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Chaves E, DiPangrazio A, Paponetti M, Stout G. Disordered Eating in Pediatric Obesity. Pediatr Clin North Am 2024; 71:879-896. [PMID: 39343499 DOI: 10.1016/j.pcl.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Children and youth with overweight and obesity are at an increased risk for the development of an eating disorder. Previous research has shown that disordered eating behaviors are prevalent in this population. Screening for disordered eating behaviors in children and youth with overweight and obesity is necessary to determine the course of the treatment. In children and youth with obesity and comorbid disordered eating behaviors, treatment should be multidisciplinary and include psychological, medical, nutrition, and physical activity care.
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Affiliation(s)
- Eileen Chaves
- Division of Neuropsychology and Pediatric Psychology; Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, 380 Butterfly Gardens Drive, LAC, Suite 5F, Columbus, OH 43215, USA; The Ohio State University, College of Medicine.
| | - Angel DiPangrazio
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, 380 Butterfly Gardens Drive, LAC, Suite 5F, Columbus, OH 43215, USA
| | - Matthew Paponetti
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, 380 Butterfly Gardens Drive, LAC, Suite 5F, Columbus, OH 43215, USA; Sports and Orthopedic Therapies
| | - Griffin Stout
- The Ohio State University, College of Medicine; Division of Child and Adolescent Psychiatry, Nationwide Children's Hospital, 444 Butterfly Gardens Drive, Columbus, OH 43215, USA
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2
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Wardzinski EK, Richter J, Moenikes S, Duysen KU, Oltmanns KM. Nondietary psychological app program leads to sustained weight loss due to trained physiological satiety perception. Appl Psychol Health Well Being 2024. [PMID: 39095995 DOI: 10.1111/aphw.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 07/15/2024] [Indexed: 08/04/2024]
Abstract
Obese people are mostly unable to maintain successful weight loss after the end of a dietary change. One reason is that conventional weight reduction concepts neglect physiological hunger and satiety perception, leading to a relapse to previous eating habits on the long run. We examined the long-term efficacy of a psychological smartphone weight loss program, which avoids any dietary instructions and aims at relearning of satiety perception. Parameters of body weight alterations and psychological features, for example, satiety perception, food cravings, and emotional eating, were explored in a nonrandomized experimental study comprising 75 obese participants. Measurements occurred at baseline, two times during program application, as well as at 6- and 12-month follow-up. Participants displayed significant weight loss during the entire study period (p = .029) and showed an improved body composition at the 6-month follow-up (p = .018). These effects were associated with increased satiety perception, as well as reduced food cravings, and emotional eating habits. Notably, all improvements in measured parameters significantly sustained between the end of the program and the 12-month follow-up (p < .005 for all). Psychological relearning of satiety perception may outclass dietary approaches in terms of long-term efficiency.
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Affiliation(s)
- Ewelina K Wardzinski
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Juliane Richter
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Sophia Moenikes
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Kai U Duysen
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Kerstin M Oltmanns
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
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3
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Eaton M, Probst Y, Foster T, Messore J, Robinson L. A systematic review of observational studies exploring the relationship between health and non-weight-centric eating behaviours. Appetite 2024; 199:107361. [PMID: 38643903 DOI: 10.1016/j.appet.2024.107361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/22/2024] [Accepted: 04/13/2024] [Indexed: 04/23/2024]
Abstract
Eating behaviour that does not centralise weight, otherwise known as weight-neutral, is associated with improved physical and psychological health, and greater health promoting behaviours. However, consolidated evidence is lacking. This study aimed to systematically evaluate 'health-centric' eating behaviour reflective of weight-neutral approaches, and their relationship with health (physical and mental) and health promoting behaviours. A systematic search was performed, identifying observational studies with adult populations, ≥1 physical/mental health outcome(s), and ≥1 validated measure(s) of health-centric eating behaviour. Study design, sample characteristics and outcomes were extracted and characterised into four domains. Our search identified 8281 records, with 86 studies, 75 unique datasets, and 78 unique exposures including 94,710 individuals. Eating behaviours included intuitive eating (n = 48), mindful eating (n = 19), and eating competence (n = 11). There were 298 outcomes identified for body composition, size, and physical health (n = 116), mental health and wellbeing (n = 123), health promoting behaviours (n = 51) and other eating behaviour (n = 8). Higher levels of intuitive eating, mindful eating and eating competence were significantly related to a lower BMI, better diet quality and greater physical activity. Higher intuitive and mindful eating were significantly related to lower levels of disordered eating, and depressive symptoms, and greater body image, self-compassion, and mindfulness. Greater eating competence and intuitive eating were significantly related to higher fruit and vegetable intake, and greater eating competence to higher fibre intake and better sleep quality. Our results demonstrate that 'health-centric' eating behaviours are related to a range of favourable health outcomes and engagement in health promoting behaviours. These findings help to enhance our understanding of eating behaviours that do not centre around body weight, providing support for health-centric eating behaviour in healthcare. Future research should focus on intervention studies and more diverse population groups.
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Affiliation(s)
- Melissa Eaton
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia.
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
| | - Tiarna Foster
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
| | - Julia Messore
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Laura Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia
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Hockin-Boyers H, Jamie K, Pope S. Intuitive tracking: Blending competing approaches to exercise and eating. SOCIOLOGY OF HEALTH & ILLNESS 2024. [PMID: 39084317 DOI: 10.1111/1467-9566.13821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/24/2024] [Indexed: 08/02/2024]
Abstract
Under the conditions of neo-liberal individual responsibilisation, self-tracking has become the predominant model of health management. More recently, though, intuition-based approaches to exercise and eating are also gaining traction. These two approaches are often located in opposition. While self-tracking uses datafication and calculability to structure health decisions, intuitive approaches encourage abandonment of rules and restrictions around exercise and food in favour of corporeal self-awareness and attunement to sensation. Although navigating these competing approaches is a common experience for all populations, the tensions between them are felt particularly acutely by people with complex health histories, such as eating disorders (EDs). In this article, we draw on mixed-methods longitudinal data, analysed using phenomenological analysis, to propose a novel framework - 'intuitive tracking'-which moves beyond understandings of self-tracking as the antithesis of intuitive engagement with exercise and health. Drawing on longitudinal interviews and photo elicitation with 19 women who are in recovery from EDs and using weightlifting as a tool to support their recovery, we demonstrate how attentiveness to bodily and emotional cues is successfully combined with an emphasis on monitoring health behaviours to support wellbeing. We conclude that theoretical understandings of self-tracking can and should make space for intuition-led decision-making.
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Affiliation(s)
| | | | - Stacey Pope
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
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5
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Joshi V, Graziani P, Del-Monte J. Interoceptive sensibility, intuitive eating, binge, and disordered eating behavior among individuals with obesity: A comparative study with the general population. J Health Psychol 2024:13591053241237900. [PMID: 38532256 DOI: 10.1177/13591053241237900] [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: 03/28/2024] Open
Abstract
The present study assessed the links between interoceptive sensibility, binge, disordered (emotional, restrained, and external) and intuitive eating among individuals with obesity (n = 57) and normal weight (n = 29). Individuals with obesity presented lower "attention regulation," "body-listening," and "trusting" interoceptive dimensions. When age was controlled, group differences on "trusting" remained significant. Individuals with obesity showed lower intuitive eating, higher emotional, and binge eating compared to controls. Higher "body listening," "eating for physical rather than emotional reasons," and "reliance on hunger and satiety cues" predicted lower binge eating whereas "external eating" predicted higher binge eating among individuals with obesity. Eating for physical reasons and reliance on hunger and satiety had protective mediating roles in the relationship between external and binge eating in both groups. Interoceptive sensibility and intuitive eating should conjointly serve as psychotherapeutic targets for disordered eating, obesity, and weight management.
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Affiliation(s)
- Vrutti Joshi
- Université de Nîmes, France
- Aix-Marseille Université, France
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6
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Jeune SC, Graziano P, Campa A, Coccia CC. Interoception and self-regulation of eating behaviors and weight status in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-12. [PMID: 38442359 DOI: 10.1080/07448481.2024.2319200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 02/08/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To determine the associations between interoception, self-regulation, eating behaviors, and weight status among college students. PARTICIPANTS 229 female undergraduates, predominantly classified as Juniors (51.1%) and identified as Hispanic/Latinx (75%) with a mean age of 23.4 (SD = 6.3), were examined. METHODS Cross-sectional data using baseline measures from a larger, longitudinal study, were examined. Confirmatory factor analyses and structural equation modeling were conducted to test hypotheses. RESULTS Interoception was directly associated to self-regulation. Interoception and self-regulation were inversely associated with non-purposeful eating. Non-purposeful eating was directly associated with weight status. CONCLUSION This study provided empirical evidence on the associations between interoception, self-regulation, eating behaviors, and weight status. Our results support the need for programs that target college students' cognitive skills to reduce unhealthy eating behaviors and optimize weight status. Future interventions are needed to enhance interoception and self-regulation skills so that college students can be more purposeful in their eating habits.
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Affiliation(s)
- Shanté C Jeune
- Department of Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Paulo Graziano
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Adriana Campa
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida, USA
| | - Catherine C Coccia
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida, USA
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Babbott KM, Consedine NS, Roberts M. Your Body Is Your Home: The feasibility of an intuitive eating intervention for early adolescents. Int J Eat Disord 2024; 57:727-739. [PMID: 38379127 DOI: 10.1002/eat.24163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE Intuitive eating (IE) is an emerging health promotion framework which has shown promise in the prevention and early intervention of disordered eating (DE) behavior in adults. This study sought to extend this work by assessing the feasibility and preliminary efficacy of a 5-week IE intervention, "Your Body is Your Home," delivered in school classrooms for early adolescents aged 11-13. METHODS The present study utilized a quasi-experimental design. Eligibility criteria were defined a priori and published in a registered protocol. Four classrooms (n = 128 student participants) were recruited into two streams, and self-report questionnaires were administered at pre-test, post-test, and 4-week follow-up. The questionnaires included the Intuitive Eating Scale for Early Adolescents (IES-2-EA), the Body Appreciation Scale (BAS-2), and the WHO Wellbeing Index (WHO-5). Linear mixed models were used to conduct preliminary efficacy testing. RESULTS The results indicate that a brief classroom-based IE intervention is feasible and acceptable for both students and teaching staff; retention, fidelity, and attendance targets were achieved. Students and teachers rated all five sessions of the intervention as a highly feasible method of health promotion. Further, preliminary efficacy data suggest IE interventions aimed at early adolescents may be a feasible way of improving certain aspects of IE (p < .001) in male and female participants, and body appreciation (p < .001) in male participants. DISCUSSION The study provides preliminary support for the implementation and evaluation of an IE intervention as part of school-based health promotion and offers preliminary effect size estimates for a larger-scale randomized trial. PUBLIC SIGNIFICANCE Existing evidence suggests that IE may be a useful framework through which relationships with food and the body can be improved. The present study seeks to extend this work by adapting the framework for early adolescents (among whom the framework is not well understood) and examining feasibility, acceptability, and preliminary changes to several health and well-being metrics following a 5-week school-based intervention.
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Affiliation(s)
- Katie M Babbott
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Nathan S Consedine
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Marion Roberts
- General Practice & Primary Healthcare, University of Auckland, Auckland, New Zealand
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Souto CR, Salaroli LB, da Silva GG, Cattafesta M, Silva YFR, Soares FLP. Intuitive eating has reduced the chances of being overweight in university students during the COVID-19 pandemic. Front Nutr 2024; 11:1329788. [PMID: 38425481 PMCID: PMC10902148 DOI: 10.3389/fnut.2024.1329788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction University students have been particularly affected during the COVID-19 pandemic, and several sociodemographic and behavioral factors may be associated with the risk of overweight in this population. The aim of this study was to assess the impact of the pandemic on the eating behavior and nutritional status of university students, and the factors associated with these changes, especially the role of intuitive eating in this process. Methods This is a repeated measures observational study with data collected in the first and third year of the COVID-19 pandemic in Brazil, from students over the age of 18 in the undergraduate programs of a federal university in southeastern Brazil. The survey was conducted using an online form. Eating behavior was assessed using the "Intuitive Eating Scale-2". Results 251 university students took part, most of them female with a median age of 22. There was an increase in body mass index (BMI) and intuitive eating score between the two periods. In the first year of the pandemic, being female and using tobacco reduced the chances of students being overweight. Living in a marital relationship, worrying about weight gain and body dissatisfaction increased the chances of this outcome. In the third year of the pandemic, it was observed that practicing restrictive diets, having inadequate body perception, worrying about weight gain and living in a marital relationship increased the chances of students being overweight. Being female and eating more intuitively, in line with bodily needs, reduced these odds, demonstrating a protective role in this scenario. Conclusion There was an increase in BMI and intuitive eating score during the pandemic. Sociodemographic, lifestyle and behavioral variables had both a positive and negative influence on nutritional status. Intuitive eating was shown to be a protective factor during this period, reducing the chances of being overweight in this population. Thus, more intuitive eating may favor greater weight stability, and may, therefore, have helped to reduce the impact of the pandemic on weight gain. In this way, people who ate more intuitively partially resisted the context that favored weight gain (stress, changes in diet and physical inactivity).
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Affiliation(s)
| | - Luciane Bresciani Salaroli
- Graduate Program in Nutrition and Health, Federal University of Espírito Santo, Vitória, Brazil
- Graduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil
| | | | - Monica Cattafesta
- Graduate Program in Nutrition and Health, Federal University of Espírito Santo, Vitória, Brazil
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9
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Giacone L, Sob C, Siegrist M, Hartmann C. Intuitive eating and its influence on self-reported weight and eating behaviors. Eat Behav 2024; 52:101844. [PMID: 38280314 DOI: 10.1016/j.eatbeh.2024.101844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 01/29/2024]
Abstract
Intuitive eating (IE) is an adaptive eating behavior that involves paying attention to the body's physiological signals, including eating when hungry and stopping when feeling full. A growing body of literature has examined the effect of IE on the development of maladaptive eating behaviors and body weight, even though IE is not centered around the latter. However, longitudinal observation studies among the general population are still rare. Therefore, this study aimed to longitudinally examine the links between IE and changes in body weight, maladaptive eating behaviors (reward, external, restrained eating), and overeating frequency over time. For this purpose, we used data from the first (2017) and the fourth waves (2020) of the Swiss Food Panel 2.0 survey, which included 1821 randomly selected Swiss participants. The same participants completed a self-administered questionnaire annually, measuring their self-reported eating behaviors and weight status. IE was measured with the Intuitive Eating Scale-2. Results showed that women with high IE scores were more likely to maintain their body weights (within ±2 kg) and less likely to gain weight (>2 kg) than women with low IE scores. No such effects were found for men. Furthermore, IE was linked to a reduction in maladaptive eating behaviors and overeating frequency over time in both genders. Results suggest that IE may counteract maladaptive eating behaviors, which can promote weight stability over time. Therefore, the encouragement of IE patterns seems to be a promising strategy to address problematic eating behaviors and the challenges associated with controlling food intake and prevention of overeating.
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Affiliation(s)
- Luana Giacone
- ETH Zurich, Institute of Food, Nutrition, and Health (IFNH), Consumer Behavior, Universitaetstrasse 22, CH-8092 Zurich, Switzerland.
| | - Cynthia Sob
- ETH Zurich, Institute of Food, Nutrition, and Health (IFNH), Consumer Behavior, Universitaetstrasse 22, CH-8092 Zurich, Switzerland
| | - Michael Siegrist
- ETH Zurich, Institute of Food, Nutrition, and Health (IFNH), Consumer Behavior, Universitaetstrasse 22, CH-8092 Zurich, Switzerland
| | - Christina Hartmann
- ETH Zurich, Institute of Food, Nutrition, and Health (IFNH), Consumer Behavior, Universitaetstrasse 22, CH-8092 Zurich, Switzerland
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Jevitt CM, Ketchum K. Pairing Evidence-Based Strategies With Motivational Interviewing to Support Optimal Nutrition and Weight Gain in Pregnancy. J Perinat Neonatal Nurs 2024; 38:25-36. [PMID: 38278641 DOI: 10.1097/jpn.0000000000000792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
OBJECTIVE Because eating, nutrition, and weight management patterns adopted during pregnancy may persist beyond the postpartum period, pregnancy provides an opportunity for health education that affects the future health of the pregnant person, the fetus, and the family. This systematic review aimed to find nutrition and weight management behaviors that could be used safely during pregnancy to optimize gestational weight gain. METHODS PubMed, MEDLINE, and Web of Science were searched for research or systematic reviews published in English from 2018 to 2023 using terms including gestational weight gain maintenance, weight, management, pregnancy, behavior, strategy, and strategies. Excluded research used pediatric or adolescent populations, restrictive diets such as no carbohydrate or no fat diets, fasting, bariatric surgery, weight loss medications, private industry, or profit-earning programs using food brands or specific diet programs. RESULTS The abstracts reviewed in these areas: excessive gestational weight gain (1019), low-glycemic index diet (640), Mediterranean diet (220), MyPlate diet (2), the Dietary Approaches to Stop Hypertension (DASH) diet (50), portion control (6), home meal preparation (6), mindful eating (13), intuitive eating (10), self-weighing (10), and motivational interviewing during pregnancy (107), were reduced to 102 studies. Studies in those 10 areas were reviewed for nutrition and eating behaviors that are safe to use during pregnancy and could be used along with motivational interviewing. CONCLUSION Clinicians can discuss these behaviors using motivational interviewing techniques to assist clients in optimizing gestational weight gain. Dialogue examples pairing these strategies with motivational interviewing principles are included.
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Affiliation(s)
- Cecilia M Jevitt
- Midwifery Program, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Ketchum K, Jevitt CM. Evidence-Based Eating Patterns and Behavior Changes to Limit Excessive Gestational Weight Gain: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:15. [PMID: 38276803 PMCID: PMC10815062 DOI: 10.3390/ijerph21010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/02/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND International prenatal care guidelines set a standard for clinicians to discuss gestational weight gain with their patients along with the complications associated with prepregnancy obesity and excessive gestational weight gain. Clinicians often lack evidence-based eating, nutrition, and activity strategies to share with patients. METHODS This systematic review aimed to find eating patterns and behaviors that could be used safely during pregnancy to limit excessive gestational weight gain. PubMed, MEDLINE, and Web of Science were searched for research or systematic reviews performed in the United States or Canada and published in English from 2013 to 2023. Keyword search terms included weight, manage, behavior, strategy, strategies, gestational weight gain, and nutrition. Excluded research used pediatric or adolescent populations, restrictive diets, such as no carbohydrate or no fat diets, fasting, bariatric surgery, weight loss medications, private industry or profit-earning programs using food brands, or specific diet programs. RESULTS A total of 844 abstracts were retrieved, with 103 full-text studies reviewed. Behaviors had to be useful for maintaining a healthy gestational weight gain and had to be safe for use during pregnancy. Behaviors useful during pregnancy included meal planning, home meal preparation, portion control, using diets such as the Mediterranean diet, the low-glycemic index diet, and the Dietary Approaches to Stop Hypertension diet (DASH), regular physical activity, sleeping 6-7 h a night, mindful eating, intuitive eating, and regular seif-weighing. CONCLUSION The evidence-based strategies outlined in this review are safe for use during pregnancy and can assist patients in avoiding excessive gestational weight gain while maintaining the nutrition needed for healthy fetal growth.
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Affiliation(s)
| | - Cecilia M. Jevitt
- Midwifery Program, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
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12
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Perreault M, Wallace A, Martin A, Sadowski A, Laila A, Lemieux S, Hutchinson JM, Kirkpatrick SI, Simpson JR, Guenther PM, Lamarche B, Jessri M, Louzada MLDC, Olstad DL, Prowse R, Vatanparast H, Haines J. Construct validity and reliability of the Canadian Eating Practices Screener to assess eating practices based on 2019 Canada's Food Guide recommendations. Appl Physiol Nutr Metab 2023; 48:919-931. [PMID: 37788488 DOI: 10.1139/apnm-2023-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
For the first time since its introduction, the 2019 Canada's Food Guide (2019-CFG) highlighted specific guidance on eating practices, i.e., recommendations on where, when, why, and how to eat. The Canadian Eating Practices Screener / Questionnaire court canadien sur les pratiques alimentaires was developed to assess eating practices based on the 2019-CFG healthy eating recommendations. The objective of this cross-sectional study was to assess the construct validity and reliability of the Canadian Eating Practices Screener. From July to December 2021, adults (n = 154) aged 18-65 years completed a sociodemographic questionnaire and the screener. Construct validity was assessed by examining variability in screener scores, by comparing screener scores among subgroups with hypothesized differences in eating practices, and by examining the correlation between screener scores and fruit and vegetable intake. Reliability, i.e., internal consistency, was assessed by calculating Cronbach's coefficient alpha. Screener item scores were summed to provide a total score ranging from 21 to 105. The mean screener score was 76 (SD = 8.4; maximum, 105), ranging from 53 (1st percentile) to 92 (99th percentile). Differences in total scores in hypothesized directions were observed by age (p = 0.006), perceived income adequacy (p = 0.09), educational attainment (p = 0.002), and smoking status (p = 0.09), but not by gender or health literacy level. The correlation between screener scores and fruit and vegetable intake was 0.29 (p = 0.002). The Cronbach's coefficient alpha was 0.79, suggesting acceptable to high internal consistency. Study findings provide preliminary evidence of the screener's construct validity and reliability, supporting its use to assess eating practices based on the 2019-CFG healthy eating recommendations.
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Affiliation(s)
- Maude Perreault
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Angela Wallace
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Alicia Martin
- Department of Geography, Environment and Geomatics, University of Guelph, Guelph, ON, Canada
| | - Adam Sadowski
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Amar Laila
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Simone Lemieux
- École de nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec city, QC, Canada
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec City, QC, Canada
| | - Joy M Hutchinson
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | | | - Janis Randall Simpson
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Patricia M Guenther
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Benoît Lamarche
- École de nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec city, QC, Canada
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec City, QC, Canada
| | - Mahsa Jessri
- Food, Nutrition and Health Program, Faculty of Land and Food Systems; Centre for Health Services and Policy Research, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Maria Laura da Costa Louzada
- Department of Nutrition, School of Public Health; Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland Labrador, Canada
| | - Hassan Vatanparast
- College of Pharmacy & Nutrition, and School of Public Health, University of Saskatchewan, SK, Canada
| | - Jess Haines
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, Canada
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Babbott KM, Tylka T, van der Werf B, Consedine NS, Roberts M. Intuitive Eating Scale-2-EA: Psychometric properties and factor structure of the adapted IES-2 for early adolescents. Eat Behav 2023; 51:101813. [PMID: 37741083 DOI: 10.1016/j.eatbeh.2023.101813] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE Intuitive Eating (IE) is an approach to eating characterised by attunement to intrinsic cues, and using those cues to guide behaviours related to food and eating. Tylka and Kroon Van Diest's (2008) Intuitive Eating Scale (IES-2) is well-validated in adults, but not yet among early adolescents. The current study was designed to adapt and validate a version suited for use in early adolescence (IES-2-EA). METHODS Data collected from two independent samples of adolescents aged 11 to 13 (N = 471) were structurally examined using exploratory factor analysis (EFA), with a subsequent confirmatory factor analysis (CFA) to confirm hypothesised model fit. Relationships between scores on the IES-2-EA and validated measures of actual-ideal body size discrepancy, body appreciation, interoceptive awareness, and psychological distress were also examined. RESULTS The adapted 17-item IES-2-EA had a three-factor structure with several key differences from the original version developed for adults. Moderate-to-strong correlations were found between scores on the IES-2-EA, body appreciation, interoceptive awareness, actual-ideal body size discrepancy, and psychological distress in the first sample of adolescents (n = 245). Secondary CFA showed good model fit in the second sample of adolescents (n = 226). CONCLUSION The IES-2-EA is well-suited to measure intuitive eating behaviour among early adolescents. The 17 items reflect a three-component structure similar to that seen in adults completing the IES-2. These early data suggest the adapted IES-2-EA has evidence of reliability and validity; it may be an effective measure for research and clinical use.
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Affiliation(s)
- Katie M Babbott
- General Practice & Primary Healthcare, University of Auckland, New Zealand.
| | - Tracy Tylka
- Department of Psychology, The Ohio State University, USA.
| | - Bert van der Werf
- Department of Epidemiology and Biostatistics, University of Auckland, New Zealand.
| | - Nathan S Consedine
- Department of Psychological Medicine, University of Auckland, New Zealand.
| | - Marion Roberts
- General Practice & Primary Healthcare, University of Auckland, New Zealand.
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14
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Małachowska A, Jeżewska-Zychowicz M. Retrospective Reports of Parental Feeding Practices and Current Eating Styles in Polish Adults. Nutrients 2023; 15:4217. [PMID: 37836501 PMCID: PMC10574465 DOI: 10.3390/nu15194217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
The role of childhood food experiences (CFEs) in determining future eating behaviors remains unclear. The aim of the study was to examine the link between CFEs and selected eating styles (ESs), i.e., intuitive (IE), restrained (ResEat) and external (ExtEat) eating, among 708 Polish adults aged 18-65 (477 women and 231 men). CFEs were measured with the Adults' Memories of Feeding in Childhood questionnaire. Polish versions of the Intuitive Eating Scale-2 and Dutch Eating Behavior Questionnaire were used to assess ESs. Mann-Whitney U test was used to compare ESs scores between those with lower and higher CFEs. In the total sample, "Restrictions" and "Pressure and Food Reward" parental feeding practices favored lower IE, while "Healthy Eating Guidance" and "Monitoring" practices predisposed higher levels of IE in adulthood. "Restrictions" were found to correlate with greater chances of ResEat, whereas "Healthy Eating Guidance" was linked with lower probability of ResEat. "Pressure and Food Reward" and "Monitoring" were associated with higher score for ExtEat. "Restrictions", "Child Control", "Monitoring" and "Healthy Eating Guidance" practices were differently linked to ESs in women and men. The findings suggest that education programs for parents should focus on the long-term consequences of feeding practices.
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Affiliation(s)
- Aleksandra Małachowska
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland;
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15
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Yoon C, Mai D, Kinariwala K, Ledoux T, Betts R, Johnston C. Sex and ethnic/racial differences in disordered eating behaviors and intuitive eating among college student. Front Psychol 2023; 14:1221816. [PMID: 37790230 PMCID: PMC10543694 DOI: 10.3389/fpsyg.2023.1221816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/28/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction Eating behaviors encompass disordered eating behaviors (e.g., overeating, binge eating, and associated symptoms of binge eating) and intuitive eating. Certain disordered eating behaviors, including binge eating, are more prevalent among female and ethnic/racial-minority college students than male and/or non-Hispanic White college students. However, sex and ethnic/racial differences among college students with other disordered eating (e.g., associated symptoms of binge eating) and intuitive eating behaviors remain unclear. Methods In 2022, 887 college students (Mage = 20.9 ± 2.6 years) self-reported their sex, ethnicity/race, disordered eating behaviors (e.g., overeating, binge eating, associated symptoms of binge eating), and intuitive eating. To examine sex and ethnic/racial differences among these students, we used modified Poisson regressions for students who reported disordered eating and linear regressions for students who reported intuitive eating. Results Except for overeating, disordered eating behaviors were more prevalent among female [adjusted prevalence ratio (aPR) = 1.3-1.8] than male college students after adjusting for sociodemographic variables, whereas intuitive eating scores did not differ by sex. Across ethnic/racial groups, disordered eating was more prevalent among all ethnic/racial-minority college students (aPR = 1.2-2.3) than non-Hispanic White college students after adjusting for sociodemographic variables. Moreover, non-Hispanic Black or African American college students had higher intuitive eating scores than non-Hispanic White college students (adjusted β = 0.7, 95% CI = -0.2, 1.6). Conclusion In our sample, notable differences emerged in the prevalence of disordered eating behaviors and mean scores by sex and ethnicity/race, while differences in intuitive eating scores emerged based on ethnicity/race.
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Affiliation(s)
- Cynthia Yoon
- Department of Health and Human Performance, University of Houston, Houston, TX, United States
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16
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Hayashi LC, Benasi G, St-Onge MP, Aggarwal B. Intuitive and mindful eating to improve physiological health parameters: a short narrative review of intervention studies. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:537-547. [PMID: 34913327 PMCID: PMC10098784 DOI: 10.1515/jcim-2021-0294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/29/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES This brief narrative review aims to give an up-to-date overview of intuitive and mindful eating (I/ME) interventions with specific focus on cardiometabolic risk factors, including glucose, lipid profile, blood pressure and inflammatory markers. CONTENT I/ME intervention studies in adults which measured at least one physiological parameter other than weight were identified from PubMed. The clinical trial/randomized controlled trial filters and publication dates 2001 through April 2021 with variations of the following keywords were applied: intuitive eating, mindful eating, weight neutral. Ten articles were identified. SUMMARY AND OUTLOOK Of the 10 studies, seven showed I/ME interventions were more effective than control in at least one cardiometabolic outcome, two showed significant I/ME within-group improvements but no between-group differences, and one showed neither within-group nor between-group differences. Specifically, I/ME improved glucose levels among pregnant women with or without gestational diabetes, lipid profile among adults with overweight or obesity, blood pressure among participants with overweight and inflammatory markers among post-menopausal women with obesity. However, the positive impact of I/ME on each of these cardiometabolic parameters was not consistent across studies: of the six studies that examined glucose regulation, two demonstrated positive outcomes for I/ME group, whereas four found no effect compared to control. Three out of five studies had positive lipid effects, one out of five demonstrated systolic blood pressure (SBP) improvements and one of two showed improvements in inflammatory markers. Given these mixed results, more research is needed to understand the possible effectiveness of I/ME to improve cardiometabolic health.
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Affiliation(s)
- Lauren C. Hayashi
- College of Medicine, University of Florida, Gainesville, FL, USA; Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Giada Benasi
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Marie-Pierre St-Onge
- Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY, USA; Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Brooke Aggarwal
- Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University Irving Medical Center. 51 Audubon Avenue, Suite 505, New York, NY 10032, USA; Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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17
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Rodgers RF, Goutama V, Sonneville K. At the Same Table: A Delphi Consensus-Based Model of Health-Promoting Eating Behaviors. Nutrients 2023; 15:3601. [PMID: 37630790 PMCID: PMC10458493 DOI: 10.3390/nu15163601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Eating behaviors and patterns are one of the key behavioral indicators of health, and as such these behaviors are a focus of interest across different areas of scholarship. Yet, to date, work in this area is impeded by the lack of a collective theoretical framework to conceptualize, assess, and intervene upon eating behaviors. The aim of this study was therefore to establish a consensus-based framework for health-promoting eating behaviors using a Delphi methodology. An initial systematic search identified constructs that yielded 150 items grouped into three topic areas: (1) the content, types of food and nutrition provided; (2) eating behaviors; and (3) thoughts and feelings related to eating and foods. Over the course of three iterative rounds of rating by a panel of n = 37 experts, a consensus was reached that included eight of the original items that represented the three topic areas. The findings from this study result in a novel consensus-based framework for health-promoting eating behaviors that can form the basis for collaborative work towards the integration of physical and mental health promotion.
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Affiliation(s)
- Rachel F. Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA 02115, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, 34295 Montpellier, France
| | - Valerie Goutama
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA 02115, USA
| | - Kendrin Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
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18
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Albajri E, Naseeb M. Sex differences in intuitive eating and its relationship with body mass index among adults aged 18-40 years in Saudi Arabia: a cross-sectional study. Front Nutr 2023; 10:1214480. [PMID: 37538925 PMCID: PMC10395086 DOI: 10.3389/fnut.2023.1214480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction Intuitive eating (IE) is eating without judgment, relying only on physiological hunger and satiety. Sex differences in IE have been reported; however, none of the studies have explicitly examined IE and its relationship with body mass index (BMI) in the Saudi Arabian population. Thus, this study aimed to investigate sex differences in IE and its relationship with BMI in the Saudi population. Subjects/methods A cross-sectional online survey of 360 participants (18 years or older) with self-reported weight and height was conducted. IE was measured using the Intuitive Eating Scale-2 (IES-2). Separate multiple linear regression analyses were conducted to determine if total IE and its subscale scores differed across sexes. It was also conducted to assess the relationship between IE and BMI across sexes. Results Women had higher total IE score, eating for physical rather than emotional reasons (EPR), and body-food choice congruence (BFCC) scores compared to men (p = 0.013, p = 0.01, p <0.001, respectively). The analysis showed a significant negative association between total IE, BFCC, EPR scores, and BMI in women compared to men (p = 0.023, p = 0.01, p = 0.003, respectively). Conclusion The data on the sex differences in IE and its subscales and their different association with BMI encourage tailing nutrition-related recommendations in the context of intuitive eating based on sexes. Future studies are needed to explore how intuitive eating functions differently in women compared to men and explore the causal relationship between IE and BMI in this population.
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19
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Małachowska A, Gębski J, Jeżewska-Zychowicz M. Childhood Food Experiences and Selected Eating Styles as Determinants of Diet Quality in Adulthood-A Cross-Sectional Study. Nutrients 2023; 15:nu15102256. [PMID: 37242139 DOI: 10.3390/nu15102256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/24/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Available studies suggest that childhood food experiences (CFE) may be linked with eating behaviors in adulthood, as well as eating style (ES); thus, both CFE and ES can determine dietary intake. Little is known about the role of both of these factors in explaining the diet quality (DQ) of adults. The aim was to investigate to what extent selected ESs, i.e., intuitive (IE), restrained (ResEat), and external (ExtEat) eating, and CFE related to parental feeding practices (PFPs) will predict the DQ of women and men. Data from 708 Polish adults (477 women and 231 men) aged 18-65 were collected via the Internet from October 2022 to January 2023. Mann-Whitney's U Test was used to compare ES and CFE levels among women and men, while DQ determinants were tested with the multiple linear regression (MLR). In the total study sample, "Healthy Eating Guidance" (CFE), "Child Control" (CFE), "Body-Food Choice Congruence" (IE), and ResEat favored higher DQ scores, while "Unconditional Permission to Eat" (IE), "Eating for Physical Rather Than Emotional Reasons" (IE), and ExtEat predisposed to lower DQ scores. After the MLR was conducted separately in women and men, differences were noted in the role of "Healthy Eating Guidance" (CFE), "Pressure and Food Reward" (CFE), "Unconditional Permission to Eat" (IE), "Eating for Physical Rather Than Emotional Reasons" (IE), ExtEat, and ResEat in predicting DQ indices. Our findings suggest that childhood food experiences and selected eating styles may differently determine the DQ of women and men. Future studies conducted within representative samples are needed to confirm these results.
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Affiliation(s)
- Aleksandra Małachowska
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland
| | - Jerzy Gębski
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland
| | - Marzena Jeżewska-Zychowicz
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland
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20
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Nelson JD, Trojanowski PJ, Aarnio-Peterson CM, Fischer S, Adams L, Matthews A. Caregiver and adolescent intuitive eating behavior: associations with weight change during family-based treatment for anorexia nervosa. Eat Weight Disord 2023; 28:32. [PMID: 36964787 PMCID: PMC10039824 DOI: 10.1007/s40519-023-01557-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 12/13/2022] [Indexed: 03/26/2023] Open
Abstract
PURPOSE Intuitive eating (IE) is an adaptive eating construct for which little research exists in eating disorder (ED) samples. IE is negatively correlated with disordered eating behaviors in healthy adolescents and adults, and similar associations have been found in adults with EDs. This study aims to examine IE in a treatment seeking sample of adolescents and their caregivers to understand the role of IE in weight gain during FBT. METHODS Descriptive statistics and bivariate correlations were calculated in a sample of 47 pairs of adolescent patients and their caregivers who initiated outpatient FBT at a large academic medical center. Analyses examined associations between caregiver and adolescent IE on the Intuitive Eating Scale (IES), change in percent expected body weight (%EBW) by session 4 and end of treatment (EOT), clinical impairment, and ED pathology. RESULTS Significant correlations were found between aspects of adolescent IE, ED symptoms, and clinical impairment. Caregiver IES scores (Reliance on Hunger and Satiety Cues, Body-Food Choice Congruence, IES Total) were negatively related to adolescent ED symptoms (EDE-Q Weight Concerns, EDE-Q Shape Concerns, EDE-Q Global) at baseline. Caregiver IE (Eating for Physical Rather than Emotional Reasons) was positively associated with adolescent weight gain at FBT session 4 and EOT, even when statistically adjusting for gender and initial level of care. CONCLUSION Study results were consistent with past research indicating adolescent IE is negatively associated with ED behaviors, cognitions, and impairment. This study is the first to provide evidence that caregiver IE is positively associated with adolescent weight gain in FBT and is the first to provide evidence that caregiver IE is negatively related to adolescent ED symptoms. Future research should examine adolescent and caregiver IE throughout FBT to understand the role of IE in treatment response. LEVEL OF EVIDENCE Level III: Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- Jillian D Nelson
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
| | - Paige J Trojanowski
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA
| | - Claire M Aarnio-Peterson
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Sarah Fischer
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA
| | - Leah Adams
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA
| | - Abigail Matthews
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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21
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Talbot CV, Campbell CER, Greville-Harris M. "Your struggles are valid, you are worthy of help and you deserve to recover": narratives of recovery from orthorexia nervosa. Eat Weight Disord 2023; 28:25. [PMID: 36849619 PMCID: PMC9971094 DOI: 10.1007/s40519-023-01554-3] [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] [Received: 10/13/2022] [Accepted: 02/15/2023] [Indexed: 03/01/2023] Open
Abstract
PURPOSE Limited research has examined recovery processes and conceptualisations of recovery within orthorexia nervosa (ON). This study harnessed Instagram data to examine how people who self-identify with ON use the hashtag #OrthorexiaRecovery and how recovery is represented within this online space. METHODS 500 textual posts containing #OrthorexiaRecovery were extracted from Instagram. Co-occurring hashtags were analysed descriptively to determine whether this online space is specific to ON, and textual data were analysed using reflexive thematic analysis. RESULTS The hashtag analysis indicated that #OrthorexiaRecovery is being used within a wider context of eating disorder recovery and awareness, but also provides deep insights into experiences of recovery from ON. The thematic analysis generated five themes: the invisibility of orthorexia; a turbulent and continuous process; finding food freedom; from compulsive exercise to intuitive movement; a community of support. Our findings suggest that people with self-reported ON experience recovery as a continuous process and the current invisibility of ON within diagnostic criteria and wider society impedes recovery. While working towards recovery, users aimed to be free from diet culture, become more attuned to their bodies, and develop more adaptive relationships with food and fitness. Users noted a general lack of support for people with ON and so used this online space to create a supportive community, though some content was potentially triggering. CONCLUSION Our findings highlight the importance of increased recognition of ON and the potential value of targeting societal norms and harnessing social identity resources within therapeutic interventions for ON.
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Affiliation(s)
- Catherine V Talbot
- Department of Psychology, Bournemouth University, Poole House, Fern Barrow, Poole, BH12 5BB, Dorset, UK.
| | - Charleigh E R Campbell
- Department of Psychology, Bournemouth University, Poole House, Fern Barrow, Poole, BH12 5BB, Dorset, UK
| | - Maddy Greville-Harris
- Department of Psychology, Bournemouth University, Poole House, Fern Barrow, Poole, BH12 5BB, Dorset, UK
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22
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Intuitive Eating Behaviour among Young Malay Adults in Malaysian Higher Learning Institutions. Nutrients 2023; 15:nu15040869. [PMID: 36839227 PMCID: PMC9964300 DOI: 10.3390/nu15040869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Despite the significance of dietary knowledge interventions, there is a lack of established studies on intuitive eating behaviour among young Malay adults in Malaysia. This cross-sectional study aimed to determine the intuitive eating score, identify the intuitive eating factors, and determine the association of intuitive eating with weight-control behaviours and binge eating. A total of 367 respondents completed self-administered questionnaires on sociodemographic characteristics, namely the Intuitive Eating Scale (IES-2) and The Diabetes Eating Problems Survey (DEPS). The findings reported IES-2 mean scores of 3.52 ± 0.32 and 3.47 ± 0.35 for both men and women. No difference in total IES-2 scores was found between genders for Unconditional Permission to Eat (UPE) and Reliance on Hunger and Satiety Cue (RHSC) subscales (p > 0.05). However, among all four subscales of IES-2, there was a gender difference in the mean EPR and B-FCC subscale scores (p < 0.05). A statistically significant difference was found in intuitive eating, which refers to a belief in one's body's ability to tell one how much to eat, in women across living areas (p < 0.05). The result shows that there is a relationship between weight-control behaviour and binge eating and dieting, with the coefficient of the relationship (R2) of 0.34. As a result, intuitive eating throughout young adulthood is likely to be related to a decreased prevalence of obesity, dieting, poor weight-management behaviours, and binge eating.
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23
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Markey CH, Strodl E, Aimé A, McCabe M, Rodgers R, Sicilia A, Coco GL, Dion J, Mellor D, Pietrabissa G, Gullo S, Granero‐Gallegos A, Probst M, Maïano C, Bégin C, Alcaraz‐Ibáñez M, Blackburn M, Caltabiano ML, Manzoni GM, Castelnuovo G, Hayami‐Chisuwa N, He Q, Fuller‐Tyszkiewicz M. A survey of eating styles in eight countries: Examining restrained, emotional, intuitive eating and their correlates. Br J Health Psychol 2023; 28:136-155. [PMID: 35942590 PMCID: PMC10086804 DOI: 10.1111/bjhp.12616] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 07/05/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Restrained, emotional and intuitive eating were examined in relation to each other and as correlates of participants' weight status, body image and self-esteem. In some past research, restrained and emotional eating have been associated with higher weight status and poorer mental health, while intuitive eating is more frequently linked to lower weight status and more positive well-being. However, these eating styles have rarely been examined together and never in a large cross-country sample. METHOD Six-thousand two-hundred and seventy-two (6272) emerging adults (M age = 21.54 years, SD = 3.13) completed scales from the Three-Factor Eating Questionnaire, the Eating Disorders Examination Questionnaire, the Intuitive Eating Scale-2, the Multidimensional Body Self Relations Questionnaire, the Rosenberg Self-Esteem Scale, and provided weight and height information that was used to calculate body mass index (BMI). Participants resided in Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States and provided information using an online survey. RESULTS Path analyses for the entire sample revealed significant pathways between higher intuitive eating and higher body satisfaction and self-esteem, and lower BMIs among participants. Higher levels of restrained and emotional eating were associated with lower body satisfaction and self-esteem, and higher BMIs among participants. Minor cross-country differences were evident in these patterns of relations, but intuitive eating emerged as a consistent predictor across countries. CONCLUSION Overall, findings suggest that efforts should be made to increase intuitive eating among emerging adults and to support individual and macrolevel interventions to decrease restrained and emotional eating behaviours.
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Affiliation(s)
- Charlotte H. Markey
- Department of Psychology, Health Sciences CenterRutgers UniversityCamdenNew JerseyUSA
| | - Esben Strodl
- School of Psychology and CounsellingQueensland University of TechnologyBrisbaneQldAustralia
| | - Annie Aimé
- Department of Psychoeducation and PsychologyUniversité du Québec en OutaouaisSaint‐JérômeQCCanada
| | - Marita McCabe
- School of Health SciencesSwinburne UniversityMelbourneVic.Australia
| | - Rachel Rodgers
- Department of Applied PsychologyNorth Eastern UniversityBostonMassachusettsUSA
- Department of Psychiatric Emergency & Acute CareLapeyronie Hospital, CHRU MontpellierMontpellierFrance
| | - Alvaro Sicilia
- Health Research Centre and Department of EducationUniversity of AlmeriaAlmeriaSpain
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Jacinthe Dion
- Department of Health SciencesUniversite du Quebec a ChicoutimiChicoutimiQCCanada
| | - David Mellor
- School of PsychologyDeakin UniversityMelbourneVic.Australia
| | - Giada Pietrabissa
- Istituto Auxologico Italiano, IRCCS, San Giuseppe HospitalOggebbioItaly
- Department of PsychologyCatholic University of MilanMilanItaly
| | - Salvatore Gullo
- Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | | | - Michel Probst
- Department of Rehabilitation SciencesKU LeuvenLeuvenBelgium
| | - Christophe Maïano
- Department of Psychoeducation and PsychologyUniversité du Québec en OutaouaisSaint‐JérômeQCCanada
| | | | | | | | | | - Gian Mauro Manzoni
- Istituto Auxologico Italiano, IRCCS, San Giuseppe HospitalOggebbioItaly
- Department of PsychologyCatholic University of MilanMilanItaly
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano, IRCCS, San Giuseppe HospitalOggebbioItaly
- Department of PsychologyCatholic University of MilanMilanItaly
| | - Naomi Hayami‐Chisuwa
- Graduate School of Human Life and EcologyOsaka Metropolitan UniversityOsakaJapan
| | - Qiqiang He
- School of Health SciencesWuhan UniversityWuhanChina
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Martin-Wagar CA, Heppner H. Adaptive depends on context: An examination of the Intuitive Eating Scale-2 in an eating disorder sample. Appetite 2023; 180:106349. [PMID: 36307052 DOI: 10.1016/j.appet.2022.106349] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/06/2022] [Accepted: 10/14/2022] [Indexed: 12/12/2022]
Abstract
Though there is a robust literature base linking intuitive eating (IE) to better psychological health and reduced eating pathology, little is known about the psychometric properties of IES-2 measurement or how IE relates to eating psychopathology within eating disorder clinical samples. Importantly, some seemingly adaptive eating behaviors in non-clinical populations could conceivably result from disordered eating within clinical eating disorder populations (e.g., not eating when not hungry because of distorted hunger-fullness cues, furthering restriction). This study examined the factor structure, psychometric properties, and correlates of the Intuitive Eating Scale-2 (IES-2) in a transdiagnostic eating disorder sample (N = 224). Participants at an eating disorder specialty treatment center completed the IES-2 upon assessment, along with other symptomology measures. A confirmatory factor analysis was performed, finding a poor model fit in this transdiagnostic sample, CFI = 0.889, TLI = 0.869, RMSEA = 0.095, TLI = 0.869, and SRMR = 0.099. Through exploratory factor analysis, we identified a factor solution for the measure that can be used transdiagnostically in this population, with revised scoring and modifications. As expected, the IES-2 demonstrated construct validity, with higher IE being associated with lower eating pathology (r = -0.36, p < .01), lower clinical impairment (r = -0.26, p < .01), lower body image dissatisfaction (r = -0.39, p < .05), and lower depressive symptoms (r = -0.20, p < .01), supporting construct validity. As anticipated, IES-2 was not related to emotion regulation, supporting discriminant validity. This study suggests that the IES-2 does not perform as expected in a transdiagnostic clinical eating disorder population, and instead, a revised scored 21-item IES-2 is suggested, with interpretation of only the total score and two subscales.
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Affiliation(s)
- Caitlin A Martin-Wagar
- University of Montana, Department of Psychology, 32 Campus Dr, Missoula, MT, 59812, USA.
| | - Hannes Heppner
- University of Montana, Department of Psychology, 32 Campus Dr, Missoula, MT, 59812, USA
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Babbott KM, Cavadino A, Brenton-Peters J, Consedine NS, Roberts M. Outcomes of intuitive eating interventions: a systematic review and meta-analysis. Eat Disord 2023; 31:33-63. [PMID: 35400300 DOI: 10.1080/10640266.2022.2030124] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Intuitive eating (IE) is an approach to health promotion that fosters a positive relationship with food and the body. The objective of this review was to aggregate and analyse the literature on IE interventions, thereby offering an early investigation of methodological approaches to intervention. This review was conducted in accordance with the preferred reporting items for systematic review and meta-analysis protocols (PRISMA) guidelines. Searching was conducted in four electronic databases. Studies were eligible for inclusion if they delivered an IE intervention and used the Intuitive Eating Scale (IES). Nine studies were included in this review. Six were eligible for meta-analysis, though only outcomes on the IES were examined; all other measures were examined individually. All interventions led to improvements on measures of IE, with a large pooled effect size (1.50 [1.15, 1.85]) and positive changes on a variety of other outcomes relating to health. This pattern preliminarily suggests that IE interventions change psychological processes as intended and can be useful in promoting health behaviour. The present review offers a synthesis of existing approaches to IE interventions and an evaluation of which specific variants appear to be more effective. This paper provides a basis upon which future interventions can be developed to improve approaches to psychoeducation.Clinical ImplicationsInterventions contributed to improvements in measures of IE lasting up to 6 months.Interventions contributed to positive changes on outcomes such as quality of life, body image, and body appreciation.Self-management through IE-based interventions may be feasible and effective.
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Affiliation(s)
- Katie M Babbott
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Alana Cavadino
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | - Nathan S Consedine
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Marion Roberts
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Healthy orthorexia vs orthorexia nervosa: associations with body appreciation, functionality appreciation, intuitive eating and embodiment. Eat Weight Disord 2022; 27:3197-3206. [PMID: 35864300 DOI: 10.1007/s40519-022-01449-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/10/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Current conceptualizations and measures of orthorexia nervosa may not be accurately distinguishing between the healthy vs pathological pursuit of a healthy diet, leading to very high prevalence rates and risking the pathologizing and stigmatizing of healthy eating more generally. Recent research has identified healthy orthorexia as a novel construct conceptually distinct from orthorexia nervosa, which represents the non-pathological pursuit of a healthy diet. In light of the strong body of evidence supporting the role of positive body image in eating behavior, the current study aimed to examine the associations between healthy orthorexia, orthorexia nervosa, intuitive eating and indices of positive body image. METHODS The current study employed a cross-sectional design. An online community sample (N = 835; 62% women; Mage = 40.24, SD = 14.45) completed self-report questionnaires including the Teruel Orthorexia Scale, Body Appreciation Scale-2, Functionality Appreciation Scale, Intuitive Eating Scale-2, and Experience of Embodiment Scale. RESULTS Intuitive eating and indices of positive body image were significantly positively associated with healthy orthorexia and inversely associated with orthorexia nervosa. A hierarchical multiple regression analysis found that intuitive eating and indices of body image were uniquely associated with 13.3% of the variance of healthy orthorexia above and beyond that accounted for by orthorexia nervosa. Intuitive eating moderated the relationship between healthy orthorexia and orthorexia nervosa. CONCLUSION The findings of this study provide support for intuitive eating and indices of positive body image as worthy of further exploration as important factors which distinguish between healthy orthorexia and orthorexia nervosa. LEVEL OF EVIDENCE V, descriptive study.
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Weight-normative messaging predominates on TikTok-A qualitative content analysis. PLoS One 2022; 17:e0267997. [PMID: 36318532 PMCID: PMC9624392 DOI: 10.1371/journal.pone.0267997] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
Tiktok is a social media platform with many adolescent and young adult users. Food, nutrition, and weight-related posts are popular on TikTok, yet there is little understanding of the content of these posts, and whether nutrition-related content is presented by experts. The objective was to identify key themes in food, nutrition, and weight-related posts on TikTok. 1000 TikTok videos from 10 popular nutrition, food, and weight-related hashtags each with over 1 billion views were downloaded and analyzed using template analysis. The one-hundred most viewed videos were downloaded from each of the ten chosen hashtags. Two coders then coded each video for key themes. Key themes included the glorification of weight loss in many posts, the positioning of food to achieve health and thinness, and the lack of expert voices providing nutrition information. The majority of posts presented a weight-normative view of health, with less than 3% coded as weight-inclusive. Most posts were created by white, female adolescents and young adults. Nutrition-related content on TikTok is largely weight normative, and may contribute to disordered eating behaviors and body dissatisfaction in the young people that are TikTok’s predominant users. Helping users discern credible nutrition information, and eliminate triggering content from their social media feeds may be strategies to address the weight-normative social media content that is so prevalent.
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Katcher JA, Suminski RR, Pacanowski CR. Impact of an Intuitive Eating Intervention on Disordered Eating Risk Factors in Female-Identifying Undergraduates: A Randomized Waitlist-Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12049. [PMID: 36231362 PMCID: PMC9566585 DOI: 10.3390/ijerph191912049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Dietary restraint and low body appreciation are common among female-identifying undergraduates and are related to the development of disordered eating, which female-identifying undergraduates engage in throughout college. Training students in intuitive eating, an approach that promotes eating by internal cues, may be a way to ameliorate dietary restraint and low body appreciation, ultimately decreasing disordered eating. The purpose of this study was to examine the impact of a five-week intuitive eating intervention on dietary restraint, body appreciation, and intuitive eating in female-identifying undergraduates. A five-week intuitive eating intervention (NCT0394700) was facilitated by two Registered Dietitians. One treatment group (TG) (n = 7) and one waitlist control group (WLCG) (n = 7) participated in the trial. From baseline to post-intervention, there was a significant decrease in dietary restraint, t(12) = -2.88, p = 0.01, and a significant increase in intuitive eating, t(12) = 4.03, p = 0.002, in the TG compared to the WLCG. The intervention had replicable effects on all outcome variables. Measurements at the five-week follow-up suggested the impact was sustained. This study provides preliminary data suggesting an intuitive eating intervention may help improve disordered eating risk factors by decreasing dietary restraint and increasing intuitive eating in female-identifying undergraduates.
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Body Dissatisfaction, Eating Styles, Weight-Related Behaviors, and Health among Young Women in the United States. Nutrients 2022; 14:nu14183876. [PMID: 36145252 PMCID: PMC9505776 DOI: 10.3390/nu14183876] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Body dissatisfaction is a common condition that poses health behavior risks, such as the use of maladaptive eating styles instead of adaptive eating styles. Few studies have simultaneously examined both adaptive and maladaptive eating styles and their association with body dissatisfaction in a comprehensive manner. To address this gap, this study examined how body dissatisfaction is related to an array of adaptive and maladaptive eating styles, weight-related behaviors, and health status as well as the associations of health status, BMI, and weight-related behaviors with body dissatisfaction in 261 young adult women. Maladaptive eating styles, such as emotional eating, tended to rise in tandem with body dissatisfaction, differing significantly among body-dissatisfaction levels with medium to large effect sizes. For adaptive eating styles, as body dissatisfaction increased, compensatory restraint increased, intuitive eating declined, and mindful eating did not differ. Weight-related dietary, physical activity, and sleep behaviors did not differ by body dissatisfaction level. BMI increased and health status decreased as body dissatisfaction increased. Binary logistic regression revealed those who were body-dissatisfied had significantly lower health status, higher BMIs, and did not differ on weight-related behaviors. Study findings suggest strategies to improve health-promotion interventions aiming to increase body satisfaction.
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Lovan P, Prado G, Lee T, Coccia C. A snapshot of eating behaviors in undergraduate college students living in South Florida. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-10. [PMID: 36084262 DOI: 10.1080/07448481.2022.2119402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/18/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Objective: To examine a) whether college students' eating behaviors are different by students' sex and/or body mass index (BMI) categories and b) the correlations between college students' eating behaviors and the degree to which they rely on internal bodily signals for food intake. Participants: Undergraduate college students 18-24 years old at a public university located in South Florida. Methods: Eligible students answered questionnaires to examine interoception, intuitive eating, and eating behaviors including emotional eating, restrained eating, cognitive restraint, external eating, and uncontrolled eating. Pearson correlation and independent t test were used (significance: p < 0.05). Results: Females reported lower interoception, intuitive eating, and higher emotional eating than males. Students with lower BMI had higher intuitive eating and lower restrained eating. Interoception was positively correlated with intuitive eating and negatively correlated with emotional, uncontrolled, restrained, and external eating. Conclusion: College students who have a better connection with their bodily signals have healthier eating behaviors and lower BMI.
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Affiliation(s)
- Padideh Lovan
- Department of Psychology, University of Miami, Miami, Florida, USA
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Miami, Florida, USA
| | - Tae Lee
- Department of Child Psychology and Education, Sungkyunkwan University, Seoul, South Korea
| | - Catherine Coccia
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida, USA
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Burnette CB, Hazzard VM, Hahn SL, Larson N, Neumark-Sztainer D. Like parent, like child? Intuitive eating among emerging adults and their parents. Appetite 2022; 176:106132. [PMID: 35700840 PMCID: PMC9667887 DOI: 10.1016/j.appet.2022.106132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 05/11/2022] [Accepted: 06/08/2022] [Indexed: 11/02/2022]
Abstract
Intuitive eating (IE) emphasizes relying on hunger and satiety cues to guide eating, and is associated with positive mental health and health-promoting behaviors. Although parents' own eating patterns often shape those of their children, no known research has explored familial associations of IE. The purpose of this cross-sectional, population-based study was to examine IE concordance between emerging adults and their parents, and whether concordance differed across sociodemographic characteristics and weight perceptions. The analytic sample included 891 emerging adults (M age = 22.0) and their primary parent (M age = 50.4) who participated in the population-based, longitudinal EAT and F-EAT 2010-2018 studies. Parents and emerging adults were grouped into dyads based on IE concordance: (1) neither are intuitive eaters; (2) only the emerging adult is an intuitive eater; (3) only the parent is an intuitive eater; (4) both are intuitive eaters. Dyads differed across socioeconomic status (SES), race/ethnicity, and weight perceptions. Concordant dyads who ate intuitively were more likely to be at higher SES and perceive their weight as "about right" than concordant dyads who did not eat intuitively. Asian emerging adults were most likely to belong to concordant non-intuitive eater dyads. Emerging adults who shared their parent's perception their weight was "overweight" were less likely to be intuitive eaters (even if their parents were). In this sample, sociodemographic characteristics and weight perceptions were related to IE concordance among emerging adults and their parents. Lower SES might be an intergenerational barrier to IE disproportionately impacting communities of color, though longitudinal data are needed. Results also suggest rather than motivating healthful eating, perceiving one's weight as "overweight" could hinder IE. Differences across sociodemographic variables likely intersect in meaningful ways, which is an important future research direction.
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Affiliation(s)
- C Blair Burnette
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
| | - Vivienne M Hazzard
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA; Department of Psychiatry and Behavioral Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Samantha L Hahn
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA; Department of Psychiatry and Behavioral Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA; Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
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Hazzard VM, Burnette CB, Hooper L, Larson N, Eisenberg ME, Neumark-Sztainer D. Lifestyle health behavior correlates of intuitive eating in a population-based sample of men and women. Eat Behav 2022; 46:101644. [PMID: 35691254 PMCID: PMC9509702 DOI: 10.1016/j.eatbeh.2022.101644] [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] [Received: 11/03/2021] [Revised: 04/28/2022] [Accepted: 06/03/2022] [Indexed: 11/16/2022]
Abstract
The aim of this observational study was to examine how lifestyle health behaviors hypothesized to influence attunement to internal cues (breakfast consumption frequency, physical activity, yoga practice, sleep, and recreational screen time) are cross-sectionally related to intuitive eating (IE). Data from 765 men and 1009 women (Mage = 31.1 ± 1.7 years) who participated in Project EAT-IV (Eating and Activity in Teens and Young Adults) were analyzed with sex-stratified linear regression models adjusted for age, race/ethnicity, socioeconomic background, and parent status. Sociodemographic-adjusted mean levels of each health behavior by sex were generated at low (one standard deviation below the mean), average (at the mean), and high (one standard deviation above the mean) levels of IE to facilitate interpretation of regression results. Among women only, more frequent breakfast consumption (p = .02), more time spent practicing yoga (p = .03), more sleep (p = .004), and less recreational screen time (p = .01) were each significantly associated with higher IE after adjusting for sociodemographic characteristics. Compared to women with low IE, women with high IE reported, on average, eating breakfast 0.3 more days a week, practicing 12 more minutes of yoga per week, getting 12 more minutes of sleep per night, and engaging in 18 fewer minutes of recreational screen time per day. Results suggest that these modifiable health behaviors may be valuable targets for interventions to increase IE among women, though longitudinal research is needed to elucidate the temporality of these associations.
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Affiliation(s)
- Vivienne M. Hazzard
- Department of Psychiatry and Behavioral Health, University of Minnesota Medical School, Minneapolis, MN,Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - C. Blair Burnette
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Laura Hooper
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Marla E. Eisenberg
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN,Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN,Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
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Giannakou K, Kyprianidou M, Basdani E, Hadjimbei E, Chrysostomou S. Cross-cultural validity of the Intuitive Eating Scale-2: Psychometric evaluation in the Greek-Cypriot population. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2022. [DOI: 10.3233/mnm-220037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Intuitive eating is defined by eating response to physiological hunger and satiety cues rather than situational or emotional cues and it has been linked to psychological well-being. The 23-item Intuitive Eating Scale-2 (IES-2) is commonly used to assess the concept of intuitive eating. OBJECTIVE: To develop the Greek version of the IES-2 questionnaire and to test its psychometric qualities. METHODS: Forward and backward translations into Greek and English were completed. Exploratory Factor Analysis (EFA) was applied to understand the underlying factor structure of the IES-2, whilst internal consistency was assessed by Cronbach’s alpha test. The concurrent validity was assessed by evaluating the correlation among the IES-2 and the Eating Attitudes Test-26 Item (EAT-26) questionnaire. RESULTS: A total of 379 adults (mean age = 34 years) participated. EFA gave a three-factor structure with the total variance explained being 54.4% . Cronbach’s alpha was 0.87 for the IES-2 total score, as well as 0.90, 0.84 and 0.70 for the IES-2 subscales. The revised IES-2 total score was significantly correlated with EAT-26 total score (rs = –0.46, p < 0.01) and BMI (rs = –0.46, p < 0.01). CONCLUSION: In this sample, the Greek version of the IES-2 showed good psychometric qualities and can be regarded a helpful tool for examining adult intuitive eating behaviours.
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Affiliation(s)
- Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Maria Kyprianidou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Evaggelia Basdani
- Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Elena Hadjimbei
- Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Stavri Chrysostomou
- Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
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Campos MB, Menezes IHCF, Peixoto MDRG, Schincaglia RM. Intuitive eating in general aspects of eating behaviors in individuals with obesity: Randomized clinical trial. Clin Nutr ESPEN 2022; 50:24-32. [DOI: 10.1016/j.clnesp.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 05/17/2022] [Accepted: 06/01/2022] [Indexed: 10/18/2022]
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Babbott KM, Mitchison D, Basten C, Thornton C, Hay P, Byrne S, Goldstein M, Heruc G, van der Werf B, Consedine NS, Roberts M. Intuitive Eating Scale-2: psychometric properties and clinical norms among individuals seeking treatment for an eating disorder in private practice. Eat Weight Disord 2022; 27:1821-1833. [PMID: 34797555 DOI: 10.1007/s40519-021-01326-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Intuitive Eating (IE) is an approach to eating designed to facilitate a positive relationship with food. Its use in clinical settings and in the community is rapidly growing in popularity. The Intuitive Eating Scale 2 (IES-2) is a widely used measure that indexes intuitive eating motivations and behaviour, however evidence of its validity in populations with clinical eating disorders remains scarce. The objective of the proposed study was thus to evaluate the factor structure of the IES-2 in a large sample of individuals seeking treatment for eating disorders in private practice. METHODS Data collected from 569 women and men aged 12-68 years seeking treatment for an eating disorder in one of eight specialist private outpatient eating disorder clinics were examined using confirmatory factor analysis (CFA). Relationships between IES-2 scores and measures of psychopathology were also examined. RESULTS Results were relatively consistent with the purported four-factor structure of the IES-2. The measure displayed strong construct validity and good internal consistency. Scores on the IES-2 were inversely associated with scores of depression, anxiety, and disordered eating, providing evidence for divergent validity of the measure. Clinical norms are provided for anorexia nervosa (AN) spectrum disorders and bulimia nervosa (BN) spectrum disorders, as well as for the clinical sample as a whole. CONCLUSION Findings suggest that the IES-2 may be an appropriate measure for evaluating behaviours relating to IE in community outpatient eating disorder settings, and provide further evidence for the association between IE and positive health outcomes. LEVEL OF EVIDENCE III, evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Katie M Babbott
- General Practice and Primary Healthcare, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Chris Basten
- Department of Psychology, Macquarie University, Sydney, Australia
| | | | - Phillipa Hay
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Sue Byrne
- University of Western Australia, Perth, Australia
| | - Mandy Goldstein
- Mandy Goldstein Psychology, Sydney, Australia
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Gabriella Heruc
- School of Medicine, Western Sydney University, Campbelltown, Australia
- Appetite for Change, Sydney, Australia
| | - Bert van der Werf
- Department of Biostatistics, University of Auckland, Auckland, New Zealand
| | - Nathan S Consedine
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Marion Roberts
- General Practice and Primary Healthcare, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
- Nurture Psychology, Auckland, New Zealand
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Lovan P, George F, Campa A, Huffman F, Coccia C. The Effect of Mood Change and Intuitive Eating Skills on Self-Regulation of Food Intake among Undergraduate College Students. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2048748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Małachowska A, Jeżewska-Zychowicz M. Polish Adaptation and Validation of the Intuitive (IES-2) and Mindful (MES) Eating Scales—The Relationship of the Concepts with Healthy and Unhealthy Food Intake (a Cross-Sectional Study). Nutrients 2022; 14:nu14051109. [PMID: 35268085 PMCID: PMC8912520 DOI: 10.3390/nu14051109] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 02/04/2023] Open
Abstract
Intuitive (IE) and mindful (ME) eating share internally focused eating, yet previous studies have shown that these concepts are not strongly correlated, which suggests that they might be differently related to food intake. The study aimed to adapt the original Intuitive (IES-2) and Mindful (MES) Eating Scales to the Polish language, to test their psychometric parameters and, further, to examine associations of IE and ME with an intake of selected food groups, i.e., healthy foods (fresh and processed vegetables, fresh fruit) and unhealthy foods (sweets, salty snacks). A cross-sectional study was conducted in 2020 in a group of 1000 Polish adults (500 women and 500 men) aged 18–65 (mean age = 41.3 ± 13.6 years). The factor structure was assessed with exploratory (EFA) and confirmatory (CFA) factor analysis as well as structural equation modeling (SEM). Measurement invariance across gender was assessed with multiple-group analysis. Internal consistency and discriminant validity of the two scales was tested. Spearman’s correlation coefficient was used to examine the correlation between IES-2 and MES subscales with food intake. A 4-factor, 16-item structure was confirmed for IES-2, while EFA and CFA revealed a 3-factor, 17-item structure of MES. Both scales demonstrated adequate internal consistency and discriminant validity. Full metric and partial scalar invariance were found for IES-2, while MES proved partial invariances. “Awareness” (MES) and “Body–Food Choice Congruence” (IES-2) positively correlated with intake of healthy foods and negatively with the intake of unhealthy ones. “Eating For Physical Rather Than Emotional Reasons” (IES-2) and “Act with awareness” (MES) favored lower intake of unhealthy foods, whereas “Unconditional Permission to Eat” and “Reliance on Hunger and Satiety Cues” (IES-2) showed an inverse relationship. A greater score in “Acceptance” (MES) was conducive to lower intake of all foods except sweets. The results confirmed that adapted versions of the IES-2 and MES are valid and reliable measures to assess IE and ME among Polish adults. Different IE and ME domains may similarly explain intake of healthy and unhealthy foods, yet within a single eating style, individual domains might have the opposite effect. Future studies should confirm our findings with the inclusion of mediating factors, such as other eating styles, childhood experiences, dieting, etc.
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Van Dyke N, Drinkwater EJ. Intuitive eating is positively associated with indicators of physical and mental health among rural Australian adults. Aust J Rural Health 2022; 30:468-477. [PMID: 35239235 PMCID: PMC9544126 DOI: 10.1111/ajr.12856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/30/2021] [Accepted: 02/06/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Rural Australians have comparatively higher rates of overweight and obesity, as well as some mental health issues. Intuitive eating has been shown to be positively associated with an array of physical and mental health indicators. Few studies, however, have been conducted with general populations, and none has explicitly examined intuitive eating among rural residents. Objective To investigate the prevalence of intuitive eating, and associations between intuitive eating and indicators of physical and mental health, among a general population of rural adults. Design Cross‐sectional telephone survey of 200 randomly selected, non‐metropolitan, English‐speaking Australian residents aged 18 or older. Findings The prevalence of intuitive eating in the sample was 17.6%, with a higher level of intuitive eating among men than women (26.1% vs 9.1%). Bivariate associations between intuitive eating and each of the six health indicators were all positive and mostly statistically significant. Particularly strong was the correlation between intuitive eating and self‐esteem for women (r = 0.53). After controlling for indication of an eating disorder and demographics, the associations between intuitive eating and the outcome variables held for body mass index (BMI), psychological distress and body esteem for men, and for BMI and self‐esteem for women. Post hoc analyses found that BMI did not moderate the relationship for women between intuitive eating and self‐esteem and that body esteem mediates the relationships between intuitive eating and BMI and psychological distress for men, and between intuitive eating and self‐esteem for women. Discussion Consistent with most prior research, this study finds that intuitive eating is positively associated with several indicators of both physical and mental health among non‐metropolitan residents in Australia. Practice of intuitive eating in this population, however, is low. These findings may help allied health professionals guide rural populations to better health, and may be a particularly effective approach for people for whom the barriers to seeking out health services are high. Conclusion Intuitive eating appears to have substantial correlations with mental health indicators, and to some extent, physical health indicators, among rural Australians and therefore should be further investigated for its potential to inform public health policy targeted to similar populations.
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Affiliation(s)
- Nina Van Dyke
- Social Research Centre, Melbourne, Victoria, Australia
| | - Eric J Drinkwater
- School of Exercise and Sport Science, Charles Sturt University, Bathurst, New South Wales, Australia
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Yoon CY, Hazzard VM, Emery RL, Mason SM, Neumark-Sztainer D. Everyday discrimination as a predictor of maladaptive and adaptive eating: Findings from EAT 2018. Appetite 2022; 170:105878. [PMID: 34952131 PMCID: PMC8761174 DOI: 10.1016/j.appet.2021.105878] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 01/25/2023]
Abstract
Various types of stressors are associated with maladaptive eating, but how the stressor of everyday discrimination (e.g., less respect, poorer service) relates to maladaptive eating and adaptive eating remains unclear. We examined everyday discrimination as a predictor of maladaptive and adaptive eating. Data were collected in a population-based study, Eating and Activity over Time (N = 1410, ages 18-30). Everyday discrimination was categorized as none, low, moderate, or high. Outcomes included maladaptive eating (i.e., overeating and binge eating) and adaptive eating (i.e., intuitive eating and mindful eating). Modified Poisson regressions estimated the prevalence ratios (PRs) for overeating and binge eating associated with everyday discrimination. Linear regressions estimated associations between everyday discrimination and intuitive and mindful eating scores. After adjustment for age, ethnicity/race, gender, and socioeconomic status, moderate and high levels of discriminatory experiences were each associated with a significantly greater prevalence of binge eating (PR = 2.2, [95% CI = 1.3-3.7] and PR = 3.1, [95% CI = 2.0-4.7], respectively) and lower intuitive (β = -0.4, [95% CI = -0.7, -0.2] and β = -0.5 [95% CI = -0.8, -0.3], respectively), and mindful eating scores (β = -0.3, [95% CI = -0.6, -0.1] and β = -0.5 [95% CI = -0.8, -0.3], respectively) compared to young adults with no discriminatory experience. Public health efforts to prevent maladaptive eating and encourage the adoption of adaptive eating should consider the potential contribution of everyday discrimination and the need to advocate for equity and inclusion.
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Affiliation(s)
- Cynthia Y. Yoon
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454,University of Houston, Department of Health and Human Performance, Houston, Texas, 77204
| | - Vivienne M. Hazzard
- Sanford Center for Biobehavioral Research, 120 Eight St S, Fargo, ND 58103, USA
| | - Rebecca L. Emery
- University of Minnesota Medical School, Duluth campus, Department of Family Medicine and Biobehavioral Health, Duluth, Minnesota, 55812
| | - Susan M. Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454
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Yoon C, Emery RL, Hazzard VM, Mason SM, Neumark-Sztainer D. Adverse experiences as predictors of maladaptive and adaptive eating: Findings from EAT 2018. Appetite 2022; 168:105737. [PMID: 34627979 PMCID: PMC9505995 DOI: 10.1016/j.appet.2021.105737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 01/03/2023]
Abstract
Adverse experiences, such as childhood abuse and other violence victimization, are associated with problematic eating. However, whether different types of adversity relate to both maladaptive and adaptive eating behaviors is unclear. This study examined the associations of different adverse experiences with maladaptive (i.e., overeating and binge eating) and adaptive (i.e., intuitive eating and mindful eating) eating by gender. Data were derived from the EAT-2018 (Eating and Activity over Time) study (N = 1411, aged 18-30 years in 2017-2018). Modified Poisson regressions were used to examine the associations between adverse experiences and the prevalence of maladaptive eating. Linear regressions were used to examine the associations between adverse experiences and adaptive eating scores. Each adverse experience was associated with greater prevalence of maladaptive eating and lower adaptive eating scores. Among women, intimate partner sexual violence was strongly associated with more overeating (PR = 2.1 [95% CI = 1.4-3.1]) and binge eating (PR = 2.4 [95% CI = 1.5-3.9]), and less mindful eating (β = -0.6, [95% CI = -0.8, -0.3]); being attacked, beaten, or mugged was most associated with less intuitive eating (β = -0.5, [95% CI = -0.8, -0.2]). Among men, being attacked, beaten, or mugged was strongly associated with more overeating (PR = 2.1 [95% CI = 1.2-3.5]) and binge eating (PR = 3.2 [95% CI = 1.6-6.5]); intimate partner physical violence was strongly associated with less intuitive eating (β = -0.6, [95% CI = -0.9, -0.2]); childhood emotional abuse was strongly associated with less mindful eating (β = -0.8, [95% CI = -1.0, -0.5]). To improve eating behaviors, adverse life experiences and the potential impact on maladaptive and adaptive eating should be considered.
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Affiliation(s)
- Cynthia Yoon
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454,University of Houston, Department of Health and Human Performance, Houston, TX 77006
| | - Rebecca L. Emery
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454
| | - Vivienne M. Hazzard
- Sanford Center for Biobehavioral Research, 120 Eight St S, Fargo, ND 58103, USA
| | - Susan M. Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454
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Intuitive Eating Among Parents: Associations with the Home Food and Meal Environment. J Acad Nutr Diet 2022; 122:1336-1344. [DOI: 10.1016/j.jand.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/03/2022] [Accepted: 01/13/2022] [Indexed: 11/20/2022]
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Stukenborg MJ, Deschamps BA, Jayne JM, Karl JP, McGraw SM, DiChiara AJ, Cole RE. Exceeding body composition standards is associated with a more negative body image and increased weight cycling in active duty U.S. soldiers. Eat Behav 2021; 42:101532. [PMID: 34120036 DOI: 10.1016/j.eatbeh.2021.101532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
Negative body image is more often identified in individuals with overweight or obesity. More than 65% of U.S. soldiers have a body mass index (BMI) that classifies them with overweight or obesity. Additionally, all soldiers must meet body composition and physical fitness standards which may increase the risk of negative body image. This cross-sectional study aimed to identify associations between compliance with body composition standards, body image, and weight cycling through surveying 969 active-duty soldiers (86% male, 24.0 ± 5.5 years of age, BMI 26.0 ± 3.6 kg/m2). Compliance with body composition standards was measured by whether a soldier had ever taken and failed the circumference-based body fat assessment. Weight cycling was self-reported as ≥3 weight fluctuations of ≥5% of body weight during their military career. Multivariate linear and logistic regression models were used to examine the relationship between compliance with body composition standards, body image, weight cycling, and sociodemographic characteristics while controlling for BMI. Failing the circumference-based body fat assessment was associated with increased concern with conforming to military image. Negative body image was associated with higher odds of weight cycling. Further examination is warranted to understand the effects of body composition standards on soldiers' body image and weight cycling.
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Affiliation(s)
- Maria J Stukenborg
- 1-2 Stryker Brigade Combat Team, Bldg. P3741 Railroad Ave, Tacoma, WA 98433, USA; Madigan Army Medical Center, Nutrition Care Division, 9040 Jackson Ave, Tacoma, WA 98431, USA.
| | - Bethany A Deschamps
- Madigan Army Medical Center, Nutrition Care Division, 9040 Jackson Ave, Tacoma, WA 98431, USA.
| | - Julianna M Jayne
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, 10 General Greene Ave, Building 42, Natick, MA 01760, USA.
| | - J Philip Karl
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, 10 General Greene Ave, Building 42, Natick, MA 01760, USA.
| | - Susan M McGraw
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, 10 General Greene Ave, Building 42, Natick, MA 01760, USA.
| | - Adam J DiChiara
- Combat Capabilities Development Command Soldier Center, Natick, MA 01760, USA.
| | - Renee E Cole
- Medical Center of Excellence, U.S. Military-Baylor University Graduate Program in Nutrition, 3599 Winfield-Scott Rd, Building 2841, Fort Sam Houston, TX 78234, USA.
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Jayne JM, Karl JP, McGraw SM, O'Connor K, DiChiara AJ, Cole RE. Eating Behaviors Are Associated With Physical Fitness and Body Composition Among US Army Soldiers. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:480-488. [PMID: 33674236 DOI: 10.1016/j.jneb.2021.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Examine associations between soldiers' eating behaviors, compliance with body composition and fitness standards, and physical performance. DESIGN Cross-sectional study. SETTING Eight Army installations. PARTICIPANTS US Army Soldiers (n = 1,591; 84% male). MAIN OUTCOME MEASURES Characteristics, eating behaviors, compliance with body composition and physical fitness standards, and fitness level were assessed via questionnaire. ANALYSIS Bivariate and multivariable logistic regression. RESULTS Eating mostly at a dining facility was associated with lower odds of body composition failure (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.26-0.73); whereas, eating at a fast rate (OR, 1.51; 95% CI, 1.05-2.17) or often/always ignoring satiety cues (OR, 2.12; 95% CI, 1.06-4.27) was associated with higher odds of body composition failure. Eating mostly fast-food/convenience meals (OR, 1.75; 95% CI, 1.19-2.59) and eating at a fast rate (OR, 1.42; 95% CI, 1.04-1.93) was associated with higher odds of physical fitness failure. Skipping breakfast was associated with lower odds of high physical performance (OR, 0.41; 95% CI, 0.23-0.74); whereas, nutrition education was associated with higher odds of high physical performance (OR, 1.02; 95% CI, 1.01-1.04). CONCLUSIONS AND IMPLICATIONS As eating behaviors are modifiable, findings suggest opportunities for improving the specificity of Army health promotion and education programs.
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Affiliation(s)
- Julianna M Jayne
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA.
| | - J Philip Karl
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Susan M McGraw
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Kristie O'Connor
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Adam J DiChiara
- Combat Capabilities Development Command Soldier Center, US Army Soldier Systems Center, Natick, MA
| | - Renee E Cole
- US Military-Baylor University Graduate Program in Nutrition, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX
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Are anthropometric measurements an indicator of intuitive and mindful eating? Eat Weight Disord 2021; 26:639-648. [PMID: 32333316 DOI: 10.1007/s40519-020-00904-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 04/09/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Intuitive eating and mindful eating are new approach eating behaviors. Assessing the relationship of some anthropometric measurements to intuitive eating and mindful eating. METHODS Cross-sectional descriptive study. Adults aged 19-45 living in the center of Ankara the capital of Turkey. 250 volunteers (68 men and 182 women) aged 19-45 years. Data were collected through face-to-face interviews using a questionnaire contained the Intuitive Eating Scale (IES-2), Mindful Eating Questionnaire (MEQ-30) and Eating Attitudes Test (EAT-26). Anthropometric measurements were performed by the researchers themselves. Between-group analyses were performed to test statistical differences and relationships. RESULTS There was a positive correlation between IES-2 and MEQ-30 scores (r = 0.477; p = 0.000), indicating that the higher the IES-2 scores, the higher the MEQ-30 scores. IES-2 scores and BMI were negatively correlated (p < 0.05) and also MEQ-30 scores were negatively correlated with waist-to-height ratio and BMI (r = - 0.143; p = 0.024, r = - 0.159; p = 0.012). The higher the "disinhibition" and "control of eating," the lower the body weight, waist circumference, waist-to-height ratio and BMI was found. CONCLUSIONS It was concluded that the more the intuitive eating, the more the mindful eating. And also it is suggested that anthropometric measurements might be an indicator of intuitive eating and mindful eating. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Intuitive eating longitudinally predicts better psychological health and lower use of disordered eating behaviors: findings from EAT 2010-2018. Eat Weight Disord 2021; 26:287-294. [PMID: 32006391 PMCID: PMC7392799 DOI: 10.1007/s40519-020-00852-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 01/18/2020] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To examine longitudinal associations of intuitive eating (IE), defined as eating according to internal hunger and satiety cues, with psychological health outcomes and disordered eating behaviors. METHODS Data from a diverse sample of 1491 participants (54.1% female, 19.7% non-Hispanic white) followed from adolescence (baseline; Mage = 14.5 years) into young adulthood (follow-up; Mage = 22.2 years) came from the population-based EAT 2010-2018 (Eating and Activity over Time) study. Logistic regression models predicting psychological health outcomes and disordered eating behaviors at follow-up simultaneously included baseline IE and change in IE from baseline to follow-up as predictors, adjusting for demographic covariates, body mass index, and outcome at baseline. RESULTS Greater baseline IE and increases in IE from baseline to follow-up were both associated with lower odds of high depressive symptoms, low self-esteem, high body dissatisfaction, unhealthy weight control behaviors (e.g., fasting, skipping meals), extreme weight control behaviors (e.g., taking diet pills, vomiting), and binge eating at 8-year follow-up. Particularly strong protective associations were observed for binge eating, such that a one-point higher IE score at baseline was associated with 74% lower odds of binge eating at follow-up, and a one-point higher increase in IE score from baseline to follow-up was associated with 71% lower odds of binge eating at follow-up. CONCLUSIONS These results indicate that IE longitudinally predicts better psychological and behavioral health across a range of outcomes and suggest that IE may be a valuable intervention target for improving psychological health and reducing disordered eating behaviors, particularly binge eating. LEVEL OF EVIDENCE Level III, cohort study.
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Christoph M, Järvelä-Reijonen E, Hooper L, Larson N, Mason SM, Neumark-Sztainer D. Longitudinal associations between intuitive eating and weight-related behaviors in a population-based sample of young adults. Appetite 2021; 160:105093. [PMID: 33428973 DOI: 10.1016/j.appet.2021.105093] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 12/24/2020] [Accepted: 12/30/2020] [Indexed: 02/08/2023]
Abstract
Intuitive eating has been associated with markers of better health in cross-sectional studies, but less is known about long-term associations between intuitive eating and subsequent eating and weight-related behaviors. This study assessed how intuitive eating in early adulthood is related to weight status, dieting, healthy and unhealthy weight control behaviors, and binge eating with loss of control five years later. Young adults (N = 1660) were asked about intuitive eating as part of the 2008-2009 third wave of the Project EAT (Eating and Activity in Teens and Young Adults) longitudinal cohort study. Weight status, dieting, healthy and unhealthy weight control behaviors, and binge eating with loss of control were assessed during both the third (EAT-III: mean age 25.3 ± 1.5) and fourth (EAT-IV mean age 31.1 ± 1.5) waves. In analyses adjusted for sociodemographic characteristics, both male and female intuitive eaters had a lower prevalence of high weight status and lower engagement in dieting, unhealthy weight control behaviors, and binge eating at the 5-year follow-up, compared to non-intuitive eaters. Among women, after additional adjustment for EAT-III values for the respective outcome measures, intuitive eating was unrelated to any of the behaviors studied at 5-year follow-up. Among men, intuitive eating predicted a lower likelihood of engaging in unhealthy weight control behaviors (intuitive eaters: 30.0% vs. non-intuitive: 41.9%, p = 0.002) and binge eating (intuitive eaters: 0.9% vs. non-intuitive: 1.5%, p = 0.046) independent of participating in these behaviors at EAT-III. In a population-based sample of young adults, intuitive eating was associated with better markers of eating and weight-related behaviors five years later, suggesting intuitive eating may have potential long-term benefits.
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Affiliation(s)
| | - Elina Järvelä-Reijonen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.
| | - Laura Hooper
- Division of Epidemiology and Community Health, University of Minnesota, USA.
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota, USA.
| | - Susan M Mason
- Division of Epidemiology and Community Health, University of Minnesota, USA.
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Erhardt GA. Intuitive eating as a counter-cultural process towards self-actualisation: An interpretative phenomenological analysis of experiences of learning to eat intuitively. Health Psychol Open 2021; 8:20551029211000957. [PMID: 33786195 PMCID: PMC7961715 DOI: 10.1177/20551029211000957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This research presents an in-depth idiographic study that illustrates how learning to eat intuitively involves socio-cultural challenges, strategies of resistance and self-actualising processes. Interviews were conducted with eight women who had been practising intuitive eating (IE) for at least 1.5 years. Data was analysed using IPA and four themes were drawn inductively from the data: IE as an ongoing process, perceived judgement of others, strategies of resistance and processes of self-actualisation. Further research is needed to explore experiences of learning to eat intuitively amongst different samples and with different cultures, and to further investigate the relationship between IE and the actualising tendency.
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Duffy ME, Rogers ML, Kennedy GA, Keel PK, Joiner TE. Examining the association between body trust and body mass index with quantile regression. Eat Weight Disord 2020; 25:1813-1819. [PMID: 31701379 DOI: 10.1007/s40519-019-00810-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Schachter's externality theory posits a connection between the inability to eat according to internal cues and higher body mass index (BMI); however, related work has not investigated associations between body trust and the wide range of BMIs found in general samples. This study examined the association between body trust and BMI across levels of BMI to determine whether this relationship differed as a function of BMI level. METHODS Participants were 534 adults (55.4% female), mean age 36 years, BMIs 15.13-67.90 (M = 27.89, SD = 7.25), recruited via MTurk. They completed self-report assessments of body trust, height, and weight. Quantile regression was utilized to estimate effects of body trust on BMI at five equidistant quantiles of BMI. RESULTS Overall linear regression analyses indicated that body trust was significantly negatively associated with BMI. Quantile regression revealed a significant negative relationship at each quantile of BMI, and Wald tests indicated the association was significantly stronger at the 0.7 and 0.9 quantiles than at the 0.1, 0.3, and 0.5 quantiles, which did not differ. CONCLUSIONS Quantile regression identified a stronger relationship between body trust and BMI at 0.7 and 0.9 quantiles than at 0.1, 0.3, and 0.5 quantiles of BMI. Results align with the externality hypothesis, which suggests those at higher weights experience difficulty using internal cues to guide eating. A weaker-than-expected association between body trust and low BMI may be due to restricted range (few low-BMI participants). Replication in eating disorder samples is merited. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306-4301, USA.
| | - Megan L Rogers
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306-4301, USA
| | - Grace A Kennedy
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306-4301, USA
| | - Pamela K Keel
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306-4301, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306-4301, USA
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Abstract
Internally regulated eating style, the eating style that is driven by internal bodily sensations of hunger and satiation, is a concept that has received increasing attention in the literature and health practice over the last decades. The various attempts that have been made so far to conceptualise internally regulated eating have taken place independently of one another, and each sheds light on only parts of the total picture of what defines internally regulated eating. This has resulted in a literature that is rather fragmented. More importantly, it is not yet clear which are the characteristics that comprise this eating style. In this paper, we identify and describe the full spectrum of these characteristics, namely, sensitivity to internal hunger and satiation signals, self-efficacy in using internal hunger and satiation signals, self-trusting attitude for the regulation of eating, relaxed relationship with food and tendency to savour the food while eating. With this research, we introduce a common language to the field and we present a new theoretical framework that does justice not just to the full breadth of characteristics that are necessary for the internally regulated eating style but also to the associations between them and the potential mechanisms by which they contribute to this eating style.
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Ruzanska UA, Warschburger P. How is intuitive eating related to self-reported and laboratory food intake in middle-aged adults? Eat Behav 2020; 38:101405. [PMID: 32599465 DOI: 10.1016/j.eatbeh.2020.101405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 01/29/2023]
Abstract
As intuitive eating (IE) is characterized by eating in response to internal cues of hunger and satiety and by monitoring the effect of food on the body, it has been hypothesized to lead to healthy food intake. Evidence concerning its link to food intake is scarce. This experimental study investigated the relationship between IE and food intake in middle-aged adults. Fifty-five participants aged 50-70 years completed the Intuitive Eating Scale-2 to measure IE. Usual consumption frequency of fruits, vegetables, snacks and sweets was assessed as a measure of healthy self-reported food intake. A taste test of apples, carrots, coated peanuts and chocolate was conducted as a measure of healthy and total laboratory food intake. Regression analyses were performed using Frequentist and Bayesian methods of inference. In line with our hypothesis, IE was associated with healthier self-reported food intake (medium effect size: f2 = 0.24). The data were 49.80 times more likely under H1 than under H0. Contrary to our hypotheses, IE was neither associated with healthy nor total laboratory food intake in classical regression analyses. The accompanying Bayes factors revealed inconclusive evidence. Data only allow drawing cautious conclusions about the different relationship between IE and the self-reported consumption frequency of the foods vs. the amount of these foods consumed in a single test situation. Future studies combining different measures of IE (e.g., behavioral paradigms) and self-reported (e.g., diet quality, portion sizes) and laboratory (e.g., repeated taste tests with pre-selected foods) food intake are warranted to further explore their relationship.
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Affiliation(s)
- Ulrike Alexandra Ruzanska
- Department of Psychology, Counseling Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany.
| | - Petra Warschburger
- Department of Psychology, Counseling Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
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