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Few studies are focused on the antioxidant status and its changes in anorexia nervosa (AN). Based on the hypothesis that renutrition improves that status, the aim was to determine the plasma antioxidant status and the antioxidant enzymes activity at the beginning of a personalized nutritional program (T0) and after recovering normal body mass index (BMI) (T1). The relationship between changes in BMI and biochemical parameters was determined. Nutritional intake, body composition, anthropometric, hematological and biochemical parameters were studied in 25 women with AN (19.20 ± 6.07 years). Plasma antioxidant capacity and antioxidant enzymes activity were measured. Mean time to recover normal weight was 4.1 ± 2.44 months. Energy, macronutrients and micronutrients intake improved. Catalase activity was significantly modified after dietary intake improvement and weight recovery (T0 = 25.04 ± 1.97 vs. T1 = 35.54 ± 2.60μmol/min/mL; p < 0.01). Total antioxidant capacity increased significantly after gaining weight (T0 = 1033.03 ± 34.38 vs. T1 = 1504.61 ± 99.73 μmol/L; p < 0.01). Superoxide dismutase activity decreased (p < 0.05) and glutathione peroxidase did not change. Our results support an association between nutrition improvement and weight gain in patients with AN, followed by an enhancement of antioxidant capacity and catalase antioxidant system.

Introduction: The literature has found that obese patients usually report more depression and anxiety than normal weight individuals. However, not many investigations have studied the relationship between obesity and quality of life from a Positive Psychology approach. Objective: In this study it is analyzed if obese patients have less psychological well-being than a control group (normal weight participants). Method: A total of 221 participants (111 obese individuals and 110 controls) were selected to conduct the study. To measure psychological well-being, the Spanish version of the Ryff's Scales was used. To measure mental health, the Spanish version of the mental health component of the Short Form 36 Health Survey (SF-36) was used. Results: It was found that obese participants reported less psychological well-being than normal weight individuals, but that there were not statistically significant differences in the case of mental health measured with the SF-36. Discussion: According to the results, it can be concluded that reports of psychological well-being problems were much more common in participants with weight problems than in the control group.

Introduction: It has been found that the olfactory-gustatory function is altered in patients with eating disorders, with an impairment affecting the perception of olfactory and gustatory stimuli. Objective: The aim was to explore the subjective reactivity after the exposure and tasting of foods with different gradient of sweetness and different fats textures. In addition, changes in the thought-shape fusion (TSF) cognitive distortion were assessed after tasting those different presentations as well as the correlations between the initial scores on TSF-Questionnaire (TSF-Q) and the different responses after that tasting. Method: A total of 15 healthy controls and 23 outpatients with anorexia nervosa underwent two sessions of tasting (sweets with different gradient of sweetness and fats with different textures) and they filled several questionnaires (pre- and post-tasting) to measure their responses after tasting. Results: Participants showed less "self-control" after tasting sweets. The score on TSF-Q increased significantly after the sweets tasting in the patients group. Patients had the worst response after tasting presentations with more quantity of glucose (less gradient of sweetness) than after tasting those with more amount of sucrose (much more sweetness). With respect to the fats, patients showed the worst reaction after tasting the most unfamiliar texture. Pre fats tasting TSF-Q scores correlated significantly with all responses in the patients group. Discussion: Both psychological and biological (e.g. genetic) factors could be involved in the reactions of patients with anorexia nervosa after tasting sweets and fats.

Objective: Recently, it has been reported that food choices of relatives of eating disorder (ED) patients are not adequate having in mind a healthy model of eating habits. The aim of this study was to analyse how work conditions relate to parents' food choice coping strategies in both families with a member suffering from an ED and families with no sick members. In addition, the differences in those strategies between the two types of working parents were studied. Methods: A total of 80 employed fathers (n = 27) and mothers (n = 53) of patients with an ED (n = 50) and healthy offsprings (n = 30) were interviewed. The mean age was 43.57 ± 5.69 and they had moderate incomes. Food choice coping strategies, used by working parents to integrate work and family demands, were measured by means of 22 items included in five categories. Results: Considering the food choice coping strategies, ED patients' relatives show better skills than relatives of healthy offsprings do. The fact of preparing more meals at home and less fast food as main meal are good examples of those better strategies as well as to miss less number of breakfasts and lunches because of work-family conflict, grabbing less frequently and overeat less after missing a meal. Discussion: The therapeutic effort to improve the food choices of ED patients' relatives, especially when both father and mother work, are a key point to improve the eating habits of ED patients, thus contributing to a better outcome.

Introduction: Human eating behaviour is regulated by multiple factors. Anorexia nervosa patients show a restrictive eating pattern while bulimia nervosa patients present bingeing-purging episodes. Although treatments are specially successful in the normalization of body composition, maladaptive eating behaviours tend to persist being a risk factor for relapse and recurrence. Objectives: The aim of this work was to assess the quality of the nutritional choice of eating disorders patients after a year of nutritional education and to assess improvements in choice capacity. Methods: Thirty-one outpatients of an eating disorders unit planned a menu after body composition normalization and repeated this plan each three months during a one-year programme of nutritional education. Results: Patients improved the time spent on the assignment (p < 0.01), Body Mass Index (p < 0.01), their body fat mass (p < 0.01) and the content of energy (p < 0.05), carbohydrates (p < 0.01) and polyunsaturated fatty acids (p < 0.05) in their chosen menus. No differences were found on proteins, total fat or fat profile, vitamins or minerals. 12.9% and 3.2% of the patients chose their menu according to the recommendations of caloric and lipid profile, respectively, after a year of nutritional education. Discussion: Although patients improved energy and carbohydrates content of the menus they tended to reduce caloric and fat food choices, which could lead to relapse and recurrence. Specific nutritional education programmes along with the mandatory psychological and psychiatric treatment may be effective. Conclusions: One year of nutritional education combined with psychological and psychiatric treatment improved those factors usually involved in relapse and recurrence, thus contributing to a proper outcome.

I Jáuregui-Lobera,1,3 MA Santed-Germán,2 P Bolaños-Ríos,3 O Garrido-Casals3 1Molecular Biology and Biochemistry Engineering Department, Pablo de Olavide University, Seville, Spain; 2Personality, Evaluation and Psychological Treatments Department, UNED, Madrid, Spain; 3Behavioral Sciences Institute, Seville, Spain Purpose: The aims of the study were to analyze the psychometric properties of the Spanish version of the Thought-Action Fusion Questionnaire (TAF-SP), as well as to determine its validity by evaluating the relationship of the TAF-SP to different instruments. Patients and methods: Two groups were studied: one comprising 146 patients with eating disorders; and another a group of 200 students. Results: Three factors were obtained: TAF–Moral; TAF–Likelihood-others; and TAF–Likelihood-oneself. The internal consistency of the TAF-SP was determined by means of Cronbach’s α coefficient, with values ranging between 0.84–0.95. The correlations with other instruments reflected adequate validity. The three-factor structure was tested by means of a linear structural equation model, and the structure fit satisfactorily. Differences in TAF-SP scores between the diagnostic subgroups were also analyzed. Conclusion: The TAF-SP meets the psychometric requirements for measuring thought-action fusion and shows adequate internal consistency and validity. Keywords: thought-action fusion, cognitive distortions, validation, eating disorders

Introduction: Is there a group of psychometric variables, which correlates with the criteria of an interdisciplinary team about the course of ED? Objectives: The aim of this study was to analyse the correlation between the clinic criteria of an interdisciplinary team with respect to the course of eating disorders (ED) and different psychometric criteria. Methods: The course was analysed in a final sample of 30 ED outpatients during their six first months of treatment. A scale of clinical criteria of the course of ED (therapeutic team's opinion) and different questionnaires on psychological, psychopathological and eating-related variables were used. The statistical analysis comprised of a discriminant analysis in order to find the variables with a discriminant function to distinguish between a fair-bad course and a good course. Results: Perceived stress, self-esteem, the variables of the SCL-90-R, depression, thought-shape fusion, anxiety, food craving and the score on body shape questionnaire were found to have discriminant function. Comparing the therapeutic team's criteria and the results of the questionnaires a 10% of patients were misclassified. Discussion: The results highlight the necessary and permanent checking of the relationship among the clinical criteria regarding the course of ED (members' team opinion) and different psychological, psychopathological and eating-related variables.

Objetivos: Analizar el nivel de estrés, en distintos momentos académicos, mediante la determinación de cortisol salivar y evaluar la influencia de dicho nivel de estrés en la eficacia de un programa de educación nutricional en adolescentes. Métodos: Se determinó el cortisol salival (mañana y noche) de 42 estudiantes de educación secundaria obligatoria, al inicio de curso y en el momento previo a los exámenes finales. Se desarrolló durante el curso un programa de educación nutricional y se recogieron datos de consumo de alimentos mediante un cuestionario de frecuencia en ambos momentos inicial y final. Igualmente, se determinó el índice de masa corporal. Resultados: El cortisol de mañana inicial fue menor que el de mañana final (p < 0,05), con niveles más elevados en las chicas (p < 0,05). En la determinación final, el cortisol de mañana también resultó más elevado en las chicas (p < 0,01). No hubo variaciones significativas en el índice de masa corporal. El 23.8% de los estudiantes refirió ingerir menos bebidas carbonatadas tras la intervención, mientras que el 28,57% destacó el hecho de haber incluido el desayuno antes de salir de casa. Se observó una reducción del consumo de frutas al final del estudio. Discusión: Para valorar adecuadamente si los cambios están relacionados con el programa de educación nutricional o con la situación estresante debida a la proximidad de los exámenes, que implicaría un aumento en la ingesta, serían necesarios más estudios a realizar en diferentes etapas del curso académico.

Introduction: Food craving consists of a strong motivational state whereby a person is driven to seek and ingest a specifically desired food. Objectives: To explore the influence of mental imagery on the food craving experience as well as to analyse the role of different psychological variables. Methods: Participants consisted of 65 normal weight undergraduate students. An experimental induction of food craving was analysed considering the actual previous craving and the induced one as a state food craving. Measures of trait food craving, imaging ability, dietary restraint, anxiety, depression, and coping strategies were considered. Results: Sweet foods in general and chocolate in particular were the most craved foods. During the induction thoughts and images were the most highly rated triggers, and all the different sensory modalities were involved. Anxiety, depression, and negative coping strategies influenced the results with regards to the food craving. Discussion: This study confirms the role of mental imagery, the correlation between state and trait food craving, and the influence of different psychological variables on the food craving.Introducción: El food craving se define como un fuerte estado motivacional por el que una persona se ve impulsada a buscar e ingerir un alimento específicamente deseado. Objetivos: Explorar la influencia de las imágenes mentales sobre la experiencia de food craving, así como analizar el papel de diferentes variables psicológicas. Métodos: Los participantes fueron 65 estudiantes de pregrado de peso normal. Se analizó un modelo de provocación experimental de food craving teniendo en cuenta el deseo real previo al experimento y el inducido durante el mismo como medida de estado. Medidas de food craving habitual, capacidad de formación de imágenes, restricción dietética, ansiedad, depresión y estrategias de afrontamiento fueron consideradas. Resultados: Los alimentos dulces en general y el chocolate, en particular, fueron los alimentos más ansiados. Durante la inducción, los pensamientos y las imágenes fueron los desencadenantes más potentes y todas las modalidades sensoriales estuvieron involucradas. Las variables ansiedad, depresión y estrategias de afrontamiento negativas influyeron en los resultados con respecto al food craving inducido. Discusión: Este estudio confirma el papel de las imágenes mentales, la correlación entre estado y rasgo de food craving y la influencia de diferentes variables psicológicas en el mismo.

Ignacio Jáuregui-Lobera,1 Patricia Bolaños-Ríos,2 Inmaculada Ruiz-Prieto21Department of Nutrition and Bromatology, Pablo de Olavide University, Seville, Spain; 2Behavioral Sciences Institute, Seville, SpainPurpose: The aim of this study was to analyze the relationships among thought–shape fusion (TSF), specific instruments to assess body image disturbances, and body image quality of life in eating disorder patients in order to improve the understanding of the links between body image concerns and a specific bias consisting of beliefs about the consequences of thinking about forbidden foods.Patients and methods: The final sample included 76 eating disorder patients (mean age 20.13 ± 2.28 years; 59 women and seven men). After having obtained informed consent, the following questionnaires were administered: Body Appreciation Scale (BAS), Body Image Quality of Life Inventory (BIQLI-SP), Body Shape Questionnaire (BSQ), Eating Disorders Inventory-2 (EDI-2), State-Trait Anxiety Inventory (STAI), Symptom Checklist-90-Revised (SCL-90-R) and Thought-Shape Fusion Questionnaire (TSF-Q).Results: Significant correlations were found between TSF-Q and body image-related variables. Those with higher scores in TSF showed higher scores in the BSQ (P < 0.0001), Eating Disorder Inventory – Drive for Thinness (EDI-DT) (P < 0.0001), and Eating Disorder Inventory – Body Dissatisfaction (EDI-BD) (P < 0.0001). The same patients showed lower scores in the BAS (P < 0.0001). With respect to the psychopathological variables, patients with high TSF obtained higher scores in all SCL-90-R subscales as well as in the STAI.Conclusion: The current study shows the interrelations among different body image-related variables, TSF, and body image quality of life.Keywords: cognitive distortions, quality of life, body appreciation, psychopathology, anorexia nervosa, bulimia nervosa

Objective: The aim of this study was to explore the lipid profile in patients with anorexia nervosa (AN), and the changes with refeeding. Methods: The sample comprised 102 AN outpatients (mean age 22.32 ± 3.17). Blood tests, after 12-hour overnight fast, were performed before refeeding (M0) and after weight restoration (M1). Total cholesterol (TC), high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides (TRG) were determined and the following cardiovascular risk markers were calculated: LDL/HDL and TC/HDL ratios. These cut-off points were considered: TC < 200 mg/dl; HDL > 40 mg/dl; LDL < 100 mg/dl and TRG < 150 mg/dl. Results: The time leading to weight restoration was 8.16 ± 7.35 months. Considering patients with scores higher and lower than the corresponding cut-off points, X²-test revealed a significant difference (M0-M1) in case of TC (p < 0.05) as well as between LDL/HDL0 and LDL/HDL1 (p < 0.05) and between TC/HDL0 and TC/HDL1 (p < 0.01). Significant differences were found between HDL0 and HDL1 (p < 0.01) and between TRG0 and TRG1 (p < 0.01). Significant and negative associations between BMI0 and TC0 (r = -0.331; p < 0.05) and between TRG0 and HDL0 (r = -0.387; p < 0.05) were found. The association between TRG1 and LDL1 was significant and positive. Discussion: Weight restoration tends to decrease the TC/HDL and LDL/HDL ratios despite a considerable percentage of patients maintain scores on the different variables of the lipid profile usually considered at risk.Objetivo: El objetivo de este estudio fue explorar el perfil lipídico en pacientes con anorexia nerviosa (AN) y los cambios con la realimentación. Métodos: Se estudiaron 102 pacientes ambulatorios con AN (edad media de 22,32 ± 3,17). Se determinaron en sangre, tras de 12 horas en ayunas, antes de la realimentación (M0) y después de la recuperación del peso (M1), colesterol total (CT), lipoproteínas de alta densidad (HDL), lipoproteínas de baja densidad (LDL) y triglicéridos (TRG) y se calcularon los siguientes marcadores de riesgo cardiovascular: LDL/HDL y CT/HDL ratios. Se consideraron los siguientes puntos de corte: CT < 200 mg/dl, HDL > 40 mg/dl, LDL

Objective: The aim was to induce the thought-shape fusion (TSF) distortion experimentally, testing: a) Whether the TSF distortion could be induced by anxiety in general or if it had a specific relationship with thoughts related to the intake of fattening foods; b) Whether the TSF could be induced in non-clinical participants as well as in the eating disorder patients; c) Whether participants with more appropriate coping strategies would experience less TSF than those who showed inadequate coping strategies; and d) That TSF could have behavioural effects (e.g., neutralization of TSF and food intake) related to emotions. Methods: The sample comprised two groups (eating disorder patients and students), with 45 participants each, aged between 18 and 25 years, 92.50% and 86.7% of women in the eating disorders group and the students group respectively. The two groups underwent three experimental conditions (TSF, anxiety, and control), measuring the results with regards to the emotional and behavioural responses. Results: Participants in the TSF induction condition reported more guilt, more feelings of fatness, more likelihood of weight gain, and higher degree of moral wrongdoing compared with participants in both the anxiety and control induction conditions. The effect of the adequate coping strategies in decreasing the strength of the TSF bias was confirmed in both eating disorder patients and non-clinical participants. Discussion: The study of the TSF distortion may have relevant implications in terms of treatment and prognostic of eating disorders. This distortion may be involved in the development and maintenance of eating disorder psychopathology.Objetivo: El objetivo fue inducir la distorsión fusión pensamiento-forma (TSF) experimentalmente, comprobando:a) Si la distorsión TSF puede ser inducida por la ansiedad en general o si hay una relación específica con pensamientos relacionados con la ingesta de alimentos que engordan; b) Si la TSF se podría inducir en los participantes no clínicos, así como en los pacientes con trastornos alimentarios, c) Si los participantes con estrategias de afrontamiento más apropiada experimentarían menos TSF que los que muestran inadecuadas estrategias de afrontamiento, y d) Que la TSF podría tener efectos conductuales (por ejemplo, la neutralización de la TSF y la ingesta de alimentos) en relación con las emociones. Métodos: La muestra estaba compuesta por dos grupos (pacientes con trastornos alimentarios y estudiantes), con 45 participantes cada uno, de edades comprendidas entre 18 y 25 años, con 92,50% y el 86,7% de mujeres en el grupo de trastornos alimentarios y en el de estudiantes, respectivamente. Los dos grupos se sometieron a tres condiciones experimentales (TSF, ansiedad y control), midiendo los resultados con respecto a las respuestas emocionales y conductuales. Resultados: Los participantes en la condición de inducción TSF presentaron más culpa, más sentimientos de gordura, más probabilidad de aumento de peso y un mayor sentimiento de haber hecho algo moralmente incorrecto, comparando con las condiciones de ansiedad y control. El efecto de unas adecuadas estrategias de afrontamiento en la disminución de la fuerza de la distorsión TSF fue confirmado tanto en pacientes con trastornos alimentarios como en los participantes no clínicos. Discusión: El estudio de la distorsión TSF puede tener implicaciones relevantes en términos de tratamiento y pronóstico de los trastornos alimentarios. Esta distorsión puede estar involucrada en el desarrollo y mantenimiento de la psicopatología de estos trastornos.

Objective: The study begins by analysing the psychometric properties of the Nepean Dyspepsia Index-Short Form (NDI-SF), before moving on to study quality of life in patients with functional dyspepsia (FD) and the psychopathological features that underlie the disorder in three groups of subjects: patients with eating disorders (ED), psychiatric patients (non-ED), and a group of students, all of whom fulfilled Rome III criteria for FD. The analysis specifically focused on the relationship between thought-shape fusion (TSF) and functional dyspepsia, and hence on the potential repercussions this could have on the quality of life of patients with eating disorders. Methods: The sample comprised 78 ED outpatients, 77 non-ED outpatients, and 90 university students, all of them with associated FD (Rome III criteria). The mental disorders (ED and non-ED) fulfilled the diagnostic criteria of DSM IV-RT. In all cases, the symptoms of dyspepsia, the related quality of life, anxiety, depression, and TSF were determined. Results: Satiation and bloating were significantly higher in ED patients. Correlations between dyspepsia and TSF were initially positive and significant in all cases, but significance was only maintained in the group of ED patients after controlling for the other psychopathological variables. Regarding the ED group, the regression analysis revealed the following predictors of quality of life: dyspepsia, depressive symptomatology, TSF-conceptual, TSF-interpretative and total TSF. Discussion: The cognitive distortion of TSF appears to constitute a general bias common to all eating disorders, with specific effect on the characteristic symptoms of FD.Objetivo: se analizaron las propiedades psicométricas del Nepean Dyspepsia Índex-Short Form (NDI-SF), previo al estudio de la calidad de vida en pacientes con dispepsia funcional (DF) y variables psicopatológicas subyacentes a dicho trastorno en pacientes con trastornos de la conducta alimentaria (TCA), pacientes psiquiátricos (no TCA) y un grupo de estudiantes, todos ellos con criterios Roma III de DF. El análisis se centró específicamente en la relación entre la fusión pensamiento-forma (TSF) y la DF, y en las repercusiones que ello podría tener en la calidad de vida de los pacientes TCA. Métodos: la muestra comprendía pacientes en tratamiento ambulatorio (78 con TCA y 77 no TCA, con criterios DSM IV-TR) y 90 estudiantes universitarios, todos ellos con DF (criterios de Roma III). Se valoraron los síntomas de dispepsia, la calidad de vida relacionada con ella, la ansiedad, la depresión y el constructo TSF. Resultados: La saciedad y la hinchazón fueron significativamente mayores en los pacientes TCA. Las correlaciones entre la dispepsia y TSF fueron positivas y significativas en todos los casos, pero sólo se mantuvo la significación en el grupo de pacientes TCA tras controlar el resto de variables psicopatológicas. En cuanto al grupo de TCA, el análisis de regresión reveló los siguientes predictores de la calidad de vida: dispepsia, sintomatología depresiva, TSF-conceptual, TSF-interpretativo y TSF total. Discusión: la distorsión cognitiva TSF parece constituir un sesgo general, común a todos los TCA, con efecto específico sobre los síntomas característicos de dispepsia funcional.

Objective: The aim of the study was to analyse the psychometric properties of the Food Choice Questionnaire (FCQ) in Spanish population (FCQ-SP), its factor structure and internal consistency. In addition, the relationships between the FCQ-SP and the General Health Questionnaire (GHQ), the Irrational Food Beliefs Scale (IFBS), and the Eating Disorders Inventory-3 (EDI-3) were analysed in order to explore the validity of the FCQSP. Possible gender differences in the food choice pattern were analysed. Methods: The sample comprised 255 women and 50 men, ranged from 25 to 64 years. In order to get a better interpretation of the results associated with changes based on the age, the participants were grouped in four age intervals (25-34, 35-44, 45-54, and 55-64). All the participants were relatives of secondary and high school students in three schools of Seville and Cordoba. Results: The factor analysis yields the seven following factors: mood, health and natural content, sensory appeal, weight control, convenience, familiarity, and price. The internal consistency was determined by means of the Cronbach's α coefficients, which ranged from 0.70 to 0.83 for the different components. With regards to the food choice profile, sensory appeal was the most motivating factor to choose food, followed by price and weight control. With respect to gender differences, women showed higher scores than men in all components except in the case of price. Discussion: The FCQ-SP has adequate psychometric properties to be applied to Spanish population, and it is useful to explore the consumers' motivation with regards to food choice.Objetivo: Analizar las propiedades psicométricas del Cuestionario de Elección de Alimentos (FCQ) en población española, su estructura factorial y consistencia interna, además de las relaciones entre el FCQ y el Cuestionario de Salud General (GHQ), la Escala de Creencias Irracionales sobre los Alimentos (IFBS) y el Inventario de Trastornos Alimentarios-3 (EDI-3), con el fin de explorar la validez del FCQ. También se analizaron las posibles diferencias de género en el patrón de elección de los alimentos. Métodos: La muestra estuvo formada por 255 mujeres y 50 hombres, con edades entre de 25 a 64 años. Para interpretar los resultados asociados a cambios en función de la edad, se establecieron cuatro intervalos de edad (25-34, 35-44, 45-54 y 55-64). Todos los participantes eran familiares de estudiantes de secundaria y bachillerato en tres escuelas de Sevilla y Córdoba. Resultados: El análisis factorial revelo siete factores: estado de animo, salud y contenido natural de los alimentos, atractivo sensorial, control del peso, comodidad, familiaridad y precio. La consistencia interna se determino mediante los coeficientes α de Cronbach, que variaron desde 0,70 hasta 0,83 para los distintos componentes. El atractivo sensorial fue el factor mas motivador para elegir los alimentos, seguido por el precio y el control del peso. Las mujeres mostraron puntuaciones mas altas que los hombres en todos los componentes excepto en el caso del precio. Discusión: El FCQ tiene adecuadas propiedades psicométricas para ser aplicado en población española, siendo útil para explorar la motivación de los consumidores en la elección de alimentos.

Ignacio Jáuregui-Lobera1,2, Patricia Bolaños-Ríos2, María José Santiago-Fernández2, Olivia Garrido-Casals2, Elsa Sánchez31Department of Nutrition and Bromatology, Pablo de Olavide University, Seville, Spain; 2Behavioral Sciences Institute, Seville, Spain; 3Professional Schools Sagrada Familia, Écija, Seville, SpainBackground: This study explored the relationship between body mass index (BMI) and weight perception, self-esteem, positive body image, food beliefs, and mental health status, along with any gender differences in weight perception, in a sample of adolescents in Spain.Methods: The sample comprised 85 students (53 females and 32 males, mean age 17.4 ± 5.5 years) with no psychiatric history who were recruited from a high school in Écija, Seville. Weight and height were recorded for all participants, who were then classified according to whether they perceived themselves as slightly overweight, very overweight, very underweight, slightly underweight, or about the right weight, using the question “How do you think of yourself in terms of weight?”. Finally, a series of questionnaires were administered, including the Irrational Food Beliefs Scale, Body Appreciation Scale, Self Esteem Scale, and General Health Questionnaire.Results: Overall, 23.5% of participants misperceived their weight. Taking into account only those with a normal BMI (percentile 5–85), there was a significant gender difference with respect to those who perceived themselves as overweight (slightly overweight and very overweight); 13.9% of females and 7.9% of males perceived themselves as overweight (χ2 = 3.957, P < 0.05). There was a significant difference for age, with participants who perceived their weight adequately being of mean age 16.34 ± 3.17 years and those who misperceived their weight being of mean age 18.50 ± 4.02 years (F = 3.112, P < 0.05).Conclusion: Misperception of overweight seems to be more frequent in female adolescents, and mainly among older ones. Misperception of being overweight is associated with a less positive body image, and the perception of being very underweight is associated with higher scores for general psychopathology.Keywords: weight misperception, self-esteem, positive body image, psychological distress, food beliefs

Ignacio Jáuregui Lobera1, Patricia Bolaños Ríos21Department of Nutrition and Bromatology, Pablo de Olavide University, Seville, Spain; 2Behavior Sciences Institute, Seville, SpainPurpose: The objective was to examine how body image affects quality of life in an eating-disorder (ED) clinical sample, a non-ED clinical sample, and a nonclinical sample. We hypothesized that ED patients would show the worst body image quality of life. We also hypothesized that body image quality of life would have a stronger negative association with specific ED-related variables than with other psychological and psychopathological variables, mainly among ED patients. On the basis of previous studies, the influence of gender on the results was explored, too.Patients and methods: The final sample comprised 70 ED patients (mean age 22.65 ± 7.76 years; 59 women and 11 men); 106 were patients with other psychiatric disorders (mean age 28.20 ± 6.52; 67 women and 39 men), and 135 were university students (mean age 21.57 ± 2.58; 81 women and 54 men), with no psychiatric history. After having obtained informed consent, the following questionnaires were administered: Body Image Quality of Life Inventory-Spanish version (BIQLI-SP), Eating Disorders Inventory-2 (EDI-2), Perceived Stress Questionnaire (PSQ), Self-Esteem Scale (SES), and Symptom Checklist-90-Revised (SCL-90-R).Results: The ED patients' ratings on the BIQLI-SP were the lowest and negatively scored (BIQLI-SP means: +20.18, +5.14, and —6.18, in the student group, the non-ED patient group, and the ED group, respectively). The effect of body image on quality of life was more negative in the ED group in all items of the BIQLI-SP. Body image quality of life was negatively associated with specific ED-related variables, more than with other psychological and psychopathological variables, but not especially among ED patients.Conclusion: Body image quality of life was affected not only by specific pathologies related to body image disturbances, but also by other psychopathological syndromes. Nevertheless, the greatest effect was related to ED, and seemed to be more negative among men. This finding is the opposite of that found in other groups studied previously.Keywords: body image, quality of life, eating disorders, self-esteem, social functioning, gender differences

Objectives: Research on the influence of body shape model on adolescent males is scarce. The current study aimed to assess this influence among adult males involved in intense physical activity and to determine its relationship to eating behaviour. Possible variations between 1998 and 2008 were also analysed. Method: A total of 950 males (672 in 1998 and 278 in 2008), all aspiring professional soldiers, were studied using the Questionnaire of Influences on Body Shape Model (CIMEC-V) and the Eating Attitudes Test-40 (EAT-40), as well as by assessing their physical/sporting activity and body mass index (BMI). Results: Scores on the CIMEC-V were significantly correlated with the EAT-40 and BMI. As regards physical activity the only positive correlation referred to gym-based exercise. A cluster analysis revealed two subgroups with respect to physical activity, BMI, and scores on the CIMEC-V and EAT-40. One of them scored higher on these three variables and they also had a BMI > 25. The comparative study of data from 1998 and 2008 showed significant changes in some variables. Conclusions: Generally, the results differ considerably from those reported for younger samples (which would suggest a lower risk of disordered eating behaviour). However, there is a higher risk group in which the influence of body shape models, physical activity and eating behaviour are related to greater body volume. The influence of the body shape model on males has increased, especially as regards the influence of friends and in terms of behaviours aimed at weight loss.Objetivos: La investigación sobre la influencia del modelo estético corporal en varones adolescentes es escasa. El presente estudio analiza tal influencia en varones con intensa actividad física y su influencia en la conducta alimentaria. También fueron analizadas las posibles variaciones entre 1998 y 2008. Método: Un total de 950 varones (672 en 1998 y 278 en 2008), aspirante a soldado profesional, fueron evaluados usando el Cuestionario de Influencia del Modelo Estético Corporal (CIMEC) y el Test de Actitudes Alimentarias (EAT), así como evaluando su actividad físico-deportiva y el Índice de Masa Corporal (IMC). Resultados: Las puntuaciones del CIMEC correlacionaron significativamente con el EAT-40 y el IMC. En cuanto a la actividad física, la única correlación positiva fue la referente a la actividad física en el gimnasio. El análisis de conglomerados mostró dos grupos con respecto a actividad física, IMC y puntuaciones del CIMEC-V y EAT-40. Uno de ellos puntuó más en esas tres variables, presentando un IMC > 25. La comparación de datos de 1998 y 2008 mostró cambios significativos en algunas de las variables. Discusión: Los resultados difieren considerablemente de los recogidos en muestras de menos edad (lo que podría indicar menos riesgo de alteraciones alimentarias). Sin embargo, hay un grupo de mayor riesgo en el que la influencia del modelo estético corporal, la actividad física y la conducta alimentaria están relacionados con un mayor volumen corporal. La influencia del modelo estético en varones ha aumentado, especialmente la de los amigos y la relacionada con conductas dirigidas a perder peso.

Ignacio Jáuregui Lobera1, Patricia Bolaños Ríos21Department of Nutrition and Bromatology, Pablo de Olavide University, Seville, Spain; 2Behavior Science Institute, Seville, SpainPurpose: The aim of the current study was to analyze the psychometric properties, factor structure, and internal consistency of the Spanish version of the Body Image Quality of Life Inventory (BIQLI-SP) as well as its test–retest reliability. Further objectives were to analyze different relationships with key dimensions of psychosocial functioning (ie, self-esteem, presence of psychopathological symptoms, eating and body image-related problems, and perceived stress) and to evaluate differences in body image quality of life due to gender.Patients and methods: The sample comprised 417 students without any psychiatric history, recruited from the Pablo de Olavide University and the University of Seville. There were 140 men (33.57%) and 277 women (66.43%), and the mean age was 21.62 years (standard deviation = 5.12). After obtaining informed consent from all participants, the following questionnaires were administered: BIQLI, Eating Disorder Inventory-2 (EDI-2), Perceived Stress Questionnaire (PSQ), Self-Esteem Scale (SES), and Symptom Checklist-90-Revised (SCL-90-R).Results: The BIQLI-SP shows adequate psychometric properties, and it may be useful to determine the body image quality of life in different physical conditions. A more positive body image quality of life is associated with better self-esteem, better psychological wellbeing, and fewer eating-related dysfunctional attitudes, this being more evident among women.Conclusion: The BIQLI-SP may be useful to determine the body image quality of life in different contexts with regard to dermatology, cosmetic and reconstructive surgery, and endocrinology, among others. In these fields of study, a new trend has emerged to assess body image-related quality of life.Keywords: body appreciation, wellbeing, self-esteem, social functioning, gender differences

Ignacio Jáuregui Lobera1, Pilar León Lozano2, Patricia Bolaños Ríos3, Juan Romero Candau2, Gregorio Sánchez del Villar y Lebreros4, M Teresa Morales Millán1,5, M Teresa Montaña González1,5, Lourdes Andrés Martín2, Isabela Justo Villalobos2, Nuria Vargas Sánchez21Área de Nutrición y Bromatología, Universidad Pablo de Olavide; 2Colegio Oficial de Farmacéuticos; 3Instituto de Ciencias de la Conducta; 4Instituto de Enseñanza Secundaria “Murillo”; 5Facultad de Farmacia, Universidad de Sevilla, Sevilla, SpainBackground: Research conducted to date into the primary prevention of eating disorders (ED) has mainly considered the provision of information regarding risk factors. Consequently, there is a need to develop new methods that go a step further, promoting a change in attitudes and behavior in the target population.Objective: This study describes an adaptation of the Girls’ Group model to the Spanish context, the main objective being to compare two types of intervention, ie, one based on this model and the other following the traditional approach of providing information. The ultimate aim was to implement a prevention program that reduces the risk factors and boosts the protection factors that have been empirically shown to be related to ED.Methods: On the basis of previous research on the primary prevention of ED, and taking into account recognized risk and protective factors, the following topics were addressed: nutritional aspects; self-esteem; coping strategies; the ideal image of what is attractive and role of the media; and body image. The total sample (174 girls and 197 boys) was divided into 12 work groups, six for the intervention group (one school) and six for the control group (two schools). School-based input (intervention group) was provided by a pharmacist, a psychologist, a qualified nutritionist/dietician, and specialist support staff (psychologists and/or educators) and teachers of the three schools.Results: Participation in the intervention group reduced body dissatisfaction (F = 13.41; P < 0.01), the drive to thinness (F = 10.79; P < 0.01), and the influence of the media with respect to the esthetic body shape model (F = 13.90; P < 0.01), while self-esteem (F = 7.34; P < 0.01) and the use of coping strategies (F = 13.74; P < 0.01) both improved. There was also an improvement in the eating habits of participants, with better outcomes being achieved when intervening with females.Conclusions: The present study shows that in the primary prevention of eating disorders, better outcomes are achieved by new models which target the attitudes and behavior of adolescents rather than focusing solely on the provision of risk information to raise awareness.Keywords: coping strategies, adolescence, primary prevention, eating disorders, positive psychology

Objective: To analyse the diets chosen by anorexic patients and a control group, assessing several nutritional aspects. Method: Forty-four outpatients with an initial diagnosis of restrictive anorexia nervosa (normal BMI at the time of the study) and 34 undergraduates chose their diet from a list of common foods. Nutritional content, frequency of consumption, and influence of illness and treatment duration on the diet chosen were all analysed. Results: Patients' diets had a lower caloric content (P = 0.01). Their diets were also lower in niacin (P = 0.03), vitamin B12 (P = 0.04), sodium (P = 0.003), zinc (P = 0.04), phosphorus, copper and selenium (P = 0.01). Frequency of consumption was lower among patients for bread and cereals, meat and cured meats (P = 0.01), sweet foods (P = 0.001), and fatty and fried foods (P = 0.05), but higher for vegetables (P = 0.01). Discussion: Patients tend to maintain some characteristic eating patterns and modify others, not so much in terms of therapeutic objectives but, rather, as a way of following more closely the usual eating patterns of the context.Objetivo: analizar las dietas elegidas por pacientes anoréxicos y un grupo control, evaluando diversos aspectosnutricionales. Método: cuarenta y cuatro pacientes ambulatorios con un diagnóstico inicial de anorexia nerviosa restrictiva (IMC normal en el momento del estudio) y 34 estudiantes de bachillerato eligieron su dieta a partir de una lista de alimentos habituales. Se analizaron el contenido nutritivo, la frecuencia del consumo y la influencia de la enfermedad y la duración del tratamiento sobre la dieta seleccionada. Resultados: el contenido calórico fue menor en las dietas de los pacientes (p = 0,01). Sus dietas también contenían menos niacina (p = 0,03), vitamina B12 (p = 0,04), sodio (p = 0,003), cinc (p = 0,04), fósforo, cobre y selenio (p = 0,01). La frecuencia del consumo fue menor en las pacientes con respecto al pan y cereales, la carne y los embutidos (p = 0,01), los dulces (p = 0,001), y los alimentos grasos y fritos (p = 0,05), pero mayor con respecto a los vegetales (p = 0,01). Discusión: los pacientes parecían retener ciertas características de patrones de alimentación y modificar otros, no tanto en términos de objetivos terapéuticos sino, más bien, como una manera de seguir de forma más estrecha los patrones de alimentación habituales del contexto.

Objetivo: En el presente trabajo se analiza la presencia de alteraciones alimentarias y la influencia que sobre ellas puede tener el grado de insatisfacción corporal entre los adolescentes. Método: Aplicando el Eating Attitudes Test-40 (EAT-40), el Sick Control On Fat Food (SCOFF) y la subescala de insatisfacción corporal (BD) del Eating Disorders Inventory-2 (EDI-2) a 841 estudiantes, de 12 a 19 años, se analizaron las conductas alimentarias de riesgo, se estudiaron las diferencias en función del sexo y la edad y se analizó la relación de dichas conductas con el grado de insatisfacción corporal. Resultados y discusión: El 21,29% tuvo puntuaciones significativas en el SCOFF y el 7,13% en el EAT-40. Por sexos, hubo diferencias significativas (13,93% y 3,23% en SCOFF y EAT-40 para los varones, 29,38% y 10,70% para las mujeres). Con respecto a datos anteriores, se observa un descenso del riesgo en las mujeres y un incremento en los varones. Se observó una mayor insatisfacción corporal en las chicas de 12 a 17 años, si bien la diferencia entre chicas y chicos, en alteraciones alimentarias, se centra en los 14-16 años. La insatisfacción corporal correlacionó positiva y significativamente con el Índice de Masa Corporal, EAT-40 y SCOFF. Para implantar programas de prevención primaria en la población adolescente, es necesario conocer las conductas alimentarias de riesgo y el grado de insatisfacción coporal, para poder plantear específicamente las intervenciones a llevar a cabo, involucrando al profesorado como agente primario de trabajo en el contexto escolar.Objective: This study examined the presence of disordered eating behaviours and the influence that on them could have the degree of body dissatisfaction among adolescents. Method: By the Eating Attitudes Test-40 (EAT-40), the Sick Control On Fat Food (SCOFF) and the subscale of body dissatisfaction (BD) of the Eating Disorders Inventory-2 (EDI-2) a total of 841 students, aged 12-19, were studied. Eating behaviours, sex and age differences, and eating attitudes and behaviours related to the degree of body dissatisfaction were analized. Results: We found that 21,29% had significant punctuations in the SCOFF and 7,13% in the EAT-40. There were significant sex-differences (13,93% and 3,23% in SCOFF and EAT-40 for males, 29,38% and 10,70% for women). With regard to previous studies, a decrease of the risk is observed in women and an increase in males. Major body dissatisfaction was observed among the 12 to 17-year-old girls, though sex-differences in eating alterations, can be mostly found between the ages of 14 and 16. Body dissatisfaction correlated positively and significantly to Body Mass Index, EAT-40 and SCOFF. Conclusion: In order to implement primary programs in the adolescent population it is necessary to explore the eating behaviours of risky and the degree of body dissatisfaction to be able to raise specifically the interventions to be carried out, involving teachers as primary agents for the work in the school context.

Objective: The aim of the study was to analyse the psychometric properties of the Food Choice Questionnaire (FCQ) in Spanish population (FCQ-SP), its factor structure and internal consistency. In addition, the relationships between the FCQ-SP and the General Health Questionnaire (GHQ), the Irrational Food Beliefs Scale (IFBS), and the Eating Disorders Inventory-3 (EDI-3) were analysed in order to explore the validity of the FCQSP. Possible gender differences in the food choice pattern were analysed. Methods: The sample comprised 255 women and 50 men, ranged from 25 to 64 years. In order to get a better interpretation of the results associated with changes based on the age, the participants were grouped in four age intervals (25-34, 35-44, 45-54, and 55-64). All the participants were relatives of secondary and high school students in three schools of Seville and Cordoba. Results: The factor analysis yields the seven following factors: mood, health and natural content, sensory appeal, weight control, convenience, familiarity, and price. The internal consistency was determined by means of the Cronbach's α coefficients, which ranged from 0.70 to 0.83 for the different components. With regards to the food choice profile, sensory appeal was the most motivating factor to choose food, followed by price and weight control. With respect to gender differences, women showed higher scores than men in all components except in the case of price. Discussion: The FCQ-SP has adequate psychometric properties to be applied to Spanish population, and it is useful to explore the consumers' motivation with regards to food choice.

Objective: To analyse the diets chosen by anorexic patients and a control group, assessing several nutritional aspects. Method: Forty-four outpatients with an initial diagnosis of restrictive anorexia nervosa (normal BMI at the time of the study) and 34 undergraduates chose their diet from a list of common foods. Nutritional content, frequency of consumption, and influence of illness and treatment duration on the diet chosen were all analysed. Results: Patients' diets had a lower caloric content (P = 0.01). Their diets were also lower in niacin (P = 0.03), vitamin B12 (P = 0.04), sodium (P = 0.003), zinc (P = 0.04), phosphorus, copper and selenium (P = 0.01). Frequency of consumption was lower among patients for bread and cereals, meat and cured meats (P = 0.01), sweet foods (P = 0.001), and fatty and fried foods (P = 0.05), but higher for vegetables (P = 0.01). Discussion: Patients tend to maintain some characteristic eating patterns and modify others, not so much in terms of therapeutic objectives but, rather, as a way of following more closely the usual eating patterns of the context.

Introduction: Food craving consists of a strong motivational state whereby a person is driven to seek and ingest a specifically desired food. Objectives: To explore the influence of mental imagery on the food craving experience as well as to analyse the role of different psychological variables. Methods: Participants consisted of 65 normal weight undergraduate students. An experimental induction of food craving was analysed considering the actual previous craving and the induced one as a state food craving. Measures of trait food craving, imaging ability, dietary restraint, anxiety, depression, and coping strategies were considered. Results: Sweet foods in general and chocolate in particular were the most craved foods. During the induction thoughts and images were the most highly rated triggers, and all the different sensory modalities were involved. Anxiety, depression, and negative coping strategies influenced the results with regards to the food craving. Discussion: This study confirms the role of mental imagery, the correlation between state and trait food craving, and the influence of different psychological variables on the food craving. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore the lipid profile in patients with anorexia nervosa (AN), and the changes with refeeding. Methods: The sample comprised 102 AN outpatients (mean age 22.32 ± 3.17). Blood tests, after 12-hour overnight fast, were performed before refeeding (M0) and after weight restoration (M1). Total cholesterol (TC), high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides (TRG) were determined and the following cardiovascular risk markers were calculated: LDL/HDL and TC/HDL ratios. These cut-off points were considered: TC < 200 mg/dl; HDL > 40 mg/dl; LDL < 100 mg/dl and TRG < 150 mg/dl. Results: The time leading to weight restoration was 8.16 ± 7.35 months. Considering patients with scores higher and lower than the corresponding cut-off points, X²-test revealed a significant difference (M0-M1) in case of TC (p < 0.05) as well as between LDL/HDL0 and LDL/HDL1 (p < 0.05) and between TC/HDL0 and TC/HDL1 (p < 0.01). Significant differences were found between HDL0 and HDL1 (p < 0.01) and between TRG0 and TRG1 (p < 0.01). Significant and negative associations between BMI0 and TC0 (r = -0.331; p < 0.05) and between TRG0 and HDL0 (r = -0.387; p < 0.05) were found. The association between TRG1 and LDL1 was significant and positive. Discussion: Weight restoration tends to decrease the TC/HDL and LDL/HDL ratios despite a considerable percentage of patients maintain scores on the different variables of the lipid profile usually considered at risk. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to analyse the psychometric properties of the Food Choice Questionnaire (FCQ) in Spanish population (FCQ-SP), its factor structure and internal consistency. In addition, the relationships between the FCQ-SP and the General Health Questionnaire (GHQ), the Irrational Food Beliefs Scale (IFBS), and the Eating Disorders Inventory-3 (EDI-3) were analysed in order to explore the validity of the FCQSP. Possible gender differences in the food choice pattern were analysed. Methods: The sample comprised 255 women and 50 men, ranged from 25 to 64 years. In order to get a better interpretation of the results associated with changes based on the age, the participants were grouped in four age intervals (25-34, 35-44, 45-54, and 55-64). All the participants were relatives of secondary and high school students in three schools of Seville and Cordoba. Results: The factor analysis yields the seven following factors: mood, health and natural content, sensory appeal, weight control, convenience, familiarity, and price. The internal consistency was determined by means of the Cronbach's [alpha] coefficients, which ranged from 0.70 to 0.83 for the different components. With regards to the food choice profile, sensory appeal was the most motivating factor to choose food, followed by price and weight control. With respect to gender differences, women showed higher scores than men in all components except in the case of price. Discussion: The FCQ-SP has adequate psychometric properties to be applied to Spanish population, and it is useful to explore the consumers' motivation with regards to food choice. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To analyse the diets chosen by anorexic patients and a control group, assessing several nutritional aspects. METHOD: Forty-four outpatients with an initial diagnosis of restrictive anorexia nervosa (normal BMI at the time of the study) and 34 undergraduates chose their diet from a list of common foods. Nutritional content, frequency of consumption, and influence of illness and treatment duration on the diet chosen were all analysed. RESULTS: Patients' diets had a lower caloric content (P = 0.01). Their diets were also lower in niacin (P = 0.03), vitamin B12 (P = 0.04), sodium (P = 0.003), zinc (P = 0.04), phosphorus, copper and selenium (P = 0.01). Frequency of consumption was lower among patients for bread and cereals, meat and cured meats (P = 0.01), sweet foods (P = 0.001), and fatty and fried foods (P = 0.05), but higher for vegetables (P = 0.01). DISCUSSION: Patients tend to maintain some characteristic eating patterns and modify others, not so much in terms of therapeutic objectives but, rather, as a way of following more closely the usual eating patterns of the context. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Recently, it has been reported that food choices of relatives of eating disorder (ED) patients are not adequate having in mind a healthy model of eating habits. The aim of this study was to analyse how work conditions relate to parents' food choice coping strategies in both families with a member suffering from an ED and families with no sick members. In addition, the differences in those strategies between the two types of working parents were studied. METHODS: A total of 80 employed fathers (n = 27) and mothers (n = 53) of patients with an ED (n =50) and healthy offsprings (n = 30) were interviewed. The mean age was 43.57 ± 5.69 and they had moderate incomes. Food choice coping strategies, used by working parents to integrate work and family demands, were measured by means of 22 items included in five categories. RESULTS: Considering the food choice coping strategies, ED patients' relatives show better skills than relatives of healthy offsprings do. The fact of preparing more meals at home and less fast food as main meal are good examples of those better strategies as well as to miss less number of breakfasts and lunches because of work-family conflict, grabbing less frequently and overeat less after missing a meal. DISCUSSION: The therapeutic effort to improve the food choices of ED patients' relatives, especially when both father and mother work, are a key point to improve the eating habits of ED patients, thus contributing to a better outcome. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To analyse the stress level at different academic times, by measuring salivary cortisol and assessing the influence of the stress level on the effectiveness of a nutrition education program for adolescents. METHODS: Salivary cortisol of 42 compulsory secondary education students was determined (morning and evening) at the beginning of the course and in the time prior to final exams. A nutrition education program was developed during the course and food consumption data were collected by means of a food frequency questionnaire in both initial and final moments. In addition, the body mass index was determined. RESULTS: The initial morning cortisol level was lower with respect to the final morning level (P < 0.05), with higher levels in females (P < 0.05). In the final determination, the morning cortisol was also higher in girls (P < 0.01). There were no significant changes in body mass index. 23.8% of students referred fewer consumption of carbonated beverages after the intervention program, while 28.57% reported having breakfast before leaving home. A reduction in the consumption of fruit at the end of the study was observed. DISCUSSION: To properly assess whether the observed changes are related to the nutrition education program or with the stressful situation due to the proximity of the exams, which would imply an increase in the intake, more studies would be necessary at the different stages of the course. [ABSTRACT FROM AUTHOR]