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
|
Urhan M, Cengisiz C, Türk M, Akanalçı C. Can mindful eating be a psycho-marker of obesity in bipolar disorder? NUTR HOSP 2024. [PMID: 39037191 DOI: 10.20960/nh.05084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND AND AIM obesity is a very important problem in individuals with bipolar disorder. The study was aimed to determine the prevalence of obesity in individuals with bipolar disorder and to evaluate the effects of factors affecting eating behavior such as mindful eating, impulsivity and eating disorders on the development of obesity in these individuals. METHODS this study is a cross-sectional study. A total of 109 individuals (52 female; 57 male) with bipolar disorder who were in a euthymic state at the time of the interview and underwent outpatient follow-up, treatment and monitorization, and 109 age- and sex-matched healthy individuals as the control group were included in the study. The Mindful Eating Questionnaire-30 (MEQ-30), Three-Factor Eating Questionnaire (TFEQ-21), Barratt Impulsiveness Scale 11-Short Form (BIS-11-SF), and Eating Attitude Test-26 (EAT-26) were used, and anthropometric measurements (height, bodyweight, etc.) were taken. RESULTS the obesity rate was 50.4 % among the cases and 24.8 % in the control group. Moreover, disinhibition (3.4 ± 0.93), emotional eating (3.5 ± 1.13), and mindfulness (2.6 ± 0.54) scores of individuals with BD were significantly lower than for healthy individuals (3.7 ± 0.82, 4.0 ± 0.93, 2.8 ± 0.55, respectively). The risk of obesity was 5.19 times higher in cases compared to the age- and gender-matched controls (OR = 5.19, 95 % CI (2.01-13.37), p = 0.001). The risk of obesity was 2.76 times higher in those with low mindful eating level (OR = 2.76, 95 % CI (1.07-5.47), p = 0.014) and 4.29 times higher in those using antipsyhotics/mood stabilizers (OR = 4.29, 95 % CI (1.12-12.24), p < 0.001). CONCLUSION A comprehensive education program on mindful eating and healthy eating would be helpful in elucidating the mechanisms of the possible relationships between bipolar disorder-specific risk factors and mindful eating.
Collapse
Affiliation(s)
- Murat Urhan
- Department of Nutriton and Dietetics. Faculty of Health Science. Ege University. Department of Nutriton and Dietetics
| | - Cengiz Cengisiz
- Department of Psychiatry. Manisa Mental Health and Diseases Hospital
| | - Melek Türk
- Department of Psychiatry. Manisa Mental Health and Diseases Hospital
| | - Ceren Akanalçı
- Department of Nutriton and Dietetics. Faculty of Health Science. Ege University. Department of Nutriton and Dietetics
| |
Collapse
|
3
|
Loh J, Loy SL, Appannah G, Colega MT, Godfrey KM, Yap F, Chong YS, Eriksson JG, Chan JKY, Chan SY, Chong MFF, Lai JS. Relation of preconception eating behaviours to dietary pattern trajectories and gestational weight gain from preconception to late pregnancy. Appetite 2024; 198:107336. [PMID: 38574819 DOI: 10.1016/j.appet.2024.107336] [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: 11/09/2023] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/06/2024]
Abstract
Studies examining preconception eating behaviours with longitudinal dietary patterns from preconception to late pregnancy as well as gestational weight gain (GWG) are limited. We derived dietary pattern trajectories from preconception to late-pregnancy, and related preconception eating behaviours to these trajectories and GWG. Preconception eating behaviours were assessed using the Three-Factor Eating Questionnaire measuring cognitive restraint (CR) - conscious restriction of food intake, emotional eating (EE) - overeating in response to negative emotions, and uncontrolled eating (UE) - overeating with a feeling of lack of control. Dietary intakes were measured at preconception, 20-21 and 34-36 weeks' gestation with food frequency questionnaires. Dietary patterns were determined using factor analysis, and trajectories derived using group-based trajectory modelling. Inadequate and excessive GWG were defined according to Institute of Medicine guidelines based on weights at preconception and the last antenatal visit (median: 38 weeks' gestation). Two dietary patterns were derived: 'Fast Food, Fried Snacks and Desserts (FFD)' and 'Soup, Fish and Vegetables (SFV)'. Adherence trajectories from preconception to late-pregnancy were characterised as consistently high ("stable-high") and low ("stable-low"). Women with higher UE scores had higher odds of being in the "stable-high" trajectory (n = 34) of the FFD pattern [Odds Ratio (OR): 1.25, 95% Confidence Interval (CI): 1.03, 1.51], compared to "stable-low" (n = 260). Percentages of women with inadequate, adequate or excessive GWG were 21.7% (n = 70), 25.8% (n = 83), and 52.5% (n = 169), respectively; women with higher EE scores had a higher likelihood of excessive GWG [Relative Risk Ratio (RRR): 1.35, 95% CI: 1.02, 1.80], but this association was attenuated after adjusting for preconception body mass index. Eating behaviour interventions to improve dietary patterns among pregnant women may need to start as early as preconception, incorporating strategies to manage UE.
Collapse
Affiliation(s)
- Jason Loh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - See Ling Loy
- Department of Reproductive Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-NUS Medical School, 8 College Road, 169857, Singapore
| | - Geeta Appannah
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Marjorelee T Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Fabian Yap
- Duke-NUS Medical School, 8 College Road, 169857, Singapore; Department of Paediatric Endocrinology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, & Folkhälsan Research Center, University of Helsinki, PO Box 20, 00014, University of Helsinki, Helsinki, Finland; Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore
| | - Jerry K Y Chan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-NUS Medical School, 8 College Road, 169857, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 16 Medical Drive, 117597, Singapore
| | - Jun S Lai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore.
| |
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
|
Clarke ED, Stanford J, Gomez-Martin M, Collins CE. Revisiting the impact of Health at Every Size® interventions on health and cardiometabolic related outcomes: An updated systematic review with meta-analysis. Nutr Diet 2024; 81:261-282. [PMID: 38563692 DOI: 10.1111/1747-0080.12869] [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: 11/16/2023] [Revised: 01/14/2024] [Accepted: 02/01/2024] [Indexed: 04/04/2024]
Abstract
AIMS To (1) synthesise evidence from Health at Every Size® interventions on physical and psychological health in people with overweight and obesity and (2) report between-group differences within interventions evaluating the impact of Health at Every Size® interventions on health and health-related outcomes. METHODS Six databases (Medline, Embase, Cochrane, PsychInfo, CINAHL, and Scopus) were searched from inception until November 2022. Included studies were conducted in adults with overweight or obesity, used Health at Every Size®-based interventions compared with control interventions and reported dietary, physical and/or psychological outcomes, including diet quality, anthropometry, or quality of life. Data on between-group differences were extracted. Risk of bias was assessed using ROB2. Random-effects meta-analyses were undertaken for outcomes with at least three studies reporting the same or comparable data. RESULTS From 128 studies identified, 19 full-text articles (10 unique studies, 6 published since 2017), were included. Meta-analysis found a significant reduction for susceptibility to hunger in Health at Every Size® intervention groups relative to controls (p = 0.005), with no significant difference (p > 0.05) between Health at Every Size® interventions and control groups for anthropometric, psychological or cardiometabolic outcomes (total cholesterol, HDL cholesterol, triglycerides, systolic or diastolic blood pressure). CONCLUSION Health at Every Size® interventions had similar results compared with weight-based interventions on anthropometric outcomes and cardiometabolic outcomes. Health at Every Size® interventions had a significant benefit for reducing susceptibility to hunger. The decision to use a Health at Every Size®-based intervention should be personalised to individual needs. Further research in more diverse populations is required using standardised outcome measures to facilitate future meta-analyses.
Collapse
Affiliation(s)
- Erin D Clarke
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Jordan Stanford
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Maria Gomez-Martin
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| |
Collapse
|
6
|
Jackson AM, Parker L, Sano Y, Cox AE, Lanigan J. Associations between body image, eating behavior, and diet quality. Nutr Health 2024; 30:93-102. [PMID: 35369805 DOI: 10.1177/02601060221090696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Weight-neutral interventions that promote adaptive eating behaviors are becoming a growing area of practice. Understanding whether adaptive eating behaviors are associated with improved diet quality is essential. Body image may be an important factor in this relationship given its close connection to eating behaviors. Aim: The purpose of this study was to develop an understanding of the relationships between positive and negative body image, adaptive and maladaptive eating behaviors, and diet quality. Methods: We recruited 288 adults 18 years and older who were living in the US using Prolific Academic. Participants completed an online survey including measures of positive and negative body image, adaptive and maladaptive eating behaviors, and a dietary screener questionnaire (DSQ). We ran a hierarchical linear regression and tested whether body image and diet quality were mediated by eating behavior. Results: Body image and maladaptive eating behaviors were not associated with diet quality. Body-food choice congruence (B-FCC), an adaptive eating behavior, was associated with diet quality. B-FCC mediated the relationship of positive and negative body image to diet quality. Conclusions: Our findings provide additional support for weight-neutral or adaptive eating interventions as a mechanism to promote diet quality. Additional research may benefit from exploring indirect effects of body image on diet intake, the relationship between eating behavior and diet quality using qualitative data, and the comparison of weight-neutral or non-diet interventions with traditional behavior change interventions.
Collapse
Affiliation(s)
| | - Louise Parker
- Extension Youth and Families Unit, Human Development, Washington State University, Seattle, WA, USA
| | - Yoshie Sano
- Human Development, Washington State University, Vancouver, WA, USA
| | - Anne E Cox
- Kinesiology & Educational Psychology, College of Education, Washington State University, Pullman, WA, USA *Present Address: Institute for Research and Education to Advance Community Health (IREACH), Washington State University, 1100 Olive Way Suite 1200 Seattle, WA 98101, USA
| | - Jane Lanigan
- Human Development, Washington State University, Vancouver, WA, USA
| |
Collapse
|
7
|
Rezende F, Oliveira BMPM, Poínhos R. Assessment of Intuitive Eating and Mindful Eating among Higher Education Students: A Systematic Review. Healthcare (Basel) 2024; 12:572. [PMID: 38470683 PMCID: PMC10931607 DOI: 10.3390/healthcare12050572] [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: 01/24/2024] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The role of mindful eating (ME) and intuitive eating (IE) in improving eating behavior, diet quality, and health is an area of increasing interest. OBJECTIVE The objective of this review was to identify the instruments used to assess ME and IE among higher education students and outcomes related to these dimensions. METHODS This review was carried out according to the PRISMA statement, through systematic searches in PubMed, Web of Science, PsycInfo, and Scopus. The inclusion criteria selected for higher education students, levels of ME and/or IE reported, and observational and clinical studies. The exclusion criteria selected against reviews, qualitative studies, and case studies. Quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS A total of 516 initial records were identified, from which 75 were included. Cross-sectional studies were the most common research design (86.7%). Most studies were conducted with samples that were predominantly female (90.7%), White (76.0%), aged 18 to 22 years (88.4%), with BMI < 25 kg/m2 (83.0%), and in the United States (61.3%). The Intuitive Eating Scale (IES), the Mindful Eating Questionnaire (MEQ), and their different versions were the most used instruments. The outcomes most studies included were eating behavior and disorders (77.3%), anthropometric assessments (47.8%), mental health (42.0%), and body image (40.6%). Regarding the quality of studies, 34.7% of studies were assigned a positive, 1.3% a negative, and 64.0% a neutral rate. CONCLUSIONS IES and MEQ were the most used instruments. RCT and cohort studies are scarce, and future research with a higher level of quality is needed, especially on the topics of food consumption, diet quality, and biochemical markers.
Collapse
Affiliation(s)
- Fabiane Rezende
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Rua do Campo Alegre 823, 4150-180 Porto, Portugal;
| | - Bruno M. P. M. Oliveira
- Laboratory of Artificial Intelligence and Decision Support, Institute for Systems and Computer Engineering, Technology and Science (LIIAD, INESC-TEC), 4200-465 Porto, Portugal;
| | - Rui Poínhos
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Rua do Campo Alegre 823, 4150-180 Porto, Portugal;
| |
Collapse
|
8
|
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
|
9
|
Loucks EB, Kronish IM, Saadeh FB, Scarpaci MM, Proulx JA, Gutman R, Britton WB, Schuman-Olivier Z. Adapted Mindfulness Training for Interoception and Adherence to the DASH Diet: A Phase 2 Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2339243. [PMID: 37917063 PMCID: PMC10623198 DOI: 10.1001/jamanetworkopen.2023.39243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/10/2023] [Indexed: 11/03/2023] Open
Abstract
Importance Hypertension is a major cause of cardiovascular disease, and although the Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP), adherence is typically low. Mindfulness training adapted to improving health behaviors that lower BP could improve DASH adherence, in part through improved interoceptive awareness relevant to dietary consumption. Objective To evaluate the effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on interoceptive awareness and DASH adherence. Design, Setting, and Participants Parallel-group, phase 2, sequentially preregistered randomized clinical trials were conducted from June 1, 2017, to November 30, 2020. Follow-up was 6 months. Participants with elevated unattended office BP (≥120/80 mm Hg) were recruited from the population near Providence, Rhode Island. Of 348 participants assessed for eligibility, 67 did not meet inclusion criteria, 17 declined, and 63 did not enroll prior to study end date. In total, 201 participants were randomly assigned, 101 to the MB-BP program and 100 to the enhanced usual care control group, with 24 (11.9%) unavailable for follow-up. Outcome assessors and the data analyst were blinded to group allocation. Analyses were performed using intention-to-treat principles from June 1, 2022, to August 30, 2023. Interventions The 8-week MB-BP program was adapted for elevated BP, including personalized feedback, education, and mindfulness training directed to hypertension risk factors. Both MB-BP and control groups received home BP monitoring devices with instructions and options for referral to primary care physicians. The control group also received educational brochures on controlling high BP. Main Outcomes and Measures The primary outcome was Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire scores (range 0-5, with higher scores indicating greater interoceptive awareness), and the secondary outcome was DASH adherence scores assessed via a 163-item Food Frequency Questionnaire (range 0-11, with higher scores indicating improved DASH adherence), all compared using regression analyses. Results Among 201 participants, 118 (58.7%) were female, 163 (81.1%) were non-Hispanic White, and the mean (SD) age was 60.0 (12.2) years. The MB-BP program increased the MAIA score by 0.54 points (95% CI, 0.35-0.74 points; P < .001; Cohen d = 0.45) at 6 months vs control. In participants with poor baseline DASH adherence, the MB-BP program also significantly increased the DASH score by 0.62 points (95% CI, 0.13-1.11 points; P = .01; Cohen d = 0.71) at 6 months vs controls. The intervention was also associated with a 0.34-point improvement in the DASH diet score in all MB-BP participants from baseline (95% CI, 0.09-0.59 points; P = .01; Cohen d = 0.27), while the control group showed a -0.04 point change in DASH diet score from baseline to 6 months (95% CI, -0.31 to 0.24 points; P = .78; Cohen d = -0.03). Conclusions and Relevance A mindfulness program adapted to improving health behaviors to lower BP improved interoceptive awareness and DASH adherence. The MB-BP program could support DASH dietary adherence in adults with elevated BP. Clinical Trial Registration ClinicalTrials.gov Identifiers: NCT03859076 and NCT03256890.
Collapse
Affiliation(s)
- Eric B. Loucks
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
- Department of Behavioral Sciences, Brown University School of Public Health, Providence, Rhode Island
- Mindfulness Center at Brown University, Providence, Rhode Island
| | - Ian M. Kronish
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York
| | - Frances B. Saadeh
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
- Mindfulness Center at Brown University, Providence, Rhode Island
| | - Matthew M. Scarpaci
- Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, Rhode Island
| | - Jeffrey A. Proulx
- Department of Behavioral Sciences, Brown University School of Public Health, Providence, Rhode Island
- Mindfulness Center at Brown University, Providence, Rhode Island
| | - Roee Gutman
- Department of Biostatistics, Brown University School of Public Health, Providence, Rhode Island
| | - Willoughby B. Britton
- Mindfulness Center at Brown University, Providence, Rhode Island
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Zev Schuman-Olivier
- Cambridge Health Alliance, Cambridge, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Center for Mindfulness and Compassion, Cambridge, Massachusetts
| |
Collapse
|
10
|
Hayashi LC, Benasi G, St-Onge MP, Aggarwal B. Intuitive and mindful eating to improve physiological health parameters: a short narrative review of intervention studies. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:537-547. [PMID: 34913327 PMCID: PMC10098784 DOI: 10.1515/jcim-2021-0294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/29/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES This brief narrative review aims to give an up-to-date overview of intuitive and mindful eating (I/ME) interventions with specific focus on cardiometabolic risk factors, including glucose, lipid profile, blood pressure and inflammatory markers. CONTENT I/ME intervention studies in adults which measured at least one physiological parameter other than weight were identified from PubMed. The clinical trial/randomized controlled trial filters and publication dates 2001 through April 2021 with variations of the following keywords were applied: intuitive eating, mindful eating, weight neutral. Ten articles were identified. SUMMARY AND OUTLOOK Of the 10 studies, seven showed I/ME interventions were more effective than control in at least one cardiometabolic outcome, two showed significant I/ME within-group improvements but no between-group differences, and one showed neither within-group nor between-group differences. Specifically, I/ME improved glucose levels among pregnant women with or without gestational diabetes, lipid profile among adults with overweight or obesity, blood pressure among participants with overweight and inflammatory markers among post-menopausal women with obesity. However, the positive impact of I/ME on each of these cardiometabolic parameters was not consistent across studies: of the six studies that examined glucose regulation, two demonstrated positive outcomes for I/ME group, whereas four found no effect compared to control. Three out of five studies had positive lipid effects, one out of five demonstrated systolic blood pressure (SBP) improvements and one of two showed improvements in inflammatory markers. Given these mixed results, more research is needed to understand the possible effectiveness of I/ME to improve cardiometabolic health.
Collapse
Affiliation(s)
- Lauren C. Hayashi
- College of Medicine, University of Florida, Gainesville, FL, USA; Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Giada Benasi
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Marie-Pierre St-Onge
- Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY, USA; Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Brooke Aggarwal
- Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University Irving Medical Center. 51 Audubon Avenue, Suite 505, New York, NY 10032, USA; Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
11
|
Manana B, El-Jor C, Abi Kharma J, Zeeni N. Effectiveness of a text-messaging intervention on intuitive eating: a randomised controlled trial. Public Health Nutr 2023; 26:1576-1584. [PMID: 37165660 PMCID: PMC10410380 DOI: 10.1017/s1368980023000939] [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: 05/22/2022] [Revised: 03/18/2023] [Accepted: 04/27/2023] [Indexed: 05/12/2023]
Abstract
Intuitive eating (IE) is a concept based on mind-body integration of instinct, emotion and rational thought, to improve eating behaviours, physical and mental health. Several attempts were developed to teach IE principles including text-messaging interventions given that they are easy to implement and low cost. OBJECTIVE The present study aimed to assess the effectiveness of a 5-week text message-based IE intervention on IE, while correcting for perceived stress (PS) and self-compassion (SC). DESIGN A randomised controlled trial. SETTING Online, in Lebanon. PARTICIPANTS Adults (n 195) were randomised into one of three groups: the active IE group receiving IE-related messages with a practice exercise, the passive IE group receiving only IE-related messages and the control group receiving general health-related tips. Ten messages were delivered over 5 weeks. Two follow-ups were made: directly post-intervention and 7 weeks later. Baseline data and follow-ups included demographics, nutrition-related variables and measures of IE, SC and PS. RESULTS Results indicated improvements in IE scores in the two intervention groups (P = 0·05), with the passive IE group showing the most improvement. Also, a significant improvement in SC (Λ = 0·88, F (2, 63) = 4·40, P = 0·01) and reduction in PS (Λ = 0·86, F (2, 63) = 5·21, P = 0·008) were observed in the active IE group. CONCLUSION Text-messaging interventions might be efficient in enhancing IE. Results shed light on the need for further large-scale interventions that use visual aids and provide practical guidance to teach IE, while further characterising the relation between IE, SC and stress.
Collapse
Affiliation(s)
- Batoul Manana
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, 36-Byblos, Lebanon
| | - Claire El-Jor
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, 36-Byblos, Lebanon
| | - Joelle Abi Kharma
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, 36-Byblos, Lebanon
| | - Nadine Zeeni
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, 36-Byblos, Lebanon
| |
Collapse
|
12
|
Loucks EB, Kronish IM, Saadeh FB, Scarpaci MM, Proulx JA, Gutman R, Britton WB, Schuman-Olivier Z. Effects of Adapted Mindfulness Training on Interoception and Adherence to the Dietary Approaches to Stop Hypertension (DASH) Diet: The MB-BP Randomized Clinical Trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.10.23289818. [PMID: 37292774 PMCID: PMC10246061 DOI: 10.1101/2023.05.10.23289818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Hypertension is a major cause of cardiovascular disease. The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP). However, adherence is typically low. Mindfulness training adapted to improving health behaviors that lower BP could improve DASH adherence, in part through improved interoceptive awareness relevant to dietary consumption. The primary objective of the MB-BP trial was to evaluate effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on interoceptive awareness. Secondary objectives assessed whether MB-BP impacts DASH adherence, and explored whether interoceptive awareness mediates DASH dietary changes. Methods Parallel-group phase 2 randomized clinical trial conducted from June 2017-November 2020 with 6 months follow-up. Data analyst was blinded to group allocation. Participants had elevated unattended office BP (≥120/80 mmHg). We randomized 201 participants to MB-BP (n=101) or enhanced usual care control (n=100). Loss-to-follow-up was 11.9%. Outcomes were the Multidimensional Assessment of Interoceptive Awareness (MAIA; range 0-5) score, and the DASH adherence score (range 0-11) assessed via a 163-item Food Frequency Questionnaire. Results Participants were 58.7% female, 81.1% non-Hispanic white, with mean age 59.5 years. Regression analyses demonstrated that MB-BP increased the MAIA score by 0.54 (95% CI: 0.35,0.74; p<.0001) at 6 months follow-up vs. control. MB-BP increased the DASH score by 0.62 (95% CI: 0.13,1.11; p=0.01) at 6 months vs. control, in participants with poor DASH adherence at baseline. Conclusions A mindfulness training program adapted to improving health behaviors that lower BP improved interoceptive awareness and DASH adherence. MB-BP could support DASH dietary adherence in adults with elevated BP. Clinical Trial Registration Clinicaltrials.gov identifier NCT03859076 (https://clinicaltrials.gov/ct2/show/NCT03859076; MAIA) and NCT03256890 (https://clinicaltrials.gov/ct2/show/NCT03256890; DASH diet adherence).
Collapse
Affiliation(s)
- Eric B Loucks
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Department of Behavioral Sciences, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center at Brown University, Providence, RI, USA
| | - Ian M Kronish
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Frances B Saadeh
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center at Brown University, Providence, RI, USA
| | - Matthew M Scarpaci
- Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, RI, USA
| | - Jeffrey A Proulx
- Department of Behavioral Sciences, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center at Brown University, Providence, RI, USA
| | - Roee Gutman
- Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA
| | - Willoughby B Britton
- Mindfulness Center at Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Zev Schuman-Olivier
- Cambridge Health Alliance, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
- Center for Mindfulness and Compassion, Cambridge, MA, USA
| |
Collapse
|
13
|
Henninger SH, Fibieger AY, Magkos F, Ritz C. Effects of Mindful Eating and YogaDance among Overweight and Obese Women: An Exploratory Randomized Controlled Trial. Nutrients 2023; 15:nu15071646. [PMID: 37049487 PMCID: PMC10096929 DOI: 10.3390/nu15071646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
Many current treatment options for managing overweight and obesity consist of rather strict diet and exercise regimes that are difficult to implement as a lifelong routine. Therefore, alternative initiatives such as mindful eating and pleasure-oriented physical activity with more focus on implementation and enjoyment are needed to reverse the obesity epidemic. Mindful eating is an approach focusing on inner hunger and satiety signals. YogaDance is a novel exercise approach combining elements of yoga and dance. This study was a randomized controlled trial investigating the individual and combined effects of mindful eating and YogaDance. Participants were healthy, inactive women with overweight or obesity (body mass index ≥ 25 kg/m2 and/or waist circumference ≥ 80 cm) who were randomized to one of four groups for 8 weeks: mindful eating alone, YogaDance alone, the combination of mindful eating and YogaDance, or control. Fat mass was the primary outcome and secondary outcomes included body weight, waist circumference, and other physiological, behavioral, and quality-of-life outcomes. Sixty-one women were included in the study and randomized to mindful eating and YogaDance combined, YogaDance, mindful eating, or control. Fat mass was reduced by 1.3 kg (95% CI [−10.0, 7.3] kg; p = 0.77), 3.0 kg (95% CI [−11.1, 5.1] kg; p = 0.48), and 1.8 kg (95% CI [−10.1, 6.6] kg; p = 0.69) for the mindful eating, YogaDance, and combined mindful eating and YogaDance interventions, respectively, compared to the control, with corresponding effect sizes of 0.15, 0.34, and 0.21. In complete-case analyses, fat percent and waist circumference were reduced whereas mental quality of life and eating behavior were improved for mindful eating and mindful eating and YogaDance combined compared to the control. In conclusion, the study found modest benefits of an 8-week combination of mindful eating and YogaDance, corroborating findings in previous studies on mindful eating, yoga, and dance. However, the study had several limitations that should be taken into consideration, including low power due to a large drop-out as well as low to moderate training load and compliance. The trial was retrospectively registered (ISRCTN87234794).
Collapse
Affiliation(s)
- Sofie Hauerberg Henninger
- Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958 Frederiksberg, Denmark
| | - Anna Yde Fibieger
- Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958 Frederiksberg, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958 Frederiksberg, Denmark
| | - Christian Ritz
- Department of National Institute of Public Health, University of Southern Denmark, DK-1455 Copenhagen, Denmark
- Correspondence: ; Tel.: +45-6550-9696
| |
Collapse
|
14
|
Morgan-Bathke M, Raynor HA, Baxter SD, Halliday TM, Lynch A, Malik N, Garay JL, Rozga M. Medical Nutrition Therapy Interventions Provided by Dietitians for Adult Overweight and Obesity Management: An Academy of Nutrition and Dietetics Evidence-Based Practice Guideline. J Acad Nutr Diet 2023; 123:520-545.e10. [PMID: 36462613 DOI: 10.1016/j.jand.2022.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
Overweight and obesity affect most adults living in the United States and are causally linked to several adverse health outcomes. Registered dietitian nutritionists or international equivalents (dietitians) collaborate with each client and other health care professionals to meet client-centered goals, informed by the best available evidence, and translated through a lens of clinical expertise and client circumstances and preferences. Since the last iteration of the Academy of Nutrition and Dietetics guideline on adult weight management in 2014, considerable research has been conducted and circumstances confronting dietitians have evolved. Thus, updated guidance is needed. The objective of this evidence-based practice guideline is to provide recommendations for dietitians who deliver medical nutrition therapy behavioral interventions for adults (18 years and older) with overweight and obesity to improve cardiometabolic outcomes, quality of life, and weight outcomes, when appropriate for and desired by the client. Recommendations in this guideline highlight the importance of considering complex contributors to overweight and obesity and individualizing interventions to client-centered goals based on specific needs and preferences and shared decision making. The described recommendations have the potential to increase access to care and decrease costs through utilization of telehealth and group counseling as effective delivery methods, and to address other barriers to overweight and obesity management interventions. It is essential for dietitians to collaborate with clients and interprofessional health care teams to provide high-quality medical nutrition therapy interventions using the nutrition care process to promote attainment of client-centered outcomes for adults with overweight or obesity.
Collapse
Affiliation(s)
- Maria Morgan-Bathke
- Department of Nutrition and Dietetics, Viterbo University, La Crosse, Wisconsin
| | - Hollie A Raynor
- College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, Tennessee
| | | | - Tanya M Halliday
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah
| | - Amanda Lynch
- Department of Interdisciplinary Health Sciences, Oakland University, Rochester, MI
| | - Neal Malik
- Department of Health Science and Human Ecology, California State University, San Bernardino, San Bernardino, California
| | - Jessica L Garay
- Department of Nutrition and Food Studies, Syracuse University, Syracuse
| | - Mary Rozga
- Academy of Nutrition and Dietetics, Chicago, Illinois.
| |
Collapse
|
15
|
Morillo-Sarto H, López-Del-Hoyo Y, Pérez-Aranda A, Modrego-Alarcón M, Barceló-Soler A, Borao L, Puebla-Guedea M, Demarzo M, García-Campayo J, Montero-Marin J. 'Mindful eating' for reducing emotional eating in patients with overweight or obesity in primary care settings: A randomized controlled trial. EUROPEAN EATING DISORDERS REVIEW 2023; 31:303-319. [PMID: 36397211 PMCID: PMC10100015 DOI: 10.1002/erv.2958] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/16/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The primary aim of this study was to analyse the efficacy of a 'mindful eating' programme for reducing emotional eating in patients with overweight or obesity. METHOD A cluster randomized controlled trial (reg. NCT03927534) was conducted with 76 participants with overweight/obesity who were assigned to 'mindful eating' (7 weeks) + treatment as usual (TAU), or to TAU alone. They were assessed at baseline, posttreatment and 12-month follow-up. The main outcome was 'emotional eating' (Dutch Eating Behaviour Questionnaire, DEBQ); other eating behaviours were also assessed along with psychological and physiological variables. RESULTS 'Mindful eating' + TAU reduced emotional eating both at posttreatment (B = -0.27; p = 0.006; d = 0.35) and follow-up (B = -0.53; p < 0.001; d = 0.69) compared to the control group (TAU alone). 'External eating' (DEBQ) was also significantly improved by the intervention at both timepoints. Significant effects at follow-up were observed for some secondary outcomes related to bulimic behaviours, mindful eating, mindfulness, and self-compassion. Weight and other physiological parameters were not significantly affected by 'mindful eating' + TAU. CONCLUSIONS These findings support the efficacy of the 'mindful eating' + TAU programme for reducing emotional and external eating, along with some other secondary measures, but no significant changes in weight reduction were observed.
Collapse
Affiliation(s)
- Héctor Morillo-Sarto
- University of Zaragoza, Zaragoza, Spain.,Research Network on Chronicity, Primary Care and Health Promotion RD21/0016/0005, RICAPPS, Zaragoza, Spain
| | - Yolanda López-Del-Hoyo
- University of Zaragoza, Zaragoza, Spain.,Research Network on Chronicity, Primary Care and Health Promotion RD21/0016/0005, RICAPPS, Zaragoza, Spain.,Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain
| | - Adrián Pérez-Aranda
- Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain.,Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain.,AGORA Research Group, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
| | - Marta Modrego-Alarcón
- University of Zaragoza, Zaragoza, Spain.,Research Network on Chronicity, Primary Care and Health Promotion RD21/0016/0005, RICAPPS, Zaragoza, Spain.,Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain
| | - Alberto Barceló-Soler
- Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain.,Navarra Medical Research Institute (IdiSNA), Pamplona, Spain
| | - Luis Borao
- University of Zaragoza, Zaragoza, Spain.,Research Network on Chronicity, Primary Care and Health Promotion RD21/0016/0005, RICAPPS, Zaragoza, Spain
| | - Marta Puebla-Guedea
- University of Zaragoza, Zaragoza, Spain.,Research Network on Chronicity, Primary Care and Health Promotion RD21/0016/0005, RICAPPS, Zaragoza, Spain.,Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain
| | - Marcelo Demarzo
- Mente Aberta, Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Javier García-Campayo
- University of Zaragoza, Zaragoza, Spain.,Research Network on Chronicity, Primary Care and Health Promotion RD21/0016/0005, RICAPPS, Zaragoza, Spain.,Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain
| | - Jesús Montero-Marin
- AGORA Research Group, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.,Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| |
Collapse
|
16
|
Fekih-Romdhane F, Malaeb D, Fawaz M, Chammas N, Soufia M, Obeid S, Hallit S. Translation and validation of the mindful eating behaviour scale in the Arabic language. BMC Psychiatry 2023; 23:120. [PMID: 36823561 PMCID: PMC9948418 DOI: 10.1186/s12888-023-04614-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND There has been a drastic increase in the prevalence of obesity and its related diseases in the Arabic-speaking countries during the last decades along with a lack of public awareness about this awareness about this public health problem. This calls for the development of novel prevention and intervention strategies that are based on new approaches, including mindful eating. In this context, we aimed through this study to explore the factor structure, composite reliability, measurement invariance across sex, convergent and divergent validity of an Arabic translation of the Mindful Eating Behaviour Scale (MEBS). METHODS A cross-sectional study carried out between September and November 2022, and enrolled 359 participants, all aged above 18 years old and recruited from all Lebanon governorates. The questionnaire used included socio-demographic questions, and the following scales: The Mindful Eating Behavior Scale (MEBS), Rosenberg Self-Esteem Scale (RSES), Intuitive Eating Scale-2, and Depression Anxiety Stress Scale (DASS-8). RESULTS McDonald's ω values ranged from .82 to .95 or the four mindful eating domains, indicating the excellent internal consistency reliability of the scale. Our study also showed that fit indices from the confirmatory factor analysis confirmed the original four-factor structure model of the MEBS. Furthermore, our analyses suggested that configural, metric, and scalar invariance was supported across sex. Our results found no sex difference in all MEBS subscales scores. Finally, we found positive correlations between Focused eating, Hunger and satiety cues on one hand, and intuitive eating on the other hand. Moreover, greater Hunger and satiety cues scores were correlated with higher self-esteem and lower body mass index. CONCLUSION Our findings support the psychometric reliability and validity of the Arabic MEBS. We suggest, accordingly, that the scale will be of high clinical and research utility, and will help in the development of information-based interventions focused on mindful eating that are aimed to combat eating disorders and obesity in the Arab world.
Collapse
Affiliation(s)
- Feten Fekih-Romdhane
- grid.414302.00000 0004 0622 0397The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia ,grid.12574.350000000122959819University, Faculty of Medicine of Tunis, Tunis El Manar , Tunis, Tunisia
| | - Diana Malaeb
- grid.411884.00000 0004 1762 9788College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates ,grid.444421.30000 0004 0417 6142School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Mirna Fawaz
- grid.18112.3b0000 0000 9884 2169Faculty of Health Sciences, Beirut Arab University, Afeef Al Tiba, Tareek Al Jadida, Beirut, 1105 Lebanon
| | - Nancy Chammas
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Michel Soufia
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Sahar Obeid
- grid.411323.60000 0001 2324 5973Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon. .,Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia. .,Applied Science Research Center, Applied Science Private University, Amman, Jordan. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| |
Collapse
|
17
|
Hoare JK, Lister NB, Garnett SP, Baur LA, Jebeile H. Weight-neutral interventions in young people with high body mass index: A systematic review. Nutr Diet 2023; 80:8-20. [PMID: 35411702 PMCID: PMC10084274 DOI: 10.1111/1747-0080.12729] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/09/2022] [Accepted: 01/24/2022] [Indexed: 01/10/2023]
Abstract
AIM This systematic review explored the feasibility, acceptability and effect on health outcomes of weight-neutral interventions in health improvement-seeking young people with overweight/obesity. METHODS Six databases were searched to March 2021 for health, but not weight, focused interventions (PROSPERO, CRD42020152671). Eligible studies recruited young people (10-24 years) with overweight/obesity. The studies were described using narrative synthesis, with numerical results summarised. The quality of included studies was assessed using the Joanna Briggs Institute critical appraisal tools. RESULTS Six articles were included, representing three pilot studies. Study 1 (n = 37, 14-17 years) compared a 6-week mindful eating program with single-session lifestyle education; Study 2 (n = 35, 14-17 years) compared 12-week weight-neutral lifestyle education focused on intuitive eating and carbohydrate quality, with/without guided imagery; and Study 3 (n = 33, 12-17 years) compared a 6-week mindfulness intervention with cognitive behavioural therapy in adolescents with depressive symptoms at risk of type 2 diabetes. All interventions explored feasibility (intervention group retention 57%-88%, attendance >80%) and reported interventions were acceptable. Studies 1 and 3 reported no change in mindfulness. Study 2 reported an increase (p < 0.05) in intuitive eating following weight-neutral plus guided imagery (0.32 ± 0.36, Hawks' Scale, score 1-4), compared with weight-neutral alone (0.15 ± 0.29). Study 1 reported decreased body mass index (p < 0.001) following mindful eating (-1.1 kg/m2 ), compared with single-session lifestyle education (+0.7 kg/m2 ); Studies 2 and 3 found no change in body mass index or body mass index z-score. CONCLUSIONS Weight-neutral interventions may be feasible and acceptable in adolescents with overweight/obesity in the short term (≤12 weeks), but data are limited.
Collapse
Affiliation(s)
- Johanna K Hoare
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| |
Collapse
|
18
|
Emotional and intuitive eating: an emerging approach to eating behaviours related to obesity. J Nutr Sci 2023; 12:e19. [PMID: 36843981 PMCID: PMC9947595 DOI: 10.1017/jns.2023.11] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/30/2023] [Accepted: 01/17/2023] [Indexed: 02/15/2023] Open
Abstract
Emotional and intuitive eating are associated with obesity. In the present study, it was aimed to evaluate the relationship between intuitive eating and emotional eating behaviours in adults with anthropometric measurements of obesity-related disease risk and gender. Body weight, body mass index (BMI), waist, hip and neck circumferences were taken. Emotional Eater Questionnaire and Intuitive Eating Scale-2 were used for the assessment of eating behaviour. A total of 3742 adult individuals (56⋅8 % (n 2125) female and (n 1617) male) were participated voluntarily. The total score and subscales of EEQ were higher in females than males (P < 0⋅001). The scores of the IES-2 subscales and the total score were higher in males than females (P < 0⋅05). In metabolic risk classification according to waist and neck circumference, EEQ scale scores (except type of food) were higher in the metabolic risk group, while IES-2 (except body-food congruence in neck circumference) scores were higher in the non-risk group (P < 0⋅05). While there was a positive correlation between EEQ and body weight, BMI, waist circumference, waist-height ratio, a negative correlation was found between age and waist-hip ratio. There was a negative correlation between IES-2 and body weight, BMI, waist-height ratio, waist-hip ratio. In addition, a negative correlation was found between IES-2 and EEQ. Intuitive eating and emotional eating differ by gender. Anthropometric measures and metabolic disease risk is associated with emotional eating and intuitive eating. Interventions to increase intuitive and decreasing emotional eating behaviour can be effective in preventing both obesity and obesity-related diseases.
Collapse
|
19
|
Hensley-Hackett K, Bosker J, Keefe A, Reidlinger D, Warner M, D'Arcy A, Utter J. Intuitive Eating Intervention and Diet Quality in Adults: A Systematic Literature Review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:1099-1115. [PMID: 36274010 DOI: 10.1016/j.jneb.2022.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/07/2022] [Accepted: 08/23/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Intuitive eating interventions aim to improve individual health and promote sustainable changes to one's relationship with food. However, there is no evidence-based consensus on the impact of intuitive eating interventions on diet quality. This systematic review aimed to investigate intuitive eating interventions and their impact on diet quality. METHOD PubMed, Embase, CINAHL, PsycInfo, and Cochrane databases were systematically searched to October 2021 for studies reporting interventions that encompassed the principles of intuitive eating and measured diet quality. Other health outcomes were used for secondary analysis. Findings were synthesized narratively. RESULTS Seventeen papers reporting 14 intervention studies (n = 3,960) were included in the review. All studies found a positive or neutral effect on diet quality following an intuitive eating intervention. A favorable change in eating behavior following these interventions was also observed. DISCUSSION Intuitive eating promotes an attunement to the body, which aids in improving diet quality because of increased awareness of physiological cues. The reduction of emotional and binge eating may also increase diet quality. IMPLICATIONS FOR RESEARCH AND PRACTICE Findings from the current review suggest that intuitive eating interventions are most effective face-to-face, in a group setting, and sustained for at least 3 months.
Collapse
Affiliation(s)
- Katie Hensley-Hackett
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Josephine Bosker
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Ashleigh Keefe
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Dianne Reidlinger
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Molly Warner
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; My Nutrition Clinic, Robina, Queensland, Australia
| | - Anna D'Arcy
- My Nutrition Clinic, Robina, Queensland, Australia
| | - Jennifer Utter
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; Department of Dietetics and Foodservices, Mater Health, South Brisbane, Queensland, Australia.
| |
Collapse
|
20
|
Haar M, Hercman R. Awkward Topics. PHYSICIAN ASSISTANT CLINICS 2022. [DOI: 10.1016/j.cpha.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
21
|
Hoare JK, Lister NB, Garnett SP, Baur LA, Jebeile H. Mindful and Intuitive Eating Imagery on Instagram: A Content Analysis. Nutrients 2022; 14:nu14183834. [PMID: 36145207 PMCID: PMC9502653 DOI: 10.3390/nu14183834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Non-dieting approaches, including mindful/intuitive eating, to health improvement are of increasing interest, yet little is known about young adults' social media exposure to them. Therefore, this study aimed to describe the imagery related to mindful/intuitive eating which is visible to young adult Instagram users. Images categorized under the hashtags 'mindfuleating' and 'intuitiveeating' were searched in September 2021 using the 'top posts' view. Screen captures of 1200 grid-view images per hashtag were used to construct coding frameworks and to determine saturation. Sample sizes for #mindfuleating and #intuitiveeating were 405 and 495 images, respectively. Individual images were coded collaboratively. Almost half of each sample depicted food or drink, of which 50-60% were healthy foods. Approximately 17% were single-person images, of which the majority were young, female adults with healthy weight. Approximately one-third of text suggested credibility through credentials, profession, or evidence. Messaging was similar for both hashtags, encompassing mindful/intuitive eating (~40%), nutrition/eating behaviours (~15%), physical/mental health (~20%), disordered eating (~12%), and body-/self-acceptance (~12%). Differences were observed between hashtags for weight-related concepts (20%/1%) and anti-diet/weight-neutral approaches (10%/35%). The representation on Instagram of mindful and intuitive eating portrays healthy lifestyles without a focus on weight but lacks demographical and body-type diversity. Instagram holds the potential for health professionals to disseminate culturally/demographically inclusive, evidence-based health/nutrition information to youth.
Collapse
Affiliation(s)
- Johanna K. Hoare
- Children’s Hospital Westmead Clinical School, The University of Sydney, Westmead 2145, Australia
- Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Westmead 2145, Australia
| | - Natalie B. Lister
- Children’s Hospital Westmead Clinical School, The University of Sydney, Westmead 2145, Australia
- Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Westmead 2145, Australia
| | - Sarah P. Garnett
- Children’s Hospital Westmead Clinical School, The University of Sydney, Westmead 2145, Australia
- Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Westmead 2145, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead 2145, Australia
| | - Louise A. Baur
- Children’s Hospital Westmead Clinical School, The University of Sydney, Westmead 2145, Australia
- Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Westmead 2145, Australia
- Weight Management Services, The Children’s Hospital at Westmead, Westmead 2145, Australia
| | - Hiba Jebeile
- Children’s Hospital Westmead Clinical School, The University of Sydney, Westmead 2145, Australia
- Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Westmead 2145, Australia
- Correspondence:
| |
Collapse
|
22
|
Kaya Cebioğlu İ, Dumlu Bilgin G, Kavsara HK, Gül A, Sarioğlu A, Aydin S, Keküllüoğlu M. Food addiction among university students: The effect of mindful eating. Appetite 2022; 177:106133. [PMID: 35753440 DOI: 10.1016/j.appet.2022.106133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/13/2022] [Accepted: 06/08/2022] [Indexed: 11/30/2022]
Abstract
Recent evidence indicated that lifestyle modifications, especially mindful eating, might be effective interventions for treating food addiction (FA). Mindful eating practices have been considered to regulate emotional eating, which is one predictor of FA along with automatic eating behaviors, including emotional, impulsive, and habitual eating. Thus, this cross-sectional study aimed to determine the effect of mindful eating on FA of university students. The research team collected the data with 2133 undergraduate students. The Mindful Eating Questionnaire examined the mindfulness status of the students, and the FA diagnosed by using the YALE Food Addiction Scale. 56.9% of participants were women, with a mean age of 21.5 ± 2.2 and a mean body mass index (BMI) of 22.5 ± 3.8 kg/m2. Although no significant differences were observed regarding sex (p > .05), the FA prevalence among men (16.1%) was higher than women. The overall prevalence of FA was 15.3%, which was 1.5 units higher among those with BMI ≥25 kg/m2. Also, FA diagnosis was significantly more prevalent among smokers and ex-smokers (p < .01). In addition, participants diagnosed with FA had a significantly lower mean mindful eating score (p < .001). Furthermore, those with lower mindfulness levels had a 4.96 higher risk of being food addicted (p < .000). Those with FA diagnosis had significantly lower scores regarding subscales of "disinhibition," "emotional eating," "control of eating," "mindfulness," and "interference" (p < .001). Consequently, it should be highlighted that determining the level of individuals' mindful eating may have remarkable and cumulative impacts on both obesity and FA in the long term. Thus, increasing mindful eating may be suggested as an essential strategy to control FA among young individuals.
Collapse
Affiliation(s)
- İrem Kaya Cebioğlu
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Gözde Dumlu Bilgin
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Hasan Kaan Kavsara
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Açelya Gül
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Aybüke Sarioğlu
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Sema Aydin
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Melis Keküllüoğlu
- Yeditepe University, Institute of Health Sciences, Physiology, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| |
Collapse
|
23
|
Tapper K. Mindful eating: what we know so far. NUTR BULL 2022; 47:168-185. [DOI: 10.1111/nbu.12559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Katy Tapper
- Department of Psychology City, University of London London UK
| |
Collapse
|
24
|
Key process features of personalized diet counselling in metabolic syndrome: secondary analysis of feasibility study in primary care. BMC Nutr 2022; 8:45. [PMID: 35534841 PMCID: PMC9081667 DOI: 10.1186/s40795-022-00540-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Personalized diet counselling, as part of lifestyle change programs for cardiometabolic risk conditions (combinations of prediabetes or type 2 diabetes, hypertension, dyslipidemia and high waist circumference) has been shown to reduce progression to type 2 diabetes overall. To identify key process of care measures that could be linked to changes in diet, we undertook a secondary analysis of a Canadian pre-post study of lifestyle treatment of metabolic syndrome (MetS). Diet counselling process measures were documented and association with diet quality changes after 3 months were assessed. Results of the primary study showed 19% reversal of MetS after 1 year. Methods Registered dietitians (RDs) reported on contact time, specific food behaviour goals (FBG), behaviour change techniques (BCT; adapted from the Michie CALO-RE taxonomy) and teaching resources at each contact. Diet quality was measured by 2005 Canadian Healthy Eating Index (HEI-C) and assessed for possible associations with individual BCT and FBG. Results Food behaviour goals associated with improved HEI-C at 3 months were: poultry more than red meat, increased plant protein, increased fish, increased olive oil, increased fruits and vegetables, eating breakfast, increased milk and alternatives, healthier fats, healthier snacks and increased nuts, with an adverse association noted for more use (> 2 times/ 3 months) of the balanced meal concept (F test; p < 0.001). Of 16 BCT, goal setting accounted for 15% of all BCT recorded, yet more goal setting (> 3 times/3 months) was associated with poorer HEI-C at 3 months (F test; p = 0.007). Only self-monitoring, feedback on performance and focus on past success were associated with improved HEI-C. Conclusions These results identify key aspects of process that impact diet quality. Documentation of both FBG and BCT is highly relevant in diet counselling and a summary diet quality score is a promising target for assessing short-term counselling success. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00540-9.
Collapse
|
25
|
Jackson A, Sano Y, Parker L, Cox AE, Lanigan J. Intuitive eating and dietary intake. Eat Behav 2022; 45:101606. [PMID: 35231798 DOI: 10.1016/j.eatbeh.2022.101606] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 01/09/2023]
Abstract
Intuitive eating has been associated with positive health benefits, yet the research investigating intuitive eating with dietary intake is minimal, inconsistent, and may differ by sex and food security status. The purpose of this study is to identify relationships between intuitive eating and dietary intake in adults living in the US and explore differences by sex and food insecurity status. We recruited 308 adults 18 years and older living in the US to complete an online survey including demographic data, intuitive eating, a diet screener questionnaire, and food insecurity status. We used structural equation modeling to analyze relationships between intuitive eating subscales, calcium, whole grains, added sugars, vegetables, and fruits. Then, we explored differences by sex and food security status. Unconditional permission to eat was associated with a higher intake of added sugar, while body-food choice congruence was associated with a lower intake of added sugar and calcium, and a higher intake of vegetables and whole grains. Eating for physical rather than emotional reasons was associated with a higher intake of calcium and vegetables. Intuitive eating differed by sex and food security status. While intuitive eating is not consistently related to the intake of more nutritious foods, eating for physical rather than emotional reasons and body-food choice congruence may promote diet quality in a community sample. Men and food secure adults scored higher in intuitive eating suggesting tailored intuitive eating interventions may be essential to increase effectiveness.
Collapse
Affiliation(s)
- Alexandra Jackson
- Human Development, Washington State University, 14204 NE Salmon Creek Ave, Vancouver, WA 98686, United States of America.
| | - Yoshie Sano
- Human Development, Washington State University, 14204 NE Salmon Creek Ave, Vancouver, WA 98686, United States of America
| | - Louise Parker
- Extension Youth and Families Unit, Human Development, Washington State University, 3158 Fremont Ave, #361, Seattle, WA, United States of America
| | - Anne E Cox
- Kinesiology & Educational Psychology, College of Education, Washington State University, Smith Gym 213C, Pullman, WA 99164, United States of America
| | - Jane Lanigan
- Human Development, Washington State University, 14204 NE Salmon Creek Ave, Vancouver, WA 98686, United States of America
| |
Collapse
|
26
|
Małachowska A, Jeżewska-Zychowicz M. Polish Adaptation and Validation of the Intuitive (IES-2) and Mindful (MES) Eating Scales—The Relationship of the Concepts with Healthy and Unhealthy Food Intake (a Cross-Sectional Study). Nutrients 2022; 14:nu14051109. [PMID: 35268085 PMCID: PMC8912520 DOI: 10.3390/nu14051109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 02/04/2023] Open
Abstract
Intuitive (IE) and mindful (ME) eating share internally focused eating, yet previous studies have shown that these concepts are not strongly correlated, which suggests that they might be differently related to food intake. The study aimed to adapt the original Intuitive (IES-2) and Mindful (MES) Eating Scales to the Polish language, to test their psychometric parameters and, further, to examine associations of IE and ME with an intake of selected food groups, i.e., healthy foods (fresh and processed vegetables, fresh fruit) and unhealthy foods (sweets, salty snacks). A cross-sectional study was conducted in 2020 in a group of 1000 Polish adults (500 women and 500 men) aged 18–65 (mean age = 41.3 ± 13.6 years). The factor structure was assessed with exploratory (EFA) and confirmatory (CFA) factor analysis as well as structural equation modeling (SEM). Measurement invariance across gender was assessed with multiple-group analysis. Internal consistency and discriminant validity of the two scales was tested. Spearman’s correlation coefficient was used to examine the correlation between IES-2 and MES subscales with food intake. A 4-factor, 16-item structure was confirmed for IES-2, while EFA and CFA revealed a 3-factor, 17-item structure of MES. Both scales demonstrated adequate internal consistency and discriminant validity. Full metric and partial scalar invariance were found for IES-2, while MES proved partial invariances. “Awareness” (MES) and “Body–Food Choice Congruence” (IES-2) positively correlated with intake of healthy foods and negatively with the intake of unhealthy ones. “Eating For Physical Rather Than Emotional Reasons” (IES-2) and “Act with awareness” (MES) favored lower intake of unhealthy foods, whereas “Unconditional Permission to Eat” and “Reliance on Hunger and Satiety Cues” (IES-2) showed an inverse relationship. A greater score in “Acceptance” (MES) was conducive to lower intake of all foods except sweets. The results confirmed that adapted versions of the IES-2 and MES are valid and reliable measures to assess IE and ME among Polish adults. Different IE and ME domains may similarly explain intake of healthy and unhealthy foods, yet within a single eating style, individual domains might have the opposite effect. Future studies should confirm our findings with the inclusion of mediating factors, such as other eating styles, childhood experiences, dieting, etc.
Collapse
|
27
|
Iceta S, Panahi S, García-García I, Michaud A. The Impact of Restrictive and Non-restrictive Dietary Weight Loss Interventions on Neurobehavioral Factors Related to Body Weight Control: the Gaps and Challenges. Curr Obes Rep 2021; 10:385-395. [PMID: 34318394 DOI: 10.1007/s13679-021-00452-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Restrictive diets, such as low-calorie diets, are difficult to maintain in the long term. For this reason, their popularity has decreased compared to non-restrictive approaches, which instead promote healthy eating strategies. Since both strategies may entail different neurobiological mechanisms, this review will examine the current evidence on the effects of restrictive and non-restrictive interventions on neurobehavioral factors. RECENT FINDINGS Restrictive diets appear to improve eating behaviors, and the evidence reviewed argues against the notion that they may worsen the severity of binge eating. Moreover, they may lead to short-term changes in brain structure and improvements in cerebrovascular markers which, in turn, could impact eating behaviors. Non-restrictive interventions may have a positive effect on weight management and eating behaviors. However, evidence of their neural effects is scarce. Small sample sizes, short follow-ups, and the absence of control groups are limitations of the studies targeting both interventions. Rigorous long-term randomized studies are needed to examine the neurobehavioral effects of restrictive and non-restrictive approaches.
Collapse
Affiliation(s)
- Sylvain Iceta
- Quebec Heart and Lung Institute Research Center, Québec, QC, G1V 4G5, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada
- School of Nutrition, Université Laval, Québec, QC, G1V OA6, Canada
| | - Shirin Panahi
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada
- Faculty of Educational Sciences, Department of Physical Education, Université Laval, Québec, QC, G1V OA6, Canada
- Faculty of Medicine, Department of Kinesiology, Université Laval, Québec, QC, G1V OA6, Canada
| | - Isabel García-García
- Department of Clinical Psychology and Psychobiology, University of Barcelona, 08035, Barcelona, Spain
| | - Andréanne Michaud
- Quebec Heart and Lung Institute Research Center, Québec, QC, G1V 4G5, Canada.
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada.
- School of Nutrition, Université Laval, Québec, QC, G1V OA6, Canada.
| |
Collapse
|