Search Results (27)

Background/Objectives: Medical nutrition therapy (MNT) is a crucial component of type 1 diabetes (T1D) management; however, the effectiveness of specific dietary approaches in adults remains unclear due to variations in study design, terminology, and reported outcomes. This scoping review summarizes evidence published between 2015 and 2025 on dietary interventions in adults with T1D, focusing on metabolic and psychosocial outcomes and adherence to international nutritional guidelines. Methods: We searched PubMed, Web of Science, Scopus, and Google Scholar, following the PRISMA-ScR recommendations, to identify observational studies, randomized clinical trials (RCTs), and guidelines involving adults (≥18 years) with T1D. Extracted data included metabolic outcomes (glycated hemoglobin A1c (HbA1c), glycemic variability (GV), insulin dose (ID), lipids, blood pressure, body weight, and others), as well as psychosocial indicators (i.e., quality of life, diabetes-related stress, and fear of hypoglycemia). Results: In total, 41 studies met the inclusion criteria, comprising 18 observational, 14 randomized, and 9 studies that evaluated psychosocial aspects. A low-carbohydrate diet (LCD) reduced HbA1c by 0.3–0.9% and total ID by approximately 15–20% without increasing the incidence of severe hypoglycemia. A low-fat vegan diet and structured carbohydrate counting (CC) programs also improved glycemic and lipid profiles. The Mediterranean diet (MedDiet) and plant-based diet mainly improved diet quality and well-being. The results showed an association between better metabolic control and lower carbohydrate (CHO) intake, as well as higher intakes of fiber and protein. In contrast, a Western diet and high intake of sweets were linked to poorer outcomes. Conclusions: Combining an LCD with education, CC, and modern diabetes technology provides the most consistent benefits for adults with type 1 diabetes (T1D adults). The MedDiet and plant-based diet support diet quality and psychosocial well-being, although current evidence remains limited, primarily due to small sample sizes and short follow-up periods. Full article

Dietary choices and patterns have enormous consequences along the lines of individual, community, and planetary health. Excess meat consumption has been linked to chronic disease risk, and at large scales, the underlying industries maintain a massive environmental footprint. For these reasons, public and planetary health experts are unified in emphasizing a whole or minimally processed plant-based diet. In response, the purveyors of ultra-processed foods have added “meat alternatives” to their ultra-processed commercial portfolios; multinational corporations have been joined by “start-ups” with new ultra-processed meat analogues. Here, in our Viewpoint, we revisit the 1990s food industry rhetoric and product innovation, a time in which multinational corporations pushed a great “low-fat transition.” We focus on the McLean Deluxe burger, a carrageenan-rich product introduced by the McDonald’s Corporation in 1991. Propelled by a marketing and media-driven fear of dietary fats, the lower-fat burger was presented with great fanfare. We reflect this history off the current “great protein transition,” a period once again rich in rhetoric, with similar displays of industry detachment from concerns about the health consequences of innovation. We scrutinize the safety of carrageenan and argue that the McLean burger should serve as a cautionary tale for planetary health and 21st century food innovation. Full article

Given the ubiquity of anti-fat prejudice, in this experimental study, we tested whether weight gain attributed to COVID-19 would influence evaluations of overweight male and female targets. Female participants (N = 160) were randomly assigned to read one of four mock medical forms that outlined distractor medical information (e.g., blood requisition results), the sex of the target (male vs. female) and stated reason for weight gain (unhealthy lifestyle choices vs. inactivity due to the COVID-19 lockdown). Participants evaluated the patient on a series of binary adjectives (e.g., lazy/industrious), and completed measures assessing anti-fat attitudes (i.e., fear of becoming fat and belief in the controllability of weight), internalization of ideal standards of appearance, and BMI (i.e., self-reported weight and height). Contrary to our predictions, we found that overweight male and female patients were evaluated similarly regardless of whether their weight gain was attributable to unhealthy lifestyle choices or inactivity due to the COVID-19 pandemic. Finally, believing that one’s weight is controllable and internalizing general standards of attractiveness correlated positively with fat disparagement of the medical patients. Participants’ BMI and fear of fat, however, were negligibly related to fat disparagement. Possible explanations for our findings, implications for healthcare settings, and directions for future research are explored. Full article

Explicit and implicit anti-fat biases are widespread among healthcare providers, leading to significant negative consequences for pregnant people, including poorer health outcomes. Fear of childbirth (FOC) can affect the length of labor, increase the risk of cesarean delivery, and negatively influence a new parent’s perception of infant bonding. This study investigated the impact of perceived anti-fat bias on FOC among pregnant people. Data were gathered from 329 pregnant people recruited from three large academic prenatal centers in the United States and via social media. Participants completed a survey that included validated instruments measuring perceptions of anti-fat bias and FOC. Participants perceiving anti-fat bias reported higher FOC. Black participants perceiving anti-fat bias reported higher FOC. These findings suggest that perceived anti-fat bias from providers is associated with FOC for pregnant people, particularly those who identify as Black. Interventions to educate providers on these important concepts could help improve pregnant people’s experience within the healthcare system. Full article

Background: Fear of fat is a relevant variable in initiating weight regulation behaviors in adolescents. However, little is known about the experiential and behavioral change processes that mediate the choice between healthy and unhealthy weight regulation behaviors in this population. Method: The general objective was to examine the predictive role of fear of fat on weight-related behaviors (healthy and unhealthy weight control behaviors) through the mediation of experiential and behavioral change processes (consciousness raising, counterconditioning, helping relationships, reinforcement management, self-liberation, self-reevaluation, stimulus control, substance use) in 838 adolescents aged 15–19 years from Mexico and Spain using parallel mediation analysis. Additionally, the study examined the correlations between the variables with regard to gender and country, as well as the differences in the use of processes of change across stages of change through the use of a multivariate analysis of variance. The Spanish version of the Fear of Fat, Stages of Change, Processes of Change, and Weight-Related Behaviors scales were used. Results: The mediation analysis showed that fear of fat predicted healthy weight control behaviors through consciousness raising, self-liberation, and stimulus control. On the other hand, fear of fat predicted unhealthy weight control behaviors through counterconditioning, stimulus control, and the use of weight loss substances. Intervening to reduce fear of fat may be a way to modify the processes of change used by adolescents to regulate their weight. Conclusions: The results of this study indicate that adolescents may initiate weight control behaviors as a result of fear of fat. This process is mediated by experiential and behavioral processes that influence weight regulation. Full article

Background: Atypical Anorexia Nervosa (AAN) is a Feeding and Eating Disorder characterized by fear of gaining weight and body image disturbance, in the absence of significantly low body weight. AAN may present specific clinical and psychopathological features. Nonetheless, the literature lacks data concerning the nutritional characteristics and body composition of children and adolescents with AAN and their variation over time. Methods: Case series, including 17 children and adolescents with AAN. All the patients were assessed at the first evaluation (T0) with a standardized dietary assessment (24 h Dietary Recall, 24 hDR). Nutritional data were compared with European dietary reference values (DRVs). Body composition parameters (weight, fat mass, fat-free mass) and their changes over time at two (T1) and six (T2) months were collected as well, using a Bioelectrical impedance analysis (Wunder WBA300 with four poles and foot contact; impedance frequency 50 kHz 500 μA; impedance measurement range 200~1000 Ω/0.1 Ω). Results: The included individuals presented eating behaviors oriented towards significantly low daily energy intake (p < 0.001) compared with DRVs set by the European Food Safety Authority (EFSA) (with low carbohydrates and fats), and increased proteins (p < 0.001). A longer latency before observation (illness duration before observation) correlated with a negative change in weight. Body composition parameters were described, with no significant changes across the six-month outpatient assessment. Discussion: This is the first research to systematically assess the body composition and nutritional features of a group of individuals with AAN in the developmental age. Further research should assess the effect of targeted treatment interventions on body composition and nutritional features. Full article

Background: Obesity is linked to chronic diseases in adults and children. Its prevalence continues to grow in the United States, necessitating the need for healthcare provider training and presenting an opportunity for the education of future medical providers. Despite this need, effectively implementing obesity education into medical school curricula has been challenging. Anti-obesity bias amongst healthcare providers and trainees represents a significant obstacle to the care of patients with obesity. Obesity bias may affect up to 1/3 of medical students. Methods: This study describes the development and preliminary testing of a brief, 2.5 h multi-modality teaching intervention consisting of online, interactive, and independent learning modules for first-year medical students and a patient panel focused on obesity, obesity bias, and motivational interviewing. The participants took Crandall’s anti-fat attitude (AFA) questionnaire before and after an online independent learning module on motivational interviewing and obesity bias. The AFA consists of three subscales (“dislike”, “fear of fat”, and “willpower”). Individual responses were measured using a nine-point Likert-type response format (0 = very strongly disagree; 9 = very strongly agree). An average composite score was calculated for each subscale. Results: Data were analyzed from 103 first-year medical students enrolled at a college of medicine in the southwestern United States in 2022. The AFA mean composite scores decreased significantly, indicating a decrease in explicit anti-obesity attitude bias after completing the online module. This decrease was present in all three domains of fear (4.63 vs. 3.72, p < 0.001), dislike (1.25 vs. 0.88, p < 0.001) and willpower (3.23 vs. 2.31, p < 0.001). Conclusions: Relatively brief educational interventions can positively impact students’ anti-obesity attitudes. Full article

(1) Background: Digital addiction has been a global concern, with college students becoming increasingly vulnerable to it. The detrimental psycho-physiological effects of digital addiction have raised concerns regarding college students’ health. This descriptive correlational study was conducted to evaluate the prevalence of digital addiction and identify influencing factors among college students, such as body shape satisfaction, time management, and psychological health. (2) Methods: Data were collected from 199 students at a university in Seoul, South Korea, from 30 May to 13 June 2023. The Digital Addiction Scale (DAS), Time Structure Questionnaire (TSQ), General Health Questionnaire (GHQ), and Body Shape Questionnaire (BSQ) were used for the assessment. Data (N = 199) were analyzed using descriptive statistics, one-way ANOVA, Pearson’s correlation coefficient, and stepwise multiple regression. (3) Results: The mean score for digital addiction was 54 ± 12, with scores ranging from 23.0 to 89.0. Digital addiction had a significant positive correlation with body shape satisfaction (r = 0.156, p = 0.028) and a negative correlation with time management (r = −0.500, p < 0.001). In the stepwise multiple regression model of digital addiction (adjusted ${\mathrm{R}}^2$ = 0.285, p < 0.001), subfactors of body shape satisfaction (fear of fatness β = −0.280, body dissatisfaction β = 0.401) and time management (effective organization β = −0.211, persistence β = −0.209, past orientation β = −0.165) were statistically significant. (4) Conclusions: Body shape satisfaction and time management are important factors influencing digital addiction among college students. However, it does not establish a direct causal relationship. The findings indicate that there is a statistical association or connection between these factors, but they do not definitively state that body shape satisfaction or time management directly cause digital addiction. To decrease digital addiction in this population, interventions should aim to improve body shape satisfaction and time management. Full article

Brain signalling pathways involved in subclinical anxiety and depressed mood can be modulated via the gut brain axis (GBA), providing the potential for diet and dietary components to affect mood. We investigated behavioural, physiological and gut microbiome responses to the Lacticaseibacillus rhamnosus strain HN001 (LactoB HN001™), which has been shown to reduce postpartum anxiety and depression, and a milk fat globule membrane-enriched product, Lipid 70 (Surestart^TM MFGM Lipid 70), which has been implicated in memory in stress-susceptible Wistar Kyoto rats. We examined behaviour in the open field, elevated plus maze and novel object recognition tests in conjunction with the expression of host genes in neuro-signalling pathways, and we also assessed brain lipidomics. Treatment-induced alterations in the caecal microbiome and short-chain fatty acid (SCFA) profiles were also assessed. Neither ingredient induced behavioural changes or altered the brain lipidome (separately or when combined). However, with regard to brain gene expression, the L. rhamnosus HN001 + Lipid 70 combination produced a synergistic effect, reducing GABAA subunit expression in the amygdala (Gabre, Gat3, Gabrg1) and hippocampus (Gabrd). Treatment with L. rhamnosus HN001 alone altered expression of the metabotropic glutamate receptor (Grm4) in the amygdala but produced only minor changes in gut microbiota composition. In contrast, Lipid 70 alone did not alter brain gene expression but produced a significant shift in the gut microbiota profile. Under the conditions used, there was no observed effect on rat behaviour for the ingredient combination. However, the enhancement of brain gene expression by L. rhamnosus HN001 + Lipid 70 implicates synergistic actions on region-specific neural pathways associated with fear, anxiety, depression and memory. A significant shift in the gut microbiota profile also occurred that was mainly attributable to Lipid 70. Full article

This article uses collaborative auto/ethnography to explore the circulation and potentiality of affect in the live performances and archive of Pretty Porky and Pissed Off (PPPOd), a Toronto-based queer fat activist performance art collective active during the late 1990s and mid-2000s. Drawing on video and audio recordings of five PPPOd performances alongside other performance ephemera and a series of conversations relating to these archival objects among the article’s three authors, we identify and theorize our affective responses to and situated recollections of these performances, both in their current form as archival objects and as historical live events. We argue that PPPOd’s archival objects/live performances disrupt the constellation of affects that constitute fat hate (e.g., fear, loathing, shame) and set in motion more affirmative affects (e.g., playfulness, pride, desire, love) that contribute to micro-worldings and prefigurative fat politics, as ephemeral as these might be. In capturing these fleeting moments of radical possibility, PPPOd’s activism and archive offer opportunities for touching and feeling a future where fat lives are more livable. Full article

Objective: The main characteristics of Anorexia Nervosa (AN) in adults are restriction of energy intake relative to requirements leading to significant weight loss, disturbed body image, and intense fear of becoming fat. Traumatic experiences (TE) have been reported as common, although less is known about the relationship with other symptoms in severe AN. We investigated the presence of TE, PTSD, and the relation between TE, eating disorder (ED) symptoms, and other symptoms in moderate to severe AN (n = 97) at admission to inpatient weight-restoration treatment. All patients were enrolled in the Prospective Longitudinal all-comer inclusion study on Eating Disorders (PROLED). Methods: TE were assessed using the Post-traumatic stress disorder checklist, Civilian version (PCL-C), and ED symptoms using the Eating Disorder Examination Questionnaire (EDE-Q); depressive symptoms were assessed using the Major Depression Inventory (MDI), and the presence of Post-traumatic Stress Disorder (PTSD) was diagnosed according to ICD-10 criteria. Results: The mean score on PCL-C was high (mean 44.6 SD 14.7), with 51% having a PCL-C score at or above 44 (n = 49, suggested cut-off for PTSD), although only one individual was clinically diagnosed with PTSD. There was a positive correlation between baseline scores of PCL-C and EDE-Q-global score (r = 0.43; p < 0.01) as well as of PCL-C and all EDE-Q subscores. None of the included patients were admitted for treatment of TE/PTSD during the first 8 weeks of treatment. Conclusions: In a group of patients with moderate to severe AN, TE were common, and scores were high, although only one had a diagnosis of PTSD. TE were related to ED symptoms at baseline, but this association diminished during the weight restoration treatment. Full article

Anxiety is one of the psychological factors associated with body weight experienced by people attempting to live up to expectations of an ideal body shape. The stigma of excessive or too low body weight and the stigmatization of people because of it is becoming a widespread problem with negative psychological and social consequences. One effect of the strong social pressure of beauty standards dependent on low body weight is the development of eating disorders and negative societal attitudes toward overweight or obese people. Research conducted to date has mainly focused on one dimension of weight-related anxiety—the fear of getting fat. Ongoing research has also revealed the other side of weight-related anxiety—fear of weight loss. Therefore, the purpose of the present project was to develop a two-dimensional scale to diagnose the level of weight-related anxiety and to preliminarily test the psychometric properties of the emerging constructs. Results: the BMAS-20 weight-related anxiety scale in both Polish and English versions was developed and its psychometric properties were confirmed. The components of body weight-change anxiety that emerged were: anxiety about getting fat and anxiety about losing weight. It was found that both AGF and ALW may have a protective function related to awareness of the negative consequences of poor eating and the health risks associated with it. Above-normal levels of anxiety may be a predictor of psychopathology. Both AGF and ALW are associated with symptoms of depression. Full article

Lipofilling is a frequently used and safe procedure for breast reconstruction. One of the most feared complications is soft tissue infection following lipofilling. Because of this, some surgeons propose the practice of rinsing fat grafts with antibiotics. This study investigates the effect of antibiotic rinses on fat grafts in an in vitro model. Adipocytes and stem cells were isolated from fat tissue harvested during 24 lipofilling procedures and incubated with different doses of clindamycin or cefazolin. Cell viability, metabolism, proliferation, and differentiation capacities were analyzed by gross morphology, fluorescence staining, -(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromid (MTT-), and Glyceraldehyde 3 Phosphate Dehydrogenase (G3PD)-assay as well as reactive oxygen species (ROS)-assay. Cefazolin and clindamycin led to significant reduction of cell viability of adipocytes. High doses of both antibiotics led to a rupture of adipocytes with visible free lipid droplets. Cell metabolism was significantly decreased after incubation with both antibiotics. There was a significant increase in ROS production. Exposure to clindamycin and cefazolin led to morphological changes in stem cells in a dose- and time-dependent manner. Furthermore, differentiation potential was significantly reduced. Antibiotic susceptibility testing, however, showed that low concentrations of antibiotics effectively inhibited bacterial growth in contaminated fat grafts. This study confirms that rinsing fat grafts with clindamycin or cefazolin not only overly prevents infection but also has cytotoxic and metabolic effects on adipocytes. Therefore, based on these results, the routine clinical application in high doses cannot be recommended. Full article

Cocoa quality is affected by genetic variability and conditions in the region of origin that impact the physicochemical, functional and sensory characteristics of the cocoa bean. For the purpose of this study, the spatial distribution was analyzed using a cocoa quality indicator that related physicochemical, functional variables (phenolic and antioxidant content) and sensory attributes (organoleptic qualities and sensory notes) of cocoa samples from different cocoa clones in the municipalities of Mesetas and Vista Hermosa in the department of Meta, Colombia. In 83 sampling plots distributed in 22 farms with agroforestry cocoa arrangements, 50 pods of the main clone were selected in each plot. Subsequently, the cocoa bean samples were subjected to fermentation and drying processes using a uniform process, then each of the samples was subjected to physicochemical, functional and sensory properties. A medium quality level was found in the cocoa beans that depended on genetic variability, whose properties ranged between protein levels of 10.312%, sugars of 2.7–3.7 °Brix, and fat contents of 51.5–52.2%, with 178.4–235.2 mg GAE g⁻¹ in total phenol content and 1208.1–3464.1 μmol AAE g⁻¹ in antioxidant capacity. Clones TSH-565 and FEAR-5 showed respectively higher and lower grain quality. Within the sensory profile, complementary aromatic notes such as floral, fruity, nutty, malty, with high correlations between acidity and fresh fruit, astringency and cocoa, and astringency and bitterness, were found. At the clone level, ICS-95 and TSH-565 presented the best sensory attributes (floral, sweet, acidity, fresh fruit). According to the physicochemical, functional and sensory variables of the cocoa beans, it was found that only 13% of the samples presented values higher than 0.8 in the cocoa quality index, with notes of banana, melon, peach, plum, and fresh fruit related to clones such as TSH-565 and ICS-95, whose notes are considered high-quality; these cocoa plantations are located in the Palestina village in the municipality of Vistahermosa and in the Las Mercedes village in the municipality of Mesetas. Full article

Individual differences exist in perceived vulnerability to disease (PVD). PVD is associated with negative responses (e.g., disgust) towards individuals with obesity and heightened sensitivity regarding personal appearance. Through increasing fear of fat (FOF), PVD may be associated with cognitive restraint and compensatory behaviors. We utilized an adult sample (n = 247; 53.3% male sex assigned at birth) recruited through Amazon’s MTurk prior to the COVID-19 pandemic to investigate associations between PVD, cognitive restraint and compensatory behaviors. Participants completed the Perceived Vulnerability to Disease Scale, Eating Disorder Diagnostic Scale, Dutch Eating Behaviors Questionnaire, and Goldfarb’s Fear of Fat Scale. Mediation analyses were used to test our hypotheses. Perceived infectability (PVD-Infection) was associated with cognitive restraint and compensatory behaviors through increased FOF. Perceived germ aversion (PVD–Germ) was associated with cognitive restraint, but FOF did not mediate this association. Sex-stratified analyses revealed no significant sex differences. PVD may be an overlooked factor associated with cognitive restraint and compensatory behaviors in males and females. FOF was an important mediating factor in these associations. Increased engagement in cognitive restraint and compensatory behaviors may reflect attempts to reduce FOF. Future longitudinal research should explore whether PVD is a risk factor for cognitive restraint and compensatory behaviors. Full article