Factor Structure and Psychometric Properties of Emotional Eater Questionnaire (EEQ) in Spanish Colleges

[Validation of the Garaulet Emotional Intake Questionnaire in students of the Universidad Nacional de Colombia]

INTRODUCTION

the emotional state influences the selection of foods that an individual consumes. In Colombia, no tool allows to detect the people most susceptible to develop emotional intake.

OBJECTIVE

to validate the Emotional Intake Questionnaire-Garaulet in a student population of the National University of Colombia.

METHODS

a cross-sectional descriptive observational study was conducted with a convenience sample of students in all the University's campuses in two stages employing the Spanish and the Colombian questionnaires through e-mail. Two questions were included in the survey, to assess the emotions of sadness and anxiety; a linearity relationship was established with the cut-off scores to maintain proportionality and preserve the dimensions of the study phenomenon.

RESULTS

in phase 1, 1177 subjects participated, and in phase 2, 831 subjects participated. Of these, 63.6 % and 52.8 % were emotional and very emotional eaters in the Colombian and Spanish versions, respectively. Taking the total amount of people, 22.3 % were emotional and very emotional eaters with body mass index > 25 kg/m². In addition, 4.7 % had an eating disorder and 14.2 % had a psychiatric disorder. Finally, sensitivity, specificity, and positive and negative predictive values were 99.0 %, 49.3 %, 89.9 % and 91.2 %, respectively.

CONCLUSIONS

the Colombian version of the Emotional Eating Questionnaire demonstrates acceptable validity and reliability compared to the Spanish version. A high prevalence of emotional eaters was observed in the university population, which could be detected early through the use of this questionnaire. Suffering from this disorder is a risk factor for developing obesity and other metabolic diseases in the future.

Nutritional habits and eating attitude in university students during the last wave of COVID-19 in Spain

Emotional Eating is eating in response to negative emotional states, such as boredom, loneliness, or anxiety. For some young people, both food and alcohol are a source of pleasure in their social life. A cross-sectional study was conducted in 2022-23 in the Health Sciences Faculty. Mediterranean Diet Adherence Test, alcohol use disorders identification test (AUDIT), Emotional Eater Questionnaire (EEQ), Pittsburgh Sleep Quality Index, Yale Food Addiction, Perceived Stress Scale, and Anxiety Questionnaire STAI, were employed. Emotional eater (EE) regarding to no emotional eater (NEE) presented a mild food addiction, a significantly high intake of carbohydrates, fat, and alcohol. Energy intake is dependent on saturated fat, also they are not conscious of their intake of calories, had worse sleep quality, high perceived stress, and worse healthy eating index (HEI) due to their intake of sweets and soft drinks. The diet quality could be affected by the stress of the pandemic. The association of emotional eating with the intake of sweet foods and alcoholic drinks maybe is a remaining situation of COVID-19. We suppose that maladaptive eating behaviors have improved over time during this pandemic. Even though it is necessary to promote healthier eating among university students, it is also necessary to improve healthy habits.

Validation of the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) in Spanish University Students

OBJECTIVE

The aim of this study was to explore the factorial structure, psychometric properties and association with anthropometric and clinical variables of the Modified Yale Addiction Scale 2.0 (mYFAS 2.0) in a Spanish university population.

METHODS

A cross-sectional study of n = 270 university students in Spain was conducted.

VARIABLES MEASURED

mYFAS 2.0, Emotional Eater Questionnaire (EEQ), Alcohol Use Disorder Identification Test (AUDIT), Pittsburg Sleep Quality index (PSQI) and Perceived Stress Scale (PSS). In mYFAS 2.0 were performed an Exploratory Factor Analysis (EFA), an Unweight Least Square (ULS), a model fit using comparative fit index (CFI) and nomological validity.

RESULTS

EFA revealed that a two-factor structure is the most appropriate in a non-clinical population of Spanish university students. The factors accounted for 18.54% and 16.33% of the variance, and the correlation between them was moderate-0.487 (p < 0.001). This different structure from that reported in the original scale could be derived from the cultural characteristics and intrinsic eating habits of the study population. The correlation matrix reported an inverse association of mYFAS 2.0 with Body Mass Index (BMI). In addition, participants with a BMI below 25 showed a higher mYFAS 2.0 and EEQ score.

CONCLUSIONS

These results suggest some changes in the psychometric assessment structure of the mYFAS 2.0 in a non-clinical population of university students, as well as the usefulness of this questionnaire to identify individuals with an adequate BMI but with compensatory behaviours that predispose to different eating disorders.

Emotional eating, internet overuse, and alcohol intake among college students: a pilot study with virtual reality

Introduction

The term emotional eating (EE) describes the tendency to eat as an automatic response to negative emotions and has been linked to anxiety and depression, common symptoms among the university population. The EE tendencies have also been associated with excessive internet use and an increase in alcohol intake among young university students.

Methods

The aim of this study is to examine the relationship between the tendency towards EE and other health-compromising behaviors, such as excessive internet use or high alcohol intake. Additionally, it aims to investigate the association of these risky behaviors with the participants' performance level in a virtual reality (VR) task that assesses their executive functioning, and to assess impulsivity and levels of anxiety and depression.

Results

The results associate EE with excessive internet (r = 0.332; p < 0.01). use but not with alcohol consumption. Alcohol consumption was not associated with anxiety, depression, or impulsivity, but it was related to altered executive functions in the VR task: flexibility and working memory explained 24.5% of the variance. By contrast, EE and internet overuse were not related to executive function but were associated with impulsivity, depression, and anxiety. Impulsivity and depressive symptoms accounted for 45% of the variance in EE. Depression, trait anxiety and impulsivity explained 40.6% of the variance in internet overuse.

Discussion

The results reveal distinct patterns of psychological and neuropsychological alterations associated with alcohol consumption compared to emotional eating (EE) and excessive internet use. These findings underscore significant differences in the contributing factors between addictions and other substance-free addictive behaviors. For a deeper understanding of the various contributing factors to EE in college students, further research is recommended.

[Emotional eating in university students: a cross-sectional and comparative study in the Iberian Peninsula]

OBJECTIVE

Although the lack of progress in reducing obesity is a global problem, different places have different contributing factors. One of the factors currently contributing to the increasing prevalence of obesity is emotional eating. The aim of this paper was to describe and compare the level of emotional eating and to analyse which variables and to what extent they affected the other variables.

METHODS

A descriptive cross-sectional study was conducted in students from 3 universities of the Iberian Peninsula (n=1,654) between October 2019 and June 2020. Data were collected through an online self-report questionnaire which included sociodemographic and anthropometric data and validated questionnaires such as: the Emotional Eaters Questionnaire, the ShortForm-36 and the Hospital Anxiety and Depression Questionnaire. Stratified random sampling was performed by faculty, degree, and class groups. For descriptive results, means, standard deviation and relative frequencies of variables were calculated. Student's t-test, chi-square and ANOVA were used to compare means. Simple and multiple linear regressions were performed for both samples.

RESULTS

The mean emotional eating score was 8.77±5.66 for spanish students and 10.02±6.19 for portuguese students, with a difference of 3.62 (<0.001). In Spain, the dependent variable that most affected emotional eating was quality of life (13.8% variance [<0.001]), while in Portugal it was anxiety (10.1% variance [<0.001]).

CONCLUSIONS

Statistically significant differences are found in the level of emotional eating between populations. In addition, there is dissimilarity in the variables influencing the principal in both countries. These findings imply that they should be considered in the design of future research or health interventions.

Nutrient intake, alcohol consumption, emotional eating and anxiety in women nursing students

Objective

The aim of the study was to analyze dietary habits, alcohol habits, emotional eating and anxiety in a sample of Spanish nursing students. These students appear to be essential to the field of public health and to teaching their future patients about their own good practices.

Methods

A cross-sectional investigation was conducted. Participants completed the Emotional Eater Questionnaire, the Alcohol Use Disorder Identification Test (AUDIT) test to evaluate alcohol intake, the State-Trait anxiety Inventory (STAI) test to measure levels of anxiety as a state and anxiety as a trait, and self-reported sociodemographic data. Following classroom instruction, three-day food records were used to gauge food intake.

Results

The calorie intake for the macronutrients Ca, Mg, K, and Fe were below the Recommended Dietary Intakes (DRI) and imbalanced. The percentage E of proteins was 132.7 % more than recommended, while the percentage of carbohydrates is below the recommended level. Dietary energy consumption barely equaled 78 % of the total energy consumed by this sex and age group. With respect to emotional eating, nursing women students were low emotional eater (44 %) > emotional eater (30 %) > non-emotional eater (22.7 %). The students' emotional eating is substantially connected with fast food and sweets, or less healthy food intake behaviors. According to the Alcohol Use Disorder Identification Test (AUDIT), 82.7 % of female students used alcohol on a regular basis in a low-risk manner.

Conclusion

The findings demonstrated a link between anxiety and dietary fat intake. Trait anxiety was negatively connected with emotional eating (EE), whereas state anxiety was positively correlated with meat consumption. It is crucial to consider these findings when creating prevention/intervention plans and profiles of harmful eating behaviors.

Mediating effect of negative perceived stress on the relationship between premenstrual syndrome and emotional eating

BACKGROUND/OBJECTIVES

Emotional eating is one of the eating behaviors in which negative emotions affect eating. During the luteal phase, premenstrual syndrome (PMS) and its associated psychological and physical symptoms can appear in some women, and a few of them suffer from premenstrual dysphoric disorder (PMDD), a severe form of PMS. Some women diagnosed with PMS/PMDD experience emotional eating during the luteal phase, which may be a coping mechanism for psychological stress. This study aimed to investigate how PMS/PMDD and negatively perceived stress are related to emotional eating.

SUBJECTS/METHODS

A total of 409 women aged 20 to 39 yrs with a body mass index (BMI) ranging from 18.5 to 29.9 kg/m2 participated in this study. Participants who responded to all the questions of the Shortened Premenstrual Assessment Form, Negative Perceived Stress Scale, and Emotional Eater Questionnaire were divided into a PMDD and a non-PMDD group according to the cut-off value for PMDD diagnosis. Independent t-tests and mediation analyses were performed to compare the 2 groups.

RESULTS

No significant differences between the 2 groups were found in terms of BMI; however, the average values for emotional eating, PMS, and negative perceived stress of the PMDD group were significantly higher than those of the non-PMDD group. Only negative perceived stress had a significant effect on emotional eating in the non-PMDD group. In the PMDD group, PMS was statistically significant for both negative perceived stress and emotional eating mediated by negative perceived stress. Consequently, it appeared to have a partial or complete mediation depending on the independent variable for the PMDD group.

CONCLUSIONS

This study highlights the importance of managing negative perceived stress to control emotional eating in PMS/PMDD for improved women's health.

Reliability and Validity of the Emotional Eater Questionnaire in Romanian Adults

Negative emotions and chronic stress trigger abnormal compensatory behaviors known as emotional eating (EE). EE is a well-known mediator for increased body mass index and weight gain. Our aim was to analyze the factor structure and validity and reliability of the Emotional Eater Questionnaire (EEQ) in a sample of 200 Romanian adults with excess weight. Principal component analysis (PCA) was used to assess the construct validity. The mindful eating questionnaire (MEQ) was used to test concurrent validity. Cronbach’s alpha and Spearman correlations were used to analyze internal and external reliability. The socio-demographic characteristics were used as factors for convergent validity. PCA revealed the existence of three major factors, disinhibition, type of food, and guilt, which accounted for 64.9% of the variance. Concurrent validity showed medium to large associations with MEQ (r = 0.650; p < 0.001) and a large association with the emotional subscale of MEQ (r = 0.732; p < 0.001). Reliability was adequate with Cronbach’s alfa = 0.841 and ICC = 0.775. In a multivariate model, the highest contribution to the EE score was the age (beta = −0.327), followed by feminine gender (beta = 0.321), high levels of perceived stress (beta = 0.215), BMI (beta = 0.184) and lower perceived health status (beta = 0.184). The Romanian version of the EEQ is a reliable and valid tool for measuring emotional eating in adults with excess weight.

Efficacy of an Online Educational Intervention in Reducing Body Weight in the Pre-Diabetic Population of 18-45 Years Old, a Randomized Trial Protocol

Aim: to analyze the efficacy of an educational online intervention focused on lifestyle changes in reducing body weight from baseline to 6 months in the pre-diabetic population of 18−45 years old in Extremadura (Spain). Methods: a single-blind, multicenter randomized parallel-comparison trial with two intervention groups in a 1:1 ratio will be carried out. Participants will be randomly assigned to intervention A or B with 37 cases in each group according to inclusion criteria of being enrolled or working at Extremadura University, scoring >7 points on the Findrisc test and not having diagnosed diabetes mellitus or physical disabilities. Intervention-A group will have access to online information about healthy diet and exercise. Intervention-B group will have access to a six-session educational program regarding behavioral changes in diet and exercise habits. They will complete follow-up activities and have a personal trainer and motivation. The primary outcome will be identifying changes in body weight from baseline to 1 and 6 months and between groups. The secondary outcomes will be accomplishing regular physical activity (>30 min/day or >4 h/week), decreasing sugary food intake or avoiding it altogether, increasing vegetable/fruit intake and lowering HbA1c levels to non-diabetic status when necessary.

Psychometric Properties of the Emotional Eater Questionnaire in University Students

Emotional Eating (EE) patterns have been shown to play a relevant role in the development of overweight and obesity. The aim of this study was to analyze the factor structure and psychometric properties of the Emotional Eater Questionnaire (EEQ) in university students from Huelva. The EEQ was administered to 1282 students (age 22.00 (±5.10), BMI 23.59 (±6.74)), belonging to the University of Huelva. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were carried out. The internal structure of the questionnaire, internal consistency, test-retest reliability, and convergent validity were analyzed. Principal component analysis of the questionnaire showed two dimensions, explaining 56% of the variance. Internal consistency showed a Cronbach's alpha of 0.859 globally, and of 0.841-0.855 if the items were removed. The corrected item-total correlation yielded values of 0.444-0.687. The test-retest stability was ICC = 0.924 (p < 0.001). The data showed significant correlations between EEQ and the rest of the variables, and a Spearman's Coefficient ranging from -0.367 to 0.400. The fit indexes were good for the confirmatory factor analysis. The results obtained with this structure found an adequate reliability and validity of the questionnaire in comparison with previous studies.

Emotional Eating and Perfectionism as Predictors of Symptoms of Binge Eating Disorder: The Role of Perfectionism as a Mediator between Emotional Eating and Body Mass Index

(1) Background: Perfectionism has been linked to eating disorders and might be a risk factor for the appearance of eating pathologies. The aims of this study are (a) to verify the relationship between perfectionism, emotional eating (EE), binge eating (BE), and body mass index (BMI); (b) to identify the variables that predict BE symptoms and BMI; (c) to study the role of perfectionism as a mediator between EE and BMI. (2) Methods: 312 adult participants answered a cross-sectional survey that included the Multidimensional Perfectionism Scale, the Emotional Eater Questionnaire (EEQ), the Binge Eating Scale (BES), and a sociodemographic questionnaire including BMI. (3) Results: The results suggest a direct correlation between EE, BE, and BMI, showing that EE is a powerful predictor of BE symptoms and BMI. Furthermore, two dimensions of perfectionism have a mediator role between EE and BMI, specifically doubts and actions and concern over mistakes: the presence of these two components of perfectionism reverses the relationship between EE and BMI. (4) Conclusions: These results have significant implications for the understanding of the two different (pathological) eating patterns: intake restriction and overeating and should be considered in intervention programs.

Emotional Eating and Dietary Patterns: Reflecting Food Choices in People with and without Abdominal Obesity

Emotional eating (EE) is food consumption in response to feelings rather than hunger. EE is related to unhealthy food intake and abdominal obesity (AO). However, little evidence exists about the association between EE and dietary patterns (DPs) and EE−AO interaction related to DPs. DPs allow describing food combinations that people usually eat. We analyzed the association of EE with DPs in adults (≥18 years) with AO (WC ≥ 80/90 cm in women/men, respectively; n = 494; 66.8% women;) or without AO (n = 269; 74.2% women) in a cross-sectional study. Principal component analysis allowed identifying four DPs from 40 food groups (validated with a semiquantitative food frequency questionnaire). Among the subjects presenting AO, being “emotional/very-emotional eater” (emotional eating questionnaire) was negatively associated with the “Healthy” DP (fruits, vegetables, olive oil, oilseeds, legumes, fish, seafood) (OR:0.53; 95% CI: 0.33, 0.88, p = 0.013) and positively with the “Snacks and fast food” DP (sweet bread, breakfast cereal, corn, potato, desserts, sweets, sugar, fast food) (OR:1.88; 95% CI: 1.17, 3.03, p = 0.010). Emotional eaters with AO have significantly lower fiber intake, folic acid, magnesium, potassium, vitamin B1, and vitamin C, while they had a higher intake of sodium, lipids, mono and polyunsaturated fatty acids, and saturated fats. In non-AO participants, EE was not associated with any DP (p > 0.05). In conclusion, EE is associated with unhealthy DPs in subjects with AO.

Quality of Life, Sleep Quality, Depression, Anxiety, Stress, Eating Habits, and Social Bounds in Nurses during the Coronavirus Disease 2019 Pandemic in Qatar (The PROTECTOR Study): A Cross-Sectional, Comparative Study

There have been numerous concerns regarding the physical and mental health of nurses during the COVID-19 pandemic. Stress, sleep deprivation, anxiety, and depression potentiated nurses’ vulnerability to poor eating habits. Aims and Objectives: The purpose of this study was to explore the differences between nurses’ characteristics with COVID-19 facility designation, and sleep quality, depression, anxiety, stress, eating habits, social bonds, and quality of life. Design: A cross-sectional, comparative study. Methods: An online survey was sent using the corporation’s email to nurses working in three hospitals in Qatar from September to December 2020. One of them is a designated COVID-19 facility. The sleep quality, depression, eating habits, social bonds, and quality of life were measured using The Insomnia Severity Index (ISI), Depression Anxiety and Stress Scale 21 (DASS-21), Emotional Eater Questionnaire (EEQ), Oslo Social Support Scale (OSSS-3), and the World Health Organization Quality of Life (WHOQOL-BREF), respectively. Results: A total of 200 nurses participated in the study (RR: 13.3%). No statistically significant association was found between designated facility (COVID-19 vs. not COVID-19) or nurses’ characteristics and ISI categories (OR 1.15; 95% CI 0.54, 2.44). Nurses working in COVID-19 facilities had increased odds of having higher EEQ categories by 2.62 times (95% CI 1.18, 5.83). Similarly, no statistically significant associations were found between any of the nurses’ characteristics and OSSS-3 categories. On the other hand, no statistically significant associations were found between any of the nurses’ characteristics and QOL domains except for the gender and social relationships’ domain. Conclusion: Overall, the quality of life of nurses in Qatar is on a positive level whether they are assigned to a COVID-19 facility or not. Although no significant difference was found with regard to the sleep quality, stress, anxiety, depression, and eating habits between nurses in a COVID-19 facility and in a non-COVID-19 facility, special interventions to diminish stressors need to be implemented and maintained.