1
|
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.
Collapse
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
| |
Collapse
|
2
|
Koller OG, Menezes VM, Busanello A, de Almeida JC. Association between intuitive eating and health outcomes in outpatients with type 2 diabetes: a cross-sectional study. Eur J Nutr 2024; 63:1623-1634. [PMID: 38492023 DOI: 10.1007/s00394-024-03361-7] [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: 10/27/2023] [Accepted: 02/26/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE To evaluate the association between intuitive eating and health outcomes in patients with type 2 diabetes in a cross-sectional study. METHODS Consecutively, outpatients attending at university hospital underwent clinical, laboratory, lifestyle, and eating behavior evaluations. Intuitive eating was assessed using the Intuitive Eating Scale-2 (IES-2), and the Three Factor Eating Questionnaire-21 was adopted as a confirmatory tool for disordered eating behavior. Optimized health outcomes were considered according to the American Diabetes Association criteria for BMI, HbA1c, lipid profile, and blood pressure values, and the International Diabetes Federation criteria for waist circumference. Considering the answers of the IES-2 items, patients were grouped by latent class analysis, and their characteristics were compared by appropriate tests. RESULTS In total, 267 patients were evaluated: 62.2% women, with 60 (53-65) years, BMI 31.9 ± 5.4 kg/m², diabetes duration of 16 ± 9 years, HbA1c 8.5 ± 1.5%, and an IES-2 total score of 58 (50-67)%. Three intuitive eating groups were identified: higher intuitive eating, nonemotional-oriented coping, and lower intuitive eating. Patients with higher intuitive eating have higher chances of having optimized BMI and serum triglycerides values compared to patients with lower intuitive eating. Also, the 10-point increase on IES-2 was associated with a 0.62 kg/m² reduction on BMI values (95%CI -1.18;-0.06), 1.90 cm on waist circumference (95%CI -3.26;-0.54), and 23 mg/dL in serum triglycerides values (95%CI -38.27;-7.40) after adjustment for age, sex, psychotropic drug use, medication effect score, smoking, and BMI. CONCLUSION Intuitive eating seems to be associated with optimized health outcomes and may contribute to better personalized interventions in nutritional treatment that promote adaptive behaviors in diabetes management, but should be tested.
Collapse
Affiliation(s)
- Olívia Garbin Koller
- Graduate Program in Nutrition, Food and Health, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brazil
| | - Vanessa Machado Menezes
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brazil
| | - Aline Busanello
- Graduate Program in Nutrition, Food and Health, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brazil
| | - Jussara Carnevale de Almeida
- Graduate Program in Nutrition, Food and Health, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brazil.
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brazil.
- Nutrition and Dietetics Division, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Porto Alegre (RS), Rua Ramiro Barcelos 2350, 1º andar, Porto Alegre, 90035-003, Brazil.
- Department of Nutrition, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brazil.
| |
Collapse
|
3
|
Tylka TL, Maïano C, Fuller-Tyszkiewicz M, Linardon J, Burnette CB, Todd J, Swami V. The Intuitive Eating Scale-3: Development and psychometric evaluation. Appetite 2024; 199:107407. [PMID: 38729580 DOI: 10.1016/j.appet.2024.107407] [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: 01/17/2024] [Revised: 03/30/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024]
Abstract
Intuitive eating has been found to protect against disordered eating and preserve well-being. Yet, there are methodological (length), conceptual (inconsideration of medical, value-based, and access-related reasons for food consumption), and psychometric (item wording) concerns with its most common measure, the Intuitive Eating Scale-2 (IES-2). To address these concerns, we developed the IES-3 and investigated its psychometric properties with U.S. community adults. Across three online studies, we evaluated the IES-3's factorial validity using exploratory factor analysis (EFA; Study 1; N = 957; Mage = 36.30), as well as confirmatory factor analysis (CFA), exploratory structural equation modeling (ESEM), bifactor-CFA, and bifactor-ESEM (Study 2; N = 1152; Mage = 40.95), and cross-validated the optimal model (Study 3; N = 884; Mage = 38.54). We examined measurement invariance across samples and time, differential item functioning (age, body mass index [BMI], gender), composite reliability, and validity. Study 1 revealed a 12-item, 4-factor structure (unconditional permission to eat, eating for physical reasons, reliance on hunger and satiety cues, body-food choice congruence). In Study 2, a bifactor-ESEM model with a global intuitive eating factor and four specific factors best fit the data, which was temporally stable across three weeks. This model also had good fit in Study 3 and, across Studies 2 and 3, and was fully invariant and lacked measurement bias in terms of age, gender, and BMI. Associations between latent IES-3 factors and age, gender, and BMI were invariant across Studies 2 and 3. Composite reliability and validity (relationships with disordered eating, embodiment, body image, well-being, and distress; negligible relationship with impression management) of the retained model were also supported. The 12-item IES-3 demonstrates strong psychometric properties in U.S. community adults. Research is now needed using the IES-3 in other cultural contexts and social identity groups.
Collapse
Affiliation(s)
- Tracy L Tylka
- Department of Psychology, The Ohio State University, Columbus, OH, USA.
| | - Christophe Maïano
- Laboratory of Cyberpsychology, Department of Psychoeducation and Psychology, Université Du Québec en Outaouais, Saint-Jérôme, Canada; Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada
| | | | - Jake Linardon
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - C Blair Burnette
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Jennifer Todd
- School of Psychology, Sport, and Sensory Sciences, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
| | - Viren Swami
- School of Psychology, Sport, and Sensory Sciences, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
| |
Collapse
|
4
|
Baer NR, Grissmer NV, Schenk L, Wortmann HR, Warschburger P, Gisch UA. Practicing Interoceptive Sensitivity as a Couple: A Mixed-Methods Acceptance Analysis of a Dyadic vs. Single Pilot Randomized Controlled Trial. Nutrients 2024; 16:1949. [PMID: 38931304 PMCID: PMC11206497 DOI: 10.3390/nu16121949] [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: 04/30/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Training interoceptive sensitivity (IS) might be a first step in effectively promoting intuitive eating (IE). A dyadic interoception-based pilot randomized controlled trial was conducted to increase IE among couples aged 50+. The training consisted of three exercises, a Body Scan (BS), a hunger exercise (HU), and a satiety (SA) exercise. This study explored how spouses accepted the (dyadic vs. single) training. In a mixed-methods convergence design, the findings of a survey (n = 68 couples) and focus groups (n = 4) were synthesized. Moderate general acceptance (e.g., regarding feasibility and low burden) and a hierarchical gradient in favor of the BS (e.g., pleasantness and improved sleep quality) emerged. Barriers concerned a perceived lack of the exercises' usefulness and a limited understanding of the training purpose. A wish for regular feedback and exchange with the study stuff and other participants was expressed. Spousal training involvement was experienced as being rather beneficial. Previously harmonized dietary practices and daily routines appeared as constructive pre-conditions for the joint training. This study highlights the potential and implications of training couples in IS. Future interventions should involve a regular exchange and closer guidance by study staff to promote a better understanding of the processes and goals of IS and IE.
Collapse
Affiliation(s)
- Nadja-R. Baer
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Noemi Vanessa Grissmer
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Liane Schenk
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Hanna R. Wortmann
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Petra Warschburger
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Ulrike A. Gisch
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
- Department of Nutritional Psychology, Institute of Nutritional Science, Justus Liebig University Giessen, Senckenbergstr. 3, 35390 Giessen, Germany
| |
Collapse
|
5
|
Zhu Y, Gao J, Gao Q, Chen D, Zeng Z. Association between body weight perception and intuitive eating among undergraduate students in China: the mediating role of body image. Front Nutr 2024; 10:1288257. [PMID: 38268671 PMCID: PMC10805991 DOI: 10.3389/fnut.2023.1288257] [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: 09/04/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Background The association between body weight perception and intuitive eating among undergraduate students in China remains insufficiently understood. In the present study, we were aimed to examine the correlation between body weight perception, body image, and intuitive eating and determine whether the link between body weight perception and intuitive eating was influenced by body image. Methods A total of 1,050 undergraduate students completed the survey. Participants provided self-reported demographic details and completed two structured scales. The Body Esteem Scale for Adolescents and Adults (BESAA) and the Intuitive Eating Scale-2 (IES-2) were employed to assess body image and intuitive eating. Analysis of the mediation model was conducted using version 4.1 of the PROCESS Macro. Results with a value of p less than 0.05 were deemed statistically significant. Results The average age of the participants was 20.08 years (SD = 1.64). Among the students, 837 (79.7%) were female, and 212 (20.3%) were male. Body image (r = -0.429, p < 0.001) and intuitive eating (r = -0.313, p < 0.001) exhibited significant negative associations with body weight perception. Furthermore, body image showed a significant positive correlation with intuitive eating (r = 0.318, p < 0.001). Significant mediating effects of body image were identified concerning intuitive eating and body weight perception in the right weight (95% bootstrap CI = 0.007, 0.040) and overweight groups (95% bootstrap CI = -0.048, -0.009). The indirect effects of body image constituted 12.19% and 15.33% of the total effects of intuitive eating in these two groups. Conclusion Although the indirect effects were not substantial, these outcomes shed light on the partial understanding of how body weight perception impacted intuitive eating via body image. Importantly, our findings emphasized the significance of body image and body weight perception, offering a novel insight for prospective interventions targeting undergraduate students.
Collapse
Affiliation(s)
- Yuanyuan Zhu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jiage Gao
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qinyi Gao
- Nursing Department, Nanjing Jiangning Hospital, Nanjing, China
| | - Dandan Chen
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhi Zeng
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| |
Collapse
|
6
|
Naraindas AM, Cooney SM. Body image disturbance, interoceptive sensibility and the body schema across female adulthood: a pre-registered study. Front Psychol 2023; 14:1285216. [PMID: 38098520 PMCID: PMC10720753 DOI: 10.3389/fpsyg.2023.1285216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Body image disturbance (BID) typically involves explicit negative attitudes toward one's shape and weight and is associated with altered interoceptive sensibility (the subjective perception of internal bodily states). This association is a known risk factor for the development and maintenance of eating disorders. However, while research has centred on younger women with eating disorders, diverse facets of BID appear in women without eating disorders across adulthood. Research shows that in the general population, young women (ages 18-25) with high BID exhibit disturbances in the body schema: an implicit sensorimotor representation of the body in space which includes mental simulation of a movement such as motor imagery. Given that body image is subject to age-related influences, it is important to investigate how age-related variation in BID can influence the body schema beyond young adulthood alone. Here, we examine the relationship between BID, interoceptive sensibility and the body schema across female adulthood. Methods Cross-sectional data was collected online from 1,214 women across four age groups: Young adults (18-24), Adults (25-39), Middle-aged adults (40-59), and Older aged adults (60-75). BID was indexed by questionnaires measuring body objectification, state, and trait body dissatisfaction. Interoceptive sensibility (IS) was measured using the MAIA-2 questionnaire. The body schema was evaluated through the Own Body Transformation task: a mental rotation task which assesses the capacity to make an embodied mental transformation. Results Analyses revealed that while body objectification and trait body dissatisfaction decreased from young to older adulthood, state body dissatisfaction showed a marked increase. A negative relationship between IS and BID across all age groups was also evidenced. Finally, age, BID and orientation of the presented body were significant predictors of the time taken to make an embodied transformation. Discussion These findings highlight the consistent relationship of BID and IS across age groups beyond young adulthood and demonstrate the varying importance of different aspects of BID as individuals age. We also evidence for the first time that disruptions in body image have the potential to impact implicit sensorimotor representations of the body even in women without eating disorders across female adulthood.
Collapse
Affiliation(s)
| | - Sarah M. Cooney
- School of Psychology, University College Dublin, Dublin, Ireland
| |
Collapse
|
7
|
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.
Collapse
|
8
|
Murray K, Rieger E, Brown PM, Brichacek A, Walker I. Body image explains differences in intuitive eating between men and women: Examining indirect effects across negative and positive body image. Body Image 2023; 45:369-381. [PMID: 37087957 DOI: 10.1016/j.bodyim.2023.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 04/25/2023]
Abstract
Intuitive eating is an adaptive and flexible form of eating. Men report higher rates of intuitive eating than women. Objectification processes are proposed to underlie this (binary) gender difference due to the intense body-related pressures that disrupt body image in women. The current study is the first known to test whether body image indirectly explains lower levels of intuitive eating in women relative to men. A cross-sectional sample of 498 adults aged 18-74 years recruited through Prolific completed an online survey assessing intuitive eating and negative and positive body image indicators. Women reported poorer body image and lower levels of intuitive eating compared to men. Significant indirect effects suggested body image explained gender differences in intuitive eating, controlling for age and body mass index. In women relative to men, greater body surveillance and lower aesthetic satisfaction explained lower total intuitive eating and reliance on hunger and satiety, greater aesthetic investment explained lower total intuitive eating and eating for physical reasons, and lower functionality investment explained lower body-food choice congruence. More research is needed, but findings suggest programs may benefit from decreasing critical views of appearance and strengthening functionality investment in women to reduce gender differences in intuitive eating.
Collapse
Affiliation(s)
- Kristen Murray
- School of Medicine and Psychology, Australian National University, Building 39, Canberra, ACT 2601, Australia; Discipline of Psychology, University of Canberra, Building 12, Faculty of Health, Bruce ACT 2617, Australia.
| | - Elizabeth Rieger
- School of Medicine and Psychology, Australian National University, Building 39, Canberra, ACT 2601, Australia
| | - Patricia M Brown
- Discipline of Psychology, University of Canberra, Building 12, Faculty of Health, Bruce ACT 2617, Australia
| | - Anna Brichacek
- Discipline of Psychology, University of Canberra, Building 12, Faculty of Health, Bruce ACT 2617, Australia
| | - Iain Walker
- School of Medicine and Psychology, Australian National University, Building 39, Canberra, ACT 2601, Australia
| |
Collapse
|
9
|
Warschburger P, Wortmann HR, Gisch UA, Baer NR, Schenk L, Anton V, Bergmann MM. An experimental approach to training interoceptive sensitivity: study protocol for a pilot randomized controlled trial. Nutr J 2022; 21:74. [PMID: 36529744 PMCID: PMC9761996 DOI: 10.1186/s12937-022-00827-4] [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: 01/27/2022] [Accepted: 11/10/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Eating in absence of hunger is quite common and often associated with an increased energy intake co-existent with a poorer food choice. Intuitive eating (IE), i.e., eating in accordance with internal hunger and satiety cues, may protect from overeating. IE, however, requires accurate perception and processing of one's own bodily signals, also referred to as interoceptive sensitivity. Training interoceptive sensitivity might therefore be an effective method to promote IE and prevent overeating. As most studies on eating behavior are conducted in younger adults and close social relationships influence health-related behavior, this study focuses on middle-aged and older couples. METHODS The present pilot randomized intervention study aims at investigating the feasibility and effectiveness of a 21-day mindfulness-based training program designed to increase interoceptive sensitivity. A total of N = 60 couples participating in the NutriAct Family Study, aged 50-80 years, will be recruited. This randomized-controlled intervention study comprises three measurement points (pre-intervention, post-intervention, 4-week follow-up) and a 21-day training that consists of daily mindfulness-based guided audio exercises (e.g., body scan). A three-arm intervention study design is applied to compare two intervention groups (training together as a couple vs. training alone) with a control group (no training). Each measurement point includes the assessment of self-reported and objective indicators of interoceptive sensitivity (primary outcome), self-reported indicators of intuitive and maladaptive eating (secondary outcomes), and additional variables. A training evaluation applying focus group discussions will be conducted to assess participants' overall acceptance of the training and its feasibility. DISCUSSION By investigating the feasibility and effectiveness of a mindfulness-based training program to increase interoceptive sensitivity, the present study will contribute to a deeper understanding of how to promote healthy eating in older age. TRIAL REGISTRATION German Clinical Trials Register (DRKS), no. DRKS00024903. Retrospectively registered on April 21, 2021.
Collapse
Affiliation(s)
- Petra Warschburger
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.11348.3f0000 0001 0942 1117Department of Psychology, Counseling Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Hanna R. Wortmann
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.11348.3f0000 0001 0942 1117Department of Psychology, Counseling Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Ulrike A. Gisch
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.11348.3f0000 0001 0942 1117Department of Psychology, Counseling Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Nadja-Raphaela Baer
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.7468.d0000 0001 2248 7639Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Liane Schenk
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.7468.d0000 0001 2248 7639Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Verena Anton
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.7468.d0000 0001 2248 7639Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Manuela M. Bergmann
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.418213.d0000 0004 0390 0098German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| |
Collapse
|
10
|
Psychometric properties of a Greek translation of the Intuitive Eating Scale-2 (IES-2) in adults from Cyprus. Body Image 2022; 43:348-361. [PMID: 36272259 DOI: 10.1016/j.bodyim.2022.09.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022]
Abstract
The construct of intuitive eating is commonly assessed using the 23-item, 4-factor Intuitive Eating Scale-2 (IES-2; Tylka & Kroon Van Diest, 2013). In this study, we assessed the psychometric properties of a novel Greek translation of the IES-2 in adults from Cyprus. In Study 1 (N = 626), an exploratory factor analysis indicated that the IES-2 should be conceptualized as consisting of six factors that showed complete invariance across women and men. Study 2 (N = 793), using exploratory structural equation modelling (ESEM) and beifactor analysis (B-ESEM), indicated that the 6-factor B-ESEM model had adequate fit and evidenced complete invariance across sex once the correlated uniqueness of negatively worded IES-2 items was accounted for. This final model evidenced adequate composite reliability, and a global G-factor evidenced adequate convergent, concurrent, and discriminant validity. In contrast, the IES-2 S-factors showed more equivocal patterns of validity, with some S-factors showing less-than-adequate associations with body image variables, self-esteem, symptoms of disordered eating, and fruit and vegetable intake. In general, these results provide satisfactory evidence of the psychometric properties of the Greek IES-2 in adults from Cyprus, but also suggest that models of IES-2 scores may vary across national or cultural contexts.
Collapse
|
11
|
Teas E, Kimiecik J, Ward RM, Timmerman K. Intuitive Eating and Biomarkers Related to Cardiovascular Disease in Older Adults. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:412-421. [PMID: 35534099 PMCID: PMC9097336 DOI: 10.1016/j.jneb.2022.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 01/20/2022] [Accepted: 01/28/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Examine whether exercise and diet motivation are associated with 4 biomarkers related to cardiovascular disease. DESIGN Cross-sectional analysis. Data collection involved questionnaires, blood draws, body composition assessments, and accelerometry. SETTING Small, midwestern college town. PARTICIPANTS Community older adults (≥ 58 years of age; n = 79) recruited through convenience sampling; the sample was representative of the population of interest for some demographic characteristics (eg, age and sex) but not representative of other characteristics (eg, level of activity). VARIABLES MEASURED Independent variables comprised self-reported intrinsic exercise motivation (Behavioral Regulation for Exercise Questionnaire-3) and intuitive eating (Intuitive Eating Scale-2). Dependent variables included inflammatory proteins (C-reactive protein and interleukin-6) and lipid levels (low-density lipoprotein/high-density lipoprotein and triglycerides) quantified from blood samples. Covariates included age, body mass index, sex, and objective physical activity measured by accelerometers worn for 7 days. ANALYSIS Multiple linear regression was used to assess the association between diet and exercise motivation and biomarker outcomes; we analyzed 4 regression models (1 for each biomarker). Significance level P < 0.05. RESULTS Greater intuitive eating was associated with a lower low-density lipoprotein/high-density lipoprotein ratio (β = -0.45, P = 0.001) and lower triglycerides (β = -0.37, P = 0.003). Intrinsic exercise motivation was not associated with the biomarkers. CONCLUSIONS AND IMPLICATIONS Intuitive eating may be a key determinant of certain biomarkers and could be a viable target for interventions to help decrease the risk of cardiovascular disease among older adults.
Collapse
Affiliation(s)
- Elizabeth Teas
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN; Center for Aging and the Life Course, Purdue University, West Lafayette, IN.
| | - Jay Kimiecik
- Department of Kinesiology, Nutrition, and Health, Miami University, Oxford, OH
| | - Rose Marie Ward
- Department of Kinesiology, Nutrition, and Health, Miami University, Oxford, OH
| | - Kyle Timmerman
- Department of Kinesiology, Nutrition, and Health, Miami University, Oxford, OH
| |
Collapse
|
12
|
Rodgers RF, Berry R, Laveway K, Carrard I. Positive body image, intuitive eating, and psychosocial functioning among older women: Testing an integrated model. Eat Behav 2022; 45:101627. [PMID: 35366520 DOI: 10.1016/j.eatbeh.2022.101627] [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: 07/12/2021] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Research on the body image and eating behaviors of older women is scarce. Moreover, the scant existing research has lacked a focus on positive dimensions, such as positive reappraisal and acceptance, body appreciation, appearance satisfaction, and intuitive eating among older women. Therefore, the aim of the present study was to examine a model of the relationships among these positive dimensions and psychological functioning in older women. METHODS A sample of 171 women aged 60-75 years were recruited through social media to respond to a survey assessing body image, eating behaviors, and psychological wellbeing. RESULTS The final model was a good fit to the data. In this model, positive reappraisal and acceptance of age-related appearance changes was associated with higher body appreciation, in turn associated with higher body image related quality of life, higher levels of intuitive eating, and lower levels of depressive symptoms. CONCLUSION Positive body image and positive reappraisal of aging-related changes in appearance are associated with psychological wellbeing among older women. Longitudinal data are needed to clarify the direction of these relationships and inform interventions. Body image remains an important dimension among older women and should be accounted for in broader health promotion efforts among this group.
Collapse
Affiliation(s)
- Rachel F Rodgers
- APPEAR, Department of Applied Educational Psychology, Northeastern University, Boston, United States of America; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France.
| | - Rachel Berry
- APPEAR, Department of Applied Educational Psychology, Northeastern University, Boston, United States of America; Counseling and Psychological Services, University of Virginia, Charlottesville, VA, United States of America
| | - Katherine Laveway
- APPEAR, Department of Applied Educational Psychology, Northeastern University, Boston, United States of America
| | - Isabelle Carrard
- Department of Nutrition and Dietetics, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
| |
Collapse
|
13
|
de Ridder D, Gillebaart M. How food overconsumption has hijacked our notions about eating as a pleasurable activity. Curr Opin Psychol 2022; 46:101324. [PMID: 35339981 DOI: 10.1016/j.copsyc.2022.101324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 01/06/2023]
Abstract
The negative effects of overconsumption of food have been extensively studied, with a focus on overweight and negative food attitudes. In this overview, we argue that this negative perspective has spilled over to food consumption in general, which is in contrast with eating as a pleasurable activity that contributes to people's well-being. We review four areas of research that have recently emerged: (de)moralization of food consumption, moderate eating for pleasure, intuitive and mindful eating, and the social benefits of eating. Throughout these four themes, it becomes clear that there needs to be a clear distinction between overconsumption of food, bearing negative consequences, and normal levels of food consumption. The latter is positively associated with enjoyment, contentment, and our social and psychological well-being.
Collapse
|