Eating style and eating behaviour in adolescents

Construct validity of the emotional eating scale adapted for children and adolescents

BACKGROUND

Emotional eating, defined as eating in response to a range of negative emotions, is common in youths. Yet, there are few easily administered and well-validated methods to assess emotional eating in pediatric populations.

OBJECTIVE

The current study tested the construct validity of the Emotional Eating Scale (EES) Adapted for Children and Adolescents (EES-C) by examining its relationship to observed emotional eating at laboratory test meals.

METHOD

A total of 151 youths (8-18 years) participated in two multi-item lunch buffet meals on separate days. They ate ad libitum after being instructed to 'eat as much as you would at a normal meal' or to 'let yourself go and eat as much as you want'. State negative affect was assessed immediately before each meal. The EES-C was completed 3 months, on average, before the first test meal.

RESULTS

Among youths with high EES-C total scores, but not low EES-C scores, higher pre-meal state negative affect was related to greater total energy intake at both meals, with and without the inclusion of age, race, sex and body mass index (BMI) standard deviation as covariates (ps<0.03).

DISCUSSION

The EES-C demonstrates good construct validity for children and adolescents' observed energy intake across laboratory test meals designed to capture both normal and disinhibited eating. Future research is required to evaluate the construct validity of the EES-C in the natural environment and the predictive validity of the EES-C longitudinally.

Associations between weight-related eating behaviors and adiposity in postmenopausal Japanese American and white women

The purpose of this study was to test the associations between cognitive and psychological eating behavior traits and detailed measures of adiposity and body fat distribution using imaging-based methods in a cross-sectional study. Eating behavior traits (compensatory and routine restraint, external eating, and emotional eating) were assessed using the validated Weight-Related Eating Questionnaire, and measures of adiposity using anthropometry, dual energy X-ray absorptiometry (DXA), and magnetic resonance imaging (MRI). Each adiposity outcome of interest (total fat, ratio of trunk fat to periphery fat, visceral and subcutaneous fats as % of abdominal area, and % liver fat) was regressed on the four eating behaviors while adjusting for age and race/ethnicity. This study included a total of 60 postmenopausal Japanese American (n=30) and white (n=30) women (age: 60-65 years, BMI: 18.8-39.6 kg/m(2)). Weight-related eating behavior traits did not differ by ethnicity. Higher external eating scores were associated with measures of total adiposity, including higher BMI (β=0.36, p=0.02) and DXA total fat mass (β=0.41, p=0.001), and with MRI abdominal subcutaneous fat (β=0.55, p=0.001). Higher routine restraint scores were associated with visceral adiposity (β=0.42, p=0.04). Our findings suggest that different weight-related eating behavior traits might increase not only total adiposity but also abdominal and visceral fat deposition associated with higher metabolic risks. Future research, preferably in a prospective study of men and women and including biomarkers related to psychological stress, will be needed to explore potential underlying biological mechanisms.

Do parental feeding practices moderate the relationships between impulsivity and eating in children?

This study examines the relationships between children's impulsivity, their eating behaviours, and their perceptions of their parent's feeding practices. 153 10-13 year old children completed questionnaires assessing their eating behaviours, their impulsiveness and their perception of their parent's feeding practices. Children's reports of dysfunctional eating behaviours were significantly correlated with their perceptions of their parents feeding practices and with their levels of impulsivity. Children's reports of parental monitoring of their food intake significantly moderated the influence of child impulsiveness upon emotional eating. Children's perceptions of parental monitoring of their food intake may potentially have a protective effect at preventing more impulsive children from eating in response to emotional feelings.

Smoking Relapse Prevention Programs and Factors That Predict Abstinence: A Controlled Study Comparing the Efficacy of Workplace Group Counselling and Proactive Phone Counselling

Aims:Most smokers who quit smoking usually relapse. Smoking relapse prevention programs are thus needed and their optimal content and duration should be therefore studied. The present study aimed to compare the efficacy of two relapse prevention programs designed for subjects who reported to be abstinent after a smoking cessation program and to assess predictors of abstinence 9 months later.Participants and design:Two-hundred and seventy-five adults who reported to be abstinent were randomised in two 9-month relapse prevention programs: Workplace Group Counselling Program (WGC) or Proactive Phone Counselling Program (PPC).Measurements:Assessment included questionnaires (Brief Symptom Inventory, BSI; Dutch Eating Behavior Questionnaire, DEBQ; Life Event Scale; sociodemographic and companies' characteristics; and companies' policy toward smoking), and abstinence measurements (self-report, breath carbon monoxide level and urinary cotinine concentration level).Findings:Quit rates at 9 months were respectively 57.5% in the PPC arm and 61.7% in the WGC arm (p= .552). Regression analysis indicated that urinary cotinine concentration level lower than or equal to 317ng/ml was associated with higher rate of abstinence (OR= 4.75, 95% CI = 1.23–18.30,p= .024). Moreover having higher BSI global severity index (OR= .36; 95% CI = .15–.83;p= .017), DEBQ external eating scores (OR= .67; 95% CI = .45–1.00;p= .050) and a free program (OR= .46; 95% CI = .22–.99;p= .048) were associated with lower rate of abstinence.Conclusions:Efficacy was similar for the two programs. This study underlines the need to monitor distress, eating behaviours, lapses and motivation, and to include in future relapse prevention programs specific psychological and/or pharmacological interventions that consider these dimensions.

Internalization of the thin and muscular body ideal and disordered eating in adolescence: the mediation effects of body esteem

This study investigates body esteem factors (weight-esteem and appearance-esteem) as mediators of the relationship between 'internalization of the ideal body figure' and disordered eating behaviors (restrained, emotional and external eating) in a community sample of adolescent males (n=810) and females (n=1137) from the Ontario Research on Eating and Adolescent Lifestyles (REAL) study. Mediation models were examined using a bootstrapping approach to test indirect effects and indirect contrasts. In males, weight-esteem partially mediated the relationship between muscular ideal and restrained eating; appearance-esteem partially mediated effects in the emotional and external eating regressions. In females, both weight-esteem and appearance-esteem partially mediated the relationship between thin ideal and all three forms of disordered eating; weight-esteem was a stronger mediator for restrained eating, and appearance-esteem a stronger mediator for emotional and external eating. Body esteem is important to consider for prevention and treatment of disordered eating in both genders.

Obesity related eating behaviour patterns in Swedish preschool children and association with age, gender, relative weight and parental weight--factorial validation of the Children's Eating Behaviour Questionnaire

Background

The Children's Eating Behaviour Questionnaire (CEBQ) is a multi-dimensional, parent-reported questionnaire measuring children's eating behaviours related to obesity risk, i.e. 'enjoyment of food', 'food responsiveness', 'slowness in eating' and 'satiety responsiveness'. It has not previously been validated in a Swedish population, neither on children under the age of 2 years. In the present study we examined the factor structure and the reliability of the Swedish version of the CEBQ, for use in an obesity intervention programme targeting preschool children 1-6 years. Further, the associations between eating behaviours and children's age, gender and relative weight (BMI SDS) and parental weight were investigated.

Methods

Parents to 174 children aged 1-6 years (50% girls, mean age 3.8 years), recruited from five kindergartens in Stockholm, completed the Swedish version of the CEBQ. Data on children's weight and height, parental weight, height and educational level was collected. Children's relative weight was calculated for a subpopulation (mean BMI SDS -0.4, n = 47). Factorial validation (Principal Component Analysis) on all CEBQ items was performed. Differences in eating behaviours by age, gender and parental weight were examined. Correlations between eating behaviours and the child's BMI SDS were analysed controlling for age, gender, parental weight and education in linear regression analyses.

Results

The factor analysis revealed a seven factor solution with good psychometric properties, similar to the original structure. The behaviour scales 'overeating'/'food responsiveness', 'enjoyment of food' and 'emotional undereating' decreased with age and 'food fussiness' increased with age. Eating behaviours did not differ between girls and boys. The children's relative weight was not related to any of the eating behaviours when controlling for age, gender, parental weight and education, and only associated with parental weight status.

Conclusions

Our results support the use of the CEBQ as a psychometric instrument for assessing children's eating behaviours in Swedish children aged 1-6 years. Measuring obesity related eating behaviours in longitudinal and interventional studies would offer opportunities for studying causal effects of eating behaviours in the development of obesity in children.

Agreement between two methods of dietary data collection in female adolescent netball players

The accuracy of a combined dietary data collection method (self-reported, weighed food diary and 24-h recall technique) in 13 female, adolescent netball players (14-16 years) was explored. The girls were observed for a 12 h period (08:00-20:00), during which food and drink items were available ad libitum throughout the day and for the period between 20:00 and 08:00 the following morning. All items were covertly weighed before and after consumption to calculate observed energy intake. To calculate participant reported energy intake, food and drink items were weighed and recorded in a food diary by the participants, which was then supplemented with information from the 24-h recall the following morning. Agreement between observed and participant reported energy intake was calculated using the Bland and Altman technique. The mean difference between observed and participant reported energy intake was 0.46 MJ d(-1) (change in mean of 4.2%) indicating a slight bias towards over-reporting using the combined dietary data collection method. There was good agreement at the group level with the confidence interval for bias ranging from 0.00 to 0.92 MJ d(-1). The combined dietary data collection method is an effective technique to employ in 14-16-year old, female adolescent netball players when quantifying energy intake.

Psychometrics of the Eating in Emotional Situations Questionnaire (EESQ) among low-income Latino elementary-school children

The current study examines the psychometric properties of the Eating in Emotional Situations Questionnaire (EESQ) and the frequency of eating in emotional situations among 159 low-income Latino fourth graders. The EESQ assesses eating in emotional situations that are emotion-driven ("I eat when I am lonely") and context-driven ("I eat when I get a really bad grade"). Internal consistencies for the EESQ subscales and total scale ranged from .70 to .86. Criterion validity of the EESQ was established by statistically significant correlations between the EESQ subscales and total scale, and uncontrollable eating, external eating, and junk food intake. Eating in emotional situations was common in the sample; almost one-half reported eating in at least 3 of the 11 types of emotional situations (e.g. when stressed, sad, or bored) and 28% reported eating in at least 6 types. Overall, these findings provide support for the internal consistency and validity of the EESQ in low-income Latino children, and suggest that eating in emotional situations is moderately present in this demographic. Future studies are needed to validate the EESQ in other ethnic groups and examine the longitudinal tracking of eating in emotional situations among Latino youth.

Mothers of young children cluster into 4 groups based on psychographic food decision influencers

This study explored how mothers grouped into clusters according to multiple psychographic food decision influencers and how the clusters differed in nutrient intake and nutrient content of their household food supply. Mothers (n = 201) completed a survey assessing basic demographic characteristics, food shopping and meal preparation activities, self and spouse employment, exposure to formal food or nutrition education, education level and occupation, weight status, nutrition and food preparation knowledge and skill, family member health and nutrition status, food decision influencer constructs, and dietary intake. In addition, an in-home inventory of 100 participants' household food supplies was conducted. Four distinct clusters presented when 26 psychographic food choice influencers were evaluated. These clusters appear to be valid and robust classifications of mothers in that they discriminated well on the psychographic variables used to construct the clusters as well as numerous other variables not used in the cluster analysis. In addition, the clusters appear to transcend demographic variables that often segment audiences (eg, race, mother's age, socioeconomic status), thereby adding a new dimension to the way in which this audience can be characterized. Furthermore, psychographically defined clusters predicted dietary quality. This study demonstrates that mothers are not a homogenous group and need to have their unique characteristics taken into consideration when designing strategies to promote health. These results can help health practitioners better understand factors affecting food decisions and tailor interventions to better meet the needs of mothers.

Differences in Eating Style between Overweight and Normal-Weight Youngsters

Differences in eating styles between overweight and normal-weight youngsters were investigated with a child version of the Dutch Eating Behavior Questionnaire (DEBQ). Subjects were children ( n = 1458; M: 10.1; SD = 1.3) and adolescents ( n = 1016; M: 14.9; SD =1.5). Overweight adolescent girls scored high on emotional eating while overweight adolescent boys displayed more external eating. In overweight children, already 10.5 per cent displayed emotional eating and 38.4 per cent reported external eating. All overweight youngsters reported restrained attitudes. Eating styles were positively associated with indicators of eating pathology. The results suggest the use of appropriate norms that take into account the child's age, gender and overweight status.

Consumption of fruit, vegetables, sweets and soft drinks are associated with psychological dimensions of eating behaviour in parents and their 12-year-old children

Objective

We investigated associations between consumption of fruits, vegetables, sweets and soft drinks and the psychological dimensions of eating in parents and their children. The role of the parent’s characteristics for their children’s food intake was also explored.

Design

Food intake patterns were assessed by self-reported consumption of the respective foods. Eating behaviour was measured by the Dutch Eating Behaviour Questionnaire and self-esteem by Harter self-perception scale. The participants were 1441 families (mother, father and their 12-year-old child), and additionally 354 mothers and thirty fathers.

Results

Among parents, reported intake of fruit and vegetables were associated with restrained eating, higher self-esteem, and higher education and age. Intake of sweets was related to more external and less restrained eating, and for mothers also emotional eating. Parent’s intake of soft drink was foremost related to a younger age, and also weakly associated with psychological characteristics. The food intake of parents was more important for the children’s food intake than any other characteristics. However, children’s intake of sweets showed clear-cut positive associations with external eating.

Conclusions

Psychological dimensions of eating behaviour are associated with patterns of food intake, in particular for consumption of sweets, and are most prominent in the parents. The children’s food intake mirrored their parents’ intake. Being sensitive to external food cues may increase unhealthy food consumption in our society, whereas more restrained eating may indicate proneness or intention to healthier food choices among parents. Emotional eating may imply a proneness to consume sweets for comfort, in particular among mothers.

BMI as a moderator of perceived stress and emotional eating in adolescents

Emotional eating has often been linked to overweight and/or obesity. Multiple group SEM analyses were conducted using cross-sectional data from 517 minority students in Los Angeles County. Results showed no differences in emotional eating between normal weight and overweight students. Perceived stress was indeed a significant correlate of emotional eating, independent of BMI status, as indicated by the lack of a modifying effect of BMI status. Findings highlight the fact that emotional eating is not an issue only for overweight and obese persons. This study shows that some children in this population at increased risk for obesity and related chronic disease have already incorporated emotional eating as a learned response to stress by the time that they enter adolescence.

The children's DEBQ for assessment of restrained, emotional, and external eating in 7- to 12-year-old children

OBJECTIVE

Construct an age adapted version of the Dutch Eating Behaviour Questionnaire (DEBQ) for measurement of restrained, emotional and external eating in 7- to 12-year-old children: the DEBQ-C.

METHOD

The DEBQ-C was constructed and tested for its reliability, factorial validity, factorial invariance for sex, overweight (BMI-status), and age, and correlations with measures for unhealthy life style in one sample (382 boys and 387 girls). In a second sample (252 boys and 263 girls) correlations were obtained with measures for body dissatisfaction and parental feeding styles. Single and multigroup confirmatory factor analyses were used.

RESULTS

The fit measures for the three factor model and the factorial invariance models with respect to sex, BMI-status, and age were satisfactory. In the (sub) samples of the 7- to 12-year-olds Cronbach's alpha's ranged from .73 to .82 and there were satisfactory correlations (p < .01) with other measures.

CONCLUSION

The DEBQ-C should provide a useful measure for young children's emerging dietary restraint and overeating tendencies. The low prevalence of emotional eating indicates that most young children show the natural reaction to emotional stressors (loss of appetite when feeling lonely, depressed or afraid) and that emotional (over) eating at this age is quite abnormal.

Similarities and reciprocal influences in eating behavior within sibling pairs: a longitudinal study

The present study investigated similarities and reciprocal influences in emotional, external and restrained eating in adolescent siblings, and the moderating role of sex and quality of relationship. A total of 415 sibling pairs (aged 13-16 years) participated in this two-wave one-year longitudinal study. Analyses were conducted by means of Structural Equation Modeling. Cross-sectional findings demonstrated that siblings are moderately similar in their eating behavior. Longitudinal findings showed that the younger siblings exert a small influence on the emotional and external eating behavior of the older siblings. No support was found for the older siblings affecting the younger siblings in their eating behavior. Furthermore, no sex differences were found in the associations between sibling eating behaviors within and over time. However, we did find a moderating effect for the quality of the relationship concerning similarities in emotional eating. Future research focusing on various sociocultural influences on adolescents' eating behaviors should also include younger siblings.

Perceived parental control of food intake is related to external, restrained and emotional eating in 7–12-year-old boys and girls

This study examined the prevalence of external, restrained and emotional eating and the relationship of these disturbed types of eating behaviours with perceived parental control of food intake (pressure to eat and restriction) in a group of 7- to 12-year-old boys and girls (n = 596). External eating turned out to be the most prevalent disturbed eating behaviour for boys and girls, followed by restrained eating and emotional eating. Sex differences were found in external and restrained eating. For the boys, perceived pressure to eat was positively related to emotional and external eating. For both sexes, perceived restriction to eat was negatively related to emotional and external eating and positively related to restrained eating. This led to the conclusion that perceived pressure to eat has a disruptive effect on a child's self-regulating mechanism of food intake, particularly so for boys, whereas perceived restriction can also have a positive effect.

Association of body mass index and dietary restraint with changes in eating behaviour throughout late childhood and early adolescence: a 5-year study

Objectives

To describe patterns of dietary behaviours specific to low quality snacking, fruit and vegetable, and fast food consumption during the transition from childhood to adolescence and to examine how these behaviours are associated with tendencies towards dietary restraint and the occurrence of overweight and obesity in mid-adolescence.

Design

A 5-year follow-up of self-reported eating. Hierarchical linear modelling was utilised to explore the relationship between dietary changes and body mass index (BMI) and dietary restraint while controlling for physical activity and smoking.

Setting

The sample was derived from students participating in the Quebec Heart Health Demonstration Project, and represents rural, suburban and inner city youths.

Subjects

A sample of 561 girls and 627 boys in the fourth, sixth, seventh and ninth grades.

Results

Overall the sample was characterised by a decrease in fruit and vegetable consumption and increase in low quality snacking, and a decrease in fast food consumption over the 5-year follow-up. Dietary restraint and BMI were found to be associated with dietary behaviour. Lower than average dietary restraint was associated with a lower frequency of fast food consumption and greater increase in low quality snacking over the 5-year period. Higher than average dietary restraint was associated with lesser frequency of low quality snacking at baseline. Having a BMI in the obese range was associated with more frequent fast food consumption in the fourth grade and a more rapid drop in fast food consumption across the 5-year period.

Conclusions

Dietary behaviours are associated with the psychological construct dietary restraint and with weight status in this population of adolescents.

Parental behaviour and adolescents’ emotional eating

Parents can influence their children's emotional eating behaviour through modelling processes and parenting. In this study, data on parenting (support, behavioural control and psychological control), emotional eating, and demographic variables were gathered among both parents and two adolescent children of 428 Dutch families. Structural equation modelling showed positive associations between parents' emotional eating and adolescents' emotional eating. Adolescent's reports of low maternal support and of high psychological control for younger adolescents and low behavioural control for older adolescents were associated with higher emotional eating. Parents' reports of parenting were not significantly associated with adolescent's emotional eating. Multi-group analyses revealed no significant differences in associations between modelling and parenting factors on the one hand, and adolescent emotional eating on the other, by sex of the older or younger adolescent.

Dietary correlates of emotional eating in adolescence

To better understand the relation between emotional eating and dietary choices, dietary correlates of emotional eating were investigated in an adolescent sample. Participants were 617 predominantly Latino middle school students from seven schools in Los Angeles County. Analyses of cross-sectional data revealed that emotional eating was associated with increased frequency of intake of sweet high energy-dense foods, such as cake and ice cream, salty high energy-dense foods like chips, and soda. Gender stratified analyses revealed an association between emotional eating and more frequent fruit and vegetable intake in boys only, and a positive association between emotional eating and salty high energy-dense intake in both boys and girls. These data support previous literature that reports a preference for high energy-dense food in emotional eating, and shows that this association may be generalizable to Latino youth. Considering that emotional eating may lead to overeating because it often takes place in the absence of hunger, it may be appropriate to develop interventions to teach youth healthier substitutions and regulate mood by means other than eating in order to reduce risk for obesity, especially in high risk populations, such as Latinos.

No energy compensation at the meal following exercise indietary restrained and unrestrained women

The objective of this investigation was to compare the acute effects of exercise and diet manipulations on energy intake, between dietary restrained and unrestrained females. Comparisons of two studies using an identical 2 × 2 repeated-measures design (level of activity (rest or exercise) and lunch type (high-fat or low-fat)) including thirteen dietary unrestrained and twelve restrained females were performed. Energy expenditure during the rest session was estimated and the energy cost of exercise was measured by indirect calorimetry. Relative energy intake was calculated by subtracting the energy expenditure of the exercise session from the energy intake of the test meal. Post-meal hedonic ratings were completed after lunch. Energy intake and relative energy intake increased during high-fat conditions compared with the low-fat, independently of exercise (P < 0·001). There was a positive relationship between dietary restraint scores and energy intake or relative energy intake in the rest conditions only (r 0·54, P < 0·01). The decrease of relative energy intake between the rest and exercise conditions was higher in restrained than in unrestrained eaters (P < 0·01). These results confirm that a high-fat diet reversed the energy deficit due to exercise. There was no energy compensation in response to an acute bout of exercise during the following meal. In restrained eaters, exercise was more effective in creating an energy deficit than in unrestrained eaters. Exercise may help restrained eaters to maintain control over appetite.

Emotional, external, restrained eating and overweight in Dutch adolescents

The purpose of this study was to determine how emotional, external and restrained eating behavior and other health-related lifestyle factors were associated with being overweight in adolescents. Moreover, demographic and ethnic differences in eating behavior have been examined. The respondents were 10,087 Dutch adolescents aged 11-16 years (M= 13.0, SD= 0.8). Self-reported eating behavior was measured with the DEBQ. Health-related lifestyle was determined by physical activity, breakfasting, fruit consumption and snacking. High restrained, and low external eating were positively associated with being overweight, whereas no significant association between emotional eating and being overweight was found for girls, and a negative association for boys. Adolescents who ate breakfast on a daily basis were less likely to be overweight than those who ate breakfast irregularly or never. Being overweight was positively associated with fruit consumption for girls and negatively with physical activity for boys.

Construct validation of the Restraint Scale in normal-weight and overweight females

The Restraint Scale (RS) is a widely used measure to assess restrained eating. The purpose of this study was to examine the construct validity of the RS in a sample of normal-weight (n=349) and overweight (n=409) females using confirmatory factor analyses of the RS in relation to other measures for dieting, overeating and body dissatisfaction. Following Laessle et al. [(1989a). A comparison of the validity of three scales for the assessment of dietary restraint. Journal of Abnormal Psychology, 98, 504-507], we assumed a three-factor structure: (1) overeating and disinhibitory eating, (2) dieting and restriction of food intake, and (3) body dissatisfaction and drive for thinness. Analyses revealed that the RS loaded significantly on all three factors for both samples, confirming its multifactorial structure. However, the RS appears to capture these constructs differently in overweight and normal-weight females such that the RS may overestimate restraint in overweight individuals. This may explain the greater effectiveness of the RS in predicting counter-regulation in normal-weight than in overweight samples of dieters.

The relationship between restrained eating and poor psychological health is moderated by pleasure normally associated with eating

This study investigated the relationship between restrained eating and poor psychological health, and the importance of pleasure normally associated with eating in this relationship. Pleasure normally associated with eating, restrained eating, and anxiety, depression and satisfaction with life were assessed concurrently by questionnaire. A relationship between restrained eating and poor psychological health was found--greater restrained eating was significantly independently associated with greater anxiety (B=1.099, p<0.01). Furthermore, pleasure associated with eating was an important moderator in this relationship--greater pleasure associated with eating combined with greater restrained eating was also significantly independently associated with greater anxiety (B=1.067, p=0.02). No effects were found for depression or satisfaction with life. These findings suggest that the pleasure normally associated with eating is important in the relationship between restrained eating and poor psychological health. Subsidiary exploratory analyses also suggest that the relationship between restrained eating and poor psychological health, and the importance of pleasure in that relationship, may differ in males and females.

The validity of Dietary Restraint Scales: Comment on Stice et al. (2004)

In 4 empirical studies, E. Stice, M. Fisher, and M. R. Lowe calculated the correlations between some widely used dietary restraint scales and food intake. Failing to find substantial negative correlations, they concluded that these scales were invalid. The current article challenges this conclusion. For one thing, there is some evidence that restrained eaters do eat less than do unrestrained eaters under controlled experimental conditions favoring self-control. Dietary restraint is also associated with tendencies toward disinhibition under conditions favoring loss of self-control; such disinhibition often masks (but does not invalidate) the construct of dietary restraint. For these and other reasons, the assessment of food intake at a single eating episode may not capture overall dietary restriction. Finally, how much one eats does not necessarily indicate whether one has eaten less than one desired to eat. The authors suggest that the existing restraint scales do in fact validly assess restriction of food intake, albeit in a more complex fashion than is evident from simple correlations in single episodes.

Gender differences in associations of eating pathology between mothers and their adolescent offspring

OBJECTIVE

To study the association of eating pathology between mothers and their adolescent offspring in a population sample.

RESEARCH METHODS AND PROCEDURES

The participants were 481 women (mean age, 47+/-SD 5 years; BMI, 25+/-4 kg/m2) and their 481 adolescent children 16 to 17 years old (BMI, 21+/-3 kg/m2) of the Stockholm Weight Development Study. Assessment methods were the Three-Factor Eating Questionnaire Revised 18 and the Eating Disorder Inventory 2.

RESULTS

A higher body weight was most related to cognitive restraint for adolescents and to emotional eating for adult women. A mother-daughter link could be identified for eating pathology, with the strongest link found for emotional eating. No mother-son link could be identified. Age subgroup analyses revealed a stronger mother-daughter link for body attitudes in younger mothers and for cognitive restraint in older mothers.

DISCUSSION

Gender differences revealed that eating pathology was shared by mothers and daughters but not by mothers and sons. A psychological strategy such as eating as a response to negative emotions was most interrelated between mothers and daughters. Younger mothers shared more attitudes toward the body with their daughters, whereas older mothers shared more restrictive eating behaviors with their daughters. The mother-daughter links found may be due to gender-specific genetic and psychological family transmission and gender-specific environmental influences. The sons' eating behaviors seem to be more independent and would be formed by other factors than for the girls.

Influence of heredity on dietary restraint, disinhibition, and perceived hunger in humans

OBJECTIVE

Dietary restraint, disinhibition, and perceived hunger have been shown to affect food intake and body weight and are thought to be risk factors for eating disorders, but little is known about their origins. We investigated the influence of heredity, shared (familial) environment, and individual environment on dietary restraint disinhibition, perceived hunger and their relation to body size and food intake.

METHODS

Scores on the Three Factor Eating Questionnaire and the Restraint Scale in addition to height, weight, body mass index, and 7-d diary reported nutrient intakes were obtained from 39 identical, 60 fraternal same-sex, and 50 fraternal opposite-sex adult twin pairs who were living independently. Linear structural modeling was applied to investigate the nature and degree of genetic and environmental influences.

RESULTS

Analysis showed significant genetic and individual environmental, but not shared (familial) environmental, influences on cognitive restraint, perceived hunger, and Restraint Scale scores, with genes accounting for 44%, 24%, and 58% of the variance, respectively. In contrast, disinhibition was found to be significantly influenced by the shared (familial) environment, accounting for 40% of the variance. Further analysis showed that cognitive restraint and perceived hunger heritabilities could not be accounted for by significant heritabilities of body weight, height, or body mass index. In contrast, the heritability of Restraint Scale scores was found to be related to body size. Cognitive restraint was negatively correlated with nutrient intake, and differences in cognitive restraint were found to be related to differences in the body sizes of identical twin pairs.

CONCLUSIONS

Dietary restraint appears to be another component in a package of genetically determined physiologic, sociocultural, and psychological processes that regulate energy balance, whereas dietary disinhibition may be the intermediary between upbringing and the development of overweight and/or eating disorders.

Gender, sexuality, body image and eating behaviours

One hundred and twenty one participants reported sexual orientation, body mass index, body shape concerns, eating motives and eating styles. Measures of body dissatisfaction were greater in heterosexual women and homosexual men (ps <.05), while heterosexual women had smaller (ps <.001) ideal body shapes. Eating weight control motive was lower in heterosexual men compared to women (ps <.05). Restrained eating was lower in heterosexual men compared to heterosexual women or homosexual men (ps <.001). The findings support the role of socially prescribed body shapes on body shape concerns, eating motivations, and eating styles in men and women and suggest impacts are greater for heterosexual women and homosexual men.

When identical twins differ: an analysis of intrapair differences in the spontaneous eating behavior and attitudes of free-living monozygotic twins

Heredity has been shown to have major influences on the body size and ingestive behaviors of humans. However, environment is also important as evidenced by the fact that even identical twins can differ in body size and nutrient intake. To investigate the relative influence of heredity and environment, differences between the body size and food intake of 110 identical adult twin pairs who were living independently were studied with a 7-day diet diary technique. Differences within twin pairs (intrapair differences) in diet density were related to differences in daily intakes, but not with body size differences. On the other hand, cognitive restraint and disinhibition were related to intrapair differences in body size, but not intake. The fact that there are important environmental and psychological factors that influence intake and body size, even in individuals who have identical genotypes, supports the recently proposed general model of intake regulation [de Castro JM, Plunkett S. A general model of intake regulation. Neurosci. Biobehav. Rev. 26 (5) (2002) 581-595].

Impressions of functional food consumers

Functional foods provide a new way of expressing healthiness in food choices. The objective of this study was to apply an indirect measure to explore what kind of impressions people form of users of functional foods. Respondents (n=350) received one of eight versions of a shopping list and rated the buyer of the foods on 66 bipolar attributes on 7-point scales. The shopping lists had either healthy or neutral background items, conventional or functional target items and the buyer was described either as a 40-year-old woman or man. The attribute ratings revealed three factors: disciplined, innovative and gentle. Buyers with healthy background items were perceived as more disciplined than those having neutral items on the list, users of functional foods were rated as more disciplined than users of conventional target items only when the background list consisted of neutral items. Buyers of functional foods were regarded as more innovative and less gentle, but gender affected the ratings on gentle dimension. The impressions of functional food users clearly differ from those formed of users of conventional foods with a healthy image. The shopping list method performed well as an indirect method, but further studies are required to test its feasibility in measuring other food-related impressions.

Tendency toward overeating and restraint as predictors of food consumption

Restrained eaters have repeatedly been found to overeat following a preload, which phenomenon is called the disinhibition effect. Remarkably, the disinhibition effect is only found when the restraint scale (RS) is used, and never when other measures of restraint, like the three-factor eating questionnaire (TFEQ) or the Dutch eating behavior questionnaire (DEBQ) are applied. Recent research has shown that tendency toward overeating appears to be a better predictor of food consumption than dietary restraint. The present study examines the predictive value of preload, tendency toward overeating and dietary restraint. An experiment was carried out with 209 female participants with the aim to evaluate whether the results of the study [Int J Eating Disorders 28 (2000) 333] are robust. In addition to the RS, the TFEQ and DEBQ were used to measure restraint and tendency toward overeating. Again, no disinhibition effect occurred, confirming the results of the previous study. Restraint, as measured by the three questionnaires, was not related to food consumption. In contrast, tendency toward overeating was significantly related to food consumption. Restraint theory's contentions that dieting leads to overeating might be valid for only some dieters, namely those with a high tendency toward overeating.

Counterregulation in female obese emotional eaters: Schachter, Goldman, and Gordon's (1968) test of psychosomatic theory revisited

In a sample of 31 obese women, the moderating role of restrained, emotional, and external eating (as was measured by the DEBQ) on the relationship between food deprivation and food intake was studied by examining the prediction of grams of cookies eaten by the preload and degree of restrained, external, and emotional eating interactions. In addition, the main effects of each type of eating behaviour on food intake was studied, and also whether any of the effects were attenuated when variance associated with the other types of eating behaviour was partialled out. Emotional eating was found to moderate the relationship between food intake and food deprivation, and this effect became even more pronounced when the variance associated with external eating was removed. Instead of eating less after a preload, emotional eaters ate more, suggesting a counter regulatory eating pattern of female obese emotional eaters. Further, also the main effect of emotional eating on food intake was significant. Both results suggest support for psychosomatic theory.

Dietary restraint in relation to nutrient intake, physical activity and iron status in adolescent females

AIM

To investigate the prevalence of dietary restraint in a female adolescent population, and to examine the nutritional consequences of dietary restraint and its implications for iron status.

METHODS

A total of 64 adolescent females, aged 14-15 years, were recruited from two all-girl schools in central London. Nutrient intake, body weight, physical activity and iron status were measured. Findings were compared between three groups of subjects classified by dietary restraint.

RESULTS

Adolescents with a higher BMI percentile were more likely to be highly restrained. Scores on the dietary restraint psychometric measures were comparable with other UK studies in this age group. Energy intake was inversely related to dietary restraint (mean energy intake (SE) for each restraint group were: low 8.99 MJ (0.48), medium 7.98 MJ (0.22) and high 7.35 MJ (0.39) P < 0.05); however, a corresponding relationship between dietary restraint and reduced micronutrient intakes was not found. Highly restrained eaters obtained more of their energy intake from bread, fruit and cheese and less from meat, meat products and confectionery. Levels of physical activity were not significantly different between the dietary restraint groups. There was a poor relationship between reported energy intake and estimated energy expenditure. Haematological parameters of iron status were similar across the restraint groups.

CONCLUSIONS

Dietary restraint was exercised by the consumption of a "healthy eating diet". Dieting was not related to a lower iron status; however, the low dietary iron intake and poor iron status of the whole sample is of concern.

Body dissatisfaction and binge eating in obese women: the role of restraint and depression

OBJECTIVE

This study examined the association between body dissatisfaction and binge eating, and the mediating role of restraint and depression among obese women.

RESEARCH METHODS AND PROCEDURES

Participants were obese women taking part in a cognitive-behavioral treatment program who completed self-report measures at baseline (n = 89) and post-treatment follow-up (n = 69).

RESULTS

At baseline, body dissatisfaction was strongly correlated with binge eating score. This was partly a direct effect and partly mediated by depression. No mediating effect of restraint was observed. Over the treatment period, a reduction in body dissatisfaction was associated with a reduction in binge-eating score. As in the cross-sectional data, there was evidence for mediation by change in depression with the greatest improvement in binge eating among those who became more restrained and less depressed.

DISCUSSION

These results suggest that it would be valuable to address psychological well-being, and especially body image, as part of the management of binge-eating behavior in obesity.

Differences in health and taste attitudes and reported behaviour among Finnish, Dutch and British consumers: a cross-national validation of the Health and Taste Attitude Scales (HTAS)

The Health and Taste Attitude Scales (HTAS) developed by Roininen, Lähteenmäki and Tuorila in 1999 measure the importance of health and taste aspects of foods in the food choice process. These multi-item scales consist of sets of statements, ranging from "strongly disagree" to "strongly agree", which further divide into three Health (General health interest, Light product interest and Natural product interest) and three Taste (Craving for sweet foods, Using food as a reward and Pleasure) sub-scales. Finnish (N=467), Dutch (N=477), and British (N=361) respondents completed a questionnaire which contained four components: the HTAS, a separate "paper and pencil task" of choosing a food for a snack; pleasantness, healthiness and frequency of consumption of eight foods; and the Restraint Eating Scale of the Dutch Eating Behaviour Questionnaire (DEBQ). The latter three components were included in order to validate various aspects of the HTAS. The factor structure of HTAS was found to be equal in all three countries. However, there were some minor differences in factor loadings among countries, e.g. the Natural product interest and Pleasure sub-scale items had lower factor loadings in the UK than in Finland and The Netherlands. Finnish respondents had the most positive attitude towards light products. Dutch and British respondents scored higher on all Taste sub-scales than their Finnish counterparts. Respondents' health-related attitudes were good predictors of their "healthy food choices" in the snack task and self-reported consumption. Two of the Taste sub-scales (Craving for sweet foods and Using food as a reward) predicted well respondents' self-reported consumption of, for example, full-fat chocolate bars. All the Health and two of the Taste sub-scales proved to be useful tools for characterizing consumer attitudes within and between countries.

Stress and food choice: a laboratory study

OBJECTIVE

This study investigated experimentally whether acute stress alters food choice during a meal. The study was designed to test claims of selective effects of stress on appetite for specific sensory and nutritional categories of food and interactions with eating attitudes.

METHODS

Sixty-eight healthy men and women volunteered for a study on "the effects of hunger on physiology, performance, and mood." Eating attitudes and food preferences were measured on entry to the study. The stressed group prepared a 4-minute speech, expecting it to be filmed and assessed after a midday meal, although in fact speeches were not performed. The ad libitum meal included sweet, salty, or bland high- and low-fat foods. The control group listened to a passage of neutral text before eating the meal. Blood pressure, heart rate, mood, and hunger were measured at baseline and after the 10-minute preparatory period, when appetite for 34 foods and food intake were recorded.

RESULTS

Increases in blood pressure and changes in mood confirmed the effectiveness of the stressor. Stress did not alter overall intake, nor intake of, or appetite for the six food categories. However, stressed emotional eaters ate more sweet high-fat foods and a more energy-dense meal than unstressed and nonemotional eaters. Dietary restraint did not significantly affect appetitive responses to stress.

CONCLUSIONS

Increased eating of sweet fatty foods by emotional eaters during stress, found here in a laboratory setting, may underlie the previously reported finding that dietary restraint or female gender predicts stress-induced eating. Stress may compromise the health of susceptible individuals through deleterious stress-related changes in food choice.

Dietary intakes, eating style and overweight in the Stanislas Family Study

OBJECTIVES

To describe the eating patterns of members of French families and to assess the relationships between dietary intakes, eating style and overweight.

DESIGN

Cross-sectional analysis of nutritional and behavioural characteristics.

SUBJECTS

1,320 members of 387 families (age 11-65y) attending the Centre for Preventive Medicine for a routine medical check-up.

MEASUREMENTS

Individual body weight and height were measured. Food intake was assessed using a three day dietary record. Eating style was measured using the French validated version of the Dutch Eating Behaviour Questionnaire.

RESULTS

In each of the four groups (men, women, boys and girls), dietary restraint was positively correlated with overweight (P< or =0.001) and associated with lower energy intakes (P < or = 0.05-P < or = 0.001). A negative association between energy intake and overweight was found in girls only (P< or =0.001). In all cases, overweight and dietary restraint exaggerated any existing macronutrient imbalance in energy intake (ie higher protein and fat contributions, lower carbohydrate contribution). Emotional eating was positively correlated to body mass index in women only (P< or =0.01). External eating was mainly a characteristic of children (P< or =0.001).

CONCLUSION

As in overweight subjects, clear relationships were found in this sample of general population between dietary intakes and eating style. The population will be followed up for 10y. In the long term, these results should have implications in the prevention of obesity.

Quantification of consumer attitudes to health and hedonic characteristics of foods

Health and Taste Attitudes Questionnaires were developed to assess consumers' orientations toward the health and hedonic characteristics of foods. Items were generated in a qualitative study. The original 37 items on health and 44 on taste were rated from "strongly disagree" to "strongly agree" by a representative sample of 1005 Finnish adults (18-81 years). The number of items was reduced using factor and item analysis, resulting in 20 health- and 18 taste-related statements. Three health-related and three taste-related factors were extracted. The health-related factors were labelled as "General health interest", "Light product interest", and "Natural product interest". The taste-related factors were named "Craving for sweet foods", "Using food as a reward", and "Pleasure". Cronbach's alphas of the multi-item scales, based on the statements loading highly on each factor, ranged from 0.67 to 0.89. Age and gender affected the responses. Females were more interested in the health and taste aspects of foods than were males. Younger respondents were less concerned with health but more interested in taste than were older respondents. A preliminary test of predictive validity was conducted by analysing subjects' responses to foods with weak and strong connotations of health and taste, and currently the questionnaires are being validated with further behavioural tests.