Attitudes and Behaviors towards Food and Weight in Late Pregnancy: A Comparative Approach between Individuals with and without Previous Bariatric Surgery.

The aims of this study were to compare, between pregnant individuals with and without bariatric surgery: (1) eating behaviors, (2) intuitive eating components and, (3) attitudes towards weight gain. This retrospective study included data collected in healthy pregnant individuals with and without previous bariatric surgery who were recruited at the Centre Hospitalier Universitaire (CHU) de Québec-Université Laval. Pregnant individuals who underwent bariatric surgery (biliopancreatic bypass with duodenal switch [n = 14] or sleeve gastrectomy [n = 5]) were individually matched, for age (±0.4 years) and body mass index (BMI) (±0.3 kg/m2), with pregnant individuals who have not received bariatric surgery. In the second trimester, participants completed the Three Factor Eating Questionnaire (TFEQ) and the Intuitive Eating Scale 2 (IES-2). In the third trimester, participants completed the French version of the Pregnancy Weight Gain Attitude Scale assessing attitudes towards weight gain. Pregnant individuals who have had bariatric surgery had a higher score for flexible restraint and a lower score for situational susceptibility to disinhibition compared to individuals who have not had undergone bariatric surgery (2.89 ± 1.15 vs. 1.95 ± 1.31; p = 0.04 and 1.11 ± 1.29 vs. 2.79 ± 1.44, respectively; p < 0.001). Regarding intuitive eating, pregnant individuals who experienced bariatric surgery had a higher score for reliance on internal hunger and satiety cues and a lower one for unconditional permission to eat compared with those who had not experienced bariatric surgery (3.99 ± 0.81 vs. 3.30 ± 1.03; p = 0.02 and 3.28 ± 0.54 vs. 3.61 ± 0.68, respectively; p = 0.03). No difference in attitudes towards weight gain was observed between groups. Overall, pregnant individuals who had undergone bariatric surgery had different eating behaviors and intuitive eating components compared to pregnant individuals without bariatric surgery. These results need to be confirmed in further studies with larger sample sizes.

Construct validity and reliability of the Canadian Eating Practices Screener to assess eating practices based on 2019 Canada's Food Guide recommendations.

For the first time since its introduction, the 2019 Canada's Food Guide (2019-CFG) highlighted specific guidance on eating practices, i.e., recommendations on where, when, why, and how to eat. The Canadian Eating Practices Screener / Questionnaire court canadien sur les pratiques alimentaires was developed to assess eating practices based on the 2019-CFG healthy eating recommendations. The objective of this cross-sectional study was to assess the construct validity and reliability of the Canadian Eating Practices Screener. From July to December 2021, adults (n = 154) aged 18-65 years completed a sociodemographic questionnaire and the screener. Construct validity was assessed by examining variability in screener scores, by comparing screener scores among subgroups with hypothesized differences in eating practices, and by examining the correlation between screener scores and fruit and vegetable intake. Reliability, i.e., internal consistency, was assessed by calculating Cronbach's coefficient alpha. Screener item scores were summed to provide a total score ranging from 21 to 105. The mean screener score was 76 (SD = 8.4; maximum, 105), ranging from 53 (1st percentile) to 92 (99th percentile). Differences in total scores in hypothesized directions were observed by age (p = 0.006), perceived income adequacy (p = 0.09), educational attainment (p = 0.002), and smoking status (p = 0.09), but not by gender or health literacy level. The correlation between screener scores and fruit and vegetable intake was 0.29 (p = 0.002). The Cronbach's coefficient alpha was 0.79, suggesting acceptable to high internal consistency. Study findings provide preliminary evidence of the screener's construct validity and reliability, supporting its use to assess eating practices based on the 2019-CFG healthy eating recommendations.

Transitioning to sustainable dietary patterns: learnings from animal-based and plant-based dietary patterns in French Canadian adults.

Introduction: Many dietary guidelines promote the substitution of animal proteins with plant-based proteins for health benefits but also to help transitioning toward more sustainable dietary patterns. The aim of this study was to examine the food and nutrient characteristics as well as the overall quality and costs of dietary patterns consistent with lower intakes of animal-based protein foods and with higher intakes of plant-based protein foods among French Canadian adults. Methods: Dietary intake data, evaluated with 24 h recalls, from 1,147 French-speaking adults of the PRÉDicteurs Individuels, Sociaux et Environnementaux (PREDISE) study conducted between 2015 and 2017 in Québec were used. Usual dietary intakes and diet costs were estimated with the National Cancer Institute's multivariate method. Consumption of animal- and plant-based protein foods was classified into quarters (Q) and differences in food and nutrient intakes, Healthy Eating Food Index (HEFI)-2019 scores and diet costs across quarters were assessed using linear regression models adjusted for age and sex. Results: Participants with lower intakes of animal-based protein foods (Q1 vs. Q4) had a higher HEFI-2019 total score (+4.0 pts, 95% CI, 0.9 to 7.1) and lower daily diet costs (-1.9 $CAD, 95% CI, -2.6 to -1.2). Participants with higher intakes of plant-based protein foods (Q4 vs. Q1) had a higher HEFI-2019 total score (+14.6 pts, 95% CI, 12.4 to 16.9) but no difference in daily diet costs (0.0$CAD, 95% CI, -0.7 to 0.7). Discussion: In a perspective of diet sustainability, results from this study among French-speaking Canadian adults suggest that a shift toward a dietary pattern focused primarily on lower amounts of animal-based protein foods may be associated with a better diet quality at lower costs. On the other hand, transitioning to a dietary pattern focused primarily on higher amounts of plant-based protein foods may further improve the diet quality at no additional cost.

Adhering to Canada's Food Guide Recommendations on Healthy Food Choices Increases the Daily Diet Cost: Insights from the PREDISE Study.

The aim of this study was to assess the association between daily diet costs and the Healthy Eating Food Index (HEFI)-2019, an index that reflects the alignment of dietary patterns to recommendations on healthy food choices in the 2019 Canada's Food Guide (CFG). Dietary intake data from 24 h recalls, completed between 2015 and 2017, of 1147 French-speaking participants of the web-based multicenter cross-sectional PRÉDicteurs Individuels, Sociaux et Environnementaux (PREDISE) study in Quebec were used. Diet costs were calculated from dietary recall data using a Quebec-specific 2015-2016 Nielsen food price database. Usual dietary intakes and diet costs were estimated using the National Cancer Institute's multivariate method. Linear regression models were used to evaluate associations between diet costs and HEFI-2019 scores. When standardized for energy intake, a higher HEFI-2019 score (75th vs. 25th percentiles) was associated with a 1.09 $CAD higher daily diet cost (95% CI, 0.73 to 1.45). This positive association was consistent among different sociodemographic subgroups based on sex, age, education, household income, and administrative region of residence. A higher daily diet cost was associated with a higher HEFI-2019 score for the Vegetables and fruits, Beverage, Grain foods ratio, Fatty acids ratio, Saturated fats, and Free sugars components, but with a lower score for the Sodium component. These results suggest that for a given amount of calories, a greater adherence to the 2019 CFG recommendations on healthy food choices is associated with an increased daily diet cost. This highlights the challenge of conciliating affordability and healthfulness when developing national dietary guidelines in the context of diet sustainability.

Dietary intakes in pregnant women with previous bariatric surgery.

PURPOSE: To (1) assess dietary intakes of pregnant women with previous bariatric surgery in comparison with Dietary Reference Intakes (DRIs); (2) compare their dietary intakes as well as their diet quality with a control group of pregnant women with no history of bariatric surgery. METHODS: Twenty-eight (28) pregnant women with previous surgery (sleeve gastrectomy, n = 7 and biliopancreatic diversion with duodenal switch, n = 21) were matched for pre-pregnancy body mass index with 28 pregnant women with no history of bariatric surgery. In at least one trimester, participants completed a minimum of 2 Web-based 24-h dietary recalls from which energy, macro- and micronutrient intakes as well as the Canadian Healthy Eating Index (C-HEI) were derived. RESULTS: No differences were observed for energy intake between groups. All women had protein intakes within the recommended range, but most women with previous surgery had carbohydrate (67%) and dietary fiber intakes (98%) below recommendations. In both groups, mean total fat, saturated fatty acids, free sugars and sodium intakes were above recommendations, as opposed to mean vitamin D, folic acid and iron dietary intakes below recommendations for most women. Compared with the control group, pregnant women with previous bariatric surgery had lower overall C-HEI scores. CONCLUSION: These results suggest that pregnant women with previous bariatric surgery would benefit from a nutritional follow-up throughout their pregnancy. LEVEL OF EVIDENCE: III: Evidence obtained from well-designed cohort or case-control analytic studies.

Assessing the impact of replacing foods high in saturated fats with foods high in unsaturated fats on dietary fat intake among Canadians.

BACKGROUND: The 2019 Canada's Food Guide (CFG) recommends that foods containing mostly unsaturated fatty acid (UFA) should replace foods that contain mostly SFA to reduce SFA intakes. OBJECTIVES: The objective of this study was to model the theoretical changes in intake of SFA at the population level if all Canadians adhered to that recommendation. METHODS: Dietary intakes from 24-h recalls in the nationally representative 2015 Canadian Community Health Survey-Nutrition were used for these analyses. Foods identified as high in SFA based on Health Canada's criteria [≥2 g SFA per reference amount and/or ≥15% of energy (%E) of the food's content as SFA] were replaced by an equal amount (gram per gram) of substitution foods that were lower in SFA and had a higher UFA to SFA ratio. Distributions of SFA and other nutrients before and after substitutions were estimated using the National Cancer Institute (NCI) method based on dietary intakes data from a 24-h recall repeated in 37% of the population. RESULTS: The mean (95% CI) dietary SFA intake among Canadians 2 y or older would be theoretically reduced from 10.8%E (10.7, 11.0%E) to 5.8%E (5.7, 5.9%E) if all high-SFA foods consumed were replaced by the corresponding low-SFA/high-UFA foods. Modeled usual intake of SFA after substitution was <10%E in 100% of Canadians, irrespective of sex and age. Almost half (44%) of the modeled reduction in SFA intake was attributed to replacement of SFA-rich foods not recommended in the 2019 CFG. CONCLUSIONS: This food-based substitution modeling analysis suggests that consumption of SFA would be below 10%E in Canada if all Canadians adhered to the 2019 CFG recommendation that foods containing mostly UFA should replace foods that contain mostly SFA.

Evaluation of Dietary Assessment Tools Used in Bariatric Population.

Severe obesity is associated with major health issues and bariatric surgery is still the only treatment to offer significant and durable weight loss. Assessment of dietary intakes is an important component of the bariatric surgery process. OBJECTIVE: To document the dietary assessment tools that have been used with patients targeted for bariatric surgery and patients who had bariatric surgery and explore the extent to which these tools have been validated. METHODS: A literature search was conducted to identify studies that used a dietary assessment tool with patients targeted for bariatric surgery or who had bariatric surgery. RESULTS: 108 studies were included. Among all studies included, 27 used a dietary assessment tool that had been validated either as part of the study per se (n = 11) or in a previous study (n = 16). Every tool validated per se in the cited studies was validated among a bariatric population, while none of the tools validated in previous studies were validated in this population. CONCLUSION: Few studies in bariatric populations used a dietary assessment tool that had been validated in this population. Additional studies are needed to develop valid and robust dietary assessment tools to improve the quality of nutritional studies among bariatric patients.

A food-level substitution analysis assessing the impact of replacing regular-fat dairy with lower fat dairy on saturated fat intake at a population level in Canada.

BACKGROUND: The 2019 Canada's Food Guide recommends the consumption of lower fat dairy products to reduce saturated fat (SFA) intakes. OBJECTIVES: The objective of this study was to assess the impact of such recommendation on SFA intake at a population level in Canada. METHODS: Analyses were conducted based on dietary intakes from the nationally representative 2015 Canadian Community Health Survey-Nutrition (unweighted n = 20,103). Dietary intake was assessed using 24-h dietary recalls. Food-based substitution modeling analyses were conducted by replacing all regular-fat dairy products reported by an equal amount of a corresponding lower fat dairy product. Regular-fat dairy products included milks ≥2% fat, cheeses >25% fat, and yogurts ≥2% fat. Corresponding lower fat replacement products were 1% fat milks, 10-25% fat cheeses, and <2% fat yogurts. The National Cancer Institute method was used to account for within-person variation in dietary intakes. RESULTS: Replacing all regular-fat dairy products consumed by Canadians (ages ≥2 y) by a corresponding lower fat product reduced the population's SFA intake from 10.8% of total energy intake (%E; 95% CI: 10.7%, 11.0%) to 10.0%E (95% CI: 9.8%, 10.2%). This reduction was mostly attributable to the milk and cheese substitutions (mean SFA reductions of -0.3%E each). The proportion of the population with an SFA intake <10%E was 34.7% (95% CI: 31.2%, 38.2%) before substitution and 51.5% (95% CI: 47.5%, 55.5%) after substitution. CONCLUSIONS: This food-based substitution modeling analysis suggests that SFA intakes at a population level are slightly reduced if all regular-fat dairy products consumed by Canadians were replaced by a lower fat dairy product. Approximately half of the population would still consume SFAs in excess of 10%E even if all regular-fat dairy consumed were replaced by lower fat dairy.

Associations of Intake of Free and Naturally Occurring Sugars from Solid Foods and Drinks with Cardiometabolic Risk Factors in a Quebec Adult Population: The PREDISE (PRÉDicteurs Individuels, Sociaux et Environnementaux) Study.

BACKGROUND: Associations between sugar consumption and cardiometabolic health, taking into account the physical form of sugar-containing foods (liquid vs. solid) and the type of sugars consumed [free sugars (FSs) vs. naturally occurring sugars (NOSs)], remain to be thoroughly documented. OBJECTIVE: The objective was to examine whether FS and NOS intakes from drinks and solid foods are associated with cardiometabolic risk factors in a sample of French-speaking adults from the province of Quebec, Canada. METHODS: Data were collected as part of the cross-sectional PREDISE (PRÉDicteurs Individuels, Sociaux et Environnementaux) study (n = 1019, 18-65 y old; 50% women). FS and NOS intakes were assessed by three 24-h dietary recalls using a self-administered, web-based application. Diet quality was assessed using the Alternative Healthy Eating Index-2010. Participants underwent on-site clinical assessment of cardiometabolic risk factors, including blood pressure, waist circumference, BMI, and fasting blood sampling (glucose, insulin, C-reactive protein, blood lipids). Multivariable linear regression models were performed to examine the associations between sugar intake and cardiometabolic risk factors with sociodemographic characteristics, lifestyle variables, and diet quality entered as covariates. RESULTS: In fully adjusted models, FS intake from drinks was associated with fasting insulin (1.06%; 95% CI: 0.30%, 1.84%; P = 0.006) and with insulin resistance as estimated using the HOMA model (1.01%; 95% CI: 0.19%, 1.84%; P = 0.02). All metabolic variables that were significantly associated with NOS intake from solid foods in minimally adjusted models were no longer significant after entering sociodemographic and lifestyle variables (e.g., educational and income levels, smoking, physical activity, daily energy intake) and diet quality in the models. CONCLUSIONS: Our data from an adult sample showed that unfavorable and favorable associations with cardiometabolic risk factors observed, respectively, for FS intake from drinks and NOS intake from foods are mostly explained by sociodemographic and lifestyle variables, as well as by diet quality.

NutriQuébec: a unique web-based prospective cohort study to monitor the population's eating and other lifestyle behaviours in the province of Québec.

INTRODUCTION: The epidemic of non-communicable diseases including cardiovascular diseases and type 2 diabetes is attributable in large part to unhealthy eating and physical inactivity. In the fall of 2016, the Québec government launched its first-ever Government Health Prevention Policy (Politique gouvernementale de prévention en santé (PGPS)) to influence factors that lead to improved health status and quality of life as well as reduced social inequalities in health in the population of Québec. NutriQuébec is a web-based prospective open cohort study whose primary aim is to provide essential data for the evaluation of the PGPS on the Québec population's eating and other lifestyle behaviours over time. METHODS AND ANALYSIS: Over a first phase of 3 years, NutriQuébec will enrol 20 000 adults living in the province of Québec in Canada through a multimedia campaign designed to reach different segments of the population, including subgroups with lower socioeconomic status. Participants will be invited to complete on a web platform nine core questionnaires on a yearly basis. Questionnaires will assess several dimensions related to lifestyle, including eating and physical activity behaviours, as well as a large number of personal characteristics and global health status. Temporal trends in eating and lifestyle behaviours will be analysed in relation to the implementation of the PGPS to provide essential data for its evaluation at a population level. Data analyses will use sociodemographic weights to adjust responses of participants to achieve, so far as is possible, representativeness of the adult Québec population. ETHICS AND DISSEMINATION: Université Laval Research Ethics Board approved the NutriQuébec project. Data analysis, presentations in conferences and publication of manuscripts are scheduled to start in 2020. TRIAL REGISTRATION NUMBER: NCT04140071.

Examining the Advantages of Using Multiple Web-Based Dietary Assessment Instruments to Measure Population Dietary Intake: The PREDISE Study.

BACKGROUND: Combining traditional dietary assessment instruments has been suggested to improve precision of dietary intake estimates. However, this has not been investigated using web-based 24-h recall (R24W) or a web-based food-frequency questionnaire (wFFQ). OBJECTIVE: The aim of this study was to compare different combinations of web-based instruments to assess population-level dietary intake estimates (means and percentiles) and their precision, either with or without statistical modeling of within-person day-to-day variations. METHODS: As part of the cross-sectional PREDISE study, 1025 French-speaking adults completed 3 randomly allocated R24W and 1 wFFQ within 21 d. Crude estimates of intake were generated from either 1 or 3 repeated R24W. The National Cancer Institute (NCI) method was used to account for within-person variation. Usual intakes were modeled from 1 R24W repeated in a subsample (40%) and from 3 R24W, with or without consideration of data from the wFFQ. RESULTS: Using crude data from 3 R24W increased precision of estimates and modified distribution of intakes compared with using data from only 1 R24W. Using NCI-modeled data from 3 repeated R24W had no impact on the precision around mean intakes but increased precision of low and high percentiles intake estimates compared with NCI-modeled data from a partially repeated R24W. Considering data from a wFFQ in combination with data derived from 3 R24W did not influence the precision of intake estimates of most foods and nutrients. CONCLUSIONS: The data suggest that relying on repeated measures of food and nutrient intake through R24W is preferable to single assessment when within-person variation is not considered. Data also suggest that when NCI modeling is applied, using 3 R24W only improves the precision of low and high percentiles intake estimates compared with using a partially repeated web-based recall.

Establishing a food addiction diagnosis using the Yale Food Addiction Scale: A closer look at the clinically significant distress/functional impairment criterion.

The concept of food addiction (FA) represents a set of problematic eating behaviors related to overeating. According to the Yale Food Addiction Scale (YFAS), which was based on the DSM-IV-TR substance dependence diagnostic criteria, a FA diagnosis is assigned when at least three criteria and the criterion evaluating clinically significant distress and/or functional impairment are endorsed. Considering the decisive role of this last criterion, the present study aimed to investigate its endorsement among individuals suffering from severe obesity and awaiting bariatric surgery. A total of 146 individuals were recruited at the Quebec Heart and Lung Institute and were invited to complete various questionnaires. Differences between individuals who endorsed at least three FA criteria and reported distress/impairment (FA+D/I; N = 24) and individuals who endorsed at least three FA criteria but did not report distress/impairment (FA-D/I; N = 27) were examined. Results revealed that 16% of the total sample fulfilled a FA diagnosis when considering the clinically significant distress/functional impairment criterion; however, this prevalence rate climbed to 35% when removing the inclusion of distress/impairment. Furthermore, individuals from the FA+D/I group showed more FA symptomatology and hedonic hunger, but did not statistically differ from the FA-D/I group on expected markers of psychological distress (depressive symptoms and quality of life). Lastly, the experience of withdrawal symptoms and hedonic hunger were found to be the best predictors of the endorsement of the distress/impairment criterion. This study underlines the impact of this criterion in establishing a FA diagnosis and highlights the importance of considering alternative ways to interpret findings from the YFAS when dealing with clinical samples.

Executive functioning and psychological symptoms in food addiction: a study among individuals with severe obesity.

Food addiction (FA) has recently emerged as a new field in the study of obesity. Previous studies have contributed to identifying psychological correlates of FA. However, few researchers have examined the cognitive profile related to this condition; up until now, attentional biases related to food cues and a poorer performance monitoring have been observed. The present study aimed to examine the psychological profile and executive functioning related to FA in individuals with severe obesity and awaiting bariatric surgery. Participants (N = 86) were split into two groups, according to their level of FA symptoms (low FA vs high FA). Groups were compared on questionnaires measuring binge eating, depression and anxiety symptoms, and impulsivity as well as on measures reflecting executive functioning (D-KEFS and BRIEF-A). The relationship between FA groups and patterns of errors during the D-KEFS' Color-Word Interference Test was further analyzed. Individuals within the high FA group reported significantly more binge eating, depressive and anxiety symptoms, and more metacognitive difficulties. They also tended to show a poorer inhibition/cognitive flexibility score and a typical pattern of errors, characterized by an increased number of errors as the tasks' difficulty rose as opposed to a decreased number of errors, which characterizes an atypical pattern of errors. The present results show that the inability to learn from errors or past experiences is related to the severity of FA and overall impairments.Level of evidence Level V, descriptive study.

Increased body fat mass explains the positive association between circulating estradiol and insulin resistance in postmenopausal women.

The relationship between circulating estrogen levels and cardiometabolic risk factors such as insulin resistance is unclear in postmenopausal women. High estradiol (E2) levels have been reported to predict increased risk of type 2 diabetes in this population. We aimed to examine associations among estrogen levels, adiposity measurements, and cardiometabolic risk variables including insulin resistance in postmenopausal women. One hundred-one healthy participants (mean ± SD: age 57 ± 4 yr, BMI 27.9 ± 4.8 kg/m2) were included in the analysis. Fifteen plasma steroids or metabolites were measured by liquid chromatography-tandem mass spectrometry. Insulin sensitivity was assessed with a hyperinsulinemic-euglycemic clamp. Body composition and fat distribution were determined with hydrostatic weighing and computed tomography, respectively. Blood lipids and circulating cytokines were also measured. Circulating E2 was positively correlated with all adiposity indexes ( r = 0.62 to 0.42, P < 0.0001) except waist-to-hip ratio. E2 was positively correlated with VLDL-cholesterol, plasma-, VLDL-, and HDL-triglyceride levels ( r = 0.31 to 0.24, P < 0.02) as well as with hs-CRP and IL-6 ( r = 0.52 and 0.29, P < 0.005) and negatively with HDL-cholesterol, adiponectin, and insulin sensitivity ( r = -0.36 to -0.20, P < 0.02). With adjustments for percent body fat, correlations between E2 and metabolic risk variables were no longer significant. Similar results were observed for circulating estrone (E1) and estrone-sulfate (E1-S) levels. In conclusion, circulating estrogen concentrations are proportional to adipose mass in postmenopausal women, although they remain in the low range. Insulin resistance as well as altered blood lipids and cytokines are observed when circulating estrogen levels are high within that range, but these differences are explained by concomitant variation in total adiposity.

Polymorphisms in FFAR4 (GPR120) Gene Modulate Insulin Levels and Sensitivity after Fish Oil Supplementation.

The objective was to test whether FFAR4 single nucleotide polymorphisms (SNPs) are associated with glycemic control-related traits in humans following fish oil supplementation. A total of 210 participants were given 3 g/day of omega-3 (n-3) fatty acids (FA) (1.9-2.2 g of eicosapentaenoic acid (EPA) and 1.1 g of docosahexaenoic acid (DHA)) during six weeks. Biochemical parameters were taken before and after the supplementation. Using the HapMap database and the tagger procedure in Haploview, 12 tagging SNPs in FFAR4 were selected and then genotyped using TaqMan technology. Transcript expression levels were measured for 30 participants in peripheral mononuclear blood cells. DNA methylation levels were measured for 35 participants in leukocytes. In silico analyses were also performed. Four gene-diet interactions on fasting insulin levels and homeostatic model assessment of insulin resistance (HOMA-IR) index values were found. rs17108973 explained a significant proportion of the variance of insulin levels (3.0%) and HOMA-IR (2.03%) index values. Splice site prediction was different depending on the allele for rs11187527. rs17108973 and rs17484310 had different affinity for transcription factors depending on the allele. n-3 FAs effectively improve insulin-related traits for major allele homozygotes of four FFAR4 SNPs as opposed to carriers of the minor alleles.

An examination of the mechanisms and personality traits underlying food addiction among individuals with severe obesity awaiting bariatric surgery.

PURPOSE: The aetiology underlying addiction has often been investigated to shed more light on the factors contributing to the development and maintenance of various disorders. In the field of addictive eating behaviours, data on the aetiological factors related to food addiction (FA) in the bariatric context remain scarce. The present study aimed to explore mechanisms and variables underlying FA among individuals suffering from severe obesity and awaiting bariatric surgery. METHODS: Participants (N = 146) were recruited at the Quebec Heart and Lung Institute during their pre-operative visit and were invited to complete questionnaires. Participants with and without FA were compared on reward sensitivity, impulsivity, emotion dysregulation, and personality traits. RESULTS: Findings showed that bariatric candidates with FA (16%) presented more emotion dysregulation, more harm avoidance, and less self-directedness. Further exploration showed that the association between harm avoidance and the number of FA criteria endorsed was mediated by emotion dysregulation, while the association between self-directedness and the number of FA criteria endorsed was mediated by reward sensitivity. CONCLUSIONS: These results indicate that an inability to regulate affect by strategies other than eating highly palatable food, in a context where negative affect and long-term goals can hardly be sustained, underlies a diagnostic of FA among bariatric candidates. From a clinical standpoint, the presence of a double vulnerability leading to FA symptomatology could help design better-targeted interventions to maximise weight loss maintenance in the bariatric context. LEVEL OF EVIDENCE: Level V, descriptive study.

Plasma Triglyceride Levels May Be Modulated by Gene Expression of IQCJ, NXPH1, PHF17 and MYB in Humans.

A genome-wide association study (GWAS) by our group identified loci associated with the plasma triglyceride (TG) response to ω-3 fatty acid (FA) supplementation in IQCJ, NXPH1, PHF17 and MYB. Our aim is to investigate potential mechanisms underlying the associations between single nucleotide polymorphisms (SNPs) in the four genes and TG levels following ω-3 FA supplementation. 208 subjects received 3 g/day of ω-3 FA (1.9-2.2 g of EPA and 1.1 g of docosahexaenoic acid (DHA)) for six weeks. Plasma TG were measured before and after the intervention. 67 SNPs were selected to increase the density of markers near GWAS hits. Genome-wide expression and methylation analyses were conducted on respectively 30 and 35 participants' blood sample together with in silico analyses. Two SNPs of IQCJ showed different affinities to splice sites depending on alleles. Expression levels were influenced by genotype for one SNP in NXPH1 and one in MYB. Associations between 12 tagged SNPs of IQCJ, 26 of NXPH1, seven of PHF17 and four of MYB and gene-specific CpG site methylation levels were found. The response of plasma TG to ω-3 FA supplementation may be modulated by the effect of DNA methylation on expression levels of genes revealed by GWAS.

A Health at Every Size intervention improves intuitive eating and diet quality in Canadian women.

BACKGROUND & AIMS: Health at Every Size® (HAES®) interventions focus on healthy lifestyle by promoting behavioral changes related to diet and physical activity while emphasizing self-acceptance and well-being through an empowerment and intuitive approach. The purpose of this study was to investigate the effects of a HAES® program on intuitive eating and diet quality in women. METHODS: The HAES® intervention, offered by professionals from Health and Social Services Centers in Quebec (Canada), was composed of thirteen 3-h weekly meetings and a 6-h intensive day. For this study, 216 women (1.9% normal-weight, 21.1% overweight, 77.0% obese) who took part to the HAES program were compared to 110 women (3.9% normal-weight, 23.3% overweight, 72.8% obese) from a control group (waiting list). Intuitive eating was assessed using the Intuitive Eating Scale and diet quality was evaluated through the calculation of the Healthy Eating Index (HEI) from a validated web-based self-administrated food frequency questionnaire. Measurements were performed at baseline, post-intervention, and at one-year follow-up. RESULTS: Women who participated in the HAES® program significantly increased their intuitive eating score compared to women in the control group at post-intervention and at follow-up (group by time interaction, p = 0.0002). A significant improvement in diet quality was also observed in the HAES® group in comparison with the control group at post-intervention (group by time interaction, p = 0.0139). The intuitive eating score and the HEI score were positively associated in the HAES® group at post-intervention (r = 0.20, p = 0.0237) and one-year follow-up (r = 0.22, p = 0.0359), but no such associations were noted in the control group (post-intervention, r = 0.04, p = 0.70; one-year follow-up, r = -0.15, p = 0.30). CONCLUSIONS: The HAES® program seems effective in improving intuitive eating and also favours improvements in diet quality. However, the association between intuitive eating and diet quality remains unclear, being positive and significant only after the HAES® intervention.

Novel Genetic Loci Associated with the Plasma Triglyceride Response to an Omega-3 Fatty Acid Supplementation.

BACKGROUND: A recent genome-wide association study (GWAS) by our group identified 13 loci associated with the plasma triglyceride (TG) response to omega-3 (n-3) fatty acid (FA) supplementation. This study aimed to test whether single-nucleotide polymorphisms (SNPs) within the IQCJ, NXPH1, PHF17 and MYB genes are associated with the plasma TG response to an n-3 FA supplementation. METHODS: A total of 208 subjects followed a 6-week n-3 FA supplementation of 5 g/day of fish oil (1.9-2.2 g of eicosapentaenoic acid and 1.1 g of docosahexaenoic acid). Measurements of plasma lipids were made before and after the supplementation. Sixty-seven tagged SNPs were selected to increase the density of markers near GWAS hits. RESULTS: In a repeated model, independent effects of the genotype and the gene-supplementation interaction were associated with plasma TG. Genotype effects were observed with two SNPs of NXPH1, and gene-diet interactions were observed with ten SNPs of IQCJ, four SNPs of NXPH1 and three SNPs of MYB. Positive and negative responders showed different genotype frequencies with nine SNPs of IQCJ, two SNPs of NXPH1 and two SNPs of MYB. CONCLUSION: Fine mapping in GWAS-associated loci allowed the identification of SNPs partly explaining the large interindividual variability observed in plasma TG levels in response to an n-3 FA supplementation.

Expression and Sequence Variants of Inflammatory Genes; Effects on Plasma Inflammation Biomarkers Following a 6-Week Supplementation with Fish Oil.

(1) BACKGROUND: A growing body of literature suggest that polymorphisms (SNPs) from inflammation-related genes could possibly play a role in cytokine production and then interact with dietary n-3 fatty acids (FAs) to modulate inflammation. The aim of the present study was to test whether gene expression of selected inflammatory genes was altered following an n-3 PUFA supplementation and to test for gene-diet interactions modulating plasma inflammatory biomarker levels. (2) METHODS: 191 subjects completed a 6-week n-3 FA supplementation with 5 g/day of fish oil. Gene expression of TNF-α and IL6 was assessed in peripheral blood mononuclear cells (PBMCs) using the TaqMan technology. Genotyping of 20 SNPs from the TNF-LTA gene cluster, IL1ß, IL6 and CRP genes was performed. (3) RESULTS: There was no significant reduction of plasma IL-6, TNF-α and C-reactive protein (CRP) levels after the 6-week fish oil supplementation. TNF-α and IL6 were slightly overexpressed in PBMCs after the supplementation (fold changes of 1.05 ± 0.38 and 1.18 ± 0.49, respectively (n = 191)), but relative quantification (RQ) within the -0.5 to 2.0 fold are considered as nonbiologically significant. In a MIXED model for repeated measures adjusted for the effects of age, sex and BMI, gene by supplementation interaction effects were observed for rs1143627, rs16944, rs1800797, and rs2069840 on IL6 levels, for rs2229094 on TNF-α levels and for rs1800629 on CRP levels (p < 0.05 for all). (4) CONCLUSIONS: This study shows that a 6-week n-3 FA supplementation with 5 g/day of fish oil did not alter gene expression levels of TNF-α and IL6 in PBMCs and did not have an impact on inflammatory biomarker levels. However, gene-diet interactions were observed between SNPs within inflammation-related genes modulating plasma inflammatory biomarker levels.