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Search Results (919)

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Keywords = anorexia

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15 pages, 286 KB  
Article
Anorexia Nervosa and Emotional Dysregulation: A Longitudinal Study on the Characteristics and Clinical Implications in a Group of Female Adolescents
by Fantozzi Pamela, Covelli Chiara, Ditaranto Francesca, Apicella Fabio, Belmonti Vittorio, Tancredi Raffaella, Levantini Valentina and Calderoni Sara
Children 2026, 13(3), 402; https://doi.org/10.3390/children13030402 - 14 Mar 2026
Viewed by 150
Abstract
Background: Anorexia nervosa (AN) is a severe eating disorder occurring most frequently in adolescence, characterized by a high prevalence of psychiatric comorbidity. Emotional dysregulation (ED) refers to a transdiagnostic construct that often drives disordered eating behavior. The present study aimed to evaluate [...] Read more.
Background: Anorexia nervosa (AN) is a severe eating disorder occurring most frequently in adolescence, characterized by a high prevalence of psychiatric comorbidity. Emotional dysregulation (ED) refers to a transdiagnostic construct that often drives disordered eating behavior. The present study aimed to evaluate differences and similarities in the clinical presentation and response to treatment of young AN patients with high levels of ED (AN+ED) and with low levels of ED (AN−ED). Methods: A total of 40 female inpatients aged between 12 and 18 years were consecutively recruited and subdivided into two groups (AN+ED: n = 21; AN−ED: n = 19), based on the median of the subscale Affective Instability (AI) of the Reactivity, Intensity, Polarity and Stability questionnaire—youth version (RIPoSt-Y). At the recruitment (T0), and after 6 months (T1), the Body Mass Index (BMI) was calculated, and questionnaires and scales were administered to assess (a) the general functioning; (b) the severity of the eating disorder; and (c) the associated psychopathology. Results: At T0, an independent-samples t-test showed that the AN+ED group was characterized by a significantly greater impairment in clinical functioning and a greater severity of both the eating disorder and the associated psychopathology compared to the AN−ED group. At T1, the AN+ED group also showed significantly higher levels of cyclothymic, depressive, and anxious symptoms than the AN−ED group. Moreover, repeated-measures ANOVAs revealed a statistically marked improvement over time of the bulimic behaviors in the AN+ED group only. Conclusions: The present study underscored distinctive clinical features in AN patients with high and low levels of ED. Specifically, the AN+ED group was characterized by a most likely severe clinical phenotype that requires tailored intervention strategies. Full article
27 pages, 1639 KB  
Article
Cognitive Behavioral Therapy Reduces Symptom Severity and Normalizes Neurophysiological and Attentional Reactivity in Anorexia Nervosa: A Randomized Controlled Trial
by Eda Yılmazer, Metin Çınaroğlu, Selami Varol Ülker and Gökben Hızlı Sayar
Brain Sci. 2026, 16(3), 309; https://doi.org/10.3390/brainsci16030309 - 13 Mar 2026
Viewed by 234
Abstract
Background: Anorexia nervosa (AN) is a severe psychiatric disorder marked by restrictive eating, distorted body image, and high relapse rates. While cognitive-behavioral therapy (CBT) is a widely used treatment, its mechanisms of action in AN remain incompletely understood, particularly beyond self-reported symptom change. [...] Read more.
Background: Anorexia nervosa (AN) is a severe psychiatric disorder marked by restrictive eating, distorted body image, and high relapse rates. While cognitive-behavioral therapy (CBT) is a widely used treatment, its mechanisms of action in AN remain incompletely understood, particularly beyond self-reported symptom change. This study investigated the effects of a 12-week CBT intervention on both clinical and multimodal laboratory-based outcomes in women with restrictive-type AN. Methods: In a two-arm, pre–post randomized controlled trial (ClinicalTrials.gov: NCT07037017), 59 women with restrictive-type AN were randomized to a CBT intervention (n = 30) or no-treatment control (n = 29). A total of 50 participants (CBT: 26; control: 24) completed baseline and post-intervention assessments and were included in analyses. Outcomes included psychometric measures (eating disorder symptoms, depression, anxiety, body image-related obsessive–compulsive symptoms, and cognitive emotion regulation) and laboratory-based indices: electroencephalography (EEG), galvanic skin response (GSR), and eye-tracking during exposure to food- and body-related stimuli. Group × Time effects were analyzed using repeated-measures mixed-effects models, and statistical analyses were conducted using SPSS (Version 31; IBM Corp., Armonk, NY, USA). Results: Significant Group × Time interactions indicated greater improvements in the CBT group across all psychometric outcomes, including reduced eating disorder symptom severity (p < 0.001, ηp2 = 0.28) and increased adaptive emotion regulation. CBT participants also showed significant reductions in EEG P300 and late positive potential (LPP) amplitudes to body-related stimuli, increased frontal alpha asymmetry, decreased visual fixation on salient body and food cues, and attenuated GSR reactivity (all p < 0.05). Exploratory correlations revealed that symptom improvements were associated with reductions in neurophysiological and attentional reactivity. Conclusions: To our knowledge, this is the first RCT in AN to demonstrate that CBT not only improves self-reported outcomes but also modulates neurophysiological and attentional processes implicated in the maintenance of the disorder. Multimodal laboratory assessments provided mechanistic insight into treatment effects and may inform personalized intervention strategies. CBT appears to facilitate recovery through both cognitive–emotional and physiological recalibration. Full article
(This article belongs to the Section Neuropsychiatry)
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10 pages, 231 KB  
Article
Perceived Isolation on the Self-Compassion Scale Is Associated with the Binge-Eating/Purging Subtype in Severe Anorexia Nervosa: A Retrospective Exploratory Study
by Fumiya Miyano, Nobuyuki Mitsui, Shuhei Ishikawa, Ryo Okubo and Takahiro A. Kato
Psychiatry Int. 2026, 7(2), 63; https://doi.org/10.3390/psychiatryint7020063 - 13 Mar 2026
Viewed by 321
Abstract
This study aimed to examine the differences in self-compassion (SC) subcomponents between anorexia nervosa (AN) subtypes, the restricting type (ANR) and binge-eating/purging type (ANBP), with a focus on perceived isolation and self-judgment. This retrospective exploratory study included 40 patients with AN at a [...] Read more.
This study aimed to examine the differences in self-compassion (SC) subcomponents between anorexia nervosa (AN) subtypes, the restricting type (ANR) and binge-eating/purging type (ANBP), with a focus on perceived isolation and self-judgment. This retrospective exploratory study included 40 patients with AN at a Japanese tertiary hospital. The participants completed the Self-Compassion Scale, Patient Health Questionnaire-9, and Eating Disorder Examination Questionnaire. Between-group comparisons were conducted using t-tests, and logistic regression was used to examine associations with the AN subtype. Compared with the ANR group, the ANBP group was older at the time of assessment, had a longer illness duration, and showed significantly more depressive symptoms, more severe eating pathologies, and lower SC scores. Specifically, patients with ANBP had significantly higher scores on the negative SCS subscales of self-judgment and isolation, indicating greater self-criticism and perceived isolation. In logistic regression analyses adjusting for the EDE-Q mean score, higher isolation scores were significantly associated with the ANBP subtype (odds ratio = 3.28, 95% confidence interval: 1.37–9.63, p = 0.01). In this exploratory sample, perceived isolation was more prominent in ANBP and may reflect affective and interpersonal difficulties related to this subtype. These findings should be interpreted as hypothesis-generating and warrant replication in larger (ideally multi-site and longitudinal) samples. If replicated, targeting these self-compassion dimensions may inform the development of subtype-sensitive interventions. Full article
22 pages, 1344 KB  
Review
Fibromyalgia, Eating Disorders and Rehabilitation: The Nrf2 Link
by Roberto Casale, Paolo Capodaglio, Kestutis Petrikonis, Antonella Paladini, Piercarlo Sarzi-Puttini and Jurga Bernatoniene
Antioxidants 2026, 15(3), 364; https://doi.org/10.3390/antiox15030364 - 12 Mar 2026
Viewed by 295
Abstract
Background: Fibromyalgia (FM) and eating disorders (ED) represent distinct clinical entities traditionally managed within separate medical specialties, yet emerging evidence suggests significant comorbidity and potential shared pathophysiological mechanisms. Both conditions disproportionately affect women, involve complex multifactorial etiologies and substantially impair quality of life. [...] Read more.
Background: Fibromyalgia (FM) and eating disorders (ED) represent distinct clinical entities traditionally managed within separate medical specialties, yet emerging evidence suggests significant comorbidity and potential shared pathophysiological mechanisms. Both conditions disproportionately affect women, involve complex multifactorial etiologies and substantially impair quality of life. Despite documented clinical overlaps, the mechanistic connections linking these conditions remain poorly characterized, and integrated treatment approaches are lacking. Objective: This narrative review examines the role of oxidative stress and nuclear factor erythroid 2-related factor 2 (Nrf2) pathway dysfunction as a unifying molecular mechanism connecting fibromyalgia and eating disorders, with emphasis on implications for integrated rehabilitation strategies. Methods: We synthesized current evidence on oxidative stress pathophysiology in fibromyalgia and eating disorders, focusing on Nrf2-Keap1 pathway function, clinical comorbidity patterns and rehabilitation interventions targeting antioxidant defense mechanisms. In PubMed, representative search strings included “(fibromyalgia [MeSH] OR fibromyalgia [Title/Abstract]) AND (“eating disorders” [MeSH] OR “anorexia nervosa” [MeSH] OR “bulimia nervosa” [MeSH])” and “fibromyalgia AND (“oxidative stress” OR Nrf2 OR “redox”)”. Articles in English published through December 2025 were considered, with additional records identified by manually screening reference lists. Results: Fibromyalgia patients exhibit elevated oxidative stress markers, impaired antioxidant enzyme function and compromised Nrf2 activity correlating with disease severity, with studies reporting approximately 30–50% reductions in coenzyme Q10 levels compared with healthy controls. Similarly, eating disorders demonstrate mitochondrial dysfunction and oxidative stress dysregulation, though patterns differ across eating disorder phenotypes. Nrf2 serves as the master regulator of cellular antioxidant defense, coordinating expression of over 500 genes involved in detoxification, cytoprotection, inflammation modulation and metabolic regulation. Evidence suggests Nrf2 activity is regulated by energy balance, potentially linking nutritional status with cellular stress responses. Rehabilitation interventions, including graduated exercise and nutritional optimization with Nrf2-activating foods (cruciferous vegetables, polyphenols, omega-3 fatty acids), offer mechanism-based therapeutic approaches through hormetic Nrf2 activation and direct Keap1 modification. Conclusions: Multidisciplinary rehabilitation programs integrating physical therapy, exercise prescription and nutritional strategies targeting Nrf2 activation offer evidence-based, mechanism-driven approaches to address shared oxidative stress pathophysiology. Nrf2 pathway dysfunction represents a promising and biologically plausible molecular target that may help to unify our understanding of fibromyalgia and eating disorders pending confirmation from prospective clinical studies in comorbid populations. Future research should prioritize prospective clinical trials testing Nrf2-targeted interventions in comorbid populations and collaborative patient-centered care models. Full article
(This article belongs to the Special Issue Chronic Pain and Oxidative Stress)
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11 pages, 714 KB  
Brief Report
Dietary Fat and Carbohydrate Exposure During a Group-Based Nutritional Psychoeducational Program in Anorexia Nervosa
by Paolo Meneguzzo, Alessandra Zattarin, Arianna Carpin, Anna Svaizer, Beatrice Varotto, Zaira Salvador, Anna Marchetto, Angela Veronese and Angela Favaro
Nutrients 2026, 18(6), 902; https://doi.org/10.3390/nu18060902 - 12 Mar 2026
Viewed by 191
Abstract
Background: Nutritional psychoeducation is a core component of multidisciplinary treatment for anorexia nervosa, yet evidence on its association with changes in eating behavior beyond weight outcomes remains limited. Methods: This pre–post observational study included 45 patients with anorexia nervosa attending a Day Hospital [...] Read more.
Background: Nutritional psychoeducation is a core component of multidisciplinary treatment for anorexia nervosa, yet evidence on its association with changes in eating behavior beyond weight outcomes remains limited. Methods: This pre–post observational study included 45 patients with anorexia nervosa attending a Day Hospital program who participated in a structured, group-based nutritional psychoeducational intervention as part of standard multidisciplinary care. Nutritional knowledge, dietary rules, eating behaviors, food group exposure assessed by a Food Frequency Questionnaire (FFQ), and body mass index (BMI) were evaluated before and after the intervention. Pre–post changes were examined using paired statistical tests with Holm correction. Associations between changes in cognitive–nutritional variables and eating behavior were explored using correlations and multiple linear regression models. Results: Significant pre–post improvements were observed in nutritional knowledge and reductions in rigid dietary rules. Eating behavior showed specific changes, with increased exposure to carbohydrate- and fat-containing foods, as well as improved meal adequacy. BMI increased during the observation period, consistent with expected outcomes of Day Hospital treatment. Changes in nutrient-related knowledge were positively associated with changes in dietary fat exposure, independent of baseline BMI and changes in dietary rules, whereas no comparable association was observed for carbohydrate exposure. Conclusions: In this Day Hospital sample, participation in a group-based nutritional psychoeducational program within a multidisciplinary treatment context was associated with specific changes in eating behavior alongside cognitive–nutritional changes and weight gain. The observed association between nutrient-related knowledge and dietary fat exposure may suggest the relevance of assessing food-specific behaviors and cognitive–nutritional processes as complementary outcomes during treatment for anorexia nervosa. Full article
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15 pages, 1245 KB  
Review
Metacognitive Dysfunction in Women with Eating Disorders: A Narrative Review
by Fabiola Raffone, Serena Testa, Concetta Iaccarino, Miriam Olivola, Tommaso Barlattani, Domenico De Berardis, Francesca Pacitti and Vassilis Martiadis
Women 2026, 6(1), 17; https://doi.org/10.3390/women6010017 - 2 Mar 2026
Viewed by 243
Abstract
Eating disorders (EDs) disproportionately affect women and are associated with substantial morbidity, chronicity, and mortality. While established psychological models focus on the content of maladaptive cognitions related to body weight, shape, and eating behaviors, growing evidence suggests that additional process-level mechanisms contribute to [...] Read more.
Eating disorders (EDs) disproportionately affect women and are associated with substantial morbidity, chronicity, and mortality. While established psychological models focus on the content of maladaptive cognitions related to body weight, shape, and eating behaviors, growing evidence suggests that additional process-level mechanisms contribute to symptom persistence and treatment resistance. Metacognitive models emphasize how individuals relate to their thoughts, emotions, and internal experiences, highlighting maladaptive beliefs about thinking and the resulting cognitive–attentional patterns (e.g., repetitive negative thinking, self-focused attention, and inflexible attentional control) as potential maintaining factors across psychopathology. This narrative review synthesizes the theoretical and empirical literature on metacognitive dysfunction in EDs, with a focus on mechanisms that may be particularly relevant for women. We integrate epidemiological data and gender-sensitive frameworks, and review evidence on metacognitive beliefs and cognitive–attentional syndrome (CAS)-related processes across anorexia nervosa, bulimia nervosa, and binge-eating disorder. Overall, studies indicate that dysfunctional beliefs about the uncontrollability and danger of thoughts, alongside perseverative cognitive styles, are associated with greater ED symptom severity. We discuss diagnosis-relevant patterns as clinically useful heuristics, interactions with sociocultural and emotional vulnerability factors, and implications for assessment, treatment integration, and prevention. The evidence base is largely correlational and derived from predominantly female samples, underscoring the need for longitudinal research and studies that explicitly test sex/gender as a moderator. Full article
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40 pages, 864 KB  
Systematic Review
Psychopathology and Other Mental Health Challenges in Siblings of Patients with Child- or Adolescent-Onset Anorexia Nervosa: A Systematic Review with a Sex/Gender Perspective
by Elisabet Tasa-Vinyals, Maria Teresa Plana, Albert Martínez-Pinteño, Mireia Mora-Porta, Arturo Rodríguez-Rey, Susana Andrés-Perpiñá, Elena Moreno, Esteban Martínez, Josefina Castro-Fornieles and Itziar Flamarique
J. Clin. Med. 2026, 15(5), 1772; https://doi.org/10.3390/jcm15051772 - 26 Feb 2026
Viewed by 578
Abstract
Background/Objectives: Anorexia nervosa (AN) is a severe psychiatric-metabolic disorder with high morbidity and mortality, profoundly impacting family systems. Siblings of patients with AN constitute a vulnerable group, yet there is a lack of specific, quantitative evidence on their mental health status, particularly [...] Read more.
Background/Objectives: Anorexia nervosa (AN) is a severe psychiatric-metabolic disorder with high morbidity and mortality, profoundly impacting family systems. Siblings of patients with AN constitute a vulnerable group, yet there is a lack of specific, quantitative evidence on their mental health status, particularly when examined from a sex/gender perspective. This review aimed to synthesize existing evidence on the prevalence of psychiatric symptoms, diagnoses, and other mental health challenges in siblings of individuals with AN and critically analyze it from a sex/gender perspective. Methods: Following PRISMAguidelines, a systematic search was conducted across five databases (April–May 2025). The protocol was registered in PROSPERO (CRD420251025535). Sixteen studies published between 1983 and 2022 met eligibility criteria. Results: Included studies were rated as high or moderate quality, and overall risk of bias was estimated as low–moderate. Only half of the studies included brothers, and overall quality assessment from a sex/gender perspective was modest. Dimensional psychopathology assessments found increased prevalence of both internalizing and externalizing symptoms in siblings compared to controls, although siblings were generally more like controls than affected probands in psychometric evaluations. The few studies based on clinically diagnosed psychopathology state that siblings are at increased risk of several mental health disorders. Conclusions: Specific quantitative evidence on psychiatric diagnoses, psychopathology and other mental health challenges in siblings of individuals with AN is relatively scarce and biased, particularly by systematic exclusion of externalizing symptoms and male siblings. Future translational research should be designed and interpreted using a sex/gender perspective and prioritize systematic assessment by clinicians. Full article
(This article belongs to the Section Mental Health)
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13 pages, 1410 KB  
Article
Validity of an AI-Assisted Dietary Recording Application for Family-Based Nutritional Management in Young Patients with Anorexia Nervosa
by Nao Shiraishi, Rieko Kawase, Haruka Ogawa and Tatsuo Akechi
Nutrients 2026, 18(4), 708; https://doi.org/10.3390/nu18040708 - 23 Feb 2026
Viewed by 420
Abstract
Background: Evidence regarding the validity of digital dietary recordings in the family-based nutritional management of anorexia nervosa (AN) remains limited. This study evaluated the validity of an AI-assisted dietary recording application (app) used by the parents of young patients with AN, with [...] Read more.
Background: Evidence regarding the validity of digital dietary recordings in the family-based nutritional management of anorexia nervosa (AN) remains limited. This study evaluated the validity of an AI-assisted dietary recording application (app) used by the parents of young patients with AN, with total energy intake as the primary outcome and major nutrient intake as the secondary outcome. Methods: During hospital leave prior to discharge, one day of dietary intake was recorded by parents using the app based on meal photographs. The energy and nutrient intakes estimated by the app were compared with a registered dietitian using visual estimation of the photographs. Differences were examined using the Wilcoxon signed-rank test, associations were assessed using Spearman’s correlation coefficients, and agreement was evaluated using Bland–Altman analysis. Sensitivity analyses excluding extreme outliers were performed. Results: Thirty female inpatients with AN (mean age: 14.8 ± 2.9 years) and their mothers participated. The median total energy intake did not differ significantly between the app and reference method (2462 vs. 2439 kcal/day). Moderate to high correlations were observed for total energy (ρ = 0.62) and major nutrient intakes. The app tended to overestimate these intakes; however, Bland–Altman analyses indicated no systematic bias. Exclusion of two outliers strengthened correlations for total energy intake (ρ = 0.74) and narrowed the limits of agreement. Conclusions: The app demonstrated an acceptable agreement for estimating energy and major nutrient intake in the therapeutic context of AN. Careful attention to dish type and portion size may further support its clinical use. Full article
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16 pages, 513 KB  
Article
From Interpersonal Insecurity to Disordered Eating: The Mediating Pathway of Appearance-Based Rejection Sensitivity
by Liang Zhang, Yang Zeng, Yanqiang Tao, Xiangping Liu and Shujian Wang
Behav. Sci. 2026, 16(2), 307; https://doi.org/10.3390/bs16020307 - 22 Feb 2026
Viewed by 269
Abstract
Eating disorders among adolescents have emerged as a significant global public health concern, with attachment anxiety identified as a critical risk factor for anorexia nervosa (AN) symptoms. Individuals with attachment anxiety often exhibit heightened sensitivity to others’ perceptions and an intense fear of [...] Read more.
Eating disorders among adolescents have emerged as a significant global public health concern, with attachment anxiety identified as a critical risk factor for anorexia nervosa (AN) symptoms. Individuals with attachment anxiety often exhibit heightened sensitivity to others’ perceptions and an intense fear of rejection, which may exacerbate their vulnerability to body image concerns. This study investigates the mediating role of appearance-based rejection sensitivity (ARS) and the moderating effect of sex in the relationship between attachment anxiety and AN symptoms among Chinese college students. A total of 826 participants aged 16–25 (M = 18.95, SD = 1.08, 60% females) completed online surveys using three validated scales: the Revised Adult Attachment Scale (RAAS) to assess attachment anxiety, the Appearance-based Rejection Sensitivity Scale (ARSS) to measure sensitivity to rejection related to physical appearance, and the Eating Disorders Inventory (EDI) to evaluate AN symptoms. The results reveal that there was no significant difference in attachment anxiety between males and females, while females experienced significantly higher levels of ARS and severity of AN symptoms than males. Attachment anxiety is positively correlated with AN symptoms, with ARS mediating this association. Sex further moderates the relationship between ARS and AN symptoms, with stronger effects observed in females. Current findings suggest that AN symptoms are closely associated with contemporaneous attachment anxiety, with passive sensitivity to potential rejection acting as a mediating factor. This underscores the importance of addressing attachment styles and communication patterns in interventions targeting adolescent AN symptoms, particularly in females. Full article
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15 pages, 1507 KB  
Article
Specific Bioelectrical Vector Reference Values for Italian Adults: A Multicentre Study
by Federica Frau, Eduardo Pizzo Junior, Valeria Succa, Silvia Stagi, Federica Moro, Francesco Sguaizer, Cristian Petri, Antonio Paoli, Gabriele Mascherini, Pascal Izzicupo, Simona Bertoli, Luisa Gilardini, Luca Cavaggioni, Emanuele Cereda, Francesco Campa, Margherita Micheletti Cremasco, Stefania Toselli and Elisabetta Marini
J. Funct. Morphol. Kinesiol. 2026, 11(1), 81; https://doi.org/10.3390/jfmk11010081 - 17 Feb 2026
Viewed by 349
Abstract
Objective: Since specific bioelectrical reference values for Italian adults are lacking, this study aims to define specific values and test their suitability in pathological cases and athletes. Methods: A sample of 1049 Italian individuals (441 men, 608 women) aged 30–65 years was considered. [...] Read more.
Objective: Since specific bioelectrical reference values for Italian adults are lacking, this study aims to define specific values and test their suitability in pathological cases and athletes. Methods: A sample of 1049 Italian individuals (441 men, 608 women) aged 30–65 years was considered. Competitive athletes (bodybuilding, streetlifting and tennis) were identified within the general sample, and an independent group of individuals with obesity or anorexia nervosa was analyzed for comparison. Anthropometric (weight, kg; stature, mid-upper arm, waist and calf circumferences; cm) and bioelectrical (resistance and reactance, at 50 kHz) variables were taken. Resistivity, (Rsp, Ωcm), reactivity (Xcsp, Ωcm), impedivity (Zsp, Ωcm) and phase angle (PhA, °) were calculated. Two-way ANOVA and Hotelling’s T2 test were applied to assess group differences. These data were then pooled with existing datasets to create a comprehensive reference for individuals aged 18 to 100 years. Results: The specific bioelectrical variables were: Rsp = 352.3 ± 55.5, Xcsp = 41.8 ± 9.1, PhA = 6.8 ± 1.0, r (Rsp, Xcsp) = 0.67 (men); Rsp = 384.9 ± 71.2, Xcsp = 40.7 ± 9.4, PhA = 6.1 ± 1.0, r (Rsp, Xcsp) = 0.72 (women). Men showed higher PhA values (p < 0.001), reflecting higher muscle mass and quality, and shorter vectors (p < 0.001), indicative of lower relative fat mass (FM%), than women. Advancing age was associated with lower PhA and longer vectors (p < 0.001). Bioelectrical vectors of individuals with obesity or anorexia nervosa were outside the 95% variability, indicating abnormal values of FM%, whereas those of athletes fell within the lower left quadrant. Conclusions: The specific tolerance ellipses for the Italian adult population fill a gap in the existing literature, providing essential new tools for evaluating body composition in clinical and sports settings, and for comparative analyses. Full article
(This article belongs to the Special Issue Body Composition Assessment: Methods, Validity, and Applications)
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26 pages, 4397 KB  
Article
Tumor-Derived LIF Promotes GDF15-Driven Cachexia and Adverse Outcomes in Gastric Cancer
by Cristina Di Giorgio, Nicola Natalizi, Maria Rosaria Sette, Martina Bordoni, Benedetta Sensini, Ginevra Lachi, Eleonora Giannelli, Francesca Paniconi, Luigi Cari, Silvia Marchianò, Michele Biagioli, Elva Morretta, Maria Chiara Monti, Bruno Charlier, Fabrizio Dal Piaz, Angela Zampella, Eleonora Distrutti, Luigina Graziosi, Annibale Donini and Stefano Fiorucci
Cells 2026, 15(4), 355; https://doi.org/10.3390/cells15040355 - 16 Feb 2026
Viewed by 640
Abstract
Cancer cachexia is a multifactorial metabolic syndrome characterized by progressive skeletal muscle and adipose tissue loss, systemic inflammation, and poor clinical outcomes, and represents a major unmet clinical need in gastric cancer. Growth Differentiation Factor 15 (GDF15) is a key mediator of cachexia-associated [...] Read more.
Cancer cachexia is a multifactorial metabolic syndrome characterized by progressive skeletal muscle and adipose tissue loss, systemic inflammation, and poor clinical outcomes, and represents a major unmet clinical need in gastric cancer. Growth Differentiation Factor 15 (GDF15) is a key mediator of cachexia-associated anorexia and tissue wasting; however, the upstream mechanisms regulating its expression in gastric cancer remain poorly defined. Leukemia Inhibitory Factor (LIF), a pleiotropic cytokine implicated in tumor progression and metabolic dysregulation, has emerged as a potential regulator of cachexia-related pathways. Here, we investigated the association between LIF in regulating GDF15 expression and its relationship with metabolic, inflammatory, and body composition alterations in gastric cancer. Transcriptomic profiling of paired neoplastic and non-neoplastic gastric mucosa from 61 gastric cancer patients revealed a significant upregulation of both LIF and GDF15 in tumor tissue, with a strong positive correlation between their expression levels. High GDF15 expression was associated with reduced overall survival, a finding validated in independent TCGA-STAD and ACRG cohorts. Intratumoral bile acid profiling uncovered a marked enrichment of primary bile acids and a depletion of secondary bile acids, resulting in reduced levels of bile acids with endogenous LIF receptor (LIFR) antagonist activity; elevated primary, LIFR non-antagonist bile acids were associated with worse survival outcomes. Clinically, increased LIF and GDF15 expression correlated with weight loss, heightened inflammatory burden, reduced serum protein and albumin levels, and impaired body composition in a sub-cohort of 19 patients. Notably, LIF expression showed a significant inverse association with both lumbar skeletal muscle index (L3SMI) and subcutaneous adipose tissue index (SATI). Mechanistically, experimental models demonstrated that LIF enhances proliferative activity in gastric cancer spheroids and exerts paracrine effects that impair myogenic differentiation and suppress hepatic metabolic gene expression. Collectively, these findings identify the LIF/GDF15 axis as a central driver of cancer-associated cachexia in gastric cancer and highlight LIF signaling as a potential therapeutic target. Full article
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18 pages, 298 KB  
Article
Muscle Strength and Functional Performance as Predictors of Metabolic and Body Composition Improvement in Anorexia Nervosa
by Eugenia Dozio, Sofia Gritti, Lorenzo Niego, Elisa Sartorello, Edoardo Scuttari, Gianluca Tori, Arianna Ruggiero, Letizia Galasso, Lucia Castelli, Angela Montaruli, Eliana Roveda, Rina Giuseppa Russo, Andrea Caumo and Ileana Terruzzi
Nutrients 2026, 18(4), 642; https://doi.org/10.3390/nu18040642 - 16 Feb 2026
Viewed by 628
Abstract
Background/Objectives: Anorexia nervosa (AN) is a severe psychiatric disorder characterized by energy restriction and associated with profound metabolic and body composition alterations. The loss of Body Cell Mass (BCM) leads to impaired muscle strength and functional capacity. Traditional monitoring based on body [...] Read more.
Background/Objectives: Anorexia nervosa (AN) is a severe psychiatric disorder characterized by energy restriction and associated with profound metabolic and body composition alterations. The loss of Body Cell Mass (BCM) leads to impaired muscle strength and functional capacity. Traditional monitoring based on body mass index (BMI, kg/m2) and weight primarily captures quantitative recovery, failing to reflect early qualitative metabolic and functional restoration. This study evaluated the longitudinal associations between improvements in physical performance and metabolic and structural recovery during intensive rehabilitation. Methods: A prospective longitudinal study was conducted on 21 AN patients undergoing a four-month intensive nutritional and functional rehabilitation program at Villa Miralago. Anthropometry, BIVA-derived parameters, indirect calorimetry and physical performance tests were assessed at baseline (T0), 2 months (T1) and 4 months (T2). Longitudinal associations were explored using Generalized Estimating Equations (GEE). Results: Improvements in functional performance (KPI-SUSS) were significantly associated with metabolic recovery, with a positive association with resting metabolic rate (β = +0.3635; p = 0.0088), indicating early metabolic reactivation before full structural reconstruction. Grip strength (KPI-grip) was significantly associated with cellular integrity (Xc β = +0.4129; p = 0.0088) and with favorable fluid redistribution (↑ intracellular water percentage (ICWp), ↓ extracellular water percentage (ECWp)). Structural recovery markers (Fat-Free Mass (FFM, kg), Fat-Free Mass Index (FFMI, kg/m2), BCM) increased significantly over time, confirming a time-dependent restoration of metabolically active mass. Fat mass (FM, kg) and fat mass percentage (FMp) were positively associated with functional improvement, although this effect attenuated longitudinally. These findings support strength performance as a sensitive functional indicator longitudinally associated with qualitative metabolic and cellular recovery. Conclusions: Muscle strength and functional performance tests are simple, non-invasive and cost-effective tools longitudinally associated with metabolic and structural normalization in AN. Their integration into clinical practice may enable the monitoring of meaningful recovery, personalized rehabilitation strategies and improving long-term outcomes. Full article
(This article belongs to the Section Nutrition and Public Health)
19 pages, 1910 KB  
Article
Clinical and Laboratory Findings in Cats with Confirmed Avian Influenza A/H5N1 Virus Infection During the 2023 Outbreak in Poland: A Retrospective Case Series of 22 Cats
by Dawid Jańczak, Anna Golke, Karol Szymański, Ewelina Hallmann, Katarzyna Pancer, Aleksander Masny, Tomasz Dzieciątkowski and Olga Szaluś-Jordanow
Pathogens 2026, 15(2), 200; https://doi.org/10.3390/pathogens15020200 - 11 Feb 2026
Viewed by 1248
Abstract
Highly pathogenic avian influenza (HPAI) A/H5N1 has emerged as a cause of severe disease in domestic cats, but clinical data from field outbreaks remain limited. We retrospectively reviewed medical records, laboratory results, and ancillary examinations from 22 domestic cats with RT-qPCR-confirmed A/H5N1 infection [...] Read more.
Highly pathogenic avian influenza (HPAI) A/H5N1 has emerged as a cause of severe disease in domestic cats, but clinical data from field outbreaks remain limited. We retrospectively reviewed medical records, laboratory results, and ancillary examinations from 22 domestic cats with RT-qPCR-confirmed A/H5N1 infection diagnosed in Poland in June 2023. To the best of our knowledge, we report the first comprehensive retrospective case series from the 2023 Polish outbreak, combining 22 laboratory-confirmed cats with detailed clinical timelines and laboratory findings. For each cat, the temporal progression of clinical signs, hematology, serum biochemistry, and, when available, imaging findings were evaluated. Post-mortem examination data were not systematically available in this retrospective cohort. Notably, six of these cats were strictly indoor cats that received raw poultry meat as part of their diet. Disease onset was acute, with fever, lethargy, and anorexia rapidly progressing to severe dyspnea and neurological signs, including ataxia, seizures, and paraplegia; case fatality was 100%, with a typical interval of ≤3 days from first signs to death or euthanasia. Hematologic changes were dominated by thrombocytopenia, lymphopenia, and marked eosinopenia, consistent with a systemic inflammatory/stress leukogram. Biochemistry indicated marked tissue injury, with increased AST, LDH, and CK activities, whereas creatinine and urea remained largely within reference intervals, arguing against primary renal failure. Imaging supported the presence of interstitial to diffuse pneumonia. These data characterize the clinical and laboratory phenotypes of feline A/H5N1 infection and underscore its importance as a rapidly fatal respiratory and neurological disease with One Health implications. Full article
(This article belongs to the Section Viral Pathogens)
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15 pages, 283 KB  
Article
Owner-Directed Feline Aggression in Thailand: Characteristics, Associated Factors, and a Clinical Comparison of Treatments
by Jarawee Supanta, Worakan Boonhoh, Orachun Hayakijkosol and Tuempong Wongtawan
Life 2026, 16(2), 307; https://doi.org/10.3390/life16020307 - 10 Feb 2026
Viewed by 630
Abstract
Despite the global increase in cat ownership, some cats exhibit owner-directed aggression, resulting in caregiver injury, infection, and anxiety. Severe cases are commonly treated with selective serotonin reuptake inhibitors such as fluoxetine; however, adverse effects, particularly transient anorexia, often discourage treatment initiation. Cannabidiol [...] Read more.
Despite the global increase in cat ownership, some cats exhibit owner-directed aggression, resulting in caregiver injury, infection, and anxiety. Severe cases are commonly treated with selective serotonin reuptake inhibitors such as fluoxetine; however, adverse effects, particularly transient anorexia, often discourage treatment initiation. Cannabidiol (CBD), a natural compound with reported anxiolytic properties and minimal anorexic effects, may represent an alternative therapy. This study aimed to characterise owner-directed feline aggression in Thailand, identify associated factors, and compare the efficacy of CBD with fluoxetine. Most caregivers were females aged 20–40 years, and most cats were neutered mixed-breeds aged 1–6 years living indoors in multi-human and multi-cat households. For demographic variables, only human–cat interactions (e.g., petting) were significantly associated with aggression. Handling-induced aggression was universal, with grooming as the most common trigger (56%). In a single-blind, 4–8-week trial, 100 cats were randomly assigned to control, CBD 1 mg/kg/day, CBD 2 mg/kg/day, fluoxetine 0.5–1 mg/kg/day, or combined CBD and fluoxetine. Aggression scores decreased significantly in all treatment groups compared with control (p < 0.05), with no differences among active treatments. CBD at 1 mg/kg/day showed efficacy comparable to fluoxetine without anorexic effects. Full article
(This article belongs to the Section Animal Science)
11 pages, 2156 KB  
Case Report
Transmural Ileal Fibroplasia Causing Mechanical Obstruction in a Dog: Surgical Management, Histopathology, and Molecular Findings
by Duhwan Park, Hyung-Seok Seo, Sangyul Lee, Kieun Bae, Young Jae Lee, Aryung Nam, Jung-Moon Kim and Hwi-Yool Kim
Vet. Sci. 2026, 13(2), 174; https://doi.org/10.3390/vetsci13020174 - 9 Feb 2026
Viewed by 373
Abstract
Small bowel obstruction (SBO) in dogs is most commonly caused by foreign bodies or neoplasia; however, SBO secondary to transmural fibroplasia remains a rare clinical complication of canine chronic enteropathy. This report describes the complex case of mechanical SBO caused by transmural ileal [...] Read more.
Small bowel obstruction (SBO) in dogs is most commonly caused by foreign bodies or neoplasia; however, SBO secondary to transmural fibroplasia remains a rare clinical complication of canine chronic enteropathy. This report describes the complex case of mechanical SBO caused by transmural ileal fibroplasia and inflammation at the ileocolic junction in a 9-year-old mixed-breed dog with concomitant hyperadrenocorticism (HAC). The primary presentation involved chronic severe weight loss and intermittent anorexia, contrasting with the acute presentation typical of most SBO cases. Imaging studies revealed severe, circumferential thickening up to 10 mm of the small intestine wall at the ileocolic junction (ICJ), resulting in complete luminal stricture and marked proximal dilation. Surgical intestinal resection and anastomosis were performed for alleviation of the obstruction, and histopathology confirmed severe mural and serosal enteritis with extensive fibroplasia extending into the adjacent mesentery, thereby excluding neoplastic processes. Quantitative PCR analysis demonstrated a significant upregulation of mRNA expression for PDGFRB and FGFR compared to normal tissue. Postoperative recovery was rapid; although soft feces persisted for one month, normal stool consistency was subsequently restored, and the patient achieved significant weight gain. This case underscores the diagnostic and therapeutic challenges associated with non-neoplastic, inflammation-driven SBO and suggests that activation of the PDGFR-β/FGFR pathways may play a key role in fibroplasia-related intestinal strictures, offering a novel molecular perspective beyond conventional SBO etiologies. Full article
(This article belongs to the Section Veterinary Surgery)
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