Appetitive traits associated with higher and lower body mass index: evaluating the validity of the adult eating behaviour questionnaire in an Australian sample

Psychometric properties of the nine-item avoidant/restrictive food intake disorder screen (NIAS) in Turkish adolescents

BACKGROUND

This study evaluates the psychometric properties of the Turkish version of the Nine-Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS) in a population of Turkish adolescents.

METHOD

The NIAS, designed to screen for ARFID symptoms, including picky eating, fear-related eating behaviors, and low appetite, was administered to secondary school students between 13 and 18 ages in Muğla, Turkiye.

RESULTS

Based on a sample of 268 adolescents, the NIAS's reliability and validity in this demographic are supported. The research utilized confirmatory factor analysis to verify its three-factor structure and various reliability tests, including Cronbach's alpha and test-retest reliability, confirming the scale's internal consistency and temporal stability. The descriptive analysis highlighted significant differences in NIAS scores across BMI categories, with underweight adolescents scoring higher, suggesting a potential link between ARFID symptoms and lower body weight. Criterion validity was supported by significant correlations between NIAS subscales and measures of anxiety, depression, and eating behaviors, indicating the scale's effectiveness in reflecting relevant psychopathological features.

CONCLUSION

Overall, the study establishes the Turkish NIAS as a useful tool for identifying ARFID in Turkish adolescents, aiding early detection and intervention in this at-risk age group. Further research is recommended to explore the scale's utility across different clinical settings and refine its diagnostic accuracy, enhancing our understanding of ARFID's impact on youth mental health and nutritional status.

Psychometric properties of the nine-item avoidant/restrictive food intake disorder screen (NIAS) in Turkish children

BACKGROUND

The nine item avoidant/restrictive food intake disorder screen (NIAS) is a short and practical assessment tool specific to ARFID with three ARFID phenotypes such as "Picky eating," "Fear," and "Appetite". This study aimed to evaluate the psychometric properties of the Turkish translation of the NIAS parent form and to investigate the relationship between ARFID symptoms and anxiety, depression symptoms, and eating behaviors in a sample of Turkish children.

METHOD

Parents were asked to provide their children's sociodemographic data and to complete the NIAS, Eating Disorder Examination Questionnaire-Short (EDE-QS), Children's Eating Behavior Questionnaire (CEBQ), and Revised Child Anxiety and Depression Scale (RCADS) scales.

RESULTS

The sample included 440 participants between 6 and 12 ages. Turkish NIAS demonstrated good internal consistency. The three-factor model of the Turkish NIAS was in an acceptable structure. The Turkish NIAS scale was shown to be valid and reliable. NIAS scores were shown to be higher in underweight participants. The NIAS-parent version subscales showed expected convergent and divergent validity with the CEBQ, EDEQ-S, and RCADS scales in children, except CEBQ emotional overeating and desire to drink subscales were correlated with NIAS.

CONCLUSION

The Turkish version of the NIAS is valid and reliable in evaluating ARFID symptoms in children.

Validation of the adult eating behavior questionnaire in a Norwegian sample of adolescents

Eating behaviors are related to health and well-being. To examine stability and change in eating behaviors throughout life, developmentally appropriate measures capturing the same eating behavior dimensions are needed. The newly developed Adult Eating Behavior Questionnaire (AEBQ) builds on the well-established parent-reported Children's Eating Behavior Questionnaire (CEBQ), and together with the corresponding Baby Eating Behavior Questionnaire (BEBQ), these questionnaires cover all ages. However, validation studies on adolescents are relatively sparse and have yielded somewhat conflicting results. The present study adds to existing research by testing the psychometric properties of the AEBQ in a sample of 14-year-olds and examining its construct validity by means of the parent-reported CEBQ. The current study uses age 14 data (analysis sample: n = 636) from the ongoing Trondheim Early Secure Study, a longitudinal study of a representative birth cohort of Norwegian children (baseline: n = 1007). Confirmatory factor analysis (CFA) was conducted to test the factorial validity of AEBQ. Construct validity was examined by bivariate correlations between AEBQ subscales and CEBQ subscales. CFAs revealed that a 7-factor solution of the AEBQ, with the Hunger scale removed, was a better-fitting model than the original 8-factor structure. The 7-factor model was respecified based on theory and model fit indices, resulting in overall adequate model fit (χ2 = 896.86; CFI = 0.924; TLI = 0.912; RMSEA = 0.05 (90% CI: 0.043, 0.051); SRMR = 0.06). Furthermore, small-to-moderate correlations were found between corresponding AEBQ and CEBQ scales. This study supports a 7-factor solution of the AEBQ without the Hunger scale and provide evidence of its construct validity in adolescents. Several of the CEBQ subscales were significantly associated with weight status, whereas this was the case for only one of the AEBQ scales.

Associations of food choice values and food literacy with overall diet quality: a nationwide cross-sectional study in Japanese adults

To date, a limited number of studies have examined aspects of food choice values and food literacy in relation to some aspects of dietary behaviours. The aim of this cross-sectional study was to comprehensively examine the associations of food choice values and food literacy with diet quality. In total, 2231 Japanese adults aged 19-80 years completed questionnaires asking about food choice values (accessibility, convenience, health/weight control, tradition, sensory appeal, organic, comfort and safety) and food literacy characterised by nutrition knowledge, cooking skills, food skills and eating behaviours (hunger, food responsiveness, emotional overeating, enjoyment of food, satiety responsiveness, emotional undereating, food fussiness and slowness in eating). As a measure of diet quality, the Healthy Eating Index-2015 (HEI-2015) was calculated using a brief-type diet history questionnaire (BDHQ) or a food combination questionnaire (FCQ). In males, after adjustment for potential confounding factors (including age, BMI and the ratio of reported energy intake to estimated energy requirement), the HEI-2015 derived from BDHQ and that derived from FCQ were associated significantly (P ≤ 0·02) and positively with the food choice values of organic and inversely with food fussiness. In females, the HEI-2015 showed positive associations with the food choice values of health/weight control, nutrition knowledge and cooking skills and an inverse association with food fussiness, irrespective of the dietary assessment questionnaire (P ≤ 0·03). In conclusion, this study suggests that several aspects of food choice values and food literacy were associated with diet quality, and the aspects related differed between males and females.

Validity and reliability of Turkish version of the Adult Eating Behaviour Questionnaire for adult participants

OBJECTIVE

The aim of this study is to assess the validity and reliability of the Adult Eating Behaviour Questionnaire (AEBQ-TR) for adults.

DESIGN

Hunot et al. (2016) developed the original questionnaire, which was modified and translated into Turkish. On data collected from adults, construct validity was assessed using exploratory factor analysis and confirmatory factor analysis. Pearson's and Cronbach's correlation coefficients were used to evaluate reliability and validity (P < 0·05).

SETTING

This research was carried out in Ankara, Turkey.

PARTICIPANTS

A total of 311 adults from Ankara (148 men and 163 women) took part in the study. Seventy-two of these adults take the retest.

RESULTS

In the present study, 311 adults with a mean age of 29·3 ± 11·3 years participated. Factor loadings ranged from 0·404 to 0·907. In general, food approach and food avoidance scales showed a positive correlation within themselves. According to the results of confirmatory factor analysis and goodness-of-fit indicators, the seven-factor model showed a better model fit in the Turkish data (chi-square/degrees of freedom = 2·137, root mean error of approximation: 0·061, comparative fit index: 0·884, and normed fit index: 0·850). Higher BMI was associated with higher Emotional Over-eating, higher Enjoyment of the Food, lower Food Satiety and lower Emotional Under-eating.

CONCLUSIONS

The Turkish AEBQ is a valid and reliable tool for 20- to 65-year adults to determine appetitive properties related to the aetiology of weight change and especially obesity risk. Besides, AEBQ testing is required for validation in early and late adulthood.

Mediating role of weight concerns in the relationship between seasonality and eating behavior among community-dwelling older adults: A path analysis

BACKGROUND

Weight concerns are common among older adults, and it is unclear how they may impact the relationship between seasonality and eating behaviors, which can contribute to various health-related issues.

AIM

This study investigated the mediating role of weight concerns in the relationship between seasonality and eating behavior among community-dwelling older adults.

METHOD

A descriptive correlational analytical design was used on 200 randomly chosen participants who completed the Personal Inventory for Depression and Seasonal Affective Disorder Self-Assessment Version, the Adult Eating Behavior Questionnaire, and the Weight Concern Subscale. A path analysis was conducted to test the hypothesized model.

RESULTS

The study findings indicated that most older adults reported moderate-to-severe seasonal variations, moderate enjoyment of food, emotional overeating, emotional undereating, and food fussiness. Weight concern partially mediated the relationship between seasonality and eating behavior.

CONCLUSION

By understanding the complex interplay between these factors, weight concerns may play an essential role in mediating the effects of seasonal changes on eating behavior, while seasonal winter symptoms may directly impact eating behavior. These results have potential implications for nurses' efforts to develop interventions to promote healthy eating behaviors and manage weight concerns during seasonal variations, especially in the winter.

Eating Behaviours of Polish and Portuguese Adults-Cross-Sectional Surveys

Eating behaviours affect energy intake through the types and amounts of foods chosen and decisions about the beginning and ending of the eating process. This study aims to determine and compare the eating behaviours of Polish and Portuguese adults and, in addition, to establish the correlations between daily behaviours, food-approaches and food-avoidance behaviours, and BMI in both populations. The study was conducted between January 2023 and March 2023. Participants from Poland and Portugal responded to the AEBQ questionnaire and questions on eating habits and body-image self-perception. The research tool was a website-based survey questionnaire with single-choice questions. No significant differences related to BMI levels were found between the Polish and Portuguese adults in terms of their eating behaviours. Both groups were characterised by the increased intensity of their food-approach behaviours, which was directly correlated with increases in BMI. Greater snacking intensity and binge drinking were associated with higher BMI. The study revealed an increased prevalence of binge drinking in the Polish sample. The study also confirmed a higher frequency of food-approach behaviours in overweight and/or obese individuals and uncontrolled calorie intake in participants imposing dietary restrictions for weight loss. Nutrition education is needed to improve eating habits and food choices, as well as to prevent overweight and obesity in adults.

The role of stress in the association among food insecurity, eating disorder pathology, and binge eating-related appetitive traits

PURPOSE

Growing literature demonstrates a positive association between food insecurity (FI) and eating disorder pathology. Additionally, FI has been associated with two appetitive traits strongly linked to binge eating, food responsiveness and emotional overeating. However, little research has investigated factors that might help to explain these associations. One hypothesis is that experiencing FI may increase stress, and that eating disorder pathology, particularly binge eating-related phenotypes, may serve as a coping strategy. This study explores stress as a potential mechanism in the association between FI and general eating disorder pathology, as well as two appetitive traits strongly associated with binge eating (food responsiveness and emotional overeating).

METHODS

Cis-gender women (N = 634) completed online questionnaires assessing FI, stress, eating disorder pathology (measured via the total score on the Short Eating Disorder Examination Questionnaire), and binge eating-related appetitive traits (measured via the Adult Eating Behavior Questionnaire). Cross-sectional indirect effects analyses with a 1000-sample bootstrap were used to test pathways among FI, stress, and eating-related constructs.

RESULTS

FI was significantly associated with eating disorder pathology and associated appetitive traits (ps < 0.001). Stress explained a significant proportion of the correlation between FI and each eating-related construct.

CONCLUSIONS

Our findings extend prior research on the relationships between FI, eating disorder pathology, and binge eating-related appetitive traits to provide preliminary evidence that stress may act as an underlying mechanism. Future studies should use longitudinal designs to assess the prospective relationships among these constructs.

The Development of Appetite: Tracking and Age-Related Differences in Appetitive Traits in Childhood

Appetitive traits are associated with body weight. Increased understanding of how appetitive traits evolve from early life could advance research on obesity risk and inform intervention development. We report on tracking and age-related differences in appetitive traits in childhood within the RESONANCE cohort. Parents of RESONANCE children aged 6.02 ± 2.99 years completed the Child Eating Behavior Questionnaire (CEBQ). Pearson correlations of appetitive traits and age were tested for all participants contributing at least one observation, using each participant’s first observation (N = 335). Children’s first and second observations of the CEBQ (n = 127) were used to test tracking (paired correlations) and age-related differences (paired t-tests) within individuals. CEBQ correlations with age suggested that satiety responsiveness, slowness in eating, emotional undereating, and desire to drink decreased with age (r = −0.111 to r = −0.269, all p < 0.05), while emotional overeating increased with age (r = 0.207, p < 0.001). Food fussiness demonstrated a quadratic relationship with age. Paired t-tests further supported an increase in emotional overeating with age (M: 1.55 vs. 1.69, p = 0.005). All CEBQ subscales demonstrated moderate to high tracking (r = 0.533 to r = 0.760, p < 0.001). Our initial findings within the RESONANCE cohort suggest that food avoidant traits are negatively related with age, while emotional overeating increases with age, and that appetitive traits track through childhood.

A comparison of meal-related appetite, food reward and eating behaviour traits in people with and without spinal cord injury

Persons with a spinal cord injury (SCI) are at a heightened risk of obesity. However, little is known about the effect of SCI on factors that influence energy intake. This study compared measures of food reward, eating behaviour traits, and appetite perceptions between adults with and without SCI. Twenty wheelchair dependent persons with chronic (>1 year) SCI (C1-T12) and twenty non-SCI individuals matched for BMI, age and sex participated. Following a familiarisation visit, participants consumed a breakfast meal, normalised for resting metabolic rate (RMR), and provided subjective appetite perceptions every 30 min for 4 h. Subsequently, energy intake was determined via an ad libitum lunch meal. Explicit liking, explicit wanting, implicit wanting and relative preference were assessed in a hungry and fed state via the Leeds Food Preference Questionnaire prior to and following the lunch meal. Eating behaviour traits were assessed via the Adult Eating Behaviour Questionnaire, Control of Eating Questionnaire, Reasons Individuals Stop Eating Questionnaire, and Three-Factor Eating Questionnaire Revised 18-item version. Sweet appeal bias was greater for explicit liking, explicit wanting, and relative preference in the group with SCI compared to the non-SCI group (p ≤ 0.024). The group with SCI also reported higher levels of cognitive restraint and satiety responsiveness (p ≤ 0.029). No group differences in postprandial appetite perceptions (p ≥ 0.690) or energy intake relative to RMR were seen (p = 0.358). However, the group with SCI demonstrated a trend toward a lower absolute energy intake (p = 0.063). In conclusion, food reward for sweet foods was greater in the group with SCI. Further, our findings suggest that acute appetite perceptions, including satiety profiles, are not different between persons with and without SCI.

Appetitive traits and body mass index in Chinese adolescents: An 18-month longitudinal study with latent growth curve analyses

A longitudinal approach with Latent Growth Curve Modeling (LGCM) was adopted to explore the trajectories of appetitive traits corresponding to BMI in Chinese adolescents. Within a large sample of adolescents (N = 2566, 45.9% boys) aged from 11 to 17 years (M = 13.80, SD = 1.56) at the baseline survey, our results indicated that appetitive traits of emotional overeating, food fussiness, and hunger increased significantly over time while enjoyment of food decreased over time. Slowness in eating and satiety responsiveness significantly increased in girls, while emotional undereating significantly decreased in boys. Moreover, the growth parameters of emotional undereating and satiety responsiveness were significantly and negatively related to BMI in girls. Our findings evidence that certain appetitive traits could change over time in adolescence and these changes relate to weight status. Gender differences are suggested in the design of future intervention and treatment of overweight/obesity in Chinese adolescents.

Eating behaviors, dietary patterns and weight status in emerging adulthood and longitudinal associations with eating behaviors in early childhood

Background

Eating behaviors may contribute to differences in body weight and diet over time. Our study aims to examine how eating behaviors of young adults relate to their current weight status and dietary patterns and to explore longitudinal associations with eating behaviors in early childhood.

Methods

Study participants are young adults (n = 698) taking part in the Quebec Longitudinal Study of Child Development. At age 22, eating behaviors were assessed using the Adult Eating Behavior Questionnaire. Dietary patterns were derived from information collected by food frequency questions. Weight status was based on self-reported data. Information on eating behaviors in childhood had been collected when participants were 2.5 to 6 years old. Pearson’s correlations were used to determine associations between adult eating behaviors and body mass index. Simple and multivariate linear regression analyses were used to examine associations between eating behaviors and dietary patterns at age 22, and longitudinal associations with behaviors in early childhood. Ordinal logistic regression analyses were used to assess associations between overeating and fussy eating in childhood and weight status at age 22.

Results

Body mass index was positively correlated with Emotional overeating, Enjoyment of food, and Food responsiveness and negatively correlated with Satiety responsiveness, Emotional undereating, Slowness in eating and Hunger. A Healthy dietary pattern was positively associated with both Enjoyment of food and Hunger, and negatively associated with Food fussiness. Inversely, a Beverage-rich dietary pattern was negatively associated with Enjoyment of food and positively associated with Food fussiness. A Protein-rich pattern was positively associated with Enjoyment of food, while a High energy density pattern was positively associated with Food fussiness. Young adults with higher scores for fussy eating in early childhood were more likely to manifest Food fussiness and Emotional undereating, and less likely to adopt a Healthy dietary pattern. Young adults with higher scores for overeating in early childhood were less likely to show traits such as Slowness in eating and more likely to be overweight.

Conclusions

Our findings suggest that eating behaviors in childhood have long-term influence on diet and weight status, thereby reinforcing the importance of early interventions that promote healthy eating.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01376-z.

The Arabic Version of the Adult Eating Behavior Questionnaire among Saudi Population: Translation and Validation

Inherited individual differences in eating behaviors known as “appetitive traits” can be measured using the Adult Eating Behavior Questionnaire (AEBQ). The AEBQ can be used to assess individuals that require intervention regarding their weight, eating habits, and for the identification of eating disorders. Arabic eating behavior assessment tools are few. This study, therefore, aimed to translate and validate the AEBQ in Arabic language (AEBQ-Ar) and to confirm the factor structure while assessing the internal consistency of all subscales. Participants completed the AEBQ-Ar and reported their sociodemographic data online. Exploratory factor analysis (EFA) was used and internal reliability was assessed using Cronbach’s α. Correlations between AEBQ-Ar subscales and body mass index (BMI) were done using Pearson’s correlation. A sample of 596 adults, mean age of 35.61 ± 12.85 years, was recruited from Saudi Arabia. The 6-factor structure was the best model, excluding emotional under- eating subscale and merging enjoyment of food and food responsiveness subscales. Internal consistency was acceptable for all subscales (Cronbach’s α = 0.89–0.66). Emotional over- eating was positively associated with BMI, and slowness in eating was negatively associated with BMI. The AEBQ-Ar with 6-subscales appears to be a valid and reliable psychometric questionnaire to assess appetitive traits in Arabic speakers.

Relationships between retrospective parental feeding practices and Chinese university students' current appetitive traits, weight status, and satisfaction with food-related life

Accumulating evidence suggests that parental feeding practices during childhood are related to adults' eating behaviors and weight status, but research exploring these relationships is largely conducted in Western contexts. However, China, a country that holds the largest world population, has distinct patterns of eating habits and food culture from Western countries. Therefore, the present study aimed to examine relationships between retrospective parental feeding practices (e.g., concern, monitoring, pressure to eat, and restriction) and current body mass index (BMI) and satisfaction with food-related life in a sample of 476 Chinese university students (195 men; Mage = 19.78 years, SD = 1.23). We also examined whether appetitive traits mediated these associations. Retrospective parental feeding practices were significantly related with participants' current BMI (concern: r = 0.26, p < .001; pressure to eat: r = -0.15, p < .001) and satisfaction with food-related life (concern: r = 0.15, p < .001; monitoring: r = 0.12, p = .009; pressure to eat: r = 0.13, p = .006; restriction: r = 0.16, p < .001). Relationships were partially mediated by young adults' current appetitive traits (e.g., enjoyment of food, emotional overeating, satiety responsiveness, slowness in eating). These findings suggest that retrospective parental feeding practices are important correlates of young adults' current weight status and satisfaction with food-related life, and that appetitive traits partially explain these relationships in the Chinese context.

Exploring acute and non-specific effects of mobile app-based response inhibition training on food evaluation and intake

Previous studies have demonstrated that response inhibition training can modify the appeal of palatable and energy-dense foods, thus serving as a potential intervention for weight management, via changes in food selection and intake. However, empirical findings of efficacy have been inconsistent across studies due to heterogenous approaches to measuring salient appetitive outcomes, training implementation strategies, and sample recruitment. Systematic assessment of both affective and motivational components of food reward may help characterise to what extent devaluation can be generalised to nutritionally similar foods post-training. In this mixed factorial experiment, a non-clinical, adult sample completed time-matched single sessions with mobile app-based response inhibition training and control tasks of short (12 min; n = 27) or long (20 min; n = 25) duration. Participants were assessed on two discrete facets of food reward pre- and post-training: pleasure (i.e., explicit liking) and desire (i.e., implicit wanting) for non-specific (i.e., novel) food stimuli differing in energy-density. Consumption of snacks categorised by energy density was also assessed in a laboratory ad libitum taste test post-training. No significant differences were found between intervention and control sessions on explicit liking or implicit wanting for non-specific energy-dense foods. Moreover, participants ate a similar volume of snack foods during both sessions. Training duration did not significantly moderate differences between intervention and control sessions in primary outcomes. Variance between intervention and control sessions in chocolate intake and frequency of choice for energy-dense foods, but not explicit liking, was associated with a higher BMI. Methodological and theoretical implications for appropriate intervention implementation and underlying mechanisms, respectively, are discussed.

Psychometric Properties of the Persian Version of Adult Eating Behavior Questionnaire in Patients with Epilepsy

Background

Adult eating behavior questionnaire (AEBQ) is an age upward extension tool that measures appetite traits in individuals. This instrument was developed by Hunot in 2016. The present study aimed to determine the psychometric properties of the Persian version of AEBQ in adults with epilepsy.

Methods

The current research is a cross-sectional study conducted in 2019 in Iran. 700 adults with epilepsy completed the 35-item AEBQ. Qualitative face validity, qualitative content and structure validity (exploratory factor analysis [EFA], N=400, and confirmatory factor analysis [CFA], N=300) appetitive traits were evaluated. Reliability was also measured using Cronbach's alpha, Construct reliability (CR), and Intra-Class Correlation (ICC). The SPSS 26-AMOS24 software was employed to analyze the data with a significance level of 0.05.

Results

The EFA and CFA results comprised eight factors, namely enjoyment of food, emotional over-eating, food responsiveness, hunger, satiety responsiveness, emotional under-eating, food fussiness, and eating slowly. Indices of root mean square error of approximation=0.068, parsimonious normed fit index=0.644, parsimonious comparative fit index=0.671, adjusted goodness of fit index=0.618, goodness of fit index=0.911, and Chi square degree-of-freedom ratio (normalized Chi square CMIN/DF=2.842) confirmed the fitness of the final model. Convergent and divergent validity was acceptable for all the factors. The results revealed that the internal stability>0.8 and CR>0.7 of the eight extracted AEBQ structures are confirmed. The ICC was 0.899 (95% CI: 0.878-0.917; P<0.001). The results also showed that AEBQ has acceptable convergent and divergent validity.

Conclusion

The eight-factor structure of AEBQ can measure eating behavior traits and is of good validity and reliability for assessing the eating behavior of Iranian adults with epilepsy.

Food Choice Values and Food Literacy in a Nationwide Sample of Japanese Adults: Associations with Sex, Age, and Body Mass Index

This cross-sectional study of 2231 Japanese adults described food choice values and food literacy in relation to sex, age, and body mass index. We assessed eight food choice values (accessibility, convenience, health/weight control, tradition, sensory appeal, organic, comfort, and safety, using a 25-item scale), as well as food literacy, which was characterized by nutrition knowledge (using a validated 143-item questionnaire), cooking and food skills (using 14- and 19-item scales, respectively), and eight eating behaviors (hunger, food responsiveness, emotional overeating, enjoyment of food, satiety responsiveness, emotional undereating, food fussiness, and slowness in eating, using the 35-item Adult Eating Behavior Questionnaire). Females had higher means of all the variables than males, except for food fussiness. Compared to participants aged 19-39 and/or 40-59 years, those aged 60-80 years had low means of some food choice values (accessibility, convenience, sensory appeal, and comfort), nutrition knowledge, and all the food approach behaviors (hunger, food responsiveness, emotional overeating, and enjoyment of food) and high means of other food choice values (tradition, organic, and safety) and slowness in eating. Age was inversely associated with cooking and food skills in males, whereas the opposite was observed in females. The associations with body mass index were generally weak. These findings serve as both a reference and an indication for future research.

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.

Validity of the Adult Eating Behavior Questionnaire and Its Relationship with Parent-Reported Eating Behaviors among Adolescents in Portugal

The Adult Eating Behavior Questionnaire (AEBQ) is a tool developed in the UK, used in the investigation of appetitive traits in adults and adolescents, and later validated in a number of countries. To date, the validity of the AEBQ has not been tested on Portuguese-speaking popula-tions. The aim of this study was to validate the AEBQ in a sample of Portuguese adolescents. Participants were 4483 13-year-olds enrolled in the population-based cohort study Generation XXI. Appetitive traits were self-reported by adolescents through the AEBQ and parents also reported adolescent eating behaviors. Confirmatory and exploratory factor analyses were conducted. Construct validity was tested through correlations between AEBQ subscales and parent-reported eating behaviors, and linear regressions between AEBQ subscales and adolescent body mass index z-scores were performed. Adequate internal consistency and several associations with parent-reported eating behaviors and measured adolescent body mass index z-scores were found. This study supports the validity of a five-factor AEBQ (Food Responsiveness and Enjoyment of Food; Slowness in Eating; Food Fussiness; Emotional Over- and Undereating) to measure appetitive traits among Portuguese adolescents and provides a convenient and easy-to-use tool to be used in large-scale research.

Intergenerational transmission of appetite: Associations between mother-child dyads in a Mexican population

The Child Eating Behaviour Questionnaire (CEBQ) and the Adult Eating Behaviour Questionnaire (AEBQ) measure 'food approach' [Food responsiveness (FR); Emotional overeating (EOE); Enjoyment of food (EF); Desire to Drink] and 'food avoidant' [Satiety responsiveness (SR); Emotional undereating (EUE); Food fussiness (FF); Slowness in eating (SE)] appetitive traits (ATs) in children and adults, respectively. 'Food approach' traits predispose to overweight while 'food avoidance' traits provide protection, but little is known about the relationships between parents' and their offspring's ATs. The aim was to examine the associations between maternal and child appetitive traits, using the AEBQ-Esp and CEBQ-Mex adapted for use in Mexican populations. Sociodemographic data, weights and heights of mothers and their children (aged 3-13 years), who were recruited from a teaching hospital in Guadalajara, Mexico, were measured. Mothers completed both the AEBQ-Esp and the CEBQ-Mex. The CEBQ-Mex was developed, and its reliability was tested using Cronbach's alpha and Omega, and Confirmatory Factor Analysis (CFA) was used to assess its validity. Pearson's correlation coefficients were used to assess associations between mothers' and children's Ats. The sample included 842 mother-child dyads (mother's mean age = 34.8±SD6.9 years, BMI 29.7±6.1 kg/m2; children's mean age = 8.5 ±SD2.5 years, BMIz 1.5±1.6). Internal reliability was moderate to high [Cronbach alpha = .68-.86; Omega = .71-.87] for the CEBQ-Mex and validity was confirmed for an 8-factor model through CFA [RMSEA = 0.065; CFI = 0.840, NFI = 0.805; IFI = 0.842; and χ2(df = 532) = 2939.51, p < 0.001]. All but one of the children's appetitive traits showed small to moderate, significant correlations with their mother's counterpart [FR (r = .22; p<001); EOE (r = .30; p < .001); EF (r = .15; < .001); SR (r = .16; p < .001); EUE (r = .34; p < .001) and FF (r = .14; p < .001). Only SE was not significantly associated with maternal SE (r = .01; p>.05). ATs tend to run in families, signalling the intergenerational transmission of eating behaviours. These may be useful targets for family-wide interventions to support the development and maintenance of healthy eating behaviours in childhood.

Examining the validity and consistency of the Adult Eating Behaviour Questionnaire-Español (AEBQ-Esp) and its relationship to BMI in a Mexican population

PURPOSE

Appetitive traits in adults and their associations with weight can be measured using the Adult Eating Behaviour Questionnaire (AEBQ). The aim of this study was to confirm the factor structure of the Spanish AEBQ (AEBQ-Esp) in a Mexican sample and explore associations between the eight traits with body mass index (BMI).

METHOD

A sample of 1023 adults, mean age of 36.8 ± 12.8 years, was recruited from Guadalajara, Mexico. Researchers weighed and measured participants, and they completed the AEBQ-Esp either online or in paper format and reported sociodemographic data. To test two alternative factor structures (eight factors including Hunger; seven factors excluding Hunger), confirmatory factor analysis (CFA) was used. Internal reliability was assessed using Cronbach's alpha; test-retest reliability was assessed using intra-class correlation coefficients. Multivariate linear regressions were used to test for associations between the AEBQ subscales and BMI, adjusted for age, sex, format of AEBQ responses, education, marital and employment status.

RESULTS

A seven-factor structure was the best model fit using CFA, excluding the Hunger subscale but similar to the original AEBQ. Internal reliability was good for all subscales (Cronbach's α = 0.70-0.86), and the intra-class correlation coefficient (0.70-0.91) reflected good test-retest reliability. In the fully adjusted models, Satiety Responsiveness [β = - 0.61; (- 1.01, - 0.21)] and Slowness in Eating [β = - 0.70; (- 1.01, - 0.39)] were negatively associated with BMI, and Emotional Over-Eating [β = 0.94; (0.62, 1.27)] was positively associated with BMI.

CONCLUSIONS

The AEBQ-Esp (excluding Hunger) appears to be a valid and reliable psychometric questionnaire for measuring appetitive traits in a Mexican Spanish-speaking population. Some traits appear to be associated with BMI in adulthood and warrant further exploration.

LEVEL OF EVIDENCE

Level III evidence obtained from well-designed cohort or case-control analytic studies. Although this was just an observational study, it was well designed and provided new evidence.

IgG antibodies reacting with ghrelin and leptin are correlated with body composition and appetitive traits in young subjects

Appetitive traits are important behavioural characteristics affecting eating and body composition. Ghrelin and leptin are two key hormones regulating appetite and metabolism. Recent studies have reported the presence of autoantibodies (autoAbs) directed to ghrelin and leptin in healthy individuals as well as affinity alterations in eating disorders such as anorexia nervosa and hyperphagic obesity. Nevertheless, the relationship of these autoAbs with appetitive traits is unknown. The goals of this exploratory study were to analyze circulating IgG autoAbs reacting to ghrelin and leptin and evaluate their relationship with body composition parameters and appetitive traits. This cross-sectional study included 180 young subjects (20 ± 2 years) that underwent body composition evaluation. Seven appetitive traits were assessed with AEBQ-Esp and were classified as low-score or high-score. A validated in-house ELISA test was performed to measure IgG ghrelin and leptin-reactive autoAbs in its free, total, and immune complexes fractions. Free IgG ghrelin-reactive were significantly higher in women than in men. Immune complexes of IgG-ghrelin were positively correlated with waist-hip ratio in the total cohort. In women, free IgG leptin-reactive were positively correlated with body fat percentage and waist-hip ratio, whereas in men, immune complexes of IgG-leptin were positively correlated with body fat percentage. Women with a low-score for 'enjoyment of food', exhibited higher levels of IgG ghrelin-reactive autoAbs on its free form than the high-score group. Men with a high-score for 'emotional undereating' had higher levels of free IgG leptin-reactive autoAbs than the low-score group. The correlation of these autoAbs with anthropometric parameters and appetitive traits in young subjects support its role as carriers and modulators of the biologic functions of ghrelin and leptin and suggest a novel role in eating behaviour through appetitive traits.

The Relationship between Eating and Screen Viewing Behavior with Nutritional Status of Adolescents in Medan City

Adolescents are vulnerable to experiencing malnutrition issues, both overnutrition and undernutrition. This study’s objective was to determine the relationship between eating and screen viewing behaviour and with nutritional status of adolescents. This study used a cross-sectional design with 145 adolescents chosen through the purposive sampling method. The samples were divided into three categories: early adolescents, middle adolescents, and late adolescents, and data on eating behaviour were obtained by using Adult Eating Behavior Questionnaire (AEBQ). The screen viewing behavior variable had two categories: low screen time and high screen time. Adolescent body mass index z-scores measured nutritional status. This study was conducted from June to August 2022. Results showed 5.5% underweight participants, 18.6% subject overweight participants, and 22.8% obese participants of the total participants. Spearman’s tests showed that there was a significant relationship between eating behaviour and nutritional status (p<0.05) only on two subscales of appetite traits (emotional overeating and food responsiveness) in early adolescents. Likewise, in late adolescents, there was a significant relationship between eating behaviour and nutritional status (p<0.05) only with emotional undereating. There was no significant relationship between screen viewing behaviour and nutritional status in all categories of adolescents. The highest prevalence of obesity was found in early adolescents, and it influenced the adolescent’s eating behavior such as emotional overeating. While in late adolescents, malnutrition cases were more or less common due to emotional undereating.

Concurrent Validity of the Adult Eating Behavior Questionnaire in a Canadian Sample

The current study aimed to test the factor structure of the Adult Eating Behavior Questionnaire (AEBQ), its construct validity against the Three-Factor Eating Questionnaire (TFEQ-R18) and its associations with body mass index (BMI) in Canadian adults (n = 534, 76% female). Confirmatory factor analysis (CFA) revealed that a seven-factor AEBQ model, with the Hunger subscale removed, had better fit statistics than the original eight-factor structure. Cronbach's alpha was used to assess the internal reliability of each subscale and resulted with α > 0.70 for all subscales except for Hunger (α = 0.68). Pearson's correlations were used to inform the convergent and discriminant validation of AEBQ against the TFEQ-R18 and to examine the relationship between AEBQ and BMI. All AEBQ Food Approach subscales positively correlated with that of the TFEQ-R18 Emotional Eating and Uncontrolled Eating subscales. Similarly, BMI correlated positively with Food Approach subscales (except Hunger) and negatively with Food Avoidance subscales (except Food Fussiness). These results support the use of a seven-factor AEBQ for adults self-reporting eating behaviors, construct validity of the AEBQ against TFEB-R18, and provide further evidence for the association of these traits with BMI.

Perceived Diet Quality, Eating Behaviour, and Lifestyle Changes in a Mexican Population with Internet Access during Confinement for the COVID-19 Pandemic: ESCAN-COVID19Mx Survey

Perceived changes in diet quality, emotional eating, physical activity, and lifestyle were evaluated in a group of Mexican adults before and during COVID-19 confinement. In this study, 8289 adults answered an online questionnaire between April and May 2020. Data about sociodemographic characteristics, self-reported weight and height, diet quality, emotional eating, physical activity, and lifestyle changes were collected. Before and after confinement, differences by sociodemographic characteristics were assessed with Wilcoxon, Anova, and linear regression analyses. Most participants were women (80%) between 18 and 38 years old (70%), with a low degree of marginalisation (82.8%) and a high educational level (84.2%); 53.1% had a normal weight and 31.4% were overweight. Half (46.8%) of the participants perceived a change in the quality of their diet. The Diet Quality Index (DQI) was higher during confinement (it improved by 3 points) in all groups, regardless of education level, marginalisation level, or place of residence (p < 0.001). Lifestyle changes were present among some of the participants, 6.1% stopped smoking, 12.1% stopped consuming alcohol, 53.3% sleep later, 9% became more sedentary, and increased their screen (43%) as well as sitting and lying down time (81.6%). Mexicans with Internet access staying at home during COVID-19 confinement perceived positive changes in the quality of their diet, smoking, and alcohol consumption, but negative changes in the level of physical activity and sleep quality. These results emphasise the relevance of encouraging healthy lifestyle behaviours during and after times of crisis to prevent the risk of complications due to infectious and chronic diseases.

Brief ‘Appetitive Trait Tailored Intervention’: Development in a Sample of Adults with Overweight and Obesity

Appetitive traits are associated with weight and could be managed using behavioural strategies. Personalised approaches to weight loss could use a person's appetitive trait profile to tailor weight management advice. This study aimed to explore participants’ experiences of a brief Appetitive Trait Tailored Intervention (ATTI) based on participants’ Adult Eating Behaviour Questionnaire (AEBQ) scores. The ATTI was developed using strategies from modified Cognitive Behavioural Therapy and behaviour change techniques. Acceptability testing of the ATTI was carried out with participants (body mass index ≥25) who completed the AEBQ online and were sent their appetitive trait profile and corresponding weight loss tips via e-mail. Participants were asked to follow the tips for 8 weeks and following the tips, perceived helpfulness, barriers, and initial and final body weight. Qualitative interviews explored their experiences. Thirty-seven participants provided feedback and reported the majority of the tips to be helpful. Thirty-two participants (92.5% female) provided their final weight; 10 reported weight loss ≥5% of initial weight. Qualitative interviews (n = 21) revealed that tailoring was seen as novel and participants felt that the ATTI increased their self-awareness and encouraged behavioural changes. The low intensity of the ATTI limited engagement for some. The ATTI is an acceptable, novel approach to weight management.

Eater profile and associated factors in pediatric patients of the PEDIANUT cohort

Appetite traits have multifactorial origins. In association with environmental and genetic factors, they could become problematic and lead to Feeding or Eating Disorders (FED). As the DSM-5 classification is not suitable for pediatric FED, another way to describe eating behavior is to distinguish the clinical profiles of "small eater" and "big eater". The aim of this study was to identify socio-demographic and medical factors associated with these profiles, and to compare problematic and non-problematic profiles. From the Pedianut study, we analyzed socio-demographic, medical and family history data among 401 children according to 4 age groups (<1 year n = 101, 1-6 years n = 99, 6-12 years n = 100, 12-18 years n = 101). The information collected on eating behavior made it possible to define small eater profile (SEP) and big eater profile (BEP) using predefined grids. BEP was more frequent in adolescents (35.6%), and SEP was more frequent in children aged 1-6 years (34.3%). BEP was associated with having separated parents, being male and the oldest sibling (p < 0.05). Problematic BEP was associated with eating while watching television, being a girl, and having sensory disorders (p < 0.05). SEP was associated, whatever age, with non-breastfeeding, chronic illness, psychological history, sensory disorders, language delays (in the 1-6 year age group), and family history of FED (in the adolescent group) (p < 0.05). This analysis of factors associated with eater profile opens new perspectives for research on risk factors associated with eating traits, which warrants further study in larger populations to delineate transition from healthy to problematic eating.

Food approach and avoidance appetitive traits in university students: A latent profile analysis

Eating behaviors are influenced by many factors including appetitive traits. Few studies have utilized latent profile analysis (LPA) to examine food approach and food avoidance appetitive traits. This study utilized LPA to define cluster profile groups based on appetitive traits in undergraduate and graduate/professional students at a large University in the southwest United States. Students completed a cross-sectional online survey in fall 2020 assessing demographic information, appetitive traits via the Adult Eating Behavior Questionnaire (AEBQ), and anxiety via the Generalized Anxiety Disorder Scale (GAD-7; higher scores indicate more severe anxiety symptoms). Appetitive traits were combined into eight scales (four food approach and four food avoidance traits). Latent profile analyses were conducted to identify homogenous subgroups of participants based on AEBQ scale scores. The final sample included 1243 students (mean age = 26.5 years, 73% female, 59% White, 57% undergraduates). LPA revealed four cluster profile groups: Cluster 1 (moderate eaters: lower than mean scores for food approach and avoidance traits), Cluster 2 (food seekers and avoiders: higher than mean scores for food approach and avoidance traits), Cluster 3 (food seekers: higher than mean scores for food approach traits), and Cluster 4 (food avoiders: higher than mean scores for food avoidance traits). Distribution of age, gender, race/ethnicity, and student status differed significantly between clusters. GAD-7 score was highest in Cluster 2 (food seekers and avoiders) and lowest in Cluster 1 (moderate eaters). Among the four LPA-defined cluster profile groups, students who endorsed both food approach and avoidance traits reported more severe anxiety symptoms compared to moderate eaters, food seekers, and food avoiders. It is useful to consider clusters of appetitive traits instead of individual appetitive traits when examining associations with physical and mental health.

Associations between Food Preferences, Food Approach, and Food Avoidance in a Polish Adolescents' COVID-19 Experience (PLACE-19) Study Population

Food preferences are among the strongest predictors of the food choices of adolescents. These are associated with appetitive traits (food approach and avoidance) to some extent. However, no research has been conducted so far analyzing the association between food preferences and appetitive traits of adolescents. The aim of this study was to evaluate the associations between food preferences and appetitive traits in adolescents (aged 15-20 years) within the Polish Adolescents' COVID-19 Experience (PLACE-19) Study population. The PLACE-19 Study was carried out in a population-based sample of 2448 secondary school students sampled across the country (random quota sampling). Food preferences (including the preference for vegetables, fruit, meat/fish, dairy, snacks, and starches) of the adolescents were assessed using the validated Food Preference Questionnaire (FPQ) while their appetitive traits (hunger, food responsiveness, emotional overeating, enjoyment of food, satiety responsiveness, emotional undereating, food fussiness, slowness in eating) were assessed using the validated Adult Eating Behavior Questionnaire (AEBQ). The k-means clustering was performed to identify the homogenous clusters of respondents based on their preferences, and linear regression was performed to determine the relationship between food preferences and appetitive traits with a model adjusted for sex and age. Based on their preferences, three homogenous clusters of respondents were defined: low-preferring respondents (low preference for all food categories), respondents preferring snacking foods (low preference for all food categories, except for fruit and snacks), and high-preferring respondents (high preference for all food categories). The low-preferring respondents showed the lowest values for all appetitive traits (p = 0.0008), as well as the lowest total score (p = 0.0001), except for food fussiness, for which they showed the highest value (p = 0.0008). All preference scores were positively associated with traits such as hunger, food responsiveness, enjoyment of food, and emotional under-eating, while negatively associated with food fussiness (all p < 0.05). The largest amount of variance was observed for preference for dairy (14.6%; R² = 0.146, p = 0.008) and snacks with respect to enjoyment of food (16.2%; R² = 0.162, p = 0.008), for vegetable with respect to food fussiness (22%; R² = 0.220, p = 0.008), and for meat/fish with respect to enjoyment of food (19.9%; R² = 0.199, p = 0.008) and food fussiness combined (19.1%; R² = 0.191, p = 0.008). These results support the association of food preferences with both food approach traits and food avoidance traits.

Anxiety is associated with appetitive traits in university students during the COVID-19 pandemic

BACKGROUND

COVID-19 has impacted mental health globally, however, associations between anxiety and appetitive traits during the pandemic are unreported. This study evaluated anxiety symptom severity and associations with appetitive traits in students at a large public University in the U.S. during the pandemic.

METHODS

Current undergraduate and graduate/professional students completed a cross-sectional survey in fall 2020. Demographic information, anxiety symptoms in the past 2 weeks assessed by the Generalized Anxiety Disorder Scale (GAD-7), and appetitive traits assessed by the Adult Eating Behavior Questionnaire (AEBQ) were evaluated. Mean scores for eight AEBQ scales (four food approach and four food avoidance traits) were calculated. Differences in mean scores were examined between participants with moderate to severe anxiety symptoms (GAD-7 score ≥ 10) and those with mild to no anxiety symptoms (GAD-7 score < 10) via independent samples t-tests and effect sizes. Associations between GAD-7 score and individual appetitive traits were also examined, adjusting for age and gender.

RESULTS

Of the 1243 students who completed the survey (57% undergraduates; mean age = 26.5 years), 51.9% reported moderate to severe anxiety symptoms. Groups experiencing the highest degree of moderate to severe anxiety symptoms included transgender, gender fluid, and other-gendered participants (73.6%); the youngest age group [18-20 years (62%)]; undergraduate students (60.7%); and Hispanic/Latinx participants (57.7%). Participants with moderate to severe anxiety symptoms had higher scores for most food approach and avoidance traits but lower scores for enjoyment of food than those with mild to no anxiety symptoms. Effect sizes were largest for hunger and emotional over-eating (Cohen's d = 0.31 and 0.30, respectively). Adjusting for age and gender, GAD-7 score was significantly and positively associated with hunger, emotional over-eating, food and satiety responsiveness, and food fussiness and negatively associated with enjoyment of food.

CONCLUSIONS

Over half of students at a U.S. University reported moderate to severe anxiety symptoms during COVID-19. More severe anxiety symptoms were associated with increased hunger, emotional over-eating, and food and satiety responsiveness and decreased enjoyment of food. Universities must consider strategies to address anxiety, particularly in younger students; transgender, gender fluid, and students of other genders; and across race/ethnicities keeping in mind associations with appetitive traits.

Infant and Early Child Appetite Traits and Child Weight and Obesity Risk in Low-Income Hispanic Families

BACKGROUND

Child appetite traits (ATs) are associated with later child weight and obesity risk. Less research has focused on ATs in low-income Hispanic children or included longitudinal associations with infant weight.

OBJECTIVE

To determine stability of ATs during infancy and childhood and their relationship with subsequent weight and obesity risk at age 3 years among low-income Hispanic children.

DESIGN

A secondary longitudinal analysis of data from the Starting Early Program randomized controlled obesity prevention trial.

PARTICIPANTS/SETTING

Three hundred twenty-two low-income, Hispanic mother-child pairs enrolled between 2012 and 2014 in a public hospital in New York City.

MAIN OUTCOME MEASURES

ATs, including Slowness in Eating, Satiety Responsiveness, Food Responsiveness, and Enjoyment of Food were assessed using the Baby and Child Eating Behavior Questionnaires at ages 3 months, 2 years, and 3 years. Main outcome measures were child standardized weight-for-age z score (WFAz) and obesity risk (WFA≥95th percentile) at age 3 years.

STATISTICAL ANALYSES PERFORMED

AT stability was assessed using correlations and multilevel modeling. Linear and logistic regression analyses examined associations between ATs and child WFAz and obesity risk at age 3 years.

RESULTS

There was limited stability for all ATs measured over time. During infancy, Slowness in Eating was associated with lower 3-year WFAz (B = -0.18, 95% CI -0.33 to -0.04; P = 0.01). At age 2 years, Slowness in Eating and Satiety Responsiveness were associated with lower WFAz (B = -0.29, 95% CI -0.47 to -0.12; P < 0.01; B = -0.36, 95% CI -0.55 to -0.17; P < 0.01) and obesity risk (adjusted odds ratio 0.49, 95% CI 0.28 to 0.85; adjusted odds ratio 0.61, 95% CI 0.38 to 0.99) at 3 years. Increased Slowness in Eating and Satiety Responsiveness over time were associated with lower 3-year WFAz (B = -0.74, 95% CI -1.18 to -0.2 [Slowness in Eating]; B = -1.19, 95% CI -1.87 to -0.52 [Satiety Responsiveness], both P values = 0.001). Higher Enjoyment of Food over time was associated with higher 3-year WFAz (B = 0.62, 95% CI 0.24 to 1.01; P = 0.002).

CONCLUSIONS

Infants with lower Slowness in Eating and Satiety Responsiveness may have higher levels of obesity risk and need more tailored approaches to nutrition counseling and obesity prevention.

Validity of the Adult Eating Behavior Questionnaire for adolescents treated in a weight management clinic

BACKGROUND

The Child and Adult Eating Behavior Questionnaires (CEBQ, AEBQ) are established measures of eating behaviors. However, no similar measure is available for adolescents. Prior research has validated the AEBQ in adult samples, and one study has explored using the measure with adolescents. However, no studies to date have examined the validity of the AEBQ in adolescent clinical populations. Furthermore, no studies have examined associations between the AEBQ and indicators of health status in adolescents.

METHODS

A total of 280 adolescents (12-17 years old, 60% female) seen in a pediatric weight management clinic completed the AEBQ at intake. Confirmatory factor analysis (CFA) was conducted with AEBQ items to evaluate the model fit of one-, two-, seven-, and eight-factor structures. Intercorrelations between scale scores from AEBQ Food Approach and Food Avoidance domains were calculated. Associations of AEBQ scales with body mass index (BMI) and binge-eating behaviors were examined using Spearman Rho correlations and independent t-tests.

RESULTS

CFAs revealed that the best fitting model was a seven-factor structure excluding the Hunger scale, although overall model fit was only marginally acceptable (X² = 980.94, CFI = 0.925, TLI = 0.915, RMSEA = 0.074). Intercorrelation analyses indicated that all Food Approach scales were significantly associated with one another (r = 0.243-0.654); Food Avoidance scales were inconsistently correlated (r = 0.034-0.439). No AEBQ scales were correlated with BMI (r = -0.101-0.082). Stronger links were found with binge eating; higher frequency binge-related behaviors were associated with higher Food Approach scores.

CONCLUSIONS

The seven-factor structure of AEBQ demonstrates a marginally acceptable fit for treatment-seeking adolescents with obesity. The Food Approach scales demonstrated more convergent validity than the Food Avoidance scales. The Food Approach scales also exhibited some clinical utility for identifying patients with increased risk for binge eating, which is a common target for behavioral intervention. Implications for maximizing the AEBQ's potential for assessing eating behaviors in adolescents with obesity are discussed.

Development and validation of the Reasons Individuals Stop Eating Questionnaire (RISE-Q): A novel tool to characterize satiation

A variety of factors can influence satiation, and individual differences in reasons for meal termination may help to explain variability in food intake and susceptibility to overconsumption. We developed and validated a questionnaire to characterize the Reasons Individuals Stop Eating (RISE-Q). The initial RISE-Q was created by reviewing the published literature and identifying 47 reasons why individuals might stop eating. The RISE-Q asks respondents to rate how often each reason influences why they stop eating at a typical dinner meal by using a seven-point scale. Adults (N = 477, 77% women) from a participant database completed a survey online that included the initial RISE-Q and the satiation-related Satiety Responsiveness and Food Responsiveness scales of the Adult Eating Behavior Questionnaire (AEBQ). Self-reported height and weight were collected to calculate body mass index (BMI). The survey also assessed self-reported typical meal size. After factor analysis, the RISE-Q retained 31 items and identified five distinct scales of reasons for stopping eating: Decreased Food Appeal (mean ± SD: 2.6 ± 0.05, Cronbach's α = 0.89), Physical Satisfaction (5.0 ± 0.04, α = 0.85), Planned Amount (4.4 ± 0.05, α = 0.82), Self-Consciousness (2.4 ± 0.05, α = 0.88), and Decreased Priority of Eating (2.3 ± 0.04, α = 0.69). Thus, the most frequently reported reasons for meal termination were related to Physical Satisfaction and Planned Amount. Each RISE-Q scale was significantly correlated with at least one of the satiation-related AEBQ scales, suggesting that the RISE-Q has construct validity. RISE-Q scales were also correlated with BMI and measures of typical meal size. The RISE-Q provides a novel tool to assess differences across individuals in reported reasons for eating cessation. The RISE-Q can aid in further understanding risk factors for overconsumption and has potential clinical utility in the design of targeted weight-management interventions.

Appetitive Traits in a Population-Based Study of Polish Adolescents within the PLACE-19 Study: Validation of the Adult Eating Behavior Questionnaire

Appetitive traits of food approach or food avoidance are commonly measured using the Adult Eating Behavior Questionnaire (AEBQ). However, there is no Polish version of the AEBQ validated for adolescents, and to the best of our knowledge, no study completed with the Polish version of the AEBQ has been published thus far. The present study aimed to validate the AEBQ in a population-based sample of Polish secondary school students and to assess differences in appetitive traits between boys and girls within the Polish Adolescents' COVID-19 Experience (PLACE-19) Study. The PLACE-19 Study was conducted in a group of 2448 adolescents recruited in May 2020 through the random quota sampling of secondary schools. The AEBQ was used to assess food approach subscales (Food Responsiveness, Emotional Over-Eating, and Enjoyment of Food) and food avoidance subscales (Satiety Responsiveness, Emotional Under-Eating, Food Fussiness, and Slowness in Eating). To validate the questionnaire, the standardized factor loadings within confirmatory factor analysis (CFA) with weighted least squares (WLS) were analyzed, and invariance was verified. The CFA presented good model fit, with χ² = 4826.105 (degrees of freedom (df) = 384), root mean square error of approximation (RMSEA) = 0.069 (90% confidence interval (CI): 0.067, 0.070), comparative fit index (CFI) = 0.90, and standardized root mean square residual (SRMR) = 0.08. The results revealed that, compared to the configural invariance model, the metric invariance model did not result in significantly decreased model fit, with ΔCFI = -0.002 and ΔRMSEA = -0.001, which were lower than the recommended cutoffs of 0.010 and 0.015, respectively. The scalar invariance model also did not result in significantly decreased fit of the model over the metric invariance model, with ΔCFI = -0.005 and ΔRMSEA = 0.000. Girls reported higher levels of Food Responsiveness (p < 0.0001), Emotional Over-Eating (p < 0.0001), Satiety Responsiveness (p < 0.0001), Emotional Under-Eating (p < 0.0001), and Slowness in Eating than boys (p < 0.0001), and the total AEBQ scores of girls were also higher (p < 0.0001). Positive inter-correlations were observed between all food approach subscales, as well as between Emotional Under-Eating and all food approach subscales for girls, boys, and the total sample; positive inter-correlations were also observed between the majority of food avoidance subscales. The present study confirmed the validity of the AEBQ in the studied population, and supported the associations between appetitive traits assessed using the AEBQ; it also indicated higher scores of both food approach and food avoidance subscales in girls than in boys in a population-based sample of Polish secondary school students.

Susceptibility to increased high energy dense sweet and savoury food intake in response to the COVID-19 lockdown: The role of craving control and acceptance coping strategies

Emerging evidence indicates that for some people, the COVID-19 lockdowns are a time of high risk for increased food intake. A clearer understanding of which individuals are most at risk of over-eating during the lockdown period is needed to inform interventions that promote healthy diets and prevent weight gain during lockdowns. An online survey collected during the COVID-19 lockdown (total n = 875; analysed n = 588; 33.4 ± 12.6 years; 82% UK-based; mostly white, educated, and not home schooling) investigated reported changes to the amount consumed and changes to intake of high energy dense (HED) sweet and savoury foods. The study also assessed which eating behaviour traits predicted a reported increase of HED sweet and savoury foods and tested whether coping responses moderated this relationship. Results showed that 48% of participants reported increased food intake in response to the COVID-19 lockdown. There was large individual variability in reported changes and lower craving control was the strongest predictor of increased HED sweet and savoury food intake. Low cognitive restraint also predicted greater increases in HED sweet snacks and HED savoury meal foods. Food responsiveness, enjoyment of food, emotional undereating, emotional overeating and satiety responsiveness were not significant predictors of changes to HED sweet and savoury food intake. High scores on acceptance coping responses attenuated the conditional effects of craving control on HED sweet snack intake. Consistent with previous findings, the current research suggests that low craving control is a risk factor for increased snack food intake during lockdown and may therefore represent a target for intervention.

How full am I? The effect of rating fullness during eating on food intake, eating speed and relationship with satiety responsiveness

Modifying eating behaviours may be an effective strategy to limit excess food intake, such as eating slower and mindfully. We hypothesized that regularly rating fullness whilst eating a standard meal in one course would increase post-meal satiety and reduce intake in a subsequent course during the same sitting. A between-subjects design was employed (n = 65; 75% female; mean age = 26.7 (s.d. = 9.5); mean body mass index = 22.4 (s.d. = 3.3)), with three conditions of within-meal visual-analogue-scale ratings: 'Fullness' (rated fullness); 'Taste' (rated pleasantness of taste of food); 'Control' (rated comfort of room). Fasted participants ate a pasta meal (327 kcal) followed by cookies ad libitum. Appetite ratings were measured at baseline, following each course and for 3-h post-meal. Satiety responsiveness was measured using the Adult Eating Behaviour Questionnaire, Intuitive Eating Scale and by calculating the satiety quotient of the pasta course alone and the whole meal. The primary outcomes were fullness ratings post-pasta course [mean (s.d.): Fullness = 67.1 (21.9); Taste = 64.4 (13.7); Control = 60.2 (21.5)] and cookie intake [mean kcal (s.d.): Fullness = 249 (236); Taste = 279 (231); Control = 255 (208)]. Eating speed was included as a secondary, control outcome [mean (s.d.): Fullness = 59.3 (9.0); Taste = 59.2 (17.7); Control = 60.7 (19.6)]. No evidence for a difference in outcomes was identified between conditions (p > 0.05). Future work could involve testing the impact of rating fullness during multiple meals over a longer period. Secondly, this study explored whether levels of satiety responsiveness influenced the impact of the manipulation on outcomes; however only weak evidence for a relationship with eating speed was found. Finally, only a weak relationship was found between the satiety responsiveness measures, suggesting that different aspects of the underlying construct are being captured.

Patterns of negative emotional eating among Chinese young adults: A latent class analysis

There is ample evidence suggesting that negative emotional eating is closely related to disordered eating behaviors. However, most previous studies on the topic focused only on emotional over-eating, but neglected emotional under-eating. Moreover, previous studies also mainly used variable-oriented methods by reducing negative emotional eating to a single dimension, which limits our understanding of individual differences in negative emotional eating. In this study, we used a person-oriented approach, latent class analysis (LCA), to examine the negative emotional eating patterns and to characterize these patterns in a sample of 1,068 Chinese young adults (52.6% females, aged 17-24 years). Negative emotional eating was measured by the Emotional Over-Eating and Emotional Under-Eating subscales of the Adult Eating Behavior Questionnaire. Four patterns, namely, "non-emotional eating" (38.9%), "emotional over- and under-eating" (15.4%), "emotional over-eating" (14.7%), and "emotional under-eating" (31.0%), were identified. Sex and BMI were found to be statistically significant predictors for negative emotional eating patterns. The identified four patterns showed significant differences in eating disorder symptoms and psychological distress. Particularly, participants in emotional over- and under-eating exhibited the highest level of eating disorder symptoms and psychological distress. Overall, this study identified four distinct negative emotional eating patterns, among which, the emotional over- and under-eating was the most problematic. Future studies regarding negative emotional eating and its impact on mental health may benefit from focusing not only on individuals with emotional over-eating, but also on those showing a mixed pattern of negative emotional eating.

Appetitive traits as targets for weight loss: The role of food cue responsiveness and satiety responsiveness

Individuals with overweight or obesity (OW/OB) are at increased risk for significant physical and psychological comorbidities. The current treatment for OW/OB is behavioral weight loss, which provides psychoeducation on nutrition and physical activity, as well as behavior therapy skills. However, behavioral weight loss is not effective for the majority of the individuals who participate. Research suggests that overeating, or eating past nutritional needs, is one of the leading causes of weight gain. Accumulating evidence suggests that appetitive traits, such as food cue responsiveness and satiety responsiveness, are associated with overeating and weight in youth and adults. The following review presents the current literature on the relationship between food cue responsiveness, satiety responsiveness, overeating, and OW/OB. Research suggests that higher food cue responsiveness and lower satiety responsiveness are associated with overeating and OW/OB cross-sectionally and longitudinally. Emerging data suggest that food cue responsiveness and satiety responsiveness may exist along the same continuum and can be targeted to manage overeating and reduce weight. We have developed a treatment model targeting food cue responsiveness and satiety responsiveness to reduce overeating and weight and have preliminary feasibility, acceptability, and efficacy data, with testing currently being conducted in larger trials. Through programs targeting appetitive traits we hope to develop an alternative weight loss model to assist individuals with a propensity to overeat.

Classifying and characterizing Chinese young adults reporting picky eating: A latent profile analysis

OBJECTIVE

Picky eating (PE) is common across the lifespan and related to psychosocial impairment and limited dietary variety. However, research about PE in non-Western countries is limited. Because eating behaviors may differ by culture, operationalizing PE in non-Western countries (e.g., China) is needed. The present study aimed to replicate two previous studies identifying PE profiles in Western countries by using latent profile analysis (LPA) to classify and characterize adults reporting picky eating in a Chinese sample.

METHOD

A sample of 1,068 Chinese young adults completed a battery of questionnaires including the adult eating behavior questionnaire (AEBQ). LPA was utilized to identify eating profiles. The three-step approach was used to examine predictors of latent memberships and profile differences on various self-reported measures.

RESULTS

The best fit was a four-profile solution, with two picky eating profiles emerging: picky eating and severe picky eating. Compared to those in the other two profiles, participants in the picky eating profile (19.4%) and severe picky eating profile (3.3%) had significantly higher scores on self-reported eating disorder symptoms and psychological distress, and lower scores on self-reported food-related life satisfaction. Relative to the picky eating profile, participants in the severe picky eating profile reported significantly greater self-reported eating disorder symptoms, psychological distress, and food-related dissatisfaction.

DISCUSSION

Characterizing PE profiles is an important step toward understanding eating behaviors among Chinese young adults. Identifying various eating profiles has implications for future research related to PE, including the development of diagnostic tools and interventions to address PE in a Chinese context.

Confirmation of the Factor Structure and Reliability of the 'Adult Eating Behavior Questionnaire' in an Adolescent Sample

Introduction

Appetitive traits, including Food Responsiveness, Enjoyment of Food, Satiety Responsiveness, Emotional Over- and Under-Eating, Food Fussiness and Slowness in Eating, have been captured across childhood using the Children’s Eating Behavior Questionnaire (CEBQ). The Adult Eating Behavior Questionnaire (AEBQ) has explored these traits in adults, but not adolescents. This study aimed to test the factor structure and reliability of the AEBQ in a sample of UK adolescents, and explore demographic differences.

Materials and Methods

Confirmatory factor analysis (CFA) tested an 8-factor and a 7-factor AEBQ, based on valid, completed AEBQ responses (n = 913) from adolescents aged 11–18 recruited from four London secondary schools. Test–retest reliability was analyzed in a subsample (n = 106) 2-weeks later, and 492 participants completed the Dutch Eating Behavior Questionnaire (DEBQ) to assess convergent validity. Demographic differences were explored using a multiple indicator multiple cause (MIMIC) model.

Results

The CFA revealed an adequate model fit for a 7-factor structure without Hunger [RMSEA = 0.038 (90% CI:0.035,0.041); CFI = 0.926, TLI = 0.916; and χ²(df = 595) = 8502.69, p < 0.001]. These seven subscales showed acceptable internal consistency (Cronbach’s α > 0.70). The ICC for the test–retest was above 0.70. Comparisons with the DEBQ supported the convergent validity of the AEBQ. Older age was associated with greater Food Responsiveness and Enjoyment of Food (all p-values < 0.005). Females reported higher levels of Emotional Over-Eating, Satiety Responsiveness, and Slowness in Eating than males (all p-values ≤ 0.003).

Conclusion

This study supports the use of the 7-factor AEBQ as a reliable measure of appetitive traits in adolescents.

Assessing Appetitive Traits Among Chinese Young Adults Using the Adult Eating Behavior Questionnaire: Factor Structure, Gender Invariance and Latent Mean Differences, and Associations With BMI

The current study examined the factor structure, measurement reliability, measurement invariance across genders, and latent gender mean differences, of a new Chinese translation of the Adult Eating Behavior Questionnaire (C-AEBQ) in a Chinese young adult sample (n = 1,068, 52.57% women). The associations between the appetitive traits assessed by the AEBQ and body mass index were also explored. The previously established eight-factor model of the AEBQ was supported in the present sample. The C-AEBQ had strong measurement invariance between genders. Cronbach's alpha estimates of the eight subscales of the C-AEBQ ranged from 0.76 to 0.97, and the test-retest reliability coefficients of the subscales ranged from 0.50 to 0.77. The C-AEBQ had adequate convergent and divergent validity, as supported by the theoretically expected correlations between C-AEBQ and the Three-Factor Eating Questionnaire. Furthermore, Satiety Responsiveness, Slowness in Eating, and Food Fussiness were inversely associated with body mass index. Overall, the C-AEBQ appears to be a psychometrically sound instrument as a comprehensive measure for appetitive traits for Chinese young adults.

A functional description of adult picky eating using latent profile analysis

OBJECTIVE

Research has indicated that adult picky eating (PE) is associated with elevated psychosocial impairment and limited dietary variety and fruit and vegetable intake; however, research operationalizing PE behaviors is limited. Previous research identified a PE profile in children, marked by high food avoidance (satiety responsiveness, fussiness, and slow eating) and low food approach (food enjoyment and responsiveness) appetitive traits. The present study aimed to replicate a similar latent eating behavior profile in an adult sample.

METHODS

A sample of 1339 US adults recruited through Amazon's MTurk completed an online survey that included a modified self-report version of the Child Eating Behavior Questionnaire (CEBQ-A). Latent profile analysis was employed to identify eating profiles using the CEBQ-A subscales, ANCOVAs were employed to examine profile differences on various self-report measures, and eating profiles were compared across BMI classifications.

RESULTS

Analyses converged on a four-profile solution, and a picky eater profile that closely resembled the past child profile emerged. Participants in the picky eater profile (18.1%) scored higher on measures of adult PE and social eating anxiety compared to all other profiles, scored higher on eating-related impairment and depression than moderate eating profiles, and were more likely to be of normal weight.

DISCUSSION

A distinct adult PE profile was observed, indicating childhood PE and appetitive behaviors may carry over into adulthood. Research identifying meaningful groups of picky eaters will help to shed light on the conditions under which picky eating is a risk factor for significant psychosocial impairment or distress, or weight-related problems.

The Adult Eating Behaviour Questionnaire in a bariatric surgery-seeking sample: Factor structure, convergent validity, and associations with BMI

The aim of this study was to validate the Adult Eating Behaviour Questionnaire (AEBQ), a measure of food approach and avoidant traits, for use in bariatric surgery candidates. Participants were 337 bariatric surgery candidates in the Mid-Atlantic United States. Confirmatory factor analysis suggested that one item did not load onto its original factor. A 34-item, eight-factor model had better fit than a seven-factor model; dropping the Hunger factor, as previously suggested, did not improve fit. The factors had good internal consistency and showed convergent/divergent validity with an existing measure of food approach traits. The emotional overeating scale was positively correlated with BMI at programme entry, whereas the slow eating scale was negatively correlated with baseline weight. The AEBQ scales had the same pattern of intercorrelations and similar means to those of two previously published samples. The AEBQ is a valid measure of appetitive traits in bariatric candidates.