Chronic insomnia, high trait anxiety and their comorbidity as risk factors for incident type 2 diabetes mellitus.

The main objective of this study was to evaluate the association of the insomnia-anxiety comorbidity with incident type 2 diabetes (T2D) in a large prospective cohort. We selected adults without diabetes at baseline from the French NutriNet-Santé cohort who had completed the trait anxiety subscale of the Spielberger State-Trait Anxiety Inventory (STAI-T, 2013-2016) and a sleep questionnaire (2014); insomnia was defined according to established criteria. Using multivariable Cox models, we compared T2D risk across 4 groups: no insomnia or anxiety (reference), insomnia alone, anxiety alone (STAI-T ≥ 40), and comorbid anxiety and insomnia. Among 35,014 participants (mean baseline age: 52.4 ± 14.0 years; 76% women), 378 (1.1%) developed T2D over a mean follow-up of 5.9 ± 2.1 years. Overall, 28.5% of the sample had anxiety alone, 7.5%-insomnia alone, and 12.5%-both disorders. In the fully-adjusted model, a higher T2D risk was associated with anxiety-insomnia comorbidity (HR = 1.40; 95% CI 1.01, 1.94), but not with each disorder separately, compared to the group without insomnia or anxiety. The findings supported a positive association between anxiety-insomnia comorbidity and incident T2D among general-population adults. Future research using clinical diagnoses of mental disorders could confirm the findings and guide diabetes prevention programs.

A scoping review of emotion regulation and inhibition in emotional eating and binge-eating disorder: what about a continuum?

BACKGROUND: Emotional eating is defined as a nonpathological eating behavior, whereas binge-eating disorder (BED) is defined as a pathological eating behavior. While different, both share some striking similarities, such as deficits in emotion regulation and inhibition. Previous research has suggested the existence of an "eating continuum" that might reflect the increased severity of overeating behaviors, that is, from nonpathological overeating to BED. The main aims of this scoping review were to explore in the literature the idea of a continuum between emotional eating and BED and to observe whether deficits in emotion regulation and inhibition follow this continuum in terms of severity. The other aims were to hopefully clarify the ill-defined concept of overeating, to question the potential role of positive emotions and to identify potential knowledge gaps. METHOD: A systematic scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Two databases (PubMed/Medline and PsycINFO) were examined in complete accordance with the beforehand sharply defined eligibility and exclusion criteria. The main criteria included adults (≥ 18) with emotional eating, BED or overeating and emotion regulation and inhibition as exposure criteria. RESULTS: Thirty-two studies were included in this scoping review. If the results showed a link between emotional eating and BED, with the presence of inhibition and emotion regulation deficits in both eating behaviors, no mention of a continuum between emotional eating and BED was found. CONCLUSION: In the absence of research directly comparing emotional eating and BED in the same studies and testing the potential increase in severity of emotion regulation and inhibition deficits along this continuum, there is currently no certainty that a continuum exists between emotional eating and BED. In the end, the idea of a continuum in terms of increased severity of overeating and in terms of emotion regulation and inhibition deficits between emotional eating and BED appears to be a gap in knowledge in the literature. This scoping review highlights the need for further research to identify knowledge gaps.

Emotional eating (EE) is defined as a nonpathological eating behavior, whereas binge-eating disorder (BED) is defined as a pathological eating behavior. While different, both share some striking similarities, such as deficits in emotion regulation (ER) and inhibition. Previous research has suggested the existence of an "eating continuum" that might reflect the increased severity of overeating behaviors, that is, from nonpathological overeating to BED. The main aims of this scoping review were to explore in the literature the idea of a continuum between EE and BED and to observe whether deficits in ER and inhibition follow this continuum in terms of severity. A systematic scoping review was conducted, and thirty-two studies were included in this review. If the results showed a link between EE and BED, with the presence of inhibition and ER deficits in both eating behaviors, no mention of a continuum between EE and BED, or in relation to a continuum, was found. Thus, in the absence of research directly comparing EE and BED in the same studies and testing the potential increase in severity of ER and inhibition deficits along this continuum, there is currently no certainty about the existence or absence of such a continuum.

Changes in Taste Perception in Patients with Minor and Major Cognitive Impairment Linked to Alzheimer's Disease Recorded by Gustatory Evoked Potentials.

BACKGROUND: The need for early diagnosis biomarkers in Alzheimer's disease (AD) is growing. Only few studies have reported gustatory dysfunctions in AD using subjective taste tests. OBJECTIVE: The main purpose of the study was to explore gustatory functions using subjective taste tests and recordings of gustatory evoked potentials (GEPs) for sucrose solution in patients with minor or major cognitive impairment (CI) linked to AD, and to compare them with healthy controls. The secondary objective was to evaluate the relationships between GEPs and the results of cognitive assessments and fasting blood samples. METHODS: A total of 45 subjects (15 healthy subjects, 15 minor CI patients, 15 major CI patients) were included to compare their gustatory functions and brain activity by recording GEPs in response to a sucrose stimulation. CI groups were combined in second analyses in order to keep a high power in the study. Correlations were made with cognitive scores and hormone levels (ghrelin, leptin, insulin, serotonin). RESULTS: Increased P1 latencies and reduced N1 amplitudes were observed in minor or major patients compared to controls. GEPs were undetectable in 6 major and 4 minor CI patients. Thresholds for sucrose detection were significantly higher in the major CI group than in controls or the minor CI group. No correlation was found with hormone levels. CONCLUSIONS: The cortical processing of sensory taste information seems to be altered in patients with minor or major CI linked to AD. This disturbance was identifiable with subjective taste tests only later, at the major CI stage.

Hypothalamic Glucose Hypersensitivity-Induced Insulin Secretion in the Obese Zücker Rat Is Reversed by Central Ghrelin Treatment.

Aims: Part of hypothalamic (mediobasal hypothalamus [MBH]) neurons detect changes in blood glucose levels that in turn coordinate the vagal control of insulin secretion. This control cascade requires the production of mitochondrial reactive oxygen species (mROS), which is altered in models of obesity and insulin resistance. Obese, insulin-resistant Zücker rats are characterized by hypothalamic hypersensitivity to glucose. This initiates an abnormal vagus-induced insulin secretion, associated with an overproduction of mROS in response to a low glucose dose. Here, we hypothesized that ghrelin, known to buffer reactive oxygen species (ROS) via mitochondrial function, may be a major component of the hypothalamic glucose hypersensitivity in the hypoghrelinemic obese Zücker rat. Results: Hypothalamic glucose hypersensitivity-induced insulin secretion of Zücker obese rats was reversed by ghrelin pretreatment. The overproduction of MBH mROS in response to a low glucose load no longer occurred in obese rats that had previously received the cerebral ghrelin infusion. This decrease in mROS production was accompanied by a normalization of oxidative phosphorylation (OXPHOS). Conversely, blocking the action of ghrelin with a growth hormone secretagogue receptor antagonist in a model of hyperghrelinemia (fasted rats) completely restored hypothalamic glucose sensing-induced insulin secretion that was almost absent in this physiological situation. Accordingly, ROS signaling and mitochondrial activity were increased by the ghrelin receptor antagonist. Innovation: These results demonstrate for the first time that ghrelin addressed only to the brain could have a protective effect on the defective control of insulin secretion in the insulin-resistant, hypoghrelinemic obese subject. Conclusions: Ghrelin, through its action on OXPHOS, modulates mROS signaling in response to cerebral hyperglycemia and the consequent vagal control of insulin secretion. In insulin-resistant obese states, brain hypoghrelinemia could be responsible for the nervous defect in insulin secretion.

Inhibition and shifting across the weight status spectrum.

Executive functioning (EF) is of major interest in the study of cognitive factors involved in obesity. Among EF, shifting is related to behavioral flexibility, and inhibition to the ability to refrain from impulsive behavior. A deficit in those two EF could predict individual difficulties to maintain a healthy lifestyle. Weak evidence of deficits in shifting and inhibition in individuals of higher Body Mass Index (BMI) have been observed. The objective was to clarify the relationship between inhibition and shifting regarding weight status group differences in healthy adults. Two neuropsychological tests from the Test of Attentional Performance (TAP) battery were used to measure EF performance of three groups of men and women: normal-weight (NW, n = 38), overweight (OW, n = 40) and obesity (OB, n = 37). The results show that individuals with higher BMI have lower inhibition capacities and that classically used weight status categories might not capture cognitive variability. No differences in shifting were observed concerning weight status nor BMI. This paper provides new insights on cognitive factors in obesity by presenting data from healthy individuals with overweight and obesity. The results support that assessing inhibition capacities might be of interest in a clinical setting for patients with difficulties to lose weight.

Hemodialysis Affects Wanting and Spontaneous Intake of Protein-Rich Foods in Chronic Kidney Disease Patients.

OBJECTIVES: Protein-energy wasting is a risk factor for mortality and morbidity in hemodialysis patients (HD patients). Food intake could be modified by HD-related changes in the food reward system (i.e., liking and wanting of specific macronutrients). In HD patients on days with and without dialysis, we evaluated (1) the reward system for protein-, fat-, and carbohydrate-rich foods, plasma hormones, and metabolite changes; and (2) the spontaneous ad libitum intake of macronutrients. (DESIGN AND) METHODS: Twenty-four HD patients evaluated their liking and wanting of macronutrients at 7:30 AM and 11:30 AM on a day with and a day without dialysis. Concentrations of hormones and plasma amino acids were determined. An additional 18 HD patients ate what they wanted from a buffet lunch comprising 8 dishes on a day with and a day without dialysis. Healthy subjects, age-, sex-, and body mass index-matched, served as controls. RESULTS: At 11:30 AM, wanting for protein-rich foods was higher on the day with than on the day without dialysis (P < .01), bringing wanting levels close to those of healthy subjects. This increase correlated with changes in the concentrations of plasma amino acids (P < .01). HD patients ate more protein from the buffet on the day with than on the day without dialysis (P < .01) and more than healthy subjects (P < .01). CONCLUSIONS: In HD patients, wanting and spontaneous intake of protein-rich foods increase immediately after dialysis. This increase correlated with decreased concentrations of plasma amino acids. Thus, in clinical practice, protein-rich foods should be recommended during and after dialysis in patients with protein-energy wasting.

Increased body fat mass reduces the association between fructosamine and glycated hemoglobin in obese type 2 diabetes patients.

Obesity is increasing in patients with type 2 diabetes. A possible reduced association between fructosamine and glycated hemoglobin (HbA1c) in obese individuals has been previously discussed, but this has never been specifically evaluated in type 2 diabetes, and the potential influence of body fat mass and fat distribution has never been studied. We studied 112 type 2 diabetes patients with assessment of fat mass, liver fat and fat distribution. Patients with body mass index (BMI) above the median (34.9 kg/m2 ), versus BMI below the median, had a correlation coefficient between fructosamine and HbA1c significantly reduced (r = 0.358 vs r = 0.765). In the whole population, fructosamine was correlated negatively with BMI and fat mass. In multivariate analysis, fructosamine was associated with HbA1c (positively) and fat mass (negatively), but not with BMI, liver fat or fat distribution. The association between fructosamine and HbA1c is significantly reduced in the most obese type 2 diabetes patients, and this is mostly driven by increased fat mass.

Fatty acid composition of the erythrocyte membrane and risk of hepatocellular carcinoma in cirrhotic patients.

BACKGROUND: Disturbances in fatty acid (FA) metabolism have been reported in cirrhosis, but the role of FAs in the development of hepatocellular carcinoma (HCC) is still unclear. Biomarkers are a promising means to explore the associations between exogenous intake or endogenous production of FAs and cancer risk. AIM: To estimate the relationship between fatty acid content in erythrocyte membranes and HCC risk in cirrhotic patients METHODS: The "CiRCE" case-control study recruited cirrhotic patients from six French hospitals between 2008 and 2012. Cases were cirrhotic patients with HCC (n = 349); controls were cirrhotic patients without HCC at inclusion (n = 550). FA composition of phospholipids in erythrocyte membranes was determined by high performance gas chromatography. Odds ratios for HCC risk according to FA concentrations were estimated with multivariable logistic regression. RESULTS: HCC patients were older and more often men (P < 0.001). In both groups, saturated FAs represented more than 39% of all FAs in erythrocyte membranes, mono-unsaturated FAs around 14%, and polyunsaturated FAs around 46%. High levels of C15:0 + C17:0, C20:1 n-9, C18:2 n-6 and C20:2 n-6 were associated with higher risk of HCC. The levels of C18:0 and C20:4 n-6 were lower in HCC cases than in controls. CONCLUSIONS: The FA composition of erythrocyte membranes differed according to the presence of HCC with higher levels of saturated FAs, linoleic and eicosadienoic acids, and lower levels of stearic and arachidonic acids. These alterations may reflect particular dietary patterns and/or altered FA metabolism. Further investigations are warranted.

A series of severe neurologic complications after bariatric surgery in France: the NEUROBAR Study.

BACKGROUND: Neurologic complications after bariatric surgery are rare, but can have dramatic consequences. Little data are available on this topic. OBJECTIVES: The aim of the Neurologic complications after BARiatric surgery (NEUROBAR) study was to define, which factors (anthropometric, nutritional, surgical, etc.) were frequently associated with neurologic complications after bariatric surgery. SETTINGS: Data were collected by the French Centers of Obesity Care Management hosted in University Hospitals. METHODS: An online standardized questionnaire was designed and submitted to the 37 French Centers of Obesity Management. This questionnaire included items about patient characteristics, bariatric surgery, neurologic complications, nutritional status, and management. Patients were retrospectively included from January 2010 to November 2018. RESULTS: Thirteen centers included 38 patients (34 females and 4 males) with neurologic complications after bariatric surgery. The 2 main bariatric procedures were gastric bypass and sleeve gastrectomy. More than half of the patients with neurologic complications had a surgical complication after bariatric surgery (53%) and gastrointestinal symptoms, including vomiting (53%). Vitamin B deficiencies were frequent (74%) including at least 47% of cases with deficiency in Vitamin B1. CONCLUSION: Early identification of patients with surgical complications and gastrointestinal symptoms after bariatric surgery could help prevent neurologic complications related to nutritional deficiencies.

Implicit food odour priming effects on reactivity and inhibitory control towards foods.

The food environment can interact with cognitive processing and influence eating behaviour. Our objective was to characterize the impact of implicit olfactory priming on inhibitory control towards food, in groups with different weight status. Ninety-one adults completed a modified Affective Shifting Task: they had to detect target stimuli and ignore distractor stimuli while being primed with non-attentively perceived odours. We measured reactivity and inhibitory control towards food pictures. Priming effects were observed on reactivity: participants with overweight and obesity were slower when primed with pear and pound cake odour respectively. Common inhibitory control patterns toward foods were observed between groups. We suggest that non-attentively perceived food cues influence bottom-up processing by activating distinguished mental representations according to weight status. Also, our data show that cognitive load influences inhibitory control toward foods. Those results contribute to understanding how the environment can influence eating behaviour in individuals with obesity.

Study of Small Intestinal Bacterial Overgrowth in a Cohort of Patients with Abdominal Symptoms Who Underwent Bariatric Surgery.

INTRODUCTION: Small intestinal bacterial overgrowth (SIBO) is a common complication of bariatric surgery. Digestive decontamination treatments with oral antibiotic therapy vary and are not codified. This retrospective study was conducted to analyse the characteristics of bariatric surgery patients who underwent a glucose breath test (GBT) and to analyse the effectiveness of the antibiotic decontamination therapy. MATERIALS AND METHODS: A total of 101 operated patients (Roux-en-Y bypass (RYB), omega bypass (ΩB) and sleeve gastrectomy (SG)) who underwent a GBT (75 g/250 mL) were included. Anthropometric data, symptoms of SIBO, type of surgery, use of proton pump inhibitors (PPIs) and antibiotic therapy were analysed. The effectiveness of the antibiotic treatment, defined by improvement of the symptoms, was evaluated during the follow-up. RESULTS: Of the 85 women and 16 men included (48.5 ± 3.6 years old), 63 underwent RYB, 31 underwent ΩB and 7 underwent SG. The GBT was positive in 83% of the patients. A positive test was associated with age (p < 0.001), female sex (p < 0.01) and PPI use (p < 0.01), but there was no significant difference according to the type of surgery. Sixty-one percent of patients treated with gentamicin/metronidazole sequential antibiotic therapy and 58% of patients treated with metronidazole alone achieved treatment efficacy (with no significant difference in efficacy between these treatments). CONCLUSION: SIBO should be systematically considered in the context of abdominal symptoms in bariatric surgery patients, regardless the type of surgery, particularly in patients who are older or female and after PPI treatment. Digestive decontamination appears to be similar between gentamycin/metronidazole and metronidazole treatments.

Differential Cerebral Gustatory Responses to Sucrose, Aspartame, and Stevia Using Gustatory Evoked Potentials in Humans.

Aspartame and Stevia are widely substituted for sugar. Little is known about cerebral activation in response to low-caloric sweeteners in comparison with high-caloric sugar, whereas these molecules lead to different metabolic effects. We aimed to compare gustatory evoked potentials (GEPs) obtained in response to sucrose solution in young, healthy subjects, with GEPs obtained in response to aspartame and Stevia. Twenty healthy volunteers were randomly stimulated with three solutions of similar intensities of sweetness: Sucrose 10 g/100 mL of water, aspartame 0.05 g/100 mL, and Stevia 0.03 g/100 mL. GEPs were recorded with EEG (Electroencephalogram) electrodes. Hedonic values of each solution were evaluated using the visual analog scale (VAS). The main result was that P1 latencies of GEPs were significantly shorter when subjects were stimulated by the sucrose solution than when they were stimulated by either the aspartame or the Stevia one. P1 latencies were also significantly shorter when subjects were stimulated by the aspartame solution than the Stevia one. No significant correlation was noted between GEP parameters and hedonic values marked by VAS. Although sucrose, aspartame, and Stevia lead to the same taste perception, cerebral activation by these three sweet solutions are different according to GEPs recording. Besides differences of taste receptors and cerebral areas activated by these substances, neural plasticity, and change in synaptic connections related to sweet innate preference and sweet conditioning, could be the best hypothesis to explain the differences in cerebral gustatory processing after sucrose and sweeteners activation.

Delivery of oral nutrition supplement in hospital: Evaluation of professional practices in evaluation of nutritional status and representations of ONS by the caregivers and patients.

BACKGROUND: Nutritional evaluation and detection of malnutrition are based on criteria recommended by French health authorities. In practice, doctors do not always ensure strict implementation of the recommendations. The aim of this study is to evaluate professional practices in France regarding nutritional follow-up on arrival, during and after the hospitalization of inpatients who have oral nutritional supplements (ONS) prescribed and to discuss how ONS are seen by medical staff and patients. METHODS: A prospective study including patients consecutively admitted to digestive surgery and endocrinology units of the Dijon university hospital was conducted. Malnutrition risk at hospital admission was identified using anthropometric and biological criteria: Body Mass Index, percentage of weight loss, albumin, prealbumin, C-reactive protein and Mini Nutritional Assessment. Nutritional evaluation and monitoring of inpatients on arrival, during and after hospitalization was analyzed. Interviews were held with caregivers and patients to raise the question of their attitudes toward ONS. RESULTS: The sample was composed of 61 patients. At the beginning of hospitalization, nutritional evaluation of patients was satisfactory. Follow-up during hospitalization was not optimal and depends on the degree of malnutrition. Post-hospitalization testing for albumin was rare, whereas ONS were regularly prescribed. ONS was viewed differently by caregivers and inpatients, which makes the status of ONS ambiguous. CONCLUSION: Our results show good evaluation of nutritional status of inpatients at the beginning of hospitalization but low follow-up during and after hospitalization. Representation of ONS differed between caregivers and patients leading to a confusion around them. Therefore, interdisciplinary work is necessary to encourage systematic assessment of nutritional status in patients and standardize the message regarding ONS.

Weight Status and Attentional Biases Toward Foods: Impact of Implicit Olfactory Priming.

Objective: Numerous studies highlight the involvement of cognitive factors in the development and maintenance of obesity. We aimed to measure attentional biases (AB) toward foods (i.e., the individual tendency to automatically orient one's attention toward food stimuli) in normal-weight (NW) individuals and those with overweight (OW) and obesity (OB). We evaluated whether implicit or explicit exposure to olfactory food cues could modify AB. Methods: Eighty-five participants with different weight statuses took part in this experiment. We measured AB toward food pictures with an adapted visual probe task and the variations in AB, while participants were primed with olfactory food cues (within-subject design: no odor/low-energy dense food odor/high-energy dense food odor). Odors were non-attentively perceived during session 1 (implicit condition) and attentively perceived during session 2 (explicit condition). Results: Our results highlighted AB toward food pictures, especially when foods were energy dense, regardless of weight status (p < 0.001). The olfactory priming effect was only significant in the implicit condition. Participants with obesity had a stronger AB toward foods when they were primed with a non-attentively perceived high-energy dense food odor than with a non-attentively perceived low-energy dense food odor (p = 0.02). The trend was reversed for normal-weight participants, while no significant effect was found for participants with overweight. Conclusion: Our results support the hypothesis that an obesity-specific cognitive vulnerability may influence the processing of food-related stimuli and only while food cues are non-attentively perceived. Future research should seek to understand the mechanisms of this phenomenon.

Proof of concept: Effect of GLP-1 agonist on food hedonic responses and taste sensitivity in poor controlled type 2 diabetic patients.

AIMS: GLP-1 analogues decrease food intake and have great promise for the fight against obesity. Little is known about their effects on food hedonic sensations and taste perception in poor controlled patients with type 2 diabetes (T2D). MATERIALS AND METHODS: Eighteen T2D patients with BMI ≥25 kg/m2 and poor controlled glycemia were studied before and after 3 months of treatment with Liraglutide. Detection thresholds for salty, sweet and bitter tastes, optimal preferences, olfactory liking, wanting and recalled liking for several food items were assessed. Subjects also answered questionnaires to measure their attitudes to food. RESULTS: T2D patients had a significant decrease in bodyweight and HbA1c after treatment with Liraglutide. Liraglutide improved gustative detection threshold of sweet flavors, and decreased wanting for sweet foods and recalled liking for fatty foods. It also led to a decrease in feelings of hunger. CONCLUSIONS: Liraglutide increases sensitivity to sweet tastes and decreases pleasure responses for fatty foods in poor controlled T2D patients, and is of particular interest in the understanding of the mechanisms of weight loss. CLINICAL TRIAL: NCT02674893.

Taste Perception and Cerebral Activity in the Human Gustatory Cortex Induced by Glucose, Fructose, and Sucrose Solutions.

Glucose, fructose, and sucrose are important carbohydrates in Western diets with particular sweetness intensity and metabolisms. No study has compared their cerebral detection and their taste perception. Gustatory evoked potentials (GEPs), taste detection thresholds, intensity perception, and pleasantness were compared in response to glucose, fructose, and sucrose solutions at similar sweetness intensities and at identical molar concentrations. Twenty-three healthy subjects were randomly stimulated with 3 solutions of similar sweetness intensity (0.75 M of glucose, 0.47 M of fructose and 0.29 M of sucrose - sit. A), and with an identical molar concentration (0.29 M - sit. B). GEPs were recorded at gustatory cortex areas. Intensity perception and hedonic values of each solution were evaluated as were gustatory thresholds of the solutions. No significant difference was observed concerning the GEP characteristics of the solutions according to their sweetness intensities (sit. A) or their molar concentration (sit. B). In sit. A, the 3 solutions were perceived to have similar intensities and induced similar hedonic sensations. In sit. B, the glucose solution was perceived to be less intense and pleasant than the fructose and the sucrose solutions (P < 0.001) and the fructose solution was perceived to be less intense and pleasant than the sucrose (P < 0.001). Since GEP recordings were similar for glucose, fructose, and sucrose solutions whatever the concentrations, activation of same taste receptor induces similar cortical activation, even when the solutions were perceived differently. Sweet taste perception seems to be encoded by a complex chemical cerebral neuronal network.

Frequency of Use of Added Sugar, Salt, and Fat in Infant Foods up to 10 Months in the Nationwide ELFE Cohort Study: Associated Infant Feeding and Caregiving Practices.

The consumption of sugar, salt, and fat in infancy may influence later health. The objective of this study was to describe the frequency of use of added sugar, salt, and fat during the complementary feeding period and the associated infant caregiving practices. Data were obtained from a monthly questionnaire filled by parents for 10,907 infants from the French Etude Longitudinale Française depuis l'Enfance (ELFE) cohort. A score of frequency of use (SU) for added sugar, salt, and fat (oil, margarine, butter, and/or cream) was calculated from the age at complementary feeding introduction (CFI) to the 10th month. Associations between the SU of each added ingredient with infant feeding and caregiving practices were studied with multivariable linear regressions adjusted for familial characteristics. Only 28% of the parents followed the recommendation of adding fat and simultaneously not adding sugar or salt. Breastfeeding mothers were more prone to add sugar, salt, and fat than non-breastfeeding mothers. CFI before four months was positively associated with the SU of added sugar and salt and negatively associated with the SU of added fat. The use of commercial baby food was negatively related to the SU of added salt and fat. The use of these added ingredients was mainly related to breastfeeding, age at CFI, and use of commercial food, and it was independent of the household socioeconomic characteristics.

Depression and obesity, data from a national administrative database study: Geographic evidence for an epidemiological overlap.

BACKGROUND: Depression and obesity are two major conditions with both psychological and somatic burdens. Some data suggest strong connections between depression and obesity and more particularly associated prevalence of both disorders. However, little is known about the geographical distribution of these two diseases. This study aimed to determine if there is spatial overlap between obesity and depression using data from the entire French territory. METHODS: Data for 5,627 geographic codes for metropolitan France were collected from the two national hospital databases (PMSI-MCO and RIM-P) for the year 2016. We identified people who were depressed, obese or both registered in the two public medico-administrative databases, and we assessed their location. In addition, a multivariable analysis was performed in order to determine geographic interactions between obesity and depression after controlling for age, sex, environmental and socio-economic factors (social/material deprivation, urbanicity/rurality). RESULTS: 1,045,682 people aged 18 years and older were identified. The mapping analysis showed several cold and hot regional clusters of coinciding obesity and depression. The multivariable analysis demonstrated significant geographic interactions, with an increasing probability of finding a high prevalence of obesity in regions with major depression (OR 1.29 95% CI 1.13-1.49, p = 0.0002) and an increased probability of finding a high prevalence of depression in regions with a high ration of obesity (OR 1.32, 95% CI 1.15-1.52, p<0.0001). CONCLUSION: Our study confirms the significant bidirectional relationships between obesity and depression at a group level. French geographic patterns reveal a partial overlap between obesity and depression, suggesting these two diseases can be included in a common approach. Further studies should be done to increase the understanding of this complex comorbidity.

Cerebral gustatory activation in response to free fatty acids using gustatory evoked potentials in humans.

There is some evidence of specific oro-detection of FFAs in rodents and humans. The aim of this study was to record gustatory evoked potentials (GEPs) in response to FFA solutions and to compare GEPs in response to linoleic acid solution with GEPs obtained after stimulation with sweet and salty tastants. Eighteen healthy men were randomly stimulated with fatty (linoleic acid), sweet (sucrose), and salty (NaCl) solutions at two concentrations in the first experiment. Control recordings (n = 14) were obtained during stimulation by a paraffin oil mixture without FFA or by water. In the second experiment, 28 men were randomly stimulated with five FFA solutions and a paraffin emulsion. GEPs were recorded with electroencephalographic electrodes at Cz, Fz, and Pz. GEPs were observed in response to FFA in all participants. GEP characteristics did not differ according to the quality and the concentration of the solutions in the first experiment and according to the FFA in the second experiment. This study describes for the first time GEPs in response to FFA and demonstrates that the presence of FFA in the mouth triggers an activation of the gustatory cortex. These data reinforce the concept that fat taste could be the sixth primary taste.

Impairment of the Ability of HDL From Patients With Metabolic Syndrome but Without Diabetes Mellitus to Activate eNOS: Correction by S1P Enrichment.

OBJECTIVE: High-density lipoprotein (HDL) from nondiabetic patients with metabolic syndrome (MetS) displays abnormalities in their lipidome, such as triglyceride enrichment and sphingosine-1-phosphate depletion. We hypothesized that these abnormalities could impair the ability of HDL to stimulate endothelial nitric oxide synthase (eNOS). APPROACH AND RESULTS: Compared with HDL from control subjects, HDL from normoglycemic patients with MetS was 39% richer in triglycerides (P<0.01) and 15% poorer in sphingosine-1-phosphate (P<0.05; n=23 in each group). eNOS activity, assessed by the conversion of L-[3H]arginine to L-[3H]citrulline, was 69% lower in human umbilical vein endothelial cells incubated with HDL from MetS patients than in cells incubated with HDL from controls (P<0.0001). In addition, the activating phosphorylation of eNOS at serine (Ser) 1177 and of Akt (protein kinase B) at Ser473 was 37% (P<0.001) and 39% (P<0.05) lower, respectively, with HDL from MetS patients. Sphingosine-1-phosphate enrichment of HDL from MetS patients restored their ability to stimulate eNOS activity (P<0.05), in relation with a significant increase in eNOS phosphorylation at Ser1177 (P<0.05) and in Akt phosphorylation at Ser473 (P=0.05). By contrast, triglyceride enrichment of HDL from control subjects did not modify eNOS activity (P=0.90) and phosphorylation at Ser1177 (P=0.87). CONCLUSIONS: We provide evidence that the activation of eNOS by HDL is decreased in MetS patients before the appearance of diabetes mellitus and that sphingosine-1-phosphate depletion of HDL is the main factor responsible for this defect. This has important consequences on the impairment of HDL functionality and antiatherogenic properties in these patients.