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PubMed1998

Factors which influence 'healthy' eating patterns: results from the 1993 Health Education Authority health and lifestyle survey in England.

OBJECTIVES: This study explores the factors that influence eating patterns in a nationally representative sample of the English population. DESIGN: Subjects were interviewed in 1993; questions covered basic demographic details, attitudes about nutrition, and they completed a short food frequency questionnaire that had previously been validated. Cluster analysis was used to summarize dietary intake into more or less healthy clusters. SETTING: A random sample of the English population. SUBJECTS: A cross-sectional survey of 5553 men and women (response rate 70%) aged between 16 and 74 years. RESULTS: As defined from the cluster analysis about half the sample were currently reporting a more healthy diet; respondents in the better educated middle-aged demographic cluster were more likely to report eating a more healthy diet than respondents in the younger lower-income family cluster. About three-quarters of all respondents believed that they either already ate a healthy diet or had changed to a healthy diet in the last 3 years. For those respondents who said they were eating a healthy diet about half of them were eating a more healthy diet. Respondents who had not changed their diet were more likely than those who had to believe that healthy foods were just another fashion (men 34% v. 13%; women 30% v. 12%), or expensive (men 50% v. 35%; women 53% v. 40%); they were less likely to care about what they ate (men 45% v. 13%; women 27% v. 7%). Nearly three-quarters of all respondents agreed that experts never agree about what foods are good for you. Younger, low-income families, and those who smoked, were the group least likely to be eating a more healthy diet. CONCLUSIONS: The results of this study suggest that about half of the population has reported a change to a healthier diet over the last 3 years and that overall about half of the population report eating a healthy diet. Those who had not made any change and were currently reporting a less healthy diet were more likely to smoke and come from the 'worse off group in the survey; they were also more likely to hold negative attitudes about healthy eating. A more focused and integrated approach to promoting healthy lifestyle in general is required, while at the same time ensuring that there is continued support for the majority of the population who have made healthy dietary changes.

Adolescent↗

PubMed1999

Eating habits and appetite control: a psychobiological perspective.

An individual's eating behaviour is shaped by factors ranging from economic conditions and cultural practices to biological influences. The physiological system controlling appetite appears to be adapted to solving the problem of an unevenness of food supply across time, and is fairly permissive in its response to undereating and overeating. Consequently, when food is abundant, the diet is energy dense and energy expenditure is low, there is a strong tendency to become obese (i.e. obesity is better viewed as due to a 'toxic' environment than to faulty physiological control of appetite). Under such conditions the most common method of avoiding obesity is through the cognitive control of eating. However, dietary restraint and dieting are demanding tasks, and are associated with psychological costs, including significant impairment of cognitive performance. Restraint is also prone to disinhibition, with the result that it can sometimes undermine eating control, even leading to the development of highly disordered eating patterns. In part, these difficulties are due to the self-perpetuating nature of dietary habits: for example, hunger tends to be diminished during strict unbroken dieting, but increased in individuals having a highly variable eating pattern (such as occurs when eating is frequently disinhibited). These features of appetite control provide both barriers and opportunities for changing behaviour. Accordingly, there is a need for future research to focus on the psycho-social factors and the dieting practices predicting successful eating and weight control, with the objective of identifying the actual cognitive and behavioural strategies used by the many dieters and restrained eaters who are able to achieve weight loss and maintain long-term weight stability.

Appetite Regulation↗

PubMed2006

Validating the EDI-2 in three Swedish female samples: eating disorders patients, psychiatric outpatients and normal controls.

The aim of the current study was to validate the Eating Disorders Inventory 2 (EDI-2) in a Swedish population by investigating how it discriminates between three female samples aged 18 to 50 years: patients with eating disorders (n = 978), psychiatric outpatients (n = 106) and normal controls (n = 602), as well as between different eating disorder diagnoses. The internal consistency of the EDI-2 was above 0.70 for most subscales. The EDI-2 discriminated well between patients with eating disorders and normal controls on all subscales. On the symptom-related subscales, eating disorder patients scored highest followed by psychiatric controls and normals. All subscales except Perfectionism, Interoceptive awareness and Asceticism discriminated eating disorder patients and psychiatric controls. Bulimia patients scored higher than anorexics on the symptom subscales. It is concluded that the EDI-2 discriminates well between eating disorder patients and both psychiatric and normal controls.

Adolescent↗

PubMed2006

Eating out: consumer perceptions of food safety.

The purpose of this investigation was to improve the understanding of the public's perception of hygiene standards in eating places and their knowledge of the inspection system. A telephone survey found that despite many claiming experience of food poisoning, and a widely held belief that using eating places may result in illness, people continue to eat out or purchase takeaways regularly. Nearly all respondents claimed that the standard of food hygiene was important to them when deciding where to eat out. Assessments of hygiene standards were mainly based on aesthetics. A minority had concerns/complaints about the hygiene standards of eating places they had used. People do not appear to be well informed about the role of the local authorities in protecting food safety and how the food safety laws are enforced. They believe that they have the right to know the result of a hygiene inspection. Half of them thought that it was difficult to find information on the hygiene standards of eating places. If access to information was easier, some consumers would eat out more often. The public will need to be educated on the inspection and enforcement process if 'scores on doors' is adopted as the main method of raising the confidence of the public in the standards of the food industry.

Consumer Behavior↗

PubMed2001

Middle school primary prevention program for eating disorders: a controlled study with a twelve-month follow-up.

The aim of this pilot study was to evaluate the efficacy of a new school-based eating disorder prevention program designed to reduce dietary restraint and the level of preoccupation with regard to shape and weight. One hundred and six (61 females and 45 males) 11 to 12-year-old students were evaluated, 55 of whom participated in the program (experimental group). An additional 51 students formed the control group. The program met for six sessions, two hours per session. After six months, the experimental group received two booster sessions of two hours in two consecutive weeks. Outcome measures included the Eating Disorder Examination Questionnaire (EDE-Q), the children's version of the Eating Attitudes Test (EAT), the Rosenberg Self-Esteem Scale (RSES), and a Knowledge Questionnaire (KQ) devised by the authors of the program. The questionnaires were administered in both the experimental and control groups, one week before the intervention, one week afterwards, and at six-month and 12-month follow-ups. Unlike a previous school-based eating disorder prevention program, in the experimental group both an increase in knowledge and a decrease in some attitudes were maintained at 12-month follow-up (Eating Concerns EDE-Q scores). Although more intensive interventions seem necessary to modify shape and weight concern and self-esteem, these findings suggest that the intervention had been useful since it led to both an increase in knowledge and a decrease in some dysfunctional eating attitudes.

Journal Article↗

PubMed2002

Assessment tools for self-harm behavior among those with eating disorders.

There appears to be a substantial minority of eating disorder patients who report self-harm behaviors. This paper reviews the available assessment tools relating to individuals with eating disorders and self-harm behaviors. Current eating disorder assessments do not contain any items relating to self-harm behaviors. Several of the self-harm measures contain some eating disorder items, but not a sufficient number to provide an eating disorder diagnosis. Among the self-harm measures, only three offer items relating to eating pathology as well as overt self-harm and high-lethal behaviors. One of the three has an established scoring that predicts borderline personality disorder. In summary, there are no currently available assessment tools that are able to simultaneously diagnose eating disorder pathology as well as measure self-harm behaviors.

Journal Article↗

PubMed2003

Eating disorder symptoms among adults with severe and persistent mental illness.

This article presents pilot data examining the: (1) prevalence of eating disorder symptoms among adults with severe and persistent mental illness (SPMI) and (2) clinical and demographic predictors of eating disorder symptoms. Participants were 149 adults with SPMI who were receiving community mental health services. The Eating Attitudes Test, Body Image Avoidance Questionnaire, purging questions, and Body Mass Index were used to assess eating disorder symptoms. Forty percent of participants indicated eating disorder symptoms. Predictors of eating disorder symptoms included female gender and greater clinical severity. The findings suggest the need for clinical attention to eating disorders for this population.

Journal Article↗

PubMed2003

Nutrition and eating in female college athletes: a survey of coaches.

The purpose of the present study was to gather information from coaches regarding their monitoring/management of athlete eating and weight, knowledge of nutritional health issues, availability of prevention/intervention services for athletes at their school, experience with athletes exhibiting symptoms of eating and body image disturbances, and their attitudes toward eating and weight in the sport. A total of 303 coaches (51% response rate) involved in six sports (i.e., gymnastics, swimming, basketball, softball, track, and volleyball) at all levels of collegiate competition (NCAA Divisions I, II, III, and NAIA) completed a 40-item survey. Gender was found to be related to differential responding on only one of the 40 items, while sport and level of competition were related to responses on multiple items. Gymnastics coaches and NCAA Division I coaches differed significantly from coaches of other sports and divisions in that they reported more monitoring/management behaviors, had more experience with athletes exhibiting eating disturbances, and had more resources available for preventing and treating athletes with eating disorders. Gymnastics coaches also differed from other coaches on a number of items related to their attitudes toward eating and weight in the sport. Many coaches have encountered disturbed eating among their athletes, and some of their coaching attitudes and behaviors may inadvertently increase the risk for such disturbances. Implications for clinical and sport psychologists providing prevention or intervention services to intercollegiate athletes are discussed.

Journal Article↗

PubMed2004

Is information about eating disorders experienced as harmful? A consumer perspective on primary prevention.

Empirical studies showing harmful side effects such as symptom learning have led to the abandoning of symptom information in school-based prevention programs on eating disorders. However, little is known about how students themselves experience information about eating disorders, and how they believe information about eating disorders may affect students in general. A positive experience may be expected because information may reduce student's worry and concern about an eating disorder for themselves and their peers. This survey of 107 15-16-year-old students in a junior high school showed that students, and girls in particular, found information about eating disorders provided in school-based prevention programs useful, meaningful, and interesting. Also, they believed that information may help students in general better understand the nature of eating disorders in order to support peers and friends. Interviews still showed that information was poorly related to their own situation as many reported dieting to be thinner to acquire prefection, and that they could diet without loosing control. Interviews also showed that students wanted more interactive classroom discussions about eating disorders. Discussion may facilitate elaboration and a better personal integration of information. It is suggested that integrated information based social support, and not information per se might be the preventive agent,and that the provision of information can then be defendable within a health promotion paradigm. Replacing the school teacher with a specialist prevention team to improve the credibility of information could be a useful strategy that needs further investigation.

Journal Article↗

PubMed2004

Culture and the development of eating disorders: a tripartite model.

Eating disorders are often conceptualized as"culture-bound problems;"however, the processes by which culture contributes to eating disorders have yet to be elucidated by researchers. This manuscript moves beyond research's current emphasis on evaluating the prevalence rates of eating disorders among ethnic groups, and presents a tripartite model to aid in understanding how cultural processes influence eating disorders. Cultural influences on the development of eating behaviors, body image ideals, and conceptions of health and illness are discussed. It is hoped that the ideas presented will be used to direct efforts to further develop models of the relations between culture and eating disorders and will be considered in the development of programs seeking to aid in the prevention and treatment of maladaptive eating patterns.

Journal Article↗

PubMed2000

EAT-20, a novel transmembrane protein with EGF motifs, is required for efficient feeding in Caenorhabditis elegans.

The pharynx of Caenorhabditis elegans is a neuromuscular organ responsible for feeding, concentrating food by its pumping movement. A class of mutants, the eat mutants, are defective in this behavior. We have identified a novel eat gene, eat-20, encoding a unique transmembrane protein with three EGF motifs. Staining with a specific polyclonal antibody reveals that EAT-20 is expressed predominantly in the pharyngeal muscles and a subset of neurons. Some hypodermal cells also express EAT-20. eat-20 mutant animals are starved, have smaller brood sizes, and have prolonged egg-laying periods. The starvation apparently results from pharyngeal pumping defects, including a reduced pumping rate and "slippery pumping," in which the contents of the pharynx sometimes move rostrally. However, electrical activity of eat-20 mutants appears normal by electropharyngeogram.

Amino Acid Sequence↗

PubMed2006

Eating behavior and weight change in healthy postmenopausal women: results of a 4-year longitudinal study.

BACKGROUND: The association of psychological eating behavior constructs with overweight and obesity during early adult life and middle age has been documented in several studies. However, the association of eating behavior with unexplained weight change in old age is relatively unexplored. METHODS: Body weight, eating behavior (dietary restraint, disinhibition, and hunger as assessed by the Eating Inventory), reported dietary intake, and physical activity level were assessed at baseline in 36 nonobese postmenopausal women aged 61.3 +/- 3.1 years (mean +/- standard deviation). Measurements were repeated 4.4 +/- 0.9 years later, and changes in body weight were examined in relation to baseline and follow-up eating behavior scores, reported dietary intake, and physical activity level. RESULTS: Participants had no major changes in health or lifestyle characteristics over the study interval. Weight change ranged from -7.5 to +5.8 kg (mean -0.3 +/- 3.5 kg), and there were no significant changes in reported dietary intake. Mean hunger score (calculated as the mean of baseline and follow-up hunger score) predicted weight change per year over the study period (bivariate r = 0.386, p =.020), even in statistical models adjusted for mean dietary intake variables (partial r = 0.658, p =.003). Restraint, disinhibition, and physical activity level did not predict weight change. CONCLUSIONS: Reported hunger assessed by the Eating Inventory was associated with unintentional weight change in healthy postmenopausal women. The Eating Inventory questionnaire may provide a clinically useful tool for identifying older individuals at risk of undesirable weight change, and particularly unintentional weight loss, a factor strongly associated with increased morbidity and premature death in this population.

Aged↗

PubMed1998

Interpretations of healthy and unhealthy eating, and implications for dietary change.

Central to many considerations of health-related dietary change is the interpretation given to 'healthy' and 'unhealthy' eating. Results are reported from two studies which investigated people's understanding of these concepts. The first study involved structured interviews with 48 respondents: a wide range of interpretations of healthy and unhealthy eating was found using content analysis techniques. The second study (n = 242) used questionnaires to assess the extent to which different interpretations were endorsed. The extent to which different eating behaviours were perceived as healthy or unhealthy varied greatly. A principal components analysis of perceptions of healthy and unhealthy eating produced five separate factors. Some differences in perceptions were found for people of different age, gender and educational level. Objectively assessed dietary intake and perceived intake were found to be two distinct quantities. 'Healthy' eaters were found to perceive 'healthy eating' slightly differently to 'unhealthy' eaters. The results suggest that lay understanding of healthy eating does generally conform with dietary guidelines, and therefore health promotion priorities should focus on physical and psychological constraints to healthy eating, rather than attempting to increase the public's knowledge as a whole.

Adolescent↗

PubMed2002

Relationship of physical activity to eating behaviors and weight loss in women.

PURPOSE: To examine whether change in physical activity is associated with compliance to changes in dietary intake and eating behaviors in an 18-month behavioral weight loss program, and to examine the contribution of exercise to weight loss when these other weight loss behaviors are also considered. METHODS: Data from 104 subjects who completed an 18-month behavioral weight loss program were analyzed in this study. All subjects were prescribed a reduced energy (1,200-1,500 kcal x d(-1)) and fat (20 to 30%) diet, and exercise progressed from 100 to 200 min x wk(-1). Subjects attended group behavioral lessons throughout the study. Weight, physical activity, energy intake, and weight loss eating behaviors were assessed at 0 and 18 months. RESULTS: Body weight decreased 7.8 +/- 7.5 kg and body mass index decreased 2.8 +/- 2.7 kg x m(-2) from 0 to 18 months ( < 0.05). Total energy intake (kcal x d(-1)) and macronutrient intake (g x d(-1)) decreased, whereas physical activity and eating behaviors associated with weight loss increased from 0 to 18 months ( < 0.05). Change in physical activity was significantly correlated with weight loss (r = 0.33), reductions in energy intake (r = 0.20), and improvements in eating behaviors associated with weight loss (r = 0.24) ( < 0.05). Regression analysis indicated that change in physical activity significantly improved weight loss after changes in energy intake and weight loss eating behaviors were considered in the analysis, with R(2)significantly improving by approximately 0.04 ( < 0.05). However, results from multiple regression showed weight loss was influence more by changes in eating behaviors than changes in physical activity (R(2) = 0.17 vs R(2) = 0.04). CONCLUSIONS: The combination of changes in eating and physical activity behaviors can improve long-term weight loss compared with either behavior alone. Interventions targeting both behaviors are recommended for improving long-term weight loss.

Adult↗

PubMed2006

Predictors of binge eating in restrictive anorexia nervosa patients in Italy.

The aim of the present study was to investigate the predictive factors for the development of binge eating in restricting anorexia nervosa patients who underwent an outpatient treatment. The sample was a group of 168 patients with restricting anorexia nervosa, consecutively admitted to an outpatient unit. All the patients underwent a routine baseline assessment. Information regarding binge eating onset and duration of treatment was prospectively recorded in clinical records. Twenty-three patients developed binge episodes during outpatient treatment. High scores on the Eating Disorders Inventory body dissatisfaction subscale and early age at menarche significantly predict the risk of developing binge eating. High levels of ineffectiveness, as measured by the Eating Disorders Inventory, and early age at menarche are significant predictors of a shortened time to develop binge eating. The identification of subjects at risk for developing binge eating should be considered an important step for a successful treatment of restricting anorexic patients.

Adolescent↗

PubMed2003

The ecology of eating: smaller portion sizes in France Than in the United States help explain the French paradox.

Part of the "French paradox" can be explained by the fact that the French eat less than Americans. We document that French portion sizes are smaller in comparable restaurants, in the sizes of individual portions of foods (but not other items) in supermarkets, in portions specified in cookbooks, and in the prominence of "all you can eat" restaurants in dining guides. We also present data, from observations at McDonald's, that the French take longer to eat than Americans. Our results suggest that in the domain of eating, and more generally, more attention should be paid to ecological factors, even though their mechanism of operation is transparent, and hence less revealing of fundamental psychological processes. Ironically, although the French eat less than Americans, they seem to eat for a longer period of time, and hence have more food experience. The French can have their cake and eat it as well.

Adult↗

PubMed2004

Impact of laparoscopic adjustable gastric banding on plasma ghrelin, eating behaviour and body weight.

BACKGROUND: Plasma ghrelin, an orexigenic peptide derived from the stomach and duodenum, increases following weight loss and might contribute to weight regain. The aim of the present study was to evaluate the effect of laparoscopic adjustable gastric banding (LAGB) on body weight and body composition as well as plasma ghrelin in relation to eating behaviour in morbidly obese patients. MATERIALS AND METHODS: This study was performed in 23 morbidly obese subjects who underwent standardized LAGB. Fasting plasma ghrelin was measured before and 6 months after surgery and was correlated with body weight, body composition, and eating behaviour. RESULTS: Six months after LAGB, body weight decreased significantly by -15.7 +/- 1.4 kg (mean +/- SEM, P = 0.0001) which was accompanied by an increased cognitive restraint of eating (P = 0.001), and by a decreased disinhibition of eating and susceptibility to hunger (P = 0.0001). Plasma ghrelin increased (P = 0.016) by 27.2% from 100.39 +/- 12.90 to 127.22 +/- 13.15 fmol mL(-1). The change in plasma ghrelin correlated with changes in body weight (r = -0.49, P = 0.02), BMI (r = -0.42, P = 0.048) and fat mass (r = -0.519, P = 0.013), but not with changes of fat-free mass and of the three dimensions of eating behaviour. CONCLUSION: Weight loss following LAGB leads to an increase in fasting plasma ghrelin and is accompanied by a decrease in hunger, disinhibition of eating and an increase in cognitive restraint. Thus, changes in eating behaviour, which promote reduction of food intake and not fasting ghrelin, determines weight loss achieved by LAGB.

Adolescent↗

PubMed1994

Eating Attitudes Test in Japan.

A Japanese version of the Eating Attitudes Test (EAT) was developed and validated using a group of anorectics and Japanese female controls. Its sensitivity was considered to be low for anorectics, especially for the fasting type anorectics. A cross-cultural comparison of the EAT scores of anorectics showed some significant differences among those found in Japan, Canada and Germany. A survey of eating disorders among 286 Japanese female students was carried out with a Japanese EAT. Three cases of bulimia nervosa were identified in this survey, although no clear case of anorexia nervosa could be identified. The EAT seemed to be useful to screen cases of bulimia nervosa and sensitive to distinguish abnormal eating attitudes among the young females in Japan.

Adult↗