Are Peripheral Biomarkers Determinants of Eating Styles in Childhood and Adolescence Obesity? A Cross-Sectional Study

Disturbances in eating behaviors have been widely related to obesity. However, little is known about the role of obesity-related biomarkers in shaping habitual patterns of eating behaviors (i.e., eating styles) in childhood. The objective of the present study was to explore the relationships between several biomarkers crucially involved in obesity (ghrelin, insulin resistance, and leptin/adiponectin ratio) and eating styles in children and adolescents with obesity. Seventy participants aged between 8 and 16 (56.2% men) fulfilled the Spanish version of the Dutch Eating Behavior Questionnaire for Children to measure external, emotional, and restrained eating styles. In addition, concentrations of ghrelin, leptin, adiponectin, insulin, and glucose were obtained through a blood test. Hierarchical multiple regression analyses controlling for age and sex were computed for each eating style. Results indicated that individuals with higher ghrelin concentration levels showed lower scores in restrained eating (β = −0.61, p < 0.001). The total model explained 32% of the variance of the restrained pattern. No other relationships between obesity-related biomarkers and eating behaviors were found. This study highlights that one of the obesity-risk factors, namely lower plasma ghrelin levels, is substantially involved in a well-known maladaptive eating style, restraint eating, in childhood obesity.

Polish Adaptation of the Dutch Eating Behaviour Questionnaire (DEBQ): The Role of Eating Style in Explaining Food Intake—A Cross-Sectional Study

Knowledge of associations between emotional, external, and restrained eating with food choices is still limited due to the inconsistent results of the previous research. The aim of the study was to adopt the Dutch Eating Behavior Questionnaire (DEBQ) and then to examine the relationship between emotional, external, and restrained eating styles and dietary patterns distinguished on the basis of intake of fruit and vegetables (fresh and processed separately), fruit and/or vegetable unsweetened juices, sweets and salty snacks, and the adequacy of fruit and vegetable intake. The cross-sectional study was conducted in 2020, in a sample of 1000 Polish adults. The questionnaire consisted of the Dutch Eating Behavior Questionnaire, questions on selected food groups intake, and metrics. DEBQ structure was tested using both exploratory and confirmatory factor analysis (EFA, CFA) and structural equation modelling (SEM), while multi-group analysis was used to test measurement invariance. Logistic regression was applied to investigate the association between eating styles and dietary patterns, identified with the use of K-means cluster analysis. EFA, CFA and SEM revealed a three-factor, 29-item tool with satisfactory psychometric parameters. Restrained eating (ResEat) and external eating (ExtEat) were found to decrease chances of low intake of both favorable (fruit, vegetables, and unsweetened juices) and unfavorable (sweets and salty snacks) foods and increased the chances of their moderate intake. ResEat increased the probability of the high intake of favorable and moderate or high intake of unfavorable foods. ResEat and ExtEat were predisposed to adequate intake of fruit and vegetables while emotional eating had the opposite effect. Gender, education, and BMI were also found to determine food intake. Our results provide evidence that both eating styles and sociodemographic characteristics should be taken into account while explaining food intake as they may favor healthy and unhealthy eating in different ways.

STUDY OF PSYCHOLOGICAL FACTORS OF INDIVIDUAL NUTRITIONAL STYLE

Purpose. The research concerns the problem of choosing an individual eating style and identifying possible psychological factors of choosing an eating style by a person. Methods. To achieve this purpose theoretical methods were used: analysis of psychological literature and generalization of psychological dates; empirical methods: Kugler-Jones guilt questionnaire, J. Rotter’s “Locus of Control” method, methods of mathematical and statistical processing and visualization of empirical data: one-way analysis of variance.Results. The results of an empirical study of psychological characteristics, in particular the features of guilt and personal responsibility in people with different eating styles. The sample was 80 people. Respondents were people aged 20 to 45 with different eating styles: traditional, healthy, alternative and interval. The traditional diet meant the consumption of food, characteristic of the culture of the subjects, healthy eating – strict restrictions on food consumption (calories, the ratio of macro- and micro-elements in the diet, restriction of harmful products and sugar), alternative (complete rejection of certain products or Interval or intermittent – alternation between meals, fasting for a day or several days. The greatest experience of guilt as a condition is inherent in people with a choice of alternative, healthy and interval eating styles. That is, people who choose a style of eating with certain restrictions have a fairly high, compared to the traditional style of eating emotional reaction to a particular behavior that may be contrary to their personal moral principles. The highest prevalence of guilt as a trait in people who follow a healthy and alternative diet. Such people have an emotional attitude, which is associated with responsibility for violating personal moral principles. Such specificity of guilt presupposes that such individuals are more likely to adhere to such severe restrictions on food consumption.Conclusions. It was researched the problem of choosing an individual eating style and identifying possible psychological factors of choosing an eating style by a person. Representatives of the traditional style of eating are attracted to the external locus of control, in contrast to the representatives of a healthy, alternative diet, which is characterized by an internal locus of control. At the same time, people with interval nutrition showed the same manifestation of both internal and external locus of personality control.Key words: orthorexia, eating styles, guilt, locus of control, morality. Мета. Дослідити проблему вибору індивідуального стилю харчування та виявлення можливих психологічних факторів вибору стилю харчування особистістю. Методи. Для реалізації цієї мети було використано теоретичні методи: аналіз психологічної літератури та узагальнення психологічних даних із проблеми дослідження, емпіричні: опитувальник провини Куглера-Джонс, методика «Локус-контролю» Дж. Роттера, методи математично-статистичної обробки та візуалізації емпіричних даних: однофакторний дисперсійний аналіз.Результати. Представлено результати емпіричного дослідження психологічних характеристик, зокрема особливостей прояву почуття провини та особистісної відповідальності в осіб з різним стилем харчування. Вибірка становила 80 осіб. Респондентами виступили особи віком від 20-ти до 45-ти років із різним стилем харчування: традиційним, здоровим, альтернативним та інтервальним. Під традиційним харчуванням малося на увазі споживання їжі, характерної для культури досліджуваних, під здоровим харчуванням – дотримання чітких обмежень у споживанні страв (калорійність, співвідношення макро- та мікроелементів у раціоні, обмеження шкідливих продуктів та цукру), альтернативним – повна відмова від певних продуктів або способів приготування їжі. Інтервальне або переривчасне – чергування між прийомами їжі, голодування протягом дня або кількох днів. Найбільше переживання провини як стану притаманне людям із вибором альтернативного, здоро-вого та інтервального стилів харчування. Тобто у людей, які вибирають стиль харчування з певними обмеженнями, виявлено досить високу, порівняно із представниками традиційного стилю харчування, емоційну реакцію на конкретну поведінку, яка може суперечити їхнім особистісним моральним прин-ципам. Найбільше переважає високий рівень переживання провини як риси у людей, які дотримуються здорового та альтернативного способу харчування. У таких осіб існує емоційна установка, яка пов’я-зана з відповідальністю за порушення особистісних моральних принципів. Така специфічність переживання почуття провини зумовлює те, що такі особистості з більшою ймовірністю можуть дотриму-ватися таких жорстких обмежень у споживанні їжі.Висновки. Досліджено особливості вибору індивідуального стилю харчування та виявлено мож-ливі психологічні фактори вибору стилю харчування. Представникам традиційного стилю харчування приманний екстернальний локус контролю на відміну від представників здорового, альтернативного харчування, яким притаманний інтернальний локус контролю. Причому в осіб з інтервальним харчуванням виявлено однаковий прояв як інтернального, так і екстернального локус контролю особистості.Ключові слова: орторексія, стилі харчування, провина, локус контролю, мораль.

Contributing roles of depression, anxiety, and impulsivity dimensions in eating behaviors styles in surgery candidates

Background Even if bariatric surgery is considered the most effective therapeutic approach, it is not equally successful among individuals suffering from severe obesity and candidates for this weight loss surgery. Among the factors that influence postsurgical outcomes, eating behaviors styles are known to play a key role in relapses. The aim of our study was to assess eating behaviors styles and several modulating psychopathological factors in patients suffering from severe obesity. Methods Patients seeking bariatric surgery (N = 127) completed a set of standardized tools assessing eating behaviors (Dutch Eating Behavior Questionnaire), comorbid psychiatric conditions (Mini International Neuropsychiatric Interview), depression, and anxiety scores (Beck Depression Inventory, State-Trait Anxiety Inventory), and impulsivity scores (UPPS-P Impulsive Behavior Scale). Results We detected significant correlations between DEBQ Emotional Eating (EmoE) and depression, state and trait anxiety, and all dimensions of impulsivity. Significant correlations were also present between DEBQ External Eating (ExtE) and depression, state and trait anxiety and UPPS-P positive urgency, lack of perseverance and sensation seeking. Regression analyses identified sex (female), trait anxiety, and lack of perseverance as explanatory factors for EmoE, and depression severity score and positive urgency for ExtE. Conclusions EmoE might be a means of dealing with negative emotions and/or intrusive thoughts, while ExtE might result from a mechanism associated with depression. These results should help to improve patients’ outcomes by defining specific therapeutic targets in psychological interventions. Plain English summary After bariatric surgery, some patients regain weight. This is likely due to various factors, including a return of maladaptive eating styles, such as emotional eating (which occurs as a response to negative emotions, like depression, anxiety, anger, sadness, and discouragement), external eating (which refers to the tendency to eat in response to positive external cues, regardless of internal signals of hunger and satiety), and restraint eating (implying to make efforts to develop and maintain strategies to control calories intake, associated with weight loss after lifestyle intervention). Our goal in this research project was to explore associated factors (particularly depression, anxiety, and impulsivity) to these eating styles in patients suffering from obesity prior to bariatric surgery. Individuals seeking bariatric surgery were asked questions about their eating styles and their levels of depression, anxiety, and impulsivity using standardized questionnaires. We found that emotional eating might be a means of dealing with negative emotions and/or intrusive thoughts (e.g. about food or body dissatisfaction), while external eating might result from a mechanism associated with depression. We detected no association between restraint eating and any of the dimensions of impulsivity, nor depression and anxiety. Therapies aimed at improving patients’ abilities to regulate negative affects seem promising among subjects suffering from obesity and those seeking bariatric surgery. If well learned, these therapies might also help them to maintain weight loss after surgery by limiting maladaptive eating styles.

Impact of the COVID-19 pandemic and related lockdown measures on lifestyle behaviors and wellbeing in children and adolescents with severe obesity

Introduction: COVID-19 lockdown measures have large impact on lifestyle behaviors and wellbeing of children. The aim of this mixed-methods study was to investigate the impact of COVID-19 lockdown measures on eating styles and behaviors, physical activity (PA), screen time, and health-related quality of life (HRQoL) in children (0-18 years) with severe obesity. Methods: During the first COVID-19 wave (April 2020), validated questionnaires were completed and semi-structured telephone interviews were conducted with parents of children with severe obesity (adult BMI-equivalent ≥35kg/m2) and/or with the children themselves. Changes in pre-pandemic versus lockdown scores of the Dutch Eating Behavior Questionnaire Children (DEBQ-C), Pediatric Quality of Life Inventory (PedsQLTM), and Dutch PA Questionnaire were assessed. Qualitative analyses were performed according to the Grounded Theory. Results: Ninety families were approached of which 83 families were included. Characteristics of the included children were: mean age 11.2 ± 4.6 years, 52% female, mean BMI SD-score +3.8 ± 1.0. Emotional, restrained, and external eating styles, HRQoL, and (non-educational) screen time did not change on group level (all p>0.05). However, weekly PA decreased (mean difference -1.9 hours/week, p=0.02), mostly in adolescents. In the majority of children, mean weekly PA decreased to ≤2 hours/week. Children with high emotional and external eating scores during lockdown or pre-existent psychosocial problems had the lowest HRQoL (p<0.01). Qualitative analyses revealed an increased demand for food in a significant proportion of children (n=21), mostly in children <10 years (19/21). This was often attributed to loss of daily structure and perceived stress. Families who reported no changes (n=15) or improved eating behaviors (n=11) attributed this to already existing strict eating schemes that they kept adhering to during lockdown. Conclusion: This study shows differing responses to COVID-19 lockdown measures in children with severe obesity. On group level, PA significantly decreased and in substantial minorities eating styles and HRQoL deteriorated. Children with pre-existent psychosocial problems or pre-pandemic high external or emotional eating scores were most at risk. These children and their families should be targeted by health care professionals to minimize negative physical and mental health consequences.

Validation of the Dutch Eating Behavior Questionnaire in a Romanian Adult Population

(1) Background: Obesity, part of the triple global burden of disease, is increasingly attracting research on its preventive and curative management. Knowledge of eating behavior can be useful both at the individual level (to individualize treatment for obesity) and the population level (to implement more suitable food policies). The Dutch Eating Behavior Questionnaire (DEBQ) is a widely used international tool to assess eating behavior, i.e., emotional, external and restricted eating styles. The aim of this study was to validate the Romanian version of DEBQ, as obesity is a major concern in Romania. (2) Methods: Our study tested the psychometric properties of the Romanian version of DEBQ on an adult population and explored the associations of eating behavior with weight status (3) Results: The study showed a factor load similar to the original version of the questionnaire and a very good internal validity (Cronbach’s alpha fidelity coefficient greater than 0.8 for all scales of the questionnaire) for the Romanian version of DEBQ and showed that all of the scales positively correlated with body mass index in both men and women. (4) Conclusions: This study will enable the use of the DEBQ Romanian version on the adult population of Romania where the findings could be incorporated into developing better strategies to reduce the burden of nutrition-related diseases.

Cerebral μ-opioid and CB1 receptor systems have distinct roles in human feeding behavior

Eating behavior varies greatly between individuals, but the neurobiological basis of these trait-like differences in feeding remains poorly understood. Central μ-opioid receptors (MOR) and cannabinoid CB1 receptors (CB1R) regulate energy balance via multiple neural pathways, promoting food intake and reward. Because obesity and eating disorders have been associated with alterations in the brain’s opioid and endocannabinoid signaling, the variation in MOR and CB1R system function could potentially underlie distinct eating behavior phenotypes. In this retrospective positron emission tomography (PET) study, we analyzed [11C]carfentanil PET scans of MORs from 92 healthy subjects (70 males and 22 females), and [18F]FMPEP-d2 scans of CB1Rs from 35 subjects (all males, all also included in the [11C]carfentanil sample). Eating styles were measured with the Dutch Eating Behavior Questionnaire (DEBQ). We found that lower cerebral MOR availability was associated with increased external eating—individuals with low MORs reported being more likely to eat in response to environment’s palatable food cues. CB1R availability was associated with multiple eating behavior traits. We conclude that although MORs and CB1Rs overlap anatomically in brain regions regulating food reward, they have distinct roles in mediating individual feeding patterns. Central MOR system might provide a pharmacological target for reducing individual’s excessive cue-reactive eating behavior.

Predictors of binge eating: relevance of BMI, emotional eating and sensivity to environmental food cues

Purpose Understanding humans’ food intake practices is helpful in reducing health problems. The purpose of this study was to investigate the relationships between eating behaviours and binge eating and to examine the influence of sex and weight status on these relationships. Design/methodology/approach A total of seventy-eight participants (39 with overweight; mean age: 38.1 ± 6.3 years; body mass index [BMI]: 25 ± 5.7 kg/m2) underwent measurements of binge eating, eating styles and body compositions. A hierarchical multiple regression analysis was performed to predict binge eating as a function of eating styles and demographic variables. Findings Women presented higher levels of binge eating symptomatology and emotional eating than men. The analysis showed that age and gender did not emerge as important predictors of binge eating. In contrast, emotional and external eating and BMI were found to be important predictors of binge eating. The results indicate that higher emotional and external eating behaviour with higher BMI are important risk factors for binge eating in a non-clinical sample. Originality/value In this study, BMI was used as a causal factor rather than a consequence of deregulation of eating behaviour. An individual’s tendency to binge eat may be determined by BMI, emotional eating and sensitivity to environmental food stimuli. Understanding sex differences and causal relationships between eating behaviours is critical for the prevention and treatment of obesity and related health problems and for proper dietary management.