Restrictive Eating Behavior Research Articles

14-18 Yaş Arası Ergenler için Bozulmuş Yeme Ölçeği’nin Geliştirilmesi

This study aimed to develop a scale for evaluating disordered eating attitudes and behaviors among adolescents aged 14 to 18. The scale’s factor structure was examined with a total of 1379 participants, revealing 14 items and three sub-dimensions that accounted for 58.46% of the total variance. The scale demonstrated good internal consistency (Cronbach’s alpha = .86) and test-retest reliability (r = .90). Regarding criterion validity, the correlation between the Disordered Eating Scale (DES) and the Eating Disorder Examination Questionnaire (EDE-Q) was found to be .86. Receiver operating characteristic (ROC) analysis results indicated a sensitivity of .930 and a specificity of .91 for the ≥31 cut-off point. Confirmatory factor analysis (CFA) was conducted, and the model fit indexes for both applications were as follows: x2 = 287.43, df = 73, x2/df = 3.94, RMSEA = 0.079, CFI = 0.938, TLI = 0.922, and SRMR = 0.045. These findings supported the three-dimensional model, suggesting that disordered eating can be measured through restriction, weight anxiety, and extraction-control behaviors dimensions with a total of 14 items. The DES is deemed suitable for screening and evaluating negative eating behaviors and potential psychopathology in adolescents, including those with and without clinical eating disorder symptoms.

Affective processes underlying restrictive eating in atypical anorexia nervosa: Comparisons to anorexia nervosa and bulimia nervosa using ecological momentary assessment.

Certain symptom and risk/maintenance factor similarities between individuals with atypical anorexia nervosa (AN) and 'typical' AN have been documented, but few studies have investigated how atypical AN compares to bulimia nervosa (BN). Further, the role of affective mechanisms in maintaining restrictive eating in atypical AN has not been examined. The current study investigated whether atypical AN resembles AN and/or BN on affect-related processes using questionnaires and ecological momentary assessment (EMA). Women with atypical AN (n = 24), AN-restrictive subtype, (n = 27), AN-binge eating/purging subtype (n = 34), and BN (n = 58) completed questionnaires measuring depressive symptoms and emotion regulation difficulties. They also completed a 14-day EMA protocol during which they reported negative and positive affect and skipped meals five times/day (signal-contingent surveys) and restrictive eating after meals/snacks (event-contingent surveys). Diagnostic groups generally did not differ on questionnaire measures nor affective patterns surrounding restrictive eating behaviors. Momentary changes in affect did not predict or follow restriction at meals/snacks, though higher momentary negative affect ratings predicted skipped meals, and higher positive affect was reported after skipped meals. Greater average negative affect and lower average positive affect predicted both restrictive eating behaviors. Across diagnoses, reductions in food intake do not appear to be influenced by momentary changes in affect, though skipping meals may serve an emotion regulation function. Atypical AN seems to resemble AN and BN on affective processes underlying restrictive eating, raising further questions regarding the unique diagnosis of atypical AN. Though atypical anorexia appears to strongly resemble anorexia nervosa, it is less clear how this disorder relates to bulimia nervosa. It is further unknown whether affective-related processes underlie restrictive eating in atypical anorexia nervosa, and how these processes compare to those in anorexia nervosa and bulimia nervosa. Results suggest that atypical anorexia does not differ from anorexia nervosa or bulimia nervosa on emotion-related measures, nor in affective patterns surrounding restrictive eating behaviors.

RISK FACTORS FOR THE DEVELOPMENT OF CARDIOVASCULAR DISEASES IN ADOLESCENTS IN YAKUTSK, SAKHA REPUBLIC (YAKUTIA)

The article presents data on the frequency of risk factors for cardiovascular diseases in adolescents. A statistical analysis was also conducted to determine the correlations between the risk factors when an individual has multiple risk factors. The following risk factors for cardiovascular diseases, already occurring frequently in adolescence, were evaluated: high blood pressure, overweight, elevated cholesterol levels, carbohydrate metabolism disorders, low physical activity, eating disorders, and stress perception. A total of 712 adolescents aged 15 –16 years were examined, including 360 girls and 352 boys, residing in the city of Yakutsk, Sakha Republic (Yakutia). The study revealed that among adolescents, low physical activity showed the highest frequency among the risk factors, followed by others in descending order: restrictive eating behavior, high cholesterol and glucose levels, overweight and obesity, and high stress perception. The differences found were based on gender, with boys being more susceptible to obesity. Correlation analyses using Spearman’s (rs) and Pearson’s (rp) coefficients and Pearson’s chi-square test were used to identify relationships between risk factors for cardiovascular diseases. The analysis showed that high blood pressure is associated with adolescents who have high body mass index. Gender-based analysis showed that girls are more prone to arterial pressure disorders and elevated cholesterol and glucose levels.

The role of short-chain fatty acids (SCFAs) in regulating stress responses, eating behavior, and nutritional state in anorexia nervosa: protocol for a randomized controlled trial

ObjectiveThis protocol proposes investigating the effects of short-chain fatty acids (SCFAs)—namely acetate, propionate, and butyrate—as mediators of microbiota-gut-brain interactions on the acute stress response, eating behavior, and nutritional state in malnourished patients with anorexia nervosa (AN). SCFAs are produced by bacterial fermentation of dietary fiber in the gut and have recently been proposed as crucial mediators of the gut microbiota's effects on the host. Emerging evidence suggests that SCFAs impact human psychobiology through endocrine, neural, and immune pathways and may regulate stress responses and eating behavior.MethodWe will conduct a randomized, triple-blind, placebo-controlled trial in 92 patients with AN. Patients will receive either a placebo or a mixture of SCFAs (acetate propionate, butyrate) using pH-dependent colon-delivery capsules for six weeks. This clinical trial is an add-on to the standard inpatient psychotherapeutic program focusing on nutritional rehabilitation.HypothesesWe hypothesize that colonic SCFAs delivery will modulate neuroendocrine, cardiovascular, and subjective responses to an acute laboratory psychosocial stress task. As secondary outcome measures, we will assess alterations in restrictive eating behavior and nutritional status, as reflected by changes in body mass index. Additionally, we will explore changes in microbiota composition, gastrointestinal symptoms, eating disorder psychopathology, and related comorbidities.DiscussionThe findings of this study would enhance our understanding of how gut microbiota-affiliated metabolites, particularly SCFAs, impact the stress response and eating behavior of individuals with AN. It has the potential to provide essential insights into the complex interplay between the gut, stress system, and eating behavior and facilitate new therapeutic targets for stress-related psychiatric disorders.This protocol is prospectively registered with ClinicalTrials.gov, with trial registration number NCT06064201.

Relationships Between Three Eating Behaviors and Nine Motives for Food Choices Among Brazilian Adults: A Structural Equation Model.

We examined the relationships between three eating behaviors and nine motives underlying food choices made by Brazilian adults. Using participant responses to the short version of the Three-Factor Eating Questionnaire and the Food Choice Questionnaire, we investigated eating behaviors (cognitive restriction, uncontrolled eating, and emotional eating) and motives for food choices (health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity, and ethical concern). We used a structural equation model to test relationship pathways (β), with eating behaviors as independent variables and motives for food choices as dependent variables. Participants were 1297 individuals (69.5% female) with a mean age of 25.0 years (SD = 5.8). We confirmed the validity and reliability of the questionnaires in this sample. Restrictive eating behavior was significantly related to motives of health (β = .415), mood (β = .127), natural content (β = .364), weight control (β = .681), and ethical concern (β = .161). Emotional eating behavior was related to motives of mood (β = .277), health (β = -.137), and natural content (β = -.136). Uncontrolled eating behavior was related to motives of convenience (β = .226), sensory appeal (β = .121), price (β = .153), and familiarity (β = .090). We believe these findings can now help design future research and clinical interventions for managing people's risky eating behaviors and promoting beneficial food choices.

Self-managed dietary changes and functional gut symptoms in endometriosis: A qualitative interview study.

Endometriosis is a chronic gynaecological condition, often causing gastrointestinal symptoms and misdiagnosed as irritable bowel syndrome (IBS). Endometriosis guidelines do not formally endorse dietary changes and little is known about how they are self-managed. The objective of this study is to understand nutritional practices and management of gut symptoms in people with endometriosis. Participants were recruited as part of a larger survey study via endometriosis support groups on social media. Eligibility criteria were: a self-reported physician-led diagnosis of endometriosis, over 18 years old and residing in the United Kingdom (UK). Semi-structured interviews were undertaken virtually via Zoom using a predefined interview guide. All interviews were transcribed and analysed using thematic analysis. 10 people with endometriosis were interviewed. All had made individual dietary changes to manage their gut-related endometriosis symptoms. Dietary changes were made based on advice from social media support, books, websites or professionals other than dietitians. Changes included the restriction and exclusion of multiple essential food groups, including dairy, grains (primarily gluten), vegetables, fruits, and animal products. These changes impacted participants' weight, nutritional status and relationship with food. Four strong themes were identified: 1) impact of pain 2) severe and unpredictable gut symptoms 3) dietary changes and their impact 4) seeking support for dietetic intervention. A common thread underlying and linking these four main themes was the feeling of being dismissed, care being delayed and lack of support. Overall the long delay waiting for a diagnosis, surgery and, at times, the re-occurrence of symptoms post-surgery led to unsupported trial and error with modifiable lifestyle factors, including diet. Overall, participants demonstrated some patterns of restrictive eating behaviour and wanted more professional support to help manage their endometriosis-related gut symptoms. This highlights the need for dietitians to be involved in endometriosis care to help alleviate gut symptoms, whilst ensuring nutritional adequacy and offering weight management support where required.

The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traits

Avoidant restrictive food intake disorder (ARFID) is a new eating disorder with a heterogeneous clinical presentation. It is unclear which patient characteristics contribute to its heterogeneity. To identify these patient characteristics, we performed symptom-level correlation and driver-level regression analyses in our cross-sectional study in up to 261 ARFID patients (51% female; median age=12.7 years) who were assessed at the Maudsley Centre for Child and Adolescent Eating Disorders, London between November 2019 and July2022. Symptoms across the three drivers 1) avoidance based on sensory characteristics of food; 2) apparent lack of interest in eating; and 3) concern about aversive consequences positively correlated with each other. Patients' anxiety traits showed the greatest positive correlations with symptoms of concern about aversive consequences of eating. Patient sex was not significantly associated with any of the three ARFID drivers. Patients with comorbid autism spectrum disorder (ASD; 28%) showed more food-related sensory sensitivities (RR=1.26) and greater lack of interest in eating (RR=1.18) than those of patients without ASD (49%). In our clinical sample, the ARFID drivers occurred together and did not show clinically meaningful differences between the sexes. ASD may accentuate food-related sensory sensitivities and lack of interest, but may not drive a completely different symptom presentation. ARFID is multi-faceted and heterogenous, requiring a comprehensive multidisciplinary assessment to sufficiently understand the drivers of the restrictive eating behaviour. Results need replication in larger samples with more statistical power. None.

Neural activation of regions involved in food reward and cognitive control in young females with anorexia nervosa and atypical anorexia nervosa versus healthy controls

Anorexia nervosa (AN) and atypical AN (AtypAN) are complex neurobiological illnesses that typically onset in adolescence with an often treatment-refractory and chronic illness trajectory. Aberrant eating behaviors in this population have been linked to abnormalities in food reward and cognitive control, but prior studies have not examined respective contributions of clinical characteristics and metabolic state. Research is needed to identify specific disruptions and inform novel intervention targets to improve outcomes. Fifty-nine females with AN (n = 34) or AtypAN (n = 25), ages 10–22 years, all ≤90% expected body weight, and 34 age-matched healthy controls (HC) completed a well-established neuroimaging food cue paradigm fasting and after a standardized meal, and we used ANCOVA models to investigate main and interaction effects of Group and Appetitive State on blood oxygenation level-dependent (BOLD) activation for the contrast of exposure to high-calorie food images minus objects. We found main effects of Group with greater BOLD activation in the dorsal anterior cingulate cortex (dACC), dorsolateral prefrontal cortex (DLPFC), hippocampus, caudate, and putamen for AN/AtypAN versus HC groups, and in the three-group model including AN, AtypAN, and HC (sub-)groups, where differences were primarily driven by greater activation in the AtypAN subgroup versus HC group. We found a main effect of Appetitive State with increased premeal BOLD activation in the hypothalamus, amygdala, nucleus accumbens, and caudate for models that included AN/AtypAN and HC groups, and in BOLD activation in the nucleus accumbens for the model that included AN, AtypAN, and HC (sub-)groups. There were no interaction effects of Group with Appetitive State for any of the models. Our findings demonstrate robust feeding-state independent group effects reflecting greater neural activation of specific regions typically associated with reward and cognitive control processing across AN and AtypAN relative to healthy individuals in this food cue paradigm. Differential activation of specific brain regions in response to the passive viewing of high-calorie food images may underlie restrictive eating behavior in this clinical population.

Exploring the relationship between food disgust and avoidant/restrictive food intake disorder (ARFID) presentations in a non-clinical collegiate sample.

Disgust is an established mechanism driving restrictive eating behavior. Avoidant/restrictive food intake disorder (ARFID) is a restrictive eating disorder diagnosis characterized by extremely selective eating with three hypothesized presentations. It has been suggested that disgust is significantly associated with ARFID; however, there is limited empirical research to support this hypothesis. This study explores relationships between food-specific disgust, ARFID symptoms, and ARFID presentations. Undergraduate students (n = 443, Mage = 19.14 years [SD = 1.25], 50.1% female, 52.7% White) completed a validated measure of food-specific disgust and an established self-report screening tool for the likely presence of ARFID and hypothesized ARFID presentations. Sixty-nine (14.5%) participants screened positively for the likely presence of ARFID. Food disgust did not differ between those who did and did not screen positively for ARFID (p > .05). Within the subsample of those screening positive for ARFID, disgust was not related to any of the three hypothesized presentations of ARFID (all p > .05). Our results did not show a significant association between disgust and positive ARFID screen or any of the hypothesized ARFID presentations. Importantly, these negative findings were obtained using validated screening tools for ARFID. Future research should seek to replicate these findings in clinical samples to further inform treatment. Avoidant/restrictive food intake disorder (ARFID) is associated with significant medical and psychosocial complications, but the mechanism involved in its development and maintenance remain poorly understood. Findings from this study of college students screening positively for ARFID suggests that food disgust in not a key driver of ARFID symptoms. Exposure-based approaches, which are generally not thought to be effective in targeting disgust, may thus be appropriate in the treatment of ARFID.

The role of the brain-derived neurotrophic factor (BDNF) in anorexia nervosa

The brain-derived neurotrophic factor (BDNF) is a growth factor belonging to the neurotrophin family which plays a pivotal role in the differentiation, survival, and plasticity of neurons in the central nervous system. Evidence suggests that BDNF is an important signal molecule in the regulation of energy balance and thus implicated in body weight control. The discovery of BDNF-expressing neurons in the paraventricular hypothalamus which is important in the regulation of energy intake, physical activity, and thermogenesis gives more evidence to the suggested participation of BDNF in eating behavior. Until now it remains questionable whether BDNF can be used as a reliable biomarker for eating disorders such as anorexia nervosa (AN) as available findings on BDNF levels in patients with AN are ambiguous. AN is an eating disorder characterized by a pathological low body weight in combination with a body image disturbance typically developing during adolescence. A severe drive for thinness leads to restrictive eating behavior often accompanied by physical hyperactivity. During therapeutic weight restoration an increase of BDNF expression levels seems desirable as it might improve neuronal plasticity and survival which is essential for learning processes and thereby essential for the success of the psychotherapeutic treatment of patients. On the contrary, the well-known anorexigenic effect of BDNF might favor relapse in patients as soon as the BDNF levels significantly increase during weight rehabilitation. The present review summarizes the association between BDNF and general eating behavior and especially focuses on the eating disorder AN. In this regard findings from preclinical AN studies (activity-based anorexia model) are outlined as well.

Understanding the Link between Childhood Emotional Abuse and Eating Behaviors: The Mediating Role of Self-Criticism

ABSTRACT Childhood neglect and abuse, defined as risk factors for various psychopathologies are significant for forming disordered eating behaviors. Nevertheless, the effect of childhood emotional abuse on eating behaviors and the mechanisms through which this relationship forms still need to be understood. This study tested the mediating role of self-criticism (hated and inadequate self) between childhood emotional abuse and eating behaviors (emotional, uncontrolled, and cognitive restricted eating). A total of 430 undergraduate students (66.3% female, N = 285) have completed measures related to emotional abuse, self-criticism, and eating behaviors. The Structural Equation Model supported the mediating role of self-criticism in the relationship between childhood emotional abuse and eating behaviors. Results indicated that self-criticism explained 12% of the eating behaviors. The indirect effect of self-criticism is significant for obesity-related eating behaviors and restricted eating behavior. In addition, results predict gender differences in eating behaviors. All these findings suggest that eating behaviors may emerge as a dysfunctional way of dealing with negative self-evaluation due to emotional abuse in childhood. Therefore, the study contributes to understanding the underlying processes of unhealthy eating behaviors that can be seen as a premise of eating pathologies.

ОСОБЕННОСТИ ЛИЧНОСТИ И ВРЕМЕННОЙ ПЕРСПЕКТИВЫ У ПОДРОСТКОВ С РАССТРОЙСТВАМИ ПИЩЕВОГО ПОВЕДЕНИЯ

The work presents the results of a study in the relationship between eating behaviors and the temporal perspective of personality, as well as the personality characterological features among older adolescents. Using the Dutch Eating Questionnaire (DEBQ) the authors identifie restrictive, emotive and external eating behaviors. The characteristics of adolescents are analyzed on the basis of the modified A. Lichko PDO questionnaire. The temporal perspective of personality is considered in accordance with the model of F. Zimbardo. Significant bilateral positive links were found between the orientation of adolescents to the negative past and restrictive and emotive types of eating behavior. The study obtained a significant positive correlation between restrictive eating behavior and the following accentuations: cycloid type, sensitive type, excitable type; between emotive eating behavior and hyperthymic, asthenoneurotic, sensitive types. As a result of the study, no significant relationships were found between external eating behavior and character accentuations.

Sleep quality, emotional and behavioral disturbances, and eating behavior in adolescents with obesity: a network analysis-based model

To attempt to identify persistent associations between sleep quality, symptoms of emotional and behavioral disturbances, and characteristics of eating behavior in obese adolescents based on a network analysis. The study included 194 adolescents, aged 12-17 years (76 girls, 118 boys), with a confirmed diagnosis of obesity due to excess calories (ICD-10 code E66.0). Sleep quality was studied on the basis of the Adolescent Sleep Wake Scale (ASWS), emotional and behavioral disturbances were assessed with the Achenbach Youth Self-Report for Ages 11-18 (YSR), eating behavior - with the Dutch Eating Behavior Questionnaire (DEBQ). Network analysis was used to identify the most significant and stable associations between the studied indicators. The association of poor sleep quality with manifestations of disinhibited behavior in the form of violations of the rules of behavior, aggressiveness, and impaired attention was revealed. Positive correlations between the manifestations of disinhibited behavior (primarily, rule-breaking behavior) and emotional eating behavior, which, in turn, had a positive relationship with external and a negative relationship with restrictive eating behavior, were noted. The disinhibited adolescent behavior is linked with uncontrolled food intake, which can contribute to the development of obesity. Impaired sleep quality, symptoms of emotional and behavioral disorders, and eating disorders in obese adolescents present a stable and specific clinical pattern that should be taken into account when justifying therapy.

Cognitive behaviour therapy (CBT) as a psychological intervention in the treatment of ARFID for children and young people

AbstractAvoidant Restrictive Food Intake Disorder (ARFID) is a condition characterised by a disturbance in eating behaviour that leads to a significant negative impact on physical, social and nutritional health. The diagnosis of ARFID relies on a comprehensive, multi-disciplinary assessment to understand the individual’s history, physical, social and mental health risk, and any co-occurring mental health difficulties. Consensus guidance suggests that psychological treatment, alongside medical and dietetic input is delivered with consideration of any appropriate adaptions to accommodate developmental stage and/or common co-occurring presentations. This paper has been authored by clinicians working in an out-patient setting for children and adolescents with ARFID, and focuses on the presentation and assessment of ARFID and cognitive behavioural therapy (CBT) approaches that can help children, young people and their families. After an introductory section, the paper is split into four sections: assessment of ARFID; drivers of avoidant restrictive eating behaviour; multi-disciplinary formulation and intervention planning; and treatment. The treatment section provides an overview of the available research on CBT for ARFID, and a brief summary of the broader evidence base for CBT in children and young people with anxiety. Following a review of the evidence base, three case descriptions are provided to illustrate the clinical application of CBT where fear-based avoidance is the main driver. The paper concludes with practice points for clinicians to take forward when working with children and young people with ARFID.Key learning aims(1)To be aware of the international consensus for the use of psychological interventions as a component of ARFID treatment alongside medical and dietetic input.(2)To understand that ARFID is characterised as a disturbance of eating behaviour, and as such, psychological intervention should target the drivers of this disturbance to promote behavioural change.(3)To gain an overview of the multi-disciplinary team assessment as an important tool to understand the contribution of each of the three drivers proposed to underpin an ARFID presentation.(4)To recognise when a CBT approach might be indicated, the current best evidence base for CBT for ARFID and how to adapt CBT to accommodate developmental stage and/or common co-occurring presentations.

Ergenlerde Ayrılma-Bireyleşme Düzeyi ve Cinsiyete Göre Beden Algısı, Duygu Düzenleme Güçlüğü ve Yeme Tutumu

Bu çalışmada, ergenlerde yeme tutumunu belirleyen etkenler olarak beden algısı
 ve duygu düzenleme güçlüğünün etkisinin incelenmesi amaçlanmıştır. Aynı zamanda,
 ergenlerin ayrılma - bireyleşme düzeylerinin ve cinsiyetin yeme tutumunda ne şekilde
 belirleyici olduğu değerlendirilmiştir. Bu amaçla, 18-22 yaş arasındaki 424 katılımcıya
 Duygu Düzenleme Güçlüğü Ölçeği, Ayrılma Bireyselleşme Ölçeği, Hollanda Yeme Davranışı
 Anketi (DEBQ), Beden Algısı Ölçeği uygulanmıştır. Elde edilen bulgulara göre,
 ergenlerde ayrılma-bireyleşme düzeyi yeme tutumunda belirleyici bir etken olup, beden
 algısı patoloji geliştirmeyen grupta kısıtlayıcı yeme davranışını yordarken, patoloji geliştirme
 ihtimali yüksek olan grupta ise duygusal yeme davranışını yordamaktadır. Cinsiyet
 bakımından patoloji gösterme ihtimali yüksek olan kadınlarda duygusal yeme beden algısı,
 açıklık, amaçlar, stratejiler ve kabul etmeme tarafından açıklanırken, patoloji gösterme ihtimali yüksek olan erkeklerde ise sadece açıklık tarafından açıklanmaktadır. Elde edilen
 bulgular literatür bulguları ile birlikte ele alınarak tartışılmıştır.

Large-Scale Exploration of Whole-Brain Structural Connectivity in Anorexia Nervosa: Alterations in the Connectivity of Frontal and Subcortical Networks

BackgroundAnorexia nervosa (AN) is characterized by disturbances in cognition and behavior surrounding eating and weight. The severity of AN combined with the absence of localized brain abnormalities suggests distributed, systemic underpinnings that may be identified using diffusion-weighted magnetic resonance imaging and tractography to reconstruct white matter pathways. MethodsDiffusion-weighted magnetic resonance imaging data acquired from female patients with AN (n= 147) and female healthy control (HC) participants (n = 119), ages 12 to 40 years, were combined across 5 studies. Probabilistic tractography was completed, and full-cortex connectomes describing streamline counts between 84 brain regions were generated and harmonized. Graph theory methods were used to describe alterations in network organization in AN. The network-based statistic tested between-group differences in brain subnetwork connectivity. The metrics strength and efficiency indexed the connectivity of brain regions (network nodes) and were compared between groups using multiple linear regression. ResultsIndividuals with AN, relative to HC peers, had reduced connectivity in a network comprising subcortical regions and greater connectivity between frontal cortical regions (p < .05, familywise error corrected). Node-based analyses indicated reduced connectivity of the left hippocampus in patients relative to HC peers (p < .05, permutation corrected). Severity of illness, assessed by body mass index, was associated with subcortical connectivity (p < .05, uncorrected). ConclusionsAnalyses identified reduced structural connectivity of subcortical networks and regions, and stronger cortical network connectivity, among individuals with AN relative to HC peers. These findings are consistent with alterations in feeding, emotion, and executive control circuits in AN, and may direct hypothesis-driven research into mechanisms of persistent restrictive eating behavior.

Exclusion Diets in Functional Dyspepsia.

Functional dyspepsia represents one of the most common and prevalent disorders of the brain–gut interaction, with a large number of widespread risk factors being identified. With an intricate pathogenesis and symptomatology, it heavily impacts the quality of life and, due to the limited efficacy of traditional pharmacological agents, patients are likely to seek other medical and non-medical solutions to their problem. Over the last few years, significant research in this domain has emphasized the importance of various psychological therapies and nutritional recommendations. Nevertheless, a correlation has been established between functional dyspepsia and food intolerances, with more and more patients adopting different kinds of exclusion diets, leading to weight loss, restrictive eating behaviour and an imbalanced nutritional state, further negatively impacting their quality of life. Thus, in this systematic review, we aimed at analysing the impact and efficiency of certain exclusion diets undertook by patients, more precisely, the gluten-free diet and the low-FODMAP diet.

A Rare Cause of Intussusception in an Adolescent Female

Question: A 14-year-old girl with a prior diagnosis of anorexia nervosa and 2 prior hospital admissions in the past 40 days owing to severe dehydration, acute kidney injury, and electrolyte derangements presented to the hospital to manage restrictive eating and purging behaviors. On day 7 of admission, she had an upper gastrointestinal barium study with findings of superior mesenteric artery obstruction of the duodenum. The patient subsequently was managed with nasojejunal feedings past the level of this obstruction for 1 month. She continued to complain of intermittent abdominal pain, emesis, and mild tenderness to palpation on physical examination. During this hospitalization, the patient developed multiple episodes of nonbloody, nonbilious emesis with associated abdominal pain. A subsequent computed tomography imaging of the abdomen and pelvis demonstrated an intestinal obstruction secondary to a long-segment duodenal–jejunal intussusception with concern for bowel ischemia involving the distal duodenum (Figure A). CME Exam 1: A Rare Cause of Intussusception in an Adolescent FemaleGastroenterologyVol. 163Issue 2Preview Full-Text PDF

Psychological, morphological and dietic aspects of violations of food behavior of young people

Background: The article shows that the development of obesity and associated health disorders is directly related to the changes in eating behavior (EB) and the psychoemotional state. However, the considered studies were carried out in obese patients of medical institutions only. The research in young people focuses mainly on the sociological and psychological aspects of EB.Aim: To study the psychological characteristics, eating behavior features and their relationship with the indicators of actual nutrition and the body composition in young men.Materials and methods: A multicenter, cross-sectional sample survey of young men aged 17 to 21 was performed. A survey of violations of the EB was carried out, on the basis of which 5 groups of young men were formed. Group 1 (comparison) consisted of young men without violations of the EB. Group 2 consisted of young men with impaired emotiogenic EB. Group 3 consisted of boys with violations of the restrictive PP; group 4 — young men with impaired external EB; group 5 — young men with a combination of impairment of emotionogenic and restrictive EB. We used the Dutch DEBQ questionnaire to study the types of eating behavior. The current mental state of the testees was evaluated by a clinical and psychological test — Symptom Checklist-90-Revised (SCL-90-R). The body composition was assessed with the ABC-01 «Medass» bioimpedansometry device. The «Analysis of the human nutritional state” computer program was applied to estimate the actual nutrition by the frequency analysis method.Results: The study included 96 volunteers. Young men with impaired external EB feature an increase in the daily average energy consumption, which resulted in an increase in BFM%. In young people with eating disorders, an increase in scores on the «Somatization», «Obsession-compulsion», and «Anxiety» scales as compared to the reference valuesis testified. The depression level in young men correlated with the severity of emotiogenic eating behavior (r = 0.455, p &lt;0.001).However, it is associated with the severity of external EB to a greater extent (r = 0.608, p &lt;0.001). On the contrary, the anxiety level more strongly correlated with the severity of emotiogenic EB (r = 0.575, p &lt;0.001) rather than of external EB type (r = 0.391, p &lt;0.001).Conclusion: EB disorders in young men are associated with psychophysiological features, eating disorders accounting for the accumulation of adipose tissue in the body.

ОСОБЕННОСТИ ЭМОЦИОНАЛЬНО-ЛИЧНОСТНОЙ СФЕРЫ И СИСТЕМЫ МЕЖЛИЧНОСТНЫХ ОТНОШЕНИЙ ЖЕНЩИН С НЕРВНОЙ ОРТОРЕКСИЕЙ

The purpose of the study was to examine the phenomenon of “nervous orthorexia” as a variant of restrictive eating behavior. A review of the literature on the problem showed both a lack of conceptual definition of the term, despite its active use, and a lack of information to distinguish orthorexia nervosa from eating disorders and normative variations in the eatingstyle. The results of an empirical study of the emotional and personality features and characteristics of interpersonal relations system in women with tendencies to orthorexia nervosa are presented. There have been hypotheses about higher rates of "negative affectivity" in women with orthorexia nervosa and specific characteristics in the sphere of interpersonal attachment. According to the results of the study, women with orthorexia nervosa show significantly higher indicators of anxiety and depression, hostility, perfectionism, as well as the predominance of unreliable attachment styles in comparison with women without specific restrictive attitudes towards the diet. The results obtained make it possible to confirm the assumption that orthorexia nervosa should be considered not as a conditionally normative variant of eating behavior, but as one of the forms of emotional and personalitywell-being disturbances.