Adaptação transcultural para o português dos Questionários de Desejos Intensos por Comida – Estado ou Traço (QDIC-E e QDIC-T) dos State and Trait Food-Cravings Questionnaires (FCQ-S and FCQ-T)

Try not to think about food: An association between fasting, binge eating and food cravings

BACKGROUND

When individuals follow a diet or limit their food intake, they activate cognitive restraint, which is defined as a mental effort to restrict dietary behavior with the goal of losing weight. As an example, fasting has also been associated with the recruitment of cognitive restraint, but further research is needed to fully understand its underlying mechanisms.

AIMS

The aim of this study was to examine the relationship between the duration of fasting and disordered eating, such as food cravings, binge eating, and potential changes in eating habits.

METHODS

An online survey was conducted among 853 first-semester university students to investigate their fasting practices and frequency over a three-month period prior to data collection. Participants who were on diets were excluded (n=214). After controlling the sample for biases, a comparison was made between 89 fasters and 369 non-fasters. The study compared levels of cognitive restraint, binge eating, food cravings, and consumption of 'forbidden' foods. A Poisson model was used to examine the association between hours of fasting and disordered eating traits. In the context of this study, the rate ratio was used to examine the relationship between fasting hours and disordered eating characteristics, such as binge eating and food cravings.

RESULTS

The study found that fasters experienced an increase in food cravings and binge eating. However, fasters consumed fewer bread slices than non-fasters. The rate ratio of fasting hours practiced is 115% higher among binge eaters (RR 2.15; CI95% 1.70-2.73) compared to those who did not binge. The rate ratio of fasting hours is 29% higher in participants with moderate binge eating (RR 1.29; CI95% 1.05-1.59), increasing to 140% (RR 2.40; CI95% 1.86-3.11) in people with severe binge eating. As for food cravings (state), the rate ratio was 2% higher (RR 1.02; CI 95% 1.01-1.03) for each increase in the unit of the scale.

CONCLUSIONS

Our study has indicated that fasting is positively associated with increased levels of binge eating and food cravings.

Psychometric Evaluation of the Food Life Questionnaire-Short Form among Brazilian Adult Women

Measures of beliefs and attitudes toward food have generally been limited to the measurement of more pathological eating attitudes (e.g., disordered eating). The Food Life Questionnaire (FLQ) and its short form (FLQ-SF) were developed to examine attitudes toward a broader range of foods; however, the factor structure of the FLQ-SF was not confirmed in any study with young women. In the present study, we performed a psychometric evaluation of the Brazilian Portuguese translation of the FLQ-SF in a sample of 604 women. We evaluated the factor structure using a two-step, split-sample exploratory and confirmatory factor analytic approach. Results supported a four-factor structure (i.e., weight concern, diet-health orientation, belief in a diet-health linkage, and food and pleasure) with 18 items (χ2/df = 2.09; CFI = 0.95; TLI = 0.94; RMSEA = 0.05 (90% CI = 0.04; 0.06; p > 0.05); and SRMR = 0.08). Additionally, we found good internal consistency for all FLQ-SF subscales (McDonald's ω = 0.79-0.89) and convergent validity with measures of feelings, beliefs, and behaviors involved in food attitudes. Collectively, these results support the use of the FLQ-SF in Brazilian women and provide a foundation to expand the literature on beliefs and attitudes toward food in this population.

Very low-calorie ketogenic diet in the treatment of adaptive thermogenesis: A case report

OBJECTIVES

The management of the phenomenon of adaptive thermogenesis poses a challenge to the successful treatment of overweight/obesity with a nutritional intervention that minimizes the loss of muscle mass, with little cognitive restraint use and disorganization of eating behavior. On the other hand, it creates a significant calorie deficit for the reduction of body fat. The aim of this case report was to discuss the effects of a very low-calorie ketogenic diet in a woman with obesity and low resting metabolic rate.

CASE DESCRIPTION

A 36-y-old white woman with a history of obesity and bulimia nervosa who has had difficulty losing and maintaining weight despite numerous dietary and pharmacologic treatments.

RESULTS

There was a loss of 12 kg in 115 d, reaching 13.4 kg, with 11.4 kg of fat mass (FM). The resting metabolic rate showed an increase of 79% in relation to the initial rate, reaching normal levels for the predictive equations and maintaining this level in the first-year follow-up. Additionally, improvement of metabolic laboratory parameters and eating behavior traits were described.

CONCLUSIONS

In this specific case of bulimia nervosa resulting in hypometabolism (low resting metabolic rate/fat-free mass) and obesity, the very low-calorie ketogenic diet intervention has demonstrated a possibility of weight loss with little cognitive restraint use, thereby increasing resting metabolic rate in the short and medium terms, ultimately promoting a negative energy balance. In relation to the numeric results, it seems positive; however, more research is necessary to evaluate the effects on the overall relationship with food and its long-term repercussions.

Craving for carbs: food craving and disordered eating in low-carb dieters and its association with intermittent fasting

Studies point to positive outcomes in a diet with reduction of carbohydrates and that the associated practice of intermittent fasting (IF) might increase weight loss. Although dieting might be related to disordered eating, little evidence is available about the role of restrictive carbohydrates diets on disordered eating. This study aimed to explore if doing low-carb (LC) diets was related to disordered eating and if IF would increase these symptoms. The sample comprised university students (n = 682), with a mean age of 22 years old and average BMI of 23.6 kg/m2 (SD = 4.3). Twenty-seven percent (n = 188) of respondents reported doing LC diet in the last three months. Of those, 31% (n = 58) reported doing LC diet combined with periods of IF. Mean scores were compared using parametric tests, and effects size and correlations between variables were calculated. Dieters showed higher levels of binge eating, food cravings, cognitive restraint, cognitive restraint toward carbohydrates when compared to non-dieters. The association of LC and IF was related to an increase in disordered eating, especially binge eating and food cravings, specifically 'Lack of control', 'Thoughts or preoccupation with food,' and 'Guilt from cravings and/or for giving in to them'. These results provide evidence that restrictive carbohydrate diets and IF may increase cognitive restraint and, consequently, food cravings.Level III: Evidence obtained from cohort or case-control analytic studies.

Cross-cultural adaptation of body image assessment instruments for university students: a systematic review

The theoretical-methodological process of cross-cultural adaptation of scales is fundamental for the expansion of research possibilities related to a given area and population, as instrument adequacy allows for the consistent assessment of the construct being studied. This article aims to highlight the different theoretical-methodological processes of cross-cultural adaptations of scales for assessing body image among young university students. The articles were selected in February 2020, with the following search descriptors: ("body image") and (young or "college students" or graduating or graduat *) and ("cross-cultural validation" or "cross-cultural adaptation"), in three databases-Scopus, PsycINFO, and Web of Science, without any time restrictions. Altogether, 304 studies were surveyed on the different bases mentioned above, and 14 studies published between 2010 and 2019 were evaluated. This study highlighted the methodological procedures used in the process of cross-cultural adaptation, as well as the population, the types of validity and reliability, and also the main limitations, strengths, and results reported in each study included in this review. The information presented in this review will allow new researchers to make more appropriate choices about instruments for assessing body image in young university students, in addition to presenting the methodological evolution on this theme.

Twenty Years of the Food Cravings Questionnaires: a Comprehensive Review

Purpose of Review

The Food Cravings Questionnaires (FCQs; Cepeda-Benito, Gleaves, Williams, & Erath, 2000) are among the most widely used instruments for measuring food cravings. In addition to the Food Cravings Questionnaire–Trait (FCQ–T) and the Food Cravings Questionnaire–State (FCQ–S), several modified versions have been developed as well. For their 20th anniversary, this article provides a comprehensive description of the FCQs and reviews studies on their psychometric properties and correlates.

Recent Findings

The FCQs and their modified versions have excellent internal reliability. Expectedly, the FCQ–T (and its derivatives) has higher retest-reliability than the FCQ–S as the FCQ–S is sensitive to situational changes such as food deprivation and food intake. However, while the FCQ–T is largely unaffected by such momentary states, it is also sensitive to change during weight-loss treatments and other interventions. Factor structure of the FCQ–T and FCQ–S has only partially been replicated. Construct validity of the FCQs is supported by experimental and longitudinal studies that measured food craving and food consumption in the laboratory and with ecological momentary assessment.

Summary

Numerous studies support reliability and validity of the FCQs and their modified versions, yet findings about their factor structures are inconsistent. Thus, using total scores or the short versions of the FCQs may be preferable.

A review of food craving measures

OBJECTIVE

Summarize and evaluate self-report measures of food craving, provide suggestions on future directions for the field of food craving measurement, and deliver guidance on how to select a food craving measure.

METHODS

Online bibliographical databases (PsycINFO and PubMed) were searched for peer-reviewed literature on self-report measures of food craving.

RESULTS

There is a wide selection of food craving measures that researchers and clinicians can use to assess state, past, and trait food cravings. Most questionnaires were tested on homogenous samples and their psychometric properties in older, male, and socioeconomically, racially, and ethnically diverse samples is largely unknown. Few questionnaires were tested in samples with overweight/obesity or eating disorders. Relatively few questionnaires adequately evaluate contextual factors that can trigger craving. There appears to be limited data on the predictive validity of food craving measures in regards to response to eating disorder treatment. A decision tree was provided to help researchers and clinicians select a food craving measure that is best suited to a particular clinical or research purpose.

CONCLUSIONS

It is recommended that researchers adequately assess the contextual factors that may trigger craving and the multi-sensory nature of craving for food. It would be beneficial for researchers to evaluate the psychometrics of food craving measures in more diverse samples (in terms of sex, race, ethnicity, socioeconomic status, weight status, and eating disorder psychopathology). More longitudinal studies should be conducted to provide information on the predictive validity of food craving measures regarding response to eating disorder treatment. Furthermore, it is suggested that researchers assess which tactics people use to reduce the frequency and strength of food cravings and restrain their consumption of craved foods.

Construction and validation of content of one instrument to assess falls in the elderly

OBJECTIVE

To develop and validate the content of the online Questionnaire for Fall Risk Assessment in the Elderly.

METHODS

The instrument was developed based on the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization. Initially, the set of items was submitted to evaluation of judges (healthcare professionals with experience in elderly health), who could suggest inclusion or exclusion of questions from the instrument; they were also asked to rate each question according to the expected scope. At this stage, clarity and relevance levels for each item were evaluated, generating a total of Content Validity Coefficient (CtVC).

RESULTS

Content Validity Coefficient values were satisfactory for both clarity (CtVC=0.76) and relevance (CtVC=0.82) of the questions. Next, a group of elderly volunteers participating in a socializing group evaluated the questionnaire for comprehension. The level of comprehension for each item was identified on a Likert scale, ranging from 0 to 5. The questionnaire was considered easy to understand by most participants (95%), with a mean of 4.75 (±0.11) points for each item.

CONCLUSION

The instrument showed acceptable psychometric qualities for screening fall risk among the elderly population. Future studies shall investigate different validation aspects of construct for this measure.