Eating styles in the morbidly obese: Restraint eating,but not emotional and external eating,predicts dietary behaviour

Objectives : The research explored (1) the relationships between self-reported eating style (restraint, emotional and external eating) and dietary intake and (2) emotional eater status as a moderator of food intake when emotional, in a morbidly obese population.

Design : A sample of 57 obese participants (BMI: M?=?51.84, SD?=?8.66) completed a five-day food diary together with a reflective diary, which assessed eating style and positive and negative affect daily.

Main outcome measures : A dietician-scored food pyramid analysis of intake.

Results : Restraint eating was the only predictor (negative) of overall food intake and the variable most strongly associated with the consumption of top-shelf foods. Emotional and external eating were unrelated to food intake. Emotional eater status did not moderate food intake in response to positive and negative mood states.

Conclusion : The findings indicated largely analogous relationships between eating style and dietary intake in this obese sample compared with previous results from healthy populations. The lack of predictive validity for emotional eating scales (when emotional) raises questions over people’s ability to adequately assess their eating style and consequently, the overall validity of emotional eater scales.     

Eating behavior in obese BED, obese non-BED, and non-obese control participants: A naturalistic study

Laboratory studies have shown considerable differences between the eating behavior, particularly binge eating behavior, of participants with and without binge eating disorder (BED). However, these findings were not replicated in two field experiments employing ecological momentary assessment (EMA) in which obese BED and obese non-BED participants reported comparable binge eating behavior. In the current study, we examined differences in binge eating with an innovative assessment scheme employing both EMA and a standardized computer-based dietary recall program to avoid some of the limitations of past laboratory and field research. Obese BED, obese non-BED, and non-obese control participants reported significant differences in eating patterns, loss of control, overeating, and binge eating behavior. Of particular importance was the finding that BED participants engaged in more overeating and more binge eating episodes than non-BED participants. These findings suggest that the use of EMA in combination with dietary recall may be a relatively objective and useful approach to assessing binge eating behavior. The findings further suggest that individuals with BED are observably different from those without the disorder, which may have implications for eating disorder diagnoses in DSM-V.     

Macronutrient intake as a prospective predictor of depressive symptom severity: An exploratory study with adolescent elite athletes

BackgroundAppropriate availability of macro- and micronutrients has an important impact on cognitive performance, mood and mental health. Although the critical role of nutrition for elite athletes’ performance was recognized early on, little is known about whether consumption of specific macronutrients (carbohydrates, proteins, fat) predict the development of future depressive symptoms in adolescent elite athletes.MethodsParticipants were recruited from three Swiss Olympic Partner Schools (SOPS) in the Northwestern German speaking part of Switzerland. A total of 97 adolescent elite athletes (38% girls, M_age = 16.35 ± 1.19) participated in the study. Depressive symptoms (PHQ9) were assessed at baseline and after 10 months follow-up. A 3-day food recall was completed three months after the baseline assessment. Linear regression analyses were used to examine whether macronutrients predict depression symptom severity after controlling for covariates and baseline depressive symptoms.ResultsHigher protein consumption in athletes was a prospective predictor of lower depressive symptom severity at follow-up (β = −35, p < .05). Several deviations from recommended nutritional standards were observed in elite athletes.ConclusionsThe findings of this exploratory study support the notion that dietary behaviour may be prospectively associated with athletes’ mental health. However, more research is required with larger samples and more in-depth assessment techniques. Future research should also examine whether nutrition education and dietary modification can be used to prevent depressive symptoms among adolescent elite athletes.     

Macronutrient intake as a prospective predictor of depressive symptom severity: An exploratory study with adolescent elite athletes

BackgroundAppropriate availability of macro- and micronutrients has an important impact on cognitive performance, mood and mental health. Although the critical role of nutrition for elite athletes’ performance was recognized early on, little is known about whether consumption of specific macronutrients (carbohydrates, proteins, fat) predict the development of future depressive symptoms in adolescent elite athletes.MethodsParticipants were recruited from three Swiss Olympic Partner Schools (SOPS) in the Northwestern German speaking part of Switzerland. A total of 97 adolescent elite athletes (38% girls, M_age = 16.35 ± 1.19) participated in the study. Depressive symptoms (PHQ9) were assessed at baseline and after 10 months follow-up. A 3-day food recall was completed three months after the baseline assessment. Linear regression analyses were used to examine whether macronutrients predict depression symptom severity after controlling for covariates and baseline depressive symptoms.ResultsHigher protein consumption in athletes was a prospective predictor of lower depressive symptom severity at follow-up (β = −35, p < .05). Several deviations from recommended nutritional standards were observed in elite athletes.ConclusionsThe findings of this exploratory study support the notion that dietary behaviour may be prospectively associated with athletes’ mental health. However, more research is required with larger samples and more in-depth assessment techniques. Future research should also examine whether nutrition education and dietary modification can be used to prevent depressive symptoms among adolescent elite athletes.     

The Effect of Variety and Dietary Restraint on Food Intake in Lean Young Women: A Preliminary Study

When satiety develops specific to sensory properties of food, variety leads to increased eating. The relationship between meal variety and dietary restraint was explored here in lean young women (18–20 years), classified into unrestrainers versus restrainers using the Dutch Eating Behavior Questionnaire Restrained Eating Scale. The expected variety effect obtained for unrestrainers (p < .05) but not for restrainers, despite a typical sensitivity to sensory-specific satiety and the same rate of habituation to sensory-based food responses (i.e., hedonics) across them. Unrestrainers’ eating appeared guided by hedonics (p < .05), but not restrainers’. These results suggest the potential involvement of an internal or participant characteristic, instead of an external factor, in moderating unrestrainers’ versus restrainers’ food consumption when offered a highly desired food (the favorite in the plain condition) versus less desired (but accepted) foods (presented successively with the favorite in the variety condition). Study limitations and suggestions for further research were discussed.     

Double trouble: restrained eaters do not eat less and feel worse

Objective: While high levels of dietary restraint do not appear to reflect actual caloric restraint, it has been found to be a risk factor for a wide array of maladaptive eating patterns. These findings raise the question what, if not caloric restriction, dietary restraint entails. We propose that the very finding that restrained eaters do not eat less than they intend to do can provide an answer. Based on this disparity between the intention to restrain oneself and actual behaviour, we therefore hypothesised that high levels of restraint are associated with eating-related guilt.

Method: Three studies (N?=?148) using unobtrusive measures of food intake; different restraint scales; and different measures of guilt tested whether restraint is related to eating-related guilt.

Results: Results indicated that restraint was not associated with food intake, but instead was associated with increased levels of guilt after eating. Guilt was explicitly related to food intake. Moreover, the observed guilt could not be attributed to a general increase in negative affect.

Conclusion: The results of these studies suggest that restraint is not an indicator of actual restricted food intake, but rather a reflection concerns about food and eating manifested in eating-related guilt.     

The effects of fat talk on body dissatisfaction and eating behavior: The moderating role of dietary restraint

Although research suggests that fat talk, the normalized conversations that involve degrading one's body shape/weight and size, can increase body dissatisfaction and disordered eating behavior, the extent to which dietary restraint may moderate these relationships remains uncertain. A pilot study (N = 30) comparing online videos with researcher-developed vignettes as prospective manipulations for fat talk exposure suggested use of the vignettes as potent yet subtle stimuli. In the main study, women undergraduates (N = 116) were randomized to read a fat talk or neutral vignette and then completed standardized measures of body dissatisfaction and dietary restraint while being concurrently presented with food stimuli. Results suggest significant moderation effects for dietary restraint: whereas fat talk exposure was associated with increased body dissatisfaction among low dietary restrainers, it appeared to reduce food consumption among high dietary restrainers. Findings highlight the importance of individual differences in shaping responses to fat talk.     

Effects of dietary restraint, obesity, and gender on holiday eating behavior and weight gain

This investigation evaluated the impact of dietary restraint, relative weight, and gender on holiday eating behavior and weight gain. 65 Ss (31 men and 34 women) completed detailed food records for the 2 days before, the 4 days during, and the 2 days after the Thanksgiving weekend. Results indicated increased eating during the Thanksgiving holiday, with men eating more than women and the obese eating less than the nonobese. There was also a significant Total Restraint X Weight X Time interaction, with unrestrained normal-weight subjects behaving similarly to high-restrained overweight subjects over time. There was also a highly reliable Total Restraint X Sex X Time interaction. The most striking finding from this interaction was that high-restrained women displayed decreases in their dietary intake over time. Correlational analyses revealed that restraint scores were negatively associated with dietary intake over the 8-day period but were positively associated with weight gain. The implications for dieting, eating behavior, and energy balance are discussed.     

Relationship Between Rate of Eating and Degree of Satiation

ABSTRACT

Behavioral psychologists have developed effective methods of treatment for overeating and weight control, including mealtime regulation, avoidance of taboo foods, and removal of identified precursors to the bingeing behavior. The current study sought to examine the relationship between speed of eating and levels of satiation in weight conscious individuals. Ten participants were instructed to eat at a fast and a slow rate in a within-subjects reversal design. Consuming food at a slow rate helped participants achieve satiation quicker with comparable amounts of food intake. Slow eaters were also less likely to overeat. These results suggest that slow eating may prevent excessive food consumption in weight conscious individuals, constituting an effective means of weight management.     

Loss of control eating and psychological maintenance in children: An ecological momentary assessment study

Objective

Recent research suggests that binge eating is a common experience in youth. However, it remains largely unknown how children's binge eating presents in everyday life and which psychological factors serve to maintain this binge eating.

Methods

Children aged 8-13 years with binge eating (n = 59), defined as at least one episode of loss of control (LOC) over eating within the past three months, and 59 matched children without LOC history were recruited from the community. Following a combined random- and event-sampling protocol, children were interviewed about their day-to-day eating behavior, mood, and eating disorder-specific cognitions using child-specific cell phones during a 4-day assessment period in their natural environment.

Results

LOC episodes led to a significantly greater intake of energy, particularly from carbohydrates, than regular meals of children with and without LOC eating. While LOC episodes were preceded and followed by cognitions about food/eating and body image, there was minimal evidence that negative mood states were antecedents of LOC eating.

Conclusions

The results provide support for the construct validity of LOC eating in children. Maintenance theories of binge eating for adults apply to children regarding eating disorder-specific cognitions, but the association with affect regulation difficulties requires further investigation.     

The Child Food Rejection Scale: Development and validation of a new scale to assess food neophobia and pickiness among 2- to 7-year-old French children

IntroductionThe two strongest obstacles to extend children's consumption of fruit and vegetables are food neophobia and pickiness, assumed to be the main kinds of food rejection in children. Accordingly, psychometric tools that provide a clear assessment of these kinds of food rejections are greatly needed.ObjectiveTo design and validate a new scale for the assessment of food neophobia and pickiness, thus filling a major gap in the psychometric assessment of food rejection by French children.MethodWe concentrated on French children aged 2–7 years, as no such scale exists for this young population, and on the two known dimensions of food rejection, namely food neophobia and pickiness, as the nature of the relationship between them is still unclear. The scale was tested on two samples (N₁ = 168; N₂ = 256) of caregivers who responded for their children. Additionally, a food choice task was administered to 17 children to check the scale's predictive validity.ResultsThe resulting scale, called the Child Food Rejection Scale (CFRS), included six items relating to food neophobia and five items relating to pickiness. A factor analysis confirmed the two-dimensional structure of the scale. Internal consistency, test–retest reliability, and convergent and discriminant validity were all satisfactory. Moreover, results from the food choice task showed that scores on the CFRS accurately predicted children's attitudes toward new and familiar foods.ConclusionTaken together, these findings suggest that the CFRS, a short and easy-to-administer scale, represents a valuable tool for studying food rejection tendencies in French children.     

The Effects of Food and Gender on Interpersonal Perceptions

Male and female subjects provided ratings of personal traits, femininity and masculinity, and total caloric consumption for a female or a male target based on the type of diet she or he had allegedly consumed. The gender associated with the foods presented for each dietary profile was manipulated. Results showed that Target Gender and Dietary Profile significantly affected impression ratings and calorie estimates. Both male and female subjects perceived male eaters and those who ate a feminine diet more favorably. Results are discussed in terms of the different underlying expectations held for males and females when food consumption is involved during the impression formation process.     

Subjective Happiness and Emotional Responsiveness to Food Stimuli

Through three studies, this study aims to investigate the relationship between subjective happiness and responsiveness to eating and to foods. In Study 1, 299 Japanese undergraduates completed the Japanese subjective happiness scale and self-report questionnaires for attitudes toward eating and food. Study 1 revealed that in daily life, people with higher happiness levels show a stronger tendency to feel pleasure by eating than those with lower happiness levels. In Study 2, 26 Japanese undergraduates performed impression assessments for foods when looking at pictures of them. In Study 3, 22 Japanese undergraduates performed the same assessments when looking at real foods and eating them using a comparison with the data from pictures of non-food items as a control condition. The results of the study indicate that people with higher happiness levels show a stronger emotional response (happy and glad) to food stimuli than those with lower happiness levels. Even images of food were effective. No such group differences were observed for appetitive responses. It was also shown that emotional responses to the pictures of non-food items’ condition in the two groups did not differ. The present studies provided empirical evidence that subjective happiness has relevance to daily eating behavior and attitudes. Further studies should investigate the possibility that subjective happiness is related to a wide range of behavior and cognition in our daily life.     

A meta-analysis of children’s self-reports of dietary intake

Objective: Although research studies increasingly use children as primary reporters in dietary assessments, it is unclear how well children’s self-reported intake correlates with independently validated reports of their intake; this meta-analysis assesses that correlation.

Design: Moderators of the correlation between self-reported and independently validated intake were predicted a priori: type of dietary intake assessment (24 h recall, food diary and food frequency questionnaires), validation measures, parental assistance and age. Online databases were searched for articles published from 1990 to 2014 that compared children’s self-reports of dietary intake to validated observations of food intake in children age 4–16.

Main outcome measures: Summary effect size Pearson r between children’s self-reported dietary intake and independently validated dietary intake were calculated.

Results: In k = 32 samples from 23 studies, a statistically significant correlation (r = .48, Z = 7.26, p < .001) was found between children’s self-reported dietary intake and independently validated reports of dietary intake. Validation method (Q = 17.49, df = 2, p < .001) and parental assistance (Z = 2.03, p = .042) were significant moderators of this correlation. Self-report methodology (Q = 3.95, df = 2, p = .139) and age (Q = .02, p = .879) were not significant moderators of the distribution of effect sizes.

Conclusion: Together, these results provide baseline information about children’s recall in dietary intake assessments conducted with children as primary reporters.     

A structural equation model of intuitive eating with adolescents

IntroductionThe tendency to eat by paying attention and respecting the body's hunger and satiety cues is called intuitive eating. This eating behavior has been linked to positive health and well-being outcomes.ObjectiveThe purpose of this study was to test a global model linking intuitive eating with self-esteem, body esteem, media influence and including fear of negative appearance evaluation in adolescents’ boys and girls.MethodIn total, 740 adolescent high school students (51.5% girls; M age = 14, SD = 1.5) completed self-report questionnaires with measures of intuitive eating, body esteem, self-esteem, media influence and fear of negative appearance evaluation.ResultsStructural equation modeling revealed an overall excellent fit for the final four-variable model excluding the fear of negative appearance evaluation variable. Mediation analyses showed an indirect relationship between intuitive eating and body esteem via media influence, for girls but not for boys. Body esteem mediated the relationship between intuitive eating and self-esteem, for girls and boys.ConclusionA new model is proposed where intuitive eating is associated with self-esteem through body esteem and media influence. These findings suggest that regulating attitudes and behaviors toward food may be related to higher psychological well-being.     

Theoretical underpinnings of a need-supportive intervention to address sustained healthy lifestyle changes in overweight and obese adolescents

ObjectivesRecent figures indicate that nearly a quarter of Australian adolescents are overweight or obese. Despite the well-established role of physical activity and healthy eating in reducing prevalence of obesity, there remains a lack of effective interventions that promote sustained behavior engagement. This paper aims to describe the theory-based integration and implementation of self-determination theory and goal setting theory in a family-based lifestyle intervention. Although these theories have been shown to independently predict motivation for behavior, a limited number of studies have described behavior-change techniques at a level to allow for effective evaluation and replication, and no studies have combined the theories in a healthy lifestyle behavior intervention.MethodsBehavior change techniques and the associated change mediators are described in relation to need-supportive environments provided by instructors and extended to parents in the home environment. Methods for motivating and promoting sustained engagement in adolescent physical activity and healthy eating and parent behaviors to support these lifestyle changes are discussed within the context of need-satisfaction and goal setting.ConclusionsThis study will contribute to understanding processes for developing and implementing behavior-change techniques based on the integration of two theories of motivation. Future interventions aimed at promoting maintenance of physical activity and healthy eating behaviors in overweight and obese adolescents will benefit by being informed of which techniques are effective at enhancing motivation within the intervention context and home environment.     

Overweight or obesity management by therapists of the obesity and overweight think thank group (G.R.O.S.). Pilot study comparing its effects with standard nutritional management

IntroductionCurrently, international recommendations for obese and overweight people that explicitly target weight loss and are based on qualitative and/or quantitative nutritional counseling and increased physical activity do not appear to be effective in the long term. In contrast, intuitive eating seems to be an interesting alternative to dieting. The G.R.O.S., a French non-profit organization, offers tri-axial management that would enable overweight or obese individuals to acquire this flexible and adaptive behavior that consists of eating naturally according to one's physiological and emotional needs.ObjectiveAfter describing the three axes of management by G.R.O.S., a pilot study is presented to evaluate the efficacy of this management type in overweight or obese subjects compared to a standard diet (DIET).MethodThirty-five subjects were divided into two groups (G.R.O.S. and DIET), and their weight, body mass index, cognitive restraint scores, emotional eating, intuitive eating, and depressive symptomatology were measured at the beginning of the study and three months later.ResultsThis pilot study showed the positive effect of weight management, body mass index, intuitive eating, and emotional eating compared with standard dietary management, which only affects the depressive symptomatology.ConclusionsThe G.R.O.S. management style seems to be an interesting and effective alternative to slimming diets. However, this study presented a number of limitations, including the sample size, nonrandomization of subjects in groups, and non-standardization of care.     

Functional Analysis and Treatment of Mealtime Problem Behavior for a Person with Developmental Disabilities

We conducted a functional analysis of problem behaviors (spitting and whining) during meals and tested an intervention based on that analysis. The participant was a 13-year-old young woman with severe mental retardation and cerebral palsy. She ate all food presented to her, and the hypotheses were tested that the problem behaviors were maintained either by contingent access to trainer attention or the pace of eating. An attention analysis examined the relationship between problem behavior and trainer attention during the meal. The effect of attention following problem behavior versus ignoring was inconclusive. An analysis of the effects of teacher paced eating, student paced eating (reinforce spoon grasping) and food presented for problem behavior was conducted next. Problem behavior rates were highest when access to food was made contingent on the performance of problem behavior and lowest when spoon grasping resulted in a bite of food. Following analysis, an intervention was designed to reduce the frequency of targeted problem behaviors during mealtime. Reinforcing spoon grasping and a 10s removal of food following problem behavior dramatically reduced spitting and whining during meals. The study provides a demonstration of an extended functional analysis and treatment of a complex behavior pattern.