Eating disorders in the preoperative phase of bariatric surgery / Transtornos alimentares durante o pré-operatório de cirurgia bariátrica

Introduction: Bariatric surgery is considered the most effective obesity treatment. Obese patients have a high prevalence of eating disorders. Objectives: Evaluate the occurrence of eating disorders and eating patterns in candidates for bariatric surgery and associate eating disorders with sociodemographic and clinical characteristics. Methods: A retrospective study was conducted using electronic charts of candidates for bariatric surgery. Data were collected on sex, age, marital status, schooling, occupation, non-communicable diseases, body mass index (BMI), eating disorders, and eating patterns. Results: Among the 281 patients evaluated, eating disorders were detected in 26.7%; 10.3% had binge eating disorder, 6.6% had bulimia nervosa, and 5.3% had the night-eating syndrome. The specific eating patterns were overeating (46.6%), binge eating during periods of stress (9.3%), eating sweets (4%), and snaking (1.3%). BMI ranged from 35.38 to 59.03 kg/m² (mean: 44.37 ± 5.89). All individuals (100%) had systemic arterial hypertension, and 23.3% had type 2 diabetes mellitus or dyslipidemia. Conclusions: The frequency of eating disorders was low in the sample studied, the most common of which was binge eating disorder. Non-communicable diseases were associated with eating disorders. Among the eating patterns observed, the most frequent was overeating (AU)

Introdução: A cirurgia bariátrica é considerada o tratamento mais eficaz para a obesidade. Pacientes obesos possuem elevada prevalência de transtornos alimentares. Objetivos: Avaliar a presença de transtornos alimentares e padrões alimentares em candidatos à cirurgia bariátrica, associando os transtornos alimentares aos dados sociodemográficos e clínicos. Métodos: Estudo retrospectivo de cunho documental, com base em prontuários eletrônicos de pacientes candidatos à cirurgia bariátrica. Foram obtidas variáveis como sexo, idade, estado civil, nível de escolaridade, ocupação, doenças crônicas não transmissíveis, índice de massa corporal (IMC), transtorno e padrão alimentar. Resultados: Dos 281 pacientes avaliados, foi detectado 26,7% de transtornos alimentares, sendo 10,3% transtorno de compulsão alimentar periódica, 6,6% de bulimia nervosa e 5,3% de síndrome do comer noturno. Os padrões alimentares específicos encontrados foram: glutões (46,6%), compulsivos alimentares em períodos de estresse (9,3%), comedores de doces (4%) e beliscadores (1,3%). O IMC variou de 35,38 a 59,03 kg/m² (44,37±5,89), com 100% do grupo apresentando Hipertensão Arterial Sistêmica e 23,3% com Diabetes Mellitus tipo 2 ou dislipidemia. Conclusões: Constatou-se baixa frequência de transtornos alimentares na amostra estudada, sendo o transtorno de compulsão alimentar periódica o mais observado. Doenças crônicas não transmissíveis foram associadas com a presença de transtornos alimentares. Dentre os padrões alimentares observados, os glutões foram os mais frequentes (AU)

Regulación circadiana, patrón horario de alimentación y sueño: Enfoque en el problema de obesidad / Circadian rhythms, eating patterns, and sleep: A focus on obesity

RESUMEN El reloj biológico determina la mantención de los ritmos circadianos en mamíferos, un tipo particular de ritmos biológicos de duración cercana a 24 horas. Existe una estrecha relación entre el funcionamiento del sistema circadiano, la alimentación y la regulación metabólica, lo que actualmente constituye un área de intensa investigación. En particular, la alteración de la ritmicidad circadiana a partir de modificaciones genéticas, conductuales o dietarias, lleva a trastornos comportamentales, ganancia de peso excesiva y alteraciones metabólicas. Algunos factores que contribuyen a la alteración o desajuste circadiano incluyen el jet-lag, el trabajo por turnos horarios, la desorganización temporal y restricción de sueño, y desorden del patrón horario de alimentación. Este trabajo resume la evidencia acerca de la influencia de los ritmos circadianos en procesos relacionados con la alimentación y las consecuencias metabólicas de su alteración. Se hace énfasis en las consecuencias de la alteración de los ritmos de alimentación-ayuno y de sueño-vigilia, y su relación con la ganancia de peso excesiva, la obesidad y trastornos metabólicos asociados, condiciones altamente prevalentes en sociedades occidentalizadas.

ABSTRACT In mammals, the biological clock is driven by circadian rhythms, a particular type of biological rhythm that last about 24 hours. There is a close relationship between the functioning of the circadian system, eating and metabolic regulation, which is currently an area of intense research. Alteration of circadian rhythmicity from genetic, behavioral or dietary modifications, leads to behavioral and metabolic disorders, and excessive weight gain. Factors that contribute to circadian disruption include, among others, jet lag, shift work, mistimed and restricted sleep, and irregular eating patterns. This review summarizes the evidence regarding the influence of circadian rhythms on eating processes and the metabolic consequences of circadian disruption. Special focus is on the consequences of disruption of regular eating-fasting and sleep-wake rhythms, and relationships with excessive weight gain, obesity and obesity-related metabolic disorders that are highly prevalent in westernized societies.

Identification of dietary patterns in urban population of Argentina: study on diet-obesity relation in population-based prevalence study.

BACKGROUND/OBJECTIVES: In Argentina, obesity prevalence rose from 14.6% in 2005 to 20.8% in 2013. Although the number of studies on noncommunicable diseases and dietary patterns as a unique dietary exposure measure has increased, information on this topic remains scarce in developing countries. This is the first population-based study investigating the association between diet and obesity using a dietary pattern approach in Argentina. We aimed (a) to identify current dietary patterns of the population of Córdoba city, (b) to investigate its association with obesity prevalence, and (c) to identify and describe dietary patterns from the subgroup of people with obesity. SUBJECTS/METHODS: The Córdoba Obesity and Diet Study (CODIES) was conducted in Córdoba city by using a random sample of n = 4,327 subjects between 2005 and 2012. Empirically derived dietary patterns were identified through principal component factor analysis. A multiple logistic regression analysis was used to investigate the association of dietary patterns with obesity. RESULTS: Four dietary patterns were identified, called "Starchy-Sugar", "Prudent", "Western", and "Sugary drinks". High scores for the "Western" pattern (with strongest factor loading on meats/eggs, processed meats, and alcohol) showed a positive association with obesity (OR: 1.33, 95% CI: 1.06-1.67, for third versus first tertile of factor score). "Meats/Cheeses" and "Snacks/Alcohol" patterns emerged in people with obesity. CONCLUSIONS: The findings suggest that high adherence to the "Western" pattern promoted obesity in this urban population. In addition, people with obesity showed characteristic dietary patterns that differ from those identified in the overall population.

Relación entre IMC, emociones percibidas, estilo de ingesta y preferencias gustativas en una población de adultos / Relationship between BMI, emotions perceived, intake style and taste preferences in an adult population

En personas con sobrepeso y obesidad el acto ingestivo puede iniciarse en ausencia de ingesta homeostática. Las emociones pueden actuar como disparadores de ingesta hedónica o emocional contribuyendo al balance positivo de energía, ganancia de peso y obesidad. Objetivos: estudiar la relación entre las emociones percibidas, las preferencias gustativas y los estilos de ingesta, según el índice de masa corporal (IMC) y género en personas adultas. Materiales y métodos:estudio descriptivo de corte transversal mediante encuesta estructurada auto-administrada a pacientes adultos (N=481) que consultaron por primera vez en un centro privado de nutrición de la Ciudad Autónoma de Buenos Aires. Resultados:se observó correlación entre el IMC y el estilo de ingesta (r=.26, p<.01) con diferencias para picoteo, salteo, desorganización e hiperfagia (p<0,01). Los hombres presentaron estilos de ingesta menos saludables que las mujeres con mayor frecuencia de hiperfagia y comida nocturna excesiva. El 31% de la muestra refirió atracones, siendo más frecuentes en las mujeres (33,8%) que en los hombres (19,5%) (p<0,01). La preferencia por lo salado se asoció a mayor IMC (IMC media 33,21, p<0,01). El 49,27% de la muestra seleccionó salado, con mayor frecuencia en hombres (68,3%) que en mujeres (45,4%). Un 55% eligió alimentos dulces, con diferencias de género (59% de las mujeres, 34% de los hombres). Se observó una asociación positiva con débil correlación (r=.13, p<.01) entre el IMC y las emociones percibidas, con diferencias significativas en los valores de IMC en función de tristeza (IMC media=33,24, desv. típ. 8,26 p<.01) y enojo (IMC media=33,18, desv. típ. 8,23 p<.01). Las mujeres (M=2,43; DE=1,55) tendieron a comer por emociones (ansiedad, tristeza, cansancio y enojo) más que los hombres. Conclusiones: estilos de ingesta no saludables, preferencia gustativa por lo salado e ingesta desencadenada por emociones percibidas se asociaron a mayor IMC. Los hombres presentaron...

In overweight and obese people, ingestive behavior can be initiated in the absence of homeostatic hunger. Emotions can trigger hedonic or emotional intake, contributing to positive energy balance, weight gain and obesity. Objectives: to study the relationship between perceived emotions, taste preferences and eating habits, according to Body Mass Index (BMI) and gender in adults.Materials and methods: a descriptive cross-sectional study by means of a self-administered structured survey in adult patients (N=481) in a single visit to a private nutrition center in the City of Buenos Aires. Results:a correlation between BMI and unhealthy eating style (r=.26, p>,01) was observed with significant statistical differences for snacking, skipping, disorganization and hyperphagia (p<0,01). Men showed more unhealthy eating styles than women with more hyperphagia and excessive nighttime meal. 31% of the patients reported binge, being more frequent in women (33,8%) than in men (p<0,01). Salty taste preference was associated with higher BMI values (BMI media=33,21, p<0,01). 49,27% of the sample preferred salty foods which resulted significantly more frequent in men (68,3%) than females (45,4%) (p<0,01). 55% preferred sweet foods, with gender differences (59% women, 34% men). We found a weak positive association (r =.13, p<,01) between BMI and perceived emotions with significant differences in the BMI values in relation to sadness ( BMI media=33,24 and anger (BMI media=33,18). Women (M=2.43; SD=1,55) tend to have more emotional eating (anxiety, sadness, fatigue and anger) than men. Conclusions: un healthy eating styles, salt taste preference and emotional eating are associated with increased BMI. Men tend to present less healthy eating habits and women higher intake related to perceived emotions.