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BackgroundHealthcare students are future health care providers and serve as role models and coaches to enhance behaviors for healthy lifestyles. However healthcare students face multiple stressors that could lead to adopting risk behaviors.ObjectivesTo assess the changes in health risk factors among healthcare students between 2007 and 2015, and to identify specific health behaviors based on the curriculum in a population of healthcare students.MethodsTwo cross sectionnal studies were conducted in 2007 and 2015 among nursing, medical, pharmacy, and physiotherapy students (Rouen, France). During compulsory courses and examination sessions students filled self-administered questionnaires on socio-demographic characteristics and behavior as: tobacco smoking, alcohol consumption, cannabis consumption, eating disorders, regular practice of sport, perceived health, stress and use of psychotropic drugs.Results2,605 healthcare students were included (1,326 in 2007 and 1,279 in 2015), comprising 1,225 medical students (47.0%), 738 nursing students (28.3%), 362 pharmacy students (13.9%), and 280 physiotherapy students (10.8%). Between 2007 and 2015, occasional binge drinking and regular practice of sport increased significantly among healthcare students, respectively AOR = 1.48 CI95% (1.20-1.83) and AOR = 1.33 CI95% (1.11-1.60), regular cannabis consumption decreased significantly, AOR = 0.32 CI95% (0.19-0.54). There was no change in smoking or overweight/obese. There was a higher risk of frequent binge drinking and a lower risk of tobacco smoking in all curricula than in nursing students. Medical students practiced sport on a more regular basis, were less overweight/obese, had fewer eating disorders than nursing students.ConclusionOur findings demonstrate a stable frequency of classic behaviors as smoking but a worsening of emerging behaviors as binge drinking among healthcare students between 2007 and 2015. Health behaviors differed according to healthcare curricula and nursing students demonstrated higher risks. As health behaviors are positively related to favorable attitudes towards preventive counseling, therefore healthcare students should receive training in preventive counseling and develop healthy lifestyles targeted according to the health curriculum.

Measuring body composition is an important issue to phenotype patients with obesity and to follow the nutritional care efficiency. Bioelectrical Impedance Analysis (BIA) is a simple and rapid technique. However, validity of BIA in patients with obesity remains controversial. Thus, we aimed to evaluate the validity of several BIA equations to assess body composition in a large cohort of patients with obesity by using dual X ray absorptiometry (DXA) as reference. Seven BIA equations have been retrospectively applied on electrical data measured by BIA in patients with obesity with BMI equal or higher than 30 kg/m2 and results were compared to DXA-derived fat mass (FM) and fat-free mass (FFM). BIA and DXA were done the same day after an overnight fasting. Results were compared with Bland-Altman method and Pearson correlation. We also calculated the accuracy defined as the percentage of patients with DXA-BIA difference within ± 10% of DXA measures for FFM and FM. Data from 2134 patients with class I and II obesity (ob1/2, n = 1452, 47.4 ± 14.2 y; 35.0 ± 2.7 kg.m−2) and class III obesity (ob3, n = 682, 48.2 ± 13.9 y; 44.1 ± 3.5 kg.m−2) were analyzed. The best results to evaluate FFM both in ob1/2 and ob3 groups were obtained with Roubenoff's equation: Bland Altman bias at −1.96 and −0.82 kg, Pearson correlation r at 0.93 and 0.87, accuracy at 75.7% and 83.3%, respectively. However, limits of agreements at 95% were high: [-9.42; 5.49 kg] and [-8.16; 6.52 kg]. For FM evaluation, Roubenoff's equation also showed best results for ob1/2 group (bias at −1.17 kg; correlation r at 0.89 and accuracy at 79.1%) but not for ob3 group. In this latter group, Deurenberg's equation exhibited the best results (bias at 2.09 kg; correlation r at 0.81 and accuracy at 76.8%). However, limits of agreements remained high. In patients with obesity, Roubenoff BIA equation should be recommended to assess fat free mass, even if limits of agreements remain high. [ABSTRACT FROM AUTHOR]

In the last decades, the role of microbiota–gut–brain axis has emerged in the regulation of eating behavior and in the pathophysiology of anorexia nervosa (AN) that remains poorly understood. Particularly, a gut-derived dysregulation of immune response has been proposed leading to immunoglobulins directed against appetite-regulating peptides. However, intestinal permeability in patients with anorexia nervosa has been poorly documented. In the present prospective case–control study, we thus compared intestinal permeability, appetite-regulating peptides and their reactive immunoglobulins measured in severely malnourished women with AN (n = 17; 28 [21–35] y; 14.9 [14.1–15.2] kg/m2) to healthy volunteers (HV, n = 34; 26 [23–35] y; 22.3 [20.6–23.6] kg/m2). Patients with AN exhibited an increased urinary lactulose/mannitol ratio, both in 0–5 h (0.033 [0.013–0.116]) and 5–24 h samples (0.115 [0.029–0.582]), when compared to HV (0.02 [0.008–0.045], p = 0.0074 and 0.083 [0.019–0.290], p = 0.0174, respectively), suggesting an increased intestinal permeability. Urinary excretion of sucralose and plasma zonulin were not different. The levels of plasma total ghrelin and desacyl-ghrelin were increased in patients with AN compared to HV, whereas plasma leptin concentration was decreased. In addition, αMSH remained unchanged compared to HV. Finally, we did not observe any modification of the levels of total or free αMSH, leptin or ghrelin-reactive immunoglobulin G and M, as well as for their affinity properties. Only, a weak decrease of the dissociation constant (kd) for acyl-ghrelin-reactive IgG was observed in patients with AN (p = 0.0411). In conclusion, severely malnourished patients with AN show a higher intestinal permeability than HV without evidence of an effect on appetite regulating peptides-reactive immunoglobulins. [ABSTRACT FROM AUTHOR]

In the last decade, the role of the microbiota–gut–brain axis in eating behavior and anxiety-depressive disorders has gained increasing attention. Although a gut microbiota dysbiosis has been reported in anorectic patients, its pathophysiological role remains poorly understood. Thus, we aimed to characterize the potential role of gut microbiota by evaluating the effects of its depletion in the Activity-Based Anorexia (ABA) mouse model both in male and female mice. Male and female C57Bl/6 mice were submitted (ABA group) or not (CT group) to the ABA protocol, which combines access to a running wheel with a progressive limited food access. Gut microbiota was previously depleted or not by a cocktail of antibiotics (ATB) delivered by oral gavages. We monitored body composition, anxiety-like behavior, leptin and adiponectin plasma levels, hypothalamic and hippocampal neuropeptides mRNA levels, as well as dopamine (DRD) and serotonin (5HT1 and 4) receptors mRNA expression. In response to the ABA model, the body weight loss was less pronounced in ATB-treated ABA compared to untreated ABA, while food intake remained unaffected by ATB treatment. ATB-treated ABA exhibited increased fat mass and decreased lean mass compared to untreated ABA both in male and female mice, whereas but plasma adipokine concentrations were affected in a sex-dependent manner. Only male ABA mice showed a reduced anticipatory physical activity in response to ATB treatment. Similarly, anxiety-like behavior was mainly affected in ATB-treated ABA male mice compared to ATB-treated ABA female mice, which was associated with male-specific alterations of hypothalamic CRH mRNA and hippocampal DRD and 5-HT1A mRNA levels. Our study provides evidence that ATB-induced gut microbiota depletion triggers alterations of nutritional and behavioral responses to the activity-based anorexia model in a sex-dependent manner. [ABSTRACT FROM AUTHOR]

Anorexia Nervosa is a severe disease depending on both biological, psychological and environmental factors. The gut microbiota has recently been proposed as one of the biological factors potentially involved in the onset or maintenance of Anorexia Nervosa. To unravel the potential role of the gut microbiota in this disease, we characterized the dysbiosis occurring in a mouse model of Anorexia and correlated bacteria level changes with different physiological parameters such as body weight, food intake or levels of hypothalamic neuropeptides. We used the Activity-Based Anorexia (ABA) mouse model, which combines food restriction and physical activity, and which mimics core features of Anorexia Nervosa. We characterized the gut microbiota alteration in ABA mice by combining 16S rRNA gene sequencing and quantitative PCR analyses of targeted genera or species. We identified 68 amplicon sequence variants (ASVs) with decreased levels and 8 ASVs with increased levels in the cecal content of ABA mice compared to control mice. We observed in particular in ABA mice increases in the abundance of Clostridium cocleatum and several Lactobacillus species and a decrease in the abundance of Burkholderiales compared to control mice. Interestingly, we show that most of the observed gut microbiota alterations are due to food restriction and are not affected by physical activity. In addition, we identified several bacterial groups that correlate with mice body weight, food intake, lean and fat masses as well as with hypothalamic mRNA levels of NPY (Neuropeptide Y) and POMC (Pro-opiomelanocortin). Our study provides a comprehensive characterization of the gut microbiota dysbiosis occurring in the Activity-Based Anorexia mouse model. These data constitute a valuable resource to further decipher the role of the gut microbiota in the different facets of anorexia pathophysiology, such as functional gastrointestinal disorders, appetite regulation and mood disorders. [ABSTRACT FROM AUTHOR]