scholarly journals Flavonoid Intake and MRI Markers of Brain Health in the Framingham Offspring Cohort

2020 ◽  
Vol 150 (6) ◽  
pp. 1545-1553
Author(s):  
Esra Shishtar ◽  
Gail T Rogers ◽  
Jeffrey B Blumberg ◽  
Rhoda Au ◽  
Charles DeCarli ◽  
...  
Keyword(s):  
Hippocampal Volume ◽  
Offspring Cohort ◽  
Linear Regression Models ◽  
Brain Health ◽  
Cross Sectional ◽  
Heart Study ◽  
Total Brain ◽  
Flavonoid Intake ◽  
The Mean ◽  
Dietary Flavonoid

ABSTRACT Background Although greater flavonoid intake is associated with a reduced risk of Alzheimer's disease (AD) and related dementias (ADRD), evidence relating dietary flavonoid intake to brain health based on MRI is lacking. Objective The objective of this study was to explore the association between dietary flavonoid intake and MRI measures of brain health, including total brain tissue volume (TBV), white matter hyperintensities volume (WMHV), and hippocampal volume (HV). Methods Eligible subjects included members of the Framingham Heart Study Offspring Cohort who were free of stroke at exam 7 and had at least 1 valid food frequency questionnaire from exams 5, 6, or 7 (n = 2086; mean age at exam 7, 60.6 y). Flavonoid intakes represented the cumulative mean of intakes across the 3 exams and were categorized based on quartiles categories of intake. TBV, WMHV, and HV were assessed at exam 7. Multiple linear regression models were used to examine the cross-sectional association between total and the 6 classes of flavonoids and the 3 aforementioned MRI measures. Results The mean (95% CI) of the WMHV of subjects in the highest quartile category of flavan-3-ols [0.56 (0.52, 0.61)] and flavonoid polymers [0.57 (0.52, 0.61)] intake was significantly smaller relative to that of subjects in the lowest quartile category of flavan-3-ols [0.65 (0.60, 0.71)] and flavonoid polymers [0.66 (0.60, 0.71)] after accounting for important demographic, lifestyle, and clinical factors. Inverse trend associations with WMHV were also seen for flavan-3-ols (P = 0.01) and flavonoid polymers (P = 0.01) as well as for total flavonoids (P = 0.01). TBV and HV were not associated with dietary flavonoid intake following the adjustment for potential confounders. Conclusions Our results contribute to the literature on flavonoids and ADRD as they suggest that higher flavonoid intakes may affect ADRD risk in middle-aged and older adults by reducing WMHV, a marker strongly associated with ADRD.

The Effects of Mean of Visit-to-Visit Blood Pressure on Incident Brain Vascular Lesions and Functional-Cognitive Decline

2021 ◽  
pp. 1-12
Author(s):  
Bibek Gyanwali ◽  
Celestine Xue Ting Cai ◽  
Christopher Chen ◽  
Henri Vrooman ◽  
Chuen Seng Tan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Decline ◽  
Hippocampal Volume ◽  
Intracranial Stenosis ◽  
Vascular Lesions ◽  
Linear Regression Models ◽  
Volume Functional ◽  
Mri Scans ◽  
The Mean

Background: Cerebrovascular disease (CeVD) is an underlying cause of cognitive impairment and dementia. Hypertension is a known risk factor of CeVD, but the effects of mean of visit-to-visit blood pressure (BP) on incident CeVD and functional-cognitive decline remains unclear. Objective: To determine the association between mean of visit-to-visit BP with the incidence and progression of CeVD [white matter hyperintensities (WMH), infarcts (cortical infarcts and lacunes), cerebral microbleeds (CMBs), intracranial stenosis, and hippocampal volume] as well as functional-cognitive decline over 2 years of follow-up. Methods: 373 patients from a memory-clinic underwent BP measurements at baseline, year 1, and year 2. The mean of visit-to-visit systolic BP, diastolic BP, pulse pressure, and mean arterial pressure were calculated. Baseline and year 2 MRI scans were graded for WMH, infarcts, CMBs, intracranial stenosis, and hippocampal volume. Functional-cognitive decline was assessed using locally validated protocol. Logistic and linear regression models with odds ratios, mean difference, and 95%confidence interval were constructed to analyze associations of visit-to-visit BP on CeVD incidence and progression as well as functional-cognitive decline. Results: Higher mean of visit-to-visit diastolic BP was associated with WMH progression. Higher tertiles of diastolic BP was associated with WMH progression and incident CMBs. There was no association between mean of visit-to-visit BP measures with incident cerebral infarcts, intracranial stenosis, change in hippocampal volume, and functional-cognitive decline. Conclusion: These findings suggest the possibility of hypertension-related vascular brain damage. Careful monitoring and management of BP in elderly patients is essential to reduce the incidence and progression of CeVD.

scholarly journals Perceived Discrimination and Reported Trust and Satisfaction in African Americans: The Jackson Heart Study

2017 ◽  
Vol 27 (3) ◽  
pp. 209 ◽  
Author(s):  
LáShauntá M. Glover ◽  
Mario Sims ◽  
Karen Winters
Keyword(s):  
African Americans ◽  
Health Care Providers ◽  
Perceived Discrimination ◽  
Discrimination Score ◽  
Care Providers ◽  
Jackson Heart Study ◽  
Cross Sectional ◽  
Heart Study ◽  
The Mean ◽  
Everyday Discrimination

<p class="Pa5"><strong>Objectives: </strong>1) To examine the association of multiple dimensions of discrimination with reported trust and satisfaction with providers; 2) to report within-group differences among African Americans (AAs). </p><p class="Pa5"><strong>Methods: </strong>Descriptive cross sectional study. The study population included AAs aged 35 to 84 years from the Jackson Heart Study (JHS) (N=5,301). Poisson regression (PR) was used to quantify the association between perceived discrimination and reported trust and satisfaction with providers before and after controlling for selected characteristics. </p><p class="Pa5"><strong>Main Measures: </strong>Measures of perceived discrimination included everyday, lifetime, burden from lifetime discrimination, and stress from discrimination. Outcomes included trust and satisfaction with providers. </p><p class="Pa5"><strong>Results: </strong>The mean everyday discrimination score was 2.11 (SD±1.02), and the mean lifetime discrimination score was 2.92 (SD±2.12). High (vs low) levels of everyday discrimination were associated with a 3% reduction in the prevalence of trust in providers (PR .97, 95% CI .96, .99) in all models. In fully-adjusted models, high (vs low) lifetime discrimination was associated with a 4% reduction in the prevalence of trust and satisfaction (PR .96, 95% CI .95, .98). Burden of discrimination was not associated with trust or satisfaction, but stress from discrimination was inversely associated with satisfaction. </p><p class="Pa5"><strong>Conclusions: </strong>The significant association between discrimination and mistrust and dissatisfaction suggests that health care providers should be made aware of AA perceptions of discrimination, which likely affects their levels of trust and satisfaction.</p><p class="Pa5"><em>Ethn Dis. </em>2017;27(3):209-216; doi:10.18865/ed.27.3.209 </p>

scholarly journals Findings of Vascular Brain Injury and Structural Loss from Cranial Magnetic Resonance Imaging in Elderly American Indians: The Strong Heart Study

2017 ◽  
Vol 48 (1-2) ◽  
pp. 39-47 ◽  
Author(s):  
Astrid M. Suchy-Dicey ◽  
Dean K. Shibata ◽  
Tara M. Madhyastha ◽  
Thomas J. Grabowski ◽  
W.T. Longstreth Jr. ◽  
...  
Keyword(s):  
Brain Injury ◽  
American Indians ◽  
Hippocampal Volume ◽  
Cortical Atrophy ◽  
Total Brain Volume ◽  
Strong Heart Study ◽  
Technical Errors ◽  
Heart Study ◽  
Total Brain ◽  
Cranial Mri

Background: The Cerebrovascular Disease and its Consequences in American Indians study conducted cranial MRI examination of surviving participants of the Strong Heart Study, a longitudinal cohort of elderly American Indians. Methods: Of the 1,033 recruited participants, some were unable to complete the MRI (n = 22), some scans were unusable due to participant motion or technical errors (n = 13), and one community withdrew consent after data collection (n = 209), leaving 789 interpretable MRI scan images. Six image sequences were obtained in contiguous slices on 1.5T scanners. Neuroradiologists graded white matter hyperintensities (WMH), sulci, and ventricles on a 0- to 9-point scale, and recorded the presence of infarcts and hemorrhages. Intracranial, brain, hippocampal, and WMH volumes were estimated by automated image processing. Results: The median scores for graded measures were 2 (WMH) and 3 (sulci, ventricles). About one-third of participants had lacunar (20%) or other infarcts (13%); few had hemorrhages (5.7%). Findings of cortical atrophy were also prevalent. Statistical analyses indicated significant associations between older age and findings of vascular injury and atrophy; male gender was associated with findings of cortical atrophy. Conclusions: Vascular brain injury is the likely explanation in this elderly American Indian population for brain infarcts, hemorrhages, WMH grade, and WMH volume. Although vascular brain injury may play a role in other findings, independent degenerative other disease processes may underlie abnormal sulcal widening, ventricular enlargement, hippocampal volume, and total brain volume. Further examination of risk factors and outcomes with these findings may expand the understanding of neurological conditions in this understudied population.

scholarly journals Association of Habitual Physical Activity With Home Blood Pressure in the Electronic Framingham Heart Study (eFHS): Cross-sectional Study

10.2196/25591 ◽  
2021 ◽  
Vol 23 (6) ◽  
pp. e25591
Author(s):  
Mayank Sardana ◽  
Honghuang Lin ◽  
Yuankai Zhang ◽  
Chunyu Liu ◽  
Ludovic Trinquart ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Habitual Physical Activity ◽  
Step Count ◽  
Daily Step ◽  
Community Based ◽  
Cross Sectional ◽  
Heart Study ◽  
Daily Step Count ◽  
The Mean

Background When studied in community-based samples, the association of physical activity with blood pressure (BP) remains controversial and is perhaps dependent on the intensity of physical activity. Prior studies have not explored the association of smartwatch-measured physical activity with home BP. Objective We aimed to study the association of habitual physical activity with home BP. Methods Consenting electronic Framingham Heart Study (eFHS) participants were provided with a study smartwatch (Apple Watch Series 0) and Bluetooth-enabled home BP cuff. Participants were instructed to wear the watch daily and transmit BP values weekly. We measured habitual physical activity as the average daily step count determined by the smartwatch. We estimated the cross-sectional association between physical activity and average home BP using linear mixed effects models adjusting for age, sex, wear time, antihypertensive drug use, and familial structure. Results We studied 660 eFHS participants (mean age 53 years, SD 9 years; 387 [58.6%] women; 602 [91.2%] White) who wore the smartwatch 5 or more hours per day for 30 or more days and transmitted three or more BP readings. The mean daily step count was 7595 (SD 2718). The mean home systolic and diastolic BP (mmHg) were 122 (SD 12) and 76 (SD 8). Every 1000 increase in the step count was associated with a 0.49 mmHg lower home systolic BP (P=.004) and 0.36 mmHg lower home diastolic BP (P=.003). The association, however, was attenuated and became statistically nonsignificant with further adjustment for BMI. Conclusions In this community-based sample of adults, higher daily habitual physical activity measured by a smartwatch was associated with a moderate, but statistically significant, reduction in home BP. Differences in BMI among study participants accounted for the majority of the observed association.

scholarly journals Cardiovascular disease protein biomarkers are associated with kidney function: the Framingham Heart Study

2022 ◽  
Author(s):  
Amena Keshawarz ◽  
Shih-Jen Hwang ◽  
Gha Young Lee ◽  
Zhi Yu ◽  
Chen Yao ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Rapid Decline ◽  
Third Generation ◽  
Offspring Cohort ◽  
Protein Biomarkers ◽  
Cross Sectional ◽  
Heart Study ◽  
Ckd Stage ◽  
Kidney Impairment ◽  
New Onset

Background. Biomarkers common to chronic kidney disease (CKD) and cardiovascular disease (CVD) may reflect early impairments underlying both diseases. Methods. We evaluated associations of 71 CVD-related plasma proteins measured in 2,873 Framingham Heart Study (FHS) Offspring cohort participants with cross-sectional continuous eGFR and with longitudinal change in eGFR from baseline to follow-up (ΔeGFR). We also evaluated the associations of the 71 CVD proteins with the following dichotomous secondary outcomes: prevalent CKD stage ≥3(cross-sectional), new-onset CKD stage ≥3 (longitudinal), and rapid decline in eGFR (longitudinal). Proteins significantly associated with eGFR and ΔeGFR were subsequently validated in 3,951 FHS Third Generation cohort participants and were tested using Mendelian randomization (MR) analysis to infer putatively causal relations between plasma protein biomarkers and kidney function. Results. In cross-sectional analysis, 37 protein biomarkers were significantly associated with eGFR at FDR<0.05 in the FHS Offspring cohort and 20 of these validated in the FHS Third Generation cohort at p<0.05/37. In longitudinal analysis, 27 protein biomarkers were significantly associated with ΔeGFR at FDR<0.05 and 12 of these were validated in the FHS Third Generation cohort at p<0.05/27. Additionally, 35 protein biomarkers were significantly associated with prevalent CKD, five were significantly associated with new-onset CKD, and 17 were significantly associated with rapid decline in eGFR. MR suggested putatively causal relations of melanoma cell adhesion molecule (MCAM; -0.011±0.003 mL/min/1.73m2, p=5.11E-5) and epidermal growth factor-containing fibulin-like extracellular matrix protein 1 (EFEMP1; -0.006±0.002 mL/min/1.73m2, p=0.0001) concentration with eGFR. Discussion/Conclusions: Eight protein biomarkers were consistently associated with eGFR in cross-sectional and longitudinal analysis in both cohorts and may capture early kidney impairment; others were implicated in association and causal inference analyses. A subset of CVD protein biomarkers may contribute causally to the pathogenesis of kidney impairment and should be studied as targets for CKD treatment and early prevention.

scholarly journals COGNITION OLDER ADULTS WITH PREDIABETES EXPERIENCE ACCELERATED NEUROCOGNITIVE DECLINE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S654-S655
Author(s):  
Joyla Furlano ◽  
Lindsay Nagamatsu
Keyword(s):  
Older Adults ◽  
Hippocampal Volume ◽  
Brain Health ◽  
Cross Sectional ◽  
Cognitive Domains ◽  
Functional Brain ◽  
Cross Sectional Analysis ◽  
Brain Changes ◽  
Sectional Analysis ◽  
Neurocognitive Decline

Abstract Type II diabetes (T2D) is associated with neurocognitive decline beyond normative aging, and thus older adults with T2D are at high risk for developing dementia. However, the extent to which similar deficits occur in prediabetic older adults is not well understood. While few studies have shown that prediabetic older adults experience some cognitive decline, further research is needed to determine the specific cognitive domains affected and the degree to which this decline occurs. Moreover, structural and functional brain changes that may occur with these deficits is currently unknown in this population. Therefore, the aim of this study was to assess cognitive function and brain health in prediabetic older adults. We conducted a cross-sectional analysis of older adults (aged 60-80) with prediabetes (FPG 6.1-7.0 mmol/L) and healthy aged-matched controls, examining 1) cognitive performance, 2) functional brain activation as measured by fMRI, and 3) structural measures such as volume of the hippocampus. Based on our cross-sectional analysis, prediabetic older adults show impaired cognition (e.g., memory), as well as decreased hippocampal volume and activation. Therefore, we conclude that older adults with prediabetes experience brain decline, and could benefit from lifestyle interventions to prevent or delay the onset of such decline.

scholarly journals Health Literacy and Active Transport in Austria: Results from a Rural Setting

2020 ◽  
Vol 17 (4) ◽  
pp. 1404 ◽  
Author(s):  
Kathrin Hofer-Fischanger ◽  
Bianca Fuchs-Neuhold ◽  
Alexander Müller ◽  
Gerlinde Grasser ◽  
Mireille N.M. van Poppel
Keyword(s):  
Health Literacy ◽  
Active Transport ◽  
Rural Areas ◽  
Descriptive Analysis ◽  
Rural Setting ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
The Mean ◽  
The Relationship ◽  
And Training

Health literacy (HL) has been determined for the general population and for subgroups, though the relationship between HL and active transport in rural areas was not explored. The aim of our study is to investigate HL among citizens in an Austrian rural region and to explore the associations between HL and active transport. This cross-sectional telephone survey included 288 adults (171 women) with a mean age of 57.8 (SD 0.9). HL was assessed using the HLS-EU-Q16 questionnaire. Active transport was measured as the minutes per week spent on walking or cycling from A to B. After descriptive analysis, the association between HL and active transport was assessed using linear regression models. The mean HL score for all participants was 37.1 (SD 7.7). Among all subjects, 6.9% showed inadequate HL, 25.7% problematic HL, 38.9% sufficient HL, and 28.5% excellent HL. HL was significantly higher among citizens with high education (p = 0.04) and training/employment in healthcare (p = 0.001). Active transport was not associated with HL (p = 0.281). Active transport in rural areas might be influenced by other predictors like distance to work, street connectivity, and accessible facilities for walking and biking. This needs to be explored further for rural areas.

scholarly journals Proteomic and Metabolomic Correlates of Healthy Dietary Patterns: The Framingham Heart Study

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1476 ◽  
Author(s):  
Maura E. Walker ◽  
Rebecca J. Song ◽  
Xiang Xu ◽  
Robert E. Gerszten ◽  
Debby Ngo ◽  
...  
Keyword(s):  
Dietary Patterns ◽  
Dietary Pattern ◽  
Molecular Mechanisms ◽  
Healthy Eating Index ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Intermediate Phenotypes ◽  
Heart Study ◽  
Alternative Healthy Eating Index ◽  
Liquid Chromatography Tandem Mass

Data on proteomic and metabolomic signatures of healthy dietary patterns are limited. We evaluated the cross-sectional association of serum proteomic and metabolomic markers with three dietary patterns: the Alternative Healthy Eating Index (AHEI), the Dietary Approaches to Stop Hypertension (DASH) diet; and a Mediterranean-style (MDS) diet. We examined participants from the Framingham Offspring Study (mean age; 55 years; 52% women) who had complete proteomic (n = 1713) and metabolomic (n = 2284) data; using food frequency questionnaires to derive dietary pattern indices. Proteins and metabolites were quantified using the SomaScan platform and liquid chromatography/tandem mass spectrometry; respectively. We used multivariable-adjusted linear regression models to relate each dietary pattern index (independent variables) to each proteomic and metabolomic marker (dependent variables). Of the 1373 proteins; 103 were associated with at least one dietary pattern (48 with AHEI; 83 with DASH; and 8 with MDS; all false discovery rate [FDR] ≤ 0.05). We identified unique associations between dietary patterns and proteins (17 with AHEI; 52 with DASH; and 3 with MDS; all FDR ≤ 0.05). Significant proteins enriched biological pathways involved in cellular metabolism/proliferation and immune response/inflammation. Of the 216 metabolites; 65 were associated with at least one dietary pattern (38 with AHEI; 43 with DASH; and 50 with MDS; all FDR ≤ 0.05). All three dietary patterns were associated with a common signature of 24 metabolites (63% lipids). Proteins and metabolites associated with dietary patterns may help characterize intermediate phenotypes that provide insights into the molecular mechanisms mediating diet-related disease. Our findings warrant replication in independent populations

scholarly journals Associations Between the DASH Diet and Nocturnal Blood Pressure in a Sample of Chinese Elderly Subjects

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 550-550
Author(s):  
Muzi Na ◽  
Yanxiu Wang ◽  
Ming Gao ◽  
Aijun Xing ◽  
Shouling Wu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Elderly Subjects ◽  
Linear Regression Models ◽  
Hypertension Status ◽  
Cross Sectional ◽  
Dash Diet ◽  
Funding Sources ◽  
Sleep Parameters ◽  
The Mean ◽  
Diet Score

Abstract Objectives The Dietary Approaches to Stop Hypertension (DASH) diet is known to reduce daytime blood pressure (BP). This study aims to examine the relationship between DASH diet and BP monitored during sleep in a sample of Chinese old adults. Methods A cross-sectional sample of 324 participants aged ≥ 60 years who did not take BP-lowering drugs were included (68.8% men; 70.1% with hypertension). Usual dietary intake was assessed using a validated food frequency questionnaire. The DSAH diet score was calculated based on the intake ranking of 9 dietary components. 24-hour ambulatory BP was measured and the mean and variability independent of the mean (VIM) for nocturnal systolic (SBP) and diastolic BP (DBP) were calculated. Multivariable linear regression models were constructed of each BP outcome as a function of the DASH diet score adjusting for socio-demographic characteristics (age, sex, and education), body mass index, hypertension, lifestyle factors (smoking, alcohol intake, and physical activity). The interaction between DASH diet and hypertension status was also tested in the above models. We further adjusted for three self-reported sleep parameters (duration, insomnia, snoring) to explore the potential impact of sleep on the diet-nocturnal BP relationship. Results Mean (SD) age of subjects was 66.3 (6.0) years. There was no significant relationship between the DASH diet score and mean nocturnal SBP or DBP. However, per one unit increase of DASH diet score, nocturnal VIM-SBP and VIM-DBP were significantly reduced by −0.16 SD (95%CI: −0.30, −0.01) and −0.16 SD (95%CI: −0.28, −0.05) in the adjusted model. No significant interaction was detected between DASH diet and hypertension status. The significant associations persisted after further adjustment for the sleep parameters. Conclusions Adherence to the DASH diet may contribute to lower nocturnal systolic and diastolic blood pressure variability in elderly people. Future studies are warrant to explore the effect of modifiable diet on blood pressure during sleep, which has significant predictive value of heart health and mortality in high-risk populations. Funding Sources Broadhurst Career Development Professorship for the Study of Health Promotion and Disease Prevention, College of Health and Human Development, Pennsylvania State University.

scholarly journals Intuitive eating is associated with weight loss after bariatric surgery in women

2019 ◽  
Vol 110 (1) ◽  
pp. 10-15
Author(s):  
Muriel Nogué ◽  
Erika Nogué ◽  
Nicolas Molinari ◽  
Valérie Macioce ◽  
Antoine Avignon ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Eating Behaviors ◽  
Cross Sectional Study ◽  
Therapeutic Education ◽  
Intuitive Eating ◽  
Postoperative Phase ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
The Mean

ABSTRACT Background Although the data on eating behavior after bariatric surgery are substantial, data on “intuitive eating” are lacking. Objective The aim of this study was to evaluate the link between intuitive eating and weight loss after bariatric surgery. Methods This cross-sectional study used a self-administered questionnaire freely available on social networks and targeted women who had undergone bariatric surgery. Intuitive eating was evaluated with the Intuitive Eating Scale-2 (IES-2). The 3 questionnaire subscores (Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Unconditional Permission to Eat) were also analyzed. The relation between IES-2 scores and the relative variation in body mass index [BMI (in kg/m2)] was assessed with linear regression models. Adjusted β (βAdj) and standardized β $( {{\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}} )$ were reported. Results We analyzed the responses of 401 women with a mean age of 39 ± 11 y, a mean preoperative BMI of 45.5 ± 7.9, and a mean current BMI of 30.5 ± 7. The mean relative BMI loss was 32.7 ± 12.9%, and the mean IES-2 score was 3.3 ± 0.6. The total IES-2 score was associated with the relative BMI loss, with ∼2.6% BMI loss for each 1-point increase in the IES-2 score [PAdj = 0.007; βAdj = −2.57 (95% CI: −4.44, −0.70); ${\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}$= −0.12] after adjusting for elapsed time since surgery and type of surgery. Eating for Physical Rather than Emotional Reasons was the subscore most strongly associated with BMI change after adjustment [PAdj = 0.002; βAdj = −2.08 (95% CI: −3.37, 0.79); ${\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}$ = −0.14]. Conclusions This study highlights a significant association between intuitive eating and BMI decrease after bariatric surgery. Furthermore, eating behaviors changed with increasing time since surgery. An intuitive nutritional approach may be complementary with bariatric surgery in the postoperative phase, which should prompt complementary prospective studies to evaluate the effectiveness of therapeutic education programs centered on intuitive eating in the postoperative period.

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