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Introduction: This study aimed to investigate whether multiple aspects of emotion dysregulation contribute to the etiology of Food Addiction (FA); as well as to provide further evidence and clarity regarding the role of loneliness on the development of addictive behaviour towards food. Methods: A correlational study was employed to assess associations within 162 participants which were recruited via online forums on FA and student population. The Yale Food Addiction Scale (YFAS), Difficulties in Emotion Regulation Scale (DERS), and UCLA Loneliness Scale, and a demographic and personal information questionnaire were all completed online. A Poisson regression analysis was carried out and statistical significance was set at P

Few studies have examined the association between the accumulation of unhealthy eating habits and the likelihood of obesity or central obesity in a general Japanese population. We examined this association in a sample of 1906 community-dwelling Japanese subjects (age: 40&ndash, 74 years) who participated in a health check-up in 2014. A face-to-face questionnaire interview was conducted to collect information about three unhealthy eating habits, i.e., snacking, eating quickly, and eating late-evening meals. Obesity was defined as body mass index &ge, 25 kg/m2 and central obesity was defined as waist circumference &ge, 90 cm in men and &ge, 80 cm in women. The odds ratios (OR) were estimated by using a logistic regression analysis. Subjects with any one of the three eating habits had a significantly higher likelihood of obesity than those without that habit after adjusting for confounding factors. The multivariable-adjusted OR for obesity increased linearly with an increase in the number of accumulated unhealthy eating habits (p for trend &lt, 0.001). Similar associations were observed for central obesity. Our findings suggest that modifying each unhealthy eating habit and avoiding an accumulation of multiple unhealthy eating habits might be important to reduce the likelihood of obesity.

RESUMEN Una alimentación saludable es determinante para el buen estado de salud de las personas en cualquier etapa de su ciclo vital. Esta alimentación debe contener los nutrientes esenciales, además de ser variada, adecuada e inocua. El propósito de este artículo fue evaluar los conocimientos sobre alimentación saludable en estudiantes de una universidad pública. Estudio transversal en 136 estudiantes seleccionados por un muestreo aleatorio con afijación proporcional de las escuelas profesionales de Enfermería, Obstetricia, Contabilidad, Derecho, Ingeniería Agrónoma, Ingeniería de Industrias Alimentarias e Ingeniería Civil a los que se aplicó un cuestionario estructurado. En los resultados se observa que el mayor porcentaje (41,2%) tiene nivel medio de conocimientos sobre alimentación saludable y el (38.2%) nivel bajo. Según escuelas profesionales, la escuela de enfermería (66,7%) y obstetricia (26,7%) presentan un mayor nivel de conocimiento sobre alimentación saludable, seguido de los alumnos de Industrias alimentarias (14,3%), Ingeniería civil (13,5%), Derecho (12,5%), Contabilidad y finanzas (9,1%) y Agronomía (5,3%). La prueba de Chi cuadrado demuestra que el nivel de conocimiento tiene relación con su especialidad (p

Unhealthy eating habits among adolescents are reflected through frequent meal skipping, fad dieting, take-out meals and consumption of fast food, sweets and sweetened beverages. The aim of this study was to estimate unhealthy eating habits among students of the University of Novi Sad. Cross-sectional study was conducted in May 2018 on 4 faculties, which have at least one course on food and dietary habits and encompassed 514 participant (133 males and 381 females). More male students (7.5%) are constantly eating throughout the day compared to females (5.5%). 4.5% of males and 3.7% of females do not consume breakfast regularly. A small number of students have lunch in a bakery, a pizzeria or a fast-food restaurant. 4.5% of boys and 2.8% of girls eat fast food every day. 35% of male students and 28% of female students consume fast food almost daily or several times a week. About 5%of students do not eat fruit and vegetables at all. Altogether, obtained results indicated that unhealthy eating habits among student population is strongly represented, and the need for healthy lifestyles promotion with emphasis on the promotion of balanced nutrition is necessary.

Uvod: Nezdrave prehrabene navike kao i poremećaji u prehrani datiraju od davnina, a danas su zbog posljedica na zdravlje postale zabrinjavajuće. Najčešće bolesti koje se tretiraju kao poremećaji u prehrani su anoreksija, bulimija i kaheksija te u novije vrijme ortoreksija. Osim ovih sve značajnije su „binge eating“, sindrom noćnog prejedanja koji se zbog svojih posljedica mogu klasificirati kao bolesti. Cilj i zadatak rada: Prikupiti i analizirati podatke o vrstama poremećaje u prehrani i njihovoj identifikaciji kao bolesti. Rezultati: Anoreksija i bulimija uz problem gojaznosti predstavljaju ozbiljne i kompleksne poremećaje neuro-psihološkog, bihevioralnog i fiziološkog funkcionisanja organizma pa su se 1980. godine prvi put pojavile u klasifikaciji bolesti DSM – III, kao podvrsta poremećaja djetinjstva i adolescencije. Posljednjih desetljeća sve je više i drugih poremećaja prehrane naročito onih koji povećavaju tjelesnu masu. Nezdrave prehrambene navike nastaju usljed jednoličnog, prekomjernog i čestog unosa ali i odricanja hrane. Takve osobe su njačešće pod kroničnim stresom, ne mogu drugačije kontrolirati svoje stanje nego im jedino ostaje da to konpeziraju prehranom. Danas je identificran čitav niz poremećaja u prehrani koji trebaju dobiti svoju klasifikaciju bolesti kao što su: ortoreksija, bigoreksija, drankoreksija, dijabulimija ali i sindrom noćnog prejedanja, „binge eating“ i druge. Ortoreksija je prisutna kod osoba koje su opsjednute dijetama i zdravom prehranom, bigoreksija se javlja kod osoba koje jedu sastojke za izgradnju mišića, a uobičajeno unose anaboličke steroide. Drunkoreksičari piju alkohol koji im smanjuje potrebe za raznolikom prehranom te se kod njih pojavljuju različite malnutricije. Dijabulimija se javlja kod oboljelih od dijabetesa, a takve osobe sebi uskraćuju inzulin. Zakluučak: Nezdrave navike i poremećaji prehrane kao što su: restriktivne dijete, prejedanje i korištenje tvari koji utiču na kontroliranje tjelesne mase, danas predstavljaju zdravstveni problem. Ove pojave i stanja da bi dobile pravi tretman trebaju biti diferencirane i klasificirane kao bolest. To bi omogućilo bolji pristup liječenju takvih stanja i bolesti., Introduction: Unhealthy eating habits as well as nutritional disorders date back to ancient times, and today due to the effects on health have become worrisome. The most common diseases that are treated as eating disorders are anorexia, bulimia and cachexia, and in recent times is orthorexia. In addition to these, all the more important are "binge eating," night overeating syndrome that can be classified as a disease due to its consequences. Goal and task: To collect and analyze data related to types of nutritional disorders and their identification as a disease. Results: Anorexia and bulimia with the problem of obesity are serious and complex disorder of the neuro-psychological, behavioral and physiological functioning of the organism, and in 1980 they first appeared in the classification of DSM-III disease, as a subtype of childhood and adolescent disorders. Over the past decade, more eating disorders are increasing, especially those that increase body mass. Unhealthy eating habits arise due to a uniform, excessive and frequent intake of foods as well renunciation of food. Such persons are the most often under chronic stress, can not control their condition, and only remains it by compensate with eating. Today, a number of nutritional disorders have been identified and need to be classified like diseases such as orthorexia, bigorexia, drankorexia, diabulimia, but also syndrome night overeating, binge eating and others. Orthorexia is present in people who are obsessed with diets and healthy eating, bigorexia occurs in people who eat ingredients for muscle building, and usually intake anabolic steroids. Drunkorexists alcohol drinking wich reduces the need for diverse nutrition and gives rise to various malnutrition. Diabulimia occurs in people with diabetes, and such people deny themselves insulin. Conclusion: Unhealthy habits and eating disorders such as restrictive diet, overeating and using substances that influence the control of body mass, today present a health problem. These phenomena and conditions to get the right treatment should be differentiated and classified as a disease. This would allow better access to the treatment of such illnesses.

We systematically reviewed research on cognitive training and neuromodulation interventions for reducing food craving/intake, unhealthy diet and weight, and discussed their mechanisms of action. We reviewed 50 studies involving six cognitive trainings: Approach and Attentional Bias Modification, Implementation Intentions, Response Inhibition, Episodic Future Thinking and Working Memory; and four neuromodulation approaches: Transcranial Magnetic Stimulation (TMS), transcranial Direct Current Stimulation (tDCS), Deep Brain Stimulation (DBS) and Neurofeedback. Response Inhibition and Implementation Intentions have shown to reduce unhealthy diet and weight in people with overweight/obesity. Attentional Bias Modification has shown promising results in healthy-weight participants. Brain stimulation of the Dorsolateral Prefrontal Cortex via tDCS and the Hypothalamus via DBS showed benefits for reducing food craving and weight in people with overweight/obesity. Studies quality was generally high, but most trials were short-term and many conducted in healthy-weight samples. Modification of cognitive control and motivational processes/circuits are common mechanisms of beneficial training and neuromodulation interventions, and thus a promising approach for overweight/obesity treatment. Longer duration trials in clinical populations are needed to confirm benefits.

Background: Lifestyle habits like tobacco use, hazardous use of alcohol, unhealthy eating habits and insufficient physical activity are risk factors for developing non-communicable diseases, which are the leading, global causes of death. Furthermore, ill health and chronic diseases are costly and put an increased burden on societies and health systems. In order to address this situation, governmental bodies and organizations’ have encouraged healthcare providers to reorient the focus of healthcare and undertake effective interventions that support patients to engage in healthy lifestyle habits. In Sweden, national clinical practice guidelines (CPGs) on lifestyle interventions were released in 2011. However, the challenges of changing clinical practice and introducing guidelines are well documented, and health interventions face particular difficulties. The overall purpose of this thesis is to contribute towards a better understanding of the complexities of shifting primary health care to become more health oriented, and to explore the implementation environment and its effect on lifestyle intervention CPGs. The specific aims are to investigate how implementation challenges were addressed during the guideline development process (Study I), to investigate several dimensions of readiness for implementing lifestyle intervention guidelines, including aspects of the intervention and the intervention context (Study II), to explore the extent to which health care professionals are working with lifestyle interventions in primary health care, and to describe and develop a baseline measure of professional knowledge, attitudes and perceived organizational support for lifestyle interventions (Study III), and to assess the progress of implementing lifestyle interventions in primary care settings, as well as investigate the uptake and usage of the CPGs in clinical practice (Study IV). Methods and results: Interviews were conducted with national guideline-developers (n=7). They were aware of numerous implementation challenges, and applied strategies and ways to address them during the guideline development process. The strategies adhered to four themes: (a) broad agreements and consensus about scope and purpose, (b) systematic and active involvement of stakeholders, (c) formalized and structured development procedures, and (d) openness and transparent development procedures. At the same time, the CPGs for lifestyle interventions challenged the development-model at the National Board of Health and Welfare (NBHW) because of their preventive and non-disease specific focus (I). A multiple case study was also conducted, using a mixed methods approach to gather data from key organizational individuals that were accountable for planning the implementation of CPGs (n=10), as well as health professionals and managers (n=340). Analysis of this data revealed that conditions for change were favorable in the two organizations that served as case studies, especially concerning change focus (health orientation) and the specific intervention (national guidelines on lifestyle interventions). Somewhat limited support was found for change and learning, and change format (national guidelines in general). Furthermore, factors in the outer context were found to influence the priority and timing of the intervention, as well as considerable inconsistencies across the professional groups (II). A cross-sectional study among physicians and nurses (n=315) in Swedish primary healthcare showed that healthcare professionals have a largely positive attitude and thorough overall knowledge of lifestyle intervention methods. However, both the level of knowledge and the involvement in patients’ lifestyle change, differed between professional groups. Organizational support like CPGs and the development of primary health care (PHC) collaborations with other stakeholders were identified as potential strategies for enhancing the implementation of lifestyle interventions in PHC (III). In addition to interviews and case studies, a longitudinal survey among health professionals (n=150; n=73) demonstrated that their use of methods to encourage patients to reduce or eliminate tobacco or alcohol use, had increased. The survey also indicated that nurses had increased the extent to which they addressed all four lifestyle habits. The progress of the implementation of CPGs on lifestyle interventions in PHC was somewhat limited, and important differences in physicians and nurses’ attitudes, as well as their use of the guidelines, were found (IV). Conclusions: Health orientation differs in many ways from more traditional fields in medicine. To strengthen the implementation of this very important (but not “urgent”) field in health care, it needs, first of all, to be prioritized at all levels! The results of the studies demonstrate relatively slow adoption of lifestyle intervention CPGs in clinical practice, and indicate room for improvement. The findings of this thesis can inform healthcare policy and research on further development of the health orientation perspective, as well as on the challenges of implementing CPGs on lifestyle interventions in primary care. In summary, this thesis presents important lessons learned regarding health orientation - from the development of CPGs in the field, via assessing healthcare organizations’ readiness to change and health professionals’ attitudes to methods to support patients with lifestyle changes. Bakgrund: Levnadsvanor som tobaksbruk, riskbruk av alkohol, ohälsosamma matvanor och otillräcklig fysisk aktivitet är riskfaktorer för att utveckla kroniska sjukdomar, vilka orsakar de flesta dödsfallen i världen. Ohälsa och dess följdsjukdomar utmanar också samhällen och hälsosystem världen över p.g.a. de höga kostnader som de medför. För att förbättra situationen så försöker regeringar och organisationer förändra hälso- och sjukvårdens perspektiv till att fokusera mer på hälsa och att arbeta med effektiva interventioner för att förebygga och att förändra människors ohälsosamma vanor. År 2011 i Sverige, publicerades nationella kliniska riktlinjer för vårdens arbete med att förebygga sjukdom genom att stödja förändring av patienters ohälsosamma levnadsvanor. Det är dock välkänt hur svårt det är att förändra klinisk praxis och att introducera riktlinjer, och interventioner på området hälsa i sjukvården brottas med specifika utmaningar. Det övergripande syftet med den här avhandlingen har varit att bidra till en bättre förståelse av komplexiteten i att hälsoorientera primärvården, och att utforska förutsättningarna till att implementera kliniska riktlinjer för att stödja förändring av patienters levnadsvanor. De mer specifika syftena var: att (I) utforska hur implementeringsutmaningarna behandlades i utvecklingsprocessen av riktlinjerna ; att (II) undersöka dimensioner av beredskapen för förändring i primärvården för att implementera riktlinjerna om levnadsvanor inkluderande aspekter av interventionen själv samt kontexten ; att (III) utforska i vilken utsträckning hälsoprofessionerna arbetar med levnadsvanor i primärvården, och att beskriva deras kunskap, attityder och uppfattat organisatoriskt stöd för livsstilsinterventioner ; att (IV) i en två-årig uppföljning utvärdera utvecklingen av arbetet med levnadsvanor i primärvården, och användningen av de specifika nationella riktlinjerna för levnadsvanor. Metod och resultat: En intervjustudie med riktlinjeutvecklare på nationell nivå (n = 7) visade att många utmaningar för implementeringen av riktlinjerna identifierades och bemöttes under utvecklingsprocessen i fyra teman av strategier: breda överenskommelser och konsensus om inriktning och syfte, systematiskt och aktivt inkluderande av stakeholders, formaliserad och strukturerad utvecklingsprocess, öppenhet och insyn utvecklingsprocess. Samtidigt utmanade dock riktlinjerna om livsstilsinterventioner Socialstyrelsens utvecklingmodell p.g.a. deras förebyggande och icke sjukdomsspecifika fokus (I). En multipel fallstudie med nyckelpersoner ansvariga för implementeringen av riktlinjerna i sjukvårdsorganisationerna (n = 10) samt vårdpersonal och chefer (n = 340), visade på gynnsamma villkor för förändring i båda organisationerna rörande förändringsfokus (d.v.s. hälsoorientering) och den specifika interventionen (d.v.s. riktlinjer om metoder för att stödja förändring av ohälsosamma levnadsvanor). Stödet för förändring och lärande visade på något svagare resultat, likaså formen för förändringen d.v.s. nationella riktlinjer i allmänhet. Faktorer i den yttre kontexten visade sig kunna påverka prioritering av och optimalt val av tidpunkt för interventionen, likaså betydande skillnader i uppfattningar mellan yrkesgrupperna (II). En tvärsnittsstudie bland läkare och sjuksköterskor (n = 315) i primärvården visade att de har en positiv attityd och en god kunskapsnivå om metoder för livsstilsförändring. Både kunskapsnivå och i vilken utsträckning man arbetar med patienters livsstil skiljer sig mellan yrkesgrupper. Organisatoriskt stöd som nationella riktlinjer och utvecklandet av primärvårdens samarbete med intressenter i närområdet identifierades som viktigt för att förbättra arbetet med livsstil interventioner (III). En longitudinell undersökning bland vårdpersonal visade att användning av metoder för att förändra patientens vanor beträffande tobaksbruk och riskbruk av alkohol har ökat över tid, och att sjuksköterskorna arbetar i högre utsträckning med alla fyra levnadsvanorna än i tidigare. Implementeringen av de nationella riktlinjerna för levnadsvanor hade inte kommit så långt vid det andra mättillfället, och stora skillnader visade sig i hur läkare och sköterskor ser på riktlinjer och i vilken utsträckning de använder dem (IV). Slutsats: Hälsofrämjande och prevention skiljer sig på många sätt från mer traditionella fält inom medicinen. För att stärka implementeringen av det här viktiga (men ej akuta) fältet i hälso- och sjukvården, så måste det först av allt prioriteras på alla nivåer! Resultatet visar på ett svagt upptag av riktlinjerna för livsstilsinterventioner i klinisk praxis, och lämnar utrymme till förbättring. Aspekter av resultatet som presenteras i avhandlingen kan vägleda fortsatt utveckling och implementering av hälsoorientering och riktlinjer för livsstilsinterventioner inom primärvården, samt användas för att påverka policy, praxis och framtida forskning. Det gäller framför allt aspekter av utveckling av nationella riktlinjer på området; hälso- och sjukvårdsorganisationernas beredskap till förändring; hälsoprofessionernas attityder, kunskap och i vilken utsträckning de arbetar med livsstilsinterventioner och riktlinjer.

La obesidad es un problema creciente en Venezuela, el objetivo fue determinar el grado de asociación de la actividad física baja o moderada y hábitos alimentarios no saludables, incluyendo omisión del desayuno, a la obesidad en adolescentes. Se estudiaron 800 adolescentes entre 15 y 19 años de edad (405 hombres). El muestreo fue bietápico: a) selección aleatoria estratificada de 31 instituciones según nivel educativo; b) selección no probabilística por cuota de los adolescentes. Se calculó índice de masa corporal e índice circunferencia abdominal - talla. Se aplicaron cuestionarios sobre hábitos alimentarios y actividad física. Se hizo análisis estratificado según edad, sexo, nivel socioeconómico, peso al nacer y exceso de peso de ambos padres como posibles variables de confusión. La frecuencia de hábitos alimentarios no saludables fue elevada en obesos y no obesos. La asociación de hábitos alimentarios no saludables con la obesidad global fue dependiente del nivel socioeconómico. La omisión del desayuno no se asoció a la obesidad y la actividad física baja o moderada se asoció solo con obesidad central de manera independiente. Se concluye que la asociación de la obesidad y los hábitos alimentarios no saludables parece ser un fenómeno complejo dependiente del contexto social y económico de los adolescentes. La asociación de la obesidad central con la actividad física baja o moderada parece ser más clara e independiente. Obesity is a growing problem in Venezuela, it was proposed to determine the degree of association of low or moderate physical activity (LMPA) and unhealthy eating habits (UEH), including omission of breakfast (OB), with obesity in adolescents. 800 adolescents between 15 and 19 years (405 men) were studied. A two-stage sampling was performed: a) random stratified selection of 31 institutions by educational level; b) selection of adolescents through non - probabilistic quota sampling. Body mass index (BMI) and waist - height ratio (WHR) were calculated. Questionnaires on eating habits and physical activity were applied. For a stratified analysis, age, sex, socioeconomic status (SES), birthweight and excess weight of both parents were considered as potential confounders. The frequency of UEH was elevated in obese and non-obese. The association of the UEH to the global obesity was dependent on the SES. The OB was not associated with obesity. The LMPA was independently associated with central obesity. We conclude that the association of obesity with UEH seems to be a complex phenomenon dependent on the social and economic context of adolescents. The association of central obesity with AFB-M seems to be more clear and independent.