Eating Attitudes From a Cardiometabolic Risk Perspective: Psoriasis Sample

Year 2023, Volume: 13 Issue: 3, 584 - 592, 11.09.2023

Hacer Akgül Ceyhun , Handan Bilen

https://doi.org/10.33808/clinexphealthsci.1146966

Abstract

Objective: In this study, we aimed to compare psoriasis patients with healthy controls in terms of impaired eating attitudes and to investigate the relationship of eating attitudes with cardiometabolic and clinical parameters, anxiety, depression, and quality of life.
Methods: 45 psoriasis patients and 45 healthy controls were included in the study. Personal and clinical information form, eating attitude test (EAT-40), body mass index (BMI) and MetS criteria were used for all participants. Psoriasis patients were evaluated with clinical information form, hospital anxiety and depression scale (HADS), dermatological quality of life index (DQLI), psoriasis area and severity index (PASI).
Results: The data of the patient and control groups differed in terms of doing sports, impaired EAT, BMI groups, and metabolic syndrome (MetS). Abnormal eating attitudes such as negative body image, inability to control oneself in eating, overeating, and some restrictive attitudes were significantly higher in the psoriasis group. Overeating, overeating or stress-induced emotional eating, presence of MetS, weight dissatisfaction, frequent dieting to lose weight, some compensatory behaviours, and loss of self-control were significantly higher in patients with BMI>25. EAT points; showed a positive moderate correlation with BMI and HAD-Anxiety. DQLI results; showed a moderate positive correlation with HADAnxiety and PASI scores.
Conclusion: Our study is the first to reveal what kind of disordered eating attitudes are at risk for cardiometabolic diseases in psoriasis patients. In psoriasis patients, the rate of not being able to control their eating behaviour is high. Our results primarily highlight the relationship that can be explained by autonomic reactivity between anxiety and difficulty resisting food cravings. Professional support including psychoeducational, cognitive behavioural therapy, and acceptance-based therapies should be provided to reduce maladaptive reactions and anxiety by improving self-regulation skills.

Keywords

anxiety, eating attitude, psoriasis, metabolic syndrome, obesity

References

• Michalek IM, Loring B, John SM. A systematic review of worldwide epidemiology of psoriasis. J Eur Acad Dermatol Venereol. 2017;31(2):205-212. DOI: 10.1111/jdv.13854
• Torales J, Echeverría C, Barrios I, García O, O’Higgins M, Castaldelli-Maia JM, Ventriglio A, Jafferany M. Psychodermatological mechanisms of psoriasis. Dermatol Ther. 2020:e13827. DOI: 10.1111/dth.13827
• Kovitwanichkanont T, Chong AH, Foley P. Beyond skin deep: addressing comorbidities in psoriasis. Med J Aust. 2020;212(11):528-534. DOI: 10.5694/mja2.50591
• Grundy SM. Metabolic syndrome update. Trends in Cardiovascular Medicine 2016;26(4):364-373. DOI: 10.1016/j.tcm.2015.10.004
• Gisondi P, Fostini AC, Fossà I, Girolomoni G, Targher G. Psoriasis and the metabolic syndrome. Clinics in Dermatology 2018;36(1):21-28. DOI: 10.1016/j.clindermatol.2017.09.005
• Altunay I, Demirci GT, Ates B, Kucukunal A, Aydın C, Karamustafalıoglu O, Altuntas Y. Do eating disorders accompany metabolic syndrome in psoriasis patients? Results of a preliminary study. Clin Cosmet Investig Dermatol. 2011;4:139-143. DOI: 10.2147/CCID.S24165
• Acar EM, İlter N, Elbeg Ş. Association of leptin, resistin, and high-molecular-weight adiponectin levels with psoriasis area and severity index scores, obesity, and insulin resistance in psoriasis patients. Dermatologica Sinica 2019;37(1):33. DOI:10.4103/ds.ds_9_18
• Izydorczyk B, Sitnik-Warchulska K, Lizińczyk S, Lipiarz A. Psychological predictors of unhealthy eating attitudes in young adults. Frontiers in Psychology 2019;10:590. DOI: 10.3389/fpsyg.2019.00590
• O’Reilly GA, Cook L, Spruijt-Metz D, Black DS. Mindfulness based interventions for obesity-related eating behaviours: A literature review. Obesity Reviews 2014;15(6):453-461. DOI:10.1111/obr.12156
• Hedman A, Breithaupt L, Hübel C, Thornton LM, Tillander A, Norring C, Larsson H, Ludvigsson JF, Sävendah L, Almqvist C, Bulik CM. Bidirectional relationship between eating disorders and autoimmune diseases. Journal of Child Psychology and Psychiatry 2019;60(7):803-812. DOI: 10.1111/jcpp.12958
• Savaşır I, Erol N. Yeme tutum testi: Anoreksiya nervoza belirtileri indeksi. Psikoloji Dergisi 1989;7(23):19-25.(Turkish)
• Aydemir O, Güvenir T, Küey L, Kültür S. Hastane Anksiyete ve Depresyon Ölçeği Türkçe Formunun Geçerlilik ve Güvenilirlik Çalışması. Reliability and Validity of the Turkish version of Hospital Anxiety and Depression Scale. Turkish Journal of Psychiatry 1997;8:280-287. (Turkish)
• Oztürkcan S, Ermertcan AT, Eser E, Sahin MT. Cross validation of the Turkish version of dermatology life quality index. Int J Dermatol. 2006;45(11):1300-1307. DOI: 10.1111/j.1365-4632.2006.02881.x
• Başkan EB. Hastalik şiddetinin tanımlanması. Türkiye Psoriasis Tedavi Kılavuzu-2016.4.
• World Health Organization, Regional Office for the Western Pacific (WPRO), International Association for the Study of Obesity, International Obesity Task Force. The Asia-Pacific Perspective: Redefining obesity and its treatment. Sydney, Health Communications Australia Pty Ltd, 2000.
• Lorenzo C, Williams K, Hunt KJ, Haffner SM. The National Cholesterol Education Program–Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions of the metabolic syndrome as predictors of incident cardiovascular disease and diabetes. Diabetes Care 2007;30(1):8-13. DOI: 10.2337/dc06-1414
• Armstrong AW, Harskamp CT, Armstrong EJ. The association between psoriasis and obesity: a systematic review and meta-analysis of observational studies. Nutrition & Diabetes 2012;2(12):e54-e. DOI: 10.1038/nutd.2012.26
• Schwarz PEH, Pinter A, Melzer N, Barteczek P, Reinhardt M. ERAPSO: Revealing the High Burden of Obesity in German Psoriasis Patients. Dermatol Ther (Heidelb). 2019;9(3):579-587. DOI: 10.1007/s13555.019.0314-1
• Singh S, Young P, Armstrong AW. Relationship between psoriasis and metabolic syndrome: a systematic review. Giornale italiano di dermatologia e venereologia: organo ufficiale, Societa İtaliana di Dermatologia e Sifilografia 2016;151(6):663-677.
• Shah M, Hurt RT, Mundi MS. Phenotypes of obesity: How it impacts management. Current Gastroenterology Reports 2017;19(11):55. DOI: 10.1007/s11894.017.0598-1
• Crosta M, Caldarola G, Fraietta S, Craba A, Benedetti C, Coco V, Janiri L, Rinaldi L, De Simone C. Psychopathology and eating disorders in patients with psoriasis. 2014.???
• García‐García I, Horstmann A, Jurado MA, Garolera M, Chaudhry SJ, Margulies DS, Villringer A, Neumann J. Reward processing in obesity, substance addiction and non‐substance addiction. Obesity Reviews 2014;15(11):853-869. DOI:10.1111/obr.12221
• Barrea L, Balato N, Di Somma C, Macchia PE, Napolitano M, Savanelli MC, Esposito K, Colao A, Savastano S. Nutrition and psoriasis: is there any association between the severity of the disease and adherence to the Mediterranean diet? J Transl Med. 2015;13:18. DOI: 10.1186/s12967.014.0372-1
• Yamashita H, Morita T, Ito M, Okazaki S, Koto M, Ichikawa Y, Takayama R, Hoashi T, Saeki H, Kanda N. Dietary habits in Japanese patients with psoriasis and psoriatic arthritis: Low intake of meat in psoriasis and high intake of vitamin A in psoriatic arthritis. The Journal of Dermatology 2019;46(9):759-769. DOI: 10.1111/1346-8138.15032
• Eppinga H, Poortinga S, Thio HB, Nijsten TEC, Nuij VJAA, van der Woude CJ, Vodegel RM, Fuhler GM, Peppelenbosch MP. Prevalence and phenotype of concurrent psoriasis and inflammatory bowel disease. Inflammatory Bowel Diseases 2017;23(10):1783-1789. DOI: 10.1097/MIB.000.000.0000001169
• Masana MF, Tyrovolas S, Kolia N, Chrysohoou C, Skoumas J, Haro JM, Tousoulis D, Papageorgiou C, Pitsavos C, Panagiotakos DB. Dietary patterns and their association with anxiety symptoms among older adults: The ATTICA study. Nutrients 2019;11(6):1250. DOI: 10.3390/nu11061250.
• Fleming P, Bai JW, Pratt M, Sibbald C, Lynde C, Gulliver WP. The prevalence of anxiety in patients with psoriasis: A systematic review of observational studies and clinical trials. J Eur Acad Dermatol Venereol. 2017;31(5):798-807. DOI: 10.1111/jdv.13891
• Sondermann W, Schreiber A, Körber A, Fiege O, Scherbaum N, Benson S, Schedlowski M. Psychosocial burden and body mass index are associated with dermatology-related quality of life in psoriasis patients. European Journal of Dermatology 2020;30(2):140-147. DOI: 10.1684/ejd.2020.3755
• Martínez-Ortega JM, Nogueras P, Muñoz-Negro JE, Gutiérrez-Rojas L, González-Domenech P, Gurpegui M. Quality of life, anxiety and depressive symptoms in patients with psoriasis: A case-control study. Journal of Psychosomatic Research 2019;124:109780. DOI: 10.1016/j.jpsychores.2019.109780
• Szlejf C, Suemoto CK, Santos IS, Brunoni AR, Nunes MA, Viana MC, Barreto SM, Lotufo PA, Benseñor IM. Poorer cardiovascular health is associated with psychiatric comorbidity: results from the ELSA-Brasil Study. International Journal of Cardiology 2019;274:358-365. DOI: 10.1016/j.ijcard.2018.06.037