Obesity-related complications, healthcare resource use and weight loss strategies in six European countries: the RESOURCE survey.

BACKGROUND: Obesity-related complications (ORCs), such as type 2 diabetes (T2D) and cardiovascular disease, contribute considerably to the clinical and economic impacts of obesity. To obtain a holistic overview of health and weight management attempts for people with obesity in Europe, we designed the cross-sectional RESOURCE survey to collect data on comorbidities, healthcare resource use (HCRU) and weight loss strategies from people with obesity in France, Germany, Italy, Spain, Sweden and the UK. METHODS: Adults (≥18 years old) with self-reported body mass index (BMI) ≥30 kg/m2 who reported interacting with primary or secondary healthcare services in the past 12 months, but had not been pregnant during this time, were recruited from an existing consumer research panel. All data were self-reported via an online survey (May-June 2021). Weight changes over the past year were calculated from participants' estimated weights. RESULTS: Of the 1850 participants in the survey, 26.3% reported that they had ≥3 ORCs from a set of 15 conditions of interest. The most frequently reported ORCs were hypertension (39.3% of participants), dyslipidaemia (22.8%) and T2D (17.5%). Participants in obesity class III (BMI 40 to <70 kg/m2) were more likely to report multiple ORCs than those in lower obesity classes. The presence of multiple ORCs was linked to various types of HCRU, including a significantly increased chance of reporting hospitalization in the past year. Most participants (78.6%) had attempted to lose weight in the past year, but of those who also reported estimated weight changes, 73.4% had not experienced clinically meaningful weight loss of ≥5%. CONCLUSIONS: ORCs are common in people with obesity, and are linked to increased HCRU. Together with the low reported success rate of weight loss attempts, this highlights an unmet need in Europe for enhanced weight management support for people with obesity.

Mindful Aging: The Effects of Regular Brief Mindfulness Practice on Electrophysiological Markers of Cognitive and Affective Processing in Older Adults.

There is growing interest in the potential benefits of mindfulness meditation practices in terms of counteracting some of the cognitive effects associated with aging. Pursuing this question, the aim of the present study was to investigate the influence of mindfulness training on executive control and emotion regulation in older adults, by means of studying behavioral and electrophysiological changes. Participants, 55 to 75 years of age, were randomly allocated to an 8-week mindful breath awareness training group or an active control group engaging in brain training exercises. Before and after the training period, participants completed an emotional-counting Stroop task, designed to measure attentional control and emotion regulation processes. Concurrently, their brain activity was measured by means of 64-channel electroencephalography. The results show that engaging in just over 10 min of mindfulness practice five times per week resulted in significant improvements in behavioral (response latency) and electrophysiological (N2 event-related potential) measures related to general task performance. Analyses of the underlying cortical sources (Variable Resolution Electromagnetic Tomography, VARETA) indicate that this N2-related effect is primarily associated with changes in the right angular gyrus and other areas of the dorsal attention network. However, the study did not find the expected specific improvements in executive control and emotion regulation, which may be due to the training instructions or the relative brevity of the intervention. Overall, the results indicate that engaging in mindfulness meditation training improves the maintenance of goal-directed visuospatial attention and may be a useful strategy for counteracting cognitive decline associated with aging.

Regular, brief mindfulness meditation practice improves electrophysiological markers of attentional control.

Mindfulness-based meditation practices involve various attentional skills, including the ability to sustain and focus ones attention. During a simple mindful breathing practice, sustained attention is required to maintain focus on the breath while cognitive control is required to detect mind wandering. We thus hypothesized that regular, brief mindfulness training would result in improvements in the self-regulation of attention and foster changes in neuronal activity related to attentional control. A longitudinal randomized control group EEG study was conducted. At baseline (T1), 40 meditation naïve participants were randomized into a wait list group and a meditation group, who received three hours mindfulness meditation training. Twenty-eight participants remained in the final analysis. At T1, after eight weeks (T2) and after 16 weeks (T3), all participants performed a computerized Stroop task (a measure of attentional control) while the 64-channel EEG was recorded. Between T1 and T3 the meditators were requested to meditate daily for 10 min. Event-related potential (ERP) analysis highlighted two between group effects that developed over the course of the 16-week mindfulness training. An early effect at left and right posterior sites 160-240 ms post-stimulus indicated that meditation practice improved the focusing of attentional resources. A second effect at central posterior sites 310-380 ms post-stimulus reflects that meditation practice reduced the recruitment of resources during object recognition processes, especially for incongruent stimuli. Scalp topographies and source analyses (Variable Resolution Electromagnetic Tomography, VARETA) indicate relevant changes in neural sources, pertaining to left medial and lateral occipitotemporal areas for the early effect and right lateral occipitotemporal and inferior temporal areas for the later effect. The results suggest that mindfulness meditation may alter the efficiency of allocating cognitive resources, leading to improved self-regulation of attention.

Domain-general mechanisms of complex working memory span.

A new fMRI complex working memory span paradigm was used to identify brain regions making domain-general contributions to working memory task performance. For both verbal and spatial versions of the task, complex working memory span performance increased the activity in lateral prefrontal, anterior cingulate, and parietal cortices during the Encoding, Maintenance, and Coordination phase of task performance. Meanwhile, overlapping activity in anterior prefrontal and medial temporal lobe regions was associated with both verbal and spatial recall from working memory. These findings help to adjudicate several contested issues regarding the executive mechanisms of working memory, the separability of short-term and working memory in the verbal and spatial domains, and the relative contribution of short-term and long-term memory mechanisms to working memory capacity. The study also provides a vital bridge between psychometric and neuroimaging approaches to working memory, and constrains our understanding of how working memory may contribute to the broader landscape of cognitive performance.

Meditation, mindfulness and cognitive flexibility.

This study investigated the link between meditation, self-reported mindfulness and cognitive flexibility as well as other attentional functions. It compared a group of meditators experienced in mindfulness meditation with a meditation-naïve control group on measures of Stroop interference and the "d2-concentration and endurance test". Overall the results suggest that attentional performance and cognitive flexibility are positively related to meditation practice and levels of mindfulness. Meditators performed significantly better than non-meditators on all measures of attention. Furthermore, self-reported mindfulness was higher in meditators than non-meditators and correlations with all attention measures were of moderate to high strength. This pattern of results suggests that mindfulness is intimately linked to improvements of attentional functions and cognitive flexibility. The relevance of these findings for mental balance and well-being are discussed.