Development and Validation of a Lifestyle Behavior Tool in Overweight and Obese Women through Qualitative and Quantitative Approaches

There is a paucity of effective intervention tools for overweight/obese women to assess, guide and monitor their eating behavior. This study aimed to develop a lifestyle intervention tool, assess its acceptability and usefulness, and verify its construct validity in overweight/obese women. The 6P tool (Portion, Proportion, Pleasure, Phase, Physicality, Psychology) was developed and 15 women with a body mass index (BMI) ≥ 25 kg/m2 were interviewed to assess its perceived acceptability and usefulness. Subsequently, the revised 6P tool was tested in 46 women with a BMI ≥ 25 kg/m2. The Three-Factor Eating Questionnaire (TFEQ), International Physical Activity Questionnaire-Short (IPAQ), and weight were measured at baseline and one-month. Most participants were satisfied with the presentation of the 6P tool (86.8%), and agreed it was useful in guiding healthy eating (81.6%) and raising awareness of eating behavior (97.4%). There were significant improvements in cognitive restraint (p = 0.010) and disinhibition (p = 0.030) (TFEQ), portion size (P1), pleasure behaviors (P3), and total composite 6P score (p < 0.001). However, there was no significant reduction in weight or increase in physical activity. The 6P tool is acceptable and presents with good validity for assessing lifestyle behaviors.

Self-Control at Meals in Order Not to Gain Weight and Its Relationship with Food Cravings in Low-Carb Dieters

Aims: This study’s objective was to verify the level of food cravings and cognitive restraint in women who reported having followed a low-carb diet. Methods: The volunteers filled out the binge eating scale, the cognitive restraint subscale, the food cravings trait and state questionnaires, and the food frequency questionnaire. This study has also compared participants according to the self-reported practice of a low-carb diet. Parametric tests were used to compare the groups and Pearson’s correlations between some variables of interest (p > 0.05 adopted). Results: According to the question regarding the practice of the low-carb diet, 39 participants had tried a low-carb diet in the last six months (46.2% of these with binge eating) and 48 did not (16.7% with binge eating). Dieters showed higher levels of binge eating, cognitive restriction, and food cravings (trait and state). Dieters consumed less rice and bread but did not present lower consumption of sweets. Correlations showed that for dieters who ‘Consciously hold back at meals in order not to gain weight’, it was negatively associated with ‘Intention and plans to eat’, ‘positive reinforcement’ and ‘relieving negative states’ and food cravings scores. Conclusions: Despite the higher levels of cognitive restriction in dieters, they are negatively correlated with food craving factors and negatively associated with the consumption of sweets.

Fear, Peer Pressure, or Encouragement: Identifying Levers for Nudging Towards Healthier Food Choices in Multi-Cultural Singapore

With roots beyond behavioural economics to psychology, nudges can be applied for influencing healthy behaviours such as food choice and portions to decrease obesity for better public health outcomes. However, the effectiveness of the type of nudges are contentious with conflicting literature. In this pilot study, we conducted a 23-day study surveying the food choices that included portion, locus of control, demographic data, and psychological measures of personality, perceived stress, narcissism, regulatory focus, food choice motive and dietary restraint, with the participants given four intervention conditions of 12 instant messaging sent every two days through WhatsApp. The messages were either factual (control), focused on consequences, through social comparison, or persuasive. Running over the COVID19 pandemic, 17 participants completed the full surveys showing significant effects between the experimental conditions with the psychological parameters except for diet confidence and extraversion and conscientiousness, as well as cognitive restraint. We found BMI and waistline measurements to be suitable measurements, with promising results from the fear and social comparison nudges for food-related behaviours and exercise. Our pilot findings have implications to the use of nudges upon which future studies investigating psychological factors can build on.

Eating Behaviour among University Students: Relationships with Age, Socioeconomic Status, Physical Activity, Body Mass Index, Waist-to-Height Ratio and Social Desirability

Eating behaviour is of particular interest for research focusing on body weight status. However, little is known about the relationships of certain factors, especially social desirability, with self-reported eating behaviour such as cognitive restraint, uncontrolled eating, and emotional eating among young adult males and females. This study aimed to evaluate the relationships between eating behaviour and age, socioeconomic status (SES), physical activity (PA), body mass index (BMI), waist-to-height ratio (WHtR), and social desirability among university students. A cross-sectional study was conducted among 353 university students (59.2% females). Eating behaviour was assessed using the 13-item Three-Factor Eating Questionnaire (TFEQ-13). SES and PA were determined using self-reporting, and the Marlowe–Crowne Social Desirability Scale assessed social desirability. BMI and WHtR were calculated based on measured parameters. Associations between self-reported eating behaviour and other variables were assessed using Pearson’s correlation coefficient and multivariate general linear models. Cognitive restraint was positively correlated with BMI and WHtR in both males (r = 0.174, P = 0.036 and r = 0.194, P = 0.020, respectively) and females (r = 0.239, P < 0.001 and r = 0.165, P = 0.017, respectively), and emotional eating was positively correlated with BMI among females (r = 0.184, P = 0.008). Social desirability was negatively correlated with uncontrolled eating (r = −0.287, P < 0.001) and emotional eating (r = −0.301, P < 0.001) among females. There were no significant correlations between eating behaviour and age or socioeconomic status (P > 0.05). Multivariate analysis showed that, among males, PA had a main effect on emotional eating (ηp2 = 0.044, F = 6.276, P = 0.013). Among females, cognitive restraint was positively associated with PA (ηp2 = 0.034, F = 7.127, P = 0.008) and BMI (ηp2 = 0.038, F = 7.959, P = 0.005), and emotional eating with BMI (ηp2 = 0.032, F = 6.638, P = 0.011). Social desirability had the highest main effect on eating behaviour among females, being negatively associated with uncontrolled eating (ηp2 = 0.077, F = 16.754, P < 0.001) and emotional eating (ηp2 = 0.082, F = 18.046, P < 0.001). This study showed that PA, BMI, WHtR, and social desirability were associated with self-reported eating behaviour among university students. Social desirability bias should be considered when evaluating uncontrolled eating and emotional eating among females.

Psychological Constructs and Dysfunctional Eating in Pakistani University Students

The&nbsp;present study aims to test a model that seeks to explainhow Parental Bonding and Loneliness may be responsible&nbsp;in the developmentof Dysfunctional Eating&nbsp;Patterns such as&nbsp;Cognitive Restraint,Emotional Eating, Uncontrolled Eating,&nbsp;Drive&nbsp;toward Thinness, Bulimiaand Dissatisfaction with Body Image.&nbsp;It was further hypothesizedthat&nbsp;Metacognitions, Core beliefs andMeta-Emotions&nbsp;would&nbsp;mediate&nbsp;between&nbsp;Loneliness,&nbsp;ParentalBonding, and the aforementioned Dysfunctional Eating Patterns. Correlationalresearch design&nbsp;has been&nbsp;used. A sample of 210 university studentswas selected from government and private universities. Urdu translated versionsof UCLA Loneliness Scale (Version 3), Three Factor Eating Questionnaire-R-18,Eating Disorders Inventory-3, Parental Bonding&nbsp;Inventory,&nbsp;Beliefsabout Emotions Scale, Eating Disorders Belief Questionnaire&nbsp;andMetacognitions Questionnaire&nbsp;were&nbsp;used for assessment purposes.Correlational&nbsp;Analysis,&nbsp;and Multiple Hierarchical Regressionwere&nbsp;used to analyze the data.&nbsp;Almost all dimensions of&nbsp;ParentalBonding showed significant relationship with some patterns of DysfunctionalEating.&nbsp;Loneliness did not show any significant&nbsp;correlation withDysfunctional Eating.&nbsp;None&nbsp;of the hypothesized mediators(Metacognitions,&nbsp;Meta-Emotions and Core Beliefs) mediated&nbsp;therelationship between&nbsp;Parental Bonding dimensions and patterns&nbsp;ofDysfunctional Eating, yet&nbsp;some&nbsp;interesting relationships emerged.&nbsp;The findings of this research can help in understanding the culturaldifferences between East and West. Possible reasons why results could notsupport the previous literature are discussed. &nbsp;

Anxiety, stress, and binge eating tendencies in adolescence: a prospective approach

Background Recent years have witnessed an increasing prevalence of binge eating tendencies in adolescence—warranting a clearer understanding of their underlying predisposing and precipitating factors. The current study investigated whether the interaction between high levels of anxiety and stress predicted increased levels of binge eating tendencies in a prospective cohort of adolescents (N = 324). Methods Measurements were taken over three waves (M ages: 13.33, 14.48, 15.65) as part of the CogBIAS Longitudinal Study. Longitudinal associations between levels of anxiety and stress with binge eating tendencies were estimated using a random intercept cross-lagged panel model (RI-CLPM), which calculates within-person fluctuations over time while accounting for individual trait-like stability and between-person variations. Binge eating tendencies were measured by the Cognitive Restraint, Uncontrolled Eating, and Emotional Eating styles from the Three-Factor Eating Questionnaire-R18. Two models were created for each binge eating tendencies variable: (1) a basic model with anxiety and stress as independent variables; (2) an interaction model with an additional anxiety*stress interaction term. Model fit was assessed by SEM fit indices: X2, CFI, NFI, TLI, RMSEA, SRMR. Superior model fit was ascertained by a chi-square difference test (p < .05). Results For Cognitive Restraint, the interaction model demonstrated superior fit to the data (p < .05). The anxiety*stress interaction at Waves 1 and 2 was significantly negatively associated with Cognitive Restraint at Waves 2 (β = −0.18, p = .002) and 3 (β = −0.14, p = .002)—suggesting that anxiety and stress interacted to predict increased binge eating tendencies linked with cognitive restraint over and above their independent effects. In contrast, the interaction term between anxiety*stress did not predict levels of Uncontrolled Eating or Emotional Eating over time. Conclusions The results highlight the importance of increasing awareness of the interaction between concurrently high anxiety and stress as a potential risk factor for binge eating tendencies in young people. Trial registration Not applicable.

Analyzing the link between anxiety and eating behavior as a potential pathway to eating-related health outcomes

Anxiety is a widespread phenomenon that affects various behaviors. We want to analyze in how far anxiety is connected to eating behaviors since this is one potential pathway to understanding eating-related health outcomes like obesity or eating disorders. We used data from the population-based LIFE-Adult-Study (n = 5019) to analyze the connection between anxiety (GAD-7) and the three dimensions of eating behaviors (FEV)—Cognitive Restraint, Disinhibition, and Hunger—while controlling for sociodemographic variables, smoking, physical activity, personality, and social support. Multivariate regression analyses showed significant positive associations between anxiety and Disinhibition as well as Hunger, but not between anxiety and Cognitive Restraint. Interventions that help individuals to better regulate and cope with anxiety, could be one potential pathway to reducing eating disorders and obesity in the population.

Do Disordered Eating Behaviors Have an Effect on Food Addiction?

Objective: We aimed to evaluate the relationship between food addiction and uncontrolled eating, cognitive restraint, and emotional eating. Methods: We carried out this study with 1168 students (758 girls and 410 boys) studying at 7 different high schools in Ankara, Turkey. We used 3 measures. The first measure part assessed the participants’ demographic characteristics. We used 2 other validated measures, the Yale Food Addiction Scale and the Three-Factor Eating Questionnaire, to assess disordered eating behaviors. Results: No statistically significant difference was found between girls (12.9%) and boys (12%) in terms of food addiction (p = .67). We found that uncontrolled eating (p < .001), cognitive restraint (p = .007), and emotional eating (p < .001) scores were higher in individuals with food addiction (60.50±22.37; 38.39±24.41 and 57.42±28.49 respectively) than those without food addiction (40.17±24.74; 32.36±25.4 and 31.11±29.46 respectively). Furthermore, these eating behaviors increased the risk of food addiction in adolescents [Uncontrolled eating: OR: 1.02 (1.01-1.03); Cognitive Restraint: OR: 1.01 (1.00-1.02); Emotional Eating: OR: 1.016(1.009-1.024)]. Conclusions: Disordered eating behaviors can be seen more frequently among adolescents with food addiction compared to those without. In addition, these eating behaviors can increase the risk of food addiction relatively.

Association of Psychobehavioral Variables With HOMA-IR and BMI Differs for Men and Women With Prediabetes in the PREVIEW Lifestyle Intervention

<b>Objective:</b> Stress, sleep, eating behavior and physical activity are associated with weight change and insulin resistance. The aim of the analysis was the assessment of the overall and sex specific association of psychobehavioral variables throughout the 3-y PREVIEW intervention using the Homeostatic Model Assessment of Insulin resistance (HOMA-IR), BMI, and length of time in the study.<b></b> <p><b>Methods</b>: Associations of psychobehavioral variables, including stress, mood, eating behavior physical activity (PA), and sleep with BMI, HOMA-IR and time spent in study were assessed in 2184 participants with pre-diabetes and overweight/ obesity (n=706 men; n=1478 women) during a 3-year lifestyle intervention utilizing linear mixed modelling and general linear modelling.The study was a randomized multicenter trial using a 2x2 diet-by- PA design.</p> <p><b>Results: </b>Overall,<b> </b>cognitive restraint and PA increased during the intervention compared to baseline, while BMI, HOMA-IR, disinhibition, hunger and sleepiness decreased (all p<0.05). Cognitive restraint and PA were negatively, while disinhibition, hunger, stress, total mood-disturbance were positively associated with both BMI and HOMA-IR. Sleep-duration, low sleep quality, total mood-disturbance, disinhibition and hunger scores were positively associated with HOMA-IR for men only. Drop-outs at 6 months had higher stress and total mood-disturbance scores at baseline and throughout their time spent in the study compared to study completers.</p> <p><b>Conclusion: </b>Eating behavior and PA, control of<b> </b>stress, mood-disturbance and sleep characteristics were associated with BMI, HOMA-IR and time spent in study with different effects in men and women during the PREVIEW-lifestyle intervention-study.<b> </b></p>