Self-reported Eating Behavior Research Articles

The effects of an 8-week mindful eating intervention on anticipatory reward responses in striatum and midbrain.

Accumulating evidence suggests that increased neural responses during the anticipation of high-calorie food play an important role in the tendency to overeat. A promising method for counteracting enhanced food anticipation in overeating might be mindfulness-based interventions (MBIs). However, the neural mechanisms by which MBIs can affect food reward anticipation are unclear. In this randomized, actively controlled study, the primary objective was to investigate the effect of an 8-week mindful eating intervention on reward anticipation. We hypothesized that mindful eating would decrease striatal reward anticipation responses. Additionally, responses in the midbrain-from which the reward pathways originate-were explored. Using functional magnetic resonance imaging (fMRI), we tested 58 healthy participants with a wide body mass index range (BMI: 19-35 kg/m2), motivated to change their eating behavior. During scanning they performed an incentive delay task, measuring neural reward anticipation responses to caloric and monetary cues before and after 8 weeks of mindful eating or educational cooking (active control). Compared with the educational cooking intervention, mindful eating affected neural reward anticipation responses, with reduced caloric relative to monetary reward responses. This effect was, however, not seen in the striatum, but only in the midbrain. The secondary objective was to assess temporary and long-lasting (1 year follow-up) intervention effects on self-reported eating behavior and anthropometric measures [BMI, waist circumference, waist-to-hip-ratio (WHR)]. We did not observe effects of the mindful eating intervention on eating behavior. Instead, the control intervention showed temporary beneficial effects on BMI, waist circumference, and diet quality, but not on WHR or self-reported eating behavior, as well as long-lasting increases in knowledge about healthy eating. These results suggest that an 8-week mindful eating intervention may have decreased the relative salience of food cues by affecting midbrain but not striatal reward responses, without necessarily affecting regular eating behavior. However, these exploratory results should be verified in confirmatory research.The primary and secondary objectives of the study were registered in the Dutch Trial Register (NTR): NL4923 (NTR5025).

Self-control training supplementing inpatient multidisciplinary obesity treatment in children and adolescents

Research points to self-control as a possible mechanism for facilitating health behaviour and weight loss. The dual pathway model underpins the role of strong bottom-up reactivity towards food and weak top-down executive functions in obesity. Despite flourishing lab studies on attention bias modification or inhibition trainings, relatively few focused on training both processes to improve self-control in children and adolescents in inpatient multidisciplinary obesity treatment (MOT).Being part of the WELCOME project, this study investigated the effectiveness of Brain Fitness training (using the Dot Probe and Go/No-Go) as an adjunct to inpatient MOT in 131 Belgian children and adolescents. Changes in self-control (performance-based inhibitory control and attention bias as well as self-reported eating behaviour) in the experimental group were compared to sham training. Multiple Imputation was used to handle missing data.Inhibitory control and external eating improved over time (pre/post/follow-up), but we found no evidence for a significant interaction between time and condition. Future research should pay more attention to the role of individual variability in baseline self-control, sham training, and ecological validity of self-control training to improve real-life health behaviour and treatment perspectives for children and adolescents with weight problems.

Habenular connectivity predict weight loss and negative emotional-related eating behavior after laparoscopic sleeve gastrectomy.

Habenular (Hb) processes negative emotions that may drive compulsive food-intake. Its functional changes were reported following laparoscopic-sleeve-gastrectomy (LSG). However, structural connectivity (SC) of Hb-homeostatic/hedonic circuits after LSG remains unclear. We selected regions implicated in homeostatic/hedonic regulation that have anatomical connections with Hb as regions-of-interest (ROIs), and used diffusion-tensor-imaging with probabilistic tractography to calculate SC between Hb and these ROIs in 30 obese participants before LSG (PreLSG) and at 12-month post-LSG (PostLSG12) and 30 normal-weight controls. Three-factor-eating-questionnaire (TFEQ) and Dutch-eating-behavior-questionnaire (DEBQ) were used to assess eating behaviors. LSG significantly decreased weight, negative emotion, and improved self-reported eating behavior. LSG increased SC between the Hb and homeostatic/hedonic regions including hypothalamus (Hy), bilateral superior frontal gyri (SFG), left amygdala (AMY), and orbitofrontal cortex (OFC). TFEQ-hunger negatively correlated with SC of Hb-Hy at PostLSG12; and increased SC of Hb-Hy correlated with reduced depression and DEBQ-external eating. TFEQ-disinhibition negatively correlated with SC of Hb-bilateral SFG at PreLSG. Increased SC of Hb-left AMY correlated with reduced DEBQ-emotional eating. Higher percentage of total weight-loss negatively correlated with SC of Hb-left OFC at PreLSG. Enhanced SC of Hb-homeostatic/hedonic regulatory regions post-LSG may contribute to its beneficial effects in improving eating behaviors including negative emotional eating, and long-term weight-loss.

Eating Behaviour among University Students: Relationships with Age, Socioeconomic Status, Physical Activity, Body Mass Index, Waist-to-Height Ratio and Social Desirability.

Eating behaviour is of particular interest for research focusing on body weight status. However, little is known about the relationships of certain factors, especially social desirability, with self-reported eating behaviour such as cognitive restraint, uncontrolled eating, and emotional eating among young adult males and females. This study aimed to evaluate the relationships between eating behaviour and age, socioeconomic status (SES), physical activity (PA), body mass index (BMI), waist-to-height ratio (WHtR), and social desirability among university students. A cross-sectional study was conducted among 353 university students (59.2% females). Eating behaviour was assessed using the 13-item Three-Factor Eating Questionnaire (TFEQ-13). SES and PA were determined using self-reporting, and the Marlowe–Crowne Social Desirability Scale assessed social desirability. BMI and WHtR were calculated based on measured parameters. Associations between self-reported eating behaviour and other variables were assessed using Pearson’s correlation coefficient and multivariate general linear models. Cognitive restraint was positively correlated with BMI and WHtR in both males (r = 0.174, P = 0.036 and r = 0.194, P = 0.020, respectively) and females (r = 0.239, P < 0.001 and r = 0.165, P = 0.017, respectively), and emotional eating was positively correlated with BMI among females (r = 0.184, P = 0.008). Social desirability was negatively correlated with uncontrolled eating (r = −0.287, P < 0.001) and emotional eating (r = −0.301, P < 0.001) among females. There were no significant correlations between eating behaviour and age or socioeconomic status (P > 0.05). Multivariate analysis showed that, among males, PA had a main effect on emotional eating (ηp2 = 0.044, F = 6.276, P = 0.013). Among females, cognitive restraint was positively associated with PA (ηp2 = 0.034, F = 7.127, P = 0.008) and BMI (ηp2 = 0.038, F = 7.959, P = 0.005), and emotional eating with BMI (ηp2 = 0.032, F = 6.638, P = 0.011). Social desirability had the highest main effect on eating behaviour among females, being negatively associated with uncontrolled eating (ηp2 = 0.077, F = 16.754, P < 0.001) and emotional eating (ηp2 = 0.082, F = 18.046, P < 0.001). This study showed that PA, BMI, WHtR, and social desirability were associated with self-reported eating behaviour among university students. Social desirability bias should be considered when evaluating uncontrolled eating and emotional eating among females.

Identifying stress-related eating in behavioural research: A review

Stress is a commonly reported precipitant of overeating. Understanding the relationship between stress and food intake is important, particularly in view of the increasing prevalence of obesity. The purpose of this review is to examine how stress-related eating has been defined and measured in the literature to date. There are no established diagnostic criteria or gold standards for quantification of stress-related eating. Questionnaires relying on the accuracy of self-report are the mainstay of identifying people who tend to eat in response to stress and emotions. There is a paucity of clinical research linking objective measurements of stress and appetite with self-reported eating behaviour. Limitations of the methodological approaches used and the heterogeneity between studies leave significant knowledge gaps in our understanding of the mechanism of stress related eating, and how best to identify it. These issues are discussed, and areas for further research are explored.

Automatic and Controlled Processing: Implications for Eating Behavior.

It is a widely held view that humans have control over their food choices and consumption. However, research also suggests that eating behavior is often triggered by contextual cues and guided by automaticities and habits. Interestingly, the dichotomy between automatic and controlled processing has recently been challenged, suggesting that they may be intertwined. In a large female sample (n = 567), we investigated the hypothesis that task-based and self-reported measures of automatic and controlled processing would interact and impact self-reported eating behavior. Results analyzed via structural equation modeling suggest that automatic, but not controlled processing, during a modified flanker task, including a context-specific proportion congruent (CSPC) manipulation, was inversely associated with self-reported self-control. The influence of self-control on unhealthy eating behavior (i.e., uncontrolled and emotional eating, heightened consumption of fat and sugar) was only indirect via habitual behavior, which itself had a strong direct impact. Unhealthy eating was further associated with real-life outcomes (e.g., body mass index (BMI)). Our findings suggest that eating behavior may indeed be guided primarily by automaticities and habits, whereas self-control might facilitate this association. Having self-control over eating might therefore be most effective by avoiding contextual cues eliciting undesired automatic behavior and establishing habits that serve long-term goals.

A bifactor analysis of the Weight Bias Internalization Scale: What are we really measuring?

Internalized weight stigma (IWS) has been linked with disordered eating behavior, both directly, and as a mediator of the relationship between experienced weight stigma and maladaptive coping. However, the construct of IWS is highly correlated with the related constructs of body image and global self-esteem, and the three constructs may better be represented by underlying trait self-judgment. This overlap is not generally accounted for in existing studies. The present study investigated the shared variance between self-esteem, body image, and IWS in an international sample of higher-weight individuals. Bifactor analysis confirmed that the intermediary role of IWS in the relationship between experienced stigma and self-reported eating behavior was largely accounted for by aspects of body image and global self-esteem. Greater conceptual clarity in the study of IWS is needed to understand the mechanisms via which societal weight stigma impacts on individuals’ self-directed judgments and downstream health-related behaviors.

Psychometric Evaluation of the German Version of the Dietary Fat and Free Sugar-Short Questionnaire

Background: The Dietary Fat and Free Sugar-Short Questionnaire (DFS) is a cost- and time-efficient self-report screening instrument to estimate dietary intake of saturated fat and free sugar. To date, only the English version has been psychometrically evaluated. We assessed the psychometric characteristics of the German version of the DFS in individuals with normal weight, overweight, and obesity. Method: Sixty-five adult participants completed a German translation of the DFS and a validated food frequency questionnaire (FFQ). We correlated participants’ percentage of energy intake from saturated fat and free sugar from the FFQ with the DFS scores. To establish test-retest reliability, participants completed the DFS a second time. To investigate convergent validity, we correlated participants’ DFS scores with self-reported eating behavior and sensitivity to reward. Results: DFS scores correlated with percentage of energy from free sugar (rs = 0.443) and saturated fatty acids (rs =0.258) but not with non-target nutrients. The correlation between DFS scores and percentage energy from free sugar was not moderated by body mass index (BMI), whereas the correlation with percentage energy from saturated fat slightly decreased with BMI. Intra-class correlation as an indicator of test-retest reliability was 0.801. DFS scores correlated significantly with restraint of eating behavior (rs = –0.380) and feelings of hunger (rs = 0.275). Correlations of the DFS score with disinhibited eating and sensitivity to rewards failed to be significant. Conclusion: Our data indicate that the German version of the DFS might be a psychometrically sound self-report instrument to estimate saturated fat and free sugar intake of German adults.

Stress and Eating Behavior: A Daily Diary Study in Youngsters.

Background: Overweight and obesity are growing problems, with more attention recently, to the role of stress in the starting and maintaining process of these clinical problems. However, the mechanisms are not yet known and well-understood; and ecological momentary analyses like the daily variations between stress and eating are far less studied. Emotional eating is highly prevalent and is assumed to be an important mechanism, as a maladaptive emotion regulation (ER) strategy, in starting and maintaining the vicious cycle of (pediatric) obesity.Objectives: The present study aims to investigate in youngsters (10 – 17 years) the daily relationship between stress and the trajectories of self-reported eating behavior (desire to eat motives; hunger eating motives and snacking) throughout 1 week; as well as the moderating role of emotion regulation and emotional eating in an average weight population.Methods: Participants were 109 average weighted youngsters between the age of 10 and 17 years (Mage = 13.49; SD = 1.64). The youngsters filled in a trait-questionnaire on emotion regulation and emotional eating at home before starting the study, and answered an online diary after school time, during seven consecutive days. Desire to eat motives, hunger eating motives and snacking were assessed daily for seven consecutive days.Results: Using multilevel analyses results revealed that daily stress is significantly associated with trajectories of desire to eat motives and hunger eating motives. No evidence was found for the moderating role of maladaptive ER in these relationships; marginally significant evidence was found for the moderating role of emotional eating in the trajectories of desire to eat and snacking.Discussion: These results stress the importance of looking into the daily relationship between stress and eating behavior parameters, as both are related with change over and within days. More research is needed to draw firm conclusion on the moderating role of ER strategies and emotional eating.

Application of Mindfulness in a Tier 3 Obesity Service Improves Eating Behavior and Facilitates Successful Weight Loss.

Mindfulness strategies may facilitate healthier eating behavior but have not previously been studied in a United Kingdom-based tier 3 obesity service. To demonstrate the clinical effectiveness of mindfulness as part of newly created group sessions within a tier 3 obesity service. Recruitment of participants (n = 53, including n = 33 completers) from patients attending a tier 3-based obesity service at University Hospitals Coventry and Warwickshire. Each participant attended four group sessions, at which mindfulness-based eating behavior strategies were taught. Self-reported eating behavior and body weight were assessed at baseline and following completion of attendance at the group sessions. Paired-sample t tests were performed. P < 0.05 was considered significant. Data are reported for the 33 completers. Weight difference was assessed in a retrospective control group of 33 patients who did not attend the group sessions but received the standard multidisciplinary input. There were statistically significant improvements (P = 0.009) in self-reported eating behavior [driven by improvements in "fast-foodism" (P = 0.031)] and reduction in body weight [3.06 kg (SD 5.2 kg), P = 0.002] at 6 months following completion of the group sessions. This was statistically more (P = 0.036) than 6-month weight loss in the control group (0.21 kg). Participants reported improved self-esteem and confidence in self-management of body weight. Application of mindfulness-based eating behavior strategies, taught at group sessions within a tier 3 obesity service, resulted in significant improvement in eating behavior, and facilitated subsequent weight loss over 6 months. Such a strategy has potential for scalability to the wider obese population.

Testing a mobile mindful eating intervention targeting craving-related eating: feasibility and proof of concept.

Theoretically driven smartphone-delivered behavioral interventions that target mechanisms underlying eating behavior are lacking. In this study, we administered a 28-day self-paced smartphone-delivered intervention rooted in an operant conditioning theoretical framework that targets craving-related eating using mindful eating practices. At pre-intervention and 1-month post-intervention, we assessed food cravings among adult overweight or obese women (N=104; M age=46.2±14.1years; M BMI=31.5±4.5) using ecological momentary assessment via text message (SMS), self-reported eating behavior (e.g., trait food craving), and in-person weight. Seventy-eight participants (75.0%) completed the intervention within 7months ('all completers'), and of these, 64 completed the intervention within 3months ('timely completers'). Participants experienced significant reductions in craving-related eating (40.21% reduction; p<.001) and self-reported overeating behavior (trait food craving, p<.001; other measures ps<.01). Reductions in trait food craving were significantly correlated with weight loss for timely completers (r=.30, p=.020), this pattern of results was also evident in all completers (r=.22, p=.065). Taken together, results suggest that smartphone-delivered mindful eating training targeting craving-related eating may (1) target behavior that impacts a relative metabolic pathway, and (2) represent a low-burden and highly disseminable method to reduce problematic overeating among overweight individuals. ClinicalTrials.gov registration: NCT02694731.

The social image of food: Associations between popularity and eating behavior

One factor that determines what we eat and why we eat is our social environment. In the present research, two online studies examined the relationship between food intake and social images. Specifically, the present research assessed the relationship between the food intake university students ascribed to peers who varied in popularity and own self-reported food intake, and whether this relationship was moderated by identification with the peer group. Participants (N = 97 in Study 1; N = 402 in Study 2) were randomly presented with one of four (Study 1) or two of eight (Study 2) vignettes describing a popular or unpopular student (male or female) from their university without receiving any information about the peer's eating behavior. Subsequently, healthy and unhealthy eating ascribed to the peers and own self-reported eating behavior were assessed. Results indicated that popular peers were perceived to eat more healthily than unpopular peers. Moreover, eating behavior ascribed to popular peers were associated with own healthy and unhealthy eating. Importantly, the relationship between healthy eating behavior ascribed to popular peers and own healthy eating behavior was moderated by identification with the student group – the more participants identified with their peers, the more their own eating was aligned with the healthy eating ascribed to a popular peer. Hence, the popularity of others seems to shape perceptions of the food they eat and may facilitate healthy eating via social influence.

Stopping at the sight of food – How gender and obesity impact on response inhibition

Recent research indicates that reduced inhibitory control is associated with higher body mass index (BMI), higher food craving and increased food intake. However, experimental evidence for the relationship between response inhibition and weight status is inconsistent and to date has been investigated predominantly in women. In the current study, 56 participants (26 obese, 30 lean; 27 female, 29 male) performed a Food Picture Rating Task followed by a Stop Signal Task where pictures of palatable high or low caloric food or non-food items were presented prior to the Go signal. We further assessed participants’ self-reported eating behavior and trait impulsivity as potential factors influencing response inhibition, in particular within the food context. Independent of BMI, women showed significantly higher liking for low caloric food items than men. This was accompanied by shorter Stop Signal Reaction Times (SSRT) after high compared to low caloric food pictures for women, and shorter SSRT in women compared to men for high caloric food. No influence of gender on SSRT was observable outside of the food context. While SSRTs did not differ between obese and lean participants across the three picture categories, we found a moderating effect of trait impulsivity on the relationship between BMI and SSRT, specifically in the high caloric food context. Higher BMI was predictive of longer SSRT only for participants with low to normal trait impulsivity, pointing at a complex interplay between response inhibition, general impulsivity and weight status. Our results support the notion that individuals with obesity do not suffer from diminished response inhibition capacity per se. Rather, the ability to withhold a response depends on context and social norms, and strongly interacts with factors like gender and trait impulsivity.

Association of eating three meals irregularly with changes in BMI and weight among young Japanese men and women: A 2-year follow-up

ObjectiveEpidemiological longitudinal investigations of the association between not eating three meals regularly and changes in BMI and weight are scarce. The aim of this study was to investigate whether or not regularly eating three meals was associated with changes in BMI and weight in young Japanese men and women. MethodsStudy participants were 1241 men and 897 women aged 19.0±1.2 and 18.8±0.8years, respectively, who underwent health checkups at a university in Japan in 2001 as the baseline and subsequently in 2003. Weight and height were measured at baseline and 2years later. Whether an individual ate three meals regularly was determined by a self-report questionnaire in 2001. ResultsDuring the 2-year follow-up, the BMI gain was 0.347 for men and 0.067 for women. In the logistic regression analysis, for men, eating three meals irregularly was significantly associated with a 4% BMI gain (OR 1.60, CI 1.11–2.30), 6% BMI gain (OR 1.72, CI 1.12–2.63), 4kg weight gain (OR 2.01, CI 1.29–3.13), 6kg weight gain (OR 1.86, CI 1.02–3.37), and incidence of obesity (BMI ≧ 25)(OR 2.96, CI 1.22–7.17). For women, eating three meals irregularly was significantly associated with a 4% BMI loss (OR 1.99, CI 1.01–3.94), 6% BMI loss (OR 2.79, CI 1.29–6.03), 4kg weight loss (OR 3.85, CI 1.62–9.12), 6kg weight loss (OR 7.65, CI 2.06–28.46), and the incidence of underweight (OR 3.95, CI 1.32–11.89). ConclusionsThe current results suggested that eating three meals irregularly was associated with subsequent BMI and weight gains for men and subsequent BMI and weight losses for women; both groups were around 20years of age. Self-reported eating behavior in this study might be used to screen and evaluate young Japanese men and women at high risk for changes in BMI and weight in a practical clinical setting.

A Psychophysiological Mechanism Underlying Women's Weight-Management Goals: Women Desire and Strive for Greater Weight Loss Near Peak Fertility.

Three studies demonstrated that conception risk was associated with increased motivations to manage weight. Consistent with the rationale that this association is due to ovulatory processes, Studies 2 and 3 demonstrated that it was moderated by hormonal contraceptive (HC) use. Consistent with the rationale that this interactive effect should emerge when modern appearance-related concerns regarding weight are salient, Study 3 used a 14-day diary to demonstrate that the interactive effects of conception risk and HC use on daily motivations to restrict eating were further moderated by daily motivations to manage body attractiveness. Finally, providing evidence that this interactive effect has implications for real behavior, daily fluctuations in the desire to restrict eating predicted daily changes in women's self-reported eating behavior. These findings may help reconcile prior inconsistencies regarding the implications of ovulatory processes by illustrating that such implications can depend on the salience of broader social norms.

Electrophysiological indices of visual food cue-reactivity. Differences in obese, overweight and normal weight women

Heightened food cue-reactivity in overweight and obese individuals has been related to aberrant functioning of neural circuitry implicated in motivational behaviours and reward-seeking. Here we explore the neurophysiology of visual food cue-reactivity in overweight and obese women, as compared with normal weight women, by assessing differences in cortical arousal and attentional processing elicited by food and neutral image inserts in a Stroop task with record of EEG spectral band power and ERP responses. Results show excess right frontal (F8) and left central (C3) relative beta band activity in overweight women during food task performance (indicative of pronounced early visual cue-reactivity) and blunted prefrontal (Fp1 and Fp2) theta band activity in obese women during office task performance (suggestive of executive dysfunction). Moreover, as compared to normal weight women, food images elicited greater right parietal (P4) ERP P200 amplitude in overweight women (denoting pronounced early attentional processing) and shorter right parietal (P4) ERP P300 latency in obese women (signifying enhanced and efficient maintained attentional processing). Differential measures of cortical arousal and attentional processing showed significant correlations with self-reported eating behaviour and body shape dissatisfaction, as well as with objectively assessed percent fat mass. The findings of the present study suggest that heightened food cue-reactivity can be neurophysiologically measured, that different neural circuits are implicated in the pathogenesis of overweight and obesity, and that EEG techniques may serve useful in the identification of endophenotypic markers associated with an increased risk of externally mediated food consumption.

Sleep duration and energy intake: timing matters

Dear Sir: It was with great interest that we read the article by Kant and Graubard (1). The authors examined both self-reported sleep duration and eating patterns of ∼15,000 adult Americans of the NHANES cohort. The main finding was that short sleepers, ie, those reporting sleeping ≤6 h/night, were found to consume breakfast earlier and consume fewer main meals but more snacks compared with average sleepers (habitual sleep duration between 7 and 8 h). In contrast, self-reported eating behavior did not differ between average and long sleepers (ie, ≥9 h). Finally, the overall self-reported 24-h energy intake was not different between short, average, and long sleepers. Notwithstanding their elegant demonstration of the association between short sleep and altered eating patterns, Kant and Graubard did not investigate whether short sleepers also eat at times of the day when the circadian system is not metabolically adjusted to process ingested nutrients or stimulants such as caffeine (ie, primarily during the night). Indeed, their article does not report how many of those who were self-reported short sleepers were also shift workers. This is an important aspect of the analysis of food intake in relation to sleep and circadian timing, because shift workers are often forced to eat, and not only sleep, at odd times of their 24-h day, including during the night (2), times during which the body is more insulin resistant and generally disadvantageously adapted to handling food intake. Not only did previous studies link shift work with the development of obesity but they also showed that under conditions of experimental circadian disruption, in which sleep is misaligned in much the same way as experienced by many shift workers, this alters the hormonal profile, increases inflammation, and reduces insulin sensitivity (3, 4). Hormones responsible for determining the appetitive and metabolic response to food intake, such as the hunger-promoting hormone ghrelin and the satiety-enhancing adipokine leptin, are known to be perturbed by circadian misalignment (4, 5). Although with ad libitum food intake such paradigms can lead to increased food intake, circadian misalignment can even promote weight loss under apparently isocaloric conditions, ie, if food intake is equal between groups, matched to the calculated 24-h energy expenditure (5). In an intervention aiming for weight loss, the timing at which food intake occurs was also linked to the success of weight loss (6), such that late lunch eaters lost less weight than did early lunch eaters during the 20-wk intervention. At the molecular level, when the circadian machinery was disrupted in mice due to genetic mutation of the gene Clock, this resulted in obesity (7). Forcing wild-type mice under ad libitum high-fat diet conditions to flip their circadian eating time by 12 h, effectively eating during their “physiological” night, led to a 48% increase in body weight, as opposed to a 20% increase for the mice with a normal meal pattern (8). Importantly, these differences were noted despite no significant differences in energy intake between the 2 groups of mice. Importantly, if food is provided at the incorrect time of day, this may in the long run not only cause an increase in body weight but also predispose individuals to develop type 2 diabetes—the risk of which a recent meta-analysis once more confirmed to be elevated for individuals who perform shift work (9). The importance of circadian misalignment for such ultimate consequences of shift work was highlighted by the fact that workers with rotating shifts, in which the timing of both sleep and food intake will keep occurring at time points to which the body cannot adapt to quickly enough from a chronobiological viewpoint, had the highest risk of developing type 2 diabetes. Shift work, or the experimental version thereof, with desynchronizing extended sleep-wake cycles or day lengths (2, 3, 9), are known to lead to reduced average sleep duration and sleep quality. Although Kant and Graubard did not find any differences in after-dinner meals between short, average, or long sleepers, they found a higher percentage of 24-h energy intake at or after 2000 h in short sleepers (1). This suggests that this sleep group may still consume significant amounts of energy at inappropriate time points of the day (ie, night), perhaps in combination with metabolically equally challenging mistimed sleep. Given that eating at the “wrong” time from a circadian perspective may increase the risk of weight gain, even under neutral energy balance conditions, an important next step would be to examine to what extent specifically misaligned sleep or rotating sleep schedules—habits typically seen in those who “work on shifts”—favor energy surplus and metabolic consequences in cohorts such as NHANES.

The Effect of SNAP Education in Indiana on Fruit, Vegetable and Whole Grain Eating Behaviors

The analyses reported here evaluate the effectiveness of SNAP nutrition education on self-reported eating behavior changes in Indiana. Supplemental Nutrition Assistance Program (SNAP) encourages adequate nutrient intake in low-income population. Promoting adequate consumption of fruits, vegetables and whole grains is a major goal. The intervention was provided through lessons, games and demonstrations, either in groups or individually. Data were collected in 92 counties in Indiana from 2008 to 2011. 2109 individuals who attended at least 4 lessons completed the questionnaires before and after the intervention. Amount and variety of fruit and vegetables, whole grain intake and breakfast pattern were evaluated using paired t-test, independent sample t-test, One Way ANOVA Test and McNemar’s Test. Less than half of the participants met the Dietary Guidelines for Americans for these food groups. Amount and variety of fruit and vegetables, whole grain intake and breakfast pattern were evaluated using paired t-test, independent sample t-test, One Way ANOVA Test and McNemar’s Test. Less than half of the participants met the Dietary Guidelines for Americans for these food groups. Less than half of the participants met the Dietary Guidelines for Americans for these food groups. The intake of fruits, vegetables, and whole grains and breakfast frequency showed significant improvement (p<0.001) after the lessons. The largest changes were found in fruits, followed by vegetables and then whole grains. The improvement in fruit variety was higher than vegetable variety. More than half of the participants did not change their breakfast pattern. Almost all gender, races, and age groups improved in all the behaviors (p<0.001), regardless of the number of lessons attended (p<0.001). The analysis demonstrates successful behavioral changes following SNAP-Ed nutrition education. Attention should be given to the 18 years old group, Blacks, White and male participants who tend to had lower intake than other groups. The results suggest that maximizing the number of participants who receive SNAP-Ed rather than the number of classes each participant receives may be the most effective and efficient use of limited educational resources.

Emotional, external, restrained eating and overweight in Dutch adolescents

The purpose of this study was to determine how emotional, external and restrained eating behavior and other health-related lifestyle factors were associated with being overweight in adolescents. Moreover, demographic and ethnic differences in eating behavior have been examined. The respondents were 10,087 Dutch adolescents aged 11-16 years (M= 13.0, SD= 0.8). Self-reported eating behavior was measured with the DEBQ. Health-related lifestyle was determined by physical activity, breakfasting, fruit consumption and snacking. High restrained, and low external eating were positively associated with being overweight, whereas no significant association between emotional eating and being overweight was found for girls, and a negative association for boys. Adolescents who ate breakfast on a daily basis were less likely to be overweight than those who ate breakfast irregularly or never. Being overweight was positively associated with fruit consumption for girls and negatively with physical activity for boys.

Pre-Surgery Binge Eating Status: Effect on Eating Behavior and Weight Outcome after Gastric Bypass

The impact of pre-surgical binge eating on postoperative outcomes is poorly understood. Previous studies have found marked preoperative differences between binge eaters (BE) and non-binge eaters (NBE) in hunger and disinhibition using the Three-Factor Eating Questionnaire (TFEQ). Short-term prospective data are mixed regarding whether these differences persist after surgery and if preoperative binge eating impacts postoperative weight outcomes. The purpose of the present study was to compare self-reported eating behavior and weight outcomes between BE and NBE after the first postoperative year. Prior to surgery, 72 Roux-en-Y gastric bypass (RYGBP) patients completed the Questionnaire of Eating and Weight Patterns (QEWP) or QEWP-Revised (QEWP-R), to assess binge eating status which was defined as one objective binge episode per week over the past 6 months. Subjects also completed the TFEQ prior to surgery and again > or = 12 months after surgery. For BE, higher scores were found for both hunger and disinhibition prior to surgery. At a mean of 18 months after surgery, BE and NBE were indistinguishable on these subscales and there were no differences in weight lost. RYGBP surgery has an equally positive impact on eating behavior and weight loss for both BE and NBE. Within a multidisciplinary clinic, preoperative BE status does not appear to be a negative prognostic indicator for RYGBP surgery in the domains of weight loss and disinhibition. Further replication is needed with longer follow-up times and larger samples.