Prevalence of food addiction among Iranian children and adolescents: Associations with sociodemographic and anthropometric indices

Food Addiction and Binge Eating Disorder in Relation to Dietary Patterns and Anthropometric Measurements: A Descriptive-Analytic Cross-Sectional Study in Iranian Adults with Obesity

Obesity is associated with maladaptive eating behaviors, including food addiction (FA) and binge eating disorder (BED). However, the key factors influencing the development of maladaptive eating behaviors remain unknown. Adherence to specified dietary patterns has been suspected of making indirect impacts. This study investigates the association of FA and BED with dietary patterns and anthropometric measurements among 400 Iranian adults (aged 18-60; 66.25% women) living with obesity (body mass index [BMI] ≥ 30 kg/m2). The Binge Eating Scale and Yale Food Addiction Scale were used to measure BED and FA. A validated 147-item semi-quantitative food frequency questionnaire underwent principal component analysis and identified three major dietary patterns: mixed, unhealthy, and healthy dietary pattern. After adjusting for confounders, higher adherence to unhealthy dietary patterns was associated with an increased risk of FA, while higher adherence to healthy dietary patterns was associated with a lower risk of FA. Also, those within obesity class III had a significantly higher risk of FA and BED than those in obesity class I. This study suggests that adherence to an unhealthy dietary pattern may be associated with a higher risk of FA. It also highlights the link between higher BMI and maladaptive eating behaviors.

Food Knowledge, Habits, Practices, and Addiction Among Adolescents: A Cross-Sectional Investigation

BACKGROUND

Changing lifestyles and food habits have an impact on both nutrient requirements and intake among adolescents. The aim of this study is to assess the level of knowledge, habits, practices, and the presence of food addiction among adolescents residing in Damanhur City.

METHODS

A descriptive correlational study design is employed to collect data from 363 adolescents selected conveniently from two youth centers in Damanhur, Egypt. Four tools are used: a demographic questionnaire, the Adolescent Food Habits Checklist (AFHC), the General Nutritional Knowledge Assessment Questionnaire (GNKQ), and the Yale Food Addiction Scale version 2.0 (YFAS 2.0).

RESULTS

The age of the participating adolescents ranges from 10 to 19 years. More than half of the participants (51.8%) reported choosing low-fat foods. Additionally, around one-third of the adolescents (34.7%) meet the diagnostic criteria for food addiction. However, there is no statistically significant association found between food addiction and adolescents' eating habits and practices.

CONCLUSION AND RECOMMENDATIONS

Most of the studied adolescents exhibit unhealthy eating practices. Food addiction is identified as a significant health concern among this population. Therefore, it is highly recommended to provide nutritional education for adolescents and their families and implement school-based strategies to promote healthy eating habits.

Socio-Demographic, Self-Control, Bullying, Parenting, and Sleep as Proximal Factors Associated with Food Addiction among Adolescents

Adolescence is considered an important period of neurodevelopment. It is a time for the emergence of psychosocial vulnerabilities, including symptoms of depression, eating disorders, and increased engagement in unhealthy eating behaviours. Food addiction (FA) in adolescents is an area of study where there has been substantial growth. However, to date, limited studies have considered what demographic characteristics of adolescents may predispose them to endorse greater symptoms of FA. Studies have found a variety of factors that often cluster with and may influence an adolescent's eating behaviour such as sleep, level of self-control, and parenting practices, as well as bullying. Therefore, this study investigated a range of socio-demographic, trait, mental health, and lifestyle-related profiles (including self-control, parenting, bullying, and sleep) as proximal factors associated with symptoms of FA, as assessed via the Yale Food Addiction Scale for Children (YFAS-C) in a large sample of Australian adolescents. Following data cleaning, the final analysed sample included 6587 students (age 12.9 years ± 0.39; range 10.9-14.9 years), with 50.05% identifying as male (n = 3297), 48.5% as female (n = 3195), 1.02% prefer not to say (n = 67), and 0.43% as non-binary (n = 28). Self-control was found to be the most significant predictor of total FA symptom score, followed by female gender, sleep quality, and being a victim of bullying. Universal prevention programs should therefore aim to address these factors to help reduce the prevalence or severity of FA symptoms within early adolescent populations.

Food addiction among university students: The effect of mindful eating

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.

Prevalence of food addiction using the Yale-C scale in Mexican children with overweight and obesity

Background

The prevalence of excess weight and obesity in children has increased significantly worldwide. The concept of food addiction (FA) has been associated with eating-related problems and obesity. Studies on this topic have primarily examined adult samples and little is known about addictive-like eating among Mexican children and adolescents.

Methods

We conducted this study to examinate the prevalence of FA in a group of 291 overweight and obese children and adolescents using YFAS scale for children (YFAS-C) in Mexico.

Results

According to the YFAS-C approximately 14.4% of participants met for FA diagnosis. Forty-two (14.4%) received a FA diagnosis: 14 children and 28 adolescents. The number of FA symptoms in participants who received an FA diagnosis (M = 4.35, SD = 1.07) compared to participants with no FA diagnosis (M = 1.70, SD = 1.53) was significantly higher (p ≤ 0.001). There were no statistically significant gender differences and the proportion of subjects with an FA diagnosis did not differ by age between children and adolescents. FA is a focus of interest in attempting to explain certain behaviors that may contribute to the development of obesity and explain the failure of the weight loose programs in children.

The Association Between Food Addiction and Weight Status in School-Age Children and Adolescents

Background

The association between food addiction (FA) and weight status in children and adolescents remains poorly understood. This study aimed to elucidate the association between FA and weight status using the validated Chinese version of the dimensional Yale Food Addiction Scale for Children 2.0 (dYFAS-C 2.0).

Methods

Participants were enrolled from clinic visitors for regular physical check in a children's hospital. The dYFAS-C 2.0 was translated into Chinese and validated using reliability and validity tests. The participants' body mass index Z score (BMIZ) and waist-to-height ratio (WHtR) were used to characterize weight status. The FA severity was assessed using the translated dYFAS-C 2.0.

Results

Among the 903 children and adolescents enrolled, 426 (47.2%) completed the survey [277 (65%) females and 149 (35%) males]. The Cronbach α of translated dYFAS-C 2.0 was 0.934, and confirmatory factor analysis indicated an acceptable model fit. FA correlated positively with BMIZ and WHtR in the whole sample after adjusting for the effect of gender (p < 0.001). Further analyses showed that the correlation remained significant in participants with BMIZ > 1 (p = 0.006) but not in those with BMIZ ≤ 1 (p = 0.220). However, the correlations between FA and WHtR were statistically significant in both participants with or without abdominal obesity (p < 0.05). The FA could explain 12.1 and 15.8% of variance in BMIZ and WHtR, respectively. The corresponding cutoff points of FA for excessive weight risk were 0.7 (BMIZ) and 0.4 (WHtR).

Conclusion

The dYFAS-C 2.0 has good reliability and validity in the Chinese population. FA is associated with weight status characterized by BMIZ and WHtR, especially in participants with BMIZ > 1 and in those with abdominal obesity.

Clinical Trial Registration

[www.chictr.org.cn], identifier [ChiCTR2100052239].

The Effect of an Obesity Prevention Program on Children's Eating Behaviors, Food Addiction, Physical Activity, and Obesity Status

PURPOSE

This study was carried out to determine the effect of an obesity prevention program on children's eating behaviors, food addiction, physical activity, and obesity prevalence.

DESIGN AND METHODS

A pretest-posttest quasi-experimental design was used in the study. The study was conducted with a total of 128 students, including 55 in the intervention and 73 in the control groups. The obesity prevention program was implemented in the intervention group, and a routine curriculum training program was followed in the control group. The study data were collected before the intervention and in the third, sixth, and fifteenth months after the completion of the intervention. The data were evaluated using the chi-square test, McNeamer test, Cochrane Q test, multivariate analysis of variance in repeated measures, the Bonferroni adjusted paired t-test, power analysis, effect size, and regression analysis.

RESULTS

At the end of the study, it was determined that the body mass index values and food addiction rates of the students in the intervention group were lower than those of the students in the control group (p < .05). There was a significant difference between the mean scores of the students in the intervention and control groups obtained from the eating behavior questionnaire and the physical activity questionnaire in terms of time, group, and group * time interaction (p < .05). Also, the intervention program was found to have a large effect size (0.39) and a strong effect (0.85) on body mass index.

CONCLUSION

The obesity prevention intervention program was found to be effective in increasing children's positive eating behaviors and mean physical activity score and decreasing food addiction rates and body mass index values.

PRACTICE IMPLICATIONS

We recommend that the intervention program implemented in this study should be used widely in the curriculum of the Ministry of Education. This program shows that the school nurse is effective in preventing obesity in children. For this reason, there should be a school nurse in schools for implementing health-promoting education programs.

Validity of the Yale Food Addiction Scale for Children (YFAS-C): Classical test theory and item response theory of the Persian YFAS-C

PURPOSE

To examine whether the child/adolescent version of the Yale Food Addiction Scale (YFAS-C) is valid to assess the Iranian adolescents who are overweight.

METHODS

After using an internationally standardized method to translate the YFAS-C into Persian, 1186 overweight/obese adolescents aged between 13 and 18 years participated in the present study [666 males; mean age = 15.5 (SD = 1.9) years; zBMI = 2.5 (1.0) kg/m²]. All the participants completed the Persian YFAS-C alongside Persian versions of the following scales: Eating Disorder Examination Questionnaire (EDEQ), Clinical Impairment Assessment (CIA), Binge Eating Scale (BES), Eating Attitudes Test (EAT-26), and Depression, Anxiety, Stress Scale (DASS-21).

RESULTS

At the scale level, confirmatory factor analysis verified the single-factor structure of the Persian YFAS-C. Additionally, the Persian YFAS-C had promising properties regarding internal consistency (KR20 = 0.81), test-retest reliability (intraclass correlation coefficient = 0.83), separation reliability (person separation reliability = 0.77; item separation reliability = 0.98), and separation index (person separation index = 2.04; item separation index = 8.01). At the item level, all items had satisfactory properties in factor loadings, corrected item-total correlation, test-retest reliability, and infit and outfit mean square. Moreover, no substantial differential item functioning (DIF) was found concerning gender (male vs. female) or weight status (overweight vs. obesity). Significant and moderate correlations were found between the Persian YFAS-C and other psychometric scales assessing eating symptomatology and general psychopathology (r = 0.352 to 0.484).

CONCLUSION

The Persian YFAS-C is a valid instrument that assists healthcare providers in assessing food addiction among Iranian adolescents.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Prevalence of food addiction in children and adolescents: A systematic review and meta-analysis

Food addiction (FA) has been as a construct that is associated with childhood obesity. However, relatively little is known regarding the prevalence of FA among children and adolescents. An instrument designed to assess FA among youth, the Yale Food Addiction Scale for Children and Adolescents (YFAS-C), has been developed and used to estimate FA prevalence among pediatric populations. The present systematic review and meta-analysis aimed to synthesize the results of FA prevalence among youth. Using keywords related to FA and children to search PubMed, Embase, Scopus, and Web of Science, we identified and analyzed 22 cross-sectional studies. No longitudinal studies were identified in the search. Meta-analysis with Freeman-Tukey Double Arcsine transformation was conducted to estimate FA prevalence. Meta-regression was applied to understand whether weight status (i.e., data from community samples vs. overweight/obese samples) is associated with FA. Eligible studies (N = 22) were analyzed using 6,996 participants. The estimated FA prevalence was 15% (95% CI 11-19%) for all samples, 12% (95% CI 8-17%) for community samples, and 19% (95% CI 14-26%) for overweight/obese samples. Meta-regression indicated that weight status was associated with FA severity (p = 0.002) and marginally with FA prevalence (p = 0.056). Healthcare providers should consider and address the high FA prevalence among pediatric population.

The prevalence of food addiction and its associations with plasma oxytocin level and anthropometric and dietary measurements in Iranian women with obesity

Obesity is a prevalent public health problem, and food addiction (FA) is one of the most controversial factors in its management. Therefore, this study was designed to validate an FA questionnaire for Iranian women with obesity and to determine the prevalence of FA and its associations with plasma oxytocin (OT) levels as well as anthropometric and dietary measurements. In this descriptive-analytical study, 450 adult women with obesity were included. The prevalence of FA was determined with a valid Yale food addiction scale (YFAS). Macronutrient intakes were measured by a valid semi-quantitative food frequency questionnaire (FFQ). In addition, plasma OT was measured after eight hours of fasting. In this study, the prevalence of FA was 26.2% in women with obesity. In comparison with class I obesity, the odds ratios (95% CI) of FA for class II and class III obesity were 2.5 (CI: 1.29-5.09) and 3.3 (CI: 1.69-6.4) respectively. Dietary intakes of energy, protein, carbohydrate, fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and cholesterol were significantly higher in food-addicted (FAD) women compared to non-food-addicted (NFA) ones (p < 0.001). Moreover, plasma OT level was lower in FAD women with obesity than in NFA subjects (p = 0.02). In conclusion, the results of this study indicate that FA is prevalent in Iranian women with obesity. In addition, FA is related to obesity severity, dietary intakes of energy, carbohydrate, protein, fat, cholesterol, and plasma OT level.