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Objective To conduct a genome-wide association study (GWAS) of anorexia nervosa and to calculate genetic correlations with a series of psychiatric, educational, and metabolic phenotypes. Method Following uniform quality control and imputation using the 1000 Genomes Project (phase 3) in 12 case-control cohorts comprising 3,495 anorexia nervosa cases and 10,982 controls, we performed standard association analysis followed by a meta-analysis across cohorts. Linkage disequilibrium score regression (LDSC) was used to calculate genome-wide common variant heritability [ hSNP2, partitioned heritability, and genetic correlations (rg)] between anorexia nervosa and other phenotypes. Results Results were obtained for 10,641,224 single nucleotide polymorphisms (SNPs) and insertion-deletion variants with minor allele frequency > 1% and imputation quality scores > 0.6. The hSNP2 of anorexia nervosa was 0.20 (SE=0.02), suggesting that a substantial fraction of the twin-based heritability arises from common genetic variation. We identified one genome-wide significant locus on chromosome 12 (rs4622308, p=4.3×10−9) in a region harboring a previously reported type 1 diabetes and autoimmune disorder locus. Significant positive genetic correlations were observed between anorexia nervosa and schizophrenia, neuroticism, educational attainment, and high density lipoprotein (HDL) cholesterol, and significant negative genetic correlations between anorexia nervosa and body mass index, insulin, glucose, and lipid phenotypes. Conclusions Anorexia nervosa is a complex heritable phenotype for which we have found the first genome-wide significant locus. Anorexia nervosa also has large and significant genetic correlations with both psychiatric phenotypes and metabolic traits. Our results encourage a reconceptualization of this frequently lethal disorder as one with both psychiatric and metabolic etiology.

Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2,907 cases with AN from 14 countries (15 sites) and 14,860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery datasets. Seventy-six (72 independent) SNPs were taken forward for in silico (two datasets) or de novo (13 datasets) replication genotyping in 2,677 independent AN cases and 8,629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication datasets comprised 5,551 AN cases and 21,080 controls. AN subtype analyses (1,606 AN restricting; 1,445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01×10-7) in SOX2OT and rs17030795 (P=5.84×10-6) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76×10-6) between CUL3 and FAM124B and rs1886797 (P=8.05×10-6) near SPATA13. Comparing discovery to replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P=4×10-6), strongly suggesting that true findings exist but that our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field.

BackgroundUnhealthy eating and physical activity behaviours are common among nurses but little is known about determinants of eating and physical activity behaviour in this population. The present study used a theoretical framework which summarises the many possible determinants of different health behaviours (the Theoretical Domains Framework; TDF) to systematically explore the most salient determinants of unhealthy eating and physical activity behaviour in hospital-based nurses.MethodsSemi-structured qualitative interviews based on the TDF were conducted with nurses (n = 16) to explore factors that behavioural theories suggest may influence nurses’ eating and physical activity behaviour. Important determinants of the target behaviours were identified using both inductive coding (of categories emerging from the data) and deductive coding (of categories derived from the TDF) of the qualitative data.ResultsThirteen of the fourteen domains in the TDF were found to influence nurses’ eating and physical activity behaviour. Within these domains, important barriers to engaging in healthy eating and physical activity behaviour were shift work, fatigue, stress, beliefs about negative consequences, the behaviours of family and friends and lack of planning. Important factors reported to enable engagement with healthy eating and physical activity behaviours were beliefs about benefits, the use of self-monitoring strategies, support from work colleagues, confidence, shift work, awareness of useful guidelines and strategies, good mood, future holidays and receiving compliments.ConclusionsThis study used a theory-informed approach by applying the TDF to identify the key perceived determinants of nurses’ eating and physical activity behaviour. The findings suggest that future efforts to change nurses’ eating and physical activity behaviours should consider targeting a broad range of environmental, interpersonal and intrapersonal level factors, consistent with a socio-ecological perspective.Electronic supplementary materialThe online version of this article (doi:10.1186/s40608-017-0154-4) contains supplementary material, which is available to authorized users.

There is growing policy maker and public concern about current trends in food bank use in Scotland. Yet little is known about the experiences of those seeking help from food banks in this country. This research aimed to address this issue by studying the use and operation of a food bank situated in a rich northeast city during January and June 2014. The study aimed to establish who was seeking help from the food bank, their reasons for doing so, and what those who did thought of, and dealt with the food they received from it. Consequently, an audit of the food bank's client database, four months of participant observation based in the food bank, and seven face-to-face interviews with current and former food bank clients were conducted. The audit revealed that clients came from a range of socio-economic backgrounds, with men more likely to access it compared to women. Debt and social security benefit delays were cited as the main reasons for doing so. Qualitative data confirmed that sudden and unanticipated loss of income was a key driver of use. Resourcefulness in making donated food last as long as possible, keeping fuel costs low, and concern to minimise food waste were commonly described by participants. Desperation, gratitude, shame and powerlessness were also prevalent themes. Furthermore, clients were reluctant to ask for food they normally ate, as they were acutely aware that the food bank had little control over what it was able offer. Insights from this study suggest that recent UK policy proposals to address food poverty may have limited impact, without concomitant effort to address material disadvantage. Research is urgently required to determine the precise nature and extent of household level food insecurity in Scotland, and to consider monitoring for adverse physical and mental health outcomes for those affected by it.

BackgroundHaving breakfast, eating food 'cooked from scratch' and eating together as a family have health and psychosocial benefits for young children. This study investigates how these parentally determined behaviours relate to children's dietary quality and uses a psychological model, the Theory of Planned Behaviour (TPB), to investigate socio-cognitive predictors of these behaviours in socially disadvantaged mothers of young children in Scotland.MethodThree hundred mothers of children aged 2 years (from 372 invited to participate, 81% response rate), recruited via General Practitioners, took part in home-based semi-structured interviews in a cross-sectional survey of maternal psychological factors related to their children's dietary quality. Regression analyses examined statistical predictors of maternal intentions and feeding behaviours.ResultsMothers of children with poorer quality diets were less likely than others to provide breakfast every day, cook from 'scratch' and provide 'proper sit-down meals'. TPB socio-cognitive factors (intentions, perceived behavioural control) significantly predicted these three behaviours, and attitudes, norms, and perceived behavioural control significantly predicted mothers' intentions, with medium to large effect sizes.ConclusionsInterventions to improve young children's dietary health could benefit from a focus on modifying maternal motivations and attitudes in attempts to improve feeding behaviours.

BackgroundThe prevalence of overweight and obesity is high amongst healthcare professionals and there is growing interest in delivering weight loss interventions in the workplace. We conducted a systematic review to (i) examine the effectiveness of workplace-based diet and/or physical activity interventions aimed at healthcare professionals and to (ii) identify and describe key components of effective interventions. Seven electronic databases were systematically searched.ResultsThirteen randomised controlled trials met the inclusion criteria, of which seven had data available for meta-analysis. Where meta-analysis was possible, studies were grouped according to length of follow-up (<12 months and ≥12 months) and behavioural target (diet only, physical activity only or diet and physical activity), with outcome data pooled using a weighted random effects model. Nine studies reported statistically significant (between-group) differences. Four studies reported being informed by a behaviour change theory. Meta-analysis of all trials reporting weight data demonstrated healthcare professionals allocated to dietary and physical activity interventions lost significantly more body weight (−3.95 Kg, [95% CI −4.96 to- 2.95 Kg]) than controls up to 12 months follow up.ConclusionsWorkplace diet and/or physical activity interventions targeting healthcare professionals are limited in number and are heterogeneous. To improve the evidence base, we recommend additional evaluations of theory-based interventions and adequate reporting of intervention content.Electronic supplementary materialThe online version of this article (doi:10.1186/s40608-014-0023-3) contains supplementary material, which is available to authorized users.

Objective: To investigate the maternal factors associated with poor diet among disadvantaged children. Design: Survey of 300 mothers of 2-year-old children from areas of high deprivation in Scotland (response rate 81 %). A diet quality score was derived from reported consumption of carbohydrates, protein, fruit and vegetables, dairy products and restriction of sugary fatty foods. Results: Most children (85 %) were classified as having a poor quality diet (low diet quality score). Mothers' general knowledge about healthy eating was high, but did not predict the quality of the children's diet. Lower frequencies of food preparation and serving, such as cooking with raw ingredients, providing breakfast daily and the family eating together, were also associated with a poorer diet. Regression modelling identified five significant factors. An increased risk of a poor diet was associated with mothers being unlikely to restrict sweets (OR 5 21?63, 95 % CI 2?70, 173?30) or finding it difficult to provide 2-3 portions of fruit daily (OR 5 2?94, 95 % CI 1?09, 7?95). Concern that the child did not eat enough increased the risk of a poor diet (OR 5 2?37, 95 % CI 1?09, 5?16). Believing a healthy diet would help the child eat more reduced the risk of having a poor diet (OR 5 0?28, 95 % CI 0?11, 0?74), as did providing breakfast daily (OR 5 0?22, 95 % CI 0?05, 0?99). Conclusions: Interventions to improve children's diet could promote more positive intentions about preparing and serving of foods, particularly of specific meals at which the family eats together. The benefits of these behaviours to the child (improved diet, weight control) should be emphasised.