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Harnois-Leblanc S, Van Hulst A, Lucibello KM, Harbec MJ, Sabiston CM, Maximova K, Sylvestre MP, Henderson M. Associations Between Weight-Loss Attempts, Weight-Related Stress, and Body Image During Childhood and Adolescence in Children With Parental Obesity. Child Obes 2024. [PMID: 38241489 DOI: 10.1089/chi.2023.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Background: Few longitudinal studies have investigated the role of weight-loss attempts or weight-related stress on body image during childhood. We examined whether weight-loss attempts and weight-related stress are associated with weight misperception and body dissatisfaction across childhood and adolescence. Methods: Data were drawn from the Quebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort of Canadian children with parental obesity (8-10 years: n = 630; 10-12 years: n = 564; 15-17 years: n = 377). We assessed weight-loss attempts and weight-related stress at baseline and first follow-up, and perceived and desired silhouettes at first and second follow-up with questionnaires. Weight misperception consisted of the difference in BMI z-score (zBMI) from the perceived silhouette and the measured zBMI. Body dissatisfaction consisted of the discordance between perceived and desired silhouettes. We estimated multivariable mixed-effects regression models adjusting for age, sex, pubertal stage, parental BMI and education, and sport-based teasing. Results: Weight loss attempts were associated with a higher weight misperception score (ever tried, beta [95% confidence intervals; CI]: 0.13 [0.01-0.24]) and with 2.13 times higher desire to be thinner (95% CI: 1.39-3.26) at the subsequent follow-up. Similarly, children stressed by their weight had a higher misperception score (beta [95% CI]: 0.15 [0.02-0.27]) and greater desire to be thinner at the next follow-up (odds ratio [95% CI]: 1.73 [0.999-3.00]). Conclusions: Weight-loss attempts and weight-related stress in children and adolescents are associated with weight misperception and body dissatisfaction, supporting empowerment and counseling focusing on healthy eating behaviors and a positive body image. Clinical Trial Registration Number: NCT03356262.
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Affiliation(s)
- Soren Harnois-Leblanc
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
- Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Research Center, Centre Hospitalier Universitaire de Montréal, Montréal, Québec, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - Kristen M Lucibello
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Marie-Josée Harbec
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
- School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Marie-Pierre Sylvestre
- Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Research Center, Centre Hospitalier Universitaire de Montréal, Montréal, Québec, Canada
| | - Mélanie Henderson
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
- Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
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Mohorić T, Pokrajac-Bulian A, Anić P, Kukić M, Mohović P. Emotion regulation, perfectionism, and eating disorder symptoms in adolescents: the mediating role of cognitive eating patterns. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 36406848 PMCID: PMC9644388 DOI: 10.1007/s12144-022-03824-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 09/14/2022] [Accepted: 09/25/2022] [Indexed: 11/10/2022]
Abstract
Poor emotion regulation, along with elevated perfectionism, is recognised as a risk factor for the development of eating disorder (ED) symptoms. Therefore, the aim of our study was to examine the relationship between emotion regulation difficulties and perfectionism with ED symptoms, while controlling for emotional eating, uncontrolled eating, and cognitive restraint as mediators. In total, 482 adolescents (246 girls and 236 boys; M = 15.00, SD = 0.31) participated in this study. Based on the participants' body height and weight measured by the medical team during their regular preventive health examinations, the body mass index (BMI) was calculated. Participants also answered the Difficulties in Emotion Regulation Scale, Multidimensional Perfectionism Scale, Three-Factor Eating Questionnaire, and Eating Disorder Examination Questionnaire. According to the results obtained, adolescent girls in our sample reported more difficulties in emotion regulation, more uncontrolled and emotional eating, and more ED symptoms. A significant direct effect was found for difficulties in emotion regulation and ED symptoms but not for perfectionism. In addition, only emotional eating and cognitive restraint (not uncontrolled eating) mediated the relationship between difficulties in emotion regulation and perfectionism and ED symptoms. The results suggest that difficulties in emotion regulation may be more important than perfectionism in explaining ED symptoms in a sample of healthy adolescents. When adolescents experience problems in emotion regulation in combination with emotional or uncontrolled eating, they might be at a higher risk of experiencing concerns about weight and a variety of other ED symptoms, and this should be considered when planning preventive interventions for adolescents.
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Affiliation(s)
- Tamara Mohorić
- Faculty of Humanities and Social Sciences, Department of Psychology, University of Rijeka, Sveučilišna avenija 4, 51 000 Rijeka, Croatia
| | - Alessandra Pokrajac-Bulian
- Faculty of Humanities and Social Sciences, Department of Psychology, University of Rijeka, Sveučilišna avenija 4, 51 000 Rijeka, Croatia
| | - Petra Anić
- Faculty of Humanities and Social Sciences, Department of Psychology, University of Rijeka, Sveučilišna avenija 4, 51 000 Rijeka, Croatia
| | - Miljana Kukić
- Faculty of Humanities and Social Sciences, Department of Psychology, University of Rijeka, Sveučilišna avenija 4, 51 000 Rijeka, Croatia
| | - Patrizia Mohović
- Faculty of Humanities and Social Sciences, Department of Psychology, University of Rijeka, Sveučilišna avenija 4, 51 000 Rijeka, Croatia
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Translation and validation of the Child Three-Factor Eating Questionnaire (CTFEQr17) in French-speaking Canadian children and adolescents. Public Health Nutr 2022; 25:543-553. [PMID: 34503600 PMCID: PMC9991566 DOI: 10.1017/s136898002100392x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To translate and validate the Child Three-Factor Eating Questionnaire (CTFEQr17), assessing cognitive restraint (CR), uncontrolled eating (UE) and emotional eating (EE), among French-speaking Canadian young individuals. DESIGN Phase 1 comprised a translation and the evaluation of the comprehension of the questionnaire. Phase 2 comprised a confirmatory factor analysis (CFA), the evaluation of internal consistency (Cronbach's α), test-retest reliability (intra-class correlation coefficients (ICC)) and construct validity, including correlations among the CTFEQr17 and Eating Attitudes Test (EAT-26), anthropometrics, dietary intake and diet quality. SETTING Primary and secondary schools, Québec City, Canada. PARTICIPANTS Phases 1 and 2 included 20 (40 % boys, mean age 11·5 (sd 2·4) years) and 145 (48 % boys, mean age 11·0 (sd 1·9) years) participants, respectively. RESULTS Phase 1 resulted in the questionnaire to be used in Phase 2. In Phase 2, the CFA revealed that the seventeen item, three-factor model (CTFEQr17) provided an excellent fit. Internal consistency was good (Cronbach's α: 0·81-0·90). Test-retest reliability was moderate to good (ICC = 0·59, (95 % CI 0·48, 0·70), ICC = 0·78, (95 % CI 0·70, 0·84), ICC = 0·50, (95 % CI 0·38, 0·62) for CR, UE and EE, respectively). CR correlated with EAT-26 score (r = 0·43, P < 0·0001). UE and EE correlated negatively with BMI Z-scores (r = -0;·26, P = 0·003; r = -0;·19, P = 0·03, respectively). CR correlated with the proportion of energy intake from protein and diet quality (r = 0·18, P = 0·04; r = 0·20, P = 0·02, respectively). CONCLUSION The CTFEQr17 is suitable to use among French-speaking Canadian young individuals.
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Stewart TM, Martin CK, Williamson DA. The Complicated Relationship between Dieting, Dietary Restraint, Caloric Restriction, and Eating Disorders: Is a Shift in Public Health Messaging Warranted? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:491. [PMID: 35010751 PMCID: PMC8745028 DOI: 10.3390/ijerph19010491] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 02/01/2023]
Abstract
The origins of theories specifying dietary restraint as a cause of eating disorders can be traced to the 1970s. This paper will present an overview of the origins of dietary restraint theories and a brief historical review of evidence will be summarized. Recent research will be presented, including the results from the CALERIE Phase 1 study, as well as CALERIE Phase 2, which were NIH-sponsored randomized controlled trials. CALERIE 2 provided a test of the effect of two years of caloric restriction (CR) on the development of eating disorder syndromes and symptoms in comparison to a control group that did not alter eating behavior or body weight. The intervention was effective for inducing a chronic (two-year) reduction in total energy expenditure and increased dietary restraint but did not increase symptoms of eating disorders. The results of this recent investigation and other studies have not provided experimental support for conventional dietary restraint theories of eating disorders. These findings are discussed in terms of potential revisions of dietary restraint theory, as well as the implications for a paradigm shift in public health messaging related to dieting.
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Affiliation(s)
- Tiffany M. Stewart
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (C.K.M.); (D.A.W.)
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Emotion dysregulation and pediatric obesity: investigating the role of Internet addiction and eating behaviors on this relationship in an adolescent sample. Eat Weight Disord 2021; 26:1767-1779. [PMID: 32893330 DOI: 10.1007/s40519-020-00999-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE The first aim was to investigate whether there was a mediator role of Internet addiction or uncontrolled/emotional eating on the association between emotion dysregulation and body mass index-standard deviation score (BMI-SDS). The second aim was to detect which of these variables (emotion dysregulation, Internet addiction, and uncontrolled/emotional eating) significantly affect the presence of obesity (OB). METHODS A total of 123 adolescents (OB (n = 65, 57% of girls, mean age = 15 ± 1.9, BMI percentile between 95 and 99) and healthy control (HC) (n = 58; 53% of girls, mean age = 15.5 ± 1.8, BMI percentile between 1 and 84) aged between 11 and 18 were recruited. Difficulties in Emotion Regulation Scale (DERS) and Internet Addiction Test (IAT) were completed by adolescents. Uncontrolled and emotional eating behaviors were measured by Three Factors Eating Questionnaire (TFE-Q)'s sub-domains. RESULTS There was no significant direct effect of DERS on BMI-SDS, whereas the indirect effect of DERS on BMI-SDS which was mediated by both IAT and TFE-Q was statistically significant. In logistic regression analysis, an increase by 1 point in DERS total score escalated the odds of being OB by 2%. Moreover, a 22-fold increased risk of OB has been detected in moderate/severe Internet addiction compared to no addiction. CONCLUSION This cross-sectional study showed that the association between emotion dysregulation and BMI-SDS was totally mediated by internet addiction and uncontrolled/emotional eating. In addition, emotion dysregulation and Internet addiction were significant determinants of OB. A prospective study is needed to detect the causal relationship between these variables. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Harnois-Leblanc S, Van Hulst A, Sabiston CM, Maximova K, Béland M, Doré I, Sylvestre MP, Henderson M. Self-reported weight loss attempts and weight-related stress in childhood: Heightening the risk of obesity in early adolescence. Int J Eat Disord 2021; 54:764-772. [PMID: 33496346 DOI: 10.1002/eat.23474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 01/06/2021] [Accepted: 01/09/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Weight loss attempts occur as early as childhood. The impacts of weight loss attempts and weight-related stress on the occurrence of obesity during childhood remain unknown. We aimed to: (a) assess the prevalence of self-reported weight loss attempts and weight-related stress in 8-10 year-old children and (b) determine associations with adiposity 2 years later. METHOD Data were collected from a cohort study of 564 Canadian children aged 8-10 years, having one or both biological parents with obesity (Quebec Adipose and Lifestyle Investigation in Youth cohort). Self-reported weight loss attempts and weight-related stress were assessed at baseline in the child's questionnaire. Adiposity was measured at baseline and 2 years later using body mass index z-scores (zBMI), waist-to-height ratio (WHtR), and percentage of body fat (%BF) obtained from dual-energy x-ray absorptiometry. Linear and logistic regression analyses were used while adjusting for potential confounders. RESULTS Forty-eight percent of children reported previous weight loss attempts and 20% reported weight-related stress. Self-reported weight loss attempts and weight-related stress were associated with higher zBMI, WHtR, and %BF 2 years later in adjusted models, although estimates were attenuated when including baseline adiposity measures. Self-reported weight loss attempts, but not weight-related stress, increased the risk of becoming overweight among children who were normal weight at baseline. DISCUSSION Weight loss attempts are prevalent in children with parental obesity. Children reporting weight loss attempts and weight-related stress tend to have higher adiposity 2 years later and are more likely to become overweight.
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Affiliation(s)
- Soren Harnois-Leblanc
- Department of Metabolic and Cardiovascular Health, Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada.,Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada.,Department of Population Health, Research Center of Centre Hospitalier Universitaire de Montréal, Montreal, Quebec, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mélanie Béland
- Department of Metabolic and Cardiovascular Health, Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | - Isabelle Doré
- Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada.,Department of Population Health, Research Center of Centre Hospitalier Universitaire de Montréal, Montreal, Quebec, Canada.,School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Marie-Pierre Sylvestre
- Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada.,Department of Population Health, Research Center of Centre Hospitalier Universitaire de Montréal, Montreal, Quebec, Canada
| | - Mélanie Henderson
- Department of Metabolic and Cardiovascular Health, Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada.,Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
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7
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Fogh M, Lund MAV, Mollerup PM, Johansen MØ, Melskens RH, Trier C, Kloppenborg JT, Hansen T, Holm JC. Disturbed eating behaviours do not impact treatment response in a paediatric obesity chronic care treatment programme. J Paediatr Child Health 2020; 56:542-549. [PMID: 31693771 DOI: 10.1111/jpc.14678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 05/31/2019] [Accepted: 10/14/2019] [Indexed: 02/03/2023]
Abstract
AIM This study investigates the prevalence of disturbed eating behaviours in children and adolescents initiating obesity treatment, and how the prevalence varies with age, sex and body mass index (BMI) standard deviation score (SDS). Secondly, it examines whether the presence of disturbed eating behaviours at enrolment is associated with the degree of weight loss after 12 months of treatment. METHODS A total of 3621 patients aged 3-18 years enrolled in a multidisciplinary obesity treatment programme were studied. Follow-up data after a median of 12.4 months were available for 2055 patients. Upon entry, patients were assessed for the following disturbed eating behaviours: meal skipping, emotional eating, overeating and rapid eating. Height and weight were measured at baseline and follow-up. RESULTS At enrolment, median age was 11.4 years, median BMI SDS was 2.87, and 82.2% of patients exhibited one or more disturbed eating behaviours. The prevalence of meal skipping, emotional eating and rapid eating increased with age (P < 0.01). Patients who reported overeating or rapid eating exhibited a 0.06-0.11 higher BMI SDS at enrolment than patients without these disturbed eating behaviours (P < 0.02). After 1 year of treatment, BMI SDS was reduced in 75.7% of patients, and the median reduction was 0.24 (95% confidence interval: 0.22-0.27). Overeating was associated with a higher degree of weight loss, while meal skipping, emotional eating and rapid eating did not associate with the degree of weight loss at follow-up. CONCLUSIONS Disturbed eating behaviours were highly prevalent in children and adolescents with overweight or obesity, and varied with age and sex. After 1 year of treatment, the degree of obesity improved, regardless of the presence of disturbed eating behaviours at treatment initiation.
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Affiliation(s)
- Mette Fogh
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Morten A V Lund
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pernille M Mollerup
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark
| | - Mia Ø Johansen
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark
| | - Rikke H Melskens
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark
| | - Caecilie Trier
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,Department of Paediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Julie T Kloppenborg
- Department of Paediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jens-Christian Holm
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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8
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Martín-García M, Alegre LM, García-Cuartero B, Bryant EJ, Gutin B, Ara I. Effects of a 3-month vigorous physical activity intervention on eating behaviors and body composition in overweight and obese boys and girls. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:170-176. [PMID: 30997263 PMCID: PMC6450925 DOI: 10.1016/j.jshs.2017.09.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/25/2017] [Accepted: 07/21/2017] [Indexed: 05/21/2023]
Abstract
PURPOSE This study aims to analyze the effects of a 3-month vigorous physical activity (VPA) intervention on eating behavior and body composition in overweight and obese children and adolescents. METHODS Forty-seven participants (7-16 years) took part in the study: 28 were assigned to the intervention group (IG) (10 boys and 18 girls) and 19 in a control group (CG) (8 boys and 11 girls). Body composition (dual-energy X-ray absorptiometry), anthropometrics (body mass, height, and body mass index (BMI)), and eating behavior traits (Three-Factor Eating Questionnaire-R21C) were determined before and after the VPA intervention. RESULTS A decrease in the percentage of body fat and BMI (-2.8% and -1.8%, respectively), and an increase in most lean mass variables were found in the IG (all p ≤ 0.05). In relation to the eating behavior traits, IG subjects showed a 14% reduction in the Emotional Eating score (p = 0.04), while Cognitive Restraint score did not change after the VPA intervention. The baseline factors of the questionnaire predicted changes in body mass and fat mass variables only in the CG. CONCLUSION A 3-month VPA intervention influenced eating behaviors of overweight or obese young, especially the Emotional Eating factor, in the presence of favorable body composition changes.
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Affiliation(s)
- María Martín-García
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo 45071, Spain
| | - Luis M. Alegre
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo 45071, Spain
| | - Beatriz García-Cuartero
- Endocrinology and Diabetes Unit, Department of Pediatrics, Hospital Severo Ochoa, Legané, Madrid 28914, Spain
| | - Eleanor J. Bryant
- Division of Psychology, University of Bradford, Bradford BD7 1DP, UK
| | - Bernard Gutin
- Georgia Prevention Institute, Department of Pediatrics, Georgia Health Sciences University, Augusta, GA 30901, USA
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo 45071, Spain
- Corresponding author.
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Validation of a child version of the Three-Factor Eating Questionnaire in a Canadian sample: a psychometric tool for the evaluation of eating behaviour. Public Health Nutr 2018; 22:431-443. [PMID: 30587254 DOI: 10.1017/s136898001800349x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine score validity and reliability of a child version of the twenty-one-item Three-Factor Eating Questionnaire (CTFEQ-R21) in a sample of Canadian children and adolescents and its relationship with BMI Z-score and food/taste preferences. DESIGN Cross-sectional study. SETTING School-based. PARTICIPANTS Children (n 158), sixty-three boys (mean age 11·5 (sd 1·6) years) and ninety-five girls (11·9 (sd 1·9) years). RESULTS Exploratory factor analysis revealed that the CTFEQ-R21 was best represented by four factors with item 17 removed (CFFEQ-R20), representing Cognitive Restraint (CR), Cognitive Uncontrolled Eating (UE 1), External Uncontrolled Eating (UE 2) and Emotional Eating (EE), accounting for 41·2 % of the total common variance with good scale reliability. ANOVA revealed that younger children reported higher UE 1 and CR scores than older children, and boys who reported high UE 1 scores had significantly higher BMI Z-scores. Children with high UE 1 scores reported a greater preference for high-protein and -fat foods, and high-fat savoury (HFSA) and high-fat sweet (HFSW) foods. Higher preference for high-protein, -fat and -carbohydrate foods, and HFSA, HFSW and low-fat savoury foods was found in children with high UE 2 scores. CONCLUSIONS The study suggests that the CFFEQ-R20 can be used to measure eating behaviour traits and associations with BMI Z-score and food/taste preferences in Canadian children and adolescents. Future research is needed to examine the validity of the questionnaire in larger samples and other geographical locations, as well as the inclusion of extraneous variables such as parental eating or socio-economic status.
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Miguet M, Masurier J, Chaput JP, Pereira B, Lambert C, Dâmaso AR, Courteix D, Duclos M, Boirie Y, Thivel D. Cognitive restriction accentuates the increased energy intake response to a 10-month multidisciplinary weight loss program in adolescents with obesity. Appetite 2018; 134:125-134. [PMID: 30576727 DOI: 10.1016/j.appet.2018.12.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/19/2018] [Accepted: 12/13/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Multidisciplinary interventions have shown some merits in weight reduction strategies in youth, however, their impact on subsequent daily energy intake remains largely unknown. The aim of the present study was to evaluate the nutritional responses to a 10-month multidisciplinary intervention among adolescents with obesity, in relation to their eating behavior characteristics. METHODS Thirty-five adolescents (mean age: 13.4 ± 1.2 years) with obesity took part in a 10-month residential multidisciplinary weight loss program. Anthropometric measurements, body composition (dual-energy X-ray absorptiometry), 24-h ad libitum energy intake (weighted), eating behaviors (Dutch Eating Behavior Questionnaire) and appetite sensations (Visual Analogue Scales) were assessed on three occasions: at their arrival in the institution (T0), after 5 months (T1), and at the end of the 10-month program (T2). RESULTS The mean weight loss reached 11% of the adolescents' initial body weight, with an important inter-individual variability (-25% to +3% of their initial body weight). Results revealed sex differences change, with boys showing a higher decrease in fat mass percent and increase in fat-free mass compared with girls. Weight loss was accompanied by a significant decrease in emotional (-8.3%, p < 0.05) and external (-14.8%, p < 0.001) eating scores and a significant increase in 24-h ad libitum energy intake (+246 kcal, p < 0.001). The observed subsequent increased 24-h ad libitum energy intake at T2 compared to T0 was significantly higher in cognitively restrained eaters (+492 kcal) compared to unrestrained eaters (+115 kcal, p = 0,015). Dietary restraint score at baseline was inversely correlated with the percentage of weight loss (r = -0.44, p = 0.010). CONCLUSION A 10-month multidisciplinary weight loss intervention induced an increase in 24-h ad libitum energy intake compared to baseline, especially in cognitively restrained eaters. Moreover, initially cognitively restrained eaters tended to lose less body weight compared to unrestrained ones. These findings suggest that cognitive restriction may be a useful eating behavior characteristic to consider as a screening tool for identifying adverse responders to weight loss interventions in youth.
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Affiliation(s)
- M Miguet
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France.
| | - J Masurier
- UGECAM Nutrition Obesity Ambulatory Hospital, Clermont-Ferrand, France
| | - J P Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - B Pereira
- Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - C Lambert
- Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - A R Dâmaso
- Post Graduate Program of Nutrition, Paulista Medicine School, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 862-Vila Clementino, São Paulo, SP 04020-050, Brazil
| | - D Courteix
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France
| | - M Duclos
- CRNH-Auvergne, Clermont-Ferrand, France; Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France; INRA, UMR 1019, Clermont-Ferrand, France; University Clermont 1, UFR Medicine, Clermont-Ferrand, France
| | - Y Boirie
- CRNH-Auvergne, Clermont-Ferrand, France; INRA, UMR 1019, Clermont-Ferrand, France; University Clermont 1, UFR Medicine, Clermont-Ferrand, France; Department of Human Nutrition, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France
| | - D Thivel
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France
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11
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Banna JC, Panizza CE, Boushey CJ, Delp EJ, Lim E. Association between Cognitive Restraint, Uncontrolled Eating, Emotional Eating and BMI and the Amount of Food Wasted in Early Adolescent Girls. Nutrients 2018; 10:nu10091279. [PMID: 30201904 PMCID: PMC6164919 DOI: 10.3390/nu10091279] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 11/16/2022] Open
Abstract
Understanding of behavioral factors associated with obesity is of importance in addressing this issue. This study examined the association between cognitive restraint, uncontrolled eating, emotional eating and body mass index (BMI) and amount of food plated, consumed, leftovers, and leftover food thrown into the trash (food wasted) in early adolescent girls nine to 13 years in O'ahu, Hawai'i (n = 93). Food plated, consumed, leftovers, and food wasted were estimated using a three-day mobile food record™ (mFR). Weight and height were measured to compute BMI (kg/m²). The three-factor eating questionnaire provided a score from 0 to 100 for cognitive restraint, uncontrolled eating, and emotional eating. Higher scores are indicative of greater cognitive restraint, uncontrolled eating, and emotional eating. Pearson's correlations were computed to examine the relationship between three factor eating scores and BMI. General linear models were conducted to examine the effect of each of three-factor eating scores on food plated, consumed, leftovers, and food wasted. Cognitive restraint was positively correlated with BMI (r = 0.36, p < 0.001) and with BMI z-score (r = 0.40, p < 0.001). There were no associations between three-factor eating scores and food plated, consumed, leftovers, and food wasted at lunch. However, at dinner, total energy plated, left over, and food wasted increased by 4.24 kcal/day (p = 0.030), 1.67 kcal/day (p = 0.002), and 0.93 kcal/day (p = 0.031), respectively, with a unit increase in uncontrolled eating score. Similarly, total energy plated and energy left over at dinner increased by 3.40 kcal/day (p = 0.045) and 1.51 kcal/day (p = 0.001), respectively, with a unit increase in emotional eating score. Additional research should examine the specific roles of cognitive restraint, uncontrolled eating, emotional eating and food waste in the development of obesity in adolescents.
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Affiliation(s)
- Jinan C Banna
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai'i at Manoa, Honolulu, HI 96822, USA.
| | - Chloe E Panizza
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai'i at Manoa, Honolulu, HI 96822, USA.
| | - Carol J Boushey
- University of Hawai'i Cancer Center, Honolulu, HI 96813, USA.
| | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907-2035, USA.
| | - Eunjung Lim
- Department of Complementary & Integrative Medicine, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI 96813, USA.
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12
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Martín-García M, Vila-Maldonado S, Rodríguez-Gómez I, Faya F, Plaza-Carmona M, Pastor-Vicedo J, Ara I. The Spanish version of the Three Factor Eating Questionnaire-R21 for children and adolescents (TFEQ-R21C): Psychometric analysis and relationships with body composition and fitness variables. Physiol Behav 2016; 165:350-7. [DOI: 10.1016/j.physbeh.2016.08.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 04/30/2016] [Accepted: 08/13/2016] [Indexed: 02/04/2023]
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13
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Preliminary Finnish measures of eating competence suggest association with health-promoting eating patterns and related psychobehavioral factors in 10-17 year old adolescents. Nutrients 2015; 7:3828-46. [PMID: 26007335 PMCID: PMC4446782 DOI: 10.3390/nu7053828] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 05/13/2015] [Indexed: 01/09/2023] Open
Abstract
Eating competence is an attitudinal and behavioral concept, based on The Satter Eating Competence Model. In adults, it has been shown to be associated with a higher quality of diet. Eating competence or its association with the quality of diet has not been studied in adolescents. The aim of the current study was to explore the utility of using a preliminary Finnish translation of the ecSI 2.0 for evaluating presumed eating competence and its association with food selection, meal patterns and related psychobehavioral factors in 10–17 year old adolescents. Altogether 976 10–17 years old Finnish adolescents filled in the study questionnaire. When exploring the construct validity of ecSI 2.0, the confirmatory factor analysis (CFA) indicated acceptable model fit and all four components of the ecSI 2.0 (eating attitudes, food acceptance, internal regulation of food intake, management of eating context) correlated with each other and were internally consistent. Over half (58%) of the adolescents scored 32 or higher and were thus classified as presumably eating competent (pEC). Eating competence was associated with greater meal frequency, more frequent consumption of vegetables and fruits, and more health-promoting family eating patterns. In addition the pEC, adolescents more often perceived their body size as appropriate, had less often tried to lose weight and had a higher self-esteem and a stronger sense of coherence than the not pEC ones. Family eating patterns and self-esteem were the main underlying factors of eating competence. In conclusion, this preliminary study suggests eating competence could be a useful concept to characterize eating patterns and related behaviors and attitudes in adolescents. However, these preliminary findings need to be confirmed in further studies with an instrument fully validated for this age group.
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14
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Mäkinen M, Marttunen M, Komulainen E, Terevnikov V, Puukko-Viertomies LR, Aalberg V, Lindberg N. Development of self-image and its components during a one-year follow-up in non-referred adolescents with excess and normal weight. Child Adolesc Psychiatry Ment Health 2015; 9:5. [PMID: 25737741 PMCID: PMC4347918 DOI: 10.1186/s13034-015-0038-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 02/16/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The proportion of overweight and obese youths is high. The present study aimed to investigate the development of self-image and its components during a one-year follow-up among non-referred adolescents with excess and normal weight. Furthermore, we separately analyzed the data for girls and boys. METHODS Altogether 86 8(th) grades (41 girls and 45 boys) with a relative weight of 26% or more above the median and 91 controls (43 girls and 48 boys) with normal weight participated the follow-up. The Offer Self-Image Questionnaire, Revised (OSIQ-R) was used to assess self-image at baseline and on follow-up. In the OSIQ-R, a low total raw score implies positive adjustment, while a high raw score implies poor adjustment and a negative self-image. The study design was doubly correlated (pairs and time), and a linear mixed model was used in the statistical analysis. RESULTS In OSIQ-R total scores, a comparative improvement was observed in girls with normal weight. Among these girls, significant change scores compared to zero were seen in impulse control, social functioning, vocational attitudes, self-confidence, self-reliance, body image, sexuality, and ethical values. In girls with excess weight, none of the change scores compared to zero were statistically significant. When the girls with normal and excess weight were compared, the difference in change scores was largest in sexuality and vocational attitudes. Change scores compared to zero were significant in sexuality and idealism for boys with excess weight, and in impulse control, mental health, self-reliance, and sexuality for normal weight boys. When the boys with excess and normal weight were compared, no statistically significant differences emerged in change scores. CONCLUSION In mid-adolescent girls, the influence of overweight and obesity on the development of self-image is substantial. Weight management programs directed at overweight adolescent girls should include psychological interventions aiming to diminish self-image distress, especially that associated with feelings, attitudes, and behavior towards the opposite sex, as well as future career plans.
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Affiliation(s)
- Mauno Mäkinen
- />Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mauri Marttunen
- />Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- />National Institute for Health and Welfare, Helsinki, Finland
| | - Erkki Komulainen
- />Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Viacheslav Terevnikov
- />Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Veikko Aalberg
- />Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nina Lindberg
- />Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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15
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Jáuregui-Lobera I, García-Cruz P, Carbonero-Carreño R, Magallares A, Ruiz-Prieto I. Psychometric properties of Spanish version of the Three-Factor Eating Questionnaire-R18 (Tfeq-Sp) and its relationship with some eating- and body image-related variables. Nutrients 2014; 6:5619-35. [PMID: 25486370 PMCID: PMC4276988 DOI: 10.3390/nu6125619] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 09/22/2014] [Accepted: 11/07/2014] [Indexed: 11/29/2022] Open
Abstract
The aims of this study were to analyze the psychometric properties of the Spanish version of the Three-Factor Eating Questionnaire-R18 (TFEQ-SP), as well as determine its validity by evaluating the relationship of the TFEQ-SP with different parameters related to body mass index, weight perception, perception of physical fitness, self-esteem, and food intake, as well as with weight control-related variables. A total of 281 participants (aged 18.38 ± 6.31) were studied. The factor analysis yielded three factors: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). The internal consistency of the TFEQ-SP was determined by means of Cronbach’s α coefficient, with values ranging between 0.75 and 0.87. Higher scores on CR were found in women (p < 0.5), overweight/obese participants (p < 0.001), participants with lower self-esteem (p < 0.05), participants who overestimated their weight (p < 0.001), participants who weighed themselves frequently (p < 0.001) and those who were about to go on a diet (p < 0.001). Higher EE scores were found in participants with lower self-esteem scores (p < 0.05), among participants with a poorer perception of their physical fitness (p < 0.01) and when participants were about to diet (p < 0.05). Higher scores on UE were observed in case of poorer perception of physical fitness (p < 0.05). The validation study of the TFEQ-SP meets the requirements for measuring the three different facets of eating behavior: CR, UE, and EE.
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Affiliation(s)
- Ignacio Jáuregui-Lobera
- Department of Molecular Biology and Biochemistry Engineering (Nutrition and Bromatology), Pablo de Olavide University, Carretera de Utrera s/n, Seville 41013, Spain.
| | | | | | - Alejandro Magallares
- Social Psychology Department, School of Psychology, Spanish Open University (UNED), Madrid 28040 Spain.
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