Is Food Addiction a Specific Feature of Individuals Seeking Dietary Treatment from Nutritionists?

Objective: Food addiction (FA) is a condition characterized by excessive and dysregulated consumption of high-energy food, and impulsivity. The diagnostic and nosological framework of FA is still controversial. Therefore, this study aimed at exploring the prevalence of FA in patients seeking help from nutritionists for weight loss, along with its relationship with eating habits, in a pool of 842 participants of both sexes. Method: Eating habits and FA were assessed by, respectively, a self-administered questionnaire and the Yale Food Addiction Scale (YFAS). Statistical analysis included Chi-square for categorical variables, independent t tests to investigate continuous variables and an univariate logistic regression analysis to determine potential risk factors for FA. The relationship between FA diagnosis and potential risk factors was assessed through a stepwise logistic regression model, controlling for age, sex, and body mass index (BMI) classes. Results: Our results indicate that a prevalence of FA in our sample was 15.3%, with no difference between women and men. A higher prevalence was recorded in overweight subjects or obese. According to the YFAS criteria, women were more likely to report a persistent desire and withdrawal than men. Patients with FA compared with those without it, reported a greater number of attempts to lose weight, to self-dieting, a different mealtime repertoire, and to nibble continuously throughout the day. Moreover, the amount of carbohydrates ingested in the same meal seems to represent an eating habit significantly associated with FA. Conclusions: Taken together, our findings show how patients seeking help from nutritionists may display some peculiar features of FA. In spite of its diagnostic controversies, it is evident that FA may play a role in obesity and may also be a feature of some psychopathological conditions. Therefore, it should be more deeply investigated and possibly specifically targeted with tailored therapeutic interventions.

The Role of Fructose as a Cardiovascular Risk Factor: An Update.

There is increasing presence of fructose in food and drinks, and some evidence suggests that its higher consumption increases cardiovascular risk, although the mechanisms still remain not fully elucidated. Cardiovascular diseases (CVD) are still responsible for one-third of deaths worldwide, and therefore, their prevention should be assessed and managed comprehensively and not by the evaluation of individual risk factor components. Lifestyle risk factors for CVD include low degree of physical activity, high body mass index, alcohol consumption, smoking, and nutritional factors. Indeed, nutritional risk factors for CVD include unhealthy dietary behaviors, such as high intake of refined foods, unhealthy fats, added sugars, and sodium and a low intake of fruits, vegetables, whole grains, fiber, fish, and nuts. Even though there is no definitive association between CVD incidence and high consumption of total sugar, such as sucrose and fructose, there is, however, evidence that total sugars, added sugars, and fructose are harmfully associated with CVD mortality. Since high fructose intake is associated with elevated plasma triglyceride levels, as well as insulin resistance, diabetes hyperuricemia, and non-alcoholic fatty liver disease, further longitudinal studies should be conducted to fully elucidate the potential association between certain sugars and CVD.

Food addiction and psychiatric comorbidities: a review of current evidence.

BACKGROUND: Food addiction (FA) is characterised by the consumption of appetible foods and by addictive psychological and behavioural symptoms such as cravings, tolerance, limited control of substance intake and withdrawal symptoms. Despite previous research on FA has been hindered by the lack of a formal definition for this condition, recent global trends have stirred the interest of the scientific community towards a proper classification and construct of FA. More specifically, recent studies have pointed towards shared defective neurobiological mechanisms as well as frequent comorbidities between FA, eating disorders, mood disorders, anxiety disorders and substance-related and addictive disorders. OBJECTIVE: In this review, we will provide an overview of the complex symptomatology of food addiction evaluating its relationship with mood disorders, anxiety disorders, eating disorders and substance-related and addictive disorders. METHODS: We wrote a systematic review and followed a PRISMA methods. RESULTS: Patients with FA and substance use disorders show similar risk factors, neurobiological and hormonal correlates, personality traits and symptom profiles. The presence of FA appears to be directly proportional to the burden of symptoms of affective disorder. The comorbidity between FA and other eating disorders is associated with worse clinical conditions and symptoms. CONCLUSION: FA should be considered a sort of transnosological construct existing in different psychopathological domains that have similarities with substance-related, affective, and eating disorders. Furthermore, FA seems to be likely an important factor related to several psychopathological dimensions, but further studies are needed to clarify this view. LEVEL OF EVIDENCE: Level V, review article.

Food addiction: is it a nosological category or a psychopathological dimension? Preliminary results of an Italian study.

Background Food addiction (FA) is a controversial concept, denoting the craving for certain foods. Given the little information available, the aim of this study was to evaluate the possible relationships between FA and full-blown and subthreshold psychopathology or eating behaviors in subjects consulting nutritional biologists. Materials and methods Three-hundred and fifty subjects completed the following self-questionnaires: Yale Food Addiction Scale (YFAS), Structured Clinical Interview for Mood Spectrum, Self-Report, Lifetime Version (MOOD-SR-LT), Symptom Checklist-90-Revised (SCL-90-R), Structured Clinical Interview for Anorexic-Bulimic Spectrum, Self-Report, Lifetime Version (ABS-SR-LT). Results Most of the subjects were women (n = 278) and the remaining were 72 men. A large proportion of the subjects (77.1%) had a YFAS score <3 and 22.9% ≥3, with no difference between men and women. The YFAS scores ≥3 were significantly and positively related to the all ABS-SR-LT domains, as well as to three dimensions (Depression, Hypomania, Rhythmicity) of the MOOD-SR-LT, and some SCL-90-R domains (Sensitivity, Psychoticism, General Symptom Index and Positive Symptom). Conclusion Our data, while indicating that FA is related to different subthreshold psychopathological domains, in particular, with both depressive and manic symptoms, as well as with rhythmicity of mood spectrum, or with eating subthreshold symptoms, would suggest that it might be a dimension underlying different conditions or symptom clusters.

Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach.

Recently, attention to the lifestyle of patients has been rapidly increasing in the field of pain therapy, particularly with regard to the role of nutrition in pain development and its management. In this review, we summarize the latest findings on the role of nutrition and nutraceuticals, microbiome, obesity, soy, omega-3 fatty acids, and curcumin supplementation as key elements in modulating the efficacy of analgesic treatments, including opioids. These main topics were addressed during the first edition of the Study In Multidisciplinary Pain Research workshop: "FYD (Feed Your Destiny): Fighting Pain", held on April 7, 2016, in Rome, Italy, which was sponsored by a grant from the Italian Ministry of Instruction on "Nutraceuticals and Innovative Pharmacology". The take-home message of this workshop was the recognition that patients with chronic pain should undergo nutritional assessment and counseling, which should be initiated at the onset of treatment. Some foods and supplements used in personalized treatment will likely improve clinical outcomes of analgesic therapy and result in considerable improvement of patient compliance and quality of life. From our current perspective, the potential benefit of including nutrition in personalizing pain medicine is formidable and highly promising.

Oocyte-follicle cell interactions during ovarian follicle development, as seen by high resolution scanning and transmission electron microscopy in humans.

The aim of this article is to summarize and update, through an integrated analysis by transmission electron microscopy (TEM) and high resolution scanning electron microscopy (SEM) after osmium-dimethyl sulfoxide-osmium (ODO) maceration, the studies of our research group on the morphodynamics of oocyte-follicle cell associations during follicle development in humans. In resting oocytes, follicular cells project few and short cytoplasmic processes in the perioocytic space. They often form bulbous terminals very close to the oolemma where zonulae adherentes, maculae adherentes, and gap junctions are present. The oolemma mostly appears smooth with short and scanty microvilli. In early growing follicles, follicular cell projections appear as (a) long and tortuous microvilli or (b) large and short extensions. The oolemma shows numerous short microvilli. By TEM, long and thin follicular "intraooplasmic processes" have been seen to penetrate deeply into some oolemma invaginations. In macerated samples, they are observed by SEM to come very close to the nucleus and contact different oocyte organelles. These processes are more likely involved in early oocyte growth. In late growing follicles, oocyte-somatic cell interactions-now established through the interposition of the zona pellucida (ZP)-preserve the general features of early growth stage, with the exceptions of "intraooplasmic processes," which are no more present. In mature follicles subjected to a long ODO maceration, corona cells appear to contact the oocyte through an apical plume of numerous very long "curly hair-like microvilli." Corona cell microvilli, quite likely provide a sort of cytoplasmic skeleton for the ZP and they are possibly involved in (a) release of nutrients or removal catabolites to/from oocyte and vice versa and (b) transfer of substances to build up ZP. In conclusion, among oocyte and somatic cells a structural and functional association is revealed. This association, certainly highly dynamic in vivo, plays a key role in regulating the healthy folliculogenesis to assure a correct and timed oocyte maturation and ovulation.

Surface morphology of the zona pellucida surrounding human blastocysts obtained after in vitro fertilization.

Human zona pellucida (ZP) is maintained up to the blastocyst stage prior to hatching. In in vitro fertilized (IVF) embryos, it eventually acts as a morphodynamic interface between the cultured embryo and its microenvironment. Ultrastructural data on the ZP of IVF blastocysts are scarce in humans. We employed correlated phase contrast microscopy (PCM) and scanning electron microscopy (SEM) to study retrospectively the ultrastructural morphology of the ZP outer surface of 20 IVF human blastocysts from 16 Japanese patients (28-44 years of age, average 36.7+/-4.2) with a history of infertility. Blastocysts were derived from conventional in vitro fertilization (cIVF) (n = 10) and from intracytoplasmic sperm injection (ICSI) (n = 10). Both cIVF and ICSI groups included "clear blastocysts" (n = 5) and "dark blastocysts" (n = 5). By PCM, the clear blastocysts exhibited a regular, round-shaped contour and consisted of clear and voluminous cells. By SEM, they displayed a spongy ZP with numerous fenestrations formed by networked filaments. By PCM, dark blastocysts appeared irregularly shaped and often collapsed, and comprised dark cells and debris. By SEM, their ZP were smooth with remnants of compact fenestrations. In conclusion, viable blastocysts presented a normal ZP outer surface ultrastructure, whereas unhealthy blastocysts showed an altered ZP outer surface, comparable to that of immature/atretic oocytes. Such alterations could reflect sub-optimal culture conditions and/or could be related to blastocyst degenerative processes. The blastocyst ZP surface ultrastructure was unaffected by the fertilization technique (cIVF or ICSI). These data suggest that blastocyst survival in vitro is related to ZP ultrastructure maintenance.

Morphodynamics of the follicular-luteal complex during early ovarian development and reproductive life.

Female reproductive activity depends upon cyclic morphofunctional changes of the ovarian tissue during the female's fertile period, but the primum movens of an active gonadal rearrangement can be found from early phases of embryo development. To offer a basic account of the main steps of ovarian dynamics, we review the morphofunctional behavior of the follicular-luteal complex in an integrated study using light microscopy and transmission and scanning electron microscopy as well as through the use of numerous drawings. Particular emphasis is given to some reproductive aspects including (1) germ-somatic cell relationships and onset of folliculogenesis during early gonadal development; (2) follicular development and oocyte-follicle cell associations through adult folliculogenesis, finally leading to ovulation; (3) morphodynamics of corpus luteum formation, development, and regression, and (4) degenerative processes involving germ and somatic cells. The results reported, many of which originated in our laboratory, arise from some experiments on laboratory mammals but mostly from a large selection of human specimens. The data obtained are integrated and correlated with classic reports as well as with current views. Crucial biochemical, histophysiological, and clinical aspects are also emphasized.

Distribution of collagen fibers in the aggregated lymphoid follicles of swine terminal ileum.

The arrangement of the collagen bundles was studied in the Peyer's patches of swine terminal ileum, by means of light microscopy (using silver-impregnation technique and picrosirius F3BA staining) and scanning electron microscopy (after NaOH-maceration). The lymphoid tissue forms a large and continuous patch along the antimesenteric border. The follicles are disposed mainly in the tela submucosa and sometimes they reached in the tunica mucosa surface (follicle/dome structures). Some follicles are located in the lamina propria of the tunica mucosa. Light microscopy showed black and brown-stained fibers, and yellow and red, and green-stained fibers, respectively by silver impregnation technique and picrosirius red staining, in the tela submucosa. In this tela, by scanning electron microscopy, the collagen fibers appeared as thick bundles forming a network of parallel layers. This network was denser in the interfollicular than in the follicular area, and formed a capsule surrounding the lymphoid follicles. Our results pointed out that a clear correspondence exists between the findings of currently used light microscopy techniques and the scanning electron microscopy after alkali-water maceration method. The arrangement of the collagen fibers in the antimesenteric border of the tela submucosa suggested a functional compartmentalization within the aggregated lymphoid follicles. This could facilitate the antigen-to-cell and cell-to-cell interaction during the immune response and thus create a suitable microenvironment for an active cell metabolism. The tunica mucosa showed a porous structure and its frequent gaps were likely the sites through which lymphocytes and other cells could freely migrate thus participating in the immunological activities of these structures.