Intuitive Eating Scale-2 Research Articles

How is intuitive eating related to self-reported and laboratory food intake in middle-aged adults?

As intuitive eating (IE) is characterized by eating in response to internal cues of hunger and satiety and by monitoring the effect of food on the body, it has been hypothesized to lead to healthy food intake. Evidence concerning its link to food intake is scarce. This experimental study investigated the relationship between IE and food intake in middle-aged adults. Fifty-five participants aged 50–70 years completed the Intuitive Eating Scale-2 to measure IE. Usual consumption frequency of fruits, vegetables, snacks and sweets was assessed as a measure of healthy self-reported food intake. A taste test of apples, carrots, coated peanuts and chocolate was conducted as a measure of healthy and total laboratory food intake. Regression analyses were performed using Frequentist and Bayesian methods of inference. In line with our hypothesis, IE was associated with healthier self-reported food intake (medium effect size: f2 = 0.24). The data were 49.80 times more likely under H1 than under H0. Contrary to our hypotheses, IE was neither associated with healthy nor total laboratory food intake in classical regression analyses. The accompanying Bayes factors revealed inconclusive evidence. Data only allow drawing cautious conclusions about the different relationship between IE and the self-reported consumption frequency of the foods vs. the amount of these foods consumed in a single test situation. Future studies combining different measures of IE (e.g., behavioral paradigms) and self-reported (e.g., diet quality, portion sizes) and laboratory (e.g., repeated taste tests with pre-selected foods) food intake are warranted to further explore their relationship.

Protocol for Research on a Model Focused on Mindfulness Training to Support Weight Management after Bariatric Surgery

Abstract Objectives Bariatric surgery has been proposed as a potential treatment for individuals who are severely obese. However, the literature indicates that 20–50% of bariatric patients, experience weight regain 18–24 months after surgery. In addition, some studies suggest that a large percentage of bariatric patients present with inability to respond appropriately to hunger and satiety cues and have difficulty dealing with stress. These factors might ultimately impact successful long-term weight management. Mindfulness meditation has been proposed as an approach that can reduce stress and increase awareness of physical sensations, such as hunger and satiety, while promoting increases in psychological flexibility. Based on these factors and research on the Acceptance and Commitment Therapy (ACT), we developed a model: The Mindfulness Meditation/Acceptance and Commitment Approach (MMACT), to support successful weight management in bariatric patients. This study will evaluate the impact of a mindfulness training, based on the MMACT model, on the constructs of mindfulness, psychological flexibility, perceived stress, and intuitive eating in adults post-bariatric surgery. We hypothesized that such intervention will increase mindfulness and psychological flexibility, which will lead to a decrease in perceived stress and an increase in intuitive eating. Methods Individuals 12 to 36 months post-bariatric surgery will be recruited to participate in a 6-session mindfulness training program. The training will take place in group settings of 8–10 participants (final n = 45) and outcome measurements will be assessed at three time points, baseline, six and ten weeks. Results The impact of the training on outcome measurements (i.e., mindfulness, psychological flexibility, perceived stress, and intuitive eating) will be evaluated through four validated questionnaires, the Short Form Five Facet Mindfulness Questionnaire, the Acceptance and Action Questionnaire II, the Perceived Stress Questionnaire, and the Intuitive Eating Scale – 2. Conclusions Evaluation of the MMACT will provide further insight into what factors may impact perceived stress and intuitive eating in bariatric patients and determine the feasibility of mindfulness-based trainings in this population. Funding Sources C.V. Starr Scholarship.

Cognitive and Behavioral Factors Differentially Related to Intuitive Eating

Abstract Objectives Inhibitory control measured by the Go/No-Go Task measures automatic inhibition. Difficulty with inhibition can extend into eating behavior, leading to unhealthy patterns such as emotional eating. Individuals who eat emotionally may also be less likely to engage in adaptive patterns of eating, such as intuitive eating (IE). IE is based on internal regulation of eating behaviors rather than eating for non-physiological reasons (e.g., emotions). This study sought to investigate the relationship between inhibitory control, emotional eating, and IE. Methods 108 adults with overweight/obesity enrolled in a weight loss trial participated in the study. The sample was 46 ± 11 years old, 72% female, 76% White, and had a mean BMI of 35.7 ± 5.9 kg/m2. All data were collected at the baseline assessment visit. Emotional eating and IE were measured via self-report with the Emotional Eating Scale (EES) and Intuitive Eating Scale-2 (IES-2), respectively. The EES provides a total score and the IES-2 provides a total score and four subscale scores: Unconditional Permission to Eat (PERM), Eating for Physical Rather than Emotional Reasons (PHYS), Reliance on Hunger and Satiety Cues (REL), and Body-Food Choice Congruence (CON). Inhibitory control was measured via behavioral tests with the Automated Neuropsychological Assessments Metrics-4 (ANAM-4) Go/No-Go subtest. Results A theoretically-driven path analysis model was calculated using AMOS, using the Go/No-Go subtest and EES as determinates of the four IE subscales. Overall, the path model was effective at capturing variability in two (PHYS & REL) of the four outcome variables. Substantial differences were observed in terms of the magnitude of the path coefficients (PERM ß = .04; PHYS ß = –.74) and the amount of variance captured across the IES-2 subscales criterion measure (R2 ranged from .00—.54). The overall fit indices for the model were above threshold: χ2(7) = 2.19, P = .95, χ2/DF = 0.31, CFI = 1.00, TLI = 1.20, and RMSEA = .000 (.000; .011). Conclusions These findings help shed light on how inhibitory control, emotional eating, and IE are associated with one another. Surprisingly, inhibitory control was unrelated to IE. Further, emotional eating may only contribute to certain facets of IE — eating for physical rather than emotional reasons and reliance on hunger and satiety cues. Funding Sources K23DK103941.

Differences in Food Susceptibility Between High and Low Intuitive Eaters

Abstract Objectives Intuitive eating (IE) is a pattern of adaptive eating behaviors that consists of four facets: Unconditional Permission to Eat (PERM), Eating for Physical Rather than Emotional Reasons (PHYS), Reliance on Hunger and Satiety Cues (REL), and Body-Food Choice Congruence (CON). The objective of this study was to observe differences in self-reported susceptibility to highly palatable foods between individuals high and low in intuitive eating. Methods 66 adults (70% female; 77% white; age 46 ± 12; BMI 36.3 ± 6.5 kg/m2) with overweight/obesity enrolled in a behavioral weight loss trial participated in the study. Measures were collected at baseline assessments or at the initial treatment session via self-report scales. Intuitive eating was measured with the Intuitive Eating Scale-2, which includes a total score and four subscale scores: PERM, CON, REL, and PHYS. Food susceptibility was measured with the Power of Food Scale. BMI was objectively measured and calculated as kg/m2. Covariates included age, sex, race, education, and BMI. Individuals were grouped as high IE (≥75th percentile) and low IE (≤25th percentile) for total and subscale scores. Data were analyzed with Analyses of Covariance. Results Overall, high IE individuals displayed less food susceptibility (M = 40.1 ± 12.3) – as observed by lower PFS scores – than low IE individuals (M = 66.1 ± 13.7, F(1,31) = 30.56, P < .001). This pattern was true for three of the four IE subscales: PHYS; Eating for Physical vs. Emotional Reasons (F(1,31) = 7.878, P = .009), REL; Reliance on Hunger and Satiety Cues (F(1,39) = 22.99, P < .001), and CON; Body-Food Choice Congruence (F(1,23) = 6.001, P = .022). However, there were no differences in PFS scores between individuals high (M = 55.82 ± 18.64) and low (M = 51.87 ± 18.90) in Unconditional Permission to Eat (PERM; F(1,21) = .269, P = .610). Conclusions In adults with overweight/obesity, individuals who displayed higher levels of IE generally reported less susceptibility to hyper-palatable foods, which may be congruent with improved health. Upon observation of the IE subscales, this was not true for Unconditional Permission to Eat. Surprisingly, there were no differences in food susceptibility between those who report giving themselves more or less permission to eat freely. Funding Sources K23DK103941.

Intuitive eating is associated with glycemic control in type 2 diabetes.

The intuitive eating approach has shown promise, but studies on its association with diabetics are scarce. The aim of this study is to identify the association between intuitive eating and glycemic control in individuals with type 2 diabetes mellitus. This is an observational cross-sectional analytical study in patients at the endocrinology service of a university hospital in Vitória/ES, Brazil. For data collection, a semi-structured questionnaire was used and intuitive eating was assessed by Intuitive Eating Scale-2. A total of 179 individuals, mostly female and elderly, and predominantly taking oral antidiabetic drugs without association with insulin were evaluated. In adjusting for the total scale score, the most intuitive eating was associated with lower chances of patients presenting inadequate glycemic control by 89% (OR = 0.114; CI 0.024-0.540; p = 0.006), and a higher score on the Body-Food-Choice Congruence subscale was associated with lower chances of participants presenting this inadequacy by almost 66% (OR = 0.341; CI 0.131-0.891; p = 0.028), regardless of their body mass index. Eating intuitively, especially in accordance with body needs may be associated with lower chances of type 2 diabetics having inadequate glycemic control. Level V, cross-sectional descriptive study.

Retrospective reports of childhood feeding in mother-daughter dyads

Significant research has linked parents' feeding practices to children's eating habits. However, much less is known about how childhood feeding relates to longer-term outcomes such as eating in adulthood. The current study uses retrospective reports from mother-daughter dyads (N = 217) to compare childhood feeding practices and to examine how recalled feeding is related to current eating (emotional eating, intuitive eating, unrestrained eating) and body mass index (BMI) in adult daughters. Mothers and daughters completed the Comprehensive Feeding Practices Questionnaire (CFPQ), subscales from the Three Factor Eating Questionnaire, and the Intuitive Eating Scale. Results of an exploratory factor analysis indicated that mothers and daughters largely had similar factor structures on retrospective reports, with factor loadings varying on four of twelve original CFPQ subscales: monitoring, restriction for health, child control, and modelling. Paired samples t-tests examined mean differences between mother and daughter reports on each subscale; there was no significant difference between mother and daughter reports on six of the 11 scales. Daughters reported significantly higher levels of pressure to eat; mothers reported significantly higher levels of healthy practices, child control, involvement, and unhealthy environment than their daughters recalled. Hierarchical regressions revealed that daughters' reports of specific childhood feeding practices accounted for significant change in unadjusted variance for uncontrolled eating (18.8%), emotional eating (13.1%), intuitive eating (14.7%), and BMI (16.1%). Similarly, regressions revealed that mothers' reports of childhood feeding practices accounted for significant change in unadjusted variance for emotional eating (11.5%) and BMI (11.2%), but not uncontrolled or intuitive eating. Collectively, results lend strong support to the use of retrospective reports on childhood feeding and provide evidence that recalled childhood feeding practices have lasting relations with adult eating behaviors.

Dimensional structure, psychometric properties, and sex and ethnic invariance of a Bahasa Malaysia (Malay) translation of the Intuitive Eating Scale-2 (IES-2)

The Intuitive Eating Scale-2 (IES-2; Tylka & Kroon Van Diest, 2013) is a widely-used measure of facets of intuitive eating. We examined the psychometric properties of a Bahasa Malaysia (Malay) translation of the IES-2 in a sample of Malaysian Malay and Chinese adults (N = 921). Participants completed a Malay translation of the IES-2 along with demographic items and measures of psychological well-being, positive and negative body image, and internalisation of appearance ideals. Exploratory factor analyses (EFAs) with Malay subsamples indicated that IES-2 scores reduced to 4 factors in women and 3 in men, both of which diverged from the parent model. Confirmatory factor analysis failed to confirm the parent 4-factor model, and indices for the EFA-derived models were acceptable but not ideal. Of the models tested, the EFA-derived 3-factor model had the best fit indices. Scores on this model had adequate internal consistency and were invariant across sex and ethnicity, but between-group differences in subscale scores were non-significant or negligible. Evidence of the construct validity of Malay IES-2 scores was mixed, particularly in men. These results lead us to question the degree to which intuitive eating as a construct is applicable to Malaysian populations specifically and non-Western populations generally.

Secondary-prevention behaviour-change strategy for high-risk patients: Benefits for all classes of body mass index.

Research is needed to support the long-term benefits of lifestyle interventions for management of high-risk patients with different BMI classifications. This prospective multicentre study assessed two-year outcomes of hospital-referred patients (BMI 25-61 kg/m2 ) attending a dietitian-led multidisciplinary Healthy Eating and Lifestyle Behaviour-Change Program in group or individual formats in hospital outpatient settings. Bodyweight, quality of life (Short Form-12) and intuitive eating (Intuitive Eating Scale) data were collected at pre-intervention, post-intervention and 2 years. Outcomes were reported in BMI classes. At pre-intervention (n = 493), 11% had pre-obesity, 25% obesity class I, 30% obesity class II and 34% obesity class III. Characteristics of participants with available data at post-intervention (n = 290) and 2 years (n = 178) were comparable (P > .05). Significant mean weight loss was seen at post-intervention (-2.0 ± 0.4 kg, P < .001, n = 290) and 2 years (-4.3 ± 0.5 kg, P < .001, n = 178). All BMI classes had significant weight losses (P < .05). Participants with higher obesity (classes II and III) had greater improvements in mental quality of life (P < .05) and initial weight reductions (P < .05) than those with lower classes. However, those with obesity class I had the greatest long-term weight reductions and significant improvements in physical quality of life at 2 years (P < .05). All BMI classes reported similar improvements in intuitive eating. No effect was found for differences in intervention format, duration or setting (P > .05). The results support dietitian-led multidisciplinary lifestyle interventions for multidisciplinary management of high-risk patients of all BMI classes.

Defining statistical measurement levels of Intuitive Eating with the Rasch Rating Scale Model

AbstractIntuitive eating is an intrinsic ability to moderate the amount and type of food, promoting a healthy diet and self-regulation of one's own weight. Different instruments (IES-H, IES-T, IES-2) have been developed to assess intuitive eating between different population groups from different countries. The construct validity and invariance of the 23-item Intuitive Eating Scale-2 (IES-2) has been widely validated by Confirmatory Factor Analysis and Exploratory Factor Analysis. However, these Classical Test Theory (CTT) methods have not always confirmed the same 4-factor structure.Rasch analysis, a Modern Test Theory method (MTT), has been used as an alternative approach to examine the psychometric properties of various health and medical instrument (HADS, KIDSCREEN-52, LANSS, MHRM). One significant difference between CTT and MT is the method of calculating a composite score. A CTT total sore is based on the summation of raw categorical scores, whereas these raw categorical scores are converted to interval-scaled measures into a Rasch composite score.Data was collected from 625 respondents was fitted to the Rasch Rating Scale Model. The data fitted the model adequately, as less than 5% and 1% of absolute standardised residuals were found to be ≥ 2 and ≥ 3, respectively. A Principle Component Analysis of Rasch residuals (PCAR) was used to determine the unidimensionality of the IES-2 and its subscales, after checking and adjusting for lack of item fit and proper rating scale functioning. PCAR indicated that all 23 items could not function as a single total unidimensional Rasch measure. However, the same item structure for the 4 subscales, originally proposed by Tylka and Kroon Van Diest, was confirmed by PCAR. The relationship between the respondents and the IES-2 items in each subscale could be explained using a Wright map, allowing both to be represented on the same logit scale.Statistical different levels of intuitive eating were determined for each subscale from a table representing the relationship between the lowest and highest possible raw scores and their Rasch measures. Wright maps showed the position of respondents between cut-off lines indicating different statistical levels along each unidimensional subscale of intuitive eating. The majority of respondents were classified into 2 out of 4 levels in the subscale Unconditional Permission to Eat, 3 out of 5 levels in Eating for Physical Rather Than Emotional Reasons, 3 out of 5 levels in Reliance on Internal Hunger and Satiety Cues and 2 out of 4 levels in Body-Food Choice Congruence.

Assessing Evidence of Validity for the Intuitive Eating Scale-2 among Adult Latina Women

Introduction/Background: No research has been conducted on the relevance of intuitive eating as a promising strategy for sustainable weight management among Latinas. This study translated Tylka and Kroon Van Diest’s (2013) Intuitive Eating Scale-2 (IES-2) into Spanish and employed an exploratory factor analysis (EFA) to examine evidence of validity. Methods: We recruited Latinas from community venues in South San Diego, California to participate in this cross-sectional study. Inclusion criteria were: at least 18 years of age, monolingual Spanish or bilingual English/Spanish speaker, and self-identified Latina. In total, 150 Latinas completed a structured, face-to-face interview, which included the Spanish IES-2. Data were used in conducting an EFA. Results: Four items were removed for not loading on the initial EFA. Once items were removed, we extracted five factors with Eigenvalues greater than 1, which accounted for almost two-thirds of the variance. Of the four original IES-2 factors, two were retained identically: Reliance on Hunger and Satiety Cues (RHSC) and Body-Food Choice Congruence (B-FCC). The Eating for Physical Rather than Emotional Reasons (EPR) subscale lost one item in the initial EFA, and was not unidimensional, resulting in two separate subscales. Evidence of score reliability was marginal to strong (α = 0.63 - 0.87). Discussion: This study is first to provide evidence of validity and reliability for a Spanish translation of the IES-2. The results suggest that the proposed Spanish IES-2 can be used to study intuitive eating behaviors and attitudes among Latinas. However, further research with larger sample sizes and other diverse populations are suggested.

Intuitive Eating

Abstract. Intuitive eating is defined as an adaptive way of eating that maintains a strong connection with the internal physiological signs of hunger and satiety. It has four elements: unconditional permission to eat whenever and whatever food is desired, eating for physical rather than for emotional reasons, reliance on hunger and satiety cues to determine when and how much to eat, and body-food choice congruence. In this study, we assessed the differences and similarities between intuitive eating, as measured with the Intuitive Eating Scale-2 (IES-2), and eating styles (restrained, emotional, and external eating), assessed with the Dutch Eating Behavior Questionnaire (DEBQ). Using a Spanish sample of mainly university students ( n = 1,095) we found that (a) unconditional permission to eat presented a large negative correlation with restrained eating, r = –.82; (b) eating for physical reasons had a large negative correlation with emotional eating, r = –.70; (c) the dimensions of intuitive eating only showed very small correlations with positive and negative affect, satisfaction with life, body dissatisfaction or weight control behavior after restrained, emotional, and external eating had been partialled out. Altogether, the present results suggest that two of the dimensions of intuitive eating as assessed with the IES-2 are not very new or innovative. The most promising new dimension of intuitive eating seems to be body-food choice congruence.

Do I look fat in this? When self-image, intuitive eating and childhood parenting practices merge across gender

There is a paucity of research regarding the relationship between self-image and intuitive eating in adulthood, particularly regarding the effect of childhood parenting. This report consists of two studies, one original and one replication. Study one investigated the effects of body image on intuitive eating using the Multidimensional Body-Self Relations Questionnaire and Appearance Scale, and Intuitive Eating Scale-2. Body image was found to be a significant predictor of intuitive eating and gender differences revealed that males eat more intuitively than females. Study two is a follow-up of these initial findings, and focuses on the body image subscales that significantly correlated with intuitive eating and investigated only the experiences of males. The Parental Authority Questionnaire and the Self-Compassion Scale were added to gain a more in-depth understanding of variables that can influence the tendency of male intuitive eating. Intuitive eating and authoritative parenting during childhood were found to correlate with self-compassion as opposed to body image. Moreover, males reported eating for physical satiety or hungriness as opposed to emotional needs. These findings suggest an association between these variables and provide room for further research to be conducted.

Associations among eating behaviour traits, diet quality and food labelling: a mediation model.

To assess the associations among eating behaviour traits, food label use and diet quality and to evaluate if the association between eating behaviour traits and diet quality is mediated by food label use. Eating behaviour traits were assessed using the Three-Factor Eating Questionnaire (TFEQ), the Restraint Scale and the Intuitive Eating Scale, whereas food label use was measured with the Label Reading Survey. Diet quality (Canadian Healthy Eating Index) was assessed with an FFQ. Cross-sectional study. Adults (n 385; mean (sd): BMI = 26·0 (4·9) kg/m2, age = 41·1 (15·0) years) involved in two previous experimental studies. When controlling for potential covariates, general food label use (β = 1·18 (se 0·26), P < 0·0001) was the main determinant of diet quality, explaining 6·7 % of its variance. General food label use partly mediated the association between TFEQ-cognitive restraint and diet quality; the indirect effect (βindirect (se); 95 % CI) was stronger in men (0·32 (0·10); 0·15, 0·55) than women (0·16 (0·05); 0·08, 0·27). General food label use also partly mediated the negative association between unconditional permission to eat and diet quality; the indirect effect (βindirect (se); 95 % CI) was also stronger in men (-1·88 (0·55); -3·11, -0·96) than women (-1·03 (0·33); -1·81, -0·49). General food label use was the main determinant of diet quality and partly mediated the association between eating behaviour traits and diet quality. The stronger mediating effect observed in men suggests they rely more on food labelling when attempting to restrained themselves, which translates into better diet quality.

Reliability and validity of Chinese version of intuitive eating scale in college students

Objective To translate the English version of the Intuitive Eating scale-2(IES-2)into Chinese, and test the reliability and validity of the Chinese version of IES-2(IES-2-CHI) in college students. Methods The reliability and validity of the Chinese version of IES-2 were tested among 1 309 college students in Liaoning province. All data were analyzed by SPSS 20.0 and AMOS 21.0. Results The Chinese version of IES-2-CHI, all inter-items and item-to-total correlation coefficients ranged from 0.444 to 0.759. The IES-2-CHI had a total Cronbach’s α of 0.933 and the test-retest correlation was 0.831. The item-level content validity index(I-CVI)ranged from 0.830 to 1.000, the scale-level content validity index(S-CVI/UA)was 0.870, and the content validity index at the average scale level(S-CVI/Ave)was 0.978.Four-factors(unconditional permission to eat, eating for physical rather than emotional reasons, reliance on hunger and satiety cues, body-food choice congruence)model were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 58.974%. The confirmatory factor analysis results showed that χ2/df=2.941, CFI=0.959, GFI=0.920, TLI=0.954, PGFI=0.747, RMSEA=0.055, and the model was basically adaptable. Conclusion The Chinese version of IES-2-CHI scale is reliable and valid instrument, which can be used to measure the level of intuitive eating among the college students in Liaoning province. Key words: Intuitive eating; Reliability; Validity; College students

Factor structure of the Intuitive Eating Scale-2 among a low-income and racial minority population

Intuitive eating, where an individual relies on one's own physiologic hunger and satiety cues instead of situational and emotional cues, is associated with healthier lifestyle choices, lower body-mass index (BMI), and positive psychological well-being. Despite the importance of this construct, no assessment measure of intuitive eating has been validated for use in a low-income Black population, who have an elevated risk for poor health outcomes. The aim of this study was to evaluate the factor structure of the Intuitive Eating Scale-2 (IES-2) in a predominately low-income Black population. A confirmatory factor analysis (CFA) followed by an exploratory factor analysis (EFA) were conducted using data from 204 adult participants. A large majority (71%) identified as Black and 89% had public insurance. The relationship between scores on the IES-2, BMI, and body-image dissatisfaction scores were also evaluated. A CFA of the previously used IES-2 structure demonstrated less than optimal fit. An EFA supported a six-factor, twenty-three item measure with the following names set for subscales: Avoiding Forbidden Foods (3 items), Permission to Eat (3 items), Avoiding Emotional Eating (4 items), Avoiding Food-Related Coping Strategies (4 items), Reliance on Hunger and Satiety Cues (6 items), and Body-Food Choice Congruence (3 items). The modified IES-2 scores were negatively associated with BMI and body-image dissatisfaction scores. A modified factor structure of the IES-2 may be a better measure of intuitive eating in low-income Black populations.

Intuitive eating, objective weight status and physical indicators of health.

SummaryIntroductionIntuitive eating (IE) has emerged as a weight‐neutral approach to health promotion for those with overweight/obesity. This weight‐neutral paradigm has some support, although research thus far has often neglected to control for potential confounds (i.e. objective weight status and demographics) and foundational studies are lacking. The objective of the current study was to observe the unique association of IE with physical health indicators in a sample of adults, independent of objective weight status.MethodsParticipants were 248 adults (32 ± 14 years old, 73% female, 64% White) of all weight categories (18.2–55.3 kg m−2), with an average body mass index (BMI) of 30 ± 8 kg m−2. IE was measured with the Intuitive Eating Scale‐2 (IES‐2). BMI was objectively measured in‐lab. Health indicators included blood pressure (BP) and fasting glucose.ResultsA series of hierarchical linear regressions revealed no significant associations between IE and systolic BP (β = −0.076, P = 0.256), diastolic BP (DBP; β = −0.122, P = 0.073) or fasting glucose (β = 0.047, P = 0.500) after controlling for BMI. All effects sizes were small or below (f 2 = 0.00 to −0.04). Sensitivity analyses revealed significantly lower DBP in high intuitive eaters versus low when analysed with a t‐test, t(111.651) = 3.602, P < 0.001, Levene corrected; however, after controlling for relevant covariates (i.e. BMI and demographics), analysis of covariance revealed no difference in DBP between groups, F(1, 116) = 0.330, P = 0.567. No significant differences in systolic BP or fasting glucose were observed between low and high intuitive eaters before or after considering covariates.ConclusionsIn sum, this study investigated associations between IE and common indicators of physical health after controlling for objective weight status. Findings revealed no unique relationship between IE and physical health, and any IE–physical health relationships that were observed were accounted for BMI and/or demographic factors.

Intuitive eating and gestational weight gain

This observational study was designed to establish whether there is a relationship between intuitive eating and gestational weight gain. Intuitive eating involves eating according to hunger and satiety cues, rather than following diet rules or eating in response to external triggers or emotions. Higher levels of intuitive eating are associated with bodyweight in the normal range in women during young and middle adulthood. Excess gestational weight gain is associated with an increased incidence of adverse health outcomes for mothers and children, including many pregnancy related conditions and, following pregnancy, an increased likelihood of obesity among mothers and children.Pregnant women were recruited at their nuchal translucency scan (11–14 weeks gestation), in Dunedin, New Zealand, between 2013 and 2015. A cohort of 218 women completed questionnaires at four times during their pregnancies. Intuitive eating was measured using a version of the Intuitive Eating Scale (IES) adapted for pregnant women and revalidated with this population. Gestational weight gain was calculated at the term visit (>35 weeks gestation) and babies' birth weight was established from the electronic maternity system.Mean total IES scores (and all IES subscales) increased across pregnancy. For every one point greater total IES score at baseline, there was a 1.7 (0.5, 2.9) kg lower gestational weight gain. There was no association between babies' birth weight and intuitive eating. Intuitive eating appears to be associated with lower gestational weight gain but not babies' birth weight. It remains to be seen whether intuitive eating can be increased by educational interventions during pregnancy and thus have an impact on gestational weight gain.

Intuitive eating is associated with weight loss after bariatric surgery in women

Although the data on eating behavior after bariatric surgery are substantial, data on "intuitive eating" are lacking. The aim of this study was to evaluate the link between intuitive eating and weight loss after bariatric surgery. This cross-sectional study used a self-administered questionnaire freely available on social networks and targeted women who had undergone bariatric surgery. Intuitive eating was evaluated with the Intuitive Eating Scale-2 (IES-2). The 3 questionnaire subscores (Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Unconditional Permission to Eat) were also analyzed. The relation between IES-2 scores and the relative variation in body mass index [BMI (in kg/m2)] was assessed with linear regression models. Adjusted β (βAdj) and standardized β $( {{\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}} )$ were reported. We analyzed the responses of 401 women with a mean age of 39±11 y, a mean preoperative BMI of 45.5±7.9, and a mean current BMI of 30.5±7. The mean relative BMI loss was 32.7±12.9%, and the mean IES-2 score was 3.3±0.6. The total IES-2 score was associated with the relative BMI loss, with ∼2.6% BMI loss for each 1-point increase in the IES-2 score [PAdj=0.007; βAdj=-2.57 (95% CI: -4.44, -0.70); ${\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}$= -0.12] after adjusting for elapsed time since surgery and type of surgery. Eating for Physical Rather than Emotional Reasons was the subscore most strongly associated with BMI change after adjustment [PAdj=0.002; βAdj=-2.08 (95% CI: -3.37, 0.79); ${\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}$=-0.14]. This study highlights a significant association between intuitive eating and BMI decrease after bariatric surgery. Furthermore, eating behaviors changed with increasing time since surgery. An intuitive nutritional approach may be complementary with bariatric surgery in the postoperative phase, which should prompt complementary prospective studies to evaluate the effectiveness of therapeutic education programs centered on intuitive eating in the postoperative period.

Intuitive eating is associated with weight and glucose control during pregnancy and in the early postpartum period in women with gestational diabetes mellitus (GDM): A clinical cohort study

IntroductionHigh pre-pregnancy weight and body mass index (BMI) increase the risk of gestational diabetes mellitus (GDM) and diabetes after pregnancy. To tackle weight and metabolic health problems, there is a need to investigate novel lifestyle approaches. Outside of pregnancy, higher adherence to intuitive eating (IE) is associated with lower BMI and improved glycemic control. This study investigated the association between IE and metabolic health during pregnancy and in the early postpartum period among women with GDM. MethodsTwo-hundred and fourteen consecutive women aged ≥18, diagnosed with GDM between 2015 and 2017 and completed the “Eating for Physical rather than Emotional Reasons (EPR)” and “Reliance on Hunger and Satiety cues (RHSC) subscales” of the French Intuitive Eating Scale-2 (IES-2) questionnaire at the first GDM clinic visit were included in this study. ResultsParticipants' mean age was 33.32 ± 5.20 years. Their weight and BMI before pregnancy were 68.18 ± 14.83 kg and 25.30 ± 5.19 kg/m2 respectively. After adjusting for confounding variables, the cross-sectional analyses showed that the two subscales of IES-2 at the first GDM visit were associated with lower weight and BMI before pregnancy, and lower weight at the first GDM visit (β = −0.181 to −0.215, all p ≤ 0.008). In addition, the EPR subscale was associated with HbA1c and fasting plasma glucose at the first GDM visit (β = −0.170 and to −0.196; all p ≤ 0.016). In the longitudinal analyses, both subscales of IES-2 at first GDM visit were associated with lower weight at the end of pregnancy, BMI and fasting plasma glucose at 6–8 weeks postpartum (β = −0.143 to −0.218, all p ≤ 0.040) after adjusting for confounders. ConclusionsIncrease adherence to IE could represent a novel approach to weight and glucose control during and after pregnancy in women with GDM.

Associations Between Intuitive Eating Behaviors and Fruit and Vegetable Intake Among College Students

ObjectiveTo assess associations between intuitive eating behaviors and fruit and vegetable intake among college students. MethodsIntuitive eating behaviors were measured with the Intuitive Eating Scale-2 (IES-2), which reports a total and 4 subscale scores. Fruit and vegetable intake was measured with the National Institutes of Health Eating at America's Table Fruit and Vegetable screener. Questionnaires were completed online. ResultsMedian age of participants was 20 years (n = 293; n = 72 male). Total IES-2 score was not correlated with fruit and vegetable intake. Body–Food Choice Congruence and Eating for Physical Rather Than Emotional Reasons subscales were positively associated with fruit and vegetable intake (r = .462, P < .001 and r = .177, P = .002, respectively). The Unconditional Permission to Eat subscale was negatively associated with fruit and vegetable intake (r = –.308, P < .001). Conclusions and ImplicationsCorrelations between fruit and vegetable intake and intuitive eating behaviors differed by IES-2 subscale scores. If IES-2 is used in nutrition research, education, or counseling with the aim of increasing fruit and vegetable intake, addressing subscale behaviors individually might be considered.