was found. DiscussionFor some individuals emotional eating scores may represent a tendency to retrospectively attribute overeating to negative affect. This could explain the lack of consistent findings for a link between self-reported emotional eating and overeating.

Dietary Intake, Behaviors and Psychosocial Factors Among Women from Food-Secure and Food-Insecure Households in the United States.

Determine whether macro- and micro-nutrient intake, energy intake, diet quality, adherence to recommended dietary intake, and psychosocial and behavioral factors are associated with household food security. Baseline data from in-person interviews and telephone-based, 24-hour dietary recall from women recruited to a diet and physical activity controlled trial. Neighborhoods encompassing 18 urban census tracts in South Carolina. Participants (n=202) were predominantly African American (87%), overweight or obese women aged 25 to 51 years with mean body mass index of 40.6±8.7. Macro- and micro-nutrient intake, energy intake, diet quality, adherence to recommended dietary intake (via multi-pass, 24-h recall); diet-related self-efficacy and social support, healthy/lowfat and emotional eating behaviors, and depressive symptoms. Women in food-secure (FS) and food insecure (FI) households were not different on health and sociodemographic characteristics. Women in FI households had lower self-efficacy and healthy/low-fat eating behaviors, and higher emotional eating and depressive symptoms compared with women in FS households. The groups did not differ on social support. Significant dietary differences were few (FS>FI on protein and lean meat; FS<FI on carbohydrate intake). For 29 of 35 (74%) dietary intake recommendations, less than 75% of women in both groups met each recommendation. While food security status was associated with diet-related psychosocial and behavioral factors, it was associated with few aspects of dietary intake. Dietary intake overall was poor. Participants were not meeting guidelines for a diet supportive of general health or weight loss and management, regardless of food security status.

Associations between dysfunctional eating behaviors and cardiovascular risk among Latinos

BackgroundLatinos bear high burden of nutrition‐related cardiovascular disease (CVD) risk factors. Dysfunctional eating behaviors including, emotional eating (EE), uncontrolled eating (UE) and cognitive restraint (CR) of eating could influence CVD risk factors but associations among these variables have been under‐researched.ObjectiveTo examine associations between dysfunctional eating behaviors and CVD risk factors among Latinos.MethodsLatino adults between the ages of 21–84 were recruited from primary care settings. Eating behaviors were assessed by the Three Factor Eating Questionnaire, CVD risk factors were assessed via self‐report (i.e., hypercholesterolemia) and medical chart review (i.e., diabetes), and anthropometrics (height, weight, waist circumference) and blood pressure were measured. Statistical analysis included binary logistic and Poisson regressions.ResultsA total of 568 participants (51.1% female, 66.7% Dominican) were included in this analysis. Controlling for age, sex and education, high EE, UE and CR were associated with greater odds of obesity (OR=1.82 (1.28, 2.57), OR=1.75 (1.23, 2.48), OR=2.18 (1.53, 3.11; respectively); high EE and CR were associated with diabetes (OR=1.57 (1.04, 2.38), OR=1.95 (1.28, 2.97); respectively); and high EE and UE were associated with hyperlipidemia (OR=1.83 (1.23, 2.73), OR=2.31 (1.54, 3.46); respectively). Lastly, high EE, UE and CR were significantly associated with greater risk of developing a greater number of CVD risk factors (IRR=1.26 (1.08, 1.46), IRR=1.29 (1.11, 1.49), IRR=1.27 (1.09, 1.48); respectively).ConclusionDysfunctional eating behaviors were associated with obesity, diabetes and hyperlipidemia in this Latino sample. Targeting dysfunctional eating behaviors may constitute an avenue for CVD risk factor prevention in this population. Further research is warranted to test whether reducing dysfunctional eating patterns impacts CVD risk factors among Latinos.Support or Funding InformationThis research is funded by: NIMH grant R01 MH085653; NIMHD grant 1 P60 MD006912‐02; and CDC grant U48 DP005031‐01.

Perceived stress and anhedonia predict short-and long-term weight change, respectively, in healthy adults

ObjectivePerceived stress; emotional eating; anhedonia; depression and dietary restraint, hunger, and disinhibition have been studied as risk factors for obesity. However, the majority of studies have been cross-sectional and the directionality of these relationships remains unclear. In this longitudinal study, we assess their impact on future weight change. MethodsPsychological predictors of weight change in short- (6month) and long-term (>1year) periods were studied in 65 lean and obese individuals in two cohorts. Subjects participated in studies of food intake and metabolism that did not include any type of medication or weight loss interventions. They completed psychological questionnaires at baseline and weight change was monitored at follow-up visits. ResultsAt six months, perceived stress predicted weight gain (r2=0.23, P=0.02). There was a significant interaction (r2=.38, P=0.009) between perceived stress and positive emotional eating, such that higher scores in both predicted greater weight gain, while those with low stress but high emotional eating scores lost weight. For long-term, higher anhedonia scores predicted weight gain (r2=0.24, P=0.04). Depression moderated these effects such that higher scores in both predicted weight gain but higher depression and lower anhedonia scores predicted weight loss. ConclusionThere are different behavioral determinants for short- and long-term weight change. Targeting perceived stress may help with short-term weight loss while depression and anhedonia may be better targets for long-term weight regulation.

The Dutch Eating Behavior Questionnaire: Further psychometric validation and clinical implications of the French version in normal weight and obese persons

This study tested the psychometric properties of the French version of the Dutch Eating Behavior Questionnaire (DEBQ) for normal weight and obese patients; determined the factors associated with each DEBQ score: emotional eating (eating in response to emotional arousal states such as fear, anger or anxiety), externality (eating in response to external food cues such as sight and smell of food), and restrained eating behavior/cognitive restraint (conscious efforts to limit and control dietary intake); and determined how to interpret the results from this scale to guide clinical practice. Between January 2009 and April 2009, we assessed non-paired normal weight persons (n=74) and all consecutive obese patients consulting in the Nutrition Ward of the University Hospital of Tours (n=75; including bariatric surgery patients) using the DEBQ. We tested the scale's factor structure using a factor analysis for ordinal data and internal consistency for each DEBQ dimension. Our results supported a three-factor structure for both normal weight and obese patients. The Cronbach's alpha coefficients were excellent for emotional eating and externality (α≥0.90) and good for cognitive restraint (α≥0.81). The emotional eating and cognitive restraint scores were higher for women (P<0.001) and obese patients (P<0.05). Higher cognitive restraint was associated with higher current and previous BMI (P<0.01). For patients who had bariatric surgery, higher length of time since surgery was significantly associated with higher externality (ρ=0.359; P≤0.05) and marginally associated with higher cognitive restraint (ρ=0.294; P=0.10) and higher emotional eating (ρ=0.302; P=0.10). Our results support a three-dimensional factor structure for the French version of the DEBQ for normal weight and obese patients. We propose the chance to change hypothesis to explain results for bariatric surgery patients: patients experience a beneficial but transient decrease in externality, emotionality and cognitive restraint, and this period of time gives the patient a chance for cognitive, behavioral and emotional change. This critical period should be well prepared before surgery to improve the patient's postoperative success, by tackling each factor that could diminish the chances for success as soon as possible (e.g., early screening and treatment for psychiatric disorders).

Recognizing disordered eating in primary care patients with obesity

ObjectiveIn clinical practice, behavioral approaches to obesity treatment focus heavily on diet and exercise recommendations. However, these approaches may not be effective for patients with disordered eating behaviors. Little is known about the prevalence of disordered eating behaviors in primary care patients with obesity or whether they affect difficulty making dietary changes. MethodsWe conducted a telephone interview of 337 primary care patients aged 18–65years with BMI≥35kg/m2 in Greater Boston, 2009–2011 (58% response rate, 69% women). We administered the Three-Factor Eating Questionnaire R-18 (scores 0–100) and the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) (scores 0–100). We measured difficulty making dietary changes using four questions regarding perceived difficulty changing diet (Scores 0–10). Results50% of the patients reported high emotional eating (score>50) and 28% reported high uncontrolled eating (score>50). Women were more likely to report emotional [OR=4.14 (2.90, 5.92)] and uncontrolled eating [OR=2.11 (1.44, 3.08)] than men. African-Americans were less likely than Caucasians to report emotional [OR=0.29 (95% CI: 0.19, 0.44)] and uncontrolled eating [OR=0.11 (0.07, 0.19)]. For every 10-point reduction in QOL score (IWQOL-lite), emotional and uncontrolled eating scores rose significantly by 7.82 and 5.48, respectively. Furthermore, participants who reported emotional and uncontrolled eating reported greater difficulty making dietary changes. SummaryDisordered eating behaviors are prevalent among obese primary care patients and disproportionately affect women, Caucasians, and patients with poor QOL. These eating behaviors may impair patients' ability to make clinically recommended dietary changes. Clinicians should consider screening for disordered eating behaviors and tailoring obesity treatment accordingly.

Effects of Roux-en-Y gastric bypass surgery on eating behaviour and allopregnanolone levels in obese women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is associated with abnormal eating habits. We examined whether surgical treatment affected allopregnanolone levels and eating behaviour in nine women with PCOS who qualified for Rou-en-Y gastric bypass surgery. Blood samples were obtained to measure sex-hormone-binding globulin, total testosterone, progesterone, and allopregnanolone, and eating behaviour was evaluated using the Three-Factor Eating Questionnaire before surgery and at 6 and 12 months after surgery. Body mass index and total testosterone levels decreased, and progesterone and sex-hormone-binding globulin levels increased after bariatric surgery compared with pre-surgical values. In patients with anovulatory menstrual cycles, both the serum allopregnanolone level and the allopregnanolone/progesterone ratio were unchanged after surgery. The patients had high uncontrolled and emotional eating scores, and low cognitive restraint scores before surgery, and these scores had improved significantly at 6 and 12 months after surgery. The presurgical allopregnanolone levels were significantly correlated with uncontrolled eating. In conclusion, these results suggest that allopregnanolone appear to be part of the mechanism underlying the abnormal eating behaviour of obese PCOS patients by causing the loss of control over food intake. Roux-en-Y gastric bypass surgery can improve eating behaviour and clinical symptoms, and may facilitate weight loss in obese women with PCOS.

Macro and micronutrient differences of AD—libitum palaeolithic vs Australian guide to healthy eating diets

s / Journal of Nutrition & Intermediary Metabolism 1 (2014) 1e55 26 out/in social situations, higher emotional eating, and lower knowledge regarding the effect of diet on health (all p < 0.001; consistent across subgroups). Conclusions: Diet and nutrition education present an important target for primary care of people with SMI. Targeting at-risk populations also presents an opportunity for prevention. Although research has identified the contribution of individual nutrients to mental health, further research needs to elucidate the role of whole diet and nutrition and mental illness. Funding source(s): N/A. MACRO AND MICRONUTRIENT DIFFERENCES OF ADdLIBITUM PALAEOLITHIC VS AUSTRALIAN GUIDE TO HEALTHY EATING DIETS A. Genoni , A. Devine , J. Lo , P. Lyons-Wall . 1 School of Exercise and Health Sciences, Perth, WA, Australia; 2 School of Engineering, Edith Cowan University, Perth, WA, Australia E-mail: agenoni@our.ecu.edu.au (A. Genoni) Background/Aims: To investigate the differences in the macronutrient composition between the palaeolithic and AGHE Diet. Methods: Thirty nine healthy women (mean ± SD age 47 ± 13 years, BMI 27 ± 4 kg/m2) were randomised to either the palaeolithic (n1⁄4 22) or AGHE diet (n 1⁄4 17) for 4-weeks. A 3-day weighed food record (WFR) was collected preand post-intervention. WFR were analysed using FoodWorks (AUSNUT2007, Xyris Software, QLD, 2012). Within group analysis was performed using paired t-tests, between group analysis was conducted using Mann-Whitney and independent t-tests. Results: The palaeolithic group had a lower intake of carbohydrate (28 ± 8% vs 41 ± 9% of energy, p < 0.05), and higher intake of fat (40 ± 10% vs 33 ± 7%, p < 0.05) and protein (27 ± 7% vs 22 ± 6%, p < 0.05) compared to AGHE. Within group analyses showed reductions in saturated fat intake in both groups (p < 0.05) but no change to dietary fibre or total sugars. Within the palaeolithic group, there were significant reductions in energy, thiamin, riboflavin, sodium and calcium and increases in vitamins C, E and bcarotene (all p < 0.05). Conclusions: Despite the reduction in carbohydrates due to the removal of whole grain cereals and dairy, fibre intake was not impacted in the palaeolithic group. However, significant reductions in B vitamins and calcium were seen. Further research to explore the health implications related to long-term palaeolithic dietary patterns are recommended. Funding source(s): N/A. LONG-TERM EFFECTS OF VERY LOWAND HIGH-CARBOHYDRATE WEIGHT LOSS DIETS ON MOOD RESPONSE IN OBESE ADULTS WITH TYPE 2 DIABETES G.D. Brinkworth , N.D. Luscombe-Marsh , C.H. Thompson , M. Noakes , J.D. Buckley , G. Wittert , C.J. Wilson . CSIRO Food and Nutrition, SA, Australia; Department of Medicine, University of South Australia, SA, Australia; Nutritional Physiology Research Centre, University of South Australia, SA, Australia; 4 School of Medicine, Flinders University,

The Associations between Emotional Eating and Consumption of Energy-Dense Snack Foods Are Modified by Sex and Depressive Symptomatology

In recent years, emotional eating (EmE) has incited substantial research interest as an important psychologic determinant of food intake and overweight. However, little is known about factors that might modulate its relations with dietary habits. The objective of this study was to examine the association between EmE and consumption of energy-dense snack food and assess the 2-way interaction of EmE with sex and depressive symptoms. A total of 7378 men and 22,862 women from the NutriNet-Santé cohort (France, 2009–2013) who completed ≥6 self-reported 24-h food records were included in this cross-sectional analysis. EmE was evaluated via the revised 21-item Three-Factor Eating Questionnaire. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale. The associations between EmE and energy-dense food consumption were assessed by multivariable logistic and linear regression models adjusted for sociodemographic and lifestyle factors. Higher EmE was associated with higher consumption of energy-dense snacks and, in particular, with consumption of sweet-and-fatty foods across most categories studied. However, these associations were stronger in women with depressive symptoms (e.g., high consumption of chocolate, OR: 1.77, 95% CI: 1.43, 2.20; cakes/biscuits/pastries, OR: 1.81, 95% CI: 1.45, 2.26) compared with those without depressive symptoms (e.g., high consumption of chocolate, OR: 1.52, 95% CI: 1.36, 1.69; cakes/biscuits/pastries, OR: 1.44, 95% CI: 1.29, 1.61). In contrast, the significant positive associations observed in men without depressive symptoms (e.g., high consumption of chocolate, OR: 1.33, 95% CI: 1.16, 1.52; cakes/biscuits/pastries, OR: 1.28, 95% CI: 1.11, 1.48) were not found in men with depressive symptoms. In conclusion, in women, EmE was positively associated with consumption of energy-dense snack food, particularly in those with depressive symptoms. For men, the relation between EmE and energy-dense snack foods was found only in those without depressive symptoms. These findings call for consideration of the psychologic state when targeting unhealthy dietary habits, especially in women. This trial was registered at eudract.ema.europa.eu as 2013-000929-31.

Hunger, inhibitory control and distress-induced emotional eating

Self-reported emotional eating has been found to significantly moderate distress-induced food intake, with low emotional eaters eating less after a stress task than after a control task and high emotional eaters eating more. The aim of the present study was to explore possible underlying mechanisms by assessing possible associations with (1) ability to experience the typical post-stress reduction of hunger and (2) inhibitory control. We studied these effects in 54 female students who were preselected on the basis of extremely high or low scores on an emotional eating questionnaire. Using a within subject design we measured the difference of actual food or snack intake after a control or a stress task (Trier Social Stress Test). As expected, the moderator effect of emotional eating on distress-induced food intake was found to be only present in females with a failure to report the typical reduction of hunger immediately after a stress task (an a-typical hunger stress response). Contrary to our expectations, this moderator effect of emotional eating was also found to be only present in females with high ability to stop motor impulses (high inhibitory control). These findings suggest that an a-typical hunger stress response but not poor inhibitory control may underlie the moderator effect of emotional eating on distress-induced food intake. However, inhibitory control may play a role whether or not there is a moderator effect of self-reported emotional eating on distress-induced food intake.

Perplexities of treatment resistance in eating disorders.

BackgroundTreatment resistance is an omnipresent frustration in eating disorders. Attempts to identify the features of this resistance and subsequently develop novel treatments have had modest effects. This selective review examines treatment resistant features expressed in core eating disorder psychopathology, comorbidities and biological features. Novel treatments addressing resistance are discussed.DescriptionThe core eating disorder psychopathology of anorexia nervosa becomes a coping mechanism likely via vulnerable neurobiological features and conditioned learning to deal with life events. Thus it is reinforcing and ego syntonic resulting in resistance to treatment. The severity of core features such as preoccupations with body image, weight, eating and exercising predicts greater resistance to treatment. Bulimia nervosa patients are less resistant to treatment with treatment failure related to greater body image concerns, impulsivity, depression, severe diet restriction and poor social adjustment. For those with binge eating disorder overweight in childhood and high emotional eating predicts treatment resistance. There is suggestive data that a diagnosis of an anxiety disorder and severe perfectionism may confer treatment resistance in anorexia nervosa and substance use disorders or personality disorders with impulse control problems may produce resistance to treatment in bulimia nervosa. Traits such as perfectionism, cognitive inflexibility and negative affect with likely genetic influences may also affect treatment resistance. Pharmacotherapy and novel therapies have been developed to address treatment resistance. Atypical antipsychotic drugs have shown some effect in treatment resistant anorexia nervosa and topiramate and high doses of SSRIs are helpful for treatment of resistant binge eating disorder patients. There are insufficient randomized controlled trials to evaluate the novel psychotherapies which are primarily based on the core psychopathological features of the eating disorders.ConclusionTreatment resistance in eating disorders is usually predicted by the severity of the core eating disorder psychopathology which develops from an interaction between environmental risk factors with genetic traits and a vulnerable neurobiology. Future investigations of the biological features and neurocircuitry of the core eating disorders psychopathology and behaviors may provide information for more successful treatment interventions.