Emotional Eating in Adolescence: Effects of Emotion Regulation, Weight Status and Negative Body Image

Maladaptive eating behaviors and health-related quality of life in Spanish children

In children, assessing health-related quality of life (HRQoL) and identifying the factors that can influence it are essential to understanding their overall health and well-being. Although eating disorders in children have been associated with reduced HRQoL, the impact of maladaptive eating behaviors, such as external eating, emotional eating and restrained eating, on children's HRQoL has not yet been prospectively explored. Therefore, the aim of this study was to determine whether external, emotional and restrained eating at baseline was associated with HRQoL in children after 14.65 months (95% CI: 14.57-14.73) of follow-up. The study involved 690 boys and 681 girls aged between 8 and 10 years, recruited from primary schools in Catalonia (Spain). To assess the relationship between external, emotional and restrained eating behaviors at baseline and HRQoL at follow-up, the Dutch Eating Behavior and KIDSCREEN-10 questionnaires were used, respectively. After adjusting for sex, age, intervention allocation group, school, maternal education, zBMI and physical activity, external and emotional eating behaviors at baseline were negatively associated with HRQoL at follow-up (p < 0.01). These associations were attenuated after final adjustment for HRQoL at baseline. Furthermore, a composite score of maladaptive eating behaviors at baseline was created by summing the individual scores for emotional, restrained and external eating behaviors. This composite score showed a significant inverse association with HRQoL at follow-up, even after adjusting for baseline HRQoL (p = 0.024). In conclusion, external and emotional eating behaviors seems to negatively affect HRQoL prospectively in Spanish children. The composite score of maladaptive eating behaviors showed a stronger inverse association with HRQoL than each eating behavior individually. TRIAL REGISTRATION NUMBER: ISRCTN registry: ISRCTN68403446; Date of registration, August 01, 2014 'Retrospectively registered'.

Impact of baseline dietary quality on the efficacy of a dietitian-guided weight reduction program

AIM

This pre-post intervention study aimed to assess the relationship between baseline dietary quality and the efficacy of a dietitian-guided weight reduction program, which has not been thoroughly documented to date.

METHODS

Ninety-two consecutive obese or overweight patients visiting a tertiary center clinic for weight reduction were enrolled in this study. Participants received a dietitian-guided weight reduction education program aimed at reducing daily caloric intake by 500 kcal and improving adherence to the Mediterranean diet for 3 months. Baseline dietary quality was assessed using the 14-item Taiwanese Mediterranean Diet Adherence Screener (T-MEDAS), where a higher T-MEDAS score reflects greater adherence to the Mediterranean diet. Additional covariates, including dietary behaviors, lifestyle factors, and comorbidities were also recorded. The primary outcome was the percentage of weight reduction at 3 months, analyzed using restricted cubic spline models and generalized estimating equations (GEE) to account for the correlation between weight change and the baseline T-MEDAS scores.

RESULTS

Thirty-nine participants were excluded due to major illnesses, use of anti-obesity medications, or loss to follow-up. Among the remaining 53 participants (mean age 41.2 ± 12.8 years, 56.6% female), the average weight reduction was 3.9 ± 3.3% from a baseline weight of 98.5 ± 12.8 kg. Participants who did not achieve a weight reduction of more than 5% had higher baseline T-MEDAS scores compared to those who did (5.4 ± 1.7 vs. 4.1 ± 1.8, p = 0.026). A restricted cubic spline model, adjusted for covariates including age, gender, diabetes mellitus (DM), dyslipidemia, and smoking, revealed a significant inverse relationship between higher baseline T-MEDAS scores and weight loss. After controlling for various confounders, GEE analysis demonstrated that higher baseline T-MEDAS scores were significantly associated with less weight loss (beta: -4.1, 95% CI: -5.6 to -2.6, p < 0.001).

CONCLUSIONS

Higher baseline dietary quality was associated with reduced effectiveness of a dietitian-guided weight reduction program. This suggests that additional strategies may be required to improve the success of weight loss interventions in individuals with higher baseline dietary quality.

Negative emotional eating patterns in Chinese adolescents: A replication and longitudinal extension with latent profile and transition analyses

This study, which is a longitudinal extension of previous cross-sectional studies in Chinese and American college students and general adults (Dixit, He, Whited, Ellis, & Zickgraf, 2023; He, Chen, Wu, Niu, & Fan, 2020; Xu et al., 2024), used latent profile and latent transition analyses to investigate negative emotional eating patterns and the stability of these patterns in 1462 Chinese adolescents (41% boys, aged 11-17 years) at baseline and 18 months later. We also explored baseline demographic predictors of negative emotional eating patterns and the associations between these patterns and outcome variables measured 18 months later. Negative emotional eating was measured with the Adult Eating Behavior Questionnaire (emotional undereating and emotional overeating subscales). Latent profile analysis (LPA) replicated the four patterns of negative emotional eating in each wave of assessment: low emotional eating (Low-EE), emotional overeating (EOE), emotional undereating (EUE), and emotional over- and under-eating (EOE-EUE). Latent transition analysis (LTA) showed that the EE patterns had transition probabilities of <55% remaining in the same class across 18 months. Furthermore, relative to adolescents in the stable Low-EE group, adolescents in all other stable or unstable emotional eating groups in LTA were linked to higher eating disorder psychopathology and psychological distress measured 18 months later. Thus, emotional eating, regardless of type (i.e., EOE, EUE, and EOE-EUE) and stability (i.e., stable or unstable), may be a viable research and treatment target in improving adolescents' eating behaviors and mental health.

Restrained Eating and Disinhibited Eating: Association with Diet Quality and Body Weight Status Among Adolescents

Background/Objectives: Problematic eating behaviours may affect food consumption and, therefore, body weight. However, these associations have not been well understood, especially among adolescents. The aim of the study was to evaluate the associations of restrained eating and disinhibited eating with diet quality and body weight status among adolescents. Methods: A cross-sectional study was conducted among 1450 primary school students aged 11-13 years (52% girls). Dietary data were collected using the food frequency questionnaire (SF-FFQ4PolishChildren®). Two diet quality scores were evaluated: (i) the pro-Healthy Diet Index (pHDI), which included vegetables, fruit, dairy products, and fish, and (ii) the non-Healthy Diet Index (nHDI), which included fast food, sweets, sweetened beverages, and energy drinks. Based on the Three-Factor Eating Questionnaire, two eating styles were identified: restrained eating (RE) and disinhibited eating (DE). Body weight status was evaluated using the body mass index (BMI) z-score and the waist-to-height ratio (WHtR). Spearman's correlation coefficient and logistic regression analysis were used to assess the association between eating styles, diet quality, and body weight status. Results: Restrained eating was negatively correlated with nHDI (r = -0.178, p < 0.001) and positively correlated with the BMI z-score (r = 0.253, p < 0.001) and WHtR (r = 0.197, p < 0.001). Disinhibited eating was positively correlated with nHDI (r = 0.232, p < 0.001). Among adolescents with different RE and DE levels, significant differences in the mean nHDI, BMI z-score, and WHtR were found. Compared to adolescents with 'low RE & DE', those with 'low RE & higher DE' were more likely to fall in the upper than bottom tertile of nHDI (odds ratio (OR) =1.90, 95% CI: 1.29-2.81). Adolescents with 'higher RE & low DE' were less likely to be underweight (OR = 0.17, 95% CI: 0.06-0.49) and more likely to be overweight (OR = 2.02, 95% CI: 1.41-2.91) and to have abdominal obesity (OR = 1.79, 95% CI: 1.13-2.82). Conclusions: The findings suggest that both eating styles may be predictors of diet quality among adolescents. Body weight status was related to restrained eating, which seems to characterise mainly adolescents with overweight or obesity.

Sleep quality and emotional eating in college students: a moderated mediation model of depression and physical activity levels

BACKGROUND

Emotional eating is a prevalent maladaptive coping mechanism among college students, which is associated with mental health and sleep concerns. Though previous studies have established a link between sleep quality, depression and emotional eating, most of these have been in Western populations. In addition, few existing studies have taken physical activities into account, and the underlying mechanisms between these four variables remain to be further studied. Therefore, our study investigated the mediating role of depression and the moderating role of physical activity levels in the relationship between sleep quality and emotional eating among Chinese college students. Our study can help to understand the characteristics of this population and provide guidance on the intervention pathways for emotional eating.

METHODS

A convenience sampling method was employed to select eligible participants for investigation. The General Information Questionnaire, the Pittsburgh Sleep Quality Index Scale, the Patient Health Questionnaire, the Dutch Eating Behavior Scale, and the International Physical Activity Questionnaire were employed to measure the general condition, sleep quality, depression, emotional eating, and physical activity. A total of 813 college students (Mage = 19.14, SD = 1.12, range = 17 ~ 25 years old, 71.1% females) completed the survey. The moderated mediation analysis was carried out using the SPSS PROCESS macro.

RESULTS

After controlling for sex, age, and body mass index (BMI), sleep quality positively predicted emotional eating. Depression primarily mediated the association between them. Besides, physical activity levels moderated the relationship between sleep quality and emotional eating via depression. Depression significantly predicted emotional eating among students with low levels of physical activity; however, it was not significant among students with moderate or high levels of physical activity.

CONCLUSIONS

The role of depression mediates the link between sleep quality and emotional eating. Regular exercise can ease the symptoms of emotional eating through depression. This implies the importance of offering more sleep hygiene education and physical activity in university settings.

Enhancing nutritional knowledge and self-regulation among adolescents: efficacy of a multifaceted food literacy intervention

This health literacy intervention study, conducted on adolescent students, aimed to evaluate the impact of a comprehensive educational program on promoting healthy eating habits. The intervention sought to enhance adolescents' knowledge about nutrition, foster self-regulation skills, and ultimately improve their overall health, including their body mass index (BMI). Through a multi-component approach that combined theoretical learning with practical activities and the integration of digital tools such as the MyFitnessPal app, the study targeted improvements in food literacy, which encompasses nutrition knowledge, food label interpretation skills, and cooking abilities. These elements are critical in influencing adolescents' food choices and eating behaviors, with a focus on increasing the consumption of fruits and vegetables while reducing the intake of fast food and processed snacks. The intervention was structured around a series of educational workshops and interactive sessions, facilitated by professionals experienced in nutrition. These sessions covered topics such as food composition, the importance of a balanced diet, and strategies for avoiding excessive consumption of processed and high-energy-density foods. A distinctive feature of the program was its use of digital tools to enhance engagement and allow for the practical application of learned concepts through food tracking and activity monitoring. Preliminary results indicate positive outcomes in terms of increased food knowledge and improved dietary habits among participants. Notably, there was a significant improvement in adolescents' BMI, highlighting the potential of food literacy interventions to contribute to better physical health outcomes. The study underscores the importance of adopting multidisciplinary and technology-enhanced approaches in educational programs aimed at promoting healthy eating among adolescents. The study's findings suggest that well-structured food education programs, tailored to address the specific needs of adolescents, can facilitate positive changes in eating behavior. This highlights the critical role of food literacy in adolescents' health and wellbeing and points to the need for continued investment in research and development to optimize intervention strategies. The integration of digital technologies and a focus on self-regulation strategies are identified as promising avenues for future research and educational practice, reinforcing the call for innovative investments in food education and health promotion among the youth.

Body Appreciation is Associated with Emotional Eating in Turkish Female Athletes

It is known that female athletes are at risk for eating disorders. It is thought that factors such as pressure and stress experienced by professional athletes may affect emotional eating and body appreciation. In this context, the aim of this study was to evaluate the emotional eating and body appreciation of professional Turkish female athletes. A total of 265 professional female athletes were categorized according to their sport types and nationality. Emotional eating was found to be higher and body appreciation to be lower in athletes competing at the national level. The results of the hierarchical regression analysis, which included variables such as age, body mass index, professional sports background, national level, and sport type show that the most effective factor in explaining emotional eating in professional female athletes is body appreciation. The present study findings support that professional female athletes are at risk in terms of emotional eating and body appreciation. In addition, emotional eating scores were found to be higher and body appreciation scores were lower in national athletes. Psychological factors such as intense stress and pressure have an impact on the eating behavior and body appreciation of national athletes. These results suggest that athletes should be evaluated by nutritionists, doctors, and psychologists from a multidisciplinary perspective.

Depression and emotional eating in children and adolescents: A systematic review and meta-analysis

Major Depressive Disorder in youth is associated with obesity and adult cardiovascular disease (CVD) risk. Eating in response to emotions (emotional eating) is a potential contributing factor to this association. Although emotional eating is associated with Major Depressive Disorder in adults, findings in children and adolescents are mixed. This systematic review and meta-analysis aims to determine the association between depression and emotional eating in children and adolescents. Systematic searches were conducted in seven databases. Studies were included if the study population had a mean age of ≤18 years and assessed both depression and emotional eating using validated measures. The search generated 12,241 unique studies, of which 37 met inclusion criteria. Random-effects meta-analyses of study outcomes were performed. Thirty-seven studies (26,026 participants; mean age = 12.4 years, SD = 3.1) were included. The mean effect size was significant for both cross-sectional and longitudinal data (Hedges' g = 0.48, p < 0.0001; g = 0.37, p = 0.002, respectively), revealing a positive moderately strong association between depressive symptoms and emotional eating in youth. Among longitudinal studies, the association was stronger when depressive symptoms and emotional eating were assessed using child and adolescent self-report versus parent-report. No studies examined youth with a clinical diagnosis of depression. Meta-analyses revealed that depressive symptoms and emotional eating are positively associated in children and adolescents. However, further research in clinical samples is needed. Results raise the possibility for the importance of emotional eating in the link between depression and early CVD risk, though further examination is required to determine whether emotional eating is a potential treatment target to decrease CVD risk among adolescents with increased depression symptoms.

The impact of emotion regulation strategies on disordered eating behavior in children and adolescents with type 1 diabetes: a cross-sectional study

Objective

Difficulties in emotion regulation (DERs) can contribute to disordered eating behavior in children and adolescents with type 1 diabetes (T1D), although it is unknown how DERs may affect eating behavior in these children and adolescents. This study examined the relationship between disordered eating behaviors and emotion regulation in children and adolescents with T1D.

Methods

For this cross-sectional study, 128 patients (aged 8-16 years) were recruited to complete the Diabetes Eating Problem Survey-Revised (DEPS-R) and Difficulties in Emotion Regulation Scale (DERs).

Results

The mean age of the 128 patients (99 females) who completed the DEPS-R was 11.63 ± 2.27 years. The participants' mean DEPS-R score was 17.78 ± 8.56 points. Of the total sample, 61 participants' scores surpassed the established threshold, resulting in a DEPS-R positivity rate of 47.66%. The participants' mean total DERS score was 72.3 ± 21.15 points, and it was found that children and adolescents with T1D who had a positive DEPS-R screening result had significant differences in emotional regulation and that eating behavior disorders were positively correlated with emotional regulation and all dimensions scores.

Conclusions

The prevalence of disordered eating behavior is high among children and adolescents with T1D. DERs are related to disordered eating behavior in children and adolescents with T1D. The novel finding that DERs may be a predictor of eating problems lends preliminary support for the inclusion of DERs in future risk models and as a potential target for intervention.

The influence of physical activity, adherence to Mediterranean diet, and weight status on the psychological well-being of adolescents

The mental health of adolescents is a determining factor for their adequate development, but is influenced by factors such as physical activity, nutrition, gender, and weight status. However, previous research has not analysed differences in psychological status, mainly in basic psychological needs and life satisfaction, among male and female adolescents with different levels of physical activity, weight status and adherence to the Mediterranean diet (AMD). For this reason, the objectives of the present investigation were to establish whether the differences between active and inactive adolescents in basic psychological needs and life satisfaction depend on gender; and to determine the differences in basic psychological needs and life satisfaction of active and inactive adolescents with different weight status and AMD. A total of 791 adolescents aged between twelve and sixteen years old participated in the study. All the participants were measured for basic psychological needs, life satisfaction, and level of physical activity, AMD, and height and body mass. The results showed a higher score in basic psychological needs and life satisfaction for active adolescents in both the males' and females' groups. No differences were found in the psychological variables when comparing adolescents with different weight status. Adolescents with a higher AMD showed higher scores in satisfaction of basic psychological needs and satisfaction with life than adolescents with a worse AMD. Therefore, it can be concluded that the level of physical activity and AMD are factors to be considered for the mental health of adolescents, but the relevance of weight status will have to be confirmed in future research.

Adolescent Health and Dark Personalities: The Role of Socioeconomic Status, Sports, and Cyber Experiences

By investigating the impact of dark personality traits on adolescent health, this study explores the interplay among economic disadvantage, spectator sports involvement, and cyber victimization. We analyzed data from 1844 students aged 13-17 in a school district in the USA, and our findings reveal positive associations between economic disadvantage and both Machiavellianism and psychopathy, influencing negative emotions-driven eating. Spectator sports engagement exhibits links with Machiavellianism and narcissism, suggesting potential drawbacks to competitive behaviors. Cyber victimization shows associations with psychopathy and negative emotions-driven eating. The results illuminate the dynamic associations between emotional eating and health outcomes, including BMI and perceived quality of life. These findings deepen our understanding of how dark personality is shaped and subsequently influences adolescents' well-being, offering insights for targeted interventions.

The effect of middle and high school students' emotional eating behavior on obesity

AIM

This study was conducted to determine the effect of middle and high school students' emotional eating behavior on obesity.

METHOD

A descriptive, correlational, and cross-sectional study design was used. The sample consisted of 267 students studying in 5th, 6th, 7th, 8th, 9th, 10th, 11th, and 12th grades. Data were collected using a Child Information Form and the Emotional Eating Scale. The researchers measured the students' height and weight and calculated their body mass indices (BMI), and BMI percentiles were evaluated according to age and gender. Percentage calculations, mean scores, Spearman correlation analysis, Pearson's correlation analysis, and multiple regression analysis were used in the analysis of the data.

RESULTS

Of the students participating in the study, 54.7% were girl and 45.3% were boy. It was determined that 28.4% of the students were overweight and obese. As a result of multiple regression analysis, it was determined that students' emotional eating behavior explained 25% of obesity (p < 0.001). It was found that anxiety-anger- frustration, one of the subscales of the emotional eating scale, was the only variable that significantly predicted students' obesity status (β = 0.387). Emotional eating significantly predicted the obesity status of boy and girl students (p < 0.001).

CONCLUSION

In this study, it was concluded that students' emotional eating behavior affected obesity.

IMPLICATIONS FOR PRACTICE

In line with these results, it is recommended that studies on other variables that may predict the effect of students' emotional eating behavior on obesity should be conducted and that nurses should contact schools to conduct emotional eating behavior screenings and provide emotional eating education for students who exhibit emotional eating behavior.

Body image, eating distress and emotional-behavioral difficulties among adolescents in Mbarara, Southwestern Uganda

BACKGROUND

Adolescents frequently have emotional and behavioral difficulties as they struggle with the challenges of transition from childhood to adulthood. Many struggle with issues of body image and eating distress as they deal with the difficult and frequently perplexing changes that occur with puberty. Yet there is surprisingly little research on the emotional and behavioral challenges, as well as body image and eating distress among this sizable population in Uganda. This study sought to assess attitudes and behaviors related to body image and eating distress, as well as emotional and behavioral difficulties among adolescents in Mbarara, Southwestern Uganda.

METHODS

This was a cross-sectional study among 788 adolescents aged 13 to 19 years in secondary schools in Mbarara city and Mbarara district in south-western Uganda. The study employed the Body Image and Eating Distress scale to assess attitudes and behaviors about dieting and body shape and the extended version of the Strengths and Difficulties Questionnaire (SDQ) to assess for perceived emotional and behavioral difficulties. Logistic regression was used to identify the association between body image and eating distress and perceived difficulties.

RESULTS

The prevalence of high body image and eating distress was 10.8% while that of perceived emotional and behavioral difficulties was 45.8%. Some of the adolescents (16.1%) were dissatisfied with their body shape, 24.6% exercised a lot to avoid gaining weight, 15.0% were terrified to gain even a little weight, and 12.1% could not control their eating. More males reported eating large amounts of food at one time (p =  < 0.001). Having emotional and behavioral difficulties (aOR: 1.89; 95% CI: 1.18 - 3.02; p = 0.019) and coming from a two-parent household (aOR: 1.79; 95% CI: 1.10 - 2.92; p = 0.019) increased the odds of high body image and eating distress.

CONCLUSION

High levels of body image and eating distress are linked to behavioral and emotional problems and adolescent's family structure. Clinicians who treat adolescents should use a holistic care strategy and be aware of the high prevalence and close association between emotional and behavioral difficulties, concerns about weight, and dieting. It is important to encourage parental involvement and support in providing information about mental health issues among adolescents.

Emotional symptoms, dietary patterns and dental caries: A cross-sectional study in adolescents

OBJECTIVES

This study investigates the relationship between emotional symptoms and dental caries in adolescents and the role of dietary patterns as mediating variables.

METHODS

This cross-sectional study used a multistage stratified random sample of schools, in Jiangsu, with a sample of 17,997 adolescents aged 11-19. Measures included emotional symptoms, dental caries, toothbrushing frequency, and dietary patterns. Logistic and Poisson regression models were conducted to test mediation hypotheses.

RESULTS

The decayed, missing, and filled teeth index (DMFT) was related to depressive symptoms following adjustment for other variables (incidence rate ratios [IRR] = 1.09; p < 0.05), but not to anxiety symptoms level (IRR = 1.02; p > 0.05). The link between depressive symptoms and DMFT had a partial mediation impact on toothbrushing frequency (a, b, c' all p < 0.05). Sugary foods, but not fried foods, partially mediated the link between depressive symptoms and caries when toothbrushing frequency was adjusted.

CONCLUSION

There are direct and indirect associations between emotional symptoms and caries; the latter may be due to changes in oral health behaviours that increase the risk of caries.

Emotional Eating among College Students in Israel: A Study during Times of War

Emotional eating, the act of consuming food to cope with negative emotions rather than responding to hunger cues, can lead to overeating in an attempt to regulate and alleviate these emotions. This study aimed to assess emotional eating among college students in Israel, specifically during times of war, which present unique and heightened stressors that accumulate on top. A total of 575 participants from the Ashkelon Academic College completed an online questionnaire examining background information, stress levels, and emotional eating symptoms. Our findings indicate that factors, such as being female, not having children, younger age, lower body satisfaction, higher BMI, and increased stress, are predictors of heightened emotional eating. These results highlight risk factors predisposing college students to engage in emotional eating. Developing targeted interventions, particularly campus-based programs to address emotional eating by promoting healthy coping strategies, a positive body image, and stress management skills is needed. In addition, raising awareness concerning emotional eating risks during challenging life transitions and distressing situations is necessary. The college leadership, led by the departments of Nutrition, Psychology, and Public Health, in collaboration with stakeholders in the Israeli Ministry of Health, must consider the mental effects of war on students and their involvement in emotional eating.

Associations Among Sleep, Emotional Eating, and Body Dissatisfaction in Adolescents

The literature on adolescent sleep has shown a bidirectional relationship between sleep difficulties and altered eating habits, including emotional eating. However, it is unclear if this relationship is related to preexisting body concerns, or if poor sleep is the prime contributor to emotional eating patterns. This study therefore seeks to examine body dissatisfaction as a moderator of the sleep-emotional eating relationship in an at-risk sample. Adolescents (N = 106) presenting for overnight polysomnography self-reported on time-in-bed, insomnia, body dissatisfaction, and emotional eating. Less time-in-bed was correlated with a greater desire for thinness and greater insomnia severity was related to overall emotional eating and eating in response to anxiety, anger, and frustration and in response to depression. Moderation analyses revealed that the relationships between time-in-bed and eating in response to feeling unsettled (b =  -.002, 95% CI[- .003,  - .001], p < .005) and eating in response to anxiety, anger, and frustration (b =  -.01, 95% CI[- .01,  - .001], p < .05) were exacerbated by worse body dissatisfaction. Optimizing sleep may attenuate the risk for disordered eating, particularly for adolescents with high body dissatisfaction.

Early Effects of Body Satisfaction on Emotional Eating: Tailored Treatment Impacts via Psychosocial Mediators in Women with Obesity

It was proposed that emotional eating is a critical factor to address early in a behavioral obesity treatment for women to improve their long-term weight-loss, which has been problematic. Poor body image/body satisfaction is a likely predictor of emotional eating. Possible social cognitive theory-based mediators of the body satisfaction-emotional eating relationship having treatment implications include disturbed mood and self-efficacy for controlled eating. Women with obesity volunteered for a community-based weight loss program. After confirming salience of disturbed mood and self-efficacy for controlling one's eating as mediators of the body satisfaction-emotional eating relationship at baseline, a 3-month protocol emphasizing exercise and targeting those mediators through a focus on self-regulation was developed and administered to the treatment group (n = 86). The control group (n = 51) received matched time in typical, educationally based weight-loss processes. Improvements in body satisfaction, emotional eating, disturbed mood, and self-efficacy for controlled eating from baseline-month 3 were each significantly greater in the treatment group. Further analysis of the treatment group found that changes in disturbed mood and self-efficacy completely mediated the body satisfaction change-emotional eating change relationship and neither age nor race (White/Black) were significant moderators. Improvement in emotional eating from baseline-month 3 significantly predicted lost weight over both 3 months and with changes incorporating a 6-month follow up. Findings confirmed the importance of addressing the relationship between body satisfaction and emotional eating over the critical initial months of a behavioral obesity treatment for women through targeting improvements in mood and controlled eating-related self-efficacy.

What causes obesity in children and adolescents?

OBJECTIVE

To present the different aspects that may be involved in the genesis and maintenance of obesity in children and adolescents.

DATA SOURCE

Narrative review of articles published in the PubMed, Scielo, Lilacs, Scopus and Google Scholar databases, using the search terms: overweight, obesity, pre-conception, prenatal, infants, schoolchildren, children, and adolescents. The search was conducted in studies written in Portuguese, English and Spanish, including narrative, integrative or systematic reviews, meta-analyses, cross-sectional, case-control and cohort studies, published between 2003 and 2023.

DATA SYNTHESIS

A total of 598 studies were initially screened and 60 of them, which showed the main biopsychosocial aspects related to greater risks of excessive adiposity in the pediatric age, were included in the review. The data were presented taking into account the incidence of risk factors and their consequences in six periods: pre-conception, pre-natal, infant, preschool, school age, and adolescence.

CONCLUSIONS

The causal factors described in the scientific literature that have been shown to be related to obesity in childhood and adolescence are presented.

Appetitive traits from childhood to adolescence: Analysis of their stability, derivation of trajectory profiles, and associated characteristics

This study aimed to assess the potential stability of appetitive traits from childhood to early adolescence, identify groups of individuals with distinct trajectories for these traits, and explore their association with other child and family characteristics. Participants were 5040 children from the Generation XXI cohort. Appetitive traits were assessed with the Children's Eating Behaviour Questionnaire (CEBQ) at ages seven, 10, and 13 (eight subscales). Mixed-effect models estimated individual trajectories of appetitive traits and Gaussian mixture models identified groups following different trajectories (appetitive trait trajectory profiles). Appetitive traits showed moderate-to-high stability across the three ages (intra-class correlation coefficients:0.66-0.83); most of the variance observed across time were due to persistent individual differences rather than age-related changes. Six appetitive trait trajectory profiles were identified: 'Moderate appetite' (scores close to the average) (29% of children), 'Small to moderate appetite' (lowest food approach and emotional eating) (26%), 'Increasing appetite' (increasing food approach) (15%), 'Avid appetite' (highest food approach and lowest food avoidance) (12%), 'Smallest appetite' (highest food avoidance and low food approach) (10%), and 'Small appetite but increasing' (decreasing high food avoidance and Desire to Drink) (8%). In multinomial logistic regression, these profiles were associated with different child and family characteristics. Compared to children with a 'Moderate appetite' profile, those with higher BMI, who desired a thinner body, whose mothers were younger, had lower education, higher pre-pregnancy BMI (OR = 1.07; 95%CI:1.04,1.09), smoked during pregnancy (OR = 1.51; 95%CI:1.21,1.90), and used more restrictive feeding practices (OR = 1.79; 95%CI:1.57,2.03) had increased odds of belonging to the 'Avid Appetite'. In conclusion, distinct appetitive trait trajectory profiles emerged, differentiating individuals with avid and small appetites. These findings have implications for identifying children at higher risk for obesogenic profiles.

Autistic traits, sensory sensitivity and eating disturbances in a sample of young adults referring to a generalized mental health clinic

PURPOSE

The relationship between autistic traits and eating disturbances has been given considerable attention over the last decades. The rise of a dimensional approach to psychopathology has expanded the way we think about autism, acknowledging that subthreshold autistic manifestations span across the general population and are more pronounced in psychiatric patients. Here we investigated the prevalence of eating disorders and its potential relationship with autistic traits and sensory sensitivity in a group of patients who were referred for the first time to a mental health outpatient clinic, without a formal diagnosis yet.

METHODS

259 young adults (between 18 and 24 years old) completed: the Eating Attitude Test (EAT-26), the Swedish Eating Assessment for Autism Spectrum Disorders (SWEAA), the Autism Quotient (AQ), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), and the Sensory Perception Quotient-Short Form 35 item (SPQ-SF35).

RESULTS

23.55% of participants scored above the cut-off at the EAT-26, suggesting that they presented a risk for eating disorders and should be assessed by a specialized clinician; associations emerged between hypersensitivity in the touch and vision domain and both the EAT-26 and the SWEAA; the presence of autistic traits was largely associated with eating disturbances.

CONCLUSIONS

This study underlines the significance of the eating domain as a central psychopathological feature in the distress experienced by young adults with general psychiatric symptoms and psychological suffering; it adds evidence to the association between autistic traits and eating disorders and opens to new research questions about the role of subthreshold autistic traits in general psychopathology.

LEVEL OF EVIDENCE

Level I: Evidence obtained from experimental studies.

Unveiling the links between physical activity, self-identity, social anxiety, and emotional eating among overweight and obese young adults

Introduction

Emotional eating not only contributes to physical obesity but also leads to the experience of guilt and shame, exacerbating emotional problems. Increasing physical activity, adopting a balanced diet, and seeking psychological support help improve emotional eating issues in overweight or obese young adults, enhancing overall mental and physical well-being.

Methods

This study investigates the correlation between physical activity, self-identity, social anxiety, and emotional eating among 373 overweight and obese college students aged 18-26 in central China. By utilizing AMOS v.26, a structural equation model was constructed to examine the hypotheses.

Results

The findings reveal that physical activity significantly influences self-identity and social anxiety, which, in turn, significantly impact emotional eating. Moreover, self-identity and social anxiety serve as mediators in the relationship between physical activity and emotional eating. These results emphasize the role of physical activity in mitigating emotional eating among young individuals struggling with overweight and obesity.

Discussion

Consequently, the government and relevant agencies are urged to address the issue of obesity among young adults and provide support for their engagement in physical activity.

Body dissatisfaction and low self-esteem in elementary school-aged children: the role of media pressure and trust in parent-child relationships

Studies have indicated that the media plays a role in the development of body dissatisfaction in children. Nevertheless, there is limited understanding of the protective factors that may reduce this association, such as the parent-child relationship. Therefore, this study investigates children's body dissatisfaction and self-esteem and the role of media pressure and a trust in parent-child relationships herein. A sample of n = 246 participants (59.8% girls, aged 8-10) was recruited. Children completed self-report questionnaires that assessed body dissatisfaction, self-esteem, media pressure, and trust in parent-child relationships. Results revealed that higher scores on media pressure were linked to increased body dissatisfaction and decreased self-esteem. On the other hand, higher scores on trust in mother and father were associated with lower levels of body dissatisfaction and higher levels of self-esteem. However, the presence of trust in parent-child relationships did not attenuate the impact of media pressure on body dissatisfaction or self-esteem. Further investigation is necessary to gain a deeper understanding of how sociocultural and interpersonal factors interact and contribute to the development of body image problems. While current prevention and intervention programs predominantly focus on the individual, it may be beneficial to place greater emphasis on the family environment.

Association between Body-Image Satisfaction and Anxiety, Depressive Symptoms among Women with PCOS: The Mediating Role of Emotion Regulation Strategies

Anxiety and depressive symptoms are prevalent in women with polycystic ovary syndrome (PCOS), and there is a great need for culturally relevant interventions to improve anxiety and depressive symptoms in women with PCOS. The current study aimed to analyze the factors influencing body-image satisfaction, anxiety, and depressive symptoms in Chinese women with PCOS. It also aimed to clarify the association between body-image satisfaction and anxiety and depressive symptoms in women with PCOS, and whether this association was mediated by cognitive reappraisal and expressive suppression. A total of 477 women with PCOS were recruited from the Department of Gynecology and Reproductive Medicine Center of one university-affiliated tertiary hospital in China. They completed the Generalized Anxiety Disorder-7 scale, the Patient Health Questionnaire-9, the Body Image States Scale, and the Emotion Regulation Questionnaire. The study found body-image satisfaction showed significant associations with anxiety and depressive symptoms. This association was mediated by cognitive reappraisal and expressive suppression. The findings of this study offer new insights into the relationship between body image and anxiety and depressive symptoms in women with PCOS. They also emphasize the potential value of promoting body-image satisfaction and enhancing cognitive reappraisal abilities to improve the mental health of women with PCOS.

Digital media exposure and cognitive functioning in European children and adolescents of the I.Family study

The digital environment can pose health risks through exposure to unhealthy content. Yet, little is known about its relation to children's cognitive functioning. This study investigates the association between digital media (DM) exposure and children's cognitive functioning. This cross-sectional study is based on examinations of children aged 8-18 years (N = 8673) of the I.Family cohort (2013-2014). Exposure to television, computer, smartphone and internet was self-reported (hours/day). Media multitasking (MMT) was defined as simultaneous use of computers with other digital or non-screen-based activities. Standard instruments were used to assess cognitive inflexibility (score: 0-39), decision-making ability (- 100 to + 100) and impulsivity (12-48). Adjusted regression coefficients and 99.9%CIs were calculated by generalized linear mixed-effects models. In total, 3261 participants provided data for impulsivity, 3441 for cognitive inflexibility and 4046 for decision-making. Exposure to smartphones and media multitasking were positively associated with impulsivity (βsmartphone = 0.74; 99.9%CI = 0.42-1.07; βMMT = 0.73; 99.9%CI = 0.35-1.12) and cognitive inflexibility (βsmartphone = 0.32; 99.9%CI = -0.02-0.66; βMMT = 0.39; 99.9%CI = 0.01-0.77) while being inversely associated with decision-making ability. Extensive smartphone/internet exposure combined with low computer/medium TV exposure was associated with higher impulsivity and cognitive inflexibility scores, especially in girls. DM exposure is adversely associated with cognitive functioning in children and adolescents. Children require protection against the likely adverse impact of digital environment.

Investigation of the relationships between mindfulness, emotional eating, weight control self-efficacy, and obesity in adolescents

PURPOSE

This research was conducted to examine the relationships between mindfulness, emotional eating, weight control self-efficacy, and obesity in adolescents.

DESIGN AND METHODS

The research was conducted with 198 adolescents aged 13-18 years in three high schools in the central county of a province in Türkiye. Data were collected using a sociodemographic information form, the Mindful Attention Awareness Scale-Adolescents, the Emotional Eating Scale for Children and Adolescents, and the Weight-Efficacy Lifestyle Questionnaire for Adolescents-Short Form. In this study, adolescents' height and weight were measured to determine the effects of the study variables on their body mass indexes (BMIs).

RESULTS

The variables were analyzed according to BMI. The mean age of the adolescents participating in the research was 15.25 ± 1.01 years; 52% were female, and 85% were ninth-grade high school students. Their mean height was 170.33 ± 8.59 cm, and their mean weight was 62.24 ± 12.84 kg. The adolescents' BMI was found to have a low-level, significant negative correlation with their mindfulness, a low-level, significant positive correlation with their emotional eating, and a low-level significant negative correlation with their weight control self-efficacy. Adolescents' mindfulness, emotional eating, and weight control self-efficacy scores significantly predicted their BMI and explained 14.1% of the variance in their BMI levels.

CONCLUSIONS

Mindfulness, emotional eating, and weight control self-efficacy in adolescents have a facilitating effect on the management of obesity.

IMPLICATIONS TO PRACTICE

Multidimensional programs should be developed that take into account the interaction of parents, children, and the environment, which will pave the way for the development of healthy nutrition behaviors and contribute to the prevention of obesity.

Are adolescent diet quality and emotional eating predicted by history of maternal caregiving quality and concurrent inhibitory control?

The risk for unhealthy eating behaviour, including poor diet quality and emotional eating, is heightened in adolescence and could result in profound and long-lasting psychological and physical implications. Caregiving quality and adolescents' regulatory skills, such as inhibitory control, may play an essential role in the development of adolescent eating behaviour. This preregistered study investigated whether maternal caregiving throughout the first 14 years of life predicts adolescent diet quality and emotional eating and whether potential associations are mediated by adolescents' inhibitory control. In this low-risk community cohort, maternal caregiving quality was observed at child ages five weeks, 12 months, 2.5, 10, and 14 years. At age 14, diet quality and emotional eating were assessed through self-report. Adolescent inhibitory control was assessed with three behavioural tasks and a maternal report. Mediation analyses were performed with structural equation modelling in R. No evidence was found for links between maternal caregiving quality and adolescent diet quality and emotional eating. Higher levels of adolescent inhibitory control predicted better adolescent diet quality. Longitudinal and experimental studies are needed to investigate directionality, and replication studies are needed in more representative samples (e.g. including high-risk families). Such studies will shed further light on potential links between the history of caregiving behaviour and adolescent regulatory and eating behaviour.

Social Networking Site Use and Emotional Eating Behaviors among Chinese Adolescents: The Effects of Negative Social Comparisons and Perspective-Taking

Emotional eating has emerged as a significant disordered eating and public health concern among adolescents. Despite the widespread prevalence of social networking site (SNS) use among this population, research investigating the influence of SNS use on adolescent eating behaviors remains limited. This study is to examine the impact of SNS use on emotional eating among Chinese adolescents, with a specific focus on exploring the mediating role of negative social comparisons and the moderating effect of perspective-taking. Data were obtained through an online survey involving 778 middle school students in China. The findings indicate that SNS use exerts a positive influence on adolescents' engagement in emotional eating, with this association being mediated by the presence of negative social comparisons. Perspective-taking demonstrated a protective role in the context of adolescents' utilization of social media platforms. For individuals characterized by high levels of perspective-taking, the effects of SNS use on negative social comparisons are mitigated, subsequently reducing its impact on emotional eating.

Emotional regulation and body dissatisfaction: the mediating role of anger in young adult women

Introduction

Emotion regulation difficulties have an important role in the presence of negative self-image. These problems in the self-regulation of emotion could lead to negative emotional processes (such as anger) that can lead to body dissatisfaction. Therefore, the aim of the present study was to examine emotion regulation difficulties than can negatively impact self-image and to understand if anger acts as mediator in the relationship between emotion regulation and body dissatisfaction.

Methods

A cross-sectional study was carried out comprising 565 young adult women aged 18-30 years. The participants were administered the Difficulties in Emotion Regulation Scale (DERS), the State-Trait Anger Expression Inventory 2 (STAXI-2), and the Body Dissatisfaction dimension of the Eating Disorder Inventory-2 (EDI-2). The proposed hypotheses were tested by path analysis in MPlus 8.0.

Results

The results indicated that anger had a positive significant effect on body dissatisfaction as well as the non-acceptance of emotional responses, the lack of emotional awareness, and the lack of emotional clarity. Of all the dimensions of emotional regulation difficulties, impulse control difficulty was the dimension which had a positive significant indirect effect on body dissatisfaction explained by increased anger.

Discussion

The present study suggests the importance of emotion regulation in the prevention of body dissatisfaction. Impulse control difficulty may be the key emotion regulation emotion in explaining the increments of anger that lead to body dissatisfaction. Among young adults, the promotion of positive body image can be promoted by helping this population to self-regulate their anger impulses.

Negative family body talk and negative emotional eating among Chinese adolescent girls and young adult women: The role of body dissatisfaction and feminism consciousness

Negative emotional eating has been increasingly a prominent disordered eating and public health problem among young women, especially during COVID-19. Although previous studies have attempted to explain the relationship between body talk and negative emotional eating, limited studies focused on examining the potential mechanisms, especially the potential protective mechanism. Thus, the current study aimed to examine the relationship between negative family body talk (NFBT) and negative emotional eating, as well as its underlying mechanism - the mediating role of body dissatisfaction (BDIS) and the moderating role of feminism consciousness (FC). A cross-sectional study was employed among a sample of Chinese girls and young women (n = 813, M_age = 19.4 years) from a junior college in central China. Participants completed surveys assessing NFBT (Adapted Body Talk Scale), BDIS (Body Image State Scale), negative emotional eating (Dutch Eating Behavior Questionnaire), and FC (Synthesis Subscale from Feminist Identity Composite). A moderated mediation analysis was conducted. The results showed that: (1) after controlling for age and BMI, NFBT was positively associated with negative emotional eating, and BDIS could significantly mediate this relationship (mediating effect = 0.03, 95% CI [0.02, 0.06]); (2) FC significantly moderated both the direct relationship between NFBT and negative emotional eating and the relationship between NFBT and BDIS. Specifically, these two associations were not significant for participants with higher FC (+1SD above average). This study deepens our understanding of the relationship between NFBT and negative emotional eating, as well as the protective role of FC. If future studies demonstrate causal relationships, this evidence could point to a need for programs to prevent negative emotional eating in young women by increasing their level of feminism consciousness.

The effect of emotion regulation on emotional eating among undergraduate students in China: The chain mediating role of impulsivity and depressive symptoms

This study aimed to examine the relationship between difficulties in emotion regulation and emotional eating and the role of impulsivity and depressive symptoms in mediating this chain. Four hundred ninety-four undergraduate students participated in the study. A self-designed questionnaire was used in the survey from February 6 to 13, 2022, to finish our purpose, including the Emotional Eating Scale (EES-R), Depression Scale (CES-D), Short Version of the Impulsivity Behavior Scale (UPPS-P) and Difficulties in Emotion Regulation Scale (DERS). The results showed that 1) difficulties in emotion regulation, impulsivity, depressive symptoms, and emotional eating were correlated; 2) impulsivity and depressive symptoms separately mediated the relationship between difficulties in emotion regulation and emotional eating; 3) impulsivity and depressive symptoms played a chain mediating role between difficulties in emotion regulation and emotional eating. The current study provided a better understanding of the psychologically related pathway of emotional eating. The results would be helpful for prevention and intervention of emotional eating among undergraduate students.

A Sociodemographic Analysis of the Impact of COVID-19-Related Schools' Closure on the Diet and Physical Activity of Children and Adolescents in Qatar

OBJECTIVES

To assess the impact of the COVID-19-related closure of government schools in Qatar on children and adolescents' dietary habits and physical activities and associated sociodemographic factors.

METHODS

An analytical cross-sectional study was conducted between June and August 2022 utilizing the national electronic health records system in Qatar to extract a sampling frame of students enrolled in governmental schools, specifically targeting students in 3rd to 9th grades, stratified by sex and developmental stage. A stratified sampling technique was employed to randomly select a proportionate number of students from each stratum, and data were collected through telephone interviews with the parents of selected students.

RESULTS

A total of 1546 interviews were completed by the end of the study. Of the included sample, 845 (54.7%) were between 8 and 11 years of age (middle childhood), while the rest were 12-15 years old (young teens and teenagers). Male to female ratio was almost 1:1. We found a significant decrease in the intake of vegetables, increases in the intake of soft drinks, fried food, fast food, and sweets, and a reduction in physical activity during schools' closure compared to before. Higher parental educational levels, maternal employment, and having a positive family history of obesity and/or overweight in first-degree relatives were significantly associated with adverse lifestyle changes during schools' closure.

CONCLUSION

The trends of lifestyle changes reported in this study during the periods of COVID-19-related schools' closure were found to be going in a health-compromising direction. These results underscore the importance of implementing targeted interventions to promote healthy lifestyles during such disruptions and emphasize the need to address lifestyle changes beyond emergencies and outbreaks to mitigate potential long-term health consequences, including the increased risk of non-communicable diseases.

An integrative model as a step toward increasing the awareness of eating disorders in the general population

Eating disorders (EDs) represent a contradictory chapter of clinical psychiatry, i.e., although they are associated with significant prevalence and risks in the long term (including vital risk, especially for anorexia nervosa), the therapeutic resources are minimal and based on low-quality data. Another contradiction arose in the last few decades, i.e., a variety of new EDs have been described, either by clinicians or signaled by mass media, but their systematic exploration is progressing very slowly. Entities like "food addiction," "orthorexia nervosa," or "emotional eating disorder" still require intensive exploration in order to find the most accurate diagnostic instruments, diagnosis criteria, prevalence data, vulnerability factors, and therapeutic approaches. This article is focused on integrating into a comprehensive model a variety of EDs not specified or loosely defined by the current international classifications of psychiatric disorders. This framework is intended as an instrument for stimulating clinical and epidemiological research, with potential favorable consequences for therapeutic research. The dimensional model suggested here includes four main categories that accommodate the already recognized EDs (i.e., anorexia nervosa, bulimia nervosa, and binge eating disorder) as well as ten EDs that still need intensive research to find their clinical and pathophysiological characteristics. More good-quality studies are urgently required regarding this topic, based on the mental and physical negative impact these EDs may have in the short and long term, especially in vulnerable populations (e.g., pregnant women, athletes, adolescents, etc.).

Reliability and validity of the Chinese version of the Sakata Eating Behavior Scale short form and preliminary analysis of the factors related to the score of the scale

Background

The obesity rate in the Chinese population is increasing and there is a lack of short and reliable scales for measuring obesity-related eating behavior in China. The EBS-SF (Sakata Eating Behavior Scale short form) has only 7 entries and has shown good reliability in studies such as those in Japan.

Objective

To translate the EBS-SF into Chinese, check its reliability, validity and explore the related factors.

Method

The EBS-SF was translated into Chinese. 3,440 residents were investigated and 34 respondents were retested. Item analysis and reliability and validity tests were carried out. Personality characteristics, family health status and depression were investigated using the BFI-10, FHS-SF and PHQ-9 to investigate the factors associated with EBS-SF. The t-test, ANOVA and Pearson correlation was used to explore the related factors of its scores.

Result

Among 3,440 residents, 1,748 (50.81%) were male and 1,692 (49.19%) were female; 1,373 (39.91%) were aged 36–50 years. All 7 items were qualified in the item analysis. As for reliability, the Cronbach's α was 0.870, the split-half reliability was 0.830, the test-retest correlation coefficient was 0.868. As for the structural validity, the standardized factor loadings were above 0.50, χ2 / df = 2.081,GFI = 0.999; NFI = 0.999; RFI = 0.996; RMSEA = 0.018, all qualified. The characteristics, personality, family health and depression were correlated with the score of the Chinese version of EBS short form.

Conclusion

The structural validity and reliability of the Chinese version of the EBS-SF are good and it can be used as a measurement tool to evaluate the eating behavior of Chinese. The scores of the EBS-SF may be related to the sociological characteristics, personality, family health, and depression status.

Self-regulation linking the quality of early parent-child relationship to adolescents' obesity risk and food consumption

BACKGROUND

The quality of parent-child relationships has been examined as a contributor to children's healthy behaviours and weight outcomes, but the mechanisms accounting for associations remain understudied.

OBJECTIVE

This study examined whether the quality of early parent-child relationship is associated with adolescent obesity risk and whether self-regulation and (un)healthful food consumption mediate these associations.

METHODS

Employing structural equation modelling, two theory-driven models were examined using a large sample (N = 1237) drawn from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Indicators of the quality of parent-child relationship included assessments of child attachment security and observational assessments of maternal sensitivity (15, 24, and 36 months). Self-regulation at 54 months was assessed using behavioural and computerized tasks and, at ages 11-12 and 15 years, using parental ratings of self-control. Food consumption was self-reported at age 11-12. Height and weight measures in early/middle childhood and adolescence were used to compute BMI z-scores.

RESULTS

No direct associations between the quality of parent-child relationship and adolescent obesity risk were found in either model. Instead, child self-regulation was found to mediate the associations between the quality of parent-child relationship and both unhealthy food consumption and higher adolescent BMI status.

CONCLUSION

The findings highlight how the nature of parent-child relationships impacts developing regulatory processes in children which, in turn, have implications for obesity-related behaviours and outcomes. Interventions to reduce childhood obesity should consider self-regulation skills across multiple domains, and early parenting practices that foster these capacities.

Emotions and Food Consumption: Emotional Eating Behavior in a European Population

Emotion can reflect in the perception of food consumption. An increase in food intake during emotional and psychological conditions may have a negative impact on human health. The aim of this cross-sectional study was to determine the associations between food consumption, emotional eating behavior, and emotional conditions such as stress, depression, loneliness, boredom eating, maintaining vigilance and alertness, and emotional food consolation. We used a Motivations for Food Choices Questionnaire (Eating Motivations, EATMOT) to determine the emotional aspects of food consumption in 9052 respondents living in 12 European countries between October 2017 and March 2018. Ordinal linear regression was used to identify the associations between the emotional eating behavior and emotional conditions such as stress, depression, loneliness, emotional consolation, and reasons to improve physical and psychological conditions. The regression models confirmed the associations between food consumption, emotional conditions, and emotional eating behavior. Associations were found between the emotional eating behavior and stress (odds ratio (OR) = 1.30, 95% confidence interval (CI) = 1.07-1.60, p = 0.010), depressive mood (OR = 1.41, 95% CI = 1.40-1.43, p < 0.001), loneliness (OR = 1.60, 95% CI = 1.58-1.62, p < 0.001), boredom (OR = 1.37, 95% CI = 1.36-1.39, p < 0.001), and emotional consolation (OR = 1.55, 95% CI = 1.54-1.57, p < 0.001). Emotional eating was associated with an effort to improve physical and psychological conditions, such as controlling body weight (OR = 1.11, 95% CI = 1.10-1.12, p < 0.001), keeping awake and alert (OR = 1.19, 95% CI = 1.19-1.20, p < 0.001) and consumption to feel good (OR = 1.22, 95% CI = 1.21-1.22, p < 0.001). In conclusion, emotions might provoke emotional eating behavior. The appropriate way to handle stress, depression, or other emotional states is important in conditions of being emotionally overwhelmed. The public should be educated on how to handle different emotional states. The focus should be moved somehow from emotional eating and the consumption of unhealthy food to healthy lifestyle practices, including regular exercise and healthy eating habits. Thus, it is necessary to halt these negative health effects on human health through public health programs.

Psychometric and cross-cultural generalizability outcomes of the Chinese version of the Kids-Palatable Eating Motives Scale (K-PEMS-C)

Overeating for non-homeostatic needs contributes to childhood obesity. However, validated measures or eating motives and cross-cultural comparisons are limited. This study aimed to validate the Kids-Palatable Eating Motives Scale (K-PEMS) and its association with body mass index z score (BMIz) in China, and further assess its generalization across Chinese and American youth. Data were from participants aged 8–18 years from Hangzhou, China ( n = 426) and Birmingham, AL, U.S ( n = 73). The K-PEMS had sound reliability and validation (Cronbach’s α = 0.920 and all factor loadings >0.50) in the Chinese sample. Multi-group nested models CFAs showed that the ∆CFI of model comparisons of measurement weights and structural covariance, variance, and means were ⩽0.01, and ∆TLI of measurement intercepts ⩽0.05. Linear regressions revealed that frequency of consuming palatable foods and drinks for Coping, Reward Enhancement, and Conformity, but not Social motives, were positively associated with BMIz. The K-PEMS had good cross-cultural generalization and could be useful in treating obesity by identifying specific motives for consuming excessive calories.

Nutritional behavior during the COVID-19 pandemic: the association of fear and sleep quality with emotional eating

PURPOSE

Even though it is known that fear and poor sleep quality trigger emotional eating, whether fear and poor sleep quality are associated with emotional eating during the COVID-19 pandemic is not clear. This study aimed to evaluate the association of fear of COVID-19, sleep quality, and some sociodemographic characteristics with emotional eating during the COVID-19 pandemic.

METHOD

This cross-sectional descriptive study was completed with 495 participants in Turkey. The participants filled out a questionnaire that asked about sociodemographic characteristics, fear of COVID-19, nutritional behaviors, sleep quality, and self-reported weight and height through email or social media.

RESULTS

The fear of COVID-19 score (β: 0.090, p < 0.05) and sleep quality score (β: 0.289, p < 0.001) were associated with the emotional eating score at the rate of 0.8% and 8.3%, respectively. The association of fear of COVID-19 with emotional eating disappeared when combined with various factors. The collective association of all factors, fear of COVID-19 (β: 0.042, p > 0.05), sleep quality (β: 0.246, p < 0.001), BMI (β: 0.275, p < 0.001), age (β:  - 0.259, p < 0.001) and gender (β:  - 0.169, p < 0.001) were associated with the emotional eating score at the rate of 18.3%.

CONCLUSIONS

These findings suggest that fear of COVID-19, sleep quality, BMI, age, and gender were associated with emotional eating during the pandemic. We hope that this study will help in the development of guidelines and strategies through understanding the factors associated with nutritional behavior during the pandemic period.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Emotion Regulation Moderates the Associations of Food Parenting and Adolescent Emotional Eating

OBJECTIVE

To explore parental feeding practices and eating behavior as predictors of the child's emotional eating (EE) and child's emotion regulation (ER) as a potential moderator.

DESIGN

Parental eating behavior (emotional, external, and restrained eating), 9 parental feeding practices (restriction, food as reward, food as ER, monitoring, healthy modeling, healthy environment, child control, and child involvement), ER, and EE were analyzed cross-sectionally and 5 parental practices longitudinally (subsample, n = 115).

SETTING

Belgium.

PARTICIPANTS

Two hundred eighteen adolescents (aged 13.7 ± 1.77 years) and parent dyads.

MAIN OUTCOME MEASURES

Child's EE.

ANALYSIS

Linear regression and moderation (cross-sectional) and linear mixed models (longitudinal). Models adjusted for multiple testing with a false discovery rate of 10% (Benjamini-Hochberg), age, sex, body mass index, socioeconomic status, and cohort.

RESULTS

Cross-sectionally but not longitudinally, there was a positive association between predictors restriction and monitoring with the outcome child's EE (β = 0.19, P = 0.006; β = 0.17, P = 0.01, respectively). Restrained eating of the parent was negatively associated with the child's EE (β = -0.22, P = 0.003). The child's maladaptive ER significantly moderated the associations of 5 feeding practices and parental EE with the child's EE.

CONCLUSIONS AND IMPLICATIONS

Parents continue to play a role in the eating behavior of their adolescent offspring, not only through their feeding practices (restrictive parenting was most detrimental) but also by displaying restrained eating (beneficial). A child's ER appears as an important moderator of the established associations; however, more research is needed to better understand these observations.

Eating Behavior Associated with Food Intake in European Adolescents Participating in the HELENA Study

Adolescence is recognized as a time of rapid physiological and behavioral change. In this transition, eating behavior is still being formed and remains an integral part of a person’s lifestyle throughout his or her life. This study aims to assess eating behavior and associations with food intake in European adolescents. We included 2194 adolescents (45.9% boys), aged 12.5 to 17.5 years, from the cross-sectional HELENA study, with two completed 24 h recalls and complete questionnaire data on their eating behavior (Eating Behavior and Weight Problems Inventory for Children- EWI-C). Three subscales of the EWI were evaluated; they measured Strength and motivation to eat (EWI 1), Importance and impact of eating (EWI 2), and Eating as a means of coping with emotional stress (EWI 3). Since these subscales were specially focused on eating behavior, participants were classified as either Low (≤P75) or High (>P75) on each of the subscales. Our results showed a higher consumption of different types of food, in the EWI 1 scales, linked to the hunger and interest in eating, and we observed a relationship with the consumption of energy-dense products. This result was repeated in EWI 3, the subscale linked to emotional eating, where we also found higher consumption of energy-dense products. This study suggests that special features of eating behavior are associated with food intake in adolescents.

Associations between Abnormal Eating Styles and Irritable Bowel Syndrome: A Cross-Sectional Study among Medical School Students

(1) Background: Few studies have investigated the association between eating styles and IBS. This study aimed to explore the association between abnormal eating styles and irritable bowel syndrome (IBS). (2) Methods: This cross-sectional study investigated students in China Medical University and Shenyang Medical College. Eating styles were evaluated by the Dutch Eating Behavior Questionnaire (DEBQ), and IBS was diagnosed according to Rome III criteria. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). (3) Results: A total of 335 students were diagnosed with IBS. Students with the total scores in tertile 2 and 3 had 1.29 times and 2.75 times higher risk of IBS than students with the total scores in tertile 1, respectively. Simultaneously, the risk of IBS in the tertile 3 of external eating, emotional eating, and restraint eating trends was 3.87 times, 2.71 times, and 3.82 times higher than that of tertile 1, respectively. (4) Conclusions: this study showed that a high score in both total eating styles and each eating style was associated with the odds of having IBS and suggested that the psychological factors behind eating styles may play a critical role in controlling the IBS.

Body Mass and Emotional Eating: Emotional Eater Questionnaire (EEQ) in the Polish Adolescents' COVID-19 Experience (PLACE-19) Study

Stress caused by the Coronavirus Disease 2019 (COVID-19) pandemic may lead to emotional eating which may have a negative impact on the weight status. This study aimed to analyze the association between emotional eating and body mass, as well as changes in body mass during the COVID-19 pandemic, within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study. A total of 1126 Polish adolescents, aged 15–20, were included. A random quota sampling was performed within a national sample, and emotional eating was assessed using Emotional Eater Questionnaire (EEQ). Based on the declared height and weight before and during the pandemic, the respondents were categorized according to their body mass (malnourished, normal weight, overweight, obese) and changes in body mass during the COVID-19 pandemic (lost weight, no body mass change, gained weight). Higher EEQ scores were achieved by female respondents compared with males (p < 0.0001), respondents who stated that they gained weight during the pandemic compared with those who stated either weight loss or no body mass change (p < 0.0001), and overweight and obese respondents compared with those who had normal weight and who were malnourished (p < 0.0001). A higher share of emotional eaters and very emotional eaters was found among female respondents, respondents stating weight gain during the pandemic, and overweight and obese respondents, compared with the other ones (p < 0.0001). Based on the findings, it may be concluded that among Polish adolescents gender, body mass, and body mass change during the COVID-19 pandemic are the major determinants of emotional eating behaviors and that female individuals, obese individuals, and those gaining weight are especially vulnerable to emotional eating behaviors. The results of the study suggest that the issue of emotional eating should be addressed in general public health policy and appropriate education should be provided to vulnerable groups such as female and obese adolescents.

Relationship between Emotional Eating, Consumption of Hyperpalatable Energy-Dense Foods, and Indicators of Nutritional Status: A Systematic Review

People's health is closely linked to their diet. Diet can be defined as the set of foods that are consumed in a day, and it is susceptible to being altered by various factors, such as physiological, environmental, psychological, and social. These, in turn, can be affected by an inadequate diet and/or a dysregulation of emotions. Emotions are an immediate response by the organism informing it of the degree of favorability of a certain stimulus or situation. Moods are similar to emotions but more intense and prolonged. Some studies indicate that the consumption of hyperpalatable energy-dense foods may be related to emotional eating. Emotional eating is characterized by the excessive consumption of hyperpalatable energy-dense foods, rich in sugars and fats, in response to negative emotions. But several reports also indicate that emotional eating may be associated with the presence of positive emotions, so further analysis of the available information is necessary. Consuming higher amounts of hyperpalatable energy-dense foods can lead to the accumulation of energy in the body that results in an increase in body weight, as well as other associated diseases. Obesity is the world's leading diet-related health problem. The objective of this work was to carry out a systematic review of the available literature using the Cochrane methodology, in accordance with the PRISMA guidelines, to evaluate the relationship between emotional eating, the consumption of hyperpalatable energy-dense foods, and indicators of nutritional status. An exhaustive search in different databases yielded 9431 scientific articles, 45 of which met the inclusion criteria. This review underscores the fact that knowing and understanding the reasons why people consume hyperpalatable energy-dense foods and the possible connection with their emotional eating can provide key data for improving and personalizing patients' nutritional treatment. This in turn can encourage compliance with treatment plans to improve people's health and quality of life using an interdisciplinary approach.

Emotional eating behaviors during the COVID-19 pandemic: A cross-sectional study

Background & aims

The study aimed to evaluate emotional eating tendency of Turkish individuals during COVID-19 pandemic.

Methods

The study comprised an online questionnaire and it was conducted from August to September 2020. The survey was distributed through social networks.

Results

A total of 1626 adults have been included in the study, aged between 18 and 65 years (69.6% females and 30.4% males). The average BMI of all participants was 24.4 ± 4.7 kg/m², 6% were underweight, and 11.6% were obese. A total of 32.7% of the participants had an increase in appetite and 34.4% had a weight gain. It was found that most of the participants (75.7%) were emotional eaters at different levels. Emotional eating was more common in obese people (43.5%) than normal weight (33.5%) and underweight (18.4%) people. It was examined the increasing food intake according to the BMI, the obese increased the consumption of fresh vegetables, fruits, pastries, and, eggs; underweight increased the consumption of fresh vegetables and fruits, milk and, eggs. As in other countries, a weight gain was observed in the individuals. However, the participants resorted to emotional eating to cope with negative emotions such as depression, anxiety, and stress caused by the pandemic.

Conclusions

In this study, it has been provided preliminary data that can be used in future studies to determine the emotional eating behaviors during the COVID-19 pandemic.

Association between Emotional Eating and Frequency of Unhealthy Food Consumption among Taiwanese Adolescents

Emotional eating is one factor that increases the consumption of unhealthy food. This study aimed to investigate the association between emotional eating and frequencies of consuming fast food, high-fat snacks, processed meat products, dessert foods, and sugar-sweetened beverages (SSBs) in adolescents. The baseline survey data (2015) from the Taiwan Adolescent to Adult Longitudinal Study (TAALS) were fitted into multivariate logistic regression models adjusted for sex, school type, Body Mass Index (BMI), eating while doing something, nutrition label reading, skipping breakfast, smoking, binge drinking, sedentary lifestyle, physical activity, peer and school support, and parental education level. Among the 18,461 participants (48.5% male and 51.5% female), those exhibiting emotional eating were more likely to consume fast food (Odds ratio (OR) = 2.40, 95% Confidence interval (CI): 2.18-2.64), high-fat snacks (OR = 2.30, 95% CI: 2.12-2.49), processed meat products (OR = 1.92, 95% CI: 1.78-2.08), dessert foods (OR = 2.49, 95% CI: 2.31-2.69), and sugar-sweetened beverages (OR = 1.83, 95% CI: 1.70-1.98). Factors that were positively associated with unhealthy food consumption included eating while doing other activities, binge drinking, smoking, and sedentary lifestyle. Among all the covariates, nutrition label reading was the only factor that was inversely associated with frequent unhealthy food consumption. Sex and school type may moderate the effect of emotional eating on the frequent consumption of specific unhealthy food groups. In conclusion, adolescents with high emotional eating were more likely to report frequent consumption of unhealthy foods in Taiwan. Our findings showed that male participants appeared to consume fast foods, high-fat snacks, processed meat, and SSBs more often and dessert foods less often than females. Future longitudinal studies are recommended for understanding the causal relationship between emotional eating and unhealthy food consumption.