External Eating Behavior Research Articles

The Effects of Demographics and Nutritional Knowledge on Hotel Employees’ External and Emotional Eating

ABSTRACT This brief research aimed to examine how hotel employees’ demographics and nutritional knowledge influence their emotional and external eating behaviors. Empirical data was collected from hotel employees (n = 372) from four- and five-star hotels in Mediterranean cities in Turkey. ANOVA was conducted to identify the significant differences in employees’ emotional and external eating behaviors based on their demographic characteristics and nutritional knowledge. The study results indicated significant differences in hotel employees’ emotional eating by their gender, income, and education level. The study results further revealed that hotel employees’ external eating behavior differed based on their gender, marital status, and nutritional knowledge. The study results provide specific theoretical and practical implications in the health care and hospitality industries.

No evidence of attentional bias to food words among non-clinical female restrained eaters

Past research has demonstrated mixed findings on attentional biases toward food and body words among non-clinical restrained eaters (Brooks, S., Prince, A., Stahl, D., Campbell, I. C., & Treasure, J. (2011). A systematic review and meta-analysis of cognitive bias to food stimuli in people with disordered eating behavior. Clinical Psychology Review, 31(1), 37–151. doi: https://doi.org/10.1016/j.cpr.2010.09.006 ; Dobson, K. S., & Dozois, D. J. (2004). Attentional biases in eating disorders: A meta-analytic review of Stroop performance. Clinical Psychology Review, 23(8), 1001−1022. doi: https://doi.org/10.1016/j.cpr.2003.09.004 ; Francis, J. A., Stewart, S. H., & Hounsell, S. (1997). Dietary restraint and the selective processing of forbidden and nonforbidden food words. Cognitive Therapy and Research, 21(6), 633–646. doi:10.1023/A:1021804207132). Addressing previous methodological issues, this study examined college female restrained eaters’ attentional bias to food words. We used 120 college females – 20 were classified as restrained eaters by the Restrained Eating subscale of Dutch Eating Behavior Questionnaire (Van Strien, T., Frijters, J. E., Bergers, G. P., & Defares, P. B. (1986). The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. International Journal of Eating Disorders, 5(2), 295–315. doi: https://doi.org/10.1002/1098-108X(198602)5:2 3.0.CO;2-T ). Using a computer-based program called MouseTracker for a Stroop test (Freeman, J. B., & Ambady, N. (2010). MouseTracker: Software for studying real-time mental processing using a computer mouse-tracking method . Behavior Research Methods, 42(1), 226–241. doi:10.3758/BRM.42.1.226), attentional bias indicators of both process (i.e., what happens while attention is captured and directed; Area under the Curve and Maximum Deviation) and outcome (i.e., the end results of attention captured by certain stimuli; Reaction Time and Percentage of Errors) were measured to forbidden (i.e., unhealthy) and unforbidden (i.e., healthy) food words over animal words (i.e., used as control condition). Word stimuli were matched on frequency and syllables between conditions (Francis, J. A., Stewart, S. H., & Hounsell, S. (1997). Dietary restraint and the selective processing of forbidden and nonforbidden food words. Cognitive Therapy and Research, 21(6), 633–646. doi:10.1023/A:1021804207132). No evidence of attentional bias to food words was found among non-clinical restrained eaters. Based on the results in the current study, non-clinical restrained eaters with no accompanying overeating may not show attentional bias to food words. Future studies could compare clinical and non-clinical restrained eaters with and without overeating symptoms on attentional bias to food versus body stimuli.

The impact of perceived stress on US millennials' external and emotional eating behavior

PurposeThe purpose of this paper is to identify the relationship between Millennials' perceived stress and their external and emotional eating behaviors. Furthermore, the moderating effect of nutritional knowledge on the relationship between perceived stress and emotional eating and perceived stress and external eating of US Millennials was tested.Design/methodology/approachData was collected from 649 Millennials between the ages of 18 and 35 in the United States, and structural equation modeling (SEM) was performed to test the study hypotheses.FindingsThis study extends the literature and provides further insights into the relationship between US Millennials' eating behavior and stress factors. Perceived stress positively influenced Millennials' emotional and external eating behavior, and nutritional knowledge significantly moderated the relationships between perceived stress and emotional eating and perceived stress and external eating.Research limitations/implicationsFirst, data was collected from Millennials living in the United States. Second, not all of the predictors, save one (perceived stress), were selected and hypothesized as predictors of Millennials' eating behavior. The paper provides the essential psychological elements of US Millennials' eating behavior.Originality/valueIf unbalanced eating and obesity are the result of negative psychological factors, the recommended diet models or physical exercise by themselves may be less effective at combating obesity and related health issues. This is because stress was found to be a highly significant reason for unbalanced eating, new and more practical stress coping strategies are needed to moderate unbalanced eating behavior.

Abnormal Regional Neural Activity and Reorganized Neural Network in Obesity: Evidence from Resting‐State fMRI

This study aimed to investigate regional neural activity and regulation of patterns inthe reorganized neural network of obesity and explore the correlation between brain activities and eating behavior. A total of 23 individuals with obesity and 23 controls with normal weight were enrolled. Functional magnetic resonance imaging (fMRI)data were acquired using 3.0-T MRI. Amplitude of low-frequency fluctuation and functional connectivity (FC) analyses were conducted using Data Processing Assistant for resting-state fMRI and Resting-State fMRI Data Analysis Toolkit (REST). The group with obesity showed increased amplitude of low-frequency values in left fusiform gyrus/amygdala, inferior temporal gyrus (ITG), hippocampus/parahippocampal gyrus, and bilateral caudate but decreased values in right superior temporal gyrus. The group with obesity showed increased FC between left caudate and right superior temporal gyrus, left fusiform gyrus/amygdala and left ITG, right caudate and left fusiform gyrus/amygdala, and right caudate and left hippocampus/parahippocampal gyrus. Dutch Eating Behavior Questionnaire-Emotional scores were positively correlated with FC between left hippocampus/parahippocampal gyrus and right caudate but negatively correlated with FC between left fusiform gyrus/amygdala and left ITG. The study indicated the reorganized neural network presented as a bilateral cross-regulation pattern across hemispheres between reward and various appetite-related functional processing, thus affecting emotional and external eating behavior. These results could provide further evidence for neuropsychological underpinnings of food intake and their neuromodulatory therapeutic potential in obesity.

The association between eating behavior and polymorphisms in GRIN2B, GRIK3, GRIA1 and GRIN1 genes in people with type 2 diabetes mellitus.

Excess body weight is the main risk factor of type 2 diabetes. Recent studies have shown that psychological and behavioral factors affect weight. Additionally, emerging evidence indicates that polymorphisms of neurotransmitter genes can impact eating behavior. The aim of this study was to detect the associations between SNPs in glutamatergic system genes and type 2 diabetes in the ethnic group of Tatars origin living in the Republic of Bashkortostan (Russian Federation). In our case-control cross-sectional study, 501 patients with type 2 diabetes (170 men and 331 women, 60.9 ± 9.2years old (mean ± SD), BMI 30.9 ± 3.9kg/m2 (mean ± SD) of Tatar ethnicity, and a control group of 420 Tatars (170 men and 250 women, 56.3 ± 11.6years old (mean ± SD), BMI 24.4 ± 4.3kg/m2 (mean ± SD), were genotyped for five SNPs in four glutamatergic genes (GRIN2B, GRIK3, GRIA1, GRIN1). Three SNPs were associated with type 2 diabetes: rs7301328 in GRIN2B [odds ratio adjusted for age, sex and BMI (ORadj) = 0.77 (95% CI 0.63-0.93), padj = 0.0077], rs1805476 in GRIN2B [ORadj = 1.25 (95% CI 1.03-1.51), padj = 0.0240], and rs2195450 in GRIA1 [ORadj = 1.35 (95% CI 1.02-1.79), padj = 0.0340]. Regression analysis revealed that rs1805476 in GRIN2B was associated with LDL level, glomerular filtration rate, BMI (p = 0.020, p = 0.012 and p = 0.018, respectively). The SNP rs7301328 in GRIN2B was associated with triglyceride levels and HbA1c (p = 0.040, p = 0.023, respectively). These associations were not significant after Bonferroni correction. We found the association between rs534131 in GRIK3, rs2195450 in GRIA1, rs1805476 in GRIN2B and diabetic retinopathy (p = 0.005, p = 0.007, p = 0.040, respectively); rs7301328 in GRIN2B was associated with hypertension (p = 0.025) and cerebrovascular disease (p = 0.013). The association between rs534131 of GRIK3, rs2195450 of GRIA1 genes and diabetic retinopathy remained significant after Bonferroni correction. The SNPs rs6293 in GRIN1 was significantly associated with eating behavior in patients with type 2 diabetes (p = 0.01). Our results demonstrate that polymorphic variants of glutamatergic genes are associated with eating behavior and diabetic complications in Tatar ethnic group residing in the Republic of Bashkortostan. We detected novel associations of the polymorphic loci in GRIN1 (rs6293) gene with external eating behavior in type 2 diabetes patients, GRIK3 (rs534131) and GRIA1 (rs2195450) genes with diabetic retinopathy.

Pythagorean self-awareness intervention: A novel cognitive stress management technique for body weight control.

Over the past decades, the prevalence of obesity has markedly increased worldwide. Stress is recognized as a substantial contributor to increased body weight; therefore, stress management interventions, especially cognitive behavioural, are becoming increasingly popular. The impact of stress management on stress- and obesity-related biomarkers (eg blood lipid profile, HBA1c, inflammatory biomarkers, such as CRP) has been scarcely studied. The aim of this study was to assess the effect of a novel cognitive behavioural stress management intervention, called 'Pythagorean Self-Awareness Intervention' (PSAI), in overweight/obese adults. This was a two-armed 1:1 randomized, nonblind controlled study including overweight/obese individuals. The control group followed a personalized Mediterranean low-calorie diet, and the intervention group followed the same diet in addition to the PSAI intervention for 8weeks. Measurements included demographic, anthropometric (ie BMI, waist-to-hip ratio), stress (ie perceived stress, salivary cortisol), dietary behaviour (ie emotional eating) and metabolic parameters (ie blood lipid profile, HBA1c, CRP, body composition in fat and water). Outcome per-protocol analysis was performed using mixed linear models adjusted for age and gender. A total of 49 of 62 eligible adults were analysed in the study (there were three dropouts in the intervention group and 10 dropouts in the control group); 28 were assigned to the intervention group (mean age 54.7±11.9years) and 21 to the control group (mean age 51.8±11.9years). The intervention group showed a statistically significant decrease in perceived stress, cortisol concentrations 30minutes after awakening, cortisol's area under the curve, BMI, waist-to-hip ratio, restrained, emotional and external eating behaviour, fasting glucose, LDL, triglycerides, HbA1c and body and trunk fat, compared with the control group. Based on the observed effect sizes, clinically meaningful changes may be more evident in stress perception, restrained and external eating behaviour, Hb1ac and trunk fat. The compliance to the PSAI intervention reached 100%, and there were no adverse effects. The PSAI technique may be an effective stress management method for overweight/obese adults. Future and larger randomized controlled studies are needed to allow generalization of these findings.

Eating Behaviour and Its Associations with Overweight among Nurses on Shift Duty in Teaching Hospital

Overweight and obesity have become a global concern and estimated with more than 1.9 billion adults worldwide were overweight and more than 650 million were obese in 2016. Nurses in Malaysia were no exception to overweight and obesity. This research was conducted with the aim to identify the prevalence of overweight among nurses on shift duty in a teaching hospital and to understand the relationship between abnormal eating behavior and body mass index. A total of 280 respondents participated in this research and Dutch Eating Behavior Questionnaire was used. Body Mass Index (BMI) score was categorized according to Clinical Practice Guidelines 2004. Results showed that 68.5% of the nurses were either overweight (37.1%) or obese (31.4%). The nurses’ BMI does not showed any association with socio-demographic data except age (r=0.156). As age increases, the nurses’ BMI also increase. This research also showed that there was no association between emotional and external eating behavior to BMI. However, there was a statistically significant differences in BMI for restraint eating (F=6.056, p=0.003). In conclusion, restraint eating behavior was the most practiced form of eating behavior in an attempt to achieve the ideal body weight but unfortunately lead to overweight among the nurses. Overweight or obese nurses will have a negative impression to the society and even reduce their confidence towards nurses’ health education. Overweight or obesity also ruined the nurses’ working performance and quality of care for patients. This issue requires immediate action and interventions to promote healthy lifestyles and eating habits among nurses should be conducted in the hospital.

BODY IMAGE AMONG ADOLESCENTS WITH EATING DISORDERS

The features of perception by adolescents of their own appearance as a factor favoring the emergence of eating disorders have been considered. The analysis of literature on psychological characteristics of people’s attitudes to themselves and their bodies has been made. It has been noted, that people’s attitudes to themselves and their bodies can cause eating disorders. The role of the media, which can provoke growing number of eating disorders, has been considered. The experiment, analysis of the research results of features of eating behavior among adolescents, dissatisfied with their own appearance, has been described. It has been shown, that adolescents, unsatisfied with their own appearance, often resort to restrictive and external eating behavior

СОЦІАЛЬНО-ПСИХОЛОГІЧНІ АСПЕКТИ ФОРМУВАННЯ ХАРЧОВОЇ ПОВЕДІНКИ В ПІДЛІТКОВОМУ ВІЦІ

У статті теоретично розглянуто проблему харчової поведінки особистості (Л. Пономарьова, Р. Комер, О. Самойлова, Т. Яблонська та ін.), яка визначає не лише вподобання, схильності, цінності, установки особистості, а й культурну, етнічну та релігійну приналежність, відтворює психологічний портрет індивіда, несе приховану інформацію про його індивідуальні характеристики. Ризик порушень харчової поведінки особистості пов’язаний із низькою соціальною адаптацією, труднощами в налагодженні міжособистісних взаємин, сімейною ситуацією тощо (А Занозін, В. Сутчук, В. Шебанова й ін.).
 Емпірично з’ясовано, що підлітки групи ризику вирізняються емоційною та екстернальною харчовою поведінкою. У ставленні до себе в них превалюють закритість, певний рівень самокерівництва, внутрішня конфліктність і схильність до самозвинувачення. Школярі цієї групи визначили ставлення батьків до них як диктаторське, вороже та непослідовно-деструктивне. Отже, підліткам групи ризику складно переробляти емоції, не вдаючись за допомогою до їжі, і стримуватися при її вигляді, вона виконує для них психотерапевтичну функцію. Вони схильні «заїдати» свої проблеми та компенсувати таким чином власні недоліки, про що свідчать кореляційні зв’язки емоційної харчової поведінки з ворожим ставленням батьків і закритістю; екстернальної харчової поведінки з диктаторським ставленням та самозвинуваченням.
 Харчова поведінка підлітків групи норми характеризується здатністю обмежувати себе в їжі, прагненні харчуватися раціонально. Вони вирізняються самовпевненістю, самоприйняттям, очікуванням позитивного ставлення з боку інших та усвідомленням власної цінності. Підлітки визначили ставлення до себе батьків як автономно-відсторонене та позитивно-гармонійне. Тобто, з одного боку, наявна довіра та позитивний інтерес у батьків до своєї дитини, її повне психологічне прийняття; з іншого – відсутність тенденцій до заступництва й певне відмежування від проблем дітей, їх оцінка як цілком дорослих осіб. Установлено кореляційні зв’язки обмежувальної харчової поведінки з автономно-відстороненим і позитивно-гармонійним ставленням батьків та із самовпевненістю; екстернальної харчової поведінки із самоприйняттям.

Evaluation of dietary magnesium intake and Its association with depression, anxiety and eating behaviors?

Research problem/Aim: Magnesium is an essential mineral for the organism. Magnesium which is necessary for the ability of more than three hundred enzymes to function found to be associated with many diseases. The aim of this study was to determine the intake of dietary Magnesium in university students and to define its relationship with depressive symptoms, anxiety and eating behaviors. Method: This study included 386 university students who were not diagnosed with any psychiatric disorder and were not using magnesium-containing nutritional supplements. A questionnaire of 6 sections including the general characteristics of participants like age, smoking, income status, Beck Depression Scale, Beck Anxiety Scale, 24-hour retrospective food consumption form, physical activity record form and Dutch Eating Behavior Questionnaire were applied face to face and anthropometric measurements were obtained. Statistical analyzes were performed using SPSS IBM© version 23. Findings: The average magnesium intake of participants in inadequate Mg intake group was 175,5±47,6 mg/day, and 353,4±107,23 mg/day in adequate Mg group. Dietary Mg intake was evaluated according to Turkey Food and Nutrition Guide. It was determined that Mg intake of inadequate Mg group were met only 48,2±12,09% of the requirement. The factors such as smoking, BMI and fiber intake were found different into groups (p <0.05). It was concluded that inadequate Mg intake was not a risk factor for depression (OR: 1.035, 95% CI: 0,543-1,975, p = 0.916). Anxiety, restricting eating and emotional behaviors had no relationship with dietary Mg intake (p>0.05), but external eating behavior scores was found to be related with Mg intake (r=0,110; p<0,05). Conclusions: According to this research, there is no relationship between adequate Mg intake and depression, anxiety and eating behaviors but further research is needed. [Abstract Text must be 12pt, Garamond, adjusted, single line space, at least 150 words. Proper translate from local language on the right column. If the study is a field research, all parts (see header-C below) of work must be mentioned here in abstract section.

Association between post-cessation weight gain and eating behavior changes.

OBJECTIVE:Fear of post-cessation weight gain may be a barrier to cessation therapy or may lead to smoking relapse. This study aimed to evaluate the relationship between the change in eating behavior and post-cessation weight gain.METHODS:A prospective study that included 103 cigarette smokers, who visited the family medicine clinics of a training and research hospital for smoking cessation treatment between June 2018 and December 2018, was planned. A face to face survey (including Turkish version of Dutch Eating Behaviour Questionnaire-DEBQ and weight measures) was applied to all individuals at first and the final visits for the assessment of restrained, emotional, and external eating behaviors. Statistical analyses were completed using the IBM SPSS Statistics 22 program.RESULTS:Of 103 patients screened (M age=38.3 years SD=9.28), 58.3% were male, and 40.8% were in heavy nicotine dependence level (NDL) group. The mean weight increased by 4.74±2.63 kg in three months of smoking cessation. In the high NDL group, three subscales score (restrained p<0.001, emotional p=0.007, external p=0.005) of the DEBQ increased. Weight gain was significative associated with NDL (p=0.01). There was a positive correlation between Fagerstrom score and weight (kg) gain (r: 0.34; p=0.001). Weight change according to the emotional eating behavior was significantly different by gender (female p=0.005; male p=0.04). Women had a higher difference in emotional eating behavior score than men. Obese smokers had a higher initial restrained eating score than non-obese smokers (p=0.009). Weight gain of nicotine replacement therapy group had a similar result in the pharmacotherapy (varenicline) group (p=0.26). Both of treatment types concluded with a significant weight change (p=0.001).CONCLUSION:This study obtained that post-cessation weight gain is related to high nicotine dependence, and quit smoking causes increased scores of emotional, restrained, external eating behavior subscales. Post-cessation eating behavior is negatively affected by quit smoking.

Pathways of the relationships among eating behavior, stress, and coping in adults with type 2 diabetes: A cross-sectional study

Stress is related to eating behavior, and eating behavior is important in diabetes treatment. The aim of this study was to examine the relationships among perceived stress, diabetes-related stress, coping strategies, and eating behaviors in adults living with type 2 diabetes (T2DM). Adults with type 2 diabetes (n = 183) were recruited from a large metropolitan area in the Midwest United States. Stress factors and coping strategies associated with eating behaviors were measured using validated questionnaires. Structural equation modeling was used to investigate the relationships among perceived stress, diabetes-related stress, coping strategies, and eating behaviors. The final model showed that emotion-oriented coping partially mediated the effect of stress on eating behaviors. Specifically, emotion-oriented coping partially mediated the effect of diabetes-related stress on restrained eating behavior (r = 0.318, p < .001) and emotional eating behavior (r = 0.399, p < .001); emotion-oriented coping partially mediated the effect of perceived stress on external eating behavior (r = 0.276, p < .001). Emotion-oriented coping was found to be a partial mediator in the path model between stress and eating behaviors in people with type 2 diabetes. Knowledge of the association of stress with eating behaviors may prove important for health care providers in treatment and care of people with type 2 diabetes.

Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in\xa0women with obesity and infertility

PurposeTo identify demographic, (bio)physical, behavioral, and psychological determinants of successful lifestyle change and program completion by performing a secondary analysis of the intervention arm of a randomized-controlled trial, investigating a preconception lifestyle intervention.MethodsThe 6-month lifestyle intervention consisted of dietary counseling, physical activity, and behavioral modification, and was aimed at 5–10% weight loss. We operationalized successful lifestyle change as successful weight loss (≥ 5% weight/BMI ≤ 29 kg/m2), weight loss in kilograms, a reduction in energy intake, and an increase in physical activity during the intervention program. We performed logistic and mixed-effect regression analyses to identify baseline factors that were associated with successful change or program completion.ResultsWomen with higher external eating behavior scores had higher odds of successful weight loss (OR 1.10, 95% CI 1.05–1.16). Women with the previous dietetic support lost 0.94 kg less during the intervention period (95% CI 0.01–1.87 kg). Women with higher self-efficacy reduced energy intake more than women with lower self-efficacy (p < 0.01). Women with an older partner had an increased energy intake (6 kcal/year older, 95% CI 3–13). A high stage of change towards physical activity was associated with a higher number of daily steps (p = 0.03). A high stage of change towards weight loss was associated with completion of the intervention (p = 0.04).ConclusionsDeterminants of lifestyle change and program completion were: higher external eating behavior, not having received previous dietetic support, high stage of change. This knowledge can be used to identify women likely to benefit from lifestyle interventions and develop new interventions for women requiring alternative support.Trial registrationThe LIFEstyle study was registered at the Dutch trial registry (NTR 1530; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1530).

Comparative assessment of metabolic, hormonal and psychological characteristics of young obese men

Aim. To study metabolic-hormonal status and psychological characteristics of young obese men. Material and methods. The study included 87 young obese men (BMI ≥30 kg/m2) aged 16-25 yr given medication or non-medication treatment for 12 weeks. Blood glucagon-like peptide-1 (GLP-1), insulin, and glucose levels were measured after orlistat intake. Final screening included biochemical and hormonal studies. 48 patients underwent psychological testing. Results. Orlistat therapy resulted in clinically significant reduction of body mass (by more than 5% in 50% of the patients). Cortisol level also decreased while testosterone level increased. Meal test revealed elevated baseline GLP-1 level in 77,7% of the patients. There was correlation between baseline GLP-1 and insulin levels (r=0,61; р=0,001). Orlistat therapy decreased anxiety and depression (p&lt;0,05) as well as manifestations of external eating behaviour but increased those of restrictive eating behaviour.

Responsiveness to healthy advertisements in adults: An experiment assessing beyond brand snack selection and the impact of restrained eating

The objective of this study was to explore the impact of different advertising messages on adults' snack choice. Eighty participants (18–24 years old) were offered the choice between two snack packs following exposure to one of three advertising conditions. The snack packs contained either healthy or high fat, sugar or salt (HFSS) foods. Participants were exposed to commercials containing either non-food products, healthy food products or HFSS food products and their subsequent choice of snack pack was recorded. The Dutch Eating Behaviour Questionnaire (DEBQ) was used to assess the impact of external, restrained and emotional eating behaviour on snack pack selection following exposure to advertisements. The majority of unrestrained participants preferentially choose the HFSS snack pack irrespective of advertisement condition. In contrast, high restrained individuals exposed to the healthy eating advertisement condition preferentially selected the healthy snack pack while those in other advertisement conditions refused to take either snack pack. The healthy eating message, when distributed through mass media, resonated with restrained eaters only. Exposure to healthy food adverts provoked restrained eaters into choosing a snack pack; while exposure to other messages results in restrained eaters refusing to take any foods.

The effects of GLP-1 analogues in obese, insulin-using type 2 diabetes in relation to eating behaviour

Background Glucagon-like peptide-1 receptor agonists (GLP-1 RA) added to insulin in type 2 diabetes patients have shown to lower body weight, improve glycaemic control and reduce total daily insulin dose in short term studies, although the individual response greatly varies. Objective To evaluate GLP-1 RA treatment on body weight, glycaemic control and total daily insulin dose in obese, insulin-using type 2 diabetes patients after 2 years follow-up in a real life setting and to explore a possible relation with eating behaviour. Setting The Martini Hospital and the University Medical Center in Groningen in the Netherlands. Methods Eligible patients were at least 18 years of age, were on insulin therapy and obese (BMI > 30 kg/m2), started GLP-1 RA treatment. At baseline eating behaviour was classified according to the validated Dutch Eating Behaviour Questionnaire. A 2 years follow-up was performed. Main outcome measures Body weight, HbA1c and total daily insulin dose. Results 151 Patients started with exenatide or liraglutide. 120 patients completed the 2 years follow-up. From baseline to 2 years, body weight (mean ± SD) changed from 117.9 ± 22.1 to 107.9 ± 22.9 kg (P < 0.0001), HbA1c (median, IQR) changed from 7.9 (7.2–8.9) to 7.6 (6.9–8.3) % [63 (55–74) to 60 (52–67) mmol/mol] (P < 0.0001), total daily insulin dose changed from 90 (56–150) to 60 (0–100) Units/day (P < 0.0001). Weight change differed between eating behaviour groups (P < 0.001) in which external eating behaviour (n = 17) resulted in the smallest decline (−3.1 %) and restrained (n = 41) in the greatest (−10.3 %) in comparison with emotional (n = 37, −8.5 %) and indifferent (n = 25, −9.6 %) eating behaviours. Conclusion Two year of GLP-1 RA treatment resulted in a sustained reduction of weight, HbA1c and total daily insulin dose in obese, insulin-using type 2 diabetes patients in a real life setting. Largest weight loss was achieved in patients with a predominant restraint eating pattern while a predominant external eating pattern resulted in the smallest weight reduction.Electronic supplementary materialThe online version of this article (doi:10.1007/s11096-015-0219-8) contains supplementary material, which is available to authorized users.

The association between types of eating behaviour and dispositional mindfulness in adults with diabetes. Results from Diabetes MILES. The Netherlands

Although healthy food choices are important in the management of diabetes, making dietary adaptations is often challenging. Previous research has shown that people with type 2 diabetes are less likely to benefit from dietary advice if they tend to eat in response to emotions or external cues. Since high levels of dispositional mindfulness have been associated with greater awareness of healthy dietary practices in students and in the general population, it is relevant to study the association between dispositional mindfulness and eating behaviour in people with type 1 or 2 diabetes. We analysed data from Diabetes MILES – The Netherlands, a national observational survey in which 634 adults with type 1 or 2 diabetes completed the Dutch Eating Behaviour Questionnaire (to assess restrained, external and emotional eating behaviour) and the Five Facet Mindfulness Questionnaire-Short Form (to assess dispositional mindfulness), in addition to other psychosocial measures. After controlling for potential confounders, including demographics, clinical variables and emotional distress, hierarchical linear regression analyses showed that higher levels of dispositional mindfulness were associated with eating behaviours that were more restrained (β = 0.10) and less external (β = −0.11) and emotional (β = −0.20). The mindfulness subscale ‘acting with awareness’ was the strongest predictor of both external and emotional eating behaviour, whereas for emotional eating, ‘describing’ and ‘being non-judgemental’ were also predictive. These findings suggest that there is an association between dispositional mindfulness and eating behaviour in adults with type 1 or 2 diabetes. Since mindfulness interventions increase levels of dispositional mindfulness, future studies could examine if these interventions are also effective in helping people with diabetes to reduce emotional or external eating behaviour, and to improve the quality of their diet.

Mindfulness and eating behaviour styles in morbidly obese males and females

Background: Morbid obesity is a highly prevalent condition that is associated with a high risk of various diseases and high health care costs. Understanding determinants of eating behaviours that are characteristic of many morbidly obese persons is important for the development of new interventions aimed at changing eating behaviour after bariatric surgery. Dispositional mindfulness seems promising as one such potential determinant. Therefore, the association between mindfulness and eating behaviour was examined in females and males with morbid obesity. Methods: Outpatients with morbid obesity who were candidates for bariatric surgery (N = 335; 78.8% female) completed the Dutch Eating Behaviour Questionnaire (DEBQ), the Freiburg Mindfulness Inventory (FMI) and the Hospital Anxiety and Depression Scale (HADS), in addition to the collection of relevant demographic and medical data. Results: Three separate multiple regression analyses with three eating behaviour styles (restrained, emotional, external) as dependent variables showed that mindfulness was positively associated with restrained eating behaviour (Beta = .28, p ≤ .001), and negatively associated with emotional (Beta = −.22, p ≤ .001) and external (Beta = −.32, p ≤ .001) eating behaviours, independent of sex, age, educational level, Body Mass Index and affective symptoms. Conclusion: Dispositional mindfulness was associated with more restrained, and less emotional and external eating behaviour in morbidly obese outpatients, above and beyond affective symptoms. Future studies, establishing the causal direction of the associations, are needed.

Interoceptive sensitivity, body weight and eating behavior in children: a prospective study.

Previous research indicates that interindividual differences in the ability to perceive one's own bodily signals (interoceptive sensitivity, IS) are associated with disordered eating behavior and weight problems. But representative and prospective data in children are lacking and therefore, the exact nature of these observed associations remains unclear. Data on IS measured by heartbeat perception ability in 1657 children between 6 and 11 years of age were collected on the basis of two measurement points with a year distance in time. Stability of the construct and its prospective association with different food approach behaviors [assessed via parent questionnaires (Children's Eating Behavior Questionnaire and Dutch Eating Behavior Questionnaire)] as well as with weight status were analyzed via structural equation modeling. Main results were that only in overweight children external and emotional eating behavior were predictive for later IS, whereas no such relation was found in normal weight children. There was no direct relation between IS and body mass index. For the first time, we could show that eating behavior and IS in middle childhood are prospectively related to each other. But surprisingly, our data indicate that altered interoceptive processes rather follow than precede non-adaptive eating behavior patterns in overweight children. This suggests a possible crucial role of faulty learning mechanisms in eating behavior early in life, undermining the later confidence in one's body.

Maternal restraint and external eating behaviour are associated with formula use or shorter breastfeeding duration

Maternal eating behaviour (e.g. restraint, disinhibition) has been associated with maternal child-feeding style (e.g. pressure to eat, restricting intake, monitoring) for children over the age of two years. In particular, mothers high in restraint are significantly more likely to restrict and monitor their child’s intake of food. Research has not however examined the impact of maternal eating behaviour upon earlier infant feeding. A controlling maternal child-feeding style has been linked with shorter breastfeeding duration and earlier introduction of solid foods but the relationship between infant milk feeding and maternal eating behaviour has not been explored despite links between maternal weight, body image and breastfeeding duration. The aim of the current study was to explore associations between maternal restraint, emotional and external eating and breastfeeding initiation and duration. Seven hundred and fifty-six mothers with an infant aged 6–12months completed a copy of the Dutch Eating Behaviour Questionnaire and reported breastfeeding duration and formula use up to six months postpartum. Mothers high in restraint and external eating were significantly more likely to formula feed from birth, to breastfeed for a shorter duration and to introduce formula milk sooner than those lower in these behaviours. Moreover these behaviours were associated with reporting greater control during milk feeding by feeding to a mother-led rather than baby-led routine. Maternal eating behaviour may therefore affect breastfeeding initiation and continuation and is an important element for discussion for those working to support new mothers.