Dr Kirrilly Pursey

Introduction: The concept of ¿food addiction¿ (FA) has gained popularity in view of clinical and neurobiological overlaps between excessive food intake and addictive disorders. However, no studies have examined the link between FA and striatocortical circuits involved in addictive disorders, or the influence of homeostatic status, which regulates the drive to eat, on these systems. This study aims to investigate changes in striatal functional connectivity between fasted and fed conditions among adults ranging in body mass index (BMI) and FA symptoms. Methods: Thirty adults were recruited from the general community and completed self-reported surveys including demographics, FA symptoms using the Yale Food Addiction Scale, as well as height and weight measures, used to determine BMI. Participants completed two 3-T MRI scans, one in a fasted state and one in a fed state. We conducted seed-based analyses to examine between-session (¿fasted > fed¿) change in resting-state functional connectivity of the ventral and dorsal striatum, and its association with FA scores (controlling for BMI). Results: Higher symptoms of FA correlated with greater changes in ventral caudate-hippocampus connectivity between fasted and fed conditions. FA symptoms did not correlate with connectivity in the dorsal caudate circuit. Post-hoc analyses revealed that participants with higher symptoms of FA had ventral caudate-hippocampus hyperconnectivity in the fasted scan only, as well as a significant reduction of this connectivity between the fasted and fed scans. Conclusions: Heightened connectivity in the ventral striatum during a fasted state, which has been linked to reward prediction signals, underpins symptoms of FA. In contrast, connectivity in the dorsal striatum or ¿habit¿ system is unrelated to homeostatic status and FA symptoms, and is thus less relevant for subclinical manifestations of FA.

Background: The present study systematically reviewed the literature aiming to determine the relationships between food addiction, as measured by the Yale Food Addiction Scale (YFAS), and mental health symptoms. Methods: Nine databases were searched using keywords. Studies were included if they reported: (i) YFAS diagnosis or symptom score and (ii) a mental health outcome, as well as the association between (i) and (ii). In total, 51 studies were included. Results: Through meta-analysis, the mean prevalence of food addiction diagnosis was 16.2%, with an average of 3.3 (range 2.85¿3.92) food addiction symptoms being reported. Subanalyses revealed that the mean number of food addiction symptoms in populations seeking treatment for weight loss was 3.01 (range 2.65¿3.37) and this was higher in groups with disordered eating (mean 5.2 3.6¿6.7). Significant positive correlations were found between food addiction and binge eating [mean r¿=¿0.602 (0.557¿0.643), P¿<¿0.05], depression, anxiety and food addiction [mean r¿=¿0.459 (0.358¿0.550), r¿=¿0.483 (0.228¿0.676), P¿<¿0.05, respectively]. Conclusions: A significant, positive relationship exists between food addiction and mental health symptoms, although the results of the present study highlight the complexity of this relationship.

Background: The majority of literature examining the effect of dietary behaviour on academic achievement has focused on breakfast consumption only. Here, we aim to systematically review the literature investigating the broader effects of dietary intake and behaviours on school-aged children's academic achievement. Methods: A search was undertaken across seven databases using keywords. For studies to be included, they needed to be conducted in: school-aged children (5¿18 years); assess and report: (i) a measure of academic performance; (ii) a measure of dietary intake/behaviour; and (iii) the association between dietary intake/behaviours and academic performance. Forty studies were included in the review. Results: The majority of studies were cross-sectional in design (n = 33) and studied children aged >10 years, with very few reports in younger age groups. More than 30 different dietary assessment tools were used, with only 40% of those using a validated/standardised assessment method. Half the studies collected outcomes of academic achievement objectively from a recognised educational authority, whereas 10 studies used self-reported measures. The dietary outcomes most commonly reported to have positive associations with academic achievement were: breakfast consumption (n = 12) and global diet quality/meal patterns (n = 7), whereas negative associations reported with junk/fast food (n = 9). Conclusions: This review highlights that moderate associations exist for dietary intakes characterised by regular breakfast consumption, lower intakes of energy-dense, nutrient-poor foods and overall diet quality with respect to outcomes of academic achievement. Future studies should consider the use of validated dietary assessment methods and standardised reporting of academic achievement.

Purpose of Review: Behavioural and neurobiological similarities have been identified between the consumption of certain foods and addiction-related disorders. However, few studies have investigated what components of food may promote an addictive-like response in humans. This review evaluates recent research concerning the nutritional aspects of addictive-like eating. Recent Findings: Based on the current evidence base, highly processed, hyper-palatable foods with combinations of fat and sugar appear most likely to facilitate an addictive-like response. Total fat content and glycaemic index also appear to be important factors in the addictive potential of foods. Despite public interest and evidence from animal studies, few studies have reported an association between sugar and addictive-like eating. Summary: Due to the paucity of studies, it is difficult to conclusively identify a specific food or ingredient as capable of triggering an addictive-like response in humans. Future studies using validated dietary assessment tools are essential and may inform the development of novel strategies to treat maladaptive eating behaviours.

Objectives: There is increasing interest in the role of addictive-like eating in weight gain. No studies have investigated associations between addictive-like eating and specific patterns of fat deposition which are sensitive indicators of chronic disease risk. This exploratory study aimed to evaluate relationships between Yale Food Addiction Scale (YFAS) assessed "food addiction" and visceral adiposity. Methods: Australian adults aged 18-35 years were recruited to an online survey including demographics and the YFAS. The YFAS is a 25-item tool designed to assess addictive-like eating behaviors and uses two scoring outputs, "diagnosis" and "symptom scores". Participants had their anthropometric measurements taken [height, weight and body composition (visceral fat, fat mass, percentage body fat)] using a standardized protocol. Results: Ninety-three female participants (age 24.3 ± 4.0years, BMI 24.3 ± 6.0 kg/m ) completed all measurements. Twenty-one participants (22.3%) met the predefined criteria for YFAS "diagnosis". YFAS "symptom scores" were moderately correlated with visceral fat area (r = 0.36, p < 0.001), and "symptom scores" predicted increases in visceral fat area [r = 0.17, ß = 1.17, p = 0.001]. Effect sizes were moderate for all variables. Conclusion: This study showed that YFAS assessed FA was associated with visceral fat deposition, a sensitive indicator of increased cardiometabolic risk. Future research is required to investigate whether FA predicts future weight gain. 2 2

The Yale Food Addiction Scale (YFAS) is a widely used tool to assess the behavioural indicators of addictive-like eating. No studies, however, have used a longitudinal design to determine whether these addictive-like eating behaviours are a stable or transient phenomenon in a community-based population. This study aimed to evaluate whether food addiction Diagnosis and Symptom scores as assessed by the YFAS remain stable over 18-months in a non-clinical population. Young adults aged 18-35 years were recruited from the community to a web-based survey in 2013. The survey included demographics, anthropometrics and the YFAS. Participants who volunteered to be recontacted for future research were invited to complete the same survey 18-months later. The YFAS scoring outputs Diagnosis and Symptom scores were tested for agreement and reliability between the two time points. Of the 303 participants who completed the original survey and agreed to be recontacted, 69 participants (22.8% of those recontacted, 94% female, 67% normal weight at baseline) completed the 18-month follow-up survey. At baseline, thirteen participants met the YFAS predefined criteria for Diagnosis, while eleven participants met these criteria at the 18-month follow-up. YFAS Diagnosis was found to have moderate agreement [K = .50, 95% CI (.23, .77)] between the two time points while Symptom scores had good agreement [K = .70, 95% CI (.54, .83)]. Intraclass correlation coefficients were interpreted as moderate over the 18-month period for both the Diagnosis [ICC = .71, 95% CI (.45, .88)] and Symptom scores [ICC = .72, 95% CI (.58, .82)]. YFAS assessed food addiction Diagnosis and Symptom scores were found to be relatively stable over 18-months in a non-clinical population of predominantly female, young adults. Future research is required to determine the impact of behavioural weight loss interventions on YFAS assessed addictive-like eating.

BackgroundIt has been suggested that addictive behaviors related to consumption of specific foods could contribute to overeating and obesity. Although energy-dense, hyper-palatable foods are hypothesized to be associated with addictive-like eating behaviors, few studies have assessed this in humans. ObjectiveTo evaluate in young adults whether intakes of specific foods are associated with 'food addiction', as assessed by the Yale Food Addiction Scale (YFAS), and to describe the associated nutrient intake profiles. DesignAustralian adults aged 18-35. years were invited to complete an online cross-sectional survey including demographics, the YFAS and usual dietary intake. Participants were classified as food addicted (FAD) or non-addicted (NFA) according to the YFAS predefined scoring criteria. ResultsA total 462 participants (86% female, 73% normal weight) completed the survey, with 14.7% (n = 68) classified as FAD. The FAD group had a higher proportion of females (p =. 01) and higher body mass index (p< .001) compared to NFA. Higher YFAS symptom scores were associated with higher percentage energy intake (%E) from energy-dense, nutrient-poor foods including candy, take out and baked sweet products, as well as lower %E from nutrient-dense core foods including whole-grain products and breakfast cereals. These remained statistically significant when adjusted for age, sex and BMI category (p = .001). ConclusionsStatistically significant associations were identified between YFAS assessed food addiction and dietary intake, specifically intakes of energy-dense, nutrient-poor foods. However, the effect sizes were small limiting clinical applications. Further examination of the relationship between addictive-like eating and intake of specific foods in a nationally representative sample is warranted.

Obesity is a global issue and it has been suggested that an addiction to certain foods could be a factor contributing to overeating and subsequent obesity. Only one tool, the Yale Food Addiction Scale (YFAS) has been developed to specifically assess food addiction. This review aimed to determine the prevalence of food addiction diagnosis and symptom scores, as assessed by the YFAS. Published studies to July 2014 were included if they reported the YFAS diagnosis or symptom score and were published in the English language. Twenty-five studies were identified including a total of 196,211 predominantly female, overweight/obese participants (60%). Using meta-analysis, the weighted mean prevalence of YFAS food addiction diagnosis was 19.9%. Food addiction (FA) diagnosis was found to be higher in adults aged >35 years, females, and overweight/obese participants. Additionally, YFAS diagnosis and symptom score was higher in clinical samples compared to non-clinical counterparts. YFAS outcomes were related to a range of other eating behavior measures and anthropometrics. Further research is required to explore YFAS outcomes across a broader spectrum of ages, other types of eating disorders and in conjunction with weight loss interventions to confirm the efficacy of the tool to assess for the presence of FA.