Abstract
Obesity is a global public health priority. Restrained eating is related to obesity and total energy intake but associations with the eating patterns are unclear. We examined the associations of restrained eating with the size and frequency of intake occasions among 1213 British adult (19–64 y) participants in a cross-sectional analysis of the UK National Diet and Nutrition Survey 2000. The Dutch Eating Behaviour Questionnaire assessed restrained eating. Overall intake occasions were all energy consumed in a 60 min period. A food-based classification separated intake occasions into meals, snacks, or drinks from seven-day weighed food diaries. Average daily frequency and size (kcal) of overall intake, meal, snack and drink occasions were calculated and associations with restrained eating were modelled using multiple linear regression including under-reporting of energy intake, age, gender, BMI, emotional eating, external eating and physical activity as covariates. Restrained eating was very weakly positively correlated with overall intake (r = 0.08, p<0.05) and meal frequency (r = 0.10, p<0.05) but not snack or drink frequency (r = 0.02 and -0.02 respectively). Adjusted regressions showed a one-point change in restrained eating was associated with 0.07 (95% CI 0.03, 0.11) more meal occasions/day and 0.13 (95% CI 0.01, 0.25) extra overall intake occasions/day. Overall intake occasion size was weakly negatively correlated with restrained eating regardless of type (r = -0.16 to -0.20, all p<0.0001). Adjusted regressions showed each one-point increase in restrained eating was associated with lower-energy meals (-15 kcal 95% CI -5.9, -24.2) and drinks (-4 kcal 95%CI -0.1, -8), but not snacks or overall intake occasions. Among a national sample of UK adults, greater restrained eating was associated with smaller and slightly more frequent eating, suggesting that restrained eaters restrict their energy intake by reducing meal/drink size rather than skipping snacks.
Highlights
Obesity is one of the most important public health problems worldwide and is the cause of at least 2.8 million global deaths [1]
We examined the associations of restrained eating with the size and frequency of intake occasions among 1213 British adult (19–64 y) participants in a cross-sectional analysis of the UK National Diet and Nutrition Survey 2000
In a large nationally representative sample of UK adults we found higher restrained eating scores were associated with smaller overall intake occasions and a slightly higher overall intake frequency and meal frequency, indicating a shift towards a smaller but more frequent pattern of consumption in restrained eaters
Summary
Obesity is one of the most important public health problems worldwide and is the cause of at least 2.8 million global deaths [1]. Eating in excess of needs is a complex process that can be influenced by cultural, social and psychological factors; theories have been developed to identify those factors that affect food intake, and body weight control. The theory of restrained eating describes the tendency of people to restrict food intake to lose weight or to prevent weight gain [4]. While some studies have observed inverse associations between higher restraint and obesity risk [5, 6], it has been suggested that chronic or excessive restriction may be a risk factor for weight gain and becoming overweight or obese [7,8,9,10,11,12,13]. In clinical studies of weight loss people randomised to an interventions focussed on relaxation of restraint tend to have poorer weight loss than people randomised to an intervention including restraint [15]
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