Abstract

Abstract Background and Aims Approaches promoting eating guided by internal cues, such as intuitive eating (IE), have emerged as an alternative to decrease the impact of external cues on eating behavior while simultaneously avoiding the risk for dysfunctional eating. IE helps to connect with internal cues (i.e. hunger and satiety) and feelings rather than relying on external strategies to regulate what, how much and when to eat. In obese women, IE-based approaches have shown to enhance motivation and adherence to lifestyle changes, hence improving metabolic and psychological parameters, quality of life and diet quality. However, studies evaluating IE in chronic kidney disease (CKD) patients are scarce. Thus, we aimed to evaluate the impact of a behavioral multi-session group intervention on IE scores of overweight non-dialysis-dependent (NDD) CKD women. Method This is a prospective non-controlled clinical trial of a behavioral multi-session group intervention for dietary management. It was conducted with overweight women with chronic kidney disease (CKD). Each group comprised 5-8 participants in fifteen weekly or biweekly sessions lasting about 90 minutes. Most of IE principles were discussed throughout the meetings. IE scale 2 (IES2) translated and adapted to Brazilian population and composed of 23 questions with 5-point Likert response scale ranging from 1=“strongly disagree” to 5=“strongly agree” and four-factor model (Unconditional Permission to Eat, Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Body-Food Choice Congruence) was applied before and after the intervention. The higher the score, the higher the intuitive eating attitudes. Results Of the 33 patients that initiated the study, 23 patients [age=62.0 (58.0-68.0) years; schooling= 9.0 (7.0-12.0) years of study; BMI=32.6 (30.2-39.3); eGFR=28.0 (22.0-31.0) ml/min/1.73m²] completed the intervention. Figure 1 shows the results regarding IES2. Conclusion The intervention approaching IE principles was effective to improve IE attitudes in the studied patients. With exception for “body-food choice congruence”, all IE subscales improved after intervention. These results are promising and may contribute to a paradigm change in the strategies aiming to enhance motivation and adherence to dietary recommendations in CKD population.

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