anorexia nervosa

Early Riser? Anorexia Nervosa Linked to Morning Chronotype

Posted by

0


Summary: Individuals with anorexia nervosa tend to be early risers, in contrast to many other mental disorders often associated with evening chronotypes. The study also finds a connection between anorexia nervosa and increased risk of insomnia.

Using genetic analysis, the researchers discovered a two-way association between genes related to anorexia nervosa and morning chronotype. These findings suggest a novel perspective on anorexia nervosa and could pave the way for circadian-based therapies for prevention and treatment.

Key Facts:

  1. Anorexia nervosa is associated with being an early riser, unlike other disorders often linked to evening chronotypes.
  2. The study used Mendelian Randomization to examine the relationship between anorexia nervosa, circadian genes, and sleep traits.
  3. This research could lead to new prevention and treatment strategies for anorexia nervosa, which has a high mortality rate.

Source: Mass General

New research indicates that the eating disorder anorexia nervosa is associated with being an early riser, unlike many other disorders that tend to be evening-based such as depression, binge eating disorder and schizophrenia.

The study, which is published in JAMA Network Open and led by investigators at Massachusetts General Hospital (MGH), in collaboration with University College London and the University of the Republic in Uruguay, also revealed a link between anorexia nervosa and insomnia risk.

This shows a woman and a clock.
This study aimed to further understand this relationship by assessing genes associated with anorexia nervosa, the circadian clock and several sleep traits including insomnia. Credit: Neuroscience News

Previous research has suggested a possible connection between eating disorders and the body’s internal clock, or circadian clock, which controls a wide range of biological functions such as sleep and affects nearly every organ in the body.

This study aimed to further understand this relationship by assessing genes associated with anorexia nervosa, the circadian clock and several sleep traits including insomnia.

The investigators used a statistical method called Mendelian Randomization to see how genes that are associated with a certain trait affect other traits of interest. For example, examining the sleep patterns of people with genetic differences that makes them more likely to have anorexia nervosa, this provides evidence on the relationship between anorexia nervosa and sleep.

They found a two-way association between genes associated with anorexia nervosa and genes associated with morning chronotype (waking early and going to bed early).

In other words, the findings suggest that being an early riser could increase the risk for having anorexia nervosa, and having anorexia nervosa could lead to an earlier wake time. The team also found an association between anorexia nervosa and insomnia.

When they further assessed the insomnia connection using the Mass General Brigham Biobank by developing a “genetic risk score” for anorexia nervosa, the scientists found that the genetic risk score was indeed associated with higher insomnia risk.

“Our findings implicate anorexia nervosa as a morning disorder in contrast to most other evening-based psychiatric diseases and support the association between anorexia nervosa and insomnia as seen in earlier studies,” says senior author Hassan S Dashti, PhD, RD, an assistant investigator in the Department of Anesthesia, Critical Care and Pain Medicine at MGH and an assistant professor of anesthesia at Harvard Medical School.

Treatments for anorexia nervosa are limited and current treatments have relapse rates of up to 52%. In addition, the cause of the disease is still unclear.

With anorexia nervosa having the second highest mortality rate of psychiatric diseases, more research is desperately needed into new prevention strategies and treatments.

“The clinical implications of our new findings are currently unclear; however, our results could direct future investigations into circadian-based therapies for anorexia nervosa prevention and treatment,” says Hannah Wilcox, lead author of the study and researcher at MGH.

Early Bird? Night Owl? It May Matter for Eating Disorder Risk

Posted by

0


Anorexia linked to chronotype in both directions

A photo of a young woman experiencing insomnia

People with anorexia nervosa may be more likely to be early risers, a genetic association study suggested.

Looking at nearly 17,000 cases with this eating disorder, genetic liability for anorexia nervosa was associated with a more morning chronotype — or a preference for the morning (β=0.039, 95% CI 0.006-0.072, P=0.02), Hassan Dashti, PhD, RD, of Massachusetts General Hospital in Boston, and colleagues found.

The same was true when looking at the other direction of this link, they wrote in JAMA Network Openopens in a new tab or window. The researchers found that having a genetic liability for morning chronotype was associated with increased risk of anorexia nervosa (β=0.178, 95% CI 0.042-0.315, P=0.01).

“Our study indicates anorexia nervosa is uniquely morning based, which is surprising as no other psychiatric disorder we are aware of has yet been morning-associated,” Dashti told MedPage Today.

While the effect sizeopens in a new tab or window of both associations would be considered small, the researchers suggested several clinical implications.

“Sleep is not often considered when treating patients living with anorexia nervosa or other eating disorders,” Dashti explained to MedPage Today. “Our study highlights the importance of asking about sleep timing and sleep quality, as sleep possibly impacts eating disorder symptoms.”

The findings lend themselves to investigating whether circadian and sleep-based interventions might be effective in the treatment or prevention of anorexia nervosa in randomized controlled trials, Dashti noted.

“For example, bright light therapy in the evening or addressing insomnia might be part of a clinicians’ treatment toolbox for anorexia nervosa,” he suggested. “This research indicates a possible circadian and sleep basis to anorexia nervosa, opening research into circadian mechanism-based possible treatments for the disorder.”

Finding new anorexia treatments is urgent as current ones are “limited, with relapse rates of up to 52%,” said Dashti.

“No mechanism-based treatment for anorexia nervosa currently exists, as the cause of the disease is still unclear,” he pointed out. “Treatments are limited to behavioral therapy and the use of medications created for the treatment of other disorders, such as depression or anxiety. With anorexia nervosa having the second highest mortality rate of psychiatric diseases, more research is desperately needed into new prevention strategies and treatments.”

Other than a morning chronotype, genetic liability for anorexia nervosa wasn’t significantly linked with other circadian and sleep traits, like daytime napping, daytime sleepiness, insomnia, or sleep duration. Likewise, genetic liabilities for sleep traits beyond morning chronotype and insomnia weren’t linked with anorexia. However, the researchers found in a sensitivity analysis that there may have been some bias due to horizontal pleiotropyopens in a new tab or window with this insomnia link.

Genome data for the analysis came from the Eating Disorders Working Group of the Psychiatric Genomics Consortium, which included 16,992 anorexia cases and 55,525 controls. Upwards of 88% of cases were female, but half to two-thirds of controls were also female. Anorexia nervosa was defined as a lifetime diagnosis from hospital or register records, structured clinical interviews, and online questionnaires based on standardized criteria like the Diagnostic and Statistical Manual of Mental Disorders or ICD codes.

The research team also looked at data in the Mass General Brigham Biobank, which contained 47,082 adult patients of European ancestry with genetic data. Around 54% of this cohort was female, and the average age was 60.4. A polygenic risk score for anorexia was calculated for each patient in this cohort and associations were tested with prevalent sleep disorders derived from electronic health records.

Here, each additional standard deviation in the anorexia nervosa polygenic risk score was tied with 10% higher odds for organic or persistent insomnia (OR 1.10, 95% CI 1.03-1.17), even after controlling for lifestyle factors. Links with other sleep disorders including sleep apnea and restless legs syndrome weren’t significant.

These findings were somewhat surprising, Dashti said, explaining how they seem to contradict previous observational data suggesting that people with anorexia nervosa tend toward later chronotypes with later bed and wake times. “This likely is due to evening-based psychiatric disorders, like depression and anxiety, being very common among those living with anorexia nervosa,” he noted. “Observational studies are confounded by the presence of other common evening-based disorders, obscuring the relationship between anorexia nervosa and chronotype.”

YALE UNIVERSITY STUDY FINDS LINK BETWEEN VACCINES & MULTIPLE BRAIN DISORDERS

Posted by

1


It’s become a common question to ask if someone is anti- or pro-vaccination. With heavy arguments on either side and truths and lies at every turn, the controversy surrounding the topic seems only to heighten with each passing year. So when researchers find valuable information that is for or against vaccinations, it’s worth reading up.

 

Over the last 50 years, we’ve seen a devastating rise in brain disorders like Autism, ADHD, and major depressive disorders — a phenomenon that, understandably, has people searching for answers, particularly those directly affected. In this regard, an overwhelming amount of parents have reported that their children went from being seemingly healthy to suddenly suffering from disorders like Autism or ADHD as a result of vaccinations.

Now a team of researchers from the Yale School of Medicine and Penn State College of Medicine have lent further weight to many of these parents’ words. The study, which analyzed five years’ worth of private health insurance data on children ages 6-15, discovered that young people vaccinated in the previous three to 12 months were much more likely to be diagnosed with certain neuropsychiatric disorders than their non-vaccinated counterparts.

The study raises more questions among an already growing list regarding whether over-vaccination can cause immunological and neurological damage in vulnerable children. The research was published in the peer-reviewed journal Frontiers in Psychiatry, Jan. 19.

Over 95,000 children in the database that were analyzed were found to have one of  seven neuropsychiatric disorders: anorexia nervosa, anxiety disorder, attention deficit and hyperactivity disorder (ADHD), bipolar disorder, major depression, obsessive-compulsive disorder (OCD), and tic disorder. The children with these disorders were measured against those without such disorders, as well as children with two other conditions unrelated to vaccination: open wounds and broken bones.

The control subjects without brain disorders were matched with subjects based on age, geographic location, and gender. The researchers found, as they had imagined they would, that broken bones and open wounds had no association with vaccinations worth noting. Additionally, new cases of major depression, bipolar disorder, or ADHD showed no noteworthy link with vaccinations.

 The study did find, however, that children who had been vaccinated were 80% more likely to be diagnosed with anorexia and 25% more likely to be diagnosed with OCD than those who had not been vaccinated. Furthermore, vaccinated children had a higher risk of being diagnosed with an anxiety disorder and with tics compared to the controls.

“This pilot epidemiologic analysis implies that the onset of some neuropsychiatric disorders may be temporally related to prior vaccinations in a subset of individuals,” the researchers wrote. “These findings warrant further investigation, but do not prove a causal role of antecedent infections or vaccinations in the pathoetiology of these conditions.”

They also caution that their research should by no means serve as a deciding factor for whether or not people should vaccinate their children. “Given the modest magnitude of these findings in contrast to the clear public health benefits of the timely administration of vaccines in preventing mortality and morbidity in childhood infectious diseases, we encourage families to maintain vaccination schedules according to CDC guidelines,” they said.

Gut bacteria population, diversity linked to anorexia nervosa: Studying the ‘gut-brain axis,’ researchers find evidence of an association.

Posted by

0


Studying the ‘gut-brain axis,’ researchers find evidence of an association between the gut microbiota and the eating disorder anorexia nervosa.
Results of this study provide more evidence that the abundance and diversity of the gut microbiota — the trillions of bacteria that affect digestive health and immunity — could also affect the so-called “gut-brain axis.”

Researchers at the UNC School of Medicine found that people with anorexia nervosa have very different microbial communities residing inside their guts compared to healthy individuals and that this bacterial imbalance is associated with some of the psychological symptoms related to the eating disorder.

The findings, published in the journal Psychosomatic Medicine, provide more evidence that the abundance and diversity of the gut microbiota — the trillions of bacteria that affect digestive health and immunity — could also affect the so-called “gut-brain axis.” This research suggests that gut bacteria could play a prominent role in the debilitating symptoms of anorexia nervosa, a serious eating disorder that affects more than 3 million Americans and has the highest mortality rate of any psychological disorder.

“Other studies have linked gut bacteria to weight regulation and behavior,” said Ian Carroll, PhD, senior author of the paper and assistant professor of medicine in the UNC Center for Gastrointestinal Biology and Disease. “Since people with anorexia nervosa exhibit extreme weight dysregulation, we decided to study this relationship further.”

Carroll added, “We’re not able to say a gut bacterial imbalance causes the symptoms of anorexia nervosa, including associated symptoms, such as anxiety and depression. But the severe limitation of nutritional intake at the center of anorexia nervosa could change the composition of the gut microbial community. These changes could contribute to the anxiety, depression, and further weight loss of people with the disorder. It’s a vicious cycle, and we want to see if we can help patients avoid or reverse that phenomenon. We want to know if altering their gut microbiota could help them with weight maintenance and mood stabilization over time.”

For this study, Carroll’s team collected fecal samples from 16 women with anorexia nervosa after they were first admitted into the UNC Center of Excellence for Eating Disorders and then again after their weight was restored — when they were discharged from UNC. Then Susan Kleiman, a graduate student in Carroll’s lab and first author of the paper, characterized the composition and diversity of the gut microbiota in each sample.

Kleiman found significant changes in the gut bacteria populations between admission and discharge. The samples taken at clinic admission had fewer different types of bacteria, making the intestinal communities much less diverse. Microbial diversity is a sign of better overall health. Upon hospital discharge, the microbial diversity had increased, but was still significantly less diverse than that of 12 healthy individuals, whose gut microbiotas were analyzed for this study.

As the microbial communities in patients with anorexia improved during clinical care and weight gain, the moods of patients also improved. Thus, the researchers noted an association between the gut microbiota and a central symptom of people with anorexia nervosa.

The question remains whether improving microbial abundance and diversity could help relieve symptoms related to the eating disorder. To find out, Carroll formed a team of researchers including Cynthia Bulik, PhD, director of the UNC Center of Excellence for Eating Disorders; John Cryan, PhD, professor at University College Cork; Lisa Tarantino, PhD, assistant professor of psychiatry at UNC-Chapel Hill; Anthony Fodor, PhD, a bioinformatics expert at UNC-Charlotte, and Hunna Watson, PhD, a psychologist and biostatistician at UNC-Chapel Hill.

This month, they received a five-year, $2.5-million grant from the National Institutes of Mental Health to further study the relationship between the gut microbiota and anorexia nervosa.

“Over the past 10 years, prominent researchers have learned that when you take gut microbial communities of an obese person and put it in germ-free mice — which are maintained in sterile conditions and lack intestinal microbiota — the mice gain more weight than germ-free mice that have been colonized with a gut microbiota from a lean individual,” Carroll said. “This suggests that gut microbes mediate weight gain or loss.”

Other animal studies showed that adding gut bacteria to previously germ-free mice altered their behavior, especially in relation to anxiety and stress.

“We’re not saying that altering gut bacteria will be the magic bullet for people with anorexia nervosa,” Carroll said. “Other important factors are at play, obviously. But the gut microbiota is clearly important for a variety of health and brain-related issues in humans. And it could be important for people with anorexia nervosa.”

As part of the new NIH grant, his team will characterize the microbiotas of a large number of people with anorexia nervosa as they enter UNC’s clinic and when they are discharged, which typically happens when they reach about 85 percent of their ideal body weight. Then his team will put those gut bacteria in germ-free mice. This will help Carroll learn how the microbiota from anorexia nervosa patients affects the biology and behavior of the mice.

If Carroll’s team learns that the bacteria has a detrimental effect on the mice, then this might suggest that cultivating a healthy microbiota could serve as a therapeutic route to help people with anorexia nervosa.

“Currently available treatments for anorexia nervosa are suboptimal,” Bulik said. “In addition, the process of weight gain and renourishment can be extremely uncomfortable for patients. Often, patients are discharged from the hospital, and within months and sometimes weeks they find themselves losing weight again and facing readmission. If specific alterations in their microbiota could make renourishment less uncomfortable, help patients regulate their weight, and positively affect behavior, then we might see fewer readmissions and more cures.”