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Malkki-Keinänen K, Lankinen M, Karhunen L, Schwab U. Psychometric evaluation of three-factor eating questionnaire -R18 in aging Finnish men with increased risk for type 2 diabetes. Nutr Health 2024; 30:279-290. [PMID: 35816365 PMCID: PMC11141102 DOI: 10.1177/02601060221112178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Deeper comprehension of eating-related behaviour (how and why people eat) can reveal new aspects to support health and prevent type 2 diabetes (T2D). However, such research is largely missing in aging men. AIM The aim was to investigate suitability of the Three-Factor Eating Questionnaire-R18 (TFEQ-R18) in Finnish aging men which is widely used to examine factors: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). METHODS Study population consisted of 420 men aged 50-75, who completed the TFEQ-R18 at the baseline of the T2D-GENE lifestyle intervention study. Inclusion criteria were impaired fasting glucose (IFG) and body mass index ≥25 kg/m2. Confirmatory factor analysis was used to study psychometrics (reliability, validity, and model fit) and factor structure of TFEQ-R18. RESULTS The items loaded to the three factors (CR, UE, EE) as in previous studies, except two items at CR factor and one at UE factor, which were therefore omitted. UE was also discovered split into two sub factors (named as 'craving' and 'loss-of-control'), UE being a higher-order (h) factor. The resultant revised version was named as Three-Factor Eating Questionnaire Revised to 15-items with higher-order factor (TFEQ-R15h). CONCLUSION The original 18-item version of the TFEQ was not optimal in the population consisting of Finnish aging men with elevated T2D risk. A modified 15-item version of the TFEQ could be used to describe EB in this population instead.
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Affiliation(s)
- Katriina Malkki-Keinänen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - Maria Lankinen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - Leila Karhunen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - Ursula Schwab
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Finland
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2
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Bonn SE, Christenson A, Eke H, Sjöblom L, Dahlgren A, Trolle Lagerros Y. Does eating behaviour among adolescents and young adults seeking obesity treatment differ depending on sex, body composition, and parental country of birth? BMC Public Health 2022; 22:1895. [PMID: 36221108 PMCID: PMC9552712 DOI: 10.1186/s12889-022-14297-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 09/27/2022] [Accepted: 10/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents and young adults around the world experience high rates of weight gain. The underlying eating behaviours that may lead to overconsumption of energy are complex and can depend on a number of factors. The aim of this study was to explore if eating behaviour among adolescents and young adults referred to specialized obesity treatment differed depending on sex, body composition, and parental country of birth. METHODS Adolescents and young adults aged 16-25 years, referred for obesity treatment in 2018-2021 were included in the study. Eating behaviour was assessed using the Three Factor Eating Questionnaire, comprising domains of uncontrolled-, emotional- and cognitive restraint eating. Student's t-test was used to compare differences in eating behaviour scores between males and females, and between those having at least one parent born in a Nordic country and those with both parents born outside the Nordic countries. Associations between BMI, waist circumference, and body fat percentage, and eating behaviour as the dependent variable, were examined using linear regression. RESULTS A total of 463 participants, mean age 21 years and mean BMI 41.3 kg/m2, were included in the analysis. Females scored statistically significantly higher than males on emotional eating (45.8 vs. 35.4, p = 0.002) and cognitive restraint eating (45.4 vs. 39.2, p = 0.009). Participants with at least one parent born in a Nordic country reported a statistically significantly lower score of uncontrolled eating (45.7 vs. 51.3, p = 0.02) compared to participants with both parents born outside the Nordic countries. Further, there were statistically significant inverse associations between cognitive restraint eating scores and BMI (β=-0.64, 95%CI: -0.97 to -0.31), waist circumference (β=-0.44, 95%CI: -0.61 to -0.27) and body fat percentage (β=-0.57, 95%CI: -1.01 to -0.14) in models adjusted for age, sex, smoking, and civil status. CONCLUSION Our findings suggest that sex and parental country of birth may influence eating behaviours among adolescents and young adults referred for specialist obesity treatment. We also found that cognitive restraint eating decreased with increasing BMI, waist circumference, and body fat percentage. This indicates that there may be an inverse association between the ability to restrain oneself from eating and gaining weight, however, the direction of the association must be investigated further. Increased knowledge about eating behaviours may be valuable in the clinical setting.
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Affiliation(s)
- Stephanie E Bonn
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.
| | - Anne Christenson
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.,Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Helén Eke
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.,Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Linnea Sjöblom
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.,Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Anna Dahlgren
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.,Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Ylva Trolle Lagerros
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.,Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
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Childhood maltreatment and disordered eating: The mediating role of emotion regulation. Appetite 2022; 172:105952. [DOI: 10.1016/j.appet.2022.105952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 11/19/2022]
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Humphreys G, Evans R, Makin H, Cooke R, Jones A. Identification of Behavior Change Techniques From Successful Web-Based Interventions Targeting Alcohol Consumption, Binge Eating, and Gambling: Systematic Review. J Med Internet Res 2021; 23:e22694. [PMID: 33560243 PMCID: PMC7902193 DOI: 10.2196/22694] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Web-based interventions are thought to overcome barriers to treatment, such as accessibility and geographical location, which can undermine the effectiveness of traditional face-to-face interventions. Owing to these features, researchers are increasingly testing the efficacy of web-based interventions as ways to reduce alcohol misuse, binge eating, and gambling. However, many web-based interventions have poorly defined mechanisms of action; therefore, it is often uncertain how they propose to bring about behavior change. OBJECTIVE This systematic review aims to identify effective behavior change techniques (BCTs) present in web-based interventions aimed at reducing alcohol consumption, binge eating, or gambling. METHODS This systematic review covered research conducted in the last 20 years. Inclusion criteria for interventions were web-based administration; targeting alcohol use, binge eating, and/or gambling; and reporting on baseline and postintervention measures of behavior. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed. We coded intervention effectiveness, study quality, and BCTs present in the interventions. RESULTS Following removal of 4152 ineligible articles, 45 were included in the review: 32 (71%) targeted alcohol misuse, 6 (13%) targeted binge eating, and 7 (16%) targeted gambling. In total, 5 frequency counts were performed to identify the most commonly used BCTs: all studies, effective interventions, high-quality studies at 2 thresholds, and both high quality and effective studies. The results obtained from this were integrated to identify 7 BCTs. These 7 BCTs were problem solving, feedback on behavior, self-monitoring of behavior, self-monitoring of outcomes, instruction on how to perform a behavior, information about social and health consequences, and social comparison. A total of 4 BCTs were found in all frequency counts: feedback on behavior, self-monitoring of behavior, instruction on how to perform a behavior, and social comparison. Self-monitoring of outcomes of behavior was found in 3 of the 5 frequency counts, problem solving was found in 2 frequency counts, and information about social and health consequences was found in 1 frequency count. CONCLUSIONS This systematic review identified 7 of the most frequently used BCTs used in web-based interventions focused on alcohol misuse, binge eating, and gambling. These results can inform the development of evidence-based eHealth interventions that have the potential to lead to effective, positive behavior changes in all 3 areas.
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Affiliation(s)
| | - Rebecca Evans
- School of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Harriet Makin
- School of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Richard Cooke
- School of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Andrew Jones
- School of Psychology, University of Liverpool, Liverpool, United Kingdom
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5
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Nourizadeh R, Azami S, Farshbaf-Khalili A, Mehrabi E. The Effect of Motivational Interviewing on Women with Overweight and Obesity Before Conception. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:859-866. [PMID: 32591267 DOI: 10.1016/j.jneb.2020.04.219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To investigate the efficacy of motivational interviewing (MI) to elicit change in eating and physical activity behaviors in women with overweight and obesity before conception. DESIGN A randomized controlled trial was conducted. The participants were randomly divided into intervention and comparison groups. Data were gathered using the Three-Factor Eating Questionnaire Revised 18-item version (TFEQ-R18), International Physical Activity Questionnaire (IPAQ), and Stages of Change checklist. SETTING Primary health centers of Tabriz, Iran. PARTICIPANTS The participants were 70 women with overweight or obesity, aged 18-35 years, who were referred for preconception care. INTERVENTION(S) The intervention group received 6 MI sessions, and the comparison group received routine preconception care. MAIN OUTCOME MEASURE(S) Variables of primary outcomes were eating behavior measures and physical activity levels 8 weeks after intervention. ANALYSIS Independent t test, ANCOVA, Fisher exact test, Mann-Whitney U test, and Wilcoxon test were used. RESULTS The MI had a positive effect on physical activity in the moderate and vigorous levels in the intervention group (P = .01, P = .02, respectively). After the intervention, the mean score of cognitive restraint in the intervention group was higher than in the comparison group (adjusted mean difference, 16.9; 95% CI, 10.8 to 23.0; P < .001), whereas there were no significant differences between the 2 groups in terms of emotional and uncontrolled eating (P = .33 and P = .25, respectively). CONCLUSIONS AND IMPLICATIONS The MI had a positive effect on physical activity and eating behavior change, except for uncontrolled and emotional eating. Future studies to examine differences between overweight and women with obesity and within other populations is warranted.
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Affiliation(s)
- Roghaiyeh Nourizadeh
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samar Azami
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azizeh Farshbaf-Khalili
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Esmat Mehrabi
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Paans NPG, Bot M, Brouwer IA, Visser M, Gili M, Roca M, Hegerl U, Kohls E, Owens M, Watkins E, Penninx BWJH. Effects of food-related behavioral activation therapy on eating styles, diet quality and body weight change: Results from the MooDFOOD Randomized Clinical Trial. J Psychosom Res 2020; 137:110206. [PMID: 32798835 DOI: 10.1016/j.jpsychores.2020.110206] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 07/14/2020] [Accepted: 07/26/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Depression and obesity are bi-directionally related, eating styles and diet quality are two important factors associated with both. It remains uncertain if and how these two factors can be modified. Therefore the current study aims to investigate whether food-related behavioral activation therapy (F-BA), targeting mood, dietary habits and food related behavior, can improve eating styles, and diet quality and reduce body weight in adults with overweight or obesity and subsyndromal depressive symptoms. METHODS Data were derived from the MooDFOOD prevention trial, a 2x2 factorial RCT investigating the effect of nutritional strategies on prevention of depression. Changes in emotional, uncontrolled, and cognitive restrained eating (Three Factor Eating Questionnaire Revised), Mediterranean Diet Score (MDS), and body weight were analyzed among 1025 adults who either received F-BA or no intervention for 12 months. Intervention effect was tested by longitudinal analysis of covariance using mixed model analysis. RESULTS The F-BA group showed a small decrease in emotional (β=-5.68, p<.001) and uncontrolled eating (β=-4.05, p=.03), and increase in cognitive restrained eating (β=5.53, p<.01), compared to no F-BA. The effect of the F-BA therapy on emotional and uncontrolled eating was stronger in those with higher baseline depressive symptoms (IDS-SR). The F-BA did also lead to small improvements in MDS (β=1.95, p<.001), but not to change in body weight. CONCLUSION Our trial showed no reduction in bodyweight, but provides support for the possibility to improve both unhealthy eating styles and diet quality using an intervention targeting these specifically, although effects were small [Trial registration: clinicaltrials.gov NCT02529423].
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Affiliation(s)
- Nadine P G Paans
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
| | - Mariska Bot
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences, Faculty of Science, and Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, and Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Margalida Gili
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS/IDISBA), Rediapp, University of Balearic Islands, Carretera de Valldemosssa km 7,5, 07071 Palma de Mallorca, Spain
| | - Miquel Roca
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS/IDISBA), Rediapp, University of Balearic Islands, Carretera de Valldemosssa km 7,5, 07071 Palma de Mallorca, Spain
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatic and Psychotherapy, Senckenberg Distinguished Professorship, Goethe-University Frankfurt, Frankfurt A.M., Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, University Leipzig, Medical Faculty, Leipzig, Germany
| | - Matthew Owens
- Department of Psychology, University of Exeter, Exeter, UK
| | - Ed Watkins
- Department of Psychology, University of Exeter, Exeter, UK
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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7
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Giudici KV, Baudry J, Méjean C, Lairon D, Bénard M, Hercberg S, Bellisle F, Kesse-Guyot E, Péneau S. Cognitive Restraint and History of Dieting Are Negatively Associated with Organic Food Consumption in a Large Population-Based Sample of Organic Food Consumers. Nutrients 2019; 11:E2468. [PMID: 31618887 PMCID: PMC6836016 DOI: 10.3390/nu11102468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 01/06/2023] Open
Abstract
Organic food consumption has risen in many countries during the past decades, but individual motives leading to these choices remain unclear. This study aimed to evaluate the associations between cognitive restraint (CR), history of dieting and organic food intake. This cross-sectional analysis included 20,085 organic food consumers from the NutriNet-Santé cohort. CR (range score 1-4) was evaluated by the Three-Factor-Eating-Questionnaire and practice of dieting (never vs. past/current) was assessed by an ad hoc questionnaire. Frequencies of organic food intake overall and in 16 food groups were assessed by the Organic Food Frequency Questionnaire. Linear regression and analysis of covariance (ANCOVA) were performed to investigate the association between CR score, history of dieting and contribution of organic food intake to the total food intake. A lower overall contribution of organic options in the diet was observed in women with higher levels of CR (β = -3.61%, 95% CI: -4.32; -2.91 for 1 point of CR, p < 0.001) and with a history of dieting (31.1 ± 0.4% in past/current vs. 32.6 ± 0.3% in never dieters; p = 0.001). Consistent associations were observed in men with a history of dieting (26.4 ± 0.8% in past/current vs. 28.7 ± 0.4% in never dieters; p = 0.012). Overall, individuals-in particular women-with higher CR scores or with a history of dieting selected fewer organic food options. Our findings illustrate the complexity of potentially concurrent motives to food choices, in a context of increasing interest in organic food consumption.
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Affiliation(s)
- Kelly Virecoulon Giudici
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Julia Baudry
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Caroline Méjean
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
- INRA, UMR 1110, Marchés, organisations, institutions et stratégies d'acteurs (MOISA), F-34000 Montpellier, France.
| | - Denis Lairon
- Nutrition, obésité et risque thrombotique (NORT), Inserm, UMR S 1062, Aix Marseille Université, INRA 1260, F-13385 Marseille, France.
| | - Marc Bénard
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
- Santé Publique France, Unité de Surveillance et d'Épidémiologie Nutritionnelle (USEN), Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
- Département de Santé Publique, Hôpital Avicenne, F-93000 Bobigny, France.
| | - France Bellisle
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Emmanuelle Kesse-Guyot
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Sandrine Péneau
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
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Ferreira SC, Penaforte FRO, Cardoso ASR, da Silva MVT, Lima AS, Correia MITD, Anastácio LR. Eating behaviour patterns are associated with excessive weight gain after liver transplantation. J Hum Nutr Diet 2019; 32:693-701. [DOI: 10.1111/jhn.12661] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- S. C. Ferreira
- Food Science Post Graduation Program Universidade Federal de Minas Gerais Belo Horizonte Minas Gerais Brazil
| | - F. R. O. Penaforte
- Nutrition Department Universidade Federal do Triângulo Mineiro Uberaba Minas Gerais Brazil
| | - A. S. R. Cardoso
- Nutrition Course Universidade Federal de Minas Gerais Belo Horizonte Minas Gerais Brazil
| | - M. V. T. da Silva
- Food Science Post Graduation Program Universidade Federal de Minas Gerais Belo Horizonte Minas Gerais Brazil
| | - A. S. Lima
- Surgery Department Universidade Federal de Minas Gerais Belo Horizonte Minas Gerais Brazil
| | - M. I. T. D. Correia
- Food Science Post Graduation Program Universidade Federal de Minas Gerais Belo Horizonte Minas Gerais Brazil
- Surgery Department Universidade Federal de Minas Gerais Belo Horizonte Minas Gerais Brazil
| | - L. R. Anastácio
- Food Science Post Graduation Program Universidade Federal de Minas Gerais Belo Horizonte Minas Gerais Brazil
- Food Science Department Universidade Federal de Minas Gerais Belo Horizonte Minas Gerais Brazil
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Pentikäinen S, Tanner H, Karhunen L, Kolehmainen M, Poutanen K, Pennanen K. Mobile Phone App for Self-Monitoring of Eating Rhythm: Field Experiment. JMIR Mhealth Uhealth 2019; 7:e11490. [PMID: 30916657 PMCID: PMC6456829 DOI: 10.2196/11490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/26/2018] [Accepted: 12/12/2018] [Indexed: 01/15/2023] Open
Abstract
Background Temporal aspects of eating are an integral part of healthy eating, and regular eating has been associated with good diet quality and more successful weight control. Unfortunately, irregular eating is becoming more common. Self-monitoring of behavior has been found to be an efficient behavioral change technique, but the solution should be simple enough to ensure long-lasting adherence. Objective This study aimed to explore the influence of self-monitoring of daily eating pattern with mobile phone app on eating rhythm, eating behavior tendencies, and the underlying motives and attitudes related to eating. Methods A mobile phone app, Button, was developed for effortless self-monitoring of eating rhythm. The feasibility of the app was tested in a 30-day intervention. The participants (N=74) recorded their eating occasions during the intervention by pressing a button in the app widget. Results The average interval between meals increased (96 [SD 24] min during the first 10 days vs 109.1[SD 36.4] during the last 10 days) and the number of daily eating occasions decreased (4.9 [SD 0.9] during the first 10 days vs 4.4 [SD 0.9] during the last 10 days). The tendencies for cognitive restraint, emotional eating, and uncontrolled eating increased. Eating-related attitudes and motives remained largely unchanged. Conclusions These results indicate that a simple self-monitoring tool is able to draw a user’s attention to eating and is a potential tool to aid people to change their eating rhythm.
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Affiliation(s)
| | - Hannu Tanner
- VTT Technical Research Centre of Finland Ltd, Oulu, Finland
| | - Leila Karhunen
- Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Kaisa Poutanen
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Kyösti Pennanen
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
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10
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Cole RE, Meyer SA, Newman TJ, Kieffer AJ, Wax SG, Stote K, Madanat H. The My Body Knows When Program Increased Intuitive Eating Characteristics in a Military Population. Mil Med 2019; 184:e200-e206. [DOI: 10.1093/milmed/usy403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/20/2018] [Indexed: 12/17/2022] Open
Abstract
Abstract
Introduction
The purpose of this pilot study was to assess the effectiveness of the revised My Body Knows When (MBKW) program to promote intuitive eating behaviors within a sample of a military population through an online or in-person delivery mode.
Materials and Methods
Fifty-six overweight or obese adults (70% female); military service members (20%), retirees (38%) and family (42%) participated in the 10-week MBKW program at two military installations from 2012 to 2014. Body Mass Index, Intuitive Eating Scale-2 (IES-2; 23-item) and Motivation for Eating scale (MFES; 43-item) were collected at baseline and 10-weeks. Data were stratified by sex. Descriptive data were reported as mean ± standard deviation (SD), frequency, or percentage. A paired t-test was conducted with data at baseline and 10 weeks (α = 0.05, 80% power).
Results
Participants were predominantly female (70%); mean age of 51 ± 13 years; and BMI of 34.1 ± 5.5 kg/m2. There were no demographic, MFES, or IES-2 baseline differences between groups (in-person vs. online) or location. All subjects were collapsed into one group for a pre-post MBKW implementation assessment due to small sample size despite the original intent to stratify by online and in-person grouping. At 10 weeks, the remaining 26 participants exhibited a significant improvement (mean ± SD) in BMI (−0.4 ± 0.6 kg/m2; p = 0.012), environmental/social eating score (2.7 ± 0.4 points [pts]; −0.5 pt change; p < 0.001), emotional eating score (2.2 ± 0.5 pts; −0.6 pt change; p = 0.001), unconditional permission to eat score (3.4 ± 0.4 pts; +0.3 pt change; p = 0.017), eating for physical rather than emotional eating score (3.7 ± 0.8 pts; +1.0 pt change; p < 0.001), and reliance on hunger and satiety cues score (3.6 ± 0.5 pts; +0.8 pt change; p = 0.001). High attrition rates at the 10-week follow-up assessment precluded accurate assessment of long-term intervention effects.
Conclusions
The MBKW program was associated with improved intuitive eating behaviors and with less external eating influence on behavior; however, a larger sample is required to assess the effectiveness of MBKW delivery mode. Modest weight loss was attained but testing the efficacy of the MBKW program in a large diverse sample with alternate scenarios may be worthwhile (e.g., primary prevention against weight gain, or during weight maintenance to prevent weight regain).
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Affiliation(s)
- Renee E Cole
- U.S. Military-Baylor Graduate Program in Nutrition, AMEDD C&S, HRCoE, 3599 Winfield-Scott Rd, JBSA-Fort Sam Houston, TX
| | - Stephanie A Meyer
- U.S. Military-Baylor Graduate Program in Nutrition, AMEDD C&S, HRCoE, 3599 Winfield-Scott Rd, JBSA-Fort Sam Houston, TX
| | - Taylor J Newman
- U.S. Military-Baylor Graduate Program in Nutrition, AMEDD C&S, HRCoE, 3599 Winfield-Scott Rd, JBSA-Fort Sam Houston, TX
- Army Specialist Corps Office of the Chief, 3630 Stanley Road, Suite 276, JBSA-Fort Sam Houston, TX
| | - Adam J Kieffer
- U.S. Military-Baylor Graduate Program in Nutrition, AMEDD C&S, HRCoE, 3599 Winfield-Scott Rd, JBSA-Fort Sam Houston, TX
| | - Sarah G Wax
- U.S. Military-Baylor Graduate Program in Nutrition, AMEDD C&S, HRCoE, 3599 Winfield-Scott Rd, JBSA-Fort Sam Houston, TX
- Moncrief Army Health Clinic, 4500 Stuart St, Fort Jackson, SC
| | - Kim Stote
- Health Sciences, State University of New York, Empire State College, 113 West Ave, Saratoga Springs, NY
| | - Hala Madanat
- Graduate School of Public Health, San Diego State University, 5000 Campanile Dr, MC 4162, San Diego, CA
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11
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Veinot TC, Mitchell H, Ancker JS. Good intentions are not enough: how informatics interventions can worsen inequality. J Am Med Inform Assoc 2018; 25:1080-1088. [PMID: 29788380 PMCID: PMC7646885 DOI: 10.1093/jamia/ocy052] [Citation(s) in RCA: 267] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 04/12/2018] [Accepted: 05/03/2018] [Indexed: 01/09/2023] Open
Abstract
Health informatics interventions are designed to help people avoid, recover from, or cope with disease and disability, or to improve the quality and safety of healthcare. Unfortunately, they pose a risk of producing intervention-generated inequalities (IGI) by disproportionately benefiting more advantaged people. In this perspective paper, we discuss characteristics of health-related interventions known to produce IGI, explain why health informatics interventions are particularly vulnerable to this phenomenon, and describe safeguards that can be implemented to improve health equity. We provide examples in which health informatics interventions produced inequality because they were more accessible to, heavily used by, adhered to, or effective for those from socioeconomically advantaged groups. We provide a brief outline of precautions that intervention developers and implementers can take to guard against creating or worsening inequality through health informatics. We conclude by discussing evaluation approaches that will ensure that IGIs are recognized and studied.
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Affiliation(s)
- Tiffany C Veinot
- School of Information and Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Hannah Mitchell
- Department of Healthcare Policy & Research, Division of Health Informatics, Weill Cornell Medical College, New York, New York, USA
| | - Jessica S Ancker
- Department of Healthcare Policy & Research, Division of Health Informatics, Weill Cornell Medical College, New York, New York, USA
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12
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An Internet-Assisted Weight Loss Intervention for Older Overweight and Obese Rural Women: A Feasibility Study. Comput Inform Nurs 2017; 34:513-519. [PMID: 27392256 DOI: 10.1097/cin.0000000000000275] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Older Appalachian women are an understudied population with few resources available to prevent obesity and chronic disease. This study explored the feasibility of a 12-week weight loss intervention using Internet technology for older rural Appalachian women. The sample (N = 24) included women 55 years or older recruited from two senior centers in the Appalachian region. The women were randomly assigned to either an Internet program called "Lose It" (Internet program for recording of daily calories and physical activity) or to a daily wellness program (health tips) delivered via e-mail. The mean age of participants was 69 ± 8 years. Their mean body mass index (kg/m) at baseline was 34.2 ± 8. A significant difference (P = .036) was observed between intervention and control group scores on the Social Pressure Subscale. Both groups improved their intake of fruits and vegetables and lost weight from baseline to week 12. Internet weight loss programs appear feasible for older rural women. Internet-delivered weight loss interventions that provide a way to record daily calories, physical activity, and weight may provide a technology platform leading to increased self-efficacy for weight loss.
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de Medeiros ACQ, Yamamoto ME, Pedrosa LFC, Hutz CS. The Brazilian version of the three-factor eating questionnaire-R21: psychometric evaluation and scoring pattern. Eat Weight Disord 2017; 22:169-175. [PMID: 26860610 DOI: 10.1007/s40519-016-0256-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/22/2016] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aimed to evaluate the psychometric properties and scoring pattern of the Brazilian version of the three-factor eating questionnaire-r21 (TFEQ-R21). METHODS Data were collected from 410 undergraduate students. Confirmatory factor analysis was conducted to examine the factor structure of the TFEQ-R21. Convergent and discriminant validity also was assessed. Cluster analysis was performed to investigate scoring patterns. RESULTS In assessing the quality setting, the model was considered satisfactory (χ 2/gl = 2.24, CFI = 0.97, TLI = 0.96, RMSEA = 0.05). The instrument was also considered appropriate in relation to the discriminant and convergent validity. There was a positive correlation between body mass index and the dimensions of cognitive restraint (r s = 0.449, p < 0.001) and emotional eating (r s = 0.112, p = 0.023). Using cluster analysis three respondent profiles were identified. The profile "A" was associated with appropriate weight, the "B" was characterized by high scores in cognitive restraint dimension, and the cluster "C" focused individuals who had higher scores on the uncontrolled eating and emotional eating dimensions. CONCLUSIONS The Brazilian version of TFEQ-R21 has adequate psychometric properties, and the identified response profiles offer a promising prospect for its use in clinical practice, in weight loss interventions.
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Affiliation(s)
- Anna Cecília Queiroz de Medeiros
- Laboratory of Evolution of the Human Behavior, Graduate Program in Psychobiology, Department of Physiology, Federal University of Rio Grande do Norte, Natal, Brazil.
- Health Sciences College of Trairi/FACISA, Federal University of Rio Grande do Norte, Rua Vila Trairi, s/n, Centro, Santa Cruz, Rio Grande do Norte, 59200-000, Brazil.
| | - Maria Emilia Yamamoto
- Laboratory of Evolution of the Human Behavior, Graduate Program in Psychobiology, Department of Physiology, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Claudio Simon Hutz
- Department of Psychology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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15
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Solenhill M, Grotta A, Pasquali E, Bakkman L, Bellocco R, Trolle Lagerros Y. The Effect of Tailored Web-Based Feedback and Optional Telephone Coaching on Health Improvements: A Randomized Intervention Among Employees in the Transport Service Industry. J Med Internet Res 2016; 18:e158. [PMID: 27514859 PMCID: PMC4999534 DOI: 10.2196/jmir.4005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 03/31/2016] [Accepted: 04/30/2016] [Indexed: 12/30/2022] Open
Abstract
Background Lifestyle-related health problems are an important health concern in the transport service industry. Web- and telephone-based interventions could be suitable for this target group requiring tailored approaches. Objective To evaluate the effect of tailored Web-based health feedback and optional telephone coaching to improve lifestyle factors (body mass index—BMI, dietary intake, physical activity, stress, sleep, tobacco and alcohol consumption, disease history, self-perceived health, and motivation to change health habits), in comparison to no health feedback or telephone coaching. Methods Overall, 3,876 employees in the Swedish transport services were emailed a Web-based questionnaire. They were randomized into: control group (group A, 498 of 1238 answered, 40.23%), or intervention Web (group B, 482 of 1305 answered, 36.93%), or intervention Web + telephone (group C, 493 of 1333 answered, 36.98%). All groups received an identical questionnaire, only the interventions differed. Group B received tailored Web-based health feedback, and group C received tailored Web-based health feedback + optional telephone coaching if the participants’ reported health habits did not meet the national guidelines, or if they expressed motivation to change health habits. The Web-based feedback was fully automated. Telephone coaching was performed by trained health counselors. Nine months later, all participants received a follow-up questionnaire and intervention Web + telephone. Descriptive statistics, the chi-square test, analysis of variance, and generalized estimating equation (GEE) models were used. Results Overall, 981 of 1473 (66.60%) employees participated at baseline (men: 66.7%, mean age: 44 years, mean BMI: 26.4 kg/m2) and follow-up. No significant differences were found in reported health habits between the 3 groups over time. However, significant changes were found in motivation to change. The intervention groups reported higher motivation to improve dietary habits (144 of 301 participants, 47.8%, and 165 of 324 participants, 50.9%, for groups B and C, respectively) and physical activity habits (181 of 301 participants, 60.1%, and 207 of 324 participants, 63.9%, for B and C, respectively) compared with the control group A (122 of 356 participants, 34.3%, for diet and 177 of 356 participants, 49.7%, for physical activity). At follow-up, the intervention groups had significantly decreased motivation (group B: P<.001 for change in diet; P<.001 for change in physical activity; group C: P=.007 for change in diet; P<.001 for change in physical activity), whereas the control group reported significantly increased motivation to change diet and physical activity (P<.001 for change in diet; P<.001 for change in physical activity). Conclusion Tailored Web-based health feedback and the offering of optional telephone coaching did not have a positive health effect on employees in the transport services. However, our findings suggest an increased short-term motivation to change health behaviors related to diet and physical activity among those receiving tailored Web-based health feedback.
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Affiliation(s)
- Madeleine Solenhill
- Karolinska Institutet, Department of Medicine, Clinical Epidemiology Unit, Stockholm, Sweden.
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16
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Swartz MC, Basen-Engquist KM, Markham C, Lyons EJ, Cox M, Chandra J, Ater JL, Askins MA, Scheurer ME, Lupo PJ, Hill R, Murray J, Chan W, Swank PR. Psychometric Analysis of the Three-Factor Eating Questionnaire-R18V2 in Adolescent and Young Adult-Aged Central Nervous System Tumor Survivors. J Adolesc Young Adult Oncol 2016; 5:278-85. [PMID: 27042872 DOI: 10.1089/jayao.2015.0058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Adolescent and young adult (AYA)-aged central nervous system (CNS) tumor survivors are an understudied population that is at risk of developing adverse health outcomes, such as obesity. Long-term follow-up guidelines recommend monitoring those at risk of obesity, thus motivating the need for an eating behavior questionnaire. An abbreviated online version of the Three-Factor Eating Questionnaire (TFEQ-R18v2) has been developed, but its applicability to this population is not yet known. This study investigated the instrument's factor structure and reliability in this population. METHODS AYA-aged CNS tumor survivors (n = 114) aged 15-39 years completed the TFEQ-R18V2 questionnaire online. Confirmatory factor analysis was used to examine the fit of the three-factor structure (uncontrollable eating, cognitive restraint, and emotional eating [EE]) and reliability (internal consistency of the TFEQ-R18v2). Associations between the three factors and body mass index (BMI) were assessed by linear regression. RESULTS The theorized three-factor structure was supported in our population (RMSEA = 0.056 and CFI = 0.98) and demonstrated good reliability (α of 0.81-0.93). EE (β = 0.07, 95% CI 0.02-0.13) was positively associated with BMI, whereas the other two subscale scores were not. CONCLUSION The TFEQ-R18v2 instrument holds promise for research and clinical use among AYA-aged CNS tumor survivors. The instrument may be a useful tool for researchers to develop tailored weight management strategies. It also may be a valuable tool for clinicians to monitor survivors who are at risk of obesity and to facilitate referral. Our results also suggest that EE in this population should be further investigated as a potential target for intervention.
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Affiliation(s)
- Maria C Swartz
- 1 Division of Rehabilitation Sciences, The University of Texas Medical Branch , Galveston, Texas
| | - Karen M Basen-Engquist
- 2 Department of Behavioral Science, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Christine Markham
- 3 Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Elizabeth J Lyons
- 1 Division of Rehabilitation Sciences, The University of Texas Medical Branch , Galveston, Texas
| | - Matthew Cox
- 2 Department of Behavioral Science, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Joya Chandra
- 4 Division of Pediatrics, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Joann L Ater
- 4 Division of Pediatrics, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Martha A Askins
- 4 Division of Pediatrics, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | | | - Philip J Lupo
- 5 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Rachel Hill
- 6 Department of Hematology & Oncology, Cook Children's Medical Center , Fort Worth, Texas
| | - Jeffrey Murray
- 6 Department of Hematology & Oncology, Cook Children's Medical Center , Fort Worth, Texas
| | - Wenyaw Chan
- 7 Department of Biostatistics, The University of Texas Health Science Center at Houston School of Public Health , Houston, Texas
| | - Paul R Swank
- 3 Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
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Analysis of Dietary Pattern Impact on Weight Status for Personalised Nutrition through On-Line Advice: The Food4Me Spanish Cohort. Nutrients 2015; 7:9523-37. [PMID: 26593942 PMCID: PMC4663610 DOI: 10.3390/nu7115482] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 10/23/2015] [Accepted: 11/03/2015] [Indexed: 11/17/2022] Open
Abstract
Obesity prevalence is increasing. The management of this condition requires a detailed analysis of the global risk factors in order to develop personalised advice. This study is aimed to identify current dietary patterns and habits in Spanish population interested in personalised nutrition and investigate associations with weight status. Self-reported dietary and anthropometrical data from the Spanish participants in the Food4Me study, were used in a multidimensional exploratory analysis to define specific dietary profiles. Two opposing factors were obtained according to food groups’ intake: Factor 1 characterised by a more frequent consumption of traditionally considered unhealthy foods; and Factor 2, where the consumption of “Mediterranean diet” foods was prevalent. Factor 1 showed a direct relationship with BMI (β = 0.226; r2 = 0.259; p < 0.001), while the association with Factor 2 was inverse (β = −0.037; r2 = 0.230; p = 0.348). A total of four categories were defined (Prudent, Healthy, Western, and Compensatory) through classification of the sample in higher or lower adherence to each factor and combining the possibilities. Western and Compensatory dietary patterns, which were characterized by high-density foods consumption, showed positive associations with overweight prevalence. Further analysis showed that prevention of overweight must focus on limiting the intake of known deleterious foods rather than exclusively enhance healthy products.
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