How is intuitive eating related to self-reported and laboratory food intake in middle-aged adults?

Exploring the Longitudinal Stability of Food Neophilia and Dietary Quality and Their Prospective Relationship in Older Adults: A Cross-Lagged Panel Analysis

Poor dietary quality is a major cause of morbidity, making the promotion of healthy eating a societal priority. Older adults are a critical target group for promoting healthy eating to enable healthy aging. One factor suggested to promote healthy eating is the willingness to try unfamiliar foods, referred to as food neophilia. This two-wave longitudinal study explored the stability of food neophilia and dietary quality and their prospective relationship over three years, analyzing self-reported data from N = 960 older adults (M_T1 = 63.4, range = 50-84) participating in the NutriAct Family Study (NFS) in a cross-lagged panel design. Dietary quality was rated using the NutriAct diet score, based on the current evidence for chronic disease prevention. Food neophilia was measured using the Variety Seeking Tendency Scale. The analyses revealed high a longitudinal stability of both constructs and a small positive cross-sectional correlation between them. Food neophilia had no prospective effect on dietary quality, whereas a very small positive prospective effect of dietary quality on food neophilia was found. Our findings give initial insights into the positive relation of food neophilia and a health-promoting diet in aging and underscore the need for more in-depth research, e.g., on the constructs' developmental trajectories and potential critical windows of opportunity for promoting food neophilia.

Do eating behavior traits predict energy intake and body mass index? A systematic review and meta-analysis

At present, it is unclear whether eating behavior traits (EBT) predict objectively measured short-term energy intake (EI) and longer-term energy balance as estimated by body mass index (BMI). This systematic review examined the impact of EBT on BMI and laboratory-based measures of EI in adults ( ≥ 18 years) in any BMI category, excluding self-report measures of EI. Articles were searched up until 28th October 2021 using MEDLINE, PsycINFO, EMBASE and Web of Science. Sixteen EBT were identified and the association between 10 EBT, EI and BMI were assessed using a random-effects meta-analysis. Other EBT outcomes were synthesized qualitatively. Risk of bias was assessed with the mixed methods appraisal tool. A total of 83 studies were included (mean BMI = 25.20 kg/m² , mean age = 27 years and mean sample size = 70). Study quality was rated moderately high overall, with some concerns in sampling strategy and statistical analyses. Susceptibility to hunger (n = 6) and binge eating (n = 7) were the strongest predictors of EI. Disinhibition (n = 8) was the strongest predictor of BMI. Overall, EBT may be useful as phenotypic markers of susceptibility to overconsume or develop obesity (PROSPERO: CRD42021288694).

An experimental approach to training interoceptive sensitivity: study protocol for a pilot randomized controlled trial

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.

Validation of the Adult Eating Behaviour Questionnaire adapted for the French-speaking Canadian population

PURPOSE

The Adult Eating Behaviour Questionnaire (AEBQ) is a newly developed questionnaire adapted from the widely used Child Eating Behaviour Questionnaire. This questionnaire assesses four food approach scales, namely hunger, food responsiveness, emotional overeating (EOE) and enjoyment of food, and four food avoidance scales, namely satiety responsiveness (SR), emotional undereating (EUE), food fussiness and slowness in eating (SE). This study aimed to validate a French version of the AEBQ in controlled conditions among French-speaking adults from Quebec, Canada.

METHODS

The AEBQ was pre-tested through structured interviews with 30 individuals. Participants of the validation study (n = 197, aged 19-65 years) had their height and weight measured and completed the AEBQ, Three-Factor Eating Questionnaire (TFEQ) and Intuitive Eating Scale-2 to assess factorial structure, internal consistency and construct validity. Test-retest reliability over 2 weeks was assessed among 144 participants.

RESULTS

Confirmatory factor analysis indicated an excellent model fit (NNFI = 0.98, CFI = 0.98, RMSEA = 0.03, χ²/df = 1.17) and provided support for the use of the original 8-factor questionnaire. Internal consistency was adequate for most scales (Cronbach's alpha = 0.66-0.94) and moderate to excellent test-retest reliability was observed for all scales (ICC = 0.70-90). Women showed higher levels of EOE and SR, and individuals with overweight and obesity showed higher levels of EOE and lower levels of EUE and SE. Construct validity was also supported by expected correlations with disinhibition and susceptibility to hunger from the TFEQ and intuitive eating.

CONCLUSION

This study indicates that the French AEBQ is a valid and reliable tool to measure eating behaviours in the adult population of Quebec.

LEVEL OF EVIDENCE

Level III: Evidence obtained from well-designed cohort or case-control analytic studies. The data are cross-sectional, but all measurement were undertaken in controlled laboratory conditions and the study provided new information.

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)

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.

Intuitive Eating is Associated With Higher Fruit and Vegetable Intake Among Adults

OBJECTIVE

Assess how intuitive eating relates to dietary intake.

METHODS

Survey data were collected in Project Eating and Activity in Teens and Young Adults, the fourth wave of a longitudinal cohort study (weighted n = 1,830, 49% women; mean age = 31 years). Intuitive eating was assessed using a 7-item scale adapted from the Intuitive Eating Scale and Intuitive Eating Scale-2. Dietary intake was measured via a semiquantitative food frequency questionnaire. Mean servings were stratified by gender and intuitive eating quartiles and adjusted for sociodemographic characteristics and caloric intake.

RESULTS

Women and men in the top intuitive eating quartile consumed 0.6-0.3 servings more fruit and 0.4-0.6 servings more vegetables daily, respectively, compared with the bottom quartile, whereas men in the top quartile also consumed 0.6 servings fewer whole grains (all P < 0.05) than the bottom quartile.

CONCLUSIONS AND IMPLICATIONS

Intuitive eating shows promise as a healthier alternative to practices such as dieting.