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Lohse B, Nguyen B, Drees BM, Bailey-Davis L, Masters KS, Nicklas JM, Daniels BT, Ruder EH, Trabold N. Examination of eating competence in a geo-diverse sample with metabolic syndrome. Appetite 2024; 199:107373. [PMID: 38677621 DOI: 10.1016/j.appet.2024.107373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
Eating competence (EatC) is an intra-individual approach to eating attitudes and behaviors associated with greater well-being. EatC research has not included persons with confirmed metabolic syndrome (MetS). Therefore, EatC of persons with MetS was explored to identify unique associations and inform implementation of MetS lifestyle interventions using baseline data from a multisite, randomized trial of a 2-year lifestyle intervention with MetS. EatC, measured with the Satter Eating Competence Inventory 2.0 (ecSI 2.0™), was examined for relationships with bioclinical measures (e.g., blood pressure, lipids), medication use, BMI, waist circumference, fruit/vegetable intake, and psychosocial factors, (e.g., stress, mindfulness). Data were collected in person and video call by trained research personnel. EatC was examined as a continuous score and as a categorical variable with ecSI 2.0™ scores ≥ 32 considered eating competent. Participants (n = 618) were predominantly female (76%), White (74%), college educated (60%). Mean age was 55.5 ± 11 y. Mean ecSI 2.0™ was 29.9 ± 7.4 and 42% were eating competent. EatC was greater for males, persons who were older and food secure. Competent eaters (vs. non-eating competent) had lower waist circumference (112.7 ± 12.5 cm vs.116.8 ± 16.0 cm; P < 0.001) and BMI (35.0 ± 6.1 vs. 37.5 ± 7.3; P < 0.001). Serum triglycerides, HDL-cholesterol, fasting blood glucose, HbA1c, and blood pressure did not differ by EatC status. Compared to non-eating competent persons, competent eaters perceived less stress, were more mindful, indicated better physical function, and more habitual vegetable intake (all P < 0.001) and sensory awareness (P < 0.05). EatC in MetS paralleled the non-MetS profile. EatC was associated with a healthier psychosocial profile, waist circumference and BMI. Findings support further research to examine the mediational or moderating influence of EatC in the treatment of MetS.
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Affiliation(s)
- Barbara Lohse
- Rochester Institute of Technology, 180 Lomb Memorial Drive, Rochester, NY, 14623, USA.
| | - Bong Nguyen
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO, 64108, USA.
| | - Betty M Drees
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO, 64108, USA.
| | - Lisa Bailey-Davis
- Geisinger Health System, 100 N Academy Avenue, Danville, PA, 17822, USA.
| | - Kevin S Masters
- University of Colorado Denver, 13001 E. 17th Place, Aurora, CO, 80045, USA.
| | - Jacinda M Nicklas
- University of Colorado Denver, 13001 E. 17th Place, Aurora, CO, 80045, USA.
| | - Bryce T Daniels
- Rush University Medical Center, 1700 W. Van Buren Street, Suite 470, Chicago, IL, 60612, USA.
| | - Elizabeth H Ruder
- Rochester Institute of Technology, 180 Lomb Memorial Drive, Rochester, NY, 14623, USA.
| | - Nicole Trabold
- Rochester Institute of Technology, 180 Lomb Memorial Drive, Rochester, NY, 14623, USA; Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA.
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Silva LC, Nakano EY, Zandonadi RP. Division of Responsibility in Child Feeding and Eating Competence: A Cross-Sectional Study in a Sample of Caregivers of Brazilian Children with Celiac Disease. Nutrients 2024; 16:1052. [PMID: 38613085 PMCID: PMC11013579 DOI: 10.3390/nu16071052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
The objective of this cross-sectional study was to assess eating competence (EC) and the adherence to the division of responsibility in child feeding (sDOR) of Brazilian caregivers of children with celiac disease (CD). It also examined the association between EC and sDOR, children's adherence to a gluten-free diet, and sociodemographic data. This study administered a survey set that included sociodemographic data, health-related data, eating habits, and the instruments ecSI2.0TMBR and sDOR.2-6yTM BR, validated for a Brazilian population. The sample comprised 50 caregivers of children with CD (between 24 and 72 months of age). The participants following a gluten-free diet (GFD) presented higher scores for all EC domains and the total EC. The total EC scores were higher for the participants over 40 y/o, frequently having meals as a family, with their children consuming more than three servings of fruit and at least one serving of vegetables daily and complying with a GFD. Different from the EC, the sDOR.2-6yTM scores did not differ between the participants complying with a GFD. The sDOR.2-6yTM mealtime structure domain scores were significantly associated with the EC eating attitude, food acceptance, contextual skills, and total. These findings support the need for greater attention to exploring the division of responsibility in feeding and EC in pediatric celiac disease, potentially enhancing intervention strategies for patients and their families.
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Affiliation(s)
- Larissa Caetano Silva
- Nutrition Department, Faculty of Health Sciences, University of Brasília, Campus Universitário Darcy Ribeiro, Brasília 70910-900, Brazil;
| | - Eduardo Yoshio Nakano
- Department of Statistics, University of Brasília, Campus Universitário Darcy Ribeiro, Brasília 70910-900, Brazil;
| | - Renata Puppin Zandonadi
- Nutrition Department, Faculty of Health Sciences, University of Brasília, Campus Universitário Darcy Ribeiro, Brasília 70910-900, Brazil;
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Chaves C, Zandonadi RP, Raposo A, Nakano EY, Ramos F, Farage P, Teixeira-Lemos E. Health-related quality of life among celiacs in Portugal: a comparison between general and specific questionnaires. Front Immunol 2024; 15:1372369. [PMID: 38500888 PMCID: PMC10944991 DOI: 10.3389/fimmu.2024.1372369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/20/2024] [Indexed: 03/20/2024] Open
Abstract
Objective This study aimed to compare the 36-Item Short Form Survey Instrument version 2 (SF-36-v2) (generic) and Celiac Disease Questionnaire (CDQ) (specific) questionnaires used to evaluate the quality of life (QoL) in celiac Portuguese adult individuals. Methods This cross-sectional study used non-probabilistic sampling based on Portuguese celiac patients who accessed the online survey in 2022. The online data collection used a self-reported instrument composed of three parts: (i) socioeconomic, health, and gluten-free diet (GFD) adherence questions; (ii) SF-36 v2 - Portuguese version (generic questionnaire) and (iii) Celiac Disease Questionnaire (CDQ) (specific questionnaire). Results A total of 234 individuals who accessed the survey completed the questionnaire. Seven of the eight SF-36 domains positively correlated to the specific questionnaire CDQ. The "General Health" domain (domain 4) showed a negative correlation with the CDQ. Differences in content between the two instruments might be able to explain this finding since the CDQ explores issues regarding the specificities of celiac disease (CD) and the lifelong GFD burden. About half of the sample from this study displayed poor diet adherence, it is possible that the SF-36 could not reflect the impact of CD treatment - the complete elimination of gluten from the diet - on patients' health. Therefore, this issue should be carefully evaluated in future research. Conclusion Specific validated questionnaires for CD individuals, such as the CDQ, contemplate social, economic, and clinical variables that permeate the patient's life context. Therefore, these instruments may be more suitable for evaluating QoL in this public. However, using a general questionnaire such as the SF-36 would be indicated for comparing QOL between celiac patients and the general population or even between CD and other disease individuals. In this case, we recommend assessing GFD compliance for control parallelly.
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Affiliation(s)
- Cláudia Chaves
- ESSV, Centre for Studies in Education and Innovation (CI&DEI), Polytechnic University of Viseu, Viseu, Portugal
| | | | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal
| | | | - Fernando Ramos
- Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
- Associated Laboratory for Green Chemistry (LAQV) of the Network of Chemistry and Technology (REQUIMTE), Porto, Portugal
| | - Priscila Farage
- Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
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Silva LC, Nakano EY, Zandonadi RP. Eating competence in caregivers of celiac children: A cross-sectional study performed in Brazil. Nutrition 2024; 119:112326. [PMID: 38199032 DOI: 10.1016/j.nut.2023.112326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES Eating competence is an intraindividual approach to eating, behaviors, and attitudes related to eating, with repercussions on the individual and family. In pediatric celiac disease, the family is involved in the gluten-free diet management, the only treatment available. A gluten-free diet might affect eating competence because gluten-free diet compliance requires knowledge about food, meal planning, and attention to food choices. The objective is to access eating competence in caregivers of children with celiac disease and the association between caregivers' eating competence, children's adherence to a gluten-free diet, and sociodemographic data of participants. METHODS This cross-sectional study used a snowball spread method by applying a questionnaire, including sociodemographic data, data related to health, eating habits, and the Satter Eating Competence Inventory version validated for the Brazilian population. The sample consisted of 220 Brazilian parents or caregivers of celiac disease children. The scores of the Satter Eating Competence Inventory version validated for the Brazilian population were described in terms of means, SDs, medians, and interquartile range. Student's t test and analysis of variance followed by Tukey's post hoc tests were applied, and the association with the variables of interest was analyzed using Pearson χ2 tests. The tests were conducted considering bilateral hypotheses and a 5% significance level. RESULTS Participants' sex, schooling level, and income did not affect their eating competence. Competent eaters were mostly those with normal weight, following a gluten-free diet, with children complying with a gluten-free diet, and who have meals with family and prepare them at home. Different from vegetable consumption, participants' eating competence did not differ considering the frequency of children's fruit consumption. CONCLUSIONS The caregivers of children with celiac disease have greater eating competence scores than general Brazilian adults, and caregivers of children with celiac disease who comply with the gluten-free diet have higher eating competence scores.
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Affiliation(s)
- Larissa Caetano Silva
- Faculty of Health Sciences, Campus Universitário Darcy Ribeiro, University of Brasília, Brasília, Brazil
| | | | - Renata Puppin Zandonadi
- Nutrition Department, Faculty of Health Sciences, Campus Universitário Darcy Ribeiro, University of Brasília, Brasília, Brazil.
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Hargreaves SM, Rosenfeld DL, Moreira AVB, Zandonadi RP. Plant-based and vegetarian diets: an overview and definition of these dietary patterns. Eur J Nutr 2023; 62:1109-1121. [PMID: 36681744 DOI: 10.1007/s00394-023-03086-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 01/06/2023] [Indexed: 01/23/2023]
Abstract
PURPOSE This paper aims to present an overview of the definitions of "plant-based and "vegetarian diets" adopted by different organizations worldwide, proposing new standard definitions and discussing the notion of vegetarianism as a restrictive dietary pattern. METHODS An extensive literature review on the different definitions of vegetarian and plant-based diets was conducted. Definitions of different international vegetarian and vegan organizations were also taken into account. Objective definitions for vegetarian and plant-based diets, as well as for their subcategories, were proposed. Other aspects related to how vegetarian diets are viewed and defined were also discussed. RESULTS We proposed that a vegetarian diet should be defined as "a dietary pattern that excludes meat, meat-derived foods, and, to different extents, other animal products". This definition would include, among others, ovolactovegetarian and vegan diets. The proposed definition for a plant-based diet was "a dietary pattern in which foods of animal origin are totally or mostly excluded". Other types of diets, such as flexitarian and pescetarian diets, could be considered plant-based. A vegetarian diet should not be considered restrictive. Instead, terms such as alternative or non-conventional could be used to define it and to distinguish it from the conventional diet adopted by most of the Western population. CONCLUSION This paper was able to elaborate objective definitions of vegetarian and plant-based diets. Standardizing nomenclatures may reduce misinterpretation and confusion in this field of study.
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Affiliation(s)
- Shila Minari Hargreaves
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Darcy Ribeiro, Asa Norte, Brasilia, DF, 70910-900, Brazil
| | - Daniel L Rosenfeld
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, CA, 90095, USA
| | | | - Renata Puppin Zandonadi
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Darcy Ribeiro, Asa Norte, Brasilia, DF, 70910-900, Brazil.
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