Relationships of eating competence, sleep behaviors and quality, and overweight status among college students

A systematic review of observational studies exploring the relationship between health and non-weight-centric eating behaviours

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.

Examination of eating competence in a geo-diverse sample with metabolic syndrome

Eating competence (EatC) is an intra-individual approach to eating attitudes and behaviors associated with greater well-being. EatC research has not included persons with confirmed metabolic syndrome (MetS). Therefore, EatC of persons with MetS was explored to identify unique associations and inform implementation of MetS lifestyle interventions using baseline data from a multisite, randomized trial of a 2-year lifestyle intervention with MetS. EatC, measured with the Satter Eating Competence Inventory 2.0 (ecSI 2.0™), was examined for relationships with bioclinical measures (e.g., blood pressure, lipids), medication use, BMI, waist circumference, fruit/vegetable intake, and psychosocial factors, (e.g., stress, mindfulness). Data were collected in person and video call by trained research personnel. EatC was examined as a continuous score and as a categorical variable with ecSI 2.0™ scores ≥ 32 considered eating competent. Participants (n = 618) were predominantly female (76%), White (74%), college educated (60%). Mean age was 55.5 ± 11 y. Mean ecSI 2.0™ was 29.9 ± 7.4 and 42% were eating competent. EatC was greater for males, persons who were older and food secure. Competent eaters (vs. non-eating competent) had lower waist circumference (112.7 ± 12.5 cm vs.116.8 ± 16.0 cm; P < 0.001) and BMI (35.0 ± 6.1 vs. 37.5 ± 7.3; P < 0.001). Serum triglycerides, HDL-cholesterol, fasting blood glucose, HbA1c, and blood pressure did not differ by EatC status. Compared to non-eating competent persons, competent eaters perceived less stress, were more mindful, indicated better physical function, and more habitual vegetable intake (all P < 0.001) and sensory awareness (P < 0.05). EatC in MetS paralleled the non-MetS profile. EatC was associated with a healthier psychosocial profile, waist circumference and BMI. Findings support further research to examine the mediational or moderating influence of EatC in the treatment of MetS.

Validation of the French-Canadian Translation of the ecSatter Inventory 2.0 in an Adult Sample

OBJECTIVE

Evaluate the psychometric proprieties of the French-Canadian translation of the Satter Eating Competence Inventory (FrCanada ecSI 2.0).

DESIGN

Cross-sectional validation study.

PARTICIPANTS AND SETTING

424 French-Canadian adult Facebook users (61.8% women, 96.0% White).

VARIABLES MEASURED

Eating competence and variables related to eating or body image.

ANALYSIS

Factor analyses to assess the structural validity. Cronbach α and intraclass correlation coefficient to estimate reliability. Chi-square test of independence, Student t test, and Pearson's correlations to assess construct validity.

RESULTS

The mean eating competence score was 33.0 ± 7.8; 62.0% of participants were considered competent eaters (total score ≥ 32/48). The original 4-factor structure was not reproduced (unsatisfactory fit indices and/or factor loadings). Therefore, it is recommended to use the global score-but not the subscale scores-of the FrCanada ecSI 2.0. The questionnaire showed good internal consistency (Cronbach α = 0.86) and test-retest reliability (intraclass correlation = 0.81). Competent and noncompetent eaters differed according to gender (39.5% vs 27.3% male; P = 0.03), age (49.3 ± 13.6 vs 42.7 ± 14.2 years; P < 0.01), education (62.3% vs 50.6% with a university degree; P = 0.03), intuitive eating (3.6 ± 0.5 vs 3.1 ± 0.6; P < 0.001), cognitive restraint (12.3 ± 3.3 vs 13.8 ± 3.7; P < 0.001), and body esteem (3.3 ± 0.8 vs 2.5 ± 0.8; P < 0.001).

CONCLUSION AND IMPLICATIONS

Results suggest that the FrCanada ecSI 2.0 is a valid and reliable tool to measure eating competence in French-Canadian adults.

Eating competence in caregivers of celiac children: A cross-sectional study performed in Brazil

OBJECTIVES

Eating competence is an intraindividual approach to eating, behaviors, and attitudes related to eating, with repercussions on the individual and family. In pediatric celiac disease, the family is involved in the gluten-free diet management, the only treatment available. A gluten-free diet might affect eating competence because gluten-free diet compliance requires knowledge about food, meal planning, and attention to food choices. The objective is to access eating competence in caregivers of children with celiac disease and the association between caregivers' eating competence, children's adherence to a gluten-free diet, and sociodemographic data of participants.

METHODS

This cross-sectional study used a snowball spread method by applying a questionnaire, including sociodemographic data, data related to health, eating habits, and the Satter Eating Competence Inventory version validated for the Brazilian population. The sample consisted of 220 Brazilian parents or caregivers of celiac disease children. The scores of the Satter Eating Competence Inventory version validated for the Brazilian population were described in terms of means, SDs, medians, and interquartile range. Student's t test and analysis of variance followed by Tukey's post hoc tests were applied, and the association with the variables of interest was analyzed using Pearson χ2 tests. The tests were conducted considering bilateral hypotheses and a 5% significance level.

RESULTS

Participants' sex, schooling level, and income did not affect their eating competence. Competent eaters were mostly those with normal weight, following a gluten-free diet, with children complying with a gluten-free diet, and who have meals with family and prepare them at home. Different from vegetable consumption, participants' eating competence did not differ considering the frequency of children's fruit consumption.

CONCLUSIONS

The caregivers of children with celiac disease have greater eating competence scores than general Brazilian adults, and caregivers of children with celiac disease who comply with the gluten-free diet have higher eating competence scores.

Gender differences in factors related to eating competence in college students: Weight-and-body shame and guilt, weight satisfaction, weight loss effort, and eating disorder risk

PURPOSE

This study aimed to determine which weight-and-body-related attitudes and behaviors were most predictive of Eating Competence (EC) in college students amidst COVID-19, according to gender.

METHODS

This cross-sectional study was part of a larger study in which an online survey was administered during autumn quarter 2020 to undergraduate students at a northwestern U.S. public university. Measures included EC (ecSI 2.0™), weight-and-body shame and/or guilt (WEBSG), weight satisfaction, current weight loss effort, and eating disorder risk.

RESULTS

Of the 1996 respondents included in the final analyses, 40.2 % were eating competent (ecSI 2.0™ ≥32). Gender distribution was 71.6 % women, 23.1 % men, and 4.6 % trans-and-gender non-conforming (TGNC). WEBSG and WEB-S were higher in women and TGNC than in men. Weight satisfaction was lower in women and TGNC students than men, and 47.3 % of the sample was trying to lose weight at the time of the study. Eating disorder (ED) risk was prevalent with nearly 34 % scoring ≥2 on SCOFF and 33 % reporting they saw themselves as having an ED now or in the past. Significant factors of EC varied for each gender, although WEB-S was a shared model factor for all genders.

CONCLUSION

EC may be protective, as this was related to less WEB-S in all genders; less WEB-G and greater weight satisfaction in men and women; and lower likelihood of ED risk and trying to lose weight among women. Further research is needed to elucidate whether these maladaptive weight-and-body attitudes and behaviors in college students can be improved to increase EC.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional study.

Insomnia Medication Use by University Students: A Systematic Review

Problematic sleep or insomnia has been a recognised issue for many individuals in society, and university students can be of particular concern due to unique academic pressures. A systematic review was designed to summarise the current evidence about the extent of insomnia medication used by university students and identify characteristics of those more willing to use medication to manage insomnia. Searches were undertaken using Psych INFO, PubMed, Embase, and Web of Science, resulting in 25 eligible studies across multiple countries between 1994 and 2020. The prevalence of sleep medication use by students varied widely, from 2% to 41.2%, with an average of 13.1%. Female gender, students experiencing poor sleep, smoking, drinking stimulant beverages, and undertaking fewer physical activities were associated with the use of insomnia medication. Insomnia medication use exists within university student populations but appears to vary considerably worldwide; identifying multiple population characteristics associated with such use would offer opportunities to identify and support those affected.

Associations between health issues and food consumption with overweight and obesity in three university students minorities

Objective: To determine the presence of overweight and obesity among minorities, and the factors contributing to this weight disparity. Participants: The study comprises 3405 students including nonwhite, international, and first-generation college students. Methods: An online cross-sectional survey collected data on demographics, height, weight, self-health perception, overall sleep quality, progress in school, and food consumption. Three logistic regressions tested abnormal weight associations with health issues and food consumption. Results: Being 31 years-old or older, perception of health and consumption of ultra-processed food was significant with abnormal weight (BMI > 25). Only nonwhite and international students were correlated with ultra-processed and fast-food consumption respectively. Conclusion: Each minority presented vulnerabilities to high percentages of weights exceeding the appropriate rates of BMI. The high consumption of fast and ultra-processed foods makes it important to consider factors related to health perception in each minority group.

Are Emotional Eating and Other Eating Behaviors the Missing Link in the Relationship between Inadequate Sleep and Obesity? A Systematic Review

Evidence is emerging to explain that the relationship between inadequate sleep and obesity could be influenced by emotional eating and other eating behaviors such as disinhibition. Therefore, our aim was to conduct a systematic review to analyze the potential role of emotional eating and other eating behaviors in the relationship between inadequate sleep and obesity. We conducted a comprehensive search on 2 databases (Medline and Scopus) looking for records from 1 January 2011 until 31 December 2022 without language restrictions. Cross-sectional, longitudinal, and interventional studies were included if they assessed the association between sleep and emotional eating, as well as the role of emotional eating on the relationship between inadequate sleep and obesity. Secondary outcomes included studies analyzing the link between sleep and other eating behaviors as well as their role in the sleep-obesity relationship. Our results showed that emotional eating and disinhibition play a significant role in the relationship between inadequate sleep and obesity, especially in women. Furthermore, we provide evidence of other eating behaviors (e.g., external eating, eating competence, and hunger), which are also associated with poor sleep outcomes. However, these behaviors do not seem to be determinants of the association between sleep and obesity. In conclusion, our results suggest that individuals with inadequate sleep who are prone to emotional eating and/or disinhibition may require tailored approaches for obesity prevention and treatment.

Eating Competence among Brazilian College Students

Eating competence (EC) is a biopsychosocial concept related to a healthier eating pattern. Studies have shown that weight gain and body shape and weight dissatisfaction are typical among college students, contributing to low self-esteem, risky eating behaviors, and a propensity to develop eating disorders. As eating habits are determinant factors for food choices that can be modified by eating behavior, this study aimed to evaluate EC in college students from Brazil, using the Brazilian version of the EC Satter Inventory (ecSI2.0™BR), and EC's association with health data. This cross-sectional study was conducted using an online survey spread using the snowball method. The self-report instrument was divided into three parts (socioeconomic and demographic data; health data; and ecSI2.0™BR). Recruitment took place through social networks, and 593 students from public and private universities from all five regions of Brazil participated in the survey. The EC average was 29.46 ± 8.67, and 46.2% of the sample were considered competent eaters. Total EC did not differ among gender and Brazilian region. Younger participants (up to 20 y/o) presented higher scores for total EC, contextual skills and food acceptance. The total EC and contextual skills of health sciences students did not differ from those of students in other areas, except for agricultural sciences in which students had lower total EC. Obese individuals and the participants who perceived themselves to be overweight had low scores for EC. This study confirmed the hypothesis that college students have low EC, causing worse health outcomes related to BMI, perceived body weight, and occurrence of hypertension and dyslipidemia.

Examining the relationship between obstructive sleep apnoea and eating behaviours and attitudes: A systematic review

BACKGROUND

Between 60 and 90% of adults with OSA are reported as overweight. The co-existence of obesity and OSA can greatly increase an individual's risk of type 2 diabetes, metabolic syndrome and cardiovascular disease. To better understand this relationship between OSA and weight, this review aimed to investigate if there is evidence of certain eating behaviours or eating attitudes that might be found in adults living with OSA.

METHODS

We searched four databases (MEDLINE, Embase, PsycInfo and Web of Science) on January 17th, 2022, to identify studies assessing the association between eating patterns and OSA in adults. Twenty-one studies met the inclusion criteria. A narrative synthesis was conducted on the included studies, following the vote-counting method.

RESULTS

There is preliminary evidence that the time of day when calories are consumed is associated with lower OSA severity. No other clear patterns of eating behaviours or attitudes were identified however this may be due to disparity within research studies and their reported results.

CONCLUSION

Further research is needed to examine the relationship between eating times and OSA severity. We recommend standardising the approach to examining the eating patterns of those living with OSA and the relationship that this might have on OSA symptoms as well as looking at attitudes towards food in this population. This may prove helpful in providing a better understanding of the relationship between OSA and persons with overweight and help in future intervention development.

Everyday discrimination is a stronger predictor of eating competence than food insecurity or perceived stress in college students amidst COVID-19

Stress is a common experience of college students, which has been exacerbated by COVID-19. Perceived stress may help predict students’ eating behaviors. Eating competence is an adaptive model of eating characterized as being flexible, comfortable, and positive with food and eating, and reliable about getting enough nourishing and enjoyable food to eat. Eating competence is associated with numerous health benefits and may be developing and/or disrupted as young adults transition to college. No prior research has explored the associations of everyday discrimination and food insecurity with eating competence, and there is limited research on the eating competence of trans and gender nonconforming (TGNC) college students. This cross-sectional study sought to examine the associations of everyday discrimination, food insecurity, and perceived stress with eating competence in a sample of 1996 undergraduate students. Participants completed an online survey comprised of validated tools assessing socio-demographics, eating competence, everyday discrimination, food insecurity, and perceived stress and stress management. After accounting for covariates (gender, stress management), multivariate regression analyses were conducted, and the coefficients of partial determination revealed that everyday discrimination was the strongest predictor of eating competence. Results demonstrated that lower experience of everyday discrimination, less stress, and being food secure were associated with greater likelihood of being eating competent (EC). Men were more likely to be EC than women or TGNC identities. Since the experience of everyday discrimination was the strongest, inverse predictor of eating competence, addressing discrimination must be considered in future efforts to improve eating competence.

Differences in health behaviors related to overweight/obesity by race/ethnicity in a diverse urban commuter college

Objective: To examine health behaviors associated with overweight/obesity by race/ethnicity at a diverse urban college. Participants: 270 undergraduates (77.0% female; 26.7% non-Hispanic white) and median body mass index (BMI) of 23.1 kg/m². Methods: A questionnaire about health-related behaviors as part of the "Get Fruved" project was used to measure health behaviors (sugar sweetened beverage (SSB), fruit and vegetable consumption, physical activity, stress, and sleep) by race/ethnicity. Multivariable logistic regression was used to assess the adjusted odds of engaging in positive health-related behaviors. Results: Non-Hispanic black and Hispanic students were 64% and 59% less likely to consume lower amounts of SSB. Hispanic students were 83% and 81% less likely to meet vegetable and fruit recommendations. Non-Hispanic black and other (including biracial) had reduced odds of meeting vegetable recommendations (AOR = 0.18 and 0.28). Conclusions: Disparities in SSB, fruit, and vegetable consumption represent potential intervention targets to improve health behaviors among racial/ethnic minorities.

Characteristics of picky eater children in Turkey: a cross-sectional study

Objective

The aim of this study is to investigate the relations of picky eating habit of children with their nutrition, physical activity, screen time and sleep habits in the context of parental picky eating habit.

Methods

In a cross-sectional study a questionnare was applied to the parents of children aged 6–13 years in two provincies. The cases were analyzed as the overall group and the two subgroups in which both parents are not picky eater, and in which at least one parent was picky eater. Child's risk of being picky eater was analyzed by logistic regression.

Results

A total of 913 children and parent pairs were included in the study. The risk of picky eating of the child increases 2.85 (AOR: 1.67–4.88) times when only the mother was picky eater, 5.99 (AOR: 3.32–7.52) times when only the father was picky eater, and 22.79 (AOR: 6.95–74.71) times when both of the parents were picky eaters. In the subgroup in which at least one parent was picky eater, it was determined that children with physical activity duration of ≥ 1 h/day and sleep time of ≥ 9 h /day were less likely to be picky eater and the children with screen time of ≥ 2 h/day were more likely to be picky eaters.

Conclusion

Picky eating habit in childhood is related to the picky eating habit of the parents. In the context of this relationship, the picky eating habit of children is related to sleep, physical activity, screen time and other eating habits.

Eating Competence and Aspects Related to a Gluten-Free Diet in Brazilian Adults with Gluten-Related Disorders

This cross-sectional study aims to assess eating competence (EC—an intra-individual approach to food, behaviors, and attitudes related to food) and aspects related to a gluten-free diet (GFD) in Brazilian adults with gluten-related disorders (GRDs). The research was conducted using an online survey with a self-reported instrument consisting of 40 items, organized into three parts: (I) Socioeconomic and demographic data; (II) the Brazilian version of the Eating Competence Satter Inventory (ec-SI2.0™BR); and (III) questions about adherence and difficulties in following the gluten-free diet. EC was measured by the ecSI2.0™BR instrument, with scores ≥32 were considered competent eaters. The instrument was applied nationwide through the GoogleForms® platform from 14 February 2022 to 30 March 2022. The publicity for the recruitment was supported by Brazilian celiac local and national associations (Acelbras and Fenacelbra), pages of food services or personal pages of tips and posts about gluten-related disorders, and specialized stores that offer gluten-free foods. The recruitment occurred through social networks (emails, Facebook groups, WhatsApp, and Instagram). A total of 1030 Brazilians with GRDs answered the questionnaire. Most participants were female, aged 40 years or older, with an income >R$3000, and a high education level. The main difficulty regarding adherence to GFD was the high cost of gluten-free foods. Individuals younger than 40 years old had lower EC scores, with no differences between men and women. Increasing socioeconomic status, schooling, and culinary practices increased the total score. Participants who “never/almost never” felt socially judged because their diet had higher scores for total EC. Competent eaters GRD individuals (EC ≥ 32) were mostly individuals aged ≥40 y/o; with income > R$3000; following a GFD; satisfied with purchased gluten-free products; consuming gluten-free products prepared at home, mainly by themselves; who do not feel judged because of the GRD and who feel that they can live a normal life with GRD. Our study showed that individuals who strictly adhere to the GFD have higher scores on eating competence than those who sometimes follow the treatment.

Eating Competence, Food Consumption and Health Outcomes: An Overview

Eating Competence (EC) is one behavioral perspective of eating practices that has been associated with a healthy lifestyle. It emphasizes eating pleasure, self-regulation of eating, body weight satisfaction, and regular meal frequency that includes food variety without focusing on dietary guidelines. EC is composed of four components (Eating Attitude, Food Acceptance, Internal Regulation, and Contextual Skill), and its assessment is performed using the Eating Competence Satter Inventory (ecSI2.0™), developed and validated in English for an adult population. EC has been associated with diet quality and health indicators for various population groups and the development of skills that increase EC might be a strategy to improve nutritional health, and prevent obesity and other chronic diseases. In this sense, this study presents an overview of the background, concepts, features, and possible associations among EC, food consumption, and health outcomes. The high prevalence of diseases associated with food/nutrition draws attention to the necessity to broaden the view on food and its relationship with health and well-being, considering not only nutrients and food combinations but also the behavioral dimensions of eating practices. Healthy nutritional recommendations that take into account attitudes and behaviors are in accordance with the EC behavioral model. Studies on eating behavior emphasize the need to better understand attitudes towards food and eating in the general population using validated instruments. In this context, measuring EC and its association with health outcomes seems to be relevant to nutritional health. The complexity of food choices has been examined in social, behavioral, and biological sciences, representing a great challenge for applying unique and simple theoretical models. Multiple methods are required, as no single theory can fully explain food selection.

Enhanced Eating Competence Is Associated with Improved Diet Quality and Cardiometabolic Profile in Finnish Adults with Increased Risk of Type 2 Diabetes

Eating competence (EC) is characterized by positive attitudes towards food and eating, having regular meals, eating a variety of foods, and internally regulated eating. We investigated the associations of changes in EC with changes in lifestyle, anthropometrics and biomarkers of glucose and lipid metabolism in 2291 adults at increased risk of type 2 diabetes as part of the StopDia study conducted in primary healthcare. EC and diet quality were assessed with validated digital questionnaires. During the intervention, the participants received either (1) the digital lifestyle intervention, (2) the combined digital and face-to-face group-based lifestyle intervention, or (3) standard care. EC increased among the participants independent of the intervention type. Increase in EC was associated with an increase in diet quality, high-density lipoprotein (HDL) cholesterol, and with a decrease in body mass index and waist circumference, regardless of baseline EC. Of the subdomains of EC, the contextual skills, food acceptance and eating attitudes were associated with various of these changes. Our results thus suggest that EC could be a potential target in lifestyle interventions aiming to improve the cardiometabolic health of people at type 2 diabetes risk.

Eating Competence and Dietary Intake of Sexual and Gender Minority College Students

Sexual and gender minority college students are underrepresented in nutrition research and may face unique challenges related to eating which impact their overall diet quality. We assessed the differences in eating competence and dietary intake between sexual and gender minority (SGM) and cisgender heterosexual (CH) college students. Participants (n = 2645) reported sexual orientation, gender identity and completed the Eating Competence Satter Inventory (ecSI 2.0™ through an online questionnaire. Three-day food records examined dietary intake. Intake was compared to recommendations for nutrients of public health concern. Chi-square and ANCOVA examined differences between eating competence and dietary intake. There were no differences in total ecSI 2.0™ scores. Subscale scores for Eating Attitudes and Contextual Skills were significantly higher in CH vs. SGM students (13.4 ± 0.1 vs. 12.4 ± 0.4 p = 0.01 and 10.7 ± 0.1 vs. 9.9 ± 0.3, p = 0.01, respectively). Most students (40.8%) met one nutrient recommendation. The proportion of students meeting nutrient recommendations were similar for SGM and CH. SGM populations may struggle with attitudes and eating behaviors. Dietary intake of SGM and CH students were similarly inadequate when compared to recommendations.

Prisoner's insomnia prevalence, insomnia associated factors and interventions with sleep as an outcome: a review and narrative analysis

PURPOSE

Insomnia is highly prevalent in prisoners. The purpose of this paper is a review of research evidence on interventions with sleep as an outcome (2000 to 2020) and rates of insomnia prevalence and associated factors in prisons (2015 to 2020).

DESIGN/METHODOLOGY/APPROACH

An internet-based search used Medline, PubMed, PsycINFO (EBSCOhost), Embase, Web of Science and Scopus. Seven interventions and eight sleep prevalence or sleep-associated factor papers were identified.

FINDINGS

Intervention research was very limited and the quality of the research design was generally poor. Interventions such as cognitive behavioural therapy for insomnia (CBT-I), yoga and mindfulness can be beneficial in a prison setting. This review identified a high prevalence of insomnia in prisons across the world, which was supported by recent evidence. Factors associated with insomnia include anxiety, depression, post-traumatic stress disorder, personality disorder and pain.

RESEARCH LIMITATIONS/IMPLICATIONS

There is a need for appropriately powered randomised control trials of CBT-I in prisons and a need to use objective measures of sleep quality.

ORIGINALITY/VALUE

Due to a lack of an up-to-date review, this paper fulfils the need for a review of the evidence on interventions in prison settings with sleep as an outcome, rates of insomnia prevalence and associated factors in prisons.

Psychosomatic Stress Responses and Sleep Disturbance Mediate the Effects of Irregular Mealtimes on Presenteeism

BACKGROUND

Presenteeism is the loss of work productivity of workers owing to physical and mental problems, and its socioeconomic effects are greater than those of absenteeism. Presenteeism is caused by psychological and physical dysfunctions. On the other hand, the regularity of mealtimes is an important factor associated with physical and mental health conditions. We hence assessed the association among the irregularity of mealtimes, presenteeism, psychological and physical stress responses, and sleep disturbance in office workers in companies.

METHODS

From May to December 2017, the data of 2905 participants who had given their consent to use their information for academic purposes, and answered a questionnaire about the survey and their lifestyle were collected. Path analysis was performed to analyze the association between the irregularity of mealtimes, psychosomatic symptoms (Brief Job Stress Questionnaire), sleep disturbance (Pittsburgh Sleep Questionnaire), and presenteeism (Work Limitations Questionnaire).

RESULTS

The direct effect of the irregularity of mealtimes on presenteeism was significant but weak. However, the irregularity of mealtimes had a strong effect on presenteeism indirectly through psychological and physical stress responses and sleep disturbance.

CONCLUSION

Psychological and physical stress responses and sleep disturbance were identified as mediating factors of the effects of irregularity of mealtimes on presenteeism.

Determinants of sleep quality in college students: A literature review

PURPOSE

To review the various determinants of sleep quality among college students.

METHODS

The PubMed, Web of Science and Cochrane Library databases were searched with the search string "sleep quality" AND "college students" for articles published between January 2007 and October 2017. Articles were excluded if they (1) examined sleep quality as a risk factor for other outcomes or (2) involved inpatients or participants under medical care.

RESULTS

The 112 identified studies were classified into categories according to the investigated determinants and their effect on sleep quality. Physical activity and healthy social relations improved sleep quality, while caffeine intake, stress and irregular sleep-wake patterns decreased sleep quality. Less consistent results were reported regarding eating habits and sleep knowledge, while proper napping during the day might improve overall sleep quality.

CONCLUSIONS

College students are vulnerable to different risk factors for sleep quality. When designing interventions to improve sleep quality among college students, the main determinants need to be taken into consideration.

Psychometric examination of the Japanese translation of the Satter eating competence Inventory-2.0™ for parents of fifth and sixth grade students

AIM

To verify the reliability and validity of a Japanese translation of the Satter eating competence Inventory-2.0™ (ecSI-2.0™) for parents of fifth and sixth grade elementary school students.

METHODS

Participants were parents who prepared meals for their children aged 10-12 years. A preliminary study was conducted with 11 parents using semi-structured interviews and questionnaires, followed by a main study of 2,825 parents. Internal consistency and test-retest methods were used to verify reliability. Face and content validity were confirmed in the preliminary study, and feasibility was examined by the valid response rate and response time. Construct validity was verified using factor validity and known population validity.

RESULTS

Of the 2,825 persons surveyed, 626 returned valid responses, and among the 60 persons who received the re-survey, 48 returned valid responses. The average score of the Japanese translation of the ecSI-2.0™ was 33.1 (SD ± 7.8) points. Cronbach's alpha coefficient for the whole scale was .87 and ranged from .67-.79 for the four subscales. The test-retest method confirmed the scale's stability. Factor analysis confirmed that reproducibility of the four factors was similar to the original version. In the examination of known population validity, the same correlation as the original edition was confirmed.

CONCLUSIONS

The Japanese translation of the ecSI-2.0™ may be reliable and valid for understanding eating competence related to behavior of parents of school-age children.

Eating Competence Associated with Food Consumption and Health Outcomes among Brazilian Adult Population

This study aimed to associate Eating Competence (EC) with food consumption and health outcomes in the Brazilian adult population. Researchers developed a questionnaire to associate EC with sociodemographic information, health outcomes, and food consumption. Data on body weight and height was referred to by participants in the questionnaire, and body mass index (BMI) was calculated and classified. A question to evaluate the perception of body size was included. After constructing the questionnaire items, content validation and semantic evaluation were performed following the Delphi method with a group of judges composed of 26 health professionals. The judges evaluated the sociodemographic information, health outcomes, and food consumption items associated with the eating competence instrument (previously validated in Brazilian-Portuguese). The final version of the questionnaire was composed of 33 items. Our results confirmed good reliability, responsiveness, and internal consistency. A total of 1810 Brazilians answered the questionnaire. Most of the participants were female, up to 40 years old, with a high education level and high income. Most of the participants did not report diabetes or hypertension. The EC total score did not differ among males and females. Individuals up to 40 years old presented a lower total score. The increase in educational level and income also increased EC total score. Excess weight individuals showed lower EC compared to the normal weight/underweight. Individuals who consumed fruits and/or vegetables five or more days/week presented the best scores for total EC.

Have Our Attempts to Curb Obesity Done More Harm Than Good?

Dieting is a common method for weight loss, maintenance, and prevention of weight gain, but the harmful outcomes of dieting are understudied. Dieting is typically advised for obese patients for the sake of their health, though this does not account for the many complicated factors surrounding obesity. We conducted a search through the PubMed database on obesity, dieting, and eating disorders and did not limit the study by population or year. We found studies showing that although dieting may cause short-term weight loss, it is associated with weight gain in the long-term. We also found studies assessing the negative psychological and physical outcomes of dieting. Though there are many studies that emphasize the negative psychological impact of dieting, few studies have explored how dieting may contribute to the development of eating disorders in the obese. Studies on the physical impact of dieting were less conclusive but warrant further study. While it is difficult to draw any substantial conclusions from the data, our results showed that dieting may carry more risks than benefits as a means to lose weight.

Eating Competence among a Select Sample of Brazilian Adults: Translation and Reproducibility Analyses of the Satter Eating Competence Inventory

This study aimed to translate and validate the Satter Eating Competence Inventory (ecSI2.0^TM) from English to Brazilian Portuguese. The process included three steps: (i) translation and back-translation of the original ecSI2.0^TM to Brazilian Portuguese; (ii) evaluation of its reproducibility; (iii) a pilot study to validate the Brazilian version of the Satter Eating Competence Inventory (ecSI2.0^TMBR) for a selected sample of the Brazilian adult population (internal consistency and factor validity). The reproducibility (test–retest reliability) was verified using the intraclass correlation coefficient (ICC) obtained by the responses of 32 Brazilian adults. All domains of the ecSI2.0^TMBR and the total score showed ICC > 0.8. Considering the entire questionnaire, none of the domains presented significant divergences among the participants’ responses (p < 0.001). In the pilot study with 662 individuals, 74.9% (n= 496) were female, mean age was 40.33 ± 12.55, and they presented a higher level of schooling and income. Analyses revealed Cronbach’s alpha coefficients of 0.869 for the ecSI2.0^TMBR total scale, 0.793 for Eating Attitudes, 0.527 for Internal Regulation, 0.728 for Food Acceptance, and 0.822 for Contextual Skills. In general, the ecSI2.0™BR presented good acceptability, showing total floor and ceiling effects of ≤0.6%. Factor validity was examined by confirmatory factor analysis. The four domains presented a good fit in the confirmatory factor analysis: RMSEA = 0.0123 (95% CI: 0–0.0266); CFI = 0.998; χ² = 75.9; df = 69; p = 0.266. The ecSI2.0^TMBR is the first tool designed to measure eating competence (EC) in the Brazilian population, showing good reproducibility and internal consistency. We expect the ecSI2.0^TMBR will support innovative research to investigate the association of EC and health outcomes, as well as new strategies based on emerging behavioral theories to enhance nutritional education policy.

Exploring Relationships of Sleep Duration with Eating and Physical Activity Behaviors among Canadian University Students

BACKGROUND

Students pursuing postsecondary education are a population described as vulnerable for sleep problems, poor dietary habits, weight gain, and reduced physical activity. The primary goal of this study was to examine relationships of sleep behaviors with eating and physical activity behaviors in a sample of undergraduate health sciences students.

METHODS

Using a cross-sectional design, undergraduate health sciences students in a small Canadian university were recruited to complete an on-line questionnaire about their sleep, eating, and physical activity behaviors using valid and reliable instruments. Key sociodemographic characteristics and self-reported height and weight data were also captured.

RESULTS

The participants (n = 245) were on average 23 years of age, female (86%), and the majority were full-time students (92%). The mean BMI was within a healthy range (mean 24.58 SD 5.55) with the majority reporting low physical activity levels (65%). Despite self-reports of very or fairly good (65%) sleep quality in the past month, the mean global sleep scores (scores > 5, mean 7.4, SD 3.3) indicated poor overall sleep quality. Poorer sleep quality was associated with higher BMIs (r = 0.265, p < 0.001).

CONCLUSIONS

The findings highlight the need to expand the scope of on-campus wellness programs to promote healthy sleep habits in a vulnerable university population.

Poor sleep quality and associated factors in university students in Bogotá D.C., Colombia

Objective

Poor sleep quality is a common problem in the general population, frequently associated with personal habits and comorbid conditions. University students may be a vulnerable population because of their daily routine, habits and sleep hygiene behavior. There are few related studies on this subject in Colombian undergraduates. The aim of this study is to characterize sleep quality in Colombian university undergraduates and examine possible associated factors.

Methods

Cross-sectional study was performed with self-administered questionnaires including demographic data, lifestyle habits, sleep hygiene habits and sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI). The study group included 414 students from different schools enrolled at the Pontificia Universidad Javeriana in Bogotá, Colombia.

Results

Prevalence of poor sleep quality according to PSQI was 58.9%. Multivariate analysis showed an association of poor sleep quality with smoking (OR = 3.17 [1.51-6.66]) and eating in bed (OR = 2.13 [1.31-3.47]), with probable protective factors in sleeping at the same time (OR = 0.37 [0.25-0.59]) and having breakfast 5 or more days of the week (OR = 0.53 [0.31-0.91]).

Discussion

Poor sleep quality is frequent among undergraduates, regardless of their area of study. The identification of possible related factors may help to design targeted preventive measures, as it is promoting healthy lifestyle habits, adequate sleep hygiene practices and avoiding tobacco use.

Influence of physical activity on weight status during the first year of college

Objective: To provide an analysis of weight change in response to physical activity levels among first year college students. Participants: First year students (N = 114) participated during the 2012-2013 academic year. Methods: Using a web-based survey, researchers gathered information on physical activity and weight at three points: twice throughout the fall and once at the end of the spring semesters. Results: Over half (56.25%) of respondents reported weight gain (between 0.45 and 13.61 kg) from baseline to 9-month follow-up. Weight gainers reported an average gain of 4.20 kg. More than half of participants were not meeting minimal recommendations for cardiorespiratory fitness (59.5%) and strength (53.2%) by the end of the first year of college. Conclusion: This research provides support for intervention and implementation of strategies to promote self-regulation in college students during the transition to college. Addressing the importance of physical activity in weight maintenance is beneficial to first year students' well-being.

Eating Competence Is Associated with Lower Prevalence of Obesity and Better Insulin Sensitivity in Finnish Adults with Increased Risk for Type 2 Diabetes: The StopDia Study

A healthy diet prevents type 2 diabetes but is often difficult to adhere to. This cross-sectional study aimed to investigate whether eating competence is associated with diet or risk factors and prevalence of type 2 diabetes in individuals screened for type 2 diabetes risk. Eating competence is an indicator of food acceptance, positive attitudes, internal regulation and contextual skills related to food and eating. In total, 3147 Finnish adults aged 18-74 at an increased risk for type 2 diabetes identified via online risk screening participated in the baseline examinations of the Stop Diabetes (StopDia) study. The participants filled out the digital questionnaire on food intake, physical activity and sleep, and the Satter Eating Competence Inventory 2.0^TM (ecSI 2.0^TM). In addition, anthropometric and laboratory measurements were performed at primary healthcare centres. Eating competent individuals (37%, classified by ecSI 2.0^TM) had a better quality of diet (p < 0.05 for all). Additionally, eating competence was associated with a lower prevalence of previously undiagnosed type 2 diabetes, abdominal obesity, metabolic syndrome and hypertriglyceridaemia, and with better insulin sensitivity (p < 0.05 for all). However, these associations, except for metabolic syndrome, were at least partly mediated by body mass index. Eating competence is associated with a healthy diet and could, thus, in the long term, support the prevention of type 2 diabetes.

Satter Eating Competence Inventory Subscale Restructure After Confirmatory Factor Analysis

OBJECTIVE

To examine the structural validity of the empirically and theoretically derived Satter Eating Competence Inventory (ecSI 2.0).

METHODS

Confirmatory factor analyses with 3 databases and a merger with 3 additional data sets (n = 2,010) from demographically heterogeneous samples.

RESULTS

Findings supported retaining all 16 items and migration of the item I trust myself to eat enough for me from the Internal Regulation to Eating Attitudes subscales, providing 4 distinct but correlated subscales and an adequately fitting model, χ²(98) = 1,364.27, P < .001, comparative fit index = .91, root mean square error of approximation = .07, 95% confidence interval, 0.07-0.08, standardized root mean square residual = .05.

CONCLUSION AND IMPLICATIONS

Psychometric integrity of the 16-item ecSI 2.0 was affirmed. Continued examination is recommended with cultural and linguistically diverse samples and network analyses to identify dynamic interactions among items.

Eating Competent Parents of 4th Grade Youth from a Predominantly Non-Hispanic White Sample Demonstrate More Healthful Eating Behaviors than Non-Eating Competent Parents

The purpose of this study was to determine if the associations between eating competence (EC) and eating behaviors that were found in a USA sample of predominantly Hispanic parents of 4th grade youth could be replicated in a USA sample of predominantly non-Hispanic white parents of 4th graders. Baseline responses from parents (n = 424; 94% white) of youth participating in a year-long educational intervention were collected using an online survey. Validated measures included the Satter Eating Competence Inventory (ecSI 2.0^TM), in-home fruit/vegetable (FV) availability, healthful eating behavior modeling, and FV self-efficacy/outcome expectancies (SE/OE). Data were analyzed with general linear modeling and cluster analyses. The findings replicated those from the primarily Hispanic sample. Of the 408 completing all ecSI 2.0^TM items, 86% were female, 65% had a 4-year degree or higher, and 53% were EC (ecSI 2.0^TM score ≥ 32). Compared with non-EC parents, EC modeled more healthful eating, higher FV SE/OE, and more in-home FV availability. Behaviors clustered into those striving toward more healthful practices (strivers; n = 151) and those achieving them (thrivers; n = 255). Striver ecSI 2.0^TM scores were lower than those of thrivers (29.6 ± 7.8 vs. 33.7 ± 7.6; p < 0.001). More EC parents demonstrated eating behaviors associated with childhood obesity prevention than non-EC parents, encouraging education that fosters parent EC, especially in tandem with youth nutrition education.

Could emotional eating act as a mediator between sleep quality and food intake in female students?

Background

Poor sleep quality is associated with overeating and unhealthy eating. The aim of this study was to investigate if emotional eating could act as a mediator between poor sleep quality and energy/macronutrients intake.

Methods

This cross-sectional study was performed with 150 female school-age students, 13 to 19 years old, living in Tabriz, Iran. The Pittsburgh Sleep Quality Index (PSQI) and Emotional Eating Questionnaire (EEQ) were completed for data collection. Intake of energy and proportion of calorie from carbohydrate, protein, and fat were evaluated by a semi-quantified food frequency questionnaire. The data were analyzed using structural equation modeling.

Results

The mean (SD) of age, weight, and BMI were not statistically different between poor and good sleepers. The mean (SD) of PSQI score was 6.73 ± 2.88, with 75.3% of the participants experiencing poor sleep quality (PSQI> 5). Students with poor sleep quality had increased energy intake and their proportion of calorie intake from fat was higher (p<0.05). There was a positive correlation between poor sleep quality and emotional eating; however, emotional eating did not mediate the relationship between poor sleep quality and energy/macronutrients intake.

Conclusions

Emotional eating did not act as a mediator between poor sleep quality and energy/macronutrients intake in female students. However, poor sleep quality directly influenced energy intake and the proportion of calorie intake from fat as well as emotional eating.

Impact of a Weight Management Intervention on Eating Competence: Importance of Measurement Interval in Protocol Design

PURPOSE

To examine changes in eating competence (EC) in 12-month weight loss intervention.

DESIGN

Randomized, parallel-arm with weight loss phase (baseline to month 4) and weight-maintenance phase (months 4-12).

SETTING

Face-to-face in University classrooms, supervised and self-directed fitness sessions at University fitness center, and home.

PARTICIPANTS

Premenopausal, mostly college-educated Pennsylvania women, body mass index >25 (n = 101).

INTERVENTION

Twenty-eight, 1-hour classes tailored for extremes of the Dietary Guidelines' fat recommendations, based on social cognitive theory, problem-based learning delivery over 12 months. Exercise component included supervised and self-directed stretching, aerobics, and strength training.

MEASURES

Anthropometrics, lipid profile, blood pressure, 24-hour dietary recalls, cognitive behavioral measures, Satter Eating Competence Inventory (ecSI).

ANALYSIS

General linear model repeated measures analysis of variance for outcome variables.

RESULTS

A total of 40% (n = 40) completed the ecSI. Overall, education and supervised exercise session attendance were 77% and 88%, respectively. Similar weight loss for lower and moderate fat groups (6.7 kg and 5.4 kg). The EC was unchanged baseline to month 4 but increased significantly from months 4 to 12, baseline to month 12 for both groups. The EC change baseline to month 12 was inversely associated with weight change from baseline to months 4 and 12.

CONCLUSION

Weight management interventions, likely to introduce concerns with eating attitudes, behaviors, and foods, can reduce EC. Short-term measurement of EC change captures these consequent adjustments without opportunity to regain self-efficacy. Extending the measurement interval better reflects intervention impact on EC.