Cross-cultural adaptation of the Brazilian version of the Questionnaire on Eating and Weight Patterns-5 (QEWP-5)

Food Consumption during Binge Eating Episodes in Binge Eating Spectrum Conditions from a Representative Sample of a Brazilian Metropolitan City

The prevalence of binge eating spectrum conditions (BESC) are increasing globally. However, there is a lack of data from general population samples in low- and middle-income countries. Thus, this study described the food consumption during objective binge eating episodes (OBE) in people with BESC from a metropolitan city in Brazil. Participants comprised 136 adults (18 years old-60 years old) with Binge Eating Disorder (BED), Bulimia Nervosa (BN), or recurrent binge eating (RBE) from a two-phase epidemiological survey. They were interviewed in their homes by trained lay interviewers using the Questionnaire on Eating and Weight Patterns updated for the DSM-5 to assess BESC diagnosis and food consumption during a typical OBE. Overall, participants consumed a mean of 1067 kcal during the episodes. For the most part, these calories were derived from carbohydrates (58%) and lipids (30%), irrespective of the diagnosis. Regarding food item consumption, individuals with BED and RBE consumed staple foods (mainly rice and beans) more frequently than those with BN. Conversely, participants with BN ingested sugar-sweetened beverages more frequently than the BED group. In conclusion, there were differences in the eating patterns of individuals with BESC in Brazil. BED and RBE participants consumed more typical foods, whereas those with BN preferred foods with a high content of energy during their OBE.

Hyperpalatable Foods Consumption in a Representative Sample of the General Population in Brazil: Differences of Binge and Non-Binge Eating Meals

The availability of hyper-palatable foods (HPF) increased over the past three decades worldwide, a period when eating disorders (ED) and obesity have become global public health concerns. The present study aimed to assess HPF consumption during binge and non-binge meals in a representative sample of adults with and without ED from a metropolitan city in Brazil. A total of 2297 individuals were interviewed in their homes by trained lay interviewers to assess the presence of binge eating disorder (BED), bulimia nervosa (BN), and recurrent binge eating (RBE). Information on their food consumption in objective and subjective binge eating episodes (OBE and SBE, respectively), as well as in the 24 h food recall were obtained. Individuals from the general population consumed 56% of their total calories from HPF. In non-binge meals, people with BN consumed substantially fewer calories from HPF than BED (63% vs. 48%) and RBE (63% vs. 48%) groups. During OBE, participants consumed an average of 70% of the calories from HPF, with no between-group differences. During SBE, subjects with BN consumed substantially fewer calories from HPF than those with BED (76% vs. 50%). In conclusion, HPF were highly consumed by the Brazilian population. However, there was a greater impact on BED and RBE subjects and during binge eating episodes.

Grazing Prevalence and Associations with Eating and General Psychopathology, Body Mass Index, and Quality of Life in a Middle-Income Country

Research from high-income countries has shown that grazing is a common but problematic eating pattern, particularly when associated with a sense of loss of control. However, it is unclear whether these patterns hold globally. Thus, the goal of this study was to extend previous research by examining the prevalence and clinical correlates of compulsive grazing (CG) and non-compulsive grazing (NCG) in a middle-income country. Participants (N = 2297) comprised adult residents from Rio de Janeiro, Brazil. Recruitment of this population-based household survey occurred from September 2019 to February 2020. The short inventory of grazing was used to operationalise grazing subtypes. Chi-square analyses, logistic regression, and univariate tests were conducted using the complex samples procedure. The point prevalence of regular CG was 10.2% (n = 239) and was consistent with high-income countries, while NCG was 29.8% (n = 679) and was less frequent than reported in high-income countries. Additionally, similar to high-income countries, CG was associated with a higher body mass index and higher odds of eating disorders, eating disorder symptomatology, depression, anxiety, and a lower physical and mental health-related quality of life, than no grazing and NCG. Overall, this study demonstrated that grazing patterns in high-income countries extend to middle-income countries.

Concurrent validity of the Brazilian Portuguese version of the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) in the general population

The Questionnaire on Eating and Weight Patterns-5 is a self-report instrument developed for the screening of Binge Eating Disorder (BED) and Bulimia Nervosa (BN) according to DSM-5. The present study aimed to examine the concurrent validity of the Brazilian version of QEWP-5 to assess BED and BN in the general population. The Brazilian version of QEWP-5 was administered to 2297 subjects, aged from 18 to 60 years. All screen-positive and a subset of screen-negative participants were also interviewed by telephone using the eating disorders (ED) module of Structured Clinical Interview for DSM-IV - Patients Version (SCID-I-P) for the assessment of BED, BN, and their subthreshold forms. For the assessment of BED, the sensitivity of QEWP-5 was 0.41 and its specificity was 0.90. The positive and negative predictive values were 0.48 and 0.87, respectively. Regarding the assessment of BN, QEWP-5 showed a sensitivity of 0.56, a specificity of 0.90, a positive predictive value of 0.35, and a negative predictive value of 0.95. For the global screening of ED (BED, BN, and subthreshold forms), QEWP-5 showed a sensitivity of 0.71, a specificity of 0.83, a positive predictive value of 0.64 and a negative predictive value of 0.87. QEWP-5 can be a useful instrument for the initial screening of diagnostic threshold ED psychopathology in general population samples. However, it has less utility in identifying cases of BED and BN independently.

Reliability of the Brazilian version of the questionnaire on eating and weight patterns-5 (QEWP-5)

PURPOSE

The Questionnaire on Eating and Weight Patterns-5 (QEWP-5) is a self-report instrument developed to screen individuals for binge eating disorder (BED) and bulimia nervosa (BN) as diagnosed by the DSM-5. This instrument was cross-culturally adapted for the Brazilian Portuguese and well understood by the target sample. The present study aimed to assess the test-retest reliability of the Brazilian version of QEWP-5 in a sample of undergraduate students from Dietitian and Psychology courses.

METHODS

The Brazilian version of QEWP-5 was administered to a sample of 345 male and female undergraduate students, from dietitian (n = 179) and psychology (n = 166) courses. The instrument was applied twice with a time interval of 2 weeks between the applications. The kappa coefficient was used to assess the temporal stability of the questionnaire in the screening of BED and BN.

RESULTS

Overall, the kappa coefficient for the screening of BED was .48, and for the screening of BN was .71. In the dietitian course, the temporal stability was .60 (for the assessment of BED) and .80 (for BN). In the psychology course, the kappa values for the assessment of BED and BN were .27 and .60, respectively. All values were statistically significant (p < .001).

CONCLUSION

In general, the stability of the Brazilian version of QEWP-5 was considered moderate to assess BED and substantial for the screening of BN in undergraduate students. Stratifying by course, the questionnaire had higher stability for the assessment of BED and BN in dietitian students.

LEVEL OF EVIDENCE

Level V, descriptive study.