Measurement of dietary restraint: validity tests of four questionnaires

Uncontrolled vaping and restraint strategies: A qualitative study

INTRODUCTION

Little is known about uncontrolled vaping, defined as vaping more than the user prefers. We sought to understand e-cigarette users' experiences with uncontrolled vaping and how they restrain their vaping.

METHODS

Participants were 24 US adult e-cigarette users recruited in 2021. We conducted semi-structured qualitative interviews about uncontrolled vaping and restraint strategies and analyzed findings based on behavioral categories described in the Process Model of Self-Control.

RESULTS

While most participants (21 of 24) described experiences of uncontrolled vaping, some expressed ambivalence about how much they vaped. To restrain vaping, willpower was rarely used and was not perceived as effective. Distraction, deployment of attention away from the urge to vape, and reappraisal, thinking differently about vaping such as reminding oneself of health consequences, were common and helped some participants limit use in the moment of wanting to vape. Participants described using both situation selection, choosing to be in situations where e-cigarette use was less possible, and situation modification, modifying their circumstances to restrict opportunities to vape.

DISCUSSION

Uncontrolled vaping is not yet a well-defined concept for many e-cigarette users. E-cigarette users employed proactive situational strategies that required planning ahead to restrain use and found these strategies more effective compared to reactive strategies. Tobacco control programs and interventions should consider leveraging restraint strategies that people who vape are naturally using and perceive to be effective.

Can eating behaviour traits be explained by underlying, latent factors? An exploratory and confirmatory factor analysis

Eating Behaviour Traits (EBTs) are psychological constructs developed to explain patterns of eating behaviour, including factors that motivate people to (over or under) eat. There is a need to align and clarify their unique contributions and harmonise the understanding they offer for human eating behaviour. Therefore, the current study examined whether 18 commonly cited EBTs could be explained by underlying, latent factors (domains of eating behaviour). An exploratory factor analysis (EFA) was used to identify latent factors, and these factors were validated using a confirmatory factor analysis (CFA). 1279 participants including the general public and members of a weight management programme were included in the analysis (957 females, 317 males, 3 others, 2 prefer not to say), with a mean age of 54 years (median = 57 years, SD = 12.03) and a mean BMI of 31.93 kg/m2 (median = 30.86, SD = 6.00). The participants completed 8 questionnaires which included 18 commonly cited EBTs and the dataset was split at random with a 70/30 ratio to conduct the EFA (n = 893) and CFA (n = 383). The results supported a four-factor model which indicated that EBTs can be organised into four domains: reactive, restricted, emotional, and homeostatic eating. The four-factor model also significantly predicted self-reported BMI and weight change. Future research should test whether this factor structure is replicated in more diverse populations, and including other EBTs, to advance these domains of eating as a unifying framework for studying individual differences in human eating behaviour.

Reliability of the original and brief versions of the Eating Disorder Examination in binge-eating disorder

OBJECTIVE

Psychometric studies evaluating the reliability of eating-disorder assessment among individuals with binge-eating disorder (BED) have been limited. The current study documents the interrater reliability and internal consistency of the Eating Disorder Examination (EDE) interview when administered to adults with Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5)-defined BED.

METHODS

Participants (N = 56) were adults seeking treatment for BED in the context of clinical trials testing pharmacological and psychological treatments. Doctoral-level, trained, and supervised clinical researchers evaluated eating-disorder psychopathology using the EDE interview and audio-recorded the interview. A second doctoral-level, trained, and supervised clinical researcher, who did not conduct the initial assessment, coded eating-disorder psychopathology using the audio recording.

RESULTS

Agreement among raters on the number of binge-eating episodes was near perfect. There was excellent interrater reliability for nearly all scales of the EDE interview. Agreement among raters for behavioral indicators of loss of control and marked distress regarding binge eating ranged from moderate to perfect. Internal consistency was variable for all scales, ranging from unacceptable to good.

CONCLUSIONS

Our study suggests that the EDE can be administered reliably by multiple interviewers to assess adults with BED. However, internal consistency was mostly subpar. Tests of reliability and other psychometric properties (e.g., validity) in other patient groups such as children with BED are warranted.

My Diet Study: protocol for a two-part observational, longitudinal, psycho-biological study of dieting in Australian youth

Introduction

Self-directed dieting (i.e., unsupervised) is very common among adolescents and young adults but has had almost no direct research. This paper describes the protocol for the My Diet Study, a two-arm observational investigation of the natural progression of dieting among young people over a period of 6-months. The study aims to examine the links between self-directed dieting, general physiological and psychological metrics of wellbeing (e.g., depressive symptoms) and biomarkers of gut-brain axis functions (e.g., microbiome and hormones) that are predicted to influence diet adherence through appetite, mood and metabolism regulation.

Methods

Young people aged 16-25, intending to start a diet will be invited to participate in this observational study. For Part 1 (psychological arm), participants will be asked to complete a set of questionnaires and diaries at the beginning of every month for 6 months, to assess overall mental (e.g., psychological distress, disordered eating) and physical (e.g., weight) health, perceived diet success, food intake and gastrointestinal movements. For Part 2 (biological arm), a subsample of 50 participants will be asked to provide feces, blood and saliva for bio-sampling each month for the first 3-months of their participation in Part 1.

Discussion

The My Diet Study will be the first longitudinal, observational study of dieting in young people combining in-depth psychological and biological data. It is anticipated that the findings will yield psychological & biological information about the impacts and effectiveness of self-directed dieting in young people, inform a framework for advice on safety in dieting among young people and help to establish the potential for biomarkers for risk management and improvement of diet-based lifestyle interventions.

To Eat or Not to Eat-A Qualitative Exploration and Typology of Restrictive Dietary Practices among Middle-Aged and Older Adults

Favorable diets often include restrictive practices that have proven health benefits, even if initiated later in life. The aim of this qualitative study is to gain a comprehensive understanding of Restrictive Dietary Practices (RDPs) among a sample of middle-aged and older German adults (aged 59-78 years). We conducted 24 narrative in-depth interviews and analyzed the data using qualitative content analysis (Kuckartz). Following an inductive thematic approach, a typology was reconstructed comprising four typical RDP characteristics: I. The Holistically Restraining Type, II. The Dissonant-savoring Restraining Type, III. The Reactively Restraining Type, and IV. The Unintentionally Restraining Type. These types differed regarding the practical implementation of, e.g., restrictive food choice into everyday routines, barriers to do so, as well as with respect to attitudes and motives underlying RDPs. The major motives for adopting a RDP involved health, well-being, ethical, and ecological concerns. The most prominent barriers to a 'successful' adoption of RDPs were the enjoyment of food and the desire for spontaneity and freedom of (food) choice. Our study offers an in-depth understanding of the aspects that shape the widespread practice of dietary restriction among middle-aged and older adults. Lifeworld-related changes in RDPs and possible 'type shiftings' are discussed as well as the meaning and chances of RDPs for public health promotion.

Eating behavior dimensions and 9-year weight loss maintenance: a sub-study of the Finnish Diabetes prevention study

BACKGROUND

Behavioral processes through which lifestyle interventions influence risk factors for type 2 diabetes (T2DM), e.g., body weight, are not well-understood. We examined whether changes in psychological dimensions of eating behavior during the first year of lifestyle intervention would mediate the effects of intervention on body weight during a 9-year period.

METHODS

Middle-aged participants (38 men, 60 women) with overweight and impaired glucose tolerance (IGT) were randomized to an intensive, individualized lifestyle intervention group (n = 51) or a control group (n = 47). At baseline and annually thereafter until nine years body weight was measured and the Three Factor Eating Questionnaire assessing cognitive restraint of eating with flexible and rigid components, disinhibition and susceptibility to hunger was completed. This was a sub-study of the Finnish Diabetes Prevention Study, conducted in Kuopio research center.

RESULTS

During the first year of the intervention total cognitive (4.6 vs. 1.7 scores; p < 0.001), flexible (1.7 vs. 0.9; p = 0.018) and rigid (1.6 vs. 0.5; p = 0.001) restraint of eating increased, and body weight decreased (-5.2 vs. -1.2 kg; p < 0.001) more in the intervention group compared with the control group. The difference between the groups remained significant up to nine years regarding total (2.6 vs. 0.1 scores; p = 0.002) and rigid restraint (1.0 vs. 0.4; p = 0.004), and weight loss (-3.0 vs. 0.1 kg; p = 0.046). The first-year increases in total, flexible and rigid restraint statistically mediated the impact of intervention on weight loss during the 9-year study period.

CONCLUSIONS

Lifestyle intervention with intensive and individually tailored, professional counselling had long-lasting effects on cognitive restraint of eating and body weight in middle-aged participants with overweight and IGT. The mediation analyses suggest that early phase increase in cognitive restraint could have a role in long-term weight loss maintenance. This is important because long-term weight loss maintenance has various health benefits, including reduced risk of T2DM.

Effect of food cues on time perception: influence of calories and diet control

The aim of this study was to investigate the influence on individuals' time perception of observing a range of foods differing in calorific content. In a first experiment, 92 adult participants performed a temporal bisection task with stimulus durations presented in the form of high- or low-calorie food pictures as well as matched non-food control pictures. In a second experiment, 102 participants performed a strict replication of Experiment 1, without the low-calorie pictures condition as it showed less pronounced effects. Across the two experiments, the data revealed common results. An overestimation of time was observed in relation to high-calorie food pictures when compared with non-food pictures (Experiment 2), and the effect was a function of participants' diet control (Experiments 1 & 2). Contrary to our hypothesis, the more the participants reported controlling their diet, the less they overestimated the time when presented with food stimuli. The participants who controlled their diet reported being less aroused by the high-calorie food pictures, allowing the assumption that the modulation in time overestimation relies on the arousal response generated by high-calorie food pictures.

The Complicated Relationship between Dieting, Dietary Restraint, Caloric Restriction, and Eating Disorders: Is a Shift in Public Health Messaging Warranted?

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.

Identification of instruments for evaluation of behavioural and psychological parameters associated with obesity management: A systematic review with narrative synthesis of the findings

BACKGROUND AND AIMS

To identify instruments used to evaluate the predictors of successful weight loss across weight loss trials.

METHODS

We searched PubMed, PsychInfo, Cochrane Reviews and Scopus for weight loss trials reporting instruments published in the last 16 years.

RESULTS

A total of 46 significant behavioral and psychological predictors were identified, of which 32 instruments were finally selected. SF-36 questionnaire and Obesity Related Problem Scale for psychosocial health, TREMORE scale for motivation, Social Support Scale for support, Weight Efficacy Lifestyle Scale for self-efficacy and Body Shape Questionnaire for body image had moderate quality. Barriers to healthy eating questionnaire scale and Dutch Eating Behavior also had moderate quality.

CONCLUSION

Use of uniform instruments with optimum quality can benefit clinical and community-based researchers to generate reliable datasets.

A meta-analysis of the relationship between eating restraint, impaired cognitive control and cognitive bias to food in non-clinical samples

AIM

Food restriction is argued to be a precursor for unhealthy preoccupation with food, possibly leading to the development of an eating disorder. We updated previous meta-analyses that examined the relationship between eating restraint and deficits in either general or food-related attentional and inhibitory control. We hypothesized that inconsistencies in the literature around eating restraint, impaired cognitive control, impulsivity and cognitive biases for food could be attributed to the scale used to measure eating restraint.

METHOD

A (preregistered) subgroup meta-analysis examined whether patterns of impaired cognitive control and cognitive bias for food in predominantly healthy (non-clinical) samples differed as a function of the scale used to measure eating restraint. A series of exploratory meta-analyses were carried out for specific attentional bias tasks. In total 57 datasets were included.

RESULTS

The subgroup analysis did not provide evidence that the relationship between eating restraint and impaired or biased cognitions differed significantly as a function of restraint scale. Heterogeneity across studies was high. When examining specific attentional bias tasks there was no evidence that increased eating restraint was associated with increased attentional bias or distraction by food cues, regardless of which scale was used to measure eating restraint.

CONCLUSIONS

There is little experimental evidence for the common narrative that increased eating restraint is related to impaired cognitive control generally or increased cognitive bias for food, in non-clinical samples.

Using psycho‐behavioral phenotyping for overweight and obesity: Confirmation of the 6 factor questionnaire

Objective

Methods

Results

Conclusions

Restrained eating in Lebanese adolescents: scale validation and correlates

BACKGROUND

Restrained eating disorder is prevalent worldwide across both ethnic and different cultural groups, and most importantly within the adolescent population. Additionally, comorbidities of restrained eating present a large burden on both physical and mental health of individuals. Moreover, literature is relatively scarce in Arab countries regarding eating disorders, let alone restrained eating, and among adolescent populations; hence, the aim of this study was to (1) validate the Dutch Restrained Eating Scale in a sample of Lebanese adolescents and (2) assess factors correlated with restrained eating (RE), while taking body dissatisfaction as a moderator between body mass index (BMI) and RE.

METHODS

This cross-sectional study, conducted between May and June 2020 during the lockdown period imposed by the Lebanese government, included 614 adolescents aged between 15 and 18 years from all Lebanese governorates (mean age of 16.66 ± 1.01 years). The scales used were: Dutch Restrained Eating Scale, body dissatisfaction subscale of the Eating Disorder Inventory-Second version, Rosenberg Self-Esteem Scale, Beirut Distress Scale (for psychological distress), Hamilton Anxiety Rating Scale and Patient Health Questionnaire (for depression).

RESULTS

The factor analysis yielded a one-factor solution with Eigen values > 1 (variance explained = 59.65 %; α_Cronbach = 0.924). Female gender (B = 0.19), higher BMI (B = 0.49), higher physical activity index (B = 0.17), following a diet to lose weight (B = 0.26), starving oneself to lose weight (B = 0.13), more body dissatisfaction (B = 1.09), and higher stress (B = 0.18) were significantly associated with more RE, whereas taking medications to lose weight (B=-0.10) was significantly associated with less RE. The interaction body mass index (BMI) by body dissatisfaction was significantly associated with RE; in the group with low BMI, higher body dissatisfaction was significantly associated with more RE.

CONCLUSIONS

Our study showed that the Dutch Restrained Eating scale is an adapted and validated tool to be used among Lebanese adolescents and revealed factors associated with restrained eating in this population. Since restrained eating has been associated with many clinically-diagnosed eating disorders, the results of this study might serve as a first step towards the development of prevention strategies targeted towards promoting a healthy lifestyle in Lebanese adolescents.

Effects of caloric restriction on human physiological, psychological, and behavioral outcomes: highlights from CALERIE phase 2

Caloric restriction (CR) is a strategy that attenuates aging in multiple nonhuman species. The Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) trials are part of a research program aiming to test the effects of CR on aging and longevity biomarkers in humans. Building on CALERIE phase 1, CALERIE phase 2 (CALERIE 2) was the largest study to date to assess sustained CR in healthy humans without obesity. In a 24-month randomized controlled trial comprising 218 participants at baseline, CALERIE 2 showed that moderate CR, 11.9% on average, induced improvements in aging-related biomarkers without adversely affecting psychological or behavioral outcomes. The objectives of this report are to summarize and review the highlights of CALERIE 2 and report previously unpublished results on eating disorder symptoms and cognitive function. This article specifically summarizes the physiological, psychological, aging, behavioral, and safety results of the trial. Also provided are research directions beyond CALERIE 2 that highlight important opportunities to investigate the role of CR in aging, longevity, and health span in humans.

Mechanisms of Action in a Behavioral Weight-Management Program: Latent Growth Curve Analysis

Background

A greater understanding of the mechanisms of action of weight-management interventions is needed to inform the design of effective interventions.

Purpose

To investigate whether dietary restraint, habit strength, or diet self-regulation mediated the impact of a behavioral weight-management intervention on weight loss and weight loss maintenance.

Methods

Latent growth curve analysis (LGCA) was conducted on trial data in which adults (N = 1,267) with a body mass index (BMI) ≥28 kg/m² were randomized to either a brief intervention (booklet on losing weight), a 12 week weight-management program or the same program for 52 weeks. LGCA estimated the trajectory of the variables over four time points (baseline and 3, 12 and 24 months) to assess whether potential mechanisms of action mediated the impact of the weight-management program on BMI.

Results

Participants randomized to the 12 and 52 week programs had a significantly greater decrease in BMI than the brief intervention. This direct effect became nonsignificant when dietary restraint, habit strength, and autonomous diet self-regulation were controlled for. The total indirect effect was significant for both the 12 (estimate = −1.33, standard error [SE] = 0.41, p = .001) and 52 week (estimate = −2.13, SE = 0.52, p < .001) program. Only the individual indirect effect for dietary restraint was significant for the 12 week intervention, whereas all three indirect effects were significant for the 52 week intervention.

Conclusions

Behavior change techniques that target dietary restraint, habit strength, and autonomous diet self-regulation should be considered when designing weight loss and weight loss maintenance interventions. Longer interventions may need to target both deliberative and automatic control processes to support successful weight management.

The Relationship Between Pre-Pregnancy Attempts to Lose Weight and Gestational Weight Gain: An Exploratory Primary Care Prospective Cohort Study

OBJECTIVE

The primary objective of this study was to explore the association between weight cycling in the 6 months prior to pregnancy and gestational weight gain concordance with the 2009 Institute of Medicine guidelines for weight gain in pregnancy.

METHODS

This was a prospective cohort study. Participants were women aged 18 years or older with a singleton pregnancy who had a prenatal appointment between April 1 and August 31, 2019. Eligible women completed a questionnaire that assessed their pre-pregnancy attempts to lose weight, measured with a modified version of the Weight Cycling subscale within the Revised Restraint Scale. After delivery, participants' last recorded gestational weight before delivery, and corresponding gestational ages were obtained from prenatal records.

RESULTS

One hundred and ninety-five pregnant women consented to participate in the study (a 95.6% response rate). Of them, 5 were excluded; therefore, 190 participants were included in the analysis. One-third of participants had attempted to lose weight in the 6 months before pregnancy. Logistic regression showed that for every one-unit increase in Weight Cycling score, the odds of excess gestational weight gain increased by a factor of 1.32.

CONCLUSION

Women's pre-conceptual efforts to enter pregnancy at a lower BMI should be approached in a manner that avoids pre-pregnancy weight cycling.

The effect of restrained eating on acute stress-induced food intake in people with obesity

Restrained eating, defined as a form of intense dieting or restrictive food intake of specific macronutrients or types of food with sporadic episodes of overeating, results in an increased risk of overweight and obesity. Acute stress situations cause irregular eating patterns and are connected to restrained eating. Therefore, the present study investigates the effect of high/low restrained eating on eating behavior in people with obesity after standardized acute stress induction as well as resting condition. Fifty men and women with obesity (BMI: 33.62 ± 3.93 kg/m²) were categorized into high restrained eaters (HRE) and low restrained eaters (LRE). The total energy intake was measured during a standardized laboratory meal after a resting and stress condition (Trier Social Stress Test) on two separate days. HRE and LRE showed differences in the total energy intake in response to acute stress but not after resting condition (F_{(1, 47)} = 9.188, p = .004, η2 = 0.164). Lower total energy intake after stress compared to resting condition could be observed in HRE (t (23) = -2.617, p = .015). LRE showed higher total energy intake after stress than after resting condition (t (25) = 2.155, p = .041). The present data suggest that restrained eating behavior might be an influencing factor for stress-induced eating in obesity. It is highly necessary to understand the association between restrained eating behavior, acute stress and obesity for the improvement of the behavioral intervention of dietary restriction.

Modeling of food intake among restrained and unrestrained eaters

The Theory of Normal Eating suggests that how much others eat sets an upper limit for how much it is appropriate to eat. This study tested the hypothesis that restrained eaters, who typically eat less than they want to, would be more responsive to a high-intake norm than would unrestrained eaters. Data were combined from 8 experimental studies (total N = 735 female participants; 305 restrained eaters, 430 unrestrained eaters). Each study: (a) included a low-intake norm, a high-intake norm, and a no-norm control condition; (b) measured participants' food intake; and (c) included the Restraint Scale as a measure of dietary restraint. There were no differences between restrained unrestrained eaters in the no-norm control condition or in the magnitude of the inhibition effect (i.e., the difference between the low-intake norm condition and the control condition). There was, however, a restraint difference in the magnitude of the augmentation effect (i.e., the difference between the high-intake norm condition and the control condition). Restrained eaters showed a larger augmentation effect (d = 0.58; 95% CI = 0.29, 0.87) than did unrestrained eaters (d = 0.20; 95% CI = -0.05, 0.45). Social norms provide an upper limit for acceptable food intake, with high-intake norms permitting (but not requiring) individuals to indulge themselves. The fact that restrained eaters were more responsive to the high-intake norm than were unrestrained eaters suggests that the high-intake norm gives restrained eaters permission to indulge when they typically eat less than they want to.

The Three-Factor Eating Questionnaire-R21: a confirmatory factor analysis in a Portuguese sample

The Three-Factor Eating Questionnaire (TFEQ) is one of the most widely used instruments to study different eating behaviors. It measures three types of eating behaviors namely: cognitive restraint, uncontrolled eating and emotional eating. The present study aims to evaluate the factor structure and reliability of the Portuguese version of the TFEQ-R21, using a confirmatory factor analysis (CFA). The sample includes 468 participants from the general population, with ages ranging from 18 to 60 years. Results from the CFA confirmed the TFEQ-R21 three-factor structure and the model revealed an acceptable fit to the data (χ²(186) = 443.211, p < 0.001; χ²/df = 2.329; CFI = 0.933; TLI = 0.925; RMSEA = 0.054; SMRS = 0.053). Multi-group analysis results support strong measurement invariance across genders. Furthermore, all three dimensions presented adequate psychometric properties. Overall, results support that the Portuguese version of the TFEQ-R21 is a useful, reliable and robust instrument to assess relevant eating behaviors.Level of evidence V, descriptive studies.

Change in self-efficacy, eating behaviors and food cravings during two years of calorie restriction in humans without obesity

Calorie restriction (CR) enhances longevity in humans who are normal weight, overweight and obese. While dietary regimens can change self-efficacy, eating behaviors, and food cravings in individuals with obesity, the responses of these measures to prolonged CR in individuals who are exclusively not obese is unknown. The aim of this analysis was to test the effects of a two-year CR intervention on self-efficacy and eating attitudes and behaviors in humans without obesity by analyzing data from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy Phase 2 (CALERIE 2) study. Participants (n = 218, BMI range = 21.3-29.0 kg/m2) were randomized to a 25% CR group or an ad libitum (AL) group. Eating attitudes and behaviors and self-efficacy were assessed using validated questionnaires at baseline, month 12, and month 24. Dietary restraint and self-efficacy increased in the CR compared to the AL group (ES ≥ 0.32). Increased self-efficacy was negatively related to weight change (ρ < -0.24). In the CR group, males showed a reduction in cravings for carbohydrates and fats at month 24, whereas females did not. The CR group showed elevations in state hunger, which were transient, and disinhibited eating (ES ≥ 0.37). In individuals without obesity, dietary restraint and self-efficacy could be important in promoting long-term CR for individuals looking to use CR as a tool to improve longevity.

Target-related autobiographical memories affect dietary intake intentions

Although there is evidence that autobiographical memory (AM) recall impacts behaviour in multiple domains, the mechanisms for this effect are unclear. Two experiments examined how AM Frame and Relatedness to target behaviour affect intention to control future dietary intake. Participants completed an AM task where they recalled success or fail-framed memories of behaviour in the target domain (dietary intake), a related domain (exercise), and an unrelated domain (work). Next they completed questionnaires about attitudes, self-efficacy, and behavioural intention for controlling dietary intake. In Experiment 1, Frame and Relatedness of AMs recalled did not affect attitudes or self-efficacy ratings of controlling dietary intake. However, Related AMs resulted in higher intention ratings to control future dietary intake compared to Unrelated AMs. Experiment 2 replicated these results for attitude and self-efficacy, but showed no effect on behavioural intention. A mini-meta analysis was conducted to clarify the effect of AM recall on intention. This analysis confirmed a significant effect of AM Relatedness on intention ratings (meta-analysis Cohen's d = .25, Z = 2.54, p = .011). These results provide evidence that recalling related AM can affect dietary behaviour intentions directly, without changes attitudes or ratings of personal control regarding dietary intake.

Eating Behaviors in Healthy Young Adult Twin Pairs Discordant for Body Mass Index

We aimed to study the eating behavioral traits that associate with body mass index (BMI) among BMI-discordant twin pairs. This cross-sectional study examined self-reported eating behaviors in 134 healthy young adult twin pairs (57 monozygotic [MZ] and 77 same-sex dizygotic [DZ]), of whom 29 MZ and 46 DZ pairs were BMI discordant (BMI difference ≥ 3 kg/m2). In both MZ and DZ BMI-discordant pairs, the heavier co-twins reported being less capable of regulating their food intake optimally than their leaner co-twins, mainly due to ‘frequent overeating’. Furthermore, the heavier co-twins reported augmented ‘disinhibited eating’, ‘binge-eating scores’ and ‘body dissatisfaction’. The twins agreed more frequently that the heavier co-twins (rather than the leaner co-twins) ate more food in general, and more fatty food, in particular. No significant behavioral differences emerged in BMI-concordant twin pairs. Overeating — measured by ‘frequent overeating’, ‘disinhibited eating’ and ‘binge-eating score’ — was the main behavioral trait associated with higher BMI, independent of genotype and shared environment.

Do restrained eaters show increased BMI, food craving and disinhibited eating? A comparison of the Restraint Scale and the Restrained Eating scale of the Dutch Eating Behaviour Questionnaire

Despite being used interchangeably, different measures of restrained eating have been associated with different dietary behaviours. These differences have impeded replicability across the restraint literature and have made it difficult for researchers to interpret results and use the most appropriate measure for their research. Across a total sample of 1731 participants, this study compared the Restraint Scale (RS), and its subscales, to the Dutch Eating Behaviour Questionnaire (DEBQ) across several traits related to overeating. The aim was to explore potential differences between these two questionnaires so that we could help to identify the most suitable measure as a prescreening tool for eating-related interventions. Results revealed that although the two measures are highly correlated with one another (rs = 0.73-0.79), the RS was more strongly associated with external (rs = -0.07 to 0.11 versus -0.18 to -0.01) and disinhibited eating (rs = 0.46 versus 0.31), food craving (rs = 0.12-0.27 versus 0.02-0.13 and 0.22 versus -0.06) and body mass index (rs = 0.25-0.34 versus -0.13 to 0.15). The results suggest that, compared to the DEBQ, the RS is a more appropriate measure for identifying individuals who struggle the most to control their food intake.

Internalised Weight Stigma Moderates the Impact of a Stigmatising Prime on Eating in the Absence of Hunger in Higher- but Not Lower-Weight Individuals

A considerable body of evidence links internalised weight stigma with higher levels of disordered eating behaviour and cognitions in both normative- and higher-weight populations. However, to date, the impact of internalised weight stigma on objectively measured food intake has not been explored. In the present study, a weight-diverse sample of 158 non-smoking adults (BMI ≥ 25 kg/m2 n = 72, BMI < 25 kg/m2 n = 86) were recruited to a study on "The effects of hunger and satiety on information processing." Participants first completed a series of online questionnaires, then attended a lab visit in a fed state. Participants were randomised to read a sham news article on the negative consequences of either weight (stigma condition) or smoking (control condition) and answer some questions about the article. Then, under the pretence of a non-study-relevant break, participants were exposed to a pre-weighed selection of sweet and savoury snacks for 15 min. Mood and hunger levels were assessed prior to and after reading the vignette, and after the break. In contrast to the relationship with self-report eating behaviour, internalised weight stigma was not a significant independent predictor of total energy intake and did not moderate the relationship between exposure to the stigma prime and calories consumed. However, differences emerged on the basis of participants' weight status. Higher-weight participants with high levels of internalised weight stigma consumed fewer snack calories following exposure to a weight-stigma prime compared with a neutral prime (B = -137, SE = 58, t = -2.35, p = 0.020, 95% CI -252, -22) whereas those with low levels of internalised weight stigma tended to eat more in the weight stigma condition (B = 118, SE = 62, t = 1.91, p = 0.059, 95% CI -4, 241). In normative-weight participants, no differences in energy intake by levels of internalised weight stigma were observed. These findings suggest differences in the relationships between internalised weight stigma and self-reported disordered eating behaviour versus eating in the absence of hunger (EAH) measured under laboratory conditions. Additionally, internalised weight stigma appears to have differential effects on response to stigma in higher-weight and normative-weight individuals.

A network analysis of psychological, personality and eating characteristics of people seeking bariatric surgery: Identification of key variables and their prognostic value

OBJECTIVE

The interplay among personality traits, anxiety and eating symptoms in candidates for bariatric surgery has never been investigated through the network analysis approach. Thus, we aimed to use this method to identify the key psychological traits that characterize these individuals and to assess their role as predictors of surgical outcomes.

METHODS

One-hundred-eighty-five candidates for bariatric surgery filled in the State Trait Anxiety Inventory (STAI), the Revised Restraint Scale, the Power of Food Scale and the Temperament and Character Inventory-Revised (TCI-R) questionnaires. All these variables were included in a network analysis. Then, the most central network nodes were entered as independent variables in a regression model that included 9-month follow-up weight outcomes as the dependent variable.

RESULTS

The network has showed a good stability. TCI-self directedness and harm avoidance scores and STAI state and trait anxiety scores were the nodes with the highest centrality in the network. Weight outcomes were assessed in 64 patients at follow-up. Among central nodes, low TCI-self directedness was found to be the only significant independent predictor of worse weight outcome.

CONCLUSIONS

Our findings show for the first time the interplay between personality traits and symptoms in candidates for bariatric surgery combining the network approach with a follow-up evaluation. Low self-directedness has been proved to be the node with highest centrality and the only predictor of short-term weight outcome. These data suggest the importance to take into consideration personality and psychological variables either in the pre-surgery assessment or as possible targets for pre or post-surgery psychotherapeutic interventions.

ORCID

0000-0002-6786-4458.

Snack selection influences glucose metabolism, antioxidant capacity and cholesterol in healthy overweight adults: A randomized parallel arm trial

Including carbohydrate/fructose-rich foods (predominantly fruit) in the diets of overweight individuals can improve chronic disease risk factors. We hypothesized dried plums (DP) would improve nutrient consumption, total antioxidant capacity (TAC), lipid and adipokine profiles, and would decrease adiposity and inflammation. To test this, we studied the effects of 8-weeks of twice-daily snacking of macronutrient-matched 100kcal servings of DP or refined carbohydrate-rich snack (low-fat muffins: LFM) on daily energy and nutrient consumption, and chronic disease risk factors in overweight adults. Body weight/composition, waist circumference, blood pressure, plasma glucose, insulin, c-peptide, lipids, TAC, adipokines and inflammation were measured at baseline and throughout the study. Postprandial glucose and insulin were assessed following assigned test foods at baseline and 8-weeks. Repeated measures ANOVAs were undertaken to examine group and time differences. Post-hoc independent and paired samples t-tests were conducted where necessary. DP increased (P<.05) overall intake of dietary fiber and potassium, and TAC, from baseline to 8-weeks. Baseline postprandial glycemia tended (P=.09) to be lower with DP versus LFM, while both groups had a decreased response after 8-weeks. Postprandial insulinemia was lower (P<.05) for DP at both time-points. No differences in body weight/composition, blood pressure, or fasting glucose, insulin, triglycerides, total cholesterol, HDL-C, inflammation or adipokines were detected. Low-density lipoprotein cholesterol (LDL-C) increased (P<.05) throughout the trial following LFM. Overall, DP lessened postprandial insulinemia, improved nutrient consumption and plasma TAC, and maintained plasma LDL-C compared to a macronutrient-matched refined carbohydrate snack, which could decrease chronic disease risk.

Effect of dietary restraint and mood state on attentional processing of food cues

BACKGROUND AND OBJECTIVES

Research linking dietary restraint to attentional bias toward food cues has been equivocal, suggesting that dietary restraint may only influence attentional processing of food in certain contexts. The present study examined whether negative mood strengthens the association between dietary restraint and attention bias for food.

METHODS

Healthy female participants were randomized to either a neutral (n = 47) or negative mood (n = 49) induction. Participants then completed a visual search task featuring targets displayed adjacent to pictures of palatable food, musical instruments, or non-instrument filler objects. Attention bias for food was operationalized as shorter response latency when the target appeared adjacent to palatable food as compared to musical instruments. Attention bias was examined in a 2 (mood condition) × 2 (picture: food vs. instrument) × 2 (target location: match vs. mismatch) repeated measures ANCOVA, with dietary restraint as a continuous covariate and response latency as the dependent variable.

RESULTS

Though there was no evidence of an interaction between mood condition and dietary restraint, mood had an influence on attention allocation. Contrary to study hypotheses, individuals in the neutral mood condition, but not those in the negative mood condition, responded in a manner indicative of bias toward food.

LIMITATIONS

Additional research is necessary to validate the experimental task used in the present study to assess food-specific attentional bias.

CONCLUSIONS

Neutral mood may be associated with enhanced processing of palatable food cues. Critically, results do not support the hypothesized link between negative mood and attention bias for food.

Starting university with high eating self-regulatory skills protects students against unhealthy dietary intake and substantial weight gain over 6 months

BACKGROUND

There is consistent evidence that suggests first year students are at risk of weight gain, but the reasons for this vulnerability are still unclear. This study aimed to explore whether the ability to regulate eating behaviours is a predictor of weight and dietary changes in first year undergraduate students.

METHODS

First year undergraduate students from universities situated in London were invited to complete a survey at the beginning of the academic year and at 6-month follow-up. Each survey included the Self-Regulation of Eating Behaviour Questionnaire, food frequency questions, socio-demographic questions and anthropometric questions. Linear and logistic regressions were performed to explore the associations between baseline eating self-regulatory skills and weight and dietary changes.

RESULTS

481 first year undergraduate students took part in the study. Students who entered university with higher eating self-regulatory skills were more likely to maintain or achieve a higher fruit and vegetable (OR = 1.8, p = 0.007) and a lower sweet and salty snack (OR = 1.9, p = 0.001) intake over the course of the first 6 months in university. Higher baseline eating self-regulatory skills were also related to lower weight changes (β = -0.15, p = 0.018) and lower likelihood of gaining 5% initial body weight (OR = 0.52, p = 0.006) at 6-month. Additionally, self-regulatory skills moderated the relationship between baseline BMI and weight changes (β = -0.25, p ≤0.001) and between baseline BMI and 5% weight gain (OR = 0.82, p = 0.008).

CONCLUSIONS

Starting university with higher eating self-regulatory skills may help students to maintain or achieve a healthy diet and protect them against substantial weight gain, especially among students with overweight.

Features and Trajectories of Eating Behavior in Weight-Loss Maintenance: Results from the German Weight Control Registry

OBJECTIVE

Eating behaviors such as dietary restraint and disinhibition caused by emotional and external cues play a relevant role in weight-loss maintenance.

METHODS

Four hundred forty individuals with successful weight-loss maintenance included in the prospective German Weight Control Registry completed the Dutch Eating Behavior Questionnaire. Participants were categorized into the following two weight groups: stable weight trajectory (WS) (n = 280) and unstable weight trajectory (WUS) (n = 160) over the 2-year assessment period.

RESULTS

Those with successful weight-loss maintenance had significantly higher scores on the restrained and emotional eating subscales compared with a general population (GP) sample. At baseline, the WS individuals had lower restrained, emotional, and external eating scores compared with the WUS individuals. Over the 2-year follow-up period, the trajectories of the restraint scores decreased in both groups but stayed elevated compared with the GP sample. Scores of the emotional and external eating subscales remained stable in the WS group but increased in the WUS group.

CONCLUSIONS

A certain degree of restraint seems to be necessary for successful weight-loss maintenance; however, high emotional and external eating may counteract this effect, resulting in weight regain in the long run.

What does self-reported "dieting" mean? Evidence from a daily diary study of behavior

Dieting is often recommended as a means of weight loss, yet research consistently shows that self-reported dieting does not result in weight loss. Toward resolving this discrepancy, this study assessed the daily dietary intake and weight control strategies of people who self-identified as dieting. College women (N = 266) provided a report of their eating pattern (dieting, "watching what I eat," and/or "eating healthy") followed by three daily diaries (24-hour recalls of dietary intake and weight control strategies) elicited on randomly selected days during a one-month period. Dieters were expected to report fewer daily calories, more daily exercise, and more daily weight control strategies than non-dieters. At baseline, 122 participants (45.9%) endorsed both "watching" and "eating healthy" ("Concerned Eaters") while 55 (20.7%) endorsed current dieting along with "watching" and "eating healthy" ("Dieters"). Just 3 (1.1%) endorsed dieting only, and 31 (11.7%) endorsed no eating pattern ("Unconcerned Eaters"). Dieters' mean BMI was in the overweight range; the mean BMIs of other groups were in the normal weight range. Dieters did not consistently endorse dieting across diaries. Nevertheless, Dieters reported fewer daily calories, and more overall weight control strategies, including more healthy weight control strategies, than Concerned Eaters. Across groups, participants' weights did not change significantly during the study. Dieters appear to engage in weight control strategies which could result in weight loss; however, their reports of whether they are dieting vary across days, suggesting a need for more consistent behavior. These results have clinical and research implications in the area of weight loss.

Intrinsic brain subsystem associated with dietary restraint, disinhibition and hunger: an fMRI study

Eating behaviors are closely related to body weight, and eating traits are depicted in three dimensions: dietary restraint, disinhibition, and hunger. The current study aims to explore whether these aspects of eating behaviors are related to intrinsic brain activation, and to further investigate the relationship between the brain activation relating to these eating traits and body weight, as well as the link between function connectivity (FC) of the correlative brain regions and body weight. Our results demonstrated positive associations between dietary restraint and baseline activation of the frontal and the temporal regions (i.e., food reward encoding) and the limbic regions (i.e., homeostatic control, including the hypothalamus). Disinhibition was positively associated with the activation of the frontal motivational system (i.e., OFC) and the premotor cortex. Hunger was positively related to extensive activations in the prefrontal, temporal, and limbic, as well as in the cerebellum. Within the brain regions relating to dietary restraint, weight status was negatively correlated with FC of the left middle temporal gyrus and left inferior temporal gyrus, and was positively associated with the FC of regions in the anterior temporal gyrus and fusiform visual cortex. Weight status was positively associated with the FC within regions in the prefrontal motor cortex and the right ACC serving inhibition, and was negatively related with the FC of regions in the frontal cortical-basal ganglia-thalamic circuits responding to hunger control. Our data depicted an association between intrinsic brain activation and dietary restraint, disinhibition, and hunger, and presented the links of their activations and FCs with weight status.

Behavioural implications of traditional treatment and closed-loop automated insulin delivery systems in Type 1 diabetes: applying a cognitive restraint theory framework

As the prevalence of obesity in Type 1 diabetes rises, the effects of emerging therapy options should be considered in the context of both weight and glycaemic control outcomes. Artificial pancreas device systems will 'close the loop' between blood glucose monitoring and automated insulin delivery and may transform day-to-day dietary management for people with Type 1 diabetes in multiple ways. In the present review, we draw directly from cognitive restraint theory to consider unintended impacts that closed-loop systems may have on ingestive behaviour and food intake. We provide a brief overview of dietary restraint theory and its relation to weight status in the general population, discuss the role of restraint in traditional Type 1 diabetes treatment, and lastly, use this restraint framework to discuss the possible behavioural implications and opportunities of closed-loop systems in the treatment of Type 1 diabetes. We hypothesize that adopting closed-loop systems will lift the diligence and restriction that characterizes Type 1 diabetes today, thus requiring a transition from a restrained eating behaviour to a non-restrained eating behaviour. Furthermore, we suggest this transition be leveraged as an opportunity to teach people lifelong eating behaviour to promote healthy weight status by incorporating education and cognitive reappraisal. Our aim was to use a transdisciplinary approach to highlight critical aspects of the emerging closed-loop technologies relating to eating behaviour and weight effects and to promote discussion of strategies to optimize long-term health in Type 1 diabetes via two key outcomes: glycaemic control and weight management.

When does behavior follow intent? Relationships between trait level dietary restraint and daily eating behaviors

BACKGROUND

The relationship between self-report trait level restriction and daily engagement in restriction behaviors is not well understood, and as a result the usefulness of such trait level measures is unclear. The present study aimed both to examine the validity of self-reported trait dietary restraint behaviors, and to examine the respective relationships among self-reported trait dietary restraint intentions and behaviors and both restrained and disinhibited eating at the daily level.

METHODS

A sample of 109 women (M_age = 24.72, SD = 4.15) completed a self-report trait level measure of dietary restraint before providing EMA data on their daily engagement in dietary restraint and disinhibited eating behaviors, as well as mood, over a period of 7 days. Multilevel hurdle models were used to test the relationship between trait levels of dietary restraint, and daily level reports of restraint and disinhibited eating behaviors.

RESULTS

Trait restraint behavior was a consistent predictor of daily presence and frequency of restraint behaviors. In contrast, trait restraint intentions was not a predictor of daily restraint behaviors, however it did predict daily frequency of overeating. In addition, daily negative affect emerged as a predictor of comfort eating, but was not predictive of restraint behaviors.

CONCLUSIONS

Findings confirm the usefulness of assessments of self-reported trait dietary restraint behaviors as a method of capturing dieting behaviors. In contrast, trait level dietary restraint intentions was a poor predictor of eating outcomes and more research on the way that restraint intentions affect eating behaviors is warranted.

Weight Status as a Mediator of the Association Between Preschool Extraversion and Adolescent Restrained Eating

Objectives

To determine the longitudinal association between preschool extraversion and weight/dieting outcomes in adolescence.

Methods

Children (N = 180) were recruited as part of a longitudinal study, with child temperament assessed in preschool (age 5.25 years), weight assessed in 2nd grade and early adolescence, and eating outcomes assessed in early adolescence (mean age = 12.02 years).

Results

Preschoolers high in extraversion were significantly more likely to have higher body mass index z-scores (zBMI) and more restrained eating behaviors in adolescence. zBMI was found to mediate the relationship between extraversion and restrained eating, such that children with high levels of extraversion were more likely to have higher zBMI in adolescence and, owing to this higher weight status, to engage in more restrained eating.

Conclusions

Temperament is an important predictor of later maladaptive weight/dieting outcomes in adolescence, making it a potentially important early factor to consider in weight management interventions.

Patterns of food avoidance and eating behavior in women with fibromyalgia

INTRODUCTION

Fibromyalgia is a form of non-articular rheumatic disorder of unknown origin. It is characterized by widespread, chronic musculoskeletal pain. Patients with fibromyalgia suffer more frequently eating disorders, obesity, metabolic syndrome, and other gastrointestinal symptoms. Studies have pointed out to nutrition as a relevant factor in these patients. Some of them think that diet has an influence on fibromyalgia symptoms, and tend to adopt certain dietary patterns. This, combined with access to non-scientific information about diets and supplements, makes analysis of dietary behavior, avoidance, and restrictions particularly important. The aim of this study was to describe dietary habits and eating avoidance behaviors in patients with fibromyalgia, and to compare these data to those of a healthy sample of similar sociodemographic characteristics.

METHODS

A descriptive case-control study was conducted in healthy subjects (n = 60) age and sex-matched to the fibromyalgia group (n = 60), whose eating habits and restrictions were analyzed using a food frequency questionnaire, a sociodemographic questionnaire, and a food restriction scale.

RESULTS

The group with fibromyalgia had significantly higher values in body mass index, weight fluctuation, use of herbal products, and development of diets, and significantly lower mean consumption of cereals, fruits, sugars, alcohol, and soft drinks.

CONCLUSIONS

These results describe a sample of patients with fibromyalgia who follow a varied diet similar to that of healthy subjects, but more frequently avoid certain foods.

Higher Heart-Rate Variability Is Associated with Ventromedial Prefrontal Cortex Activity and Increased Resistance to Temptation in Dietary Self-Control Challenges

Higher levels of self-control in decision making have been linked to better psychosocial and physical health. A similar link to health outcomes has been reported for heart-rate variability (HRV), a marker of physiological flexibility. Here, we sought to link these two, largely separate, research domains by testing the hypothesis that greater HRV would be associated with better dietary self-control in humans. Specifically, we examined whether total HRV at sedentary rest (measured as the SD of normal-to-normal intervals) can serve as a biomarker for the neurophysiological adaptability that putatively underlies self-controlled behavior. We found that HRV explained a significant portion of the individual variability in dietary self-control, with individuals having higher HRV being better able to downregulate their cravings in the face of taste temptations. Furthermore, HRV was associated with activity patterns in the ventromedial prefrontal cortex (vmPFC), a key node in the brain's valuation and decision circuitry. Specifically, individuals with higher HRV showed both higher overall vmPFC blood-oxygen-level-dependent activity and attenuated taste representations when presented with a dietary self-control challenge. Last, the behavioral and neural associations with HRV were consistent across both our stress induction and control experimental conditions. The stability of this association across experimental conditions suggests that HRV may serve as both a readily obtainable and robust biomarker for self-control ability across environmental contexts.

SIGNIFICANCE STATEMENT

Self-control is associated with better health, but behavioral and psychometric self-control measures allow only indirect associations with health outcomes and may be distorted by reporting bias. We tested whether resting heart-rate variability (HRV), a physiological indicator of psychological and physical health, can predict individual differences in dietary self-control in humans. We found that higher HRV was associated with better self-control and improved predictions of choice behavior. Specifically, higher HRV was associated with more effective downregulation of taste temptations, and with a diminished neural representation of taste temptations during self-control challenges. Our results suggest that HRV may serve as an easily acquired, noninvasive, and low-cost biomarker for self-control ability.

Development of a six-factor questionnaire for use in weight management counseling

OBJECTIVE

To develop and validate a new 6 factor questionnaire (6-FQ) that identifies unhealthful behavioral, cognitive and affective lifestyle pattern factors among a large sample of adults who are overweight or obese.

METHODS

Based on a previously developed 53-item lifestyle patterns questionnaire completed by 10,000 subjects, a new 6-FQ was developed and validated by using two prospective subject groups (n=640) with combined mean age of 43±11.4years and BMI 33.8±9.1kg/m².

RESULTS

An exploratory factor analysis and multidimensional scaling were conducted that identified 6 distinct factors with excellent psychometric properties. Cronbach's internal consistency reliability estimates ranged from 0.76 to 0.85. The prevalence rates and odds ratios of the factors are generally and directly related with increasing BMI categories. The 6-FQ is highly correlated with multiple subscales from the co-administered IWQOL-Lite questionnaire.

CONCLUSIONS

The 6-FQ is a 27-item self-administered instrument with excellent psychometric properties that measures patients' lifestyle pattern factors.

PRACTICE IMPLICATIONS

The 6-FQ is a convenient, short, self-administered instrument that has potential to target patients' self-identified lifestyle patterns related to body weight, and should allow clinicians to efficiently and effectively counsel patients on targeted treatment recommendations.

The neurobiological and behavioral overlaps of nicotine and food addiction

Both cigarette smoking and obesity are significant public health concerns and are associated with increased risk of early mortality. It is well established that the mesolimbic dopamine pathway is an important component of the reward system within the brain and is implicated in the development of addiction. Indeed, nicotine and highly palatable foods are capable of altering dopamine release within this system, engendering addictive like responses in susceptible individuals. Although additional research is warranted, findings from animal and human literature have elucidated many of neuroadaptions that occur from exposure to nicotine and highly palatable foods, leading to a greater understanding of the underlying mechanisms contributing to these aberrant behaviors. In this review we present the findings taken from preclinical and clinical literature of the known effects of exposure to nicotine and highly palatable foods on the reward related circuitry within the brain. Further, we compare the neurobiological and behavioral overlaps between nicotine, highly palatable foods and obesity. Lastly, we examine the stigma associated with smoking, obesity and food addiction, and the consequences stigma has on the overall health and wellbeing of an individual.

Brain regions involved in ingestive behavior and related psychological constructs in people undergoing calorie restriction

Human food intake is regulated by physiological energy homeostatic mechanisms and hedonic mechanisms. These are affected by both very short-term and longer-term calorie restriction (CR). To date, there are parallel discussions in the literature that fail to integrate across these disciplines and topics. First, much of the available neuroimaging research focusses on specific functional paradigms (e.g. reward, energy homeostasis). These paradigms often fail to consider more complex and inclusive models that examine how potential brain regions of interest interact to influence ingestion. Second, the paradigms used focus primarily on short-term CR (fasting) which has limited generalizability to clinical application. Finally, the behavioral literature, while frequently examining longer-term CR and related psychological constructs in the context of weight management (e.g. hedonic restraint, 'liking', 'wanting' and food craving), fails to adequately tie these phenomena to underlying neural mechanisms. The result is a less than complete picture of the brain's role in the complexity of the human experience of ingestion. This disconnect highlights a major limitation in the CR literature, where attempts are persistently made to exert behavioral control over ingestion, without fully understanding the complex bio behavioral systems involved. In this review we attempt to summarize all potential brain regions important for human ingestion, present a broad conceptual overview of the brain's multifaceted role in ingestive behavior, the human (psychological) experiences related to ingestion and to examine how these factors differ according to three forms of CR. These include short-term fasting, extended CR, and restrained eating. We aim to bring together the neuroimaging literature with the behavioral literature within a conceptual framework that may inform future translational research.

Development and validation of the Self-Regulation of Eating Behaviour Questionnaire for adults

Background

Eating self-regulatory capacity can help individuals to cope with the obesogenic environment and achieve, as well as maintain, a healthy weight and diet. At present, there is no comprehensive, reliable and valid questionnaire for assessing this capacity and measuring change in response to self-regulation interventions in adults. This paper reports the development of the Self-regulation of Eating Behaviour Questionnaire (SREBQ) for use in UK adults, and presents evidence for its reliability and construct validity.

The development of the SREBQ involved generation of an item pool, followed by two pilot studies (Samples 1 and 2) and a test of the questionnaire’s underlying factor structure (Sample 3). The final version of the SREBQ was then assessed for reliability and construct validity (Sample 4).

Results

Development of the SREBQ resulted in a 5-item questionnaire. The face validity was satisfactory, as assessed by the pilot studies. The factor structure analysis (Sample 3) suggested that it has a single underlying factor, which was confirmed in a second sample (Sample 4). The SREBQ had strong construct validity, showing a positive correlation with general measures of self-regulation. It was also positively correlated with motivation and behavioural automaticity, and negatively correlated with food responsiveness and emotional over-eating (p < 0.001). It showed good discriminant validity, as it was only weakly associated with satiety responsiveness, food fussiness and slowness in eating.

Conclusions

The SREBQ is a reliable and valid measure for assessment of eating self-regulatory capacity in the general UK adult population.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-016-0414-6) contains supplementary material, which is available to authorized users.

The relation of hedonic hunger and restrained eating to lateralized frontal activation

Asymmetrical alpha activation in the prefrontal cortex (frontal asymmetry) in electroencephalography (EEG) has been related to eating behavior. Prior studies linked dietary restraint with right frontal asymmetry [1] and disinhibition with left frontal asymmetry [2]. The current study simultaneously assessed restrained eating and hedonic hunger (drive for food reward in the absence of hunger) in relation to frontal asymmetry. Resting-state EEG and measures of restrained eating (Revised Restraint Scale; RRS) and hedonic hunger (Power of Food Scale; PFS) were assessed in 61 non-obese adults. Individually, hedonic hunger predicted left asymmetry. However, PFS and RRS were correlated (r=0.48, p<0.05) and there was a significant interaction between PFS and RRS on frontal asymmetry, p<0.01. Results indicated that those high in hedonic hunger exhibited left asymmetry irrespective of RRS scores; among those low in PFS, only those high in RRS showed right asymmetry. Results were consistent with literature linking avoidant behaviors (restraint) with right-frontal asymmetry and approach behaviors (binge eating) with left-frontal asymmetry. It appears that a strong drive toward palatable foods predominates at a neural level even when restraint is high. Findings suggest that lateralized frontal activity is an indicator of motivation both to consume and to avoid consuming highly palatable foods.

Dietary restraint: what's the harm? A review of the relationship between dietary restraint, weight trajectory and the development of eating pathology

Dietary restraint has historically been implicated as a risk factor for the development of eating pathology. Despite existing findings, recent research suggests that many individuals are capable of practicing dietary restraint without negative effects. In order to successfully incorporate the positive aspects of dietary restraint into interventions for healthy weight management, a nuanced examination of the relationship between dietary restraint and resulting eating patterns is necessary. Accordingly, the current review seeks to clarify the existing literature with regard to dietary restraint. First, this review examines the construct of dietary restraint and differentiates dietary restraint from related constructs, such as weight loss dieting. Second, it identifies situations in which dietary restraint has been linked with positive outcomes, such as healthy weight management and prevention of eating pathology. Altogether, it appears that dietary restraint can prove a beneficial strategy for those attempting to control their weight, as it does not relate to increased levels of eating pathology when practiced as part of a well-validated weight management programme.

What factors mediate the relationship between global self-worth and weight and shape concerns?

The primary aim of this study was to investigate whether the relationship between global self-worth and weight concerns and global self-worth and shape concerns was mediated by pertinent body image factors, while controlling for gender and estimated BMI. Participants were 775 adolescents (56% male) aged 12-18years (M=14.6; SD=1.50). Mediation analysis revealed a direct and a mediated effect between global self-worth and two body image models: 1) weight concerns and 2) shape concerns. The strongest mediators in both models were physical appearance, restrained eating, and depression. Partial mediation was observed for both models, indicating that body image factors which span cognitive, affective, and behavioral constructs, explain the association between global self-worth and weight and shape concerns. Implications for future research, weight and shape concern prevention and global self-worth enhancement programs are discussed.